2020-11-16T08:31:44-06:00 2019-12-31 350921680 CROWE LLP 750 N St Paul Suite 850 Dallas TX 75201 990 2019-01-01 474837308 OCH Holdings OCHH 2144567000 1935 Medical District Drive Dallas TX 75235 Robert Fries Senior Vice President, Finance 2020-11-16 true Rachel Spurlock P00520729 2147775200 2019 2021-01-29 14:40:06Z Our Children's House David Berry 1935 Medical District Drive Dallas TX 75235 36149821 false X www.childrens.com X 2015 TX Dedicated to making life better for children. 3 0 364 0 0 0 18247 29289 29789087 36040174 0 -1720 72812 80358 29880146 36148101 0 2000 0 15922867 16347404 0 0 0 15097767 17991565 31020634 34340969 -1140488 1807132 29548780 25913691 26623341 21049770 2925439 4863921 OCH Holdings, doing business as Our Children's House (OCH), is a specialty hospital providing comprehensive services to children from infancy through age 18 with developmental or birth disorders, traumatic injuries or severe illnesses. Our Children's House is the only one of its kind in the region, providing transition from acute-care hospitals to home after experiencing life-changing health issues. The hospital focuses on patient stabilization, family education and maximizing the patient's functional ability. Inpatient programs include feeding, rehabilitation and pulmonary services, while the intensive day patient programs include neurological, feeding and constraint-induced therapies. false false 20326767 2000 36120532 OCH Holdings, doing business as Our Children's House (OCH) is a specialty hospital providing comprehensive services to children from infancy through age 18 with developmental or birth disorders, traumatic injuries or severe illnesses, which furthers the exempt purposes of OCH. Our Children's House facilitates transition from acute-care hospitals to home after experiencing life-changing health issues. The hospital focuses on patient stabilization, family education and maximizing the patient's functional ability. Inpatient programs include feeding, rehabilitation and pulmonary services, while the intensive day patient programs include neurological, feeding and constraint-induced therapies. From the moment a child enters Our Children's House, a care coordinator and social worker are assigned to assist the family in identifying community resources for appropriate counseling as well as designing a thorough discharge plan. Family care conferences are also held within the first week after admission and every two weeks thereafter. Every child is unique, as is every child's treatment. The approach is to create individualized care plans for each patient with short- and long-term, clinically based goals and success markers. Feeding Program: Our Children's House offers unique feeding programs aimed at helping children overcome physical and behavioral problems that manifest themselves at mealtime. An interdisciplinary approach is utilized and includes a speech-language pathologist, occupational therapist, psychologist and registered dietitian. Rehabilitation Services: A multi-disciplinary rehab team provides care and therapy to assist children who have experienced a major life-changing event or diagnosis. The goal is to restore function and educate the family as they prepare to return home. Pulmonary Services: A dedicated team educates families on how to support their child requiring short- or long-term mechanical ventilation with a tracheotomy, working to make the transition to home seamless. During 2019, there were 845 patient encounters and 9,175 patient days. 20326767 true true false false false false false false false true false false false true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true false false false true X 104 0 true 364 true false false false false false false false false false false false false X 3 0 false false false false true true true true true false false false true true true true true false false false X Amy Yeager 2144567000 1935 Medical District Drive Dallas TX 75235 David T Berry Chair & President 1.0 54.0 X X 0 1113867 214261 Vanessa U Walls Director & VP/Administrator, SVP (until 12/12/19) 1.0 54.0 X X 0 511447 91985 Mary E Stowe RN Director (until 1/5/19) 1.0 49.0 X 0 868152 5242 Peter C Perialas Director 1.0 54.0 X 0 1013454 275752 Rustin Morse MD Director 1.0 49.0 X 0 661096 81386 Amy Yeager Secretary 1.0 49.0 X 0 488378 447960 Jeffrey Vawrinek Secretary (until 10/18/19) 1.0 49.0 X 0 690250 0 Jeremiah Radandt Treasurer 1.0 54.0 X 0 620876 149591 Joe Cavender VP and Interim CNO (until 10/1/19) 1.0 49.0 X 0 440574 81571 Kelli Terpstra VP Administrator & ACNO 40.0 0 X 0 270921 52846 Richard P Goode Treasurer (until 9/23/19) 1.0 54.0 X 0 1076840 191178 Tammy Webb EVP and CNO 55.0 0.0 X 0 159959 16505 Christopher J Durovich Former Chairman (CHST Pres. & CEO) 0.0 60.0 X 0 3413104 207572 0 11328918 1815849 0 true true false DPR CONSTRUCTION 9606 MOPAC EXPRESSWAY STE 300 AUSTIN TX 78759 CONSTRUCTION SERVICES 494611 SHEARWATER HEALTH INC 20 BURTON HILLS BLVD STE 400 Nashville TN 37215 Staffing Services 297134 PEDIATRIC PULMONARY & SLEEP Specialist 7777 FOREST LANE SUITE B-309 Dallas VI 75230 Professional Services 273825 EAGLE SYSTEMS INC PO Box 21115 Waco TX 767021115 Security Services 230391 PREMIER TRANSPORTATION SVCS 4525 Production Dr Dallas TX 75235 Transportation Services 167533 6 29289 29289 Medical Service Revenue 621110 36040174 36040174 0 0 0 0 36040174 0 0 1720 0 -1720 -1720 -1720 Dietary Revenue 621990 80358 80358 0 0 0 0 80358 36148101 36120532 0 -1720 2000 2000 13012399 11365123 1647276 678154 586140 92014 1771715 1582536 189179 885136 817875 67261 2897734 2680149 217585 0 1400 1400 29538 27482 2056 19026 19026 2358187 1411087 947100 11248 10292 956 37696 20391 17305 743539 160030 583509 Shared Services 10241656 10241656 Medical Surgical Supplies 1300076 1300076 Dietary and Food Costs 204858 203447 1411 Special Events & Projects 2358 2358 144249 137355 6894 0 34340969 20326767 14014202 0 13133204 17563050 0 0 0 0 104770 108626 10214 7954626 2045611 9666131 5909015 0 0 6634461 2333000 0 0 29548780 25913691 1042371 2332800 0 0 25580970 18716970 26623341 21049770 2925439 4863921 2925439 4863921 29548780 25913691 X 1807132 131350 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1095190 13690 1081500 4949019 1366872 3582147 1190881 665049 525832 719536 719536 5909015 LT Advances - Affiliates 18716970 18716970 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote OCH Holdings' financial information is included in the consolidated audited financial statements of Children's Health System of Texas, a related organization. Children's Health System of Texas's FIN 48 (ASC 740) footnote for the year ended December 31, 2019, reads as follows: "The authoritative guidance in ASC 740 Income Taxes, creates a single model to address uncertainty in tax positions and clarifies the accounting for income taxes by prescribing the minimum recognition threshold a tax position is required to meet before being recognized in the financial statements. Management annually reviews its tax positions and has determined that there are no material uncertain tax positions that require recognition in the accompanying consolidated balance sheets. The statute of limitations remains open for tax years 2016 through 2019 in Children's Health main taxing jurisdictions." true true X true X true X true true true false true true 34893 0 34893 0.0010 21674425 20403760 1270665 0.0370 680302 611497 68805 0.0020 0 0 22389620 21015257 1374363 0.0400 510679 12872 497807 0.0145 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 0 0.0 0 0 510679 12872 497807 0.0145 0 0 22900299 21028129 1872170 0.0545 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 19927 140015 -120088 X true true 1 1 Our Children's House 1340 Empire Central Dallas TX 75247 www.childrens.com 100383 X X Our Children's House 1 false false true X X X X X X X X X 19 true true false true X https://www.childrens.com/keeping-families-healthy/dfw-childrens-health-assessment X true 19 true https://www.childrens.com/keeping-families-healthy/dfw-childrens-health-assessment false true X 200.0 400.0 X X X X true true X X X true X (see statement in part VI) X (see statement in part VI) X (see statement in part VI) X X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY ARE INCLUDED AND PRIORITIZED WITHIN THE joint CHNA conducted by Children's Health. The priority needs identified are health, economic security, safety, and education. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - OCH Holdings dba Our Children's House. EVERY OTHER YEAR, CHILDREN'S HEALTH RECRUITS A CITIZEN ADVISORY COUNCIL MADE UP OF KEY STAKEHOLDERS SERVING CHILDREN AND KNOWLEDGEABLE IN PUBLIC HEALTH. THESE COMMUNITY LEADERS MEET REGULARLY TO DISCUSS CHILDREN'S HEALTH CARE ISSUES AND TO CONTRIBUTE THEIR EXPERIENCE, INSIGHTS AND EXPERT RECOMMENDATIONS FOR THE BEYOND ABC REPORT PREPARED BY CHILDREN'S HEALTH. THE CITIZEN ADVISORY BOARDS FOR BEYOND ABC IDENTIFY RECOMMENDATIONS FOR ADVOCATES AND PUBLIC OFFICIALS IN ORDER TO IMPROVE THE LIVES AND HEALTH OF CHILDREN. RECENT ADVISORY BOARDS HAVE INCLUDED CITY AND COUNTY OFFICIALS, FORMER LEGISLATORS, MEMBERS OF LAW ENFORCEMENT, SCHOOL DISTRICT ADMINISTRATORS, NONPROFIT ORGANIZATIONS' EXECUTIVES, CHILD-ADVOCACY REPRESENTATIVES, CHAMBERS OF COMMERCE AND SENIOR STAFF FROM CORPORATIONS AND FINANCIAL INSTITUTIONS. ADDITIONALLY, CHILDREN'S HEALTH PARTICIPATES IN THE REGIONAL HEALTHCARE PARTNERSHIP (RHP) TASK FORCE, WHICH WAS CREATED AS PART OF THE TEXAS HEALTHCARE TRANSFORMATION AND QUALITY IMPROVEMENT PROGRAM. HOSPITALS WITHIN EACH REGION WORK TOGETHER TO IDENTIFY NEEDS AND DEVELOP PLANS TO RESPOND TO THOSE NEEDS AND TRANSFORM THE HEALTH CARE DELIVERY SYSTEM. CHILDREN'S HEALTH PARTICIPATES IN THE (RHP) FOR REGIONS 9 AND 10. SOME OF THE ORGANIZATIONS FROM WHICH INPUT WAS SOLICITED FOR THIS YEAR'S CHNA ARE AS FOLLOWS: TEXOMA COUNCIL OF GOVERNMENTS, MCKINNEY ISD, UNITED WAY OF METROPOLITAN DALLAS, TEXPROTECTS, ASSISTANCE CENTER OF COLLIN COUNTY, CITYSQUARE, FRISCO FAMILY SERVICES, YMCA OF METROPOLITAN DALLAS, COLLIN COUNTY DISTRICT ATTORNEY'S OFFICE, DALLAS HOUSING AUTHORITY, CHILDREN AT RISK, DALLAS ISD, THE CONCILIO, CITY OF DALLAS, COMMUNITY COUNCIL OF GREATER DALLAS, TEXAS HEALTH RESOURCES, PLANO ISD, REES-JONES CENER FOR FOSTER CARE EXCELLENCE, DALLAS CHILDREN'S ADVOCACY CENTER, DALLAS-FORT WORTH HOSPITAL COUNCIL, GENESIS WOMEN'S SHELTER, LIFEPATH SYSTEMS, THE COMMIT PARTNERSHIP, COLLIN COUNTY HEALTH CARE SERVICES, DALLAS COUNTY HEALTH AND HUMAN SERVICES, DALLAS AREA HABITAT FOR HUMANITY, SOCIAL VENTURE PARTNERS DALLAS, CATHOLIC CHARITIES OF DALLAS, CITY OF PLANO, CHILDCARE GROUP, NORTH TEXAS FOOD BANK, MOMENTOUS INSTITUTE, AND THE AMERICAN HEART ASSOCIATION - DALLAS. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - OCH Holdings dba Our Children's House. As a part of Children's Health, OCH Holdings doing business as Our Children's House (OCH) collaborated on the 2019 Children's Health joint Community Health Needs Assessment (CHNA). The collaboration was conducted with Children's Medical Center of Dallas (CMCD) and Children's Medical Center Plano (CMCP). The Children's Health CHNA collaboration was conducted in compliance with the Final Federal Regulations to Section 501(r), specifically §1.501(R)-3(B)(6)(V) Joint CHNA reports. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - OCH Holdings dba Our Children's House. Upon conducting the CHNA and developing the Community Health Implementation Strategy, Children's Health decided on priority areas of the identified health needs that were reviewed. The priority areas are those areas which Children's Health has decided to focus its resources and integrate into its strategic and operational plans. Multiple goals were developed for each priority area, along with strategies to accomplish those goals. Children's Health has implemented and/or is working towards implementation of the strategies for accomplishing the developed goals. Full details of priority areas, goals, and strategies are contained with the publicly available CHNA and Community Health Implementation Strategy. Actions taken during the tax year to address significant health needs identified through its most recently conducted CHNA include the following: Health: Nearly two-thirds of the children we serve at Children's Health depend on Medicaid or CHIP for their health care coverage. Children's Health participates in the Children's Health Coverage Coalition and Enroll North Texas, two coalitions that work on strategies to promote CHIP and Children's Medicaid and reduce the number of uninsured children in the state. Dedicated outreach representatives at Children's Health help eligible families with children enroll in CHIP and Medicaid, ensuring North Texas families have access to health care. In 2018, the Children's Health Community Outreach Team directly helped more than 2,200 children and families apply for CHIP and Medicaid assistance. Children's Health is using telemedicine to provide more children access to behavioral health care and address youth mental health issues such as anxiety, bullying and depression. In 2017, Children's Health launched an integrated tele-behavioral health program that connects students with licensed behavioral health providers at school via secure mobile technology, eliminating traditional barriers to access such as limited provider availability and transportation issues. School-based tele-behavioral health services are now available to more than 38,000 students. Economic Security: Children's Health participates in the Collin County Early Childhood Coalition and the Early Matters Dallas Coalition. These broad-based coalition groups are dedicated to working together to raise awareness about the importance of quality early education, coordinate advocacy efforts and increase funding for quality early learning to ultimately ensure a strong future workforce. Children's Health serves as a member of the Dallas Coalition for Hunger Solutions, which is focused on providing education and advocacy opportunities for different programs that impact food security for families such as the Supplemental Nutrition Assistance Program (SNAP), the 2020 Census and the public charge. The Children's Health Community Outreach Team also helps eligible families and children enroll in other government assistance programs, such as SNAP, and provides referrals to additional community resources and services. Safety: The Rees-Jones Center for Foster Care Excellence at Children's Health provides integrated primary care for children in foster care, many of whom have experienced abuse and neglect. As a regional leader in trauma-informed care, the Center collaborates with school districts, child welfare organizations and other community partners to facilitate trauma-informed trainings and curriculums for educators, providers, volunteers and caregivers. The trainings promote education about the effects of trauma and encourage effective, safe trauma-informed services and treatments. The Rees-Jones Center has also conducted approximately 200 training sessions to date. Education: Children's Health is part of a community-wide initiative led by the Dallas-Fort Worth Hospital Council to train 10,000 people in Mental Health First Aid, a national curriculum that teaches lay people how to identify and respond to a mental health crisis. Children's Health has three behavioral health clinicians who are certified in the Youth Mental Health First Aid Curriculum and provide the eight-hour training to different groups, primarily schoolteachers and school administrative staff. This helps school personnel talk with students they identify as in need of behavioral health treatment and make appropriate referrals to care. To date, the Children's Health Behavioral Health team has conducted 30 Mental Health First Aid trainings to date. Needs Not Addressed: Some issues identified through the Children's Health CHNA have not been addressed in this plan. In initial discussion and subsequent prioritization, Children's Health Needs Assessment Team considered the levels to which some needs were already being addressed in the service area. Additionally, some community needs fall out of the scope of expertise and resources of Children's Health. Children's Health Community Health Implementation Strategy includes details on Needs Not Addressed. The following are some of the needs that have been identified in the current and prior assessments that are addressed by others or in different ways: safe and affordable housing, palliative care capacity/need for increased geriatric/long-term/home care resources, discourage elective deliveries/increase the percentage of women who receive prenatal care, provide comprehensive sexuality education/high incidence of STDs in RHP Region 10, protect green spaces/add bike lanes/improve access to parks. These needs are not being addressed by Children's as our priorities were established based on unmet community health needs that intersect with our mission and key clinical strengths. There are community and state agencies that have greater expertise in housing, palliative care, prenatal care, sex education, and protecting green spaces in our community. At this time, these issues have not been incorporated into our community benefit plan because we do not have the infrastructure, expertise, or funding needed to have a significant impact in these areas. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - OCH Holdings dba Our Children's House. As a part of the Children's Health System of Texas, Our Children's House adheres to and is under the the Children's Health Patient Financial Assistance Policy. CHILDREN'S HEALTH USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR LOW INCOME INDIVIDUALS. 200% OF THE FEDERAL POVERTY GUIDELINES IS USED FOR 100% CHARITY ADJUSTMENT, AND 201% TO 400% OF THE FEDERAL POVERTY GUIDELINES IS USED FOR A SLIDING SCALE ADJUSTMENT. CHILDREN'S HEALTH USES VARIOUS DOCUMENTS AND FORMS TO VERIFY INCOME AND EXPENSES WHEN DETERMINING THE ELIGIBILITY FOR FINANCIAL ASSISTANCE OF A PATIENT AND THEIR FAMILY. THESE DOCUMENTS INCLUDE, BUT ARE NOT LIMITED TO, W-2 FORM, WAGE AND EARNING STATEMENT, PAY CHECK REMITTANCE, WORKER'S COMPENSATION, UNEMPLOYMENT COMPENSATION DETERMINATION LETTERS, INCOME TAX RETURNS, STATEMENT FROM EMPLOYER, BANK STATEMENTS, COPY OF CHECKS, DOCUMENTS OF SOURCES OF INCOME, TELEPHONE VERIFICATION OF GROSS INCOME WITH THE EMPLOYER, PROOF OF PARTICIPATION IN GOVERNMENT ASSISTANCE PROGRAMS SUCH AS MEDICAID, SIGNED AFFIDAVIT OR ATTESTATION BY PATIENT, AND VETERANS BENEFIT STATEMENT. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - OCH Holdings dba Our Children's House. In addition to ensuring that the Children's Health charity care criteria is posted prominently and continuously in common entry points of the facility, a Director of Patient Financial Service ensures that the Children's Health charity care criteria is published at all times on its web site. 0 Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT Beginning with calendar year 2016, OCH Holdings dba Our Children's House was required to file a Community Benefit Plan with the State of Texas as required by Senate Bill 427. Any state community benefit reporting prior to calendar year 2016 was required of the predecessor organization that conducted the activities of Our Children's House. Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE https://www.childrens.com/patient-families/billing-and-insurance/financial-assistance-and-support Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE https://www.childrens.com/patient-families/billing-and-insurance/financial-assistance-and-support Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE https://www.childrens.com/patient-families/billing-and-insurance/financial-assistance-and-support Schedule H, Part I, Line 6a Community benefit report prepared by related organization Children's Health also known as Children's Health System of Texas Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount As a part of Children's Health System of Texas (Children's Health), Our Children's House adheres to the Children's Health processes and methodologies for calculating bad debt expense. Children's Health has agreements with third-party payors that generally provide for payments at amounts different from its established charges. For uninsured patients who do not qualify for charity care, Children's Health recognizes revenue based on established charges subject to certain discounts and implicit price concessions. Children's Health determines the transaction price based on standard charges for services provided, reduced by explicit price concessions provided to third-party payors. Discounts are provided to uninsured patients in accordance with policy and implicit price concessions provided to uninsured patients. Explicit price concessions are based on contractual agreements, discount policies and historical experience. Implicit price concessions represent differences between amounts billed and the estimated consideration Children's Health expects to receive from patients which are determined based on historical collection experience and other factors. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization's financial statements do not contain a bad debt footnote. Children's Health has adopted ASU 2016-09 which treats the provision for doubtful accounts as an implicit price concession within net patient service revenue. the provision for doubtful accounts in no longer separately stated as a reduction to net patient service revenue. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The source used to determine the amount reported as Medicare Allowable Costs on Part III, line 6 was 2019 gross charges for Medicare multiplied by the cost to charge ratio from worksheet 2. Per IRS Revenue Ruling 69-545, treating patients with Medicare coverage is an indication that the hospital is working to promote community health while understanding that such costs of treatment may exceed government reimbursement. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance As a part of Children's Heath System of Texas (Children's Health), Our Children's House adheres to and follows Children's Health Collection Policy and Practices. If a patient qualifies or is attempting to qualify for assistance under the Children's Health financial assistance policy and is attempting in good faith to settle an outstanding bill by negotiating a reasonable payment plan or making regular partial payments of a reasonable amount, the unpaid bill will not be sent to any collection agency or other assignee. Children's Health does not engage in extraordinary collection action against patients to obtain payment for care. Schedule H, Part V, Section B, Line 16a FAP website - Our Children's House: Line 16a URL: (see statement in part VI); Schedule H, Part V, Section B, Line 16b FAP Application website - Our Children's House: Line 16b URL: (see statement in part VI); Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Our Children's House: Line 16c URL: (see statement in part VI); Schedule H, Part VI, Line 2 Needs assessment As a part of the Children's Health System of Texas (Children's Health), OCH Holdings dba Our Children's House (OCH) adheres to the Children's Health processes and procedures for assessing the health care needs of the communities it serves. CHILDREN'S HEALTH PRODUCED A 2019 COMMUNITY HEALTH NEEDS ASSESSMENT FROM AN INTEGRATED SYSTEM PERSPECTIVE THAT INCLUDES ALL THREE LICENSED HOSPITAL FACILITIES. IN ADDITION, CHILDREN'S HEALTH PRODUCED "BEYOND ABC," A COMPREHENSIVE QUALITY-OF LIFE REPORT ON CHILDREN IN THE NORTH TEXAS COUNTIES OF DALLAS, COLLIN, COOKE, DENTON, FANNIN AND GRAYSON. SINCE 1996, CHILDREN'S HEALTH HAS PUBLISHED BEYOND ABC. THE REPORT TRACKS NOT ONLY HEALTH AND SAFETY FACTORS, BUT ALSO ECONOMIC AND EDUCATION DATA. THESE REPORTS PROVIDE TRENDED DATA ON MORE THAN 50 INDICATORS OF WELL-BEING FOR CHILDREN IN OUR COMMUNITY. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance CHILDREN'S HEALTH MAKES EXTENSIVE EFFORTS TO INFORM AND EDUCATE PATIENTS AND PATIENT'S FAMILIES ABOUT ELIGIBILITY FOR FINANCIAL ASSISTANCE. THE CHILDREN'S HEALTH FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE APPLICATION ARE MADE WIDELY AVAILABLE ONLINE AND IN PRINT, ALONG WITH A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY. ALL THREE DOCUMENTS ARE AVAILABLE WITHOUT CHARGE AND AVAILABLE IN THE PRIMARY LANGUAGES SPOKEN BY LEP POPULATIONS. A copy of the Plain Language Summary of the Financial Assistance Policy is provided to patients on discharge. IN ADDITION, CHILDREN'S HEALTH FINANCIAL COUNSELORS OR CUSTOMER SERVICE REPRESENTATIVES WORK WITH PATIENTS' GUARDIANS/GUARANTORS TO ENSURE THAT ALL PUBLIC AND VOLUNTARY ASSISTANCE PROGRAMS ARE FULLY EXPLORED. CHILDREN'S HEALTH HAS A FINANCIAL PROGRAM FOR PATIENTS WHO ARE CONSIDERED INDIGENT AND DO NOT QUALIFY FOR A FEDERAL OR STATE PROGRAM. THE ELIGIBILITY CRITERIA FOR FINANCIAL ASSISTANCE IS BASED UPON FEDERAL POVERTY GUIDELINES PUBLISHED ANNUALLY. PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE WILL HAVE CHARGES REDUCED TO THE LOWEST LEVEL CHARGED TO INDIVIDUALS WHO HAVE INSURANCE COVERING SUCH CARE. GROSS CHARGES WILL NOT BE USED TO CALCULATE PATIENT'S BILLS. Schedule H, Part VI, Line 4 Community information Community Served by OCH Holdings dba Our Children's House - Our Children's House hospital facility is currently located at 1340 Empire Central, Dallas, Texas. THE CITY OF DALLAS IS THE COUNTY SEAT OF DALLAS COUNTY. THE CITY OF DALLAS IS ONE OF THE MOST POPULOUS CITIES IN TEXAS, AS WELL AS THE UNITED STATES. Identification and Description of Geographical Community - THE CITY OF DALLAS IS THE THIRD LARGEST CITY IN TEXAS. THE CITY OF DALLAS IS ACCESSIBLE FROM 1-30, l-35E, 1-45 AND 1-635. PATIENTS PRIMARILY ORIGINATE FROM TEXAS (96.7 PERCENT). NEARLY 50 PERCENT (49.3 PERCENT) OF CHILDREN'S DISCHARGES ORIGINATE IN DALLAS COUNTY, TEXAS. COLLIN COUNTY IS THE SIXTH-MOST POPULOUS COUNTY IN TEXAS AND INCLUDES TWO OF THE FASTEST GROWING CITIES IN THE NATION - FRISCO AND MCKINNEY. FOR CHILDREN'S HEALTH FISCAL YEAR ENDING DECEMBER 31,2018, 72 PERCENT OF INPATIENT DISCHARGES AND 77 PERCENT OF OUTPATIENT VISITS ORIGINATED IN THE SIX COUNTIES REFERRED TO AS NORTH TEXAS IN THE 2019-2020 BEYOND ABC REPORT - DALLAS, COLLIN, COOKE, DENTON, FANNIN AND GRAYSON COUNTIES. Community Population and Demographics - THE U.S. BUREAU OF CENSUS HAS COMPILED POPULATION AND DEMOGRAPHIC DATA BASED ON THE 2010 CENSUS. THE NIELSEN COMPANY, A FIRM SPECIALIZING IN THE ANALYSIS OF DEMOGRAPHIC DATA, HAS EXTRAPOLATED THIS DATA TO ESTIMATE POPULATION TRENDS FROM 2013 THROUGH 2018. BASED ON THE DATA, THE OVERALL POPULATION FOR CHILDREN'S SERVICE AREA IS PROJECTED TO INCREASE OVER THE FIVE-YEAR PERIOD FROM 3,320,715 TO 3,608,755. THE AGE CATEGORIES THAT REPRESENT YOUTH AND ADOLESCENTS (0-14 AND 15-20) IS PROJECTED TO INCREASE 7.0 PERCENT AND 8.9 PERCENT, RESPECTIVELY. ACCORDING TO THE AMERICAN COMMUNITY SURVEY, 681,537 CHILDREN UNDER THE AGE OF 18 LIVED IN DALLAS COUNTY IN 2017. THE PROPORTION OF THE POPULATION SELF-IDENTIFYING AS WHITE/NONHISPANIC DECREASED FROM 19.1 PERCENT IN 2013 TO 17.2 PERCENT IN 2017. AT THE SAME TIME, THE PROPORTION OF THE CHILD POPULATION IDENTIFYING AS HISPANIC OR LATINO INCREASED FROM 51 .7 PERCENT TO 53 PERCENT. OVER THAT TIME PERIOD, THE NUMBER OF BLACK OR AFRICAN AMERICAN CHILDREN REMAINED NEARLY CONSTANT, CHANGING FROM 22.6 PERCENT TO 22.4 PERCENT. THE POPULATION OF ASIAN CHILDREN INCREASED FROM 4.5 PERCENT TO 5.1 PERCENT. Schedule H, Part VI, Line 5 Promotion of community health The sole member of OCH Holdings dba Our Children's House (OCH) is Children's Health Clinical Operations (Children's Health), an organization described in IRC Section 501(c)3. THE MISSION OF CHILDREN'S HEALTH IS TO MAKE LIFE BETTER FOR CHILDREN. WITH OVERSIGHT FROM A BOARD OF DIRECTORS COMPRISED OF INDIVIDUALS WHO ARE REPRESENTATIVE OF THE COMMUNITY SERVED, CHILDREN'S HEALTH PROMOTES HEALTH AND BENEFITS TO THE COMMUNITY through its licensed hospital. OCH provides both inpatient and outpatient care for conditions such as communication disorders, developmental delay, traumatic brain injury, feeding disorders, congenital disorders, chromosomal abnormalities, premature birth and more, which furthers the exempt purposes of OCH. Parents of patients at OCH find an extraordinary amount of support, education and counseling. An average inpatient length of stay is approximately 25 days due to the time required to progress rehabilitative care and therapy while also equipping parents to care for their children in a home setting. CHILDREN'S HEALTH MEDICAL STAFF IS OPEN TO PHYSICIANS IN THE COMMUNITY WHO MEET ALL REQUIREMENTS OUTLINED IN THE CHILDREN'S HEALTH MEDICAL AND DENTAL STAFF BYLAWS. CHILDREN'S HEALTH CONSIDERS IT A PRIVILEGE AND RESPONSIBILITY TO SERVE AS ADVOCATES FOR KIDS IN TEXAS AND ACROSS THE COUNTRY. THROUGH PROGRAMMATIC INITIATIVES, ORGANIZATIONAL PARTNERSHIPS AND COMMUNITY EVENTS, CHILDREN'S HEALTH SPREADS ITS INFLUENCE THROUGHOUT THE REGION AND PROVIDES AREA CHILDREN WITH MUCH-NEEDED ACCESS TO A BETTER QUALITY OF LIFE. WHETHER THAT MEANS ESTABLISHING PROGRAMS TO INCREASE SERVICES TO THE AREA'S UNDER SERVED CHILDREN OR FOSTERING PARTNERSHIPS WITH EXISTING ORGANIZATIONS, CHILDREN'S HEALTH IS COMMITTED TO CONNECTING FAMILIES TO THE SERVICES THEY NEED. COMMUNITY OUTREACH EXPANDING ACCESS TO PEDIATRIC MENTAL HEALTH SERVICES: CHILDREN'S HEALTH IS USING TELEMEDICINE TO PROVIDE MORE CHILDREN ACCESS TO BEHAVIORAL HEALTH CARE AND ADDRESS YOUTH MENTAL HEALTH ISSUES. IN 2017, CHILDREN'S HEALTH LAUNCHED AN INTEGRATED TELEBEHAVIORAL HEALTH PROGRAM THAT CONNECTS STUDENTS WITH LICENSED BEHAVIORAL HEALTH PROVIDERS AT SCHOOL VIA SECURE MOBILE TECHNOLOGY. SAFEGUARDING ACCESS TO CHIP AND MEDICAID/INCREASE THE NUMBER OF INSURED TEXAS CHILDREN: NEARLY TWO-THIRDS OF THE CHILDREN WE SERVE AT CHILDREN'S HEALTH DEPEND ON MEDICAID OR CHIP FOR THEIR HEALTH CARE COVERAGE. CHILDREN'S HEALTH PARTICIPATES IN THE CHILDREN'S HEALTH COVERAGE COALITION AND ENROLL NORTH TEXAS, TWO COALITIONS THAT WORK ON STRATEGIES TO PROMOTE CHIP AND CHILDREN'S MEDICAID AND REDUCE THE NUMBER OF UNINSURED CHILDREN IN THE STATE. DEDICATED OUTREACH REPRESENTATIVES AT CHILDREN'S HEALTH HELP ELIGIBLE FAMILIES WITH CHILDREN ENROLL IN CHIP AND MEDICAID. ENSURING ALL WORKING PARENTS, INCLUDING LOW-INCOME FAMILIES, HAVE ACCESS TO AFFORDABLE, SAFE AND QUALITY CHILDCARE: CHILDREN'S HEALTH PARTICIPATES IN THE COLLIN COUNTY EARLY CHILDHOOD COALITION AND THE EARLY MATTERS DALLAS COALITION. THESE BROAD-BASED COALITION GROUPS ARE DEDICATED TO RAISING AWARENESS ABOUT THE IMPORTANCE OF QUALITY EARLY EDUCATION, COORDINATING ADVOCACY EFFORTS AND INCREASING FUNDING FOR QUALITY EARLY LEARNING. COMBATING CHILD POVERTY: CHILDREN'S HEALTH SERVES AS A MEMBER OF THE DALLAS COALITION FOR HUNGER SOLUTIONS, WHICH IS FOCUSED ON PROVIDING EDUCATION AND ADVOCACY OPPORTUNITIES FOR PROGRAMS THAT IMPACT FOOD SECURITY FOR FAMILIES SUCH AS THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP), THE 2020 CENSUS AND THE PUBLIC CHARGE. THE CHILDREN'S HEALTH COMMUNITY OUTREACH TEAM ALSO HELPS ELIGIBLE FAMILIES AND CHILDREN ENROLL IN OTHER GOVERNMENT ASSISTANCE PROGRAMS, SUCH AS SNAP, AND PROVIDES REFERRALS TO ADDITIONAL COMMUNITY RESOURCES. EXPANDING TRAUMA-INFORMED CARE EDUCATION, TRAINING AND INTERVENTION THROUGHOUT THE CHILD WELFARE SYSTEM: THE REES-JONES CENTER FOR FOSTER CARE EXCELLENCE AT CHILDREN'S HEALTH PROVIDES INTEGRATED PRIMARY CARE FOR CHILDREN IN FOSTER CARE, MANY OF WHOM HAVE EXPERIENCED ABUSE AND NEGLECT. AS A REGIONAL LEADER IN TRAUMA-INFORMED CARE, THE CENTER COLLABORATES WITH SCHOOL DISTRICTS, CHILD WELFARE ORGANIZATIONS AND OTHER COMMUNITY PARTNERS TO FACILITATE TRAUMA-INFORMED TRAININGS AND CURRICULUMS FOR EDUCATORS, PROVIDERS, VOLUNTEERS AND CAREGIVERS. INCREASE EDUCATION AND TRAINING OPPORTUNITIES FOR TEACHERS IN MENTAL HEALTH: CHILDREN'S HEALTH IS PART OF A COMMUNITY-WIDE INITIATIVE LED BY THE DALLAS-FORT WORTH HOSPITAL COUNCIL TO TRAIN 10,000 PEOPLE IN MENTAL HEALTH FIRST AID, A NATIONAL CURRICULUM THAT TEACHES LAY PEOPLE HOW TO IDENTIFY AND RESPOND TO A MENTAL HEALTH CRISIS. CHILDREN'S HEALTH HAS THREE BEHAVIORAL HEALTH CLINICIANS WHO ARE CERTIFIED IN THE YOUTH MENTAL HEALTH FIRST AID CURRICULUM AND PROVIDE THE EIGHT-HOUR TRAINING PRIMARILY TO SCHOOLTEACHERS AND SCHOOL ADMINISTRATIVE STAFF. COMMUNITY-BASED PROGRAMMING IN RECENT YEARS, CHILDREN'S HEALTH HAS STRENGTHENED AND EXPANDED OUR COMMUNITY PROGRAMS AND SERVICES TO CATALYZE WELLNESS FROM THE GROUND UP, ULTIMATELY CREATING A HEALTHIER COMMUNITY. BY WORKING WITH COMMUNITY LEADERS AND ORGANIZATIONS TO MEET FAMILIES WHERE THEY ARE, WE CONNECT HEALTH CARE PROVIDERS ACROSS THE COMMUNITY TO BETTER INTEGRATE CARE FOR CHILDREN. CHILDREN'S HEALTH ENCOURAGES ORGANIZATIONS TO PROVIDE WELLNESS PROGRAMS AND PRIMARY-CARE OPTIONS IN NON-TRADITIONAL LOCATIONS SUCH AS NEIGHBORHOOD CHURCHES AND COMMUNITY CENTERS. THESE PROGRAMS INCLUDE SCHOOL-BASED HEALTH CARE, ASTHMA MANAGEMENT PROGRAM, GET UP AND GO WEIGHT MANAGEMENT PROGRAM, AND INJURY PREVENTION PROGRAM. ASTHMA MANAGEMENT PROGRAM: THE CHILDREN'S HEALTH ASTHMA MANAGEMENT PROGRAM, CERTIFIED BY THE JOINT COMMISSION, IS A FREE THREE-TO SIX-MONTH EDUCATION AND CARE COORDINATION PROGRAM TO HELP CHILDREN AGE 18 AND YOUNGER BETTER MANAGE THEIR ASTHMA CONDITION. IT HAS PROVEN TO REDUCE ASTHMA-RELATED EMERGENCY ROOM VISITS AND SCHOOL ABSENCES, ULTIMATELY HELPING CHILDREN WITH AN ASTHMA DIAGNOSIS EXPERIENCE SYMPTOM-FREE SLEEP, LEARNING AND PLAY. GET UP AND GO WEIGHT MANAGEMENT PROGRAM: DESIGNED BY PHYSICIANS AND REGISTERED DIETICIANS, GET UP AND GO ADDRESSES THE NEEDS OF CHILDREN WITH HIGH WEIGHT OR OBESITY BY CREATING AWARENESS AND UNDERSTANDING OF HOW LIFESTYLE CHOICES IMPACT HEALTH. THIS FREE 10-WEEK PHYSICIAN-REFERRED WEIGHT MANAGEMENT PROGRAM FOR CHILDREN AND FAMILIES IS OFFERED AT SEVERAL YMCA LOCATIONS IN DALLAS AND COLLIN COUNTIES. INJURY PREVENTION: THE INJURY PREVENTION SERVICE AT CHILDREN'S HEALTH HELPS KEEP CHILDREN SAFE FROM UNINTENTIONAL AND TRAUMATIC INJURIES. FROM CAR SEAT SAFETY TO WATER SAFETY, OUR PROGRAM PROVIDES EDUCATIONAL MATERIALS AND INTERACTIVE EVENTS IN BOTH ENGLISH AND SPANISH. SCHOOL-BASED TELEHEALTH: SCHOOL NURSES CAN NOW CONNECT STUDENTS WITH HEALTH CARE PROVIDERS AT SCHOOL USING SCHOOL-BASED TELEHEALTH BY CHILDREN'S HEALTH VIRTUAL CARE. OUR SCHOOL-BASED TELEHEALTH PROGRAM HAS REACHED 180 SCHOOLS THROUGHOUT 26 SCHOOL DISTRICTS IN TEXAS AND HAS CONDUCTED MORE THAN 15,000 VISITS SINCE 2014. A RECENT SURVEY ALSO SHOWED THE PROGRAM HAS RESULTED IN DECREASED ABSENTEEISM AND A PERCEIVED 84 PERCENT COST SAVINGS FOR FAMILIES. TELEBEHAVIORAL HEALTH: TELEBEHAVIORAL HEALTH BY CHILDREN'S HEALTH VIRTUAL CARE ALLOWS STUDENTS TO VIDEO CHAT WITH A LICENSED BEHAVIORAL HEALTH PROVIDER AT SCHOOL. THE PROGRAM IS CURRENTLY IN 87 NORTH TEXAS SCHOOLS AND AVAILABLE TO MORE THAN 65,000 STUDENTS. SINCE SEPTEMBER 2017, 519 STUDENTS HAVE RECEIVED TELEPHONIC BEHAVIORAL HEALTH ASSESSMENTS AT NO COST AND PROGRAM THERAPISTS HAVE PERFORMED 1,589 VIRTUAL THERAPY SESSIONS. HEALTH & WELLNESS ALLIANCE FORUMS: CHILDREN'S HEALTH SERVES AS A COMMUNITY CONVENER BY OFFERING FREE QUARTERLY FORUMS. ALL FORUMS ARE OPEN TO THE COMMUNITY AND OFFER A THOUGHT-PROVOKING SPEAKER TOUCHING ON A BEYOND ABC REPORT PILLAR WITH THE OPPORTUNITY TO GROW, NETWORK, AND COLLABORATE WITH OTHER MEMBERS OF THE COMMUNITY. MEDICAID/CHIP OUTREACH: CHILDREN'S HEALTH OUTREACH TEAM CONDUCTS MEDICAID/CHILDREN'S HEALTH INSURANCE PROGRAM OUTREACH AT AREA SCHOOL DISTRICTS AND COMMUNITY PARTNER ORGANIZATIONS WITH A COMBINED ENROLLMENT OF MORE THAN 350,000. AT PARTNER SCHOOLS, EACH STUDENT'S FAMILY RECEIVES INFORMATION ON THE IMPORTANCE OF HEALTH INSURANCE AND THE TOOLS TO APPLY FOR CHIP/MEDICAID. AT PARTNER SITES, LIKE DALLAS WIC AND BROTHER BILLS, REPRESENTATIVES MEET FAMILIES TO PROVIDE ASSISTISTANCE IN APPLING FOR BENEFITS. CHILDREN'S HEALTH WEBSITE: OUR HOSPITAL WEB SITE, WWW.CHILDRENS.COM, EMPOWERS PARENTS WITH INFORMATION ABOUT CHILDHOOD ILLNESSES, PREVENTION, TREATMENT AND SERVICES AVAILABLE AT THE HOSPITAL. MORE THAN 1,300 COMMON PEDIATRIC TOPICS ARE ADDRESSED ON THE WEB SITE. ALSO AVAILABLE ARE INTERACTIVE GUIDES PROMOTING HEALTHY LIVING. Schedule H, Part VI, Line 6 Affiliated health care system OCH Holdings dba Our Children's House is A PART OF CHILDREN'S HEALTH SYSTEM OF TEXAS. CHILDREN'S HEALTH IS ONE OF THE LARGEST AND MOST PRESTIGIOUS PEDIATRIC HEALTH CARE PROVIDERS IN THE COUNTRY AND THE LEADING PEDIATRIC HEALTH CARE SYSTEM IN NORTH TEXAS. THE CHILDREN'S HEALTH SYSTEM INCLUDES OUR FLAGSHIP HOSPITAL, CHILDREN'S MEDICAL CENTER DALLAS, AS WELL AS CHILDREN'S MEDICAL CENTER PLANO, OUR CHILDREN'S HOUSE INPATIENT REHABILITATION HOSPITAL, MULTIPLE SPECIALTY CENTERS, REHABILITATION FACILITIES, PHYSICIAN SERVICES AND THE CHILDREN'S MEDICAL CENTER RESEARCH INSTITUTE AT UT SOUTHWESTERN. CHILDREN'S HEALTH PROVIDES A FULL SPECTRUM OF HEALTH CARE SERVICES - FROM DAILY WELLNESS AND PRIMARY CARE TO SPECIALTY VISITS AND CRITICAL CARE. CHILDREN'S HEALTH IS AFFILIATED WITH UT SOUTHWESTERN AS THE OFFICIAL PEDIATRIC TEACHING HOSPITAL FOR THE MEDICAL SCHOOL. THIS PROVIDES NORTH TEXAS FAMILIES ACCESS TO A WORLD-RENOWNED MEDICAL FACULTY AND TRANSFORMATIVE BIOMEDICAL RESEARCH. CHILDREN'S HEALTH HAS BEEN CONSISTENTLY NAMED ONE OF THE NATION'S TOP PEDIATRIC PROVIDERS BY U.S. NEWS & WORLD REPORT. Schedule H, Part VI, Line 7 State filing of community benefit report TX true true false false false false false false false David T Berry Chair & President 0 629139 0 395628 0 89100 0 203246 0 11015 0 1328128 0 0 Vanessa U Walls Director & VP/Administrator, SVP (until 12/12/19) 0 304948 0 157242 0 49257 0 80155 0 11830 0 603432 0 0 Christopher J Durovich Former Chairman (CHST Pres. & CEO) 0 1193522 0 1531410 0 688172 0 184839 0 22733 0 3620676 0 0 Rustin Morse MD Director 0 386718 0 228708 0 45670 0 70796 0 10590 0 742482 0 0 Peter C Perialas Director 0 521612 0 391823 0 100019 0 269545 0 6207 0 1289206 0 0 Mary E Stowe RN Director (until 1/5/19) 0 13542 0 237346 0 617264 0 4753 0 489 0 873394 0 0 Joe Cavender VP and Interim CNO (until 10/1/19) 0 250675 0 121170 0 68729 0 71208 0 10363 0 522145 0 0 Richard P Goode Treasurer (until 9/23/19) 0 562462 0 451779 0 62599 0 182532 0 8646 0 1268018 0 0 Jeremiah Radandt Treasurer 0 400899 0 212365 0 7612 0 135652 0 13939 0 770467 0 0 Kelli Terpstra VP Administrator & ACNO 0 215413 0 30390 0 25118 0 40492 0 12354 0 323767 0 0 Jeffrey Vawrinek Secretary (until 10/18/19) 0 243042 0 63598 0 383610 0 0 0 0 0 690250 0 0 Tammy Webb EVP and CNO 0 85178 0 50000 0 24781 0 15144 0 1361 0 176464 0 0 Amy Yeager Secretary 0 334085 0 150000 0 4293 0 438873 0 9087 0 936338 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE COMMON PAYING AGENT FOR OCH HOLDINGS (OCH). THEREFORE, OCH'S TOP MANAGEMENT OFFICIAL, OTHER OFFICERS, AND KEY EMPLOYEES ARE EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). The CHST process for determining executive compensation is as follows: The Human Resources Committee (Committee) of the CHST Board is responsible for setting the compensation for executives. The Committee is comprised of independent, non-employee directors. A written compensation philosophy has been developed by the Human Resources Committee for timeliness and appropriateness and defines the desired peer groups for compensation surveys. The HR Committee engages the services of an independent compensation consultant for executive compensation. COMPENSATION PROGRAM COMPONENTS: The elements of total compensation provided to CHST executives include: - Cash compensation (i.e., base salary, short-term and long-term incentive compensation, and/or other cash compensation), determined in consideration of competitive market practices, organizational and individual performance, recruitment and retention considerations, and other relevant factors. - Standard benefits, assisting in each executive's medical, dental, disability, life insurance, time off, and retirement needs, reflective of the employment status (i.e., full or part time) of the executive. - Supplemental benefits, including supplemental insurance, retirement benefits, and/or other supplemental benefits determined by the Committee to be appropriate and reasonable in relation to marketplace practices. Compensation and benefits decisions are made in consideration of each executive's position, responsibilities, skills, effort, and performance, in relation to documented practices within the appropriate comparator group(s). PEER GROUP: The Committee has defined its primary peer group for executives as not-for-profit health care organizations similar in size, structure, and complexity. This group will include leading pediatric health systems as well as integrated health systems and academic medical centers. - Data will be compiled in a manner consistent with the IRS Intermediate Sanctions rules of federal tax law, to reflect what is "ordinarily paid to like executives by like enterprises under like circumstances." - In certain circumstances, market data from additional comparator groups (e.g., research institutions, insurance industry, and general industry companies) may also be referenced. - The specific nature of the role at CHST will be considered when adding comparator groups outside of the primary peer group, and the Committee will discuss and agree on the appropriateness of adding comparator groups whenever the specific nature of the CHST role requires additional comparator groups to be used. Schedule J, Part I, Line 4a Severance or change-of-control payment Jeffrey Vawrinek - $263,029 Mary Stowe - $567,200 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Retirement Income Restoration Plan: Christopher J. Durovich participated in the Retirement Income Restoration Plan and received $315,458 in taxable income during 2019. Savings Restoration Plan: Employees who received taxable income from the Savings Restoration Plan include: Christopher J. Durovich - $200,478. Additional employees who participated in the Savings Restoration Plan but who did not receive payments include: Vanessa Walls. Executive Defined Contribution Retirement Plan (EDCRP): Employees who received taxable income from the EDCRP include: Christopher J. Durovich - $150,116, David Berry - $55,786, Richard Goode - $53,248, Peter Perialas - $56,527, Jeffrey Vawrinek - $77,906, Joe Cavender - $36,566, Mary Stowe - $4,209, and Vanessa Walls - $30,902. Employees who participated in and have contributions to the EDCRP include: Christopher J. Durovich - $165,839, David Berry - $192,046, Richard Goode - $171,332, Peter Perialas - $258,345, Rustin Morse - $59,596, Jeremiah Radandt - $124,452, Amy Yeager - $427,673, Joe Cavender - $52,208, Kelli Terpstra - $24,369, Tammy Webb - $12,981, and Vanessa Walls - $63,355. Form 990, Part V, Line 2a CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST) EIN 75-2062019 IS THE COMMON PAYING AGENT FOR OCH Holdings (OCH) THEREFORE, ALL APPLICABLE IRS TAX COMPLIANCE FILINGS ARE REPORTED BY CHST ON BEHALF OF OCH. OCH HAS APPROXIMATELY 364 EMPLOYEES. Form 990, Part VI, Line 8b Committees Children's Health System of Texas has established seven standing Committees of the Board, which have the authority to act for and on behalf of CHST, Children's Health Clinical Operations, Children's Medical Center Foundation, and their affiliates, operating divisions and division facilities to fulfill the responsibilities designated in the respective Committee charters. Written minutes are prepared and maintained for all formal meetings of each Committee. Actions by Written Consent are also prepared and maintained as they occur. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION OF OFFICERS AND OTHER KEY EMPLOYEES Line 15b is answered no in accordance with the IRS Form 990 instructions because salary is paid and determined by a related party, Children's Health System of Texas (CHST). CHST is the sole member and officers are employed and paid by CHST. Form 990, Part VI, Line 6 Classes of members or stockholders CHCO is the sole member. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHCO elects all voting members of the organization's board of directors. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders Member reserve powers are specified in the the organization's bylaws and represent those actions which require member approval. These powers generally encompass changes in the mission of the organization, addition of new members, certain dispositions of assets, amendments to the organization's Certificate of Formation and Bylaws, and appointment of directors. Form 990, Part VI, Line 11b Review of form 990 by governing body A draft of the Form 990 is presented to the CHST Audit Committee for review. A copy of the Form 990 is made available to the CHST directors through our Board portal before it is filed. Form 990, Part VI, Line 12c Conflict of interest policy Officers, directors, and key employees receive annually a copy of the Children's Health Statement of Interest form to complete. Disclosures made are reviewed by the CHST Legal Department and the Chief Compliance Officer, who are authorized under the Children's Health Conflict of Interest Policy to make determinations under the Policy regarding persons who are medical staff members or employees of Children's Health and its affiliates. Disclosures made by senior officers (as defined in the Policy) are reviewed by the Compliance Officer, the Chief Legal Officer, and CHST's President and Chief Executive Officer to determine if a conflict exists. Disclosures made by directors of CHST and its affiliates, as well as by the President and Chief Executive Officer of CHST, are discussed as necessary with the appropriate delegated Board Committee and, if required pursuant to the Policy, by the appropriate Board of Directors at meetings to determine if further action is needed. A Statement of Interest must be completed annually and Board members are requested to report changes if they occur. A Committee or Board member with a potential conflict is prohibited from participating in deliberations regarding the transaction in question and will recuse themselves from voting. Form 990, Part VI, Line 19 Required documents available to the public IRC section 6104 does not require disclosure of the financial statements, conflict of interest policy and governing documents. The Certificate of Formation, Consolidated Financial Statements, and the conflict of interest policy are made available upon request. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Restricted Gifts - F/A Acquisition - 131350; FORM 990, PART VI, LINE 15A PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL CHILDREN'S HEALTH SYSTEM OF TEXAS (EIN 75-2062019) IS THE COMMON PAYING AGENT FOR OCH HOLDINGS (OCH). THEREFORE, OCH'S TOP MANAGEMENT OFFICIAL IS EMPLOYED AND COMPENSATED BY CHILDREN'S HEALTH SYSTEM OF TEXAS (CHST). 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