2016-11-15T13:26:17-06:00 2015-12-31 521855942 Tate and Tryon 2021 L Street NW Suite 400 Washington DC 20036 990 2015-01-01 270386722 CHILD HEALTH PATIENT SAFETY ORGANIZATION INC CHIL 9132621436 16011 College Blvd No 250 lenexa KS 66219 Nancy Stahl CFO 9132621436 2016-11-15 1 Deborah G Kosnett P00290720 2022932200 2016-11-14 2015 2017-02-10 21:41:12Z X Nancy Stahl 16011 College Blvd No 250 lenexa KS 66219 765000 0 X N/A X 2010 KS TO IMPROVE THE SAFETY AND QUALITY OF CHILD HEALTH CARE DELIVERY BY CREATING A SECURE ENVIRONMENT TO ANALYZE DATA THAT WILL ENABLE THE REDUCTION OF RISKS AND HAZARDS ASSOCIATED WITH PATIENT CARE. 5 5 0 14 0 0 0 0 682500 765000 0 0 0 0 682500 765000 0 0 0 0 0 0 0 0 0 613198 817601 613198 817601 69302 -52601 76132 224715 15000 216184 61132 8531 X TO IMPROVE THE SAFETY AND QUALITY OF CHILD HEALTH CARE DELIVERY BY CREATING A SECURE ENVIRONMENT WHERE CLINICIANS AND HEALTH CARE ORGANIZATIONS CAN COLLECT, AGGREGATE, AND ANALYZE DATA THAT WILL ENABLE THE IDENTIFICATION AND REDUCTION OF RISKS AND HAZARDS ASSOCIATED WITH PATIENT CARE. 0 0 694961 765000 THE CHILD HEALTH PATIENT SAFETY ORGANIZATION, INC. (PSO) WAS ORGANIZED IN 2010 TO IMPROVE THE SAFETY OF CHILDREN'S HOSPITALS BY SHARING DATA AND EXPERIENCES. MANDATED BY THE PATIENT SAFETY AND QUALITY IMPROVEMENT ACT (PSQIA), THE PSO PROVIDES FEDERAL PROTECTIONS FOR CHILDREN'S HOSPITALS, NOT ONLY TO LEAD IN PATIENT SAFETY, BUT TO ELIMINATE HARM, UTILIZING COLLABORATIVE INITIATIVES AND USE OF NATIONAL EXPERTS. IT IS THE LARGEST PSO IN THE UNITED STATES DEDICATED TO CHILDREN'S HOSPITALS. IT PROVIDES:- A SAFE LEARNING COMMUNITY: CONFIDENTIALITY, MONTHLY USER GROUP CALLS PLUS AN ANNUAL MEETING, REVIEW DATA ANALYSIS, DEVELOPMENT OF NEW STANDARDS FROM BEST PRACTICES, AND SHARD LEARNING AND STANDARDIZED METHODS.- ALERTS TO POTENTIAL SAFETY RISKS: EVIDENCE-BASED RECOMMENDATIONS, SUPPORT FOR SPECIFIC HOSPITAL CULTURES, BENEFITS FOR PEDIATRIC PATIENTS THROUGHOUT THE COMMUNITY.- COMMITMENT TO STATE AND NATIONAL AGENCIES: MEETS STATE MANDATES FOR PSO PARTICIPATION, MEETS LEAPFROG SERIOUS REPORTABLE EVENT POLICY, PROVIDES ALTERNATIVE TO THE JOINT COMMISSION SENTINEL EVENT REPORTING. 694961 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 0 0 0 0 0 0 0 0 0 X 5 5 0 1 0 0 1 1 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X Nancy Stahl 9132621436 16011 College Blvd No 250 lenexa KS 66219 Patricia DePompeiMSN CHAIR/PRESIDENT 1.00 0.00 X X 0 0 0 Tom Shufflebarger Vice Chair/Vice President 1.00 0.00 X X 0 0 0 Tom Kmetz Secretary/treasurer 1.00 1.00 X X 0 0 0 James Shmerling DHA FACHE Director 1.00 1.00 X 0 0 0 Christopher A Gessner Director 1.00 0.00 X 0 0 0 Mark Wietecha CEO 1.00 39.00 X 22623 882269 188197 Amy Knight COO 5.00 35.00 X 69068 483472 102267 D Brian Humphreys VP of Finance 1.00 39.00 X 6501 253548 48959 Nancy Stahl Chief Financial Officer 1.00 39.00 X 2108 82230 12789 Katherine Conrad VP, Delivery System Transformation 20.00 20.00 X 115459 115459 29808 215759 1816978 382020 1 0 1 0 ECRI Institute Inc 5200 Butler Pike Plymouth Meeting PA 19462 IT and Analytics Services 360500 1 PARTICIPATION FEES 900099 765000 765000 765000 765000 765000 0 0 X 145187 123409 21778 15836 13461 2375 2040 1734 306 411200 349520 61680 1759 1495 264 3071 2610 461 7400 6290 1110 55798 47428 8370 Overhead Allocation 175310 149014 26296 817601 694961 122640 0 224715 76132 0 76132 224715 882 15000 52500 0 162802 15000 216184 X 61132 8531 61132 8531 76132 224715 -52601 0 X 0 1 X 0 0 X 250000 290521 570000 682500 765000 2558021 250000 290521 570000 682500 765000 2558021 0 200000 235521 342000 338550 367500 1483571 200000 235521 342000 338550 367500 1483571 1074450 250000 290521 570000 682500 765000 2558021 0.42000 0.36380 0.00000 X 0 Due to CHCA 33 Due to NACHRI 162769 162802 765000 0 765000 0 765000 817601 0 817601 0 817601 0 1 0 0 0 0 0 0 0 Mark Wietecha CEO 17334 676010 5250 204750 39 1509 4096 159754 683 26637 27402 1068660 0 0 Amy Knight COO 51499 360491 15000 105000 2569 17981 9740 68180 3415 23905 82223 575557 0 0 D Brian Humphreys VP of Finance 5366 209292 1100 42900 35 1356 594 23166 631 24601 7726 301315 0 0 Katherine Conrad VP, Delivery System Transformation 97393 97393 17750 17750 316 316 6655 6655 8265 8265 130379 130379 0 0 Part I, Line 4b THE FOLLOWING LISTED EMPLOYEE PARTICIPATED IN A 457(F) PLAN DURING THE YEAR: -MARK WIETECHA (NO DISTRIBUTION IN 2015, $140,000 WAS CONTRIBUTED TO THE PLAN) -NANCY STAHL (NO DISTRIBUTION IN 2015, $10,108 WAS CONTRIBUTED TO THE PLAN) -AMY KNIGHT ($20,009 DIStribution 2015, $36,071 WAS CONTRIBUTED TO THE PLAN) Form 990, Part VI, Section A, line 3 THERE IS AN "OFFICE SHARING AND ADMINISTRATIVE SERVICES AGREEMENT" WITH CHILD HEALTH CORPORATION OF AMERICA, A RELATED FOR-PROFIT DELAWARE CORPORATION. Form 990, Part VI, Section A, line 6 THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, INC., A SECTION 501(c)(6) ORGANIZATION, IS THE PSO'S SOLE MEMBER. Form 990, Part VI, Section A, line 7a AS SOLE MEMBER, THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, INC. MAY APPOINT MEMBERS OF THE GOVERNING BOARD. Form 990, Part VI, Section B, line 11 An outside firm prepares the tax return. It is then reviewed by staff. One week before filing, the entire return is provided to the full Board of Trustees. The CFO receives comments back and clears these up prior to filing a final return. Form 990, Part VI, Section B, line 12c PERIODICALLY, THE BOARD OF TRUSTEES MUST FILL OUT A CONFLICT OF INTEREST QUESTIONNAIRE AND ALSO SUBMIT TO BACKGROUND CHECKS OF VARYING DEGREES. THE RESULTS ARE REVIEWED BY THE CEO AND ALSO THE EXTERNAL AUDITORS. AT THE START OF ALL BOARD AND COMMITTEE MEETINGS, THE PARTICIPATING MEMBERS ARE ASKED TO DECLARE ANY CONFLICT OF INTEREST ACCORDINGLY. PERIODICALLY, ALL STAFF MUST FILL OUT A CONFLICT OF INTEREST FORM AND MUST ADHERE TO THE ASSOCIATION'S CONFLICT OF INTEREST POLICY. ANY CONFLICTS OF INTEREST ARE RESOLVED AS APPROPRIATE. THE HUMAN RESOURCE DEPARTMENT ENCOURAGES STAFF TO BRING ANY SITUATIONS TO THEIR ATTENTION AND MAKE PROMPT AND FULL DISCLOSURE OF ANY POTENTIAL SITUATIONS THAT MAY INVOLVE A CONFLICT OF INTEREST. THE POLICY IS INCLUDED IN OUR EMPLOYEE MANUAL AND WHISTLEBLOWER POLICY. Form 990, Part VI, Section B, line 15 THE CURRENT PRESIDENT AND CEO WAS HIRED IN SEPTEMBER 2011 AND The Current COO WAS HIRED IN DECEMBER 2011. THIS PROCESS INVOLVED A NATIONAL SEARCH FIRM THAT WAS CLOSELY MONITORED BY A TASK FORCE AND THE BOARD OF TRUSTEES. IN ADDITION, THE GOVERNANCE COMMITTEE ALSO ACTS AS THE COMPENSATION COMMITTEE AND REVIEWS, and approves, ALL COMPENSATION RELATED MATTERS. THE CEO AND COO's COMPENSATION WAS BASED ON MARKET COMPARABLES OF SIMILAR SIZED ORGANIZATIONS AND RESPONSIBILITIES. THE COMPENSATION IS ALSO INCLUDED IN A WRITTEN EMPLOYMENT AGREEMENT. A COMPLETE REVIEW OF ALL SALARIES occurred during 2014. Salary INCREASES are RECOMMENDED BY THE GOVERNANCE COMMITTEE TO THE FULL BOARD FOR APPROVAL IN EXECUTIVE SESSION WITHOUT THE CEO PRESENT. FOR ALL OTHER STAFF, THE ASSOCIATION PERIODICALLY ENGAGES AN OUTSIDE CONSULTANT FOR COMPENSATION STUDIES TO REVIEW ALL JOB DESCRIPTIONS AND SALARIES. THIS CONSULTANT HAS EXPERTISE IN THE NON-PROFIT AND HEALTH FIELDS AND IS VERY FAMILIAR WITH THE COMPENSATION PRACTICES. THE CONSULTANT REVIEWS THE COMPENSATION OF OTHER NATIONAL ASSOCIATIONS AND PEER GROUPS. SELECTED SENIOR STAFF WERE GIVEN RAISES AS A RESULT OF A CONSOLIDATION OF POSITIONS AND THESE WERE REVIEWED BY THE GOVERNANCE COMMITTEE. A FORMAL EVALUATION OF ALL CURRENT SALARIES occured during 2015. ALL OTHER STAFF RECEIVED MINIMAL INCREASES IN LINE WITH THE MOST RECENT COMPENSATION STUDIES COMPLETED. Form 990, Part VI, Section C, line 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. Form 990, Part IX, line 11g Consulting fees: Program service expenses 349,520. Management and general expenses 61,680. Fundraising expenses 0. Total expenses 411,200. NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC (NACH) 600 13TH STREET NW SUITE 500 WASHINGTON DC 20005 582176067 ASSIST CHILDREN'S HOSPITALS IN COMMON BUSINESS INTERESTS AND ECON. WELFARE GA 501(C)(6) N/A N/A 0 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS INC 600 13TH STREET NW SUITE 500 wASHINGTON DC 20005 510120256 TO PROMOTE SUPPORT OF CHILDREN'S HOSPITALS GA 501(C)(3) 509(A)(2) NACH 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS INC N 145187 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS INC O 175311