2016-11-15T13:25:31-06:00 2015-12-31 521855942 Tate and Tryon 2021 L Street NW Suite 400 Washington DC 20036 990 2015-01-01 510120256 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS INC NATI 2027535500 600 13th street nw No 500 washington DC 20005 Nancy Stahl Chief Financial Officer 2027535500 2016-11-15 1 Deborah G Kosnett P00290720 2022932200 2016-11-14 2015 2017-02-10 21:41:12Z NACHRI Mark Wietecha 600 13th street nw No 500 washington DC 20005 56611245 0 X WWW.CHILDRENSHOSPITALS.NET X 1970 GA TO PROMOTE THE HEALTH AND WELL-BEING OF CHILDREN AND THEIR FAMILIES THROUGH SUPPORT OF CHILDREN'S HOSPITALS AND HEALTH SYSTEMS THAT ARE COMMITTED TO EXCELLENCE IN PROVIDING HEALTH CARE TO CHILDREN. THIS IS ACCOMPLISHED THROUGH EDUCATION, RESEARCH, HEALTH PROMOTION AND ADVOCACY. 13 12 222 50 64221 -3950 3336559 12727788 17004449 40604375 3493477 1211657 2633876 1666892 26468361 56210712 2190841 2784638 0 0 8722795 27789121 0 0 533761 11206747 19491175 22120383 50064934 4347978 6145778 51558871 58542353 10851028 13003542 40707843 45538811 X TO PROMOTE THE HEALTH AND WELL-BEING OF CHILDREN AND THEIR FAMILIES THROUGH SUPPORT OF CHILDREN'S HOSPITALS AND HEALTH SYSTEMS THAT ARE COMMITTED TO EXCELLENCE IN PROVIDING HEALTH CARE TO CHILDREN. 0 0 7340642 0 2471800 Quality and Safety: NACHRI sponsors and facilitates a broad set of quality, safety, and cost management cooperatives. These cooperatives range in size from five hospitals to over 80 hospital participants and hundreds of clinicians, all focused on finding best practice solutions to priority problems. The goal is to identify best practice protocols that can then be spread across the larger group and improve children's health on a national basis. 5982835 0 10224642 Data Analytics/Performance Improvement: The analytics programs help members measure and improve quality and efficiency, inform and support strategies, showcase improvements in children's health care and identify opportunities for further improvement. Collection and analysis of data has supported advocacy for graduate medical education funding, for increasing children's access under Medicaid and CHIP programs and for strengthening reimbursement for children's hospitals. The tools available to members include a suite of data, benchmarking, and quality improvement programs and software. These tools allow users to back internal and policy decision-making efforts with concrete evidence and allow member hospitals nationally to shape how pediatric care is measured for quality and reimbursement. 4579503 0 9351591 Education and Programming: NACHRI runs one of the nation's largest set of educational programs dedicated to pediatrics. This includes senior executive education and networking events, the Annual Leadership Conference, quality conferences, analytics conferences, and other topic-specific programs for leadership within children's hospitals. These programs and conferences occur in person and via web. 3723275 2784638 8892575 POLICY AND ADVOCACY: AS THE VOICE FOR CHILDREN'S HOSPITALS AND CHILD HEALTH, NACHRI ACTS AS ITS MEMBERS' "EYES AND EARS" IN WASHINGTON, FOCUSING ON LEGISLATION AND REGULATORY ACTION THAT DIRECTLY AFFECT ITS CONSTITUENCIES. SENSITIVE PUBLIC POLICIES ARE CRITICAL TO THE ABILITY OF CHILDREN'S HOSPITALS TO CARE FOR ALL CHILDREN THROUGH CLINICAL CARE, TRAINING, RESEARCH AND PUBLIC HEALTH ADVOCACY. AS HEALTH CARE POLICIES ARE DEBATED AT THE STATE AND FEDERAL LEVELS, NACHRI AND ITS MEMBER HOSPITALS WORK WITH POLICYMAKERS TO ENSURE CHILDREN'S UNIQUE HEALTH CARE NEEDS ARE NOT OVERLOOKED AND THAT EVERY CHILD HAS ACCESS TO HIGH QUALITY, COST-EFFECTIVE PRIMARY, PREVENTIVE AND SPECIALTY CARE SERVICES TAILORED TO MEET THEIR NEEDS. 9599546 0 9599546 Management Fees 13322821 2784638 18492121 31225801 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 80 0 1 222 1 1 1 0 0 0 0 1 1 0 0 0 0 X 13 12 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X Nancy Stahl CFO 9132621436 600 13TH STREET NW NO 500 WASHINGTON DC 20005 Peggy Troy RN MSN Chair 1.00 1.00 X X 0 0 0 Steve J Allen MD Vice Chair 1.00 1.00 X X 0 0 0 Thomas D Kmetz Treasurer 1.00 1.00 X X 0 0 0 Amy B Mansue Secretary 1.00 1.00 X X 0 0 0 Michael Aubin FACHE Director 1.00 1.00 X 0 0 0 Madeline Bell Director 1.00 1.00 X 0 0 0 Kim Cripe Director 1.00 1.00 X 0 0 0 Herman B Gray MD MBA FAAP Director 1.00 1.00 X 0 0 0 Rick Merrill Director 1.00 1.00 X 0 0 0 Kurt Newman MD Director 1.00 1.00 X 0 0 0 James E Shmerling DHA FACHE Director 1.00 1.00 X 0 0 0 Jeff Sperring MD Director 1.00 1.00 X 0 0 0 Mark Wietecha CEO 10.00 30.00 X 226223 678668 188197 Amy Knight COO 25.00 15.00 X 345337 207202 102267 D Brian Humphreys VP of Finance 23.00 17.00 X 149528 110521 48959 Nancy Stahl Chief Financial Officer 30.00 10.00 X 63253 21085 12789 David Bertoch VP, Informatics & Comparative Data 40.00 0.00 X 261708 0 46688 Richard Stepanek Chief Information Officer 40.00 0.00 X 280395 0 38348 Kassandra Jensen VP, Education & Executive Learning 40.00 0.00 X 236192 0 27694 Milton J Kauffman vp of public policy 0.00 40.00 X 0 310159 70697 David Spizman Vice President 0.00 40.00 X 0 295995 49049 Robert Davidson Vice President, Insurance Advisory Services 0.00 40.00 X 0 262760 42866 Jerry Rutherford VP, Special Projects 40.00 0.00 X 246483 0 36728 Katherine Conrad VP, Delivery System Transformation 20.00 20.00 X 115459 115459 29808 1924578 2001849 694090 60 0 1 0 Truven Health Analytics Inc 39353 Treasury Center Chicago IL 60694 Database Administrator 3059742 Cornerstone on Demand Dept CH 19590 Palatine IL 60055 Learning Platform Subscription 1057107 CDW Direct LLC PO Box 75723 Chicago IL 60675 Computer/Equipment Vendor 952728 Health Catalyst 3165 Millrock Dr Suite 400 Salt Lake City UT 84121 Database Warehouse 681017 Children's National Medical Center 801 Roeder Road Suite 500 Silver Spring MD 20910 CMMI Grant Administration 581629 12 6139416 6588372 2637190 12727788 PROJECT PARTICIPATION FEES 900099 20525948 20525948 REIMBURSED EXPENSES 900099 9708806 9708806 membership dues 900099 8892575 8892575 MEETINGS AND CONFERENCE 900099 944803 944803 other fees 900099 468022 468022 64221 64221 40604375 485448 485448 1900181 1900181 164865 400533 -235668 -235668 -235668 726209 0 726209 726209 726209 MISCELLANEOUS 900099 2379 2379 2379 56210712 40540154 64221 2878549 X 2784638 2784638 3051142 1836610 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-1314810 56144341 66371 66371 56210712 49948619 -49944 -49944 49998563 66371 66371 50064934 Part XI, Line 2d - Other Adjustments: Equity in gain of VPS 189,942. Part XII, Line 2d - Other Adjustments: BENEFIT CHANGES OTHER THAN NET PERIODIC COST -49,944. 1 Advocate Children's Hospital 4440 West 95th Street Oak Lawn IL 60453 362169147 501(C)(3) 5693 FMV American Girl dolls Holiday donation Advocate Children's Hospital-Park Ridge 1775 Dempster Street Park Ridge IL 60068 362169147 501(C)(3) 29650 FMV American Girl dolls Holiday donation Akron Children's Hospital One Perkins Square Akron OH 44308 340714357 501(C)(3) 5693 FMV American Girl dolls Holiday donation All Children's Hospital 501 6th Ave South Saint Petersburg FL 33701 590683252 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ann & Robert H Lurie Children's Hospital of Chicago 225 E Chicago Ave Chicago IL 60611 362170833 501(C)(3) 29650 FMV American Girl dolls Holiday donation Arnold Palmer Hospital for Children 92 West Miller St Orlando FL 32806 680147193 501(C)(3) 11860 FMV American Girl dolls Holiday donation Atlanta Ronald McDonald House Charities 5420 Peachtree Dunwoody ROad Sandy Springs GA 30342 391655790 501(C)(3) 29650 FMV American Girl dolls Holiday donation Baystate Children's Hospital 759 Chestnut Street - C4109 Springfield MA 01094 042790311 501(C)(3) 29650 FMV American Girl dolls Holiday donation Blank Children's Hopsital 1200 pleasant st Des Moines IA 50309 421467682 501(C)(3) 5693 FMV American Girl dolls Holiday donation Bon Secours St Mary's Hosptial 5801 Bremo Rd Pediatrics 6-West Richmond VA 23226 540793767 501(C)(3) 5693 FMV American Girl dolls Holiday donation CS Mott Children's Hospital 1500 E Medical Center Dr F-2519 Ann Arbor MI 48108 386006309 501(C)(3) 5693 FMV American Girl dolls Holiday donation California Pacific Medical Center 3700 California St B-336 San Francisco CA 94118 942728423 501(C)(3) 5693 FMV American Girl dolls Holiday donation Cardinal Glennon Childrens Hospital 1465 S Grand Blvd Saint Louis MO 63104 431754347 501(C)(3) 11860 FMV American Girl dolls Holiday donation Cardon Children's Medical Center 1400 S Dobson Road Phoenix AZ 85202 450233470 501(C)(3) 11860 FMV American Girl dolls Holiday donation Children's Health Children's Medical Center Dallas 1935 Medical District Drive Dallas TX 75235 750800628 501(C)(3) 29650 FMV American Girl dolls Holiday donation Children's Healthcare of Atlanta 1405 Clifton Rd NE Atlanta GA 30322 582367819 501(C)(3) 5693 FMV American Girl dolls Holiday donation Children's Hospital 200 Henry Clay Avenue New Orleans LA 70118 720467503 501(C)(3) 5693 FMV American Girl dolls Holiday donation Children's Hospital Colorado 13123 East 16th Avenue Aurora CO 80045 840166760 501(C)(3) 29650 FMV American Girl dolls Holiday donation Children's Hospital Los Angeles 4650 Sunset Blvd Los Angeles CA 90027 951690977 501(C)(3) 23720 FMV American Girl dolls Holiday donation Children's Hospital Los Angeles 4650 Sunset Blvd MS-64 Los Angeles CA 90027 951690977 501(C)(3) 11860 FMV American Girl dolls Holiday donation Children's Hospital of Eastern Ontario 401 Smyth Road Ottawa ottawa CA K1H 8L1 501(C)(3) 5693 FMV American Girl dolls Holiday donation Children's Hospital of Georgia 1446 Harper Street BT-1847 Augusta GA 30912 352310573 501(C)(3) 29650 FMV American Girl dolls Holiday donation Children's Hospital of Nevada at UMC 1800 W Charleston Blvd Las Vegas NV 89102 886000436 501(C)(3) 11860 FMV American Girl dolls Holiday donation CHildren's Hospital of Pittsburgh of UPMC 4401 Penn Avenue room 1266 PIttsburgh PA 15224 250965387 501(C)(3) 5693 FMV American Girl dolls Holiday donation Children's Hospital Sant Joan de Deu P St Joan de Deu 2 Esplugues de Llobregat Esplugues de SP 08950 501(C)(3) 5693 FMV American Girl dolls Holiday donation Children's Hospitals and Clinics of MN 2525 Chicago Ave S Minneapolis MN 55404 411754276 501(C)(3) 11860 FMV American Girl dolls Holiday donation Children's Memorial Hermann 6411 Fannin Street Houston TX 77030 741152597 501(C)(3) 11860 FMV American Girl dolls Holiday donation Children's National 111 Michigan Ave NW Washington DC 20010 530196580 501(C)(3) 23720 FMV American Girl dolls Holiday donation Children's of Alabama 1600 7th Ave South Birmingham AL 35233 630307306 501(C)(3) 11860 FMV American Girl dolls Holiday donation Children's Specialized Hospital 200 Somerset Street New Brunswick NJ 08901 221487148 501(C)(3) 11860 FMV American Girl dolls Holiday donation Chrs Evert Children's Hospital 1600 SAndrews Avenue Fort Lauderdale FL 33316 596012065 501(C)(3) 5693 FMV American Girl dolls Holiday donation Cincinnati Children's Hospital 3333 Burnet Avenue Cincinnati OH 45229 310833936 501(C)(3) 29650 FMV American Girl dolls Holiday donation Cleveland Clinic Children's 8624 Station St Mentor OH 440604316 340714585 501(C)(3) 29650 FMV American Girl dolls Holiday donation Cleveland Clinic Childrens Hospital - Shaker Campus 2801 MLK Jr Drive Cleveland OH 44104 340714585 501(C)(3) 5693 FMV American Girl dolls Holiday donation Cottage Children's Medical Center 400 West Pueblo Street Santa Barbara CA 93102 951644629 501(C)(3) 29650 FMV American Girl dolls Holiday donation Dartmouth Medical Center 1 Medical Center Dr Lebanon NH 03756 020222140 501(C)(3) 5693 FMV American Girl dolls Holiday donation Denver Health 777 Bannock Street Denver CO 80204 841343242 501(C)(3) 5693 FMV American Girl dolls Holiday donation Driscoll Children's Hospital 3533 S Alameda Corpus Christi TX 78411 742577746 501(C)(3) 11860 FMV American Girl dolls Holiday donation East Tennessee Children's Hospital 2018 Clinch Ave Knoxville TN 37916 626002604 501(C)(3) 23720 FMV American Girl dolls Holiday donation El Paso Children's Hospital 4845 Alameda Ave El Paso TX 79905 263075429 501(C)(3) 11860 FMV American Girl dolls Holiday donation Essentia Health St Mary's Children's Hospital 407 E Third Street Duluth MN 55805 200360007 501(C)(3) 11860 FMV American Girl dolls Holiday donation Florida Hospital for Children 601 E Rollins Street Orlando FL 32803 858015017 501(C)(3) 29650 FMV American Girl dolls Holiday donation Franciscan Hospital for Children 30 Warren Street Brighton MA 02129 042156082 501(C)(3) 11860 FMV American Girl dolls Holiday donation Geisinger Janet Weis Children's Hospital 100 North Academy Ave Danville PA 178222742 240795959 501(C)(3) 11860 FMV American Girl dolls Holiday donation Gillette Children's Specialty Healthcare 205 University Avenue East Saint Paul MN 55101 411200302 501(C)(3) 11860 FMV American Girl dolls Holiday donation Golisano Children's Hospital of SWFL 9981 S Healthpark Dr Ft Myers FL 33908 590714812 501(C)(3) 5693 FMV American Girl dolls Holiday donation Harlem Hospital Pediatrics 506 Lenox Ave rm 16-137 New York NY 10037 Government 11860 FMV American Girl dolls Holiday donation Hasbro Children's Hospital 593 Eddy Street Rm 144 Providence RI 02903 050258954 501(C)(3) 5693 FMV American Girl dolls Holiday donation Holtz Children's HospitalJackson Health Sys 1611 NW 12th Ave Miami FL 33136 591713947 501(C)(3) 29650 FMV American Girl dolls Holiday donation Hoops Family Children's Hospital 1340 Hal Greer Boulevard Huntington WV 25701 311096222 501(C)(3) 11860 FMV American Girl dolls Holiday donation Hurley Children's Hospital 1 Hurley Plaza Flint MI 48503 386005601 501(C)(3) 11860 FMV American Girl dolls Holiday donation Inova Children's Hospital 3300 Gallows Rd Falls Church VA 22042 540525802 501(C)(3) 29650 FMV American Girl dolls Holiday donation James and Connie Maynard Children's Hospital at Vidant Medical Center 2100 Santonsburg Road Greenville NC 27834 560585243 501(C)(3) 5693 FMV American Girl dolls Holiday donation Jeff Gordon Children's HospitalCarolinas Med Ctr NE 920 Church St N Concord NC 28025 Government 11860 FMV American Girl dolls Holiday donation Joe DiMaggio Children's Hospital 1005 Joe DiMaggio Dr Hollywood FL 33021 596014973 501(C)(3) 23720 FMV American Girl dolls Holiday donation Johns Hopkins Children's Medical Center 1800 ORLEANS STREET 7N RM7217 BALTIMORE MD 21287 520591656 501(C)(3) 5693 FMV American Girl dolls Holiday donation Joseph M Sanzari Children's Hospital 30 Prospect Avenue Hackensack NJ 07601 222339534 501(C)(3) 29650 FMV American Girl dolls Holiday donation JourneyCare All About Kids 405 Lake Zurich Rd Barrington IL 60010 363820916 501(C)(3) 5693 FMV American Girl dolls Holiday donation Kravis Children's Hospital at Mount Sinai 1184 5 Ave 1st Floor The Zone Child Life New York NY 10029 131624096 501(C)(3) 5693 FMV American Girl dolls Holiday donation Levine Children's Hospital 1000 Blythe Blvd Charlotte NC 28203 566060481 501(C)(3) 29650 FMV American Girl dolls Holiday donation Loma Linda Uni Children's Hospital 11234 Anderson Street Loma Linda CA 92354 463214504 501(C)(3) 11860 FMV American Girl dolls Holiday donation Loma Linda University Children's Hosp-Child Life Department 1269 E San Bernardino San Bernardino CA 924082943 463214504 501(C)(3) 11860 FMV American Girl dolls Holiday donation Lucile Packard Children's Hospital Stanford 725 Welch Road Palo Alto CA 94304 770003859 501(C)(3) 11860 FMV American Girl dolls Holiday donation Maimonides Medical Center 4802 tenth avenue brooklyn NY 11219 111635081 501(C)(3) 11860 FMV American Girl dolls Holiday donation Maria Fareri Children's Hospital Westchester Health Network 100 Woods Rd Room 3505 Valhalla NY 10595 133964321 501(C)(3) 5693 FMV American Girl dolls Holiday donation Mayo Clinic Children's Center 200 First Street SW 3 Francis 116 Rochester MN 55905 416011702 501(C)(3) 11860 FMV American Girl dolls Holiday donation Medical City Children's Hospital 7777 Forest Lane - 6D Dallas TX 75230 350868132 501(C)(3) 11860 FMV American Girl dolls Holiday donation Memorial Children's Hospital 615 North Michigan Street South Bend IN 466019986 351536129 501(C)(3) 5693 FMV American Girl dolls Holiday donation Mercy Children's Hospital St Louis 615 South New Ballas Road St Louis MO 63141 430653493 501(C)(3) 11860 FMV American Girl dolls Holiday donation Miller Children's & Women's Hospital Long Beach 2801 Atlantic Ave Long Beach CA 90806 956105984 501(C)(3) 23720 FMV American Girl dolls Holiday donation Monroe Carell Jr Children's Hospital at Vanderbilt 2200 Childrens Way Ste 2116 Nashville TN 37027 620476822 501(C)(3) 11860 FMV American Girl dolls Holiday donation MUMC Children's Hospital 4700 Waters Avenue Savannah GA 31403 311126469 501(C)(3) 5693 FMV American Girl dolls Holiday donation Nationwide Children's Hospital 700 Childrens Drive Room G160 Columbus OH 43205 010782751 501(C)(3) 11860 FMV American Girl dolls Holiday donation Nemours Children's ClinicPed Med Svcs Florida 5153 N 9th Ave Pensacola FL 32504 453584225 501(C)(3) 5693 FMV American Girl dolls Holiday donation NemoursAlfred I duPont Hospital for Children 1600 Rockland Road Wilmington DE 19803 501(C)(3) 11860 FMV American Girl dolls Holiday donation New York Presbyterian Hospital 525 East 68th Street New York NY 10065 133792361 501(C)(3) 5693 FMV American Girl dolls Holiday donation Miami Children's HospitalNicklaus Care Center 3100 Sw 62 Ave Miami FL 33155 591720704 501(C)(3) 29650 FMV American Girl dolls Holiday donation Niswonger Children's Hospital 400 N State of Franklin Rd Johnson City TN 37604 620476292 501(C)(3) 29650 FMV American Girl dolls Holiday donation Novant Health Hemby Children's Hospital 200 Hawthorne lane Charlotte NC 28204 501(C)(3) 5693 FMV American Girl dolls Holiday donation NYPresbyterian Morgan Stanley 3959 Broadway Tower 5 Room 561 New York NY 10032 133957095 501(C)(3) 5693 FMV American Girl dolls Holiday donation NYU Langone Medical Center-TR Dept 545 1st Avenue Ste SC1-069 New York NY 10016 111839567 501(C)(3) 11860 FMV American Girl dolls Holiday donation Phoenix Childrens Hospital 1919 East Thomas Road Phoenix AZ 85016 860422559 501(C)(3) 29650 FMV American Girl dolls Holiday donation Ponderosa Elementary School 2135 S Mountain View Ave Anaheim CA 92802 Government 11860 FMV American Girl dolls Holiday donation Primary Children's Hospital 100 North Mario Capecchi Drive Salt Lake City UT 84113 800225150 501(C)(3) 29650 FMV American Girl dolls Holiday donation Promedica Toledo Children's Hospital 2142 N Cove Blvd Toledo OH 43606 341517672 501(C)(3) 29650 FMV American Girl dolls Holiday donation Rady Childrens Hospital San Diego 3020 Childrens Way San Diego CA 92126 951691313 501(C)(3) 5693 FMV American Girl dolls Holiday donation Rainbow Babies & Children's Hospital 11100 Euclid Ave RBC 6041 Cleveland OH 44106 341567805 501(C)(3) 5693 FMV American Girl dolls Holiday donation Randall Children's Hospital 2725 N Gantenbein Ave Portland OR 97227 931314469 501(C)(3) 29650 FMV American Girl dolls Holiday donation Riley Hospital for Children at IU Health 705 Riley Hospital Drive Room 1990 Indianapolis IN 46202 351955872 501(C)(3) 11860 FMV American Girl dolls Holiday donation RMH of Akron 245 Locust Street Akron OH 44313 341860682 501(C)(3) 11860 FMV American Girl dolls Holiday donation RMHC 711 East Livingston Ave Columbus OH 43205 570724845 501(C)(3) 29650 FMV American Girl dolls Holiday donation RMHC Western WA & AK 5130 40th Avenue NE Seattle WA 98105 911061043 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House 1300 East 21st Ave Denver CO 80205 840728926 501(C)(3) 29650 FMV American Girl dolls Holiday donation Ronald McDonald House 333 Westmoreland Drive Rochester NY 14620 161271311 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House 1500 17th Street Huntington WV 25701 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House 850 2nd ST SW Rochester MN 55902 850283204 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House 1705 W Clinch Avenue Knoxville TN 37916 352181050 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House at Stanford 520 Sand Hill Road Palo Alto CA 94304 943083711 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Charities 16 South Winooski Avenue Burlington VT 05401 521132262 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Charities 3312 GALLOWS ROAD falls church VA 22042 521132262 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House Charities 2501 Cherry St Kansas City MO 64108 561420505 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House Charities 300 E CALIFORNIA AVE EL PASO TX 799024200 222430393 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House Charities in Omaha 620 South 38th Ave Omaha NE 68105 341269123 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House Charities NC 2555 49th Street Sacramento CA 95817 680147193 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of Central PA 745 West Governor Road Hershey PA 17033 232204761 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of Central Texas 1315 Barbara Jordan Blvd Austin TX 78723 742277664 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of Greater Cincinnati 350 Erkenbrecher Avenue Cincinnati OH 45229 232204761 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of Morgantown Inc 841 Country Club Drive Morgantown WV 26505 550668138 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of NM 1011 Yale NE Albuquerque NM 87106 581295754 501(C)(3) 29650 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of Pittsburgh 451 44th Street - Penthouse Floor Pittsburgh PA 15201 251320272 501(C)(3) 23720 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of Southern Colorado 311 N Logan Ave Colorado Springs CO 80909 841013843 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House Charities of Southern West Virginia 302 30th St SE Charleston WV 25304 042627411 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Charities Spokane 1015 W 5th Ave Spokane WA 99204 911176115 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House Houston 1907 Holcombe Houston TX 77030 741984499 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House New York 405 E 73rd St New York NY 10021 132933654 501(C)(3) 29650 FMV American Girl dolls Holiday donation Ronald McDonald House of Charleston SC 81 Gadsden St Charleston SC 29401 161391596 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House of Charlotte 1613 E Morehead Street Charlotte NC 28207 521359486 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House of Cleveland 10415 Euclid Ave Cleveland OH 44136 030287584 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House of Detroit 4707 St Antonie Suite 200 Detroit MI 48201 310890152 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House of Ft Worth 1001 8th Ave Ft Worth TX 76104 751754490 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House of Memphis 535 Alabama Ave Memphis TN 38105 411344744 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ronald McDonald House of SNJ 550 Mickle Blvd Camden NJ 08103 742277664 501(C)(3) 29650 FMV American Girl dolls Holiday donation Ronald McDonald House of Winston-Salem 419 S Hawthorne Rd WinstonSalem NC 27103 742257357 501(C)(3) 11860 FMV American Girl dolls Holiday donation Ronald McDonald House Southwest Virginia 2224 Jefferson Street SE Roanoke VA 24014 541244769 501(C)(3) 5693 FMV American Girl dolls Holiday donation Rush University Medical Center 711 South Paulina Chicago IL 60612 362174823 501(C)(3) 5693 FMV American Girl dolls Holiday donation Ryan House 110 W Merrell Street Phoenix AZ 85281 201852393 501(C)(3) 5693 FMV American Girl dolls Holiday donation Sacred Heart Children's Hospital 101 W 8th Avenue Spokane WA 99202 510216586 501(C)(3) 23720 FMV American Girl dolls Holiday donation Sanford Children's Hospital 1305 W 18th St Sioux Falls SD 57117 450226909 501(C)(3) 11860 FMV American Girl dolls Holiday donation Sanford Children's Hospital-Fargo 801 Broadway N Rte 0111 Fargo ND 58122 450226909 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospital For Children 1900 Richmond Road Lexington KY 40502 362193608 501(C)(3) 29650 FMV American Girl dolls Holiday donation Shriners Hospital for Children Fairfax Road at Virginia Street Salt Lake City UT 84103 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospital for Children Cincinnati 3229 Burnet Ave Cincinnati OH 45229 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospitals For Children 3551 North Broad Street Philadelphia PA 19140 362193608 501(C)(3) 29650 FMV American Girl dolls Holiday donation Shriners Hospitals for Children 4400 Clayton Avenue St Louis MO 63110 362193608 501(C)(3) 11860 FMV American Girl dolls Holiday donation Shriners Hospitals for Children 1310 Punahou Street Honolulu HI 96826 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospitals for Children 3100 Samford Ave Shreveport LA 71103 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospitals for Children 950 West Faris Rd Greenville SC 29605 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospitals for Children 6977 Main Street Houston TX 77030 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospitals for Children - Galveston 815 Market St Galveston TX 77550 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation Shriners Hospitals for Children Portland Unit 3101 SW Sam Jackson Park Rd Portland OR 97239 362193608 501(C)(3) 23720 FMV American Girl dolls Holiday donation Shriners Hospitals for Children Tampa 12502 USF Pine Drive Tampa FL 33612 362193608 501(C)(3) 5693 FMV American Girl dolls Holiday donation St Christopher's Hospital for Children 160 East Erie Ave Philadelphia PA 19134 232274198 501(C)(3) 11860 FMV American Girl dolls Holiday donation St Cloud Hospital 1406 6th Ave N St Cloud MN 56303 410695596 501(C)(3) 11860 FMV American Girl dolls Holiday donation St John Providence Children's Hospital - 4th floor CCB Building Pediatric 22101 Moross Road Detroit MI 48236 381359063 501(C)(3) 11860 FMV American Girl dolls Holiday donation St Joseph's Children's Hospital 703 Main Street Paterson NJ 07503 271344467 501(C)(3) 5693 FMV American Girl dolls Holiday donation St Jude Children's Research Hospital 262 Danny Thomas Place MS 121 Memphis TN 38105 620646012 501(C)(3) 5693 FMV American Girl dolls Holiday donation St Louis Children's Hospital One Childrens Place St Louis MO 63110 431626863 501(C)(3) 23720 FMV American Girl dolls Holiday donation St Mary's Hospital for Children 2901 216th Street Bayside NY 11360 111679599 501(C)(3) 11860 FMV American Girl dolls Holiday donation Stony Brook Children's 100 Nicolls Road Hospital Level 11 Rm 146 Stony Brook NY 117947111 116077945 501(C)(3) 29650 FMV American Girl dolls Holiday donation Fl Health Sciences Ctr DBA Tampa General Hospital 1 Tampa General Circle Tampa FL 33606 593458145 501(C)(3) 5693 FMV American Girl dolls Holiday donation Texas Children's Hospital 6621 Fannin 16-WT-277 Houston TX 77030 741100555 501(C)(3) 29650 FMV American Girl dolls Holiday donation Texas Scottish Rite Hospital for Children 2222 Welborn Street Dallas TX 75219 750818178 501(C)(3) 5693 FMV American Girl dolls Holiday donation The Children's Hospital at Sacred Heart 5151 N Ninth Avenue Pensacola FL 32504 590634434 501(C)(3) 29650 FMV American Girl dolls Holiday donation The Children's Hospital of Montefiore 3415 Bainbridge Avenue Bronx NY 10467 131740114 501(C)(3) 5693 FMV American Girl dolls Holiday donation Santa Rosa Children's Hospital DBA Ch Hosp of San Antonio 333 North Santa Rosa San Antonio TX 78207 741109665 501(C)(3) 11860 FMV American Girl dolls Holiday donation The Children's Inn at NIH 7 West Drive Bethesda MD 20814 521638207 501(C)(3) 11860 FMV American Girl dolls Holiday donation Tufts Medical Center 800 Washington St Boston MA 01803 043400617 501(C)(3) 23720 FMV American Girl dolls Holiday donation UCSF Benioff Children's Hospital Oakland 747 52nd Street Oakland CA 94609 940382330 501(C)(3) 29650 FMV American Girl dolls Holiday donation University of Wisconsin-Madison 600 Highland Avenue H4/447 CSC Madison WI 537924108 396006492 501(C)(3) 29650 FMV American Girl dolls Holiday donation UNM Carrie Tingely Hospital 1127 University Blvd NE Albuquerque NM 87102 Government 5693 FMV American Girl dolls Holiday donation Upstate Golisano Children's Hosptial at Syracuse Receiving 117 Monroe St Syracuse NY 13210 161068101 501(C)(3) 11860 FMV American Girl dolls Holiday donation UVA Children's Hospital 1215 Lee Street 7613B Charlottesville VA 22908 Government 5693 FMV American Girl dolls Holiday donation UVM Children's Hospital 111 Colchester Avenue Burlington VT 05401 030219309 501(C)(3) 29650 FMV American Girl dolls Holiday donation Valley Children's Hospital 9300 Valley Childrens Place Madera CA 93636 941294954 501(C)(3) 29650 FMV American Girl dolls Holiday donation Voorhees Pediatric Facility 1304 Laurel Oak Rd Voorhees NJ 08043 corporation 11860 FMV American Girl dolls Holiday donation WakeMed Children's Hospital 3000 New Bern Avenue Raleigh NC 27610 566017737 501(C)(3) 5693 FMV American Girl dolls Holiday donation Walter Reed Military medical center 8901 Wisconsin Ave Bldg 10 Pediatrics 3West Room 3161 Bethesda MD 20889 Government 5693 FMV American Girl dolls Holiday donation Wolfson Children's Hospital 800 Prudential Drive Jacksonville FL 32207 590747311 501(C)(3) 5693 FMV American Girl dolls Holiday donation WVU Medicine Children's 1 Medical Center Drive 6th Floor Morgantown WV 26506 556011282 501(C)(3) 11860 FMV American Girl dolls Holiday donation Children's National Medical Center 111 Michigan Avenue NW Washington DC 20010 521640403 501(C)(3) 362237 Federal CMMI Grant Children's Hospital 200 Henry Clay Ave New Orleans LA 70118 720467503 501(C)(3) 10000 Hospital Play Grants Children's Hospital of Wisconsin 9000 W Wisconsin Ave Milwaukee WI 53151 390812532 501(C)(3) 10000 Hospital Play Grants Texas Scottish Rite Hospital 2222 Welborn Street Dallas TX 75219 750818178 501(C)(3) 10000 Hospital Play Grants Children's Hospital at Montefiore 3415 Bainbridge Ave Bronx NY 10467 131740114 501(C)(3) 10000 Hospital Play Grants Joseph M Sanzari Children's Hospitalhackensack u 30 Prospect Ave Hackensack NJ 07601 221487576 501(C)(3) 10000 Hospital Play Grants Arkansas Children's Hospital 1 Childrens Way Little Rock AR 72202 431626863 501(C)(3) 10000 Hospital Play Grants Miller Children's Hospital - Long Beach 2801 Atlantic Ave Long Beach CA 90806 953527031 501(C)(3) 10000 Hospital Play Grants UCSF Benioff Children's Hosp 747 52nd Street Oakland CA 94609 940382330 501(C)(3) 10000 Hospital Play Grants Johns Hopkins Children's Center 1800 Orleans St Baltimore MD 21287 520591656 501(C)(3) 10000 Hospital Play Grants 185 Part I, Line 2: NACHRI USES A COMPETITIVE APPLICATION PROCESS FOR ITS PLAY GRANTS, AND HAS A REVIEW COMMITTEE COMPOSED OF CHILD LIFE, DEVELOPMENT, AND PROGRAM EXPERTS TO SCORE THE APPLICATIONS ACCORDING TO MERIT. THE TOP-RANKED APPLICATIONS WERE SELECTED FOR GRANTS. GRANTEES ARE REQUIRED TO SUBMIT 6-MONTH AND FINAL REPORTS THAT INCLUDE BUDGET INFORMATION, AND MUST ALSO EXPLAIN ANY CHANGES TO THEIR ORIGINAL PROJECT GRANT APPLICATION, IN TERMS OF HOW THE FUNDS WERE ULTIMATELY USED. X X X 0 1 0 0 0 0 0 1 0 Mark Wietecha CEO 173336 520007 52500 157500 387 1161 40963 122888 6830 20490 274016 822046 0 0 Amy Knight COO 257494 154496 75000 45000 12843 7706 48700 29220 17075 10245 411112 246667 0 0 D Brian Humphreys VP of Finance 123428 91230 25300 18700 800 591 13662 10098 14508 10723 177698 131342 0 0 David Bertoch VP, Informatics & Comparative Data 218053 0 43000 0 655 0 21489 0 25231 0 308428 0 0 0 Richard Stepanek Chief Information Officer 233131 0 46000 0 1264 0 23850 0 14531 0 318776 0 0 0 Kassandra Jensen VP, Education & Executive Learning 199335 0 36600 0 257 0 18551 0 9175 0 263918 0 0 0 Milton J Kauffman vp of public policy 0 244385 0 55000 0 10774 0 46350 0 27320 0 383829 0 0 David Spizman Vice President 0 255616 0 40000 0 379 0 23850 0 25231 0 345076 0 0 Robert Davidson Vice President, Insurance Advisory S 0 226311 0 35000 0 1449 0 23850 0 19048 0 305658 0 0 Jerry Rutherford VP, Special Projects 193839 0 50000 0 2644 0 22230 0 14531 0 283244 0 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: -MILTON KAUFMAN ($4,363 DISTRIBUTION IN 2015, $4,500 WAS CONTRIBUTED TO THE PLAN) -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) Part I, Line 7 mark wietecha'S compensation agreement allows for an annual bonus with a target of 35% of base salary, with the actual amount determined by the Board. SCHEDULE J, LINE 3 THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS, INC. (NACHRI) ACTS AS THE "COMMON PAYMASTER" FOR ITS RELATED ENTITIES. NACHRI ISSUES ALL W-2S FOR ALL EMPLOYEES OF THIS GROUP. THE W-2S ARE REPORTED ONLY ON THE NACHRI RETURN, WHILE COMPENSATION ALLOCATED BY TIME-SPENT IS REPORTED ON THE RETURNS OF THESE ENTITIES. X American Girl Dolls 22236 2637190 FMV 0 0 0 Form 990, Part VI, Section A, line 6 MEMBERSHIP IS COMPOSED OF TWO CATEGORIES, VOTING AND NONVOTING, AND MAY BE GRANTED UPON APPLICATION TO THE BOARD OF TRUSTEES, WHICH SHALL ESTABLISH MEMBERSHIP CRITERIA, GRANT OR DENY MEMBERSHIP AND ASSIGN APPLICANTS TO MEMBERSHIP CATEGORIES AT ITS PLEASURE. THE SOLE VOTING MEMBER IS THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, INC., A RELATED, NON-PROFIT ENTITY. Form 990, Part VI, Section A, line 7a NACHRI'S BOARD OF TRUSTEES CONSISTS OF THOSE PERSONS WHO SERVE AS TRUSTEES OF NACHRI'S SOLE MEMBER, THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (N.A.C.H), A RELATED 501(C)(6) ORGANIZATION. Form 990, Part VI, Section A, line 7b THE MEMBERSHIP MAY APPROVE VARIOUS DECISIONS 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 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 2014. ALL OTHER STAFF RECEIVED MINIMAL INCREASES IN LINE WITH THE MOST RECENT COMPENSATION STUDIES COMPLETED. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy, and audited financial statements are not generally made available to the general public, but if requests for copies of these documents were to be received, the organization would consider making them available to the requestor. Form 990, Part IX, line 11g Consulting Fees: Program service expenses 5,263,047. Management and general expenses 3,381,791. Fundraising expenses 98,609. Total expenses 8,743,447. Form 990, Part XI, line 9: EQUITY IN VPS 189,942. FORM 990, PART XII, LINE 2C: THE AUDIT OVERSIGHT PROCESS HAS REMAINED UNCHANGED FROM THE PREVIOUS YEAR. National Association of Children's Hospitals Inc 600 13TH STREET NW SUITE 500 WASHINGTON DC 20090 582176067 Assist children's hospitals in common bus. interest and economic welfare GA 501 (c)(6) 0 child health patient safety organization inc 6803 west 64th street suite 208 overland park KS 66202 270386722 improve safety of children's hospitals by sharing data & experiences KS 501 (c)(3) 509(a)(2) 0 CHILD HEALTH CORPORATION OF AMERICA 6803 WEST 64TH STREET STE 308 SHAWNEE MISSION KS 66202 521421302 HOSPITAL BUSINESS ALLIANCE TO BETTER SERVE CHILDREN KS N/A C 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 nATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC L 1631390 Actual Cost NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC O 2038684 Actual Cost NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC N 543796 Actual Cost