2016-05-06T07:51:28-05:00 2015-06-30 990 2014-07-01 590683252 ALL CHILDREN'S HOSPITAL INC ATTN FINANCE DEPT 9010 ALLC 7277674401 501 SIXTH AVENUE SOUTH ST PETERSBURG FL 33701 NANCY STAHL VP FINANCE AND CFO 7277674401 2016-05-06 2014 2016-08-17 19:52:53Z JONATHAN ELLEN MD 501 SIXTH AVENUE SOUTH ST PETERSBURG FL 33701 573431025 0 X WWW.ALLKIDS.ORG X 1967 FL PROVIDE LEADERSHIP IN CHILD HEALTH THROUGH TREATMENT, EDUCATION, ADVOCACY AND RESEARCH. 33 29 3018 547 0 0 5503580 7157368 411869881 449768816 13079148 2363787 3310216 3271567 433762825 462561538 0 0 0 0 200607773 208578950 0 0 0 198807804 210512494 399415577 419091444 34347248 43470094 970556377 960005225 337327876 328315888 633228501 631689337 X THIS ORGANIZATION'S MISSION IS TO PROVIDE LEADERSHIP IN CHILD HEALTH THROUGH TREATMENT, EDUCATION, ADVOCACY, AND RESEARCH. THE ORGANIZATION (1) DELIVERS QUALITY INPATIENT AND OUTPATIENT HOSPITAL AND HEALTHCARE SERVICES WITH COMPASSION AND COMMITMENT TO FAMILY-CENTERED CARE, (2) PROVIDES EDUCATIONAL PROGRAMS FOR THE ORGANIZATION'S PATIENTS, FAMILIES, EMPLOYEES, AND HEALTHCARE PROFESSIONALS, (3) PROVIDES LEADERSHIP IN PROMOTING THE WELL-BEING OF CHILDREN AND (4) DEVELOPS, SUPPORTS AND PARTICIPATES IN CLINICAL, BASIC, AND TRANSLATIONAL RESEARCH. 0 0 99239000 100944000 THE CRITICAL CARE PROGRAM AT THE HOSPITAL INCLUDES THE PEDIATRIC INTENSIVE CARE UNIT AND PEDIATRIC MEDICINE. THIS PROGRAM EXPERIENCED 12,634 INPATIENT BEDS DAYS DURING THE PERIOD COVERED UNDER THIS RETURN. IN ADDITION, 41,943 OUTPATIENT VISITS WERE ATTRIBUTABLE TO THE CRITICAL CARE PROGRAM. THIS PROGRAM TREATS ACUTELY-ILL PATIENT'S PRESENTING WITH MEDICAL CONDITIONS OTHER THAN SURGICAL, CARDIAC AND HEMATOLOGY/ONCOLOGY. EXAMPLES INCLUDE PNEUMONIA, MENINGITIS AND OTHER INFECTIOUS DISEASES. HOSPITAL-BASED PHYSICIANS CARING FOR THESE PATIENTS INCLUDE 28 PEDIATRIC HOSPITALISTS AND 9 PEDIATRIC INTENSIVISTS. IN ADDITION, THE HOSPITAL PROVIDES EMPLOYED CHAPLAIN SERVICES, CHILD LIFE SERVICES, SOCIAL WORK SERVICES, DIETICIAN SERVICES AND REHABILITATIVE SERVICES TO THESE PATIENTS. MANY OF THESE PATIENTS ARE REFERRED TO THE HOSPITAL FROM OUTLYING COMMUNITY ACUTE-CARE HOSPITALS PRIMARILY SERVING ADULTS THAT LACK THE BREADTH AND DEPTH OF PEDIATRIC SUBSPECIALTY PROVIDERS NEEDED TO TREAT THESE MORE ACUTE PATIENTS. 70866000 103390000 THE NEONATOLOGY PROGRAM AT ALL CHILDREN'S HOSPITAL IS A SPECIALITY OF PEDIATRICS THAT FOCUSES ON TREATING PREMATURE INFANTS OR INFANTS WITH CRITICAL MEDICAL CONDITIONS. AN ALL CHILDREN'S AFFILIATE EMPLOYS 33 NEONATOLOGISTS THAT PROVIDE TWENTY-FOUR HOUR CARE IN THE NEONATAL INTENSIVE CARE UNIT (NICU). ALL CHILDREN'S NICU IS A LEVEL III NICU OFFERING THE HIGHEST LEVEL OF NEONATAL CARE TO THE NEWBORNS OF FLORIDA, THE SOUTHEAST US, AND MANY NEIGHBORING INTERNATIONAL LOCATIONS. THE HOSPITAL IS DESIGNATED A REGIONAL PERINATAL INTENSIVE CARE CENTER (RPICC) BY THE STATE OF FLORIDA'S CHILDREN'S MEDICAL SERVICES, PROVIDING HIGH-RISK OBSTETRICAL CARE AND NEONATAL INTENSIVE CARE TO ALL PATIENTS REGARDLESS OF FINANCIAL NEEDS. THE NICU PROVIDED 28,303 DAYS OF INPATIENT CARE DURING THE PERIOD COVERED BY THIS RETURN. THE NEONATOLOGY PROGRAM IS ALSO SUPPORTED BY AN EMPLOYED NEONATAL TRANSPORT TEAM AVAILABLE AT ANY TIME TO TRANSPORT THESE PATIENTS SAFELY AND EFFICIENTLY BY AMBULANCE OR AIR TRANSPORT FROM OUTLYING FACILITIES. 48412000 44780000 THE ALL CHILDREN'S CENTER FOR PEDIATRIC CANCER AND BLOOD DISORDERS ("CENTER") PROVIDES CLINICAL CARE AND RESEARCH TRIALS FOR CHILDREN, ADOLESCENTS, AND YOUNG ADULTS IN WEST AND WEST CENTRAL FLORIDA. ALL CHILDREN'S IS THE PRIMARY CANCER CENTER IN WEST FLORIDA PROVIDING MULTIDISCIPLINARY CARE FOR CHILDREN AND ADOLESCENTS. THE CENTER'S PROGRAMS INCLUDE THE ONCOLOGY PROGRAM SUPPORTED BY DIAGNOSTIC RADIOLOGISTS WITH EXPERTISE IN INTERVENTIONAL RADIOLOGY, PEDIATRIC SURGEONS, PEDIATRIC RADIATION ONCOLOGISTS, CHILD LIFE SPECIALISTS, PHYSICAL AND OCCUPATIONAL THERAPY, A CLINICAL PHARMACIST, AND SOCIAL WORKERS. OTHER PROGRAMS INCLUDE THE HEMATOLOGY PROGRAM THAT FOLLOWS APPROXIMATELY 300 PATIENTS WITH SICKLE CELL DISEASE AND OFFERS MULTIDISCIPLINARY THERAPY FOR THESE PATIENTS AND THEIR FAMILIES. INPATIENT ACCOMMODATIONS INCLUDE A 28-BED UNIT FOR HEMATOLOGY/ONCOLOGY AND MARROW/STEM TRANSPLANT PATIENTS, A POSITIVE-PRESSURE AIRFLOW SYSTEM, UNIT-BASED ONCOLOGY SOCIAL WORKER, CASE MANAGER AND CHILD LIFE SPECIALIST, DEDICATED PLAYROOM, HOSPITAL-BASED TEACHER, IN-ROOM ACCOMMODATIONS FOR TWO PARENTS AND A DAY-INFUSION CENTER. DURING THE PERIOD COVERED BY THIS RETURN, 7,566 DAYS OF INPATIENT CARE WERE PROVIDED AND 10,023 OUTPATIENT VISIT EPISODES OF CARE WERE PROVIDED TO THESE PATIENTS. 92834306 200654816 92834306 200654816 311351306 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 X 302 0 1 3018 1 0 0 0 0 0 0 0 0 0 0 X 33 29 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X DOUGLAS MYERS 7277672582 501 SIXTH AVENUE SOUTH ST PETERSBURG FL 33701 R WILLIAM HORTON SR VP-STRATEGIC PLAN/TRUST 20.00 40.00 X X 391334 0 49194 SANDRA DIAMOND SECRETARY OF TRUSTEE 1.00 0.00 X X 0 0 0 HAMDEN BASKIN III TRUSTEE 1.00 0.00 X 0 0 0 KEN COPPEDGE TREASURER BOARD OF TRUSTEE 3.00 0.00 X X 0 0 0 MICHAEL CANNOVA TRUSTEE 1.00 0.00 X 0 0 0 VINCENT DOLAN TRUSTEE 1.00 0.00 X 0 0 0 GEORGE J DOVER MD TRUSTEE 1.00 0.00 X 0 0 0 JONATHAN ELLEN MD PRESIDENT/VICE DEAN/PIC/TR 47.00 7.00 X X 776719 0 138958 JOSEPH W FLEECE III CHAIRMAN BOARD OF TRUSTE 3.00 0.00 X X 0 0 0 DARLENE GRAYSON TRUSTEE 1.00 0.00 X 0 0 0 NANCY HAMILTON TRUSTEE 1.00 0.00 X 0 0 0 TROY HOLLAND TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM HORNER EX OFFICIO/TRUSTEE 3.00 0.00 X 0 0 0 JACK KIRKLAND TRUSTEE 3.00 0.00 X 0 0 0 ERIC KOBREN TRUSTEE 1.00 0.00 X 0 0 0 WILLIAM LANE JR TRUSTEE 1.00 0.00 X 0 0 0 DARRYL LECLAIR TRUSTEE 3.00 0.00 X 0 0 0 MARK LETTELLEIR TRUSTEE 1.00 0.00 X 0 0 0 TOM MAHAFFEY TRUSTEE 1.00 0.00 X 0 0 0 MILTON H MILLER JR TRUSTEE 1.00 0.00 X 0 0 0 MARK MONDELLO TRUSTEE 1.00 0.00 X 0 0 0 RONALD PETERSON CORP VICE CHAIR/TRUSTEE 3.00 57.00 X X 0 2133111 481135 PAUL RESOP TRUSTEE 1.00 0.00 X 0 0 0 CRAIG SHER TRUSTEE 1.00 0.00 X 0 0 0 RAYMOND SMITH TRUSTEE 1.00 0.00 X 0 0 0 MARK STROUD VICE CHAIRMAN OF THE BOARD 3.00 1.00 X X 0 0 0 STEPHANIE GOFORTH TRUSTEE 3.00 0.00 X 0 0 0 STEVEN A RAYMUND TRUSTEE 1.00 0.00 X 0 0 0 EDWARD D MILLER MD TRUSTEE 1.00 0.00 X 0 0 0 MARTHA LITTLE TRUSTEE 1.00 3.00 X 0 0 0 TIMOTHY BARBER TRUSTEE 1.00 0.00 X 0 0 0 DWAYNE HAWKINS TRUSTEE 1.00 0.00 X 0 0 0 PAUL DANIELSON TRUSTEE 1.00 40.00 X 139500 650991 49101 NANCY STAHL VP FINANCE/CFO 41.00 19.00 X 423531 0 40580 CALVIN L POPOVICH VP INFORMATION TECHNOLOGY 60.00 0.00 X 354454 0 44883 JAY KUHNS VP HUMAN RESOURCES 60.00 0.00 X 310238 0 49827 CYNTHIA ROSE VP MARKETING & COMMUNITY R 59.00 1.00 X 222914 0 29768 HELENE M MARRA ASSISTANT SECRETARY 53.00 7.00 X 60573 0 17532 BRIGITTA MUELLER MD VICE PRESIDENT MEDICAL AFF 37.00 23.00 X 0 336092 38726 ROBERTA ALESSI VP COO 32.00 28.00 X 0 301963 47538 TAMMY REYES ASSISTANT SECRETARY 53.00 7.00 X 55214 0 16727 ANTHONY NAPOLITANO MD CO-CHAIR DEPT OF PED MEDIC 59.00 1.00 X 361009 0 36872 PAUL COLOMBANI MD CHAIR OF SURGERY 29.00 31.00 X 710708 0 104122 ROBERT SOSA MD MEDICAL DIRECTOR OF INTERNATIONAL PROGRAM 60.00 0.00 X 257266 257266 5376 CAROLYN CAREY MD NEUROSURGEON 10.00 40.00 X 305000 637830 36444 GERALD TUITE MD NEUROSURGEON 10.00 40.00 X 295000 628411 49906 LUIS RODRIGUEZ MD NEUROSURGEON 10.00 40.00 X 312500 629148 43076 RICHARD HARMEL MD PED SURGEON 10.00 40.00 X 139500 571834 44315 NICOLE CHANDLER PED SURGEON 10.00 40.00 X 142500 389915 48406 ARNOLD T STENBERG JR FORMER EXEC VP/CAO/TRUSTEE 0.00 0.00 X 890430 0 0 JENNIFER R CASATELLI MD FORMER TRUSTEE 0.00 40.00 X 0 195517 28983 HELLA EWING FORMER OFFICER 0.00 0.00 X 122154 0 24472 6270544 6732078 1425941 164 1 1 1 CHILDREN'S ORTHOPAEDIC & SCOLIOSIS SURGE 625 6TH AVE SOUTH STE 450 ST PETERSBURG FL 33701 PHYSICIANS SERVICES 990406 BHG STRUCTURED SETTLEMENTS INC 3024 HARNEY ST OMAHA NE 68131 SETTLEMENT SERVICES 920000 COMPREHENSIVE CARE SERVICESINC 31330 SCHOOLCRAFT 200 LIVONIA MI 48150 HEALTH CONTRACT SERVICES 762906 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNAPOLIS MN 55480 LAB SERVICES 599842 MCKESSON SPECIAL HEALTH 401 MASON RD LA VERGNE TN 37086 HEALTH CONTRACT SERVICES 591315 36 2071070 4527944 558354 7157368 HOSPITAL INPT & OUTPT 621990 408417298 408417298 STATE OF FLORIDA SPECI 621990 20352451 20352451 CHILDREN'S HOSPITAL GR 621990 3323862 3323862 RETAIL PHARMACY INCOME 621990 2714676 2714676 14960529 14960529 449768816 6605274 6605274 3271567 0 3271567 3271567 3271567 106628000 100602491 10266996 6025509 -10266996 -4241487 -4241487 462561538 449768816 0 5635354 1444818 1444818 157760160 133527800 24232360 10504216 8142709 2361507 27569482 23061430 4508052 11300274 9820220 1480054 2435666 1133296 1302370 56018 56018 167275 167275 26633 26633 788373 146817 641556 10867526 10586661 280865 93230324 84503703 8726621 6725699 3211030 3514669 10439699 8229993 2209706 2219199 840236 1378963 263329 199576 63753 5033536 5033536 34385944 34385944 10247116 10247116 OTHER SERVICES 16783217 6093441 10689776 HOSPITAL MEMBERSHIP FEE 7500766 56820 7443946 INDIGENT FEE ASSESSMENT 5389857 5389857 COLLECTION SERVICES 2068254 2068254 1884063 1127065 756998 419091444 311351306 107740138 0 3458055 2630016 92408776 103816157 668350 787940 60030519 55687959 8529321 8845201 9610884 12598089 534219352 151124828 399959263 383094524 281490786 272334929 1158591 1117001 14719062 14247757 98522770 104845652 970556377 960005225 68412917 74676964 210703107 97450000 58211852 156188924 337327876 328315888 X 609846332 609041887 9308263 9189065 14073906 13458385 633228501 631689337 970556377 960005225 X 43470094 -22354891 -22654367 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 26633 0 0 26633 0 SCHEDULE C, PART 11-B, LINE 1G ALL CHILDRENS HOSPITAL PAID ITS PARENT CORPORATION, THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION $26,633 DURING THE FISCAL YEAR ENDED JUNE 30, 2015 TO SUPPORT THEIR LOBBYING ACTIVITIES. THE JOHNS HOPKINS HEALTH SYSTEM MAINTAINS A DEPARTMENT OF GOVERNMENTAL RELATIONS. THE PRIMARY PURPOSE OF THIS DEPARTMENT IS TO MAINTAIN CONTACT WITH ELECTED AND APPOINTED STATE OFFICIALS, AND OCCASIONAL FEDERAL OFFICIALS, REGARDING ISSUES WHICH IMPACT THE JOHNS HOPKINS HEALTH SYSTEM OR ITS AFFILIATES AS WELL AS THE HEALTHCARE INDUSTRY IN GENERAL. 15878278 -771000 15107278 14436278 1442000 15878278 13601278 835000 14436278 14315278 -714000 13601278 12995278 26000 1294000 14315278 1.00000 0 0 22389676 22389676 303087784 51671738 251416046 1129598 777948 351650 204049282 98675142 105374140 3563012 3563012 383094524 DUE TO AFFILIATES 14506100 INTEREST IN NET ASSETS OF FOUNDATION 73727514 TRADE NAME 11670000 DEBT ISSUANCE COSTS 95504 OTHER ASSETS 4846534 104845652 PROFESSIONAL LIABILITY 29807667 INTEREST RATE SWAP AGREEMENTS 27498865 OTHER LIABILITIES 1800194 DUE TO AFFILIATES 97082198 156188924 X 440503000 -22354889 296148 -22058741 462561741 -203 -203 462561538 419092000 556 556 419091444 0 419091444 PART V, LINE 4: THE INTENDED USE FOR ALL CHILDREN'S HOSPITAL ENDOWMENT FUNDS ARE SPECIFIC TO PROGRAM NEEDS AS DESIGNATED BY THE DONORS. PART X, LINE 2: FASB'S GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES CLARIFIES THE ACCOUNTING FOR UNCERTAINTY OF INCOME TAX POSITIONS. THIS GUIDANCE DEFINES THE THRESHOLD FOR RECOGNIZING TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON ITS TECHNICAL MERITS. THE GUIDANCE ALSO PROVIDES GUIDANCE ON THE MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS. THERE WAS NO IMPACT ON THE HOSPITAL'S FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2015 AND 2014. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTION 296,148. PART XI, LINE 4B - OTHER ADJUSTMENTS: ROUNDING -203. PART XII, LINE 2D - OTHER ADJUSTMENTS: ROUNDING 556. 1 1 X 1 X 1 X 1 1 0 1 1 2200129 0 2200129 0.00520 260878213 237867448 23010765 0.05490 263078342 237867448 25210894 0.06010 1946692 0 1946692 0.00460 8032717 3323862 4708855 0.01120 11758949 5972119 5786830 0.01380 1295054 0 1295054 0.00310 283613 0 283613 0.00070 23317025 9295981 14021044 0.03340 286395367 247163429 39231938 0.09350 115382 0 115382 0.00030 115382 115382 0.00030 0 6667979 0 661696 802682 -140986 X 1 0 1 1 ALL CHILDREN'S HOSPITAL INC 501 6TH AVENUE SOUTH ST PETERSBURG FL 33701 WWW.ALLKIDS.ORG/ 4042 X X X X ALL CHILDREN'S HOSPITAL INC 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X WWW.ALLKIDS.ORG/COMMUNITY/IN-THE-COMMUNITY/ X 1 12 1 WWW.ALLKIDS.ORG/COMMUNITY/IN-THE-COMMUNITY/ 0 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X WWW.ALLKIDS.ORG/ABOUT-ACH/IMPORTANT-NOTICES/FINANCIAL-ASSISTANCE X WWW.ALLKIDS.ORG/PATIENTS-FAMILIES/AFTER-YOUR-STAY/UNDERSTANDING-YOUR-BILL/P X WWW.ALLKIDS.ORG/PATIENTS-FAMILIES/AFTER-YOUR-STAY/UNDERSTANDING-YOUR-BILL/P X X X X 1 X 0 X X X X 1 X 0 0 ALL CHILDREN'S HOSPITAL, INC PART V, SECTION B, LINE 5: TO GATHER INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY ACH THE FOLLOWING WAS DONE:A)ESTABLISHED A COMMUNITY ADVISORY COMMITTEE (CAC). B)THE JUVENILE WELFARE BOARD FACILITATED THE INVOLVEMENT OF COMMUNITY-BASED ORGANIZATIONS IN THE QUALITATIVE RESEARCH PROCESS, BY HELPING TO RECRUIT AND HOST FOCUS GROUPS WITH PARENTS AND CAREGIVERS.C)SIX FOCUS GROUPS AND 16 INTERVIEWS WITH COMMUNITY STAKEHOLDER WERE CONDUCTED.D)FIVE FOCUS GROUPS WERE CONDUCTED WITH PARENTS AND CAREGIVERS OF THE GENERAL PUBLIC RESIDING IN THE FIVE AT-RISK COMMUNITIES. A TOTAL OF 62 INDIVIDUALS PARTICIPATED IN THESE FOCUS GROUPS.E)ONE FOCUS GROUP WITH ACH STAFF AND INCLUDED 18 INDIVIDUALS REPRESENTING A WIDE RANGE OF DEPARTMENTS.F)INTERVIEWS WERE CONDUCTED WITH 18 INDIVIDUALS FROM A RANGE OF SECTORS INCLUDING GOVERNMENT OFFICIALS, EDUCATIONAL LEADERS, SOCIAL SERVICE PROVIDERS, AND HEALTH CARE PROVIDERS. ALL CHILDREN'S HOSPITAL, INC PART V, SECTION B, LINE 11: FOCUSING THE ALL CHILDREN'S HOSPITAL CHNA AND THE SUBSEQUENT STRATEGIC COMMUNITY BENEFIT PLAN ON PINELLAS COUNTY, FLA., FACILITATES THE ALIGNMENT OF THE HOSPITAL'S EFFORTS WITH COMMUNITY AND GOVERNMENT PARTNERS, SPECIFICALLY, THE HEALTH DEPARTMENT, SCHOOLS AND MULTIPLE COMMUNITY-BASED ORGANIZATIONS. TARGET POPULATIONS FOR ALL CHILDREN'S HOSPITAL COMMUNITY BENEFIT INITIATIVES WERE IDENTIFIED THROUGH A COMMUNITY INPUT AND PLANNING PROCESS, COLLABORATIVE EFFORTS, AND THE CHNA. WITHIN THE HOSPITAL'S COMMUNITY BENEFIT SERVICE AREA (CBSA), ALL CHILDREN'S IS FOCUSED ON CERTAIN TARGET POPULATIONS, SUCH AS AT-RISK CHILDREN AND ADOLESCENTS, UNINSURED FAMILIES, WOMEN OF CHILDBEARING AGE, AND UNDERINSURED AND LOW-INCOME FAMILIES AND HOUSEHOLDS. THROUGH THE CHNA PROCESS CONDUCTED IN SPRING 2013, 15 POTENTIAL HEALTH PRIORITIES WERE DISCOVERED. WHILE ALL OF THE AREAS WERE IMPORTANT, THREE AREAS WERE PRIORITIZED BASED ON A CLEAR SET OF CRITERIA TO FACILITATE A TARGETED FOCUS THAT WILL LEAD TO GREATER COMMUNITY IMPACT. THE MOST PRESSING NEEDS IDENTIFIED WERE BIRTH OUTCOMES, CHRONIC DISEASE WITH A FOCUS ON CHILDHOOD OBESITY, AND MENTAL HEALTH AND SUBSTANCE ABUSE.PART OF THE CHNA PROCESS INCLUDED THE CREATION OF AN ADVISORY COMMITTEE, WHICH WAS COMPRISED OF LEADERSHIP FROM LOCAL NONPROFIT AND GOVERNMENTAL ORGANIZATIONS, AND KEY PERSONNEL FROM THE ALL CHILDREN'S HOSPITAL TEAM. THE ADVISORY COMMITTEE PROVIDED OVERSIGHT FOR THE CHNA, IDENTIFIED HEALTH PRIORITIES, AND DEVELOPED THE STRATEGIC COMMUNITY BENEFIT PLAN. THE PLAN WAS ENACTED VIA THE CREATION AND IMPLEMENTATION OF THE UNITE4KIDS HEALTH COALITION, WHICH TOOK A STRUCTURAL CHANGE APPROACH TO IMPACT LAWS, POLICIES AND PRACTICES TO IMPROVE IDENTIFIED COMMUNITY HEALTH NEEDS. CHILDHOOD OBESITY WAS SELECTED AS THE FIRST HEALTH NEED TO BE ADDRESSED BY THE COALITION.HEALTHY START AT ALL CHILDREN'S HOSPITAL, WEST CENTRAL EARLY STEPS, FIT4ALLKIDS, LAKEWOOD HEALTH SQUAD PROGRAM, THE PHYSICAL EDUCATION PROGRAM (PEP) GRANT WITH PINELLAS COUNTY SCHOOLS, KOHL'S COOK'S FOR KIDS AND THE UNITE4KIDS HEALTH COALITION ARE SOME OF THE COMMUNITY BENEFIT INITIATIVES AND PROGRAMS THAT ARE PROVIDED TO THE CBSA OF PINELLAS COUNTY. ALL INITIATIVES RESPOND TO THE COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE MOST RECENT CHNA PROCESS. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY ALL CHILDREN'S HOSPITAL, INC PART V, SECTION B, LINE 16A WEBSITE: WWW.ALLKIDS.ORG/ABOUT-ACH/IMPORTANT-NOTICES/FINANCIAL-ASSISTANCE ALL CHILDREN'S HOSPITAL, INC PART V, SECTION B, LINE 16B WEBSITE: WWW.ALLKIDS.ORG/PATIENTS-FAMILIES/AFTER-YOUR-STAY/UNDERSTANDING-YOUR-BILL/P ALL CHILDREN'S HOSPITAL, INC PART V, SECTION B, LINE 16C WEBSITE: WWW.ALLKIDS.ORG/PATIENTS-FAMILIES/AFTER-YOUR-STAY/UNDERSTANDING-YOUR-BILL/P 9 ALL CHILDREN'S OUTPT CARE - BRANDON 885 SOUTH PARSONS AVE BRANDON FL 33511 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S OUTPT CARE - EAST LAKE 3850 TAMPA RD PALM HARBOR FL 34684 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S OUTPT CARE - FT MYERS 4550 COLONIAL BLVD FT MYERS FL 33966 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S OUTPT CARE - LAKELAND 3310 LAKELAND HILLS BLVD LAKELAND FL 33805 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S OUTPATIENT CARE - PASCO 4443 ROWAN RD NEW PORT RICHEY FL 34653 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S SERTOMA OUTPATIENT CARE 538 NORTH LECANTO HWY STE 538 LECANTO FL 34461 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S OUTPT CARE - SARASOTA 5881 RAND BLVD SARASOTA FL 34238 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S OUTPT CARE - TAMPA 12220 BRUCE B DOWNS BLVD TAMPA FL 33612 PEDIATRIC OUTPATIENT CLINIC ALL CHILDREN'S OUTPT CARE - SOUTH TAMPA 1202 SOUTH CHURCH AVE TAMPA FL 33629 PEDIATRIC OUTPATIENT CLINIC PART I, LINE 3C: IN ADDITION TO FPG, THE HOSPITAL ALSO PROVIDES FINANCIAL ASSISTANCE DISCOUNTS BASED ON MEDICAL FINANCIAL HARDSHIP CAUSED BY SIGNIFICANT MEDICAL DEBT. FACTORS THE HOSPITAL CONSIDERS WHEN EVALUATING MEDICAL DEBT LEVELS FOR FINANCIAL ASSISTANCE INCLUDE (1) MEDICAL DEBT INCURRED OVER THE PRIOR TWELVE MONTHS PRECEDING THE DATE OF A FINANCIAL HARDSHIP APPLICATION, (2) AN ASSET TEST SUCH THAT A LIQUID ASSETS OF THE GUARANTOR WILL NOT FALL BELOW $10,000 DUE TO MEDICAL DEBT, AND (3) FAMILY INCOME. PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A&7B (FINANCIAL ASSISTANCE AT COST AND UNREIMBURSED MEDICAID). THE AMOUNTS FOR LINES 7E-7I COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO CHARGE RATIO. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES DO NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL SPONSORS AND TAKES PART IN COMMUNITY HEALTH SERVICES THAT ADDRESS CHILD SAFETY, DISEASE MANAGEMENT, AND PREVENTATIVE HEALTH WITH PROGRAMS THAT INCLUDE: ASTHMA EDUCATION; INFANT AND TODDLER HEALTH AND DEVELOPMENTAL SCREENING; PARENT SUPPORT GROUPS; AND A WEIGHT MANAGEMENT AND OBESITY PREVENTION PROGRAM. ALL CHILDRENS SPONSORS THE SUNCOAST SAFE KIDS COALITION AND ITS PROGRAMS ON CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, WATER SAFETY AND DROWNING PREVENTION. PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED UPON A COMBINATION OF THE PAYOR SOURCE, THE AGING OF RECEIVABLES AND MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TRENDS IN HEALTH INSURANCE COVERAGE, AND OTHER COLLECTION INDICATORS. PART III, LINE 3: ALL CHILDREN'S HOSPITAL (ACH) DOES NOT REPORT AN ESTIMATE FOR THE PORTION OF BAD DEBT EXPENSE THAT MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. ACH TAKES THE POSITION THAT AMPLE OPPORTUNITY AND ASSISTANCE IS PROVIDED TO THE PATIENT TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. IF SUFFICIENT INFORMATION IS NOT PROVIDED, THEN ACH MUST ASSUME THE PATIENT DOES NOT QUALIFY. PART III, LINE 4: ACH AUDITED FINANCIAL STATEMENTS PAGE 11. PART III, LINE 8: PART III, LINE 7 - THE SHORTFALL IN MEDICARE ALLOWABLE COSTS IS NOT TREATED AS A COMMUNITY BENEFIT.PART III, LINES 5 AND 6 METHODOLOGY: A STEP-DOWN PROCESS IS USED TO ALLOCATE ADMINISTRATIVE AND GENERAL COSTS TO PATIENT CARE DEPARTMENTS, AS WELL AS DEPARTMENTS THAT ARE NON-ALLOWABLE FOR MEDICARE. UPON ALLOCATION, A DAILY COST RATE IS COMPUTED FOR ROOM AND BOARD SERVICES. THE RESULTING DAILY COSTS ARE APPLIED TO THE NUMBER OF MEDICARE DAYS TO DETERMINE ALLOWABLE ROOM AND BOARD COSTS. FOR ANCILLARY SERVICES, A RATIO OF COST TO CHARGES (RCC) IS COMPUTED USING TOTAL ANCILLARY CHARGES. THE RCC IS THEN APPLIED TO CHARGES INCURRED BY MEDICARE PATIENTS TO DETERMINE ALLOWABLE MEDICARE COSTS. WITH THE EXCEPTION OF PASS-THROUGH COSTS (CAPITAL-RELATED, NON-PHYSICIAN ANESTHETIST, AND MEDICAL EDUCATION COSTS), ALLOWABLE MEDICARE COSTS ARE SUBJECT TO A TEFRA TARGET AMOUNT, WHICH IS COMPUTED ON A DISCHARGE BASIS. IF ALLOWABLE COSTS EXCEED THE TEFRA TARGET AMOUNT, THE FACILITY IS REIMBURSED IN THE AMOUNT OF THE TARGET LIMIT PLUS A RELIEF PAYMENT. IF ALLOWABLE COSTS ARE UNDER THE TARGET AMOUNT, THE FACILITY IS REIMBURSED BY THE AMOUNT OF THE TARGET LIMIT PLUS A BONUS PAYMENT. PART VI, LINE 2: EXISTING SOCIAL, ECONOMIC, AND HEALTH DATA WERE DRAWN FROM NATIONAL, STATE, COUNTY, AND LOCAL SOURCES, SUCH AS THE U.S. CENSUS AND FLORIDA DEPARTMENT OF HEALTH, WHICH INCLUDE SELF-REPORT, PUBLIC HEALTH SURVEILLANCE, AND VITAL STATISTICS DATA. OVER 80 INDIVIDUALS FROM MULTI-SECTOR ORGANIZATIONS, COMMUNITY STAKEHOLDERS, AND RESIDENTS WERE ENGAGED IN FOCUS GROUPS AND INTERVIEWS TO GAUGE THEIR PERCEPTIONS OF THE COMMUNITY, PRIORITY HEALTH CONCERNS, AND WHAT PROGRAMMING, SERVICES, OR INITIATIVES ARE MOST NEEDED TO ADDRESS THESE CONCERNS. FINALLY, AN ENVIRONMENTAL SCAN OF HEALTH-RELATED PROGRAMS AND SERVICES WAS CONDUCTED IN ORDER TO ASSESS THE CURRENT LANDSCAPE OF ACTIVITY RELATED TO CHILDHOOD OBESITY, ASTHMA, TOBACCO, INJURY AND VIOLENCE PREVENTION, MENTAL HEALTH, SUBSTANCE USE, AND YOUTH EMPOWERMENT.MUCH OF THE SECONDARY DATA WAS DERIVED FROM HEALTHY TAMPA BAY, AN INITIATIVE OF ONE BAY: HEALTHY COMMUNITIES. PART VI, LINE 3: ACH WILL POST NOTICES OF AVAILABILITY AT PATIENT REGISTRATION SITES, ADMISSIONS, THE BUSINESS OFFICE, AT THE EMERGENCY DEPARTMENT AND ON THE HOSPITAL'S WEBSITE. NOTICE OF AVAILABILITY WILL ALSO BE SENT TO PATIENTS OR WITH PATIENTS' BILL. A SUMMARY OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WILL BE PROVIDED TO INPATIENTS BEFORE DISCHARGE AND WILL BE AVAILABLE TO ALL PATIENT UPON REQUEST.IF A PATIENT INDICATES A NEED FOR CHARITY CARE, THE PATIENT IS REFERRED TO A FINANCIAL COUNSELOR WHO REVIEWS WITH THEM THE AVAILABILITY OF VARIOUS GOVERNMENT BENEFIT AND PROGRAMS, AND ASSISTS THEM WITH APPLICATION TO SUCH PROGRAMS. IF THE PATIENT DOES NOT HAVE INSURANCE, ACH FINANCIAL COUNSELORS WILL SCHEDULE AN INTERVIEW WITH THE PATIENT TO DETERMINE PAYMENT ARRANGEMENTS AND/OR ASSIST THE PATIENT IN COMPLETING A MEDICAL ASSISTANCE APPLICATION. PART VI, LINE 4: FOR THE PURPOSE OF DEFINING A COMMUNITY BENEFIT SERVICE AREA (CBSA), ALL CHILDREN'S FOCUSED ON PINELLAS COUNTY. THE POPULATION OF PINELLAS COUNTY IS A PREDOMINANTLY WHITE (83%), AGING POPULATION, WITH WIDE VARIATIONS IN SOCIOECONOMIC LEVEL AND EDUCATIONAL ATTAINMENT, AND HIGH NUMBERS OF FEMALE-HEADED HOUSEHOLDS. 10.9% OF THE CBSA IDENTIFIES AS BLACK OR AFRICAN-AMERICAN, WHILE 8.8% IDENTIFIES AS HISPANIC OR LATINO. DESPITE PERCEIVED COMMUNITY RESOURCES, ECONOMIC CHALLENGES AND INCOME INEQUALITY WERE FREQUENTLY CITED BY COMMUNITY HEALTH NEEDS ASSESSMENT PARTICIPANTS, AND WERE DESCRIBED AS A ROOT CAUSE OF HEALTH ISSUES IN THE COUNTY. THE MEDIAN HOUSEHOLD INCOME IN PINELLAS COUNTY ($45,535) IS LOWER THAN THAT OF FLORIDA ($46,956) AND THE U.S. ($53,046). 21.4% OF PINELLAS COUNTY CHILDREN LIVE IN POVERTY. ADDITIONALLY, 40.7% OF CHILDREN IN THE CBSA LIVE IN HOUSEHOLDS HEADED BY A SINGLE PARENT. FEMALE-HEADED HOUSEHOLDS ARE DISPROPORTIONATELY AFFECTED BY POVERTY IN PINELLAS COUNTY, WITH MORE THAN ONE QUARTER LIVING IN POVERTY. (HHS COMMUNITY HEALTH STATUS INDICATORS, U.S. CENSUS BUREAU). THE PROPORTION OF BLACK CHILDREN LIVING BELOW POVERTY (38.8%) IN PINELLAS COUNTY WAS MORE THAN THREE TIMES THAT OF THEIR WHITE COUNTERPARTS (10.5%) (U.S. CENSUS BUREAU; CENSUS 2010).NOTABLY, FIVE OF THE STATE'S LOWEST-RANKED ELEMENTARY SCHOOLS CAN BE FOUND IN THE CITY OF ST. PETERSBURG, HOME OF ALL CHILDREN'S MAIN CAMPUS, WHICH IS LOCATED IN THE SOUTHERNMOST PART OF PINELLAS COUNTY. THE ON-TIME HIGH SCHOOL GRADUATION RATE IN PINELLAS COUNTY IS ONLY 65%. FURTHERMORE, ONE QUARTER OF THE COUNTY'S ADULT POPULATION HAD A BACHELOR'S DEGREE OR HIGHER, 61% HAD A HIGH SCHOOL DIPLOMA OR SOME COLLEGE, AND 11.9% HAD LESS THAN A HIGH SCHOOL DIPLOMA. (U.S. CENSUS BUREAU; AMERICAN COMMUNITY SURVEY, 2006-2010 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES). WITHIN THIS CBSA, ALL CHILDREN'S IS FOCUSED ON CERTAIN TARGET POPULATIONS, SUCH AS AT-RISK CHILDREN AND ADOLESCENTS, UNINSURED FAMILIES, WOMEN OF CHILDBEARING AGE, AND UNDERINSURED AND LOW-INCOME FAMILIES AND HOUSEHOLDS.NUMBER OF OTHER HOSPITALS SERVING THE COMMUNITY OR COMMUNITIES: 48FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS OR POPULATIONS ARE PRESENT IN THE COMMUNITY . PART VI, LINE 5: ALL CHILDREN'S IS DEDICATED TO ONE OF THE MOST EFFECTIVE TOOLS IN PROMOTING GOOD HEALTH - EDUCATION THROUGH COMMUNITY OUTREACH TO CHILDREN AND FAMILIES. ALL CHILDREN'S SPONSORS MORE HEALTH, A NONPROFIT THAT PROVIDES HIGH-ENERGY, INTERACTIVE HEALTH AND SAFETY EDUCATION LESSONS EACH YEAR TO NEARLY 60,000 K-12 STUDENTS IN PINELLAS COUNTY, THE SEVENTH LARGEST SCHOOL DISTRICT IN FLORIDA. MORE HEALTH LESSONS HIGHLIGHT BONE HEALTH, DENTAL HEALTH, NUTRITION AND FITNESS, SKIN CANCER PREVENTION, FIREARM SAFETY, HEART HEALTH, PEDESTRIAN AND BICYCLE SAFETY, AND HEAD TRAUMA. ALL CHILDREN'S INSTRUCTORS REACH AN ADDITIONAL 6,500 PRE-K AND KINDERGARTEN STUDENTS WITH BASIC HEALTH AND SAFETY MESSAGES, WHILE HUNDREDS OF PRE-TEENS AND TEENS LEARN ABOUT THE DANGERS OF TOBACCO PRODUCTS AND E-CIGARETTES. ALL CHILDREN'S STAFF MEMBERS SHARE THEIR EXPERTISE WITH HUNDREDS OF TEACHERS, SCHOOL NURSES, AND SUPPORT SERVICES STAFF AT DISTRICTWIDE TRAININGS, AND WITH THOUSANDS OF STUDENTS DURING THE ANNUAL GREAT AMERICAN TEACH-IN.THE ALL CHILDREN'S HOSPITAL-LED FLORIDA SUNCOAST SAFE KIDS COALITION SERVES FIVE COUNTIES AND IS AN AFFILIATE OF SAFE KIDS WORLDWIDE, A GLOBAL ORGANIZATION DEDICATED TO PREVENTING INJURIES IN CHILDREN, THE NO. 1 KILLER OF CHILDREN IN THE U.S. FOR 25 YEARS, SUNCOAST SAFE KIDS HAS UNITED HEALTH AND SAFETY EXPERTS, FIRST RESPONDERS, EDUCATORS, LOCAL AGENCIES, CIVIC GROUPS, BUSINESSES, AND VOLUNTEERS TO RAISE AWARENESS OF CHILD PASSENGER SAFETY, WATER SAFETY, MEDICATION SAFETY, SAFE DRIVING AND SAFETY BELT USAGE FOR TEENS, AND HOME SAFETY. A COMPLEMENTARY PROGRAM TO SAFE KIDS IS SAFE ROUTES TO SCHOOL, A FEDERALLY-FUNDED PROGRAM DESIGNED TO EDUCATE CHILDREN, PARENTS, STUDENTS AND THE COMMUNITY ABOUT BICYCLE AND PEDESTRIAN SAFETY. THROUGH PARTNERSHIPS WITH LOCAL LAW ENFORCEMENT, FIRE DEPARTMENTS, SCHOOL DISTRICTS, AND CITY OFFICIALS, SAFE ROUTES EDUCATORS TEACH CURRICULUM AND CONDUCT BIKE AND PEDESTRIAN PROGRAMMING FOR MORE THAN 82,500 INDIVIDUALS AT 200 SCHOOLS ACROSS EIGHT COUNTIES.ALL CHILDREN'S HOSPITAL BOARD OF TRUSTEES IS COMPRISED OF 33 MEMBERS, OF WHICH 2 ARE APPOINTED AND 5 SERVE ON THE BOARD BY VIRTUE OF THEIR POSITION AS MEMBERS OF AFFILIATE BOARDS, MEDICAL STAFF, VOLUNTEER AND ACADEMIC OFFICERS, ETC. THE REMAINING 26 BOARD MEMBERS ARE ELECTED FROM THE COMMUNITY AT LARGE FOR MAXIMUM TERMS OF 9 YEARS PER INDIVIDUAL. PART VI, LINE 6: THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION (JHHSC) IS INCORPORATED IN THE STATE OF MARYLAND TO, AMONG OTHER THINGS, FORMULATE POLICY AMONG AND PROVIDE CENTRALIZED MANAGEMENT FOR JHHSC AND AFFILIATES (JHHS). JHHS IS ORGANIZED AND OPERATED FOR THE PURPOSE OF PROMOTING HEALTH BY FUNCTIONING AS A PARENT HOLDING COMPANY OF AFFILIATES WHOSE COMBINED MISSION IS TO PROVIDE PATIENT CARE IN THE TREATMENT AND PREVENTION OF HUMAN ILLNESS WHICH COMPARES FAVORABLY WITH THAT RENDERED BY ANY OTHER INSTITUTION IN THIS COUNTRY OR ABROAD.JHHSC IS THE SOLE MEMBER OF THE JOHNS HOPKINS HOSPITAL (JHH), AN ACADEMIC MEDICAL CENTER, JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC. (JHBMC), A COMMUNITY BASED TEACHING HOSPITAL AND LONG-TERM CARE FACILITY, HOWARD COUNTY GENERAL HOSPITAL, INC. (HCGH), A COMMUNITY BASED HOSPITAL, SUBURBAN HOSPITAL, INC. (SHI), A COMMUNITY BASED HOSPITAL, SIBLEY MEMORIAL HOSPITAL (SMH), A D.C. COMMUNITY BASED HOSPITAL, AND ALL CHILDRENS HOSPITAL, INC (ACH), A FL ACADEMIC CHILDRENS HOSPITAL. X 0 0 X X X X X 1 1 0 0 0 0 0 0 0 R WILLIAM HORTON SR VP-STRATEGIC PLAN/TRUST 388519 0 0 0 2815 0 26875 0 22319 0 440528 0 0 0 JONATHAN ELLEN MD PRESIDENT/VICE DEAN/PIC/TR 590197 0 181140 0 5382 0 113880 0 25078 0 915677 0 0 0 RONALD PETERSON CORP VICE CHAIR/TRUSTEE 0 1309445 0 566178 0 257488 0 456542 0 24593 0 2614246 0 0 PAUL DANIELSON TRUSTEE 139500 650991 0 0 0 0 0 26875 0 22226 139500 700092 0 0 NANCY STAHL VP FINANCE/CFO 365680 0 0 0 57851 0 26875 0 13705 0 464111 0 0 0 CALVIN L POPOVICH VP INFORMATION TECHNOLOGY 351737 0 0 0 2717 0 26875 0 18008 0 399337 0 0 0 JAY KUHNS VP HUMAN RESOURCES 272999 0 0 0 37239 0 26875 0 22952 0 360065 0 0 0 CYNTHIA ROSE VP MARKETING & COMMUNITY R 221229 0 0 0 1685 0 19755 0 10013 0 252682 0 0 0 BRIGITTA MUELLER MD VICE PRESIDENT MEDICAL AFF 0 286653 0 45434 0 4005 0 36256 0 2470 0 374818 0 0 ROBERTA ALESSI VP COO 0 251551 0 25000 0 25412 0 44680 0 2858 0 349501 0 0 ANTHONY NAPOLITANO MD CO-CHAIR DEPT OF PED MEDIC 361009 0 0 0 0 0 26875 0 9997 0 397881 0 0 0 PAUL COLOMBANI MD CHAIR OF SURGERY 496248 0 93998 0 120462 0 89174 0 14948 0 814830 0 0 0 ROBERT SOSA MD MEDICAL DIRECTOR OF INTERNATIONAL PR 257266 257266 0 0 0 0 2688 2688 0 0 259954 259954 0 0 CAROLYN CAREY MD NEUROSURGEON 305000 637830 0 0 0 0 0 22877 0 13567 305000 674274 0 0 GERALD TUITE MD NEUROSURGEON 295000 628411 0 0 0 0 0 26875 0 23031 295000 678317 0 0 LUIS RODRIGUEZ MD NEUROSURGEON 312500 629148 0 0 0 0 0 26875 0 16201 312500 672224 0 0 RICHARD HARMEL MD PED SURGEON 139500 571834 0 0 0 0 0 26875 0 17440 139500 616149 0 0 NICOLE CHANDLER PED SURGEON 142500 389915 0 0 0 0 0 26875 0 21531 142500 438321 0 0 ARNOLD T STENBERG JR FORMER EXEC VP/CAO/TRUSTEE 0 0 0 0 890430 0 0 0 0 0 890430 0 0 0 JENNIFER R CASATELLI MD FORMER TRUSTEE 0 195517 0 0 0 0 0 20843 0 8140 0 224500 0 0 HELLA EWING FORMER OFFICER 121599 0 0 0 555 0 20312 0 4160 0 146626 0 0 0 PART I, LINE 1A ORGANIZATION PROVIDED BENEFITS FORM 990, SCHEDULE J, PART 1, QUESTION 1A THE NON-SUBSTANTIATED PORTION OF MONTHLY AUTOMOBILE ALLOWANCES ARE GROSSED UP FOR FICA TAXES ONLY. HOUSING ALLOWANCES ARE PROVIDED ONLY IN LIMITED CIRCUMSTANCES AND FOR FINITE PERIODS OF TIME AS PART OF SOME EMPLOYEE RELOCATION AGREEMENTS. PART I, LINES 4A-B THE FOLLOWING INDIVIDUAL LISTED ON THE 990 RECEIVED SEVERANCE FROM ALL CHILDREN'S HOSPITAL: ARNOLD T. STENBERG, JR. $890,429.88 THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE PLAN) OF ALL CHILDREN'S HEALTH SYSTEM, INC. (THE COMPANY) IS A NONQUALIFIED DEFERRED COMPENSATION PLAN INTENDED TO BE GOVERNED BY SECTION 457(F) OF THE INTERNAL REVENUE CODE. THE BOARD OF DIRECTORS OF THE COMPANY DETERMINES ELIGIBILITY FOR THE PLAN FROM AMONG A SELECT GROUP OF KEY EMPLOYEES AND MANAGEMENT. THE PLAN PROVIDES FOR A SUPPLEMENTAL RETIREMENT BENEFIT BEGINNING AT RETIREMENT OR UPON SEPARATION FROM THE COMPANY. DURING THE TIME PERIOD COVERED BY THE RETURN, THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE PLAN AND WERE AWARDED AMOUNTS AS FOLLOWS WHICH ARE INCLUDED ON SCHEDULE J, COLUMN B(III): JAY KUHNS $34,879 AND NANCY STAHL $55,134. THE MAKE WHOLE AND SERP I PLANS ARE FROZEN DEFINED BENEFIT PLANS PROVIDED BY THE RELATED ORGANIZATION JOHNS HOPKINS HEALTH SYSTEM CORPORATION. THE PLANS ARE LIMITED TO THE EXISTING PLAN PARTICIPANTS. THE PLANS ARE SUBJECT TO CLAIMS OF EMPLOYER'S BANKRUPTCY/INSOLVENCY CREDITORS. THE MAKE WHOLE PLAN WAS DESIGNED TO REPLACE THE BENEFITS THE PARTICIPANTS LOST AS DO THE COMPENSATION LIMITS THAT WERE IMPOSED UPON OUR QUALIFIED DEFINED BENEFIT PLAN. FURTHERMORE, IF A PARTICIPANT TERMINATES EMPLOYMENT PRIOR TO COMPLETING THE SERVICE REQUIREMENTS, THE PARTICIPANT'S BENEFIT IS FORFEITED. NOTE THAT ANY ITEM BEING REPORTED AS COMPENSATION WAS ALSO REPORTED IN PREVIOUS YEARS FORMS 990 AS REQUIRED, WHEN AMOUNTS ACCRUED UNDER THE PLAN. THE FOLLOWING INDIVIDUAL LISTED ON FORM 990, PART VII, SECTION A, LINE 1A PARTICIPATED IN A NONQUALIFIED RETIREMENT PLAN AND RECEIVED ACCRUED DEFERRED COMPENSATION THAT IS REPORTED ON SCHEDULE J, PART II, COLUMN (C): RONALD R. PETERSON $450,612; ROBERTA ALESSI $15,167; AND BRIGITTA MUELLER, M.D. $14,251 FORM 990, SCHEDULE J, PART 1, QUESTION 3 SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, LINES 15(A) & (B) REGARDING THE PROCESS USED BY ALL CHILDREN'S HEALTH SYSTEM, INC. TO DETERMINE EXECUTIVE COMPENSATION WHICH IS RELIED UPON BY ALL CHILDREN'S HOSPITAL. FORM 990, PART VII, SECTION A, QUESTION 5 THE FOLLOWING OFFICER OF ALL CHILDREN'S HOSPITAL RECEIVED COMPENSATION FROM AN UNRELATED ORGANIZATION FOR SERVICES RENDERED TO THE FILING ORGANIZATION. ALL CHILDREN'S HOSPITAL REIMBURSED THE JOHNS HOPKINS UNIVERSITY FOR SERVICES ASSOCIATED WITH THE OFFICER AND HIS ROLE AT THE HOSPITAL. JONATHAN ELLEN, M.D. BASE COMPENSATION $590,197.00, BONUS & INCENTIVE COMPENSATION $181,140.00, OTHER REPORTABLE COMPENSATION $5,382.00, DEFERRED COMPENSATION $113,880.00 AND NON-TAXABLE BENEFITS $25,078.00. A CITY OF ST PETERSBURG HEALTH FACILITIES AUTHORITY 596000424 793309JM8 2012-06-28 102400000 REFUND PRIOR ISSUE (04/20/05 A&B) 0 0 0 A 4950000 102400000 2007 1 0 1 1 A 0 0 0 0 0.00010 0.00010 0 0 0 A 0 0 1 0 1 1 SEE SCHEDULE O 22.300000000000 0 0 0 0 0 A 1 SCHEDULE K - TAX-EXEMPT BOND ISSUES CUSIP NUMBERS OF BONDS ISSUED ON 04/20/2005 ARE 793309HM0, 793309HN8 AND 793309HP3. HEDGES WERE PROVIDED WITH RESPECT TO THE BOND ISSUE BY CITIBANK AND ROYAL BANK OF CANADA. SCHEDULE K, PART II, LINE 13 - YEAR OF SUBSTANTIAL COMPLETION DUE TO REFUNDING, YEAR OF SUBSTANTIAL COMPLETION IS NOT APPLICABLE SCHEDULE K, PART III, LINES 7-9 - NONQUALIFIED BONDS THE ORGANIZATION ANSWERED 'NO' BECAUSE IT HAS NO NONQUALIFIED BONDS. FORM 990, PART V, QUESTION 2A ALL COMPENSATION OF ALL CHILDREN'S HOSPITAL EMPLOYEES IS PAID THROUGH ALL CHILDREN'S HEALTH SYSTEM, INC. USING ITS FEDERAL TAX ID NUMBER. THIS IS KNOWN AS A COMMON PAYMASTER AGREEMENT. EMPLOYEES OF ALL CHILDREN'S HEALTH SYSTEM AND ITS OTHER SUBSIDIARIES ARE ALSO PAID THROUGH THE SAME AGREEMENT. FORM 990, PART VI, SECTION A, LINE 6 THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION IS THE SOLE CORPORATE MEMBER OF ALL CHILDREN'S HOSPITAL, INC. FORM 990, PART VI, SECTION A, LINE 7A THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION, A IRC 501(C)(3) TAX EXEMPT SOLE MEMBER OF ALL CHILDREN'S HOSPITAL, INC. ELECTS THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNING BODY OF ALL CHILDREN'S HOSPITAL, INC. IS EMPOWERED BY ITS BYLAWS TO MAKE CERTAIN DECISIONS; ALL OTHER DECISIONS ARE SUBJECT TO APPROVAL OF THE SOLE MEMBER, THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S GOVERNING BODY BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C ALL CHILDREN'S HOSPITAL, INC HAS AN ANNUAL CONFLICT OF INTEREST DISCLOSURE PROCESS THAT HAS BEEN FORMALLY DOCUMENTED IN POLICY. THE PROCESS IS FACILITATED BY THE COMPLIANCE OFFICER WITH OVERSIGHT FROM THE ALL CHILDREN'S HEALTH SYSTEM (FORMER PARENT AND CURRENT AFFILIATE) BOARD'S COMPLIANCE COMMITTEE. DISCLOSURES ARE REQUESTED FROM KEY EMPLOYEES, KEY CONTRACTORS, BOARD MEMBERS AND OFFICERS, AND DESIGNATED MEDICAL STAFF. ALL DISCLOSURES ARE REVIEWED BY THE COMPLIANCE OFFICER. SELECTED DISCLOSURES ARE REVIEWED BY THE PRESIDENT/CHIEF EXECUTIVE OFFICER. A FORMAL REPORT IS MADE ANNUALLY TO THE COMPLIANCE COMMITTEE WHERE CONFLICT MANAGEMENT IS ADDRESSED FOR EMPLOYEES, CONTRACTORS, AND PHYSICIANS. BOARD MEMBER DISCLOSURES ARE REVIEWED BY THE RESPECTIVE BOARD PRESIDENTS FOR CONFLICT MANAGEMENT. BOARD MEMBERS ARE REQUIRED TO DECLARE ANY POTENTIAL CONFLICTS PRIOR TO CONDUCTING BUSINESS AT EACH MEETING. IF A CONFLICT IS FOUND TO EXIST BY A BOARD MEMBER, THAT BOARD MEMBER IS PROHIBITED FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 EVERY THREE YEARS AN INDEPENDENT STUDY IS CONDUCTED GATHERING INDUSTRY COMPENSATION AVERAGES FROM SELECT PEER INSTITUTIONS. EVERY YEAR THE JOHNS HOPKINS BOARD OF TRUSTEES COMPENSATION COMMITTEE REVIEWS COMPENSATION AMOUNTS FOR OFFICERS AND ALL EMPLOYEES AT THE DIRECTOR AND HIGHER LEVELS. FORM 990, PART VI, SECTION C, LINE 19 ALL CHILDREN'S HOSPITAL, INC. DOES NOT MAKE ITS GOVERNING DOCUMENTS OR CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH WWW.DACBOND.COM FORM 990, PART XI, LINE 9: CHANGE INTEREST IN NET ASSETS OF THE FOUNDATION 924,196. INTEREST EXPENSE ON SWAP AGREEMENT -3,350,824. NON-OPERATING SERVICES -6,000,000. CHANGE IN MARKET VALUE OF INTEREST RATE SWAPS -2,334,739. NET ASSETS RELEASED FROM RESTRICTION -59,584. TRANSFER BETWEEN AFFILIATES -11,833,416. JOHNS HOPKINS HEALTH SYSTEM CORPORATION 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521465301 SUPPORTING ORGANIZATION MD 501(C)(3) LINE 11C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORP 0 THE JOHNS HOPKINS HOSPITAL 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 520591656 HOSPITAL MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORP 0 LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES 5255 LOUGHBORO RD NW WASHINGTON DC 20016 530196602 HOSPITAL DC 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORP 0 JOHNS HOPKINS COMMUNITY PHYSICIANS INC 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521467441 HEALTHCARE SERVICES MD 501(C)(3) LINE 11C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORP 0 JOHNS HOPKINS MEDICAL SERVICES CORPORATION 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521232569 HEALTHCARE SERVICES MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORP 0 JOHNS HOPKINS BAYVIEW MEDICAL CENTER INC 3910 KESWICK RD SOUTH BLDG 4TH FL S BALTIMORE MD 21211 521341890 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