TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) Steven J Fishman MD...................................................................... Director	5.00 ................. 55.00	X		1,552,989	106,981
(2) Richard Bachur MD...................................................................... President	15.00 ................. 45.00	X	X	651,102	93,008
(3) Joseph P Cravero MD...................................................................... Director	5.00 ................. 55.00	X		877,782	133,885
(4) Young-Jo Kim MD...................................................................... Clerk/Treasurer	5.00 ................. 55.00	X	X	1,517,308	73,441
(5) Minider S Kocher MD...................................................................... Director	5.00 ................. 55.00	X		1,929,996	118,534
(6) Christina VanderPluym MD...................................................................... PO BOD at Large	5.00 ................. 55.00	X		308,124	85,007
(7) Caroline Robson MD...................................................................... Non-Chief Member (7/22-9/22)	5.00 ................. 55.00	X		557,949	75,920
(8) Nicole Ullrich MD...................................................................... Non-Chief Member	5.00 ................. 55.00	X		254,747	71,284
(9) Reza Rahbar MD...................................................................... Non-Chief Member (10/21-6/22)	5.00 ................. 55.00	X		1,400,345	111,489
(10) Menno Verhave MD...................................................................... Non-Chief Member	5.00 ................. 55.00	X		335,178	68,396
(11) Mark R Proctor MD...................................................................... Chairman	5.00 ................. 55.00	X	X	1,310,906	102,461
(12) Tal Geva MD...................................................................... Director	5.00 ................. 55.00	X		735,654	137,070
(13) John G Meara MD DMD...................................................................... Director	5.00 ................. 55.00	X		1,104,748	117,025
(14) Man Wai Ng DDS MPH...................................................................... Director	5.00 ................. 55.00	X		390,379	50,855
(15) David DeMaso MD...................................................................... Director	5.00 ................. 55.00	X		530,428	39,503
(16) Gary Fleisher MD...................................................................... Director	5.00 ................. 55.00	X		849,921	54,292
(17) Gregory Young MD...................................................................... Director (non-voting)	5.00 ................. 55.00	X		504,624	68,396

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) Scott L Pomeroy MD PhD........................................................................ Director	5.00 .......................55.00	X		225,262	64,421
(19) David G Hunter MD PhD........................................................................ Director	5.00 .......................55.00	X		1,027,412	118,666
(20) Mark D Fleming MD........................................................................ Director	5.00 .......................55.00	X		937,022	89,510
(21) Martha M Murray MD........................................................................ Director	5.00 .......................55.00	X		351,630	41,336
(22) Pedro del Nido MD........................................................................ Director	5.00 .......................55.00	X		2,958,170	51,633
(23) Michael J Cunningham MD FACS........................................................................ Director	5.00 .......................55.00	X		977,615	91,061
(24) Steven D Krichmar........................................................................ Community Representative	5.00 .......................	X		0	0
(25) Kevin Churchwell MD........................................................................ Director	5.00 .......................55.00	X		2,753,801	104,479
(26) Michele Garvin........................................................................ Director	5.00 .......................55.00	X		1,152,711	58,731
(27) Carlos R Estrada MD........................................................................ Director	5.00 .......................55.00	X		2,203,097	110,244
(28) Jeanne Chow MD........................................................................ Director	5.00 .......................55.00	X		472,955	75,777
(29) Peter Laussen MD........................................................................ Director	5.00 .......................55.00	X		1,253,860	69,705
(30) Thomas J Hart........................................................................ CFO	60.00 .......................1.00		X	517,974	98,980
(31) Irene G Paresky........................................................................ COO	45.00 .......................1.00		X	603,939	72,572

(A) Name and business address	(B) Description of services	(C) Compensation
Harvard Medical Faculty Physicians at BI 375 Longwood Ave 3rd Floor Boston,MA02115	Physician services	1,122,211
Baker Newman & Noyes LLC PO Box 507 Portland,ME04112	Audit & Tax services	481,800
Thomas Vorder Dpm 100 Landsdowne Street Apt 904 Cambridge,MA02139	Physician services	387,533
CapFinancial Partners LLC 6408 Brigantine Lane Rockford,IL61114	Investment advisors	277,309
Dr Neo Farrag Pllc 6408 Brigantine Lane Rockford,IL61114	Physician services	167,250
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 16

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Physicians Organization at Children's
Hospital Inc

Employer identification number

04-3266103

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................16

Provide the following information about the supported organization(s).

(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)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) Boston Children's Heart Foundation Inc	042790699	10	Yes		0	1,369,511
(B) Boston Pediatric Neurosurgical Foundation Inc	042986097	10	Yes		0	381,299
(C) Boston Plastic & Oral Surgery Foundation Inc	043286718	10	Yes		0	638,964
(D) CHMC Anesthesia Foundation Inc	042702169	10	Yes		0	2,283,839
(E) CHMC Cardiovascular Surgical Foundation Inc	042764370	10	Yes		0	596,056
(F) CHMC Otolaryngologic Foundation Inc	042751258	10	Yes		0	746,945
(G) CHMC Surgical Foundation Inc	042767602	10	Yes		0	797,504
(H) CH Neurology Foundation Inc	222678594	10	Yes		0	931,081
(I) Children's Hospital Ophthalmology Foundation Inc	042864081	10	Yes		0	694,161
(J) Children's Orthopaedic Surgery Foundation Inc	042943146	10	Yes		0	1,088,070
(K) Children's Hospital Pathology Foundation Inc	043085427	10	Yes		0	298,769
(L) Children's Hospital Pediatric Associates Inc	431987409	10	Yes		0	4,363,195
(M) Children's Hospital Radiology Foundation Inc	043259647	10	Yes		0	860,800
(N) Children's Sports Medicine Foundation Inc	042970129	10	Yes		0	773,572
(O) Children's Urological Foundation Inc	042910304	10	Yes		0	596,417
(P) Children's Medical Center Corporation	042774441	3	Yes		0	0
Total 16					0	16,420,183

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

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.

Section B. Total Support

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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

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.)

Section B. Total Support

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.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Yes

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Yes

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

Yes

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Yes

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Yes

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Yes

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
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
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	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
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

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
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
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.
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.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
Part I, Question 12c:	The Physicians Organization at Children's Hospital, Inc. (the PO) is responsible for providing management services to the supported organizations listed. The PO has the power to approve the independent auditor and legal counsel of the supported organizations. The PO has delegated the process to the Medical Center's audit committee. The PO also has the right to review the annual budgets and approve the by-law changes of these organizations. The support amounts in Column VI represents an approximation of the value of support provided to each supported organization.
Part IV, Section D, Line 3:	As board members of the organization, representatives of the supported organizations have direct responsibility for and control over all of the Organization's operations, policies, and assets.
Part IV, Section E, Line 2a:	The Physicians Organization at Children's Hospital, Inc. (the PO) provides management services to the supported organizations listed in Part I, Question 12. These services included patient billing, receivables management, accounting, access, and scheduling; insurance contract negotiations; benefits administration; and a billing reporting system. By providing these services, the PO allowed the supported organizations to further their exempt purposes through providing services to patients, medical research, and educational services for the community.
Part IV, Section E, Line 2b:	The supported organizations of the Physicians Organization at Children's Hospital, Inc. (the PO) would engage in the services provided to them without the involvement of the PO. The services are an integral part of operations that are essential to the Organizations' ability to fulfill their charitable missions.

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

Physicians Organization at Children's
Hospital Inc

Employer identification number

04-3266103

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization Physicians Organization at Children's Hospital Inc

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization Physicians Organization at Children's Hospital Inc		Employer identification number 04-3266103

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization Physicians Organization at Children's Hospital Inc			Employer identification number 04-3266103
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Physicians Organization at Children's
Hospital Inc

Employer identification number

04-3266103

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	4,539,820	1,839,833	1,990,011	2,116,284	2,345,664
b	Contributions ...	16,721,405	18,402,450	12,865,571	12,415,117	6,639,718
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	16,423,475	15,702,463	13,015,749	12,541,390	6,869,098
g	End of year balance ......	4,837,750	4,539,820	1,839,833	1,990,011	2,116,284

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

0 %

Term endowment SchDMd Bullet

100.000 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....
c	Leasehold improvements	2,429,590	1,789,782	639,808
d	Equipment ....
e	Other .....	7,443,887	7,382,198	61,689
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				701,497

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) Private Investment Partnership	26,860,136	F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	26,860,136

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)Due from member Foundations				6,219,125
(2)Due from Insurance Carriers				615,360
(3)Due from Boston Children's Hospital				504,074
(4)Other receivables				161,339
(5)Right of use asset				8,947,185
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				16,447,083

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	48,489,617
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	84,183,802
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-2,516,074
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................			2e	-2,516,074
3	Subtract line 2e from line 1..................			3	86,699,876
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	0
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	86,699,876

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	88,967,962
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e	0
3	Subtract line 2e from line 1...................		3	88,967,962
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	88,967,962

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Part V, Line 4:

The restricted funds represent a donation that was given for IT projects and ACO contributions to enhance clinical care. The use of these funds was restricted by the donor.

Part X, Line 2:

The Organization is a tax-exempt organization, as described in Section 501(c)(3) of the Internal Revenue Code (the Code), and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. In addition, the Organization qualifies for the charitable contribution deduction under Section 170(b)(1)(A), and has been classified as an organization that is not a private foundation under Section 509(a)(3). Tax-exempt organizations could be required to record an obligation for income taxes as the result of a tax position they have historically taken on various tax exposure items, including unrelated business income or tax status. Management of the Organization has evaluated the positions taken on the Organization's filed tax returns and has concluded that no uncertain income tax positions exist at September 30, 2022.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Physicians Organization at Children's
Hospital Inc

Employer identification number

04-3266103

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Pedro del Nido MD Director	(i) (ii)	0 ------------- 2,766,033	0 ------------- 30,860	0 ------------- 161,277	0 ------------- 0	0 ------------- 51,633	0 ------------- 3,009,803	0 ------------- 0
2Kevin Churchwell MD Director	(i) (ii)	0 ------------- 1,254,040	0 ------------- 1,100,000	0 ------------- 399,761	0 ------------- 23,200	0 ------------- 81,279	0 ------------- 2,858,280	0 ------------- 0
3Carlos R Estrada MD Director	(i) (ii)	0 ------------- 697,359	0 ------------- 1,449,974	0 ------------- 55,764	0 ------------- 55,250	0 ------------- 54,994	0 ------------- 2,313,341	0 ------------- 0
4Minider S Kocher MD Director	(i) (ii)	0 ------------- 605,170	0 ------------- 1,255,000	0 ------------- 69,826	0 ------------- 61,000	0 ------------- 57,534	0 ------------- 2,048,530	0 ------------- 0
5Steven J Fishman MD Director	(i) (ii)	0 ------------- 1,118,926	0 ------------- 377,464	0 ------------- 56,599	0 ------------- 58,000	0 ------------- 48,981	0 ------------- 1,659,970	0 ------------- 0
6Young-Jo Kim MD Clerk/Treasurer	(i) (ii)	0 ------------- 385,152	0 ------------- 1,050,000	0 ------------- 82,156	0 ------------- 61,000	0 ------------- 12,441	0 ------------- 1,590,749	0 ------------- 0
7Reza Rahbar MD Non-Chief Member (10/21-6/22)	(i) (ii)	0 ------------- 800,000	0 ------------- 532,655	0 ------------- 67,690	0 ------------- 58,000	0 ------------- 53,489	0 ------------- 1,511,834	0 ------------- 0
8Mark R Proctor MD Chairman	(i) (ii)	0 ------------- 767,910	0 ------------- 468,474	0 ------------- 74,522	0 ------------- 59,000	0 ------------- 43,461	0 ------------- 1,413,367	0 ------------- 0
9Peter Laussen MD Director	(i) (ii)	0 ------------- 814,819	0 ------------- 326,504	0 ------------- 112,537	0 ------------- 29,000	0 ------------- 40,705	0 ------------- 1,323,565	0 ------------- 0
10John G Meara MD DMD Director	(i) (ii)	0 ------------- 550,000	0 ------------- 475,000	0 ------------- 79,748	0 ------------- 58,750	0 ------------- 58,275	0 ------------- 1,221,773	0 ------------- 0
11Michele Garvin Director	(i) (ii)	0 ------------- 673,012	0 ------------- 357,402	0 ------------- 122,297	0 ------------- 23,200	0 ------------- 35,531	0 ------------- 1,211,442	0 ------------- 0
12David G Hunter MD PhD Director	(i) (ii)	0 ------------- 901,749	0 ------------- 102,565	0 ------------- 23,098	0 ------------- 78,250	0 ------------- 40,416	0 ------------- 1,146,078	0 ------------- 0
13Michael J Cunningham MD FACS Director	(i) (ii)	0 ------------- 850,000	0 ------------- 55,860	0 ------------- 71,755	0 ------------- 58,000	0 ------------- 33,061	0 ------------- 1,068,676	0 ------------- 0
14Mark D Fleming MD Director	(i) (ii)	0 ------------- 691,701	0 ------------- 231,037	0 ------------- 14,284	0 ------------- 57,250	0 ------------- 32,260	0 ------------- 1,026,532	0 ------------- 0
15Joseph P Cravero MD Director	(i) (ii)	0 ------------- 730,500	0 ------------- 67,400	0 ------------- 79,882	0 ------------- 84,000	0 ------------- 49,885	0 ------------- 1,011,667	0 ------------- 0
16Gary Fleisher MD Director	(i) (ii)	0 ------------- 425,722	0 ------------- 121,000	0 ------------- 303,199	0 ------------- 36,259	0 ------------- 18,033	0 ------------- 904,213	0 ------------- 0
17Tal Geva MD Director	(i) (ii)	0 ------------- 634,765	0 ------------- 52,951	0 ------------- 47,938	0 ------------- 96,106	0 ------------- 40,964	0 ------------- 872,724	0 ------------- 0
18Richard Bachur MD President	(i) (ii)	0 ------------- 463,004	0 ------------- 12,453	0 ------------- 175,645	0 ------------- 55,759	0 ------------- 37,249	0 ------------- 744,110	0 ------------- 0
19Irene G Paresky COO	(i) (ii)	0 ------------- 457,021	0 ------------- 94,202	0 ------------- 52,716	0 ------------- 35,000	0 ------------- 37,572	0 ------------- 676,511	0 ------------- 0
20Caroline Robson MD Non-Chief Member (7/22-9/22)	(i) (ii)	0 ------------- 438,836	0 ------------- 74,915	0 ------------- 44,198	0 ------------- 35,000	0 ------------- 40,920	0 ------------- 633,869	0 ------------- 0
21Thomas J Hart CFO	(i) (ii)	0 ------------- 428,092	0 ------------- 82,400	0 ------------- 7,482	0 ------------- 61,000	0 ------------- 37,980	0 ------------- 616,954	0 ------------- 0
22Gregory Young MD Director (non-voting)	(i) (ii)	0 ------------- 487,725	0 ------------- 4,317	0 ------------- 12,582	0 ------------- 36,115	0 ------------- 32,281	0 ------------- 573,020	0 ------------- 0
23David DeMaso MD Director	(i) (ii)	0 ------------- 430,471	0 ------------- 94,093	0 ------------- 5,864	0 ------------- 31,900	0 ------------- 7,603	0 ------------- 569,931	0 ------------- 0
24Jeanne Chow MD Director	(i) (ii)	0 ------------- 381,614	0 ------------- 61,182	0 ------------- 30,159	0 ------------- 35,000	0 ------------- 40,777	0 ------------- 548,732	0 ------------- 0
25Man Wai Ng DDS MPH Director	(i) (ii)	0 ------------- 378,753	0 ------------- 9,700	0 ------------- 1,926	0 ------------- 31,900	0 ------------- 18,955	0 ------------- 441,234	0 ------------- 0
26Menno Verhave MD Non-Chief Member	(i) (ii)	0 ------------- 312,452	0 ------------- 6,851	0 ------------- 15,875	0 ------------- 36,115	0 ------------- 32,281	0 ------------- 403,574	0 ------------- 0
27Christina VanderPluym MD PO BOD at Large	(i) (ii)	0 ------------- 234,258	0 ------------- 30,000	0 ------------- 43,866	0 ------------- 44,043	0 ------------- 40,964	0 ------------- 393,131	0 ------------- 0
28Martha M Murray MD Director	(i) (ii)	0 ------------- 325,505	0 ------------- 0	0 ------------- 26,125	0 ------------- 40,763	0 ------------- 573	0 ------------- 392,966	0 ------------- 0
29Nicole Ullrich MD Non-Chief Member	(i) (ii)	0 ------------- 239,100	0 ------------- 8,350	0 ------------- 7,297	0 ------------- 34,375	0 ------------- 36,909	0 ------------- 326,031	0 ------------- 0
30Scott L Pomeroy MD PhD Director	(i) (ii)	0 ------------- 175,886	0 ------------- 25,406	0 ------------- 23,970	0 ------------- 29,172	0 ------------- 35,249	0 ------------- 289,683	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference

Explanation

Part I, Line 4b

The Severance Benefit is to reward a key employee with a monetary severance benefit based on years of service with the Organization. Under the terms of the plan, the participant is eligible for benefits upon completion of a number of years of service. The liability owed to that officer or director listed on Part VII for the Severance Benefit Plan is the COO. A Supplemental Executive Retirement Plan (SERP) was established to reward licensed physician employees with a benefit based on service. The SERP's sources of contributions are from employer discretionary amounts (if any), severance benefits, and elective deferrals. The Foundations made contributions to the retirement plans for Gary Fleisher, MD, $36,259 (401(k)); Richard Bachur, MD, $36,115 (401(k)); Tal Geva, MD, $67,606 (defined benefit pension plan); Christina VanderPluym, MD, $15,543 (defined benefit pension plan); and David G. Hunter, MD, PhD, $19,500 (457(b)). Boston Children's Hospital made contributions to the supplemental non-qualified retirement plan for Michele Garvin, $23,200.

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Physicians Organization at Children's
Hospital Inc

Employer identification number

04-3266103

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No
(1) Steven J Fishman MD	Director	Purchase of common stock		X	428,645	428,645		No	Yes		Yes





Total ............... $						428,645

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference

Explanation

Schedule L, Part II

During the year ended September 30, 2018, the Physicians Organization at Children's Hospital, Inc. (the PO) entered into a promissory note in the amount of $428,645 with a Director of the PO, Steven J. Fishman, MD, to purchase common stock in the Longwood Medical Trust (LMT) on behalf of the PO. The LMT requires that each shareholder be a physician. An agency agreement was executed between the PO and the Director to meet the shareholder requirement. The Director's interest in LMT cannot be sold without the written consent of the PO. LMT retains the right of first refusal to repurchase the stock if the Director is: incapacitated; files for bankruptcy; ceases to be employed by an affiliated Foundations of Boston Children's Hospital; or dies. However, the PO has the right to assign a replacement purchaser upon the triggering of any right of first refusal of LMT to repurchase the share.

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Physicians Organization at Children's
Hospital Inc

Employer identification number

04-3266103

Return Reference	Explanation
Form 990, Part VI, Section A, line 6	The Children's Medical Center Corporation (the Medical Center) is the Class "A" member of the Physicians Organization at Children's Hospital, Inc. (the Organization). The Class "B" members consist of those persons time to time as the Elected Officers of the Corporation and the four non-chief At-Large individuals elected by the Physicians Organization Congress. The Chief Operating Officer and the Chief Financial Officer of the Organization have the right to attend all meetings of the Board of Directors but they are not entitled to vote.
Form 990, Part VI, Section A, line 7a	The majority of the board members of the Physicians Organization at Children's Hospital, Inc. (the Organization) are elected by the Physicians Organization Congress. The President, the Chair of the Board, the Chief Operating Officer, the Chief Financial Officer, and the Clerk/Treasurer are the principal officers of the Organization. The principal officers may appoint such assistants and other officers as they deem necessary, and such other officers shall have such authority and shall perform such duties as from time to time may be prescribed by the Board or principal officers. The Organization may also have such agents, if any, as the Board from time to time and at its discretion may appoint. A lay member of the Board of Trustees of the Class "A" member serves as the community representative of the Organization.
Form 990, Part VI, Section A, line 7b	All of the board decisions are subject to approval by the Class "B" members of the Physicians Organization at Children's Hospital, Inc. (the Organization). The Class "A and "B" members have the right to approve the following: a) hiring and firing of senior management of the Organization excluding the officers; b) legal counsel of the Organization and any Foundation which approval shall not be withheld if selected from an approved list of firms mutually agreed to by the Board and the Members; and c) amendments to the Articles of Organization and by-laws of any Foundation but only after initiation and approval of such amendments by the Board of Directors of such Foundation. The Board has delegated the audit and compliance authority to the Boston Children's Hospital (the Hospital) Audit Committee for the selection of the external auditor or internal audit programs. The Audit Committee shall meet according to a schedule developed by the Hospital in consultation with the PO. The Audit Committee shall: (a) approve the selection of all external auditors to ensure quality and integrity of Foundation financial statements or other related regulatory or internal audits; and (b) monitor internal controls (including, but not limited to, accounting, compliance, regulatory matters, and designing policies to mitigate risk).
Form 990, Part VI, Section B, line 11b	The board has voted to designate the review process to the Executive Committee which is comprised of the elected and non-elected members of the Organization. A copy of the Form 990 will be provided to the Physicians Organization Executive Committee 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	In conjunction with Boston Children's Hospital (the Hospital), the Physicians Organization at Children's Hospital, Inc. (the Organization) has a Conflict of Interest and Commitment policy that applies to all Chiefs, Senior Directors, Directors, and others who exercise influence over important strategic, business, and purchasing decisions of the PO. They are required to complete an annual conflict of interest disclosure questionnaire about their financial interest and outside activities. If an expected questionnaire is not returned, the Compliance Officer notifies the individual's supervisor or the CEO/COO, and repeated requests for the completed questionnaire are made until the questionnaire is completed. Responses are reviewed by the Compliance Officer and any potential conflicts are discussed with the Office of General Counsel and/or the individual's supervisor; any actual or potential conflicts are managed by resolution of the conflict. Management of the conflict, recusal, disclosure, review, or a combination thereof. Any person not receiving a disclosure statement nevertheless 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 Organization prohibits the member from voting on any matter to which the conflict relates or otherwise influence the voting on such matter. Violation of this policy may result in disciplinary or other remedial action, including disruption of employment and removal from office.
Form 990, Part VI, Section B, line 15	The Physicians Organization at Children's Hospital, Inc. (the Organization) has a compensation committee that is comprised of elected officers. Compensation of non-elected officers and key employees are reviewed annually and benchmarked against comparable positions at similar entities. Goals are established at the beginning of the fiscal year which is an indicator in determining the subsequent year annual compensation increase. The Organization committee reviews and approves the annual compensation of the Chief Operating Officer, the Chief Financial Officer, and the Directors of the Organization. Faculty compensation must comply with the Boston Children's Hospital Physician Compensation Guidelines. These guidelines are developed in consultation with an independent external compensation consulting firm and are approved by independent Compensation Committee of the Board of Children's Medical Center Corporation and Boston Children's 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, research, teaching and administrative responsibilities, 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 each 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 prospective basis by the Boston Children's Hospital Chief Executive Officer and President.
Form 990, Part VI, Section C, line 19	The Organization maintains all financial statements, 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 XII, Line 2c:	The audit process and scope has not changed from the prior year.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

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.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Physicians Organization at Children's
Hospital Inc

Employer identification number

04-3266103

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) Boston Business Advisors LLC 101 Station Drive Westwood,MA02090 84-4320270	Accounts Receivable Management	MA	238,783	370,445	Physicians Organization at Children's Hospital 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?
(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	Yes	No
(1)Boston Children's Heart Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2790699	Healthcare	MA	501(c)(3)	10	N/A		No
(2)Boston Pediatric Neurosurgical Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2986097	Healthcare	MA	501(c)(3)	10	N/A		No
(3)Boston Plastic & Oral Surgery Foundation Inc 300 Longwood Avenue Boston,MA02115 04-3286718	Healthcare	MA	501(c)(3)	10	N/A		No
(4)CHMC Anesthesia Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2702169	Healthcare	MA	501(c)(3)	10	N/A		No
(5)CHMC Cardiovascular Surgical Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2764370	Healthcare	MA	501(c)(3)	10	N/A		No
(6)CHMC Otolaryngologic Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2751258	Healthcare	MA	501(c)(3)	10	N/A		No
(7)CHMC Surgical Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2767602	Healthcare	MA	501(c)(3)	10	N/A		No
(8)CH Neurology Foundation Inc 300 Longwood Avenue Boston,MA02115 22-2678594	Healthcare	MA	501(c)(3)	10	N/A		No
(9)Children's Hospital Ophthalmology Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2864081	Healthcare	MA	501(c)(3)	10	N/A		No
(10)Children's Orthopaedic Surgery Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2943146	Healthcare	MA	501(c)(3)	10	N/A		No
(11)Children's Hospital Pathology Foundation Inc 300 Longwood Avenue Boston,MA02115 04-3085427	Healthcare	MA	501(c)(3)	10	N/A		No
(12)Children's Hospital Pediatric Association Inc 300 Longwood Avenue Boston,MA02115 43-1987409	Healthcare	MA	501(c)(3)	10	N/A		No
(13)Children's Hospital Radiology Foundation Inc 300 Longwood Avenue Boston,MA02115 04-3259647	Healthcare	MA	501(c)(3)	10	N/A		No
(14)Children's Sports Medicine Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2970129	Healthcare	MA	501(c)(3)	10	N/A		No
(15)Children's Urological Foundation Inc 300 Longwood Avenue Boston,MA02115 04-2910304	Healthcare	MA	501(c)(3)	10	N/A		No
(16)Boston Children's Hospital 300 Longwood Avenue Boston,MA02115 04-2774441	Hospital	MA	501(c)(3)	3	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

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?
(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	Yes	No

Schedule R (Form 990) 2021

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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) 2021

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)	(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
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: The Organization was formed to promote health by coordinating the practice of (see Schedule O) pediatric medicine and related health care services provided by its affiliated member Foundations. The Organization supports the Foundations by assisting in managed care and risk based contracts, quality management, patient safety, and other professional management services that enhance the Foundations' operations.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	27
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	1
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	-229
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	18,402,450	16,721,405
9	Program service revenue (Part VIII, line 2g) .........	65,990,800	69,944,738
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	3,729	33,733
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	84,396,979	86,699,876
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	500	100
14	Benefits paid to or for members (Part IX, column (A), line 4).....	31,704,437	35,347,488
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	0	0
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	51,086,090	53,620,374
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	82,791,027	88,967,962
19	Revenue less expenses. Subtract line 18 from line 12.......	1,605,952	-2,268,086
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	74,839,781	75,684,514
21	Total liabilities (Part X, line 26).............	45,508,565	51,137,458
22	Net assets or fund balances. Subtract line 21 from line 20.....	29,331,216	24,547,056

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	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 41,354,843 including grants of $ 100 ) (Revenue $ 34,888,672 )
	The Physicians Organization at Children's Hospital, Inc. (the Organization) sponsors health, dental, life, and disability benefit plans for the member Foundations. The health and dental plans are self-funded with internal premiums based upon the expected utilization of the plan members. Any surplus or deficit generated at the plan year-end is applied to the calculation when determining the subsequent year's premiums. Life and disability revenue is directly offset by premiums paid to the insurance carriers.

4b	(Code: ) (Expenses $ 17,782,242 including grants of $ ) (Revenue $ 15,001,841 )
	The Organization provides professional services to certain member Foundations to assist them in accounting, consulting, strategic management, quality programs, patient billing, patient safety, coordinated care cost containment, and other administrative services. Annual membership dues received from member Foundations support the administrative activities of the members by arranging for the delivery of healthcare services with insurers, managed care plans, and health maintenance organizations.

4c	(Code: ) (Expenses $ 23,771,021 including grants of $ ) (Revenue $ 20,054,225 )
	The Organization has entered into leases at satellite locations for clinical and general office space. Member Foundations reimburse the Organization for use of these facilities at cost. In addition, the Organization provides management services to the Hospital and Foundations. The Hospital or Foundation reimburses the Organization for salary and fringe support of employees.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses82,908,106

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	30,247,628	2,554,662

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	16,721,405
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		16,721,405

		Business Code
2a	Insurance premiums	524298	34,888,671	34,888,671
b	Other service revenue	524298	20,054,225	20,054,225
c	Membership dues	524298	17,419,172	17,419,172
d	Patient service revenue	621300	-2,417,330	-2,417,330
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		69,944,738

3 Investment income (including dividends, interest, and othersimilar amounts) ......			33,733		-229	33,962
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			86,699,876	69,944,738	-229	33,962

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	100	100
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......	35,347,488	35,347,488
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	321,343		321,343
c	Accounting ...........	592,250		592,250
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	4,937,289	3,205,019	1,732,270
12	Advertising and promotion ....
13	Office expenses .......	1,876,560	786,734	1,089,826
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	1,427,738	1,427,738
17	Travel ............	28,806	28,806
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	65,010	65,010
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	140,112	140,112
23	Insurance ...	137,845		137,845
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Payroll reimbursement e	24,292,463	22,106,141	2,186,322
b	Integrated care coordin	17,901,996	17,901,996
c	Collection expenses	1,110,557	1,110,557
d	Minor equipment	325,385	325,385
e	All other expenses	463,020	463,020
25	Total functional expenses. Add lines 1 through 24e	88,967,962	82,908,106	6,059,856	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			11,445,670	1	6,865,643
2	Savings and temporary cash investments .........			2,524,166	2	2,705,984
3	Pledges and grants receivable, net ......			18,368,362	3	19,491,080
4	Accounts receivable, net .............				4
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				428,645	5	428,645
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			218,292	9	207,556
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	9,873,477
b	Less: accumulated depreciation	10b	9,171,980	805,848	10c	701,497
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			28,744,720	12	26,860,136
13	Investments—program-related. See Part IV, line 11 ..			2,608,380	13	1,976,890
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			9,695,698	15	16,447,083
16	Total assets. Add lines 1 through 15 (must equal line 33)...			74,839,781	16	75,684,514

17	Accounts payable and accrued expenses .....	3,522,251	17	2,647,841
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	41,986,314	25	48,489,617
26	Total liabilities. Add lines 17 through 25..	45,508,565	26	51,137,458

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	24,791,396	27	19,709,306
28	Net assets with donor restrictions ...........	4,539,820	28	4,837,750
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	29,331,216	32	24,547,056
33	Total liabilities and net assets/fund balances ........	74,839,781	33	75,684,514