2022-04-20T11:28:56-05:00 2021-06-30 135565207 KPMG LLP 8350 BROAD STREET SUITE 900 MCLEAN VA 22102 990 2020-07-01 540506321 CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS CHIL 7576687000 601 CHILDRENS LANE NORFOLK VA 23507 DENNIS RYAN CFO/ASST TREAS/SECR 7576687000 2022-04-19 1 DENNIS RYAN 999009999 ANDREW ROE P01876391 7032868000 2022-04-19 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z JAMES D DAHLING 601 CHILDRENS LANE NORFOLK VA 23507 901674694 0 X WWW.CHKD.ORG X 1961 VA SEE SCHEDULE ODEDICATED TO THE MISSION OF PROVIDING THE BEST POSSIBLE CARE AND SERVICES FOR ALL CHILDREN WHO COME TO US BECAUSE OF SICKNESS AND INJURY. 20 17 3292 234 742622 392485 46947279 99087320 444916296 405576468 9115220 49345049 2777693 4363837 503756488 558372674 13564952 19703670 0 0 204014176 213621050 455799 200918 2916182 223783170 232798272 441818097 466323910 61938391 92048764 805448811 1001729901 243917851 328154515 561530960 673575386 X SEE SCHEDULE O 0 0 408211120 19703670 408047418 SEE SCHEDULE OFOR SIX DECADES, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) HAS BEEN THE ONLY FACILITY OF ITS KIND IN VIRGINIA, SERVING THE MEDICAL AND SURGICAL NEEDS OF CHILDREN THROUGHOUT THE STATE. ITS PRIMARY SERVICE AREA ENCOMPASSES GREATER HAMPTON ROADS, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA, A REGION THAT IS HOME TO APPROXIMATELY 553,000 CHILDREN UNDER THE AGE OF 21.CHKD WAS ESTABLISHED AS AN 88-BED, NOT-FOR-PROFIT HOSPITAL IN 1961 BY THE KING'S DAUGHTERS, A WOMEN'S SERVICE ORGANIZATION DEDICATED TO THE HEALTH AND WELL BEING OF THE COMMUNITY'S INDIGENT CHILDREN. THE HOSPITAL HAS ALWAYS UPHELD THE CHARITABLE MISSION OF ITS FOUNDERS, AND IN FY2021, OVER 58 PERCENT OF ITS INPATIENT DAYS WERE COVERED BY MEDICAID.OVER THE PAST 60 YEARS, CHKD HAS GROWN INTO A 206-BED TEACHING HOSPITAL THAT IS THE HEART OF AN EXTENSIVE PEDIATRIC HEALTH CARE SYSTEM. TODAY, THAT SYSTEM PROVIDES COMPREHENSIVE MEDICAL CARE TO CHILDREN AT THE HOSPITAL AND MULTI-SERVICE HEALTH CENTERS IN VIRGINIA BEACH, NEWPORT NEWS, CHESAPEAKE, HAMPTON, SUFFOLK, NORFOLK AND WILLIAMSBURG. ITS SERVICES INCLUDE EVERYTHING FROM WELLNESS AND PREVENTION INITIATIVES TO PRIMARY CARE, SURGERY AND REHABILITATION. MANY OF ITS UNIQUE SERVICES AND PROGRAMS ADDRESS PRESSING PUBLIC HEALTH NEEDS THAT WOULD OTHERWISE GO UNMET.LIKE HOSPITALS EVERYWHERE, CHKD SPENT MUCH OF 2021 FOCUSED ON THE COVID-19 PANDEMIC, TESTING FOR COVID-19, AND TREATING CHILDREN WITH COVID-19 AND MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C), A RARE BUT SERIOUS CONDITION ASSOCIATED WITH COVID-19. THE HOSPITAL SAW ITS HIGHEST LEVEL OF COVID-19 HOSPITALIZATIONS AND CHILDREN TESTING POSITIVE FOR COVID-19 IN SEPTEMBER 2021. THE HOSPITAL ALSO CONTINUED CONSTRUCTION OF A $224 MILLION MENTAL HEALTH FACILITY, WHICH IS EXPECTED TO OPEN 2022. THE 14-STORY MENTAL HEALTH CENTER WILL HAVE 60 INPATIENT BEDS, INDOOR AND OUTDOOR EXERCISE AREAS, AND ROOMS FOR OUTPATIENT SERVICES. A FULL CONTINUUM OF MENTAL HEALTH CARE, FROM OUTPATIENT THERAPY TO MORE INTENSIVE INPATIENT TREATMENT WILL BE PROVIDED IN A BUILDING THAT WILL ALSO HOUSE PRIMARY CARE AND SPORTS MEDICINE PRACTICES. THE AIM IS TO MAKE SEEKING MENTAL HEALTH CARE AS ROUTINE AND ACCEPTED AS OTHER TYPES OF HEALTH CARE TO EASE STIGMA.AS THE PREMIER PROVIDER OF HEALTHCARE SERVICES TO THE REGION'S CHILDREN, CHKD HAS SECURED A PLACE IN THE HEART OF THE COMMUNITY. THE HOSPITAL IS AN EAGER COLLABORATOR WITH OTHER COMMUNITY ORGANIZATIONS AND INSTITUTIONS THAT SHARE ITS CONCERN FOR THE WELL-BEING OF YOUNG PEOPLE AND OFFERS A VARIETY OF EDUCATION, RESEARCH AND HEALTH INITIATIVES TO IMPROVE THE HEALTH AND WELL BEING OF CHILDREN IN THIS COMMUNITY AND BEYOND.THE HEALTH SYSTEM'S PRIMARY SERVICES CENTER ON INPATIENT AND OUTPATIENT CARE, COMMUNITY OUTREACH PROGRAMS AND MEDICAL EDUCATION/RESEARCH.SECTION ONE: INPATIENT CARECHILDREN WITH A VAST RANGE OF MEDICAL PROBLEMS - INCLUDING LIFE-THREATENING ILLNESSES AND INJURIES -- TURN TO CHKD FOR INPATIENT CARE. IN FY21, CHKD HAD 4,378 ADMISSIONS RESULTING IN 45,046 PATIENT DAYS. APPROXIMATELY 58 PERCENT OF THESE DAYS WERE COVERED BY MEDICAID.CHKD HAS 206 INPATIENT BEDS, AND ALMOST HALF OF THOSE ARE FOR PEDIATRIC INTENSIVE CARE. THE HOSPITAL IS HOME TO THE REGION'S HIGHEST LEVEL NEONATAL INTENSIVE CARE UNIT, WHERE EACH YEAR CRITICALLY ILL NEWBORNS, SOME AS YOUNG AS 22 WEEKS GESTATION, BENEFIT FROM A UNIQUE COMBINATIONOF ADVANCED MEDICAL TECHNOLOGY, DEVELOPMENTAL CARE, FAMILY SUPPORT, AND PALLIATIVE CARE. IN SEPTEMBER 2020, A RENOVATION OF THE NICU WAS COMPLETED CREATING 50 PRIVATE ROOMS AND 10 SEMI-PRIVATE ROOMS TO CREATE A MORE INDIVIDUALIZED AND FAMILY-CENTERED APPROACH, GIVING FAMILIES MORE PRIVACY TO BOND WITH THEIR BABIES. THERE WERE APPROXIMATELY 478 ADMISSIONS TO THE NICU IN FY21.THE REGION'S LARGEST AND MOST EXPERIENCED PEDIATRIC INTENSIVE CARE UNIT IS AT CHKD. IN THIS UNIT, A FULL-TIME STAFF OF BOARD-CERTIFIED PEDIATRIC INTENSIVE CARE PHYSICIANS, CRITICAL CARE NURSES AND RESPIRATORY THERAPISTS PROVIDE EXTREMELY SOPHISTICATED, TECHNOLOGICALLY-ADVANCED CARE TO CHILDREN WITH LIFE-THREATENING INJURIES AND ILLNESSES. MEDICAL CARE IS SUPPLEMENTED WITH SUPPORT FROM CHILD LIFE SPECIALISTS, SOCIAL WORKERS AND CHAPLAINS WHO HAVE EXTENSIVE EXPERIENCE HELPING FAMILIES THROUGH THE TRAUMA AND STRESS OF A SEVERE ILLNESS OR INJURY IN A CHILD. THERE WERE 1,413 ADMISSIONS TO OUR PICU IN FY21.MANY PATIENTS ARE BROUGHT FROM OTHER AREA HOSPITALS TO CHKD BY THE HOSPITAL'S NEONATAL PEDIATRIC TRANSPORT PROGRAM, WHICH OPERATES OUT OF FOUR FULLY-EQUIPPED MOBILE INTENSIVE CARE UNITS. TWO CRITICAL CARE TRANSPORT TEAMS ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO ALL AREA MEDICAL FACILITIES THAT NEED TO SEND SICK OR INJURED CHILDREN TO CHKD. CHKD TRANSPORT TEAMS ARE EQUIPPED AND TRAINED TO TRANSPORT ALL TRAUMA PATIENTS UNDER THE AGE OF 15 TO CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS FOR SPECIALIZED PEDIATRIC TRAUMA CARE. ONE ACUTE CARE TRANSPORT TEAM IS STAFFED DAILY WITH TWO PARAMEDICS TO PROVIDE TRANSPORT TO PEDIATRIC PATIENTS THROUGHOUT THE COMMUNITY, SERVING URGENT CARE FACILITIES AS WELL AS EMERGENCY ROOMS WITHIN THE TIDEWATER REGION. EACH CRITICAL CARE TRANSPORT CALL IS ANSWERED BY A NEONATAL/PEDIATRIC CRITICAL CARE NURSE, A REGISTERED RESPIRATORY THERAPIST AND A CERTIFIED EMT PARAMEDIC TRAINED IN NEONATAL/PEDIATRIC CARE. IN FY21, THE TEAM TRANSPORTED 1,292 PATIENTS. OF THOSE, 399 WERE NEWBORNS COMING TO OUR NEONATAL INTENSIVE CARE UNIT. CHKD'S TRANSPORT SERVICE IS ALSO UNDER CONTRACT TO THE NAVAL MEDICAL CENTER, PORTSMOUTH, TO PROVIDE ALL NEONATAL AND PEDIATRIC MILITARY TRANSPORTS IN THE REGION. BESIDES GROUND TRANSPORTS IN OUR MOBILE ICUS OR ACUTE CARE TRANSPORT, THE TEAM CAN RESPOND VIA FIXED WING AIRCRAFT OR HELICOPTER TRANSPORT WHEN MEDICALLY NECESSARY. CHKD TRANSFER CENTER IS STAFFED WITH PARAMEDICS WHO OPERATE TO ENSURE APPROPRIATE DISPATCH SERVICES TO THE TRANSPORT TEAM AS WELL AS TO DELIVER ASSISTANCE AND SUPPORT FOR REFERRAL FACILITIES AND STAFF THROUGHOUT THE COMMUNITY.STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSCHKD OPERATES THE REGION'S ONLY PEDIATRIC SURGERY PROGRAM, OFFERING YOUNG PEOPLE STATE-OF-THE-ART TREATMENT IN A SUPPORTIVE, NON-THREATENING ENVIRONMENT CREATED EXCLUSIVELY TO MEET THEIR NEEDS. IN FY21, SURGEONS PERFORMED 12,298 SURGERIES AT CHKD FACILITIES FOR A VAST RANGE OF PROBLEMS, FROM THE SIMPLEST OUTPATIENT PROCEDURES TO COMPLEX CRANIOFACIAL, ORTHOPEDIC AND CHEST WALL SURGERIES. CHKD'S CARDIAC SURGERY PROGRAM IS PART OF A REGIONAL COLLABORATIVE BETWEEN CHKD AND THE UNIVERSITY OF VIRGINIA. CHKD AND UVA COMBINE THE EFFORTS OF PEDIATRIC CARDIOLOGISTS, CARDIAC SURGEONS, CARDIAC ANESTHESIOLOGISTS, INTENSIVE CARE PHYSICIANS AND CARDIAC SUPPORT PROFESSIONALS FROM BOTH INSTITUTIONS WITH THE GOAL OF IMPROVING OUTCOMES FOR CHILDREN WITH COMPLEX CONGENTIAL HEART DEFECTS. (SEE OUTPATIENT SERVICES AND PROGRAMS FOR MORE INFORMATION OF CHKD'S SURGERY PROGRAM.)CHKD EMPLOYS DOZENS OF PROFESSIONALS WHO PROVIDE EMOTIONAL, RECREATIONAL, SPIRITUAL AND PRACTICAL SUPPORT TO CHILDREN AND FAMILIES DURING HOSPITALIZATIONS. THE WORK OF THESE PROFESSIONALS COMPLEMENTS OUR EXPERT MEDICAL CARE TO CREATE A UNIQUE TREATMENT AND HEALING ENVIRONMENT FOR CHILDREN AND THEIR FAMILIES.OUR CHAPLAINCY SERVICES PROVIDE EMOTIONAL SUPPORT, SPIRITUAL CARE, ETHICAL REFLECTION, BEREAVEMENT CARE/RESOURCES/FOLLOW-UP (INCLUDING PARENT AND CHILD SUPPORT GROUP), SPIRITUAL ASSESSMENT AND GUIDANCE TO PATIENTS, FAMILIES AND STAFF WITH IN-HOSPITAL PRESENCE SEVEN DAYS A WEEK AND 24 HOURS A DAY. CHAPLAINS ASSIST WITH ADVANCE DIRECTIVES, ADVANCE CARE PLANS AND SERVE ON THE TRAUMA TEAM AS PRIMARY PROVIDERS OF FAMILY SUPPORT.THE HOSPITAL EMPLOYS A CHAPLAINCY MANAGER, FIVE FULL-TIME CHAPLAINS, ONE FULL-TIME FAMILY/STAFF SUPPORT COORDINATOR, AND SIX PER-DIEM CHAPLAINS WHO REFLECT THE DIVERSITY OF THE COMMUNITY AND ARE PROFESSIONALLY TRAINED TO MEET THE VARIED SPIRITUAL NEEDS OF FAMILIES AND STAFF WITH RESPECT AND COMPASSION. THE CHAPLAINS PROVIDE AN ANNUAL MEMORIAL SERVICE TO REMEMBER AND CELEBRATE THE LIVES OF THE CHILDREN WHO HAVE PASSED ON DURING THE PREVIOUS YEAR. THE CHAPLAINS ALSO FACILITATE EDUCATIONAL PROGRAMS FOR HOSPITAL STAFF AND PHYSICIANS, AS WELL AS PLANNING AND PARTICIPATING IN OUTREACH TO THE COMMUNITY. 408211120 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 1 101 0 1 3292 1 1 1 0 0 0 1 1 1 1 0 0 0 1 0 0 0 X 20 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 AL FL GA IL KY MD MA MN NJ NY NC SC UT VA WI X DENNIS RYAN 7576687000 601 CHILDRENS LANE NORFOLK VA 23507 JAMES D DAHLING PRESIDENT/DIRECTOR 1.00 42.00 X X 0 1302389 88728 ROBERT OBERMEYER MD DIRECTOR 1.00 41.00 X 0 683960 38041 SCOTT NOTTINGHAM MD DIRECTOR 1.00 41.00 X 0 385030 37936 AKHIL JAIN CHAIRMAN/DIRECTOR 2.00 2.00 X X 0 0 0 EDWARD WHITMORE TREASURER/DIRECTOR 2.00 2.00 X X 0 0 0 ELLY BRADSHAW SMITH DIRECTOR 1.00 1.00 X 0 0 0 JULIA CHILDRESS BECK DIRECTOR 1.00 1.00 X 0 0 0 KATHRYN M VAN BUREN DIRECTOR 1.00 1.00 X 0 0 0 KIM GEORGES SECRETARY/DIRECTOR 2.00 2.00 X X 0 0 0 MARTA SATIN-SMITH DIRECTOR 1.00 1.00 X 0 0 0 MARTHA COLEN DIRECTOR 1.00 1.00 X 0 0 0 MILES LEON DIRECTOR 1.00 1.00 X 0 0 0 R JUSTIN FULTON VICE CHAIRMAN/DIRECTOR 2.00 2.00 X X 0 0 0 SUSAN R EINHORN DIRECTOR 1.00 1.00 X 0 0 0 SVINDER S TOOR MD DIRECTOR 1.00 1.00 X 0 0 0 KIERAN POULOS DIRECTOR 1.00 1.00 X 0 0 0 STACEY VELLINES DIRECTOR 1.00 1.00 X 0 0 0 OWEN GRIFFEN DIRECTOR 1.00 1.00 X 0 0 0 KEVIN MURPHY DIRECTOR 1.00 1.00 X 0 0 0 BRIAN SKINNER DIRECTOR 1.00 1.00 X 0 0 0 DENNIS RYAN CFO/ASST TREAS/ASSIST SECR 1.00 42.00 X 0 1021453 485645 DEBORAH BARNES VP - IS OPERATIONS 0.00 40.00 X 0 711700 390222 KAREN MITCHELL VP- PATIENT CARE SERVICES 40.00 0.00 X 682953 0 39481 JOHN HARDING CHIEF OPERATING OFFICER 0.00 40.00 X 0 756586 349879 ALLISON SILVA VP - ANCILLARY SERVICES 40.00 0.00 X 380132 0 127103 JALANA MCCASLAND VP PHYSICIAN PRACTICE MANAGEME 40.00 0.00 X 348711 0 129854 KATHRYN ABSHIRE VP FINANCE 0.00 40.00 X 0 270719 158305 TAMIKA HARRIS VP FACILITIES & SUPPORT SERV 40.00 0.00 X 257134 0 86535 SANDIP GODAMBE MD VP - QUALITY & PATIENT SAFETY 40.00 0.00 X 482631 0 270051 SUZANNE BRIXEY PHYSICIAN 40.00 0.00 X 324009 0 15888 JOSHUA GUINTER DIRECTOR PHARMACY 40.00 0.00 X 211605 0 22591 MICHELLE CLAYTON MEDICAL DIRECTOR CHILD ADVOCACY 40.00 0.00 X 214434 0 31909 JOHN WARBURTON VP MENTAL HEALTH 40.00 0.00 X 284781 0 76784 3186390 5131837 2348952 195 0 1 0 W M JORDAN CO INC 11010 JEFFERSON AVE NEWPORT NEWS VA 23601 CONSTRUCTION 88446474 CHILDREN'S SPECIALTY GROUP PO BOX 11049 NORFOLK VA 23517 MEDICAL 27126120 EASTERN VIRGINIA MED SCHOOL PO BOX 1980 NORFOLK VA 235011980 MEDICAL 12675705 COMPASS ONE PO BOX 1022289 ATLANTA GA 30368 FOOD SERVICES 8199764 ARRAY ARCHITECTS 1 WEST ELM STREET SUITE 400 CONSHOHOCKEN PA 19428 CONSTRUCTION 4643557 134 206251 55600000 20096366 23184703 2386702 99087320 PATIENT SERVICES 900099 380994429 380994429 OTHER RELATED SERVICES 900099 23839417 23839417 LAB SERVICES 621500 595383 595383 SPORTS RELATED SERVICE 900099 147239 147239 405576468 2541859 2541859 4669179 35122 3550805 3231 1118374 31891 1150265 1150265 386359373 191801 339589374 158610 46769999 33191 46803190 46803190 GRADUATE MEDICAL EDUCA 900099 3213572 3213572 3213572 558372674 408047418 742622 50495314 19703670 19703670 1506529 1198411 308118 177034048 159756689 15641919 1635440 5474867 3985651 1440852 48364 17353025 15639363 1539274 174388 12252581 11106504 1020283 125794 60000 60000 177454 177454 41700 41700 200918 200918 48840559 45796269 2987623 56667 208265 10183 186692 11390 2861972 1990539 757198 114235 2171935 1665803 466570 39562 15543012 13727979 1792069 22964 210796 178269 30754 1773 550242 425748 123826 668 3936376 3082709 853667 24955127 22540971 2289285 124871 2108648 603310 1504291 1047 SUPPLIES 72203305 71625966 558980 18359 EQUIP RENTAL AND MAINT. 21212896 19073091 2058294 81511 PURCHASED SERVICES 18445674 13914753 4445357 85564 CORPORATE SUPPORT 14870424 14870424 4399887 2185242 2041978 172667 466323910 408211120 55196608 2916182 82255207 77981519 16309113 20108722 80107050 83448509 10408519 11180116 9385650 9171291 741355557 321850382 308312947 419505175 258921689 319345255 27075234 39639946 12673402 21349368 805448811 1001729901 55686150 53441384 1527375 3236982 129293278 198693628 57411048 72782521 243917851 328154515 X 510511507 605246805 51019453 68328581 561530960 673575386 805448811 1001729901 X 92048764 -3631596 -489149 24116407 X 0 1 X 1 1 1 X 12513662 15064465 15669332 46947279 99087320 189282058 12513662 15064465 15669332 46947279 99087320 189282058 0 189282058 7348692 8097824 10139234 10070432 7246160 42902342 473903 363689 349255 397998 392485 1977330 234161730 2116132107 0.80830 0.69550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25741292 482624 3489607 620349 29093174 25731316 322831 754876 1067731 25741292 25265775 546670 1056618 1137747 25731316 25040857 359017 992800 1126899 25265775 23954985 117553 1700191 731872 25040857 1.00000 0 0 18417162 18417162 301815014 132582881 169232133 15616994 6683620 8933374 231075901 182348155 48727746 174430486 235726 174194760 419505175 DSH 39657938 DERIVATIVE INSTRUMENTS 15483152 CAPITAL LEASE 7894978 INSURANCE IBNR & IBNE 7312313 ANNUITY PAYABLE 1589901 MEDICARE ADVANCE PAYMENTS 777009 INTERCOMPANY 35145 ACCRUED TAIL COVERAGE 32085 72782521 X PART V, LINE 4: ENDOWMENT FUNDS ARE USED ACCORDING TO SPECIFIC WRITTEN REQUESTS OF THE DONOR ENDOWMENT AGREEMENT. IF NO DIRECT REQUESTS ARE MADE, FUNDS ARE USED IN ACCORDANCE WITH THE OVERALL MISSION OF THE ORGANIZATION. PART X, LINE 2: ASC 740 FOOTNOTE FROM CONSOLIDATED AUDIT REPORT CHS RECOGNIZES ANY BENEFITS FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. IF APPLICABLE, THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION WOULD BE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE RESOLUTION. CHS DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY UNCERTAIN TAX PROVISIONS. X X X X X X X 1 CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 CONSULTING 0 1470933 185918 1285015 HEALTH GIVING 3996 N HAMPTON DRIVE POWELL OH 43065 CONSULTING 0 0 15000 -15000 1470933 200918 1270015 AL AR CA CO CT DC FL GA HI IL KS KY LA ME MD MA MI MN MO NV NJ NY NC OH OK PA RI SC TN UT VA WA WV WI 1 1 X 1 X 175.000000000000 1 X 1 1 0 1 1 2517651 2517651 0.00550 217013847 129258060 87755787 0.19260 219531498 129258060 90273438 0.19810 74874735 12706171 62168564 0.13640 13652379 7116585 6535794 0.01430 48566786 22318209 26248577 0.05760 250989 6648 244341 0.00050 137344889 42147613 95197276 0.20880 356876387 171405673 185470714 0.40690 0 10626317 5072078 2744467 7338147 -4593680 X 1 1 3 1 CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS 601 CHILDRENS LANE NORFOLK VA 23507 H1843 X X X X X X MEDICAID DSH HOSPITAL A 2 CHKD HEALTH AND SURGERY CENTER 2021 CONCERT DRIVE VIRGINIA BEACH VA 23456 OH713 X OUTPATIENT SURGICAL HOSPITAL A 3 CHKD HEALTH AND SURGERY CENTER 11783 ROCK LANDING DRIVE NEWPORT NEWS VA 23608 OH694 X OUTPATIENT SURGICAL HOSPITAL A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 18 1 1 0 1 X WWW.CHKD.ORG X 1 19 1 WWW.CHKD.ORG 0 1 X 175.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.CHKD.ORG X WWW.CHKD.ORG X WWW.CHKD.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, - FACILITY 2: CHKD HEALTH AND SURGERY CENTER, - FACILITY 3: CHKD HEALTH AND SURGERY CENTER FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: CHKD'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED COLLECTING DATA FROM SEVERAL DIFFERENT SOURCES: A COMMUNITY HEALTH SURVEY (IN COLLABORATION WITH OTHER AREA HOSPITAL SYSTEMS), FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS AND HEALTH INDICATOR ANALYSIS.TWO VERSIONS OF THE SURVEY WITH SIMILAR QUESTIONS WERE CIRCULATED ACROSS CHKD'S SERVICE AREA. THE FIRST VERSION WAS A STAKEHOLDER SURVEY IN WHICH PARTICIPANTS PROVIDED (OR HAD KNOWLEDGE OF) HEALTH, PREVENTIVE AND SUPPORT SERVICES, INCLUDING FOR MANY LOW INCOME AND MINORITY RESIDENTS. THE SECOND VERSION WAS A COMMUNITY SURVEY THAT WAS CIRCULATED MORE BROADLY TO COMMUNITY MEMBERS. THERE WERE A TOTAL OF 768 PARTICIPANTS WHO COMPLETED ALL OF THE REQUIRED QUESTIONS, INCLUDING 329 RESPONSES TO THE STAKEHOLDER SURVEY AND 439 RESPONSES TO THE COMMUNITY SURVEY.GIVEN THE PREVIOUSLY IDENTIFIED PRIORITY OF MENTAL AND BEHAVIORAL HEALTH AND AN INTEREST IN HEARING FROM STAKEHOLDERS FROM ACROSS THE REGION WHO WERE FAMILIAR WITH THESE ISSUES, TWO FOCUS GROUPS WERE CONDUCTED. ONE OF THE FOCUS GROUPS WAS FACILITATED WITH MENTAL AND BEHAVIORAL HEALTH SERVICE PROVIDERS IN THE HAMPTON ROADS AREA. THE OTHER FOCUS GROUP WAS FACILITATED DURING ONE OF THE MONTHLY MEETINGS OF A NETWORK OF AGENCIES AND ORGANIZATIONS THAT COME TOGETHER TO ENSURE THAT THE HAMPTON ROADS COMMUNITY HAS ACCESS TO QUALITY PARENTING EDUCATION.KEY STAKEHOLDER INTERVIEWS TARGETED SCHOOL NURSES AND OTHER CORE SERVICE PROVIDERS THAT SERVE MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. ORGANIZATIONAL PARTICIPANTS INCLUDED HOSPITALS, SCHOOL SYSTEMS, SOCIAL SERVICES, CHKD'S CARE CONNECTION, ACOMMUNITY-BASED NETWORK OF EARLY CARE AND EDUCATION SPECIALISTS, DEPRESSION AND SUICIDE EDUCATION AWARENESS SPECIALISTS, A NON-PROFIT BEHAVIORAL HEALTH SYSTEM AND OTHER COMMUNITY-BASED ORGANIZATIONS.NATIONAL, STATE AND PRIVATE DATA SOURCES WERE USED IN THE HEALTH INDICATOR ANALYSIS. KEY HEALTH ISSUES WERE IDENTIFIED WHEN MULTIPLE LOCALITIES HAD WORSE RATES OR PERCENTAGES IN COMPARISON TO STATE AVERAGES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR CHKD'S THREE LICENSED FACILITIES LISTED IN PART V, SECTION A. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: AFTER COMPILING ALL OF THE RESULTS FROM THE STAKEHOLDER AND COMMUNITY SURVEYS, FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS AND HEALTH INDICATOR ANALYSIS, COMMON THEMES AND SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED ACROSS DATA SOURCES. THESE THEMES EITHER AROSE AS PRIORITIES IN AT LEAST TWO OF THE DATA SOURCES OR IF DATA FROM ONE OF THE SOURCES REVEALED OVERWHELMING NEED. THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED: MENTAL/BEHAVIORAL HEALTH, OBESITY, CHILD ABUSE, ASTHMA, SEXUALLY TRANSMITTED INFECTIONS, TEEN PREGNANCY, ALCOHOL/SUBSTANCE ABUSE, AND SOCIAL DETERMINANTS, INCLUDING POVERTY, UNEMPLOYMENT, AND COMMUNITY VIOLENCE.CHKD LEADERS REVIEWED RESULTS FROM ALL THREE DATA SOURCES TO BETTER UNDERSTAND THE SIGNIFICANT HEALTH NEEDS AND PRIORITIES TO DETERMINE THE BEST FOCUS FOR ITS IMPLEMENTATION PLAN. INDIVIDUALS AND GROUPS INVOLVED IN THIS PROCESS INCLUDED THE FOLLOWING: THE HOSPITAL'S SENIOR LEADERSHIP TEAM, WHICH INCLUDES ITS CEO, PRESIDENT AND VICE PRESIDENTS; CHKD PHYSICIAN LEADERS; AND CHKD'S PARENT AND FAMILY ADVISORY COUNCIL.GIVEN THE SCOPE AND DEPTH OF THE NEED FOR MENTAL HEALTH CARE AND THE SIGNIFICANT RESOURCES CHKD PLANS TO DEVOTE TO EXPANDING ITS MENTAL HEALTH SERVICES, CHKD IS FOCUSING SOLELY ON THIS ISSUE IN ITS IMPLEMENTATION PLAN STRATEGY FROM 2019 TO 2021. ADDRESSING PEDIATRIC MENTAL/BEHAVIORAL HEALTH WOULD HAVE A POSITIVE EFFECT ON PEDIATRIC HEALTH AND WELL-BEING OVERALL, AFFECTING MULTIPLE OTHER IDENTIFIED HEALTH NEEDS, SUCH AS VIOLENCE, CRIME, SUBSTANCE ABUSE AND, AS OUR PEDIATRIC POPULATION GROWS OLDER, CHILD ABUSE AND NEGLECT AND CHILDHOOD OBESITY.MENTAL/BEHAVIORAL HEALTH: CHILDREN AND ADOLESCENTS IN MENTAL HEALTH CRISIS CONTINUE TO SEEK CARE 24/7 THROUGH CHKD'S EMERGENCY DEPARTMENT. FACED WITH AN ONGOING SHORTAGE OF INPATIENT PLACEMENTS FOR THESE PATIENTS, CHKD SOUGHT AND RECEIVED STATE APPROVAL TO ADD 60 INPATIENT MENTAL HEALTH BEDS TO ITS NORFOLK CAMPUS. THIS PROJECT WILL ALSO INCLUDE PARTIAL HOSPITALIZATION/DAY TREATMENT AND AFTERCARE PROGRAMS FOR PEDIATRIC MENTAL HEALTH PATIENTS. ALL MENTAL HEALTH PROGRAMMING WILL BE DESIGNED SPECIFICALLY TO MEET THE NEEDS OF OUR REGION'S MOST UNDER SERVED MENTAL HEALTH PATIENTS: CHILDREN UNDER AGE 5, CHILDREN WITH CO-OCCURRING MEDICAL AND MENTAL HEALTH NEEDS, CHILDREN WITH DEVELOPMENTAL AND MENTAL HEALTH CHALLENGES AND CHILDREN WITH EATING DISORDERS. CHKD ALSO CONTINUES TO EXPAND ITS OUTPATIENT MENTAL HEALTH PROGRAM WITH ADDITIONAL THERAPISTS IN MORE LOCATIONS.CHKD PLANS TO CONTINUE TO COMMIT PROGRAMMING AND RESOURCES TO ITS ONGOING INITIATIVES TO ADDRESS OBESITY, CHILD ABUSE AND SOCIAL DETERMINANTS OF HEALTH. OTHER SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA ARE NOT BEING SPECIFICALLY ADDRESSED IN THE CURRENT IMPLEMENTATION ARE ASTHMA, SEXUALLY TRANSMITTED INFECTIONS, TEEN PREGNANCY, AND ALCOHOL/SUBSTANCE USE DISORDER, THESE ARE ALL CONDITIONS THAT CHKD EITHER CURRENTLY PROVIDES CARE FOR AND/OR COLLABORATES WITH OTHER COMMUNITY AGENCIES TO ADDRESS. CHKD REGULARLY AND ROUTINELY OFFERS ITS EXPERTISE AND ASSISTANCE, SEEKS TO COLLABORATE AND DEDICATES COMMUNITY RESOURCES TO ADDRESS A BROAD RANGE OF ISSUES RELATING TO THE HEALTH AND WELFARE OF CHILDREN. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:1. STATE-FUNDED PRESCRIPTION PROGRAMS;2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC;3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);4. FOOD STAMP ELIGIBILITY;5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY;6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN);7. LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND8. PATIENT IS DECEASED WITH NO KNOWN ESTATE. 16 1 - CHKD HEALTH CENTER AT OAKBROOKE 500 DISCOVERY DRIVE CHESAPEAKE VA 23320 OUTPATIENT SERVICES 2 - CHKD HLTH CTR & URGENT CARE AT LOEHMAN'S 3960 VIRGINIA BEACH BLVD VIRGINIA BEACH VA 23452 URGENT CARE & OUTPATIENT SERVICES 3 - CHKD HLTH CTR & URGENT CARE AT TECH CNTR 680 OYSTER POINT ROAD NEWPORT NEWS VA 23602 URGENT CARE & OUTPATIENT SERVICES 4 - HEALTH CENTER AT MEDICAL CENTER CAMPUS 850 SOUTHAMPTON AVENUE NORFOLK VA 23510 OUTPATIENT SERVICES 5 - CHKD URGENT CARE AT VOLVO 817 VOLVO PARKWAY CHESAPEAKE VA 23320 URGENT CARE & OUTPATIENT SERVICES 6 - CHKD HLTH CTR & URGENT CARE AT LANDSTOWN 1924 LANDSTOWN WAY VIRGINIA BEACH VA 23456 URGENT CARE & OUTPATIENT SERVICES 7 - SATELLITE AT MEDICAL TOWER 400 GRESHAM DRIVE NORFOLK VA 23507 OUTPATIENT SERVICES 8 - SPORTS MEDICINE IN GHENT 702 WEST 21ST STREET NORFOLK VA 23517 OUTPATIENT SERVICES 9 - CHKD HEALTH CENTER AT LIGHTFOOT 6425 RICHMOND ROAD WILLIAMSBURG VA 23188 OUTPATIENT SERVICES 10 - CHKD HEALTH CENTER AT HARBOUR VIEW 5835 HARBOUR VIEW BLVD SUFFOLK VA 23435 OUTPATIENT SERVICES 11 - HEALTH CENTER AT BURNETT'S WAY 152 BURNETTS WAY SUFFOLK VA 23456 OUTPATIENT SERVICES 12 - CHKD CAP 935 REDGATE AVENUE NORFOLK VA 23507 OUTPATIENT SERVICES 13 - CHKD HEALTH CENTER AT KEMPSVILLE 171 KEMPSVILLE ROAD NORFOLK VA 23507 OUTPATIENT SERVICES 14 - CHKD AT BUTLER FARM ROAD 421 BUTLER FARM ROAD HAMPTON VA 23666 OUTPATIENT SERVICES 15 - CHKD HEALTH CENTER AT HARBOUR VIEW NORTH 7021 HARBOUR VIEW BLVD SUFFOLK VA 23435 OUTPATIENT SERVICES 16 - FORT NORFOLK PLAZA MEDICAL BUILDING 301 RIVERVIEW AVENUE NORFOLK VA 23510 OUTPATIENT SERVICES PART I, LINE 7(E) THE AMOUNT REPORTED ON PART I, LINE 7(E) INCLUDES $54,390,381 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS.PART I, LINE 7(F)THE AMOUNT OF BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) THAT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSE IN PART I, LINE 7, COLUMN (F) IS $10,626,317. PART I, LINE 7 A HYBRID APPROACH WAS USED FOR DETERMINING COSTS RELATED TO COMMUNITY BENEFIT. ACTUAL COSTS FROM ALL PATIENT SEGMENTS ARE IDENTIFIED BY DEPARTMENT IN THE GENERAL LEDGER AND THEN WERE GROUPED INTO LIKE COMMUNITY BENEFIT PROGRAMS. INDIRECT COSTS WERE ADJUSTED FOR COSTS ATTRIBUTABLE TO UNREIMBURSED MEDICAID COSTS REPORTED ELSEWHERE, MARKETING AND GRANT WRITING EXPENSES. THE MEDICAID COSTS ADJUSTMENT WAS CALCULATED USING A COST TO CHARGE RATIO OF APPLICABLE EXPENSES DIVIDED BY TOTAL APPLICABLE CHARGES APPLIED TO MEDICAID REVENUE. THE REMAINING INDIRECT COSTS WERE ALLOCATED PROPORTIONATELY TO THE DIRECT COSTS REPORTED BY DEPARTMENT. IN ADDITION, EXPENSES WERE CALCULATED AT COST AND THEN COSTS RELATED TO CHARITY CARE, BAD DEBT AND MEDICAID WERE REMOVED BEFORE ARRIVING AT THE AMOUNTS FOR COMMUNITY BENEFIT AT COST. PART III, LINE 2 BAD DEBT REPORTED IN PART III, LINE 2 IS BASED ON THE AMOUNT REPORTED AS BAD DEBT IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE AMOUNT DOES NOT INCLUDE DISCOUNTS OR OTHER ADMINISTRATIVE WRITE OFFS. IF A PATIENT ACCOUNT HAS BEEN WRITTEN OFF TO BAD DEBT AND IS SUBSEQUENTLY COLLECTED, BAD DEBT EXPENSE IS REDUCED IN THAT PERIOD BY THE PAYMENT.PART III, LINE 3THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED OFF THE PERCENTAGE OF CHARITY CARE EXPENSES AS A PERCENTAGE OF SELF-PAY REVENUE. CHKD DOES NOT MAINTAIN RECORDS THAT TRACK PATIENTS WHO COULD HAVE QUALIFIED FOR CHARITY CARE. THIS AMOUNT IS AN ESTIMATE OF PATIENTS WHO LIKELY WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO DETERMINE THEIR ELIGIBILITY. THIS AMOUNT IS NOT INCLUDED AS COMMUNITY BENEFIT. PART III, LINE 4 CHKD PRESENTS BAD DEBT PROVISION ON THE FINANCIAL STATEMENTS AS A DEDUCTION FROM NET PATIENT SERVICE PER ACCOUNTING STANDARDS UPDATE (ASU) 2011-07. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING RECEIVABLES. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE, NET OF PAYMENTS AND DISCOUNTS, AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR THE RECOVERY IS CONSIDERED REMOTE. FOR ADDITIONAL DETAILS SEE FOOTNOTE 17 ON PAGE 32 OF AUDITED FINANCIAL STATEMENTS.PART III, LINE 8AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE SHORTFALL WAS CALCULATED USING THE HOSPITAL'S OVERALL COST TO CHARGE RATIO APPLIED TO MEDICARE GROSS CHARGES. THIS SHORTFALL IS NOT SEPARATELY INCLUDED AS A COMMUNITY BENEFIT AS 100% OF IT HAS ALREADY BEEN CAPTURED IN THE APPROPRIATE CATEGORY ON PART I, LINE 7. PART III, LINE 9B ACCOUNTS WITH AN UNPAID BALANCE OR WITHOUT AN ESTABLISHED PAYMENT PLAN ARE REFERRED TO A COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION EFFORTS. CHKD MAKES REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE/CHARITY CARE BEFORE REFERRING TO A COLLECTION AGENCY OR AN ATTORNEY. REASONABLE EFFORT INCLUDES AND IS NOT LIMITED TO NOTIFICATION ABOUT THE FINANCIAL ASSISTANCE - CHARITY CARE/COLLECTION POLICY POSTED IN ADMISSIONS, EMERGENCY DEPARTMENT OR OTHER DESIGNATED AREAS. THE INFORMATION REGARDING THE POLICY IS INCLUDED IN THE ADMISSION PACKAGE AND ON THE PATIENT BILL. THE HEALTH BENEFITS ANALYST AND CUSTOMER SERVICE REPRESENTATIVE WHO MAY SPEAK WITH THE GUARANTOR BY PHONE PROVIDE THEM WITH FINANCIAL ASSISTANCE INCLUDING CHARITY CARE INFORMATION. THE FINANCIAL ASSISTANCE-CHARITY CARE/COLLECTION POLICY IS AVAILABLE UPON REQUEST AND VIA WWW.CHKD.ORG. CHKD ENSURES ALL COLLECTION PROTOCOLS ARE MET PRIOR TO REFERRAL TO COLLECTIONS AGENCY OR ATTORNEY. APPROVED CHARITY CARE AMOUNT WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES. THE REMAINING BALANCE WILL BE SUBJECT TO CHKD'S STANDARD COLLECTION PROTOCOLS.NEEDS ASSESSMENT:AS THE ONLY HEALTHCARE PROVIDER IN VIRGINIA DEVOTED EXCLUSIVELY TO THE NEEDS OF CHILDREN, CHKD ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF PEDIATRIC CARE AND THE PROMOTION OF CHILDREN'S HEALTH AND IS TRUSTED THROUGHOUT ITS COMMUNITY TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. CHKD USES A VARIETY OF METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON PROFIT AND PUBLIC HEALTH AGENCIES AND ORGANIZATIONS AND THROUGH REGIONAL, STATE AND NATIONAL DATA. FROM NOVEMBER 2018 TO APRIL 2019, CHKD CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH SUPPORT FROM TOXCEL, LLC, A GAINESVILLE, VIRGINIA-BASED SCIENCE, ENGINEERING AND HEALTH RESEARCH AND CONSULTING FIRM. THIS JOINT CHNA COVERS ALL THREE LICENSED FACILITIES ASSOCIATED WITHIN THE CHKD HEALTH SYSTEM: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) LOCATED IN NORFOLK AND CHKD'S TWO HEALTH AND SURGERY CENTERS, ONE AT OYSTER POINT IN NEWPORT NEWS AND ONE AT PRINCESS ANNE IN VIRGINIA BEACH. CHKD'S CHNA PROVIDES AN OVERVIEW OF THE PRIMARY AND SECONDARY DATA USED TO IDENTIFY KEY HEALTH ISSUES WITHIN THE CHKD COMMUNITY. IT COMBINES AND COMPARES RESULTS FROM THREE SOURCES: A COMMUNITY HEALTH SURVEY, KEY STAKEHOLDER INTERVIEWS, AND HEALTH INDICATOR ANALYSES. CHKD'S CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT WWW.CHKD.ORG/COMMUNITYBENEFIT.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:CHKD'S CHARITY CARE ELIGIBILITY CRITERIA AND PROCEDURES FOR APPLYING ARE PROVIDED TO ALL PATIENTS. CHARITY CARE INFORMATION IS INCLUDED IN EVERY INPATIENT ADMISSION PACKET AND DISTRIBUTED TO THE OUTPATIENT DURING THE OUTPATIENT REGISTRATION PROCESS. AN APPLICATION FOR CHARITY CARE, ALONG WITH A LETTER EXPLAINING THE PROCESS, IS SENT TO ANY PATIENT OR GUARANTOR WHO REQUESTS INFORMATION ON ANY PROGRAMS OR PROVISIONS THE HOSPITAL MAY HAVE TO HELP ASSIST PATIENTS OR GUARANTORS IN PAYING THEIR HOSPITAL BILL. THE CHARITY CARE POLICY AND APPLICATION ARE PROMINENTLY DISPLAYED ON THE MAIN "BILLING" PAGE OF THE HOSPITAL WEBSITE, JUST ONE CLICK FROM THE HOME PAGE, AT WWW.CHKD.ORG/BILLING/FINANCIAL-ASSISTANCE. PRINTED COPIES ARE ALSO AVAILABLE AT EACH REGISTRATION WORKSTATION. ALL BILLING STATEMENTS MAILED TO GUARANTORS INCLUDE A NOTICE OF THE AVAILABILITY OF CHARITY AND HOW TO OBTAIN THE INFORMATION/APPLICATION. ASSISTANCE WITH THE APPLICATION PROCESS IS AVAILABLE THROUGH THE HEALTH BENEFITS ANALYST (HBA). THE HBA SENDS OUT APPLICATIONS VIA MAIL AND REFERS FAMILIES TO THE HOSPITAL'S WEBSITE. THE UNIT SOCIAL WORKER IS AVAILABLE TO PROVIDE INFORMATION OR REFERRAL TO THE HBA DURING AN INPATIENT STAY.COMMUNITY INFORMATION:CHKD IS THE REGIONAL PEDIATRIC REFERRAL CENTER FOR SOUTHEASTERN VIRGINIA, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA.CHKD SERVES THE FOLLOWING REGIONS IN VIRGINIA:ACCOMACK COUNTY, CHESAPEAKE CITY, FRANKLIN CITY, GLOUCESTER COUNTY, HAMPTON CITY, ISLE OF WIGHT COUNTY, JAMES CITY COUNTY, MATHEWS COUNTY, NEWPORT NEWS CITY, NORFOLK CITY, NORTHAMPTON COUNTY, POQUOSON CITY, PORTSMOUTH CITY, PRINCE GEORGE COUNTY, SOUTHAMPTON COUNTY, SUFFOLK CITY, SURRY COUNTY, SUSSEX COUNTY, VIRGINIA BEACH CITY, WILLIAMSBURG CITY AND YORK COUNTY. WITHIN NORTH CAROLINA, CHKD SERVES THE FOLLOWING REGIONS: BERTIE COUNTY, CAMDEN COUNTY, CHOWAN COUNTY, CURRITUCK COUNTY, DARE COUNTY, GATES COUNTY, HERTFORD COUNTY, PASQUOTANK COUNTY AND PERQUIMANS COUNTY.AS REFLECTED IN OUR 2019 CHNA, THIS SERVICE REGION INCLUDED 553,054 PERSONS AGE 0-21. APPROXIMATELY 18 PERCENT OF ALL FAMILIES WITH CHILDREN UNDER THE AGE OF 18 HAVE INCOMES BELOW THE FEDERAL POVERTY LEVEL. FOR FAMILIES HEADED BY SINGLE MOTHERS, THAT PERCENTAGE INCREASES TO 38 PERCENT.CHKD'S SERVICE AREA COMPRISES A DIVERSE MIX OF URBAN, SUBURBAN AND RURAL COMMUNITIES, AS WELL AS 10 MILITARY INSTALLATIONS. CHKD IS WELL VERSED IN THE SPECIAL NEEDS OF MILITARY FAMILIES AND HAS ONE OF THE HIGHEST TRICARE PAYER PERCENTAGES AMONG THE CHILDREN'S HOSPITALS IN THE NATION.PROMOTION OF COMMUNITY HEALTHCHKD PLAYS A UNIQUE ROLE IN ITS COMMUNITY BY PROVIDING PEDIATRIC HEALTHCARE SERVICES AVAILABLE NOWHERE ELSE IN THE REGION AND, AT THE SAME TIME, SERVING AS THE SAFETY NET PROVIDER TO THE REGION'S INDIGENT CHILDREN. IN FY 2021, CHKD HAD 4,378 ADMISSIONS RESULTING IN 45,046 PATIENT DAYS. APPROXIMATELY 58 PERCENT OF THESE DAYS, WERE COVERED BY MEDICAID, WHICH IS THE HIGHEST PERCENTAGE BY FAR OF ANY ACUTE-CARE HOSPITAL IN VIRGINIA.CHKD LEADS THE REGION IN EFFORTS TO ADDRESS PUBLIC HEALTH CONCERNS LIKE CHILD ABUSE AND CHILDHOOD OBESITY. IT IS THE SOLE PROVIDER OF PEDIATRIC SUBSPECIALTY CARE FOR CHILDREN WITH CHRONIC ILLNESSES LIKE CANCER AND DIABETES AND EMPLOYS THE REGION'S ONLY PEDIATRIC SURGEONS. THE HOSPITAL'S VIBRANT COMMUNITY OUTREACH PROGRAM COORDINATES PARENT, PROFESSIONAL AND STUDENT PROGRAMS THAT BRING IMPORTANT HEALTH, SAFETY AND WELLNESS INFORMATION TO THOUSANDS OF PARTICIPANTS. CHKD ALSO TAKES AN ACTIVE ROLE IN THE EDUCATION OF PEDIATRICIANS.COMPREHENSIVE INFORMATION ON CHKD'S EFFORTS TO IMPROVE THE HEALTH OF CHILDREN IS AVAILABLE AT WWW.CHKD.ORG/COMMUNITYBENEFIT. PART III, LINE 9B AFFILIATED HEALTH CARE SYSTEM:CHKD IS PART OF CHILDREN'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CHKD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS ARE USED TO MEET THE NEEDS OF THE ORGANIZATION AS DETERMINED BY CHKD SENIOR MANAGEMENT AND THE CHS BOARD OF DIRECTORS. HISTORICALLY, SURPLUS FUNDS HAVE BEEN USED FOR A VARIETY OF PURPOSES INCLUDING PATIENT CARE PROGRAMS, CAPITAL IMPROVEMENT NEEDS, RESERVES, ETC.ROLES OF ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED: THE CHILDREN'S HEALTH SYSTEM IS COMPRISED OF SEVERAL ORGANIZATIONS. CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS IS A FREESTANDING CHILDREN'S HOSPITAL THAT PROVIDES A BROAD SPECTRUM OF INPATIENT AND OUTPATIENT CARE SERVICES ACROSS MANY PEDIATRIC SPECIALTIES, INCLUDING EVERYTHING FROM PRIMARY CARE AND WELLNESS INITIATIVES TO NEONATAL AND PEDIATRIC INTENSIVE CARE. OTHER ENTITIES UNDER THE CHILDREN'S HEALTH SYSTEM UMBRELLA INCLUDE:* CHILDREN'S HEALTH FOUNDATION, WHICH MANAGES INVESTMENTS AND FUNDS EDUCATION, RESEARCH AND OTHER PROGRAMS FOR CHILDREN'S HEALTH SYSTEM* CHILDREN'S MEDICAL GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC PHYSICIAN PRACTICES.* CMG OF NORTH CAROLINA, INC., A NORTH CAROLINA STOCK CORPORATION, WHICH OWNS AND OPERATES A PEDIATRIC PHYSICIAN PRACTICE IN NORTHEASTERN NORTH CAROLINA.* CHILDREN'S SURGICAL SPECIALTY GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC SURGICAL SUBSPECIALTY PRACTICES, INCLUDING PEDIATRIC GENERAL SURGERY, PEDIATRIC UROLOGY, PEDIATRIC CARDIAC SURGERY, PEDIATRIC ORTHOPEDIC SURGERY, PEDIATRIC NEUROSURGERY AND PEDIATRIC PLASTIC SURGERY.* CHILREN'S HEALTH INSURANCE, LLC, A CAPTIVE INSURANCE COMPANY INCORPORATED IN SOUTH CAROLINA IS A DISREGARDED ENTITY OF CHKD.* CHKD THRIFT STORES, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.* CHILDREN'S REAL ESTATE, LLC, IS A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.* CHILDREN'S RESEARCH HOLDING, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.FACILITY REPORTING GROUP(S):FACILITY REPORTING GROUP A INCLUDES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, CHKD HEALTH AND SURGERY CENTER IN NEWPORT NEWS AND CHKD HEALTH AND SURGERY CENTER IN VIRGINIA BEACH.STATE FILING OF COMMUNITY BENEFIT REPORTVA, 1 CHILDREN'S HEALTH FOUNDATION INC 601 CHILDRENS LANE NORFOLK VA 23507 541278865 501(C)(3) 4309876 CASH GENERAL SUPPORT CHILDREN'S HEALTH SYSTEM INC 601 CHILDRENS LANE NORFOLK VA 23507 541278830 501(C)(3) 15350000 CASH GENERAL SUPPORT OLD DOMINION UNIVERSITY RESEARCH FOUNDATION PO BOX 6369 NORFOLK VA 23508 546068198 501(C)(3) 14328 CASH CHEST WALL STUDY FRIENDS OF THE ELIZABETH RIVER TRAIL FOUNDATION PO BOX 3042 NORFOLK VA 23514 814431199 501(C)(3) 20000 0 CASH GENERAL SUPPORT 4 0 PART I, LINE 2: PROCESS FOR AWARDS AWARDS ARE MADE TO INVESTIGATORS/PHYSICIANS BY CHKD (CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS) FOR SPECIFIC PROJECT OR RESEARCH ENDEAVORS. FUNDING REQUESTS ARE COMPLETED AND SUBMITTED WHERE THEY ARE REVIEWED BY THE FINANCE DEPARTMENT, THE CEO AND THE APPLICABLE BOARD. AFTER AN AWARD IS MADE, THE AWARDEE MUST FILE QUARTERLY FINANCIAL SUMMARIES AND A FINAL REPORT TO BE SUBMITTED TO THE CEO AT THE END OF THE FUNDING PERIOD. ADDITIONALLY, CHKD GIVES CONTRIBUTIONS TO ITS PARENT ORGANIZATION, CHILDREN'S HEALTH SYSTEM, AND TO CHILDREN'S HEALTH FOUNDATION. X X 1 1 X X X X 0 1 0 0 0 0 0 1 0 DENNIS RYAN CFO/ASST TREAS/ASSIST SECR 0 550018 0 0 0 471435 0 445037 0 40608 0 1507098 0 452439 JAMES D DAHLING PRESIDENT/DIRECTOR 0 1079360 0 0 0 223029 0 54989 0 33739 0 1391117 0 154986 JOHN HARDING CHIEF OPERATING OFFICER 0 609706 0 0 0 146880 0 311500 0 38379 0 1106465 0 131386 DEBORAH BARNES VP - IS OPERATIONS 0 409822 0 0 0 301878 0 363472 0 26750 0 1101922 0 283171 SANDIP GODAMBE MD VP - QUALITY & PATIENT SAFETY 456448 0 0 0 26183 0 217063 0 52988 0 752682 0 9344 0 KAREN MITCHELL VP- PATIENT CARE SERVICES 357212 0 0 0 325741 0 23914 0 15567 0 722434 0 154190 0 ROBERT OBERMEYER MD DIRECTOR 0 664773 0 18750 0 437 0 11400 0 26641 0 722001 0 0 ALLISON SILVA VP - ANCILLARY SERVICES 286177 0 0 0 93955 0 111963 0 15140 0 507235 0 76270 0 JALANA MCCASLAND VP PHYSICIAN PRACTICE MANAGEME 312639 0 0 0 36072 0 90517 0 39337 0 478565 0 20303 0 KATHRYN ABSHIRE VP FINANCE 0 249849 0 0 0 20870 0 123297 0 35008 0 429024 0 5739 SCOTT NOTTINGHAM MD DIRECTOR 0 384778 0 0 0 252 0 11400 0 26536 0 422966 0 0 JOHN WARBURTON VP MENTAL HEALTH 237700 0 0 0 47081 0 57093 0 19691 0 361565 0 0 0 TAMIKA HARRIS VP FACILITIES & SUPPORT SERV 231785 0 0 0 25349 0 51461 0 35074 0 343669 0 15693 0 SUZANNE BRIXEY PHYSICIAN 323729 0 0 0 280 0 11400 0 4488 0 339897 0 0 0 MICHELLE CLAYTON MEDICAL DIRECTOR CHILD ADVOCACY 212458 0 0 0 1976 0 6750 0 25159 0 246343 0 0 0 JOSHUA GUINTER DIRECTOR PHARMACY 185076 0 2995 0 23534 0 0 0 22591 0 234196 0 0 0 PART I, LINE 1A IN CONNECTION WITH A RETIREMENT PROGRAM, TAX GROSS-UP PAYMENTS ARE PROVIDED TO CERTAIN EMPLOYEES WHOSE EMPLOYER FUNDED CONTRIBUTIONS ARE IMMEDIATELY TAXABLE, IN ORDER TO PROVIDE THEM WITH BENEFITS THAT ARE TAX-EQUIVALENT TO BENEFITS OF PARTICIPANTS WHOSE CONTRIBUTIONS ARE NOT IMMEDIATELY TAXABLE. CHILDREN'S HEALTH SYSTEM HAS A RELOCATION PROGRAM THAT PROVIDES BENEFITS AND THE APPLICABLE TAX LIABILITY FOR NEWLY HIRED EMPLOYEES WHO LIVE OUT OF STATE AND MUST RELOCATE TO PERFORM THEIR JOB. IT IS A STRUCTURED PROGRAM THAT COVERS A DEFINED LIST OF EXPENDITURES, INCLUDING TEMPORARY HOUSING. JOHN WARBURTON RECEIVED $10,658 FOR TEMPORARY HOUSING. PART I, LINE 4B CHILDREN'S HEALTH SYSTEM SPONSORS TWO SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS ("THE PLANS"). THE PLANS ARE DESIGNED TO RETAIN EXECUTIVES IN POSITIONS ESSENTIAL TO THE SUCCESS OF CHILDREN'S HEALTH SYSTEM. DURING THE YEAR, THE FOLLOWING INDIVIDUALS WERE PARTICIPANTS IN ONE OF THE SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AND RECEIVED THE FOLLOWING ANNUAL ACTUARIAL INCREASE OR DEFERRED CONTRIBUTION (INCLUDED IN SCHEDULE J, PART II, COLUMN (C)) AND/OR PAYMENT (INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III)). AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III) MAY DIFFER FROM AMOUNTS PAID DUE TO TIMING DIFFERENCES IN VESTING AND PAYMENTS. NAME: KAREN MITCHELL ACT. INCREASE: $0 AMT. PAID: $441,535 NAME: ALLISON SILVA ACT. INCREASE: $81,354 AMT. PAID: $26,943 NAME: JOHN HARDING ACT. INCREASE: $264,365 AMT. PAID: $42,892 NAME: DEBORAH BARNES ACT. INCREASE: $335,000 AMT. PAID: $120,084 NAME: KATHY ABSHIRE ACT. INCREASE: $109,755 AMT. PAID: $0 NAME: TAMIKA HARRIS ACT. INCREASE: $23,202 AMT. PAID: $0 NAME: DENNIS RYAN ACT. INCREASE: $ 398,185 AMT. PAID: $194,068 NAME: JOHN WARBURTON ACT. INCREASE: $57,093 AMT. PAID: $0 NAME: SANDIP GODAMBE ACT INCREASE: $191,806 AMT PAID: $0 NAME: JALANA MCCASLAND ACT INCREASE: $57,481 AMT PAID: $0 PART I, LINE 7 OFFICERS AND VICE PRESIDENTS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET UP BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. DEPARTMENT DIRECTORS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET BY MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS. A VA SMALL BUSINESS FINANCING AUTHORITY 541300845 000000000 2012-09-09 76400000 REFUNDING OF 1/31/2006 ISSUE 0 0 0 B VA SMALL BUSINESS FINANCING AUTHORITY 541300845 000000000 2015-12-01 100000000 FINANCING OF HEALTH CARE FACILITIES 0 0 0 C VA SMALL BUSINESS FINANCING AUTHORITY 541300845 000000000 2020-06-10 100000000 FINANCING OF HOSPITAL FACILITIES 0 0 0 A 24441009 76400000 76400000 2012 1 0 1 1 B 1915363 48650000 48650000 2018 0 0 1 1 C 100000000 100000000 2020 0 0 1 1 A 0 1 1 1 1 1 0.00580 0.00580 0 0 1 B 0 1 1 1 1 1 0.00330 0.00330 0 0 1 C 0 1 1 1 1 1 0 0 1 A 0 0 1 0 1 0 0 0 1 B 0 0 0 1 1 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 PART II, LINE 11, COLUMN A: ALL PROCEEDS OF THE BOND WERE USED TO CURRENTLY REFUND A PRIOR ISSUE. PART II, LINE 10 COLUMN B: LINE 10 - CAPITAL EXPENDITURES FROM PROCEEDS ALLOCATED CURRENTLY TOTAL $99,950,000, OF WHICH $51,300,000 WAS ALLOCATED TO CHILDREN'S HEALTH SYSTEM AND $48,650,000 WAS ALLOCATED TO CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. PART II, LINES 3 AND 10, COLUMN C: LINE 3 - FUNDS WERE DRAWN BY CHILREN'S HOSPITAL OF THE KING'S DAUGHTERS FROM THE TOTAL ISSUE PRICE OF THE BOND. ALL PROCEEDS WERE DRAWN TOTALLING $100,000,000. LINE 10 - CAPITAL EXPENDITURES FROM PROCEED TOTALLED $100,000,000. PART III, LINE 4 COLUMN A: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.5863% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR. COLUMN B: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.3264% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR. PART IV, LINE 2B, COLUMN A: OBLIGATED GROUP PNC BANK, NATIONAL ASSOCIATION AND BANK OF AMERICA, N.A., EACH HOLD PARITY NOTES OF CHKD'S OBLIGATED GROUP (INCLUDING CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED; CHILDREN'S HEALTH SERVICES, INC.; AND CHILDREN'S HEALTH FOUNDATION, INC.) ISSUED UNDER THE MASTER TRUST INDENTURE. ACCORDINGLY, PNC AND BANK OF AMERICA HAVE THE BENEFIT, ON A PARITY BASIS, OF A VALID AND PERFECTED, FIRST PRIORITY SECURITY INTEREST HELD BY THE MASTER TRUSTEE IN THE TOTAL REVENUES PLEDGED UNDER THE MASTER TRUST INDENTURE AND IN ANY OTHER SECURITY INTEREST GRANTED BY THE MASTER TRUST INDENTURE. THE MASTER TRUST INDENTURE AND THE FINANCING DOCUMENTS WITH PNC AND BANK OF AMERICA PLACE CERTAIN RESTRICTIONS UPON CHKD'S OBLIGATED GROUP RELATIVE TO OPERATING RATIOS, INCURRENCE OF ADDITIONAL INDEBTEDNESS, MAINTENANCE OF TAX-EXEMPT STATUS AND FINANCIAL REPORTING REQUIREMENTS. X 4 3200 CASH ON SALE X 45 2345673 AVG FMV ON DATE REC X OTHER 14 37829 AVG FMV ON DATE REC 0 1 1 PART I, LINE 32B: CHKD PAYS ABC VIRGINIA AUTO AUCTION, LLC A FEE TO AUCTION CARS FOR THE BENEFIT OF THE ORGANIZATION. COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS, NOT THE NUMBER OF ITEMS RECEIVED. FORM 990, PART III, LINE 4A THE HOSPITAL EMPLOYS 16 CHILD LIFE STAFF MEMBERS, INCLUDING AN ART AND MUSIC THERAPIST, WHO HELP CHILDREN ADJUST AND COPE DURING HOSPITALIZATION. THEIR GOAL IS TO MAKE THE CHILD'S HOSPITAL EXPERIENCE AS NORMAL AS POSSIBLE BY DEVELOPING SUPPORTIVE RELATIONSHIPS WITH PATIENTS AND FAMILIES, PROVIDING AGE-APPROPRIATE PREPARATION FOR MEDICAL PROCEDURES AND SURGERIES, COPING STRATEGIES AND PLAY OPPORTUNITIES FOR CHILDREN TO RELIEVE STRESS. BEFORE THE CORONAVIRUS PANDEMIC CHILD LIFE STAFF MEMBERS ALSO SCHEDULED AND FACILITATED COMMUNITY GROUP VISITORS TO THE HOSPITAL AND MANAGE APPROXIMATELY 100 VOLUNTEERS WEEKLY. ONCE THE PANDEMIC SET IN, WE TEMPORARILY SUSPENDED IN HOSPITAL VOLUNTEERS AND CONTINUE TO HAVE COMMUNITY MEMBER VISITS ON HOLD. THERE ARE THREE POPULAR ACTIVITY AREAS THROUGHOUT THE HOSPITAL, PROVIDING HOSPITALIZED CHILDREN OPPORTUNITIES FOR SOCIALIZATION AND CREATIVE PLAY. CHILD LIFE ASSISTANTS WORK WITH CHKD'S VOLUNTEER SERVICES DIVISION TO MANAGE THE HOSPITAL'S POPULAR PET THERAPY PROGRAM - THE BUDDY BRIGADE - WHICH BRINGS VISITS OF DOG/HANDLER TEAMS TO THE HOSPITAL SEVERAL TIMES EACH WEEK. THE BUDDY BRIGADE VISITS WENT TO A VIRTUAL PLATFORM DURING THE PANDEMIC, WHICH ACTUALLY, ALLOWED INCREASED ACCESSIBILITY TO ALL HOSPITALIZED PATIENTS NO MATTER DIAGNOSIS, ISOLATION, OR FEVER STATUS. IN FY21, THE BUDDY BRIGADE BEGAN IN-PERSON VISITS AGAIN, BUT ALSO CONTINUED THE VIRTUAL BUDDY BRIGADE VISITS AS WELL. CHILD LIFE STAFF MEMBERS COLLABORATE WITH OTHER HOSPITAL STAFF TO PROVIDE SUPPORT FOR PARENTS AND SIBLINGS, OFFERING AN ANNUAL TEDDY BEAR CLINIC, WEEKLY CLOSED-CIRCUIT TV BINGO, INPATIENT DEVELOPMENTAL SCREENINGS, AND A KIDS-AS-PARTNERS ADVISORY COUNCIL. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CHKD'S MENTAL HEALTH SERVICE LINE IS COMPRISED OF ONE MANAGER, ONE OFFICE SUPERVISOR, 16 FULL-TIME MEDICAL SOCIAL WORKERS AND TWO PER DIEM SOCIAL WORKERS. ALL OF THE MEDICAL SOCIAL WORKERS HOLD MASTER'S DEGREES IN SOCIAL WORK. THERE ARE TWO LICENSED CLINICAL SOCIAL WORKERS IN THE DEPARTMENT. THIRTEEN SOCIAL WORKERS ARE IN SUPERVISION WORKING TOWARD CLINICAL LICENSURE. THE PRIMARY FOCUS OF THE MEDICAL SOCIAL WORK TEAM IS BIOPSYCHOSOCIAL EVALUATION, SUPPORT TO FAMILIES, CRISIS INTERVENTION, CONNECTION TO RESOURCES AND SUPPORTING ADJUSTMENT TO ILLNESSES AND HELPING TO MITIGATE THE STRESS OF HOSPITALIZATION. THE MEDICAL SOCIAL WORK TEAM PROVIDES MANY SERVICES, INCLUDING: * CONDUCT BIOPSYCHOSOCIAL AND BEHAVIORAL ASSESSMENTS. * PROVIDE SUPPORT DURING HOSPITALIZATION TO CHKD PATIENTS AND FAMILIES DEALING WITH TRAUMA, CHRONIC ILLNESS AND LOSS. * REFER TO CHKD'S ELIGIBILITY WORKERS TO COMPLETE APPLICATIONS FOR INSURANCE COVERAGE FOR MEDICAL CARE, PRESCRIPTIONS, AND MEDICAL SUPPLIES. * COORDINATE REFERRALS AND ONGOING COMMUNICATIONS TO OTHER COMMUNITY RESOURCES FOR ASSISTANCE WITH NEEDS SUCH AS HOUSING, MENTAL HEALTH COUNSELING, EDUCATIONAL ADVOCACY, LEGAL ASSISTANCE AND MUCH MORE. * AID IN COMMUNICATION WITH FAMILIES WITH THE MEDICAL TREATMENT TEAMS BY COORDINATING PATIENT CARE CONFERENCES AND TEAM MEETINGS. * EVALUATE AND REPORT SUSPICION FOR CHILD ABUSE/NEGLECT. MEDICAL SOCIAL WORKERS ALSO FACILITATE A VARIETY OF SUPPORT GROUPS THAT HELP PATIENTS AND FAMILIES CONNECT WITH OTHERS IN THE COMMUNITY WHO SHARE THEIR CHALLENGES. SOME EXAMPLES ARE SIBSHOPS, HEALTHY MOMMY HEALTHY BABY, DINE AND DISCOVER FOR NICU FAMILIES. THE MEDICAL SOCIAL WORK TEAM MANAGES THE HALO FUND AND BUTTERFLY BLESSINGS FUND WHICH ASSIST PATIENTS AND PARENTS WITH COSTS ASSOCIATED WITH TRANSPORTATION, MEALS, MEDICATIONS AND OTHER DISCHARGE-RELATED NEEDS. THESE DONATED FUNDS MAY ALSO BE USED IN EMERGENCY SITUATIONS TO ASSIST WITH SPECIAL HEALTHCARE NEEDS, LIKE PARTIAL OR ONE-TIME PAYMENTS FOR UTILITIES NECESSARY TO SUPPORT A PATIENT IN THE HOME FOLLOWING A DISCHARGE. THE MSW TEAM ALSO COORDINATES HOLIDAY FUNDS FOR FAMILIES IN NEED. THESE FUNDS HELPED MORE THAN 2,600 FAMILIES IN FY21. THE MENTAL HEALTH TEAM PROVIDES OUTPATIENT AND HOSPITAL-BASED HEALTH SERVICES TO PATIENTS WHO PRESENT TO OUR ED OR WHO ARE ADMITTED TO CHKD FOR MEDICAL REASONS BUT ALSO HAVE A CONCURRENT MENTAL HEALTH CONDITION. IN ADDITION, WE PROVIDE OUTPATIENT EVIDENCE BASED THERAPY AT FIVE LOCATIONS IN VIRGINIA BEACH, CHESAPEAKE, NORFOLK, AND NEWPORT NEWS. IN 2018, CHKD HAD ONE CHILD AND ADOLESCENT PSYCHIATRIST. TODAY, IN THE SECOND QUARTER OF FY22, WE HAVE 11 CHILD AND ADOLESCENT PSYCHIATRISTS WITH COMMITMENT FROM TWO ADDITIONAL ONES AS WE CONTINUE TO RECRUIT TO ACCOMPLISH OUR GOAL OF 20. WE HAVE FIVE PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONERS ON THE TEAM, UP FROM TWO IN 2018. IN SEPTEMBER OF 2019, WE BROKE GROUND FOR A 14-STORY MEDICAL BUILDING WHICH WILL PROVIDE 60 INPATIENT BEDS FOR ACUTE MENTAL HEALTH CARE, EXPANDED OUTPATIENT SERVICES, INCLUDING PARTIAL HOSPITALIZATION PROGRAMS AND INTENSIVE OUTPATIENT SERVICES. THE NEW MENTAL HEALTH HOSPITAL IS SCHEDULED TO OPEN OUTPATIENT FLOORS IN APRIL OF 2022 AND OUR INPATIENT ACUTE BEDS WILL BE PHASED IN STARTING AUGUST OF 2022. WE ARE OPERATING A COMPREHENSIVE CONSULT SERVICE AT THE MAIN HOSPITAL FOR MEDICALLY COMPROMISED CHILDREN WITH A MENTAL HEALTH DIAGNOSIS. WE CONTINUE TO OPERATE OUR OUTPATIENT CRISIS "BRIDGE" CLINIC, WHICH EXTENDS OUR SERVICES TO KIDS WHO ARE NOT CONNECTED TO A PROVIDER AS THEY ARE WAITING TO CONNECT TO OUTPATIENT SERVICES. WE CONTINUE TO EXPAND OUR OUTPATIENT WORKFORCE BY ADDING ADDITIONAL PSYCHOLOGISTS AND MENTAL HEALTH THERAPISTS AND THE NEED CONTINUES TO BE OVERWHELMING WITH MORE THAN 3,000 CHILDREN WAITING FOR OUTPATIENT MENTAL HEALTH CARE. WE HAVE A FULL COMPLEMENT OF LEADERS FOR OUR PROGRAMS AND SERVICES THAT WILL OPEN PARTIAL HOSPITAL PROGRAMMING IN AUGUST 2022, AND WE ARE LOOKING AT INTENSIVE OUTPATIENT PROGRAMMING TO ROUND OUT OUR CONTINUUM OF CARE. WE CONTINUE TO TRAIN AND EDUCATE OUR TEAM ON EVIDENCE-BASED RESEARCH AND SUPPORTED-CARE DELIVERY. WE'VE ADDED DIALECTICAL BEHAVIOR THERAPY IN ADDITION TO TRAINING SEVERAL MORE CLINICIANS IN OTHER EVIDENCE-BASED TREATMENTS. WE HAVE ALSO PARTNERED WITH OUR COMMUNITY ON SEVERAL FOUNDATION GRANTS TO SUPPORT SCHOOLS, HOUSING REDEVELOPMENTS, AND PEDIATRIC INTEGRATION OF CARE FOR EARLY CHILDHOOD CONSULTATION. WE ARE THE EASTERN REGION'S PARTNER FOR THE VIRGINIA MENTAL HEALTH ACCESS PROGRAM, WHICH WAS FULLY FUNDED THROUGH THE STATE BUDGET. WE CONTINUE TO EXPAND OUR REACH INTO OUR COMMUNITY WITH SCHOOL-BASED PARTNERSHIPS AND IN TRAINING OUR TEAM IN EVIDENCE-BASED TREATMENT. THE TEAM COLLABORATES WITH THE CHILD'S PEDIATRICIAN, PSYCHIATRIC PROVIDER, SPECIALIST AND FAMILY TO ENSURE THE CHILD RECEIVES COMPREHENSIVE AND INTEGRATED SUPPORT. AMONG THE SERVICES OUR MENTAL HEALTH TEAM PROVIDES ARE THE FOLLOWING: * CONDUCT PSYCHOSOCIAL HISTORY AND MENTAL HEALTH ASSESSMENTS OF PATIENTS: OUTPATIENT, ED, AND IN-HOUSE. * UTILIZE EVIDENCE-BASED PRACTICES TO OFFER BRIEF THERAPY TO IN-HOUSE PATIENTS BY PHYSICIAN REFERRAL TO ADDRESS ACUTE OR CHRONIC MENTAL HEALTH ISSUES. * OFFER INDIVIDUALIZED BEHAVIOR PLANS FOR CHILDREN WITH MEDICAL AND BEHAVIORAL ISSUES ADMITTED TO CHKD FOR THEIR MEDICAL CONDITION. * PROVIDE OUTPATIENT MENTAL HEALTH SERVICES UTILIZING EVIDENCE-BASED TREATMENT (COGNITIVE BEHAVIORAL THERAPY, PARENT CHILD INTERACTION THERAPY, TRAUMA-FOCUSED COGNITIVE BEHAVIORAL THERAPY, FAMILY BASED THERAPY FOR ANOREXIA NERVOSA, BEHAVIORAL THERAPY FOR CHILDREN WITH AUTISM SPECTRUM DISORDER AND OTHER NEURODEVELOPMENTAL CONDITIONS, EMDR, AND A GROUP THERAPY IN ORDER TO PROVIDE MENTAL HEALTH SKILLS FOR PATIENTS. * HELP PATIENTS AND FAMILIES DEAL WITH SITUATIONAL CRISES RESULTING FROM ACCIDENT, ILLNESS OR TRAUMA. * 24-HOUR COVERAGE BY A LICENSED CLINICIAN OR SUPERVISEE FOR NIGHTS, WEEKENDS AND HOLIDAYS. THE CHKD'S CULTURAL/LANGUAGE SERVICES DEPARTMENT MEETS THE NEEDS OF PATIENTS AND FAMILIES WITH LIMITED ENGLISH PROFICIENCY BY COORDINATING ACCESS TO LANGUAGE INTERPRETATION VIA FACE-TO-FACE, OVER THE PHONE AND VIDEO REMOTE INTERPRETATION THROUGHOUT THE HEALTH SYSTEM. IN FY21, CHKD PROVIDED INTERPRETATION SERVICES IN 33 DIFFERENT LANGUAGES FOR OUR LIMITED ENGLISH POPULATION THROUGH 11,726 OUTPATIENT VISIT. ON AVERAGE, 88% OF OUR LIMITED ENGLISH PROFICIENT PATIENTS AND FAMILIES SPEAK SPANISH. TO MEET THIS DEMAND, IN ADDITION TO OVER THE PHONE INTERPRETATION AND VIDEO REMOTE INTERPRETATION AVAILABLE THROUGHOUT CHKDHS, THE LANGUAGE SERVICES DEPARTMENT CONSISTS OF 3 SPANISH MEDICAL INTERPRETERS AT THE MAIN HOSPITAL AND ONE REMOTE PRN DOCUMENT TRANSLATOR. ADDITIONALLY, THE HEALTH SYSTEM RELIED ON THE ASSISTANCE OF 22 DUAL ROLE BILINGUAL STAFF WHO PROVIDED MEDICAL INTERPRETATION IN THEIR ASSIGNED AREAS. DURING FY21 LANGUAGE SERVICES STAFF DIRECTLY ASSISTED IN 8,443 PATIENT ENCOUNTERS AT THE MAIN HOSPITAL, 241 DOCUMENT TRANSLATIONS AND EIGHT LANGUAGE PROFICIENCY ASSESSMENTS. FORM 990, PART III, LINE 4A AS THE REGIONAL PROVIDER OF PEDIATRIC CARE, CHKD IS AN INTEGRAL PART OF THE COMMUNITY'S NATURAL OR MAN-MADE DISASTER PLANNING EFFORTS. CHKDHS RECOGNIZES THE IMPORTANCE OF A NATIONAL INCIDENT MANAGEMENT SYSTEM(NIMS) COMMUNITY-INTEGRATED, ALL-HAZARD EMERGENCY OPERATIONS PLAN. THIS PLAN IS PREPARED, EXERCISED AND SHARED INTERNALLY AND EXTERNALLY WITH COMMUNITY, STATE AND FEDERAL EMERGENCY RESPONSE AGENTS. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS SECTION TWO: OUTPATIENT SERVICES AND PROGRAMS CHKD HEALTH SYSTEM ALSO OFFERS THE COMMUNITY MANY IMPORTANT PEDIATRIC SERVICES ON AN OUTPATIENT BASIS. IN FY20, CHILDREN MADE APPROXIMATELY 598,563 OUTPATIENT VISITS TO CHKD PEDIATRICIANS, SURGEONS AND SUBSPECIALTY SPECIALTY CLINICS. THEY MADE 348,248 VISITS TO THE PRIMARY CARE PEDIATRICIANS OF CHKD'S MEDICAL GROUP, WHICH OFFERS CARE IN 20 PRACTICES AND 32 OFFICES THROUGHOUT OUR SERVICE AREA. CHKD'S SURGICAL SPECIALTY GROUP MAKES THE SERVICES OF THE REGION'S ONLY PEDIATRIC GENERAL, UROLOGICAL, CARDIAC, NEUROSURGICAL, PLASTIC AND ORTHOPEDIC SURGEONS AVAILABLE TO THOUSANDS OF CHILDREN WHO MIGHT OTHERWISE HAVE TO TRAVEL OUTSIDE OF THE AREA FOR SURGERY. CHILDREN MADE 46,131 VISITS TO THE SURGICAL GROUP PRACTICES IN FY21. THE SURGEONS PERFORMED 5,698 SURGICAL CASES. THE HOSPITAL ALSO PROVIDES CARE TO CHILDREN FACING HEALTH CONDITIONS SUCH AS CANCER, GENETIC DISORDERS, OBESITY, HEART PROBLEMS, DEVELOPMENTAL DISABILITIES, ASTHMA/ALLERGIES AND DIABETES THROUGH MORE THAN 50 OUTPATIENT SPECIALTY CLINICS OFFERING SPECIALIZED PEDIATRIC CARE. IN FY21, CHILDREN MADE 204,184 VISITS TO OUR OUTPATIENT CLINICS. CHILDREN'S HOSPITAL WAS FOUNDED ON THE PREMISE THAT ALL CHILDREN DESERVE EQUAL ACCESS TO QUALITY PEDIATRIC CARE. AS OUR POPULATION GREW AND SETTLED INTO THE FAR CORNERS OF OUR BRIDGE-AND TUNNEL-LACED REGION, TRAVEL TO CHKD'S MAIN FACILITY IN NORFOLK BECAME MORE OF A HARDSHIP FOR FAMILIES. TO EASE THAT BURDEN AND IMPROVE CHILDREN'S ACCESS TO CARE IN EVERY CORNER OF OUR SERVICE AREA, CHKD HAS ESTABLISHED MULTI-SERVICE HEALTH CENTERS IN STRATEGIC LOCATIONS. THESE INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: * THE CHKD HEALTH AND SURGERY CENTER AT OYSTER POINT OFFERS FAMILIES WHO LIVE NORTH OF THE HAMPTON ROADS BRIDGE TUNNEL A WEALTH OF IMPORTANT SERVICES IN A CONVENIENT LOCATION. THE CENTER IS HOME TO THE REGION'S FIRST PEDIATRIC AMBULATORY SURGERY CENTER. OTHER SERVICES OFFERED AT THE SITE INCLUDE PRIMARY, SURGICAL AND SUB-SPECIALTY PEDIATRICS; LAB AND RADIOLOGY (INCLUDING ULTRASOUND AND MRI), AUDIOLOGY TESTING AND OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY. AQUATIC THERAPY AND CHILD ABUSE PROGRAM SERVICES ARE ALSO AVAILABLE THERE. * THE CHKD HEALTH CENTER AND URGENT CARE AT TECH CENTER IS HOME TO THE PENINSULA'S ONLY PEDIATRIC URGENT CARE AS WELL AS THE CENTER FOR PEDIATRIC SLEEP MEDICINE, X-RAY, LAB, PHYSICAL MEDICINE AND REHABILITATION, RHEUMATOLOGY, AND SPORTS MEDICINE PRIMARY CARE, PHYSICAL THERAPY, AND PERFORMANCE TRAINING. * THE CHKD HEALTH CENTER AT OAKBROOKE SERVES FAMILIES IN CHESAPEAKE AND NORTHEASTERN NORTH CAROLINA. IT IS HOME TO A PRIMARY CARE PEDIATRIC PRACTICE; PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY; X-RAY AND LAB SERVICES, A SPORTS MEDICINE GYM, SLEEP STUDIES UNIT AND THERAPY POOL, AS WELL AS CLINIC SPACE FOR A VARIETY OF PEDIATRIC SPECIALISTS AND SURGEONS PROVIDING EVALUATION, TREATMENT AND FOLLOW-UP. * THE CHKD HEALTH AND SURGERY CENTER AT PRINCESS ANNE SERVES THE GROWING MEDICAL NEEDS OF FAMILIES IN VIRGINIA BEACH. THE CENTER IS HOME TO VIRGINIA BEACH'S FIRST AMBULATORY SURGERY CENTER EXCLUSIVELY FOR CHILDREN. BEACH FAMILIES CAN ALSO FIND PRIMARY CARE PEDIATRICIANS AND IN-HOUSE LAB AND RADIOLOGY SERVICES - INCLUDING MRI - AT THE CENTER. OTHER SERVICES INCLUDE SPECIALTY CARE PEDIATRICS FOR HELP WITH CHRONIC PROBLEMS SUCH AS DIABETES. THIS YEAR, A THIRD OPERATING ROOM WAS ADDED TO THIS LOCATION TO SUPPORT THE PEDIATRIC DENTAL NEEDS OF THE COMMUNITY. IT WAS BUILT AND DESIGNED ACCORDING TO THE INPUT FROM COMMUNITY DENTISTS. * THE CHKD HEALTH CENTER AT LANDSTOWN IS LOCATED JUST DOWN THE ROAD FROM CONCERT DRIVE AND OFFERS DEDICATED VIRGINIA BEACH SPACE FOR SERVICES SUCH AS SPORTS MEDICINE, DERMATOLOGY AND GYNECOLOGY. * THE CHKD HEALTH CENTER AND URGENT CARE AT LOEHMANN'S SERVES THE NORTHERN AND MIDDLE VIRGINIA BEACH REGION AND IS HOME TO CHKD URGENT CARE, SPORTS MEDICINE (PRIMARY CARE) AND THERAPY, SPORTS PERFORMANCE TRAINING AND PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. * THE CHKD HEALTH CENTER AT BUTLER FARM OFFERS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, AND SPORTS MEDICINE PHYSICAL THERAPY TO CHILDREN AND TEENS ON THE PENNISULA. DEVELOPMENTAL PEDIATRICS ALSO HOSTS A WHEELCHAIR CLINIC AT THIS LOCATION. * THE CHKD HEALTH CENTER AT HARBOUR VIEW NORTH OFFERS SPECIALIZED PEDIATRIC CARE TO FAMILIES IN SUFFOLK. THE SITE OFFERS APPOINTMENTS IN PEDIATRIC DERMATOLOGY, ALLERGY, GASTROENTEROLOGY, CARDIOLOGY AND NEPHROLOGY, AS WELL AS DEVELOPMENTAL PEDIATRICS. * THE CHKD HEALTH CENTER AT LIGHTFOOT OFFERS FAMILIES IN THE NORTHERN CORNER OF OUR SERVICE AREA APPOINTMENTS IN PEDIATRIC CARDIOLOGY, NEPHROLOGY, GYNECOLOGY, PHYSICAL MEDICINE AND REHABILITATION, REHABILITATIVE THERAPIES, SPORTS MEDICINE AND UROLOGY. CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS OPERATES THE REGION'S ONLY PEDIATRIC URGENT CARE. PARENTS OF CHILDREN WITH URGENT, BUT NOT EMERGENT MEDICAL NEEDS, NOW HAVE ACCESS TO QUALITY MEDICAL CARE JUST FOR KIDS AFTER-HOURS, ON WEEKENDS AND HOLIDAYS. IN FY21, CHILDREN MADE 61,620 VISITS TO CHKD URGENT CARE CENTERS IN CHESAPEAKE, VIRGINIA BEACH AND NEWPORT NEWS. CHKD'S CHILD ADVOCACY CENTER (CAC) COORDINATES THE REGION'S EFFORTS TO ACCURATELY IDENTIFY, TREAT AND SUPPORT CHILDREN WHO HAVE BEEN SUSPECTED OF ABUSE OR NEGLECT. IN ADDITION TO THE MAIN PROGRAM IN NORFOLK, SERVICES ARE ALSO AVAILABLE AT CHKD'S OUTPATIENT CENTERS IN VIRGINIA BEACH AND NEWPORT NEWS. THE CAC PROVIDES COMPREHENSIVE ASSESSMENT, EVALUATION AND TREATMENT SERVICES, INCLUDING CASE MANAGEMENT AND ADVOCACY, AN ARRAY OF EVIDENCE-BASED MENTAL HEALTH SERVICES, FORENSIC INTERVIEWING, MEDICAL EXAMINATIONS AND CONSULTATIONS, WHICH INCLUDE 24/7 COVERAGE OF ACUTE SEXUAL ASSAULTS OF CHILDREN. THE CAC ALSO HELPS COORDINATE THE EFFORTS OF INVESTIGATIVE AGENCIES INVOLVED IN THE INVESTIGATION AND PROSECUTION OF CHILD MALTREATMENT AND FACILITATES THE COLLABORATION OF 12 MULTIDISCIPLINARY TEAMS (MDTS). THESE TEAMS DISCUSS ALL CHILDREN REFERRED TO THE PROGRAM TO HELP ENSURE THE BEST OUTCOMES CAN BE REALIZED. DURING FY21, PROFESSIONS AT THE PROGRAM PROVIDED SERVICES FOR 1,649 CHILDREN AND THEIR FAMILIES, WITH REFERRALS RISING EVEN MORE DURING THE COVID-19 PANDEMIC. A SPECIALTY PROGRAM WITHIN THE CAC HELPS ACCURATELY IDENTIFY AND PROVIDE ASSISTANCE AND TREATMENT TO COMMERCIALLY SEXUALLY EXPLOITED CHILDREN (CSEC). SINCE LAUNCHING OUR PROGRAM AND CSEC MDT WE HAVE SEEN A SHARP INCREASE IN THE NEED FOR SERVICES FOR THIS POPULATION. WE HAVE CREATED A SURVIVOR-LEAD MENTORING PROGRAM, AND OUR TEAM OFTEN COORDINATES WITH FEDERAL AND LOCAL INVESTIGATORS AS WELL AS JUVENILE COURT SERVICES AND MEDICAL AND MENTAL HEALTH PROVIDERS TO BEST SERVE THE UNIQUE NEEDS OF EACH CHILD. THE CAC IS ALSO THE BACKBONE AGENCY FOR THE HAMPTON ROADS TRAUMA INFORMED COMMUNITY NETWORK (HRTICN). THE NETWORK EXISTS TO PROMOTE AN UNDERSTANDING OF HOW TRAUMA AFFECTS INDIVIDUALS AND COMMUNITIES, AND TO ADVOCATE PRACTICES THAT HELP ALL PEOPLE REACH THEIR FULL POTENTIAL. THE EPIDEMIC OF CHILDHOOD OBESITY CONTINUES TO BE A CONCERN AND FOCUS AREA FOR CHKD. IN ORDER TO ADDRESS THIS CRITICAL ISSUE, IN 2001, CHKD ESTABLISHED A COMPREHENSIVE PROGRAM CALLED HEALTHY YOU FOR LIFE THAT IS OFFERED TO CHILDREN AGES 3 THROUGH HIGH SCHOOL. HEALTHY YOU FOR LIFE OFFERS A MULTIDISCIPLINARY TEAM APPROACH THAT PROVIDES CLINICAL AND PSYCHOLOGICAL EVALUATION AND TREATMENT PLANNING FOR INDIVIDUALS EITHER IN PERSON OR BY TELEMEDICINE VISITS. THE PROGRAM'S STAFF INCLUDES PHYSICIANS, NURSE PRACTITIONERS, REGISTERED DIETITIANS, LICENSED CLINICAL SOCIAL WORKERS AND EXERCISE PHYSIOLOGIST. THE HEALTHY YOU FOR LIFE PROGRAM ALSO OFFERS INDIVIDUAL COUNSELING SESSIONS. IN FY21 THE TEAM CONDUCTED NEARLY 2,000 VISITS COVERING 90 ZIP CODES. MOVING INTO THE NEW FISCAL YEAR, THE TEAM IS CONTINUING TO USE TELEMEDICINE AS A WAY TO IMPROVE ACCESS TO A BEHAVIORAL HEALTH COUNSELOR TO ADDRESS PSYCHO-SOCIAL STRESSORS MANY PATIENTS EXPERIENCE. MIDDLE SCHOOL AND HIGH SCHOOL GROUP THERAPY SESSIONS HAVE BEEN INITIATED VIA TELEHEALTH TO HELP PRE-TEEN AND TEENAGERS FEEL CONNECTED AND SUPPORTED DURING THE PANDEMIC. PERSONAL TRAINING IS ALSO OFFERED FOR INTERESTED PATIENTS. HEALTHY YOU CONTINUES TO PARTNER WITH VARIOUS COMMUNITY ORGANZIATIONS TO EDUCATE AND ENCOURAGE HEALTHY LIFESTYLES FOR CHRONICALLY OBESE CHILDREN AND THEIR FAMILIES IN HAMPTON ROADS. FORM 990, PART III, LINE 4A STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D) CHKD'S DIABETES EDUCATION PROGRAM HELPS APPROXIMATELY 1,500 LOCAL CHILDREN WHO LIVE WITH THE CHRONIC DISEASE. THREE CERTIFIED DIABETES EDUCATORS, A SOCIAL WORKER, A REGISTERED DIETITIAN AND OFFICE COORDINATOR HELP PATIENTS AND FAMILIES AT THE ONSET OF THE DISEASE AND UNTIL ADULTHOOD. THE DIABETES CENTER PROVIDES INPATIENT AND OUTPATIENT CLINICAL MANAGEMENT, DIABETES EDUCATION, SUPPORT GROUPS, AND PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS. A TRANSITION PROGRAM HELPS THE OLDER TEENS AND YOUNG ADULTS BEGIN TRANSFERRING CARE TO ADULT PROVIDERS IN THE COMMUNITY. CHILDREN MADE 873 VISITS TO THE DIABETES CENTER IN FY21. THE CHILDREN'S CANCER AND BLOOD DISORDERS CENTER PROVIDES CARE TO YOUNG PEOPLE WITH CANCER, SICKLE CELL DISEASE, BLEEDING AND OTHER BLOOD DISORDERS THROUGH TREATMENT PROGRAMS THAT ENCOMPASS CHILDREN'S PHYSICAL, EMOTIONAL AND EDUCATIONAL NEEDS AND INCORPORATES THE WHOLE FAMILY. PATIENTS MADE 8,831 VISITS TO THE CENTER IN FY21. CHKD IS THE ONLY EMERGENCY DEPARTMENT AND LEVEL 1 TRAUMA CENTER EXCLUSIVELY SERVING CHILDREN AND THEIR FAMILIES IN THE SOUTHEAST REGION OF VIRGINIA. IN FY21, CHILDREN MADE 32,777 VISITS TO OUR EMERGENCY CENTER. CHKD PROVIDES CARE FOR PATIENTS AND THEIR FAMILIES FROM BIRTH TO YOUNG ADULTHOOD WITH VARIED LEVELS OF ACUITY FROM TRAUMA AND RESUSCITATIONS TO URGENT CARE TYPE PATIENTS. OUR COLLABORATIVE TEAM INCLUDES PEDIATRIC BOARD-CERTIFIED EMERGENCY PHYSICIANS, NURSE PRACTITIONERS, NURSES, ED TECHS, NURSING CARE PARTNERS, BEHAVIORAL HEALTH TECHS, PHARMACISTS, SOCIAL WORKERS, CHILD LIFE SPECIALISTS, CHAPLAINS, RESPIRATORY THERAPISTS AND MORE. CHKD OFFERS THE ONLY PEDIATRIC RENAL DIALYSIS SERVICE IN THE AREA. DIALYSIS IS A TIME-CONSUMING PROCESS AND CHILDREN APPRECIATE THE CHANCE TO HAVE THE SERVICE IN A SETTING WHERE THEY CAN MEET WITH FRIENDS THEIR OWN AGES AS WELL AS HOSPITAL SUPPORT STAFF AND SCHOOL TEACHERS. CHILDREN MADE 3,070 CHRONIC AND ACUTE DIALYSIS VISITS IN FY21, AND 5,634 VISITS TO THE RENAL CLINIC AND RECEIVED 406 RENAL INFUSIONS. CHKD IS A STAND-ALONE PEDIATRIC TRANSPLANT HOSPITAL. SINCE 2005, CHKD HAS PERFORMED 88 KIDNEY TRANSPLANTS FROM LIVING DONORS AS WELL AS DECEASED DONORS. LIVING DONATION OPTIONS INCLUDE A PARTNERSHIP WITH SENTARA NORFOLK GENERAL HOSPITAL AND THE NATIONAL KIDNEY REGISTRY (NATIONWIDE LIVING DONOR PAIRED-EXCHANGE PROGRAM). ONE MARK OF CHKD'S DISTINCTIVE PEDIATRIC CARE HAS ALWAYS BEEN CHILD-CENTERED DIAGNOSTIC SERVICES, SUCH AS RADIOLOGY AND LABORATORY. OVER THE PAST SEVERAL YEARS, CHKD HAS WORKED HARD TO MAKE THESE UNIQUE SERVICES MORE ACCESSIBLE TO FAMILIES THROUGHOUT OUR SERVICE REGION. IN ADDITION TO THE LAB AT THE MAIN HOSPITAL, CHKD NOW HAS LAB SERVICES AT ITS OYSTER POINT, HARBOUR VIEW, PRINCESS ANNE, OAKBROOKE, LOEHMANN'S AND TECH CENTER LOCATIONS AS WELL AS THE VOLVO URGENT CARE CENTER. THE LABORATORY ALSO OPERATES A COURIER SERVICE THAT FACILITATES QUICK TURNAROUND OF SPECIMENS. OF THE 865,695 LAB TESTS PERFORMED IN FY21, APPROXIMATELY 68 PERCENT WERE FOR OUTPATIENTS. CHKD RADIOLOGY SERVICES ARE ALSO AVAILABLE TO FAMILIES AT OUR CHKD FACILITIES IN NEWPORT NEWS, CHESAPEAKE, SUFFOLK, HAMPTON, NORFOLK AND VIRGINIA BEACH. THE RADIOLOGY DEPARTMENT IS A FULLY INTEGRATED DIGITAL IMAGING CENTER THAT ALLOWS DIAGNOSTIC IMAGES AND REPORTS TO BE TRANSMITTED AND VIEWED ELECTRONICALLY. IN FY21, 97,598 DIAGNOSTIC EXAMS WERE PERFORMED, INCLUDING X-RAYS, FLUOROSCOPIC TESTS, URODYNAMICS AND BONE DENSITY TESTS, CT AND MRI SCANS, ULTRASOUND, PVL AND NUCLEAR MEDICINE STUDIES. APPROXIMATELY 76 PERCENT WERE OUTPATIENT BASED. CHKD'S REHABILITATIVE THERAPY SERVICES ARE OFFERED IN LOCATIONS THROUGHOUT THE COMMUNITY, INCLUDING NORFOLK, CHESAPEAKE, VIRGINIA BEACH, SUFFOLK, WILLIAMSBURG AND NEWPORT NEWS. IN ADDITION TO ITS HIGHLY SPECIALIZED PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, THE DEPARTMENT ALSO OFFERS: * AQUATIC THERAPY - PHYSICAL AND OCCUPATIONAL THERAPISTS WORK WITH CHILDREN IN THE WATER TO HELP RELAX TIGHT MUSCULATURE, INCREASE RANGE OF MOTION AND IMPROVE STRENGTH, BALANCE AND ENDURANCE. * ASSISTIVE TECHNOLOGY/AUGMENTATIVE PROGRAM - SERVICES PROVIDED FOR CHILDREN WHO ARE UNABLE TO COMMUNICATE VERBALLY OR THROUGH GESTURES DUE TO VARIOUS MEDICAL CONDITIONS, THEREBY ALLOWING THEM AN ALTERNATIVE WAY TO INCREASE THEIR PARTICIPATION AND INCLUSION IN DAILY ACTIVITIES. IN FY21, WE DID 209 AUGMENTATIVE COMMUNICATION EVALUATIONS. * CAR SEAT PROGRAM - SPECIALLY TRAINED THERAPISTS OFFER CAR SEAT SAFETY RESTRAINT EVALUATIONS FOR PATIENTS WITH SPECIAL NEEDS. IN FY21, WE DID 250 CAR SEAT EVALUATIONS, DISTRIBUTED 70 CAR SEATS DURING THOSE EVALUATIONS, DISTRIBUTED AN ADDITIONAL 126 STANDARD CAR SEATS, AND PARTICIPATED IN ONE COMMUNITY-BASED CAR SEAT SAFETY CHECKS THROUGH THIS PROGRAM. * WHEELCHAIR CLINIC - CERTIFIED THERAPISTS COMPLETE A COMPREHENSIVE EVALUATION TO DETERMINE AND PRESCRIBE THE APPROPRIATE WHEELCHAIR AND SEATING SYSTEM. CHILDREN MADE ALMOST 895 VISITS TO THIS CLINIC IN FY21 FOR EVALUATION AND TECHNICAL ADJUSTMENTS. SECTION THREE: COMMUNITY OUTREACH CHKD REACHED FAMILIES IN THEIR HOMES, DOCTORS' OFFICES, SCHOOLS, NEIGHBORHOODS AND COMMUNITY CENTERS WITH A WIDE VARIETY OF PROGRAMS, SOCIAL MEDIA AND PUBLICATIONS THAT PROMOTE MENTAL WELLNESS, PREVENT INJURIES, AND STRENGTHEN FAMILIES. USING CREATIVE AND INNOVATIVE WAYS WITH OUR STRONG COMMUNITY PARTNERS, OUR COMMUNITY OUTREACH AND ENGAGEMENT (CORE) PROGRAM CONDUCTED 230 OUTREACH EVENTS REACHING 27,840 FAMILIES. DESPITE COVID-19 LIMITATIONS, CORE WAS ABLE TO ADJUST AND CONTINUE TO PROGIVE QUALITY PARENT EDUCATION AND RESOURCES. EFFORTS FOCUSED ON MENTAL HEALTH, TRAUMA, AND SOCIAL EMOTIONAL LEARNING FOR BOTH PARENTS AND PROFESSIONALS AND DEVELOPING PROGRAMS ON DEMAND. OUR STRONG COMMUNITY PARTNERS ASSISTED WITH PROGRAM MARKETING AND COLLABORATION TO PROVIDE A VARIETY OF TIMELY PRESENTATIONS TO EQUIP PARENTS, PROFESSIONALS AND CHILDREN DURING THESE UNPRECEDENTED TIMES. CHKD IS A SITE OF THE NATIONAL "REACH OUT AND READ" LITERACY PROGRAM, WHICH ENCOURAGES READING BY DISTRIBUTING FREE BOOKS TO CHILDREN AT THEIR WELL CHILD VISITS TO THEIR PEDIATRICIANS. THROUGH THE DONOR-FUNDED PROGRAM, CHKD PRIMARY CARE PEDIATRICIANS GAVE APPROVIMATELY 75,100 BOOKS TO CHILDREN IN FY21. THE PROGRAM ALSO EXPANDED THIS FISCAL YEAR TO INCLUDE CHKD'S NEONATAL INTENSIVE CARE UNIT, THE FIRST OFFICIAL NICU REACH OUT AND READ SITE IN VIRGINIA. CHKD'S WEBSITE, WWW.CHKD.ORG, CONTINUES TO BE A POPULAR AND EFFECTIVE METHOD OF COMMUNICATION. IN FY21, CHKD.ORG HAD MORE THAN 3 MILLION VISITS. NEARLY 2 MILLION NEW AND RETURNING VISITORS VIEWED 5,374,585 PAGES ON OUR SITE. THE CONTENT MANAGEMENT SYSTEM THAT IS IN PLACE ALLOWS MULTIPLE USERS TO CREATE AND UPDATE CONTENT AS NEEDED. CHKD.ORG IS A RESPONSIVE DESIGN SITE AND AUTOMATICALLY FORMATS ITSELF TO ANY DEVICE (PC, TABLET OR SMARTPHONE)- NO APP NEEDED. CLICKABLE PHONE NUMBERS AND INTERACTIVE MAPS MAKE IT EASY FOR OUR PATIENTS TO CALL OR FIND ANY PRACTICE, AND FAMILIES HAVE EASY ACCESS TO TEST RESULTS, SHOT RECORDS, AND CAN EVEN REQUEST PRESCRIPTION REFILLS AND MAKE APPOINTMENTS ONLINE STRAIGHT FROM THE HOMEPAGE BY ACCESSING THE MYCHKD PATIENT PORTAL. ENHANCED PHYSICIAN PROFILES, INCLUDING CLICKABLE PHONE NUMBERS, INTERACTIVE MAPS, BIOGRAPHICAL INFORMATION AND A LINK TO THE PHYSICIAN'S PRACTICE MAKE IT EASIER THAN EVER TO CHOOSE THE DOCTOR THAT'S RIGHT FOR YOU. CHKD CONTINUES TO UTILIZE SOCIAL MEDIA OUTLETS SUCH AS FACEBOOK, TWITTER, LINKEDIN, PINTEREST AND INSTAGRAM TO INCREASE DIRECT INTERACTION WITH OUR PATIENTS AND THEIR FAMILIES. THE WEBSITE CONTINUES TO BE A RESOURCE FOR OUR SERVICES AND HEALTH INFORMATION. FORM 990, PART III, LINE 4A CHKD IS ONE OF SIX LOCATIONS IN THE STATE FOR THE CARE CONNECTION FOR CHILDREN (CCC), THE STATE-FUNDED TITLE V PROGRAM THAT PROVIDES COMPREHENSIVE CARE COORDINATION, INFORMATION AND REFERRAL FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. THERE ARE APPROXIMATELY 12,000 CHILDREN WITH SPECIAL HEALTH CARE NEEDS IN THE REGION'S PUBLIC HEALTH DISTRICTS. IN FY21, CCC ASSISTED WITH 576 INFORMATION AND REFERRAL CALLS AND PROVIDED COMPREHENSIVE CASE MANAGEMENT SERVICES TO 600 FAMILIES. FINANCIAL ASSISTANCE WAS PROVIDED FOR 28 CHILDREN AND YOUTH WHO WERE UNINSURED OR UNDERINSURED AND 120 FAMILIES WERE ASSISTED IN APPLYING FOR STATE HEALTH PROGRAMS, TO INCLUDE VIRGINIA'S WAIVER SERVICES. THE PROGRAM PROVIDED ONGOING BILINGUAL CARE COORDINATION SERVICES TO 105 CLIENTS AND FAMILY MEMBERS AND ASSISTED THEM WITH ACCESS TO COMMUNITY RESOURCES AND FINANCIAL ASSISTANCE. WE MAINTAINED AN UPDATED LOCAL AND REGIONAL COMMUNITY DATABASE WITH CATALOGED RESOURCES FOR ALL 21 CITIES AND COUNTIES IN OUR REGION. THIS RESOURCE DIRECTORY WAS MADE AVAILABLE TO THE HEALTH SYSTEM AS WELL AS LOCAL AGENCIES AND THE COMMUNITY. THE PARENT EDUCATORS FROM THE FAMILIES AS EDUCATORS PROGRAM (SHARING OF CHALLENGES AND POSITIVE EXPERIENCES IN RAISING CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS), WHICH PROVIDES COMMUNIY BASED EXPERIENCES TO PARTICIPATING RESIDENTS WAS TEMPORARILY DISCONTINUED BECAUSE OF COVID-19. WE MAINTAINED A SPECIAL NEEDS LISTSERV WITH OVER 500 SUBSCRIBERS. 2020-2021 HIGHLIGHTS *DEVELOPED, IMPLEMENTED AND CONTINUED TO MODERATE A LISTSERV FOR THE COMMUNITY ON DISABILITY TOPICS WITH MORE THAN 500 FOLKS REGISTERED. MEMBERS ARE PATIENTS, PARENTS, CAREGIVERS, AND PROVIDERS. *ONGOING COLLABORATION WITH CHKD, FORTIFY CLINICALLY INTEGRATED NETWORK AND CMG TO INTEGRATE CARE COORDINATION ACTIVITIES WITHIN THE ELECTRONIC RECORD TO IMPROVE COMMUNICATION WITH PATIENT CENTERED MEDICAL HOME. *HAMPTON ROADS CYSN CONSORTIUM MEMBERS DEVELOPED AND IMPLEMENTED FIVE VIRTUAL TRAININGS ATTENDED BY 266 COMMUNITY MEMBERS BOTH PROFESSIONALS AND FAMILY MEMBERS. *ACTIVELY ENGAGED IN HOME VISITING COLLABORATION (9 TO 5 EVMS PROGRAM), AUTISM COLLABORATIVE, EDHI LEARNING COLLABORATIVE, CINCH, TRICC, PEATC, FAPT TEAMS, SEAC STATE REPRESENTATIVE FOR MEDICAID ADVISORY GROUP. *A TRACKING TOOL FOR ALL STAFF WAS DEVELOPED FOR MONITORING AND OPENING AND CLOSING OF CASES AND RELATED ACTIVITIES REQUIRED FOR COMPLETION. THIS EXCEL DOCUMENT IS UPDATED AND STORED IN A CENTRAL SHARE DIRECTORY TO ALLOW STAFF ACCESS TO VIEW WHAT NEEDS TO BE UPDATED FOR CASE. *IMPLEMENTED A MONTHLY VIRTUAL BILINGUAL SUPPORT GROUP WITH OUR PARENT COORDINATOR AND OUR BILINGUAL SOCIAL WORK CARE COORDINATOR. *DEVELOPED A NEW TRAINING MODULE ON SAFETY AND HOME/AGENCY VISITING INCORPORATING COVID CDC GUIDANCE FOR STAFF SAFETY. * ACTIVELY ENGAGED WITH INTERCENTER WORK GROUP MEETINGS, TRAININGS, EMAIL COLLABORATIONS AND TELECONFERENCE SESSIONS. GROUP MEMBERS SUPPORT ONE ANOTHER TO IDENTIFY RESOURCES WHEN WE FACE CHALLENGES. WE ALSO ADVOCATE TO CLOSE GAPS IN SERVICES. * CONTINUE TO OFFER EDUCATIONAL CONSULTANT SERVICES PER VDOE REGULATIONS. PROVIDE INFORMATION AND REFERRAL SERVICES FOR HEALTH SYSTEM RELATED TO EDUCATIONAL CONCERNS (IEP/IFSP). SECTION FOUR: MEDICAL EDUCATION AND RESEARCH CHKD INVESTS IN THE PRESENT AND FUTURE HEALTH OF OUR CHILDREN THROUGH A VARIETY OF RESEARCH PROGRAMS AND EDUCATIONAL ACTIVITIES. CHILDREN'S HOSPITAL IS HOME TO EASTERN VIRGINIA MEDICAL SCHOOL'S PEDIATRIC RESIDENCY PROGRAM, WHERE NEW PHYSICIANS BECOME SPECIALISTS IN THE FIELD OF PEDIATRICS. MANY OF OUR RESIDENTS ELECT TO STAY AND PRACTICE PEDIATRICS IN THIS COMMUNITY OR IN THE STATE OF VIRGINIA. CHKD ALSO SERVES AS THE EXCLUSIVE PEDIATRIC TEACHING SITE FOR PHYSICIAN ASSISTANTS AND RESIDENTS IN FAMILY MEDICINE, EMERGENCY MEDICINE, OBSTETRICS-GYNECOLOGY, ENT, PLASTIC SURGERY, AND GENERAL SURGERY. CHKD PARTICIPATES IN THE EDUCATION OF ALL EVMS MEDICAL STUDENTS AND IS THE EXCLUSIVE SITE FOR SOME 150 THIRD-YEAR MEDICAL SCHOOL STUDENTS FOR THEIR SIX-WEEK PEDIATRIC CLERKSHIP ROTATION. CHKD PROVIDES A SETTING FOR MANY CLINICAL RESEARCH TRIALS. HIGHLIGHTS OF THE BASIC SCIENCE RESEARCH INCLUDE NEW GENE THERAPY FOR NEUROMUSCULAR DISORDERS, BREAKTHROUGHS IN TREATMENT OF CYSTIC FIBROSIS, INNOVATIVE THERAPIES IN SPORTS MEDICINE, ADVANCE GROWTH HORMONE TREATMENTS, AND INTERVENTIONS FOR DISORDERED SLEEP. IN ADDITION, RESEARCH INCLUDES NEW MEDICATIONS AND OTHER THERAPIES, CLINICAL OUTCOMES ANALYSES AND EPIDEMIOLOGICAL STUDIES SANCTIONED BY THE EASTERN VIRGINIA MEDICAL SCHOOL INSTITUTIONAL REVIEW BOARD. THERE WERE 232 IRB-APPROVED ACTIVE FUNDED STUDIES IN FY21. TOPICS OF STUDY INCLUDED HEMATOLOGY/ONCOLOGY, ALLERGY/ASTHMA, INFECTIOUS DISEASE, NEUROLOGY, PEDIATRIC SURGERY, CARDIOLOGY, OTOLARYNGOLOGY, PULMONOLOGY, GASTROENTEROLOGY, CHILD ABUSE, ENDOCRINOLOGY, DERMATOLOGY, NEONATOLOGY AND MENTAL HEALTH. MANY OF THESE STUDIES ARE PHASE THREE CLINICAL TRIALS THAT BRING CUTTING-EDGE TREATMENTS TO CHKD PATIENTS YEARS BEFORE THEY ARE AVAILABLE TO THE PUBLIC. THIS FISCAL YEAR THERE WERE ALSO NEW PHASE ONE TRIALS OPENED, WHICH ALLOWED OUR PATIENTS THE EARLIEST POSSIBLE ACCESS TO NOVEL THERAPIES. THERE IS AN INCREASED FOCUS ON REGISTRY STUDIES ACROSS ALL DISCIPLINES. DATA COLLECTED IN THESE REGISTRIES IS INTENDED TO STANDARDIZE OPTIMAL LEVELS OF CARE AND LEAD TO IMPROVED PATIENT OUTCOMES. THERE HAVE ALSO BEEN OPPORTUNITIES TO STUDY THE EFFECTS OF VARIOUS TELEHEALTH TELEMEDICINE INTERVENTIONS, NOT ONLY TO ADAPT TO THE COVID-19 PANDEMIC, BUT TO BE ABLE TO REACH SUBJECTS WHO CANNOT TRAVEL TO THE SITE, SUCH AS SUBJECTS WHO ARE HOMEBOUND OR IN HOSPICE CARE. THE NUSS PROCEDURE FOR THE CORRECTION OF PECTUS EXCAVATUM, DEVELOPED AT CHKD MORE THAN 30 YEARS AGO, CONTINUES TO DRAW NATIONAL ATTENTION FROM BOTH PATIENTS AND SURGEONS. THE CHILDREN'S SURGICAL SPECIAL GROUP SURGEONS CONTINUE TO PUBLISH MANUSCRIPTS AND PRESENT THEIR WORK AT NATIONAL MEETINGS TO REINFORCE AND MAINTAIN OUR REPUTATION OF EXCELLENCE ON AN INTERNATIONAL SCALE. THE NUSS CENTER CONTINUES TO OFFER NON-SURGICAL TREATMENT THERAPIES AS WELL. THE COMPRESSION BRACE INITIATED IN 2009 HAS HELPED MORE THAN 521 PATIENTS WITH OVER 90% OF THOSE PATIENTS EXPERIENCING A CORRECTION TO THEIR DEFORMITY. THAT TYPE OF TREATMENT WAS EXPANDED IN 2020 BY USING A BRACE KNOWN AS THE EMBRACE, WHICH CHKD HAS USED WITH 14 PATIENTS. IN ADDITION, THE VACUUM BELL TREATMENT FIRST OFFERED IN 2012 HAS HELPED OVER 360 PATIENTS. IN JUNE 2016, CHKD OPENED THE NEW NUSS CENTER, OFFERING A SPACE DEDICATED TO THE EVALUATION AND TREATMENT OF CHEST WALL CONDITIONS. THE HOSPITAL CONTINUES ITS ENDEAVORS ON MULTIPLE RESEARCH STUDIES IN AN EFFORT TO FURTHER UNDERSTAND CHEST WALL DEFORMITIES. TO DATE, MORE THAN 2,575 SURGICAL PATIENTS HAVE UNDERGONE THE NUSS PROCEDURE AT CHKD AND OVER 5,878 PATIENTS HAVE BEEN EVALUATED FOR CHEST WALL CONDITIONS. CHKD IS A MEMBER OF CHILDREN'S ONCOLOGY GROUP (COG), AN INTERNATIONAL RESEARCH GROUP THAT CONDUCTS CLINICAL TRIALS FOR CHILDREN WITH CANCER. AS A MEMBER, CHKD HAS ACCESS TO THE LATEST PROTOCOLS FOR TREATMENT OF CHILDHOOD CANCER, PROVIDING THE COMMUNITY AND REGION WITH THE BEST PRACTICES AND TREATMENT RESULTS FROM MORE THAN 250 (285 TOTAL) COG-MEMBER HOSPITALS IN NORTH AMERICA, AUSTRALIA, NEW ZEALAND, EUROPE, AND SAUDI ARABIA. OUR PRIMARY GOAL IS TO INCREASE PARTICIPATION IN CLINICAL TRIALS WHICH WE FEEL WILL ADVANCE THE FIELD OF PEDIATRIC ONCOLOGY. IN FY21, CHKD HAD 110 COG STUDIES INCLUDING LTF STUDIES OPEN TO ENROLLMENT OR UNDERGOING DATA ANALYSIS. SEVERAL OF THESE STUDIES WERE INCLUDED IN COG'S LONG-TERM FOLLOW-UP STUDY, WHICH COLLECTS DATA ON PATIENTS WHO HAVE PARTICIPATED IN STUDIES THAT ARE NO LONGER OPEN TO ENROLLMENT. IN ALL, OVER 200 CHKD PATIENTS PARTICIPATED IN EITHER OPEN OR FOLLOW-UP COG STUDIES IN FY21.THE HEMATOLOGY ONCOLOGY DIVISION HAD 21 RESEARCH STUDIES OPEN THAT WERE NOT COG STUDIES. IN FY21, CHKD HOSTED 5 CONTINUING MEDICAL EDUCATION EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE REGION. HELPING CHILD HEALTH EXPERTS IN OUR REGION KEEP UP WITH THEIR SKILLS AND THEIR ACCREDITATION. (THREE CONFERENCES WERE CANCELED DUE TO COVID-19.) THERE WERE NINE REGULARLY SCHEDULED SERIES FOR A TOTAL OF 177 ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6 LINE 6: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK CORPORATION WITH A SOLE MEMBER. THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS CHILDREN'S HEALTH SYSTEM, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS MANAGED BY ITS SOLE MEMBER, CHILDREN'S HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A LINE 7A: CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, MANAGES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. ACCORDINGLY, THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED. AS A VIRGINIA NON-STOCK CORPORATION, CHILDREN'S HEALTH SYSTEM, INC., HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. THE MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC., THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. ARE THE CLASS A MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. (I.E., THE THEN CURRENT MEMBERS IN GOOD STANDING OF THE NORFOLK CITY UNION OF THE KING'S DAUGHTERS, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION) AND THE CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM INC. (I.E., THE THEN CURRENT DIRECTORS ON THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC.). FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED USING THE ANNUAL FINANCIAL STATEMENTS THAT ARE REVIEWED BY THE BOARD AND AUDITED ANNUALLY AS A PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC. UPON COMPLETION OF THE DRAFT OF THE RETURN A DETAIL REVIEW IS PERFORMED BY SEVERAL MEMBERS OF STAFF AND MANAGEMENT. PRIOR TO FILING WITH THE IRS, THE BOARD IS PROVIDED A COPY TO REVIEW. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT POLICY CONSIDERATIONS: CHKD CONFLICT OF INTEREST POLICY INCLUDES OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES, KEY EMPLOYEES, ALL OTHER EMPLOYEES, PROFESSIONAL STAFF AND SUBSTANTIAL DONORS. ANNUALLY, A QUESTIONNAIRE IS DISTRIBUTED AND COLLECTED FROM OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES AND KEY EMPLOYEES. THE QUESTIONNAIRES ARE REVIEWED BY THE LEGAL DEPARTMENT. FOR KNOWN CONFLICTS, THE PERSON INVOLVED RECUSES HIMSELF OR HERSELF FROM DELIBERATIONS REGARDING THE TRANSACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY ARE REPORTED TO THE CHKD BOARD CHAIR OR THE CHKD COMPLIANCE OFFICER, AS APPLICABLE, AND MAY REQUIRE CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15B LINE 15A: COMPENSATION PROCESS CONSIDERATIONS: CHILDREN'S HEALTH SYSTEM ESTABLISHES THE COMPENSATION OF THE CEO JAMES DAHLING. LINE 15B: CHILDREN'S HEALTH SYSTEM AND CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS USE THE FOLLOWING PROCESS TO ESTABLISH COMPENSATION FOR OFFICERS AND KEY EMPLOYEES: AN INDEPENDENT COMPENSATION CONSULTANT APPROVED AND RETAINED BY THE COMPENSATION COMMITTEE OF THE BOARD ANNUALLY, USUALLY IN APRIL, PROVIDES EDUCATION AND PRESENTS TO THE FULL BOARD COMPARATIVE SALARIES AND SALARY RANGES FROM A DATABASE COMPRISED OF CHILDREN'S HOSPITALS AND OTHER APPLICABLE HOSPITALS FOR OFFICERS & EXECUTIVES FOR THE BOARD TO REVIEW. THE COMPENSATION COMMITTEE WITH THE AID OF THE CONSULTANT REVIEWS AND MAKES DECISIONS AS TO EXECUTIVE SALARIES OF CHKD AND ITS SUBSIDIARIES. THOSE SALARY CHANGES AND APPROVALS ARE CONTEMPORANEOUSLY DOCUMENTED BY MINUTES MAINTAINED BY THE COMPENSATION COMMITTEE AND SIGNED BY THE CHAIRMAN OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS (PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC.) ALONG WITH GOVERNING DOCUMENTS OF THE ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC THROUGH DIRECT INQUIRY AND REQUEST. FORM 990, PART XI, LINE 9: GAIN/LOSS ON DERIVATIVE INVESTMENTS 19,719,855. CHANGE IN DONOR RESTRICTED CONTRIBUTIONS 4,396,552. 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