2021-08-16T18:15:54-05:00 2020-09-30 BKD LLP 14241 DALLAS PARKWAY SUITE 1100 DALLAS TX 75254 990 2019-10-01 263075429 El Paso Children's Hospital Corporation % CINDY STOUT ELPA 9152985444 4845 Alameda Ave El Paso TX 79905 CINDY STOUT CEO 9152985444 2021-08-16 true Jeanette Verrelli P00742631 9727028262 2019 2022-09-23 18:48:47Z El Paso Children's Hospital CINDY STOUT 4845 ALAMEDA AVE EL PASO TX 79905 139679143 false X ELPASOCHILDRENS.ORG X 2007 TX TO PROVIDE COMPASSIONATE, COORDINATED, FAMILY-CENTERED CARE FOR CHILDREN WITH A DEDICATED COMMITMENT TO EXCELLENT PATIENT OUTCOMES, ... (CONTINUED ON SCH O) 9 9 873 9 0 3201514 2614843 123692747 137064300 0 0 0 0 126894261 139679143 29000 1500 0 0 39633447 41201976 0 0 0 84110838 91545449 123773285 132748925 3120976 6930218 37727185 65199826 55314291 74172071 -17587106 -8972245 X TO PROVIDE COMPASSIONATE, COORDINATED, FAMILY-CENTERED CARE FOR CHILDREN WITH A DEDICATED COMMITMENT TO EXCELLENT PATIENT OUTCOMES, INCLUSIVE LEADERSHIP AND INNOVATIVE PEDIATRIC RESEARCH AND EDUCATION. false false 122928506 1500 137064300 EL PASO CHILDREN'S HOSPITAL IS THE ONLY SEPARATELY LICENSED, NON-TAXING, INDEPENDENT, 501(C)(3) NOT-FOR-PROFIT CHILDRENS HOSPITAL IN THE EL PASO, TEXAS REGION AND THE ONLY DEDICATED PEDIATRIC HOSPITAL WITHIN A 200-MILE RADIUS. THE HOSPITAL PROVIDES PEDIATRIC INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES TO CHILDREN FROM BIRTH THROUGH ADOLESCENCE. IT OPENED FEBRUARY 14, 2012, RECEIVED THE JOINT COMMISSION ACCREDITATION ON MARCH 9, 2012, AND ITS MEDICAID PROVIDER NUMBER IN JUNE 2012. THROUGH THE HOSPITAL'S AFFILIATION WITH TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER, THE HOSPITAL CONDUCTS PEDIATRIC RESEARCH AND EDUCATION, AND SERVES AS A TEACHING HOSPITAL FOR THE TEXAS TECH RESIDENCY PROGRAM. THE HOSPITAL HAS FOUR FULL-TIME TEXAS MEDICAID HEALTHCARE PARTNERSHIP (TMHP) PERSONNEL LOCATED IN THE BUILDING TO ENSURE THAT EVERY ELIGIBLE PATIENT IS ENROLLED IN CHIP-TEXAS WHICH IS SPECIFICALLY LEGISLATED TO PROVIDE MEDICAID-LIKE COVERAGE TO CHILDREN EVEN IF THEIR PARENTS DO NOT QUALIFY. THE LARGE MAJORITY OF CHILDREN CAN BE ENROLLED IN SOME TYPE OF GOVERNMENT PROGRAM. AS A RESULT, ONLY A VERY FEW CASES REMAIN IN THE TRADITIONAL CATEGORY OF CHARITY. THOSE PATIENTS REMAINING IN A CHARITY CLASSIFICATION ARE PROVIDED FREE OR REDUCED CHARGES PER WRITTEN EL PASO CHILDREN'S HOSPITAL POLICY. MORE CHARITY CARE INFORMATION IS AVAILABLE ON PAGE 11 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. SEE ATTACHED 122928506 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false true false false false false true true true false false true 137 0 873 true false false false false false false false false false false false false X 9 9 false false false false true true true true true false false false true true true true true true true false X CINDY STOUT 9152985444 4845 ALAMEDA AVE EL PASO TX 79905 X William Spurbeck physician 1.0 39.0 X 0 823801 15404 CINDY STOUT CEO 39.0 1.0 X 414031 0 24584 Angelica Chavez Physician 1.0 39.0 X 0 400551 17986 JOHN RUNKLES COO 39.0 1.0 X 262188 0 24584 RANAE THOMPSON CNO, END: 08/2020 39.0 1.0 X 270702 0 10503 MELISSA CAMPA CFO 39.0 1.0 X 220541 0 16673 Bert Johansson physician 1.0 39.0 X 0 219033 11930 Erika Estrada Director of Pharmacy 40.0 0.0 X 148309 0 19688 Ana Medina Spv. Pharmacy (Night) 40.0 0.0 X 156595 0 8337 Nicholas Hogue Spv. Pharmacy (Night) 40.0 0.0 X 144059 0 8290 Laura Barron Mgr. Pediatric Pharmacist 40.0 0.0 X 146010 0 6136 Pamela Walker Rn, Transport Team 37.0 0.0 X 131244 0 16119 LAUREL HUSTON CHIEF LEGAL OFFICER 39.0 1.0 X 104184 0 15245 STEPHEN RYBOLT FORMER CFO 0.0 0.0 X 103843 0 0 CINDY FIELDS CHAIRMAN 1.15 0.0 X X 0 0 0 PATRICK GORDON VICE CHAIR 1.15 0.0 X X 0 0 0 MICA SHORT SECRETARY 1.15 0.0 X X 0 0 0 AMY ROSS DIRECTOR 1.15 0.0 X 0 0 0 DR ISELA IBARRA DIRECTOR 1.15 0.0 X 0 0 0 ALAN ABBOTT DIRECTOR, END: 04/2020 1.15 0.0 X 0 0 0 STEVE ANDERSON DIRECTOR, BEG: 06/2020 1.15 0.0 X 0 0 0 TED HOUGHTON DIRECTOR, END: 04/2020 1.15 0.0 X 0 0 0 STEVE DEGROAT DIRECTOR, BEG: 06/2020 1.15 0.0 X 0 0 0 MIGUEL FERNANDEZ DIRECTOR 1.15 0.0 X 0 0 0 JOE CARDENAS DIRECTOR 1.15 0.0 X 0 0 0 2101706 1443385 195479 30 true true false TEXAS TECH UNIVERSITY 4801 ALBERTA EL PASO TX 79905 PHYSICIAN SERVICES 10670756 EL PASO IMAGING CONSULTANT 10 CAMINO PENASCO EL PASO TX 79912 PHYSICIAN SERVICES 663233 QUEST DIAGNOSTICS 12436 COLLECTION CENTER DR CHICAGO IL 60693 PHYSICIAN SERVICES 519160 MEDLINE INDUSTRIES INC Three Lakes Drive NORTHFIELD IL 60093 PHYSICIAN SERVICES 506226 KPMG LLP 2323 Ross Ave 1400 DALLAS TX 75201 acctg/consulting 433520 51 978755 1536124 99964 169972 2614843 Patient Service Revenue 621110 129220404 129220404 Supplemental Medicaid Revenue 900099 7821776 7821776 EHR Incentive Revenue 900099 22120 22120 137064300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 139679143 137064300 X 1500 1500 0 0 0 1363235 1363235 0 33756911 31360908 2396003 1307479 1193685 113794 2269360 2082981 186379 2504991 2237476 267515 0 434754 434754 132164 132164 0 0 0 30955304 29391596 1563708 447102 399355 47747 71448 54840 16608 169944 151795 18149 0 11430843 10210110 1220733 68884 61528 7356 0 51041 45590 5451 1818536 55613 1762923 0 1226826 1114671 112155 778400 695272 83128 Dues & Subscriptions 794725 709854 84871 Medical/ Surgical Supplies 17767611 17767611 Bad Debts 25362793 25362793 Recruitment Expense 34991 31254 3737 83 74 9 132748925 122928506 9820419 0 4452012 29081691 0 0 94811 31348 17234155 15321328 0 0 0 0 0 0 2066799 1467958 351591 774437 12290793 4915601 4064588 7375192 0 0 0 0 0 0 4557000 4557000 4906229 6590872 37727185 65199826 12618162 11076163 0 0 0 21041680 0 0 0 0 0 0 8070036 5231315 0 0 34626093 36822913 55314291 74172071 X -22493335 -15747151 4906229 6774906 -17587106 -8972245 37727185 65199826 X 6930218 1684643 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8741 8741 false SCHEDULE C, PARTII-B, LINE 1 OTHER ACTIVITIES: THE HOSPITAL PAYS DUES TO THE TEXAS HOSPITAL ASSOCIATION AND NACH, A PERCENTAGE OF WHICH ARE FOR LOBBYING PURPOSES. 520630 157559 363071 11770163 4758042 7012121 7375192 INTEREST IN N/A OF UMC FDN 6590872 6590872 0 Due to UMC 31667743 Est Self-Insurance Costs 290827 DUE TO RELATED PARTY 3190691 CAPITAL LEASE OBLIGATION 1673652 36822913 SCHEDULE D, PART X, LINE 2 ASC 740 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X true false true true 457938 457938 0.00430 64904358 51707585 13196773 0.12280 10596319 34347872 75958615 86055457 13654711 0.12710 642751 642751 0.00600 157359 157359 0.00150 800110 800110 0.00750 76758725 86055457 14454821 0.13460 true 25362793 3170349 62351 70087 -7736 X true true 1 1 EL PASO CHILDREN'S HOSPITAL 4845 ALAMEDA AVE EL PASO TX 79905 ELPASOCHILDRENS.ORG 100133 X X X EL PASO CHILDREN'S HOSPITAL false false true X X X X X X X X 17 true false false true X SEE PART V, SECTION C X true 17 true SEE PART V, SECTION C false true X 100 200. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 CHNA INPUT FROM REPRESENTATIVES OF THE COMMUNITY: PRIMARY DATA WAS COLLECTED THROUGH FOCUS GROUPS TO HELP BETTER UNDERSTAND THE PERCEPTION OF PROGRAMS THAT HAVE ALREADY BEEN ADOPTED BY THE HOSPITAL, AND TO BETTER UNDERSTAND THE NEEDS THAT STILL NEED TO BE ADDRESSED. THE INDIVIDUALS WHO PARTICIPATED IN THESE FOCUS GROUPS WERE FROM THE FOLLOWING: COMMUNITY PEDIATRICIANS, PICU NURSES, EPCH SPECIALTY PHYSICIANS, NICU NURSES, HEM/ONC NURSES, ED NURSES, TTUHSC PEDIATRIC SPECIALISTS AND SURGEONS, RADIOLOGY TECHNICIANS, AND EPCH BOARD MEMBERS. SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS ADDRESSED AND NOT ADDRESSED ON THE CHNA: THROUGH UTILIZING THE PRIORITIZED NEEDS LIST AND GROUP DISCUSSION, EL PASO CHILDREN'S HOSPITAL IDENTIFIED 4 NEW NEEDS TO ADDRESS OVER THE NEXT FEW YEARS. Outreach: From 2019 -2020, there were over 40,000 pediatric patients that required some form of hospitalization. Through improved outreach efforts, our marketing staff conducted various events to provide education on our hospital programs and, even during COVID-19, Gotomeetings continued. The Business Development team advance the process of visiting community physicians. Also, through social media, the marketing team has been able to gain free advertisement along with budgeted dollars to educate the community on improved pediatric services/needs. Program Development: Since the hospitals opening, migration from the region has been reduced by 80%. In 2020, a Board Certified Pediatric Cardiologist was recruited and the Pediatric Neurosurgery Program expanded. New software incorporated to help with the admission process and better communication with PCPs. To support affected families, the hospital in 2019 brought on Dr. David F. Jimenez to provide the community with convenient medical and surgical care to support an active life. We provide surgical treatment for diseases affecting the brain, spinal cord and nerves in infants, children, teens and young adults. We actively support our mission to provide the safest and highest quality care by implementing the use of advanced technology. Our patients benefit by undergoing safer, less invasive procedures, and less time under general anesthesia. Cutting-edge technology coupled with our specialized skill and training ensure children receive exceptional neurosurgical care. Year over year we have been able to increase the total number of neurosurgery surgical cases by 100%. This means that less patients are having to leave El Paso and are able to get world-renowned treatment here in the comfort of their home. Community Engagement: EPCH strives to improve the lives and outcomes for children and families needing health care and treatment. To accomplish this, EPCH collaborates with several non-profit agencies, local community groups and childrens charities each year. Our relationship with these entities is an important part of improving health outcomes for children across our region by supporting education, advocacy and promotion of partner events and initiatives. In 2020 alone, EPCH provided close to $25,000 in sponsorships and countless hours of community engagement by hospital staff, bringing awareness to a multitude of health topics affecting children in the region. Some of these events were held virtually due to the pandemic. Access to care: In 2020, the hospital increased access points by hiring an experienced case management director and medical director to work with patients and staff for patients needing specialized care. THE HOSPITAL'S CHNA DID NOT IDENTIFY ANY ADDITIONAL NEEDS WITHIN THE COMMUNITY THAT WERE NOT ADDRESSED THROUGH THE IMPLEMENTATION STRATEGY. SCHEDULE H, PART V, SECTION B, LINE 13H ELIGIBILITY CRITERIA EXPLAINED IN THE FAP: THE HOSPITAL ALSO USES MEDICAID AND MEDICARE TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART V, SECTION B, LINE 7 & 10 chna and implementation strategy: the chna and implementation strategy can be found on the following website: HTTPS://elpasochildrens.org/about-us/#1541351930530-3ebe804a-c36e SCHEDULE H, PART V, SECTION B, LINES 16A, 16B & 16C FINANCIAL ASSISTANCE AVAILABILTY: THE FAP, THE FAP APPLICATION FORM, AND A PLAIN LANGUAGE SUMMARY ARE WIDELY AVAILABLE ON THE FOLLOWING WEBSITE: https://elpasochildrens.org/patient-resources/ SCHEDULE H, PART V, LINES 18, 19 & 20 billing and collections: neither el paso children's hospital, nor third parties authorized by el paso children's hospial, take any actions upon non-payment from a patient before making reasonable effort to determine if the patient is eligible for the facility's financial assistance policy. 1 EL PASO CHILDREN'S PHYSICIAN SPECIALISTS 5340 EL PASO DRIVE STE M EL PASO TX 79905 SPECIALISTS/SURGERY SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBT EXPENSE: THE AMOUNT REPORTED ON LINE 2 IS BASED ON THE BAD DEBT PER THE ORGANIZATION'S FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION A, LINE 3 BAD DEBT ATTRIBUTABLE TO PATIENTS UNDER FINANCIAL ASSISTANCE POLICY: THE ORGANIZATION HAS ESTIMATED THE AMOUNT OF BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE POLICY AT ABOUT 12.5%. SCHEDULE H, PART III, SECTION A, LINE 4 BAD DEBT FOOTNOTE: Accounts receivable are reduced by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for doubtful accounts and provision for uncollectible accounts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for doubtful accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for uncollectible accounts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated or provided by policy) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts. SCHEDULE H, PART III, SECTION B, LINE 8 COSTING METHODOLOGY: THE HOSPITAL USES COST REPORT METHODOLOGY, WHICH APPORTIONS ROUTINE COSTS BASED ON MEDICAID OR MEDICARE DAYS TO TOTAL DAYS AND APPORTIONS ANCILLARY COSTS BASED ON PROGRAM CHARGES TO TOTAL CHARGES. THE ORGANIZATION HAD A MEDICARE SHORTFALL IN THE AMOUNT OF $7,736. THE STATE OF TEXAS TREATS MEDICARE SHORTFALL AS COMMUNITY BENEFIT FOR MEETING STATUTORY REQUIREMENTS FOR CHARITY CARE AND COMMUNITY BENEFIT. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTIONS PRACTICES: IF A PATIENT APPEARS TO BE INDIGENT, ACCOUNTS SHOULD BE REVIEWED, AT ANY TIME DURING THE COLLECTION PROCESS, FOR POSSIBLE CONSIDERATION AS A CHARITY CASE IN ACCORDANCE WITH THE ORGANIZATION'S CHARITY CARE POLICY. THE HOSPITAL WILL NOT TAKE ANY EXTRAORDINARY COLLECTIONS ACTIONS, INCLUDING SELLING THE DEBT TO A COLLECTION AGENCY, UNTIL REASONABLE EFFORTS ARE TAKEN TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. ONCE A PATIENT HAS BEEN DETERMINED ELIGIBLE FOR ASSISTANCE ALL COLLECTION ACTIONS ARE STOPPED. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: IN ADDITION TO THE CHNA, THE HOSPITAL OFTEN LEARNS ABOUT THE HEALTH NEEDS OF THE COMMUNITY THROUGH ITS AFFILIATIONS AND PARTNERSHIPS WITH SEVERAL PHYSICIAN PRACTICES, ACADEMIC PARTNERS, PEDIATRIC ORGANIZATIONS AND REPORTS AND FEEDBACK FROM STATE AND OTHER AGENCIES. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ALL PATIENTS WITHOUT THIRD PARTY INSURANCE RECEIVE INFORMATION WHILE AT EPCH REGARDING GOVERNMENTAL ASSISTANCE AND ARE ADVISED TO MAKE AN APPOINTMENT WITH A CERTIFIED MEDICAID ENROLLMENT CENTER TO DETERMINE THEIR ELIGIBILITY FOR MEDICAID ASSISTANCE. THOSE PATIENTS ARE INFORMED THAT THEY MAY BE ELIGIBLE FOR THE HOSPITAL'S CHARITY CARE PROGRAM. ALSO, ALL INPATIENTS WITHOUT THIRD PARTY COVERAGE ARE VISITED DURING THEIR HOSPITAL STAY AND SENT INFORMATION. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: THE CITY OF EL PASO IS LOCATED IN FAR WEST TEXAS, ALONG THE US/MEXICO BORDER. ON THE MEXICAN SIDE OF THE BORDER, THE POPULATION OF THE CIUDAD JUAREZ EXCEEDS THAT OF EL PASO, TEXAS. MOST OF EL PASO COUNTY'S POPULATION IS CENTERED AROUND THE CITY OF EL PASO. THE EL PASO CITY AND COUNTY UNEMPLOYMENT RATES IN JUNE 2014 WERE SIGNIFICANTLY HIGHER THAN THE STATE OF TEXAS AND NATIONAL AVERAGE. THE MEDIAN AGE OF PEOPLE IN THE EL PASO CHILDREN'S HOSPITAL COMMUNITY IS VARIED, WITH SOME AREAS IN THE COMMUNITY BELOW 21.0 AND OTHER AREAS AS HIGH AS 40.7. THIS LIKELY TRANSLATES TO A BROAD VARIETY OF HEALTH NEEDS ACROSS THE COMMUNITY, BASED ON AGE POPULATION, AND PROPORTIONATELY MORE CHILDREN IN CERTAIN ZIP CODES OVER OTHERS. AS A COMPARISON, THE MEDIAN AGE IN TEXAS IS 33.6 YEARS, AND THE NATIONAL MEDIAN AGE IS 36.8 YEARS. THE RACIAL MAKEUP OF THE HOSPITAL COMMUNITY IS PREDOMINATELY WHITE, AND AFRICAN AMERICAN AS A VERY DISTANT SECOND. EL PASO COUNTY IS LESS RACIALLY DIVERSE THAN THE STATE OF TEXAS OVERALL. AT 81 PERCENT OF THE TOTAL POPULATION IN THE HOSPITAL COMMUNITY, THE HISPANIC POPULATION IN EL PASO COUNTY IS VERY LARGE, RELATIVE TO 38 PERCENT IN TEXAS. EL PASO COUNTY HAS A SIGNIFICANTLY LOWER MEDIAN HOUSEHOLD INCOME THAN THE STATE OF TEXAS. NOT SURPRISINGLY, THE POVERTY LEVEL IN EL PASO COUNTY IS ALSO SIGNIFICANTLY HIGHER THAN THAT OF TEXAS. THE CHILD POVERTY RATE IN EL PASO COUNTY IS ALSO HIGHER THAN THE TEXAS STATE AVERAGE. SEVERAL OF THE ZIP CODES IN THE HOSPITAL COMMUNITY HAVE PARTICULARLY HIGH CHILD POVERTY RATES. ZIP CODES 79901, 79916, AND 79838 ARE NEARLY TWICE THE RATE OF EL PASO COUNTY AND THREE TIMES THAT OF THE STATE OF TEXAS. IN THE 2010-2011 SCHOOL YEAR, 68.8% OF EL PASO COUNTY CHILDREN WERE ELIGIBLE FOR FREE OR REDUCED PRICE SCHOOL LUNCHES, COMPARED TO 50.1% OF CHILDREN IN TEXAS. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: In 2020 alone, EPCH provided close to $25,000 in sponsorships and countless hours of community engagement by hospital staff, bringing awareness to a multitude of health topics affecting children in the region. Some of these events were held virtually due to the pandemic. EPCH supported Ronald McDonald, Community health fairs, March of Dimes, YMCA, Walk a Mile in Her Shoes YWCA, Candlelighters of El Paso, Royal Run for Hope, KCOS Physician Show, Diabetes Association and Lee Moors Children Home. El Paso Childrens Physician Specialist have grown, including our Cranial and Facial Clinic, Neurosurgeon, General Surgery experts and finally being able to add a pediatric cardiology experts. In order to accommodate the growth of our physicians specialists we expanded the clinic to include four physician offices, three assistant offices, a conference room and new flooring and lighting. Our Physician specialist clinic continues to enhance the access to critical pediatric specialists in our region. The Zachary Bowling Pediatric Outpatient Diabetes Education Services (ZBPODEs) at El Paso Childrens Hospital has been expanded with the help of an Empower Grant awarded. Diabetes Self-Management Education & Support (DSMES) and Medical Nutrition Therapy (MNT) to over 200 children with diabetes, many with multiple visits. The Zachary Bowling Pediatric Outpatient Diabetes Education Services at El Paso Childrens Hospital is Recognized by the American Diabetes Association for Quality Diabetes Self-Management Education* and Support. It is the only pediatric outpatient diabetes education services in El Paso and the 350-mile surrounding area that is Recognized by the American Diabetes Association. El Paso Childrens Hospitals Certified Diabetes Educators are Certified Insulin Pump trainers and Certified Continuous Glucose Monitor trainers; they are up-to-date on the newest technology available for children with diabetes. The Pediatric Diabetes Education Services at El Paso Childrens Hospital now hosts an annual Pediatric Diabetes Conference for community healthcare professionals and school nurses. The Certified Diabetes Educators at El Paso Childrens Hospital serve as medical staff at summer camps for children with diabetes; Camp Lydia Mann (day camp) held in El Paso and Camp 180 held at Fort Lone Tree Camp in Capitan, NM (near Ruidoso, NM). In-services to school employees throughout the region are provided by the Certified Diabetes Educators at El Paso Childrens Hospital to teach the school employees how to safely take care of children with diabetes. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: EPCH COOPERATES WITH UNIVERSITY MEDICAL CENTER (UMC) IN PROVIDING HEALTH CARE SERVICES TO THE REGIONAL SERVICE AREA. WHILE UMC'S SCOPE PRIMARILY INCLUDES PROVIDING ACUTE CARE TO THE ADULT POPULATION, EPCH'S SCOPE INCLUDES PROVIDING ACUTE CARE TO THE PEDIATRIC POPULATION. THE COOPERATION EXTENDS TO PEDIATRIC TRAUMA AND NEONATAL PATIENTS WHO ORIGINATE AT UMC AND ARE THEN TRANSFERRED TO EPCH FOR CONTINUED CARE. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: TEXAS SCHEDULE H, PART I, LINE 3C factors other than fpg determining free or discounted care: the hospital uses the following criteria to determine eligibility for free or discounted care: - medical indigency - insurance status - medicare/medicaid SCHEDULE H, PART I, LINE 7, COLUMN F bad debt excluded in calculation of patient care cost to charges: bad debt expense in the amount of $25,362,793 was included in form 990, part IX, line 25 in total expenses. however, this amount was excluded for purposes of calculating the percentage of patient care cost to charges. SCHEDULE H, PART I, LINE 7 COSTING METHODOLOGY: THE COST TO CHARGE RATIO CALCULATED ON IRS WORKSHEET 2 WAS USED IN THE CALCULATION OF COST ON IRS WORKSHEETS 1 AND 3. WORKSHEET 5 WAS COMPUTED USING THE TEXAS SUPPLEMENTAL SURVEY AND Worksheet 8 was completed using the hospital's internal accounting system for tracking donated time. X X X X true false false false false false false false false CINDY STOUT CEO 334031 0 80000 0 0 0 6650 0 17934 0 438615 0 0 0 RANAE THOMPSON CNO, END: 08/2020 227702 0 43000 0 0 0 6340 0 4163 0 281205 0 0 0 JOHN RUNKLES COO 212188 0 50000 0 0 0 6650 0 17934 0 286772 0 0 0 MELISSA CAMPA CFO 170541 0 50000 0 0 0 6016 0 10657 0 237214 0 0 0 Ana Medina Spv. Pharmacy (Night) 156595 0 0 0 0 0 2081 0 6256 0 164932 0 0 0 Erika Estrada Director of Pharmacy 148309 0 0 0 0 0 1754 0 17934 0 167997 0 0 0 Laura Barron Mgr. Pediatric Pharmacist 146010 0 0 0 0 0 5095 0 1041 0 152146 0 0 0 Nicholas Hogue Spv. Pharmacy (Night) 144059 0 0 0 0 0 2034 0 6256 0 152349 0 0 0 STEPHEN RYBOLT FORMER CFO 0 0 0 0 103843 0 0 0 0 0 103843 0 0 0 Angelica Chavez Physician 0 356181 0 0 0 44370 0 12350 0 5636 0 418537 0 0 Bert Johansson physician 0 208654 0 0 0 10379 0 4550 0 7380 0 230963 0 0 William Spurbeck physician 0 450000 0 141700 0 232101 0 8668 0 6736 0 839205 0 0 SCHEDULE J, PART I, LINE 4A Severance Payments: Stephen Andrew Rybolt received a severance as part of HIS termination prior to the start of the fiscal year. Stephen Andrew Rybolt $103,843 In exchange for the severance payment, the Employee must also return all hospital property that is in his possesion, and he must also agree that during the term of the agreement or any time after he should not disclose or share confidential information regarding any matter affecting or relating to the business of the hospital. Additionally, He must also immediately notify the hospital in the event that he becomes employed within the thirteen month period following the termination of his employment with the hospital and disclose his new salary so that the hospital may appropriately calculate any additional severance pay that may be due to the employee. X SKYLIGHT (GETWELL NETWORK) 1 169972 FMV false false false SCHEDULE M, PART I, COLUMN B number of contributions: the amount reported in this column is the number of contributions received. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS: THE SOLE CORPORATE MEMBER OF THE HOSPITAL IS UNIVERSITY MEDICAL CENTER OF EL PASO (UMC). FORM 990, PART VI, SECTION A, LINE 7A MEMBERS WITH POWER TO ELECT MEMBERS OF THE GOVERNING BODY: UMC HAS THE POWER TO NOMINATE AND APPROVE FOUR PERSONS. THE MEDICAL EXECUTIVE COMMITTEE OF THE HOSPITAL HAS THE POWER TO NOMINATE ONE PHYSICIAN BOARD MEMBER. THREE PERSONS WILL BE NOMINATED BY THE MAJORITY VOTE OF THE INDEPENDENT BOARD OF MEMBERS AS COMMUNITY BOARD MEMBERS. THE COMMUNITY BOARD MEMBERS AND THE PHYSICIAN BOARD MEMBERS HAVE THE POWER COLLECTIVELY TO NOMINATE THE INDEPENDENT BOARD MEMBER. FORM 990, PART VI, SECTION A, LINE 7B GOVERNANCE DECISIONS RESERVED TO THE MEMBER: UMC HAS THE POWER TO APPOINT FOUR MEMBERS TO THE BOARD AND HAS THE POWERS STATUTORILY REQUIRED TO BE MAINTAINED BY A MEMBER IN V.T.C.A, BUSINESS ORGANIZATIONS CODE SECTION 22.164. FORM 990, PART VI, SECTION B, LINE 11B PROCESS USED TO REVIEW FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. PRIOR TO FILING WITH THE IRS, THE ORGANIZATION'S ACCOUNTING STAFF AND CEO WILL REVIEW THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY: EL PASO CHILDREN'S HOSPITAL (EPCH) LEADERS AND MEMBERS OF THE MEDICAL STAFF SIGN A CONFLICT OF INTEREST CERTIFICATION AND ACKNOWLEDGEMENT OF CONFLICT OF INTEREST POLICY ANNUALLY, CERTIFYING THAT THEY RECEIVED, READ, AND UNDERSTOOD THIS CONFLICT OF INTEREST POLICY AND AGREE TO COMPLY WITH IT. THE LEADERS OBTAIN THE CERTIFICATION FORM FROM THE COMPLIANCE OFFICE. MEMBERS OF THE MEDICAL STAFF OBTAIN THE CERTIFICATION FORM FROM MEDICAL STAFF SERVICES AT THE TIME OF INITIAL CREDENTIALING AND RECREDENTIALING. IT IS THE MEDICAL STAFF MEMBERS RESPONSIBILITY TO RETURN THE SIGNED FORM TO MEDICAL STAFF SERVICES IN A TIMELY MANNER. MEDICAL STAFF MEMBERS WILL NOT BE (RE)CREDENTIALED IN THE ABSENCE OF A SIGNED CONFLICT OF INTEREST CERTIFICATION AND ACKNOWLEDGEMENT OF CONFLICT OF INTEREST POLICY. EACH TIME A PROCUREMENT PROCESS IS INITIATED AND A COMMITTEE IS INVOLVED IN MAKING A DECISION OR RECOMMENDATION ON A BUSINESS RELATIONSHIP, A CONFLICT OF INTEREST CERTIFICATION STATEMENT MUST BE COMPLETED BY THOSE COMMITTEE MEMBERS WHO HAVE NOT PREVIOUSLY COMPLETED THE ANNUAL CERTIFICATION. THE COMPLIANCE OFFICER REVIEWS WITH THE CEO AND GENERAL COUNSEL ANY CONFLICT OF INTEREST CERTIFICATION FORMS THAT IDENTIFY POTENTIAL CONFLICTS. THE COMPLIANCE OFFICER MAY ASK THE INTERESTED PERSON TO DISCUSS THE TRANSACTION IN ORDER TO OBTAIN FURTHER DETAILS. THE COMPLIANCE OFFICER MAY, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO ANY TRANSACTION OR ARRANGEMENT AND DETERMINES WHETHER THE HOSPITAL CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A CONFLICT IS FOUND TO EXIST, THE CONFLICTED BOARD MEMBER IS PROHIBITED FROM PARTICIPATING IN GOVERNING BODY DELIBERATIONS AND DECISIONS IN THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15A & 15B PROCESS FOR DETERMINING COMPENSATION: EL PASO CHILDREN'S HOSPITAL DETERMINES COMPENSATION FOR ITS CEO AND OTHER OFFICERS AND KEY EMPLOYEES BY CONSIDERING SALARY RANGES, SALARY SURVEYS, AND MARKET ANALYSES FOR EACH POSITION. SPECIFICALLY, THE BOARD OF DIRECTORS COMPENSATION COMMITTEE REVIEWS AND RECOMMENDS SALARIES FOR THE CEO, OTHER OFFICERS, AND KEY EMPLOYEES. THE BOARD OF DIRECTORS APPROVES SALARIES FOR THE CEO AND OTHER OFFICERS. THE CEO APPROVES SALARIES FOR KEY EMPLOYEES (DIRECTOR LEVEL AND BELOW). THE MOST RECENT REVIEW WAS CONDUCTED BY PRUDENTIAL GLOBAL ON AUGUST 2020 AND DOCUMENTED IN THE HUMAN RESOURCE FILES. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF DOCUMENTS: THE ORGANIZATION FURNISHES COPIES OF ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FORM 990, AND/OR FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. FORM 990, PART I, LINE 1 ORGANIZATION'S MISSION: (CONTINUED FROM PAGE 1) ... INCLUSIVE LEADERSHIP AND INNOVATIVE PEDIATRIC RESEARCH AND EDUCATION. FORM 990, PART XI, LINE 9 Other Changes in Net Assets: Change in Interest in Net Assets of UMC Foundation $1,684,643 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACT PERSONNEL TOTAL FEES:1005242 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES TOTAL FEES:13637190 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:16312872 EL PASO CHILDREN'S PHYSICIAN GROUP 4845 ALAMEDA AVE EL PASO TX 79905 455465061 PHYSICIAN SVS TX 501(C)(3) 3 EPCH true UMC FOUNDATION 1400 HARDAWAY SUITE 220 EL PASO TX 79903 742540513 SUPPORT TX 501(C)(3) 7 UMC true UNIVERSITY MEDICAL CENTER OF EL PASO 4815 ALAMEDA AVE EL PASO TX 79905 746000756 HEALTHCARE TX 501(C)(3) 3 NA false EL PASO CHILDREN'S HOSPITAL FOUNDATION 1400 HARDAWAY SUITE 213 EL PASO TX 79903 812298318 SUPPORT TX 501(C)(3) 7 UMC FDN true EL PASO HEALTH 1145 WESTMORELAND EL PASO TX 79925 742930226 HMO TX 501(C)(4) N/A UMC true false false true true false false false false false false true false true true true true true false false UMC FOUNDATION C 978755 FMV EL PASO HEALTH M 1063710 FMV