2019-05-15T15:28:25-05:00 2018-06-30 420714325 RSM US LLP 6 S PATTERSON BLVD DAYTON OH 45402 990 2017-07-01 310672132 DAYTON CHILDREN'S HOSPITAL DAYT 9376415819 ONE CHILDRENS PLAZA DAYTON OH 454041815 CHRIS BERGMAN VP FINANCE AND CFO 9376415819 2019-05-14 1 KAREN O CRIM P00368385 9372890201 66.98.98.9 2019-05-14 18:43:25 ED P 59C35BB899559E3B024B3866120A79C2CF16557D 562A18F8DC23C297E42EF16009230818801A988B 2017 2019-02-21 02:37:17Z CHRIS BERGMAN ONE CHILDRENS PLAZA DAYTON OH 454041815 378750930 0 X WWW.CHILDRENSDAYTON.ORG X 1967 OH TO IMPROVE THE HEALTH STATUS OF ALL CHILDREN THROUGH SERVICE, EDUCATION, RESEARCH AND ADVOCACY. 19 15 3288 888 0 158515 24245976 12341969 305391677 324875357 11757490 24607256 2573864 2828364 343969007 364652946 423116 445628 0 0 156986437 207982427 0 0 2545110 149173504 162676776 306583057 371104831 37385950 -6451885 785777932 941142295 198437599 212323946 587340333 728818349 X TO IMPROVE THE HEALTH STATUS OF ALL CHILDREN THROUGH SERVICE, EDUCATION, RESEARCH AND ADVOCACY. 0 0 334728926 445628 325107058 DAYTON CHILDREN'S HOSPITAL IS A PEDIATRIC HOSPITAL LOCATED IN DOWNTOWN DAYTON, OHIO. THE HOSPITAL AND ITS STAFF ARE COMMITTED TO SERVING AS AN ADVOCATE FOR THE CHILDREN AND THEIR FAMILIES IN THE MIAMI VALLEY THROUGH A VARIETY OF DIFFERENT PROGRAMS. IT OFFERS INPATIENT, OUTPATIENT AND ANCILLARY SERVICES TO THE CHILDREN IN THE SURROUNDING 20 COUNTIES. SERVICES ARE PROVIDED TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. FOR THE FISCAL YEAR ENDING JUNE 30, 2018, THE HOSPITAL'S MIX OF PATIENTS WAS 55.8% MEDICAID, 38.4% COMMERCIAL, 3.5% OTHER GOVERNMENT PROGRAMS AND 2.3% SELF PAY. THE HOSPITAL PROVIDES A LEVEL III NEONATAL NURSERY FOR PREMATURE NEWBORNS AS WELL AS CRITICAL CARE AND GENERAL PEDIATRIC INPATIENT BEDS. A 24 HOUR EMERGENCY DEPARTMENT IS AVAILABLE TO ALL CHILDREN IN THE AREA. SOME OF THE SPECIALTIES OFFERED AT THE HOSPITAL ARE NEUROSURGERY, HEMATOLOGY/ONCOLOGY, PULMONARY, GASTROENTEROLOGY, NEUROLOGY, UROLOGY, DEVELOPMENTAL DISORDERS, PSYCHOLOGY, PSYCHIATRY, ENDOCRINOLOGY, GENETICS, CARDIOLOGY, ORTHOPEDICS AND GENERAL SURGERY. WITHOUT DAYTON CHILDREN'S HOSPITAL, MANY CHILDREN IN THE AREA WOULD HAVE TO TRAVEL A GOOD DISTANCE TO RECEIVE THESE SERVICES. THE HOSPITAL ALSO OFFERS A PEDIATRIC RESIDENCY PROGRAM THAT TRAINS NEW PEDIATRICIANS WHO WILL CARE FOR THE NEXT GENERATION OF CHILDREN. DAYTON CHILDREN'S ALSO SPONSORS MANY COMMUNITY EVENTS WHERE CHILDREN'S HEALTH AND SAFETY ARE PROMOTED. SOME STATISTICS FOR THE FISCAL YEAR ENDING JUNE 30, 2018 ARE AS FOLLOWS # OF BEDS 177, INPATIENT DAYS 26,428, ADMISSIONS 4,707. AVERAGE LENGTH OF STAY 5.61 DAYS. AVERAGE DAILY CENSUS 98.6, OCCUPANCY RATE 67%, SURGERIES PERFORMED 12,410, X-RAY STUDIES 49,307, LAB TEST 560,080, RESPIRATORY THERAPY PROCEDURES 84,049, PHARMACY DOSES DISPENSED 744,183, CARDIOLOGY PROCEDURES 19,223, NEUROLOGY PROCEDURES 3,330, URGENT CARE VISITS 15,703, EMERGENCY DEPARTMENT VISITS 93,548, OUTPATIENT CLINICS 220,910 334728926 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 285 0 1 3288 1 1 1 1 BD 0 0 0 1 1 0 0 0 0 X 19 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 OH X X CHRIS BERGMAN 9376415819 ONE CHILDRENS PLAZA DAYTON OH 45404 LAURENCE KLABEN CHAIRMAN 1.00 0.00 X X 0 0 0 LINDA BLACK-KUREK VICE CHAIR 1.00 0.00 X X 0 0 0 JAMES WHALEN SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 MICHAEL MCQUISTON ASST SECRETY/TREASURER 1.00 0.00 X X 0 0 0 CLINTON BROWN TRUSTEE 1.00 0.00 X 0 0 0 MARK CHILSON TRUSTEE 1.00 0.00 X 0 0 0 GREGORY EBERHART MD TRUSTEE 1.00 0.00 X 900 0 0 THOMAS KRZMARZICK MD TRUSTEE 1.00 0.00 X 20000 0 0 JOHN DUBY MD TRUSTEE 1.00 0.00 X 0 0 0 JACQUELINE GAMBLIN BEG 1117 TRUSTEE 1.00 0.00 X 0 0 0 MATTHEW HARDWICK MD TRUSTEE 1.00 0.00 X 0 0 0 TIFFANY KELLNER TRUSTEE 1.00 0.00 X 0 0 0 JAMES MCGREGOR TRUSTEE 1.00 0.00 X 0 0 0 TIMOTHY PEPPER TRUSTEE 1.00 0.00 X 0 0 0 MICHAEL SHANE TRUSTEE 1.00 0.00 X 0 0 0 BEVERLY SHILLITO TRUSTEE 1.00 0.00 X 0 0 0 CHRISTINE SOWARD TRUSTEE 1.00 0.00 X 0 0 0 THERESE MCNEA-WILEY END 1017 TRUSTEE 1.00 0.00 X 0 0 0 VISHAL SOIN END 1017 TRUSTEE 1.00 0.00 X 0 0 0 ADAM MEZOFF MD CMO 40.00 0.00 X 721212 0 303932 DEBORAH FELDMAN CEO 40.00 0.00 X X 772357 0 528349 CHRIS BERGMAN CFO 40.00 0.00 X 440586 0 40157 CYNTHIA BURGER VP PATIENT & FAMILY EXPERIENCE 40.00 0.00 X 304427 0 165280 LISA COFFEY VP PHYSICAN SERVICES 40.00 0.00 X 285669 0 280104 MATTHEW GRAYBILL VP HR AND CHIEF ADMINISTRATION 40.00 0.00 X 427646 0 218986 KELLY KAVANAUGH VP AND CHIEF STRATEGY OFFICER 40.00 0.00 X 277775 0 83418 DR GREGORY RAMEY EXECUTIVE DIRECTOR MENTAL HEALTH SERVICES 40.00 0.00 X 308998 0 81745 DAVID MILLER FORMER CFO (END 1/16) 0.00 0.00 X 273166 0 0 3832736 0 1701971 9 1 1 0 DAYTON CHILDREN'S SPECIALTY PHYSICIANS 1 CHILDRENS PLAZA DAYTON OH 45404 PHYSICIAN SERVICES 19824671 HCTEC PARTNERS LLC PO BOX 306180 NASHVILLE TN 37230 CONSULTING 1949146 CHILDREN'S EMERGENCY SERV 1 CHILDRENS PLAZA DAYTON OH 45404 PHYSICIAN SERVICES 1251319 CLARO GROUP LLC 321 N CLARK STREET SUITE CHICAGO IL 60654 CONSULTING 1136562 BRICKER & ECKLER 100 SOUTH THIRD STREET COLUMBUS OH 43215 LEGAL SERVICES 976495 37 29245 553084 6122008 617627 5020005 12341969 PATIENT SERVICE REVENUE 624100 238821104 238821104 MEDICARE/MEDICAID 624100 86054253 86054253 324875357 11567993 11567993 452944 1201473 -748529 -748529 -748529 25347862 6500 12263761 51338 13084101 -44838 13039263 -44838 13084101 103857 553084 124660 -20803 -20803 521583 456752 64831 64831 CAFETERIA/KIDS CARE 900099 1973400 1973400 CHILD CARE CENTER 812930 760702 760702 RETAIL PHARMACY/MEDICAL RECORDS 900099 522224 522224 276539 276539 3532865 364652946 325107058 0 27203919 X 208750 208750 236878 236878 2827493 2827493 159762875 144087584 14423345 1251946 12981746 11504424 1377363 99959 20516940 18182113 2176847 157980 11893373 10539907 1261887 91579 1158872 1158872 309713 309713 238852 238852 1586279 1586279 38787584 34748933 3252262 786389 900940 900940 8519232 7882712 547002 89518 10512722 10512722 4349914 4132469 217445 1254706 777918 414053 62735 2626369 2626369 31003920 29453724 1550196 872529 872529 MEDICAL SUPPLIES AND DR 40407844 40407844 BAD DEBT EXPENSE 12429883 12429883 STATE HOSPITAL ASSESSME 5442944 5442944 REPAIRS AND MAINTENANCE 2274473 2167800 101669 5004 371104831 334728926 33830795 2545110 17297 77513 8349988 10002651 10471232 221375 48159354 78494029 3393889 5653234 1730977 4110591 483834919 124974763 303161590 358860156 307463532 324737595 78307363 130675127 22996131 26540462 1726579 1769562 785777932 941142295 29637479 17270830 142534863 151894138 10415000 26265257 32743978 198437599 212323946 X 571435320 727527945 15905013 1290404 587340333 728818349 785777932 941142295 X -6451885 10911360 137018541 X 0 1 X 1 0 X 0 1 0 0 0 1 80646 1 22652 1 67006 0 170304 0 PART II-B, LINE 1: LINE 1F: OHIO HOSPITAL ASSOCIATION $2,431 OHIO CHILDREN'S HOSPITAL ASSOCIATION $41,888 CHILDREN'S HOSPITAL ASSOCIATION $36,327 TOTAL $80,646 LINE 1G: MANAGEMENT TIME $22,652 DAYTON CHILDREN'S SPENDS TIME TRACKING SPECIFIC LEGISLATION THAT IS OF INTEREST TO PEDIATRIC HEALTH ISSUES. THEY PROVIDE SUGGESTIONS AND FEEDBACK TO LOCAL, STATE AND FEDERAL LEGISLATURES. THEIR MAIN FOCUS CONCERNS MEDICAID, CHILDREN'S SPECIFIC HEALTH ISSUES AND MEDICAL EDUCATION FUNDING. LINE 1H: CONSULTING EXPENSE $67,006 TOTAL LINE 1J : $170,304 183912987 760296 640717 3340064 180372563 1601373 167616099 106014 22473043 6271797 10372 183912987 168335550 9088944 -3634804 6153591 20000 167616099 172836657 3053446 -1954780 5599773 168335550 147083123 7058671 23624463 4892230 37370 172836657 1.00000 0 1 1 22293444 22293444 165399595 32861118 132538477 250959967 79164340 171795627 45181913 12949305 32232608 358860156 HEDGE FUNDS 75839320 F LIMITED PARTNERSHIP 32445729 F PRIVATE EQUITY 22390078 F 130675127 DEFERRED COMP PAYABLE 12146326 PENSION LIABILITIES 18884551 OTHER RECEIVABLES 1713101 32743978 X PART X, LINE 2: ALL SUBSIDIARIES OF THE HOSPITAL, EXCEPT CCG, CAG, AND SELECTED JOINT VENTURE ENTITIES, ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE WHOLLY OWNED FOR-PROFIT SUBSIDIARIES CCG AND CAG HAD NO TAXABLE INCOME IN 2018 OR 2017. THE PROVISION FOR INCOME TAXES FOR THE JOINT VENTURE ENTITIES IS NOT SIGNIFICANT TO THE HOSPITAL. THE HOSPITAL COMPLETED AN ANALYSIS OF ITS UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2018 OR 2017. THE TAX CUTS AND JOBS ACT (THE ACT) WAS ENACTED ON DECEMBER 22, 2017. FOR TAX-EXEMPT ENTITIES, THE ACT REQUIRES ORGANIZATIONS TO CATEGORIZE CERTAIN FRINGE BENEFIT EXPENSES AS A SOURCE OF UNRELATED BUSINESS INCOME, PAY AN EXCISE TAX ON REMUNERATION ABOVE CERTAIN THRESHOLDS THAT IS PAID TO EXECUTIVES BY THE ORGANIZATION, AND REPORT INCOME OR LOSS FROM UNRELATED BUSINESS ACTIVITIES ON AN ACTIVITY-BY-ACTIVITY BASIS, AMONG OTHER PROVISIONS (WHICH WILL NOT BE EFFECTIVE UNTIL THE 2019 TAX YEAR). CERTAIN REGULATORY GUIDANCE PROVIDES FOR A MEASUREMENT PERIOD OF UP TO ONE YEAR, DURING WHICH THE ACCOUNTING FOR THE TAX EFFECTS OF THE ACT MAY BE COMPLETED. THE HOSPITAL MAY RECORD FURTHER ADJUSTMENTS IN FUTURE PERIODS UPON OBTAINING, PREPARING, OR ANALYZING ADDITIONAL INFORMATION ABOUT FACTS AND CIRCUMSTANCES THAT EXISTED AS OF THE DATE OF ENACTMENT. THE HOSPITAL WILL CONTINUE TO REVISE AND REFINE THE CALCULATIONS AS ADDITIONAL IRS GUIDANCE IS ISSUED; HOWEVER, THE HOSPITAL DOES NOT ANTICIPATE ANY MATERIAL IMPACT TO THE CONSOLIDATED FINANCIAL STATEMENTS. SUPPLEMENTAL INFORMATION THE ENDOWMENTS ARE HELD BY DAYTON CHILDREN'S HOSPITAL FOUNDATION, A SUBSIDIARY OF DAYTON CHILDREN'S HOSPITAL. THE FUNDS ARE USED EXCLUSIVELY TO SUPPORT DAYTON CHILDREN'S HOSPITAL AND ITS SUBSIDIARIES. THE INTENDED USE OF THE FUNDS IS TO SUPPORT MEDICAL RESEARCH, THE CHILD LIFE PROGRAM AND THE MEDICAL CHAIRS OF SPECIFIC HOSPITAL DEPARTMENTS. CENTRAL AMERICA/CARIBBEAN 1 2 INVESTMENTS 136092861 CENTRAL AMERICA/CARIBBEAN 1 2 PROGRAM SERVICE SELF INSURANCE 1857939 EAST ASIA AND THE PACIFIC 0 0 INVESTMENTS 403084 NORTH AMERICA 0 0 INVESTMENTS 945121 SOUTH AMERICA 0 0 INVESTMENTS 4850 EUROPE (INCLUDING ICELAND & GREENLAND) 0 0 INVESTMENTS 3274801 MIDDLE EAST AND NORTH AFRICA 0 0 INVESTMENTS 61706 2 4 0 0 2 4 142640362 0 142640362 1 0 1 0 0 0 K99.1FM RADIOTHON 257895 257895 236 78 GEM CITY JAM 197926 165570 32356 1960 16102 6274 19766 3 201120 129619 71501 5433 22423 37301 2682 12405 656941 553084 103857 7393 22659 53403 8956 32249 124660 -20803 1 1 X 1 X 1 X 1 1 1 0 1 1 360819 360819 0.00100 173871887 114655298 59216589 0.16510 174232706 114655298 59577408 0.16610 2190684 2190684 0.00610 2712433 1499649 1212784 0.00340 35057940 13008930 22049010 0.06150 364112 364112 0.00100 40325169 14508579 25816590 0.07200 214557875 129163877 85393998 0.23810 269972 269972 0.00080 1459 1459 0.00000 382 382 0.00000 271813 271813 0.00080 0 6578985 324102 324102 X 1 1 1 1 DAYTON CHILDREN'S HOSPITAL 1 CHILDRENS PLAZA DAYTON OH 454041815 WWW.CHILDRENSDAYTON.ORG 020035650 X X X X X DAYTON CHILDREN'S HOSPITAL 1 0 0 1 X X X X X X X X X 16 1 0 0 1 X SEE PART V, SECTION C X 1 16 1 SEE PART V, SECTION C 0 1 X 100.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X 1 X 0 X X 1 X 0 0 DAYTON CHILDREN'S HOSPITAL PART V, SECTION B, LINE 5: IMPROVING THE HEALTH STATUS OF ALL CHILDREN IS THE MISSION OF DAYTON CHILDREN'S HOSPITAL. TO HELP DEVELOP MEANINGFUL AND IMPACTFUL COMMUNITY ENGAGEMENT AND CHILD HEALTH PROGRAMS, DAYTON CHILDREN'S EVALUATES THE STATUS OF OUR REGION'S PEDIATRIC HEALTH EVERY THREE YEARS THROUGH OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). DAYTON CHILDREN'S CHNA INCLUDES FEEDBACK FROM THE GROUPS CONVENED BY THE HOSPITAL INCLUDING COMMUNITY MEMBERS, EXPERTS IN PUBLIC HEALTH AND CLINICAL PRACTITIONERS, AND INCLUDES DATA REGARDING THE HEALTH NEEDS OF VULNERABLE PEDIATRIC POPULATIONS, THOSE WITH CHRONIC ILLNESSES, AS WELL AS HEALTH DISPARITIES AMONG MINORITIES, LOW-INCOME AND MEDICALLY-UNDERSERVED POPULATIONS. OUR MOST CURRENT ASSESSMENT WAS COMPLETED IN JUNE 2017.FUNDED BY THE DAYTON CHILDREN'S FOUNDATION BOARD, GUIDED BY THE DAYTON CHILDREN'S BOARD OF TRUSTEES ADVOCACY COMMITTEE, AND ADOPTED BY THE DAYTON CHILDREN'S BOARD OF TRUSTEES, THE NEEDS ASSESSMENT UNCOVERS THE HIGHEST PRIORITY CHILD HEALTH AND SAFETY ISSUES. AS THE REGIONAL LEADER IN CHILDREN'S HEALTH, DAYTON CHILDREN'S CONDUCTS THE ASSESSMENT TO PROVIDE COMMUNITY HEALTH ADVOCATES INSIGHTS INTO THE HEALTH AND WELL-BEING OF OUR REGION'S CHILDREN AND TO SET A ROBUST AGENDA TO IMPROVE CHILDREN'S HEALTH. THE ASSESSMENT OFFERS A PATH TO WORK TOGETHER TO DEVELOP OR REFINE PROGRAMS TO IMPROVE THE HEALTH STATUS OF ALL CHILDREN THROUGH COMMUNITY BENEFIT INVESTMENTS.TO CONDUCT THE 2017 CHNA AND CRAFT THE IMPLEMENTATION PLAN, DAYTON CHILDREN'S CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO TO COLLECT THE DATA, GUIDE THE HEALTH ASSESSMENT PROCESS, AND INTEGRATE SOURCES OF PRIMARY AND SECONDARY DATA INTO THE FINAL REPORT. THIS COMMUNITY HEALTH ASSESSMENT WAS CROSSSECTIONAL IN NATURE AND INCLUDED A WRITTEN SURVEY OF PARENTS WITHIN THE GREATER DAYTON AREA. FROM THE BEGINNING, COMMUNITY LEADERS AND PUBLIC HEALTH PARTNERS WERE ACTIVELY ENGAGED IN THE PLANNING PROCESS AND HELPED DEFINE THE CONTENT, SCOPE, AND SEQUENCE OF THE STUDY. ACTIVE ENGAGEMENT OF COMMUNITY MEMBERS THROUGHOUT THE PLANNING PROCESS IS REGARDED AS AN IMPORTANT STEP IN COMPLETING A VALID NEEDS ASSESSMENT. THE DAYTON CHILDREN'S CHNA MULTIDISCIPLINARY TEAM REVIEWED THE DATA AND THEN RATED THE NEEDS AGAINST CRITERIA INCLUDING PREVALENCE, SERIOUSNESS (HOSPITALIZATION AND/OR DEATH), IMPACT ON OTHER HEALTH ISSUES, URGENCY, PREVENTION, ECONOMICS/FEASIBILITY, ACCEPTABILITY AND RESOURCES. AFTER GROUP RANKING AND DISCUSSION, THE PRIORITIES OUTLINED IN THE IMPLEMENTATION PLAN WERE ADOPTED. THE HOSPITAL FACILITY ALSO CONSULTED WITH THE FOLLOWING COMMUNITY PARTNERS:CLARK COUNTY COMBINED HEALTH DISTRICTECHO (EMPOWERING CHILDREN WITH HOPE AND OPPORTUNITY) AT THE UNIVERSITY OF DAYTONGREENE COUNTY PUBLIC HEALTHCOMMUNITY HEALTH CENTERS OF GREATER DAYTONHEALTHY COMMUNITIES CONSULTING, LLCLEARN TO EARN DAYTONMIAMI COUNTY PUBLIC HEALTHMIAMI VALLEY CHILD DEVELOPMENT CENTERSMIAMI VALLEY REGIONAL PLANNING COMMISSIONMONTGOMERY COUNTY ADAMHS BOARDMONTGOMERY COUNTY HEALTH AND HUMAN SERVICESMONTGOMERY COUNTY JOB AND FAMILY SERVICES - CHILDREN SERVICE DIVISIONPUBLIC HEALTH - DAYTON & MONTGOMERY COUNTYSINCLAIR COMMUNITY COLLEGE, DIVISION OF HEALTH SCIENCESUNITED WAY OF GREATER DAYTONWARREN COUNTY HEALTH DISTRICTWRIGHT STATE UNIVERSITY DEPARTMENT OF PEDIATRICSWRIGHT STATE UNIVERSITY DEPARTMENT OF POPULATION & PUBLIC HEALTH SCIENCES DAYTON CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11: THE 2017 CHNA POINTED TO KEY AREAS WHERE THE DAYTON COMMUNITY CAN WORK TO IMPROVE THE HEALTH OF CHILDREN.1. MENTAL HEALTH AND ADDICTION (INCLUDES EMOTIONAL WELLBEING, MENTAL ILLNESS CONDITIONS, AND SUBSTANCE ABUSE DISORDERS) 9% OF CHILDREN EXPERIENCED 2 OR MORE ADVERSE CHILDHOOD EXPERIENCES. 19% OF MOTHERS AND 11% OF FATHERS OF 0 TO 5 YEAR OLDS RATED THEIR MENTAL AND EMOTIONAL HEALTH AS LESS THAN GOOD. 2. CHRONIC DISEASE (INCLUDES CONDITIONS SUCH AS HEART DISEASE, DIABETES, ASTHMA, AND RELATED CLINICAL RISK FACTORS SUCH AS OBESITY, HYPERTENSION, AND HIGH CHOLESTEROL, AS WELL AS BEHAVIORS CLOSELY ASSOCIATED WITH THESE CONDITIONS AND RISK FACTORS INCLUDING NUTRITION, PHYSICAL ACTIVITY, AND TOBACCO USE) 50% OF CHILDREN AGES 0 TO 11 WERE CLASSIFIED AS OVERWEIGHT (14%) OR OBESE (36%) BY BODY MASS INDEX (BMI) CALCULATIONS. 9% OF PARENTS WERE TOLD BY A DOCTOR THAT THEIR CHILD HAD ASTHMA. 6% OF PARENTS REPORTED THEIR CHILD WAS EXPOSED TO SECONDHAND SMOKE OR VAPING PRODUCTS AT HOME. 13% OF PARENTS REPORTED EXPERIENCING FOOD INSECURITY, INCREASING TO 19% OF PARENTS WITH A CHILD AGE 0 TO 5 AND 60% OF PARENTS WITH INCOMES LESS THAN $25,000. 3. MATERNAL AND INFANT HEALTH (INCLUDES INFANT AND MATERNAL MORTALITY, BIRTH OUTCOMES, AND RELATED RISK AND PROTECTIVE FACTORS IMPACTING PRECONCEPTION, PREGNANCY, AND INFANCY, INCLUDING FAMILY AND COMMUNITY CONTEXTS) 11% OF PARENTS REPORTED THEIR CHILD WAS BORN PREMATURE, INCREASING TO 21% OF AFRICAN AMERICAN PARENTS. 30% OF PARENTS OF 0 TO 5 YEAR OLDS REPORTED THEIR CHILD WAS NEVER BREASTFED. 41% OF PARENTS OF 0 TO 5 YEAR OLDS REPORTED THEIR CHILD SLEPT IN BED WITH A PARENT OR ANOTHER PERSON AS AN INFANT.THE IMPLEMENTATION PLAN INCLUDES A ROBUST SET OF PRIORITY ACTIONS TO IMPROVE HEALTH OUTCOMES IN THE THREE KEY PEDIATRIC HEALTH ISSUES AS WELL AS STRATEGIES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH TO WORK AT THE ROOT CAUSES OF POOR HEALTH FOR CHILDREN. TO WORK TOWARD IMPROVING MENTAL HEALTH AND ADDICTION OUTCOMES, DAYTON CHILDREN'S WILL EXECUTE A PLAN TO CREATE A PSYCHIATRY UNIT IN DAYTON CHILDREN'S HOSPITAL AND PROMOTE TRAUMA-INFORMED HEALTH CARE. TO WORK TOWARD IMPROVING CHRONIC DISEASE OUTCOMES, DAYTON CHILDREN'S WILL IMPLEMENT NUTRITION POLICY IN SCHOOLS, IMPLEMENT SAFE ROUTES TO SCHOOL, AND ENHANCE THE DAYTON ASTHMA ALLIANCE. TO WORK TOWARD IMPROVING MATERNAL AND INFANT HEALTH, DAYTON CHILDREN'S WILL INCREASE THE USE OF SAFE SLEEP PRACTICES.TO ADDRESS MOST PRIORITY AREAS, THE FOLLOWING CROSS-CUTTING STRATEGIES ARE RECOMMENDED: 1. INCREASE BREASTFEEDING2. EXPLORE AND IMPLEMENT SCREENINGS TO ADDRESS SOCIAL AND BEHAVIORAL NEEDS3. INTEGRATE COMMUNITY HEALTH WORKERS INTO CLINICAL SERVICES4. PROMOTE A REGIONAL CHILDHOOD VACCINATION CAMPAIGN5. IMPLEMENT A FOOD INSECURITY SCREENING AND REFERRAL PROGRAM6. IMPLEMENT A FOOD PHARMACY PROGRAMTHE 2017-2020 DAYTON CHILDREN'S IMPLEMENTATION PLAN PRIORITIES ALIGN WITH REGIONAL, STATE AND NATIONAL PRIORITIES. DAYTON CHILDREN'S WILL BE ADDRESSING THE FOLLOWING PRIORITIES TO REACH THE CHILD POPULATION IN THE GREATER DAYTON AREA (MONTGOMERY, CLARK, GREENE, MIAMI, AND WARREN COUNTIES): MENTAL HEALTH AND ADDICTION, CHRONIC DISEASE, AND MATERNAL AND INFANT HEALTH. PUBLIC HEALTH OFFICIALS FROM THESE COUNTIES WERE PART OF THE PLANNING PROCESS TO ENSURE ALIGNMENT. IN ADDITION, AS IMPLEMENTATION STRATEGIES WERE DEVELOPED, THE OHIO STATE HEALTH IMPROVEMENT PLAN (SHIP) WAS CONSULTED. THE 2017-2019 SHIP SERVES AS A STRATEGIC MENU OF PRIORITIES, OBJECTIVES, AND EVIDENCE-BASED STRATEGIES TO BE IMPLEMENTED BY STATE AGENCIES, LOCAL HEALTH DEPARTMENTS, HOSPITALS, AND OTHER COMMUNITY PARTNERS AND SECTORS BEYOND HEALTH INCLUDING EDUCATION, HOUSING, EMPLOYERS, AND REGIONAL PLANNING. THE ASSESSMENT AND IMPLEMENTATION PLAN WAS ADOPTED BY THE HOSPITAL BOARD OF TRUSTEES AND POSTED ON THE HOSPITAL WEBSITE IN JUNE 2017. DATA IS AVAILABLE TO PUBLIC HEALTH AND OTHER CHILD-SERVING ENTITIES TO ASSIST IN THEIR INDIVIDUAL NEEDS ASSESSMENTS AS WELL. WE CONTINUOUSLY WORK TO ALIGN OUR IMPLEMENTATION STRATEGIES WITH OTHER LOCAL AND STATE HEALTH DEPARTMENTS AND OTHER HEALTH ENTITIES TO ENSURE THE GREATEST IMPACT ON HEALTH ISSUES. PART V, SECTION B, LINE 7A: THE CHNA REPORT IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/ADVOCACY-AND-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT PART V, SECTION B, LINES 16A-16C: THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/PATIENTS-VISITORS/AFTER-YOUR-VISIT/ BILLING/FINANCIAL-ASSISTANCE PART V, SECTION B LINE 10A: THE IMPLEMENTATION STRATEGY IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/ADVOCACY-AND-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT CONTINUATION OF PART V, SECTION B, LINE 11: TIED DIRECTLY TO THE COMMUNITY NEEDS IDENTIFIED THROUGH OUR CHNA, DAYTON CHILDREN'S PARTICIPATES COMMUNITY OUTREACH INITIATIVES TO ADDRESS THE LEADING HEALTH ISSUES AFFECTING CHILDREN IN THE COMMUNITY. BELOW IS AN UPDATE ON THE STRATEGIES OUTLINED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTATION PLAN. TO WORK TOWARD IMPROVING MENTAL HEALTH AND ADDICTION OUTCOMES, THE FOLLOWING STRATEGIES WERE IDENTIFIED AND EXECUTED:STRATEGY: EXECUTE PLAN TO CREATE A PSYCHIATRY UNIT IN DAYTON CHILDREN'S HOSPITAL IN FY2017-2018, DAYTON CHILDREN'S BEGIN RENOVATING AN AREA ADJACENT TO THE EMERGENCY DEPARTMENT TO HOUSE A BEHAVIORAL CRISIS CENTER. IN THE CRISIS CENTER, TRAINED BEHAVIORAL HEALTH CLINICIANS WILL PROVIDE AN ASSESSMENT AND CONNECT THESE CHILDREN TO THE APPROPRIATE SERVICES. THIS ALLOWS THE EXPERTS AT MENTAL AND BEHAVIORAL HEALTH TO GET A CHILD HELP QUICKER, WHILE ALLOWING THE EXPERTS IN THE EMERGENCY DEPARTMENT TO FOCUS ON THE MEDICAL NEEDS OF CHILDREN. THE CRISIS CENTER OPENED IN JULY 2018. PLANS FOR A NEW A 24-BED INPATIENT MENTAL HEALTH UNIT TO PROVIDE NEEDED STABILIZATION CARE TO CHILDREN AND THEN CONNECT THEM TO THE APPROPRIATE FOLLOW UP CARE ALSO BEGAN THIS FISCAL YEAR. THE NEW INPATIENT UNIT IS SLATED TO OPEN IN JULY 2019. IN ADDITION TO THE NEW SERVICES BEING OFFERED TO ADDRESS CRITICAL COMMUNITY NEEDS AROUND MENTAL AND BEHAVIORAL HEALTH, THE CENTER FOR PEDIATRIC MENTAL HEALTH RESOURCES ESTABLISHED IN 2014 CONTINUES TO EVOLVE AND GROW. THE HOSPITAL PARTNERED WITH 22 AGENCIES IN ESTABLISHING THE MENTAL HEALTH ADVISORY ALLIANCE TO IMPROVE COMMUNICATION AND COORDINATION OF SERVICES. WITH SUPPORT FROM MONTGOMERY COUNTY ALCOHOL, DRUG ADDICTION AND MENTAL HEALTH SERVICES AS WELL AS DEVELOPMENTAL DISABILITIES SERVICES, WE HAVE ENHANCED PROGRAMS TO BETTER SERVE CHILDREN AND FAMILIES. THE HOSPITAL CARED FOR A RECORD NUMBER OF PATIENTS IN FY 2017-2018 IN THE FOLLOWING AREAS: THE HOSPITAL PSYCHIATRY DEPARTMENT TREATED HAD 4,697 PATIENT VISITS. THE HOSPITAL HAS TWO FULL-TIME, ONE PART-TIME PSYCHIATRISTS AND ONE PSYCHIATRIC NURSE PRACTITIONER. DAYTON CHILDREN'S ALSO SERVES AS THE TRAINING SITE FOR WRIGHT STATE UNIVERSITY DEPARTMENT OF CHILD PSYCHIATRY. THE HOSPITAL PSYCHOLOGY DEPARTMENT EXPANDED TO 20 PROFESSIONALS. IN FY 2017-2018, THE DEPARTMENT SAW 11,393 PATIENT VISITS, AND CONTINUES AS THE TRAINING SITE FOR THE WRIGHT STATE SCHOOL OF PROFESSIONAL PSYCHOLOGY. SERVICES WERE EXPANDED IN OUR SOUTHERN REGION, WITH A NEW OFFICE IN SPRINGBORO. THE DEPARTMENT ALSO HIRED TWO NEUROPSYCHOLOGISTS TO PROVIDE CRITICAL DIAGNOSTIC SERVICES TO PEDIATRIC PATIENTS.THE MENTAL HEALTH RESOURCE CONNECTION PROGRAM RECEIVED 4,743 PATIENT REFERRALS. THE HOSPITAL DEVELOPED A PARTNERSHIP WITH CARESOURCE TO PROVIDE ENHANCED SERVICES FOR ITS MEMBERS, AND IS DOING A RESEARCH STUDY ON THE IMPACT OF TIMELY ACCESS TO MENTAL HEALTH SERVICES. HOSPITAL SOCIAL WORKERS MANAGED 10,044 REFERRALS, PROVIDING SERVICES TO FAMILIES IN NEED. THE PSYCHOLOGY DEPARTMENT PROVIDED 81 PRESENTATIONS TO SCHOOLS, COMMUNITY AGENCIES, MEDICAL STUDENTS AND THE MEDIA ON VARIOUS TOPICS INCLUDING BULLYING, CHILDHOOD TRAUMA, ADHD AND OTHER LEARNING DISABILITIES, SUICIDE PREVENTION, SCHOOL VIOLENCE, BEHAVIOR MANAGEMENT AND OTHERS. STRATEGY: PROMOTE TRAUMA-INFORMED HEALTH CARE IN 2018, SENIOR LEADERSHIP IDENTIFIED A MULTI-DISCIPLINARY TEAM OF REPRESENTATIVES TO MEET MONTHLY AND SUPPORT THE HOSPITAL'S EFFORTS TO PROMOTE TRAUMA-INFORMED CARE. THIS GROUP COMPLETED A SURVEY/NEEDS ASSESSMENT AND IDENTIFIED AREAS OF STRENGTH AND AREAS OF OPPORTUNITY RELATED TO TRAUMA-INFORMED CARE IN THE HOSPITAL. CLEAR STRENGTHS INCLUDE STAFF PROMOTING ACTIVE PARTICIPATION OF CAREGIVERS IN TREATMENT PROCESS, FAMILY-CENTERED CARE, STAFF ACCEPTANCE FOR PERSONAL RELIGIOUS OR CULTURAL PRACTICES, AND INCENTIVIZATION OF EMPLOYEE WELLNESS BY HOSPITAL LEADERSHIP. KEY AREAS OF OPPORTUNITY INCLUDE ASSESSMENT OF CAREGIVER HISTORY OF TRAUMA AND UNDERSTANDING AND ASSESSMENT OF SECONDARY TRAUMATIC STRESS IN HEALTH CARE WORKERS. THE GROUP IS CURRENTLY PILOTING A "STRESS THERMOMETER" ASSESSMENT OF CAREGIVERS OF CHILDREN HOSPITALIZED IN THE INTENSIVE CARE UNIT. TO WORK TOWARD IMPROVING CHRONIC DISEASE OUTCOMES, THE FOLLOWING STRATEGIES WERE IDENTIFIED AND EXECUTED:STRATEGY: IMPLEMENT NUTRITION POLICY IN SCHOOLSIN PARTNERSHIP WITH PUBLIC HEALTH DAYTON/MONTGOMERY COUNTY, 4 C FOR CHILDREN, AND PRESCHOOL PROMISE, DAYTON CHILDREN'S HOSPITAL ENDORSED THESE PARTNERS' EFFORTS TO INCREASE THE NUMBER OF CHILDCARE CENTERS PARTICIPATING IN OHIO HEALTHY PROGRAM. ALSO IN PARTNERSHIP WITH PUBLIC HEALTH DAYTON/MONTGOMERY COUNTY AND SUMMER FOOD SERVICE PROGRAM SPONSORING AGENCIES, DAYTON CHILDREN'S HOSPITAL PROVIDED LEADERSHIP TO DEVELOP A SUMMER FOOD SERVICE PROMOTIONAL CAMPAIGN. AS PART OF THIS CAMPAIGN, DAYTON CHILDREN'S SPONSORED A WEB-BASED INTERACTIVE MAP TO INDICATE LOCATION, DATES, AND TIMES OF FOOD SITES OPEN TO THE PUBLIC.STRATEGY: IMPLEMENT SAFE ROUTES TO SCHOOLDAYTON CHILDREN'S, THROUGH OUR SAFE KIDS GREATER DAYTON COALITION, PARTNERED WITH THE LOCAL SAFE ROUTES TO SCHOOLS COMMITTEE TO ENSURE ALL CHILDREN IN DAYTON HAVE A SAFE WAY TO WALK OR BIKE TO SCHOOL. SAFE ROUTES TO SCHOOLS COMPLETED THEIR INITIAL DATA COLLECTION IN DECEMBER 2017, AND PASSED A LARGE DISTRICT TRAVEL PLAN FOR 20 ELEMENTARY SCHOOLS IN THE DAYTON PUBLIC SCHOOL DISTRICT MAY OF 2018. STRATEGY: ENHANCE THE DAYTON ASTHMA ALLIANCETHE DAYTON ASTHMA ALLIANCE AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, FOCUSING ON THE MOST AT-RISK POPULATIONS. USING THE COLLECTIVE IMPACT FRAMEWORK, THE ALLIANCE ENGAGES LOCAL PARTNER ORGANIZATIONS TO COLLABORATIVELY IMPLEMENT A VARIETY OF STRATEGIC ACTIONS TO IMPROVE OUTCOMES FOR CHILDREN WITH ASTHMA. TO HAVE THE GREATEST IMPACT AND TO ENSURE ALL CHILDREN WITH ASTHMA HAVE OPTIMAL HEALTH OUTCOMES, THE ALLIANCE IDENTIFIED THREE STRATEGIC FOCUS AREAS FOR THEIR WORK 1) ENSURE ASTHMA-FRIENDLY ENVIRONMENTS; 2) ENHANCE ACCESS TO HIGH QUALITY HEALTHCARE AND SUPPORTIVE SOCIAL SERVICES THROUGH CLINICAL-COMMUNITY LINKAGES; AND 3) EDUCATE AND EQUIP CHILDREN, FAMILIES AND THE COMMUNITY FOR ASTHMA WELLNESS. TO SUPPORT WORK IN THESE AREAS, DAYTON CHILDREN'S SERVES AS THE BACKBONE ORGANIZATION CONVENING THE GROUP OF COMMITTED STAKEHOLDERS AND SUPPORTING THE ALLIANCE WITH STAFF AND RESOURCES. THE ALLIANCE IS GOVERNED BY ENTITIES WITH A COMMON PURPOSE TO IMPROVE HEALTH OUTCOMES FOR CHILDREN WITH ASTHMA IN THE DAYTON REGION. THE ALLIANCE CONSULTS WITH ADDITIONAL ORGANIZATIONS TO GATHER DATA AND RESEARCH, ASCERTAIN BEST PRACTICES, AND TO IDENTIFY COMMUNITY RESOURCES TO SUPPORT CHILDREN WITH ASTHMA AND TO INFORM THE STRATEGIC FOCUS AREAS. ULTIMATELY, THE ALLIANCE AIMS TO REDUCE HOSPITAL ADMISSION RATES AND EMERGENCY DEPARTMENT VISITS TRIGGERED BY UNCONTROLLED ASTHMA AS REPORTED BY THE OHIO HOSPITAL ASSOCIATION AND DAYTON CHILDREN'S. THE ALLIANCE ALSO AIMS TO REDUCE SCHOOL ABSENCES RELATED TO ASTHMA. TO MEET THESE GOALS THE ALLIANCE IS IMPLEMENTING MULTIPLE PROJECTS FOCUSING ON IMPROVED EDUCATION OF CHILDREN AND FAMILIES AROUND ASTHMA TRIGGERS AND MANAGEMENT, ENHANCED EDUCATION OF SCHOOL PERSONNEL AROUND ASTHMA TRIGGERS AND MANAGEMENT, GREATER COMMUNITY RESOURCES PROVIDED TO CHILDREN AND FAMILIES TO HELP MANAGE ASTHMA, IMPROVED PRIMARY HEALTH CARE OF CHILDREN, AND DECREASED ENVIRONMENTAL TRIGGERS. THIS WORK COULD NOT BE DONE WITHOUT ALIGNMENT WITH A VARIETY OF COMMUNITY STAKEHOLDERS. IN ADDITION TO STAFF AND PERSONNEL FROM DAYTON CHILDREN'S CENTER FOR CHILD HEALTH AND WELLNESS AND DAYTON CHILDREN'S PULMONARY CLINIC, PARTNERS IN THE DAYTON ASTHMA ALLIANCE INCLUDE COMMUNITY PRIMARY CARE PHYSICIANS, COMMUNITY ALLERGISTS, CARESOURCE, COMMUNITY HEALTH CENTERS OF GREATER DAYTON, DAYTON PUBLIC SCHOOLS, GREATER DAYTON PREMIER MANAGEMENT, LEGAL AID OF WESTERN OHIO (MEDICAL-LEGAL PARTNERSHIP), PUBLIC HEALTH DAYTON & MONTGOMERY COUNTY, MIAMI VALLEY CHILD DEVELOPMENT CENTERS, THINK TV, WRIGHT STATE UNIVERSITY CENTER FOR HEALTHY COMMUNITIES AND SCHOOL OF NURSING. ADDITIONAL PARTNERS AND COLLABORATORS ARE CONTINUALLY INVITED TO JOIN THE ALLIANCE AS THE NEEDS OR INTEREST ARISE. DURING FY 2017-2018, THE ALLIANCE CONTINUED A SCHOOL-BASED ASTHMA PROGRAM TO 17 ELEMENTARY SCHOOLS IN DAYTON PUBLIC SCHOOLS IMPACTING 125 STUDENTS WITH ASTHMA. IN THIS PROGRAM, CHILDREN WITH ASTHMA RECEIVED THE AMERICAN LUNG ASSOCIATION'S OPEN AIRWAYS TRAINING IN-SCHOOL. THOSE CHILDREN AND THEIR CAREGIVERS WERE THEN INVITED TO COME TO A CLINICAL EDUCATION SESSION AT THE SCHOOL WHERE THEY RECEIVED EDUCATION FROM THE DAYTON CHILDREN'S ASTHMA EDUCATOR. FINALLY, THE FAMILIES WERE OFFERED HOME VISITS BY A COMMUNITY HEALTH WORKER EMPLOYED BY DAYTON CHILDREN'S. THE HOME VISITOR ASSESSES HOMES AND IDENTIFIES OPPORTUNITIES FOR REMEDIATION AND ASSISTED FAMILIES WITH THEIR SOCIAL NEEDS. CONTINUATION OF PART V, SECTION B, LINE 11: DAYTON CHILDREN'S ALSO PARTNERED WITH MIAMI VALLEY CHILD DEVELOPMENT CENTERS (MVCDC) THROUGH ANOTHER PROGRAM UNDER THE ASTHMA ALLIANCE UMBRELLA. IN THIS PROGRAM, MVCDC HOME-BASED VISITORS RECEIVED TRAINING ON COMMON ASTHMA TRIGGERS INCLUDING DUST, MOLD AND TOBACCO/SECOND-HAND SMOKE. IN TURN, THE HOME-BASED VISITORS EDUCATED OVER 100 FAMILIES ABOUT ASTHMA TRIGGERS IN THE HOME. IN ADDITION TO THE STRATEGIES LISTED ABOVE, THE HOSPITAL WORKED ON THE FOLLOWING PROGRAMS TO ADDRESS CHRONIC DISEASE PREVENTION AND SUPPORT HEALTHY LIFESTYLES.STARTING IN MAY 2017 PHYSICIANS FROM DAYTON CHILDREN'S PARTNERS WITH A NATURALIST FROM FIVE RIVERS METROPARKS TO CO-LEAD AN APPROXIMATELY 1 MILE STROLLER FRIENDLY WALK THROUGH DOWNTOWN DAYTON AS PART OF A MONTHLY WALK WITH A DOC PROGRAM. THIS PROGRAM IS ATTENDED BY APPROXIMATELY 20 PEOPLE PER MONTH DURING FY 2017-2018 IMPROVING ACCESS TO HEALTHY LIFESTYLES PROGRAMS IN OUR COMMUNITY.THE HEALTHY WAY COLLABORATIVE SERVES AS A FORUM TO DISCUSS AND OFFER SOLUTIONS TO HEALTH AND SAFETY ISSUES IN THE GREATER OLD NORTH DAYTON NEIGHBORHOOD. TOGETHER WITH OVER 10 NEIGHBORHOOD PARTNERS, THE HOSPITAL FINDS WAYS TO ADDRESS HEALTH NEEDS, INCLUDING OBESITY, IN THE COMMUNITY. ONE WAY THE COLLABORATIVE ADDRESSES THIS NEED IS THROUGH THE HEALTHY WAY PROGRAM, WHICH REACHED 22 FAMILIES IN FY 2017-2018 WITH NUTRITION EDUCATION, HEALTHY MEALS AND HEALTHY LIFESTYLE LESSONS. THIS PROGRAM IS A COLLABORATION BETWEEN THE OHIO STATE EXTENSION SERVICE, THE SALVATION ARMY KROC CENTER, KISER NEIGHBORHOOD SCHOOLS CENTER AND NEIGHBORHOOD LEADERS. DAYTON CHILDREN'S DIETITIANS ALSO WORK TO TRAIN STUDENTS IN THE FIELD WITH OVER 1,900 HOURS DEDICATED TO THE OVERSIGHT OF STUDENT INTERNS AND VOLUNTEERS. THE CLINICAL NUTRITION STAFF ALSO REACHED 10 DIFFERENT SCHOOLS AND COMMUNITY AGENCIES WITH HEALTHY LIFESTYLE MESSAGING IN FY 2017-2018. TO WORK TOWARD IMPROVING MATERNAL AND INFANT HEALTH, THE FOLLOWING STRATEGIES WERE IDENTIFIED AND EXECUTED:STRATEGY: INCREASE THE USE OF SAFE SLEEP PRACTICESDAYTON CHILDREN'S IS A DESIGNATED CRIBS FOR KIDS SITE. THROUGH THIS PROGRAM, PARENTS/CAREGIVERS NEEDING A SAFE PLACE FOR THEIR BABY TO SLEEP ATTEND A ONE HOUR SAFE-SLEEP CLASS GIVEN BY TRAINED STAFF. AT THE END OF THE CLASS, PARENTS/CAREGIVERS ARE PROVIDED WITH A PORTABLE CRIB. THE HOSPITAL ALSO OFFERS A COMPLETE 'SAFE SLEEP SURVIVAL KIT,' WHICH CONTAINS A HALO SLEEP SACK (WEARABLE BLANKET), A PACK N PLAY CRIB SHEET, AND A PACIFIER APPROVED BY THE AMERICAN ACADEMY OF PEDIATRICS. IN FY 2017-2018, DAYTON CHILDREN'S DISTRIBUTED OVER 214 PACK N PLAYS THROUGH THIS PROGRAM, PARTIALLY FUNDED BY THE OHIO DEPARTMENT OF HEALTH. IN ADDITION, THE HOSPITAL'S INFANT MORTALITY PREVENTION AND AWARENESS COMMITTEE, OFFERS COMMUNITY BASED EDUCATION ON SAFE SLEEP IN A VARIETY OF SETTINGS. THE COMMITTEE ALSO WORKS TO PROVIDE SAFE SLEEP EDUCATION TO INTERNAL STAFF AND PATIENT FAMILIES. TO ADDRESS MOST PRIORITY AREAS, THE FOLLOWING CROSS-CUTTING STRATEGIES WERE IDENTIFIED AND EXECUTED: STRATEGY: INCREASE BREASTFEEDINGAS PART OF THE HOSPITAL'S INFANT MORTALITY AWARENESS AND PREVENTION COMMITTEE, A HOSPITAL PHYSICIAN WORKED TO INCREASE RESIDENT'S KNOWLEDGE, CONFIDENCE AND ATTITUDES OF BREASTFEEDING IN ORDER TO FURTHER BREASTFEEDING ADOPTION WITHIN THE COMMUNITY. THE GOAL OF THE PROJECT WAS TO IMPROVE RESIDENT'S KNOWLEDGE BY PROVIDING FOUR LECTURES ABOUT BREASTFEEDING AND SURVEYING THE RESIDENTS BEFORE AND AFTER THE EDUCATION. THE RESULTS SHOWED THAT THE EDUCATION IMPROVED KNOWLEDGE AND CONFIDENCE. STRATEGY: EXPLORE AND IMPLEMENT SCREENINGS TO ADDRESS SOCIAL AND BEHAVIORAL NEEDSTHE FAMILY RESOURCE CONNECTION USES A PATIENT'S VISIT TO THE DOCTOR AS AN OPPORTUNITY TO ADDRESS THE NON-MEDICAL ISSUES THAT HAVE AN IMPACT ON HEALTH. THIS PROGRAM SCREENS PATIENT FAMILIES FOR SOCIAL NEEDS. IDENTIFIED FAMILIES THEN ARE REFERRED TO AN ADVOCATE WORKING IN THE DAYTON CHILDREN'S HOSPITAL FAMILY RESOURCE CONNECTION FOR RESOURCE CONNECTION AND FOLLOW-UP. THE FAMILY RESOURCE CONNECTION IS MODELED AFTER THE WELL-KNOWN AND RESPECTED HEALTH LEADS PROGRAM.HEALTH LEADS (HEALTHLEADSUSA.ORG) IS A NATIONAL MOVEMENT THAT ENVISIONS A HEALTHCARE SYSTEM THAT ADDRESSES ALL PATIENTS' BASIC RESOURCE NEEDS AS A STANDARD PART OF QUALITY CARE. HEALTH LEADS' MISSION IS TO CATALYZE THIS HEALTHCARE SYSTEM BY CONNECTING PATIENTS WITH THE BASIC RESOURCES THEY NEED TO BE HEALTHY, AND IN DOING SO, BUILD LEADERS WITH THE CONVICTION AND ABILITY TO CHAMPION QUALITY CARE FOR ALL PATIENTS. HEALTH LEADS HAS OVER 19 YEARS OF EXPERIENCE BUILDING SOCIAL NEEDS PROGRAMS IN HOSPITAL AND CLINIC SETTINGS.IN FY 2017-2018, THE FAMILY RESOURCE CONNECTION HAS PROVEN OUTCOMES IN CONNECTING PATIENT FAMILIES TO RESOURCES. IN ITS FIRST YEAR, 838 FAMILIES ENGAGED IN THE PROGRAM AND OVER 612 RESOURCE CONNECTIONS WERE MADE. THE GREATEST NEEDS IDENTIFIED IN THE FAMILY RESOURCE CONNECTION ARE COMMODITIES INCLUDING DIAPERS, CRIBS AND BEDS, SCHOOL SUPPLIES AND CLOTHING.IN ADDITION TO PROVIDING POSITIVE OUTCOMES FOR FAMILIES, THE FAMILY RESOURCE CONNECTION HELPS TO TRAIN THE NEXT GENERATION OF THE HEALTH CARE WORKFORCE. OVER THE LAST YEAR, 28 STUDENT ADVOCATES FROM MULTIPLE COLLEGES AND UNIVERSITIES IN A VARIETY OF PROGRAMS AND MAJORS ENGAGED WITH THE PROGRAM. THE STUDENTS HAVE RANGED FROM CERTIFICATE PROGRAMS, ASSOCIATE, BACHELOR TO MASTERS DEGREES WITH A VARIETY OF PROGRAMS AND MAJORS WHICH HAVE INCLUDED PRE-MEDICAL, SOCIAL WORK, HEALTH CARE ADMINISTRATION, PUBLIC HEALTH, SOCIAL SERVICES AND HEALTH CARE NAVIGATOR.STRATEGY: INTEGRATE COMMUNITY HEALTH WORKERS INTO CLINICAL SERVICESRECOGNIZING THAT A SIGNIFICANT PORTION OF A CHILD'S HEALTH IS DETERMINED BY NON-CLINICAL FACTORS, DAYTON CHILDREN'S BEGIN EMPLOYING COMMUNITY HEALTH WORKERS TO SUPPORT SOME OF OUR MOST VULNERABLE POPULATIONS. THROUGH A GRANT FROM THE OHIO DEPARTMENT OF JOB AND FAMILY SERVICES AND MONTGOMERY COUNTY, DAYTON CHILDREN'S EMPLOYS TWO KINSHIP NAVIGATORS WHO KINSHIP FAMILIES BY HELPING THEM NAVIGATE SAFETY NET SYSTEMS, CONNECT TO RESOURCES AND COMPLETE BENEFIT FORMS FOR COUNTY, STATE, AND LOCAL AGENCIES. ANY KINSHIP CAREGIVER IN OUR COMMUNITY CAN ACCESS THE KINSHIP NAVIGATORS HOWEVER THE NAVIGATORS WORK CLOSELY WITH OUR NEW FOSTER/KINSHIP CLINIC AS WELL. IN ADDITION TO THE KINSHIP NAVIGATORS, DAYTON CHILDREN'S HIRED A COMMUNITY HEALTH WORKER ASSIGNED TO THE DAYTON ASTHMA ALLIANCE AND THE PULMONARY CLINIC. THIS COMMUNITY HEALTH WORKER WORKS DIRECTLY WITH FAMILIES IMPACTED BY ASTHMA TO IDENTIFY THE NON-MEDICAL BARRIERS TO OPTIMAL HEALTH INCLUDING HOUSING, FOOD INSECURITY AND EDUCATIONAL SUPPORT. THE COMMUNITY HEALTH WORKER OFTEN CONDUCTS HOME VISITS TO IDENTIFY ASTHMA TRIGGERS AND OFFERS REMEDIATION AND OTHER SOCIAL SUPPORT.STRATEGY: PROMOTE A REGIONAL CHILDHOOD VACCINATION CAMPAIGNTHIS STRATEGY BEGAN WITH WORK AROUND IDENTIFYING HOW MANY CHILDREN IN OUR COMMUNITY MIGHT NOT BE VACCINATED. THE HOSPITAL BEGAN OFFERING THE FLU SHOT TO CAREGIVERS OF OUR INPATIENT CHILDREN IN 2017 AND SUCCESSFULLY VACCINATED SEVERAL HUNDRED ADULTS. WE WANTED TO EXTEND THE PROGRAM TO OUR OUTPATIENT CHILDREN AND CAREGIVERS, BUT NEEDED TO PLAN FOR HOW MANY EXTRA SHOTS WE WOULD NEED TO ORDER. WE ASKED EVERY FAMILY WHO CAME TO US THROUGH THE EMERGENCY DEPARTMENT OR FOR AN OUTPATIENT VISIT IF THEIR CHILD HAD RECEIVED THE FLU VACCINE. THE NUMBERS WERE STAGGERING. LESS THAN 30 PERCENT OF CHILDREN WHO CAME TO DAYTON CHILDREN'S FOR ANY REASON WERE VACCINATED AGAINST THE FLU. A TEAM WITH MEMBERS FROM INFECTIOUS DISEASE, PHARMACY, VALUE IMPROVEMENT, MARKETING AND COMMUNITY HEALTH ALL CAME TOGETHER TO FIND HOW TO BETTER SERVE OUR CHILDREN IN SUBSEQUENT FLU SEASONS.STRATEGY: IMPLEMENT A FOOD INSECURITY SCREENING AND REFERRAL PROGRAMIN FY 2017-2018, DAYTON CHILDREN'S LEVERAGED OUR FAMILY RESOURCE CONNECTION PROGRAM WITHIN DAYTON CHILDREN'S PEDIATRICS TO SCREEN FAMILIES FOR FOOD INSECURITY AND CONNECT THEM TO COMMUNITY RESOURCES. SCREENING ALSO SPREAD INTO THE HOSPITAL'S NUTRITION CLINIC. PLANS BEGAN FOR HOW THIS PROGRAM WILL BE INTEGRATED IN TO THE FOOD PHARMACY PROGRAM. STRATEGY: IMPLEMENT A FOOD PHARMACY PROGRAMIN FY 2017-2018, PLANS WERE MADE TO LOCATE A FOOD PHARMACY WITHIN THE CHILD HEALTH PAVILION CURRENTLY UNDERGOING CONSTRUCTION. THE PHARMACY WOULD BE CO-LOCATED NEXT TO THE PRIMARY CARE CLINIC GIVING PATIENT FAMILIES EASY ACCESS TO THIS RESOURCE. A RELATIONSHIP BEGAN WITH THE FOOD BANK TO HELP SUPPORT THE FOOD PHARMACY WITH THE WRITING OF A GRANT TO OBTAIN THE INITIAL FOOD NEEDED IN THE PHARMACY. 8 1 - SPRINGBORO SOUTH URGENT CARE & OP CARE C 3333 WEST TECH ROAD MIAMISBURG OH 45342 URGENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER 2 - HUBER HEIGHTS OUTPATIENT TESTING CENTER 8501 OLD TROY PIKE HUBER HEIGHTS OH 45424 OUTPATIENT DIAGNOSTIC CENTER 3 - SPRINGFIELD SPECIALTY CARE CENTER 30 W MCCREIGHT AVENUE SPRINGFIELD OH 45504 OUTPATIENT DIAGNOSTIC CENTER 4 - BEAVERCREEK OUTPATIENT TESTING CENTER 3224 DAYTON-XENIA ROAD BEAVERCREEK OH 45431 OUTPATIENT DIAGNOSTIC CENTER 5 - VANDALIA OUTPATIENT TESTING CENTER 810 FALLS CREEK DRIVE SUITE A VANDALIA OH 45377 OUTPATIENT DIAGNOSTIC CENTER 6 - WARREN COUNTY SPECIALTY CARE CENTER 100 CAMPUS LOOP ROAD SUITE A FRANKLIN OH 45005 OUTPATIENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER 7 - KETTERING OUTPATIENT TESTING CENTER 4475 FAR HILLS AVENUE KETTERING OH 45429 OUTPATIENT DIAGNOSTIC CENTER 8 - SUGARCREEK OUTPATIENT TESTING CENTER 6116 WILMINGTON PIKE CENTERVILLE OH 45459 OUTPATIENT DIAGNOSTIC CENTER PART I, LINE 3C: IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS AND RESIDENCY TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE. PART I, LINE 7: THE FOLLOWING COSTING METHODOLOGIES WERE USED IN PREPARATION OF SCHEDULE H, PART I, LINE 7:- CHARITY CARE AT COST WAS CALCULATED USING THE COST TO CHARGE RATIO. - UNREIMBURSED MEDICAID WAS CALCULATED USING THE COST TO CHARGE RATIO. - COMMUNITY HEALTH IMPROVEMENT SERVICES WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION. - HEALTH PROFESSIONS EDUCATION COSTS WERE DETERMINED USING THE FACILITY'S MEDICARE COST REPORTED, SUPPLEMENTED BY THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. - SUBSIDIZED HEALTH SERVICES COSTS WERE DETERMINED USING THE FACILITY'S INTERNAL COST ACCOUNTING SYSTEM. THE COST OF THESE SERVICES INCLUDES DIRECT COSTS ATTRIBUTABLE TO HEALTH SERVICES OPERATIONS, TOGETHER WITH AN ALLOCATION OF FACILITY DIRECT AND INDIRECT OVERHEAD USING A COST FINDING METHODOLOGY PATTERNED AFTER THE MEDICARE COST REPORT. - CASH AND IN KIND CONTRIBUTIONS WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION. PART I, LINE 7G: DAYTON CHILDREN'S INCLUDED $35,057,940 OF PHYSICIAN CLINIC COSTS IN THE SUBSIDIZED HEALTH SERVICES CATEGORY. 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 $ 12,429,883. PART II, COMMUNITY BUILDING ACTIVITIES: AS THE ONLY CHILDREN'S HOSPITAL IN THE REGION, WE TAKE OUR PEDIATRIC EXPERTISE INTO THE COMMUNITY TO SOLVE PROBLEMS AND CREATE A HEALTHY COMMUNITY FOR OUR CHILDREN. OUR COMMUNITY RELATIONSHIPS DEMONSTRATE OUR COMMITMENT TO DAYTON AND THE SURROUNDING COMMUNITY - A COMMUNITY WE HAVE CALLED HOME FOR NEARLY 50 YEARS. DAYTON CHILDREN'S IS COMMITTED TO WORKING WITH OUR MANY VALUED PARTNERS TO HELP ENSURE DAYTON REMAINS A GREAT CITY FOR CHILDREN TO LIVE, LEARN, GROW AND PLAY.SENSORY PROGRAMSDAYTON CHILDREN'S PARTNERED WITH THE BOONSHOFT MUSEUM OF DISCOVERY, THE DAYTON BALLET AND THE VICTORIA THEATRE ASSOCIATION TO PROVIDE THE SUPPORTS NEEDED TO BRING SENSORY FRIENDLY PROGRAMMING TO LIFE. EACH OF THESE ORGANIZATIONS DECIDED TO GO ABOVE AND BEYOND FOR THE CHILDREN IN THE GREATER DAYTON AREA BY PROVIDING SENSORY FRIENDLY OPPORTUNITIES TO FAMILIES. SENSORY-FRIENDLY DAYS PROVIDE A REDUCTION OF LOUD OR JARRING SOUNDS, THE ABSENCE OF FLASHING OR STROBE LIGHTING OR LOUD EQUIPMENT, AND JUDGMENT-FREE ENVIRONMENT WHERE ALL PATRONS ARE FREE TO VOCALIZE OR MOVE AROUND. ON THESE DAYS NO ONE WILL BE ASKED TO LEAVE DUE TO SOUND, MOVEMENT OR BEHAVIORS RELATED TO COGNITIVE/DEVELOPMENTAL ABILITIES. THE BOONSHOFT MUSEUM OF DISCOVERY WITH THE SUPPORT AND EXPERTISE OF DAYTON CHILDREN'S STAFF HOSTED 6 SENSORY SUNDAY EVENTS, OPENING THE MUSEUM TO FAMILIES OUTSIDE THEIR NORMAL BUSINESS HOURS WITH LOWER LIGHTING, LOWER VOLUME AND PLENTY OF VOLUNTEERS TO SUPPORT FAMILIES. BOTH THE DAYTON BALLET AND THE VICTORIA THEATRE ASSOCIATION OFFERED SENSORY FRIENDLY PERFORMANCES OF THE NUTCRACKER, GO DOG, GO. AND JOURNEY TO OZ. BEFORE CHILDREN ATTENDED THE MUSEUM AND THE THEATER, DAYTON CHILDREN'S STAFF ENSURED ALL POTENTIAL OVERSTIMULATING ELEMENTS WERE ADDRESSED AND PLANNED FOR BY STAFF AND VOLUNTEERS. THE DAVINCI PROJECTTHE DAVINCI PROJECT IS A COMPREHENSIVE STRATEGY FOR NEIGHBORHOOD REVITALIZATION SUPPORTED IN THE OLD NORTH DAYTON AND MCCOOK FIELD NEIGHBORHOODS AND THE BUSINESS COMMUNITY AROUND IT INCLUDING DAYTON CHILDREN'S. DAYTON CHILDREN'S LEADS THIS EFFORT AND IS JOINED BY PARTNERS INCLUDING THE CITY OF DAYTON, GREATER OLD NORTH DAYTON BUSINESS ASSOCIATION, THE SALVATION ARMY KROC CENTER, THE UNIVERSITY OF DAYTON FITZ CENTER OF LEADERSHIP IN COMMUNITY, ST. MARY'S COMMUNITY DEVELOPMENT CORP. AND CITY WIDE DEVELOPMENT. THE DAVINCI PROJECT IS WORKING ON EFFORTS TO DEMOLISH NUISANCE BUILDINGS, REALIGN STREETS, BUILD A CHILDREN'S GARDEN, REVITALIZE BUS STOPS, IMPROVE WAYFINDING, AND BEAUTIFY THE NEIGHBORHOOD SO IT CONTINUES TO BE ATTRACTIVE TO FAMILIES AND BUSINESSES. THIS PROJECT IS IMPORTANT TO DAYTON CHILDREN'S, NOT ONLY BECAUSE WE WANT TO BE AN ACTIVE PARTICIPANT IN OUR COMMUNITY, WE WANT PATIENTS, STAFF, VOLUNTEERS AND VISITORS TO FEEL WELCOME WHEN THEY ENTER THE OLD NORTH DAYTON A NEIGHBORHOOD THAT WE ARE PROUD TO CALL HOME. BRIGID'S PATHIN FY 2017-2018, DAYTON CHILDREN'S SUPPORTED BRIGID'S PATH TO PROVIDE A SUPPORTIVE TRANSITION OF CARE FOR NEWBORNS WHO HAVE BEEN BORN WITH NEONATAL ABSTINENCE SYNDROME. THE HOSPITAL IS COMMITTED TO COMMUNITY PARTNERS WORKING TOGETHER TO SUPPORT NEWBORNS, CHILDREN AND FAMILIES. DAYTON CHILDREN'S, ALONG WITH THE BIRTHING HOSPITALS IN THE COMMUNITY, HAVE BEEN SUPPORTIVE OF BRIGID'S PATH. BRIGID'S PATH IS A COMMUNITY-BASED ORGANIZATION WHICH PROVIDES SHORT-TERM, INPATIENT CARE IN A HOME-LIKE SETTING FOR NEWBORNS SUFFERING FROM PRENATAL DRUG EXPOSURE. IN SUPPORT OF THIS PROGRAM, DAYTON CHILDREN'S PROVIDES IN-KIND CLINICAL GUIDANCE AS BRIGID'S PATH NAVIGATED THE CHALLENGES OF BECOMING A FULLY LICENSED CHILDREN'S CRISIS CARE FACILITY THROUGH THE OHIO DEPARTMENT OF JOBS AND FAMILY SERVICES. IN ADDITION, FOR THIS PAST YEAR WE PROVIDED THE HIRING AND LEASING OF RN AND PCA EMPLOYEES, OUR VOLUNTEER EXPERIENCE TEAM WORKED CLOSELY WITH BRIGID'S PATH TO TRAIN THEIR VOLUNTEERS WHO NOW PROVIDE SUPPORT TO THE FACILITY AND OUR TRANSPORT TEAM PROVIDES TRANSPORTATION OF THE NEWBORN FROM THE HOSPITAL SETTING TO BRIGID'S PATH. COMMUNITY LEADERSHIPBEYOND PARTICIPATION IN ORGANIZATIONS THAT DIRECTLY IMPACT CHILDREN AND CHILDREN'S HEALTH, DAYTON CHILDREN'S STAFF AND LEADERSHIP SERVE ON VARIOUS COALITIONS TO IMPROVE THE ECONOMIC AND SOCIAL HEALTH OF OUR COMMUNITY INCLUDING THE PRESCHOOL PROMISE, UNITED WAY, THE FAMILY AND CHILDREN FIRST COUNCIL, AND THE MARCH OF DIMES. THROUGH THESE ACTIVITIES, DAYTON CHILDREN'S STRIVES TO CREATE A COMMUNITY THAT IS A PLACE WHERE ALL CHILDREN AND FAMILIES GROW AND THRIVE. DAYTON CHILDREN'S IS AN INDISPENSABLE RESOURCE TO OUR COMMUNITY BECAUSE WE: -SERVE AS THE COMMUNITY'S SAFETY NET HOSPITAL BY CARING FOR ALL CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, WHILE PROVIDING AND SUBSIDIZING HOSPITAL AND COMMUNITY-BASED SERVICES THAT ARE EITHER LIMITED OR UNAVAILABLE ELSEWHERE IN OUR COMMUNITY.-SERVE AS A VOICE FOR CHILDREN THROUGH PUBLIC POLICY ADVOCACY TO CHANGE LAWS, POLICIES, OR SYSTEMS LEADING TO THE IMPROVEMENT OF HEALTH AND SAFETY FOR CHILDREN AND FAMILIES.-JOIN WITH COMMUNITY PARTNERS AND LEND SUPPORT THROUGHOUT OUR REGION TO IMPROVE THE LIVES OF CHILDREN AND THEIR FAMILIES.-TRAIN FUTURE DOCTORS AND HEALTH CARE PROVIDERS TO BECOME THE NEXT GENERATION OF HIGH QUALITY, PROFESSIONAL PEDIATRIC EXPERTS, OFTEN AT A FINANCIAL LOSS TO THE HOSPITAL.AS A TEACHING HOSPITAL, DAYTON CHILDREN'S IS DEDICATED TO TRAINING THE NEXT GENERATION OF PEDIATRICIANS AND PEDIATRIC SPECIALISTS. EACH YEAR, DAYTON CHILDREN'S HOSTS MEDICAL RESIDENTS FROM THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE. IN ADDITION, DAYTON CHILDREN'S HOUSES THIS COUNTRY'S ONLY CIVILIAN/MILITARY INTEGRATED PEDIATRIC RESIDENCY PROGRAM WITH WRIGHT-PATTERSON AIR FORCE BASE. PHYSICIANS TRAINED AT DAYTON CHILDREN'S ARE CARING FOR CHILDREN IN OUR REGION AND THROUGHOUT THE WORLD. IN ADDITION, WE WORK WITH NUMEROUS COLLEGES AND UNIVERSITIES TO HELP TRAIN STUDENTS IN MULTIPLE DISCIPLINES INCLUDING NURSING, PUBLIC HEALTH, SOCIAL WORK, AND MANY MORE AREAS REQUIRED BY MODERN HEALTHCARE. TRAINING INVOLVES SIGNIFICANT COSTS FAR BEYOND THOSE USUALLY ASSOCIATED WITH PATIENT CARE. HOWEVER, WE RECOGNIZE TRAINING THE NEXT GENERATION OF HEALTH CARE WORKERS IS ESSENTIAL TO THE OVERALL HEALTH OF OUR COMMUNITY. DAYTON CHILDREN'S JOINS WITH OTHER CHILDREN'S HOSPITALS ACROSS THE COUNTRY TO ADDRESS ISSUES UNIQUE TO THE POPULATION WE SERVE. WE WORK WITH THE CHILDREN'S HOSPITAL ASSOCIATION, THE OHIO CHILDREN'S HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION TO ENSURE CHILDREN HAVE A VOICE IN POLICY MATTERS. DAYTON CHILDREN'S FURTHER SUPPORTS COMMUNITY EFFORTS TO IMPROVE THE HEALTH AND SAFETY OF CHILDREN THROUGHOUT THE REGION THROUGH DONATIONS AND SPONSORSHIPS MADE TO PROGRAMS THAT SUPPORT, HELP AND IMPROVE THE HEALTH STATUS OF CHILDREN AND IMPROVE THE QUALITY OF LIFE FOR CHILDREN AND THEIR FAMILIES. DAYTON CHILDREN'S HAS ASSISTED MANY ORGANIZATIONS INCLUDING: A SPECIAL WISH, AMERICAN HEART ASSOCIATION, AMERICAN RED CROSS, BIG BROTHERS AND BIG SISTERS, CLOTHES THAT WORK, JUVENILE DIABETES RESEARCH FOUNDATION, MARCH OF DIMES, RONALD MCDONALD HOUSE CHARITIES, ST. VINCENT DE PAUL, AND THE YMCA. IN ADDITION, WE HAVE SUPPORT MANY COMMUNITY YOUTH SPORTS TEAMS TO ENSURE LOCAL CHILDREN HAVE ACCESS TO HEALTHY ACTIVITIES. AT DAYTON CHILDREN'S, WE BELIEVE THAT ALL CHILDREN IN OUR REGION DESERVE A GREAT CHILDREN'S HOSPITAL CLOSE TO HOME. WE ARE DEDICATED TO ADDRESSING THE HEALTH AND WELLNESS NEEDS OF CHILDREN BOTH THROUGH CLINICAL PRACTICE AS WELL AS OUR COMMUNITY BENEFIT ACTIVITIES. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE OF SELF-PAY ACCOUNTS RECEIVABLE INCLUDING THOSE BALANCES AFTER INSURANCE PAYMENTS AND NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR BAD DEBTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENTS THEMSELVES HAVE BEEN EXHAUSTED, THE HOSPITAL MAY PLACE CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE HOSPITAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. PART III, LINE 4: THE COSTING METHODOLOGY USED IN PREPARATION OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS IS THE COST TO CHARGE RATIO, RATIO OF PATIENT COST-TO-CHARGE. THE DAYTON CHILDREN'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE. A PROVISION FOR BAD DEBT EXPENSE IS SHOWN ON THE PROFIT AND LOSS STATEMENT. THE CALCULATION FOR BAD DEBT EXPENSE IS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES REQUIRING MANAGEMENT TO MAKE ESTIMATES AND ASSUMPTIONS BASED ON HISTORICAL DATA THAT AFFECT THE REPORTED AMOUNTS OF REVENUE AND EXPENSES DURING THE REPORTED PERIOD. LIKEWISE, AN ALLOWANCE FOR BAD DEBT IS SHOWN ON THE BALANCE SHEET UNDER THE SAME PRINCIPLE AFFECTING THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES DURING THE REPORTED PERIOD. PART III, LINE 8: THE COSTS REPORTED FOR SERVICES PROVIDED TO MEDICARE PATIENTS COME FROM SCHEDULE E OF THE FACILITY'S COST REPORT AS FILED. SINCE DAYTON CHILDREN'S IS REIMBURSED FOR MEDICARE SERVICES UNDER A TEFRA METHODOLOGY, THERE IS NORMALLY NO SHORTFALL, AS ALLOWED COSTS AND PAYMENTS DUE ARE EQUAL. PART III, LINE 9B: THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE UNDER THE "FINANCIAL MATTERS" TAB. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT AND OTHER FINANCIAL ASSISTANCE PROGRAMS UP FRONT BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS. EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSITANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE0-TO-FACE INTERVIEWS. THESE FINANCIAL ASSISTANCE COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE PROGRAMS IF DESIRED. PART VI, LINE 2: IN ADDITION TO OUR CHNA, DAYTON CHILDREN'S ASSESSES THE NEEDS OF OUR COMMUNITY IN A VARIETY OF WAYS. WE SERVE AS A KEY COMMUNITY PARTNER ON MANY LOCAL INITIATIVES WHICH ALLOWS US TO BETTER UNDERSTAND COMMUNITY NEEDS AND TRENDS. WE ALSO HAVE SEVERAL OTHER COMMUNITY BASED PROGRAMS WHICH ALLOW FOR FEEDBACK ABOUT THE COMMUNITY. CENTER FOR CHILD HEALTH AND WELLNESSDAYTON CHILDREN'S MISSION IS TO IMPROVE THE HEALTH AND WELLBEING OF ALL CHILDREN, NOT JUST THOSE WHO COME TO THE ORGANIZATION FOR CARE. AS A RESULT, THE BOARD OF TRUSTEES APPROVED THE FORMATION OF THE CENTER FOR CHILD HEALTH AND WELLNESS IN FEBRUARY 2015 TO BETTER ADDRESS THE ISSUES IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT. THE CENTER ADDS MORE CAPACITY TO ADDRESS CHILD HEALTH AND SAFETY CONCERNS BEYOND THE WALLS OF THE HOSPITAL AND TO HELP PRIORITIZE THE HEALTH AND SAFETY NEEDS IN OUR COMMUNITY ENSURING ALL CHILDREN IN OUR REGION THRIVE. THE CENTER FOR CHILD HEALTH AND WELLNESS ENGAGES WITH A BROAD AND DIVERSE SET OF STAKEHOLDERS TO INFLUENCE AND POSITIVELY IMPACT CHILDREN'S OVERALL HEALTH IN A MEASURABLE WAY IN SUPPORT OF DAYTON CHILDREN'S MISSION. THE CENTER IS RESPONSIBLE FOR FOCUSING THE HOSPITAL'S COMMUNITY ENGAGEMENT TO HAVE A TRUE IMPACT ON CHILDREN'S HEALTH. THIS WORK IS ACCOMPLISHED THROUGH RESOURCE CONNECTION AND COMMUNITY COLLABORATION AND IS BASED IN DATA AND RESEARCH OF THE COMMUNITY'S GREATEST PEDIATRIC HEALTH NEEDS. THE CENTER AIMS TO ADDRESS THE "UPSTREAM" SOCIAL DETERMINANTS OF HEALTH MOST GREATLY AFFECTING CHILDREN IN OUR REGION. DAYTON ASTHMA ALLIANCETHE DAYTON ASTHMA ALLIANCE AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, FOCUSING ON THE MOST AT-RISK POPULATIONS. USING THE COLLECTIVE IMPACT FRAMEWORK, THE ALLIANCE ENGAGES LOCAL PARTNER ORGANIZATIONS TO COLLABORATIVELY IMPLEMENT A VARIETY OF STRATEGIC ACTIONS TO IMPROVE OUTCOMES FOR CHILDREN WITH ASTHMA. TO HAVE THE GREATEST IMPACT AND TO ENSURE ALL CHILDREN WITH ASTHMA HAVE OPTIMAL HEALTH OUTCOMES, THE ALLIANCE IDENTIFIED THREE STRATEGIC FOCUS AREAS FOR THEIR WORK 1) ENSURE ASTHMA-FRIENDLY ENVIRONMENTS; 2) ENHANCE ACCESS TO HIGH QUALITY HEALTHCARE AND SUPPORTIVE SOCIAL SERVICES THROUGH CLINICAL-COMMUNITY LINKAGES; AND 3) EDUCATE AND EQUIP CHILDREN, FAMILIES AND THE COMMUNITY FOR ASTHMA WELLNESS. TO SUPPORT WORK IN THESE AREAS, DAYTON CHILDREN'S SERVES AS THE BACKBONE ORGANIZATION CONVENING THE GROUP OF COMMITTED STAKEHOLDERS AND SUPPORTING THE ALLIANCE WITH STAFF AND RESOURCES. THE ALLIANCE IS GOVERNED BY ENTITIES WITH A COMMON PURPOSE TO IMPROVE HEALTH OUTCOMES FOR CHILDREN WITH ASTHMA IN THE DAYTON REGION. THE ALLIANCE CONSULTS WITH ADDITIONAL ORGANIZATIONS TO GATHER DATA AND RESEARCH, ASCERTAIN BEST PRACTICES, AND TO IDENTIFY COMMUNITY RESOURCES TO SUPPORT CHILDREN WITH ASTHMA AND TO INFORM THE STRATEGIC FOCUS AREAS. THIS WORK COULD NOT BE DONE WITHOUT ALIGNMENT WITH A VARIETY OF COMMUNITY STAKEHOLDERS. IN ADDITION TO STAFF AND PERSONNEL FROM DAYTON CHILDREN'S CENTER FOR CHILD HEALTH AND WELLNESS AND DAYTON CHILDREN'S PULMONARY CLINIC, PARTNERS IN THE DAYTON ASTHMA ALLIANCE INCLUDE COMMUNITY PRIMARY CARE PHYSICIANS, COMMUNITY ALLERGISTS, CARESOURCE, COMMUNITY HEALTH CENTERS OF GREATER DAYTON, DAYTON PUBLIC SCHOOLS, GREATER DAYTON PREMIER MANAGEMENT, LEGAL AID OF WESTERN OHIO (MEDICAL-LEGAL PARTNERSHIP), PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY, MIAMI VALLEY CHILD DEVELOPMENT CENTERS, AND THINK TV. ADDITIONAL PARTNERS AND COLLABORATORS ARE CONTINUALLY INVITED TO JOIN THE ALLIANCE AS THE NEEDS OR INTEREST ARISE. FAMILY RESOURCE CONNECTIONWHEN PATIENTS AND THEIR FAMILIES SEEK MEDICAL CARE, THEY ARE OFTEN FACING ADDITIONAL CRITICAL CHALLENGES IN THEIR LIVES - THEY MAY HAVE LITTLE FOOD, THEY MAY NOT HAVE A JOB, OR THEY STRUGGLE TO KEEP UP WITH BILLS FOR UTILITIES. UNFORTUNATELY, THESE CHALLENGES OFTEN AFFECT THEIR HEALTH. THE FAMILY RESOURCE CONNECTION USES A PATIENT'S VISIT TO THE DOCTOR AS AN OPPORTUNITY TO ADDRESS THE NON-MEDICAL ISSUES THAT HAVE AN IMPACT ON HEALTH. THIS PROGRAM SCREENS PATIENT FAMILIES FOR SOCIAL NEEDS. IDENTIFIED FAMILIES THEN ARE REFERRED TO AN ADVOCATE WORKING IN THE DAYTON CHILDREN'S HOSPITAL FAMILY RESOURCE CONNECTION FOR RESOURCE CONNECTION AND FOLLOW-UP. THE FAMILY RESOURCE CONNECTION IS MODELED AFTER THE WELL-KNOWN AND RESPECTED HEALTH LEADS PROGRAM.IN FY 2017, THE FAMILY RESOURCE CONNECTION HAS PROVEN OUTCOMES IN CONNECTING PATIENT FAMILIES TO RESOURCES. IN ITS FIRST YEAR, OVER 1000 FAMILIES ENGAGED IN THE PROGRAM AND OVER 700 RESOURCE CONNECTIONS WERE MADE. THE GREATEST NEEDS IDENTIFIED IN THE FAMILY RESOURCE CONNECTION ARE COMMODITIES INCLUDING DIAPERS, CRIBS AND BEDS, SCHOOL SUPPLIES AND CLOTHING.IN ADDITION TO PROVIDING POSITIVE OUTCOMES FOR FAMILIES, THE FAMILY RESOURCE CONNECTION HELPS TO TRAIN THE NEXT GENERATION OF THE HEALTH CARE WORKFORCE. OVER THE LAST YEAR, 32 STUDENT ADVOCATES FROM MULTIPLE COLLEGES AND UNIVERSITIES IN A VARIETY OF PROGRAMS AND MAJORS ENGAGED WITH THE PROGRAM. THE STUDENTS HAVE RANGED FROM CERTIFICATE PROGRAMS, ASSOCIATE, BACHELOR TO MASTERS DEGREES WITH A VARIETY OF PROGRAMS AND MAJORS WHICH HAVE INCLUDED PRE-MEDICAL, SOCIAL WORK, HEALTH CARE ADMINISTRATION, PUBLIC HEALTH, SOCIAL SERVICES AND HEALTH CARE NAVIGATOR. THIS PROGRAM ALSO HELPS US IDENTIFY CURRENT CHALLENGES THAT OUR FAMILIES ARE FACING IN THE COMMUNITY AND WORK WITH COMMUNITY PARTNERS TO ADDRESS THOSE ISSUES.KISER NEIGHBORHOOD SCHOOLS CENTERDAYTON CHILDREN'S BECAME THE NEW COMMUNITY PARTNER TO KISER NEIGHBORHOOD SCHOOLS CENTER BEGINNING JULY 1, 2016, AS PART OF THE DAYTON PUBLIC SCHOOL'S NEIGHBORHOOD SCHOOL CENTER PROGRAM. NEIGHBORHOOD SCHOOL CENTERS ARE DAYTON PUBLIC SCHOOLS THAT ARE CENTERED ON THEIR NEIGHBORHOODS, SERVING AS HEALTHY PLACES OF LEARNING FOR CHILDREN AND FAMILIES. THEY SEEK TO IMPROVE STUDENT PERFORMANCE, REALIGN COMMUNITY RESOURCES TO SUPPORT YOUTH ACHIEVEMENT AND IMPROVE QUALITY OF LIFE IN THE NEIGHBORHOOD. FOCUSED ON COMMUNITY LEADERSHIP, NEIGHBORHOOD SCHOOL CENTERS BRING TOGETHER PARTNERS TO OFFER A RANGE OF OPPORTUNITIES TO CHILDREN, FAMILIES, AND COMMUNITIES. TO AID IN THIS PARTNERSHIP, A GRANT-FUNDED DAYTON CHILDREN'S STAFF MEMBER SERVES AS SITE COORDINATOR IN THE SCHOOL. IN ADDITION TO MANAGING THE DUTIES OF THE SITE COORDINATOR, DAYTON CHILDREN'S OFFERED VARIOUS SERVICES TO CHILDREN AT KISER INCLUDING A RESILIENCY PROGRAM IN FY 2017. THIS IS A KEY PARTNERSHIP AS KISER NEIGHBORHOOD SCHOOLS CENTER IS IN OUR BACKGROUND, THE GREATER OLD NORTH DAYTON. PART VI, LINE 3: THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE UNDER THE "FINANCIAL MATTERS" TAB. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT, AND OTHER FINANCIAL ASSISTANCE PROGRAMS BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE-TO-FACE INTERVIEWS. THESE FINANCIAL COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: DAYTON CHILDREN'S HOSPITAL IS LOCATED IN OLD NORTH DAYTON, NORTHEAST OF DOWNTOWN DAYTON AND THE URBAN CORE, IN MONTGOMERY COUNTY IN SOUTHWESTERN OHIO. THE HOSPITAL'S ROOTS CAN BE TRACED BACK TO 1919, WHEN PHILANTHROPIST AND ACTIVIST ANNA BARNEY GORMAN PLANNED A NORTH DAYTON COMMUNITY CENTER TO OFFER HEALTH SERVICES, EDUCATION AND RECREATION. THE BARNEY COMMUNITY CENTER LATER DEVELOPED INTO THE BARNEY CONVALESCENT HOSPITAL, WHICH CARED FOR POLIO VICTIMS. IN 1967 A FULL-SERVICE CHILDREN'S HOSPITAL, THE BARNEY CHILDREN'S MEDICAL CENTER, OPENED. THE NAME WAS CHANGED IN 1970 TO THE CHILDREN'S MEDICAL CENTER OF DAYTON. IN SPRING 2013, THE HOSPITAL CHANGED ITS NAME ONCE AGAIN TO DAYTON CHILDREN'S HOSPITAL. THE HOSPITAL CELEBRATED ITS 50-YEAR ANNIVERSARY IN 2017. DAYTON CHILDREN'S NOW SERVES INFANTS, CHILDREN AND TEENS FROM 20 OHIO COUNTIES, WITH 75 PERCENT OF PATIENTS COMING FROM MONTGOMERY, GREENE, CLARK, MIAMI AND NORTHERN WARREN COUNTIES. THE SERVICE AREA SPANS 9,000 SQUARE MILES WITH A 2.1 MILLION PEDIATRIC POPULATION THAT INCLUDES POOR URBAN AND RURAL AREAS. DAYTON CHILDREN'S IS THE ONLY PEDIATRIC HEALTH CARE PROVIDER AND THE LARGEST PROVIDER OF MEDICAL CARE TO LOW-INCOME CHILDREN IN THE REGION. CURRENTLY, THE HOSPITAL SERVES A DISPROPORTIONATE SHARE OF CHILDREN FROM LOW-INCOME FAMILIES. OVER 55 PERCENT OF THE PATIENTS AT DAYTON CHILDREN'S ARE COVERED BY MEDICAID. IN ADDITION, DAYTON CHILDREN'S SERVES AS THE PEDIATRIC RESOURCE FOR MILITARY FAMILIES STATIONED AT NEARBY WRIGHT-PATTERSON AIR FORCE BASE. DAYTON CHILDREN'S HAS ALWAYS BELIEVED THAT INFANTS, CHILDREN AND TEENS NEED TO BE CARED FOR BY PEDIATRIC SPECIALISTS. WITH IMPROVED ACCESS TO PEDIATRIC SPECIALTY SERVICES, THE HOSPITAL PROVIDES EXPERT CARE TO NEARLY 320,000 CHILDREN IN ITS 20-COUNTY REGION. OUTPATIENT AND ALTERNATIVE SERVICES INCLUDE PEDIATRIC LABORATORY AND IMAGING WHICH COMPLEMENT THE HOSPITAL'S INPATIENT SERVICES. MANY PROGRAMS HAVE RECEIVED CERTIFICATIONS AND ACCREDITATIONS FROM ORGANIZATIONS SETTING THE STANDARDS OF QUALITY CARE; THE HOSPITAL'S SCORES FROM THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS ARE CONSISTENTLY AMONG THE HIGHEST IN THE NATION. IN SUMMER 2018, DAYTON CHILDREN'S RECEIVED MAGNET DESIGNATION FOR THE SECOND TIME, RECOGNIZING THE HOSPITAL AS PROVIDING THE GOLD STANDARD IN PATIENT CARE AND THE PROFESSIONAL PRACTICE OF NURSING BY THE AMERICAN NURSES CREDENTIALING CENTER (ANCC) AND WILL BE APPLYING FOR REDESIGNATION IN FALL 2018. IN JUNE, 2018, DAYTON CHILDREN'S RANKED IN THE TOP 50 CHILDREN'S HOSPITALS IN THE COUNTRY FOR CARE IN PULMONOLOGY IN U.S. NEWS AND WORLD REPORT. PART VI, LINE 5: IN AN EFFORT TO BETTER ALIGN AND FOCUS ON OUR COMMUNITY ENGAGEMENT AND COMMUNITY HEALTH EFFORTS, IN FALL 2017, DAYTON CHILDREN'S FORMALLY ESTABLISHED THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY REALIGNS AND ELEVATES CLINICAL PROGRAMS PROVIDING A GREATER FOCUS ON PRIMARY AND PREVENTATIVE CARE AND COMMUNITY ENGAGEMENT PROGRAMS AIMED AT IMPROVING THE HEALTH OF CHILDREN BEYOND THE WALLS OF THE HOSPITAL. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY PUTS OUR CHILDREN'S HEALTH AGENDA IN FOCUS EMPHASIZING OUR COMMITMENT TO IMPROVING THE HEALTH STATUS OF ALL CHILDREN AND UNDERSCORING OUR COMMITMENT TO MOST VULNERABLE POPULATIONS AND HEALTH DISPARITIES.HAVE YOU HEARD THE PHRASE "A PERSON'S HEALTH IS DETERMINED MORE BY ZIP CODE THAN GENETIC CODE?" THAT PHRASE HAS BECOME POPULAR BECAUSE WE NOW KNOW THAT AT THE MAJORITY OF WHAT CONTRIBUTES TO A CHILD'S WELLNESS IS RELATED TO THE FAMILY WITH WHOM THEY LIVE AND THE ENVIRONMENT IN WHICH THEY ARE RAISED. CONSIDER A CHILD WITH ASTHMA WHO MAY RECEIVE MEDICATION AND EDUCATION FROM A PEDIATRICIAN HOWEVER LIVES IN A HOME WITH MOLD, PESTS AND SECONDHAND SMOKE WHICH CAUSE HIS OR HER ASTHMA TO BE UNCONTROLLED. THERE EXIST SOCIAL DETERMINANTS OF HEALTH SUCH AS POVERTY, LACK OF QUALITY AFFORDABLE HOUSING, EXPOSURE TO VIOLENCE AND NEGLECT, AND FOOD INSECURITY THAT ARE CRITICAL TO DETRACTING FROM A CHILD'S HEALTH AND WELLBEING. WE KNOW CHILDREN LIVE IN THE CONTEXT OF THEIR FAMILY AND COMMUNITY AND CLINICAL-COMMUNITY LINKAGES ARE ESSENTIAL TO IMPROVE CHILDREN'S HEALTH.AT DAYTON CHILDREN'S WE ARE PART OF THE TRANSFORMATION OF HEALTH CARE. JUST AS WE HAVE STATE-OF-THE-ART SERVICES FOR CHILDREN WHO ARE UNWELL DUE TO MEDICAL ISSUES, SO TOO DO WE NEED A STATE-OF-THE-ART RESPONSE FOR CHILDREN THAT ARE UNWELL BECAUSE OF THE ENVIRONMENT IN WHICH THEY ARE RAISED AND THE SOCIAL DETERMINANTS OF HEALTH WHICH THEY EXPERIENCE. DAYTON CHILDREN'S CENTER FOR COMMUNITY HEALTH AND ADVOCACY IS THE FIRST STEP IN THAT RESPONSE AND WILL WORK TO INTEGRATE CLINICAL SERVICES AND COMMUNITY-BASED PROGRAMS TO SUPPORT CHILDREN AND THEIR FAMILIES. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY IS RESPONSIBLE FOR THE PLANNING AND EXECUTION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ALONG WITH MANY OTHER COMMUNITY BENEFIT PROGRAMS. PROGRAMS AND SERVICES ALIGNED UNDER THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY-DAYTON CHILDREN'S PEDIATRICS IS A PRIMARY CARE PATIENT-CENTERED MEDICAL HOME PROVIDING COMPREHENSIVE WELL-CHILD SERVICES, TREATMENT FOR ILLNESSES AND MEDICAL CONDITIONS, AND REFERRALS FOR SPECIALTY CARE. DAYTON CHILDREN'S PEDIATRICS IS ALSO THE HOME OF PRIMARY CARE TRAINING FOR MANY OF THE PEDIATRIC MEDICINE RESIDENTS AT THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE.-A SPECIALTY MEDICAL HOME TO SUPPORT CHILDREN WITH DISPARATE MEDICAL AND BEHAVIORAL HEALTH CARE NEEDS, INCLUDING CHILDREN IN FOSTER/KINSHIP CARE AND CHILDREN WITH MEDICAL COMPLEXITIES. PATIENTS IN THESE PROGRAMS BENEFIT FROM DEDICATED CARE COORDINATION, SOCIAL WORK, AND COMMUNITY HEALTH WORKER SUPPORT.-THE DIVISION OF CHILD ADVOCACY INCLUDING THREE CHILD ADVOCACY CENTERS: CARE HOUSE, MICHAEL'S HOUSE, AND THE WARREN COUNTY CHILD ADVOCACY CENTER. THE DIVISION PROVIDES COMPREHENSIVE ASSESSMENTS FOR CHILDREN WHO ARE SUSPECTED VICTIMS OF ALL FORMS OF CHILD MALTREATMENT, INCLUDING PHYSICAL AND SEXUAL ABUSE. -A CONSULTATIVE SERVICE TO SUPPORT CHILDREN DEALING WITH ISSUES RELATED TO WEIGHT MANAGEMENT AND HEALTHY LIFESTYLES. THIS PROGRAM PROVIDES MULTIDISCIPLINARY SUPPORT INCLUDING RECOMMENDATIONS ON HEALTHY EATING, EXERCISE, AND DIAGNOSIS AND MANAGEMENT OF COMPLICATIONS RELATED TO OBESITY. -A COMMUNITY HEALTH WORKER PROGRAM WHEREBY NAVIGATORS INTEGRATE INTO CLINICS WHILE PROVIDING COMMUNITY SUPPORTS FOR CHILDREN AND FAMILIES.-COMMUNITY ENGAGEMENT PROGRAMS OUTLINED WITHIN THE CHNA IMPLEMENTATION PLAN INCLUDING THE FAMILY RESOURCE CONNECTION, THE DAYTON ASTHMA ALLIANCE, AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, THE SAFE KIDS GREATER DAYTON COALITION AND OTHER INJURY PREVENTION PROGRAMMING. WHILE THE CENTER EXTENDS WELL BEYOND THE WALLS OF THE HOSPITAL AND OUR CAMPUS ON VALLEY STREET, THE NEW HOME OF THE CENTER'S ADMINISTRATION WILL BE AT OUR NEW CHILD HEALTH PAVILION ON THE CORNER OF VALLEY AND STANLEY STREETS. CONSTRUCTION FOR THE CHILD HEALTH PAVILION BEGAN IN FY 2017-2018 WITH A TENTATIVE OPENING IN SPRING 2019. INJURY PREVENTIONDAYTON CHILDREN'S CONTINUES OUR WORK TO PREVENT CHILDHOOD INJURIES AS UNINTENTIONAL INJURY IS A LEADING CAUSE OF DEATH AND DISABILITY FOR CHILDREN ACROSS THE COUNTY AND REGIONALLY. DAYTON CHILDREN'S WORKS WITH PARTNERS SUCH AS THE OHIO INJURY PREVENTION PARTNERSHIP, OHIO OCCUPANT PROTECTION REGIONAL COORDINATOR PROGRAM, AND THE MONTGOMERY COUNTY CHILD FATALITY REVIEW BOARD TO ADDRESS SOME OF THE KEY UNINTENTIONAL INJURIES TO CHILDREN IN OUR COMMUNITY, SUCH AS MOTOR VEHICLE ACCIDENTS, PEDESTRIAN ACCIDENTS, AND UNSAFE SLEEP PRACTICES. DAYTON CHILDREN'S IS THE LEAD AGENCY OF SAFE KIDS GREATER DAYTON, WHICH IS OUR REGION'S LEADER IN CHILDHOOD INJURY PREVENTION PROGRAMMING. THE SAFE KIDS GREATER DAYTON COALITION ADDRESSES KEY PEDIATRIC SAFETY ISSUES WITH COMMUNITY PROGRAMMING INCLUDING CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, HOME/FIRE SAFETY, MEDICATION POISONING PREVENTION, WATER SAFETY AND BICYCLE HELMET EDUCATION. IN OCTOBER 2017, SAFE KIDS GREATER DAYTON PARTNERED WITH AREA SAFE ROUTES TO SCHOOLS PROGRAMS TO HOST INTERNATIONAL WALK TO SCHOOL DAY AT RUSKIN NEIGHBORHOOD SCHOOLS CENTER AND FIVE ELEMENTARY SCHOOLS IN KETTERING, OHIO TO TEACH CHILDREN ABOUT WALKING TO SCHOOL SAFELY. RUSKIN AND OTHER LOCAL ELEMENTARY SCHOOLS WERE PROVIDED COPIES OF CLIFFORD TAKES A WALK TO READ WITH THEIR STUDENTS TO LEARN PEDESTRIAN SAFETY HABITS. LATER IN OCTOBER, SAFE KIDS WORKED TO PROMOTE "BE SAFE, BE SEEN ON HALLOWEEN" AT SCHOOLS THROUGHOUT THE DAYTON REGION. BIKE TO SCHOOL DAY WAS HELD AT FAIRVIEW NEIGHBORHOOD SCHOOLS CENTER IN DAYTON, OHIO. SINCE THE SCHOOL IS LOCATED NEAR TWO BUSY STREETS, THE STUDENTS LEARNED HOW TO SAFELY CROSS THE INTERSECTIONS NEAREST THEIR SCHOOL. ALL STUDENTS IN NEED OF A HELMET WERE GIVEN ONE, AND STUDENTS HAD A CHANCE TO ENTER A RAFFLE FOR ONE OF 6 NEW BIKES. SAFE KIDS GREATER DAYTON ALSO SUPPORTED A BIKE TO SCHOOL DAY EVENT IN SUGARCREEK TOWNSHIP AT BELL CREEK INTERMEDIATE SCHOOL. STUDENTS IN THIRD, FOURTH AND FIFTH GRADE PARTICIPATED IN WALKING AND BIKING EVENTS, AND HAD A CHANCE TO WIN ONE OF 20 NEW BIKES. OVER 500 CHILDREN PARTICIPATED IN BIKE TO SCHOOL DAY EVENTS. BEYOND SAFE KIDS GREATER DAYTON, DAYTON CHILDREN'S HOSPITAL HAS OTHER OUTREACH PROGRAMS TO PREVENT INJURY BY EDUCATING PROFESSIONALS TO UNDERSTAND THE UNIQUE PHYSIOLOGY OF CHILDREN. THESE PROGRAMS INCLUDE EMS OUTREACH AND EDUCATION, THE NURSING LIAISON PROGRAM AND SPORTS MEDICINE. DAYTON CHILDREN'S EMS OUTREACH COORDINATORS TRAINED THE STAFF AT 41 FIRE DEPARTMENTS ON SPECIFIC PEDIATRIC TRAUMA CASES AS WELL AS CHILDREN WITH SPECIFIC HEALTH CARE NEEDS. BY COVERING TOPICS RANGING FROM SEIZURES TO RESPIRATORY, TO HIDDEN HAZARDS (POISON), THE EMS OUTREACH COORDINATORS ENSURE EMTS ARE EDUCATED IN VARIOUS PEDIATRIC HEALTH ISSUES. THE EMS OUTREACH COORDINATORS ENSURE ALL FIRE DEPARTMENTS HAD ACCESS TO TRAINING AS NEEDED IN THE GREATER DAYTON AREA. DAYTON CHILDREN'S NURSE LIAISONS PROVIDE CONTINUING EDUCATION TO COMMUNITY AND SCHOOL NURSES IN MONTGOMERY AND CLARK COUNTIES. COMMUNITY AND SCHOOL NURSES RECEIVED TRAINING ON SEIZURES, SCHOOL AVOIDANCE, USE OF NAR CAN, AND OTHER PERTINENT TOPICS. NURSE LIAISONS ALSO PROVIDED SUPPORT TO TWO LOCAL SUMMER CAMP PROGRAMS AT THE KROC CENTER AND BOONSHOFT MUSEUM OF DISCOVERY TO ENSURE THOSE SUMMER CAMPS WERE ABLE TO INCLUDE CHILDREN WHO NEEDED ACCESS TO MEDICAL CARE DURING CAMP HOURS. DAYTON CHILDREN'S PROVIDES THE COMMUNITY WITH CERTIFIED ATHLETIC TRAINERS SPECIALIZED IN PREVENTION, RECOGNITION, AND TREATMENT OF SPORTS RELATED INJURIES. ALL ATHLETIC TRAINERS ARE LICENSED BY THE STATE OF OHIO AND ENGAGE IN REGULAR CONTINUING EDUCATION IN SPORTS MEDICINE. ATHLETIC TRAINER SERVICES INCLUDE COVERAGE OF SPORTING EVENTS AND TOURNAMENTS, SPEAKING ENGAGEMENTS AND COACHES TRAINING. TOPIC COVERED INCLUDE RECOGNIZING OVER EXERTION, RETURN TO PLAY AND HYDRATION. PART VI, LINE 7, REPORTS FILED WITH STATES OH 1 ADVOCATES FOR BASIC LEGAL EQUALITY INC 515 JEFFERSON AVENUE STE 300 TOLEDO OH 43604 237376131 501 (C) (3) 10000 PROGRAM DONATION AMERICAN HEART ASSOCIATION 1313 W DOROTHY LANE DAYTON OH 45409 135613797 501 (C) (3) 10000 PROGRAM DONATION CHILDREN'S MIRACLE NETWORK HOSPITALS 500 SPEEDWAY DRIVE ENON OH 45323 311551430 501 (C) (3) 7000 PROGRAM DONATION CULTURE WORKS 110 N MAIN STREET STE 165 DAYTON OH 45402 237412338 501 (C) (3) 6500 PROGRAM DONATION DAYTON PERFORMING ARTS ALLIANCE 126 NORTH MAIN ST STE 120 DAYTON OH 45402 316000101 501 (C) (3) 5000 PROGRAM DONATION DAYTON SOCIETY OF NATURAL HISTORY 2600 DEWEESE PKWY DAYTON OH 45414 310585917 501 (C) (3) 5500 PROGRAM DONATION GIRLS ON THE RUN PO BOX 752105 DAYTON OH 45475 272528377 501 (C) (3) 7500 PROGRAM DONATION GOODWILL EASTER SEALS MIAMI VALLEY 660 S MAIN STREET DAYTON OH 45402 310537112 501 (C) (3) 7500 PROGRAM DONATION MARCH OF DIMES 3131 S DIXIE DRIVE STE 416 DAYTON OH 45439 131846366 501 (C) (3) 5500 PROGRAM DONATION NORTHEAST OHIO MEDICAL UNIVERSITY 4209 ST RT 44 ROOTSTOWN OH 44272 341131513 GOVERNMENT 10000 PROGRAM DONATION RONALD MCDONALD HOUSE CHARITIES 555 VALLEY STREET DAYTON OH 45404 310964793 501 (C) (3) 12500 CORPORATE DONATION SOCCER CENTERVILLE INC PO BOX 750651 DAYTON OH 45475 311412968 501 (C) (3) 12500 PROGRAM DONATION SOUTHESTERN OHIO COUNCIL FOR HIGHER EDUCATION 3155 RESEARCH BLVD DAYTON OH 45420 237109141 501 (C) (3) 5000 PROGRAM DONATION THE DAYTON ART INSTITUTE 456 BELMONTE PARK NORTH DAYTON OH 45405 310537480 501 (C) (3) 7600 PROGRAM DONATION THE GALA OF HOPE FOUNDATION 3500 PENTAGON BLVD STE 500 BEAVERCREEK OH 45431 464277044 501 (C) (3) 50000 PROGRAM DONATION UNITED WAY OF THE GREATER DAYTON AREA 33 W FIRST STREET STE 500 DAYTON OH 45402 310536658 501 (C) (3) 25000 CORPORATE PLEDGE VICTORIA THEATRE ASSOCIATION 138 N MAIN STREET DAYTON OH 45402 310897638 501 (C) (3) 5000 PROGRAM DONATION WRIGHT STATE UNIVERSITY FOUNDATION 3640 COLONEL GLENN HWY DAYTON OH 45435 237019799 501 (C) (3) 6650 CORPORATE PLEDGE YMCA OF GREATER DAYTON - Y ON THE FLY 118 W FIRST ST STE 300 DAYTON OH 45402 310537517 501 (C) (3) 5000 PROGRAM DONATION YWCA - WOMAN OF INFLUENCE AWARDS 141 W THIRD STREET DAYTON OH 45402 310537168 501 (C) (3) 5000 PROGRAM DONATION 20 0 PHARMACY 550 76933 MEALS/FOOD 1630 30487 TRANSPORTATION 1829 48737 RENT/UTILITIES 56 33534 SPECIAL EQUIPMENT 6 26177 OTHER 27 21010 PART I, LINE 2: THE FINANCE COMMITTEE AND COMMUNITY RELATIONS MANAGER APPROVE ALL GRANTS AND CHARITABLE DONATIONS. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 ADAM MEZOFF MD CMO 710199 0 0 0 11013 0 271100 0 32832 0 1025144 0 0 0 DEBORAH FELDMAN CEO 740012 0 0 0 32345 0 528349 0 0 0 1300706 0 0 0 CHRIS BERGMAN CFO 433062 0 0 0 7524 0 14900 0 25257 0 480743 0 0 0 CYNTHIA BURGER VP PATIENT & FAMILY EXPERIENCE 296903 0 0 0 7524 0 125285 0 39995 0 469707 0 0 0 LISA COFFEY VP PHYSICAN SERVICES 276738 0 0 0 8931 0 240452 0 39652 0 565773 0 0 0 MATTHEW GRAYBILL VP HR AND CHIEF ADMINISTRATION 410551 0 0 0 17095 0 179932 0 39054 0 646632 0 0 0 KELLY KAVANAUGH VP AND CHIEF STRATEGY OFFICER 274519 0 0 0 3256 0 44982 0 38436 0 361193 0 0 0 DR GREGORY RAMEY EXECUTIVE DIRECTOR MENTAL HEALTH SER 296333 0 0 0 12665 0 65316 0 16429 0 390743 0 0 0 DAVID MILLER FORMER CFO (END 1/16) 0 0 0 0 273166 0 0 0 0 0 273166 0 273166 0 PART I, LINE 4B PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND THE INCREASE IN ACTUARIAL VALUE: CHRIS BERGMAN 0 CYNTHIA BURGER 59,223 LISA COFFEY 195,886 DEBORAH FELDMAN 513,450 MATTHEW GRAYBILL 95,169 ADAM MEZOFF 255,000 GREGORY RAMEY 0 RECEIVED PAYMENT FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DAVID MILLER 273,166 A COUNTY OF MONTGOMERY 316000172 000000000 2016-10-13 30000000 HOSPITAL RENOVATION 0 0 0 B COUNTY OF MONTGOMERY 316000172 000000000 2015-11-20 12675000 HOSPITAL RENOVATION 0 0 0 C COUNTY OF MONTGOMERY 316000172 000000000 2014-08-19 117055000 HOSPITAL RENOVATION 0 0 0 A 30000000 30000000 2017 0 0 0 1 B 12675000 40000 12635000 2017 0 0 0 1 C 117055000 400070 109407734 7247196 2017 0 0 0 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 1 0 0 1 0 0 0 0 B 0 1 0 0 1 0 0 0 0 C 0 1 0 0 1 0 0 0 0 A 0 B 0 C 0 SARA GUERRERO-DUBY SPOUSE OF BOARD MEMBER 130814 EMPLOYED 0 FORM 990, PART VI, SECTION B, LINE 11B THE CFO REVIEWS KEY DISCLOSURES WITH APPROPRIATE COMMITTEES OF THE BOARD OF TRUSTEES. THEN PRIOR TO FILING, THE FORM 990 IS ELECTRONICALLY LOADED TO A SECURE WEBSITE FOR THE ENTIRE BOARD OF TRUSTEES TO REVIEW. AN EMAIL IS SENT TO ALL MEMBERS NOTIFYING THEM THAT THE FORM IS AVAILABLE FOR THEIR REVIEW AND THAT IT WILL BE FILED ON OR BEFORE 05/15/2019. FORM 990, PART VI, LINE 12C - MONITORING CONFLICT OF INTEREST AT THE BEGINNING OF EACH MEETING, THE CHAIRMAN OF THE BOARD ASKS EACH MEMBER TO IDENTIFY AND DISCLOSE ANY POTENTIAL CONFLICTS, THE MEMBER(S) RECUSE THEMSELVES AND DO NOT PARTICIPATE IN THE DISCUSSION AND DO NOT VOTE ON THE ITEM. THIS THEN IS NOTED IN THE MINUTE OF THAT MEETING. BOARD MEMBERS ANNUALLY AGREE TO ABIDE BY WRITTEN CONFLICT OF INTEREST AND CONFIDENTIALITY POLICIES. BOARD MEMBERS ALSO WORK TO REPRESENT AND BALANCE THE INTEREST OF DAYTON CHILDREN'S HOSPITAL'S MANY CONSTITUENTS. THE BOARD ANNUALLY EVALUATES ITS OWN PERFORMANCE. FORM 990, PART VI, SECTION B, LINE 12C AT THE BEGINNING OF EACH MEETING, THE CHAIRMAN OF THE BOARD ASKS EACH MEMBER TO IDENTIFY AND DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST BASED ON THE AGENDA OR ANY CHANGES IN THEIR BUSINESS PRACTICE THAT MIGHT BE RELEVANT. IF THERE ARE ANY CONFLICTS, THE MEMBER(S) RECUSE THEMSELVES AND DO NOT PARTICIPATE IN THE DISCUSSION AND DO NOT VOTE ON THE ITEM. THIS THEN IS NOTED IN THE MINUTES OF THAT MEETING. BOARD MEMBERS ANNUALLY AGREE TO ABIDE BY WRITTEN CONFLICT OF INTEREST AND CONFIDENTIALITY POLICIES. BOARD MEMBERS ALSO WORK TO REPRESENT AND BALANCE THE INTERESTS OF DAYTON CHILDREN'S HOSPITAL'S MANY CONSTITUENTS. THE BOARD ANNUALLY EVALUATES ITS OWN PERFORMANCE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE HOSPITAL'S CHIEF EXECUTIVE OFFICER (CEO) IS SET BY AN EXECUTIVE COMPENSATION COMMITTEE (THE COMMITTEE) MADE UP OF THREE INDEPENDENT TRUSTEES WHO ARE ALSO OFFICERS OF THE BOARD. THIS COMMITTEE ALSO APPROVES COMPENSATION LEVELS AND EXECUTIVE BENEFITS FOR EACH EXECUTIVE EMPLOYED BY THE HOSPITAL. THE COMMITTEE OPERATES UNDER A FORMAL CHARTER AND KEEPS CONTEMPORANEOUS MINUTES OF ITS PROCEEDINGS. THE COMMITTEE USED A TOTAL COMPENSATION PHILOSOPHY TO GUIDE ALL DECISIONS RELATED TO EXECUTIVE COMPENSATION AT DAYTON CHILDREN'S HOSPITAL (DCH), AND AS SUCH DETERMINES AND APPROVES ALL ASPECTS OF THE CEO'S TOTAL COMPENSATION PACKAGE, INCLUDING BENEFITS AND EXPENSE ALLOWANCES. THESE ARE DETAILED IN A WRITTEN EMPLOYMENT AGREEMENT FOR THE CEO. THE COMMITTEE USES AN OUTSIDE CONSULTANT TO CONDUCT PERIODIC REVIEWS OF THE EXECUTIVE COMPENSATION LEVELS OF THE ORGANIZATION VERSUS THOSE OF SIMILARLY SIZED AND SITUATED ORGANIZATIONS USING PUBLISHED SURVEYS. THESE SURVEY RESULTS ARE USED BY THE COMMITTEE IN SETTING EXECUTIVE LEVELS AND THE CEO'S COMPENSATION IN PARTICULAR. THE COMMITTEE FOLLOWS A FORMAL CALENDAR OF MEETINGS AND THE CHAIRMAN OF THE COMMITTEE REPORTS TO THE BOARD OF TRUSTEES AT LEAST ANNUALLY ON THE COMMITTEE'S ACTIVITIES AND ON DETAILS OF THE CEO'S COMPENSATION AND BENEFITS PACKAGE. THE COMMITTEE ALSO REVIEWS AND APPROVES DISCLOSURES RELATED TO EXECUTIVE COMPENSATION MADE AS PART OF IRS FORM 990. FORM 990, PART VI, SECTION C, LINE 19 AVAILABILITY OF FINANCIAL STATEMENTS, CONFLICT OF INTEREST, ORGANIZING DOCUMENTS. DAYTON CHILDREN'S HOSPITAL'S CONFLICT OF INTEREST POLICY IS MADE AVAILABLE ON OUR WEBSITE. THE FINANCIAL STATEMENTS AND THE ORGANIZING DOCUMENTS ARE MADE AVAILABLE AS REQUIRED BY THE EXTENT OF THE LAW. FORM 990, PART IX, LINE 11G OTHER SERVICES: PROGRAM SERVICE EXPENSES 34,748,933. MANAGEMENT AND GENERAL EXPENSES 3,252,262. FUNDRAISING EXPENSES 786,389. TOTAL EXPENSES 38,787,584. FORM 990, PART XI, LINE 9: TRANSFER TO DAYTON CHILDREN'S HOSPITAL FOUNDATION 130,026,541. RESTRICTED NET ASSETS USED FOR PURCHASE OF PP&E 13,367,000. TEMPORARILY RESTRICTED NET ASSETS -14,098,000. CHANGE IN PENSION BENEFIT OBLIGATION 4,532,000. CONTRIBUTIONS AND INVESTMENT INCOME 3,191,000. CENTER FOR COMMUNITY HEALTH AND ADVOCACY ONE CHILDRENS PLAZA DAYTON OH 45404 824391789 NEW MARKETS TAX CREDIT OH -2502 10002651 DAYTON CHILDREN'S HOSPITAL CHILDREN'S HOME CARE OF DAYTON ONE CHILDRENS PLAZA DAYTON OH 45404 311356037 HOME CARE OH 501(C)(3) LINE 10 DAYTON CHILDREN'S HOSPITAL 1 DAYTON CHILDREN'S HOSPITAL FOUNDATION ONE CHILDRENS PLAZA DAYTON OH 45404 311045247 SUPPORT OH 501(C)(3) LINE 12A, I DAYTON CHILDREN'S HOSPITAL 1 PEDIATRIC ASSURANCE COMPANY LTD BUTTERFIELD BANK BLDG 6TH FLOOR HAMILTON BERMUDA HM BERMUDA BD 980478183 SELF-INSURANCE BD DAYTON CHILDREN'S HOSPITAL 1.00000 1 CHILDREN'S CARE GROUP ONE CHILDRENS PLAZA DAYTON OH 45404 311411364 SPEC PHYS GRO OH DAYTON CHILDREN'S HOSPITAL C 16847370 1.00000 0 CHILDREN'S ANESTHESIA GROUP ONE CHILDRENS PLAZA DAYTON OH 45404 260887231 ANESTHESIA SV OH DAYTON CHILDREN'S HOSPITAL C 2042866 1.00000 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 CHILDREN'S CARE GROUP R 6310585 CASH CHILDREN'S ANESTHESIA GROUP Q 5769531 CASH CHILDREN'S HOME CARE OF DAYTON O 5195094 CASH CHILDREN'S HOME CARE OF DAYTON R 21475 CASH DAYTON CHILDREN'S HOSPITAL FOUNDATION C 2861843 CASH PEDIATRCI ASSURANCE COMPANY R 347492 FMV