2022-05-11T08:01:26-05:00 2021-06-30 135565207 KPMG LLP 550 SOUTH HOPE STREET LOS ANGELES CA 90071 990 2020-07-01 330528802 CHILDREN'S HOSPITAL AT MISSION CHIL 7149973000 1201 WEST LA VETA AVENUE ORANGE CA 92868 KERRI RUPPERT SCHILLER EVP/CFO/ASSISTANT SECRETARY 7145098451 2022-04-29 1 KERRI RUPPERT SCHILLER 999009999 JAMES R LANCASTER P00742579 2139724000 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z KIMBERLY C CRIPE 1201 WEST LA VETA AVENUE ORANGE CA 92868 65022734 0 X WWW.CHOC.ORG X 1991 CA TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. 10 9 181 89 0 0 136347 5235104 78529858 59697246 133986 51095 5874 39289 78806065 65022734 26000000 16475000 0 0 17053701 16112879 0 0 0 42329278 36136706 85382979 68724585 -6576914 -3701851 40292163 55659576 11808760 30637987 28483403 25021589 TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. 0 0 65252075 16475000 59697246 CHILDREN'S HOSPITAL AT MISSION (CCMH) PROVIDES SPECIALIZED PEDIATRIC SERVICES FOR THE MEDICAL/SURGICAL CARE OF CHILDREN FROM BIRTH TO AGE 18. THERE WERE 6,791 INPATIENT CARE DAYS; 7,902 EMERGENCY ROOM VISITS; 432 SURGERIES AND 12,566 OUTPATIENT VISITS. SEE OUR COMPLETE COMMUNITY BENEFIT REPORT ON OUR WEBSITE AT WWW.CHOC.ORG. 65252075 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 X 34 0 1 181 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MARY NGUYEN 7145094124 1201 WEST LA VETA AVENUE ORANGE CA 928683874 KIMBERLY CRIPE DIRECTOR/PRESIDENT 2.00 38.00 X X 0 1794655 103462 DOUGLAS MCCOMBS DIRECTOR/VICE CHAIR 1.00 4.00 X X 0 0 0 JANET T DAVIDSON DIRECTOR 1.00 2.00 X 0 0 0 MARSHALL ROWEN MD DIRECTOR 1.00 3.00 X 0 0 0 JOE KIANI DIRECTOR/VICE CHAIR 1.00 2.00 X 0 0 0 JIM MORRIS DIRECTOR 1.00 2.00 X 0 0 0 THOMAS PHELPS DIRECTOR 1.00 1.00 X 0 0 0 KEN POTROCK DIRECTOR 1.00 1.00 X 0 0 0 KIMBERLY SENTOVICH DIRECTOR 1.00 2.00 X 0 0 0 MARIA MINON MD DIRECTOR (FROM 9/20) 1.00 1.00 X 0 0 0 CHRIS FURMAN CHAIR 1.00 5.00 X X 0 0 0 MATTHEW GERLACH EVP/COO (TO 12/20) 5.00 35.00 X 0 922583 80210 KERRI RUPPERT SCHILLER EVP/CFO/ASSISTANT SECRETARY 3.00 37.00 X 0 903062 73762 JAY GABRIEL CHIEF LEGAL OFFICER/SECRETARY 3.50 36.50 X 0 692908 78770 PAUL VAN DOLAH INTERIM EVP/COO (FROM 12/20) 5.00 35.00 X 0 88116 0 EMMA SANDHU VP, ADMIN/CNO 40.00 0.00 X 355494 0 60195 JAMES CAPPON INTERIM CMO 2.00 38.00 X 0 580101 60209 BONNIE GRAVETT CLINICAL NURSE IV NICU 40.00 0.00 X 200177 0 25141 KRISTY HAFFAR CHARGE NURSE 40.00 0.00 X 182375 0 16626 EVA ESMAEILI NURSE MANAGER-NICU 40.00 0.00 X 181604 0 30375 ALLISON LEE O'BRIEN CHARGE NURSE 40.00 0.00 X 183490 0 14789 BRONWYN STACKLEATHER DIRECTOR, CLINICAL SERVICE 40.00 0.00 X 203860 0 23933 1307000 4981425 567472 44 0 1 0 AYA HEALTHCARE INC PO BOX 123519 DALLAS TX 753123519 TEMPORARY STAFFING 744624 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 PATIENT ACCOUNTING 155291 2 144164 5090940 5235104 NET PATIENT SERVICES 621400 59697246 59697246 59697246 51095 51095 OTHER MISCELLANEOUS RE 621400 39289 39289 39289 65022734 59697246 0 90384 X 16475000 16475000 383107 191554 191553 12320809 11088728 1232081 455079 409571 45508 1735393 1561854 173539 1218491 1096642 121849 11453652 10308287 1145365 6129 5516 613 7054 7054 19092475 18940070 152405 378823 340941 37882 709834 638851 70983 1577883 1420095 157788 971 874 97 3667 3300 367 1019896 917906 101990 347661 312895 34766 PROVIDER FEE EXPENSE 1481424 1481424 0 LICENSE AND TAXES 34487 31038 3449 OSHPD FEE 20672 18605 2067 2078 1870 208 68724585 65252075 3472510 0 331714 2176082 10012551 9446177 13767618 12754451 2012707 3028013 23968037 17643909 6128162 6324128 5800679 5800679 2238732 16130046 40292163 55659576 1449530 2786021 6009170 10438011 4350060 17413955 11808760 30637987 X 27396716 23937610 1086687 1083979 28483403 25021589 40292163 55659576 -3701851 240037 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7054 7054 0 PART II-B, LINE 1: GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES FORM 990, SCHEDULE C, PART II-B, LINE 1I DURING FYE 06/30/2021, CHILDREN'S HOSPITAL AT MISSION PAID DUES TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, $7,054 OF WHICH SUPPORTED LOBBYING PURPOSES. 14354942 10442779 3912163 8509275 7201130 1308145 1103820 1103820 6324128 OTHER RECEIVABLE 3300 PROVIDER FEE PROGRAM RECEIVABLE 697994 RECEIVABLES FROM RELATED PARTY 85382 OPERATING LEASE ROU ASSETS 14491777 BENEFICIAL INT IN FDN 41024 INVESTMENT IN OCMRRG 810569 16130046 DUE TO RELATED PARTIES 2922178 OPERATING LEASE LIABILITY 14491777 17413955 X PART X, LINE 2: U.S. GAAP REQUIRES THE ORGANIZATION'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2021, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 1 X 1 1 0 1 1 24137 24137 0.00040 16537129 8295094 8242035 0.11990 16561266 8295094 8266172 0.12030 11277 11277 0.00020 11277 11277 0.00020 16572543 8295094 8277449 0.12050 4 37321 600 36721 0.00050 4 37321 600 36721 0.00050 1 3670428 X 1 1 1 1 CHILDREN'S HOSPITAL AT MISSION 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 WWW.CHOC.ORG 060000348 X X X CHILDREN'S HOSPITAL AT MISSION 0 0 1 X X X X X X X X X 19 1 1 0 1 X SEE PART V, SECTION C X 1 19 1 SEE PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X X 1 X HTTPS://WWW.CHOC.ORG/PATIENTS-FAMILY/PAY-BILL/ X HTTPS://WWW.CHOC.ORG/PATIENTS-FAMILY/PAY-BILL/ X HTTPS://WWW.CHOC.ORG/PATIENTS-FAMILY/PAY-BILL/ X X X X X X 1 X 0 X X X X 1 X 0 0 CHILDREN'S HOSPITAL AT MISSION PART V, SECTION B, LINE 5: CHILDREN'S HOSPITAL AT MISSION (CCMH) AND ITS AFFILIATE, CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) CONDUCTED THE CHNA PROCESS IN THE FALL OF 2019, WITH INPUT AND DATA FROM NUMEROUS AUTHORITATIVE, PUBLICLY AVAILABLE SOURCES, A SURVEY OF COMMUNITY LEADERS FROM VARIOUS BUSINESSES, SOCIAL SERVICE, AND PUBLIC AGENCIES AND A SURVEY OF THE COMMUNITY-AT-LARGE. THE CHNA REPORT INCLUDES BOTH PRIMARY AND SECONDRAY DATA ANALYSES THAT FOCUS ON THE HEALTH AND SOCIAL NEEDS OF THE POPULATION IN EACH CHOC HOSPITAL'S PRIMARY SERVICE AREA. CHILDREN'S HOSPITAL AT MISSION PART V, SECTION B, LINE 6A: CHOC AND CCMH TOGETHER CONDUCTED THE HEALTH NEEDS ASSESSMENTS.SCHEDULE H, PART V, LINES 7A & 10ABOTH THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT THE FOLLOWING URL: HTTP://CHOC.ORG/ABOUT BY CLICKING THE LINKS LABELED "COMMUNITY BENEFIT PLAN AND "COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA)". CHILDREN'S HOSPITAL AT MISSION PART V, SECTION B, LINE 11: ADDRESSING HIGH PRIORITY COMMUNITY HEALTH NEEDS CCMH COORDINATES ITS RESPONSE TO ITS MOST RECENT CHNA WITH ITS LARGER AFFILIATE, CHOC.CHOC'S AND CCMH'S MOST RECENT CHNA IDENTIFIED TWELVE HIGH-PRIORITYNEEDS:MENTAL HEALTH AND AUTISM, ACCESS TO PEDIATRIC SPECIALISTS, IMMUNIZATIONS AND INFECTIOUS DISEASES, SUBSTANCE ABUSE, PEDIATRIC OBESITY, RESPIRATORY ILLNESS, ORAL HEALTH, COLLABORATION AND PARTNERSHIPS WITH SCHOOL PROGRAMS, BULLYING AND OTHER STRESSORS IN SCHOOL, PEDIATRIC DIABETES,COST OF CHILD CARE, AND HOUSING AFFORDABILITY. THE LAST TWO PRIORITY NEEDS, COST OF CHILD CARE AND HOUSING AFFORDABILITY, ARE NOT ADDRESSED IN THE IMPLEMENTATION PLAN AS CHOC HAS NEITHER THE RESOURCES OR EXPERTISE TO ADDRESS. OVER THE NEXT THREE YEARS, CHOC IS INVESTING APPROXIMATELY$3.7M, THAT INCLUDES THE HIRING OF APPROXIMATELY 13 FTES, TO ASSIST IN DEVELOPING SCHOOL-BASED INITIATIVES AND PROGRAMS TO HELP ADDRESS THE PRIORITY NEEDS IDENTIFIED. SPECIFIC INITIATIVES FOR THE HIGH-PRIORITY NEEDS ARE AS FOLLOWS:1) MENTAL HEALTH AND AUTISMCHOC AND CCMH, IN PARTNERSHIP WITH COMMITTED ORGANIZATIONS AND COMMUNITY GROUPS, ASPIRES TO CREATE AN OUTSTANDING MENTAL HEALTH SYSTEM OF CARE FOR ALL CHILDREN, TEENS AND YOUNG ADULTS IN ORANGE COUNTY. OUR GOAL IS TO PROVIDE A COMPREHENSIVE APPROACH TO PEDIATRC MENTAL ILLNESS.TO FULFILL THIS INITATIVE, CHOC BUILT AN INPATIENT CHILDREN'S MENTAL HEALTH CENTER WHICH OPENED IN APRIL 2018. THE NEW CENTER HAS 18 BEDS IN A SECURED AND HEALING ENVIRONMENT, IN ADDITION TO AN OUTDOOR AREA FOR RECREATION. THE CENTER PROVIDES A SAFE, NUTURING PLACE FOR CHILDREN AGES3 TO 18, AND SPECIALTY PROGRAMMING FOR CHILDREN YOUNGER THAN 12. IN ADDITION, CHOC AND CCMH BUILT THE THOMPSON AUTISM CENTER WHICH OPENED IN JANUARY 2019. THE NEW CENTER IS DEDICATED TO BRINGING THE LATEST TREATMENTS AND RESOURCES TO THE AUTISM COMMUNITY IN ORANGE COUNTY. THROUGH UNIQUEPROGRAMS, CHILDREN HAVE A CENTRALIZED PLACE WHERE THEY CAN RECEIVE EARLY DIAGNOSIS, ADVANCED THERAPY AND THE POSSIBILITY TO REACH THEIR TRUE POTENTIAL.THE OPENING OF THE INPATIENT CENTER AND THE THOMPSON AUTISM CENTER AUGMENTS MENTAL HEALTH SERVICES ALREADY OFFERED BY CHOC AND CCMH. THOSE SERVICES INCLUDE CHOC'S AND CCMH'S OUTPATIENT EATING DISORDERS PROGRAM, OUTPATIENT PROGRAMS TO KEEP STRUGGLING CHILDREN OUT OF THE HOSPITAL AND ASSISTANCE TO THOSE WHO HAVE BEEN RELEASED, AND MENTAL HEALTH SERVICES FOR CHOC AND CCMH PATIENTS BEING TREATED FOR SERIOUS/CHRONIC ILLNESSES.2) ACCESS TO PEDIATRIC SPECIALTIES/SUBSPECIALTIES CHOC AND CCMH RECOGNIZE THE COMMUNITY NEED FOR ACCESS TO PEDIATRIC SPECIALISTS/SUBSPECIALISTS AND CONTINUES TO BUILD THE RESOURCES AVAILABLE THROUGHOUT THE COMMUNITIES SERVED BY CHOC AND CCMH. CHOC'S MEDICAL FOUNDATION WAS CREATED IN 2011, AND SINCE THAT TIME HAS CONTINUED TO GROW TO PROVIDE THE SPECIALTY SERVICES SOUGHT BY THE COMMUNITY AND INDICATD AS A HIGH PRIORITY IN THE MOST RECENTLY COMPLETED COMMUNITY NEEDS ASSESSMENT. THE SPECIALTY PHYSICIAN GROUPS THAT HAVE CONTRACTED WITH CHOC AND CCMH TO PROVIDE THE SERVICES HAVE GROWN TO A TOTAL OF 270 PROVIDERS AND OFFERS EXPERTISE AND CARE IN OVER 23 PEDIATRIC MEDICAL SPECIALTIES. IN THE PAST YEAR, THE PHYSICIAN GROUP HAS ADDED THE FULL TIME EQUIVALENT OF OVER 17 PROVIDERS.3) IMMUNIZATIONS AND INFECTIOUS DISEASES: CHOC AND CCMH ASPIRE TO IMPROVE OVERALL IMMUNIZATION COMPLETION RATES FOR ORANGE COUNTY CHILDREN, LEADING TO A REDUCTION IN IMMUNIZATION PREVENTABLE DISEASES. CHOC AND CCMH ARE IDENTIFYING OPPORTUNITIES FOR PROVIDING VACCINES AT EVERY PRIMARY CARE VISIT AND IS COORDINATING DIRECT PHYSICIAN-TO-PHYSICIAN DISCUSSIONS TO ENSURE ALL BARRIERS TO COMPLETING IMMUNIZATIONS ARE ADDRESSED. EDUCATIONAL MATERIALS REGARDING THE EFFICACY AND SAFETY OF VACCINES IS MADE AVAILABLE TO ALL CHOC AND CCMH PROVIDERS AND PATIENTS. GREATER EFFORT WILL BE MADE TO INCREASE AVAILABILITY OF MATERIAL TO THE BROADER PUBLIC. CHOC'S AND CCMH'S COMMUNITY EDUCATION DEPARTMENT HAVE IMPLEMENTED PROJECT DULCE THAT PAIRS A FAMILY SPECIALIST WITH NEWBORNS THROUGH AGE 6 MONTHS AND THEIR FAMILIES AT THE SANTA ANA BOYS AND GIRLS CLINIC AND CLINICA CHOC PARA NINOS. THE FAMILY SPECIALIST ENSURES FAMILIES ARE KEEPING AND ATTENDING ALL VISITS AND MAINTAINING COMPLIANCE WITH VISIT RECOMMENDATIONS INCLUDING VACCINATIONS.4) SUBSTANCE ABUSECHOC AND CCMH ARE INCREASING EDUCATION TO PROVIDE ADDITIONAL TREATMENT OPTIONS TO LOCAL PROVIDERS, INCLUDING INCREASED OUTREACH TO LOCAL SCHOOLS AND COMMUNITIES. CHOC'S AND CCMH'S EMERGENCY DEPARTMENT SCREENS CHILDREN 11 AND OLDER WHO PRESENT FOR AN EMERGENCY PSYCHIATRIC CONCERN TO DETERMINE LEVEL OF CONCERNING SUBSTANCE USE AND PROVIDE BRIEF ALCOHOL AND OTHER DRUG EDUCATION AS WELL AS REFERRALS FOR TREATMENT IF CONCERNING LEVELS ARE IDENTIFIED. THESE STRATEGIES WILL INDUCE PREVENTION AS WELL AS ALLOWING FOR EARLIER IDENTIFICATION OF SUBSTANCE USE IN CONJUNCTION WITH MENTAL HEALTH DISORDERS FOR EARLY LINKAGE TO SERVICES.5) OBESITY CHOC AND CCMH HAVE CONVENED A MULTI-DISCIPLINARY COALITION OF COMMUNITY MEMBERS TO WORK ON THE ISSUE OF OBESITY. THIS TASK FORCE INCLUDES REPRESENTATIVES FROM THE HEALTH CARE COMMUNITY (PHYSICIANS, DIETICIANS AND PSYCHOLOGISTS), THE UNIVERSITY OF CALIFORNIA - IRVINE, ORANGE COUNTY SOCIAL SERVICES AND THE SCHOOL DISTRICTS THROUGHOUT THE COMMUNITY. EFFORTS TO DATE INCLUDE OFFERING CLASSES AND EDUCATIONAL MATERIALS AND A KIDS FIT CLUB. ADEQUATE AND PROPER NUTRITION IS IMPORTANT FOR A CHILD'S NORMAL GROWTH AND DEVELOPMENT. CHOC'S AND CCMH'S CLINICAL NUTRITION AND LACTATION SERVICES AIM TO BE A RELIABLE SOURCE OF NUTRITION AND LACTATION INFORMATION FOR OUR PATIENTS, FAMILIES AND COMMUNITY. WE ARE HERE TO HELP PATIENTS WITH GROWTH AND DEVELOPMENT, WHILE GIVING THEM A FOUNDATION FOR LIFELONG HEALTH AND WELLNESS. WE PROVIDE FAMILY-CENTERED, CULTURALLY SENSITIVE CARE THAT IS CUSTOMIZED FOR EVERY INDIVIDUAL, USING EVIDENCE-BASED TECHNIQUES AND BEST PRACTICES WITH A MULTI-DISCIPLINARY APPROACH.6) RESPIRATORY ILLNESSRESPIRATORY ILLNESS IS A CRITICAL CONCERN IN ORANGE COUNTY AS NEARLY 14% BARRIERS TO ADDRESSING RESPIRATORY ILLNESSES INCLUDE LACK OF ACCESS TO PEDIATRIC SUBSPECIALISTS, AND LANGUAGE AND CULTURAL PERSPECTIVES TO UNDERSTANDING AND MANAGING RESPIRATORY DISEASES. THROUGH USE OF THE BREATHMOBILE AND THE DEVELOPMENT OF SCHOOL-BASED WELLNESS CENTERS IN PARTNERSHIP WITH THE ORANGE COUNTY DEPARTMENT OF EDUCATION, CHOC WILL ENGAGE CHILDREN AND FAMILIES IN THE COMMUNITY, IN A CULTURALLY AND LINGUISTICALLY COMPETENT MANNER. THIS, ALONG WITH EFFORTS TO ASSURE FRONTLINE PROVIDERS ARE USING STATE OF THE ART APPROACHES TO CARE, WILL IMPROVE CONTROL OF ASTHMA SYMPTOMS WITH CONCURRENT REDUCTIONS IN EMERGENCY DEPARTMENT UTILIZATION, HOSPITAL ADMISSIONS, AND SCHOOL ABSENTEEISM. ORANGE COUNTY'S PEDIATRIC POPULATION HAVE BEEN DIAGNOSED WITH ASTHMA. CARE WILL BE BROUGHT TO CHILDREN BY CONTINUING TO DEPLOY THE BREATHMOBILE UNIT TO SCHOOLS AND COMMUNITIES AS WELL AS DEVELOPING SCHOOL BASED WELLNESS CENTERS IN PARTNERSHIP WITH THE ORANGE COUNTY DEPARTMENT OF EDUCATION.7) ORAL HEALTHCHOC AND CCMH SEEK TO ENHANCE ACCESS TO DENTAL PREVENTATIVE CARE SERVICES AND IMPROVE THE PREVENTION OF DENTAL CAVITIES IN THE BROADER POPULATION OF CHILDREN, WHICH WILL REDUCE DENTAL DISEASE AND COMPLICATIONS. CHOC AND CCMH WILL EXPAND TELEDENTISTRY SERVICES TO INCLUDE MORE WEEKDAY AND WEEKEND HOURS IN CHOC'S AND CCMH'S PRACTICE LOCATIONS. CHOC AND CCMH WILL ALSO INCREASE DISTRIBUTION AND EDUCATION FOR TOPICAL FLUORIDE APPLICATION AT PRIMARY CARE WELL-VISITS FOR ALL PATIENTS IN THE CHOC HEALTH ALLIANCE NETWORK. CHOC AND CCMH WILL CONTINUE TO PROVIDE SCREENING SERVICES AND MORE EDUCATION TO FAMILIES REGARDING DENTAL HEALTH.8) COLLABORATION AND PARTNERSHIPS WITH SCHOOL PROGRAMSCOLLABORATION AND PARTNERSHIPS WITH SCHOOL PROGRAMS IS A WAY TO OVERCOME BARRIERS WHEN ADDRESSING OTHER CRITICAL ISSUES IDENTIFIED IN THE CHNA. CHOC AND CCMH WILL COLLABORATE WITH THE ORANGE COUNTY DEPARTMENT OF EDUCATION TO ENHANCE THE PHYSICAL, MENTAL, EMOTIONAL, AND EDUCATIONAL HEALTH OF THE CHILDREN IN ORANGE COUNTY. CHOC'S AND CCMH'S ASTHMA OUTREACH PROGRAM PROVIDES EDUCATION, DIAGNOSIS AND TREATMENT VIA THE BREATHMOBILE AND THROUGH THE LUNCH AND LEARN PROGRAM TO SCHOOL PERSONNEL AND TO CHILDREN WITH ASTHMA. THE BREATHMOBILE PROGRAM HAS AGREEMENTS WITH VARIOUS LOCATIONS THROUGHOUT THE COUNTY TO PROVIDE ACCESS TO CARE. SCHEDULE H, PART V, LINE 11 - CONTINUED 9) BULLYING AND OTHER STRESSORS IN SCHOOL BULLYING AND OTHER STRESSORS IN SCHOOL CAN CAUSE CHRONIC ABSENTEEISM AND CAN EXACERBATE OTHER CRITICAL HEALTH ISSUES SUCH AS MENTAL HEALTH, OBESITY, AND HUNGER. TO REDUCE THESE STRESSORS, CHOC AND CCMH WILL IMPLEMENT UNIVERAL SCREENING ACROSS ALL ORANGE COUNTY PRIMARY CARE PEDIATRIC OFFICES. CHOC HEALTH ALLIANCE, WIITH OVERSIGHT OF 150,000 OF THE MOST VULNERABLE CHILDREN IN ORANGE COUNTY, WILL ALIGN ITS INCENTIVE PROGRAM WITH COMPLETION OF SCREENING TO HELP PRACTICES OPERATIONALIZE SCREENING COMPLETION. SCREENING WILL AID IN THE EARLY IDENTIFICATION AND REFERRAL OF AT-RISK YOUTH TO COMMUNITY, SOCIAL AND MENTAL/BEHAVIORAL HEALTH SERVICES AND WILL ULTIMATELY REDUCE SCHOOL ABSENTEEISM, IMPROVEMENT IN GRADE PROGRESSION, AND REDUCTION IN SUICIDE/VIOLENT EVENTS.10) PEDIATRIC DIABETESOBESITY AND DIABETES ARE MAJOR CONTRIBUTORS TO THE LEADING CAUSES OF DEATH INCLUDING HEART DISEASE, STROKE, AND CERTAIN CANCERS.CHALLENGES TO ADDRESSING DIABETES INLCUDE A LACK OF ACCESS TO HEALTHY FOODS, LACK OF PARTNERSHIPS AND COLLABORATIONS WITH OTHER AGENCIES, INCREASED SOCIAL MEDIA EXPOSURE AND SCREEN TIME AND DECREASED PHYSICAL ACTIVITY. CHOC SEEKS TO REDUCE THE RATE OF PEDIATRIC DIABETES IN THE COMMUNITY THROUGH THE IDENTIFICATION OF CHILDREN WITH ELEVATED BMI VALUES, INCREASING ACCESS TO PROGRAMS SUCH AS PODER (PREVENTION OF OBESITY AND DIABETES THROUGH EDUCATION AND RESOURCES), AND ENSURING THAT PRIMARY CARE PHYSICIANS IN CHOC'S NETWORK HAVE ACCESS TO SPECIFIC DIABETES SCREENING GUIDLEINES TO IDENTIFY HIGH-RISK CHILDREN. THESE STRATEGIES WILL LEAD TO EARLIER INSTITUTION OF MEDICAL AND LIFESTYLE INTERVENTIONS. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY CHOC AND CCMH ANNUALLY AND IS FILED IN ACCORDANCE WITH CALIFORNIA SB697. PART I, LINE 7: THE ORGANIZATION USES THE COST-TO-CHARGE RATIO METHODOLOGY TO DETERMINE THE COST OF CHARITY CARE AND UNREIMBURSED COST OF CARE PROVIDED TO MEDI-CAL PATIENTS. COSTS ARE ACCOUNTED FOR USING AN INTERNAL DECISION SUPPORT SYSTEM. THE COST-TO-CHARGE RATIO FOLLOWS THE METHOD DEFINED BY THE MEDICARE COST REPORT AND IS UPDATED MONTHLY USING THE MOST RECENT ORGANIZATIONAL INFORMATION.PROVIDER FEE PROGRAMCCMH RECOGNIZED REVENUES FOR THE 6-MONTH PROGRAM OF $2,184,000 AND PROVIDER FEES AND OTHER EXPENSES OF $729,000. IN ADDITION, CMS ISSUED FINAL APPROVAL DURING FY2021 OF THE FEE FOR SERVICE PORTION OF THE 30 MONTH PROGRAM ENDED JUNE 30, 2021. UNDER THIS PORTION OF THE PROGRAM, CCMH RECOGNIZED REVENUES OF $3,194,000 AND PROVIDER FEES AND OTHER EXPENSES OF $1,930,000. THE AMOUNTS WERE RECOGNIZED AS NET PATIENT REVENUE AND OPERATING EXPENSES, REPSECTIVELY, IN THE FISCAL YEAR ENDED JUNE 30, 2021. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY BUILDING ACTIVITIESCOMMUNITY SUPPORT IS BEST EXEMPLIFIED BY THE ORGANIZATION'S INCREASED EMPHASIS ON COMMUNITY OUTREACH AND COMMUNITY EDUCATION, WHICH INCLUDES INJURY PREVENTION SAFETY AND WELLNESS. THE ORGANIZATION HAS 84 DIFFERENT COMMUNITY BENEFIT PROGRAMS CATEGORIZED ACCORDING TO THE CALIFORNIA COMMUNITY BENEFITS LAW, SB697. WITHIN THESE CATEGORIES, THE CATEGORY WHICH MOST CLOSELY CORRELATES TO LINE 3, COMMUNITY SUPPORT, IS HEALTHCARE ACCESS. THROUGH HEALTHCARE ACCESS, THE ORGANIZATION INCREASES ACCESS TO QUALITY PEDIATRIC HEALTHCARE RESOURCES AND INFORMATION TO FAMILIES, ESPECIALLY LOW-INCOME AND MEDICALLY UNDERSERVED, THROUGHOUT ORANGE COUNTY. THIS IS ACCOMPLISHED THROUGH COMMUNITY OUTREACH CLINICS AND EDUCATION. PART III, LINE 2: THE ORGANIZATION CHARGES BAD DEBT FOR (A) THE WRITE-OFF OF PATIENT ACCOUNTS WHERE FAMILIES DID NOT COOPERATE IN THE COMPLETION OF MEDI-CAL OR CHARITY CARE APPLICATIONS AND WHERE INSUFFICIENT INFORMATION COULD BE OBTAINED REGARDING THE FINANCIAL STATUS OF THE FAMILY, AND (B) A PROVISION FOR OUTSTANDING ACCOUNTS RECEIVABLE FROM SELF-PAY (INCLUDING PENDING MEDI-CAL AND PENDING CHARITY) ACCOUNTS. UNDER NEW REVENUE RECOGNITION CRITERIA, ACCOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT ARE NOW RECORDED AS DEDUCTIONS FROM REVENUE.THE ORGANIZATION APPLIES ITS CHARITY CARE POLICY TO DETERMINE ELIGIBILITY BASED ON FAMILIES' SATISFYING THE APPLICATION REQUIREMENTS AND THE ORGANIZATION'S ELIGIBILITY CRITERIA. THE ORGANIZATION DOES, HOWEVER, HAVE FAMILIES WHO FAIL TO COMPLETE THE REQUIRED PAPERWORK DESPITE THE ORGANIZATION'S EFFORTS TO EDUCATE ALL FAMILIES OF THE CHARITY CARE OPTIONS. IN THESE CASES, AN ASSESSMENT OF CHARITY CARE ELIGIBILITY IS MADE BASED ON KNOWN INFORMATION. PART III, LINE 3: THE HOSPITAL FOLLOWS HFMA STATEMENT 15 AND THEREFORE NO PART OF BAD DEBT, AS DEFINED BY STATEMENT 15, REPRESENTS AMOUNTS ATTRIBUTABLE TO PATIENTS ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE. PART III, LINE 4: AUDITED FINANCIAL STATEMENT FOOTNOTE: PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT THE INVOICED AMOUNT, NET OF ANY EXPECTED CONTRACTUAL ADJUSTMENTS AND DO NOT BEAR INTEREST. THE ORGANIZATION HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS AT AMOUNTS DIFFERENT FROM THE ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. PATIENT SERVICES REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. CONTRACTUAL ADJUSTMENTS ARISING UNDER REIMBURSEMENT ARRANGEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ARE ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. IMPLICIT PRICE CONCESSIONS ARE TAKEN BASED ON HISTORICAL COLLECTION EXPERIENCE AND REFLECT THE ESTIMATED AMOUNTS THE ORGANIZATION EXPECTS TO COLLECT. PART III, LINE 8: AS A CHILDREN'S HOSPITAL, CCMH MEDICARE ALLOWABLE COSTS ARE ZERO. THEREFORE, THERE IS NO AMOUNT ENTERED ON PART III LINE 6 AND NO MEDICARE SHORTFALL REPORTED ON LINE 7. PART III, LINE 9B: THE HOSPITAL'S WRITTEN BAD-DEBT COLLECTION POLICY STATES THE FOLLOWING:1. IF A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM (FAP) AND IS MAKING EVERY EFFORT TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, CCMH OR ITS AGENT WILL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID ACCOUNT TO AN OUTSIDE AGENCY IF DOING SO MAY NEGATIVELY IMPACT A PATIENT'S CREDIT. IF CCMH IS FORCED TO SEND THE ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY WILL REFLECT THE REDUCED PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE FAP. AT NO TIME WILL A PATIENT ACCOUNT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY IF THE ACCOUNT IS LESS THAN 150 DAYS FROM ORIGINAL BILLING.2. IN DEALING WITH IDENTIFIED UNINSURED PATIENTS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL, CCMH WILL NOT USE WAGE GARNISHMENTS OR LIENS ON PATIENT'S OR PATIENT FAMILY'S PRIMARY RESIDENCE AS A MEANS OF COLLECTING UNPAID CCMH BILLS. THIS REQUIREMENT DOES NOT PRECLUDE CCMH FROM PURSUING REIMBURSEMENT FROM THIRD PARTY LIABILITY SETTLEMENTS. PART VI, LINE 2: NEEDS ASSESSMENT:IN ADDITION TO THE TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENT, CCMH REGULARLY TRACKS KEY DEMOGRAPHIC CHANGES IN THE PEDIATRIC POPULATION OF ITS COMMUNITY AND THE UTILIZATION OF KEY SERVICES DELIVERED, AND EVALUATES THE PROGRAMS IT PROVIDES TO MEET IDENTIFIED NEEDS. THROUGH CONSTANT CONTACT WITH A VARIETY OF COMMUNITY CONSTITUENTS, CCMH IS ABLE TO LEARN ABOUT EMERGING TRENDS AND NEEDS. IT THEN EVALUATES OPTIONS TO MEET THOSE NEEDS, EITHER ALONE OR IN COLLABORATION WITH OTHERS IN THE COMMUNITY.ALL OF THE PROGRAMS ASSOCIATED WITH THE COMMUNITY HEALTH NEEDS ASSESSMENT ARE AVAILABLE IN THE REPORT ON THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTP://CHOC.ORG/ABOUT AS WELL AS A PAPER COPY THAT IS AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:PATIENTS ARE INFORMED OF THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE HOSPITAL'S CHARITY CARE POLICY IN OUR FINANCIAL ASSISTANCE AND DISCOUNT PROGRAM POLICY. THIS INFORMATION, EITHER IN FULL OR IN SUMMARY, IS POSTED IN ALL OF THE HIGH TRAFFIC PATIENT AREAS: ADMITTING, EMERGENCY ROOM, CLINIC AND THE BUSINESS OFFICE. THE PATIENTS ARE ALSO INFORMED IF THERE IS A FINANCIAL NEED IDENTIFIED BY THE HOSPITAL FINANCIAL COUNSELORS WHEN SPEAKING TO THE FAMILIES ABOUT THEIR INSURANCE OR LACK OF INSURANCE. PATIENTS ARE PROVIDED A COPY OF THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE ANDDISCOUNT PAYMENT PROGRAM POLICY. FAMILIES ARE ALSO NOTIFIED ON EVERY PATIENT STATEMENT THAT IF THERE IS A FINANCIAL NEED, THEY SHOULD CALL THE DESIGNATED PHONE NUMBER FOR MORE INFORMATION AND ASSISTANCE. FINANCIAL ASSISTANCE COMMUNICATION: AS PART OF THE HOSPITALS' ONGOING PUBLIC AWARENESS CAMPAIGNS, THE MISSION STATEMENTS (INCLUDING THE FINANCIAL ASSISTANCE POLICY) ARE INCLUDED WHEREVER POSSIBLE ON PROGRAM BROCHURES,FACILITY BROCHURES, MEDICAL EDUCATION INFORMATION, COMMUNITY EDUCATION MATERIALS, CONFERENCE INVITATIONS AND ADMISSION MATERIALS. ADDITIONALLY,THE HOSPITALS' FINANCIAL ASSISTANCE POLICY IS EMPHASIZED IN PUBLIC RELATIONS AND MEDIA RELATIONS EFFORTS, FOUNDATION CAMPAIGNS, AND SELECTED MARKETING CAMPAIGNS. THE FINANCIAL ASSISTANCE POLICY IS ALSO INCLUDED AS PART OF THE ANNUAL COMMUNITY BENEFIT REPORT. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN ENGLISH AND SPANISH. PART VI, LINE 4: COMMUNITY INFORMATION: THE HOSPITAL SERVES ALL OF ORANGE COUNTY AND A LIMITED NUMBER OF PATIENTS FROM THE WESTERN RIM OF RIVERSIDE COUNTY, THE NORTHERN PORTION OF SAN DIEGO COUNTY AND SOUTHEAST AREAS OF LOS ANGELES COUNTY. THE PRIMARY SERVICE AREA IS THE SOUTHERN PORTION OF ORANGE COUNTY, AND IS THE SOURCE OF APPROXIMATELY 84% OF ITS PATIENTS. SIGNIFICANT CITIES IN THIS AREA ARE: MISSION VIEJO, SAN CLEMENTE, SAN JUAN CAPISTRANO, LAGUNA NIGUEL, RANCHO SANTA MARGARITA, LAGUNA HILLS, AND LAKE FOREST. THE SECONDARY SERVICE AREA INCLUDES ALL THE OTHER ORANGE COUNTY CITIES AND UNINCORPORATED AREAS. THE COMMUNITY SERVED BY THE HOSPITAL INCLUDES FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS.COMMUNITY CHARACTERISTICS: POPULATION AND SOCIOECONOMIC DATA PROJECTIONS HAVE BEEN COLLECTED FROM A VARIETY OF LOCAL COUNTY AND STATE SOURCES REPRESENTING COMMUNITY DEMOGRAPHIC,SOCIAL AND ECONOMIC FACTORS, HEALTH ACCESS AND UTILIZATION, AND RESOURCES AVAILABLE IN THE COMMUNITY FOR THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT, THE MOST RECENTLY AVAILABLE. ORANGE COUNTY'S POPULATION IS 3,252,459, MAKING IT THE THIRD MOST POPULOUS COUNTY IN CALIFORNIA. THE MEDIAN AGE IS 37.4, AND CHILDREN UP TO 18 YEARS OF AGE MAKE UP 22.1% OF THE TOTAL POPULATION. THE MEDIAN FAMILY INCOME IN THE COUNTY IS APPROXITMATELY $88,453. IN THE CHOC SERVICE AREA. 16.4% OF CHILDREN UNDER THE AGE OF 18 LIVE IN POVERTY, COMPARED TO 20.8% OF CALIFORNIA'S CHILDREN. THIS INDICATOR VARIES ACROSS THE COUNTY, WITH 24.7% OF CHILDREN IN SANTA ANA LIVING IN POVERTY COMPARED TO 1.7% OF CHILDREN IN YORBA LINDA. CHILDREN OF LOW INCOME FAMILIES WILL BE ELIGIBLE FOR MEDI-CAL AND POTENTIALLY CCS (CALIFORNIA CHILDREN'S SERVICES) IF THEY HAVE A QUALIFING CONDITION. ORANGE COUNTY'S POPULATION IS DIVERSE, WITH 49.2% OF THE POPUATION BEING WHITE; 1.8% BEING BLACK/AFRICAN AMERICAN; .6% BEING AMERICAN INDIAN/ALASKA NATIVE; 18.1% BEING ASIAN; .3% BEING PACIFIC ISLANDER; 8.8% IDENTIFYING AS MULTIPLE RACES; AND 21.2% AS OTHER. OF THE TOTAL ORANGE COUNTY POPULLATION, 48.7% IDENTIFY AS HISPANIC ETHNICITY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHCHILDREN'S HEALTHCARE OF CALIFORNIA (CHC) IS THE NOT-FOR-PROFIT, TAX-EXEMPT PARENT CORPORATION OF CHOC AND CCMH. THE HOSPITALS ARE THE PRINCIPAL TERTIARY AND QUATERNARY PEDIATRIC HOSPITALS SERVING ORANGE COUNTY AND ARE THE ONLY HOSPITALS EXCLUSIVELY SERVING INFANTS, CHILDREN AND ADOLESCENTS. CCMH ALSO OFFERS PEDIATRIC TRAUMA SERVICES TO THE COMMUNITY. THE ORGANIZATION IS COMPRISED OF TWO HOSPITALS; SEVERAL PRIMARY AND SPECIALTY CLINICS, PROGRAMS AND SERVICES; AND FOUR CENTERS OF EXCELLENCE, THE CHOC HEART, NEUROSCIENCE, ONCOLOGY AND ORTHOPAEDIC INSTITUTES. CHOC ALSO HAS A RESEARCH INSTITUTE PERFORMING BASIC SCIENCE AND CLINICAL RESEARCH. THROUGH ITS RESIDENCY PROGRAM, THE ORGANIZATION ALSO TRAINS TOMORROW'S PHYSICIANS. THE COMMUNITY BENEFIT PLAN FOR THE FISCAL YEAR ENDING JUNE 30, 2021, DESCRIBES THE BENEFIT PLANNING PROCESS, THE BENEFITS PROVIDED, AND THE ECONOMIC VALUE OF THE BENEFITS. COMMUNITY BENEFITS ARE FREE OR SUBSIDIZED PROGRAMS AND SERVICES PROVIDED TO MEET IDENTIFIED COMMUNITY NEEDS AND TO SERVE THE PUBLIC INTEREST. THE ORGANIZATION'S COMMUNITY BENEFIT PLAN IS AVAILABLE ONLINE AT: HTTP://WWW.CHOC.ORG/ABOUT.THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPOSED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF.CLINICAL PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS AS MEMBERS OF THE MEDICAL STAFF. MEDICAL STAFF MEMBERS PROVIDE PATIENT CARE AND HAVE ACCESS TO HOSPITAL RESOURCES(INCLUDING EQUIPMENT, FACILITIES AND PERSONNEL) WHICH ARE NECESSARY TO EFFECTIVELY EXERCISE THEIR PRIVILEGES. PHYSICIANS ARE QUALIFIED TO BE MEMBERS OF THE MEDICAL STAFF IF THEY MEET THE FOLLOWING CRITERIA: SECTION 1. NATURE OF MEDICAL STAFF MEMBERSHIP ON THE MEDICAL STAFF OF CCMH IS A PRIVILEGE THAT SHALL BE EXTENDED ONLY TO PROFESSIONALLY COMPETENT PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS SET FORTH IN THESE BYLAWS. A PRACTITIONER MAY ADMIT OR PROVIDE SERVICES TO PATIENTS IN THE HOSPITAL ONLY IF THE PRACTITIONER IS A MEMBER OF THE MEDICAL STAFF OR HAS BEEN GRANTED TEMPORARY PRIVILEGES IN ACCORDANCE WITH THE BYLAWS, RULES AND REGULATIONS. APPOINTMENT TO THE MEDICAL STAFF SHALL CONFER ONLY SUCH CLINICAL PRIVILEGES AND PREROGATIVES AS HAVE BEEN GRANTED IN ACCORDANCE WITH THESE BYLAWS. SECTION 2. QUALIFICATIONS FOR MEMBERSHIP A. ONLY PRACTITIONERS WHO HOLD AN UNRESTRICTED LICENSE TO PRACTICE MEDICINE, DENTISTRY, PODIATRY OR CLINICAL PSYCHOLOGY IN THE STATE OF CALIFORNIA, WHO CAN DOCUMENT THE FOLLOWING WITH SUFFICIENT ADEQUACY TO ASSURE THE MEDICAL STAFF AND THE GOVERNING BODY THAT ANY PATIENT TREATED BY THEM IN THE HOSPITAL WILL RECEIVE CARE OF THE GENERALLY RECOGNIZED PROFESSIONAL LEVEL AND EFFICIENCY ESTABLISHED BY THE MEDICAL STAFF AND HOSPITAL, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF THEIR BACKGROUND; EDUCATION; EXPERIENCE; JUDGMENT; TRAINING; DEMONSTRATED CURRENT COMPETENCE; ABILITY TO COMMUNICATE INCLUDING A DEMONSTRATED PROFICIENCY IN THE ENGLISH LANGUAGE SUCH THAT THERE IS REASONABLE ASSURANCE THAT THERE WILL BE NO RISK OF MISUNDERSTANDING IN COMMUNICATION WITH ENGLISH SPEAKING COLLEAGUES, PATIENTS AND HEALTH CARE WORKERS; PHYSICAL AND MENTAL HEALTH STATUS; ADHERENCE TO THE ETHICS OF THEIR PROFESSION; GOOD REPUTATION; AND ABILITY TO WORK WITH OTHERS. NO PRACTITIONER SHALL BE ENTITLED TO MEMBERSHIP ON THE MEDICAL STAFF OR TO THE EXERCISE OF PARTICULAR CLINICAL PRIVILEGES IN THE HOSPITAL MERELY BECAUSE HE IS DULY LICENSED TO PRACTICE MEDICINE, DENTISTRY, CLINICAL PSYCHOLOGY OR PODIATRY IN THIS OR IN ANY OTHER STATE, HOLDS A CERTAIN DEGREE, IS CERTIFIED BY ANY CLINICAL BOARD, OR THAT HE IS A MEMBER OF SOME PROFESSIONAL ORGANIZATION, OR THAT HE HAD IN THE PAST, OR PRESENTLY HAS SUCH PRIVILEGES AT ANOTHER HOSPITAL INCLUDING BUT NOT LIMITED TO MISSION HOSPITAL OR CHOC. NO APPLICANT SHALL BE DENIED MEMBERSHIP ON THE BASIS OF SEX, SEXUAL ORIENTATION, RACE, RELIGION, ANCESTRY, AGE, CREED, COLOR, NATIONAL ORIGIN, MARITAL STATUS, HANDICAP OR DISABILITY (EXCEPT TO THE EXTENT THE HANDICAP OR DISABILITY PREVENTS THE PRACTITIONER FROM PERFORMING ESSENTIAL FUNCTIONS OR POSES A HEALTH OR SAFETY RISK TO THE PRACTITIONER OR OTHERS AND THE HANDICAP OR DISABILITY CANNOT BE REASONABLY ACCOMMODATED OR ON THE BASIS OF ANY OTHER CRITERION THAT IS NOT RELATED TO AN INDIVIDUAL'S PROFESSIONAL CAPABILITIES (CCMH MEDICAL STAFF BYLAWS). B. ONLY PRACTITIONERS WHO MAINTAIN IN FORCE PROFESSIONAL LIABILITY INSURANCE IN NOT LESS THAN THE MINIMUM AMOUNTS JOINTLY DETERMINED BY THE GOVERNING BODY AND THE MEDICAL STAFF EXECUTIVE COMMITTEE, BUT IN NO EVENT LESS THAN $1.0 MILLION PER INCIDENT AND $3.0 MILLION IN THE AGGREGATE IN A POLICY YEAR, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF. THE INSURANCE MUST COVER ALL PRIVILEGES THE PRACTITIONER IS GRANTED BY THE BODY. A CARRIER ADMITTED TO DO BUSINESS IN CALIFORNIA OR A MUTUAL COOPERATIVE TRUST MUST PROVIDE THE INSURANCE. INFORMATION REGARDING EACH APPLICANT'S AND MEMBER'S INSURANCE COVERAGE MUST BE PROVIDED IN THE FORM OF A CURRENT CERTIFICATE OF INSURANCE WHICH SHALL BE MAINTAINED IN EACH PRACTITIONER'S CREDENTIALS FILE. INFORMATION REGARDING INSURANCE COVERAGE MUST BE PROVIDED AT THE TIME OF APPOINTMENT AND REAPPOINTMENT AND IMMEDIATELY UPON RECEIPT OF EACH ANNUAL RENEWAL CERTIFICATE. EACH MEMBER SHALL REPORT TO THE MEDICAL STAFF SERVICES OFFICE ANY REDUCTION, RESTRICTION, CLAIMS, CANCELLATION OR TERMINATION OF THE REQUIRED PROFESSIONAL LIABILITY INSURANCE OR CHANGE IN CARRIER IMMEDIATELY UPON THE NOTICE OF ACTION OR CHANGE. C. ACCEPTANCE OF MEMBERSHIP ON THE MEDICAL STAFF SHALL CONSTITUTE THE STAFF MEMBER'S CERTIFICATION THAT HE HAS IN THE PAST, AND HIS AGREEMENT THAT HE WILL IN THE FUTURE, BEHAVE ACCORDING TO ETHICAL PRINCIPLES APPLICABLE TO HIS PROFESSION, AND WILL ABIDE BY ALL STATE AND FEDERAL LAWS AND REGULATIONS GOVERNING THE PROFESSION, INCLUDING, BUT NOT LIMITED TO, MEDICARE/MEDICAID LAWS AND REGULATIONS. FURTHER, ALL MEMBERS OF THE MEDICAL STAFF SHALL PLEDGE THAT THEY WILL NOT RECEIVE FROM, OR PAY TO ANOTHER PHYSICIAN, DENTIST, CLINICAL PSYCHOLOGIST OR PODIATRIST, EITHER DIRECTLY OR INDIRECTLY, ANY PART OF A FEE RECEIVED FOR PROFESSIONAL SERVICES AND THEY WILL NOT DECEIVE A PATIENT AS TO THE IDENTITY OF AN OPERATING SURGEON, OR ANY OTHER MEDICAL PRACTITIONER PROVIDING TREATMENT. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: CCMH AND CHOC ARE MEMBERS OF A TWO-HOSPITAL SYSTEM. BOTH HOSPITALS HAVE A SOLE CORPORATE MEMBER, CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), THAT PROVIDES MANAGEMENT SERVICES TO BOTH HOSPITALS. THE HOSPITALS SHARE A COMMON MISSION AND ARE STRATEGICALLY ALIGNED IN THEIR EFFORT TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY.SCHEDULE H, PART VI, LINE 7A COMMUNITY BENEFIT REPORT IS FILED ANNUALLY IN THE STATE OF CALIFORNIA. 1 CHILDREN'S HEALTHCARE OF CALIFORNIA 1201 WEST LA VETA AVENUE ORANGE CA 92868 330265266 501(C)(3) 16475000 N/A N/A SUPPORT 1 PART I, LINE 2: PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS THE GRANT FROM CCMH TO CHC WAS IN ACCORDANCE WITH THE BYLAWS OF BOTH ORGANIZATIONS. X X X X 0 1 0 0 0 0 0 0 0 KIMBERLY CRIPE DIRECTOR/PRESIDENT 0 1106414 0 397073 0 291168 0 68315 0 35147 0 1898117 0 49744 MATTHEW GERLACH EVP/COO (TO 12/20) 0 641030 0 141983 0 139570 0 37846 0 42364 0 1002793 0 25431 KERRI RUPPERT SCHILLER EVP/CFO/ASSISTANT SECRETARY 0 603953 0 147954 0 151155 0 44383 0 29379 0 976824 0 23844 JAY GABRIEL CHIEF LEGAL OFFICER/SECRETARY 0 500216 0 100072 0 92620 0 36419 0 42351 0 771678 0 16777 JAMES CAPPON INTERIM CMO 0 431800 0 85603 0 62698 0 17845 0 42364 0 640310 0 13772 EMMA SANDHU VP, ADMIN/CNO 282000 0 57185 0 16309 0 59527 0 668 0 415689 0 0 0 BRONWYN STACKLEATHER DIRECTOR, CLINICAL SERVICE 186123 0 17712 0 25 0 3850 0 20083 0 227793 0 0 0 BONNIE GRAVETT CLINICAL NURSE IV NICU 191080 0 3008 0 6089 0 11328 0 13813 0 225318 0 0 0 EVA ESMAEILI NURSE MANAGER-NICU 171983 0 9596 0 25 0 10305 0 20070 0 211979 0 0 0 KRISTY HAFFAR CHARGE NURSE 172111 0 4500 0 5764 0 4934 0 11692 0 199001 0 0 0 ALLISON LEE O'BRIEN CHARGE NURSE 170077 0 7500 0 5913 0 0 0 14789 0 198279 0 0 0 PART I, LINE 4B SEVERANCE ARRANGEMENTS PART I, LINE 4A SOME OF THE ORGANIZATION'S PERSONNEL LISTED ON FORM 990 PART VII AND SCHEDULE J PARTICIPATE IN A SEPARATION ARRANGEMENT THAT PROVIDES FOR A PORTION OF THE EMPLOYEE'S ANNUAL SALARY BASED ON THEIR POSITION IN THE ORGANIZATION. FOR THE SENIOR EXECUTIVE LEVEL, THE AMOUNT IS BASED ON YEARS OF SERVICE UP TO A MAXIMUM NUMBER OF MONTHS. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PART I, LINE 4B CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN EFFECTIVE JANUARY 1, 2010 IN WHICH CERTAIN INDIVIDUALS LISTED ON THE FORM 990, PART VII AND SCHEDULE J ARE PARTICIPANTS. UNDER THE ESTABLISHED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE PLAN) OR SERP, FOR EACH PLAN YEAR THAT BEGINS PRIOR TO THE PARTICIPANT'S CASH DATE, CHOC SHALL CREATE A NEW SERP ACCOUNT ON ITS BOOKS FOR THE PARTICIPANT AND SHALL CREDIT TO SUCH ACCOUNT AT TIMES SPECIFIED. THE PARTICIPANTS OF THE PLAN ARE GENERAL CREDITORS OF THE COMPANY. THE PARTICIPANT'S SERP ACCOUNT SHALL BE UTILIZED SOLELY AS A DEVICE FOR THE MEASUREMENT AND DETERMINATION OF THE AMOUNTS TO BE PAID TO THE PARTICIPANT UNDER THIS PLAN. THE PARTICIPANT IS ENTITLED TO HIS/HER SERP BENEFIT AMOUNT UPON THE EARLIEST OF (1) REMAINING EMPLOYED WITH THE COMPANY TO THE THIRD ANNIVERSARY OF THE FIRST DAY OF THE PLAN YEAR FOR WHICH THE SERP ACCOUNT WAS CREATED; (2) REMAINING EMPLOYED WITH THE COMPANY TO THE PARTICIPANT'S 60TH BIRTHDAY; (3) REMAINING EMPLOYED WITH THE COMPANY TO THE DATE THE PARTICIPANT HAS BOTH ATTAINED AT LEAST AGE 55 AND HAS COMPLETED AT LEAST 10 YEARS OF SERVICE; (4) DISABILITY; (5) INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE; (6) VOLUNTARY SEPARATION FROM SERVICE FOR GOOD REASON OR (7) DEATH. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN DURING CALENDAR YEAR 2021. MS. CRIPE ($216,367), MS. SCHILLER ($103,710), MR. GABRIEL ($73,241), MR. GERLACH ($110,616), AND MR. CAPPON ($61,513.) COMPENSATION FROM AN AFFILIATED ORGANIZATION KIMBERLY C. CRIPE IS COMPENSATED THROUGH CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), HOWEVER, IN ADDITION TO HER RESPONSIBILITIES FOR CHC, SHE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHOC FOUNDATION, CRC REAL ESTATE CORPORATION AND CHILDREN'S HOSPITAL AT MISSION (ALL IRC SECTION 501(C)(3) AFFILIATES). MS. CRIPE DEVOTES APPROXIMATELY 5% OF HER TIME EACH WEEK TO CHILDREN'S HOSPITAL AT MISSION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS AFFAIRS. KERRI RUPPERT SCHILLER IS COMPENSATED THROUGH CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), HOWEVER, IN ADDITION TO HER RESPONSIBILITIES FOR CHC, SHE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHOC FOUNDATION, CRC REAL ESTATE CORPORATION AND CHILDREN'S HOSPITAL AT MISSION (ALL IRC SECTION 501(C)(3) AFFILIATES). MS. SCHILLER DEVOTES APPROXIMATELY 5% OF HER TIME EACH WEEK TO CHILDREN'S HOSPITAL AT MISSION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS AFFAIRS. MATTHEW GERLACH IS COMPENSATED THROUGH CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), HOWEVER, IN ADDITION TO HIS RESPONSIBILITIES FOR CHC, HE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHILDREN'S HOSPITAL AT MISSION AND CRC REAL ESTATE CORPORTATION (ALL IRC SECTION 501(C)(3) AFFILIATES). MR. GERLACH DEVOTES APPROXIMATELY 13% OF HIS TIME EACH WEEK TO CHILDREN'S HOSPITAL AT MISSION RESPONSIBILITIES WITH THE BALANCE OF HIS TIME BEING SPENT ON CHILDREN'S HOSPITAL OF ORANGE COUNTY BUSINESS AFFAIRS. FORM 990, PART I, LINE 5 AND PART V, LINE 2 CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) ACTS AS A COMMON PAYMASTER, ISSUING FORMS W-2 AND 1099 ON BEHALF OF CHILDREN'S HOSPITAL AT MISSION. CHILDREN'S HOSPITAL AT MISSION HAS 153 EMPLOYEES, HOWEVER BECAUSE OF THE COMMON PAYMASTER ARRANGEMENT RESULTING IN THE FORMS W-2 BEING ISSUED UNDER CHOC'S EMPLOYER IDENTIFICATION NUMBER, THERE ARE NO W-2S ISSUED DIRECTLY BY CHILDREN'S HOSPITAL AT MISSION. FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATION MEMBER INFORMATION THE SOLE MEMBER OF CHILDREN'S HOSPITAL AT MISSION (CHM) IS CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC). FORM 990, PART VI, SECTION A, LINE 7A PLEASE SEE THE EXPLANATION FOR LINE 7B. FORM 990, PART VI, SECTION A, LINE 7B ORGANIZATION MEMBER INFORMATION THE APPROVAL OF THE MEMBER SHALL BE REQUIRED WITH RESPECT TO ANY OF THE FOLLOWING ACTIONS: (1) CHANGING THE PURPOSES AND POWERS OF CHM; (2) OBLIGATING CHM TO UNDERTAKE ANY CAPITAL EXPENDITURE IN EXCESS OF $5,000,000; (3) ADOPTING CHM'S ANNUAL OPERATING AND CAPITAL BUDGETS; (4) ADOPTING A LONG-TERM CAPITAL BUDGET; (5) BUYING, SELLING, LEASING, MORTGAGING, PLEDGING, OR OTHERWISE HYPOTHECATING ANY REAL PROPERTY; (6) INCURRING ANY INDEBTEDNESS IN EXCESS OF $5,000,000; (7) OBLIGATING CHM TO ACT AS GUARANTOR WITH RESPECT TO ANY DEBT OF ANY PERSON OR OTHER ENTITY; (8) ACCEPTING ANY DONATION WHICH IS CONDITIONED UPON CHM'S UNDERTAKING ANY UNBUDGETED CAPITAL EXPENDITURE IN EXCESS OF $5,000,000 OR ANY UNBUDGETED EXPENDITURE IN EXCESS OF $5,000,000; (9) ENTERING INTO ANY CONTRACT WHICH INVOLVES THE FOLLOWING: (A) ANY FINANCIAL OBLIGATION ON THE PART OF CHM IN AN AMOUNT IN EXCESS OF $5,000,000 OR (B) ANY PURPOSE OR ACTIVITY WHICH IS OUTSIDE THE SCOPE OF CHM'S ORDINARY COURSE OF BUSINESS. (10) INVOLVING CHM IN ANY MERGER, ACQUISITION, CORPORATE RESTRUCTURING, OR FORMAL AFFILIATION; (11) INVOLVING CHM AS A MEMBER, SHAREHOLDER, OR PARTNER IN ANY NEW CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITY; (12) DISSOLVING CHM; (13) ENTERING INTO ANY TRANSACTION INVOLVING THE SALE, CONVEYANCE, EXCHANGE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF CHM'S ASSETS; (14) AMENDING CHM'S ARTICLES OF INCORPORATION; (15) ADOPTING NEW BYLAWS OR AMENDING EXISTING BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS OF REVIEW PRIOR TO FILING, THE TAX RETURN AND RELATED SCHEDULES ARE PROVIDED TO THE CHOC EXECUTIVE COMPENSATION COMMITTEE, AN EMPOWERED BOARD COMMITTEE DELEGATED WITH THIS AUTHORITY. THE CHIEF FINANCIAL OFFICER REVIEWS THE MATERIALS WITH THE COMMITTEE PRIOR TO FILING THE FINAL RETURN. PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE, A COMPLETE COPY OF THE FINAL FORM 990 IS ALSO SHARED ELECTRONICALLY WITH ALL BOARD MEMBERS VIA DIRECTOR'S DESK, A SECURE WEB SITE THAT PROVIDES A CONFIDENTIAL AND SECURE ACCESS FOR ALL BOARD MATERIALS TO OUR BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 12C MONITORING/ENFORCING COMPLIANCE OF CONFLICT OF INTEREST POLICY THE CHIEF COMPLIANCE OFFICER IS CHARGED WITH MONITORING PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. PURSUANT TO THE CONFLICT OF INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, AIMED AT DETERMINING ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT, IS DISTRIBUTED TO ALL COVERED PERSONS (I.E., BOARD MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP OR KEY EMPLOYEES). COVERED PERSONS ARE REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME WHEN SUCH CONFLICTS ARISE. WHEN AN INDIVIDUAL BECOMES A COVERED PERSON AND ANNUALLY THEREAFTER, EACH COVERED PERSON IS REQUIRED TO SIGN A STATEMENT AFFIRMING THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY AND UNDERSTANDS SAID POLICY; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICT OF INTEREST QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE OFFICER AND ANY PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS ARE INFORMED VIA WRITTEN COMMUNICATION. THE PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD OF DIRECTORS; (2)THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED; (3) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM ANY DISCUSSION OR APPROVAL OF SUCH TRANSACTION; (4) ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; (5) THE TRANSACTION OR ACTION MUST BE APPROVED BY A MAJORITY OF DISINTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION DETERMINATION AN INDEPENDENT BOARD COMMITTEE OF THE ORGANIZATION CHARGED WITH THE DUTIES OF THE COMPENSATION COMMITTEE, WHOSE MEMBERS ARE DISINTERESTED AND INDEPENDENT, IS IN PLACE WITH A WRITTEN COMPENSATION COMMITTEE CHARTER. THIS COMMITTEE ANNUALLY RETAINS AN INDEPENDENT HEALTHCARE COMPENSATION CONSULTING FIRM TO PROVIDE RELEVANT COMPARABILITY DATA AND OTHER COMPENSATION STUDIES. THE CEO, OFFICERS AND EXECUTIVE MANAGEMENT SALARIES, INCENTIVES AND BENEFITS, AS WELL AS OVERALL COMPENSATION PHILOSOPHY AND POLICIES, ARE DISCUSSED WITH THE INDEPENDENT CONSULTANT REPRESENTATIVES AND THE COMPENSATION COMMITTEE MEMBERS, IN PERSON, IN CLOSED SESSIONS WITH NO STAFF MEMBERS PRESENT. THIS ANNUAL REVIEW WAS LAST PERFORMED IN OCTOBER 2021. ALL COMPARATIVE MARKET DATA, SUCH AS ANNUAL COMPENSATION SURVEY COMPRISED OF A PEER GROUP OF COMPARABLY SIZED PEDIATRIC HOSPITALS, IS WELL DOCUMENTED AND THERE ARE MINUTES FROM THESE MEETINGS THAT DOCUMENT THE MEMBERS PRESENT AND VOTING, THE COMPARATIVE DATA USED AND HOW IT WAS OBTAINED AND THE DELIBERATIONS AND DECISIONS OF THE COMMITTEE. THE RESULTS AND RECOMMENDATIONS FROM THE COMMITTEE ARE SHARED IN AN EXECUTIVE SESSION WITH THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE FOR PUBLIC INSPECTION. FORM 990 AND THE COPY OF AUDITED FINANCIAL STATEMENTS ATTACHED TO IT ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G NURSING REGISTRY PERSONNEL: PROGRAM SERVICE EXPENSES 125,075. MANAGEMENT AND GENERAL EXPENSES 13,897. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 138,972. MEDICAL PHYSICIANS: PROGRAM SERVICE EXPENSES 6,748. MANAGEMENT AND GENERAL EXPENSES 750. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,498. DR-DIRECT-INFECTION CONTROL: PROGRAM SERVICE EXPENSES 10,800. MANAGEMENT AND GENERAL EXPENSES 1,200. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,000. DR-DIRECT-OPHTHALMOLOGY: PROGRAM SERVICE EXPENSES 25,380. MANAGEMENT AND GENERAL EXPENSES 2,820. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,200. DR-COVERG-NEUROLOGICAL SURG: PROGRAM SERVICE EXPENSES 98,550. MANAGEMENT AND GENERAL EXPENSES 10,950. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,500. DR-COVERG-NEUROLOGY: PROGRAM SERVICE EXPENSES 90,000. MANAGEMENT AND GENERAL EXPENSES 10,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100,000. DR-COVERG-NICU: PROGRAM SERVICE EXPENSES 75,600. MANAGEMENT AND GENERAL EXPENSES 8,400. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,000. DR-COVERG-PICU: PROGRAM SERVICE EXPENSES 526,199. MANAGEMENT AND GENERAL EXPENSES 58,467. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 584,666. DR-COVERG-SURGERY GENERAL: PROGRAM SERVICE EXPENSES 158,374. MANAGEMENT AND GENERAL EXPENSES 17,597. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 175,971. COLLECTION AGENCY SERV FEES: PROGRAM SERVICE EXPENSES 201,761. MANAGEMENT AND GENERAL EXPENSES 22,418. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 224,179. OTHER MISC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 53,040. MANAGEMENT AND GENERAL EXPENSES 5,893. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,933. MISC PURCH SVCS - COVID 19: PROGRAM SERVICE EXPENSES 117. MANAGEMENT AND GENERAL EXPENSES 13. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 130. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 17,568,426. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,568,426. CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 WEST LA VETA AVENUE ORANGE CA 92868 952321786 HEALTHCARE CA 501(C)(3) LINE 3 CHC 0 CHOC FOUNDATION 1201 WEST LA VETA AVENUE ORANGE CA 92868 956097416 FUNDRAISING CA 501(C)(3) LINE 7 CHC 0 CRC REAL ESTATE CORPORATION 1201 WEST LA VETA AVENUE ORANGE CA 92868 330612565 REAL ESTATE CA 501(C)(3) LINE 11 CHC 0 CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC) 1201 WEST LA VETA AVENUE ORANGE CA 92868 330265266 HEALTHCARE CA 501(C)(3) LINE 7 N/A 0 ORANGE COUNTY MEDICAL RECIPROCAL INS CO 2999 NORTH 4TH STREET SUITE 250 PHOENIX TX 85108 201620666 INSURANCE AZ CHOC C 35291 3602306 0.50000 0 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0