Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
Do not enter social security numbers on this form as it may be made public.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2024
Open to Public Inspection
A For the 2024 calendar year, or tax year beginning 09-01-2024 , and ending 12-31-2024
BCheck if applicable:
CName of organization
Lurie Children's Pediatric Anesthesia Associates
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
225 E CHICAGO AVE BOX 282
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
CHICAGO, IL606112991
D Employer identification number

37-1838535
E Telephone number

G Gross receipts $ 14,156,504
F Name and address of principal officer:
OLUWATOYIN OLUTOYE MD
225 E CHICAGO AVE BOX 282
CHICAGO,IL606112991
I
Tax-exempt status: (   ) (insert no.) or
J
Website:
WWW.LURIECHILDRENS.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number  
K Form of organization:  
L Year of formation: 2016
M State of legal domicile: IL
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2 Check this box
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 7
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 2
5 Total number of individuals employed in calendar year 2024 (Part V, line 2a) ...... 5 46
6 Total number of volunteers (estimate if necessary) ............. 6 2
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b  
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 8,222,929 6,298,751
9 Program service revenue (Part VIII, line 2g) ......... 24,001,339 7,857,753
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....   0
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)   0
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 32,224,268 14,156,504
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...   0
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 32,343,994 10,965,185
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) 0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 5,474,921 1,899,652
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 37,818,915 12,864,837
19 Revenue less expenses. Subtract line 18 from line 12....... -5,594,647 1,291,667
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 3,214,232 0
21 Total liabilities (Part X, line 26)............. 4,868,199 0
22 Net assets or fund balances. Subtract line 21 from line 20..... -1,653,967 0
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
Signature of officer Date
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name

Firm's EIN
Firm's address



Phone no.
May the IRS discuss this return with the preparer shown above? See Instructions. ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2024)
Form 990 (2024)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: SEE SCHEDULE O.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 12,779,394 including grants of $   ) (Revenue $ 7,857,753 )
SEE SCHEDULE O.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expenses12,779,394
Form 990 (2024)
Form 990 (2024)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II.........
4
 
No
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D,
Part VI. ...................
11a
 
No
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IX............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part X
11e
 
No
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....
20a
 
No
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?
20b
 
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....
21
 
No
Form 990 (2024)
Form 990 (2024)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part IClick to see attachment
List of Attached Documents:
// Content
31
Yes
 
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
0
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
 
 
Form 990 (2024)
Form 990 (2024)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
46
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country:
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, or any disqualified or other person engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2024)
Form 990 (2024)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
7
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
2
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
No
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
 
No
b
Other officers or key employees of the organization ................
15b
 
No
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
No
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filed
IL
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
ALEX P MILLER225 E CHICAGO AVE   CHICAGO,IL606112991 (312) 227-7133
Form 990 (2024)
Form 990 (2024)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, box 6 of Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) OLUWATOYIN OLUTOYE MD......................................................................
EX-OFFICIO DIRECTOR/PRESIDENT/DEPT CHAIR ANESTHESIA
40.0
.................
1.0
X   X       984,877 0 119,046
(2) ANN C MONAHAN MD......................................................................
DIRECTOR/PHYSICIAN
40.0
.................
0.0
X           362,408 0 64,819
(3) ERIN TOAZ MD......................................................................
DIRECTOR/PHYSICIAN
40.0
.................
0.0
X           385,174 0 24,224
(4) HUBERT BENZON MD......................................................................
DIRECTOR/PHYSICIAN
40.0
.................
0.0
X           510,692 0 64,819
(5) JAMES H ROTH......................................................................
DIRECTOR
1.0
.................
0.0
X           0 0 0
(6) THOMAS P SHANLEY MD......................................................................
EX-OFFICIO DIRECTOR/PRESIDENT & CEO LCH
1.0
.................
46.0
X           0 1,992,705 624,794
(7) WILLIAM JAMES GREGORY HANIFEE......................................................................
DIRECTOR
1.0
.................
0.0
X           0 0 0
(8) ALEX P MILLER......................................................................
SVP, CHIEF FINANCIAL OFFICER
1.0
.................
46.0
    X       0 757,988 158,968
(9) FATEMA ZANZI......................................................................
EVP, CHIEF ADMIN & LEGAL OFFICER, CORP SEC
1.0
.................
46.0
    X       0 932,953 173,884
(10) ALINA LAZAR MD......................................................................
PHYSICIAN
40.0
.................
0.0
        X   521,971 0 59,819
(11) LISA SOHN MD......................................................................
PHYSICIAN
40.0
.................
0.0
        X   546,546 0 33,026
(12) RAVI SHAH MD......................................................................
PHYSICIAN
40.0
.................
0.0
        X   592,617 0 59,819
(13) RICHARD M DSIDA MD......................................................................
PHYSICIAN
40.0
.................
0.0
        X   667,792 0 47,794
(14) SCOTT A STENQUIST MD......................................................................
PHYSICIAN
40.0
.................
0.0
        X   553,881 0 47,794
(15) BRENDA DAVIS......................................................................
FORMER INTERIM CHIEF FINANCIAL OFFICER THROUGH 2/6/23
0.0
.................
42.0
          X 0 354,713 29,463




Form 990 (2024)
Form 990 (2024)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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)
(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)
(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;


























1b Sub-Total..............
c Total from continuation sheets to Part VII, Section A..
d Total (add lines 1b and 1c)......... 5,125,958 4,038,359 1,508,269
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization 44
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual
...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0
Form 990 (2024)
Form 990 (2024)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 6,298,751
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f....... 6,298,751
 Program Service RevenueAmt Business Code
2a PATIENT SERVICE REVENUE 621111 5,831,173 5,831,173    
b MED ADMIN AND TEACHING 621111 804,433 804,433    
c PHYSICIAN CONTRACT REVENUE 621111 218,992 218,992    
d MEDICARE/MEDICAID PAYMENTS 621111 884,430 884,430    
e OTHER PROGRAM SERVICE REVENUE 621111 118,725 118,725    
f All other program service revenue. 0 0 0 0
g Total. Add lines 2a–2f ..... 7,857,753
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......        
4 Income from investment of tax-exempt bond proceeds        
5 Royalties...........        
(i) Real (ii) Personal
6a Gross rents 6a    
b Less: rental expenses 6b    
c Rental income or (loss) 6c 0 0
d Net rental income or (loss).......        
(i) Securities (ii) Other
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 0 0
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.. 0    
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..        
 OtherRevenueMiscAmt
Business Code
11a            
b            
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... 0
12 Total revenue. See instructions..... 14,156,504 7,857,753 0 0
Form 990 (2024)
Form 990 (2024)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....    
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 .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 921,107 921,107    
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........ 8,424,934 8,377,738 47,196  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 329,636 327,849 1,787  
9 Other employee benefits ....... 1,215,367 1,203,096 12,271  
10 Payroll taxes ........... 74,141 73,760 381  
11 Fees for services (non-employees):        
a Management ......        
b Legal .........        
c Accounting ...........        
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) 318,446 294,638 23,808 0
12 Advertising and promotion ....        
13 Office expenses .......        
14 Information technology ......        
15 Royalties ..        
16 Occupancy ........... 3,254 3,254    
17 Travel ............ 77,723 77,723    
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 8,886 8,886    
20 Interest ...........        
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..        
23 Insurance ... 353,618 353,618    
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 BAD DEBT EXPENSE 777,570 777,570    
b BILLING AND COLLECTION FEES 307,264 307,264    
c DUES & LICENSES 32,656 32,656    
d RECRUITMENT 15,667 15,667    
e All other expenses 4,568 4,568 0 0
25 Total functional expenses. Add lines 1 through 24e 12,864,837 12,779,394 85,443 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).        
Form 990 (2024)
Form 990 (2024)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ........   1  
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 2,746,376 4 0
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 .......
0 5 0
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) ...
0 6 0
7 Notes and loans receivable, net ...........   7  
8 Inventories for sale or use ............   8  
9 Prepaid expenses and deferred charges ...... 159,523 9 0
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 0
b Less: accumulated depreciation 10b 0 0 10c 0
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 0 12  
13 Investments—program-related. See Part IV, line 11 .. 0 13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 308,333 15 0
16 Total assets. Add lines 1 through 15 (must equal line 33)... 3,214,232 16 0
Liabilities 17 Accounts payable and accrued expenses ..... 4,494,057 17 0
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 .........
0 22 0
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 374,142 25 0
26 Total liabilities. Add lines 17 through 25.. 4,868,199 26 0
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... -1,653,967 27 0
28 Net assets with donor restrictions ...........   28  
Organizations that do not follow FASB ASC 958, check here right arrow 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 ........... -1,653,967 32 0
33 Total liabilities and net assets/fund balances ........ 3,214,232 33 0
Form 990 (2024)
Form 990 (2024)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
14,156,504
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
12,864,837
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
1,291,667
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
-1,653,967
5
Net unrealized gains (losses) on investments ...............
5
 
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
362,300
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
0
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Uniform Guidance, 2 C.F.R. Part 200, Subpart F?
3a
 
No
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
 
 
Form 990 (2024)
Form 990 (2024)
Additional Data


Software ID: 24020961
Software Version: 2024v5.1
Form 990, Special Condition Description:
Special Condition Description
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
2024
Open to Public
Inspection
Name of the organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number

37-1838535
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
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)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2024

Schedule A (Form 990) 2024
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) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..           0
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....           0
3 The value of services or facilities furnished by a governmental unit to the organization without charge..           0
4 Total. Add lines 1 through 3 0 0 0 0 0 0
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) .. 0
6 Public support. Subtract line 5 from line 4. 0
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (f) Total
7 Amounts from line 4.. 0 0 0 0 0 0
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...           0
9 Net income from unrelated business activities, whether or not the business is regularly carried on..           0
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. 0 0 0 0 0 0
11 Total support. Add lines 7 through 10 0
12
12
0
13
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
14
14
0 %
15
15
0 %
16a
33 1/3% support test—2024. 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
b
33 1/3% support test—2023. 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—2024. 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
b
10%-facts-and-circumstances test—2023. 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
18
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) 2024

Schedule A (Form 990) 2024
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) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .           0
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           0
3 Gross receipts from activities that are not an unrelated trade or business under section 513 .....           0
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...           0
5 The value of services or facilities furnished by a governmental unit to the organization without charge           0
6 Total. Add lines 1 through 5 0 0 0 0 0 0
7a Amounts included on lines 1, 2, and 3 received from disqualified persons 0 0 0 0 0 0
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. 0 0 0 0 0 0
c Add lines 7a and 7b.. 0 0 0 0 0 0
8 Public support. (Subtract line 7c from line 6.) 0
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2020 (b) 2021 (c) 2022 (d) 2023 (e) 2024 (f) Total
9 Amounts from line 6... 0 0 0 0 0 0
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..           0
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.           0
c Add lines 10a and 10b. 0 0 0 0 0 0
11 Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.           0
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. 0 0 0 0 0 0
13 Total support. (Add lines 9, 10c, 11, and 12.).. 0 0 0 0 0 0
14
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
15
15
0 %
16
16
0 %
Section D. Computation of Investment Income Percentage
17
17
0 %
18
18
0 %
19a
33 1/3% support tests-2024. 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
b
33 1/3 % support tests—2023. 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
20
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) 2024

Schedule A (Form 990) 2024
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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) 2024

Schedule A (Form 990) 2024
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990) 2024

Schedule A (Form 990) 2024
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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 0
2 Enter 85% of line 1 2 0
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3 0
4 Enter greater of line 2 or line 3 4 0
5 Income tax imposed in prior year 5 0
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6 0
7
Schedule A (Form 990) 2024

Schedule A (Form 990) 2024
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 2024 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-2024
(iii)
Distributable
Amount for 2024
1 Distributable amount for 2024 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions.
 
3 Excess distributions carryover, if any, to 2024:
a From 2019.......  
b From 2020.......  
c From 2021.......  
d From 2022.......  
e From 2023.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2024 distributable amount  
i Carryover from 2019 not applied (see
instructions)
 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2024 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2024 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2024, 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 2024. 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 2025. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a Excess from 2020.....  
b Excess from 2021.....  
c Excess from 2022.....  
d Excess from 2023.....  
e Excess from 2024.....  
Schedule A (Form 990) (2024)

Schedule A (Form 990) 2024
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
Schedule A, Part I, Line 3 DISCLOSURE FOR NOT FILING SCHEDULE H LURIE CHILDREN'S PEDIATRIC ANESTHESIA ASSOCIATES DOES NOT FILE A SCHEDULE H EVEN THOUGH THE ENTITY MARKS THE HOSPITAL BOX IN SCHEDULE A BECAUSE IT IS NOT REQUIRED TO BE LICENSED, REGISTERED OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL.
Schedule A (Form 990) 2024


Additional Data


Software ID: 24020961
Software Version: 2024v5.1
Schedule B
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

right arrow Attach to Form 990, 990-EZ, or 990-PF.
right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
Name of the organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number

37-1838535
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 ......... Right Arrow $  
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) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025) Page 2
Name of organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number
37-1838535
Part I
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


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025)
Page 3
Name of organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number

37-1838535
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) (Rev. 1-2025)
Schedule B (Form 990) (Rev. 1-2025)
Page 4
Name of organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number

37-1838535
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 (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (Rev. 1-2025)
Additional Data


Software ID: 24020961
Software Version: 2024v5.1
Schedule J
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic Attach to Form 990.
medium right arrow graphic Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public Inspection
Name of the organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number

37-1838535
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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 .....
1b
 
 
2
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? ....
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) (Rev. 1-2025)

Schedule J (Form 990) (Rev. 1-2025)
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
(i) Base
compensation
(ii) Bonus & incentive
compensation
(iii) Other reportable compensation
1OLUWATOYIN OLUTOYE MD
EX-OFFICIO DIRECTOR/PRESIDENT/DEPT CHAIR ANESTHESIA
(i)

(ii)
884,361
-------------
0
100,000
-------------
0
516
-------------
0
104,918
-------------
0
14,128
-------------
0
1,103,923
-------------
0
0
-------------
0
2THOMAS P SHANLEY MD
EX-OFFICIO DIRECTOR/PRESIDENT & CEO LCH
(i)

(ii)
0
-------------
1,285,552
0
-------------
449,624
0
-------------
257,529
0
-------------
590,810
0
-------------
33,984
0
-------------
2,617,499
0
-------------
0
3ANN C MONAHAN MD
DIRECTOR/PHYSICIAN
(i)

(ii)
340,765
-------------
0
21,523
-------------
0
120
-------------
0
18,975
-------------
0
45,844
-------------
0
427,227
-------------
0
0
-------------
0
4ERIN TOAZ MD
DIRECTOR/PHYSICIAN
(i)

(ii)
364,079
-------------
0
20,987
-------------
0
108
-------------
0
18,975
-------------
0
5,249
-------------
0
409,398
-------------
0
0
-------------
0
5HUBERT BENZON MD
DIRECTOR/PHYSICIAN
(i)

(ii)
477,017
-------------
0
33,516
-------------
0
159
-------------
0
18,975
-------------
0
45,844
-------------
0
575,511
-------------
0
0
-------------
0
6BRENDA DAVIS
FORMER INTERIM CHIEF FINANCIAL OFFICER THROUGH 2/6/23
(i)

(ii)
0
-------------
300,378
0
-------------
52,988
0
-------------
1,348
0
-------------
12,986
0
-------------
16,477
0
-------------
384,177
0
-------------
0
7FATEMA ZANZI
EVP, CHIEF ADMIN & LEGAL OFFICER, CORP SEC
(i)

(ii)
0
-------------
619,075
0
-------------
235,530
0
-------------
78,348
0
-------------
170,345
0
-------------
3,539
0
-------------
1,106,837
0
-------------
0
8ALEX P MILLER
SVP, CHIEF FINANCIAL OFFICER
(i)

(ii)
0
-------------
579,360
0
-------------
177,840
0
-------------
788
0
-------------
118,228
0
-------------
40,740
0
-------------
916,956
0
-------------
0
9RICHARD M DSIDA MD
PHYSICIAN
(i)

(ii)
636,374
-------------
0
30,626
-------------
0
792
-------------
0
18,975
-------------
0
28,819
-------------
0
715,586
-------------
0
0
-------------
0
10RAVI SHAH MD
PHYSICIAN
(i)

(ii)
524,398
-------------
0
68,039
-------------
0
180
-------------
0
18,975
-------------
0
40,844
-------------
0
652,436
-------------
0
0
-------------
0
11LISA SOHN MD
PHYSICIAN
(i)

(ii)
515,649
-------------
0
30,717
-------------
0
180
-------------
0
18,975
-------------
0
14,051
-------------
0
579,572
-------------
0
0
-------------
0
12ALINA LAZAR MD
PHYSICIAN
(i)

(ii)
488,270
-------------
0
33,451
-------------
0
250
-------------
0
18,975
-------------
0
40,844
-------------
0
581,790
-------------
0
0
-------------
0
13SCOTT A STENQUIST MD
PHYSICIAN
(i)

(ii)
528,211
-------------
0
24,681
-------------
0
989
-------------
0
18,975
-------------
0
28,819
-------------
0
601,675
-------------
0
0
-------------
0
Schedule J (Form 990) (Rev. 1-2025)

Schedule J (Form 990) (Rev. 1-2025)
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
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation PURSUANT TO THE BYLAWS OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER ("MEDICAL CENTER"), THE COMPENSATION COMMITTEE OF THE MEDICAL CENTER IS CHARGED WITH REVIEWING AND APPROVING SENIOR EXECUTIVE COMPENSATION FOR THE MEDICAL CENTER AND ITS AFFILIATES (INCLUDING ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO (LURIE CHILDREN'S) AND LURIE CHILDREN'S PEDIATRIC ANESTHESIA ASSOCIATES) AND THE COMPENSATION FOR ANY PHYSICIAN WHO MEETS THE CRITERIA FOR REVIEW AND APPROVAL BY THE COMMITTEE. THE COMPENSATION COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT. THE COMPENSATION PHILOSOPHY IS SUBJECT TO PERIODIC REVIEW BY THE COMPENSATION COMMITTEE FOR CONTINUED APPROPRIATENESS IN THE CURRENT MARKET. WITH THE ASSISTANCE OF INDEPENDENT COMPENSATION CONSULTANTS AND INFORMATION FROM A VARIETY OF SOURCES (SPECIFIED ON SCHEDULE J), THE COMPENSATION COMMITTEE CONFIRMED THE TOTAL AMOUNTS TO BE PAID TO IDENTIFIED EXECUTIVES AND PHYSICIANS WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS TO INDIVIDUALS IN FUNCTIONALLY SIMILAR POSITIONS. LEGAL COUNSEL PERIODICALLY ADVISES THE COMPENSATION COMMITTEE WITH RESPECT TO FEDERAL TAX REQUIREMENTS IN SETTING COMPENSATION AND THE ESTABLISHMENT OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL TAX LAW INTERMEDIATE SANCTIONS RULES. THE PROCESS FOLLOWED BY THE COMPENSATION COMMITTEE, INCLUDING A DESCRIPTION OF THE DATA RELIED UPON AND THE COMPENSATION COMMITTEE'S DECISIONS, WAS THOROUGHLY AND CONTEMPORANEOUSLY DOCUMENTED. THE COMPENSATION COMMITTEE HAS EXPRESSLY REVIEWED THE REASONABLENESS OF COMPENSATION PAID TO IDENTIFIED EXECUTIVES AND PHYSICIANS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED. THE COMPENSATION COMMITTEE IS COMPRISED OF MEMBERS OF THE MEDICAL CENTER BOARD OF DIRECTORS WHO HAVE BEEN DETERMINED TO BE DISINTERESTED (WHICH MEANS NO COMMITTEE MEMBER HAS A CONFLICT OF INTEREST) FOR THESE PURPOSES. THE COMPENSATION COMMITTEE CONDUCTS AN ONGOING, REGULAR REVIEW OF THE DISINTERESTED STATUS OF ITS MEMBERS, AND WILL SEEK THE RECUSAL FROM DECISIONMAKING OF ANYONE HAVING AN INTEREST WITH RESPECT TO ONE OR MORE EXECUTIVES SO AS TO PRESERVE THE DISINTERESTED STATUS OF THE COMMITTEE AND, AS A RESULT, THE APPLICATION OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Ann & Robert H. Lurie Children's Hospital of Chicago maintains a defined contribution supplemental executive retirement plan ("DC SERP"), which was established on January 1, 2017 and is a nonqualified deferred compensation plan for certain employees in executive positions. The benefits in the DC SERP are in the form of a fixed annual contribution rate and an earnings credit. Each year's contribution and earnings are at risk and will become fully vested and taxable only after five years of future employment service, or upon reaching age 62 with at least three years of service. Several listed persons in this Form 990 participate in the DC SERP, and the unvested contributions made for them are included in Schedule J, Part II, Column (C). The following individuals participated in the DC SERP and received a vested payment during 2024 which is reported in Column B (iii): Thomas P. Shanley, MD $253,173 Fatema Zanzi $77,376 CEO Deferred Compensation Listed individual Thomas Shanley MD is the sole participant in an additional supplemental retirement benefit arrangement that began in 2021. He is eligible to earn a benefit that will not become vested for several years. A prorated portion of the benefit (representing the portion earned in 2024) is reported in Column (C) as unvested deferred compensation, and will be reported again as compensation if and when the full benefit becomes vested and is subject to tax. The independent Compensation Committee of the Children's Hospital of Chicago Medical Center board, whose diligent review and approval process is described elsewhere in these narratives, has reviewed and approved Dr. Shanley's total compensation in a manner that qualifies for the rebuttable presumption of reasonableness under the federal tax law intermediate sanctions rules, and as part of this review process took into account the benefit being earned under this additional arrangement.
Schedule J, Part I, Line 7 Non-fixed payments The organization provides annual incentive compensation to senior management under a senior management incentive compensation plan. These amounts are included in Schedule J, Part II, Column B (ii). The plan is designed to offer opportunities for additional compensation tied to performance against pre-determined financial, patient satisfaction, patient safety and individual goals approved in advance by the Compensation Committee of the Children's Hospital of Chicago Medical Center (Medical Center) board of directors, which serves as the Compensation Committee of Lurie Children's and Lurie Children's Pediatric Anesthesia Associates. The Compensation Committee has expressly reviewed the reasonableness of all such payments and has concluded, as the result of a process that is designed to qualify for the rebuttable presumption of reasonableness under federal tax law, that all such amounts are reasonable and do not exceed fair market value for the services provided.
Schedule J, Part II RELATED COMPENSATION THE FOLLOWING INDIVIDUALS ARE NOT COMPENSATED BY THE REPORTING ORGANIZATION FOR THEIR SERVICE AS DIRECTORS OR OFFICERS OF THE REPORTING ORGANIZATION. Rather, the compensation reported on Form 990, Part VII and on Schedule J, Part II reflects compensation paid by Ann & Robert H. Lurie Children's Hospital of Chicago (Lurie Children's) for the individual's substantial and full-time services as an employee. For more details, please refer to the 2024 Form 990 of Lurie Children's, FEIN 36-2170833. Alex P. Miller Brenda Davis Fatema Zanzi Thomas P. Shanley, MD
Schedule J (Form 990) (Rev. 1-2025)

Additional Data


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SCHEDULE N
(Form 990)

Department of the Treasury
Internal Revenue Service
Liquidation, Termination, Dissolution, or Significant Disposition of Assets
Right arrow Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.
Right arrow Attach certified copies of any articles of dissolution, resolutions, or plans.
Right arrow Attach to Form 990 or 990-EZ.
Right arrow Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2024
Open to Public
Inspection
Name of the organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number
37-1838535
Part I
Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 31, or Form 990-EZ, line 36. Part I can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid
(b) Date of
distribution
(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
NET ASSETS TRANSFERRED IN MERGER 12-31-2024 362,300 FAIR MARKET VALUE 36-3279680 LCMG Inc FKA PFF
225 E Chicago Ave Box 282
Chicago,IL606112991
501(c)(3)
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? ...........................
Yes
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? .....................
Yes
 
c
Become a direct or indirect owner of a successor or transferee organization? .........................
 
No
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? ........
 
No
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. Right arrow
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50087Z
Schedule N (Form 990) (2024)

Schedule N (Form 990) (2024)
Page 2
Part I
Liquidation, Termination, or Dissolution (continued)
Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.
Yes
No
3
Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III ...............
3
Yes
 
4a
Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? .........
4a
Yes
 
b
If "Yes," did the organization provide such notice? ................................
4b
Yes
 
5
Did the organization discharge or pay all of its liabilities in accordance with state laws? .......................
5
Yes
 
6a
Did the organization have any tax-exempt bonds outstanding during the year? .........................
6a
 
No
b
If "Yes" on line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?
6b
 
 
c
If "Yes" on line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" on line 6b, explain in Part III.

Part II
Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.
1(a) Description of asset(s)
distributed or transaction
expenses paid
(b) Date of
distribution
(c) Fair market value of
asset(s) distributed or
amount of transaction
expenses
(d) Method of
determining FMV for
asset(s) distributed or
transaction expenses
(e) EIN of recipient (f) Name and address of recipient (g) IRC section
of recipient(s) (if
tax-exempt) or type
of entity
Yes
No
2
Did or will any officer, director, trustee, or key employee of the organization:
a
Become a director or trustee of a successor or transferee organization? ...........................
 
 
b
Become an employee of, or independent contractor for, a successor or transferee organization? .....................
 
 
c
Become a direct or indirect owner of a successor or transferee organization? .........................
 
 
d
Receive, or become entitled to, compensation or other similar payments as a result of the organization's significant disposition of assets? ..........
 
 
e
If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. Right arrow
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50087Z
Schedule N (Form 990) (2024)

Schedule N (Form 990) (2024)
Page 3
Part III
Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.
Return Reference Explanation
Schedule N, Part I, Line 2a Interested person is a director or trustee of successor org. 1. Thomas P. Shanley, MD 2. Oluwatoyin Olutoye, MD 3. Erin Toaz, MD 4. James H. Roth
Schedule N, Part I, Line 2b Interested person is an employee or ind. contractor of successor org. 1. Oluwatoyin Olutoye, MD 2. Richard M. Dsida, MD 3. Ravi Shah, MD 4. Scott A. Stenquist, MD 5. Alina Lazar, MD 6. Lisa Sohn, MD 7. Hubert Benzon, MD 8. Ann C. Monahan, MD 9. Erin Toaz, MD
Schedule N (Form 990) (2024)



Additional Data


Software ID: 24020961
Software Version: 2024v5.1


SCHEDULE O
(Form 990)
(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
Open to Public
Inspection
Name of the organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number

37-1838535
Return Reference Explanation
Form 990, Part I, Line 1 THE ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES In pursuit of such purposes, the corporation may: (i) engage in the professional enterprise of furnishing information, research, and clinical studies and performing other services associated with the specialty of pediatric anesthesia and all its related fields; (ii) provide information and instruction to graduate physicians and other healthcare personnel in medical specialty education related to pediatrics and pediatric anesthesia; (iii) conduct research in all branches of clinical medicine, with specialties in pediatrics and pediatric anesthesia; (iv) provide medical information to patients in connection with the foregoing, without regard to the patient's ability to pay; (v) propose, encourage and stimulate research, experiments and studies related to diseases affecting pediatric patients and foster the education of the medical community and the dissemination of information relating to maladies and illnesses affecting pediatric patients and the alleviation thereof; and (vi) engage in such other activities of a charitable and/or medical and educational nature as may be permitted under the provisions of the Illinois act.
Form 990, Part III, Line 1 ORGANIZATION'S MISSION In pursuit of such purposes, the corporation may: (i) engage in the professional enterprise of furnishing information, research, and clinical studies and performing other services associated with the specialty of pediatric anesthesia and all its related fields; (ii) provide information and instruction to graduate physicians and other health care personnel in medical specialty education related to pediatrics and pediatric anesthesia; (iii) conduct research in all branches of clinical medicine, with specialties in pediatrics and pediatric anesthesia; (iv) provide medical information to patients in connection with the foregoing, without regard to the patient's ability to pay; (v) propose, encourage and stimulate research, experiments and studies related to diseases affecting pediatric patients and foster the education of the medical community and the dissemination of information relating to maladies and illnesses affecting pediatric patients and the alleviation thereof; and (vi) engage in such other activities of a charitable and/or medical and educational nature as may be permitted under the provisions of the Illinois act.
Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION Lurie Children's Pediatric Anesthesia Associates ("LCPAA") is an Illinois not for profit corporation and an organization described under section 501(c)(3) of the code. On January 1, 2019, Children's Hospital of Chicago Medical Center (FEIN 36-3357004) became the sole corporate member of LCPAA. LCPAA is the exclusive provider of pediatric anesthesiology services to patients of Ann & Robert H. Lurie Children's Hospital of Chicago ("Lurie Children's"). LCPAA is composed of trained pediatric anesthesiologists who are best equipped to safely care for children because of their deep understanding of how children's bodies work, how children react to medications and anesthesia, and how the illnesses children suffer from differ from those in older patients. LCPAA provides specialized programs, including post-operative pain relief, chronic pain services, and patient-controlled analgesia. In addition to providing a wide range of pediatric anesthesia services, LCPAA engages in research and education. Anesthesiologists employed by LCPAA provide information and instruction to medical students, graduate physicians in residencies and fellowships, and other health care professionals in medical specialty education related to pediatrics and pediatric anesthesia. LCPAA conducts research in all branches of clinical medicine, with specialties in pediatrics and pediatric anesthesia, and proposes, encourages and stimulates research, experiments, and studies related to diseases affecting pediatric patients. Through this work, LCPAA fosters the education of the medical community and the dissemination of information relating to maladies and illnesses affecting pediatric patients and the alleviation of those conditions. LCPAA provides services regardless of the patient's ability to pay. It accepts patients covered by Medicare and Medicaid and provides financial assistance under its financial assistance policy.
Form 990, Part III, Line 3 Significant changes in program services Effective January 1, 2025, Lurie Children's Surgical Foundation, Inc., Children's Hospital of Chicago Faculty Practice Plan, Inc., Lurie Children's Pediatric Anesthesia Associates, Lurie Children's Primary Care, Inc., and Lurie Children's Multispecialty Group, Inc. merged with and into Pediatric Faculty Foundation, Inc. Also effective on January 1, 2025, Pediatric Faculty Foundation, Inc. changed its name to Lurie Children's Medical Group, Inc.
Form 990, Part V, Line 2a ALLOCATION OF SALARY EXPENSES ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO PAYS AND ISSUES FORMS W-2 TO EMPLOYEES WHO WORK FOR LURIE CHILDREN'S PEDIATRIC ANESTHESIA ASSOCIATES. THE ALLOCATION OF THE SALARY COSTS ARE DISCLOSED ON FORM 990, PART IX, STATEMENT OF FUNCTIONAL EXPENSES.
Form 990, Part V, Line 1a Form 1099/1096 Filing VENDORS FOR THE FILING ORGANIZATION ARE PAID BY ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO ("LURIE CHILDREN'S") (EIN 36-2170833). AS SUCH, ALL REQUIRED FORM 1099 AND FORMS 1096 REPORTING IS FILED UNDER THE LURIE CHILDREN'S EIN.
Form 990, Part VI, Line 15 EXECUTIVE COMPENSATION DESCRIPTION OF THE PROCESS BY WHICH THE COMPENSATION OF CERTAIN EXECUTIVES WAS DETERMINED THE AUTHORITY TO REVIEW AND APPROVE EXECUTIVE COMPENSATION HAS BEEN DELEGATED TO THE COMPENSATION COMMITTEE OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER BOARD OF DIRECTORS ("COMPENSATION COMMITTEE"). THE COMPENSATION COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT. THE COMPENSATION PHILOSOPHY IS SUBJECT TO PERIODIC REVIEW FOR CONTINUED APPROPRIATENESS BY THE COMPENSATION COMMITTEE. WITH THE ASSISTANCE OF A COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (SPECIFIED ON SCHEDULE J), THE COMPENSATION COMMITTEE CONFIRMED THE TOTAL AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. LEGAL COUNSEL ADVISES THE COMPENSATION COMMITTEE WITH RESPECT TO FEDERAL TAX REQUIREMENTS IN SETTING COMPENSATION AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS. THE PROCESS FOLLOWED BY THE COMPENSATION COMMITTEE, INCLUDING A DESCRIPTION OF THE DATA RELIED UPON AND THE COMPENSATION COMMITTEE'S DECISIONS, WAS THOROUGHLY AND CONTEMPORANEOUSLY DOCUMENTED. THE COMPENSATION COMMITTEE HAS EXPRESSLY REVIEWED THE REASONABLENESS OF COMPENSATION PAID TO IDENTIFIED EXECUTIVES, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED. THE COMPENSATION COMMITTEE IS COMPRISED OF MEMBERS OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER BOARD OF DIRECTORS WHO HAVE BEEN DETERMINED TO BE DISINTERESTED FOR THESE PURPOSES. THE COMPENSATION COMMITTEE CONDUCTS AN ONGOING AND PERIODIC REVIEW OF THE DISINTERESTED STATUS OF ITS MEMBERS, AND WILL TAKE APPROPRIATE ACTION WITH RESPECT TO ANYONE HAVING AN INTEREST WITH RESPECT TO ONE OR MORE EXECUTIVES SO AS TO PRESERVE THE APPLICATION OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS.
Form 990, Part VI, Line 6 Classes of members or stockholders Children's Hospital of Chicago Medical Center is the organization's sole corporate member.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The organization's sole corporate member, Children's Hospital of Chicago Medical Center, has certain reserved powers, including the power to appoint and remove physician directors of the Lurie Children's Pediatric Anesthesia Associates board.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Children's Hospital of Chicago Medical Center, through its board of directors or designated committee, as the sole corporate member of the organization, has certain reserved powers with respect to appointment and removal of certain directors, appointment of certain officers, approval of amendments to governing documents, approval of financial matters, and approval of significant transactions including, but not limited to, merger, dissolution, disposition of assets other than in the ordinary course of business, and creation of subsidiaries.
Form 990, Part VI, Line 11b Review of form 990 by governing body The Audit and Compliance Committee is the committee of the Medical Center board charged with the oversight of audit, tax and compliance matters for the parent and affiliates. During a special Audit and Compliance Committee meeting, and before Form 990 was filed, the Committee was provided a review of Form 990 by the Chief Financial Officer ("CFO"). The CFO and outside tax advisor also responded to the Audit and Compliance Committee members' questions and afforded them the opportunity for detailed discussion of Form 990, prior to the Audit and Compliance Committee taking action to approve the filing of Form 990. A full copy of the organization's Form 990 was then provided to the respective filing organization's board following the Audit and Compliance Committee's approval. As part of its annual return preparation process, the organization, on an ongoing basis, consulted its tax consulting firm and outside tax legal counsel, both of which possess expertise in health care and tax-exempt return preparation, to advise and assist in the preparation of Form 990. These advisors worked closely with the organization's finance personnel and other members of the organization's team assembled to participate in the preparation of Form 990. Prior to presenting Form 990 to the Medical Center board's Audit and Compliance Committee, the organization's team, including its advisors, met frequently to discuss and review drafts of Form 990. Subsequent to the Audit and Compliance Committee review and approval, Form 990 was provided to the respective filing organization's board of directors.
Form 990, Part VI, Line 12c Conflict of interest policy On an annual basis, Children's Hospital of Chicago Medical Center (The "Medical Center") and its affiliates (collectively the "Corporation") provide a comprehensive questionnaire to its board members, senior management and other key employees posing questions about actual or potential conflicts of interest. The Medical Center initiates follow up contact to those who do not respond and to clarify responses, where necessary. The Medical Center reviews each disclosure and provides a summary of relevant disclosures for the review and approval of the Medical Center Board's Nominating and Governance Committee. Board members, senior management, and key employees are subject to an applicable Medical Center conflict of interest policy and to a Code of Conduct, which includes the ongoing responsibility to promptly disclose conflicts of interests or duality of interests to a designated individual(s). Disclosures are provided to the Nominating and Governance Committee of the Medical Center Board of Directors, which considers all conflict and duality of interests issues. If the disinterested members of the Nominating and Governance Committee have determined that a potential or actual conflict of interest or duality of interest exists, the Nominating and Governance Committee shall determine if preparation of Conflicts Management Guidelines will sufficiently mitigate the potential or actual conflict of interest and/or duality of interest. If the Nominating and Governance Committee determines that Conflicts Management Guidelines will sufficiently mitigate the potential or actual conflict of interest and/or duality of interest, the Chief Legal Officer will prepare said Conflicts Management Guidelines regarding the particular person's potential or actual conflict of interest and/or duality of interest for review, approval, and oversight by the Nominating and Governance Committee. The Chief Legal Officer shares the Conflict Management Guidelines with the applicable person following approval by the Nominating and Governance Committee. The Conflicts Management Guidelines may require any or all of the aspects below. 1. The relevant person shall recuse themselves from all or a portion of the meeting of the board or committee on which the person serves while the proposed contract, transaction, or arrangement giving rise to the conflict of interest and/or the situation giving rise to a duality of interest is discussed. In addition, the person shall recuse themselves from all or a portion of the meeting of the board or committee on which the person serves while the matter is voted on, and only disinterested directors or committee members, as the case may be, may vote to determine whether to approve the contract, transaction, arrangement, or situation giving rise to the conflict of interest or duality of interest. In determining whether and when to require the person to recuse themselves during discussion of the proposed contract, transaction, or arrangement giving rise to the conflict of interest and/or the situation giving rise to a duality of interest, the disinterested board directors or committee members, as the case may be, shall balance the need to facilitate the discussion by having such person on hand to provide additional information with the need to preserve the independence of the determination process. 2. With respect to a conflict of interest or duality of interest, the disinterested members of the Nominating and Governance Committee shall exercise due diligence to determine whether the contract, transaction, or arrangement presented by the conflict of interest or duality of interest is fair and reasonable and in the best interest to the Corporation. In reaching such determination, the Nominating and Governance Committee shall determine whether there are alternatives to the proposed contract, transaction or arrangement that would not give rise to a conflict of interest or duality of interest. If a more advantageous contract, transaction, or arrangement that would not give rise to a conflict of interest or duality of interest is not reasonably attainable under the circumstances, the disinterested members of the Nominating and Governance Committee must determine by a majority vote that the contract, transaction, or arrangement presented by the conflict of interest or duality of interest is fair and reasonable and in the best interest to the Corporation before such contract, transaction, or arrangement may be approved for execution by the board of directors of its executive committee. If the Nominating and Governance Committee determines that Conflicts Management Guidelines will not sufficiently mitigate the potential or actual conflict of interest and/or duality of Interest, the Nominating and Governance Committee shall determine the appropriate steps. The Chief Legal Officer shares the Nominating and Governance Committee's decision with the applicable person following approval by the Nominating and Governance Committee.
Form 990, Part VI, Line 19 Required documents available to the public The organization's financial statements are publicly available online at www.dacbond.com. The organization's Articles of Incorporation and annual reports are available through the Illinois Secretary of State. The organization also makes its general governing documents available to the general public upon request.
Form 990, Part VII, Section B, Line 1 INDEPENDENT CONTRACTORS VENDORS FOR THE FILING ORGANIZATION ARE PAID BY ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO ("LURIE CHILDREN'S"). AS SUCH, THE FIVE HIGHEST COMPENSATED INDEPENDENT CONTRACTORS ARE REPORTED ON THE FORM 990 FOR LURIE CHILDREN'S (EIN 36-2170833).
Form 990, Part XI, Line 9 Other changes in net assets or fund balances Net Assets Transferred to Pediatric Faculty Foundation, Inc. In Merger - 362300;
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) (Rev. 1-2025)


Additional Data


Software ID: 24020961
Software Version: 2024v5.1
SCHEDULE R
(Form 990)

(Rev. January 2025)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
Open to Public Inspection
Name of the organization
Lurie Children's Pediatric Anesthesia Associates
 
Employer identification number

37-1838535
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











Part II
Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)ALMOST HOME KIDS
7 S 721 ROUTE 53

NAPERVILLE,IL60540
36-3822010
TRANSITION CR IL 501(c)(3) 10 MEDICAL CTR
 
 
No
(2)STANLEY MANNE CHILDREN'S RESC INSTITUTE
225 E CHICAGO AVE

CHICAGO,IL60611
36-3357005
RESEARCH IL 501(c)(3) 4 MEDICAL CTR
 
 
No
(3)LURIE CHILDREN'S HOSPITAL OF CHICAGO FDN
225 E CHICAGO AVE

CHICAGO,IL60611
36-3357006
FUNDRAISING IL 501(c)(3) 7 MEDICAL CTR
 
 
No
(4)CHILDREN'S HOSPITAL OF CHICAGO MED CTR
225 E CHICAGO AVE

CHICAGO,IL60611
36-3357004
HEALTH CARE IL 501(c)(3) 10 NA
 
 
No
(5)PEDIATRIC FACULTY FOUNDATION INC
225 E CHICAGO AVE

CHICAGO,IL60611
36-3279680
HLTH CRE/RSCH IL 501(c)(3) 10 MEDICAL CTR
 
 
No
(6)LURIE CHILDRENS LIABILITY PROTECTION PRG
225 E CHICAGO AVE

CHICAGO,IL60611
36-6638400
INSURANCE IL 501(c)(3) Type III-FI MEDICAL CTR
 
 
No
(7)LURIE CHILDREN'S
225 E CHICAGO AVE

CHICAGO,IL60611
36-2170833
HOSPITAL IL 501(c)(3) 3 MEDICAL CTR
 
 
No
(8)CHILDREN'S HOSPITAL OF CHICAGO FPP
737 NORTH MICHIGAN AVE
2040
CHICAGO,IL60611
36-3393780
SUPPORTING ORG IL 501(c)(3) Type I MEDICAL CTR
 
 
No
(9)LURIE CHILDREN'S SURGICAL FOUNDATION INC
225 E CHICAGO AVE

CHICAGO,IL60611
83-1650513
HLTH CRE/RSCH IL 501(c)(3) 3 MEDICAL CTR
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No
(1) LURIE CHILDRENS CIN LLC

225 E CHICAGO AVE
CHICAGO,IL60611
90-1025439
CONTRACTING SVCS IL NA
 
                 












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CMMC INSURANCE CO LTD

225 E CHICAGO AVE
CHICAGO,IL60611
98-1049532
SELF INSURANCE   NA
 
C Corporation         No












Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
Page 3
Part V
Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved





Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) (Rev. 1-2025)
Schedule R (Form 990) (Rev. 1-2025)
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) (Rev. 1-2025)

Additional Data


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