2022-05-13T15:25:54-05:00 2021-06-30 366055558 GRANT THORNTON LLP 1000 WILSON BLVD SUITE 1400 ARLINGTON VA 22209 990 2020-07-01 530196580 CHILDREN'S HOSPITAL CHIL 3015723502 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 ALDWIN LINDSAY CFO 3015723502 2022-05-13 1 ALDWIN LINDSAY MARY TORRETTA P00847851 7038477500 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z CHILDREN'S NATIONAL HOSPITAL KURT DOUGLAS NEWMAN MD 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 1767630790 0 X WWW.CHILDRENSNATIONAL.ORG X 1870 DC SEE SCHEDULE O. 10 9 8513 794 1099499 -308874 85105614 58540048 1191972532 1253800132 5887558 12340686 -6076045 -1752338 1276889659 1322928528 0 0 0 0 740162751 762971951 0 0 0 498566229 518132970 1238728980 1281104921 38160679 41823607 1849683254 2170063672 1084047001 1343954392 765636253 826109280 X SEE SCHEDULE O. 0 0 959412750 1243775498 CHILDREN'S HOSPITAL DBA CHILDREN'S NATIONAL HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER DBA CHILDREN'S NATIONAL IS THE PARENT COMPANY OF THE HOSPITAL. CHILDREN'S NATIONAL AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE H, PART VI FOR COMPLETE FY21 COMMUNITY BENEFIT REPORT. 959412750 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 0 0 1 1 0 1 0 0 0 1 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 601 0 1 8513 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 10 9 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X CORPORATE OFFICERS 3015723502 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 39.00 16.00 X X 2128231 0 300163 SCHONAY BARNETT-JONES BOARD CHAIR 2.00 2.00 X X 0 0 0 AMANDA LELAND BOARD MEMBER 1.00 0.00 X 0 0 0 MARY GEN LEDECKY BOARD MEMBER 1.00 0.00 X 0 0 0 CAROLINE VAN VLECK MD BOARD MEMBER 1.00 1.00 X 0 0 0 AMY FREEMAN BOARD VICE CHAIR 2.00 0.00 X X 0 0 0 ARTENCIA HAWKINS-BELL BOARD MEMBER 1.00 0.00 X 0 0 0 JERRY STOUCK BOARD MEMBER 1.00 0.00 X 0 0 0 JEFF ZIENTS BOARD CHAIRMAN TO 01/21 2.00 5.00 X 0 0 0 PAUL KALB MD BOARD MEMBER 1.00 0.00 X 0 0 0 HORACIO ROZANSKI BOARD MEMBER AS OF 01/21 1.00 3.00 X 0 0 0 MARY ANNE HILLIARD EVP/CHIEF LEGAL OFFICER 35.00 20.00 X 822880 0 126992 ALEC KING EVP/CFO TO 10/20 35.00 20.00 X 702850 0 35922 ALDWIN LINSDAY EVP/CFO AS OF 12/20 35.00 20.00 X 440893 0 38519 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 37.00 18.00 X 1479905 0 187960 ELIZABETH FLURY CHIEF STRATEGIC OFFICER TO 08/20 53.00 2.00 X 1499585 0 36580 DENICE CORA-BRAMBLE MD CHIEF MEDICAL OFFICER TO 03/21 48.00 7.00 X 1241502 0 62467 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 52.00 3.00 X 1206561 0 156799 MARK L BATSHAW MD EVP & CHIEF ACADEMIC OFFICER 29.00 26.00 X 1191198 0 54576 DAVID WESSEL MD CHIEF MEDICAL OFFICER 48.00 7.00 X 1043806 0 87823 ROGER PACKER MD SVP CENTER OF EXCELLENCE 50.00 5.00 X 952191 0 79551 CHARLES WEINSTEIN CHIEF REAL ESTATE OFFICER 54.00 1.00 X 824526 0 14777 DARRYL VARNADO CHIEF PEOPLE OFFICER 54.00 1.00 X 703563 0 64837 VITTORIO GALLO PHD CHIEF RESEARCH OFFICER 1.00 54.00 X 697763 0 98459 LINDA TALLEY CHIEF NURSING OFFICER 54.00 1.00 X 509637 0 54112 MICHELLE M MCGUIRE EVP/CHIEF STRATEGY OFFICER 54.00 1.00 X 485931 0 62148 RICHARD JONAS MD CHIEF OF CARDIOLOGY 55.00 0.00 X 2523554 0 90189 ROBERT KEATING MD CHIEF OF NEUROSURGERY 55.00 0.00 X 1147620 0 118842 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 55.00 0.00 X 1014841 0 38602 RICARDO MUNOZ MD CHIEF OF CARDIAC CRIT MED 55.00 0.00 X 936232 0 82319 DEANN MARSHALL PRESIDENT OF FOUNDATION 1.00 54.00 X 858437 0 60183 BRIAN JACOBS MD FMR CHIEF INFO OFFICER TO 06/19 0.00 0.00 X 386763 0 457 MENDEL TUCHMAN MD FORMER CRO TO 06/17 0.00 0.00 X 127211 0 11530 22925680 0 1863807 1879 1 1 0 CERNER CORPORATION 2800 ROCKCREEK PARKWAY N KANSAS CITY MO 64117 IT 30740936 LAZ KARP ASSOCIATES LLC 1 FINANCIAL PLZ HARTFORD CT 06103 PARKING 3073346 MORRISON MANAGEMENT SPECIALIST LLC 5801 PEACHTREE DUNWOODY RD ATLANTA GA 30342 PURCHASED FOOD SERVICES 1917110 GEORGETOWN UNIVERSITY HOSPITAL 3800 RESERVOIR RD NW WASHINGTON DC 20007 PURCHASED MEDICAL SERVICES 1612986 QUEST DIAGNOSTIC CLINICAL LAB INC 1201 S COLLEGEVILLE RD COLLEGEVILLE PA 19426 LAB TESTING 1608035 149 19145204 33962885 5431959 794839 58540048 PATIENT REVENUE 621400 1143490769 1143490769 ALL OTHER PROGRAM SERV 900099 110309363 110309363 1253800132 8622963 8622963 3372397 0 3372397 3372397 3372397 448110985 309000 444634056 68206 3476929 240794 3717723 3717723 PARKING 812390 3800400 3800400 LAB FEES 621500 1099499 1099499 EQUITY AND PARTNERSHIP 621110 -10024634 -10024634 -5124735 1322928528 1243775498 1099499 19513483 14555219 733112 13822107 158655 158655 623443239 453538750 169904489 24951876 17760612 7191264 57793418 41137046 16656372 42069544 29944877 12124667 2497805 1777924 719881 1573209 1573209 492225 492225 349626 248862 100764 65989554 47286339 18703215 5530915 3936876 1594039 13134204 9348856 3785348 68959284 49084850 19874434 27864243 19833619 8030624 350454 249451 101003 210391 149755 60636 26938294 19174534 7763760 84916332 60442992 24473340 19416379 13820475 5595904 MEDICAL SUPPLIES 137363336 137363336 BAD DEBT EXPENSE 31436139 31436139 REPAIRS AND MAINTENANCE 22606166 16090948 6515218 ALL OTHER EXPENSES 8504414 6053397 2451017 1281104921 959412750 321692171 0 58287616 60361549 2414125 2240981 229575519 328824144 240000 100000 12142450 14636328 47286123 54911176 1715225857 913497753 731634641 801728104 270998571 239232220 6133761 14050171 490970448 653978999 1849683254 2170063672 198727652 234185952 3680119 4464912 380144346 370399269 96944444 352790642 404550440 382113617 1084047001 1343954392 X 765636253 826109280 765636253 826109280 1849683254 2170063672 X 41823607 18042686 606734 X 0 1 X 1 1 1 X 87200911 33258313 24932071 85105614 58540048 289036957 87200911 33258313 24932071 85105614 58540048 289036957 1027453 288009504 2946140 3802733 5535245 7995875 11995360 32275353 4210622 4375469 4441568 4528932 3800400 21356991 342669301 5783712672 0.84050 0.84290 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: PARKING - 2016 AMOUNT: $ 4,210,622. 2017 AMOUNT: $ 4,375,469. 2018 AMOUNT: $ 4,441,568. 2019 AMOUNT: $ 4,528,932. 2020 AMOUNT: $ 3,800,400. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 401430 0 1 90795 492225 0 SCHEDULE C, PART II-B, LINE 1A: VOLUNTEERS COORDINATED THE PARTICIPATION OF THE PATIENT FAMILIES IN THE CHILDREN'S HOSPITAL ASSOCIATION FAMILY ADVOCACY DAY FOCUSED PRIMARILY ON PROTECTING HEALTH CARE SERVICES FOR CHILDREN. SCHEDULE C, PART II-B, LINE 1B: PAID STAFF OR MANAGEMENT FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS AND ADVANCE PUBLIC POLICY THAT SUPPORT THE HEALTH AND WELL-BEING OF CHILDREN. SCHEDULE C, PART II-B, LINE 1G: DIRECT CONTACT THE LOBBYING ACTIVITIES ENGAGED IN BY CHILDREN'S HOSPITAL FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR CHILDREN IN PUBLIC HEALTH PROGRAMS AND ADVANCE PUBLIC POLICY THAT SUPPORTS THE HEALTH AND WELL-BEING OF CHILDREN. THOSE LOBBYING ACTIVITIES INCLUDE CONTINUAL MONITORING OF LEGISLATION VIA DISCUSSIONS WITH LEGISLATIVE STAFF, HOSTING EDUCATIONAL BRIEFING SESSIONS FOR MEMBERS OF CONGRESS, EXECUTIVE BRANCH, STATE AND LOCAL OFFICIALS/STAFF REGARDING CHILD HEALTH ISSUES, AND COORDINATING THE SUBMISSION OF CORRESPONDENCE AND WRITTEN COMMENTS ON PROPOSED LEGISLATION AND REGULATIONS, AS WELL AS THE PRESENTATION OF TESTIMONY BEFORE LEGISLATIVE COMMITTEES. CHILDREN'S HOSPITAL ALSO DEVELOPS POLICY POSITIONS IN RESPONSE TO PROBLEMS AND OPPORTUNITIES IN THE PUBLIC SECTOR. SCHEDULE C, PART II-B, LINE 1I: OTHER ACTIVITIES THE HOSPITAL IS A MEMBER OF THE CHILDREN'S HOSPITAL ASSOCIATION (CHA), AMERICAN HOSPITAL ASSOCIATION (AHA), DISTRICT OF COLUMBIA HOSPITAL ASSOCIATION (DCHA), MARYLAND HOSPITAL ASSOCIATION (MHA) AND VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION (VHHA). ALL OF THE INDUSTRY ASSOCIATIONS THAT THE HOSPITAL IS A MEMBER OF HAVE CHILD ADVOCACY AND LEGISLATIVE ADVOCACY PROGRAMS. 24350843 24350843 353718244 84265847 269452397 875400031 593466320 281933711 343822753 232562027 111260726 117933986 3203559 114730427 801728104 OTHER RECEIVABLES 441349383 DUE FROM AFFILIATES 94224383 OPERATING ROU ASSETS 75039669 DEFERRED COMPENSATION PLAN 43365564 653978999 FINANCE LEASE OBLIGATIONS 146296599 RESERVE FOR CLAIMS 104336159 OPERATING LEASE OBLIGATIONS 84037817 OTHER LIABILITIES 41916004 DUE TO AFFILIATES 3838449 SETTLEMENTS TO THIRD PARTY PAY 1688589 382113617 X PART X, LINE 2: LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL), OF WHICH CHILDREN'S NATIONAL HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: CHILDREN'S NATIONAL EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THERE WAS NO IMPACT ON CHILDREN'S NATIONAL'S FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2021 AND 2020 AS CHILDREN'S NATIONAL HAS NO UNCERTAIN TAX POSITIONS. MIDDLE EAST AND NORTH AFRICA 0 1 PROGRAM SERVICES PATIENT REFFERALS 273422 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES INSURANCE PREMIUMS 13660958 0 1 0 0 0 1 13934380 0 13934380 1 0 0 0 0 0 PART III ACCOUNTING METHOD: PART I, LINE 3, COLUMN F: ACCOUNTING METHOD USED THE EXPENDITURES, PER REGION, ARE PRESENTED ON THE ACCRUAL BASIS OF ACCOUNTING. 1 1 1 X 400.000000000000 1 X 1 1 0 1 1 5586920 5586920 0.00450 133953891 133953891 0.10720 139540811 139540811 0.11170 77177 7937428 3954436 3982992 0.00320 1050 52857204 6833697 46023507 0.03680 1864910 1864910 0.00150 16304 803439 11300 792139 0.00060 94531 63462981 10799433 52663548 0.04210 94531 203003792 10799433 192204359 0.15380 79318 79318 0.00010 8589 94793 1960 92833 0.00010 6990 6990 0.00000 244178 244178 0.00020 320 909825 17876 891949 0.00070 8909 1335104 19836 1315268 0.00110 1 31436139 2144000 2371809 3201675 -829866 X 1 1 1 1 CHILDREN'S HOSPITAL 111 MICHIGAN AVE NW WASHINGTON DC 20010 WWW.CHILDRENSNATIONAL.ORG HFD01-0208 X X X X X X X X CHILDREN'S HOSPITAL 1 0 0 1 X X X X X X X X X X 19 1 1 1 1 X WWW.CHILDRENSNATIONAL.ORG X WWW.DCHEALTHMATTERS.ORG X X 1 19 1 WWW.CHILDRENSNATIONAL.ORG 0 1 X 400.000000000000 400.000000000000 X X X X 1 1 X X X 1 X WWW.CHILDRENSNATIONAL.ORG X WWW.CHILDRENSNATIONAL.ORG X WWW.CHILDRENSNATIONAL.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 3J: CHILDREN'S NATIONAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN PARTNERSHIP WITH THE DC HEALTH MATTERS COLLABORATIVE. THE COLLABORATIVE IS A COALITION OF WASHINGTON, D.C., HOSPITALS AND COMMUNITY HEALTH CENTERS THAT ENVISION AN EQUITABLE AND SUSTAINABLE STATE OF HEALTH FOR ALL DISTRICT OF COLUMBIA RESIDENTS. WE CAME TOGETHER IN 2012 IN RESPONSE TO NEW REQUIREMENTS IN THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 MANDATING NON-PROFIT HOSPITALS TO ISSUE A CHNA AND CORRESPONDING IMPLEMENTATION STRATEGY - REFERRED TO AS OUR "COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP)" - EVERY THREE YEARS.TO DATE, WE HAVE PARTNERED TO COMPLETE THREE JOINT NEEDS ASSESSMENTS IN 2013, 2016 AND 2019, WITH A COMPANION CHIP. THROUGH OUR 2019 CHNA WORK, WE CONNECTED WITH OVER 300 INDIVIDUAL STAKEHOLDERS THROUGH INTERVIEWS, FOCUS GROUPS AND TOWN HALLS. WE ALSO ANALYZED HEALTH CARE AND DEMOGRAPHIC DATA TO CREATE THE CLEAREST POSSIBLE PICTURE OF THE NEEDS OF OUR COMMUNITY. THE 2019 CHNA AND CHIP PLACE ONGOING FOCUS ON THE 2016 CHNA PRIORITIES: MENTAL HEALTH, CARE COORDINATION, HEALTH LITERACY AND PLACE-BASED CARE. WE LEVERAGE THE CAPACITY, EXPERTISE AND RELATIONSHIPS THAT HAVE BEEN BUILT TO ADDRESS THESE NEEDS.DURING OUR MOST RECENT CHNA AND FEATURED IN THE REPORT, CHILDREN'S NATIONAL COORDINATED A UNIQUE OUTREACH AND COMMUNITY ENGAGEMENT EFFORT TO INFORM THE QUALITATIVE DATA. WE PARTNERED WITH THE LATIN AMERICAN YOUTH CENTER (LAYC) AND SEVEN STUDENTS, REPRESENTING A DIVERSE GROUP OF DC HIGH SCHOOLS, ON A PHOTOVOICE PROJECT. PHOTOVOICE IS A QUALITATIVE METHOD USED IN COMMUNITY BASED PARTICIPATORY RESEARCH THAT GIVES VOICE TO UNDERREPRESENTED POPULATIONS THROUGH THE USE OF PHOTOGRAPHY. PHOTOVOICE PROGRAMS ARE A STRUCTURED CREATIVE PROCESS THROUGH WHICH PEOPLE EXPRESS THEIR VOICES, OPINIONS, AND RAISE AWARENESS ABOUT A TOPIC IN THE COMMUNITY. THE STUDENTS WERE SELECTED THROUGH A COMPETITIVE PROCESS AND COMPENSATED TO PARTICIPATE IN THE 12-WEEK PHOTOVOICE AFTER SCHOOL PROGRAM. LAYC STAFF LED THE STUDENTS THROUGH A SERIES OF EDUCATIONAL ACTIVITIES RELATED TO MENTAL HEALTH ISSUES AS WELL AS PHOTOVOICE CONCEPTS. AFTER DISCUSSING THESE TOPICS TOGETHER, PARTICIPANTS WENT OUT INTO THE COMMUNITY WITH CAMERAS TO CAPTURE IMAGES THAT REPRESENTED THEIR PERSPECTIVES RELATED TO THE RISKS AND PROTECTIVE FACTORS RELATED TO MENTAL HEALTH IN THEIR COMMUNITY AND SCHOOLS. THE PHOTOGRAPHS WERE TAKEN IN THE COMMUNITY AND AT THE STUDENTS' HIGH SCHOOLS. SELECTED PHOTOGRAPHS WERE INTERPRETED THROUGH DISCUSSIONS IN A GROUP SETTING AND NARRATIVES WERE DEVELOPED THAT EXPLAIN HOW THE PHOTOS RESPOND TO THE RESEARCH QUESTION. THESE SELECTIONS WERE PRINTED ON CANVAS AND PARTICIPANTS PRESENTED TWO EXHIBITS - ONE AT LATIN AMERICAN YOUTH CENTER AND ANOTHER FOR COMMUNITY HEALTH IMPROVEMENT WEEK AT CHILDREN'S NATIONAL. PART V, SECTION B, LINE 5: IN CONDUCTING THE MOST RECENT CHNA, CHILDREN'S NATIONAL TOOK INTO ACCOUNT INPUT FROM THE DC HEALTH MATTERS COLLABORATIVE MEMBERS WHICH INCLUDES FOUR DC HOSPITALS (CHILDREN'S NATIONAL HEALTH SYSTEM, HOWARD UNIVERSITY HOSPITAL, HSC HEALTH CARE SYSTEM, AND SIBLEY MEMORIAL HOSPITAL) AND FOUR COMMUNITY HEALTH CENTERS (BREAD FOR THE CITY, COMMUNITY OF HOPE, MARY'S CENTER, AND UNITY HEALTH CARE). THE COLLABORATIVE ALSO INCLUDES PARTICIPATION AND INPUT FROM THE DC PRIMARY CARE ASSOCIATION, THE DC HOSPITAL ASSOCIATION, THE DC BEHAVIORAL HEALTH ASSOCIATION, AND DC HEALTH.THE 2019 CHNA USES A CONCURRENT NESTED STUDY DESIGN. THIS DESIGN USES MULTIPLE APPROACHES TO COLLECT DATA, BUT PRIORITIZES ONE APPROACH THAT ULTIMATELY GUIDES THE PROJECT. IN OUR CASE, WE PRIORITIZED QUALITATIVE METHODS THAT FOCUSED ON COLLECTING COMMUNITY PERSPECTIVES. THE OTHER APPROACH - COLLECTING QUANTITATIVE DATA - IS EMBEDDED OR NESTED INTO OUR APPROACH AND PLAYS A SUPPORTING ROLE.IN OUR QUALITATIVE WORK, WE ENGAGED WITH OVER 300 COMMUNITY STAKEHOLDERS ACROSS A DIVERSE CROSS-SECTION OF DC SPANNING HEALTH AND NON-HEALTH DISCIPLINES. USING SEMI-STRUCTURED DATA COLLECTION TOOLS, WE CONDUCTED 32 STAKEHOLDER INTERVIEWS, 7 FOCUS GROUPS, AND A TOWN HALL TO PROBE COMMUNITY PARTNERS ON HOW POLICY AND SYSTEMS CHANGES CAN ADDRESS COMMUNITY NEEDS WITH A PARTICULAR FOCUS ON ELEVATING HEALTH EQUITY IN OUR CITY. AS A SUPPLEMENT TO THE FORMAL QUALITATIVE DATA COLLECTION PROCESS, WE PILOTED A PHOTOVOICE PROJECT WITH A GROUP OF ADOLESCENTS TO SOLICIT THEIR PERSPECTIVES RELATED TO THE INFLUENCE OF SCHOOLS AND COMMUNITIES ON THEIR MENTAL HEALTH. WITH OUR QUALITATIVE METHODS FOCUSED ON COLLECTING COMMUNITY PERSPECTIVES, WE WERE ABLE TO CONSIDER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY OUR COLLABORATIVE ORGANIZATIONS. PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED WITH MEMBERS OF THE DC HEALTH MATTERS COLLABORATIVE INCLUDING FOUR NON-PROFIT HOSPITALS: CHILDREN'S NATIONAL HOSPITAL, HSC HEALTH CARE SYSTEM, HOWARD UNIVERSITY HOSPITAL, AND SIBLEY MEMORIAL HOSPITAL. PART V, SECTION B, LINE 6B: CHILDREN'S NATIONAL CONDUCTED THE CHNA WITH MEMBERS OF THE DC HEALTH MATTERS COLLABORATIVE THAT INCLUDES FOUR HOSPITALS AND FOUR FEDERALLY QUALIFIED HEALTH CENTERS (BREAD FOR THE CITY, COMMUNITY OF HOPE, MARY'S CENTER, AND UNITY HEALTH CARE); AND TWO EX-OFFICIO MEMBERS (DC HOSPITAL ASSOCIATION AND DC PRIMARY CARE ASSOCIATION). DC HEALTH AND THE DC BEHAVIORAL HEALTH ASSOCIATION IS ALSO A PARTNER OF THE COLLABORATIVE. THE COLLABORATIVE WORKS TO ELIMINATE HEALTH DISPARITIES AND CREATE HEALTH EQUITY FOR ALL COMMUNITIES IN DC TO REALIZE ONE HEALTHY CAPITAL CITY. WITH THE UNIQUE PERSPECTIVES OF EACH HOSPITAL AND COMMUNITY HEALTH CENTER, COLLABORATIVE MEMBERS PROVIDED GUIDANCE AND FEEDBACK RESPECTIVE TO POPULATIONS AND NEIGHBORHOODS SERVED. PART V, SECTION B, LINE 7D: CHILDREN'S NATIONAL USES SEVERAL METHODS TO MAKE THE CHNA REPORT WIDELY AVAILABLE. FIRST, THE CHNA IS LOCATED ON THE HOSPITAL WEBSITE AND THE DC HEALTH MATTERS COLLABORATIVE WEB PORTAL (DCHEALTHMATTERS.ORG). AS PART OF THE DC HEALTH MATTERS COLLABORATIVE OUTREACH AND EDUCATION, CHILDREN'S NATIONAL PARTICIPATED IN A PRESS RELEASE, HOSTED A TOWN HALL AND CONDUCTED FOUR WEBINARS TO SHARE THE CHNA FINDINGS AND RECEIVE INPUT ON THE IMPLEMENTATION STRATEGY. IN ADDITION, CHILDREN'S NATIONAL ORGANIZED SEVERAL MEETINGS WITH CHILDREN'S NATIONAL RESEARCH COMMUNITY, MEMBERS OF THE COLLABORATIVE'S COMMUNITY ADVISORY BOARD, GOVERNMENT AND COMMUNITY LEADERS. CHILDREN'S NATIONAL ALSO SHARED FINDINGS AND ANNOUNCEMENTS ABOUT THE CHNA WITH CHILDREN'S NATIONAL LEADERSHIP AND BOARD MEMBERS AND ON SEVERAL SOCIAL MEDIA PLATFORMS AND WROTE SEVERAL BLOGS TO HIGHLIGHT THE DATA. PART V, SECTION B, LINE 8: CHILDREN'S HOSPITAL ADOPTED AN IMPLEMENTATION STRATEGY, REFERRED TO AS THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) THAT ADDRESSES FOUR OF THE SIX PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CITYWIDE CHNA. THE CHIP IS AVAILABLE AT:HTTPS://CHILDRENSNATIONAL.ORG/ADVOCACY-AND-OUTREACH/CHILD-HEALTH-ADVOCACY-INSTITUTE/COMMUNITY-AFFAIRS/IMPROVING-COMMUNITY-HEALTH PART V, SECTION B, LINE 11: FOR THE 2019 ASSESSMENT, CHILDREN'S NATIONAL AND THE DC HEALTH MATTERS COLLABORATIVE PRIORITIZED THE NEEDS IDENTIFIED IN THE 2016 ASSESSMENT: MENTAL HEALTH, CARE COORDINATION, HEALTH LITERACY, AND PLACE-BASED CARE.GIVEN THE TIME AND EFFORT THAT IT TAKES TO MAKE SUBSTANTIVE PROGRESS IN THESE FOUR CRITICAL AREAS, WE - IN CONSULTATION WITH OVER 300 COMMUNITY PARTNERS - DECIDED TO CARRY FORWARD THE FOUR NEEDS RATHER THAN RE-CANVAS OUR COMMUNITY TO IDENTIFY NEW NEEDS. OUR DATA COLLECTION PROCESS RESULTED IN A RICH COLLECTION OF 28 THEMES THAT FOCUS ON HOW BEST TO ADDRESS OUR FOUR PRIORITY AREAS.WHILE ALL THE FINDINGS IN THE CHNA WERE SALIENT AND IMPORTANT, COLLABORATIVE MEMBERS CAREFULLY REVIEWED AND SELECTED FINDINGS TO FOCUS ON OVER THE NEXT THREE YEARS. MEMBER ORGANIZATIONS COMPLETED A MATRIX TO IDENTIFY THE STRATEGIES THAT MOST ALIGNED WITH THEIR ORGANIZATIONAL GOALS AND RESOURCES. CRITERIA FOR SCORING INCLUDED:- WILLINGNESS TO PUBLICLY SUPPORT ADVOCACY AND POLICY ACTION ON THE ISSUE, - ALIGNMENT WITH THE ORGANIZATION'S MISSION OR VISION,- WILLINGNESS TO CONTRIBUTE RESOURCES TO ACTIVITIES, AND- WILLINGNESS TO DEDICATE SIGNIFICANT STAFF TIME TO ACTIVITIES, INCLUDING TAKING A LEADERSHIP ROLE.THROUGH A STRUCTURED PRIORITIZATION PROCESS WITH ALL COLLABORATIVE MEMBER ORGANIZATIONS AND COMMUNITY ADVISORY BOARD MEMBERS, THE COLLABORATIVE ULTIMATELY SELECTED NINE STRATEGIES FOR THE 2019 CHIP THAT OFFER THE OPPORTUNITY TO INFLUENCE POLICIES, SYSTEMS, OR SOCIAL CONDITIONS THAT CAN MAKE A DIFFERENCE IN THE LIVES OF DC RESIDENTS.THE COLLABORATIVE IDENTIFIED WHICH STRATEGIES WERE ALREADY BEING ADDRESSED BY OTHER GROUPS OR PROGRAMS. SOME RECOMMENDED STRATEGIES WERE CONSOLIDATED TO ELIMINATE REDUNDANCY AND INCREASE IMPACT. A SUBSET OF THE STRATEGIES WAS ASSIGNED TO THE POLICY AGENDA, MEANING THE COLLABORATIVE WILL MONITOR AND ADVOCATE FOR LEGISLATIVE ACTION. FOR THE FINDINGS NOT ADDRESSED THROUGH THE 2019 CHIP, INDIVIDUAL COLLABORATIVE ORGANIZATIONS MAY ADDRESS THEM SEPARATELY IN OTHER EFFORTS. IN ADDITION, THE COLLABORATIVE PLANS TO ALIGN WITH OTHER ONGOING WORK SUCH AS THE DC HEALTH'S COMMUNITY HEALTH NEEDS ASSESSMENT, THE MAYOR'S COMMISSION ON HEALTHCARE SYSTEMS TRANSFORMATION'S RECOMMENDATIONS, AND THE COMMUNITY HEALTH IMPROVEMENT EFFORTS OF THE DC HOSPITAL ASSOCIATION AND DC PRIMARY CARE ASSOCIATION.FOR EACH STRATEGY, ORGANIZATIONS SELECTED ROLES WITH THE FOLLOWING EXPECTATIONS: - LEAD - MEMBER ORGANIZATION LEADS OR DELEGATES SPRINT TASKS SUCH AS MAPPING STAKEHOLDERS, DEVELOPING LOGIC MODELS, AND PLANNING AND EXECUTING ASSOCIATED ACTIVITIES. THE LEAD ORGANIZATION IS RESPONSIBLE FOR FACILITATING SPRINT MEETINGS AND REPORTING ON PROGRESS.- COLLABORATE - MEMBER ORGANIZATION PARTICIPATES ON SPRINT TEAM AND SUPPORTS SPRINT LEAD TO ACHIEVE OBJECTIVES WITH RESOURCES, ENGAGEMENT, AND EXECUTION OF ACTIVITIES AND DOCUMENTATION OF OUTCOMES.- SUPPORT - THROUGH STEERING COMMITTEE PARTICIPATION, MEMBER AND EX-OFFICIO ORGANIZATIONS SUPPORT SPRINT AND POLICY IMPLEMENTATION EFFORTS BY PROVIDING CONTINUOUS FEEDBACK AND SUBJECT MATTER EXPERTISE. THOUGH NOT ON SPRINT TEAM, ORGANIZATIONS MAY IDENTIFY COLLEAGUES TO CONTRIBUTE TO ACTIVITIES.AS PART OF THE COLLABORATIVE, CHILDREN'S NATIONAL IS LEADING TWO OF THE NINE IDENTIFIED STRATEGIES FOCUSED ON MENTAL HEALTH AND CARE COORDINATION AND COLLABORATE AND SUPPORT ALL OTHER STRATEGIES. THESE TWO STRATEGIES MOST ALIGNED WITH OUR MISSION, ORGANIZATIONAL STRATEGIC PLAN AND ABILITY TO CONTRIBUTE RESOURCES.- MENTAL HEALTH: EDUCATE STAKEHOLDERS OF ALL KINDS ABOUT MENTAL HEALTH, SUCH AS DC RESIDENTS, COMMUNITY GROUPS, POLICYMAKERS, HEALTH PROVIDERS, HEALTH SYSTEM LEADERSHIP AND STUDENTS. TOPICS COULD INCLUDE IDENTIFYING MENTAL HEALTH CONDITIONS, FINDING SERVICES, THE CHALLENGES OF SYSTEM NAVIGATION, TREATING MENTAL HEALTH AS PART OF WHOLE-PERSON HEALTH, AND FIGHTING STIGMA.IN FISCAL YEAR 2021, CHILDREN'S NATIONAL LED AN EFFORT TO DEVELOP AND IMPLEMENT A STORY MAP AND A THREE-PART VIRTUAL EDUCATIONAL WEBINAR SERIES TO INCREASE KNOWLEDGE AND AWARENESS OF BEHAVIORAL HEALTH SERVICES AND EXPERIENCES IN THE DISTRICT OF COLUMBIA. ACROSS THE THREE WEBINARS, INDIVIDUALS WERE REPRESENTED FROM THE DC COUNCIL, ADVISORY NEIGHBORHOOD COMMISSIONS, GOVERNMENT AGENCIES, POLICY AND ADVOCACY ORGANIZATIONS, COMMUNITY BASED AND FAMILY RUN ORGANIZATIONS, AND HOSPITALS/HEALTH SYSTEMS. THIS EFFORT ALSO INCLUDED MEETING WITH A DC COUNCILMEMBER STAFF TO FURTHER DISCUSS CHILDREN AND SCHOOL-BASED BEHAVIORAL HEALTH ISSUES. THE STORY MAP AND RECORDED WEBINAR SERIES ARE POSTED ONLINE AT DCHEALTHMATTERS.ORG. - CARE COORDINATION: IN FISCAL YEAR 2021, CHILDREN'S NATIONAL LED THE COLLABORATIVE EFFORT TO PROMOTE THE DC HEALTH MATTERS CONNECT TOOL (HTTPS://DCHEALTHMATTERSCONNECT.AUNTBERTHA.COM), AN ONLINE RESOURCE DIRECTORY AIMED AT IMPROVING ACCESS TO PRIMARY CARE, SOCIAL RESOURCES AND IMPROVE HEALTH EDUCATION BY CONNECTING RESIDENTS WITH FREE AND REDUCED COST RESOURCES AT THE LOCAL, STATE AND NATIONAL LEVEL. WE HAVE PROVIDED TRAINING AND SUPPORT FOR STAFF AND COMMUNITY PARTNERS TO EFFECTIVELY UTILIZE THE TOOL TO IMPROVE CARE COORDINATION AND REFERRING FAMILIES TO THE SERVICES AND PROGRAMS NECESSARY TO MEET SOCIAL NEED FOR IMPROVED OUTCOMES.IN FY21, THERE WERE APPROXIMATELY 5,332 UNIQUE USERS THAT CONDUCTED 6,869 SEARCHES ON THE SITE. THE MOST COMMON SEARCH TERMS ON THE SITE WERE HELP FINDING HOUSING, EMERGENCY FOOD AND FOOD PANTRIES. THE TOP SEARCHES ON THE SITE WERE IN THE FOOD, HOUSING AND HEALTH DOMAINS. IN ADDITION, CHILDREN'S NATIONAL IS LEADING SEVERAL ORGANIZATIONAL EFFORTS TO ADDRESS HEALTH LITERACY EDUCATION AMONG ITS EMPLOYEES, INCREASE ACCESS TO CARE BY EXTENDING CARE INTO THE COMMUNITY THROUGH SCHOOL HEALTH AND NEW CLINIC LOCATIONS, AND ADDRESS EARLY CHILDHOOD EDUCATION AND MENTAL HEALTH NEEDS OF CHILDREN AND FAMILIES. 21 1 - CHILDREN'S OUTPATIENT CTR MONTGOMERY SHADY GROVE MEDICAL PARK ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER 2 - CHILDREN'S OUTPATIENT CTR NORTHERN VA 3023 HAMACKER COURT SUITE 300 FAIRFAX VA 22031 REGIONAL OUTPATIENT CENTER 3 - CHILDREN'S HEALTH CTR TAKOMA THEATRE 6833 4TH STREET NW WASHINGTON DC 20012 HEALTH CENTERS 4 - CHILDREN'S HEALTH CTR AT COLUMBIA HEIGHT 3336 14TH STREET NW WASHINGTON DC 20010 HEALTH CENTERS 5 - CHILDREN'S HEALTH CENTER ANACOSTIA 2101 MARTIN LUTHER KING JR AVENUE SE WASHINGTON DC 20020 HEALTH CENTERS 6 - CHILDREN'S OUTPATIENT CTR PRINCE GEORGE 2900 CAMPUS WAY NORTH LANHAM MD 20706 REGIONAL OUTPATIENT CENTER 7 - MOBILE VAN - HEALTH CARE N/A NA DC 20010 MOBILE HEALTH CARE 8 - CHILDREN'S OUTPATIENT CTR ANNAPOLIS 1730 WEST STREET SUITE 100 ANNAPOLIS MD 21401 REGIONAL OUTPATIENT CENTER 9 - CHILDREN'S NATIONAL EMERG DEPT UNIT 1301 SOUTHERN AVENUE SE 1ST FLOOR WASHINGTON DC 20032 ED FACILITY 10 - CHILDREN'S OUTPATIENT CTR FRIENDSHIP 5028 WISCONSIN AVE SUITES 250 310 WASHINGTON DC 20016 REGIONAL OUTPATIENT CENTER 11 - CHILDREN'S NAT'L AMBU SURGERY CTR 9850 KEY WEST AVENUE ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER 12 - CHILDREN'S OUTPATIENT CTR FREDERICK 5285 WESTVIEW DRIVE SUITE 103 FREDERICK MD 21703 REGIONAL OUTPATIENT CENTER 13 - MOBILE VAN - DENTAL N/A NA DC 20010 MOBILE HEALTH CARE 14 - CHILDREN'S HEALTH CENTER AT THEARC 1801 MISSISSIPPI AVE SE WASHINGTON DC 20020 HEALTH CENTERS 15 - CHILDREN'S OUTPATIENT CTR MONTGOMERY 15245 SHADY GROVE ROAD SUITE 350 ROCKVILLE MD 20858 REGIONAL OUTPATIENT CENTER 16 - CHILDREN'S OUTPATIENT FREDRICKSBURG 1300 HOSPITAL DRIVE SUITE 201 FREDRICKSBURG VA 22401 REGIONAL OUTPATIENT CENTER 17 - CHILDREN'S NATIONAL IMAGING CENTER 9850 KEY WEST AVENUE SUITE 110 ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER 18 - CHILDREN'S NATIONAL PULMONARY MED-R 9711 MEDICAL CENTER DRIVE SUITE 212 ROCKVILLE MD 20850 HEALTH CENTERS 19 - CHILDREN'S OUTPATIENT CTR HOWARD CTY 7625 MAPLE LAWN BLVD SUITE 230 FULTON MD 20759 REGIONAL OUTPATIENT CENTER 20 - FIGHT FOR CHILDREN SPORTS MED CTR 1 INVENTA PLACE SUITE 150 SILVER SPRING MD 20910 HEALTH CENTERS 21 - CHILDREN'S NAT'L RARE DISEASE INST 7125 13TH PLACE NW WASHINGTON DC 20012 HEALTH CENTERS PART I, LINE 3C: ELIGIBILITY FOR CHARITY CARE PROGRAMCHILDREN'S NATIONAL USED THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR ITS CHARITY CARE PROGRAM. ELIGIBILITY WAS INCOME BASED AND NOT ASSET BASED.PART I, LINE 6A:CHILDREN'S NATIONAL MEDICAL CENTER ANNUAL REPORTCHILDREN'S NATIONAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS POSTED ON THE HOSPITAL WEBSITE AND HARD COPIES ARE MADE AVAILABLE AND DISTRIBUTED TO HOSPITAL'S KEY INTERNAL AND EXTERNAL STAKEHOLDERS. AS PART OF OUR COMMITMENT TO OUR COMMUNITY, BELOW ARE SOME OF THE PROGRAMS AND ACTIVITIES THAT WERE CONDUCTED IN FY 2021. COVID-19 VACCINATION EFFORTSAS VACCINATIONS BECAME AVAILABLE IN LATE 2020, HEALTH CARE PROVIDERS WERE PRESENTED WITH A LOGISTICAL CHALLENGE: HOW DO WE GET VACCINES INTO THE ARMS OF THOSE WHO NEED THEM MOST, AS QUICKLY AS POSSIBLE. CHILDREN'S NATIONAL HOSPITAL MOBILIZED TO VACCINATE AS MANY CHILDREN'S NATIONAL STAFF MEMBERS AS POSSIBLE BEGINNING IN DECEMBER 2020. DC HEALTH REACHED OUT TO CHILDREN'S NATIONAL LEADERSHIP TO SEE IF WE COULD OVERSEE VACCINATION OF THE DC PUBLIC SCHOOL'S FACULTY AND STAFF. THEIR GOAL WAS TO GET TEACHERS AND CHILDREN BACK INTO SCHOOLS AS THEY FELT IT CRITICAL TO CHILDHOOD WELLNESS, HEALTH, AND FUTURE SUCCESS. CHILDREN'S NATIONAL WAS DETERMINED TO ASSIST IN THE REOPENING OF SCHOOLS AS SAFELY AND QUICKLY AS POSSIBLE AND THUS UTILIZED THE LESSONS LEARNED FROM OUR INTERNAL VACCINATION PROCESS TO SET UP THE CLINICS IN MERE WEEKS. PARTNERING WITH DC PUBLIC SCHOOLS, SEVEN MASS VACCINATION EVENTS WERE HELD IN JANUARY AND FEBRUARY 2021. COMPRISED OF OVER 100 CHILDREN'S NATIONAL FACULTY AND STAFF MEMBERS, AS WELL AS COMMUNITY VOLUNTEERS, WE WERE ABLE TO VACCINATE AROUND 4,000 DCPS TEACHERS, STAFF, AND FACULTY. THE MASS VACCINATION CLINICS WERE HELD IN COOPERATION WITH SCHOOL OFFICIALS, AND HELD IN THE ATRIUM OF DUNBAR HIGH SCHOOL IN NORTHWEST WASHINGTON D.C. THE SCHOOL'S SCIENCE LAB WAS TURNED INTO A PHARMACY, WHERE CHILDREN'S NATIONAL PHARMACISTS PREPARED VACCINES. OTHER MEMBERS OF CHILDREN'S NATIONAL STAFF ADMINISTERED VACCINES, OBSERVED POST-VACCINATION, ASSISTED WITH REGISTRATION, SUPPORTED IT ISSUES, AND OVERSAW LINE-MANAGEMENT. CHILDREN'S NATIONAL'S DCPS VACCINE CLINICS WERE THE MAIN CLINICS HELD FOR DCPS FACULTY AND STAFF AND ALLOWED THOSE PREFORMING CRITICAL ROLES FOR THE CHILDREN IN OUR COMMUNITY TO GET BACK INTO SCHOOLS AND CLASSROOMS AS QUICKLY AS POSSIBLE. EVERFI MENTAL WELLNESS BASICS DIGITAL COURSE THE COVID-19 PANDEMIC CAME NOT ONLY WITH CHALLENGES TO PHYSICAL HEALTH, BUT MENTAL HEALTH AS WELL. SINCE MARCH 2020, ADOLESCENTS HAVE REPORTED RISING LEVELS OF ANXIETY AND DEPRESSION, OFTEN ATTRIBUTED TO THE ISOLATION OF SOCIAL DISTANCING AND ONLINE LEARNING. TO HELP CONNECT YOUTH WITH THE TOOLS THEY NEED FOR GOOD MENTAL HEALTH, CHILDREN'S NATIONAL IS SPONSORING MENTAL WELLNESS BASICS DIGITAL COURSE FOR DC PUBLIC SCHOOLS. THIS COURSE IS INTENDED AS AN EDUCATIONAL RESOURCE FOR HIGH SCHOOL AND MIDDLE SCHOOL STUDENTS, GRADES 8-10.EVERFI LAUNCHED THE MENTAL WELLNESS BASICS COURSE IN 2018, WHICH HAS REACHED OVER 65,000 STUDENTS ACROSS THE COUNTRY WITH CRITICAL MENTAL WELLNESS EDUCATION. IN SUMMER 2020, EVERFI LAUNCHED A PARENT PORTAL WEBSITE TO INCREASE ACCESS OF ITS COURSES.STUDENTS MUST BE EQUIPPED WITH THE COPING, COMMUNICATION, AND SELF ASSESSMENT SKILLS THEY NEED TO PROACTIVELY ADVOCATE FOR THEIR OWN MENTAL HEALTH AND THE MENTAL HEALTH OF THEIR PEERS. CHILDREN'S NATIONAL HAS PARTNERED WITH DC PUBLIC SCHOOLS (DCPS), THE DC PUBLIC CHARTER SCHOOL BOARD, THE OFFICE FOR THE STATE SUPERINTENDENT OF EDUCATION, AND DC COORDINATING COUNCIL ON SCHOOL MENTAL HEALTH TO PROMOTE THIS COURSE. IN ADDITION, EVERFI WAS INVITED TO PRESENT ON THE COURSE AT OUR DECEMBER 2020 SCHOOL HEALTH COLLABORATIVE MEETING ATTENDED BY CHILDREN'S NATIONAL SCHOOL HEALTH PROGRAM STAFF AND LEADERSHIP.THE ONLINE RESOURCE, FREE TO DCPS STUDENTS, ALLOWS THEM TO PERFORM SELF-ASSESSMENT AND PRACTICE SKILLS AND USE TOOLS TO PROMOTE GOOD MENTAL HEALTH. AS OF JUNE 2021, MENTAL WELLNESS BASICS IS BEING USED BY 506 STUDENTS FROM 9 DC PUBLIC SCHOOLS WITH A TOTAL OF 133 STUDENTS COMPLETED THE FULL COURSE. THE FAMILY LIFESTYLE PROGRAM (FLIP)THE FAMILY LIFESTYLE PROGRAM (FLIP) IS A FAMILY-CENTERED CLINICAL COMMUNITY COLLABORATIVE STARTED IN 2017 BY CHILDREN'S NATIONAL HOSPITAL, THE YMCA OF METROPOLITAN WASHINGTON, AND THE AMERICAN HEART ASSOCIATION TO DEVELOP INNOVATIVE WAYS TO BETTER ADDRESS DIET-RELATED CHRONIC DISEASE. TOGETHER, WE HAVE CREATED AND IMPLEMENTED MECHANISMS THAT STREAMLINE REFERRAL OF FAMILIES TO COMMUNITY RESOURCES RELATED TO IMPROVED HEALTH, MORE EFFECTIVELY MANAGE DIET-RELATED CHRONIC DISEASE IN CLINICAL SETTINGS, AND OFFER PROGRAMS TAILORED FOR OUR DEMOGRAPHIC POPULATION. OUR WORK IS OVERSEEN BY A STRONG COMMUNITY ADVISORY BOARD OF ACTIVE COMMUNITY KEY STAKEHOLDERS, PARENTS, RESEARCHERS, DIETITIANS, AND PHYSICIANS. FLIPRX IS A PRODUCE PRESCRIPTION INITIATIVE BUILT UPON A MULTI-TIERED APPROACH THAT ALLOWS FOR MULTIPLE LEVELS OF ENGAGEMENT TO MEET EACH FAMILY'S UNIQUE FOOD ACCESS AND EDUCATIONAL NEEDS. CREATED TO ADDRESS THE COMPLICATED ISSUE OF WEIGHT MANAGEMENT AND DIET RELATED CHRONIC DISEASES IN FAMILIES, FLIP IS A DC-BUILT, CLINICAL-COMMUNITY INITIATIVE THAT AIMS TO SUPPORT FAMILIES AND EQUIP CLINICIANS WITH THE NECESSARY SKILLS AND TOOLS. IN FY2021, OVER 500 YOUTH AND THEIR FAMILIES WERE ENGAGED AS A RESULT OF THE PROGRAM AND GIVEN TOOLS FOR PHYSICAL ACTIVITY AND SUSTAINABLE, HEALTHY EATING. EARLY CHILDHOOD INNOVATION NETWORK (ECIN)EARLY CHILDHOOD INNOVATION NETWORK (ECIN), AN INITIATIVE SPEARHEADED BY CHILDREN'S NATIONAL AND MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL WITH PARTNERSHIPS THROUGHOUT THE CITY, IS AIMED AT IMPROVING EARLY CHILDHOOD AND PERINATAL MENTAL HEALTH, FOCUSING ON SUPPORT AND RESOURCES GIVEN DURING THE FIRST FIVE YEARS OF LIFE. UTILIZING FOUR GUIDING PRINCIPLES, ECIN IS DEDICATED TO WORK THAT IS MULTI-GENERATIONAL AND GROUNDED IN SCIENCE, GUIDED BY COMMUNITY AND FAMILIES' KNOWLEDGE AND EXPERIENCE, COLLABORATIVE ACROSS SECTORS, AND INTEGRATED WITH EXISTING RESOURCES. IN FY2021, ECIN: -CONTINUED TO BUILD INFRASTRUCTURE AND INTERNAL CAPACITY TO MEET THE NEEDS OF A GROWING NETWORK. -IMPLEMENTATION AND EVALUATION OF A PEDIATRIC PRIMARY CARE INTERVENTION, CALLED HEALTHYSTEPS, AT CHILDREN'S NATIONAL PRIMARY CARE CLINICS.-INTEGRATION OF BEHAVIORAL HEALTH IN EARLY LEARNING THROUGH THE FAMILY WELL BEING PROGRAM.-OFFERED VIRTUAL PARENT CAFES AND PROVIDED SUPPORT TO COMMUNITY PARTNERS IN DELIVERING PARENT CAFES.-LAUNCHED THE INFANT/TODDLER SOCIAL AND EMOTIONAL LEARNING (SEL) COMMUNITY OF PRACTICE (COP), WHICH PREPARES COACHES TO BETTER SUPPORT THE ONGOING LEARNING OF TEACHERS ON INFANT AND TODDLER SOCIAL-EMOTIONAL DEVELOPMENT AND BEST PRACTICES AND PROVIDE PROFESSIONAL DEVELOPMENT TRAINING MATERIALS FOR EARLY CHILDHOOD EDUCATORS.-PROVIDED PEDIATRIC PRIMARY CARE PROVIDERS/PRACTICES WITH NEEDED SUPPORTS IN SCREENING AND REFERRAL FOR PERINATAL MOOD AND ANXIETY DISORDERS.-PERINATAL MENTAL HEALTH TASKFORCE LEAD ADVANCEMENT OF SCREENING AND SUPPORT MODELS.-LAUNCHED THE DC PRITZKER CHILDREN'S INITIATIVE, A CITY-WIDE INITIATIVE FOCUSED ON BUILDING CAPACITY AND ADVANCING POLICY AND SYSTEMS CHANGE IN KEY PRENATAL TO THREE AREAS OF HEALTH AND BEHAVIORAL HEALTH.-ENGAGED IN PARTNERSHIP WITH SPACES IN ACTION AND CHILDREN'S LAW CENTER TO IMPROVE COVERAGE OF WORKFORCE SPECIALTIES, SUCH AS DOULAS AND COMMUNITY HEALTH WORKERS, TO IMPROVE MATERNAL HEALTH OUTCOMES.-CONTINUED PRODUCTION AND IMPLEMENTATION, RESPECTIVELY, OF WELLNESS AND TRAUMA INFORMED CARE MODULES FOR PROVIDERS; 50 PEDIATRIC HEALTH PROVIDERS PARTICIPATED IN WELLNESS GROUPS. IN FY2021, ECIN PROVIDED RESOURCES, SERVICES AND SUPPORT TO OVER 5,000 CHILDREN AND FAMILIES. PART I, LINE 7: CHARITY AT COSTHOSPITAL AND PHYSICIAN CHARITY AMOUNTS REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS. COVID-19 RELATED EXPENSES, COVERED BY CARES PROVIDER RELIEF FUNDING, WERE EXCLUDED FROM THE COST TO CHARGE RATIO CALCULATION.PART I, LINE 7B:MEDICAIDHOSPITAL AND PHYSICIAN GROSS PATIENT REVENUE AND PAYMENT FROM FINANCIAL DECISION SUPPORT SYSTEMS WERE ADJUSTED TO COST USING THE COST TO CHARGES RATIO PER THE IRS INSTRUCTIONS. COVID-19 RELATED EXPENSES, COVERED BY CARES PROVIDER RELIEF FUNDING, WERE EXCLUDED FROM THE COST TO CHARGE RATIO CALCULATION. MEDICAID GRADUATE MEDICAL EDUCATION (GME) ADD-ON PAYMENTS WERE EXCLUDED AS THEY ARE REPORTED ON THE HEALTH EDUCATION LINE. CHILDREN'S NATIONAL GME INDIRECT MEDICAL EDUCATION (IME) PAYMENTS WERE INCLUDED AS PER 990 INSTRUCTIONS.PART I, LINE 7F:HEALTH EDUCATIONTHE HEALTH EDUCATION COST INCLUDES THE TOTAL COST OF INTERNS AND RESIDENTS FROM THE FY21 SUBMITTED MEDICARE COST REPORT. EDUCATION PAYMENTS AND RESIDENT FUNDING AMOUNTS OFFSET THE REPORTED EXPENSE. DC MEDICAID GME PAYMENTS WERE CALCULATED AND DEDUCTED FROM TOTAL MEDICAID PAYMENTS TO BE REPORTED ON THE LINE FOR HEALTH EDUCATION (PART I, LINE 7B). PART I, LINE 7G: SUBSIDIZED HEALTH SERVICESTHE HOSPITAL AND PHYSICIAN COMBINED SERVICE LINES FOR PROGRAMS IN UNDERSERVED AREAS WITH LOSSES WERE REPORTED AS SUBSIDIZED HEALTH SERVICES. TOTAL CHARGES WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO BASED ON THE IRS INSTRUCTIONS. THE CLAIMS PAYMENTS WERE NETTED AGAINST THE COST. COVID-19 RELATED EXPENSES, COVERED BY CARES PROVIDER RELIEF FUNDING, WERE EXCLUDED FROM THE COST TO CHARGE RATIO CALCULATION. ADDITIONALLY, THE SUBSIDIZED HEALTH SERVICE LOSS WAS OFFSET BY CARES PROVIDER RELIEF FUNDING APPLICABLE TO PATIENT CARE REVENUE LOSS.COSTS ATTRIBUTABLE TO A PHYSICAL CLINIC:SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. THE SERVICES ARE PROVIDED DESPITE THE FINANCIAL LOSS TO MEET THE IDENTIFIED AND UNMET NEEDS OF THE COMMUNITY. IF THE SERVICES WERE NOT PROVIDED, THEY WOULD NOT BE AVAILABLE TO THE AREA OR WOULD RESULT IN THE GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION PROVIDING THE SERVICES. THE SUBSIDIZED HEALTH SERVICES AMOUNT IN PART I, LINE 7G INCLUDES $1,864,910 WHICH IS ATTRIBUTED TO THE PRIMARY CLINICAL SERVICES PROVIDED VIA CHILDREN'S NATIONAL HOSPITAL. CHILDREN'S HEALTH CENTERS PROVIDE PROGRAMS AND INITIATIVES INCLUDING COMPREHENSIVE AND HIGH-QUALITY PREVENTIVE SERVICES, IMPROVEMENT OF IMMUNIZATION RATES, AND COORDINATION OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THE AMOUNT INCLUDES SALARY, FRINGE, DIRECT, AND INDIRECT COSTS EXPENDED TO PROVIDE THE CLINICAL SERVICES. OUR CHILDREN'S HEALTH CENTERS ARE ESTABLISHING BEST PRACTICES IN COMMUNITY HEALTH.PART I, LINES 7E & I:OTHER BENEFITSIN CALCULATING THE AMOUNTS REPORTED IN THE TABLE IN PART I RELATING TO OTHER BENEFITS (E - I), WE USE AN ACCOUNTABILITY AND ELIGIBILITY SYSTEM BASED ON THE COMMUNITY BENEFIT DEFINITION AND GUIDELINES FOR DETERMINING WHERE PROGRAMS FIT INTO EACH COMMUNITY BENEFIT CATEGORY. TIME SPENT ON PROGRAMS/ACTIVITIES AND PROGRAM FUNDING IS PROVIDED BY PROGRAM STAFF. AVERAGE SALARY RATES ARE USED TO CALCULATE SALARY EXPENSES AND A FRINGE RATE IS ATTACHED AS NECESSARY. THE COMMUNITY BENEFIT STAFF ANALYZES THE FINANCIALS SUBMITTED TO ENSURE CONSISTENCY IN REPORTING AND CONFIRM WITH PROGRAM STAFF THE ACCURACY OF THE FINANCIALS. THE COMMUNITY BENEFIT STAFF ALSO WORKS WITH THE ACCOUNTING & FINANCE DEPARTMENT TO VERIFY THE ACCURACY OF SUBMITTED FINANCIALS. PART I, LINE 7, COLUMN (F):CHILDREN'S NATIONAL DOES NOT INCLUDE ITS BAD DEBT EXPENSE ($31,436,139) REPORTED ON FORM 990, PART IX, LINE 25 FOR PURPOSES OF ITS COMMUNITY BENEFIT CALCULATION HERE. SCHEDULE H, PART II: COMMUNITY BUILDING ACTIVITIESPART II INCLUDES THE COST INCURRED FOR ACTIVITIES AND PROGRAMS TO PROTECT OR IMPROVE THE COMMUNITY'S HEALTH OR SAFETY. PROGRAMS ACCOUNTED FOR AS COMMUNITY BUILDING ACTIVITIES FALL INTO THE SUBCATEGORIES OF ECONOMIC DEVELOPMENT, COMMUNITY SUPPORT, COALITION BUILDING, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, AND WORKFORCE DEVELOPMENT. ECONOMIC DEVELOPMENT: CHILDREN'S NATIONAL LEADERSHIP PARTICIPATES IN BOARDS AND COUNCILS THAT FOCUS ON THE ECONOMIC DEVELOPMENT OF OUR LOCAL COMMUNITY. STAFF LED LEADERSHIP ROUNDTABLE EVENTS AS WELL AS CONVERSATIONS WITH FRONTLINE STAFF REGARDING THE ECONOMY AND THE IMPACTS OF COVID-19 IN OUR REGION. COMMUNITY SUPPORT: IN FY 2021, OUR STAFF PARTNERED WITH A VARIETY OF ORGANIZATIONS INCLUDING OTHER CHILDREN'S HOSPITALS, LOCAL FOOD BANKS AND COMMUNITY-BASED ORGANIZATIONS THAT PROVIDE FOOD AND SERVICES TO THE HOMELESS POPULATION AND THOSE LIVING WITH SERIOUS ILLNESSES, THE HOMELESS CHILDREN'S PLAYTIME PROJECT, AND THE DC HEALTH AND MEDICAL COALITION. FOR MANY YEARS, OUR NURSING STAFF ALONG WITH OTHER CHILDREN'S HOSPITALS HAVE WORKED TO COLLECT AND DONATE CEREAL TO LOCAL FOOD BANKS SO THAT CHILDREN CAN HAVE BREAKFAST DURING SUMMER BREAK. DURING THE FALL SEASON, THE COMMUNITY AFFAIRS TEAM PARTNERED WITH THE PLAYTIME PROJECT TO SPONSOR EXTRACURRICULAR ACTIVITIES FOR CHILDREN CURRENTLY LIVING AT FAMILY SHELTERS ACROSS THE DISTRICT. THE COMMUNITY AFFAIRS DEPARTMENT ALSO COORDINATES AND PARTICIPATES IN DAYS OF SERVICES WHERE THEY HELP TO PACKAGE MEALS. SIMILARLY, THE NURSING STAFF PARTICIPATES IN ACTIVITIES WITH LOCAL COMMUNITY-BASED ORGANIZATIONS. AS A MEMBER OF THE DC HEALTH AND MEDICAL COALITION, OUR EMERGENCY MEDICINE AND TRAUMA CENTER STAFF, PLANS AND PARTICIPATES IN EMERGENCY PREPAREDNESS ACTIVITIES IN THE DISTRICT OF COLUMBIA. COALITION BUILDING: CHILDREN'S NATIONAL STAFF WORKS WITH LOCAL GOVERNMENT AND HEALTHCARE PARTNERS TO ENSURE EMERGENCY PREPAREDNESS AND RESPONSE AND BRINGS THE PEDIATRIC HOSPITAL PERSPECTIVE. MEETINGS INCLUDE PLANNING FOR LARGE-SCALE EVENTS SUCH AS THE PRESIDENTIAL INAUGURATION, EVACUATION PLANS, EMERGENCY PREPAREDNESS AND DECONTAMINATION EXERCISES, AND FAMILY REUNIFICATION. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: THE HOSPITAL'S GOVERNMENT AFFAIRS TEAM SERVES AS A VOICE FOR CHILDREN AT THE LOCAL, STATE, AND FEDERAL LEVELS BY BRINGING ATTENTION TO AND RALLYING SUPPORT FOR PUBLIC POLICIES THAT PROTECT THE INTEREST OF CHILDREN'S HEALTH, AIM TO ELIMINATE HEALTH DISPARITIES, AND SUPPORT MEDICAL AND RESEARCH INNOVATION. IN 2021, THE TEAM EDUCATED POLICY MAKERS ON CHILDREN'S HEALTH ISSUES AND WORKED WITH EXPERT PHYSICIANS AND RESEARCHERS TO TESTIFY ON BILLS AND/OR PROVIDE WRITTEN STATEMENTS ON ISSUES SUCH AS EXPANSION OF ACCESS TO CARE, FRAMEWORKS TO ALLOW FOR THE STOCKING OF UNDESIGNATED ALBUTEROL IN PUBLIC SCHOOLS, ENSURING APPROPRIATE MEDICAL AND EDUCATIONAL SERVICES PROVIDED TO MEDICALLY CHALLENGED CHILDREN, AND INCREASING PEDIATRIC MENTAL HEALTH RESOURCES INCLUDING TELEMEDICINE. THE TEAM ALSO COORDINATED ADVOCACY EFFORTS WITH OTHER COMMUNITY ORGANIZATIONS AND ADVOCATES AT THE LOCAL AND NATIONAL LEVEL.WORKFORCE DEVELOPMENT: CHILDREN'S NATIONAL IS DEDICATED TO ENGAGING IN AND PROVIDING OPPORTUNITIES OF LEARNING AND DEVELOPMENT FOR SCHOOL-AGED CHILDREN. WE WORK WITH MANY LOCAL HIGH SCHOOLS, COLLEGES AND UNIVERSITIES TO PROVIDE LEARNING OPPORTUNITIES FOR STUDENTS INTERESTED IN HEALTH PROFESSIONS. THOUGH THE COVID-19 PANDEMIC CREATED CHALLENGES TO ENGAGING WITH YOUTH DIRECTLY, THROUGH PREVIOUS PROGRAMS LIKE HOSPITAL CAREER DAYS, TOURS AND PANELS, TEAMS ADAPTED TO OFFER DIGITAL SOLUTIONS. CHILDREN'S NATIONAL OFFERED VIRTUAL RESUME BUILDING AND EDITING WORKSHOPS IN THE DIGITAL SPACE FOR LOCAL UNIVERSITY STUDENTS. IN ADDITION, CHILDREN'S NATIONAL OFFERED A VIRTUAL INTERNSHIP FOR LOCAL HIGH SCHOOL STUDENTS INTERESTED IN HEALTH-RELATED CAREERS. DURING THIS INTERNSHIP, STUDENTS LEARNED FROM A VARIETY OF HEALTHCARE PROFESSIONALS, INCLUDING PHYSICIANS AND PUBLIC HEALTH SPECIALISTS, WHO EDUCATED THEM ON CAREERS IN HEALTH AND OTHER PROFESSIONAL SKILLS. THE STUDENTS CONDUCTED A RESEARCH PROJECT, WHICH THEY THEN PRESENTED TO THEIR ADULT MENTORS AND OTHER FACULTY AND STAFF, WHO PROVIDED FEEDBACK, ALL IN THE VIRTUAL SPACE. STUDENTS RATED THEMSELVES AS IMPROVED IN TOPICS INCLUDING KNOWLEDGE OF HEALTHCARE INEQUALITY AND PUBLIC SPEAKING. THERE ARE PLANS TO CONTINUE AND EXPAND THE INTERNSHIP IN THE SUMMER OF 2022. IN ADDITION, WE PARTNERED WITH THE TOWSON UNIVERSITY HEALTH ADMINISTRATIVE INTERNSHIP PROGRAM TO PROVIDE STUDENTS THE OPPORTUNITY TO LEARN ABOUT THE ADMINISTRATIVE OPERATIONS OF A CHILDREN'S HOSPITAL AND THE SEACREST STUDIOS INTERNSHIP TEACHES BROADCAST MEDIA SKILLS TO UNIVERSITY STUDENTS. CHILDREN'S NATIONAL ALSO SUPPORTS THE LAUNCH PROGRAM - NURSE TRAINEE AND FLYNN FELLOWSHIP PROGRAM WHICH ALLOWS UNIVERSITY STUDENTS INTERESTED IN NURSING TO SHADOW PEDIATRIC NURSES DURING A SUMMER INTERNSHIP. THESE STUDENTS WORK CLOSELY WITH A PRECEPTOR AND SUPERVISOR LEARNING THE SKILLS AND TECHNIQUES OF A PEDIATRIC NURSE. PART III, LINE 2: BAD DEBT EXPENSETHE HOSPITAL AND PHYSICIAN BAD DEBT WRITE-OFF REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS. COVID-19 RELATED EXPENSES, COVERED BY CARES PROVIDER RELIEF FUNDING, WERE EXCLUDED FROM THE COST TO CHARGE RATIO CALCULATION. DISCOUNTS AND PAYMENTS REDUCE THE PATIENT'S ACCOUNT BALANCE PRIOR TO SENDING THE PATIENT A STATEMENT FOR ANY REMAINING BALANCES DUE TO CHILDREN'S NATIONAL HOSPITAL. FINANCIAL ASSISTANCE ELIGIBLE PATIENTS RECEIVE A 100% DISCOUNT ON THE BALANCE DUE. PAYMENT PLANS ARE ALSO AVAILABLE FOR PATIENT BALANCES DUE. ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER COLLECTION EFFORTS (BILLING STATEMENTS AND PHONE CALLS) ARE UNSUCCESSFUL.BAD DEBT IS NOT INCLUDED IN CHILDREN'S NATIONAL'S COMMUNITY BENEFIT. A DEMOGRAPHIC ANALYSIS BASED ON ZIP CODES WAS COMPLETED TO ESTIMATE THE AMOUNT OF BAD DEBT THAT COULD HAVE BEEN ATTRIBUTED TO PATIENTS WITH A LIKELIHOOD OF QUALIFYING FOR FINANCIAL ASSISTANCE HAD SUFFICIENT INFORMATION BEEN OBTAINED TO DETERMINE THEIR ELIGIBILITY. BASED ON THE ANALYSIS, APPROXIMATELY $2.1M OF BAD DEBT COULD HAVE BEEN ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. CHILDREN'S NATIONAL HOSPITAL REPORTS ITS APPLICABLE BAD DEBT ($31.4M) AMOUNT WITHIN THE AUDITED FINANCIAL STATEMENTS. THERE IS NO SPECIFIC FOOTNOTE FOR BAD DEBT IN THE STATEMENTS. PART III, LINE 3: SEE NARRATIVE FOR PART III, LINE 2. PART III, LINE 4: SEE NARRATIVE FOR PART III, LINE 2. PART III, LINE 8: COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT ON LINE 6MEDICARE SHORTFALLS ARE NOT INCLUDED AS A COMMUNITY BENEFIT AS ANY SHORTFALL DETERMINATION FROM THE MEDICARE COST REPORT IS EVENTUALLY PAID AS A SETTLEMENT. PART III, LINE 9B: COLLECTION PRACTICESCHILDREN'S NATIONAL HOSPITAL HAS A WRITTEN COLLECTION POLICY. THE POLICY IS APPLIED UNIFORMLY TO ALL PATIENTS. CHILDREN'S NATIONAL HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS WHILE MAINTAINING RESPONSIBLE AND EFFECTIVE FINANCIAL PROGRAMS WHICH ENSURE THAT THIS COMMITMENT CAN CONTINUE. CHILDREN'S NATIONAL HOSPITAL SUPPORTS FAMILIES IN CARRYING OUT THEIR RESPONSIBILITY FOR OBTAINING MEDICAL CARE FOR THEIR CHILDREN. CHILDREN'S NATIONAL HOSPITAL THEREFORE WILL ASSIST FAMILIES IN VERIFYING THEIR ABILITY TO MEET THEIR FINANCIAL OBLIGATION TO THE HOSPITAL OR IN SECURING THE RESOURCES NECESSARY TO DO SO. THE PURPOSE OF THIS POLICY IS TO ESTABLISH GUIDELINES FOR THE EFFECTIVE AND RESPONSIBLE FISCAL PROGRAMMING, WHICH ASSURES THE FINANCIAL VIABILITY OF THE INSTITUTION AND MAINTAINS THE DIGNITY OF THE FAMILY.COLLECTION EFFORTS ARE THEREFORE THE SAME FOR ALL PATIENTS. ONCE THE APPROVED CHARITY ADJUSTMENT HAS BEEN DETERMINED, THE ACCOUNT BALANCE IS WRITTEN OFF TO CHARITY AND COLLECTION EFFORTS CEASE. FOR PATIENT BALANCES THAT ARE NOT FINANCIAL ASSISTANCE ELIGIBLE, CHILDREN'S OFFERS PAYMENT PLANS. BILLING STATEMENTS WILL BE SENT TO GUARANTORS FOR OUTSTANDING BALANCES. ATTEMPTS TO CONTACT THE GUARANTORS VIA PHONE WILL ALSO OCCUR. ACCOUNTS WITH BALANCES AND NO RESPONSE FROM GUARANTORS AFTER REPEATED STATEMENTS AND PHONE CALLS WILL BE WRITTEN OFF TO BAD DEBT. AN EXTERNAL AGENCY WILL THEN ATTEMPT TO REACH THE PATIENT FOR PAYMENT. IF THE PATIENT SUBSEQUENTLY PAYS, THE BAD DEBT ADJUSTMENT WILL BE REVERSED, AND PAYMENT POSTED TO THE PATIENT'S ACCOUNT. IF THE EXTERNAL AGENCY'S EFFORTS PROVE TO BE INEFFECTIVE, THE ACCOUNT WILL BE CLOSED WITH THE AGENCY AND THEIR EFFORTS WILL CEASE. CHILDREN'S NATIONAL HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES, E.G. CREDIT REPORTING, WAGE GARNISHMENTS, LIENS, ETC. PART VI, LINE 2: COMMUNITY HEALTH CARE NEEDS ASSESSMENTCHILDREN'S NATIONAL, IN CONJUNCTION WITH THE DC HEALTH MATTERS COLLABORATIVE, CONDUCTS A COMMUNITY-WIDE CHNA EVERY THREE YEARS TO INVEST IN COMMUNITY HEALTH INITIATIVES THAT ADDRESS COMMUNITY NEEDS - WITH THE ULTIMATE GOAL OF CREATING A CULTURE OF HEALTH AND IMPROVING HEALTH AND WELLNESS. IN ADDITION TO THE COMMUNITY-WIDE ASSESSMENT, THE HOSPITAL ALSO ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH ADDITIONAL AND SPECIFIC EFFORTS LED ACROSS THE HOSPITAL ORGANIZATION. FOR EXAMPLE, THE CHILDREN'S NATIONAL ASTHMA PROGRAM, IMPACT DC, ANALYZES ON AN ANNUAL BASIS EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS FOR ASTHMA TO ALL NON-MILITARY HOSPITAL EMERGENCY DEPARTMENTS IN DC. THIS ALLOWS THE HOSPITAL TO TRACK TRENDS OVER TIME AND ACROSS ZIP CODES IN DC. THE HOSPITAL ALSO CONDUCTS A NUMBER OF STUDIES TO IDENTIFY BARRIERS TO CARE, INTERVENTION PREFERENCES, AND PARENT CONCERNS ABOUT ASTHMA. IN 2018-2019, THE HOSPITAL USED FUNDING FROM NIH TO SPECIFICALLY CONDUCT A COMMUNITY NEEDS ASSESSMENT FOCUSED ON ASTHMA. IMPACT DC PRODUCED REPORTS USING BOTH QUANTITATIVE AND QUALITATIVE METHODS. THE HOSPITAL SUBSEQUENTLY SUBMITTED ANOTHER NIH GRANT TO REFINE AND STUDY AN ASTHMA INTERVENTION THAT IS HIGHLY RESPONSIVE TO THE FINDINGS. MOST RECENTLY, THE ASTHMA PROGRAM LED FOCUS GROUPS WITH FAMILIES TO LEARN HOW HOUSING CONDITIONS IMPACT ASTHMA CARE AND IS WORKING TOGETHER WITH COMMUNITY-BASED ORGANIZATIONS TO ADDRESS SOME OF THE BARRIERS IDENTIFIED THROUGH THE ASSESSMENT. SIMILARLY, THE HOSPITAL PUBLISHED THREE REPORTS IN FY 2021 ON BEHAVIORAL HEALTH SERVICES IN WASHINGTON, D.C. ONE REPORT DESCRIBED THE CURRENT LANDSCAPE OF BEHAVIORAL HEALTH SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDER INSURED BY MEDICAID IN WASHINGTON, D.C. AND ANOTHER REPORT ON HOW TO TRANSFORM BEHAVIORAL HEALTH IN THE DISTRICT OF COLUMBIA WITH PERSPECTIVES AND RECOMMENDATIONS FROM CHILDREN'S NATIONAL HOSPITAL AND THE EARLY CHILDHOOD INNOVATION NETWORK. THE THIRD REPORT ILLUSTRATED HOW COVID-19 HAD AN IMPACT ON CHILD BEHAVIORAL HEALTH OUTCOMES AND THE BEHAVIORAL HEALTH CARE SYSTEM. ALL THREE REPORTS ARE AVAILABLE ON THE HOSPITAL WEBSITE: HTTPS://CHILDRENSNATIONAL.ORG/ADVOCACY-AND-OUTREACH/CHILD-HEALTH-ADVOCACY-INSTITUTE/COMMUNITY-MENTAL-HEALTH/PUBLICATIONS RESPONDING DIRECTLY TO COMMUNITY FEEDBACK IN THE COMMUNITY HEALTH NEEDS ASSESSMENT, AN INTERNAL HEALTH LITERACY ENVIRONMENTAL SCAN WAS CONDUCTED IN FY 2020, TAKING STOCK OF HEALTH LITERACY PRACTICES AND BELIEFS AT CHILDREN'S NATIONAL. THE SCAN REACHED OVER 170 EMPLOYEES DIRECTLY, GATHERING FEEDBACK VIA SURVEY, FOCUS GROUP, AND KEY-INFORMANT INTERVIEWS. THIS DATA WILL BE USED TO DRIVE FORWARD CHANGE INSTITUTIONALIZING HEALTH LITERACY BEST PRACTICES. FINALLY, TO SUPPORT CONTINUOUS ASSESSMENT OF THE NEEDS OF OUR COMMUNITY, THE HOSPITAL ESTABLISHED THE CHILD HEALTH DATA LAB OVER TEN YEARS AGO WHERE DATA SCIENTIST USE EVIDENCE-BASED APPROACHES TO IDENTIFY AND TRACK TRENDS IN POPULATION HEALTH USING BIG DATA ANALYSIS, DEVELOPING INTERACTIVE MAPS, AND COLLECTING COMMUNITY INPUT. THE CHILD HEALTH DATA LAB OVERSEES THE DC HEALTH MATTERS WEB PORTAL THAT PROVIDES A ONE-STOP RESOURCE FOR ONLINE ACCESS TO COMMUNITY HEALTH INDICATORS THAT IMPACT THE HEALTH OF DC COMMUNITIES. PART VI, LINE 3: ELIGIBILITY EDUCATIONCHILDREN'S NATIONAL HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY (FAP) THAT PROVIDES ELIGIBLE PATIENTS WITH DISCOUNTED EMERGENCY OR OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES PROVIDED BY CHILDREN'S NATIONAL HOSPITAL. CHILDREN'S WILL PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. CHILDREN'S NATIONAL HOSPITAL PROHIBITS ANY ACTIONS THAT WOULD DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE. FINANCIAL ASSISTANCE INFORMATION, INCLUDING THE POLICY AND PLAIN LANGUAGE GUIDES, AND APPLICATION FORM, IS AVAILABLE ON CHILDREN'S PUBLIC WEBSITE. FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND VIA PHONE. THE COUNSELORS CONTACT INFORMATION IS PUBLICIZED ON THE WEBSITE. CUSTOMER SERVICE CONTACT INFORMATION IS ALSO PROVIDED ON THE WEBSITE AS WELL AS BILLING STATEMENTS. SIGNAGE ALERTING PATIENTS TO THE AVAILABILITY OF FINANCIAL AID IS POSTED AT REGISTRATION AREAS AND APPLICATIONS ARE READILY AVAILABLE. CHILDREN'S ALSO WORKS WITH EXTERNAL VENDORS WHO ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE APPLICATION AS WELL AS APPLYING FOR STATE MEDICAID AND OTHER FEDERAL AND LOCAL PROGRAMS.THE FOLLOWING PROCESSES TAKE PLACE FOR FAMILIES WHO DO NOT HAVE INSURANCE OR WHO CANNOT PAY:1. THROUGH OUR CONTRACTED COMPANIES (MEDLAW AND DECO) WHO RESIDE IN OUR FINANCIAL INFORMATION CENTER (FIC), AN APPLICATION IS MADE FOR MEDICAL ASSISTANCE AND OUR FINANCIAL ASSISTANCE PROGRAM (FAP). ELIGIBILITY IS CONSIDERED FOR ALL APPROPRIATE PUBLIC PROGRAMS. IN AN EFFORT TO HAVE THIS PROCESS TAKE PLACE PRIOR TO THE MEDICAL VISIT, FAP APPLICATIONS ARE MAILED TO SELF-PAY PATIENTS WHEN THEY MAKE AN APPOINTMENT.2. WHILE THE APPLICATION IS IN PROCESS, THE PATIENT IS REGISTERED AS MEDICAID PENDING AND THE MEDICAL VISIT TAKES PLACE (CITIZENS ONLY). NON-CITIZENS ARE REGISTERED AS SELF-PAY.3. IF THE PATIENT IS DETERMINED TO BE MEDICAID ELIGIBLE, THE PATIENT REGISTRATION IS CONVERTED TO THE MEDICAID PLAN.4. IF NOT ELIGIBLE, THE PATIENT'S CHARITY CARE APPLICATION IS FURTHER EVALUATED FOR CHARITY CARE BY CHILDREN'S CUSTOMER SERVICE STAFF IN THE FIC.5. IF FAP IS APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. THE ACCOUNTS ARE MANAGED BY CUSTOMER SERVICE STAFF. ONLY EXPECTED BALANCES REMAIN ON THE ACCOUNT AND FAMILIES RECEIVE STATEMENTS SHOWING THEIR RESPONSIBILITY.6. IF FAP IS NOT APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. FAMILIES CAN SET UP PAYMENT PLANS TO RESOLVE THEIR ACCOUNT BALANCES.7. MEDICALLY INDIGENT STATUS CAN APPLY FOR INSURED FAMILIES. THIS STATUS CAN BE EVALUATED AT ANY TIME IF A FAMILY'S REMAINING BALANCE (EXCLUDING ANY DEDUCTIBLES) AFTER THIRD PARTY PAYER PAYMENT IS GREATER THAN 30% OF ANNUAL INCOME LESS HOUSING EXPENSES.- WHENEVER APPLICABLE, IT IS ENCOURAGED THAT FAMILIES REVIEW THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE THE APPOINTMENT DATE. APPOINTMENTS ARE TYPICALLY MADE WITH THE FIC OFFICE WHEN FAMILIES MAKE THEIR MEDICAL APPOINTMENTS. THEY CAN GO DIRECTLY TO THE FIC OFFICE AT CHILDREN'S NATIONAL HOSPITAL AT ANY OTHER TIME.- FAMILIES ARE ENCOURAGED TO COOPERATE WITH OUR STAFF BY SUPPLYING ALL NECESSARY INFORMATION FOR THE MEDICAID AND FAP APPLICATIONS. PART VI, LINE 4: DESCRIPTION OF COMMUNITY SERVEDAS THE ONLY EXCLUSIVE PROVIDER OF PEDIATRIC CARE IN THE NATION'S CAPITAL, CHILDREN'S NATIONAL SERVES A DIVERSE AND BROAD COMMUNITY, SPANNING FROM THE DISTRICT OF COLUMBIA TO MARYLAND AND VIRGINIA AND BEYOND. IN 2019, THE DISTRICT OF COLUMBIA WAS HOME TO 710,893 RESIDENTS, A POPULATION COMPARABLE TO THE CITIES OF BOSTON AND DENVER. DC'S POPULATION HAS INCREASED BY 18.1% SINCE 2010. MARYLAND AND VIRGINIA ARE HOME TO 6 MILLION AND 8 MILLION RESIDENTS, RESPECTIVELY. THE SOCIAL DEMOGRAPHICS FOR THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA, ACCORDING TO THE U.S. CENSUS, ARE AS FOLLOWS: DISTRICT OF COLUMBIA: ABOUT 44.5% BLACK; 41.7% WHITE; 11.9% LATINO; 4.4% ASIAN AND 0.4% AMERICAN INDIAN/ALASKA NATIVE; MARYLAND: APPROXIMATELY 59% WHITE; 31% BLACK; 10% HISPANIC; 6.7% ASIAN AND VIRGINIA 69.7% WHITE, 19.8% BLACK, 9.4% HISPANIC, 6.8% ASIAN, AND 0.5% AMERICAN INDIAN/ALASKA NATIVE. SINCE 2010, THE LARGEST POPULATION GROWTH OF 33% HAS BEEN IN THE HISPANIC GROUP WHILE THE PORTION OF BLACK POPULATION HAS BEEN DECREASING. IN THE DISTRICT OF COLUMBIA, CHILDREN 18 YEARS OLD AND YOUNGER MAKE UP 19 PERCENT OF THE POPULATION WITH THE HIGHEST PERCENTAGE RESIDING IN WARDS 7 AND 8, 3.14% AND 3.30% RESPECTIVELY. IN BOTH MARYLAND AND VIRGINIA ABOUT 23 PERCENT OF THE POPULATION IS CHILDREN 18 YEARS OLD AND YOUNGER. CHILDREN AGED FIVE AND YOUNGER MAKE UP APPROXIMATELY 6.5% PERCENT OF THE POPULATION IN THE DISTRICT OF COLUMBIA, MARYLAND, AND VIRGINIA. SOCIOECONOMIC STATUS IS THE SOCIAL STANDING OF AN INDIVIDUAL OR GROUP. IT IS OFTEN MEASURED AS A COMBINATION OF EDUCATION, INCOME, AND OCCUPATION. LOW SOCIOECONOMIC STATUS IS STRONGLY CORRELATED WITH INEQUITIES IN ACCESS TO RESOURCES, AS WELL AS ISSUES RELATED TO PRIVILEGE, POWER, AND CONTROL. PEOPLE WITH LOWER SOCIOECONOMIC STATUS TYPICALLY EXPERIENCE POORER HEALTH AND DIE YOUNGER THAN THOSE WITH MORE ECONOMIC ADVANTAGE. CITYWIDE AVERAGES OFTEN PAINT DC AS A SOCIALLY AND ECONOMICALLY RICH CITY; HOWEVER, A MORE DETAILED LOOK REVEALS A STORY OF PROFOUND INEQUITIES. SOCIOECONOMIC CHARACTERISTICS OF DC RESIDENTS VARY IMMENSELY ACROSS THE CITY. HEALTH INEQUITIES FOLLOW THE SAME PATTERN. FOR EXAMPLE, THERE ARE DIRECT CORRELATIONS BETWEEN THE CONCENTRATION OF POVERTY IN SEGMENTS OF THE CITY, PARTICULARLY IN WARDS 7 AND 8, AND PATTERNS OF POOR HEALTH OUTCOMES CONCENTRATED IN THE SAME AREAS. 48.5% OF CHILDREN IN WARD 8, THE WARD WITH THE LOWEST HOUSEHOLD INCOME IN THE DISTRICT OF COLUMBIA, LIVE IN POVERTY, AS COMPARED TO 3.5% OF CHILDREN IN WARD 3, THE WEALTHIEST WARD. ADDITIONALLY, DC HAS A 15+ YEAR DIFFERENCE IN LIFE EXPECTANCY BY WARD: 87.6 YEARS IN WARD 3 COMPARED TO 72 YEARS IN WARD 8. RACIAL DIFFERENCES IN LIFE EXPECTANCY ARE ALSO STRIKING. WHEN COMPARED TO OTHER RACIAL GROUPS, THE LIFE EXPECTANCY FOR BLACK RESIDENTS IS THE LOWEST. WHITE MALES IN THE DISTRICT ARE EXPECTED TO LIVE ALMOST 15 YEARS LONGER THAN BLACK MALES (83.2 AND 68.8 YEARS, RESPECTIVELY). WHITE FEMALES IN THE DISTRICT ARE EXPECTED TO LIVE APPROXIMATELY 9 YEARS LONGER THAN BLACK FEMALES (85.2 AND 76.2 YEARS, RESPECTIVELY).CHILDREN'S NATIONAL IS LOCATED IN AN URBAN COMMUNITY WHERE THERE ARE SEVERAL LARGE ACADEMIC AND COMMUNITY HOSPITALS. HOWEVER, WE SERVE A MAJORITY OF THE CHILDREN IN DC. WE CARE FOR MORE THAN 35,000 CHILDREN THROUGH OUR HEALTH CENTERS EACH YEAR, AS THE LARGEST NON-GOVERNMENT PROVIDER OF PRIMARY CARE IN THE DISTRICT OF COLUMBIA. MARYLAND RESIDENTS ACCOUNTED FOR 58% CHILDREN'S NATIONAL PATIENTS, AND CHILDREN'S NATIONAL IS THE LARGEST PROVIDER OF PEDIATRIC CARE FOR RESIDENTS OF NORTHERN VIRGINIA AS WELL. THE NEEDS OF THE POPULATION SERVED IN MARYLAND AND NORTHERN VIRGINIA ARE SIMILAR TO THE DISTRICT OF COLUMBIA. WE ALSO OFFER FAMILIES A LINK TO QUALITY PEDIATRIC CARE THROUGH OUR MOBILE MEDICAL PROGRAM AND AT COMMUNITY CENTERS. OUR TEAM AVERAGES MORE THAN 460,000 OUTPATIENT VISITS EACH YEAR AT HEALTH CLINICS IN THE DISTRICT OF COLUMBIA, AFFILIATED CENTERS IN MARYLAND AND VIRGINIA, AND AT THE SHEIKH ZAYED CAMPUS IN WASHINGTON, DC. ON AVERAGE, THAT EQUALS NEARLY 1,000 PATIENT VISITS IN ONE DAY TO ONE OF CHILDREN'S NATIONAL'S 30 LOCATIONS IN THE DISTRICT OF COLUMBIA AND THROUGHOUT THE METROPOLITAN AREA. IN FISCAL YEAR 2021, WE PERFORMED 16,960 SURGICAL PROCEDURES, 114,939 DIAGNOSTIC IMAGING PROCEDURES, AND MORE THAN 1 MILLION LABORATORY TESTS. PART VI, LINE 5: PROMOTING THE HEALTH OF THE COMMUNITYCHILDREN'S NATIONAL WAS FOUNDED 150 YEARS AGO AS A MODEST 12-BED FACILITY DEDICATED TO SERVING THE CHILDREN OF THE NATION'S CAPITAL. WHILE THE HEALTH CARE LANDSCAPE LOOKS VERY DIFFERENT TODAY THAN IT DID IN THE 19TH CENTURY, OUR CORE MISSION REMAINS THE SAME. THE MISSION OF CHILDREN'S NATIONAL IS TO EXCEL IN CARE, ADVOCACY, RESEARCH, AND EDUCATION. WE ACCOMPLISH THIS THROUGH PROVIDING A QUALITY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND FAMILIES, IMPROVING HEALTH OUTCOMES FOR CHILDREN, AND LEADING THE CREATION OF INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES. RECOGNIZING THAT A CHILD'S HEALTH IS THE RESULT OF COUNTLESS FACTORS, CHILDREN'S NATIONAL ALSO ADVOCATES FOR POLICIES THAT PROMOTE HEALTH AND WELL-BEING FOR CHILDREN, MANY OF WHICH EXIST OUTSIDE THE CLINICAL SETTING. WHILE THE HOSPITAL HAS SUPPORTED ADVOCACY AND COMMUNITY HEALTH EFFORTS FOR DECADES, IN 2007, THE CHILDREN'S HEALTH BOARD PROVIDED FUNDING TO FORMALLY ESTABLISH THE CHILD HEALTH ADVOCACY INSTITUTE (CHAI). CHILDREN'S NATIONAL BECAME THE FIRST PEDIATRIC HOSPITAL IN THE NATION TO FORM AN IN-HOUSE ADVOCACY INSTITUTE. CHAI FOUNDERS BELIEVED THAT TO CREATE AN ENVIRONMENT WHERE CHILDREN COULD GROW UP TO FULFILL THEIR POTENTIAL, THERE SHOULD BE A COHORT OF ADVOCATES AND COMMUNITY HEALTH EXPERTS TO ENSURE SYSTEMS AND POLICY DID NOT IGNORE THE NEEDS OF THE REGION'S SMALLEST RESIDENTS. THAT MISSION IS EVEN MORE IMPORTANT TODAY.COMPRISED OF CLINICIANS, PUBLIC HEALTH EXPERTS, DATA ANALYSTS, AND GOVERNMENT AFFAIRS PROFESSIONALS, THE CHAI IS DEDICATED TO ADVANCING COMMUNITY HEALTH AND WELL-BEING, WITH A FOCUS ON CHILDREN AND FAMILIES IN UNDER-RESOURCED COMMUNITIES. CHAI'S PORTFOLIO INCLUDES A WIDE RANGE OF INITIATIVES THAT PROMOTE COMMUNITY HEALTH. FROM LEADING THE CHILDREN'S NATIONAL COMMUNITY BENEFIT PROGRAM TO EDUCATING AND MOBILIZING STAFF TO ENGAGE IN COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY - THE CHAI IS DEVOTED TO ADVANCING POLICY AND SYSTEMS CHANGES WITH THE GOAL OF ACHIEVING HEALTH EQUITY FOR ALL CHILDREN. IT IS THROUGH THIS LENS THAT CHILDREN'S NATIONAL ADDS A UNIQUE APPROACH TO ADDRESSING COMMUNITY HEALTH PRIORITIES AND PROMOTING HEALTH EQUITY. THIS WORK CANNOT BE DONE ALONE; THUS, THE CHAI SERVES AS A CONDUIT THROUGH WHICH THE COMBINED EXPERTISE OF MORE THAN 7,600 CHILDREN'S NATIONAL EMPLOYEES AND COUNTLESS COMMUNITY STAKEHOLDERS INTERACT WITH, REACT TO, AND SPEAK ON BEHALF OF CHILDREN AND FAMILIES. IN ADDITION, CHILDREN'S NATIONAL IS ENSURING THAT WE ARE ON THE PATH TOWARD BECOMING A MORE DIVERSE, EQUITABLE AND INCLUSIVE ORGANIZATION TO IMPROVE HEALTH AND RACIAL EQUITY. OUR HOSPITAL HAS BEEN ON A JOURNEY TOWARD GREATER DIVERSITY, EQUITY AND INCLUSION SINCE THE EARLY 2000S. UP TO THE YEAR 2020, WE FOCUSED ON RECRUITMENT, ACADEMIC ADVANCEMENT AND LEADERSHIP DEVELOPMENT OF FACULTY MEMBERS AND TRAINEES UNDERREPRESENTED IN MEDICINE. THIS WORK HAS CONTRIBUTED TO IMPORTANT MILESTONES, INCLUDING WELCOMING A 2021 RESIDENCY CLASS THAT IS OUR MOST DIVERSE CLASS EVER AND MORE THAN THREE TIMES THE NATIONAL AVERAGE FOR DIVERSITY, BETTER REFLECTING OUR PATIENTS AND FAMILIES IN OUR COMMUNITY. OUR HISTORY OF LEADING THESE EFFORTS MEANT WE WERE POISED TO EXPAND OUR SCOPE OF WORK ON DIVERSITY, EQUITY AND INCLUSION. IN FISCAL YEAR 2021, WE BEGAN DESIGNING EFFECTIVE, DATA-DRIVEN AND RESPONSIVE HOSPITAL AND COMMUNITY PROGRAMS THAT LED TO A MORE DIVERSE, EQUITABLE AND INCLUSIVE WORKPLACE AND MORE IMPORTANTLY, WILL ENSURE THE CONTINUED DELIVERY OF HIGH-QUALITY HEALTH CARE SERVICES AND EDUCATION TO ALL PATIENTS AND FAMILIES. THIS IS NOT AN EASY PATH - DEVELOPING INITIATIVES AND PROGRAMS TO REACH THE GOAL OF EQUITY AND INCLUSION FOR ALL REQUIRES US TO OVERCOME CENTURIES OF PERVASIVE RACISM, SEXISM AND CULTURAL AND RELIGIOUS BIAS THAT HAVE CREATED FUNCTIONAL, ECONOMIC AND STRUCTURAL BARRIERS IN SOCIETY. BUT THE DEDICATION AND PASSION THAT OUR TEAMS CONTINUE TO SHOW IN THE FACE OF THESE CHALLENGES GIVE US CONFIDENCE THAT WE HAVE THE VISION, RESOLVE, KNOWLEDGE AND SKILLS TO ADVANCE THIS IMPORTANT BODY OF WORK ON BEHALF OF OUR PATIENTS, FAMILIES AND COMMUNITY. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLESCHILDREN'S HOSPITAL DBA CHILDREN'S NATIONAL HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING ADDITIONAL TAX-EXEMPT ENTITIES:- CHILDREN'S NATIONAL MEDICAL CENTER DBA CHILDREN'S NATIONAL- 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBLE FOR HEALTH CARE SYSTEM- CHILDREN'S HOSPITAL FOUNDATION DBA CHILDREN'S NATIONAL HOSPITAL FOUNDATION- 501(C)(3), FUNDRAISING- CHILDREN'S RESEARCH INSTITUTE DBA CHILDREN'S NATIONAL RESEARCH INSTITUTE- 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS- SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN- BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN- CHILDREN'S SCHOOL SERVICES - 501(C)(3), OPERATION OF A SCHOOL NURSE PROGRAM- CHILDREN'S HOSPITAL SELF-INSURANCE TRUST - 501(C)(3), PROVISION OF INSURANCE TO SYSTEM- HSC FOUNDATION - 501(C)(3), SUPPORT FOR THE HSC ENTITIES- HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS - 501(C)(3), HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES FOR YOUNG INDIVIDUALS WITH SPECIAL NEEDS- THE HOSPITAL FOR SICK CHILDREN DBA THE HSC PEDIATRIC CENTER - 501(C)(3), ACUTE CARE HOSPITAL FACILITY THAT PROVIDES REHABILITATION AND TRANSITIONAL CARE FOR CHILDREN AND ADOLESCENTS WITH DISABILITIES AND CHRONIC ILLNESSES- HSC HOME CARE, LLC - 501(C)(3), HOME AND COMMUNITY PROVIDES ACCESS TO QUALITY REHABILITATIVE AND SPECIALTY SERVICES FOR INFANTS, CHILDREN AND ADOLESCENTS WITH SPECIAL NEEDSEACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS. PART VI, LINE 7, REPORTS FILED WITH STATES DC X X 1 1 X X X X 1 1 0 0 0 0 0 1 1 1 RICHARD JONAS MD CHIEF OF CARDIOLOGY 2063406 0 255000 0 205148 0 14250 0 75939 0 2613743 0 0 0 KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 1399628 0 693183 0 35420 0 221126 0 79037 0 2428394 0 0 0 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 916307 0 367708 0 195890 0 151455 0 36505 0 1667865 0 170930 0 ELIZABETH FLURY CHIEF STRATEGIC OFFICER TO 08/20 408505 0 641823 0 449257 0 14250 0 22330 0 1536165 0 203810 0 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 759520 0 297560 0 149481 0 125280 0 31519 0 1363360 0 127081 0 DENICE CORA-BRAMBLE MD CHIEF MEDICAL OFFICER TO 03/21 651829 0 264221 0 325452 0 14250 0 48217 0 1303969 0 197917 0 ROBERT KEATING MD CHIEF OF NEUROSURGERY 914606 0 142877 0 90137 0 102856 0 15986 0 1266462 0 85781 0 MARK L BATSHAW MD EVP & CHIEF ACADEMIC OFFICER 741444 0 296776 0 152978 0 14250 0 40326 0 1245774 0 0 0 DAVID WESSEL MD CHIEF MEDICAL OFFICER 646983 0 264221 0 132602 0 14250 0 73573 0 1131629 0 0 0 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 785135 0 226868 0 2838 0 14250 0 24352 0 1053443 0 0 0 ROGER PACKER MD SVP CENTER OF EXCELLENCE 596721 0 234411 0 121059 0 14250 0 65301 0 1031742 0 0 0 RICARDO MUNOZ MD CHIEF OF CARDIAC CRIT MED 760043 0 112333 0 63856 0 66498 0 15821 0 1018551 0 0 0 MARY ANNE HILLIARD EVP/CHIEF LEGAL OFFICER 526285 0 207524 0 89071 0 91684 0 35308 0 949872 0 65414 0 DEANN MARSHALL PRESIDENT OF FOUNDATION 586684 0 238091 0 33662 0 14250 0 45933 0 918620 0 0 0 CHARLES WEINSTEIN CHIEF REAL ESTATE OFFICER 515308 0 207030 0 102188 0 14250 0 527 0 839303 0 0 0 VITTORIO GALLO PHD CHIEF RESEARCH OFFICER 386536 0 147820 0 163407 0 68428 0 30031 0 796222 0 142544 0 DARRYL VARNADO CHIEF PEOPLE OFFICER 432124 0 177468 0 93971 0 14250 0 50587 0 768400 0 0 0 ALEC KING EVP/CFO TO 10/20 540791 0 -20853 0 182912 0 14250 0 21672 0 738772 0 100312 0 LINDA TALLEY CHIEF NURSING OFFICER 376746 0 78046 0 54845 0 41382 0 12730 0 563749 0 30989 0 MICHELLE M MCGUIRE EVP/CHIEF STRATEGY OFFICER 350011 0 89727 0 46193 0 36956 0 25192 0 548079 0 25175 0 ALDWIN LINSDAY EVP/CFO AS OF 12/20 323772 0 72276 0 44845 0 36741 0 1778 0 479412 0 24355 0 BRIAN JACOBS MD FMR CHIEF INFO OFFICER TO 06/19 0 0 0 0 386763 0 3 0 454 0 387220 0 0 0 MENDEL TUCHMAN MD FORMER CRO TO 06/17 115566 0 5077 0 6568 0 4591 0 6939 0 138741 0 0 0 SCHEDULE J, PART I, LINE 1A: FIRST CLASS OR CHARTER TRAVEL THE CEO PER HIS EMPLOYMENT CONTRACT IS ENTITLED TO USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS. HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL. SCHEDULE J, PART I, LINE 1A: PERSONAL SERVICES CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. SCHEDULE J, PART 1, LINE 4A: SEVERANCE THE FOLLOWING FORMER OFFICERS AND KEY EMPLOYEES RECEIVED A SEVERANCE PAYMENT. THE SEVERANCE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF OTHER REPORTABLE COMPENSATION: ELIZABETH FLURY $133,050 BRIAN JACOBS, MD $387,217 SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II COLUMN (C ) AS PART OF DEFERRED COMPENSATION OR SCHEDULE J, PART II, COLUMN (B)(III) WHEN AMOUNTS ARE DEFERRED AND DISTRIBUTED IN THE SAME CALENDAR YEAR: KURT NEWMAN, MD $206,876 ANTHONY SANDLER, MD $137,205 MARK BATSHAW, MD $110,737 DAVID WESSEL, MD $98,590 KATHY CHAVANU GORMAN $111,030 ROGER PACKER, MD $87,467 VITTORIO GALLO, PHD $55,157 ELIZABETH FLURY $88,323 DENISE CORA-BRAMBLE, MD $98,590 ALDWIN LINDSAY $22,491 CHARLES WEINSTEIN $77,250 MICHELLE MCGUIRE $22,706 LINDA TALLEY $29,122 DARRYL VARNADO $66,220 RICHARD JONAS $163,200 MARY ANNE HILLIARD $77,434 ROBERT KEATING $88,606 RICARDO MUNOZ $52,248 SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT. SCHEDULE J, PART I, LINE 8: INITIAL CONTRACT EXCEPTION CERTAIN INDIVIDUALS HIRED DURING THE YEAR HAVE EMPLOYMENT CONTRACTS WHICH MEET THE INITIAL CONTRACT EXCEPTIONS DESCRIBED IN THE TREASURY REGULATIONS. SCHEDULE J, PART II, COLUMN (F): COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990 THE AMOUNTS REPORTED IN COLUMN F REPRESENT THE ACCUMULATION OVER MANY YEARS OF DEFERRED COMPENSATION BENEFITS WHICH ARE NOW TAXABLE TO THE RECIPIENT. THE ORGANIZATION HAS ALSO REPORTED THESE SAME AMOUNTS AS ACCRUED DEFERRED COMPENSATION IN PRIOR YEARS' COLUMN C. A DISTRICT OF COLUMBIA 536001131 254764KB8 2015-09-17 413728662 SEE PART VI 0 0 0 A 23730000 413728662 410562146 3166515 2012 0 1 1 1 A 0 1 1 1 1 1 0.00100 0.00000 0.00100 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DISTRICT OF COLUMBIA DATE THE REBATE COMPUTATION WAS PERFORMED: 09/17/2020 SCHEDULE K, PART I, LINE A, COLUMN (F): DESCRIPTION OF PURPOSE ADV REFUND BOND ISSUES 10/26/2005 AND 4/10/2008. DEANN MARSHALL HCE HOUSING X 500000 100000 0 1 1 100000 SCHEDULE L, PART II: LOANS TO AND/OR FROM INTERESTED PERSONSTHE HOUSING LOAN TO DEANN MARSHALL WAS APPROVED IN ADVANCE BY INDEPENDENT PERSONS SERVING ON THE BOARD OF DIRECTORS. THE LOAN IS DOCUMENTED BY A SIGNED WRITTEN AGREEMENT BETWEEN THE PARTIES, AND THE ORGANIZATION BELIEVES THIS AGREEMENT MEETS THE INCOME TAX DEFINITION OF A LOAN. DR. MARSHALL IS CURRENTLY IN COMPLIANCE WITH ALL TERMS OF THE AGREEMENT. X 1 2451 COST X 181 656365 COST X PC PERIPHERALS 1 130023 COST X EVENT TICKETS 1 6000 COST 0 1 0 PART I, COLUMN (B): THE AMOUNTS IN COLUMN (B) REPRESENT THE NUMBER OF CONTRIBUTIONS. FORM 990, PART I, LINE 1 AND PART III, LINE 1: ORGANIZATION'S MISSION TO IMPROVE HEALTH OUTCOMES FOR CHILDREN; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH. AS THE NATION'S CHILDREN'S HOSPITAL, THE MISSION OF CHILDREN'S NATIONAL IS TO EXCEL IN CARE, ADVOCACY, RESEARCH AND EDUCATION. WE ACCOMPLISH THIS THROUGH: - PROVIDING A QUALITY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND FAMILIES. - IMPROVING HEALTH OUTCOMES FOR CHILDREN REGIONALLY, NATIONALLY, AND INTERNATIONALLY. - LEADING THE CREATION OF INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS CHILDREN'S NATIONAL IS THE SOLE MEMBER OF CHILDREN'S NATIONAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS THE SOLE MEMBER OF CHILDREN'S NATIONAL HOSPITAL HAS THE RIGHT TO ELECT DIRECTORS OF CHILDREN'S NATIONAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OR STOCKHOLDERS THE ARTICLES AND BY-LAWS OF CHILDREN'S NATIONAL HOSPITAL DESCRIBE CERTAIN RIGHTS RESERVED TO THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS THE RELEVANT COMMITTEES OF THE ORGANIZATION REVIEW APPLICABLE PORTIONS OF THE 990. THE FORM 990 IS REVIEWED AND RECOMMENDED FOR FILING BY THE CHAIRPERSON OF THE AUDIT COMMITTEE OF CHILDREN'S NATIONAL PRIOR TO FILING WITH IRS. CHILDREN'S NATIONAL HOSPITAL PROVIDES A COPY OF THE FORM 990 TO THE FULL CHILDREN'S NATIONAL HOSPITAL BOARD PRIOR TO FILING WITH THE IRS. THE COMPLETED FORM 990 IS ALSO MADE AVAILABLE TO THE BOARD OF CHILDREN'S NATIONAL BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT CHILDREN'S NATIONAL HOSPITAL ASKS THAT EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE COMPLETE A CONFLICT OF INTEREST FORM AT LEAST EVERY YEAR. IN ADDITION, EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS INSTRUCTED TO AMEND THE CONFLICT OF INTEREST FORM IMMEDIATELY UPON A CHANGE IN STATUS OF ANY OF THE QUESTIONS ON THE FORM. THESE FORMS ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND CONFLICTS OF INTERESTS ARE NOTED. THE CHILDREN'S NATIONAL HOSPITAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY. IF ANYONE IS FOUND TO BE CONFLICTED OR A SIGNIFICANT PERCEIVED CONFLICT EXISTS, THAT BOARD MEMBER WOULD RECUSE HIMSELF OR HERSELF FROM ALL DISCUSSIONS RELATED TO THE TRANSACTION. FORM 990, PART VI, LINES 13 & 14: GOVERNING POLICIES CHILDREN'S NATIONAL HOSPITAL IS GOVERNED BY THE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL. THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION THE PEOPLE, CULTURE AND COMPENSATION COMMITTEE OF THE CHILDREN'S NATIONAL BOARD OF DIRECTORS IS COMPRISED WHOLLY OF DISINTERESTED, INDEPENDENT BOARD MEMBERS. THE COMMITTEE HAS RETAINED INDEPENDENT OUTSIDE CONSULTANTS EXPERT ON COMPENSATION MATTERS. THE COMMITTEE DETERMINES ADJUSTMENTS IN COMPENSATION, INCLUDING BASE PAY, INCENTIVES, AND OTHER FORMS OF COMPENSATION FOR EACH PERSON DEEMED BY THE COMPENSATION COMMITTEE TO BE A "DISQUALIFIED PERSON" AS THAT TERM IS USED IN THE INTERMEDIATE SANCTIONS REGULATIONS OF THE IRS. THE COMMITTEE IS INFORMED IN ITS DECISION-MAKING BY COMPENSATION STUDIES AND COMPARISONS DONE BY THE INDEPENDENT CONSULTANT AND RELIES UPON "REASONABLENESS" OPINIONS FOR SUCH CONSULTANTS, PRIOR TO OR CONTEMPORANEOUS WITH MAKING COMPENSATION DECISIONS. THE COMMITTEE MEETS 4-6 TIMES PER YEAR TO CONSIDER SUCH MATTERS AND DOCUMENTS THESE MEETINGS IN MINUTES. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC CHILDREN'S NATIONAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 ARE PROVIDED ON REQUEST. FORM 990, PART XI, LINE 9: UNRESTRICTED EQUITY TRANSFER 606,734. CHILDREN'S NATIONAL AT WALTER REED LLC 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 383987350 HEALTH CARE DC 85452 100823795 CH CHILDREN'S HOSPITAL FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521640402 FUNDRAISING DC 501(C)(3) LINE 7 CNMC 0 CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521640403 HEALTH CARE DC 501(C)(3) LINE 12C, III-FI N/A 0 CHILDREN'S RESEARCH INSTITUTE 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521654453 RESEARCH DC 501(C)(3) LINE 7 CNMC 0 CHILDREN'S HOSPITAL SELF-INSURANCE TRUST 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521640399 INSURANCE DC 501(C)(3) LINE 12C, III-FI CH 1 SAFE KIDS WORLDWIDE 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521627574 INJURY PREVENTION DC 501(C)(3) LINE 7 CNMC 0 BRAINY CAMPS ASSOCIATION 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 271547370 CHILD CAMPS DC 501(C)(3) LINE 12A, I CH 1 CHILDREN'S SCHOOL SERVICES 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 814291601 NURSING SERVICES DC 501(C)(3) LINE 12A, I CNMC 0 THE HSC FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521346603 HEALTH CARE DC 501(C)(3) LINE 12C, III-FI CNMC 0 THE HOSPITAL FOR SICK CHILDREN 111 MICHIGAN AVE NW WASHINGTON DC 20010 530204670 HOSPITAL DC 501(C)(3) LINE 3 HSC FNDN 0 HEALTH SVCS FOR CHILDREN W SPEC NEEDS 1101 VERMONT AVE NW STE 1200 WASHINGTON DC 20010 521862406 HEALTH CARE DC 501(C)(3) LINE 10 HSC FNDN 0 CHILDREN'S PEDIATRICIANS AND ASSOCIATES LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 522072589 HEALTH CARE DC N/A RELATED -344835 5399434 0 0 0.50000 5253 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 832873855 PROPERTY MANAGEMENT DC N/A 0 0 5253 HTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 833044006 PROPERTY MANAGEMENT DC N/A 0 0 54 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 833358685 PROPERTY MANAGEMENT DC N/A 0 0 54 HTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 833385522 PROPERTY MANAGEMENT DC N/A 0 0 CHILDREN'S NATIONAL HEALTH NETWORK 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521996521 HEALTH CARE DC N/A C 0 BEARACUDA RE PO BOX 69 GRANDCAYMAN CJ KY1-1102 REINSURANCE CJ N/A C 0 PEDIATRIC HEALTH NETWORK INC 12211 PLUM ORCHARD DR STE 102 SILVER SPRING MD 20904 833415276 HEALTH CARE DC N/A C 0 BUILDING 5253 MANAGING MEMBER LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 832801690 PROPERTY MANAGEMENT DC N/A C 0 BUILDING 54 MANAGING MEMBER LLC 111 MICHIGAN AVE WASHINGTON DC 20010 833272918 PROPERTY MANAGEMENT DC N/A C 0 0 0 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 BRAINY CAMPS ASSOCIATION Q 257692 COST BRAINY CAMPS ASSOCIATION S 68060 COST CHILDREN'S HOSPITAL SELF-INSURANCE TRUST R 12663982 COST CHILDREN'S HOSPITAL SELF-INSURANCE TRUST S 453735 COST