2020-08-13T19:43:28-05:00 2019-09-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2018-10-01 941294954 VALLEY CHILDREN'S HOSPITAL VALL 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 936368762 MICHELE WALDRON CFO 5593533000 2020-08-12 1 TRACY S PAGLIA P00366884 2099556100 2020-08-12 67.161.92.235 2020-08-12 16:02:09 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 EA091DC5D04A82BA751EB0452936D76C219FA255 2018 2020-11-19 02:30:22Z MICHELE WALDRON 9300 VALLEY CHILDRENS PLACE MADERA CA 936368762 1251985810 0 X WWW.VALLEYCHILDRENS.ORG X 1949 CA PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN 13 11 3714 407 48602 0 34039952 22589742 614207247 700460709 24789411 28557962 20176687 19565741 693213297 771174154 38678604 10663364 0 0 302339673 315753975 0 0 0 293519984 402900727 634538261 729318066 58675036 41856088 1540317940 1643182800 473320364 444971050 1066997576 1198211750 X TO PROVIDE HIGH QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. 0 0 134074086 10663364 414194757 SEE SCHEDULE O 428968794 286265952 SEE SCHEDULE O 563042880 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 0 0 0 1 0 0 0 0 1 0 0 0 1 1 1 0 0 1 326 0 1 3714 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 13 11 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 CA X MICHELE WALDRON CFO 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 TODD SUNTRAPAK CEO 17.50 32.50 X X 1601913 0 -290532 JEANNINE CAMPOS GRECH BOARD TREAS/CHAIR 1.00 1.00 X X 0 0 0 DAVE NALCHAJIAN BOARD TREAS/VICE CHAIR (THRU 9/19) 1.00 1.00 X X 0 0 0 MICHAEL HANSON BOARD SECRETARY/TREAS (THRU 2/19) 1.00 1.00 X X 0 0 0 ADAM HOLMES MD CHIEF OF STAFF 1.00 X 62500 0 0 RILEY WALTER BOARD MEMBER 1.00 1.00 X 0 0 0 BILL SMITTCAMP BOARD MEMBER 1.00 1.00 X 0 0 0 KIM RUIZ BECK BOARD MEMBER 1.00 1.00 X 0 0 0 DAN ADAMS BOARD MEMBER 1.00 1.00 X 0 0 0 DAN KOONTZ BOARD MEMBER 1.00 X 0 0 0 JOSE ELGORRIAGA BOARD MEMBER 1.00 X 0 0 0 MENDY LAVAL BOARD MEMBER 1.00 X 0 0 0 ROB YRACEBURU BOARD MEMBER (THRU 6/19) 1.00 X 0 0 0 VICKI BURKHALTER BOARD MEMBER 1.00 X 0 0 0 SISSY DALENA WOOD BOARD MEMBER 1.00 X 0 0 0 DANIELLE PARNAGIAN BOARD MEMBER 1.00 1.00 X 0 0 0 MICHELE R WALDRON SVP, CFO 18.50 31.50 X 815408 0 -351435 DEBRA FLORES PRESIDENT & COO (THRU 4/19) 40.00 X 508565 0 8048 DAVID CHRISTENSEN SVP, MEDICAL AFFAIRS & CPE 27.00 18.00 X 912885 0 141105 BEVERLY HAYDEN-PUGH SVP, CLINICAL INT, PATIENT EXP 18.00 27.00 X 1496458 0 -509203 MICHAEL GOLDRING PRESIDENT, VCMG 12.00 28.00 X 681682 0 102169 WILLIAM CHALTRAW SVP/CHIEF LEGAL OFFICER 40.00 X 535118 0 101666 KAREN DAHL VP, QUALITY & PATIENT SAFETY 40.00 X 547018 0 84268 KEVIN SHIMAMOTO VP AND CIO 40.00 X 530979 0 77230 NATALE PONTICELLO JR SVP, CHIEF PEOPLE OFFICER 29.00 11.00 X 527454 0 72699 JOEL BROWNELL MD VP, CHIEF MEDICAL INFO OFFICER 40.00 X 478084 0 86344 DAVID SINGH VP, COO OF VCMG 40.00 X 472536 0 61450 LYNNE ASHBECK SVP, COMM ENGAGEMENT & POP. WELLNESS 40.00 X 424397 0 45833 DANIELLE BARRY VP, REVENUE CYCLE MGMT 40.00 X 344030 0 69784 BRIAN SMULLIN VP, MANAGED CARE 40.00 X 327506 0 73459 JOLIE LIMON VP ACAD AFFAIRS, DIO & CHIEF OF PED 40.00 X 370098 0 22966 JANE WILLSON SVP, CHIEF STRATEGY OFFICER 8.00 32.00 X 598809 0 25117 DAVID HODGE JR VP CLINICAL OPS & ANCILLARY SVCS 40.00 X 359821 0 35081 STEPHANIE VANCE FINANCE, VP 40.00 X 388999 0 10089 DANIEL DAVIS VP, PATIENT CARE (THRU 4/19) 40.00 X 401093 0 -143614 JESSIE HUDGINS VP, FACILITIES 40.00 X 447926 0 51088 TRACY BLAIR EXEC DIR.&DEP GEN.COUNC.(THRU 7/19) 40.00 X 281417 0 -22668 KRISTINE AUBRY EXEC DIREC.AMB. SVCS (THRU 4/19) 40.00 X 267231 0 -42191 PAUL LEBBY NEURODEV PROGRAM DIRECTOR 40.00 X 246170 0 -142150 THOMAS ORR SUPV PHARMACY HOME INFUSION 40.00 X 235757 0 21182 YVONNE WOOD MANAGER PATIENT THROUGHPUT 40.00 X 229067 0 -26434 14092921 0 -438649 706 0 1 0 VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 SUBSPEC PHYSICIAN SERVICES 74825000 PEDIATRIC ANETHESIA ASSOCIATES 6235 N FRESNO ST STE 103 FRESNO CA 93710 ANETHESIA/CRITICAL CARE 12939738 SODEXO INC & ASSOCIATES PO BOX 360170 PITTSBURGH PA 152516170 HOUSEKEEPING SERVICES 5037838 TECH KNOWLEDGE ASSOC 1 CENTERPOINT DR ST 200 LA PALMA CA 906232529 BIOMED EQIPMENT MAINTENANCE 4414357 ZUMWALT CONSTRUCTION INC 5520 E LAMONA AVE FRESNO CA 93727 CONSTRUCTION SERVICES 3835730 91 15224743 6764514 600485 3354608 22589742 PATIENT SERVICES 900099 696361819 696361819 MANAGEMENT SERVICES 541610 3943660 3943660 LAB SERVICES 900099 155230 155230 700460709 21157121 48602 21108519 2948681 2948681 564735 610368 -45633 -45633 -45633 484365902 6543 479896867 23418 4469035 -16875 4452160 4452160 605523 281003 324520 324520 CAFETERIA REVENUE 900099 3188475 3188475 16098379 16098379 19286854 771174154 700460709 48602 48075101 10421374 10421374 241990 241990 20319566 20319566 199665016 163280197 36384819 13276491 10619418 2657073 64806213 46597554 18208659 17686689 13093931 4592758 1793791 19560 1774231 1622118 1622118 221544 221544 2450843 2450843 70765884 70477438 288446 2353187 81523 2271664 96169828 87607954 8561874 7138032 7138032 6004628 4165072 1839556 1223590 288166 935424 511579 150081 361498 12425378 9407051 3018327 26740580 16179464 10561116 4392022 3181998 1210024 PENSION PLAN TERM SETTL 92839591 68905545 23934046 HOSPITAL FEE PROGRAM 29326167 29326167 PURCHASED SERVICES 25308026 17383193 7924833 BAD DEBT 10884442 10884442 10729497 730762 9998735 729318066 563042880 166275186 0 14394 21023 389975007 412626543 560199 508290 75373277 83334570 25976912 32087175 9763049 11304869 19488786 22453853 647713246 305593199 270678018 342120047 321908138 359036948 296311715 300638065 19506083 43952458 110762362 35098959 1540317940 1643182800 53631715 54716352 106083936 93455816 313604713 296798882 473320364 444971050 X 1032895353 1183770455 34102223 14441295 1066997576 1198211750 1540317940 1643182800 X 41856088 -1648161 91006247 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 8248 0 1 315296 323544 0 PART II-B, LINE 1 VALLEY CHILDREN'S HOSPITAL HAS HAD DIRECT CONTACT WITH AND HAS ENCOURAGED OTHERS TO HAVE DIRECT CONTACT WITH LOCAL, STATE AND FEDERAL LEGISLATORS REGARDING CHILDREN'S HEALTH CARE PUBLIC POLICY. THESE CONTACTS HAVE PROVIDED INFORMATION REGARDING THE PROVISION OF HEALTH CARE SERVICES TO CHILDREN, THE ANTICIPATED EFFECT ON CHILDREN'S HEALTH OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING CURRENT STATE AND FEDERAL FUNDING LEVELS FOR MEDI-CAL AND OTHER PUBLIC PROGRAMS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. VALLEY CHILDREN'S HOSPITAL HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $8,248 ASSOCIATION DUES RELATED TO LOBBYING NACH 43,595 NACH CONTRIBUTION 3,300 AMERICAN SOCIETY FOR HEALTHCARE ENGINEERING 69 ASSOCIATION FOR HEALTHCARE RESOURCE PROFESSIONALS 40 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 423 CALIFORNIA CHAMBER OF COMMERCE 117 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 65,955 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 21,049 CHILDREN'S SPECIALTY CARE COALITION 3,800 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIF. 30,385 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 BROWNSTEIN HYATT FARBER SCHRECK 146,443 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $323,544 55100315 55100315 335618449 121375308 214243141 3735262 3123407 611855 223059089 157736036 65323053 30200131 23358448 6841683 342120047 LIMITED PARTNERSHIPS 195462758 F HEDGE FUNDS 105175307 F 300638065 MALPRACTICE RESERVE 6251783 ACCRUED PENSION LIABILITY 1546308 457 LIABILITY 3579152 1732 LIABILITY 1318412 WORKERS COMP 4344672 INS LIABILITY 3128328 DC SERP LIABILITY 999283 BONDS 275630944 296798882 CENTRAL AMERICA AND THE CARIBBEAN - ANTIGUA & BARBUDA, ARUBA, BAHAMAS, 0 0 INVESTMENTS 58202340 EUROPE (INCLUDING ICELAND & GREENLAND) - ALBANIA, ANDORRA, AUSTRIA, BELGIUM 0 0 INVESTMENTS 29867107 0 0 0 0 0 0 88069447 0 88069447 1 0 1 1 1 0 PART I, LINE 3: THE AMOUNT IN COLUMN F IS BASED ON FAIR MARKET VALUE. 1 1 1 X 1 X 1 0 1 1 346213 346213 0.00050 449374225 451499918 0 0.00000 56200 14752 41448 0.00010 449776638 451514670 387661 0.00060 1842714 1842714 0.00260 10326057 1186978 9139079 0.01270 974752 494300 480452 0.00070 9967754 9967754 0.01390 23111277 1681278 21429999 0.02990 472887915 453195948 21817660 0.03050 1 3427168 0 204838 271754 -66916 X 1 1 2 1 VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 WWW.VALLEYCHILDRENS.ORG 040000160 X X A 2 VALLEY CHILDREN'S HOME CARE 5085 E MCKINLEY AVE FRESNO CA 93727 WWW.VALLEYCHILDRENS.ORG 040000160 X A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.VALLEYCHILDRENS.ORG X 1 16 1 WWW.VALLEYCHILDRENS.ORG 0 1 X 200.000000000000 350.000000000000 X X X 1 1 X X X X 1 X WWW.VALLEYCHILDRENS.ORG X WWW.VALLEYCHILDRENS.ORG X WWW.VALLEYCHILDRENS.ORG X X X X X X X 1 X 0 X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: VALLEY CHILDREN'S HOSPITAL, - FACILITY 2: VALLEY CHILDREN'S HOME CARE FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: IN ORDER TO CONDUCT THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR FRESNO, KINGS, MADERA AND TULARE COUNTIES, HOSPITAL LEADERS FROM EACH COUNTY, INCLUDING VALLEY CHILDREN'S HOSPITAL, ENGAGED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA TO FORM THE HOSPITAL COUNCIL COMMUNITY BENEFIT WORKGROUP. THIS WORKGROUP REPRESENTS 15 HOSPITALS THROUGHOUT THE FOUR COUNTIES. UNDER THEIR DIRECTION, CONSULTANTS REVIEWED THE SECONDARY DATA IN THE REGION IN ORDER TO BEGIN LOOKING FOR EVIDENCE OF HEALTH NEEDS, TO DESIGN A COMMUNITY ENGAGEMENT PROCESS TO SOLICIT FEEDBACK ON THESE NEEDS, AND TO CREATE A PROCESS TO PRIORITIZE THESE NEEDS BASED ON COMMUNITY INPUT. CONSULTANTS FROM LEAP SOLUTIONS REVIEWED THREE SOURCES TO DETERMINE WHAT THE MOST COMMON HEALTH NEEDS ARE FOR CONSIDERATION IN A CHNA. INCLUDED IN THE REVIEW WERE METRICS OR INDICATORS IDENTIFIED BY THE CENTER FOR DISEASE CONTROL (CDC) AND METRICS USED BY HEALTHY PEOPLE 2020 INITIATIVE, A COLLABORATION OF THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES AND OTHER FEDERAL AGENCIES AND RESEARCH INSTITUTIONS. CONSULTANTS ALSO REVIEWED THE LIST OF THE MOST COMMONLY IDENTIFIED HEALTH NEEDS ACROSS KAISER PERMANENTE'S CHNA DATA PLATFORM (WWW.CHNA.ORG). AFTER REVIEWING ALL THE LISTS, THE CONSULTANTS FOUND THAT THE 15 POTENTIAL HEALTH NEEDS IDENTIFIED BY THE CHNA DATA PLATFORM ALIGN WELL WITH THOSE DEFINED BY THE CDC AND THOSE USED BY THE HEALTHY PEOPLE 2020 INITIATIVE. THEY WERE ADOPTED FOR USE IN THIS CHNA TO GUIDE THE PRIMARY AND SECONDARY DATA COLLECTION. THESE HEALTH NEEDS ARE: - ACCESS TO CARE - BREATHING PROBLEMS (ASTHMA) - CANCERS - CLIMATE AND HEALTH - CARDIOVASCULAR DISEASE/STROKE (HEART DISEASE) - DIABETES - ECONOMIC SECURITY - HIV/AIDS/STDS - MATERNAL, INFANT AND CHILD HEALTH - MENTAL HEALTH - OBESITY - ORAL HEALTH - OVERALL HEALTH - SUBSTANCE ABUSE - VIOLENCE/INJURY PREVENTIONTHE NEXT STEP IN THE CHNA PROCESS REQUIRED ENGAGING THE COMMUNITY TO SOLICIT THEIR PERCEPTIONS OF THE MOST PRESSING HEALTH NEEDS IN THE COMMUNITY. THIS EFFORT INCLUDED CHNA SURVEYS, FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS WITH PUBLIC HEALTH DIRECTORS, HOSPITAL CEOS AND NONPROFIT ORGANIZATION LEADERS SERVING UNIQUE SEGMENTS OF THE COMMUNITY (I.E. THE DISABLED, POOR, OR UNIQUE ETHNIC GROUPS). THESE THREE METHODOLOGIES WERE USED IN ORDER TO REACH COMMUNITY MEMBERS WHO MIGHT BE MORE COMFORTABLE SHARING THEIR PERSPECTIVES ON AN INDIVIDUAL SURVEY VERSUS ATTENDING A FOCUS GROUP. IN ORDER TO LEVERAGE THE OPPORTUNITY TO USE A CONSISTENT SET OF QUESTIONS ACROSS ALL FOUR COUNTIES, THE WORKGROUP SELECTED A CHNA SURVEY DESIGNED BY THE HEALTHY MADERA COALITION WITH THE COUNTY PUBLIC HEALTH DEPARTMENT STAFF. THIRTY-SIX QUESTIONS CENTERED ON KEY HEALTH CONCERNS AND FACTORS THAT INFLUENCE THE HEALTH OF THE COMMUNITY AND INCLUDED DEMOGRAPHIC. THE CHNA SURVEY FOCUSED ON: - COMMUNITY HEALTH NEEDS, - ENVIRONMENTAL FACTORS THAT INFLUENCE THE HEALTH OF THE COMMUNITY, - BEHAVIORS THAT IMPACT HEALTH - BARRIERS TO GETTING HEALTH CARE IN THEIR COUNTY - INDICATORS OF A HEALTHY COMMUNITY, AND - FACTORS IN THEIR COMMUNITIES NEEDING MOST IMPROVEMENT. THE SURVEY WAS PROVIDED THROUGH SURVEY MONKEY, AN ONLINE WEB PLATFORM, IN BOTH SPANISH AND ENGLISH AND CORRESPONDING WEBSITE LINKS WERE EMAILED TO HOSPITAL AND FACILITY STAFF AS WELL AS COMMUNITY MEMBERS. THE SURVEY LINK WAS CONFIGURED TO ALLOW FOR CONFIDENTIALITY OF RESPONSES AND THE SURVEY WAS AVAILABLE FROM JULY 1, 2015 TO DECEMBER 2, 2015. TWO COMMUNITY ORGANIZATIONS WERE CONTRACTED TO ASSIST WITH THE COMMUNITY OUTREACH EFFORTS. THESE WERE: FRESNO METRO MINISTRYA NONPROFIT ESTABLISHED IN 1970 WITH A MISSION TO ADVOCATE FOR THE HEALTH AND WELL-BEING OF THE COMMUNITY AND CENTRO LA FAMILIA ADVOCACY SERVICESA NONPROFIT WORKING TO EMPOWER LOW INCOME PEOPLE TO ACCESS LIFE SUSTAINING RESOURCES THROUGH EDUCATION, TRAINING AND SOCIAL SERVICES. IN ADDITION, THE MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH AND CAMARENA HEALTH, A FEDERALLY QUALIFIED HEALTH CENTER, ASSISTED WITH THE OUTREACH EFFORTS IN THEIR OWN COUNTY AND PROVIDED THE COMMUNITY SURVEY USED FOR THIS CHNA. FOCUS GROUPSA TOTAL OF 15 FOCUS GROUPS WERE CONDUCTED RANGING IN SIZE FROM 4 TO 24 PARTICIPANTS. THE FOCUS GROUPS WERE ATTENDED BY HOSPITAL AND FACILITY STAFF, COMMUNITY LEADERS FROM NONPROFIT AND FAITH-BASED ORGANIZATION AND ELECTED OFFICIALS AND RESIDENTS. THESE SESSIONS WERE CONDUCTED PRIMARILY IN ENGLISH. OTHER FOCUS GROUPS WERE COMPRISED OF PRIMARILY RESIDENTS, INCLUDING MOTHERS AND YOUTH, AND WERE CONDUCTED IN ENGLISH AND SPANISH. CHILDCARE WAS PROVIDED AT TWO OF THE FOCUS GROUPS. ALL OF THE FOCUS GROUPS FOLLOWED THE SAME FORMAT AND AGENDA: - AN INTRODUCTION AND OVERVIEW OF THE CHNA PROCESS AND PURPOSE- A REVIEW OF EIGHT KEY HEALTH INDICATORS TO UNDERSTAND HOW THE COUNTIES RANKED IN COMPARISON WITH CALIFORNIA AND THE UNITED STATES- A REVIEW OF HOW OTHER RESIDENTS AND HEALTH CARE WORKERS RESPONDED TO THE CHNA SURVEY AND WHETHER THOSE ATTENDING AGREE OR DISAGREE WITH MOST COMMON RESPONSES TO THE ABOVE-MENTIONED FIVE KEY QUESTIONS (Q11, Q12, Q13, Q14 AND Q16)- A LARGE GROUP DISCUSSION WAS FACILITATED ON THREE ADDITIONAL QUESTIONS THAT WERE USED TO SEEK THE GROUP'S CONSENSUS ON: WHAT ARE SOME KEY SERVICES YOU BELIEVE WOULD HELP ADDRESS THESE CHALLENGES FROM THE FOLLOWING OPTIONS: 1. MORE COMMUNITY CLINICS/AMBULATORY CENTERS 2. MORE REGIONAL INITIATIVES ON COMMUNITY HEALTH 3. ENGAGING NONPROFITS IN COORDINATED CARE 4. USING COMMUNITY ADVISORY COUNCILS 5. MORE PATIENT SUPPORT GROUPS 6. MORE HEALTH EDUCATION FAIRS/ EVENTS 7. MORE UPSTREAM HEALTH INTERVENTIONS 8. OTHER: WHAT ONE EFFORT WOULD MAKE THE GREATEST IMPACT ON HEALTH OUTCOMES IN YOUR COMMUNITY FROM THE FOLLOWING OPTIONS: 1. MORE DISEASE PREVENTION EFFORTS 2. MORE COORDINATED CARE PROGRAMS/SERVICES 3. MORE UPSTREAM HEALTH INITIATIVES 4. BETTER COMMUNITY INFRASTRUCTURE TO SUPPORT HEALTHY LIVING 5. IMPROVED HEALTH EDUCATION 6. IMPROVED ENVIRONMENTAL CONDITIONS 7. IMPROVED ECONOMIC CONDITIONS 8. OTHER ARE YOU AWARE OF ANY NEW PROGRAMS OR SERVICES THAT WERE CREATED IN THE LAST THREE YEARS THAT HAVE THE POTENTIAL TO ADDRESS YOUR COMMUNITY'S HEALTH NEEDS?IN ORDER TO KEEP EACH OF THE FOCUS GROUPS TO A 60-MINUTE FORMAT, IT WAS NECESSARY TO CHOOSE AMONG A SIGNIFICANT AMOUNT OF SECONDARY DATA TO SHARE WITH PARTICIPANTS. THE CONSULTANTS SELECTED HEALTH INDICATORS DIRECTLY LINKED TO THE RESULTS OF THE 2013 HOSPITAL COUNCIL REGIONAL CHNA REPORT PRODUCED FOR THE SAME FOUR COUNTIES. THIS ALLOWED THE FOCUS GROUP PARTICIPANTS TO CONTINUE DISCUSSING ASTHMA, OBESITY, ACCESS TO CARE, MENTAL HEALTH AND SOCIOECONOMIC FACTORS THAT WERE CONCERNS RAISED IN 2013 CHNA.KEY STAKEHOLDER INTERVIEWSTHE WORKGROUP IDENTIFIED APPROXIMATELY 95 KEY STAKEHOLDERS IN THE REGION WHO WOULD BE IMPORTANT TO INTERVIEW. CONSULTANTS CONTACTED EACH STAKEHOLDER OFFERING TO CONDUCT PHONE OR IN-PERSON INTERVIEWS. PARTICIPANTS IN THIS EFFORT INCLUDED: COUNTY PUBLIC HEALTH DIRECTORS, HOSPITAL EXECUTIVES AND NONPROFIT LEADERS WHO SERVE THE COMMUNITY WITH SOCIAL, HEALTH, OR EDUCATIONAL SUPPORT SERVICES. THESE KEY STAKEHOLDERS WERE SELECTED AS THEY COULD PROVIDE A UNIQUE PERSPECTIVE ON THE HEALTH OF THE COMMUNITY, HEALTH CARE DELIVERY SYSTEMS AND OVERALL CONDITIONS THAT INFLUENCE HEALTH BEHAVIORS. IN ADDITION, THE CHNA COMMUNITY OUTREACH ALSO INVOLVED THE TULE RIVER NATION ELDERS AND TRIBAL COUNCIL MEMBERS IN TULARE COUNTY. EACH STAKEHOLDER WAS GIVEN THE OPPORTUNITY TO REVIEW THE KEY HEALTH INDICATORS FOR THEIR COUNTY AND THEN WAS ASKED TO RANK RESPONSES TO THE FIVE KEY QUESTIONS REVIEWED BY THE FOCUS GROUPS.IDENTIFYING HEALTH NEEDSIN ORDER TO IDENTIFY THE HEALTH NEEDS IN THIS CHNA REPORT, THE WORKGROUP AND HEALTH OFFICERS FROM EACH COUNTY'S DEPARTMENT OF PUBLIC HEALTH MET NOVEMBER 12, 2015 TO REVIEW THE SURVEY DATA AND A SUMMARY OF SECONDARY DATA ON THE HEALTH NEEDS FOR ALL FOUR COUNTIES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: - ADVENTIST HEALTH CENTRAL - HANFORD- ADVENTIST HEALTH CENTRAL - REEDLEY- ADVENTIST HEALTH CENTRAL - SELMA- COMMUNITY REGIONAL MEDICAL CENTER FRESNO- CLOVIS COMMUNITY MEDICAL CENTER- COALINGA REGIONAL MEDICAL CENTER- KAISER PERMANENTE FRESNO REGION - KAWEAH DELTA HEALTH CARE DISTRICT - MADERA COMMUNITY HOSPITAL - SAINT AGNES MEDICAL CENTER - SAN JOAQUIN VALLEY REHABILITATION HOSPITAL- SIERRA VIEW DISTRICT HOSPITAL- TULARE REGIONAL MEDICAL CENTER FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B: - HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA- MADERA COUNTY PUBLIC HEALTH DEPARTMENT- CENTRO LA FAMILIA- FRESNO METRO MINISTRY FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES. FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16J: ADDITIONALLY THE POLICY IS SENT BY US POSTAL SERVICE TO COMMUNITY AGENCIES TO BE DISTRIBUTED. PART I, LINE 7: CHARITY CARE AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE DECISION SUPPORT SYSTEM WAS USED TO CALCULATE COST-TO-CHARGE FOR DETERMINING UNREIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THIS DECISION SUPPORT SYSTEM ADDRESSES ALL PATIENT SEGMENTS (I.E INPATIENT, OUTPATIENT, ETC.). PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 10,884,442. PART III, LINE 4: FOOTNOTE DESCRIBING BAD DEBT EXPENSE: SEE PAGE 15, NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS.COSTING METHODOLOGY:ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND REVIEW OF LARGE BALANCE SELF-PAY ACCOUNTS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBT IF SUBSEQUENTLY COLLECTED. THE COST OF BAD DEBT WRITE-OFFS WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF. PART III, LINE 8: MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2019 MEDICARE COST REPORT. MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE SERVICES. ADDITIONALLY, THE MAJORITY OF THE HOSPITAL'S MEDICARE PATIENTS WOULD BE COVERED BY MEDI CAL IF THEY DID NOT FALL UNDER THE MEDICARE COVERAGE OPTION. PART III, LINE 9B: COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE; INSURANCE COLLECTION ATTEMPTS CONTINUE AS APPROPRIATE. PART VI, LINE 2: COMMUNITY HEALTH NEEDS ASSESSMENT: VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CONSISTENT WITH STATE AND FEDERAL LAW, VALLEY CHILDREN'S HOSPITAL COMPLETES A FORMAL CHNA AT LEAST ONCE EVERY THREE YEARS. VALLEY CHILDREN'S HOSPITAL'S 2019 COMMUNITY BENEFITS PROGRAM IS BUILT UPON THE OUTCOMES OF A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDED THE FOLLOWING ACTIVITIES:JOINT NEEDS ASSESSMENT -VALLEY CHILDREN'S HOSPITAL PARTNERED WITH HOSPITALS IN A FOUR-COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. COUNTIES COVERED INCLUDED MADERA, KINGS, FRESNO, AND TULARE. THROUGH THEIR REGIONAL HOSPITAL ASSOCIATION, THE HOSPITALS CONTRACTED JOINTLY WITH LEAP SOLUTIONS TO FACILITATE THE CHNA, WHICH WAS CONDUCTED BETWEEN OCTOBER 2015 AND FEBRUARY 2016 AND PUBLISHED IN MARCH 2016. LEAP SOLUTIONS, LLC FOLLOWED SEVERAL STEPS TO ENSURE THAT THE HOSPITALS WOULD HAVE ADEQUATE INFORMATION FROM WHICH TO IDENTIFY POSSIBLE ACTIONS. FIRST, IT WAS IMPORTANT TO REVIEW THE WORK THAT HAD BEEN DONE IN THE PAST AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. SECOND, IT WAS ESSENTIAL TO AGREE UPON THE DATA TO BE USED FOR THE REPORT IN ORDER TO APPLY A CONSISTENT SET OF KEY SOCIAL DETERMINANTS OF HEALTH IN EACH OF THE FOUR COUNTIES. SUPPLEMENTAL ASSESSMENT ACTIVITY - IN ADDITION TO THE LEAP SOLUTIONS' FACILITATED ASSESSMENT, VALLEY CHILDREN'S HOSPITAL STAFF ACCESSED OTHER RESOURCES TO FURTHER ASSESS CHILDREN'S HEALTH CARE NEEDS THROUGHOUT THE HOSPITAL'S ENTIRE SERVICE AREA. RESOURCES INCLUDED DATA SOURCES AS WELL AS CONVERSATIONS WITH LOCAL HEALTH CARE PROVIDERS AND ADVOCATES. DATA SOURCES INCLUDED KIDSDATA.ORG, THE CALIFORNIA HEALTH INTERVIEW SURVEY DATA, THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH'S PEDIATRIC NUTRITION SURVEILLANCE DATA, AND THE CALIFORNIA CHILD WELFARE INDICATORS PROJECT AT THE UNIVERSITY OF CALIFORNIA AT BERKELEY. LOCAL PROVIDERS AND ADVOCATES CONSULTED INCLUDED FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, THE CENTRAL CALIFORNIA CHILDREN'S INSTITUTE AND THE CENTRAL VALLEY HEALTH POLICY INSTITUTE.VALLEY CHILDREN'S HOSPITAL STAFF ALSO REMAINED ACTIVELY ENGAGED IN A NUMBER OF COMMUNITY-BASED ORGANIZATIONS AND INITIATIVES IN 2019. THIS CONTINUOUS ENGAGEMENT KEPT THE HOSPITAL CLOSE TO THE ISSUES MOST IMPACTING THE HEALTH AND WELLBEING OF CHILDREN IN ITS SERVICE AREA AND ALLOWED THE HOSPITAL TO MAKE ADJUSTMENTS TO ITS COMMUNITY BENEFITS PROGRAM ACTIVITIES AS APPROPRIATE. PART VI, LINE 4: COMMUNITY INFORMATION: AS THE ONLY PEDIATRIC NETWORK OF ITS KIND IN ALL OF CENTRAL CALIFORNIA, VALLEY CHILDREN'S SERVICE AREA EXTENDS FROM SACRAMENTO COUNTY IN THE NORTH TO KERN COUNTY IN THE SOUTH, AND PICKS UP MUCH OF THE CENTRAL COAST AND EASTERN SIERRA AS WELL. VALLEY CHILDREN'S SERVICE AREA IS FOCUSED ON THOSE SEVEN COUNTIES THAT COLLECTIVELY ACCOUNT FOR MORE THAN 95% OF VALLEY CHILLDREN'S INPATIENT AND OUTPATIENT VOLUME. THOSE COUNTIES ARE FRESNO, KERN, KINGS, MADERA, MERCED, STANISLAUS AND TULARE. ACCORDING TO WWW.KIDSDATA.ORG, APPROXIMATELY 1/3 OF CHILDREN LIVING IN THESE SEVEN COUNTIES LIVE IN POVERTY, 3/4 ARE AN ETHNICITY OTHER THAN CAUCASIAN AND CLOSE TO 1/4 LIVE IN FAMILIES WHERE ENGLISH IS NOT THE PRIMARY LANGUAGE SPOKEN AT HOME. IN 2019, VALLEY CHILDREN'S HOSPITAL HAD 12,139 INPATIENT CASES, 108,335 EMERGENCY DEPARTMENT VISITS AND A COMBINED 305,096 OUTPATIENT CENTER, REGIONAL SPECIALTY CARE CENTER AND DAY SURGERY VISITS. MEDI-CAL BENEFITS COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 77% OF THE OUTPATIENT VISITS AT VALLEY CHILDREN'S HOSPITAL. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: VALLEY CHILDREN'S HOSPITAL PARTNERS WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING THE FOLLOWING. CHILD ABUSE PREVENTION - PREVENTING AND PROTECTING CHILDREN FROM ABUSE AND NEGLECT FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH A NUMBER OF PRIVATE AND PUBLIC AGENCIES, THE PROGRAM PROVIDED EDUCATION, LEADERSHIP, AND DIRECT SERVICES FOR CHILDREN WHO WERE VICTIMS OF ABUSE AND TO PARENTS AND COMMUNITY-BASED ORGANIZATIONS TO HELP PREVENT ABUSE.CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN - VALLEY CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. TO HELP ENSURE THESE CHILDREN RECEIVE MEDICALLY APPROPRIATE CARE AT SCHOOL, VALLEY CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, VALLEY CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. VALLEY CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO REFERRING HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. IN FY2019, VALLEY CHILDREN'S PROVIDED CONTINUING MEDICAL EDUCATION TO MORE THAN 600 COMMUNITY-BASE PRIMARY CARE PHYSICIANS. PEDIATRIC SUBSPECIALTY PHYSICIANS FROM VALLEY CHILDREN'S SERVED AS FEATURED FACULTY, PROVIDING COMMUNITY-BASED PHYSICIANS WITH GUIDANCE ON A VARIETY OF PEDIATRIC MEDICAL CONDITIONS INCLUDING DERMATOLOGY, DEVELOPMENTAL DYSPLASIA OF THE HIP, HEADACHES, HERNIAS, HEART DISEASE AND EXERCISE, HYPERTENSION, NEONATAL ABSTINENCE SYNDROME, NEW ONSET SEIZURES, SHORT STATURE AND GROWTH FAILURE, AND SURGERY URGENCIES AND EMERGENCIES.PROGRAMS WERE PROVIDED AT LOCATIONS THROUGHOUT THE VALLEY CHILDREN'S SERVICE AREA, INCLUDING BAKERSFIELD, HANFORD, MADERA, MERCED, MODESTO, POTERVILLE, REEDLEY AND VISALIA.VALLEY CHILDREN'S PARTICIPATED IN A NUMBER OF INITIATIVES SUPPORTING THE HEALTHY DEVELOPMENT OF CHILDREN BOTH DURING PREGNANCY AND DURING THE FIRST THREE TO FIVE YEARS OF LIFE. EXAMPLES INCLUDE THE FOLLOWING:FRESNO COUNTY PRE-TERM BIRTH INITIATIVE: FRESNO COUNTY HAS ONE OF CALIFORNIA'S HIGHEST RATES OF PREMATURE BIRTH WITH 1 OUT OF EVERY 9 BABIES BORN TOO EARLY. PREMATURE BIRTH CAN CAUSE SERIOUS PHYSICAL AND MENTAL DISABILITIES, OR EVEN DEATH, BEFORE THE BABY'S FIRST BIRTHDAY. OVER A 10-YEAR PERIOD, THE FRESNO COUNTY PRE-TERM BIRTH INITIATIVE IS WORKING TO IMPROVE THE HEALTH OF FRESNO MOTHERS AND REDUCE THE RATE OF PREMATURE BABIES. USING AN APPROACH CALLED COLLECTIVE IMPACT, PARTNERS ACROSS MANY SECTORS HAVE COME TOGETHER TO CREATE CHANGE IN FRESNO COUNTY. VALLEY CHILDREN'S HAS BEEN AN ACTIVE PARTICIPANT IN THIS INITIATIVE, WITH VALLEY CHILDREN'S SENIOR VICE PRESIDENT FOR COMMUNITY ENGAGEMENT AND POPULATION WELLNESS SERVING AS CHAIR OF THE INITIATIVE'S STEERING COMMITTEE. CRADLE TO CAREER: BOTH FRESNO AND STANISLAUS COUNTIES HAVE BEGUN FORMAL CRADLE TO CAREER INITIATIVES FOR THE PURPOSE OF CONVENING PUBLIC AND PRIVATE SECTOR STAKEHOLDERS TO WORK TOGETHER TO IMPROVE OUTCOMES FOR CHILDREN IN THEIR COMMUNITIES, FROM PRE-CONCEPTION TO COLLEGE AND/OR VOCATIONAL TRAINING. VALLEY CHILDREN'S PARTICIPATES IN BOTH INITIATIVES AND HAS BEEN A STRONG VOICE FOR THE INCLUSION OF OUTCOMES AND INDICATORS FOCUSED ON CHILD HEALTH AND WELLNESS. HELP ME GROW FRESNO AND KERN COUNTIES: HELP ME GROW IS A COORDINATED SYSTEM OF EARLY IDENTIFICATION AND REFERRAL FOR CHILDREN AGES 0-5 WHO ARE AT RISK FOR DEVELOPMENTAL DELAYS. IN FY2019, VALLEY CHILDREN'S SUPPORTED THE IMPLEMENTATION OF HELP ME GROW IN ITS PEDIATRIC PRIMARY CARE PRACTICES IN FRESNO AND KERN COUNTIES BY PROMOTING THE USE OF A SPECIFIC DEVELOPMENTAL ASSESSMENT AND SCREENING TOOL THAT IS PART OF THE HELP ME GROW MODEL. MARCH OF DIMES: VALLEY CHILDREN'S PARTNERED CLOSELY WITH THE MARCH OF DIMES TO ADVOCATE ON BEHALF OF POLICIES AT THE STATE AND FEDERAL LEVEL THAT PROMOTE HEALTHY PREGNANCIES AND HEALTHY BABIES. IN 2019, VALLEY CHILDREN'S DIRECTOR OF COMMUNITY AND GOVERNMENT RELATIONS CHAIRED THE MARCH OF DIMES OF CALIFORNIA'S ADVOCACY AND GOVERNMENT AFFAIRS COMMITTEE AND VALLEY CHILDREN'S DIRECTOR FOR CLINICAL CARE SERVED ON THE MARCH OF DIMES CENTRAL VALLEY DIVISION BOARD OF DIRECTORS.BEHAVIORAL HEALTH - BEHAVIORAL HEALTH IS ONE OF THE MOST PRESSING NEEDS FACING CHILDREN IN CALIFORNIA - WITH CHILDREN IN VALLEY CHILDREN'S HEALTHCARE'S SERVICE AREA PARTICULARLY UNDERSERVED DUE TO THE GEOGRAPHY, PROVIDERS SHORTAGES, AND LIMITED COMMUNITY-BASED SERVICES. IN 2019, VALLEY CHILDREN'S DEMONSTRATED ITS COMMITMENT TO MEETING THE MENTAL HEALTH NEEDS OF CHILDREN IN A NUMBER OF WAYS. AT THE LOCAL LEVEL, VALLEY CHILDREN'S STAFF PROVIDED TEEN SUICIDE PREVENTION EDUCATION TO STUDENTS AND STAFF AT AREA HIGH SCHOOLS. IN ADDITION, VALLEY CHILDREN'S STAFF EITHER LED OR PARTICIPATED IN A NUMBER OF COMMUNITY-BASED INITIATIVES, INCLUDING SERVING AS MEMBERS OF THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND THE MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE, AS WELL AS CHAIRING COMMUNITY CONVERSATIONS, A COMMUNITY-WIDE PARTNERSHIP ADDRESSING ISSUES OF MENTAL HEALTH, HOMELESSNESS, AND THEIR IMPACT ON FAMILIES. VALLEY CHILDREN'S ALSO PROVIDED EDUCATION AND RESOURCES FOR COMMUNITY STAKEHOLDERS, INCLUDING CONTINUING MEDICAL EDUCATION FOR COMMUNITY-BASED PROVIDERS IN COLLABORATION WITH THE AMERICAN ACADEMY OF PEDIATRICS CALIFORNIA CHAPTER 1 MENTAL HEALTH ACCESS TASK FORCE. IN SEPTEMBER 2019, VALLEY CHILDREN'S ANNOUNCED A PARTNERSHIP WITH UNIVERSAL HEALTH SERVICES (UHS), ONE OF THE NATION'S LARGEST AND MOST RESPECTED PROVIDERS OF HOSPITAL AND HEALTHCARE SERVICES. UNDER THE PARTNERSHIP, UHS WILL CONSTRUCT AN 81,600-SQUARE-FOOT, 128-BED BEHAVIORAL HEALTH HOSPITAL FOR CHILDREN AND ADULTS IMMEDIATELY ADJACENT TO THE VALLEY CHILDREN'S HOSPITAL CAMPUS IN MADERA. THE FACILITY WILL INCLUDE A 24-BED INPATIENT UNIT FOR CHILDREN AND ADOLESCENTS, AGES 5 -17, REPRESENTING A 49% INCREASE IN AVAILABLE BEDS FOR KIDS FROM KERN TO SAN JOAQUIN COUNTIES. THE HOSPITAL IS EXPECTED TO OPEN IN 2022.WHILE THE PERMITTING AND CONSTRUCTION PROCESS GETS UNDERWAY, UHS WILL WORK CLOSELY WITH VALLEY CHILDREN'S TO INVEST RESOURCES IN MEETING IMMEDIATE BEHAVIORAL HEALTH NEEDS, ESTABLISHING ADDITIONAL TELE-PSYCHIATRY SERVICES IN SUPPORT OF OUR HOSPITAL AND PRIMARY CARE SERVICES, AND DEVELOPING A NEW PSYCHIATRY RESIDENCY PROGRAM IN THE REGION. AT THE STATE LEVEL, VALLEY CHILDREN'S STAFF SERVED ON AND CHAIRED CALIFORNIA'S MENTAL HEALTH SERVICES OVERSIGHT & ACCOUNTABILITY COMMISSION AND HELPED SUCCESSFULLY ADVOCATE FOR AN INCREASE IN MEDI-CAL COVERAGE FOR POSTPARTUM DEPRESSION.INJURY PREVENTION - VALLEY CHILDREN'S OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. IN FY2019, THE PROGRAM RECORDED 14,132 CONTACTS WITH CHILDREN, PARENTS, HEALTHCARE PROFESSIONAL AND OTHERS AT 113 DIFFERENT COMMUNITY, MEDIA AND PROFESSIONAL EVENTS CONCERNING THE FOLLOWING TOPICS: CHILD PASSENGER SAFETY, ABUSIVE HEAD TRAUMA, PEDESTRIAN SAFETY, SAFE SLEEP, TRAUMATIC BRAIN INJURY (HELMET SAFETY), HALLOWEEN SAFETY, POISON PREVENTION, RESPONDING TO A BLEEDING EMERGENCY, DRIVER SAFETY AND AWARENESS (INCLUDING DRUNK/DISTRACTED DRIVING), BABY BASICS, MEDICATION SAFETY, CHOKING PREVENTION, HOME SAFETY, CONCUSSION PREVENTION AND MANAGEMENT, BICYCLE SAFETY, PEDIATRIC TRAUMA, WATER SAFETY AND SUICIDE PREVENTION. THE MISSION OF VALLEY CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND IS AN INDEPENDENT NON PROFIT ORGANIZATION GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES WHICH IS THEREFORE ACCOUNTABLE TO OUR COMMUNITY AND ONLY OUR COMMUNITY. PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES CA 1 BUDDHIST TZU CHI MEDICAL FOUNDATION 1008 S GARFIELD AVE ALHAMBRA CA 91801 954457939 501(C)(3) 8333 SPONSORSHIP PROFESSIONAL RESEARCH CONSULTANTS INC 11326 P ST OMAHA NE 68137 470628654 8500 COMMUNITY HEALTH NEEDS CLOVIS BOTANICAL GARDEN COMMITTEE INC 1865 HERNDON AVE STE K BOX 330 CLOVIS CA 93611 770382551 501(C)(3) 15000 SPONSORSHIP SAN JOAQUIN VALLEY RIVER PARKWAY 11605 OLD FRIANT ROAD FRESNO CA 93730 770196692 501(C)(3) 15000 SPONSORSHIP CSUF FOUNDATION PO BOX 26267 FRESNO CA 93729 946003272 501(C)(3) 25000 SPONSORSHIP CATHOLIC CHARITIES DIOCESE OF FRESNO 149 N FULTON ST FRESNO CA 93701 941678938 501(C)(3) 30000 SPONSORSHIP MARJAREE MASON CENTER INC 1600 M STREET FRESNO CA 93721 941156639 501(C)(3) 65000 SPONSORSHIP VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 936368782 464150987 501(C)(3) 9639441 DONATION VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA CA 936368782 464150987 501(C)(3) 575000 DONATION 8 1 NURSING SCHOLARSHIP 11 22000 EDUCATION SCHOLARSHIP - RESPIRATORY FOCUS 2 2000 EDUCATION SCHOLARSHIP - NEONATAL FOCUS 2 5000 CAFETERIA MEALS 13200 81180 FMV MEAL COUPONS FOR PATIENT FAMILIES TAXI, BUS AND TRANSIT SERVICES 652 131810 BOOK SUBSIDIZATION OF BUS AND TRANSIT SERVICES PART I, LINE 2: NURSING SCHOLARSHIPS ARE DESIGNED TO HELP EMPLOYEES MEET FINANCIAL NEEDS THAT ARE NOT COVERED BY OTHER TUITION REIMBURSEMENT PROGRAMS. A SCHOLARSHIP COMMITTEE REVIEWS APPLICATIONS BI-ANNUALLY BASED ON CERTAIN CRITERIA. RECIPIENTS ARE CHOSEN BY THE COMMITTEE AND THE CHIEF NURSING OFFICER APPROVES THE SELECTIONS. ALL RECIPIENTS ARE EMPLOYEES OF THE HOSPITAL AND THE HOSPITAL IS MADE AWARE WHEN THE RECEIPIENT COMPLETES THEIR EDUCATION. OTHER SERVICES ARE PURCHASED FROM VARIOUS VENDORS AND ARE SUPPLIED TO PATIENTS AND THEIR FAMILIES. THE RECORDS FOR THESE PURCHASED SERVICES ARE MAINTAINED BY THE HOSPITAL. X 1 1 X X X X 0 1 0 1 1 1 1 0 0 TODD SUNTRAPAK CEO 1049041 0 336667 0 216205 0 -317728 0 27196 0 1311381 0 145530 0 MICHELE R WALDRON SVP, CFO 550239 0 155934 0 109235 0 -367753 0 16318 0 463973 0 69875 0 DEBRA FLORES PRESIDENT & COO (THRU 4/19) 479702 0 6274 0 22589 0 8048 0 0 0 516613 0 0 0 DAVID CHRISTENSEN SVP, MEDICAL AFFAIRS & CPE 605524 0 175680 0 131681 0 113909 0 27196 0 1053990 0 100740 0 BEVERLY HAYDEN-PUGH SVP, CLINICAL INT, PATIENT EXP 445423 0 129813 0 921222 0 -520081 0 10878 0 987255 0 897606 0 MICHAEL GOLDRING PRESIDENT, VCMG 466770 0 133458 0 81454 0 91291 0 10878 0 783851 0 60002 0 WILLIAM CHALTRAW SVP/CHIEF LEGAL OFFICER 394834 0 112393 0 27891 0 79909 0 21757 0 636784 0 8367 0 KAREN DAHL VP, QUALITY & PATIENT SAFETY 381493 0 96721 0 68804 0 78829 0 5439 0 631286 0 49303 0 KEVIN SHIMAMOTO VP AND CIO 353662 0 89941 0 87376 0 71791 0 5439 0 608209 0 64855 0 NATALE PONTICELLO JR SVP, CHIEF PEOPLE OFFICER 319402 0 97501 0 110551 0 72699 0 0 0 600153 0 62920 0 JOEL BROWNELL MD VP, CHIEF MEDICAL INFO OFFICER 322683 0 82430 0 72971 0 70026 0 16318 0 564428 0 56750 0 DAVID SINGH VP, COO OF VCMG 319583 0 81574 0 71379 0 61450 0 0 0 533986 0 49726 0 LYNNE ASHBECK SVP, COMM ENGAGEMENT & POP. WELLNESS 335283 0 45176 0 43938 0 45833 0 0 0 470230 0 32368 0 DANIELLE BARRY VP, REVENUE CYCLE MGMT 264197 0 61356 0 18477 0 48027 0 21757 0 413814 0 18104 0 BRIAN SMULLIN VP, MANAGED CARE 264911 0 61611 0 984 0 51702 0 21757 0 400965 0 0 0 JOLIE LIMON VP ACAD AFFAIRS, DIO & CHIEF OF PED 313275 0 55665 0 1158 0 20700 0 2266 0 393064 0 0 0 JANE WILLSON SVP, CHIEF STRATEGY OFFICER 378732 0 105220 0 114857 0 19678 0 5439 0 623926 0 70681 0 DAVID HODGE JR VP CLINICAL OPS & ANCILLARY SVCS 276099 0 67136 0 16586 0 13324 0 21757 0 394902 0 0 0 STEPHANIE VANCE FINANCE, VP 263215 0 68607 0 57177 0 -11668 0 21757 0 399088 0 38006 0 DANIEL DAVIS VP, PATIENT CARE (THRU 4/19) 266751 0 70681 0 63661 0 -149960 0 6346 0 257479 0 38632 0 JESSIE HUDGINS VP, FACILITIES 261875 0 74035 0 112016 0 34770 0 16318 0 499014 0 53501 0 TRACY BLAIR EXEC DIR.&DEP GEN.COUNC.(THRU 7/19) 235106 0 40831 0 5480 0 -27201 0 4533 0 258749 0 0 0 KRISTINE AUBRY EXEC DIREC.AMB. SVCS (THRU 4/19) 232003 0 34407 0 821 0 -45364 0 3173 0 225040 0 0 0 THOMAS ORR SUPV PHARMACY HOME INFUSION 234592 0 0 0 1165 0 10304 0 10878 0 256939 0 0 0 YVONNE WOOD MANAGER PATIENT THROUGHPUT 227373 0 1448 0 246 0 -48191 0 21757 0 202633 0 0 0 PART I, LINE 1A TODD SUNTRAPAK AND BEVERLY HAYDEN-PUGH FLEW BUSINESS/FIRST CLASS TO ATTEND A MEETING RELATED TO THE IMPLEMENTATION OF A NEW ELECTRONIC MEDICAL RECORD SYSTEM THAT THE ENTITY INSTALLED. NO PART OF THE EXPENSE WAS TREATED AS TAXABLE COMPENSATION TO ANY OF THE EMPLOYEES. PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE 1) A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), 2) A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES AND 3) A NONCONTRIBUTORY, NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (DCSERP) AND 4) A SPLIT DOLLAR LIFE INSURANCE PROGRAM AVAILABLE TO CERTAIN KEY EXECUTIVES (SEE SCHEDULE L PART V FOR A BROADER DESCRIPTION). TODD SUNTRAPAK, BEVERLY HAYDEN-PUGH, MICHAEL GOLDRING, DAVID HODGE JR, DANIELLE BARRY, LYNNE ASHBECK, AND BRIAN SMULLIN ARE ELIGIBLE TO CONTRIBUTE TO THE DEFERRED COMPENSATION PLAN, BUT NO CONTRIBUTIONS WERE MADE. $1,879,702 WAS PAID OUT OF THE DCSERP PLAN DURING THE YEAR. EMPLOYER CONTRIBUTIONS TO THE DCSERP AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR CALENDAR YEAR 2018 ARE AS FOLLOWS: MICHELE WALDRON - DCSERP $83,162; NOT ELIGIBLE FOR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $477,015. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO A PERSONAL IRA ACCOUNT. TODD SUNTRAPAK - NOT ELIGIBLE FOR DCSERP OR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $333,928. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO A PERSONAL IRA ACCOUNT. BEVERLY HAYDEN-PUGH - DCSERP $67,745; CHANGE IN SERP ACTUARIAL VALUE $0. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $613,926. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO A PERSONAL IRA ACCOUNT. OTHER REPORTABLE COMPENSATION INCLUDES A PAYOUT FROM THE SERP PLAN IN THE AMOUNT OF $829,849. JESSIE HUDGINS - DCSERP $43,380; CHANGE IN SERP ACTUARIAL VALUE $14,394. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $437,158. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO AN EMPLOYER SPONSORED PLAN. DAVID CHRISTENSEN - DCSERP $93,209; NOT ELIGIBLE FOR SERP. JANE WILLSON - DCSERP $56,523; CHANGE IN SERP ACTUARIAL VALUE $7,147. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $302,677. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO AN EMPLOYER SPONSORED PLAN. DAVID SINGH - DCSERP $48,973; CHANGE IN SERP ACTUARIAL VALUE $0. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $39,836. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO AN EMPLOYER SPONSORED PLAN. STEPHANIE VANCE - DCSERP $41,760; NOT ELIGIBLE FOR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $207,714. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO AN EMPLOYER SPONSORED PLAN. NATALIE PONTICELLO - DCSERP $51,999; NOT ELIGIBLE FOR SERP. MICHAEL GOLDRING - DCSERP $70,591; NOT ELIGIBLE FOR SERP. JOEL BROWNELL - DCSERP $49,326; NOT ELIGIBLE FOR SERP. KAREN DAHL - DCSERP $58,147; NOT ELIGIBLE FOR SERP. KEVIN SHIMAMOTO - DCSERP $51,195; NOT ELIGIBLE FOR SERP. DANIEL DAVIS - DCSERP $42,220; NOT ELIGIBLE FOR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $217,551. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO A PERSONAL IRA ACCOUNT. DANIELLE BARRY - DCSERP $36,081; NOT ELIGIBLE FOR SERP. BRIAN SMULLIN - DCSERP $37,132; NOT ELIGIBLE FOR SERP. WILLIAM CHALTRAW - DCSERP $60,027; NOT ELIGIBLE FOR SERP. DAVID HODGE - DCSERP $36,319; NOT ELIGIBLE FOR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $172,734. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO AN EMPLOYER SPONSORED PLAN. LYNNE ASHBECK - DCSERP $32,363; NOT ELIGIBLE FOR SERP. DEBRA FLORES - DCSERP $8,048; NOT ELIGIBLE FOR SERP. TRACY BLAIR - NOT ELIGIBLE FOR DCSERP OR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $43,221. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO A PERSONAL IRA ACCOUNT. KRISTINE AUBRY - NOT ELIGIBLE FOR DCSERP OR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $62,360. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO A PERSONAL IRA ACCOUNT. THOMAS ORR - NOT ELIGIBLE FOR DCSERP OR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $177,885. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO AN EMPLOYER SPONSORED PLAN. YVONNE WOOD - NOT ELIGIBLE FOR DCSERP OR SERP. DEFERRED COMPENSATION ALSO INCLUDES A DECREASE IN ACTUARIAL VALUE FOR THE DEFINED BENEFIT PLAN IN THE AMOUNT OF $211,367. THE PLAN WAS TERMINATED AND THE EMPLOYEE ELECTED TO TRANSFER THE FUNDS INTO AN EMPLOYER SPONSORED PLAN. PART I, LINE 5 AN EXECUTIVE INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON BOTH NETWORK WIDE AND INDIVIDUAL GOALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING REVENUE, OPERATIONAL AND QUALITY RESULTS OF THE HOSPITAL AND ITS RELATED ENTITIES. THE INCENTIVE PLAN HAS BEEN APPROVED BY THE COMPENSATION COMMITTEE OF THE VALLEY CHILDREN'S HEALTHCARE BOARD OF TRUSTEES. THE COMMITTEE REVIEWS THE FORECASTED PAYOUTS AT THE END OF EACH YEAR BASED ON THE FINANCIAL AND OPERATING RESULTS. PART I, LINE 6 SEE EXPLANATION FOR LINE 5, ABOVE TODD SUNTRAPAK CURRENT OFFICER SEE BELOW X 10434500 10898042 0 1 1 MICHELE WALDRON CURRENT OFFICER SEE BELOW X 8325373 8578022 0 1 1 DAVID CHRISTENSEN CURRENT KEY EMPLOYEE SEE BELOW X 5013793 5165946 0 1 1 WILLIAM CHALTRAW CURRENT KEY EMPLOYEE SEE BELOW X 2014651 2075790 0 1 1 MICHAEL GOLDRING CURRENT KEY EMPLOYEE SEE BELOW X 5228683 5369375 0 1 1 32087175 PART II, COLUMN C: THE ORGANIZATION PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS THROUGH AN ALTERNATIVE FUNDING ARRANGEMENT THE IRS CALLS "COLLATERAL ASSIGNMENT SPLIT DOLLAR" (CASD). ALTHOUGH THE IRS REQUIRES REPORTING IN THE LOAN SECTION OF THE SCHEDULE L, CASD IS NOT AN ACTUAL LOAN AS NO FUNDS ARE TRANSFERRED TO THE EXECUTIVES. RATHER, THE "LOAN" TREATMENT APPLIES BECAUSE AFTER THE EXECUTIVES HAVE RECEIVED RETIREMENT BENEFITS, THE ORGANIZATION RECOVERS ALL OF ITS OUTLAYS PLUS INTEREST. X 1 3354608 FMV 0 0 1 0 PART I, COLUMN (B): THE NUMBER IN COLUMN B IS BASED ON THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART III, LINE 4A: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE I. DESCRIPTION OF PROGRAM SERVICE ONE NEARLY 70 YEARS AGO, OUR FOUNDING MOTHERS HAD A DREAM TO CARE FOR CHILDREN IN A HOSPITAL AS SPECIAL AS ITS PATIENTS. VALLEY CHILDREN'S HOSPITAL HAS FLOURISHED EVER SINCE, CARING FOR HUNDREDS OF THOUSANDS OF CHILDREN. OUR MISSION GUIDES US AS WE TRAVEL THE ROAD TO OUR FUTURE ALONGSIDE STAFF, PHYSICIANS, CHILDREN, FAMILIES, OUR COMMUNITY AND OUR PARTNERS THROUGHOUT THE REGION. MISSION THE MISSION OF VALLEY CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. VISION OUR VISION CAPTURES THE PATH WE'VE TRAVELED AND SHOWCASES OUR COMMITMENT AND PASSION TO BE THE BEST. OUR CLEAR FOCUS IS TO CONTINUE TO PROVIDE THE BEST CARE AND THE BEST QUALITY PEDIATRIC SERVICES AVAILABLE ANYWHERE WITH A VISION TO BECOME THE NATION'S BEST CHILDREN'S HOSPITAL. CORE VALUES THE FOLLOWING CORE ORGANIZATIONAL VALUES GUIDE THE INVESTMENTS AND SUPPORT PROVIDED BY VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM. EXCELLENCE - WE DEPEND ON EXCEPTIONAL PEOPLE TO PROVIDE EXCEPTIONAL QUALITY HEALTH CARE AND SERVICES THROUGHOUT VALLEY CHILDREN'S HOSPITAL. WE SET HIGH STANDARDS AND WE SUPPORT EACH OTHER AS WE STRIVE TO ACHIEVE THEM. WE INVEST IN EACH OTHER AND WE VALUE THE INDIVIDUAL AND CULTURAL DIFFERENCES THAT MAKE US STRONG. WE ARE PROUD OF OUR SUPERIOR SERVICES AS MEASURED BY QUALITY OUTCOMES. COMPASSIONATE CARE - WE TREAT EVERY CHILD, EVERY FAMILY, EACH OTHER, OUR VISITORS AND OUR VENDORS WITH RESPECT, KINDNESS, HOPE, JOY AND GOOD HUMOR. WE DISPLAY OUR HELPFUL, HEALING, FAMILY-CENTERED SPIRIT AT EVERY OPPORTUNITY. WE RECOGNIZE THE IMPORTANCE OF PLAYFULNESS IN HUMAN INTERACTION AND IN THE HEALTH OF CHILDREN. WE LOOK FOR WAYS TO EASE SUFFERING AND PROVIDE COMFORT. INTEGRITY - WE ARE HONEST, ETHICAL AND RESPONSIBLE IN OUR WORK AND IN THE WAY WE DEAL WITH OTHERS. WE KEEP OUR PROMISES AND ADMIT OUR MISTAKES. WE KNOW OURSELVES AND WE AVOID HIDDEN AGENDAS. BY THE WAY WE LIVE OUR LIVES EVERYDAY, WE ARE WORTHY OF THE TRUST PEOPLE PLACE IN US. INNOVATION - WE EMBRACE CHANGE, CREATIVITY, CONTINUOUS LEARNING AND PERSONAL GROWTH. WE INCORPORATE NEW IDEAS, TECHNOLOGY AND METHODS TO IMPROVE THE HEALTH CARE AND SERVICES WE PROVIDE. WE ANTICIPATE FUTURE TRENDS AND WE CREATE STRATEGIC PLANS TO INSURE FUTURE GROWTH AND CONTINUED VITALITY. COLLABORATION - WE BUILD ENDURING INTERNAL AND EXTERNAL RELATIONSHIPS, JOINING WITH COLLEAGUES ACROSS ORGANIZATIONAL BOUNDARIES TO IMPROVE THE CARE AND SERVICES WE PROVIDE. WE ENCOURAGE AND REWARD BOTH INDIVIDUAL AND TEAM ACHIEVEMENTS. WE PUT THE COMMON GOOD AHEAD OF NARROW INTERESTS. STEWARDSHIP - WE ARE RESOURCEFUL, ADAPTABLE AND RESILIENT. WE HAVE A "CAN DO" ATTITUDE THAT GETS THE JOB DONE. WE ARE FISCALLY RESPONSIBLE AND EFFICIENT WITH OUR TIME. WE PROTECT OUR RESERVES AND MANAGE OUR OPERATING COSTS IN ORDER TO INVEST IN THE NEXT GENERATION OF KIDS. WE ARE EACH PERSONALLY DEDICATED TO MAKING VALLEY CHILDREN'S HOSPITAL BETTER BECAUSE WE WERE HERE. COMMITMENT TO THE COMMUNITY VALLEY CHILDREN'S IS CENTRAL CALIFORNIA'S ONLY HIGH-QUALITY, COMPREHENSIVE HEALTH CARE NETWORK DEDICATED TO CHILDREN, FROM BEFORE BIRTH TO YOUNG ADULTHOOD, AS WELL AS TO HIGH RISK PREGNANT WOMEN, AND AS SUCH PLAYS A VITAL ROLE IN MEETING THE HEALTH CARE NEEDS OF SOME OF OUR REGION'S SICKEST AND MOST MEDICALLY VULNERABLE RESIDENTS. VALLEY CHILDREN'S NETWORK IS ANCHORED BY A 330-BED STAND-ALONE CHILDREN'S HOSPITAL IN MADERA PLUS THREE NEONATAL UNITS (28 BEDS IN TOTAL) LOCATED ACROSS CENTRAL CALIFORNIA. IN ADDITION, VALLEY CHILDREN'S NETWORK INCLUDES PEDIATRIC SPECIALTY CARE CENTERS, PEDIATRIC PRIMARY CARE PRACTICES, AN URGENT CARE CENTER AND WOMEN'S HEALTH SERVICES LOCATED STRATEGICALLY THROUGHOUT THE REGION TO BEST MEET THE NEEDS OF CHILDREN AND THEIR FAMILIES. VALLEY CHILDREN'S CONSISTENTLY RANKS AT THE TOP OF ITS PEER GROUP FOR QUALITY PATIENT OUTCOMES AS EVIDENCED BY ITS DESIGNATION BY THE LEAP FROG GROUP IN 2019 AS ONE OF THE NATION'S TOP 10 CHILDREN'S HOSPITALS FOR EXCELLENCE IN PATIENT SAFETY AND QUALITY, ITS MAGNET DESIGNATION FOR NURSING EXCELLENCE, ITS BEACON AWARD FOR EXCELLENCE IN CRITICAL CARE, AND ITS U.S. NEWS AND WORLD REPORT RECOGNITION IN 2019 AS ONE OF THE NATION'S BEST CHILDREN'S HOSPITALS FOR NEONATOLOGY, PEDIATRIC ORTHOPEDICS, PEDIATRIC DIABETES & ENDOCRINOLOGY, PEDIATRIC GASTROENTEROLOGY & GASTROINTESTINAL SURGERY, AND PEDIATRIC UROLOGY. WHILE PROVIDING EXCEPTIONAL CARE IS THE SINGLE GREATEST CONTRIBUTION THE HOSPITAL MAKES FOR OUR CHILDREN AND THEIR FAMILIES, THE HOSPITAL ALSO APPRECIATES THAT IT IS UNIQUELY POSITIONED TO SUPPORT THE NEEDS OF CHILDREN IN OTHER WAYS AS WELL. AS AN EXTENSION OF THE HOSPITAL'S MISSION AND VISION, THE GOAL OF VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS TO ADVANCE THE HEALTH AND WELLBEING OF UNDERSERVED, MEDICALLY NEEDY CHILDREN THROUGH COLLABORATION AND COMMON CONCERN. II. SERVICE AREA DEMOGRAPHICS AND PATIENT VOLUME SERVICE AREA DEMOGRAPHICS AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, VALLEY CHILDREN'S HOSPITAL'S SERVICE AREA EXTENDS FROM SAN JOAQUIN COUNTY IN THE NORTH TO KERN COUNTY IN THE SOUTH, AND SERVES MUCH OF THE CENTRAL COAST AND EASTERN AS WELL. VALLEY CHILDREN'S HOSPITAL'S PATIENT VOLUME IN 2019, VALLEY CHILDREN'S HOSPITAL HAD 12,139 INPATIENT CASES, 108,335 EMERGENCY DEPARTMENT VISITS AND A COMBINED 305,096 HOSPITAL BASED OUTPATIENT SPECIALTY CARE CENTER, REGIONAL SPECIALTY CARE CENTER, PRIMARY CARE CENTER, AND URGENT CARE VISITS. MEDI-CAL COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 77% OF TOTAL OUTPATIENT VISITS AT THE HOSPITAL. FORM 990, PART III, LINE 4A III. COMMUNITY BENEFITS PROGRAM ACCORDING TO THE CATHOLIC HEALTH ASSOCIATION, COMMUNITY BENEFITS ARE GENERALLY DEFINED AS THOSE ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING IN RESPONSE TO IDENTIFIED COMMUNITY NEEDS, AND MEET AT LEAST ONE OF THE FOLLOWING OBJECTIVES: - IMPROVE ACCESS TO HEALTH CARE SERVICES - ENHANCE HEALTH OF THE COMMUNITY - ADVANCE MEDICAL OR HEALTH CARE KNOWLEDGE - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR PRIVATE, COMMUNITY-BASED EFFORTS ALSO INCLUDED IN THE DEFINITION IS THE PROVISION OF CHARITY CARE AND THE UNREIMBURSED COST OF PROVIDING HEALTH CARE SERVICES TO THOSE ENROLLED IN PUBLIC PROGRAMS, INCLUDING MEDI-CAL. IN FY 2019, VALLEY CHILDREN'S HOSPITAL PROVIDED COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS WITHIN ITS SERVICE AREA. A SUMMARY OF THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS IN 2019: *COMMUNITY HEALTH EDUCATION CLINICAL PARTNERSHIPS VALLEY CHILDREN'S CLINICAL PARTNERSHIP PROGRAM BRINGS TOGETHER INSTITUTIONS FOCUSED ON ENHANCING NEONATAL AND PEDIATRIC CARE, REGARDLESS IF THE ILL OR INJURED CHILD BECOMES A VALLEY CHILDREN'S PATIENT. THIS EFFORT HELPS PREVENT CHILDREN FROM BEING TRANSFERRED OR REFERRED UNNECESSARILY TO VALLEY CHILDREN'S, AS WELL AS POTENTIALLY IDENTIFIES EARLIER WHEN A CHILD NEEDS ADVANCED PEDIATRIC CARE. WITH IMPROVED COMMUNICATION AND TOOLS, WE DECREASE STRESS FOR PATIENTS AND FAMILIES AND INCREASE PROVIDER CONFIDENCE IN PROVIDING PEDIATRIC CARE, WHILE ENHANCING PERFORMANCE AT BOTH INSTITUTIONS. THE GOALS OF OUR CLINICAL PARTNERSHIPS INCLUDE PROVIDING: -IMPROVED QUALITY AND CONFIDENCE IN PROVIDING PEDIATRIC CARE -MORE CARE DELIVERED CLOSER TO HOME -ENHANCED, COORDINATED CARE IN 2019, VALLEY CHILDREN'S SUPPORTED 16 INPATIENT CLINICAL PARTNERS AND 2 OUTPATIENT CLINICAL PARTNERS. INJURY PREVENTION VALLEY CHILDREN'S OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. IN FY2019, THE PROGRAM RECORDED 14,132 CONTACTS WITH CHILDREN, PARENTS, HEALTHCARE PRFESSIONALS AND OTHERS AT 113 DIFFERENT COMMUNITY, MEDIA, AND PROFESSONALS EVENTS, COVERING THE FOLLOWING TOPICS: CHILD PASSENGER SAFETY, ABUSIVE HEAD TRAUMAS, SAFE SLEEP, TRAUMATIC BRAIN INJURY (HELMET SAFETY), HALLOWEEN SAFETY, POISON PREVENTION, RESPONDING TO A BLEEDING EMERGENCY, DRIVER SAFETY AWARENESS (INCLUDING DRUNK/ DISTRACTED DRIVING), BABY BASICS, MEDICATION SAFETY, CHOKING PREVENTION, HOME SAFETY, CONCUSSION PREVENTION AND MANAGEMENT, BICYCLE SAFETY, PEDIATRIC TRAUMA, WATER SAFETY AND SUICIDE PREVENTION. REGARDING BICYCLE SAFETY, VALLEY CHILDREN'S DISTRIBUTED 582 BICYCLE HELMETS TO CHILDREN AND FAMILIES WHOSE EXISTING HELMETS DID NOT MEET MINIMUM SAFETY STANDARDS OR WHO DID NOT HAVE HELMETS AT ALL. REGARDING CAR SEAT SAFETY, VALLEY CHILDREN'S CONDUCTED SAFETY CHECKS ON 579 CAR SEATS AND DISTRIBUTED 298 CAR SEATS TO FAMILIES WHOSE EXISTING CAR SEATS DID NOT MEET MINIMUM SAFETY STANDARDS OR WHO SIMPLY DID NOT HAVE A CAR SEAT AND NEEDED ONE. MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN VALLEY CHILDREN'S RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY-BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. THE HOSPITAL PROVIDED OUTREACH EDUCATION TO HOSPITAL STAFF AND COMMUNITY-BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN, INCLUDING CHILDREN WITH TRACHEOSTOMIES AND VENTILATORS. ADAPTIVE SPORTS PROGRAM VALLEY CHILDREN'S ADAPTIVE SPORTS PROGRAM PROVIDES FREE RECREATIONAL AND ATHLETIC EXPERIENCES FOR CHILDREN, ADOLESCENTS AND YOUNG ADULTS WITH DISABILITIES, REGARDLESS OF WHETHER THEY HAVE BEEN OR CURRENTLY ARE PATIENTS AT VALLEY CHILDREN'S. THE ONLY ONE OF ITS KIND IN CENTRAL CALIFORNIA, THE PROGRAM IS DESIGNED FOR INDIVIDUALS WITH PHYSICAL IMPAIRMENTS AND CONDITIONS RANGING FROM CEREBRAL PALSY TO SPINAL CORD INJURIES. DISABLED YOUTH UP TO AGE 21 ARE ESPECIALLY ENCOURAGED TO ATTEND. * HEALTH CARE SUPPORT SERVICES VALLEY CHILDREN'S PROVIDED HEALTH CARE SUPPORT SERVICES TO HELP ADDRESS THE HEALTH CARE NEEDS OF CHILDREN AND THEIR FAMILIES, AT HOME, AT SCHOOL, AND IN THE COMMUNITY. CHILD ABUSE PREVENTION THE GUILDS OF VALLEY CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER'S MISSION IS TO PROVIDE COMPREHENSIVE SERVICES TO CHILDREN, DEPENDENT ADULTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY, CHILD-FRIENDLY PROGRAM, AND TO MEET THE PHYSICAL AND EMOTIONAL NEEDS OF VICTIMS WITH ABUSE CONSIDERATIONS. THE CENTER'S VISION IS TO BE THE PREMIER PROVIDER IN CENTRAL CALIFORNIA FOR DIAGNOSTIC PHYSICAL ABUSE ASSESSMENTS, FOSTER CARE MEDICAL CLEARANCE EXAMINATIONS AND PEDIATRIC SEXUAL ASSAULT EVALUATIONS, INCLUDING CHILDREN WHO HAVE BEEN VICTIMS OF COMMERCIAL SEXUAL EXPLOITATION. ADDITIONALLY, THE CENTER'S PROVIDERS, KNOWN AS THE CHILD ADVOCACY TEAM, REGULARLY TESTIFY IN BOTH DEPENDENCY AND CRIMINAL COURTS THROUGHOUT THE VALLEY. THE CENTER IS RECOGNIZED IN CENTRAL CALIFORNIA AND AROUND THE STATE AS A LEADER IN ADVOCACY,INJURY PREVENTION, CLINICAL RESEARCH AND ACADEMIC TRAINING. IN FY2018, THE CENTER BECAME A MEMBER OF THE CHILD ADVOCACY CENTERS OF CALIFORNIA, CENTRAL CHAPTER. MEMBERSHIP PROVIDES A NUMBER OF BENEFITS AND OPPORTUNITIES TO EXPAND EFFORTS IN CHILD ABUSE PREVENTION AND TREATMENT. ACCORDING TO THE REPORT "CHILD MALTREATMENT 2018," AN ESTIMATED 4.3 MILLION REFERRALS INVOLVING THE SUSPECTED MALTREATMENT OF ABOUT 7.8 MILLION CHILDREN WERE MADE TO CHILD PROTECTIVE SERVICES (CPS) AGENCIES IN THE UNITED STATES IN 2018. THIS IS AN INCREASE OF APPROXIMATELY 16.4% REFERRALS FROM 2014. IN CALIFORNIA, AN ESTIMATED 408,666 SUSPECTED CHILD MALTREATMENT REPORTS WERE COMPLETED, OF WHICH ABOUT 84,231 REPORTS CAME FROM VALLEY CHILDREN'S SERVICE AREA. THE CENTER INCLUDES THE CHILD ADVOCACY CLINIC, WHICH OPERATES FIVE DAYS A WEEK AND SEES APPROXIMATELY 1,000 CHILDREN EACH YEAR. CENTER PROVIDERS ALSO ARE AVAILABLE SEVEN DAYS A WEEK, 24 HOURS A DAY FOR EMERGENCY COVERAGE. THE CENTER INCLUDES AN INPATIENT COMPONENT THAT EVALUATES ABOUT 100 CHILDREN YEARLY IN THE PEDIATRIC EMERGENCY DEPARTMENT, ACUTE-CARE FLOORS AND PEDIATRIC INTENSIVE CARE UNIT. THESE CHILDREN ARE EVALUATED FOR SUSPECTED PHYSICAL ABUSE, SEXUAL ABUSE AND NEGLECT. THE STAFF INCLUDES CHILD ABUSE PEDIATRICIANS, NURSE PRACTITIONERS SPECIALIZED IN CHILD MALTREATMENT, FORENSIC NURSES, SOCIAL WORKERS, FORENSIC INTERVIEWERS, A CENTER COORDINATOR, A LICENSED MENTAL HEALTH PROVIDER AND SUPPORT STAFF. IN ADDITION TO THE CLINICAL SERVICES OFFERED BY THE CENTER, A MULTI-DISCIPLINARY INTERVIEWING CENTER IS ALSO AVAILABLE FOR VICTIMS OR WITNESSES OF CRIMES. FORENSIC INTERVIEWING SERVICES ARE REQUESTED BY LAW ENFORCEMENT AND/OR CPS. THE PURPOSE OF THE FORENSIC INTERVIEWING PROGRAM COMPONENT IS TO REDUCE THE NUMBER OF INTERVIEWS AND DECREASE THE NUMBER OF INDIVIDUALS WHO WILL TALK TO THE VICTIM. THE CENTER STRIVES TO PROVIDE A WELCOMING, CHILD-FRIENDLY ENVIRONMENT WHERE CHILDREN/DEPENDENT ADULTS CAN FEEL SAFE AND BE INTERVIEWED BY A TRAINED PROFESSIONAL. THERE IS ONGOING COLLABORATION WITH EXTERNAL COMMUNITY PARTNERS AND OTHER HOSPITAL SERVICES INCLUDING SUBSPECIALTY CLINICS, PATIENT AND FAMILY SERVICES, INTERPRETER SERVICES, RADIOLOGY, DIAGNOSTIC CLINICAL LABORATORIES, CHILD LIFE SERVICES AND PASTORAL CARE. THE CENTER WORKS CLOSELY WITH LAW ENFORCEMENT, CPS AND DISTRICT ATTORNEYS' OFFICES IN THEIR INVESTIGATIVE EFFORTS OF CHILD MALTREATMENT. COLLABORATIVE EFFORTS INCLUDE CASE CONSULTATION AND MONTHLY SUSPECT CHILD ABUSE AND NEGLECT (SCAN) MEETINGS FACILITATED BY OUR CHILD ADVOCACY CLINIC IN AN EFFORT TO TRACK, MONITOR AND ADVOCATE FOR THE HEALTH AND SAFETY OF AT-RISK CHILDREN THROUGHOUT THE VALLEY. FORM 990, PART III, LINE 4A FOR PREVENTION EDUCATION, THE CENTER COLLABORATES WITH INTERNAL AND EXTERNAL PARTNERS TO PROVIDE EDUCATION TO PARENTS, CAREGIVERS, HEALTHCARE PERSONNEL, TEACHERS AND MANDATED REPORTERS OF SUSPECTED CHILD MALTREATMENT. THESE PARTNERS INCLUDE VALLEY CHILDREN'S TRAUMA DEPARTMENT'S INJURY PREVENTION TEAM, SAFE KIDS, CHILD ABUSE PREVENTION COUNCILS OF CALIFORNIA, COMPREHENSIVE YOUTH SERVICES, CPS, EXCEPTIONAL PARENTS UNLIMITED, SEXUAL ASSAULT RESPONSE TEAMS (SART) AND COUNCIL PUBLIC HEALTH DEPARTMENTS. ENROLLMENT IN HEALTH INSURANCE VALLEY CHILDREN'S IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM, OR THE VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S STAFF ASSISTED THE FAMILY WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. FOOD FOR FAMILIES VALLEY CHILDREN'S DIETARY DEPARTMENT PROVIDED MEAL COUPONS TO BREAST-FEEDING MOMS WHOSE INFANTS WERE AT VALLEY CHILDREN'S. ADDITIONALLY, THROUGH A PROGRAM CALLED MEALS OF THE HEART, WHICH IS SPONSORED BY RONALD MCDONALD CHARITIES OF CENTRAL CALIFORNIA, VALLEY CHILDREN'S SOCIAL WORK TEAM PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. THE SOCIAL WORK TEAM ALSO WORKS CLOSELY WITH THE CALIFORNIA CHILDREN'S SERVICES PROGRAM TO PROVIDE FOOD FOR ELIGIBLE FAMILIES. VALLEY CHILDREN'S ALSO RECEIVED SUPPORT FROM A NUMBER OF OTHER ORGANIZATIONS, INCLUDING THE MENDIBURU MAGIC FOUNDATION BASED IN BAKERSFIELD, THE ROMAN CATHOLIC DIOCESE OF FRESNO, THE SWEET NECTAR SOCIETY, AND WESTLEY UNITED METHODIST CHURCH IN FRESNO THAT EITHER DONATED FOOD TO VALLEY CHILDREN'S TO DISTRIBUTE TO NEEDY FAMILIES OR DONATED CASH TO GIVE TO FAMILIES TO PURCHASE FOOD. TRANSPORTATION GIVEN THE CENTRAL VALLEY'S LARGELY RURAL LANDSCAPE AND HIGH CONCENTRATION OF POVERTY, TRANSPORTATION HAS LONG BEEN A CHALLENGE FOR MANY FAMILIES. VALLEY CHILDREN'S CONTINUES TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND ACCESS TO CARE. VALLEY CHILDREN'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING GAS CARDS, TAXI VOUCHERS, AMTRAK TICKETS AND BUS TOKENS. VALLEY CHILDREN'S ALSO SUBSIDIZED BUS AND OTHER PUBLIC TRANSIT SERVICES FROM THE CITY OF FRESNO AND KINGS COUNTY. *SOCIAL AND ENVIRONMENTAL IMPROVEMENT ACTIVITIES VALLEY CHILDREN'S SUPPORTED A NUMBER OF PROGRAMS AND ACTIVITIES TO IMPROVE THE CAPACITY OF COMMUNITIES TO PROMOTE HEALTH AND WELLNESS AMONG CHILDREN. CHILDHOOD OBESITY PREVENTION HIGH RATES OF CHILDHOOD OBESITY CONTINUE TO CREATE SIGNIFICANT CHALLENGES FOR CHILDREN AND THEIR FAMILIES THROUGHOUT VALLEY CHILDREN'S SERVICE AREA. TO HELP REVERSE THIS TREND, VALLEY CHILDREN'S FOCUSED ITS EFFORTS IN 2019 IN TWO SIGNIFICANT AREAS: FOOD INSECURITY AND ESTABLISHING A REGIONAL AGENDA TO ADDRESS THE ISSUE. FOOD INSECURITY AS A CRITICAL SOCIAL DETERMINANT OF HEALTH, FOOD INSECURITY IMPACTS THE HEALTH AND WELL-BEING OF OUR PATIENTS AND FAMILIES. CHILDREN WHO ARE FOOD INSECURE LACK ACCESS TO AFFORDABLE AND HEALTHY FOODS, WHICH LEADS TO ADVERSE HEALTH OUTCOMES INCLUDING INCREASED OBESITY RATES. ADDRESSING FOOD INSECURITY WITHIN THE HEALTHCARE SETTING PROVIDES VALLEY CHILDREN'S THE ABILITY TO FURTHER FOSTER THE HEALTH OF OUR PATIENTS AND COMMUNITIES. IN EARLY 2019, VALLEY CHILDREN'S IMPLEMENTED A PRESCRIPTION FOR FOOD PROGRAM AT ITS MERCED OLIVEWOOD PEDIATRICS PRACTICE. WITH FUNDING FROM THE CENTRAL CALIFORNIA ALLIANCE FOR HEALTH, VALLEY CHILDREN'S PRIMARY CARE PROVIDERS IN MERCED SCREEN CHILDREN FOR FOOD INSECURITY USING A SIMPLE SURVEY DEVELOPED BY THE AMERICAN ACADEMY OF PEDIATRICS. A FAMILY IS DETERMINED TO BE FOOD INSECURE IF, DURING THE LAST 12 MONTHS, THEY WORRIED ABOUT NOT HAVING ENOUGH MONEY TO BUY FOOD OR THEY RAN OUT OF FOOD AND DID NOT HAVE ENOUGH MONEY TO BUY MORE. FOR CHILDREN AND FAMILIES FOUND TO BE FOOD INSECURE, OUR PROVIDERS HAND THE FAMILIES A "PRESCRIPTION FOR FOOD" VOUCHER, WHICH ENTITLES THEM TO RECEIVE A FREE 30-POUND BOX OF NUTRITIOUS AND HEALTHY FOODS FROM THE MERCED COUNTY FOOD BANK ON A MONTHLY BASIS FOR 12 MONTHS. THROUGH THE PRESCRIPTION FOR FOOD PROGRAM IN 2019, PROVIDERS AT OLIVEWOOD PEDIATRICS SCREENED A TOTAL OF 1,398 PATIENTS; 328 WERE DETERMINED TO BE FOOD INSECURE. BASED ON FOOD REDEMPTION NUMBERS REPORTED BY THE MERCED COUNTY FOOD BANK, A TOTAL OF 1,790 INDIVIDUALS (THE 328 CHILDREN PLUS THEIR FAMILY MEMBERS) RECEIVED FREE FOOD THROUGH THE PROGRAM. IN ADDITION, VALLEY CHILDREN'S PARTNERED WITH VALLARTA SUPERMARKET IN FRESNO DURING THE SUMMER OF 2019 TO PROMOTE ACCESS TO HEALTHY FOODS. THROUGH THE PROGRAM, CHILDREN WHO WERE SHOPPING WITH THEIR FAMILIES AT ANY ONE OF THREE PARTICIPATING VALLARTA SUPERMARKET LOCATIONS WERE OFFERED FREE FRUIT. GIVEN THAT MANY CHILDREN RELY ON MEALS PROVIDED BY SCHOOLS FOR MUCH OF THEIR FOOD INTAKE, VALLEY CHILDREN'S FELT IT WAS IMPORTANT TO MAKE HEALTHY FOOD AVAILABLE DURING THE SUMMER MONTHS WHEN MOST CHILDREN ARE NOT AT SCHOOL. IN 2019, VALLEY CHILDREN'S FORMALLY LAUNCHED "COMMUNITIES FOR HEALTHY KIDS," A MULTI-SECTOR REGIONAL INITIATIVE THAT ALIGNS AND SUPPORTS EXISTING PARTNERSHIPS TO REDUCE CHILDHOOD OBESITY IN FRESNO, KINGS, AND MADERA COUNTIES THROUGH EDUCATION, ADVOCACY AND THE COORDINATED IMPLEMENTATION OF IDENTIFIED STRATEGIES. THE INITIATIVE IS COMMITTED TO INCREASING ACCESS TO AND CONSUMPTION OF HEALTHY FOODS, INCREASING ACCESS TO AND CONSUMPTION OF CLEAN DRINKING WATER, AND INCREASING OPPORTUNITIES FOR AND PARTICIPATION IN PHYSICAL ACTIVITY. TO HELP ADVANCE THESE GOALS, THE INITIATIVE ENCOURAGES THE ADOPTION OF EVIDENCE-BASED APPROACHES TO PROMOTING HEALTHY CHILD WEIGHT ACROSS THE FOLLOWING EIGHT SECTORS: AGRICULTURE, BUSINESS, COMMUNITY-BASED ORGANIZATIONS, EARLY CHILDHOOD, GOVERNMENT, HEALTHCARE, MEDIA AND SCHOOLS. EARLY CHILD DEVELOPMENT AND CARE COORDINATION VALLEY CHILDREN'S PARTICIPATED IN A NUMBER OF INITIATIVES SUPPORTING THE HEALTHY DEVELOPMENT OF CHILDREN BOTH DURING PREGNANCY AND INTO THE FIRST 3-5 YEARS OF LIFE. EXAMPLES INCLUDE THE FOLLOWING: FRESNO COUNTY PRE-TERM BIRTH INITIATIVE: FRESNO COUNTY HAS ONE OF CALIFORNIA'S HIGHEST RATES OF PREMATURE BIRTH WITH 1 OUT OF EVERY 9 BABIES BORN TOO EARLY. PREMATURE BIRTH CAN CAUSE SERIOUS PHYSICAL AND MENTAL DISABILITIES, OR EVEN DEATH, BEFORE THE BABY'S FIRST BIRTHDAY. OVER A 10-YEAR PERIOD, THE FRESNO COUNTY PRE-TERM BIRTH INITIATIVE IS WORKING TO IMPROVE THE HEALTH OF FRESNO MOTHERS AND REDUCE THE RATE OF PREMATURE BABIES. USING AN APPROACH CALLED COLLECTIVE IMPACT, PARTNERS ACROSS MANY SECTORS HAVE COME TOGETHER TO CREATE CHANGE IN FRESNO COUNTY. VALLEY CHILDREN'S HAS BEEN AN ACTIVE PARTICIPANT IN THIS INITIATIVE, WITH VALLEY CHILDREN'S SENIOR VICE PRESIDENT FOR COMMUNITY ENGAGEMENT AND POPULATION WELLNESS SERVING AS CHAIR OF THE INITIATIVE'S STEERING COMMITTEE. CRADLE TO CAREER: BOTH FRESNO AND STANISLAUS COUNTIES HAVE BEGUN FORMAL CRADLE TO CAREER INITIATIVES FOR THE PURPOSE OF COVENING PUBLIC AND PRIVATE SECTOR STOCKHOLDERS TO WORK TOGETHER TO IMPROVE OUTCOMES FOR CHILDREN'S IN THEIR COMMUNITIES, FROM PRE-CONCEPTION TO COLLEGE AND/OR VOCATIONAL TRAINING. VALLEY CHILDREN'S PARTICIPATES IN BOTH INITIATIVES AND HAS BEEN A STRONG VOICE FOR THE INCLUSION OF OUTCOMES AND INDICATORS FOCUSED ON CHILD HEALTH AND WELLNESS. HELP ME GROW FRESNO AND KERN COUNTIES: HELP ME GROW IS A COORDINATED SYSTEM OF EARLY IDENTIFICATION AND REFERRAL FOR CHILDREN AGES 0-5 WHO ARE AT RISK FOR DEVELOPMENTAL DELAYS. IN FY2019, VALLEY CHILDREN'S SUPPORTED THE IMPLEMENTATION OF HELP ME GROW IN ITS PEDIATRIC PRIMARY CARE PRACTICES IN FRESNO AND KERN COUNTIES BY PROMOTING THE USE OF A SPECIFIC DEVELOPMENTAL ASSESSMENT AND SCREENING TOOL THAT IS PART OF THE HELP ME GROW MODEL. MARCH OF DIMES: VALLEY CHILDREN'S PARTNERED CLOSELY WITH THE MARCH OF DIMES TO ADVOCATE ON BEHALF OF POLICIES AT THE STATE AND FEDERAL LEVEL THAT PROMOTE HEALTHY PREGNANCIES AND HEALTHY BABIES. ADDITIONALLY, VALLEY CHILDREN'S DIRECTOR OF COMMUNITY AND GOVERNMENT RELATIONS CHAIRED THE MARCH OF DIMES OF CALIFORNIA'S ADVOCACY AND GOVERNMENT AFFAIRS COMMITTEE AND VALLEY CHILDREN'S DIRECTOR FOR CLINICAL CARE SERVED ON THE MARCH OF DIMES CENTRAL VALLEY DIVISION BOARD OF DIRECTORS IN FY2019. FORM 990, PART III, LINE 4A BEHAVIORAL HEALTH BEHAVIORAL HEALTH IS ONE OF THE MOST PRESSING NEEDS FACING CHILDREN IN CALIFORNIA. CHILDREN LIVING IN VALLEY CHILDREN'S SERVICE AREA ARE PARTICULARLY UNDERSERVED DUE TO THE GEOGRAPHY, PROVIDER SHORTAGES, AND LIMITED COMMUNITY-BASED SERVICES. IN 2019, VALLEY CHILDREN'S DEMONSTRATED ITS COMMITMENT TO MEETING THE BEHAVIORAL HEALTH NEEDS OF CHILDREN IN A NUMBER OF WAYS, INCLUDING THOSE LISTED BELOW: COMMUNITY-BASED EDUCATION AND OUTREACH AT THE LOCAL LEVEL, VALLEY CHILDREN'S STAFF PROVIDED TEEN SUICIDE PREVENTION EDUCATION TO STUDENTS AND STAFF AT AREA HIGH SCHOOLS. IN ADDITION, VALLEY CHILDREN'S STAFF EITHER LED OR PARTICIPATED IN A NUMBER OF COMMUNITY-BASED INITIATIVES, INCLUDING SERVING AS MEMBERS OF THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND THE MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE, AS WELL AS CHAIRING COMMUNITY CONVERSATIONS, A COMMUNITY-WIDE PARTNERSHIP ADDRESSING ISSUES OF BEHAVIORAL HEALTH, HOMELESSNESS AND THEIR IMPACT ON FAMILIES. VALLEY CHILDREN'S ALSO PROVIDED EDUCATION AND RESOURCES FOR COMMUNITY STAKEHOLDERS, INCLUDING CONTINUING MEDICAL EDUCATION FOR COMMUNITY-BASED PROVIDERS IN COLLABORATION WITH THE AMERICAN ACADEMY OF PEDIATRICS CALIFORNIA CHAPTER 1 MENTAL HEALTH ACCESS TASK FORCE. REGIONAL CAPACITY IN SEPTEMBER 2019, VALLEY CHILDREN'S ANNOUNCED A PARTNERSHIP WITH UNIVERSAL HEALTH SERVICES (UHS), ONE OF THE NATION'S LARGEST AND MOST RESPECTED PROVIDERS OF HOSPITAL AND HEALTHCARE SERVICES. UNDER THE PARTNERSHIP, UHS WILL CONSTRUCT, OWN AND OPERATE AN 81,600-SQUARE-FOOT, 128-BED BEHAVIORAL HEALTH HOSPITAL FOR CHILDREN AND ADULTS IMMEDIATELY ADJACENT TO THE VALLEY CHILDREN'S HOSPITAL CAMPUS IN MADERA. THE FACILITY WILL INCLUDE A 24-BED INPATIENT UNIT FOR CHILDREN AND ADOLESCENTS, AGES 5 -17, REPRESENTING A 49% INCREASE IN AVAILABLE BEDS FOR KIDS FROM KERN TO SAN JOAQUIN COUNTIES. THE HOSPITAL IS EXPECTED TO OPEN IN 2023. WHILE THE PERMITTING AND CONSTRUCTION PROCESS GETS UNDERWAY, UHS WILL WORK CLOSELY WITH VALLEY CHILDREN'S TO INVEST RESOURCES IN MEETING IMMEDIATE BEHAVIORAL HEALTH NEEDS, ESTABLISHING ADDITIONAL TELE-PSYCHIATRY SERVICES IN SUPPORT OF OUR HOSPITAL AND PRIMARY CARE SERVICES, AND DEVELOPING A NEW PSYCHIATRY RESIDENCY PROGRAM IN THE REGION. STATEWIDE ADVOCACY AT THE STATE LEVEL, VALLEY CHILDREN'S STAFF SERVED AS VICE CHAIR OF CALIFORNIA'S MENTAL HEALTH SERVICES OVERSIGHT & ACCOUNTABILITY COMMISSION AND HELPED SUCCESSFULLY ADVOCATE FOR AN INCREASE IN MEDI-CAL COVERAGE FOR POSTPARTUM DEPRESSION. FORM 990, PART III, LINE 4B: STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO COMMITMENT TO MEDI-CAL - VALLEY CHILDREN'S HOSPITAL'S COMMITMENT TO SERVING ITS COMMUNITY IS EVIDENCED BY THE LARGE NUMBER OF PATIENTS SERVES THAT ARE COVERED BY MEDI-CAL. IN 2019, 75% OF HOSPITAL INPATIENT DAYS WERE COVERED BY MEDI-CAL. THE COMBINED NET EFFECT OF TOTAL MEDI-CAL REIMBURSEMENT AND DISPROPORTIONATE SHARE FUNDING IN RELATION TO THE COST OF THESE SERVICES RESULTED IN A NET LOSS TO THE HOSPITAL IN 2019 OF $133,782,106. THIS FIGURE IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS, AND ALSO EXCLUDES THE REVENUE AND EXPENSES ASSOCIATED WITH THE HOSPITAL FEE PROGRAM, WHICH IS DESCRIBED IN MORE DETAIL BELOW. HOSPITAL FEE PROGRAM - IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING VALLEY CHILDREN'S HOSPITAL, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. THE PROGRAM WAS FUNDED BY A QUALITY ASSURANCE FEE PAID BY HOSPITALS THAT THE STATE THEN USES TO COLLECT ADDITIONAL FEDERAL FUNDING. HOSPITAL FEE PROGRAMS LIKE CALIFORNIA'S ARE ALLOWABLE UNDER FEDERAL LAW, AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROVED CALIFORNIA'S PROGRAM. IN 2019, VALLEY CHILDREN'S HOSPITAL RECOGNIZED PROGRAM REVENUE OF $135,907,799, NET OF THE HOSPITAL'S QUALITY ASSURANCE FEE AND HOSPITAL CONTRIBUTIONS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT). CHFT WAS ESTABLISHED UNDER THE PROGRAM FOR THE PURPOSE OF SUPPORTING CHARITABLE ACTIVITIES. CHARITY CARE - IN KEEPING WITH OUR MISSION, VALLEY CHILDREN'S HOSPITAL CONTINUES TO ACCEPT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2019, CHILDREN'S HOSPITAL PROVIDED $346,213 IN CHARITY CARE. THE AMOUNT REPRESENTS COSTS ASSOCIATED WITH PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES IN RELATION TO THE COST OF THESE SERVICES. CHARITY CARE INCLUDES COUNTY INDIGENT AND FREE CARE, WHICH IS BASED ON THE PATIENT'S INABILITY TO PAY FOR SERVICES. IN ORDER TO ASSIST FAMILIES WITH ONGOING CARE NEEDS, VALLEY CHILDREN'S HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES PATIENT FAMILIES TO APPLY FOR APPROPRIATE GOVERNMENT FUNDING IN CONJUNCTION WITH APPLYING FOR FINANCIAL ASSISTANCE (CHARITY CARE). AS A RESULT, MANY FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS AND DO NOT ULTIMATELY REQUIRE CHARITY CARE. THE HOSPITAL'S CHARITY CARE AMOUNT IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS. FORM 990, PART V, LINE 15: THE ORGANIZATION HAS MARKED NO FOR THE FISCAL YEAR ENDED 2019 TAX RETURN BECAUSE COMPENSATION FROM 10/1/18 TO 12/31/18 DID NOT MEET THE THRESHOLD FOR EXCISE COMPENSATION TAX AND THEREFORE NO FORM 4720 WILL BE FILED FOR FISCAL YEAR 2019. FORM 990, PART VI, SECTION A, LINE 6 THE AMENDED AND RESTATED BYLAWS OF VALLEY CHILDREN'S HOSPITAL, EFFECTIVE 10/17/13, ESTABLISHED VALLEY CHILDREN'S HEALTHCARE AS THE SOLE MEMBER OF THE CORPORATION. CERTAIN MEMBER RIGHTS, INCLUDING THE RIGHT TO APPROVE, FIX THE NUMBER, ELECT, AND REMOVE ELECTED TRUSTEES, ARE INCLUDED IN THESE BYLAWS. FORM 990, PART VI, SECTION A, LINE 7A SEE ANSWER FOR LINE 6 ABOVE FORM 990, PART VI, SECTION A, LINE 7B SEE ANSWER FOR LINE 6 ABOVE FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS. FORM 990, PART VI, SECTION B, LINE 15 AS PROVIDED BY THE VALLEY CHILDREN'S HEALTHCARE BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE NETWORK AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE FORM 990, PART VI, SECTION C, LINE 19 A COPY OF VALLEY CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF VALLEY CHILDREN'S HOSPITAL IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE ANNUAL FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 91,171,906. HERNDON TEMPERANCE LLC NET EQUITY -117,057. PASS-THROUGH INVESTMENT INCOME -48,602. 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