2022-05-13T18:40:22-05:00 2021-06-30 135565207 KPMG LLP MISSION TOWERS I 3975 FREEDOM CIRCLE DR SANTA CLARA CA 95054 990 2020-07-01 951691313 RADY CHILDREN'S HOSPITAL - SAN DIEGO RADY 8585761700 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 921234282 JAMES J ULI JR CFO/TREASURER 8585761700 2022-05-13 1 JAMES ULI JR 999009999 JAMES R LANCASTER P00742579 4083675764 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z PATRICIO A FRIAS MD 3020 CHILDRENS WAY MC SAN DIEGO CA 921234282 1893260030 0 X WWW.RCHSD.ORG X 1954 CA THE HOSPITAL PROVIDES COMPREHENSIVE PEDIATRIC MEDICAL SERVICES IN SAN DIEGO, SOUTHERN RIVERSIDE, AND IMPERIAL COUNTIES. 26 26 5891 525 2065791 0 97611136 138071860 1125744151 1086576280 20802927 83171647 15724178 16058698 1259882392 1323878485 4537109 5663815 0 0 484620749 505852155 0 0 105125 654288601 655483194 1143446459 1166999164 116435933 156879321 2427505044 3154030389 955658395 1144047054 1471846649 2009983335 X TO RESTORE, SUSTAIN AND ENHANCE THE HEALTH AND DEVELOPMENTAL POTENTIAL OF CHILDREN THROUGH EXCELLENCE IN CARE, EDUCATION, RESEARCH AND ADVOCACY. 0 0 925707297 5389098 1086576280 SEE SCHEDULE ORADY CHILDREN'S HOSPITAL SAN DIEGO (THE HOSPITAL) IS A REGIONAL TERTIARY AND QUATERNARY REFERRAL CENTER AND PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT ACUTE, PSYCHIATRIC AND INTENSIVE CARE PEDIATRIC SERVICES. THE HOSPITAL ALSO IS THE SOLE PEDIATRIC PROVIDER AND DESIGNATED PEDIATRIC TRAUMA CENTER FOR SAN DIEGO COUNTY AND IS THE PRIMARY SOURCE OF PEDIATRIC AND NEONATAL INTENSIVE CARE SERVICES FOR BOTH SAN DIEGO AND IMPERIAL COUNTIES. ON ITS MAIN CAMPUS THE HOSPITAL OPERATES THE ONLY LEVEL 4 FULL SCOPE NEONATAL INTENSIVE CARE UNIT IN SAN DIEGO, RIVERSIDE AND IMPERIAL COUNTIES. IN ADDITION, THE HOSPITAL OPERATES AN 11-BED LEVEL 3 NEONATAL INTENSIVE CARE UNIT AT SOUTHWEST HEALTHCARE SYSTEM IN RANCHO SPRINGS, AN 8-BED LEVEL 2 NEONATAL INTENSIVE CARE UNIT FOR SCRIPPS MEMORIAL HOSPITAL IN ENCINITAS, AN 18-BED LEVEL 3 NEONATAL INTENSIVE CARE UNIT FOR SCRIPPS MEMORITAL HOSPITAL IN LA JOLLA, AND TWO LEVEL 2 NEONATAL INTENSIVE CARE UNITS FOR SCRIPPS MERCY HOSPITAL LOCATED IN SAN DIEGO AND CHULA VISTA; AN 11-BED PEDIATRIC MEDICAL UNIT FOR SHARP HEALTH LOCATED AT ITS SHARP GROSSMONT CAMPUS; AND A LEVEL 3, 4-BED NEONATAL INTENSIVE CARE UNIT, LOCATED AT PALOMAR MEDICAL CENTER IN ESCONDIDO. THE HOSPITAL IS AMALGAMATED WITH THE UNIVERSITY OF CALIFORNIA, SAN DIEGO, HEALTH SCIENCES, AND SERVES AS A CENTER FOR GRADUATE AND POST-GRADUATE EDUCATION IN THE FIELD OF PEDIATRICS. ANNUALLY, THE HOSPITAL HAS APPROXIMATELY 15,000 INPATIENT ADMISSIONS AND APPROXIMATELY 344,000 VISITS PER YEAR IN ITS OUTPATIENT DEPARTMENTS. ADDITIONALLY, THE EMERGENCY DEPARTMENT AND URGENT CARE CENTERS PROVIDE APPROXIMATELY 65,000 AND 24,000 VISITS, RESPECTIVELY, PER YEAR. 925707297 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 1 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 708 0 1 5891 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 26 26 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X NISHANTHA RATNAYAKE 8585761700 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 921234282 S DOUGLAS HUTCHESON CHAIR 4.00 12.00 X X 0 0 0 PAUL J HERRING VICE CHAIR 4.00 8.00 X 0 0 0 LISA A BARKETT BOARD MEMBER 2.00 2.00 X 0 0 0 MARTIN BROTMAN MD BOARD MEMBER 2.00 2.00 X 0 0 0 BRIDGETT M BROWN BOARD MEMBER 2.00 6.00 X 0 0 0 MICHAEL J FARRELL BOARD MEMBER 2.00 2.00 X 0 0 0 MICHAEL A FRIEDMAN MD BOARD MEMBER (FROM 03/2021) 2.00 2.00 X 0 0 0 JOHN M GILCHRIST JR BOARD MEMBER 2.00 4.00 X 0 0 0 DAVID F HALE BOARD MEMBER 2.00 6.00 X 0 0 0 DEBRA L REED-KLAGES BOARD MEMBER 2.00 2.00 X 0 0 0 CATHERINE J MACKEY PHD BOARD MEMBER 2.00 4.00 X 0 0 0 DIEGO G MIRALLES MD BOARD MEMBER 2.00 4.00 X 0 0 0 HENRY L NORDHOFF BOARD MEMBER 2.00 4.00 X 0 0 0 TINA S NOVA PHD BOARD MEMBER 2.00 6.00 X 0 0 0 HARRY M RADY BOARD MEMBER 2.00 4.00 X 0 0 0 THEODORE D ROTH BOARD MEMBER 2.00 2.00 X 0 0 0 DONALD J ROSENBERG BOARD MEMBER 2.00 4.00 X 0 0 0 BYRON SCOTT MD BOARD MEMBER (FROM 03/2021) 2.00 2.00 X 0 0 0 MICHAEL R STONE BOARD MEMBER (FROM 03/2021) 2.00 2.00 X 0 0 0 VANESSA V WERTHAM PHD BOARD MEMBER 2.00 2.00 X 0 0 0 SCOTT N WOLFE BOARD MEMBER 2.00 4.00 X 0 0 0 DAVID A BRENNER MD EX-OFFICIO BOARD MEMBER 2.00 4.00 X 0 0 0 ANDREW J SKALSKY MD EX-OFFICIO BOARD MEMBER 2.00 2.00 X 0 0 0 PRADEEP KHOSLA PHD EX-OFFICIO BOARD MEMBER 2.00 2.00 X 0 0 0 JOHN STOBO MD EX-OFFICIO BOARD MEMBER 2.00 2.00 X 0 0 0 GEORGE CHIANG MD EX-OFFICIO BOARD MEMBER (FROM 01/20) 2.00 3.00 X 0 0 0 PATRICK FRIAS MD PRESIDENT & CEO 29.00 11.00 X 1468731 0 37494 JAMES J ULI JR SVP, CFO, TREASURER (FROM 03/20) 31.00 9.00 X 609574 0 18167 ANGELA M VIEIRA GENERAL COUNSEL (FROM 03/20) 35.00 5.00 X 579301 0 79414 BELINDA SANTOS-RAMIREZ BOARD ADMIN & CHIEF OF STAFF 35.00 5.00 X 129987 0 28382 NICHOLAS M HOLMES SR VP, COO 35.00 5.00 X 817492 0 38095 JILL STRICKLAND SR VP, CAO 32.00 8.00 X 271827 0 6818 GAIL L KNIGHT MD SR VP, CMO 37.00 3.00 X 806411 0 12132 STEPHEN JENNINGS SR VP, EXEC DIR FOUNDATION 0.00 40.00 X 0 643427 75931 CHRIS ABE VP, OPERATIONS 40.00 0.00 X 439768 0 106052 SCOTT D CAMPBELL VP, CFO & ADMIN OFFICER - MPF 40.00 0.00 X 482488 0 71738 CHARLES B DAVIS SR VP, MPF COO & CARE REDESIGN 40.00 0.00 X 699054 0 67275 MARY J FAGAN VP, PATIENT CARE SVCS/CNO 40.00 0.00 X 470483 0 93550 CHRISTINA GALBO CHIEF COMPL & PRIV OFFICER 40.00 0.00 X 226054 0 55929 MEREDITH LURIE VP, STRATEGIC AND ORG PLANNING 40.00 0.00 X 330021 0 70424 CATHY NUGENT VP, HUMAN RESOURCES 40.00 0.00 X 486895 0 109743 ALBERT ORIOL VP, INFO MGMT/CIO 40.00 0.00 X 546809 0 60591 NISHANTHA S RATNAYAKE VP, FINANCE & CONTROLLER 40.00 0.00 X 383190 0 44945 BARBARA L RYAN VP, GOVERNMENT AFFAIRS 40.00 0.00 X 438886 0 128614 GLENN F BILLMAN CHIEF QUALITY OFFICER 40.00 0.00 X 427555 0 84806 MICHAEL HESTER SR DIR, REVENUE CYCLE 40.00 0.00 X 290628 0 22991 GLIDA E RECODO CLINICAL NURSE II 40.00 0.00 X 290907 0 20318 MARK SEY PHARMACIST IN CHIEF 40.00 0.00 X 292127 0 21261 SCOTT A VOIGTS SR DIR, CHIEF TECH OFFICER 40.00 0.00 X 292996 0 10985 KATHLEEN M CAIN SVP, CFO, TREASURER (THRU 02/20) 16.00 4.00 X 289442 0 13191 MARGARETA E NORTON EXEC VP, CAO, SECRETARY (THRU 02/20) 20.00 0.00 X 1134424 0 -66096 DONALD B KEARNS MD MMM PRESIDENT EMERITUS 14.00 6.00 X 678312 0 22218 12883362 643427 1234968 1367 1 1 0 CHILDREN'S SPECIALISTS OF SAN DIEGO 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 MEDICAL SERVICES 132403655 THE REGENTS OF THE UNIVERSITY OF CALIFOR 9500 GILMAN DRIVE LA JOLLA CA 92093 MEDICAL SERVICES 40786645 CHILDREN'S PHYSICIANS MEDICAL GROUP 5855 COPLEY DRIVE SUITE 100 SAN DIEGO CA 92111 MEDICAL SERVICES 31495986 HUMAN CAPITAL SELECT LLC 2680 S VAL VISTA DRIVE SUITE 161 GILBERT AZ 85295 AGENCY LABOR 11036964 SCRIPPS MEMORIAL HOSPITAL LA JOLLA 9888 GENESEE AVENUE LA JOLLA CA 92037 MEDICAL SERVICES 9923253 399 81218180 50297081 6556599 138071860 NET PATIENT SERVICE RE 622110 1063635999 1063635999 OUTPATIENT PHARMACEUTI 622110 7881554 7881554 MEDICAL OFFICE BUILDIN 622110 4427805 4427805 MEDICAL SERVICES REIMB 622110 3463664 3463664 7167258 7167258 1086576280 18098100 18098100 1440945 0 1440945 1440945 1440945 634455092 569381545 65073547 65073547 65073547 TPA SERVICES 900099 6793100 6793100 PARKING 812930 1817739 1817739 FOOD SERVICE REVENUE 721000 1724794 1724794 4282120 2065791 2216329 14617753 1323878485 1086576280 2065791 97164554 X 5389098 5389098 274717 274717 8714237 2044123 6564989 105125 380091184 274548652 105542532 44794986 31557052 13237934 42408353 29875723 12532630 29843395 21023995 8819400 7210865 2027057 5183808 606455 23032 583423 481930 481930 130918 130918 1303091 1303091 373419025 345956196 27462829 1552091 634934 917157 2051074 989717 1061357 16328223 1896691 14431532 14613984 11691187 2922797 452686 336541 116145 481792 99672 382120 14936569 11949255 2987314 44077907 28650640 15427267 13718631 81503 13637128 MEDICAL SUPPLIES 107520177 107520177 TAXES AND LICENSES 28767063 27132434 1634629 REPAIRS 6411698 1209619 5202079 DUES AND SUBSCRIPTIONS 2386042 2386042 19032973 18409240 623733 1166999164 925707297 241186742 105125 210341413 124181860 187572375 173334496 231034 212109 105031 93729 9346494 10629863 27228332 35345481 1025049919 548558252 471952826 476491667 1260259393 2008686205 143097007 206461266 713000 608000 116658139 117985713 2427505044 3154030389 181663692 210981900 95706201 200076372 356648260 262243361 321640242 470745421 955658395 1144047054 X 1371514207 1868738821 100332442 141244514 1471846649 2009983335 2427505044 3154030389 X 156879321 297110885 84146480 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 130918 0 0 0 130918 0 PART II-B, LINE 1: PAID OUTSIDE CONSULTANTS TO INCREASE AND OBTAIN FUNDING FOR BUILDING DEVELOPMENT PROJECTS AND TO INFLUENCE FEDERAL, STATE AND LOCAL LEGISLATION AS IT AFFECTS RADY CHILDREN'S HOSPITAL'S HEALTHCARE REIMBURSEMENT AND REGULATIONS. 114591220 4258030 29121590 3568781 70538 144331521 112673421 5561460 701427 4235454 109634 114591220 109949631 4481919 2755878 4421460 92547 112673421 101712762 6622916 6082110 4360156 108001 109949631 93441640 2751574 9143887 3522210 102129 101712762 0.55330 0.32230 0.12440 1 1 1 19590822 19590822 643041582 317442939 325598643 14307865 8683001 5624864 307002770 218239818 88762952 41106880 4192494 36914386 476491667 ACTIS ENERGY 3 1810867 F ADVENT INTERNATIONAL GPE IX-C, L.P. 4342466 F ADVENT INTERNATIONAL GPE VIIIC, L.P. 8417369 F AMERICAN INDUSTRIAL PARTNERS CAPITAL FUND V, L.P. 2920338 F AMERICAN INDUSTRIAL PARTNERS CAPITAL FUND VI, L.P. 5599986 F AMERICAN SECURITIES PARTNERS V, L.P. 15002 F AMERICAN SECURITIES PARTNERS VI, L.P. 3848792 F AMERICAN SECURITIES PARTNERS VII, L.P. 7346004 F AMERICAN SECURITIES PARTNERS VIII, L.P. 3065442 F AMPERSAND 2020 779116 F ARDIAN ASF VIII 3204084 F CLEARLAKE CAPITAL PARTNERS VI 5494500 F CLEARLAKE OPPORTUNITIES PARTNERS (OFFSHORE) II, L.P. 3649925 F CVC CREDIT PARTNERS GLOBAL SPECIAL SITUATIONS 3674388 F CVC CREDIT PARTNERS GLOBAL SPECIAL SITUATIONS II 3595429 F ENCAP ENERGY CAPITAL FUND X, L.P. 3054660 F ENERGY TRUST PARTNERS V, L.P. 8476547 F FORTISSIMO CAPITAL FUND IV, L.P. 5942805 F FORTISSIMO CAPITAL FUND V, L.P. 2615126 F GLENDON OPPORTUNITIES FUND II, LP 11312615 F GLOBAL INFRASTRUCTURE PARTNERS III, L.P. 8879790 F GOLDMAN SACHS CAPITAL PARTNERS VI PARALLEL, L.P. 600129 F GOLDMAN SACHS VINTAGE FUND IV OFFSHORE LP 845085 F IPI PARTNERS IIA 154913 F ISQ GLOBAL INFRASTRUCTURE 5810008 F KPS SPECIAL SITIATUIONS FUND V 2252914 F MILLENNIUM TECHNOLOGY VALUE PARTNERS II, L.P. 1951274 F NY LIFE INSURANCE - ROBERT LIPSCHULTZ 38376 F OAKTREE EUROPEAN PRINCIPAL FUND, III, L.P. 3051936 F PATRIA BRAZILIAN PRIVATE EQUITY FUND IV, L.P. 2696956 F PATRIA BRAZILIAN PRIVATE EQUITY FUND V, L.P. 8037417 F PRIMAVERA CAPITAL FUND III 10928515 F PROVIDENCE STRATEGIC GROWTH EUROPE I 959436 F RIDGEMONT EQUITY PARTNERS ENERGY OPPORTUNITY FUND, L.P. 3900553 F RIVERSTONE GLOBAL ENERGY AND POWER FUND VI, L.P. 5242128 F STEPSTONE ENDURANCE FUND 10086366 F STEPSTONE SECONDARY OPPORTUNITIES FUND II, L.P. 2219306 F STEPSTONE SECONDARY OPPORTUNITIES FUND, L.P. 1406584 F STEPSTONE SECONDARY OPPORTUNITY FUND III 9208131 F TPG HEALTHCARE PARTNERS, LP 683958 F TPG PARTNERS VII, L.P. 11407994 F TPG PARTNERS VIII, L.P. 3214145 F TRG GROWTH PARTNERSHIP 1161995 F TSSP OPPORTUNITIES PARTNERS IV (B), L.P. 4414555 F U.S. FARMING REALTY TRUST II, L.P. 4723122 F VISTA EQUITY PARTNERS V, L.P. 6248160 F WATERLAND PRIVATE EQUITY FUND VII C.V. 3281889 F WHITE DEER ENERGY TE LP II 3025366 F YORKTOWN ENERGY PARTNERS IX, L.P. 864804 F 206461266 PAYABLE TO BENEFICIARIES 298506 INTEREST RATE SWAPS 81320347 DEFERRED COMPENSATION 15915 MALPRACTICE IBNR 6830453 BENEFITS PAYABLE 22923287 SANFORD INVSTMNT OCEANSIDE BUI 2948673 SECURITY DEPOSITS 132613 PENSION LIABILTY 43991431 CONTRACTOR RETAINAGE 1463424 DEFERRED LEASE LIABILITY - LT 12327160 SERIES 2021A TAXABLE BONDS 298493612 470745421 X PART V, LINE 4: RADY CHILDREN'S BOARD DESIGNATED ENDOWMENT FUNDS SUPPORT THE HIGHEST AND MOST URGENT NEEDS OF THE ORGANIZATION AS DETERMINED BY ITS BOARD OF TRUSTEES. IN ADDITION, DONOR DESIGNATED (OR RESTRICTED) ENDOWMENT FUNDS SUPPORT A WIDE RANGE OF INITIATIVES IDENTIFIED BY THE DONOR. PART X, LINE 2: RCHSD RECOGNIZES AND MEASURES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED, BASED SOLELY ON ITS TECHNICAL MERITS, WITH THE TAXING AUTHORITY HAVING FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. RCHHC RECORDS LIABILITIES FOR UNRECOGNIZED TAX BENEFITS FROM UNCERTAIN TAX POSITIONS AS DISCRETE TAX ADJUSTMENTS IN THE FIRST PERIOD THAT THE MORE LIKELY THAN NOT THRESHOLD IS NOT MET. RCHSD HAS NOT TAKEN ANY SIGNIFICANT UNCERTAIN TAX POSITIONS THEREFORE NO LIABILITY (OR ASSET) HAS BEEN RECOGNIZED AS OF JUNE 30, 2021. 0 CENTRAL AMERICA AND THE CARIBBEAN INVESTMENTS 88278183 NORTH AMERICA GRANT MAKING 274717 0 0 0 0 0 0 88552900 0 88552900 NORTH AMERICA GRANT MAKING 274717 CHECK 1 0 0 1 0 0 0 PART I, LINE 2: THE ORGANIZATION IS REPORTING THE AMOUNT OF INVESTMENTS ON PART I, LINE 3, COLUMN F. THE ORGANIZATION USES THE ACCRUAL METHOD OF ACCOUNTING FOR ALL AMOUNTS REPORTED. PART III ACCOUNTING METHOD: 1 1 X 1 X 350.000000000000 1 X 450.000000000000 1 0 1 1 4333659 78179 4255480 0.00360 378307993 378307993 0.00000 7444758 1332 7443426 0.00640 390086410 378387504 11698906 0.01000 35988080 21983457 14004623 0.01200 19837405 7929810 11907595 0.01020 40397786 14964597 25433189 0.02180 27758134 19339061 8419073 0.00720 4028 0 4028 0.00000 123985433 64216925 59768508 0.05120 514071843 442604429 71467414 0.06120 576074 253361 322713 0.00030 576074 253361 322713 0.00030 0 20680886 6014002 5957042 4729344 1227698 X 1 1 1 1 RADY CHILDREN'S HOSPITAL SAN DIEGO 3020 CHILDRENS WAY MC 5133 SAN DIEGO CA 92123 WWW.RCHSD.ORG 80000028 X X X X X RADY CHILDREN'S HOSPITAL SAN DIEGO 1 0 0 1 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 350.000000000000 450.000000000000 X X 1 1 X X X X 1 X WWW.RCHSD.ORG X WWW.RCHSD.ORG X WWW.RCHSD.ORG X X X X X 1 X 0 X X X X 1 X 0 0 RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 5: THE CHNA IS IMPLEMENTED AND MANAGED BY A STANDING CHNA COMMITTEE COMPRISED OF REPRESENTATIVES FROM SEVEN HOSPITALS AND HEALTH SYSTEMS. THE 2019 CHNA BUILT ON THE RESULTS OF THE 2016 CHNA AND INCLUDED THREE TYPES OF COMMUNITY ENGAGEMENT EFFORTS: FOCUS GROUPS WITH RESIDENTS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PROVIDERS, AND HEALTH CARE LEADERS; KEY INFORMANT INTERVIEWS WITH HEALTH CARE EXPERTS; AND AN ONLINE SURVEY FOR RESIDENTS AND STAKEHOLDERS. IN ADDITION, THE CHNA INCLUDED EXTENSIVE QUANTITATIVE ANALYSIS OF NATIONAL AND STATE-WIDE DATA SETS, SAN DIEGO COUNTY EMERGENCY DEPARTMENT AND INPATIENT HOSPITAL DISCHARGE DATA, COMMUNITY CLINIC USAGE DATA, COUNTY MORTALITY AND MORBIDITY DATA, AND DATA RELATED TO SOCIAL DETERMINANTS OF HEALTH.TWO PRIMARY METHODS WERE EMPLOYED IN THE 2019 CHNA. FIRST, QUANTITATIVE ANALYSES WERE CONDUCTED OF EXISTING PUBLICLY AVAILABLE DATA TO PROVIDE AN OVERARCHING VIEW OF CRITICAL HEALTH ISSUES ACROSS SAN DIEGO COUNTY. SECOND, EXTENSIVE FEEDBACK WAS GATHERED FROM COMMUNITY RESIDENTS, COMMUNITY-BASED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS), HOSPITALS AND HEALTH SYSTEMS, LOCAL GOVERNMENT AGENCIES, PHILANTHROPIC ORGANIZATIONS AND SAN DIEGO COUNTY PUBLIC HEALTH SERVICES THROUGH A COMPREHENSIVE COMMUNITY ENGAGEMENT PROCESS TO UNDERSTAND THE EXPERIENCES AND NEEDS OF PEOPLE IN THE COMMUNITY. ONCE THESE ANALYSES WERE COMPLETE, THE CHNA COMMITTEE REVIEWED THESE DATA, ALONG WITH OTHER CRITERIA, TO PRIORITIZE THE TOP HEALTH NEEDS IN SAN DIEGO COUNTY. THE CHNA COMMITTEE WORKED WITH COMMUNITY PARTNERS TO PLAN COMMUNITY ENGAGEMENT ACTIVITIES WITH STAKEHOLDERS REPRESENTING EVERY REGION OF SANDIEGO COUNTY AND ALL AGE GROUPS. IN ADDITION, THE CHNA COMMITTEE EXPLICITLY SOUGHT TO ENGAGE A WIDE VARIETY OF STAKEHOLDERS REPRESENTING DIVERSE NUMEROUS RACIAL AND ETHNIC GROUPS. HEALTH LEADERS AND A DIVERSE SET OF ADVOCACY GROUPS AND ORGANIZATIONS WERE ALSO RECRUITED FOR THEPROCESS. A TOTAL OF 579 INDIVIDUALS PARTICIPATED IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT: 138 COMMUNITY RESIDENTS AND 441 LEADERS AND EXPERTS.KEY INFORMANT INTERVIEWS AND FOCUS GROUPS WERE UTILIZED TO IDENTIFY AND EXPLORE PRIORITY HEALTH NEEDS, SOCIAL DETERMINANTS OF HEALTH, BARRIERS TO CARE, AND COMMUNITY ASSETS AND RESOURCES.THE CHNA ONLINE SURVEY WAS USED TO RANK HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH IN ORDER OF IMPORTANCE WITHIN THE COMMUNITY. THE SURVEY WAS DISTRIBUTED VIA EMAIL TO TARGETED COMMUNITY-BASED ORGANIZATIONS, SOCIAL SERVICE PROVIDERS, RESIDENT LED ORGANIZATIONS, FEDERALLY QUALIFIED HEALTH CENTERS, GOVERNMENTAL AGENCIES, AND HOSPITALS AND HEALTH SYSTEMS WHO SERVE A DIVERSE ARRAY OF PEOPLE IN SAN DIEGO COUNTY. RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 6A: RADY CHILDREN'S HOSPITAL - SAN DIEGO CONDUCTED ITS CHNA WITH THE FOLLOWING HOSPITALS (SEE CHNA, PAGE 9):- KAISER FOUNDATION HOSPITAL- PALOMAR HEALTH- SCRIPPS HEALTH- SHARP HEALTHCARE- TRI-CITY MEDICAL CENTER- UNIVERSITY OF CALIFORNIA SAN DIEGO HEALTH SYSTEM RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS ADDRESSED:ACCORDING TO CHNA COMMITTEE FINDINGS, THE FOLLOWING HEALTH CONDITIONS AND SOCIAL DETERMINANTS OF HEALTH ARE CONSIDERED TOP PRIORITIES FOR SAN DIEGO COUNTY FOR ALL AGE GROUPS (LIST IS IN ALPHABETICAL ORDER):1) ACCESS TO HEALTH CARE;2) AGING CONCERNS;3) BEHAVIORAL HEALTH;4) CANCER;5) CHRONIC HEALTH CONDITIONS (OBESITY, DIABETES);6) COMMUNITY AND SOCIAL SUPPORT;7) ECONOMIC SECURITY;8) EDUCATION;9) HOUSING AND HOMELESSNESS;10) SAFETY AND VIOLENCE.RECOGNIZING THAT CHILDREN HAVE UNIQUE HEALTHCARE NEEDS, RADY CHILDREN'S SUPPLEMENTED THE FINDINGS OF THE CHNA WITH THE 2017 SAN DIEGO COUNTY REPORT CARD ON CHILDREN & FAMILIES. MANAGEMENT AND CLINICAL LEADERSHIP ALSO CONSIDERED OTHER PEDIATRIC ASSESSMENTS.TOP HEALTH PRIORITIES IDENTIFIED FOR CHILDREN INCLUDE:1) BEHAVIORAL AND MENTAL HEALTH- DEPRESSION AND SUICIDE SCREENING INITIATIVE - RCHSD INSTITUTED THE DEPRESSION AND SUICIDE SCREENING INITIATIVE TO PROVIDE PATIENT HEALTH QUESTIONNAIRE (PHQ-2) SCREENINGS, INCLUDING PHQ9, A BRIEF, 9-ITEM SELF-REPORT SCREENING TOOL. THE QUESTIONNAIRE IS BEING USED TO IDENTIFY YOUTH WITH DEPRESSION AND SUICIDE IDEATION REGARDLESS OF WHETHER THEY ARE SEEN IN AN AMBULATORY CLINIC, THE EMERGENCY DEPARTMENT, OR ADMITTED AS AN INPATIENT. THE IDENTIFICATION OF AT-RISK YOUTH (BASED ON A HIGH PHQ-9 SCORE OR ANSWERING YES TO THE QUESTION OF WHETHER THE CHILD/TEEN WAS CONSIDERING SUICIDE) ALLOW ACTIONS TO BE TAKEN TO ENSURE THAT THE YOUTH ARE KEPT SAFE, RECEIVE IMMEDIATE CARE, AND ARE CONNECTED TO FOLLOW-UP CARE AS NEEDED.- SUICIDE PREVENTION: RADY CHILDREN'S CENTER FOR HEALTHIER COMMUNITIES (CHC) IS WORKING COLLABORATIVELY WITH THE 9TH DISTRICT PTA AND QUALITY DEPARTMENT TO HOST ANNUAL SYMPOSIUMS TO EDUCATE PARENTS IN SUICIDE PREVENTION. IN ADDITION, CHC STAFF ATTENDS SUICIDE PREVENTIONCOALITION MEETINGS MONTHLY.- MENTAL AND BEHAVIORAL HEALTH PSYCHIATRIC EMERGENCY DEPARTMENT - RADY CHILDREN'S WILL ESTABLISH A FULLY-FUNCTIONING, 6-BED PSYCHIATRIC EMERGENCY DEPARTMENT IN SPRING 2020, DEDICATED TO RESPONDING TO MENTAL AND BEHAVIORAL HEALTH EMERGENCIES OF CHILDREN AND ADOLESCENTS. RADY CHILDREN'S ALSO WILL PROVIDE PATIENTS AND THEIR FAMILIES REFERRALS TO APPROPRIATE CARE AND CARE COORDINATION SERVICES THROUGH A BEHAVIORAL HEALTH CARE CONNECTION CENTER LAUNCHED AS PART OF THE PSYCHIATRIC EMERGENCY DEPARTMENT.2) CHRONIC HEALTH CONDITIONS (OBESITY) - THE SAN DIEGO COUNTY CHILDHOOD OBESITY INITIATIVE (COI) IS A PUBLIC-PRIVATE PARTNERSHIP WITH THE MISSION OF REDUCING AND PREVENTING CHILDHOOD OBESITY THROUGH POLICY, SYSTEMS AND ENVIRONMENTAL CHANGE. TO FULFILL ITS MISSION, THE COI CREATES, SUPPORTSAND MOBILIZES PARTNERS FROM MULTIPLE DOMAINS (I.E., SECTORS: GOVERNMENT, HEALTHCARE, SCHOOLS & AFTER SCHOOL, EARLY CHILDHOOD, COMMUNITY, MEDIA AND BUSINESS), PROVIDES LEADERSHIP AND VISION, AND COORDINATES COUNTY-WIDE EFFORTS IN THE PREVENTION AND REDUCTION OF CHILDHOOD OBESITY. THE DIRECTOR OF THE CENTER FOR HEALTHIER COMMUNITIES CHAIRS THE HEALTHCARE DOMAIN SUB-COMMITTEE, WHICH BRINGS TOGETHER HEALTHCARE SYSTEMS, PLANS AND PROVIDERS TO ENHANCE CARE AND RESOURCES FOR THE PREVENTION AND REDUCTION OF CHILDHOOD OBESITY. THE CENTER FOR HEALTHIER COMMUNITIES HAS PARTICIPATED IN, AND PROVIDED LEADERSHIP FOR, THE COI HEALTH DOMAIN SINCE ITS INCEPTION IN 2006.3) OTHER (INJURY PREVENTION, AUTISM).THE DEVELOPMENTAL SERVICES DEPARTMENT AT RADY CHILDREN'S PROVIDES A CONTINUUM OF INTEGRATED SERVICES ACROSS VARIOUS DISCIPLINES AND COMMUNITY PARTNERS TO SUPPORT EARLY BRAIN DEVELOPMENT, SOCIAL/EMOTIONAL DEVELOPMENT, AND THE NEEDS OF THE WHOLE CHILD THROUGH EVERY ASPECT OF CARE DELIVERY. EMPHASIZING EARLY IDENTIFICATION, DIAGNOSIS AND INTERVENTION, A VARIETY OF PROGRAMS ARE PROVIDED, INCLUDING PROGRAMS FOCUSED ON AUTISM AND ADHD.MANY OF OUR PROGRAMS DEAL WITH SOCIAL DETERMINANTS OF HEALTH INCLUDING:1) ACCESS TO HEALTH CARE2) EDUCATION3) SAFETY AND VIOLENCE4) COMMUNITY AND SOCIAL SUPPORTMID-CITY BEHAVIORAL HEALTH URGENT CARE (BHUC)SOCIAL DETERMINANTS NEEDS ADDRESSED: ACCESS TO CARE, BEHAVIOR AND MENTAL HEALTH, EDUCATION, SAFETY AND VIOLENCE PREVENTION, COMMUNITY AND SOCIAL SUPPORT.THE MID-CITY BEHAVIORAL HEALTH URGENT CARE CLINIC ADDRESSES THE NEED FOR IMMEDIATE ACCESS TO MENTAL HEALTH SERVICES FOR FAMILIES CONCERNED ABOUT THEIR CHILD OR ADOLESCENT'S URGENT MENTAL HEALTH OR BEHAVIORAL SYMPTOMS. THE MID-CITY FACILITY ADDRESSES THIS COMMUNITY'S UNMET MENTAL HEALTH NEEDS BY MAKING SERVICES DIRECTLY AVAILABLE TO CHILDREN AND FAMILIES IN THEIR OWN NEIGHBORHOOD. THE COMPREHENSIVE BEHAVIORAL HEALTH PROGRAM INCLUDES A RANGE OF HIGH-QUALITY BEHAVIORAL HEALTH SERVICES, INCLUDING ASSESSMENT, CRISIS INTERVENTION, MEDICATION EVALUATION, CASE MANAGEMENT AND REFERRAL TO ON-GOING TREATMENT, IF NEEDED. THE SERVICES ARE AVAILABLE ON A "WALK-IN", NO APPOINTMENT REQUIRED BASIS. THE BHUC SERVES CHILDREN AND TEENS AGES 5 TO 17 IN THE MID-CITY COMMUNITY AND SURROUNDING AREAS, ACCEPTS MEDI-CAL AND IS ABLE TO PROVIDE SERVICES TO THE UNINSURED. AFTER RECEIVING SERVICES AT THE BHUC, RADY CHILDREN'S STAFF CONNECTS PATIENTS WITH REFERRALS TO FOLLOW-UP SERVICES WITH COMMUNITY PROVIDERS AND PARTNERS.HEALTH STARSSOCIAL DETERMINANT OF HEALTH ADDRESSED: EDUCATION, ACCESS TO CARE, SAFETY & VIOLENCETHE HEALTH STARS LITERACY PROGRAM HOLDS EDUCATION SESSIONS FOR LOW-INCOME AND HOMELESS PARENTS WITH CHILDREN AGES 0-5. THESE FAMILIES MAY LIVE IN AFFORDABLE HOUSING COMPLEXES OR HOMELESS SHELTERS. HEALTH STARS BRINGS VOLUNTEER PEDIATRICIANS INTO THE COMMUNITIES THEY SERVE TO ENGAGE WITH FAMILIES IN THEIR OWN NEIGHBORHOODS. THIS IS DONE TO BETTER UNDERSTAND THE CHALLENGES THESE FAMILIES FACE IN ACHIEVING A HEALTHY LIFESTYLE. FAMILIES LEARN HEALTHY HABITS DURING A SERIES OF READING AND PLAY SESSIONS, EACH FOCUSED ON A SPECIFIC HEALTH TOPIC. THE PROGRAM ADDRESSES KEY CHILD HEALTH ISSUES, INCLUDING DISCIPLINE, NUTRITION, SAFETY, SLEEP AND ORAL HEALTH, PROVIDING FAMILIES WITH CHILDREN'S BOOKS TO REINFORCE HEALTHY BEHAVIORS AND ENCOURAGE DAILY READING WITH CHILDREN. CLINICIANS LEAD INTERACTIVE DISCUSSIONS IN A FUN, ENGAGING ENVIRONMENT WITH THE GOAL OF BUILDING PARENTS' TRUST AS WELL AS THEIR CONFIDENCE WITH THEIR OWN CHILD INTERACTIONS AND PARENTING SKILLS. HEALTH STARS ALSO WORKS TO CONNECT FAMILIES WITH LOCAL RESOURCES TO MEET THEIR HEALTH, SOCIAL AND BEHAVIORAL NEEDS.SAFE ROUTES TO SCHOOL (SRTS)SOCIAL DETERMINANT OF HEALTH ADDRESSED: EDUCATION; SAFETY & VIOLENCE SAFE ROUTES TO SCHOOL (SRTS) IS A COLLABORATION BETWEEN RADY CHILDREN'S, LOCAL GOVERNMENT AND SCHOOL DISTRICTS TO MAKE BIKING AND WALKING TO SCHOOL SAFE AND HEALTHY ALTERNATIVES TO DRIVING. A MAJORITY OF ELEMENTARY AND MIDDLE SCHOOLERS ARRIVE TO SCHOOL IN A FAMILY CAR. SRTS IS A SERIES OF STRATEGIES THAT WILL MOVE PARENTS AWAY FROM DRIVING THEIR STUDENTS TO SCHOOL AND INSTEAD, WALK THEM EITHER PART OR THE ENTIRE WAY, OR DROP THEM IN A SECURE LOCATION WITH ADULTS (WALKING SCHOOL BUS) SO THE KIDS CAN ALL WALK TOGETHER.NEEDS NOT ADDRESSED:PRIORITIES NOT ADDRESSED IN THIS REPORT AND THE REASONS INCLUDE: CANCER (HIGH INCIDENCE IN THE CHNA PERTAINED TO ADULTS); ECONOMIC SECURITY (NOT WITHIN THE PURVIEW OF A CHILDREN'S HOSPITAL); HOUSING AND HOMELESSNESS (NOT A MAJOR FACTOR FOR A CHILDREN'S HOSPITAL, ALTHOUGH HOUSING INSECURE PATIENTS ARE SERVED). RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 16J: ALL LANGUAGE REGARDING THE POLICY IS COMMUNICATED TO PATIENTS VIA SIGNAGE IN ALL ADMITTING AREAS. AT THE POINT OF REGISTRATION, ALL PATIENTS RECEIVE BROCHURES EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS; ALL INITIAL STATEMENTS TO UNINSURED PATIENTS INCLUDES VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE CHARITY CARE APPLICATION. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE. SCHEDULE H, PART V, SECTION B, LINE 7A HTTPS://WWW.RCHSD.ORG/DOCUMENTS/2019/06/2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF/ SCHEDULE H, PART V, SECTION B, LINE 10A HTTPS://WWW.RCHSD.ORG/DOCUMENTS/2019/11/COMMUNITY-HEALTH-NEEDS-IMPLEMENTATION-STRATEGY.PDF/ SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, 16C THE FAP, THE FAP APPLICATION, AND THE PLAIN LANGUAGE FAP WERE ALL MADE AVAILABLE ONLINE AT:HTTPS://WWW.RCHSD.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 22D THE HOSPITAL DETERMINED, DURING THE TAX YEAR, THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE, BASED ON MEDI-CAL RATES (AB 774). 20 1 - RADY CHILDREN'S DEVELOPMENT SERVICES 11752 EL CAMINO REAL SUITE 100 SAN DIEGO CA 92130 DEVELOPMENTAL AND BEHAVIORAL SERVICES 2 - RADY CHILDREN'S SPECIALISTS OF SAN DIEGO 25485 MEDICAL CENTER DRIVE SUITE 100 MURRIETA CA 92562 CLINIC 3 - CHADWICK CENTER FOR CHILDREN & FAMILIES 333 H ST SUITE 3010 CHULA VISTA CA 91910 TRAUMA COUNSELING 4 - SANFORD CHILDREN'S CLINIC 3605 VISTA WAY SUITE 130 OCEANSIDE CA 92056 CLINIC 5 - RADY CHILDREN'S SPECIALISTS OF SAN DIEGO 3605 VISTA WAY SUITE 172 OCEANSIDE CA 92056 CLINIC/ URGENT CARE 6 - RADY CHILDREN'S HEALTH SERVICES 3665 KEARNY VILLA ROAD SAN DIEGO CA 92123 DEVELOPMENTAL AND BEHAVIORAL SERVICES 7 - RADY CHILDREN'S SPECIALISTS OF SAN DIEGO 385 W MAIN STREET EL CENTRO CA 92243 CLINIC 8 - RADY CHILDREN'S HEALTH SERVICES 386 EAST H STREET SUITE 202 CHULA VISTA CA 91910 CLINIC/ URGENT CARE 9 - RADY CHILDREN'S URGENT CARE 4305 UNIVERSITY AVE 150 SAN DIEGO CA 92105 CLINIC/ URGENT CARE 10 - CITY HEIGHTS WELLNESS CENTER 4440 WIGHTMAN STREET SUITE 200 SAN DIEGO CA 92105 WELLNESS CENTER 11 - RADY CHILDREN'S SPECIALISTS OF SAN DIEGO 477 NORTH EL CAMINO REAL BUILDING D ENCINITAS CA 92024 CLINICS 12 - RADY CHILDREN'S URGENT CARE 5565 GROSSMONT CENTER DRIVE BUILDING 2 LA MESA CA 91942 URGENT CARE 13 - RADY CHILDREN'S SPECIALISTS OF SAN DIEGO 625 WEST CITRACADO PARKWAY ESCONDIDO CA 92025 CLINICS/ URGENT CARE 14 - RADY CHILDREN'S SPECIALISTS OF SAN DIEGO 2204 EL CAMINO REAL SUITE 102 OCEANSIDE CA 92054 CLINIC 15 - RADY CHILDREN'S HOSPITAL 7910 FROST SUITE 140 SAN DIEGO CA 92123 CLINICS 16 - RADY CHILDREN'S HOSPITAL 7920 FROST SUITE 140 SAN DIEGO CA 92123 CLINICS 17 - NELSON FAMILY PAVILION 8001 FROST STREET SAN DIEGO CA 92123 CLINICS 18 - RADY CHILDREN'S HOSPITAL 8010 FROST SUITE 140 SAN DIEGO CA 92123 CLINICS 19 - RADY CHILDREN'S HOSPITAL 8110 BIRMINGHAM DRIVE SAN DIEGO CA 92123 CLINICS 20 - HOMECARE 8291 AERO PLACE SUITE 130 SAN DIEGO CA 92123 HOME HEALTHCARE PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, THE COST TO CHARGE RATIO WAS CALCULATED USING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES AND APPLIED TO THOSE CATEGORIES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S DETAILED FINANCIAL INFORMATION. PART II, COMMUNITY BUILDING ACTIVITIES: RADY CHILDREN'S CENTER FOR HEALTHIER COMMUNITIES PROVIDES THE FACES FOR THE FUTURE PROGRAM AT A LOCAL HIGH SCHOOL. THE FACES PROGRAM IS A YOUTH AND FUTURE HEALTHCARE WORKFORCE DEVELOPMENT PROGRAM THAT PREPARES UNDERREPRESENTED, ETHNICALLY DIVERSE YOUTH FOR CAREERS IN ALL AREAS OF THE HEALTH PROFESSIONS. THE PROGRAM ALSO AIMS TO ASSIST LOCAL PUBLIC SCHOOLS IN MOTIVATING AND PREPARING UNDERREPRESENTED HIGH SCHOOL STUDENTS FOR ENTRY INTO COLLEGE, HEALTHCARE/RESEARCH CAREERS AND OTHER VIABLE EMPLOYMENT OPPORTUNITIES IN THE HEALTHCARE INDUSTRY. THE PARTICIPATING STUDENTS ROTATE THROUGH CLINICAL DEPARTMENTS AT RADY CHILDREN'S HOSPITAL -SAN DIEGO AND RECEIVE MENTORSHIP. PART III, LINE 2: FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, RCHSD RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED, OR ON THE BASIS OF DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF RCHSD'S UNINSURED PATIENTS ARE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. RCHSD RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS RELATED TO UNINSURED PATIENTS IN THE PERIOD SERVICES ARE PROVIDED. RCHSD RECORDS IMPLICIT PRICE CONCESSIONS BASED UPON THE HISTORICAL EXPERIENCE, AS WELL AS COLLECTION TRENDS FOR MAJOR PAYOR TYPES. PART III, LINE 3: RCHSD DOES NOT TREAT ANY PART OF THE BAD DEBT AS COMMUNITY BENEFIT EXPENSE. PART III, LINE 4: SEE PAGE 13-17 OF THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 ARE DETERMINED USING A PRO FORMA COST REPORT AS DESCRIBED IN PART I, LINE 7 ABOVE. THE ORGANIZATION BELIEVES THAT THE TEFRA COST LIMITATION SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BASED ON THE INPATIENT COST OVER THE TEFRA LIMITS. PART III, LINE 9B: IN ITS BILLING AND COLLECTION ACTIVITY, RADY CHILDREN'S HOSPITAL - SAN DIEGO TREATS ALL PATIENTS AND PATIENT FAMILIES OR REPRESENTATIVES WITH FAIRNESS, DIGNITY AND RESPECT. RCHSD DOES NOT UTILIZE WAGE GARNISHMENTS, LIENS ON A PATIENT'S PRIMARY RESIDENCE, OR WRIT OF BODY ATTACHMENTS IN ITS COLLECTION ACTIVITIES. RCHSD ONLY UTILIZES THOSE OUTSIDE OR THIRD PARTY COLLECTION AGENCIES THAT AGREE TO COMPLY WITH APPLICABLE STATE AND FEDERAL LAWS AND WITH RCHSD POLICIES, AND RCHSD DEBT COLLECTION STANDARDS AND PRACTICES. IN DETERMINING THE DEBT THAT RCHSD SEEKS TO RECOVER, RCHSD WILL CONSIDER ONLY THE INCOME AND CERTAIN MONETARY ASSETS OF THE PATIENT/GUARANTOR ELIGIBLE FOR THE RCHSD FINANCIAL ASSISTANCE PROGRAM. IN MAKING THIS DETERMINATION, RCHSD WILL NOT CONSIDER RETIREMENT OR DEFERRED COMPENSATION PLANS (EITHER QUALIFIED OR NON-QUALIFIED UNDER THE INTERNAL REVENUE CODE), THE FIRST $10,000 OR THE REMAINING 50 PERCENT OF THEPATIENT/GUARANTOR'S MONETARY ASSETS. RCHSD SHALL NOT SEND AN ACCOUNT TO A COLLECTION AGENCY IF THE PATIENT HAS A PENDING APPLICATION FOR THE RCHSD FINANCIAL ASSISTANCE PROGRAM OR GOVERNMENT-SPONSORED INSURANCE PROGRAM OR IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL BY NEGOTIATING AN INTEREST FREE, EXTENDED PAYMENT PLAN OR BY MAKING REGULAR PARTIAL PAYMENTS OF A REASONABLE AMOUNT. A "PENDING APPLICATION" IS DEFINED AS AN APPLICATION THAT HAS BEEN FULLY COMPLETED AND INCLUDES COPIES OF THE REQUIRED DOCUMENTATION BY THE PATIENT/GUARANTOR, SUBMITTED TO THE RELEVANT PUBLIC AGENCY IN THE CASE OF GOVERNMENT PROGRAMS AND TO RCHSD IN THE CASE OF THE RCHSD FINANCIAL ASSISTANCE PROGRAM. IF A PATIENT ACCOUNT IS SENT TO COLLECTIONS AND IT IS DETERMINED THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE PATIENT ACCOUNT IS REMOVED FROM THE COLLECTION PROCESS AND THE FINANCIAL ASSISTANCE APPLICATION PROCESS IS IMPLEMENTED. PART VI, LINE 2: NEEDS ASSESMENTCONTINUING A LONGSTANDING COMMITMENT TO ADDRESS COMMUNITY HEALTH NEEDS IN SAN DIEGO, RADY CHILDREN'S AND SIX OTHER HEALTHCARE SYSTEMS RECONVENED IN 2018-2019 THROUGH THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC), WITH THE INSTITUTE OF PUBLIC HEALTH, TO COMPLETE A 2019 TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNAIDENTIFIES AND PRIORITIZES THE MOST CRITICAL HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY AND INCLUDES FEEDBACK FROM COMMUNITY RESIDENTS IN VULNERABLE NEIGHBORHOODS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCERCHSD PROVIDES WRITTEN INFORMATION ABOUT THE AVAILABILITY OF THE RCHSD FINANCIAL ASSISTANCE PROGRAM, INCLUDING A BROCHURE THAT IS DISSEMINATED THROUGHOUT OUR PATIENT CLINICS. THIS INFORMATION IS PROVIDED AT PATIENT REGISTRATION, INCLUDING PATIENT INFORMATIONAL MATERIALS, EMERGENCY DEPARTMENT, OUTPATIENT CLINICS, AND PATIENT FINANCIAL SERVICES. IN ADDITION, A STATEMENT REGARDING THE FINANCIAL ASSISTANCE PROGRAM IS INCLUDED ON PATIENT BILLING STATEMENTS. WRITTEN NOTICE IS PROVIDED TO POTENTIALLY ELIGIBLE PATIENTS DURING THE REGISTRATION PROCESS OR AS SOON AS POSSIBLE THEREAFTER AND DURING THE BILLING PROCESS. THIS INFORMATIONIS PROVIDED IN ENGLISH AND SPANISH AND IS TRANSLATED FOR PATIENTS/GUARANTORS WHO SPEAK OTHER LANGUAGES. NOTIFICATION OF FINANCIAL ASSISTANCE DISCUSSES, AT A MINIMUM, THE FOLLOWING:- IF A PATIENT MEETS CERTAIN INCOME REQUIREMENTS, THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED HEALTH INSURANCE PROGRAM OR THE RCHSD FINANCIAL ASSISTANCE PROGRAM.IDENTIFICATION OF RCHSD FINANCIAL COUNSELING- PATIENT FINANCIAL SERVICES PHONE NUMBER WITH HOURS OF AVAILABILITY SO THAT PATIENTS MAY CALL TO OBTAIN FURTHER INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM. RADY CHILDREN'S PROVIDES HEALTHCARE SUPPORT SERVICES TO THE COMMUNITY THROUGH THE FINANCIAL COUNSELING TEAM. RADY CHILDREN'S FINANCIAL COUNSELORS PROACTIVELY EXPLORE AND ASSIST PATIENTS/GUARANTORS IN APPLYING FOR HEALTH INSURANCE COVERAGE FROM PUBLIC AND PRIVATE PAYMENT PROGRAMS.- THE RCHSD WEBSITE PROVIDES INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM, AND THE FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE PROGRAM APPLICATION ARE POSTED ON THE RCHSD WEBSITE. PART VI, LINE 4: COMMUNITY INFORMATIONSAN DIEGO COUNTY (SAN DIEGO) IS THE SECOND MOST POPULOUS OF CALIFORNIA'S 58 COUNTIES, AND THE FIFTH LARGEST COUNTY IN THE UNITED STATES AND IS CURRENTLY HOME TO 3.4 MILLION RESIDENTS, AND IS ANTICIPATED TO GROW TO FOUR MILLION BY 2050. THE REGION IS SOCIALLY AND ETHNICALLY DIVERSE, WITH OVER 22% OF THE POPULATION UNDER THE AGE OF EIGHTEEN AND ON AVERAGE, 230,000 VETERAN RESIDE HERE. WHILE THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $75,000, OVER 16% OF PERSONS ARE LIVING BELOW POVERTY LEVEL; CHILDREN UNDER AGE 18 ARE DISPROPORTIONATELY AFFECTED. IN ADDITION, 38% OF PERSONS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. RADY CHILDREN'S HOSPITAL SAN DIEGO (THE HOSPITAL) IS A REGIONAL TERTIARY AND QUATERNARY REFERRAL CENTER AND PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT ACUTE, PSYCHIATRIC AND INTENSIVE CARE PEDIATRIC SERVICES. THE HOSPITAL ALSO IS THE SOLE PEDIATRIC PROVIDER AND DESIGNATED PEDIATRIC TRAUMA CENTER FOR SAN DIEGO COUNTY AND IS THE PRIMARY SOURCE OF PEDIATRIC AND NEONATAL INTENSIVE CARE SERVICES FOR BOTH SAN DIEGO AND IMPERIAL COUNTIES. ALSO, RCHSD IS THE PEDIATRIC SAFETY NET HOSPITAL FOR THE REGION WITH A MEDI-CAL PAYOR MIX HOVERING OVER 50%. RCHSD SERVES AS THE TEACHING HOSPITAL FOR THE SCHOOL OF MEDICINE AT THE UNIVERSITY OF CALIFORNIA, SAN DIEGO (UCSD) AND, IN 2001, RCHSD AND UCSD AMALGAMATED WHERE RCHSD BECAMETHE PEDIATRIC PROVIDER OF INPATIENT AND OUTPATIENT MEDICAL AND SURGERY SERVICES AND CERTAIN OTHER CLINICAL SERVICES FOR UCSD PEDIATRIC PATIENTS. THERE ARE THREE LARGE HEALTH SYSTEMS OPERATING IN SAN DIEGO, SHARP HEALTHCARE, SCRIPPS HEALTH AND KAISER PERMANENTE, AS WELL AS OTHER HOSPITAL PROVIDERS. TO HELP CARE FOR PEDIATRIC PATIENTS, RCHSD COLLABORATES WITH SHARP HEALTHCARE, SCRIPPS HEALTH AND PALOMAR POMERADO HEALTH THROUGH AFFILIATED PROGRAM AGREEMENTS. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE RADY CHILDREN'S HOSPITAL - SAN DIEGO IS GOVERNED BY A 24-MEMBER BOARD OF TRUSTEES. THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING THE SAN DIEGO COMMUNITY, WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. RCHSD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. RCHSD APPLIES ITS SURPLUS FUNDS TO SUPPORT THE HIGHEST AND MOST URGENT NEEDS OF THE ORGANIZATION AND THE COMMUNITY INCLUDING IMPROVING PATIENT CARE; PROVIDING SUPPORT FOR OUR PATIENTS' FAMILIES; RESEARCH; DEVELOPMENTAL SERVICES; MENTAL HEALTH SERVICES; CHILD ABUSE PREVENTION AND TREATMENT SERVICES; EDUCATION PROGRAMS; AND PURCHASING STATE-OF-THE ART EQUIPMENT AND TECHNOLOGY TO FURTHER ENHANCE PATIENT CARE. RCHSD PROMOTES THE HEALTH OF THE COMMUNITY IT SERVES THROUGH A VARIETY OF MECHANISMS. THE RCHSD COMMUNITY BENEFIT REPORT FOR FISCAL YEAR 2019 (JULY 1, 2018 THROUGH JUNE 30, 2019) PROVIDES DETAILED INFORMATION ON OVER 30 PROGRAMS AND RELATED ACTIVITIES RCHSD CONDUCTS EACH YEAR TO IMPROVE PATIENT'S HEALTH STATUS. FROM PROVIDING FREE MEDICAL EDUCATION TRAINING SEMINARS TO COMMUNITY-BASED PHYSICIANS AND OTHER HEALTH PROVIDERS, SUPPORT GROUPS, PARENT EDUCATIONAL RESOURCE MATERIALS, PEDIATRIC RESEARCH, TO PROGRAMS DIRECTED TO IMPROVE THE HEALTH NEEDS OF PATIENTS, RCHSD USES A MULTI-PRONGED APPROACH TO PROVIDE BENEFIT TO THE COMMUNITY. SCHEDULE H, PART VI, LINE 7 RCHSD FILES A COMMUNITY BENEFIT REPORT IN THE STATE OF CALIFORNIA. 0 UCSD 9500 GILMAN DRIVE SAN DIEGO CA 92093 956006144 501(C)(3) 1779948 FMV SUPPORT MISSION LA MAESTRA COMMUNITY HEALTH CENTERS 4060 FAIRMOUNT AVE SAN DIEGO CA 92105 330473171 501(C)(3) 40000 FMV SUPPORT MISSION RADY CHILDREN'S HOSPITAL RESEARCH CENTER 3020 CHILDRENS WAY SAN DIEGO CA 92123 953814185 501(C)(3) 3569150 FMV SUPPORT MISSION 3 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS RCHSD TRANSFERRED FUNDS TO RCHRC TO FURTHER ITS EXEMPT PURPOSE. RCHRC SUPPORTS RCHSD IN ITS EXEMPT ACTIVITIES. X 0 0 X X X X 1 1 0 0 0 0 0 0 0 PATRICK FRIAS MD PRESIDENT & CEO 1072502 0 308076 0 88153 0 8550 0 28944 0 1506225 0 0 0 MARGARETA E NORTON EXEC VP, CAO, SECRETARY (THRU 02/20) 528639 0 159265 0 446520 0 -73663 0 7567 0 1068328 0 0 0 NICHOLAS M HOLMES SR VP, COO 569993 0 130676 0 116823 0 8550 0 29545 0 855587 0 0 0 GAIL L KNIGHT MD SR VP, CMO 584834 0 129196 0 92381 0 8550 0 3582 0 818543 0 0 0 CHARLES B DAVIS SR VP, MPF COO & CARE REDESIGN 506379 0 111617 0 81058 0 64078 0 3197 0 766329 0 0 0 STEPHEN JENNINGS SR VP, EXEC DIR FOUNDATION 0 421589 0 126566 0 95272 0 47132 0 28799 0 719358 0 0 DONALD B KEARNS MD MMM PRESIDENT EMERITUS 329135 0 76833 0 272344 0 6840 0 15378 0 700530 0 0 0 ANGELA M VIEIRA GENERAL COUNSEL (FROM 03/20) 446550 0 72577 0 60174 0 65116 0 14298 0 658715 0 0 0 JAMES J ULI JR SVP, CFO, TREASURER (FROM 03/20) 496882 0 100000 0 12692 0 8550 0 9617 0 627741 0 0 0 ALBERT ORIOL VP, INFO MGMT/CIO 418147 0 68574 0 60088 0 40334 0 20257 0 607400 0 0 0 CATHY NUGENT VP, HUMAN RESOURCES 388196 0 61692 0 37007 0 107138 0 2605 0 596638 0 0 0 BARBARA L RYAN VP, GOVERNMENT AFFAIRS 330201 0 54993 0 53692 0 126709 0 1905 0 567500 0 0 0 MARY J FAGAN VP, PATIENT CARE SVCS/CNO 360054 0 62094 0 48335 0 79549 0 14001 0 564033 0 0 0 SCOTT D CAMPBELL VP, CFO & ADMIN OFFICER - MPF 367028 0 61636 0 53824 0 48902 0 22836 0 554226 0 0 0 CHRIS ABE VP, OPERATIONS 327263 0 70322 0 42183 0 94180 0 11872 0 545820 0 0 0 GLENN F BILLMAN CHIEF QUALITY OFFICER 392305 0 23525 0 11725 0 70694 0 14112 0 512361 0 0 0 NISHANTHA S RATNAYAKE VP, FINANCE & CONTROLLER 276675 0 61577 0 44938 0 25921 0 19024 0 428135 0 0 0 MEREDITH LURIE VP, STRATEGIC AND ORG PLANNING 264636 0 44932 0 20453 0 58823 0 11601 0 400445 0 0 0 MICHAEL HESTER SR DIR, REVENUE CYCLE 261316 0 15870 0 13442 0 8541 0 14450 0 313619 0 0 0 MARK SEY PHARMACIST IN CHIEF 155419 0 0 0 136708 0 5341 0 15920 0 313388 0 0 0 GLIDA E RECODO CLINICAL NURSE II 285496 0 1500 0 3911 0 8550 0 11768 0 311225 0 0 0 SCOTT A VOIGTS SR DIR, CHIEF TECH OFFICER 276433 0 16563 0 0 0 8550 0 2435 0 303981 0 0 0 KATHLEEN M CAIN SVP, CFO, TREASURER (THRU 02/20) 205702 0 60000 0 23740 0 8359 0 4832 0 302633 0 0 0 CHRISTINA GALBO CHIEF COMPL & PRIV OFFICER 208631 0 10542 0 6881 0 37381 0 18548 0 281983 0 0 0 JILL STRICKLAND SR VP, CAO 191058 0 75000 0 5769 0 0 0 6818 0 278645 0 0 0 BELINDA SANTOS-RAMIREZ BOARD ADMIN & CHIEF OF STAFF 123135 0 6852 0 0 0 15549 0 12833 0 158369 0 0 0 PART I, LINE 1A THE ORGANIZATION PROVIDED A DISCRETIONARY SPENDING ACCOUNT TO SEVEN OFFICERS AND KEY EMPLOYEES LISTED ON FORM 990 PART VII. THE AMOUNT PROVIDED WAS INCLUDED IN EACH INDIVIDUAL'S TAXABLE COMPENSATION. PART I, LINES 4A-B RADY CHILDREN'S HOSPITAL - SAN DIEGO HAS ESTABLISHED A NON-QUALIFIED PLAN PURSUANT TO 457(F) OF THE INTERNAL REVENUE CODE. THE PURPOSE OF THIS PLAN IS TO INCENTIVIZE RADY CHILDREN'S HOSPITAL - SAN DIEGO ELIGIBLE SENIOR MANAGEMENT EMPLOYEES (PRESIDENT, SENIOR VICE PRESIDENTS, VICE PRESIDENTS, SENIOR MANAGING DIRECTORS) IN RECOGNITION OF THE FACT THAT THEY ARE REQUIRED TO DEVOTE SIGNIFICANT AMOUNTS OF TIME, SKILL AND ENERGY TO THE ORGANIZATION. ONCE VESTED THE AMOUNTS UNDER THIS PLAN ARE REPORTED ON FORM W-2 AS TAXABLE COMPENSATION TO THE INDIVIDUAL. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN DURING CALENDAR YEAR 2021: MR. ALBERT ORIOL ($47,627), MS. ANGELA VIEIRA ($47,712), MS. BARBARA RYAN (38,115),MS. CATHY NUGENT ($116,273), MR. CHARLES DAVIS ($272,220), MS. CHRIS ABE ($29,564), MS. CHRISTINA GALBO ($6,881), DR. DONALD KEARNS ($253,651), DR. GAIL KNIGHT ($76,804), MS. MARGARETA NORTON ($117,086), MS. MARY FAGAN ($35,874), MS. MEREDITH LURIE ($7,991), MR. NICHOLAS HOLMES ($101,246), MR. NISHANTHA RATNAYAKE ($32,476), DR. PATRICIO FRIAS ($33,850), MR. SCOTT CAMPBELL ($41,363), AND MR. STEPHEN JENNINGS ($79,695). THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENT DURING CALENDAR YEAR 2020: MR. MARK SEY ($114,845). A CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY 680164610 130795VTI 2008-07-31 101155000 CURRENT REFUNDING SERIES 2006CD BO 0 0 0 B CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY 680164610 1307955Y9 2012-06-14 115580000 REISSUANCE OF 2008B & 2008D BONDS 0 0 0 C CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY 680164610 NONEAVAIL 2013-09-25 63485000 REISSUANCE OF 2008A 0 0 0 D CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY 680164610 NONEAVAIL 2013-10-24 50580000 REISSUANCE OF SERIES 2012D 0 0 0 A 50580000 101088386 731760 100424579 1 0 1 1 B 54140000 115580000 115580000 1 0 1 1 C 2970000 63485000 63485000 1 0 1 1 D 50580000 50580000 1 0 1 1 A 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 1 1 1 0 0.00340 0.00340 0.00680 0 0 1 C 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 D 0 1 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 1 1 1 GOLDMAN SACHSWELLS 24.080000000000 0 1 1 HYPO REPURCHASE 2.550000000000 1 1 B 0 0 1 1 1 1 GOLDMAN SACHS BANK 35.190000000000 0 0 0 0 1 C 0 0 1 1 1 1 GOLDMAN SACHS BANK 35.190000000000 0 0 0 0 1 D 0 0 1 1 1 1 GOLDMAN SACHS BANK 26.250000000000 0 0 0 0 1 A 1 B 1 C 1 D 1 SET 1, COLUMN A PART I, (F): THE ISSUE DATE OF THE 2006CD BONDS WAS 10/26/06. PART II, LINE 3: THE DIFFERENCE BETWEEN THE ISSUE PRICE LISTED IN PART I(E) IS DUE TO INTEREST EARNINGS ON BOND PROCEEDS AND THE CUMULATIVE REBATE LIABILITY PAID TO THE IRS NO LATER THAN 09/29/13. PART II, LINE 13: SINCE THE PROCEEDS OF THE 2008CD BONDS ARE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART IV, LINE 4(E): THE 2008C GOLDMAN SACHS HEDGE WAS ORIGINALLY A HEDGE ON THE 2006C BONDS WITH A TERM OF 29.82 YEARS, AND WAS REINTEGRATED INTO THE 2008C BONDS ON JULY 31, 2008, WITH A TERM OF 28.06 YEARS. ON APRIL 15, 2016, THE HEDGE WAS SPLIT INTO TWO TRANSACTIONS. SUBSEQUENTLY, ONE OF THE TRANSACTIONS WAS NOVATED TO WELLS FARGO BANK, N.A. ON APRIL 25, 2016. THE NOVATED WELLS FARGO HEDGE HAS A TERM OF 3.98 YEARS, AND THE GOLDMAN SACHS PORTION OF THE TRANSACTION HAS A TERM OF 24.08 YEARS. THE ORIGINAL TERM OF THE ENTIRE TRANSACTION OF 28.06 YEARS REMAINS UNCHANGED. PART IV, LINE 4(E): THE 2008D GOLDMAN SACHS HEDGE WAS ORIGINALLY A HEDGE ON THE 2006D BONDS WITH A TERM OF 33.14 YEARS, AND WAS REINTEGRATED INTO THE 2008D BONDS ON JULY 31, 2008, WITH A RESTRUCTURED TERM OF 33.06 YEARS. THIS HEDGE WAS DEEMED TERMINATED ON JUNE 14, 2012, AND HAD A TERM OF 3.87 YEARS AT TERMINATION. PART IV, LINE 5(A): GROSS PROCEEDS OF THE 2008CD BONDS PROJECT FUNDS WERE INVESTED IN A HYPO REPURCHASE AGREEMENT. SET 1, COLUMN B PART I, (F): THE ISSUE DATE OF THE PRIOR 2008B BONDS WAS 07/02/08. THE ISSUE DATE OF THE PRIOR 2008D BONDS WAS 07/31/08. PART II, LINE 13: SINCE THE PROCEEDS OF THE 2012B AND 2012D BONDS ARE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2(B) & 2(C): THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION TO REBATE. NO REBATE CALCULATION HAS BEEN OR WILL EVER BE MADE, BEFORE OR AFTER THE DUE DATE OF AN 8038-T. PART IV, LINE 4(E): THE 2012B GOLDMAN SACHS HEDGE WAS ORIGINALLY A HEDGE ON THE 2008B BONDS WITH A TERM OF 39.15 YEARS, AND WAS REINTEGRATED INTO THE 2012B BONDS ON JUNE 15, 2012. THE REINTEGRATED HEDGE HAS A TERM OF 35.19 YEARS. PART IV, LINE 4(E): THE 2012D GOLDMAN SACHS HEDGE WAS ORIGINALLY A HEDGE ON THE 2008D BONDS WITH A TERM OF 33.06 YEARS, AND WAS REINTEGRATED INTO THE 2012D BONDS ON JUNE 15, 2012. THIS REINTEGRATED HEDGE HAS A TERM OF 29.19 YEARS THAT IS ALLOCABLE TO THE 2012D BONDS. SET 1, COLUMN C PART I, (F): THE ISSUE DATE OF THE 2008A BONDS WAS 07/02/08. PART II, LINE 13: SINCE THE PROCEEDS OF THE 2008A-REISSUED BONDS ARE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2(B) & 2(C): THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION TO REBATE. NO REBATE CALCULATION HAS BEEN OR WILL EVER BE MADE, BEFORE OR AFTER THE DUE DATE OF AN 8038-T. PART IV, LINE 4(E): BASED ON THE PROPOSED REGULATIONS, THE 2008A GOLDMAN SACHS HEDGE IS TREATED AS CONTINUING TO THE 2008A-REISSUED BONDS INSTEAD OF BEING TERMINATED AND REINTEGRATED. SET 1, COLUMN D: PART I, (F): THE ISSUE DATE OF THE 2012D BONDS WAS 06/14/12. PART II, LINE 13: SINCE THE PROCEEDS OF THE 2012D-REISSUED BONDS ARE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART IV, LINE 2(B) & 2(C): THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION TO REBATE. NO REBATE CALCULATION HAS BEEN OR WILL EVER BE MADE, BEFORE OR AFTER THE DUE DATE OF AN 8038-T. PART IV, LINE 4(E): BASED ON THE PROPOSED REGULATIONS, THE 2012D GOLDMAN SACHS HEDGE IS TREATED AS CONTINUING TO THE 2012D-REISSUED BONDS INSTEAD OF BEING TERMINATED AND REINTEGRATED. ON APRIL 1, 2016, THE HEDGE WAS SPLIT INTO TWO TRANSACTIONS. SUBSEQUENTLY, ONE OF THE TRANSACTIONS WAS NOVATED TO WELLS FARGO BANK, N.A. ON APRIL 25, 2016. THE NOVATED WELLS FARGO HEDGE HAS A TERM OF 2.93 YEARS, AND THE GOLDMAN SACHS PORTION OF THE TRANSACTION HAS A TERM OF 26.25 YEARS. THE ORIGINAL TERM OF THE ENTIRE TRANSACTION OF 29.19 YEARS REMAINS UNCHANGED. SET 2, COLUMN A PART I (F): THE ISSUE DATE OF THE 2006AB BONDS WAS OCTOBER 26, 2006. PART II, LINE 3: THE DIFFERENCE BETWEEN THE ISSUE PRICE LISTED IN PART I(E) IS DUE TO INTEREST EARNINGS ON BOND PROCEEDS. PART II, LINE 13: SINCE THE PROCEEDS OF THE 2016AB BONDS ARE USED FOR REFUNDING PURPOSES, THE YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE. PART IV, LINE 2(B): THE ISSUE QUALIFIED FOR A SPENDING EXCEPTION TO REBATE. NO REBATE CALCULATION HAS BEEN OR WILL EVER BE MADE, BEFORE OR AFTER THE DUE DATE OF AN 8038-T. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. A CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY 680164610 13080SLZ5 2016-05-18 61552785 CURRENT REFUNDING SERIES 2006AB 0 0 0 A 16060000 61592971 987816 60605151 1 0 1 1 A 0 1 1 1 0 0.34000 0.00000 0.34000 0 0 1 A 0 1 1 0 0 0 0 0 1 A 1 PATRICIO FRIAS OFFICER RELOCATION HOUSING LOAN X 250000 212109 0 1 1 212109 FORM 990, PART VI, SECTION A, LINE 6 RADY CHILDREN'S HOSPITAL AND HEALTH CENTER (RCHHC) IS THE SOLE MEMBER AS THAT TERM IS DEFINED IN CALIFORNIA CORPORATIONS CODE 5056 ("MEMBER") OF RADY CHILDREN'S HOSPITAL - SAN DIEGO (RCHSD). FORM 990, PART VI, SECTION A, LINE 7A THE RCHSD BOARD OF DIRECTORS CONSISTS OF THOSE INDIVIDUALS SERVING AS THE BOARD OF TRUSTEES OF THE MEMBER. ONLY THE MEMBER MAY REMOVE A DIRECTOR. THE FOLLOWING ACTIONS OF THE RCHSD BOARD REQUIRE "PRIOR WRITTEN APPROVAL" OF THE MEMBER TO BE EFFECTIVE: - ANY AMENDMENT, REVISION, MODIFICATION OF THE ARTICLES OF INCORPORATION OR THE BYLAWS - ANY CHANGE IN THE NATURE OF THE BUSINESS ACTIVITIES OF RCHSD - APPROVAL OF OPERATING AND CAPITAL BUDGETS OF RCHSD - BORROWING ANY AMOUNT OR INCURRING ANY DEBT IN THE AMOUNT OF $100,000 OR MORE - MAKING OR INCURRING ANY UNBUDGETED EXTRAORDINARY OR NON-RECURRING EXPENSE OR EXPENDITURE OF $1,000,000. THE RCHSD BOARD CANNOT AUTHORIZE OR DIRECT ANY OFFICER OF RCHSD TO PERFORM OR COMMIT ANY OF THE FOLLOWING ACTS, WITHOUT PRIOR WRITTEN APPROVAL OF THE MEMBER: - BORROW MONEY IN RCHSD'S NAME OR UTILIZE PROPERTY OWNED BY RCHSD AS SECURITY FOR LOANS, EXCEPT IN THE ORDINARY COURSE OF BUSINESS - MAKE, EXECUTE, OR DELIVER ANY ASSIGNMENT FOR THE BENEFIT OR CREDITORS, OR ANY BOND, CONFESSION, JUDGMENT, CHATTEL MORTGAGE, SECURITY AGREEMENT, DEED, GUARANTY, INDEMNITY BOND, SURETY BOND, CONTRACT TO SELL OR BILL OF SALE OF THE PROPERTY OF RCHSD, EXCEPT IN THE ORDINARY COURSE OF BUSINESS. - ACQUIRE, PURCHASE, DEVELOP, IMPROVE, SELL, LEASE OR MORTGAGE ANY CORPORATE REAL ESTATE OR ANY INTEREST THEREIN OR ENTER INTO ANY CONTRACT FOR ANY SUCH PURPOSES. - MAKE ANY LOAN OR INVESTMENT OF ANY RCHSD ASSETS, OR ENTER INTO ANY CONTRACT OR INCUR ANY LIABILITY ON BEHALF OF RCHSD OTHER THAN FOR FAIR CONSIDERATION OR IN THE ORDINARY COURSE OF BUSINESS RELATING TO ITS NORMAL DAILY OPERATION. FORM 990, PART VI, SECTION A, LINE 7B PLEASE REFER TO LINE 7A EXPLANATION. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF FORM 990 THE FORM 990 WAS REVIEWED BY THE CFO AND THEN PROVIDED TO THE ORGANIZATION'S AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE FOR REVIEW. FOLLOWING REVIEW BY THE COMMITTEE, THE RETURNS WERE FINALIZED, SIGNED AND SUBMITTED TO THE INTERNAL REVENUE SERVICE. A COMPLETE COPY OF THE FORM 990 WAS PROVIDED TO EACH VOTING BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY ON AN ANNUAL BASIS AND UPON ELECTION OR APPOINTMENT, THE POLICY AND DISCLOSURE STATEMENT IS DISTRIBUTED TO ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES AND MEDICAL STAFF LEADERS. ALL COMPLETED AND SIGNED STATEMENTS ARE RETURNED TO THE CORPORATE COMPLIANCE OFFICER FOR REVIEW. IF A PERSON DISCLOSES A POTENTIAL OR ACTUAL CONFLICT IS IDENTIFIED THE PERSON WITH THE POTENTIAL OR ACTUAL CONFLICT OF INTEREST IS RECUSED FROM ANY DISCUSSION OR APPROVAL OF ANY SUCH RELATED TRANSACTION. FINANCIAL INTEREST DISCLOSURES BY BOARD MEMBERS AND OFFICERS ARE BROUGHT TO THE RCHHC BOARD OF TRUSTEES OR THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE FOR REVIEW AND, AS NEEDED, APPROPRIATE ACTION. FINANCIAL INTEREST DISCLOSURES BY KEY EMPLOYEES AND MEDICAL STAFF LEADERS ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND REFERRED TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OR TO THE RCHHC BOARD OF TRUSTEES. THE CORPORATE COMPLIANCE OFFICER REPORTS ANNUALLY TO THE EXECUTIVE CORPORATE COMPLIANCE COMMITTEE AND THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE A SUMMARY OF ALL DISCLOSURES AND ACTION TAKEN, IF ANY. ALL OTHER EMPLOYEES ARE REQUIRED TO COMPLETE A DISCLOSURE STATEMENT ON AN ANNUAL BASIS THAT IS REVIEWED BY THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 DETERMINATION OF COMPENSATION RADY CHILDREN'S HOSPITAL AND HEALTH CENTER/RADY CHILDREN'S HOSPITAL - SAN DIEGO WORKING THROUGH THE BOARD COMPENSATION COMMITTEE HAS A PROCESS FOR ESTABLISHING, REVIEWING AND APPROVING COMPENSATION OF OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ON A NO LESS THAN AN ANNUAL BASIS. THE COMPENSATION COMMITTEE IS COMPRISED OF INDEPENDENT, LAY MEMBERS OF THE BOARD OF TRUSTEES. PRIOR TO CONDUCTING ITS REVIEW, THE CHAIR OF THE COMPENSATION COMMITTEE DETERMINES WHETHER ANY MEMBER HAS A CONFLICT OF INTEREST WITH RESPECT TO THE MATTER(S) UNDER REVIEW. IF THERE IS A CONFLICT, THE CONFLICTED MEMBER RECUSES HIMSELF/HERSELF AND IS NOT PRESENT DURING DISCUSSION OR VOTE ON THE ARRANGEMENT UNDER REVIEW. IN DETERMINING AND APPROVING THE COMPENSATION ARRANGEMENT, THE COMMITTEE CONSIDERS ALL COMPONENTS OF COMPENSATION. IT CONSIDERS COMPARABILITY DATA AND RETAINS AN INDEPENDENT COMPENSATION CONSULTANT TO PROVIDE COMPARABILITY DATA TO THE COMMITTEE. TOTAL COMPENSATION IS TARGETED TO BE BETWEEN THE 50TH AND 75TH PERCENTILES OF THE COMPARABILITY DATA. THE COMMITTEE'S DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN MINUTES THAT ARE REVIEWED AT ITS NEXT MEETING. THE COMMITTEE'S WRITTEN RECORDS INCLUDE THE (1) TERMS OF THE ARRANGEMENT WITH THE DISQUALIFIED PERSON (INCLUDING THE DATE THE ARRANGEMENT WAS APPROVED); (2) A LIST OF MEMBERS PRESENT DURING THE DISCUSSION OF THE TRANSACTION (AND HOW THE MEMBERS VOTED WHEN IT WAS APPROVED); AND (3) A DESCRIPTION OF THE COMPARABLE DATA RELIED ON BY THE COMMITTEE AND HOW IT WAS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 THE FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION. THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST AND THEY ARE ALSO ATTACHED TO THIS FORM 990. FORM 990, PART IX, LINE 11G PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 212,284,366. MANAGEMENT AND GENERAL EXPENSES 2,476,074. TOTAL EXPENSES 214,760,440. CLAIMS EXPENSES: PROGRAM SERVICE EXPENSES 57,827,563. TOTAL EXPENSES 57,827,563. PURCHASED SERVICES - UCSD: PROGRAM SERVICE EXPENSES 24,459,132. TOTAL EXPENSES 24,459,132. LEASED LABOR - NON-PHYSICIAN: PROGRAM SERVICE EXPENSES 15,559,013. MANAGEMENT AND GENERAL EXPENSES 1,100,747. TOTAL EXPENSES 16,659,760. PURCHASED SERVICES - MEDICAL: PROGRAM SERVICE EXPENSES 30,154,983. MANAGEMENT AND GENERAL EXPENSES 21,820,217. TOTAL EXPENSES 51,975,200. PURCHASED SERVICES - PHARMACY: PROGRAM SERVICE EXPENSES 306,212. TOTAL EXPENSES 306,212. PURCHASED SERVICES - RCPMS: MANAGEMENT AND GENERAL EXPENSES 2,065,791. TOTAL EXPENSES 2,065,791. MISCELLANEOUS MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 5,364,927. TOTAL EXPENSES 5,364,927. FORM 990, PART XI, LINE 9: CHANGE IN FMV OF INTEREST RATE SWAP 30,608,174. CHANGE IN SPLIT INTEREST AGREEMENTS 7,359. INTERCOMPANY SETTLEMENT -21,841,956. CHANGE IN DEFINED BENEFIT COST 81,953,025. TRANSFER OF NET ASSETS TO RCHRC -15,000,000. TREASURY LOCK SWAP GAIN 8,419,878. RADY CHILDREN'S HOSPITAL AND HEALTH CENTER 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 953545901 SUPPORT CA 501(C)(3) LINE 12B, II N/A 0 RADY CHILDREN'S HOSPITAL RESEARCH CENTER 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 953814185 RESEARCH CA 501(C)(3) LINE 12A, I RCHHC 0 RADY CHILDREN'S HOSPITAL FOUNDATION - SD 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 330170626 FUNDRAISING CA 501(C)(3) LINE 7 RCHHC 0 RADY CHILDREN'S HEALTH SERVICES - SD 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 330278018 SUPPORT CA 501(C)(3) LINE 12A, I RCHSD 1 CHILDREN'S HOSPITAL INTEGRATED RISK PROT 22 VICTORIA STREETHAMILTON HM12 HAMILTON BD HM12 CAPTIVE INSURANCE BD RCHHC C 0 RADY CHILDREN'S PHYSICIAN MANAGEMENT SER 3860 CALLE FORTUNADASUITE 200 SAN DIEGO CA 921234282 330670694 MANAGEMENT CA RCHHC C 0 CHILDREN'S HOSPITAL INSURANCE LTD CANONS COURT 22 VICTORIA STREET H HAMILTON BD HM12 CAPTIVE INSURANCE BD RCHHC C 0 0 1 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 1 RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO P 306212 ACTUAL COST RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO Q 7881554 ACTUAL COST