Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
CHILDREN'S HOSPITAL MEDICAL CENTER |
310833936 | 3 | No | 11,887,261 | 0 | |
|
Total 1
|
11,887,261 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | 0 | |||
| 2 | Recoveries of prior-year distributions | 2 | 0 | |||
| 3 | Other gross income (see instructions) | 3 | 4,108,132 | |||
| 4 | Add lines 1 through 3 | 4 | 4,108,132 | |||
| 5 | Depreciation and depletion | 5 | 0 | |||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | 238,009 | |||
| 7 | Other expenses (see instructions) | 7 | 0 | |||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | 3,870,123 | |||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | 182,513,733 | |||
| b | Average monthly cash balances | 1b | 1,954,917 | |||
| c | Fair market value of other non-exempt-use assets | 1c | 0 | |||
| d | Total (add lines 1a, 1b, and 1c) | 1d | 184,468,650 | |||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): 0 |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | 0 | |||
| 3 | Subtract line 2 from line 1d | 3 | 184,468,650 | |||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | 2,767,030 | |||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | 181,701,620 | |||
| 6 | Multiply line 5 by 0.035 | 6 | 6,359,557 | |||
| 7 | Recoveries of prior-year distributions | 7 | 0 | |||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | 6,359,557 | |||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | 3,870,123 | |||
| 2 | Enter 85% of line 1 | 2 | 3,289,605 | |||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | 6,359,557 | |||
| 4 | Enter greater of line 2 or line 3 | 4 | 6,359,557 | |||
| 5 | Income tax imposed in prior year | 5 | 0 | |||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | 6,359,557 | |||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | 11,887,261 |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | 0 |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | 0 |
| 4 Amounts paid to acquire exempt-use assets | 4 | 0 |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | 0 |
| 6 Other distributions (describe in Part VI). See instructions | 6 | 0 |
| 7Total annual distributions. Add lines 1 through 6. | 7 | 11,887,261 |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | 11,887,261 |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | 6,359,557 |
| 10 Line 8 amount divided by Line 9 amount | 10 | 18691.96 % |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | 6,359,557 | |||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
0 | |||
| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016.......0 | ||||
| b From 2017.......0 | ||||
| c From 2018.......0 | ||||
| d From 2019.......0 | ||||
| e From 2020.......1,945,630 | ||||
| fTotal of lines 3a through e | 1,945,630 | |||
| g Applied to underdistributions of prior years | 0 | |||
| h Applied to 2021 distributable amount | 1,945,630 | |||
|
i
Carryover from 2016 not applied (see instructions) |
0 | |||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | 0 | |||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ 11,887,261 | ||||
| a Applied to underdistributions of prior years | 0 | |||
| b Applied to 2021 distributable amount | 4,413,927 | |||
| c Remainder. Subtract lines 4a and 4b from line 4. | 7,473,334 | |||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
0 | |||
|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
0 | |||
|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
7,473,334 | |||
| 8 Breakdown of line 7: | ||||
| a Excess from 2017.....0 | ||||
| b Excess from 2018.....0 | ||||
| c Excess from 2019.....0 | ||||
| d Excess from 2020.....0 | ||||
| e Excess from 2021.....0 | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, Part IV, Section A, Line 1 | HOW SUPPORTED ORGANIZATIONS ARE DESIGNATED The purpose of the Convalescent Hospital fund for Children (the Corporation), as determined by its Board of Trustees, is to provide financial support to Children's Hospital Medical Center (Cincinnati Children's). The Corporation provides programmatic support to programs such as brain injury and mental health programs at Cincinnati Children's. Such financial support is provided primarily from expendable income received from the investment of the permanently restricted endowment net assets and unrestricted net assets of the Corporation. It is the policy of the Corporation to invest gifts and bequests received and to reinvest net assets obtained from sales of investments to increase net assets and enhance future expendable income. |
| SCHEDULE A, Part IV, Section D, Line 3 | RESPONSIVE TO NEEDS OF SUPPORTED ORGANIZATION The Corporation provides financial support to Cincinnati Children's. The relationship between the two organizations is such that Cincinnati Children's is attentive to the Corporation. A portion of the corporation's governing body overlaps with its supported organization. |
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Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part I, LINE 1 | ORGANIZATION'S MISSION To support, enable and promote programs at Cincinnati Children's that ensure the sufficiency of access, the highest quality of clinical care, and the tools and skills for the pursuit of productive, independent lifestyles for children impacted by chronic illness, brain injury, developmental challenges and mental health conditions. |
| Form 990, Part III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS CONVALESCENT HOSPITAL FUND FOR CHILDREN ("CHFC") WAS FORMED FOR THE SOLE PURPOSE OF PROVIDING FINANCIAL SUPPORT TO CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER WHICH PARTICIPATES IN THE TREATMENT OF, OR RESEARCH INTO, DISEASES OR DISORDERS AFFECTING CHILDREN. DURING CHFC'S FISCAL YEAR OF JULY 1, 2021 THROUGH JUNE 30, 2022 (THE YEAR COVERED BY THIS RETURN), CHFC PROVIDED FINANCIAL SUPPORT AMOUNTING TO $11,887,261 TO CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER ("CCHMC"), AN OHIO NOT-FOR-PROFIT PEDIATRIC HOSPITAL LOCATED IN HAMILTON COUNTY, OHIO. ONGOING FINANCIAL SUPPORT IS PROVIDED FROM EXPENDABLE INCOME RECEIVED FROM INVESTMENTS OF RESTRICTED AND UNRESTRICTED FUNDS AND SPECIAL COMMITMENTS ARE FUNDED FROM PRINCIPAL BALANCES OF UNRESTRICTED FUNDS. IT IS THE POLICY OF CHFC TO INVEST SUCH ASSETS, THEREBY INCREASING FUND PRINCIPAL AND ENHANCING FUTURE EXPENDABLE INCOME. CCHMC UTILIZED THE FINANCIAL SUPPORT FROM CHFC TO SUPPORT THE OPERATING COSTS OF ITS PEDIATRIC REHABILITATION PROGRAM, ADOLESCENT PSYCHIATRIC SERVICES PROGRAM, DISABILITY SERVICES PROGRAM, PSYCHOLOGY ADHERENCE PROGRAM, SPECIAL NEEDS CHILDREN PROGRAM, AND TO SUPPORT THE GENERAL MENTAL AND BEHAVIORAL HEALTH AND LONG-TERM CARE OPERATIONS OF CCHMC. CHFC PROVIDED ADDITIONAL SUPPORT TO CCHMC FOR THE CONSTRUCTION OF A NEW FACILITY AT THE COLLEGE HILL CAMPUS, WHICH PROVIDES A WIDE RANGE OF SERVICES FOR PATIENTS WITH PSYCHIATRIC, PSYCHOLOGIC, MENTAL AND BEHAVIORAL HEALTH NEEDS. |
| Form 990, Part VI, Section A, line 2 | FAMILY AND BUSINESS RELATIONSHIPS C. Francis Barrett and Marian Leibold have a family relationship. Robert D.H. Anning and RObert H. Anning II have a family relationship. Lee Carter (Board Member - Mindpeace), Nancy Eigel-Miller (Board Member - Mindpeace) and Susan Shelton (Executive Director - Mindpeace) have a business relationship outside of CHFC. |
| Form 990, Part VI, Section B, Line 11 | Form 990 Review CONVALESCENT HOSPITAL FUND FOR CHILDREN ("CHFC") FORM 990 IS PREPARED AND REVIEWED BY EXTERNAL TAX CONSULTANTS. A DRAFT OF THE RETURN IS REVIEWED BY THE SENIOR MANAGEMENT FROM CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER ("CCHMC"), A RELATED ORGANIZATION, FOR COMPLETENESS AND ACCURACY. THE FORM 990 IS THEN MADE AVAILABLE TO ALL CHFC BOARD MEMBERS IN ADVANCE OF FILING. |
| Form 990, Part VI, Section B, Line 12c | Conflict of Interest Monitoring All of CHFC's board members receive an annual questionnaire requesting information regarding family and business relationships that could potentially result in a conflict of interest under CHFC's Conflict of Interest Policy. Once the questionnaires have been completed by all of CHFC's board members, the questionnaires are reviewed and if CHFC determines that a relationship exists that presents a conflict of interest, CHFC follows the provisions set forth in CHFC's Conflict of Interest Policy to resolve the conflict and determines the appropriate reporting to board committees and, if required, Form 990 disclosure. |
| Form 990, Part VI, Section B, Line 13 | Whistleblower Policy CHFC's board of trustees has not formally adopted a written whistleblower policy. However, CHFC is a related organization of Cincinnati Children's Medical Center ("CCHMC"). CCHMC has a written whistleblower policy and CHFC abides by the provisions of this policy. |
| Form 990, Part VI, Section B, Line 14 | Document Retention and Destruction Policy CHFC's board of trustees has not formally adopted a written document retention and destruction policy. However, CHFC is a related organization of Cincinnati Children's Hospital Medical Center ("CCHMC"). CCHMC has a written document retention and destruction policy and CHFC abides by the provisions of this policy. |
| Form 990, Part VI, Section B, Line 15 | Process for Determining Compensation CHFC does not have any employees. However, CHFC does have an officer that is employed by Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization. CCHMC has a compensation committee that annually reviews the recommendations of CCHMC management regarding employee performance evaluation and compensation adjustments for disqualified persons to ensure that CCHMC has complied with the provisions of the rebuttable presumption of reasonableness under IRC sec. 4958. |
| Form 990, Part VI, Section C, Line 19 | Documents CHFC's governing documents, Conflict of Interest Policy, and financial statements are maintained on file by CCHMC senior management and are available to the public upon request either in-person, by telephone, or by written request. |
| Form 990, Part VII | Compensation Michael L. Bauer was employed by Cincinnati Children's Hospital Medical Center ("CCHMC"), a related organization, through November 30, 2021. Mr. Bauer devoted an average of 50 hours/week for his duties to CCHMC and affiliated entities. |
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