2022-11-15T20:30:19+00:00 2021-12-31 346565596 ERNST & YOUNG US LLP 221 EAST 4TH STREET SUITE 2900 CINCINNATI OH 45202 990 2021-01-01 311429047 Children's Hospital and Physician's Healthcare Network CHIL 6147225958 700 CHILDRENS DRIVE COLUMBUS OH 43205 SEAN GLEESON MD President 6147225958 2022-11-15 true LUKE BROWN 999009999 Julie Sparks P01268401 5136121400 2021 2022-09-23 18:48:47Z Partners for Kids SEAN GLEESON MD 700 CHILDRENS DRIVE COLUMBUS OH 43205 1580562038 false X WWW.PARTNERSFORKIDS.ORG X 1994 OH IMPROVING THE HEALTH OF CHILDREN THROUGH HIGH VALUE, INNOVATIVE CARE AND COMMUNITY PARTNERSHIPS. 19 8 0 8 0 0 18087 578448 1249262752 1579788803 552136 194606 0 181 1249832975 1580562038 750000 0 0 0 13275976 15405759 0 0 0 1101114427 1406812939 1115140403 1422218698 134692572 158343340 326841457 428734589 192148888 135990607 134692569 292743982 IMPROVING THE HEALTH OF CHILDREN THROUGH HIGH VALUE, INNOVATIVE CARE AND COMMUNITY PARTNERSHIPS. false false 1400541365 1579776803 MEMBER HEALTH CARE SERVICE PARTNERS FOR KIDS (PFK) ACTS AS AN ACCOUNTABLE CARE ORGANIZATION AND IS COMMITTED TO PROVIDING AND IMPROVING MEDICAL CARE FOR CHILDREN ENROLLED IN MANAGED MEDICAID AND LIVING IN THE SOUTH CENTRAL, SOUTH EAST, AND WEST CENTRAL (10 COUNTIES) REGIONS OF OHIO. IT HAS FULL-RISK CAPITATION AGREEMENTS WITH THE 4 MEDICAID MANAGED CARE PLANS AND IS FINANCIALLY RESPONSIBLE FOR THE MEDICAL, DENTAL, VISION AND PHARMACY CLAIMS EXPENSES FOR APPROXIMATELY 475,000 CHILDREN. PFK WORKS CLOSELY WITH HOSPITALS, PHYSICIAN PRACTICES AND MEDICAID MANAGED CARE PLANS TO ENSURE COMPREHENSIVE AND QUALITY MEDICAL CARE IS AVAILABLE TO THE MEDICAID POPULATION WITHIN ITS SERVICE AREA. 8593288 0 CARE NAVIGATION PARTNERS FOR KIDS CARE NAVIGATION PROVIDES BOTH EPISODIC AND COMPLEX CASE MANAGEMENT BASED ON PATIENT NEEDS, INTENSITY OF SERVICE REQUIRED, AND LEVEL OF CARE. THE GOALS OF CARE NAVIGATION PROGRAM ARE: A. ASSIST PATIENTS IN ACHIEVING OPTIMUM HEALTH OUTCOMES, FUNCTIONAL CAPABILITY, AND QUALITY OF LIFE THROUGH IMPROVED MANAGEMENT OF THEIR DISEASE OR CONDITION. B. IDENTIFYING, ACCESSING AND MAXIMIZING AVAILABLE BENEFITS AND RESOURCES. C. ASSIST PATIENTS IN ACHIEVING GOALS BY IMPROVING THEIR ABILITY TO SELF-MANAGE THEIR DISEASE OR CONDITION. D. COORDINATING SERVICES AMONG PROVIDERS INVOLVED BY CREATING COLLABORATION BETWEEN PATIENTS, FAMILY, PROVIDERS, AND COMMUNITY ORGANIZATIONS TO DEVELOP GOALS. E. FACILITATING TIMELY RECEIPT OF APPROPRIATE SERVICES IN THE MOST APPROPRIATE SETTING. PARTNERS FOR KIDS' CARE NAVIGATION CONDUCTS SEMI-ANNUAL PROGRAM EVALUATIONS WHICH MEASURE: A. REDUCTION IN UTILIZATION - TESTING OF SELECT PATIENTS DEMONSTRATES A SIGNIFICANT REDUCTION IN INPATIENT ADMISSIONS, BED DAYS, AND ED VISITS. B. OUTREACH ENGAGEMENT RATES BY POPULATION TYPE - 2021 PATIENT OUTREACH RESULTED IN 47.9% ENROLLMENT. C. SATISFACTION SURVEY RESULTS - COMPOSITE SCORE MEAN ON PATIENT SURVEY REGARDING INTEGRATED CARE IS 67.9 FOR 2021. 5780002 12181 QUALITY IMPROVEMENT, COMMUNITY HEALTH & RESEARCH QUALITY IMPROVEMENT COACHING - PARTNERS FOR KIDS QUALITY IMPROVEMENT COACHING PROGRAM CONCENTRATES ON KEY ISSUES AFFECTING CHILDREN'S HEALTH, AND IS TAILORED TO PARTICIPATING COMMUNITY PRIMARY CARE AND BEHAVIORAL HEALTH PROVIDERS IN A 34-COUNTY REGION. PRACTICES ARE SUPPORTED ON-SITE BY A PFK QUALITY STRATEGIST OR QUALITY CONSULTANT WHO COACHES PRACTICE TEAMS THROUGH PROJECTS, SHARES IDEAS FOR CHANGE AND TESTS CHANGES. THE IMPROVEMENT PROCESS AT THE COMMUNITY PRIMARY CARE PRACTICE OR BEHAVIORAL HEALTH ORGANIZATION IS THEN SUPPORTED BY PARTICIPATION IN A DIVERSE NETWORK WHERE BEST PRACTICES AND CHALLENGES ARE SHARED. IMPROVEMENT IS MEASURED USING OBJECTIVE DEFINITIONS, OFTEN BASED ON HEDIS MEASURES PRIORITIZED BY THE OHIO DEPARTMENT OF MEDICAID, AND STATISTICAL TOOLS TO SUPPORT DECISION MAKING. IN 2021, THE PARTNERS FOR KIDS QUALITY IMPROVEMENT COACHING PROGRAM: A. ENGAGED 40 COMMUNITY PRACTICES WITH AT LEAST ONE ACTIVE QI PROJECT DURING THE YEAR, WITH 125,514 PARTNERS FOR KIDS PATIENTS RECEIVING CARE AT THOSE SITES - OF THESE ENGAGED PRACTICES, NEARLY HALF OF THEM (17) PARTICIPATED IN MORE THAN ONE ACTIVE PROJECT IN 2021 - THREE OF THESE PRACTICES PARTICIPATED IN THREE OR MORE DIFFERENT PROJECTS B. ENGAGED SIX COMMUNITY BEHAVIORAL HEALTH ORGANIZATIONS WITH AT LEAST ONE ACTIVE QI PROJECT DURING THE YEAR - TWO OF THESE ENGAGED BEHAVIORAL HEALTH ORGANIZATIONS PARTICIPATED IN BOTH QUALITY IMPROVEMENT PROJECTS OFFERED C. FACILITATED 69 ACTIVE QI PROJECTS WITH COMMUNITY PROVIDERS, INCLUDING: - 6 ASTHMA PROJECTS - 8 DEPRESSION PROJECTS - 3 EMERGENCY DEPARTMENT REDUCTION PROJECTS - 7 FLUORIDE VARNISH PROJECTS - 2 IMMUNIZATION PROJECTS - 9 REPRODUCTIVE HEALTH PROJECTS - 26 WELL VISIT PROJECTS - 3 PATIENT ENGAGEMENTS PROJECTS - 4 FOLLOW UP AFTER HOSPITAL DISCHARGE FOR BEHAVIORAL HEALTH CONDITION PROJECTS - 1 ANTIPSYCHOTIC PRESCRIBING PROJECT D. SHOWED IMPROVEMENT IN NEARLY HALF OF ACTIVE QI PROJECTS IN PRIMARY CARE PRACTICES AND BEHAVIORAL HEALTH ORGANIZATIONS E. THE PFK QI COACHING TEAM ALSO SUPPORTED THE DEVELOPMENT OF A SISTER QUALITY IMPROVEMENT COACHING PROGRAM IN THE WEST CENTRAL REGION OF PFK, WHICH ENCOMPASSES 10 ADDITIONAL COUNTIES, THROUGH PROJECT PORTFOLIO DEVELOPMENT, DATA ANALYSIS AND QUALITY IMPROVEMENT TRAINING. THE PARTNERS FOR KIDS OFFICE OF THE MEDICAL DIRECTOR HOSTS A PROJECT ECHO LEARNING COLLABORATIVE AROUND THE DELIVERY OF BEHAVIORAL HEALTH CARE IN THE PRIMARY CARE SETTING. PROJECT ECHO IS A HUB AND SPOKE MODEL, WITH A MULTIDISCIPLINARY TEAM INCLUDING PSYCHOLOGY, PSYCHIATRY, PRIMARY CARE PEDIATRICS AND A NETWORK SPECIALIST SERVING AS THE HUB TEAM, AND COMMUNITY BASED PRIMARY CARE PROVIDERS AS THE SPOKES. USING SHORT DIDACTICS AND PARTICIPANT LED CASE PRESENTATIONS AND DISCUSSIONS, PROJECT ECHO AIMS TO INCREASE THE COMFORT AND COMPETENCE OF PRIMARY CARE PROVIDERS IN MANAGING PATIENTS WITH BEHAVIORAL HEALTH CONCERNS. THE TOPICS FOR THE WEEKLY SESSIONS INCLUDE A WIDE RANGE OF BOTH FOUNDATIONAL LEARNING AND DEEPER DIVES INTO THE MOST PREVALENT PEDIATRIC BEHAVIORAL HEALTH CONDITIONS. THIS OFFICE HAS ALSO DEVELOPED SPECIFIC PRESCRIBING GUIDELINES FOR THE MOST PREVALENT BEHAVIORAL HEALTH CONDITIONS IN YOUTH AND IS SUPPORTING COMMUNITY PROVIDERS WITH WEBINAR EDUCATIONAL SESSIONS AND IN-PERSON CONSULTATION WITH PHARMACISTS WITH RELEVANT EXPERTISE. SCHOOL-BASED HEALTH CENTERS AND MOBILE UNITS - THE SCHOOL-BASED HEALTH PROGRAM IS A PARTNERSHIP WITH CENTRAL OHIO SCHOOLS THAT IS DESIGNED TO REACH PATIENTS WITH THE GREATEST NEED. THE PROGRAM IS CO-FUNDED BY NATIONWIDE CHILDREN'S HOSPITAL AND PARTNERS FOR KIDS AND MANAGED BY NATIONWIDE CHILDREN'S HOSPITAL. THE 14 SCHOOL-BASED HEALTH CENTERS (SBHC) AND 2 MOBILE UNITS PROVIDE UNIQUE ACCESS TO PRIMARY CARE FOR THOSE NOT OTHERWISE ACCESSING CARE. PROVIDERS IN THESE CLINICS AND MOBILE UNITS INTEGRATE CARE WITH SERVICES PROVIDED IN SCHOOLS, COMMUNITY SITES AND ALSO RECONNECT PATIENTS TO A MEDICAL HOME. A PRIMARY GOAL OF THE SCHOOL-BASED HEALTH CENTERS AND MOBILE UNITS IS TO REDUCE HEALTH INEQUITIES FOR AN AT-RISK POPULATION OF STUDENTS. SECONDARILY, THE AIMS INCLUDE: REDUCING PREVENTABLE SCHOOL ABSENCES, INCREASING THE NUMBER OF CHILDREN RECEIVING PREVENTATIVE CARE, IMPROVING OUTCOMES FOR STUDENTS WITH CHRONIC MEDICAL CONDITIONS AND REDUCING PHYSIOLOGICAL AND ENVIRONMENTAL FACTORS THAT IMPEDE ACADEMIC ATTAINMENT. IMPORTANT MEASURES OF THIS PROGRAM INCLUDE: A. THE SCHOOL HEALTH TEAM PLAYED A VITAL ROLE IN COVID-19 VACCINE DISTRIBUTION TO CHILDREN, PROVIDING 21,608 VACCINES, REACHING CHILDREN WITH BARRIERS TO ACCESS TO THE VACCINE. B. THE SBHC STAFF COMPLETED 5,857 PATIENT VISITS AND THE MOBILE TEAM COMPLETED 1,464 VISITS. 2,633 OF THESE TOTAL VISITS WERE WELL CHECKS. C. THE CLINIC STAFF SUBMITTED 1,115 REFERRALS, WITH THE MOST COMMON BEING BEHAVIORAL HEALTH AND OPHTHALMOLOGY, AND DENTAL CLINIC REFERRALS. D. IN 2021, THE MOBILE UNITS SERVED 44 UNIQUE SITES. THESE SITES WERE A COMBINATION OF SCHOOLS, EARLY CHILDHOOD CENTERS AND COMMUNITY LOCATIONS. SCHOOL-BASED ASTHMA THERAPY (SBAT) PROGRAM -THE SCHOOL-BASED ASTHMA THERAPY (SBAT) PROGRAM WORKS AS A LIAISON BETWEEN THE SCHOOL AND THE ASTHMA CARE PROVIDER TO DESIGN A PLAN FOR STUDENTS WITH HIGH-RISK ASTHMA TO RECEIVE HIS/HER ASTHMA PREVENTION MEDICATION RIGHT AT SCHOOL. ONE OF THE PRIMARY GOALS OF THE PROGRAM IS TO MAINTAIN THE STUDENT'S ASTHMA CARE WITH THEIR ASTHMA CARE PROVIDER, WHILE HELPING IMPROVE COMPLIANCE OF THE STUDENT'S ASTHMA CARE WITH THEIR CONTROLLER MEDICATIONS. WORKING WITH COMMUNITY PARTNERS, SUCH AS THE SCHOOL NURSE TO HELP CHILDREN GET THEIR MEDICINE MAKES THIS POSSIBLE. THE PROGRAM IS CO-FUNDED BY NATIONWIDE CHILDREN'S HOSPITAL AND PARTNERS FOR KIDS. A. THERE WERE 508 UNIQUE STUDENTS ENROLLED IN SBAT BY THE END OF THE 2021-22 SCHOOL YEAR FROM 241 PARTICIPATING SCHOOLS. B. WHEN COMPARING PATIENT OUTCOMES 1 YEAR PRE- AND 1 YEAR POST-SBAT ENROLLMENT, THE FOLLOWING RESULTS WERE ACHIEVED: - A 52% REDUCTION IN ED RATES - A 73% REDUCTION IN IP RATES - A 78% REDUCTION IN PICU RATES RESEARCH - PARTNERS FOR KIDS' DATA IS USED TO SUPPORT RESEARCH. WE BELIEVE THAT RESEARCH ENABLES PFK TO: A. UPHOLD OUR RESPONSIBILITY TO IMPROVE THE QUALITY AND EFFICIENCY OF CARE FOR CHILDREN; B. SUPPORT MEASURES POPULATION HEALTH; C. ENABLE CLINICIANS TO DEVELOP, EVALUATE AND LEAD IMPROVEMENT INTERVENTIONS RESEARCH PRODUCTIVITY IS MEASURED BY THE USE OF PFK IN ARTICLES PUBLISHED IN PEER-REVIEWED JOURNALS AND USED IN SCHOLARLY POSTER PRESENTATIONS. IN 2021, PFK PARTICIPATED IN EIGHT PEER-REVIEWED PUBLICATIONS AND 1 ORAL PRESENTATION AT A REGIONAL CONFERENCE. 1414914655 true true false false false false false false false false false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true false false false true X 1 0 true 0 false false false false false false false false false false false false X 19 8 true false false false true true false true true false false false true true true false false false false false OH X CHRISTINA SHAVER 6143553119 700 CHILDRENS DRIVE COLUMBUS OH 43205 Luke Brown TREASURER / DIRECTOR 3.0 64.0 X X 0 912339 88287 William Long MD DIRECTOR / CHAIRMAN 3.0 23.0 X X 0 102865 1209 Adebomi Omikunle MD DIRECTOR 3.0 0 X 0 0 0 Aimee White DIRECTOR 3.0 0 X 0 0 0 Alex Kemper MD DIRECTOR 3.0 0 X 0 0 0 Chris Bergman DIRECTOR 3.0 0 X 0 0 0 David Axelson MD DIRECTOR 3.0 3.0 X 0 386542 67518 Deborah Feldman DIRECTOR 3.0 0 X 0 0 0 Garey Noritz MD DIRECTOR 3.0 0 X 0 0 0 H Scott Tyson MD DIRECTOR 3.0 0 X 0 0 0 John A Barnard MD DIRECTOR 3.0 38.0 X 0 596877 56490 Lee Ann Wallace DIRECTOR 3.0 50.0 X 0 625899 62741 Meredith Merz Lind MD DIRECTOR - EX-OFFICIO 3.0 50.0 X 0 565211 66318 Olivia Thomas MD DIRECTOR 3.0 3.0 X 0 0 0 Oluyinka Olutoye MD DIRECTOR 3.0 47.0 X 0 1069421 61241 Prashant Malhotra MD DIRECTOR 3.0 3.0 X 0 430703 63337 Richard Miller DIRECTOR 3.0 52.0 X 0 1588102 69237 Rustin Morse MD DIRECTOR 3.0 51.0 X 0 710410 69487 Timothy C Robinson DIRECTOR 3.0 63.0 X 0 1534239 62437 Vinay Prasad MD DIRECTOR 3.0 3.0 X 0 303221 69559 Charitha Gowda MD INTERIM MEDICAL DIRECTOR (3/2021 - 12/2021) 3.0 0 X 0 0 0 Gilbert Liu MD MEDICAL DIRECTOR (TO 3/2021) 50.0 0 X 113698 0 23036 Mary DiOrio MD MEDICAL DIRECTOR (AS OF 12/2021) 50.0 0 X 11730 0 1472 Rhonda Comer SECRETARY 3.0 64.0 X 0 956070 170275 Sara Evans ASSISTANT SECRETARY 3.0 47.0 X 0 252982 63296 Sean Gleeson MD PRESIDENT 50.0 0 X 375525 0 57384 Pamela Edson VICE PRESIDENT 50.0 0 X 233631 0 42738 Janis Baldwin CLINICAL SERVICES DIRECTOR 50.0 0 X 142205 0 27038 Kelin Wheaton CLINICAL PHARMACIST 50.0 0 X 120293 0 15156 Mary Siefke CORPORATE FINANCE MANAGER 50.0 0 X 144017 0 19626 Melanie Pinnow PRIMARY CARE DIRECTOR - PFK 50.0 0 X 119956 0 35733 Stephanie Patrick BEHAVIORAL HEALTH DIRECTOR - PFK 50.0 0 X 117915 0 21021 1378970 10034881 1214636 14 false true false PEDIATRIC ACADEMIC ASSOCIATION INC 555 SOUTH 18TH STREET COLUMBUS OH 43205 CAPITATION PAYMENTS 19144723 SEQUIOA REINSURANCE SERVICES LLC 15800 32ND AVENUE N SUITE 120 PLYMOUTH MN 55447 REINSURANCE PAYMENTS 6569171 PROMINENCE ADVISORS INC 23556 N KINGSTON ROW LINCOLNSHIRE IL 60069 IMPLEMENTATION SERVICES 753414 IBM CORP PO BOX 645670 PITTSBURGH PA 15264 CONSULTING SERVICES 603608 PEDIATRIC ASSOCIATES INC 1021 COUNTRY CLUB ROAD COLUMBUS OH 43213 CAPITATION PAYMENTS 539548 20 0 0 0 578448 0 0 0 578448 CAPITATION PREMIUMS 900099 1579776803 1579776803 CREDENTIALING FEES 900099 12000 12000 0 0 0 0 1579788803 194606 194606 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 181 181 0 0 181 1580562038 1579788984 0 194606 0 0 0 0 0 0 0 0 859212 74968 784244 0 0 0 0 0 11339310 8896311 2442999 0 0 0 0 0 3207237 2460045 747192 0 0 0 0 0 0 0 0 0 12188 0 12188 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6471002 3372418 3098584 0 0 0 0 0 195674 145193 50481 0 892 0 892 0 0 0 0 0 260234 193098 67136 0 30502 26058 4444 0 0 0 0 0 3254 0 3254 0 22175 0 22175 0 0 0 0 0 0 0 0 0 0 0 0 0 Claims Expense 1391019389 1391019389 0 0 Reinsurance Premiums 8726175 8726175 0 0 Accreditation Survey 23270 0 23270 0 Membership And Association Fees 12982 0 12982 0 35202 1000 34202 0 1422218698 1414914655 7304043 0 0 0 0 0 99665520 185396511 50450127 50000000 169071959 88519570 0 0 0 0 205583 185456 0 0 0 0 0 99827085 0 0 7448268 4805967 326841457 428734589 19944825 41244368 0 0 172204063 94746239 192148888 135990607 X 134692569 292743982 134692569 292743982 326841457 428734589 158343340 -291927 0 X false true X true false X X X 1 NATIONWIDE CHILDREN'S HOSPITAL 314379441 3 true 434618368 0 1 434618368 0 true false false false false false false false false false false false false false false true false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED DUE TO NATIONWIDE CHILDREN'S HOSPITAL 1398609 CLAIMS PAYABLE 93347630 94746239 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote PFK IS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF NATIONWIDE CHILDREN'S HOSPITAL (NCH). NCH'S ASC 740 FOOTNOTE READS AS FOLLOWS: NATIONWIDE CHILDREN'S RECORDS ACCRUALS FOR UNCERTAIN TAX POSITIONS UNDER ASC 740, INCOME TAXES. NATIONWIDE CHILDREN'S HAD NO SIGNIFICANT UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 AND 2020. false true false false false false false false false Luke Brown TREASURER / DIRECTOR 0 557781 0 204188 0 150370 0 64150 0 24137 0 1000626 0 75000 David Axelson MD DIRECTOR 0 306542 0 80000 0 0 0 39150 0 28368 0 454060 0 0 John A Barnard MD DIRECTOR 0 339935 0 256942 0 0 0 34200 0 22290 0 653367 0 0 Prashant Malhotra MD DIRECTOR 0 381425 0 49278 0 0 0 39150 0 24187 0 494040 0 0 Meredith Merz Lind MD DIRECTOR - EX-OFFICIO 0 463713 0 81998 0 19500 0 39150 0 27168 0 631529 0 0 Richard Miller DIRECTOR 0 1114047 0 454555 0 19500 0 39150 0 30087 0 1657339 0 0 Rustin Morse MD DIRECTOR 0 565910 0 125000 0 19500 0 39150 0 30337 0 779897 0 0 Oluyinka Olutoye MD DIRECTOR 0 736217 0 306281 0 26923 0 39150 0 22091 0 1130662 0 0 Vinay Prasad MD DIRECTOR 0 265721 0 18000 0 19500 0 39150 0 30409 0 372780 0 0 Timothy C Robinson DIRECTOR 0 295989 0 218750 0 1019500 0 39150 0 23287 0 1596676 0 0 Lee Ann Wallace DIRECTOR 0 427397 0 198502 0 0 0 39150 0 23591 0 688640 0 0 Rhonda Comer SECRETARY 0 595155 0 360915 0 0 0 139150 0 31125 0 1126345 0 0 Sara Evans ASSISTANT SECRETARY 0 252982 0 0 0 0 0 24413 0 38883 0 316278 0 0 Sean Gleeson MD PRESIDENT 301025 0 5000 0 69500 0 26210 0 31174 0 432909 0 0 0 Pamela Edson VICE PRESIDENT 233631 0 0 0 0 0 20374 0 22364 0 276369 0 0 0 Janis Baldwin CLINICAL SERVICES DIRECTOR 142205 0 0 0 0 0 7979 0 19059 0 169243 0 0 0 Melanie Pinnow PRIMARY CARE DIRECTOR - PFK 119956 0 0 0 0 0 8180 0 27553 0 155689 0 0 0 Mary Siefke CORPORATE FINANCE MANAGER 144017 0 0 0 0 0 8367 0 11259 0 163643 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation The following methods were used by Nationwide Children's Hospital, a related organization, to establish the compensation of the President for the tax year: Compensation committee Independent compensation consultant Compensation survey or study Approval by the board or compensation committee Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: , LUKE BROWN, RHONDA COMER, AND JOHN BARNARD, M.D. PAYOUT OF SRP AMOUNT THAT HAD BEEN PREVIOUSLY FUNDED, OCCURRED FOR THE FOLLOWING EMPLOYEES: LUKE BROWN $120,370 CONTRIBUTIONS WERE MADE ON BEHALF OF THE FOLLOWING EMPLOYEES: RHONDA COMER $100,000 LUKE BROWN $25,000 EFFECTIVE FOR PLAN YEAR 2010, NATIONWIDE CHILDREN'S HOSPITAL CHOSE TO ELIMINATE FUTURE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. CURRENT BALANCES OF THIS PLAN ARE MAINTAINED IN THE ACCOUNTS. FOR CHILDREN'S RADIOLOGICAL INSTITUTE, INC., CONTRIBUTIONS ARE STILL BEING MAINTAINED, BUT THERE WAS A PLAN DESIGN CHANGE ALLOWING ANNUAL CONTRIBUTIONS TO BE VESTED AFTER 5 YEARS. Form 990, Part V, Line 2a NUMBER OF EMPLOYEES PARTNERS FOR KIDS (PFK) EMPLOYEES WERE LEASED THROUGH NATIONWIDE CHILDREN'S HOSPITAL, A RELATED ORGANIZATION. THERE WERE NO W-2S FILED BY PFK. Form 990, Part VI, Line 1a INDEPENDENT VOTING MEMBER PERCENTAGE NATIONWIDE CHILDREN'S HOSPITAL (NCH), AN OHIO NONPROFIT CORPORATION EXEMPT FROM TAXATION UNDER SECTION 501(C)(3), APPOINTS A MAJORITY OF THE DIRECTORS TO PARTNERS FOR KIDS' (PFK) BOARD. PFK IS A SUBSIDIARY OF NCH, ONE OF THE NATION'S PREMIER PEDIATRIC HEALTH CARE AND RESEARCH ORGANIZATIONS. NCH'S BOARD MEMBERS BROADLY REPRESENT THE INTERESTS OF THE COMMUNITY AND A MAJORITY OF THE BOARD MEMBERS ARE INDEPENDENT OF NCH. AS A SUBSIDIARY OF NCH, PFK IS ALSO UNDER THE CONTROL OF A COMMUNITY BOARD. BOTH ORGANIZATIONS HAVE FORMALLY ADOPTED AND ADHERE TO CONFLICTS OF INTEREST POLICIES. Form 990, Part VI, Line 13 WHISTLEBLOWER POLICY PARTNERS FOR KIDS (PFK) DOES NOT HAVE ITS OWN WHISTLEBLOWER POLICY. ALL INDIVIDUALS WHO WORK ON BEHALF OF PFK ARE NATIONWIDE CHILDREN'S HOSPITAL (NCH) EMPLOYEES THAT ARE LEASED TO PFK. AS NCH EMPLOYEES, ALL PERSONNEL ARE SUBJECT TO NCH'S EMPLOYMENT POLICIES AND STANDARD OF CONDUCT, WHICH CONTAINS WHISTLEBLOWER PROVISIONS. Form 990, Part VI, Line 14 DOCUMENT RETENTION AND DESTRUCTION POLICY PARTNERS FOR KIDS (PFK) CREDENTIALS PROVIDERS FOR PARTICIPATION IN VARIOUS INSURANCE PLANS. IT DOES HAVE A DOCUMENT RETENTION POLICY FOR CREDENTIALING DOCUMENTS, BUT FOR ALL OTHER DOCUMENTS IT FOLLOWS THE NATIONWIDE CHILDREN'S HOSPITAL RETENTION AND DESTRUCTION POLICY. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons WILLIAM LONG, M.D. AND H. SCOTT, TYSON, M.D. - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders PARTNERS FOR KIDS (PFK) HAS TWO CLASSES OF MEMBERS - HOSPITAL AND PHYSICIAN MEMBERS. THE HOSPITAL MEMBERS OF PFK ARE NATIONWIDE CHILDREN'S HOSPITAL AND DAYTON CHILDREN'S HOSPITAL. A PHYSICIAN MAY BECOME A MEMBER OF PFK (A) BEING ONE OF THE FOLLOWING FIVE TYPES OF PHYSICIANS: 1) A HOSPITAL-BASED SPECIALIST (WITH A PRINCIPAL PRACTICE IN ANESTHESIOLOGY, PATHOLOGY OR RADIOLOGY); 2) A MEDICAL SPECIALIST; 3) A PEDIATRIC PRIMARY CARE PHYSICIAN; 4) A SURGICAL SPECIALIST; OR 5) A PSYCHIATRIST, (B) HAVING A MEDICAL STAFF APPOINTMENT AT NATIONWIDE CHILDREN'S HOSPITAL, AND (C) EXECUTING A PARTICIPATING PROVIDER SERVICE AGREEMENT WITH PFK. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body NATIONWIDE CHILDREN'S HOSPITAL, HOSPITAL MEMBER OF PFK, APPOINTS 10 OF THE 19 BOARD MEMBERS OF PFK'S BOARD OF DIRECTORS. DAYTON CHILDREN'S HOSPITAL, HOSPITAL MEMBER OF THE PFK, APPOINTS 2 BOARD MEMBERS. THE PHYSICIAN MEMBERS APPOINT THE REMAINING SEVEN DIRECTORS. Form 990, Part VI, Line 11b Review of form 990 by governing body THIS FORM 990 WAS REVIEWED PRIOR TO FILING BY NATIONWIDE CHILDREN'S HOSPITAL CHIEF EXECUTIVE OFFICER/PARTNERS FOR KIDS BOARD DIRECTOR; NATIONWIDE CHILDREN'S HOSPITAL CHIEF FINANCIAL OFFICER/PARTNERS FOR KIDS BOARD TREASURER; AND NATIONWIDE CHILDREN'S HOSPITAL SENIOR VICE PRESIDENT OF LEGAL SERVICES/PARTNERS FOR KIDS BOARD SECRETARY. Form 990, Part VI, Line 12c Conflict of interest policy THE CONFLICT OF INTEREST POLICY REQUIRES THAT STAFF MEMBERS, MANAGEMENT AND BOARD MEMBERS REPORT CONFLICTS OF INTEREST OR COMMITMENT AT THE TIME THE CONFLICT ARISES. MANAGEMENT AND BOARD MEMBERS ARE ALSO REQUIRED TO COMPLETE DISCLOSURE FORMS ANNUALLY, REGARDLESS OF THE EXISTENCE OF CONFLICT. ALL DISCLOSURES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER OR THE BOARD SECRETARY. IF A CONFLICT EXISTS, A CONFLICT MANAGEMENT PLAN MAY BE PUT IN PLACE TO MITIGATE THE CONFLICT. STAFF, MANAGEMENT AND BOARD MEMBERS ARE PROHIBITED FROM VOTING ON ANY MATTERS WITH RESPECT TO WHICH THE INDIVIDUAL HAS DISCLOSED A POTENTIAL CONFLICT OF INTEREST. Form 990, Part VI, Line 19 Required documents available to the public NATIONWIDE CHILDREN'S HOSPITAL'S (NCH) FINANCIAL STATEMENTS, IN WHICH PARTNERS FOR KIDS (PFK) IS INCLUDED, ARE DISCLOSED ON THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBPAGE. THE PFK ARTICLES OF INCORPORATION ARE ON THE OHIO SECRETARY OF STATE'S WEBPAGE. CURRENTLY, PFK DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Other - Total Revenue: 181, Related or Exempt Function Revenue: 181, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; CHILDREN'S RADIOLOGICAL INSTITUTE INC 700 CHILDRENS DRIVE COLUMBUS OH 43205 311439570 RADIOLOGY OH 501(c)(3) 10 NCH false PEDIATRIC PATHOLOGY ASSOCIATES OF COLUMBUS 700 CHILDRENS DRIVE COLUMBUS OH 43205 311595013 PATHOLOGY OH 501(c)(3) 10 NCH false CHILDREN'S SURGICAL ASSOCIATES CORP 700 CHILDRENS DRIVE COLUMBUS OH 43205 311654000 SURGICAL SERV OH 501(c)(3) 10 NCH false NATIONWIDE CHILDREN'S HOSPITAL FOUNDATION 700 CHILDRENS DRIVE COLUMBUS OH 43205 311036370 FUNDRAISING OH 501(c)(3) 7 NCH false RESEARCH INSTITUTE AT NCH 700 CHILDRENS DRIVE COLUMBUS OH 43205 316056230 RESEARCH OH 501(c)(3) 7 NCH false CENTER FOR CHILD & FAMILY ADVOCACY AT NCH 700 CHILDRENS DRIVE COLUMBUS OH 43205 020627166 ADVOCACY OH 501(c)(3) 10 NCH false CHILDREN'S ANESTHESIA ASSOCIATES INC 700 CHILDRENS DRIVE COLUMBUS OH 43205 310650338 ANESTHESIA OH 501(c)(3) 10 NCH false NATIONWIDE CHILDREN'S HOSPITAL 700 CHILDRENS DRIVE COLUMBUS OH 43205 314379441 HOSPITAL OH 501(c)(3) 3 NA false NATIONWIDE CHILDREN'S HOSPITAL HOMECARE 700 CHILDRENS DRIVE COLUMBUS OH 43205 311296332 HOMECARE OH 501(c)(3) 10 NCH false NCH REALTY INC 700 CHILDRENS DRIVE COLUMBUS OH 43205 821052739 REALTY OH NCH C Corporation 0 0 0 false false false false false false false false false false false false false false false false true false true false