2015-05-15T10:16:10-05:00 2014-06-30 Grant Thornton LLP 2010 CORPORATE RIDGE SUITE 400 MCLEAN VA 22102 990 2013-07-01 530196580 Children's Hospital % CORPORATE OFFICERS CHIL 3015723502 111 Michigan Avenue NW Suite Washington DC 20010 DOUGLAS MYERS cfo 3015726283 2015-05-15 true Mary Torretta P00847851 3015726283 2013 2016-04-25 22:37:26Z KURT DOUGLAS NEWMAN MD 111 Michigan Avenue NW Washington DC 20010 1019730769 false X www.childrensnational.org X 1870 DC see schedule o. 18 14 7534 1451 1176750 -263339 24876905 15746236 939338067 964559428 1926045 2726062 3891674 522306 970032691 983554032 0 2415133 0 0 564441141 565408241 0 0 0 381165008 372391003 945606149 940214377 24426542 43339655 993489726 1012567155 586092278 559761603 407397448 452805552 X see schedule o. false false 658972013 2415133 958586930 CHILDREN'S HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER (CNMC) IS THE PARENT COMPANY OF THE HOSPITAL. CNMC AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE O FOR COMPLETE FY14 COMMUNITY BENEFIT REPORT. 658972013 true true false true false false false false false false true false false false true true false true false true true true false false false false true true true false true true false true false false false true false false false false false false false false true true true true false false true 2905 0 true 7534 true true true true AE false false false false false false false false X 18 14 false false false false true true true true true false false true true true true true true true true false DC X CORPORATE OFFICERS 3015723502 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 X CAROLYN A THORNELL BOARD CHAIRMAN 2.0 1.0 X X 0 0 0 DEBRA L FRIEDMAN BOARD VICE CHAIRMAN 2.0 X X 0 0 0 GREGORY A O'DELL BOARD SECRETARY-TREASURER 2.0 1.0 X X 0 0 0 KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 39.0 16.0 X X 1511782 0 432063 DIANA ABNEY MD BOARD MEMBER (EXP: 12/31/13) 1.0 1.0 X 0 0 0 DEIDRE ADKINS BOARD MEMBER 1.0 X 0 0 0 SCHONAY BARNETT-JONES BOARD MEMBER 1.0 X 0 0 0 ELIZABETH DUGGAL BOARD MEMBER 1.0 X 0 0 0 GAIL FEAGLES BOARD MEMBER 1.0 1.0 X 0 0 0 ALBERTO GOMEZ BOARD MEMBER 1.0 X 0 0 0 RAHUL K SHAH MD BOARD MEMBER 55.0 X 424358 0 14891 MARY HELEN THOMPSON BOARD MEMBER 1.0 X 0 0 0 DAVID WHISTON DDS BOARD MEMBER 1.0 X 0 0 0 BONNIE NORMAN BOARD MEMBER 1.0 1.0 X 0 0 0 DARLY DAVIS BOARD MEMBER (BEG: 01/01/14) 1.0 X 0 0 0 MAE H GRENNAN BOARD MEMBER (BEG: 01/01/14) 1.0 1.0 X 0 0 0 CAROLINE VAN VLECK MD BOARD MEMBER (BEG: 01/01/14) 1.0 X 0 0 0 DAVID WESSEL MD BRD MEMBER/CMO (BEG: 01/01/14) 52.0 3.0 X 895750 0 150436 DENICE CORA-BRAMBLE MD BRD MEMBER/CMO (BEG: 01/01/14) 51.0 4.0 X 841354 0 151387 DOUGLAS MYERS CHIEF FINANCIAL OFFICER 44.0 11.0 X 1033864 0 122994 MARK BATSHAW MD PHY IN CHIEF / CAO 9.0 46.0 X 1213279 0 327794 RAYMOND S SCZUDLO CHIEF LEGAL OFFICER 51.0 4.0 X 945827 0 61523 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 53.0 2.0 X 883021 0 140163 ROGER PACKER MD SVP CENTER OF EXCELLENCE 43.0 12.0 X 758369 0 131404 JOSEPH WRIGHT MD SVP CENTER OF EXCELLENCE 52.0 3.0 X 621848 0 150367 MENDAL TUCHMAN MD CHIEF RESEARCH OFFICER 5.0 50.0 X 611601 0 110429 GERARD MARTIN MD SVP CENTER OF EXCELLENCE 53.0 2.0 X 866301 0 111666 PAM KING SAMS CHIEF DEVELOPMENT OFFICER 5.0 50.0 X 479404 0 173075 MARY ANNE HILLIARD CHIEF RISK OFFICER 54.0 1.0 X 506546 0 93060 ROBERTA ALESSI VP OPERATIONS 54.0 1.0 X 401164 0 65850 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 54.0 1.0 X 761117 0 88925 ELIZABETH FLURY CHIEF STRATEGY OFFICER 52.0 3.0 X 695672 0 112597 BRIAN JACOBS MD CHIEF INFORMATION OFFICER 54.0 1.0 X 470191 0 82067 MARY OTTOLINI MD PHD VICE CHAIR MED. EDUCATION 54.0 1.0 X 316213 0 21939 LINDA TALLEY CHIEF NURSING OFFICER 54.0 1.0 X 305291 0 23402 DARRYL VARNADO CHIEF PEOPLE OFFICER 54.0 1.0 X 418610 0 70978 RICHARD JONAS MD Chief of Cardiac Surgery 54.0 1.0 X 1856744 0 195230 ROBERT KEATING MD CHIEF OF NEUROSURGERY 55.0 X 856324 0 109880 PETER KIM MD VP SHEIKH ZAYED INSTITUTE 55.0 X 871500 0 34641 H GIL RUSHTON MD CHIEF OF UROLOGY 55.0 X 621923 0 93228 JOHN MYSEROS MD NEUROSURGEON 55.0 X 687137 0 34245 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 55.0 X 694794 0 21911 NELLIE ROBINSON FORMER CHIEF NURSING OFFICER 55.0 X 703545 0 60661 DAVID SPARKS FORMER VP FINANCE & CONTROLLER 55.0 X 444761 0 88232 21698290 0 3275038 964 true true false CERNER CORPORATION PO BOX 412702 KANSAS CITY MO 641412702 IT SERVICES 9016550 COLONIAL PARKING 2145 K STREET NW WASHINGTON DC 20037 PARKING 4072097 ATLANTIC SERVICES GROUP 2131 K STREET NW WASHINGTON DC 20037 PARKING 3762084 NATIONAL NURSES SERVICE DEPT L-9032 COLUMBUS OH 432609032 NURSING 3246672 FTI CONSULTING INC PO BOX 418005 BOSTON MA 022418005 STRATEGIC OPS 3220310 260 15746236 15746236 PATIENT REVENUE 621400 880960940 880960940 FEES AND CONTRACTS 900099 8636174 8636174 ALL OTHER PROGRAM SERVICES 900099 74962314 74962314 964559428 3274153 3274153 0 0 0 0 0 35610646 18000 36176737 -566091 18000 -548091 -548091 0 0 0 PARTNERSHIP LOSS 621110 -5470790 -5470790 PARKING 812930 4816346 4816346 LAB FEES 621500 1176750 1176750 522306 983554032 959088638 1176750 7542408 2378747 2378747 0 36386 36386 0 16641402 16641402 0 0 468224038 340099008 128125030 16492723 11568485 4924238 31825465 22323326 9502139 32224613 22603300 9621313 0 1881805 1319954 561851 795458 795458 329629 329629 0 0 58093745 40748676 17345069 5204426 3650539 1553887 9092096 6377466 2714630 33908410 23784365 10124045 0 22477652 15766492 6711160 3679041 2580588 1098453 0 777545 545393 232152 26143217 18337628 7805589 0 56704759 39774401 16930358 28657219 20101024 8556195 MEDICAL SUPPLIES 82174459 57628741 24545718 BAD DEBT EXPENSE 19100353 19100353 REPAIRS AND MAINTENANCE 14608935 10247141 4361794 OVERHEAD 2571706 2571706 6190548 6190548 940214377 658972013 281242364 0 0 0 59376517 80288535 4416815 7994785 186580547 175816200 0 0 0 0 0 0 6910911 7410283 5824315 11035619 1030278246 510481071 526750689 519797175 132119472 132304887 32065538 35582245 0 0 20000 20000 39424922 42317426 993489726 1012567155 150809067 154860336 0 0 5630726 15025591 411076761 406619378 0 0 0 0 75342852 75257136 0 0 -56767128 -92000838 586092278 559761603 X 407397448 452805552 0 0 0 0 407397448 452805552 993489726 1012567155 X 43339655 1885951 182498 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 313592 false true 16037 329629 false Paid Staff or Management Schedule C, Part II-B, Line 1b FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS Direct Contact Schedule C, Part II-B, Line 1g THE LOBBYING ACTIVITIES ENGAGED IN BY CHILDREN'S HOSPITAL FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS. THOSE LOBBYING ACTIVITIES INCLUDE CONTINUAL MONITORING OF LEGISLATION VIA DISCUSSIONS WITH LEGISLATIVE STAFF, HOSTING EDUCATIONAL BRIEFING SESSIONS FOR MEMBERS OF CONGRESS, EXECUTIVE BRANCH, STATE AND LOCAL OFFICIALS/STAFF REGARDING CHILD HEALTH ISSUES, AND COORDINATING THE SUBMISSION OF CORRESPONDENCE/WRITTEN COMMENTS ON PROPOSED LEGISLATION AND REGULATIONS, AS WELL AS THE PRESENTATION OF TESTIMONY BEFORE LEGISLATIVE COMMITTEES. CHILDREN'S HOSPITAL ALSO DEVELOPS POLICY POSITIONS IN RESPONSE TO PROBLEMS AND OPPORTUNITIES IN THE PUBLIC SECTOR. EXPENSES TOTALED $313,592 OTHER ACTIVITIES SCHEDULE C, PART II-B, LINE 1i THE HOSPITAL IS A MEMBER OF THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH). NACH HAS CHILD ADVOCACY AND LEGISLATIVE ADVOCACY PROGRAMS. 1440758 1440758 84952732 72343534 12609198 768170456 337158047 431012409 173718080 99693180 74024900 1996220 1286310 709910 519797175 0 CAPITAL LEASE OBLIGATIONS 9327169 DUE TO AFFILIATES -198732806 RESERVE FOR CLAIMS 41339326 OTHER LIABILITIES 47721762 SETTLEMENTS TO THIRD PARTY PAY 8343711 -92000838 X Liability for Uncertain Tax Position (ASC 740) Schedule D, Part X, Line 2 FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (MEDICAL CENTER), OF WHICH CHILDREN'S HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ON SUCH BASIS, THE EXEMPT ENTITIES WILL NOT INCUR ANY LIABILITY FOR FEDERAL INCOME TAXES, EXCEPT FOR POSSIBLE UNRELATED BUSINESS INCOME. THE MEDICAL CENTER EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THE MEDICAL CENTER HAD NO UNCERTAIN TAX POSITIONS DURING THE YEARS ENDED JUNE 30, 2014 AND 2013. true Middle East and North Africa 1 Program Services PATIENTS REFFERALS 269072 Central America and the Caribbean Program Services INSURANCE PREMIUMS 28309248 Sub-Saharan Africa Grantmaking PATIENT SERVICES 36386 1 1 28614706 28614706 Sub-Saharan Africa PATIENT CARE DEBT FORGIVENESS 36386 WIRE FMV 1 true false false false false false Procedure for monitoring the use of grant funds outside of the US Schedule F, Part I, Line 2 Annually, a physician of Childrens Hospital travels to Uganda to provide specialized medical care for children. The physician is an employee of the hospital, and reports back on the activities to his department. true true X true X 350. true X true true true false true true 6249897 6249897 0.00680 68057934 68057934 0.07390 74307831 74307831 0.08070 43 153765 16087555 13573518 2514037 0.00270 18 1481 28653010 8275035 20377975 0.02210 1 5017649 4110394 907255 0.00100 1 8824338 8824338 0.00960 5 596 179800 8140 171660 0.00020 68 155842 58762352 25967087 32795265 0.03560 68 155842 133070183 25967087 107103096 0.11630 3 11219 40301 4000 36301 1 20 27650 3500 24150 3 31 176848 16500 160348 0.00020 7 11270 244799 24000 220799 0.00020 true 7660053 2218668 1996355 222313 X true true 1 1 CHILDREN'S HOSPITAL 111 MICHIGAN AVE NW WASHINGTON DC 20010 X X X X X X X X CHILDREN'S HOSPITAL 1 true X X X X X X X X X X 13 true true true X www.childrensnational.org X www.dchealthmatters.org X X X X X X X X false false true true 350. true 350. true X X X X X X X true true X X X X X true false X X X X true X false false Childrens Hospital - Facility Information Schedule H, Part V, Section B, Line 1J The community health needs assessment also includes illustrative maps/figures of assets and vulnerabilities related to specific health metrics, including but not limited to major outlet fast food locations per ward of the District, hospitals and primary care centers in the District, medically underserved areas in the District, and locations of primary care and mental health professionals shortage areas in the District. By providing this information this will assist in overall data analysis, program planning and informing decision making on important health related issues affecting the residents of Washington, DC. Schedule H,Part V, Section B, Line 3 In conducting the most recent CHNA, input was received via four focus groups conducted with key stakeholders who are advocates or providers of health and social services. Two of the groups focused on health and health service issues. The other two groups focused on social determinants and related social service issues that impact health. There was a total of 30 focus group participants including hospital patient advocates, case managers, Department of Health officials, and community-based health and social service stakeholders. Stakeholders were queried about a number of major issues, including what they viewed as priority health and social services needs for the city in general, the particular needs that were relevant to the populations they serve, and their specific recommendations for concrete steps that could be implemented to improve overall health and social services for residents. Social scientists from RAND developed the script for the focus groups. The focus group guide included additional information specifically the questions asked of focus groups' participants. The questions aligned with the health needs identified through the quantitative analyses, and were analyzed as part of the qualitative component of the community health needs assessment. In addition, RAND spearheaded the recruitment efforts of the focus groups to ensure representation of the community as a whole. RAND has records and access to all focus group participants' names along with the focus group guide on file and available upon request from RAND. Schedule H,Part V, Section B, Line 4 Children's National, through its membership in the DC Healthy Communities Collaborative, conducted the CHNA in participation with three additional non-profit hospitals: Howard University Hospital, Providence Hospital, Sibley Memorial Hospital; and three community health centers, two of which are Federally qualified health centers, Bread for the City, Community of Hope, and Unity Health Care, Inc. ANOTHER COMMUNITY HEALTH CENTER, MARY'S CENTER JOINED THE DC HEALTHY FAMILIES COLLABORATIVE AFTER THE NEEDS ASSESSMENT WAS CONDUCTED AND PARTICIPATED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN DEVELOPMENT PROCESS. The DC Healthy Communities Collaborative (DCHCC) works to eliminate health disparities and create health equity for all communities in the District of Columbia to realize one healthy Capital city. With the unique perspectives of each hospital and community health center, DCHCC members provided guidance and feedback respective to populations and neighborhoods served. Schedule H,Part V, Section B, Line 5d In addition to the broad distribution via the hospital's website and the DCHCC's DC Health Matters web portal, Children's National also participated in community-based meetings and forums to disseminate the CHNA report findings, and as part of the launch of the DCHM, a news release was distributed with URL information for viewing the CHNA report. Additionally, each DCHCC member organization has an electronic copy of the CHNA report on their website. Schedule H,Part V, Section B, Line 6i Children's Hospital adopted an implementation strategy, referred to as the Community Health Improvement Plan (CHIP) that addresses four of the six priority community health needs identified through the citywide CHNA. The CHIP is available online at: HTTP://CHILDRENSNATIONAL.ORG/~/MEDIA/CNHS-SITE/FILES/ABOUT/ADVOCACY/FINAL_ CHILDRENS_NATIONAL_CHIP_FY_20142016.ASHX Schedule H,Part V, Section B, Line 7 The DCHCC accepted the six top health issues -- Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, Asthma, Access to Care, and Stress-Related Conditions - that emerged through analyses of quantitative data sources (including the Behavioral Risk Factor Survey, Youth Behavioral Risk Survey, hospital discharge data, American Community Survey, and US Census data) and qualitative data (input from community representatives obtained during stakeholder focus groups). Members of the DCHCC deliberated and decided access to care and stress-related conditions should not be addressed as independent priority issues as they are systemic issues that impact all of the other priority health areas. Thus, the implementation strategy (Community Health Improvement Plan) addresses the remaining four priority issues: Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, and Asthma. In preparation for developing the implementation strategy, Children's National conducted a series of internal meetings with experts to assess its capacity to address and prioritize the identified health areas based on organizational strategy. With the organizational capacity identified and sanctioned, Children's National reconvened as part of the DCHCC process to develop the implementation strategy (Community Health Improvement Plan) as follows: conducted Gap and Strength, Weaknesses, Opportunities, and Threats (SWOT) analyses (for each health priority); prioritization of issues (to rank the health issues); creation of action plan; and monitoring of the action plan. DCHCC members included in their individual organization's implementation strategy (community health improvement plan) additional health issues that support their organization's mission, including but not limited to, access to care and stress-related conditions. Children's National added oral health and injury prevention to their implementation strategy. Each DCHCC member organization received approval of the implementation strategy (community health improvement plan) by their Board of Directors/Trustees. Children's National received approval by its Board on May 23, 2013. BY THE CLOSE OF FY14, THE DISTRICT OF COLUMBIA HEALTHY COMMUNITIES COLLABORATIVE ADDRESSED COMMUNITY HEALTH IMPROVEMENT IN THE AREAS OF MENTAL HEALTH/SUBSTANCE ABUSE, OBESITY/OVERWEIGHT, ASTHMA, AND SEXUAL/REPRODUCTIVE HEALTH. FACILITATION OF BEST PRACTICE STRATEGIES, ADDRESSING CONTINUING EDUCATION REQUIREMENTS FOR MEDICAL PRACTITIONERS, DEVELOPING ASSET MAPS SHOWCASING CITYWIDE RESOURCES, AND PROMOTING THE INTEGRATION OF MENTAL HEALTH SCREENING IN THE PRIMARY CARE SETTINGS ARE EXAMPLES OF WAYS THE DCHCC IS ADDRESSING THE NEEDS OF THE WASHINGTON, DC COMMUNITY. 19 CHILDREN'S OUTPATIENT CTR OF MONTGOMERY 9850 KEY WEST AVE ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 6565 ARLINGTON BLVD SUITE 200 FALLS CHURCH VA 22031 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR IN LAUREL 13922 BALTIMORE AVE LAUREL MD 20707 REGIONAL OUTPATIENT CENTER CHILDREN'S HEALTH CENTER - ADAMS MORGAN 1630 EUCLID STREET NW WASHINGTON DC 20009 HEALTH CENTERS CHILDREN'S HEALTH CENTER - GOOD HOPE RD 2501 GOOD HOPE ROAD SE WASHINGTON DC 20020 HEALTH CENTERS CHILDREN'S HEALTH CENTER - MLK JR AVE 3029 MARTIN LUTHER KING JR AVE SE WASHINGTON DC 20032 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR - UPR MARLBORO 9440 PENNSYLVANIA AVENUE UPPER MARLBORO MD 20772 REGIONAL OUTPATIENT CENTER MOBILE VAN - HEALTH CARE N/A NA DC 20010 MOBILE HEALTH CARE CHILDREN'S OUTPATIENT CTR IN ANNAPOLIS 888 BESTGATE ROAD STE 320 ANNAPOLIS MD 21401 REGIONAL OUTPATIENT CENTER CHILDREN'S HEALTH CENTER - SHAW 2220 11TH STREET NW WASHINGTON DC 20001 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR SPRING VALLEY 4900 MASSACHUSETTS AVENUE NW WASHINGTON DC 20016 REGIONAL OUTPATIENT CENTER CHILDREN'S NAT'L AMBULATORY SURGERY CTR 9850 KEY WEST AVENUE ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR IN FREDERICK 5910 FREDERICK CROSSING LANE STE 1 FREDERICK MD 21704 REGIONAL OUTPATIENT CENTER MOBILE VAN - DENTAL N/A NA DC 20010 MOBILE HEALTH CARE CHILDREN'S HEALTH CENTER AT THEARC 1901 MISSISSIPPI AVE SE WASHINGTON DC 20020 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR MONTGOMERY CTY 15245 SHADY GROVE ROAD STE 350 ROCKVILLE MD 20858 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 3023 Hamaker Court suite 300 FAIRFAX VA 22031 REGIONAL OUTPATIENT CENTER CHILDREN'S NATIONAL IMAGING CENTER 9850 KEY WEST AVENUE Suite 110 ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S NATIONAL SPECIALISTS OF VIRGI 3023 HAMAKER cOURT SUITE 500 FAIRFAX VA 22031 HEALTH CENTER Criteria for Free or Discounted Care Schedule H, Part I, Line 3c Children's Hospital and its parent, Childrens National Medical Center, is committed to provide quality pediatric health care for all patients regardless of their ability to meet the associated financial obligations and without discrimination on the grounds of race, color, national origin or creed. COMMUNITY BENEFIT REPORT CHILDREN'S NATIONAL IS DEDICATED TO FULFILLING ITS VISION OF SETTING THE STANDARD IN EXCELLENCE IN PEDIATRIC CARE, ADVOCACY, RESEARCH , AND EDUCATION, HERE IN THE NATION'S CAPITAL, AROUND THE COUNTRY, AND THROUGHOUT THE WORLD. AS PART OF OUR COMMITMENT TO OUR COMMUNITY, BELOW ARE SOME OF THE PROGRAMS THAT WERE IMPLEMENTED IN FY 2014. CENTRAL SOUTHERN MARYLAND MEDICAL PEDIATRIC SOCIETY ESTABLISHED IN 2012, THE CENTRAL SOUTHERN MEDICAL SOCIETY WAS CREATED TO PROVIDE A FORUM FOR CLINICIANS CARING FOR CHILDREN IN ANNE ARUNDEL, CALVERT, CHARLES, PRINCE GEORGE'S AND ST. MARY'S COUNTIES. THE SOCIETY'S FOCUS IS FOSTERING EDUCATION AND KNOWLEDGE SHARING AROUND CLINICAL ISSUES, BEST PRACTICES AND POLICY DECISIONS IMPACTING THE COMMUNITIES THEY SERVE IN AND AROUND CENTRAL SOUTHERN MARYLAND. IN 2014, THE SOCIETY CONVENED ON THREE OCCASIONS. THE TOPICS FOCUSED ON MENTAL AND BEHAVIORAL HEALTH, AUTISM, AND ASTHMA. DR. STEPHEN TEACH, DIRECTOR OF IMPACT DC, (IMPROVING PEDIATRIC ASTHMA CARE IN THE DISTRICT OF COLUMBIA) SPOKE AT THE LAST MEETING ON THE TOPIC OF CONTROLLING PEDIATRIC ASTHMA: PAST, PRESENT AND FUTURE. THE DISCUSSION FOCUSED ON UNDERSTANDING DISPARITIES IN ASTHMA CARE AND OUTCOMES, NATIONAL INSTITUTES OF HEALTH GUIDELINE BASED CARE IN AN AT-RISK PEDIATRIC POPULATION, AND THE ROLE OF IMMUNOMODULATORS IN PHENOTYPICALLY-DRIVEN ASTHMA CARE. MORE THAN 100 CLINICIANS ATTENDED THE SOCIETY'S MEETINGS, INCREASING PARTICIPATION BY ABOUT 10 PERCENT FROM THE FIRST YEAR. THE CENTRAL SOUTHERN MARYLAND PEDIATRIC MEDICAL SOCIETY IS COMMITTED TO EXTENDING THE VOICE OF CHILDREN AND FAMILIES OF THIS REGION THROUGH THE COLLECTIVE VOICE OF THE PEDIATRIC MEDICAL COMMUNITY. EAST OF THE RIVER LACTATION CENTER MEDICAL, PSYCHOLOGICAL AND ECONOMIC BENEFITS ARE CITED AS THE TOP REASONS TO BREASTFEED FOR THE FIRST SIX MONTHS OF LIFE, ACCORDING TO THE AMERICAN ACADEMY OF PEDIATRICS (AAP), THE AMERICAN ACADEMY OF FAMILY PHYSICIANS (AAFP), AND THE WORLD HEALTH ORGANIZATION. IN FACT, THESE ORGANIZATIONS ALSO RECOMMEND CONTINUED BREASTFEEDING AFTER INFANT FOODS ARE STARTED UNTIL AT LEAST 12 MONTHS OF AGE. THE EAST OF THE RIVER LACTATION CENTER WAS FORMED TO ASSIST MOTHERS IN THE WASHINGTON, DC AREA WITH REACHING THESE AND OTHER GOALS IN BREASTFEEDING. THROUGH COLLABORATION BETWEEN CHILDREN'S NATIONAL, THE WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM, AND THE DISTRICT OF COLUMBIA BREASTFEEDING COALITION THE PROGRAM AIMS TO ASSIST MOMS WITH PRENATAL BREASTFEEDING EDUCATION AND POST-PARTUM BREASTFEEDING SUPPORT. THE PROGRAM INCLUDES A FOUR-WEEK PRENATAL BREASTFEEDING EDUCATION CLASS FACILITATED BY A LACTATION CONSULTANT, A BREASTFEEDING PEER COUNSELOR AND A WIC NUTRITIONIST. CLASSROOM TOPICS INCLUDE, "GETTING STARTED", "BREASTFEEDING THE FIRST FEW WEEKS"," KEEPING THINGS GOING WHEN LIFE RETURNS", AND "BREASTFEEDING AFTER SIX MONTHS." COMMUNITY LACTATION SUPPORT SERVICES ARE ALSO OFFERED TO BREASTFEEDING FAMILIES FROM THE ENTIRE WASHINGTON, DC METROPOLITAN AREA. IN ADDITION, THE CENTER OFFERS MOM TO MOM BREASTFEEDING SUPPORT GROUPS AND BACK TO WORK BREASTFEEDING CONSULTS TO HELP BREASTFEEDING MOTHERS PREPARE TO RETURN TO WORK OR SCHOOL WHILE MEETING THEIR BREASTFEEDING GOALS. CLASSES ARE PROVIDED AT NO COST TO PARTICIPANTS. THE PROGRAM WAS FUNDED INITIALLY BY A GRANT FROM THE U.S. DEPARTMENT OF AGRICULTURE/WIC. IN 2013, THE W.K. KELLOGG FOUNDATION PROVIDED ADDITIONAL FUNDING TO SUPPORT RESEARCH EFFORTS AND SERVICES IN THE COMMUNITY. DURING 2014, THE CENTER PROVIDED SERVICES TO 445 MOMS WITH 71% OF THE MOM'S INITIATING BREASTFEEDING. FORTY PERCENT OF THE MOMS ENROLLED AND COMPLETED ALL THREE PRENATAL BREASTFEEDING EDUCATION CLASSES. S.T.A.B.L.E. AND CARDIAC S.T.A.B.L.E. SPECIAL ATTENTION AND SKILL IS A NECESSITY FOR NEWLY BORN INFANTS THAT BECOME ILL AT BIRTH. CHILDREN'S NATIONAL IS AT THE FOREFRONT IN HELPING TO EDUCATE HEALTH CARE PROVIDERS CARING FOR OUR SMALLEST COMMUNITY MEMBERS. THE S.T.A.B.L.E. PROGRAM WAS DEVELOPED TO MEET THE EDUCATIONAL NEEDS OF HEALTH CARE TEAMS - NURSES, PHYSICIANS, THERAPISTS AND ASSISTANTS WHO MUST DELIVER THIS IMPORTANT STABILIZATION CARE. S.T.A.B.L.E. STRESSES THE PROFESSIONAL RESPONSIBILITIES PROVIDERS HAVE TO CARE FOR SICK INFANTS AND STANDS FOR THE SIX ASSESSMENT AND CARE MODULES: SUGAR, TEMPERATURE, AIRWAY, BLOOD PRESSURE, LAB WORK AND EMOTIONAL SUPPORT. THE CARDIAC S.T.A.B.L.E. MODULE PROVIDES GUIDELINES FOR THE STABILIZATION OF NEONATES SUSPECTED TO HAVE CONGENITAL HEART DISEASE. BOTH LONG-TERM AND IMMEDIATE HEALTH OF THESE INFANTS CAN BE IMPACTED BY THE EARLY TRANSITIONAL CARE RECEIVED. CARE FOR THESE LITTLE ONES MUST BE TIMELY, EFFICIENT, ANTICIPATORY AND EFFECTIVE. CHILDREN'S NATIONAL NEONATAL INTENSIVE CARE UNIT HELPS TO ENSURE THAT HEALTH PROFESSIONALS THROUGHOUT THE WASHINGTON METROPOLITAN AREA CAN GET THE NEEDED TRAINING. CHILDREN'S PROVIDES S.T.A.B.L.E. EDUCATION TO MAINTAIN CERTIFICATION FOR AREA HOSPITALS. IN ADDITION, WE HELP COMMUNITY REFERRAL CENTERS PREPARE FOR INFANTS WITH SUSPECTED CONGENITAL HEART DISEASE. IN 2014, 300 HEALTH CARE PROFESSIONALS RECEIVED S.T.A.B.L.E. AND CARDIAC S.T.A.B.L.E. EDUCATION SCORING 85% OR HIGHER ON THE S.T.A.B.L.E. EXAM. HEALTH CAREERS INTERNSHIP PROGRAM BY 2030, IT IS EXPECTED THAT ONE-FOURTH OF THE U.S. POPULATION WILL BE OVER AGE 65 ACCORDING TO THE U.S. CENSUS BUREAU. FOR MANY, THAT MEANS THE NEED FOR HEALTH CARE SERVICES WILL BE GREATER THEREBY INCREASING THE NEED FOR MORE HEALTH CARE WORKERS. IN THE DISTRICT OF COLUMBIA, SENIORS 65 AND OLDER REPRESENT 11.4 PERCENT OF THE POPULATION, A NUMBER THAT MANY BELIEVE WILL ONLY INCREASE IN COMING YEARS. CHILDREN'S NATIONAL IS HELPING SOME LOCAL HIGH SCHOOL STUDENTS GET A JUMP START IN HEALTH CARE CAREERS BY PROVIDING ON- THE- JOB-TRAINING EARLY. CHILDREN'S NATIONAL THROUGH COLLABORATION WITH DISTRICT OF COLUMBIA PUBLIC SCHOOLS (DCPS) OFFICIALS DEVELOPED AND IMPLEMENTED THE HEALTH CAREERS INTERNSHIP GUIDE FOR DISTRICT OF COLUMBIA PUBLIC HIGH SCHOOLS. THE PROGRAM SELECTS STUDENTS FROM THREE DCPS CAREER AND TECHNICAL EDUCATION PROGRAMS WHICH OFFER A HEALTH CARE CURRICULUM - ANACOSTIA SENIOR HIGH SCHOOL, BALLOU SENIOR HIGH SCHOOL AND HD WOODSON HIGH SCHOOL. IN APRIL OF 2014 THE ORGANIZATIONS JOINTLY HELD A HEALTH CAREERS FAIR EXTRAVAGANZA, WHICH PROVIDED HEALTH CAREER WORKSHOPS AND INFORMATION ON INTERNSHIP OPPORTUNITIES WITH CHILDREN'S NATIONAL TO 54 STUDENTS. DCPS AND CHILDREN'S NATIONAL WORKED TOGETHER TO PRESCREEN AND INTERVIEW CANDIDATES FOR SUMMER INTERNSHIP POSITIONS. THE PROGRAM PAIRS STUDENTS WITH HEALTH PROFESSIONALS FROM VARIOUS DEPARTMENTS SUCH AS PHARMACY, CHILDREN'S SCHOOL SERVICES, PATIENT REGISTRATION, AND HUMAN RESOURCES/OCCUPATIONAL HEALTH. IN ADDITION, STUDENTS ALSO ATTEND SEMINARS LED BY DEPARTMENT STAFF, FURTHERING THEIR EXPOSURE TO ADDITIONAL OPPORTUNITIES THAT EXIST IN A HEALTH CARE ENVIRONMENT. THE INTERNSHIPS ARE PAID AND FULLY INTEGRATE EDUCATION WITH ON-THE-JOB-TRAINING, CAREER DEVELOPMENT AND PUBLIC SERVICE. DC INJURY PREVENTION ALLIANCE IN 2014, THE INJURY PREVENTION ALLIANCE WAS DEVELOPED TO ADDRESS INTENTIONAL AND UNINTENTIONAL PUBLIC POLICY AND ADVOCACY COMPONENTS OF CHILDHOOD INJURY PREVENTION. CHILDHOOD INJURY PREVENTION STAKEHOLDERS REPRESENTING VARIOUS COMMUNITY-BASED ORGANIZATIONS CAME TOGETHER COLLABORATIVELY TO DEVELOP THE MISSION AND SCOPE OF WORK FOR THIS NEWLY FORMED ALLIANCE. THIS ALLIANCE WILL FOCUS ON ADVOCACY AND PUBLIC POLICY EFFORTS NEEDED TO ADEQUATELY ADDRESS IDENTIFIED AREAS OF INJURY PREVENTION. INJURY PREVENTION GRASSROOTS OUTREACH EFFORTS ARE STILL ADDRESSED WITHIN THE HOSPITAL THROUGH THE TRAUMA AND BURN SURGERY DEPARTMENT THROUGH THE WORK OF THE SAFE KIDS DC COALITION. COALITION ACTIVITIES ARE PROVIDED THROUGHOUT THE CITY AND FOCUS ON CHILD PASSENGER SAFETY, BICYCLE SAFETY, PEDESTRIAN SAFETY, AND FIRE SAFETY. AS A RESULT OF THIS COMBINED WORK FROM THE INJURY PREVENTION ALLIANCE AND THE SAFE KIDS DC COALITION, CHILDHOOD INJURY PREVENTION WORK WILL ILLUSTRATE THE COMPLETE ADVOCACY CYCLE BY PLANNING ON HOW THE ISSUE WILL BE ADDRESSED, EXECUTING AN ACTION PLAN, AND MONITORING/EVALUATING THE OUTCOMES OF THIS WORK. CHILDREN'S NATIONAL MEDICAL CENTER ANNUAL REPORT Schedule H, Part I, Line 6a CHILDREN'S NATIONAL MEDICAL CENTER PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT FOR MASS PUBLIC DISTRIBUTION. THE REPORT IS POSTED TO OUR WEBSITE. IN ADDITION, AN EXECUTIVE SUMMARY INCLUDING THE LINK TO THE REPORT IS DISTRIBUTED TO THE HOSPITAL'S KEY INTERNAL AND EXTERNAL STAKEHOLDERS. BAD DEBT EXPENSE Schedule H, Part I, Line 7 A COST ACCOUNTING SYSTEM HAS BEEN UTILIZED TO CALCULATE AMOUNTS REPORTED IN THE TABLE IN PART I, LINE 7A-D. THE COST ACCOUNTING SYSTEM INCLUDES CHARITY, MEDICAID SHORTFALLS, SELF-PAY, AND PUBLIC PROGRAMS. THE AMOUNTS REPORTED ARE BASED ON A COST-ACCOUNTING SYSTEM. A COST TO CHARGE RATIO WAS NOT USED TO CALCULATE ANY OF THE FIGURES REPORTED IN THE TABLE IN PART I. THE AMOUNTS WERE PULLED FROM FINANCIAL DATABASES MANAGED BY THE CHILDREN'S NATIONAL ACCOUNTING AND FINANCE DEPARTMENT. DetermiNATIOn of net commnuity benefit expenses Schedule H, Part I, Line 7 IT IS IMPORTANT TO NOTE THAT IN DETERMINING THE NET COMMUNITY BENEFIT EXPENSE AS A PERCENT OF CHILDREN'S HOSPITAL'S TOTAL EXPENSES, CHILDREN'S HOSPITAL'S BAD DEBT EXPENSE ($19,100,353) WAS NETTED FROM CHILDREN'S HOSPITAL'S TOTAL EXPENSES ($940,214,377), AS REPORTED ON FORM 990, PART IX, LINE 25. Cost Attributable to a Physical Clinic Schedule H, Part I, Line 7g AS DESCRIBED BY DEFINITION, SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. THE SERVICES ARE PROVIDED DESPITE THE FINANCIAL LOSS TO MEET THE NEEDS OF THE COMMUNITY. IF THE SERVICES WERE NOT PROVIDED, THEY WOULD NOT BE AVAILABLE TO THE AREA OR WOULD RESULT IN THE GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION PROVIDING THE SERVICES. THE SUBSIDIZED HEALTH SERVICES AMOUNT IN PART I, LINE 7G INCLUDES $907,255 WHICH IS ATTRIBUTED TO THE PRIMARY CLINICAL SERVICES PROVIDED VIA CHILDREN'S NATIONAL. CHILDREN'S HEALTH CENTERS PROVIDE PROGRAMS AND INITIATIVES INCLUDING COMPREHENSIVE AND HIGH QUALITY PREVENTIVE SERVICES, IMPROVEMENT OF IMMUNIZATION RATES, AND COORDINATION OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THE AMOUNT INCLUDES SALARY, FRINGE, DIRECT, AND INDIRECT COSTS EXPENDED TO PROVIDE THE CLINICAL SERVICES. OUR CHILDREN'S HEALTH CENTERS ARE ESTABLISHING BEST PRACTICES IN COMMUNITY HEALTH. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II PART II INCLUDES THE COSTS INCURRED FOR ACTIVITIES AND PROGRAMS TO PROTECT OR IMPROVE THE COMMUNITY'S HEALTH OR SAFETY. AS REPORTED IN PART II AND DEFINED, COMMUNITY-BUILDING ACTIVITIES INCLUDE PROGRAMS THAT ADDRESS THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS HOMELESSNESS, POVERTY, AND ENVIRONMENTAL PROBLEMS. EACH PROGRAM INCLUDED IN PART II MEETS THE DEFINITION OF COMMUNITY BENEFIT INCLUDING MEETING ONE OR MORE OF THE COMMUNITY BENEFIT OBJECTIVES: IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING HEALTH, ADVANCING GENERALIZABLE KNOWLEDGE, OR RELIEF OF GOVERNMENT BURDEN. THE PRIMARY PURPOSE OF THE PROGRAMMING IS TO IMPROVE THE HEALTH OF THE COMMUNITY. PROGRAMS ACCOUNTED FOR AS COMMUNITY BUILDING ACTIVITIES FALL INTO THE SUBCATEGORIES OF COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. CHILDREN'S NATIONAL IS DEDICATED TO ENGAGING AND PROVIDING OPPORTUNITIES OF LEARNING AND DEVELOPMENT TO STUDENTS WITH AN INTEREST IN HEALTH PROFESSIONS AND AS SUCH, HAS A FEW PROGRAMS THAT FALL WITHIN THE WORKFORCE DEVELOPMENT SUBCATEGORY OF COMMUNITY BUILDING. THROUGH PARTNERSHIPS WITH URBAN ALLIANCE AND DON BOSCO CRISTO REY, LOCAL ORGANIZATIONS THAT WORK WITH AREA BUSINESSES TO PROVIDE EMPLOYMENT OPPORTUNITIES FOR UNDER RESOURCED STUDENTS, CHILDREN'S NATIONAL PROVIDES VALUABLE LEARNING AND WORK EXPERIENCES TO LOCAL HIGH SCHOOL STUDENTS. LOCAL YOUTH ARE IMMERSED IN A NUMBER OF DEPARTMENTS THROUGHOUT THE HOSPITAL GAINING BOTH WORK SKILLS AND PROFESSIONAL DEVELOPMENT THROUGH PAID INTERNSHIPS. IN ADDITION TO SUPPORTING AREA HIGH SCHOOL STUDENTS THROUGH PROFESSIONAL DEVELOPMENT, CHILDREN'S IS ALSO DEDICATED TO ENHANCING THE GOALS AND ASPIRATIONS OF COLLEGE STUDENTS INTERESTED IN PURSUING CAREERS IN HEALTH PROFESSIONS. THE PRINCETON INTERNSHIP PROGRAM IS ANOTHER EXAMPLE OF OUR COMMITMENT TO HANDS ON LEARNING. THE PROGRAM PROVIDES STUDENTS WITH AN IMMERSION INTO THE ACADEMIC PRACTICES OF PEDIATRIC SURGICAL CARE, MODELING MANY OF THE DAY TO DAY ACTIVITIES OF AN ACADEMIC SURGEON. STUDENTS INTERNING ARE ALSO ABLE TO GAIN SKILLS IN AREAS SUCH AS RESEARCH. FOR EXAMPLE, STUDENTS WORKING IN THE TRAUMA AND BURN DEPARTMENT AT CHILDREN'S NATIONAL PARTICIPATED IN MEDICAL RESEARCH, DEVELOPING SKILLS SUCH AS DATA COLLECTION, USE OF STATISTICS FOR DATA ANALYSIS AND AUTHORSHIP. OUR EMERGENCY COMMUNICATION AND INFORMATION CENTER (ECIC) PROVIDES COMMUNITY SUPPORT, ANOTHER SUBCATEGORY WITHIN THE COMMUNITY BUILDING CATEGORY, IN THE AREA OF DISASTER READINESS. THE ECIC IS A STATE OF THE ART FACILITY OPEN 24 HOURS A DAY EVERY DAY OF THE YEAR. IN ADDITION TO ITS REGULAR RESPONSIBILITIES OF CONNECTING PRIMARY CARE PHYSICIANS WITH CHILDREN'S EMERGENCY SPECIALISTS AND DISPATCHING AND MONITORING ALL AIR AND GROUND TEAMS, ECIC TEAM MEMBERS COORDINATES COMMUNICATIONS FOR ALL HOSPITALS THROUGH THE WASHINGTON, DC HOSPITAL ASSOCIATION HOSPITAL MUTUAL AID RADIO SYSTEM. THE ECIC CENTER SERVES AS A COALITION NOTIFICATION CENTER FOR SUCH EVENTS ON A ROTATING BASIS WITH TWO FACILITIES. TEAM MEMBERS TRAIN ANNUALLY, CONDUCTING WEEKLY AND MONTHLY DRILLS ON DISASTER PREPAREDNESS FOR THE REGION. Bad Debt Expense Schedule H, Part III, Lines 2-4 BAD DEBT IS ACCOUNTED FOR IN THE FOOTNOTES FOR ACCOUNTS RECEIVABLE IN THE ORGANIZATION'S FINANCIAL STATEMENTS. Children's Hospital reports $19,100,353 on its Statement of Functional Expenses for its bad debt; however, in this section, the reporting of the $7,660,053 is appropriate because it reflect the value of the bad debt at cost. ACCOUNTS RECEIVABLE FOR PATIENT SERVICES CONSIST OF AMOUNTS DUE DIRECTLY FROM PATIENTS OR PATIENTS' THIRD PARTY PAYORS SUCH AS INSURANCE COMPANIES, MANAGED CARE PROGRAMS, AND MEDICAID PROGRAMS FOR SERVICES RENDERED. PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE FINANCIAL STATEMENTS OF THE ORGANIZATION IS SHOWN NET OF RECOVERIES ON AMOUNTS PREVIOUSLY WRITTEN OFF. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTIMATED BASED ON PRIOR EXPERIENCE AND MANAGEMENT'S JUDGMENT AND IS, THEREFORE, SUSCEPTIBLE TO CHANGE. THE PROCESS OF DETERMINING BAD DEBT MAY ALSO INCLUDE THE REDUCTION OF AN ACCOUNT BASED ON PROCEDURES ASSOCIATED WITH INSURANCE CONTRACTUAL AGREEMENTS, GUARANTOR CHARITY EVALUATION, AND GUARANTOR BAD DEBT EVALUATION. THE COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINES 2 AND 3. BAD DEBT IS NOT INCLUDED IN CHILDREN'S HOSPITAL'S COMMUNITY BENEFIT DETERMINATION. THE FY 2014 SETTLED COST REPORT- WORKSHEET E-3 PART IV WAS USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6. Collection Practices Schedule H, Part III, Line 9b THE COLLECTION POLICY DOES NOT CONTAIN SPECIFIC PROVISIONS FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY. ALL PATIENTS ARE TREATED THE SAME. CHILDREN'S NATIONAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS WHILE MAINTAINING RESPONSIBLE AND EFFECTIVE FINANCIAL PROGRAMS WHICH ENSURE THAT THIS COMMITMENT CAN CONTINUE. CHILDREN'S NATIONAL SUPPORTS FAMILIES IN CARRYING OUT THEIR RESPONSIBILITY FOR OBTAINING MEDICAL CARE FOR THEIR CHILDREN. CHILDREN'S HOSPITAL, THEREFORE, WILL ASSIST FAMILIES IN VERIFYING THEIR ABILITY TO MEET THEIR FINANCIAL OBLIGATIONS TO THE HOSPITAL OR IN SECURING THE RESOURCES NECESSARY TO DO SO. THE PURPOSE OF THIS POLICY IS TO ESTABLISH GUIDELINES FOR EFFECTIVE AND RESPONSIBLE FISCAL PROGRAMMING, WHICH ASSURES THE FINANCIAL VIABILITY OF THE INSTITUTION AND MAINTAINS THE DIGNITY OF THE FAMILY. COLLECTION EFFORTS ARE THEREFORE THE SAME FOR ALL PATIENT RESPONSIBLE BALANCES ONCE THE APPROVED CHARITY ADJUSTMENT HAS BEEN MADE. Community Health Care Needs Assessment Schedule H, Part VI, Line 2 CHILDREN'S NATIONAL COMMITS TO CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS TO UNDERSTAND THE HEALTH AND HEALTH CARE STATUS OF THE PEDIATRIC POPULATION IN OUR COMMUNITY. THE ASSESSMENT WILL GUIDE THE HOSPITAL IN TARGETING ITS RESOURCES TO ACHIEVE THE GREATEST IMPACT ON CHILD HEALTH AND WELLNESS AT A POPULATION-LEVEL. OUR MOST RECENT CITYWIDE CHNA WAS RELEASED IN JUNE 2013 (FY 2013), IN COLLABORATION WITH THE DC HEALTHY COMMUNITIES COLLABORATIVE (DCHCC). THE DCHCC IS AN ALLIANCE OF DC HOSPITALS AND COMMUNITY HEALTH CENTERS THAT HAVE PARTNERED TO DEVELOP A CITYWIDE CHNA AND IMPLEMENTATION STRATEGY THAT IS RESPONSIVE TO NEEDS IDENTIFIED BY THE CHNA. THE DCHCC WORKS TO ELIMINATE HEALTH DISPARITIES AND CREATE HEALTH EQUITY FOR ALL COMMUNITIES IN THE DISTRICT OF COLUMBIA TO REALIZE ONE HEALTHY CAPITAL CITY. THE MISSION OF THE DCHCC IS TO MERGE THE TWO FACES OF THE CAPITAL CITY INTO ONE HEALTHY AND THRIVING COMMUNITY THAT HOLDS THE SAME PROMISE FOR ALL RESIDENTS. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS A UNIQUE BLEND OF BOTH QUANTITATIVE DATA AND QUALITATIVE COMMUNITY PERSPECTIVES THAT PROVIDE A COMPREHENSIVE AND GRASSROOTS VIEW OF THE STATE OF HEALTH IN THE DISTRICT. IN RESPONSE TO THE FINDINGS OF THE NEEDS ASSESSMENT, THE DCHCC, WITH INPUT FROM COMMUNITY STAKEHOLDERS DEVELOPED AN IMPLEMENTATION STRATEGY. THE STRATEGY PROVIDES A TARGETED AND COORDINATED APPROACH TO ADDRESSING THE PRIORITY AREAS - MENTAL HEALTH AND SUBSTANCE ABUSE, ASTHMA, OBESITY/OVERWEIGHT, AND SEXUAL HEALTH WITH THE ULTIMATE GOAL OF IMPROVING LOCAL HEALTH AND QUALITY OF LIFE FOR DC RESIDENTS. AS THE ONLY PEDIATRIC FOCUSED MEMBER OF THE DCHCC, CHILDREN'S NATIONAL IDENTIFIED TWO ADDITIONAL HEALTH PRIORITIES-ORAL HEALTH AND INJURY PREVENTION. USING THE DCHCC CITYWIDE IMPLEMENTATION STRATEGY AS A BASIS, CHILDREN'S NATIONAL DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN APPROVED AND ADOPTED BY THE CHILDREN'S NATIONAL MEDICAL CENTER BOARD OF DIRECTORS. THE CHNA AND THE IMPLEMENTATION STRATEGY ARE HOUSED ON THE DC HEALTH MATTERS WEBSITE. DC HEALTH MATTERS PROVIDES A ONE-STOP RESOURCE FOR ON-LINE ACCESS TO COMMUNITY HEALTH INDICATORS AND RELATED RESOURCES THAT IMPACT THE HEALTH OF DC COMMUNITIES. THE SITE CONTAINS COMMUNITY HEALTH MEASURES, EVIDENCE-BASED PROMISING PRACTICES, LOCAL RESOURCES, AND FUNDING OPPORTUNITIES. DC HEALTH MATTERS WILL BE USED AS A PLATFORM TO TRACK PROGRESS OF THE IMPLEMENTATION STRATEGY. INTERNALLY, ONGOING EVALUATION AND MONITORING OF THE IMPLEMENTATION STRATEGY WILL TAKE PLACE BY THE ADVOCACY AND COMMUNITY AFFAIRS AND CHILD HEALTH DATA LAB DEPARTMENTS OF CHILDREN'S NATIONAL. THE 2013 CHNA IS AVAILABLE ONLINE AT: http://childrensnational.org/~/media/cnhs-site/files/about/advocacy/distri ct_of_columbia_community_health_needs_assessment_2013_final.ashx IMPLEMENTATION PLAN IS AVAILABLE ONLINE AT: http://childrensnational.org/~/media/cnhssite/files/about/advocacy/final_c hildrens_national_chip_fy_20142016.ashx Eligibility Education Schedule H, Part VI, Line 3 THE FOLLOWING PROCESSES TAKE PLACE FOR FAMILIES WHO DO NOT HAVE INSURANCE OR WHO CANNOT PAY. 1. AN APPLICATION IS MADE FOR MEDICAL ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAM (FAP) STAFFED BY CONTRACTED COMPANIES, MED LAW & DECO IN THE FINANCIAL INFORMATION CENTER (FIC). ELIGIBILITY IS CONSIDERED FOR ALL APPROPRIATE PUBLIC PROGRAMS. WE WOULD LIKE THIS PROCESS TO TAKE PLACE PRIOR TO THE MEDICAL VISIT. FAP APPLICATIONS ARE MAILED TO SELF PAY PATIENTS WHEN THEY MAKE AN APPOINTMENT. 2. WHILE THE APPLICATION IS IN PROCESS, THE PATIENT IS REGISTERED AS MEDICAID PENDING AND THE MEDICAL VISIT TAKES PLACE (CITIZENS ONLY). NON CITIZENS ARE REGISTERED AS SELF PAY. 3. IF MEDICAID ELIGIBLE, THE PATIENT REGISTRATION IS CONVERTED TO THE MEDICAID PLAN. 4. IF NOT ELIGIBLE, THE PATIENT'S CHARITY CARE APPLICATION IS FURTHER EVALUATED FOR CN CHARITY CARE BY CNMC CUSTOMER SERVICE IN THE FIC. 5. IF FAP IS APPROVED, ACCOUNTS NOTES ARE UPDATED AND THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. THE ACCOUNTS ARE MANAGED BY CUSTOMER SERVICE STAFF. ONLY EXPECTED BALANCES REMAIN ON THE ACCOUNT AND FAMILIES RECEIVE STATEMENTS SHOWING THEIR RESPONSIBILITY. 6. IF FAP IS NOT APPROVED, ACCOUNTS NOTES ARE UPDATED AND THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. FAMILIES CAN SET UP PAYMENT PLANS TO RESOLVE THEIR ACCOUNT BALANCES 7. FOR INSURED FAMILIES: MEDICALLY INDIGENT STATUS CAN APPLY. THIS STATUS CAN BE EVALUATED AT ANY TIME IF A FAMILY'S REMAINING BALANCE (EXCLUDING ANY DEDUCTIBLES) AFTER 3RD PARTY PAYER IS GREATER THAN 30% OF ANNUAL INCOME LESS HOUSING EXPENSES. - WHENEVER APPLICABLE, IT IS ENCOURAGED THAT FAMILIES REVIEW THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE THE APPOINTMENT DATE. APPOINTMENTS ARE TYPICALLY MADE WITH THE FIC OFFICE WHEN FAMILIES MAKE THEIR MEDICAL APPOINTMENTS. THEY CAN GO DIRECTLY TO THE FIC OFFICE AT CN AT ANY OTHER TIME. - FAMILIES ARE ENCOURAGED TO COOPERATE WITH OUR STAFF BY SUPPLYING ALL NECESSARY INFORMATION FOR THE MEDICAID AND FAP APPLICATIONS. Description of Community Served Schedule H, Part VI, Line 4 AS THE ONLY EXCLUSIVE PROVIDER OF PEDIATRIC CARE IN THE NATIONS CAPITAL, CHILDRENS NATIONAL HAS THE PRIVILEGE OF SERVING A DIVERSE AND BROAD COMMUNITY, SPANNING FROM THE DISTRICT OF COLUMBIA TO MARYLAND AND VIRGINIA AND BEYOND. OUR COMMUNITY HAS BROAD ETHNIC DIVERSITY AND VIBRANT CULTURES. ACCORDING TO THE U.S. CENSUS BUREAU, POPULATION FIGURES FOR THE REGION ARE ESTIMATED AT JUST UNDER 650,000 FOR THE DISTRICT OF COLUMBIA; NEARLY 6 MILLION IN MARYLAND; AND A LITTLE OVER 8 MILLION IN VIRGINIA. THE SOCIAL DEMOGRAPHICS FOR THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA, ACCORDING TO THE U.S. CENSUS, ARE AS FOLLOWS: DISTRICT OF COLUMBIA: ABOUT 50% BLACK; 43.4%WHITE; 10.1% LATINO 3.9% ASIAN AND 0.6% AMERICAN INDIAN/ALASKA NATIVE; MARYLAND: APPROXIMATELY 60% WHITE; 30% BLACK; 9% HISPANIC; 6% ASIAN AND 0.6% AMERICAN INDIAN/ALASKA NATIVE AND VIRGINIA: ABOUT 70% WHITE, 19% BLACK; 8.6% HISPANIC; 6% ASIAN AND 0.5% AMERICAN INDIAN/ALASKA NATIVE. IN THE DISTRICT OF COLUMBIA, CHILDREN 18 YEARS OLD AND UNDER MAKE UP 17 PERCENT OF THE POPULATION AND ABOUT 23 PERCENT OF THE POPULATION IN MARYLAND AND VIRGINIA. CHILDREN AGE FIVE AND UNDER MAKE UP APPROXIMATELY 6 PERCENT OF THE POPULATION IN THE DISTRICT OF COLUMBIA, MARYLAND, AND VIRGINIA. IN THE DISTRICT OF COLUMBIA AND VIRGINIA ABOUT 15 PERCENT OF THE POPULATION AGE FIVE AND OLDER REPORT SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME WHILE IN MARYLAND THE PERCENTAGE IS SLIGHTLY HIGHER AT NEARLY 17 PERCENT. THE U.S. CENSUS REPORTS MEDIAN HOUSEHOLD INCOME AT APPROXIMATELY $65,800 IN THE DISTRICT; $63,900 IN VIRGINIA AND $73,500 IN MARYLAND. THE PERCENTAGE OF PERSONS LIVING BELOW THE POVERTY LINE IS REPORTED AT 18.6% FOR THE DISTRICT OF COLUMBIA, 11.3% IN VIRGINIA, AND 9.8% IN MARYLAND. THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) REPORTS TOTAL MEDICAID AND CHIP ENROLLMENT FIGURES BASED ON ENROLLMENT DATA AS OF SEPTEMBER 2014 AT 68,429,414. THE BREAKDOWN FOR TOTAL MEDICAID AND CHIP ENROLLMENT BASED ON OCTOBER FIGURES FROM CMS FOR THE DISTRICT OF COLUMBIA MEDICAID AND CHIP ENROLLMENT WAS 255,707, 1,077,179 IN MARYLAND AND 941,639 IN VIRGINIA. IN 2014, THE PERCENTAGE OF HOSPITAL INPATIENTS RECEIVING MEDICAID WAS 76 PERCENT FROM THE DISTRICT OF COLUMBIA, 28 PERCENT FROM VIRGINIA, AND 31 PERCENT FROM THE STATE OF MARYLAND. SERVING CHILDREN FOR MORE THAN 140 YEARS, CHILDRENS NATIONAL IS A PROVEN LEADER IN DEVELOPING AND PROVIDING INNOVATIVE NEW TREATMENTS FOR CHILDHOOD ILLNESS AND INJURY. WE CARE FOR MORE THAN 35,000 CHILDREN THROUGH OUR HEALTH CENTERS EACH YEAR, AS THE LARGEST NON-GOVERNMENT PROVIDER OF PRIMARY CARE IN THE DISTRICT OF COLUMBIA. ABOUT 56 PERCENT OF OUR PATIENTS LIVE IN MARYLAND. WE ALSO OFFER FAMILIES A LINK TO QUALITY PEDIATRIC CARE THROUGH OUR MOBILE MEDICAL PROGRAM AND AT COMMUNITY CENTERS. OUR TEAM AVERAGES MORE THAN 460,000 OUTPATIENT VISITS EACH YEAR AT HEALTH CLINICS IN THE DISTRICT OF COLUMBIA, AFFILIATED CENTERS IN MARYLAND AND VIRGINIA, AND AT THE SHEIKH ZAYED CAMPUS IN WASHINGTON, D.C. ON AVERAGE THAT EQUALS NEARLY 1,000 PATIENT VISITS IN ONE DAY TO ONE OF CHILDRENS NATIONALS 30 LOCATIONS IN THE DISTRICT OF COLUMBIA AND THROUGHOUT THE METROPOLITAN AREA. IN 2013, WE PERFORMED MORE THAN 17,860 SURGICAL PROCEDURES, 123,332 RADIOLOGICAL EXAMINATIONS, AND MORE THAN 1 MILLION LABORATORY TESTS. WITH OUR FOCUS RESOLUTELY ON DOING WHATS BEST FOR THE CHILDREN OF THE REGION, THE NATION AND THE WORLD, OUR MULTI-CAMPUS ORGANIZATION CONSISTS OF MANY ENTITIES FOCUSED ON PROVIDING RESEARCH-BASED CARE (IN DOZENS OF SPECIALIZED CLINICAL PROGRAMS.) CHILDRENS NATIONAL HOUSES 313 INPATIENT BEDS, INCLUDING 54 DEDICATED TO THE LEVEL IV NEWBORN INTENSIVE CARE UNIT (NICU), RECOGNIZED BY THE ACADEMY OF PEDIATRICS WITH ITS HIGHEST DESIGNATION. MORE THAN 60 BEDS ARE DEDICATED TO INTENSIVE CARE, INCLUDING THE ONLY PEDIATRIC NEURO-INTENSIVE CARE AND CARDIAC INTENSIVE CARE UNITS IN THE MID-ATLANTIC REGION. WE ALSO HAVE EIGHT REGIONAL OUTPATIENT CENTERS THAT PROVIDE SPECIALTY CARE AROUND THE REGION, INCLUDING AN AMBULATORY SURGERY CENTER. THE REGIONAL OUTPATIENT CENTERS MAKE IT MORE CONVENIENT FOR FAMILIES TO ACCESS CHILDRENS CLINICAL EXPERTISE AT THESE CENTERS THAT INCLUDE IMAGING, CARDIOLOGY, GASTROENTEROLOGY, SURGERY, ONCOLOGY, NEUROLOGY AND MUCH MORE. OUR EMERGENCY MEDICINE AND TRAUMA CENTER IS THE REGIONS LEVEL I PEDIATRIC TRAUMA CENTER, THE HIGHEST RATING POSSIBLE, AND SERVES THE DISTRICT OF COLUMBIA, VIRGINIA, MARYLAND, DELAWARE, AND WEST VIRGINIA. ADDITIONALLY, CHILDRENS NATIONAL IS THE ONLY HOSPITAL IN THE REGION WITH PEDIATRIC-ONLY TRAINED FLIGHT TEAMS READY TO PROVIDE CRITICAL TREATMENT VIA SKYBEAR, OUR RAPID HELICOPTER TRANSPORT SERVICE, AND STAT MEDEVAC, A DIRECT AIR CARRIER THAT ARRANGES AND COORDINATES THE OPERATION OF SKYBEAR AMBULANCE SERVICES. CHILDRENS NATIONAL STRIVES EVERY DAY TO IMPROVE UPON OUR COMMITMENT TO IMPROVE THE HEALTH OF OUR CHILDREN. IN FY 2014, Children's Hospital reports $15,666,019 in charity care; however, in Part I, Line 7, the reporting of the $6,249,897 is appropriate because it reflects the value of the charity care at cost. OUR COMMITMENT TO IMPROVE HEALTH STATUS OF CHILDREN EXTENDS BEYOND OUR LOCAL AND REGIONAL AREA. THROUGH OUR INTERNATIONAL PROGRAM WE ARE ABLE TO EXTEND OUR COMMUNITY AND PROVIDE CARE TO FAMILIES FROM AROUND THE WORLD SEEKING CARE FOR THEIR CHILDREN AT OUR INSTITUTION. FAMILIES FROM MORE THAN 50 COUNTRIES SEEK CARE FOR THEIR CHILDREN AT CHILDRENS NATIONAL. OUR GLOBAL SERVICES PROGRAM AT CHILDRENS NATIONAL HAS SERVED THE UNIQUE NEEDS OF PATIENTS AND FAMILIES TRAVELING FROM AROUND THE WORLD FOR MORE THAN 20 YEARS. GLOBAL SERVICES TEAM MEMBERS PROVIDE A DIRECT LINK BETWEEN INTERNATIONAL FAMILIES, THEIR PHYSICIANS AT HOME AND THE LATEST AND MOST ADVANCED TREATMENTS FOR CHILDHOOD ILLNESSES AND INJURIES, INCLUDING MEDICAL EXPERTISE AND COMPASSIONATE CARE TRUSTED BY THOUSANDS OF FAMILIES. BECAUSE THE HOSPITAL IS LOCATED IN THE HEART OF THE NATIONS CAPITAL, CHILDRENS NATIONAL HAS THE UNIQUE ADVANTAGE OF RESOURCES, SUCH AS EMBASSIES AND THREE MAJOR AIRPORTS TO WELCOME OUR INTERNATIONAL FAMILIES. THE TEAM ASSISTS PATIENTS WITH APPOINTMENT SCHEDULING, MEDICAL CONSULTATIONS, INTERPRETER SERVICES, TRAVEL PLANNING, COORDINATING CARE WITH EMBASSIES AS NEEDED AND INFORMATION ON NAVIGATING THE U.S. VISA PROCESS. ADDITIONALLY, CHILDRENS NATIONAL ALSO HAS IN-COUNTRY LIAISONS IN ABU DHABI, UNITED ARAB EMIRATES (UAE) AND KUWAIT CITY, KUWAIT. THE OFFICE SERVES AS A LIAISON OFFICE FOR CHILDREN'S NATIONAL AND WASHINGTON HOSPITAL CENTER IN THE GULF REGION AND IS RESPONSIBLE FOR COORDINATING CONFERENCES AND CONTINUING MEDICAL EDUCATION COURSES FOR MEDICAL STAFF AND FACILITATING SECOND OPINION SERVICES VIA THE INTERNET AND TELEMEDICINE, BRINGING THE EXPERTISE OFFERED AT THE TWO WASHINGTON, DCBASED HOSPITALS TO THE CITIZENS OF THE UAE AND OTHER GULF COUNTRIES. ADDITIONALLY, THE SHEIKH ZAYED INSTITUTE FOR PEDIATRIC SURGICAL INNOVATION LOCATED ON THE MAIN CAMPUS OF CHILDRENS NATIONAL IS REDEFINING WHAT IS POSSIBLE IN SURGERY THROUGH INNOVATIVE, INTEGRATED RESEARCH. THE INSTITUTES TEAM, MADE UP OF PHYSICIANS, SCIENTISTS, AND ENGINEERS ARE APPLYING THEIR EXPERTISE IN THEIR SPECIALIZED FIELDS TO PURSUE THE COMMON GOAL OF FINDING NEW TREATMENTS, DEVICES AND OTHER INNOVATIVE APPROACHES TO IMPROVING CHILDRENS HEALTH. THROUGH FOCUSED LEADERSHIP, TRACKING AND MEASURING ADVANCES, AND BY PROMOTING CREATIVITY, DISCOVERY, AND INVENTION, THE INSTITUTE IS DEVELOPING INNOVATIONS THAT WILL ALLOW CHILDREN TO LIVE LONGER, HEALTHIER LIVES. CHILDRENS NATIONAL IS DEDICATED TO PROVIDING HIGH QUALITY EDUCATIONAL OPPORTUNITIES FOR INTERNAL AND EXTERNAL PHYSICIANS, NURSES, AND ALLIED HEALTH PROFESSIONALS THROUGH INTERNSHIPS, RESIDENCY, FELLOWSHIPS, GRADUATE MEDICAL EDUCATION, AND CONTINUING MEDICAL EDUCATION. OUR PEDIATRIC PROGRAM IS ONE OF THE MOST COMPETITIVE IN THE NATION, RECEIVING MORE THAN 2,000 APPLICATIONS FOR 40 OPEN INTERN POSITIONS. EACH YEAR, WE HAVE 150 SUBSPECIALTY FELLOWS IN 30 FELLOWSHIP PROGRAMS, 117 PEDIATRIC RESIDENTS, 750 ROTATING RESIDENTS, AND 300 MEDICAL STUDENTS. WE PROVIDE PEDIATRIC TRAINING FOR APPROXIMATELY 180 THIRD-YEAR MEDICAL STUDENTS FROM GEORGE WASHINGTON UNIVERSITY, 48 THIRD-YEAR MEDICAL STUDENTS FROM HOWARD UNIVERSITY, AND MORE THAN 100 FOURTH-YEAR STUDENTS FROM GEORGE WASHINGTON AND OTHER MEDICAL SCHOOLS. Promoting the Health of the Community Schedule H, Part VI, Line 5 FOR MORE THAN 140 YEARS, CHILDRENS NATIONAL HAS BEEN COMMITTED TO SERVING THE COMMUNITY BY PROMOTING AND IMPROVING THE HEALTH OF CHILDREN AND SUPPORTING THE HEALTH IMPROVEMENTS IN THEIR HOMES, SCHOOLS, NEIGHBORHOODS, AND BROADER COMMUNITY. THIS COMMITMENT IS EVIDENCED FROM THE GOVERNING BOARDS TO COMMUNITY HEALTH INITIATIVES TO THE DEVELOPMENT OF DC HEALTHY COMMUNITIES COLLABORATIVE (DCHCC). CHILDRENS NATIONAL, THE 501 (C)(3) NOT-FOR-PROFIT ORGANIZATION, IS GOVERNED BY BOARD OF DIRECTORS REPRESENTING THE DIVERSITY OF THE LOCAL, REGIONAL, NATIONAL, AND INTERNATIONAL COMMUNITIES THAT WE SERVE. THE MAJORITY OF OUR BOARD OF DIRECTORS RESIDES WITHIN THE PRIMARY SERVICE AREA OF THE WASHINGTON, DC METROPOLITAN AREA, INCLUDING THE DISTRICT OF COLUMBIA, MARYLAND, AND VIRGINIA. CHILDRENS NATIONAL IS A PIONEER IN INNOVATIVE PROGRAMS THAT MOVE BEYOND AWARENESS TO TARGETED INTERVENTIONS THAT IMPROVE THE LIVES OF CHILDREN AND THEIR FAMILIES, LOCALLY, REGIONALLY, NATIONALLY, AND INTERNATIONALLY. THE CHILDRENS NATIONAL ADVOCACY AND PUBLIC POLICY, INC. (CNAPPI) GOVERNS THE ADVOCACY COMPONENT OF OUR CARE, ADVOCACY, RESEARCH, AND EDUCATION (CARE) MISSION AS A CHARITABLE ORGANIZATION. THE CNAPPI IS COMPRISED OF LEADERS FROM THROUGHOUT THE REGION WITH EXPERIENCE IN POLICY, ADVOCACY, LEADERSHIP AND STRATEGIC PLANNING. WITH THIS CAPACITY, THE CNAPPI SERVES AS A PLATFORM FOR THE CHILDRENS NATIONAL TO REACH BEYOND THE BOUNDARIES OF THE INSTITUTION; ADVOCATE FOR ALL CHILDREN REGARDLESS OF THEIR CIRCUMSTANCE OR LOCATION; AND PRIORITIZE AND GUIDE OFFICIAL POLICY STATEMENTS AND ACTION, GOVERNMENT RELATIONS, COMMUNITY BENEFIT OUTREACH AND OTHER RELEVANT ISSUES. OVER THE PAST 20 YEARS, CHILDRENS HEALTH BOARD HAS AWARDED APPROXIMATELY $5 MILLION IN GRANTS TO MORE THAN 200 CHILDRENS NATIONAL MEDICAL CENTER PROGRAMS. OUR GRANTS HAVE TURNED EARLY IDEAS INTO PROVEN MODELS THAT HAVE ATTRACTED SUPPORT FROM LEADING INVESTORS IN IMPROVED HEALTH OUTCOMES FOR CHILDREN NATIONWIDE. THE COMMUNITY AFFAIRS DEPARTMENT ESTABLISHED A PARTNERSHIP WITH THE CHILDRENS HEALTH BOARD, A SERVICE AFFILIATE OF CHILDRENS NATIONAL HEALTH SYSTEM, THAT WORKS TO ADVANCE THE HEALTH AND WELL-BEING OF CHILDREN IN THE WASHINGTON, DC METROPOLITAN COMMUNITY, ESPECIALLY THOSE MOST IN NEED, THROUGH ADVOCACY, EDUCATION, PREVENTION AND EARLY INTERVENTION. BEGINNING IN FY 2014, THE CHILDRENS HEALTH BOARD IMPLEMENTED AN UPDATED GRANT MAKING STRATEGY WHICH INCLUDES THE COMMUNITY BENEFIT GRANT PROGRAM. THROUGH THE COMMUNITY BENEFIT GRANT PROGRAM THE CHILDRENS HEALTH BOARD WILL FOCUS ITS GRANT MAKING ON SUPPORTING THE CHILDRENS NATIONAL COMMUNITY HEALTH IMPROVEMENT PLAN (IMPLEMENTATION STRATEGY), IN AN EFFORT TO IMPROVE COMMUNITY HEALTH DEMONSTRATED BY MEASURABLE OUTCOMES. IN 2013, THE COMMUNITY BENEFIT TEAM WORKED WITH THE CHILDRENS HEALTH BOARD TO ESTABLISH THIS NEW GRANT PROCESS AND WILL ENGAGE IN THE GRANT APPLICATION REVIEW PROCESS TO REVIEW GRANT APPLICATIONS FOR COMMUNITY BENEFIT PROGRAM ALIGNMENT. GRANT AWARDEES ARE NOW REQUIRED TO REPORT THEIR PROGRAMS/INITIATIVES AS COMMUNITY BENEFIT AND WILL BE INCLUDED IN THE COMMUNITY BENEFIT REPORT. CHILDRENS NATIONAL HEALTH SYSTEM IS FURTHER PROMOTING THE HEALTH OF THE COMMUNITY THROUGHOUT THE REGION, THE NATION AND THE WORLD THROUGH THE CHILDRENS TELEMEDICINE PROGRAM. OUR TELEMEDICINE TEAM DESIGNS, DEVELOPS AND EXECUTES STRATEGIES THAT USE ELECTRONIC AND TELECOMMUNICATIONS TECHNOLOGIES TO IMPROVE ACCESS TO CARE AND OUTCOMES. THE PROGRAM SERVES COMMUNITY HOSPITALS, SUBURBAN HEALTH CENTERS, INNER CITY HEALTH CLINICS, NATIONAL HOSPITALS, AND INTERNATIONAL PARTNERS ACROSS A WIDE RANGE OF PEDIATRIC SUBSPECIALTIES INCLUDING NEUROLOGY, GENETICS, RADIOLOGY, AND GENERAL SURGERY. MORE THAN 1,000 CONSULTATIONS ARE PROVIDED ANNUALLY BY THE TEAM. DISTANCE LEARNING INITIATIVES OCCUR LOCALLY, REGIONALLY, NATIONALLY, AND IN MANY OTHER COUNTRIES, INCLUDING GERMANY, MOROCCO, UGANDA, QATAR KUWAIT, UNITED ARAB EMIRATES, AND IRAQ. IN PARTNERSHIP WITH THE CHILDRENS HOSPITAL OF RABAT, MOROCCO, A NEW PROGRAM EMPHASIZES IMPROVING EDUCATION, TECHNOLOGY AND HEALTHCARE STAFFING, TO IMPROVE THE LEVEL OF HEALTH CARE FOR CHILDREN AVAILABLE IN NORTH AFRICA. THIS INITIATIVE, SUPPORTED BY THE MOSAIC FOUNDATION, HAS GIVEN LOCAL PHYSICIANS IN MOROCCO ACCESS TO CONTENT INCLUDING LIVE VIDEO LECTURES BY CHILDRENS STAFF MEMBERS. THESE PROGRAMS ARE JUST A FEW EXAMPLES OF THE MANY WAYS CHILDRENS NATIONAL IS WORKING TO IMPROVE THE HEALTH OF OUR COMMUNITY. Affiliated Health Care System Roles Schedule H, Part VI, Line 6 CHILDREN'S HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING ENTITIES: - CHILDREN'S NATIONAL MEDICAL CENTER - 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBLITY FOR HEALTH CARE SYSTEM - CHILDREN'S HOSPITAL FOUNDATION - 501(C)(3), FUNDRAISING - CHILDREN'S RESEARCH INSTITUTE - 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS - SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN - BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN - CHILDREN'S NATIONAL ADVOCACY & PUBLIC POLICY INC - 501(C)(3), ADVOCATING FOR CHILDREN'S HEALTH ISSUES - CHILDREN'S HOSPITAL SELF-INSURANCE TRUST - 501(C)(3), PROVISION OF INSURANCE TO SYSTEM EACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL MEDICAL CENTER'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS. true SAFE KIDS WORLDWIDE 1301 PENNSYLVANIA AVENUEwashingtn WASHINGTON DC 20001 521627574 501(c)(3) 2378747 FMV DEBT FORGIVENESS DEBT FORGIVENESS FORGIVENESS 1 Procedure for monitoring the use of grant funds in the US SCHEDULE I, PART I, Line 2 DURING THE YEAR, CHILDREN'S HOSPITAL MADE A CONTRIBUTION TO A RELATED ENTITY, Safe Kids Worldwide, WHICH IS ALSO TAX-EXEMPT UNDER IRC SECTION 501(C)(3) IN RECOGNITION AND FURTHERANCE OF THE SAFEKIDS CHARITABLE PURPOSES. Safe Kids Worldwide IS ORGANIZED AS A TYPE I SUPPORTING ORGANIZATION OF CHILDERN'S HOSPITAL. X X X X true true X X X X X false true false false false false false true true true KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 778236 0 708157 0 25389 0 343885 0 88178 0 1943845 0 0 0 RAHUL K SHAH MD BOARD MEMBER 258086 0 165678 0 594 0 12750 0 2141 0 439249 0 0 0 DAVID WESSEL MD BRD MEMBER/CMO (BEG: 01/01/14) 521173 0 349703 0 24874 0 95250 0 55186 0 1046186 0 0 0 DENICE CORA-BRAMBLE MD BRD MEMBER/CMO (BEG: 01/01/14) 514516 0 305508 0 21330 0 95250 0 56137 0 992741 0 0 0 DOUGLAS MYERS CHIEF FINANCIAL OFFICER 563087 0 395438 0 75339 0 92251 0 30743 0 1156858 0 0 0 MARK BATSHAW MD PHY IN CHIEF / CAO 602517 0 569896 0 40866 0 262750 0 65044 0 1541073 0 0 0 RAYMOND S SCZUDLO CHIEF LEGAL OFFICER 437187 0 467716 0 40924 0 12750 0 48773 0 1007350 0 0 0 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 583933 0 296336 0 2752 0 72750 0 67413 0 1023184 0 0 0 ROGER PACKER MD SVP CENTER OF EXCELLENCE 404544 0 325117 0 28708 0 77334 0 54070 0 889773 0 0 0 JOSEPH WRIGHT MD SVP CENTER OF EXCELLENCE 347472 0 252667 0 21709 0 103856 0 46511 0 772215 0 0 0 MENDAL TUCHMAN MD CHIEF RESEARCH OFFICER 322297 0 260903 0 28401 0 64889 0 45540 0 722030 0 0 0 GERARD MARTIN MD SVP CENTER OF EXCELLENCE 523163 0 333572 0 9566 0 61783 0 49883 0 977967 0 0 0 PAM KING SAMS CHIEF DEVELOPMENT OFFICER 317988 0 154413 0 7003 0 145211 0 27864 0 652479 0 0 0 MARY ANNE HILLIARD CHIEF RISK OFFICER 266846 0 214407 0 25293 0 57196 0 35864 0 599606 0 0 0 ROBERTA ALESSI VP OPERATIONS 271162 0 125848 0 4154 0 36523 0 29327 0 467014 0 0 0 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 529675 0 212659 0 18783 0 74867 0 14058 0 850042 0 0 0 ELIZABETH FLURY CHIEF STRATEGY OFFICER 491242 0 202060 0 2370 0 80694 0 31903 0 808269 0 0 0 BRIAN JACOBS MD CHIEF INFORMATION OFFICER 362702 0 86650 0 20839 0 32750 0 49317 0 552258 0 0 0 MARY OTTOLINI MD PHD VICE CHAIR MED. EDUCATION 249144 0 64231 0 2838 0 12669 0 9270 0 338152 0 0 0 LINDA TALLEY CHIEF NURSING OFFICER 251746 0 52027 0 1518 0 10936 0 12466 0 328693 0 0 0 DARRYL VARNADO CHIEF PEOPLE OFFICER 275479 0 122922 0 20209 0 50195 0 20783 0 489588 0 0 0 RICHARD JONAS MD Chief of Cardiac Surgery 1078661 0 743459 0 34624 0 101301 0 93929 0 2051974 0 0 0 ROBERT KEATING MD CHIEF OF NEUROSURGERY 757280 0 98161 0 883 0 88447 0 21433 0 966204 0 0 0 PETER KIM MD VP SHEIKH ZAYED INSTITUTE 640672 0 229310 0 1518 0 12750 0 21891 0 906141 0 0 0 H GIL RUSHTON MD CHIEF OF UROLOGY 480320 0 136126 0 5477 0 60249 0 32979 0 715151 0 0 0 JOHN MYSEROS MD NEUROSURGEON 618669 0 67478 0 990 0 12750 0 21495 0 721382 0 0 0 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 564871 0 129865 0 58 0 0 0 21911 0 716705 0 0 0 NELLIE ROBINSON FORMER CHIEF NURSING OFFICER 304004 0 366215 0 33326 0 12750 0 47911 0 764206 0 0 0 DAVID SPARKS FORMER VP FINANCE & CONTROLLER 273879 0 143587 0 27295 0 42515 0 45717 0 532993 0 0 0 First-class or charter travel Schedule J, Part I, Line 1a FIRST CLASS OR CHARTER TRAVEL THE CEO PER HIS EMPLOYMENT CONTRACT IS ENTITLED TO (A) USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS, AND (B) TAKE HIS SPOUSE ON UP TO 7 TRIPS PER YEAR FOR CONFERENCES WHERE HER PRESENCE BENEFITS THE HOSPITAL AND ITS BUSINESS RELATIONS. HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL. Tax indemnification and gross-up payments Schedule J, Part I, Line 1a TWO KEY EMPLOYEES AND ONE FORMER KEY EMPLOYEE RECEIVED CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS, UPON APPROVAL OF THE COMPENSATION COMMITTEE, WHICH ARE INCREASED BY A TAX EQUALIZATION AMOUNT, WHICH IS SIGNIFICANTLY LESS THAN THE AMOUNT THAT WOULD BE DETERMINED BY A TAX GROSS UP OR INDEMNIFICATION METHOD. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. Health or social club dues or initiation fees Schedule J, Part I, Line 1a CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR HEALTH CLUB OR SOCIAL CLUB DUES. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. Personal services Schedule J, Part I, Line 1a CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. THERE ARE NO EXPENDITURES FOR MAIDS, CHAUFFEURS OR CHEFS. Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTALNON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AS PART OF DEFERRED COMPENSATION: MARK L. BATSHAW, MD $250,000 KURT D. NEWMAN, MD $331,135 DOUGLAS MYERS $79,501 ANTHONY SANDLER, MD $60,000 GERARD MARTIN, MD $49,033 DAVID WESSEL, MD $82,500 ROGER PACKER, MD $64,584 MENDAL TUCHMAN, MD $52,139 JOSEPH WRIGHT, MD $91,106 PAM KING SAMS $132,461 DENICE CORA-BRAMBLE, MD $82,500 DAVID SPARKS $29,765 MARY ANNE HILLIARD $44,446 ROBERTA ALESSI $24,808 ELIZABETH FLURY $75,002 KATHLEEN CHAVANU GORMAN $71,252 DARRYL VARNADO $45,003 BRAIN JACOBS, MD $20,000 RICHARD JONAS, MD $88,551 ROBERT KEATING, MD $75,697 H. GIL RUSHTON, MD $47,499 Non-fixed payments Schedule J, Part I, Line 7 THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT. Initial contract exception Schedule J, Part I, Line 8 Certain individuals hired during the year have employment contracts which meet the initial contract exceptions described in the Treasury Regulations. 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Form 990, Part III, Line 1 TO IMPROVE HEALTH OUTCOMES FOR CHILDREN REGIONALLY, NATIONALLY, AND INTERNATIONALLY; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH, AND EDUCATION TO MEET UNIQUE NEEDS OF CHILDREN, ADOLESCENTS, AND THEIR FAMILIES. Program Services Part III, Line 4a Children's Mission Statement As the nation's children's hospital, the mission of Children's National Medical Center is to excel in Care, Advocacy, Research and Education. We accomplish this through: - Providing a quality health care experience for our patients and families. - Improving health outcomes for children regionally, nationally, and internationally. - Leading the creation of innovative solutions to pediatric health challenges. Children's Vision Statement As the nation's children's hospital, we will set the standard of excellence for the care of children. - We will serve as the voice for the most vulnerable among us: our children. - We will lead the quest to cure some of childhood's most devastating diseases. - We will prepare the nation's future leaders in child health. - We will be the children's hospital against which all others are measured. Children's Child-Centered Vision By incorporating feedback from our families, we have developed our first child-centered vision, which looks at the hospital experience through a child's eyes. Healing a child's body, mind and spirit takes more than medicine: it takes a team to fulfill a family's dream. - My hospital is a bright and happy place that feels like home. - My providers, my family, and I are a team, and everyone's job is important. - The way my hospital works is built around me. - My providers don't all look alike. - My hospital is my family's connection to everything I need for my health, whether they provide it or blaze trail it. About Children's National Children's National Medical Center is the premier provider of pediatric care in the Washington, DC, metropolitan area and is the only freestanding children's hospital between Philadelphia, Pittsburgh, Norfolk, and Atlanta. Serving the nation's children for 140 years, Children's National is a proven leader in the development and application of innovative new treatments for childhood illness and injury. Children's internationally recognized team of pediatric healthcare professionals care for more than 360,000 patients each year who come from throughout the region, nation and world. Serving as an advocate for all children, Children's is the largest non-governmental provider of pediatric care in the District of Columbia, providing more than $50 million in uncompensated care. In addition, Children's serves as the regional referral center for pediatric emergency, trauma, cancer, cardiac and critical care as well as neonatology, orthopedic surgery, neurology, and neurosurgery. Children's National is proudly ranked consistently among the best pediatric hospitals in America by US News & World Report and the Leapfrog Group, and has received Magnet designation by the ANCC. At Children's National Medical Center, we stand for children! Our vision of advancing the health and wellbeing of children has been the motivation behind a number of forward-focused initiatives aimed at creating a lasting standard for prevention and community education, coupled with top-notch treatment and continuous improvement. As always, the vision is carried out through a cadre of nationally recognized healthcare professionals, staff, and administrators who tirelessly serve the unique and diverse medical needs of the residents of the Washington, DC, metropolitan area and the broader community. Their work provides a unique perspective of the health improvements important for all children, in every family. With this in mind, the hospital is committed to building a universal blueprint for improving healthcare that can be replicated in health systems, hospitals, and clinics in communities across the country. The programs highlighted in this report provide a snapshot of the important work being done at Children's National every day to improve the health and wellbeing of kids and our communities. Every member of our team is committed to giving children and our communities the best chance for a healthy future, it's all we do. COMMUNITY BENEFIT REPORT CHILDREN'S NATIONAL IS DEDICATED TO FULFILLING ITS VISION OF SETTING THE STANDARD IN EXCELLENCE IN PEDIATRIC CARE, ADVOCACY, RESEARCH , AND EDUCATION, HERE IN THE NATION'S CAPITAL, AROUND THE COUNTRY, AND THROUGHOUT THE WORLD. AS PART OF OUR COMMITMENT TO OUR COMMUNITY, BELOW ARE SOME OF THE PROGRAMS THAT WERE IMPLEMENTED IN FY 2014. CENTRAL SOUTHERN MARYLAND MEDICAL PEDIATRIC SOCIETY ESTABLISHED IN 2012, THE CENTRAL SOUTHERN MEDICAL SOCIETY WAS CREATED TO PROVIDE A FORUM FOR CLINICIANS CARING FOR CHILDREN IN ANNE ARUNDEL, CALVERT, CHARLES, PRINCE GEORGE'S AND ST. MARY'S COUNTIES. THE SOCIETY'S FOCUS IS FOSTERING EDUCATION AND KNOWLEDGE SHARING AROUND CLINICAL ISSUES, BEST PRACTICES AND POLICY DECISIONS IMPACTING THE COMMUNITIES THEY SERVE IN AND AROUND CENTRAL SOUTHERN MARYLAND. IN 2014, THE SOCIETY CONVENED ON THREE OCCASIONS. THE TOPICS FOCUSED ON MENTAL AND BEHAVIORAL HEALTH, AUTISM, AND ASTHMA. DR. STEPHEN TEACH, DIRECTOR OF IMPACT DC, (IMPROVING PEDIATRIC ASTHMA CARE IN THE DISTRICT OF COLUMBIA) SPOKE AT THE LAST MEETING ON THE TOPIC OF CONTROLLING PEDIATRIC ASTHMA: PAST, PRESENT AND FUTURE. THE DISCUSSION FOCUSED ON UNDERSTANDING DISPARITIES IN ASTHMA CARE AND OUTCOMES, NATIONAL INSTITUTES OF HEALTH GUIDELINE BASED CARE IN AN AT-RISK PEDIATRIC POPULATION, AND THE ROLE OF IMMUNOMODULATORS IN PHENOTYPICALLY-DRIVEN ASTHMA CARE. MORE THAN 100 CLINICIANS ATTENDED THE SOCIETY'S MEETINGS, INCREASING PARTICIPATION BY ABOUT 10 PERCENT FROM THE FIRST YEAR. THE CENTRAL SOUTHERN MARYLAND PEDIATRIC MEDICAL SOCIETY IS COMMITTED TO EXTENDING THE VOICE OF CHILDREN AND FAMILIES OF THIS REGION THROUGH THE COLLECTIVE VOICE OF THE PEDIATRIC MEDICAL COMMUNITY. EAST OF THE RIVER LACTATION CENTER MEDICAL, PSYCHOLOGICAL AND ECONOMIC BENEFITS ARE CITED AS THE TOP REASONS TO BREASTFEED FOR THE FIRST SIX MONTHS OF LIFE, ACCORDING TO THE AMERICAN ACADEMY OF PEDIATRICS (AAP), THE AMERICAN ACADEMY OF FAMILY PHYSICIANS (AAFP), AND THE WORLD HEALTH ORGANIZATION. IN FACT, THESE ORGANIZATIONS ALSO RECOMMEND CONTINUED BREASTFEEDING AFTER INFANT FOODS ARE STARTED UNTIL AT LEAST 12 MONTHS OF AGE. THE EAST OF THE RIVER LACTATION CENTER WAS FORMED TO ASSIST MOTHERS IN THE WASHINGTON, DC AREA WITH REACHING THESE AND OTHER GOALS IN BREASTFEEDING. THROUGH COLLABORATION BETWEEN CHILDREN'S NATIONAL, THE WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM, AND THE DISTRICT OF COLUMBIA BREASTFEEDING COALITION THE PROGRAM AIMS TO ASSIST MOMS WITH PRENATAL BREASTFEEDING EDUCATION AND POST-PARTUM BREASTFEEDING SUPPORT. THE PROGRAM INCLUDES A FOUR-WEEK PRENATAL BREASTFEEDING EDUCATION CLASS FACILITATED BY A LACTATION CONSULTANT, A BREASTFEEDING PEER COUNSELOR AND A WIC NUTRITIONIST. CLASSROOM TOPICS INCLUDE, "GETTING STARTED", "BREASTFEEDING THE FIRST FEW WEEKS"," KEEPING THINGS GOING WHEN LIFE RETURNS", AND "BREASTFEEDING AFTER SIX MONTHS." COMMUNITY LACTATION SUPPORT SERVICES ARE ALSO OFFERED TO BREASTFEEDING FAMILIES FROM THE ENTIRE WASHINGTON, DC METROPOLITAN AREA. IN ADDITION, THE CENTER OFFERS MOM TO MOM BREASTFEEDING SUPPORT GROUPS AND BACK TO WORK BREASTFEEDING CONSULTS TO HELP BREASTFEEDING MOTHERS PREPARE TO RETURN TO WORK OR SCHOOL WHILE MEETING THEIR BREASTFEEDING GOALS. CLASSES ARE PROVIDED AT NO COST TO PARTICIPANTS. THE PROGRAM WAS FUNDED INITIALLY BY A GRANT FROM THE U.S. DEPARTMENT OF AGRICULTURE/WIC. IN 2013, THE W.K. KELLOGG FOUNDATION PROVIDED ADDITIONAL FUNDING TO SUPPORT RESEARCH EFFORTS AND SERVICES IN THE COMMUNITY. DURING 2014, THE CENTER PROVIDED SERVICES TO 445 MOMS WITH 71% OF THE MOM'S INITIATING BREASTFEEDING. FORTY PERCENT OF THE MOMS ENROLLED AND COMPLETED ALL THREE PRENATAL BREASTFEEDING EDUCATION CLASSES. S.T.A.B.L.E. AND CARDIAC S.T.A.B.L.E. SPECIAL ATTENTION AND SKILL IS A NECESSITY FOR NEWLY BORN INFANTS THAT BECOME ILL AT BIRTH. CHILDREN'S NATIONAL IS AT THE FOREFRONT IN HELPING TO EDUCATE HEALTH CARE PROVIDERS CARING FOR OUR SMALLEST COMMUNITY MEMBERS. THE S.T.A.B.L.E. PROGRAM WAS DEVELOPED TO MEET THE EDUCATIONAL NEEDS OF HEALTH CARE TEAMS - NURSES, PHYSICIANS, THERAPISTS AND ASSISTANTS WHO MUST DELIVER THIS IMPORTANT STABILIZATION CARE. S.T.A.B.L.E. STRESSES THE PROFESSIONAL RESPONSIBILITIES PROVIDERS HAVE TO CARE FOR SICK INFANTS AND STANDS FOR THE SIX ASSESSMENT AND CARE MODULES: SUGAR, TEMPERATURE, AIRWAY, BLOOD PRESSURE, LAB WORK AND EMOTIONAL SUPPORT. THE CARDIAC S.T.A.B.L.E. MODULE PROVIDES GUIDELINES FOR THE STABILIZATION OF NEONATES SUSPECTED TO HAVE CONG Form 990 Review Process Form 990, Part VI, Line 11b THE RELEVANT COMMITTEES OF THE ORGANIZATION AND ITS PARENT ORGANIZATION, CNMC, REVIEW APPLICABLE PORTIONS OF THE FORM 990: The legal affairs and audit committee reviews the financial disclosures, the CNAPPI board reviews the public benefit sections, and the executive compensation committee reviews the compensation disclosures. The full board reviewed the entire Form 990. The completed Form 990 is made available to the board of Children's National Medical Center before filing. Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c CHILDREN'S HOSPITAL REQUIRES THAT EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE COMPLETE A CONFLICT OF INTEREST FORM AT LEAST EVERY YEAR. IN ADDITION EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS INSTRUCTED AND REQUIRED TO AMEND THE CONFLICT OF INTEREST FORM IMMEDIATELY UPON A CHANGE IN STATUS OF ANY OF THE QUESTIONS ON THE FORM. THESE FORMS ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND CONFLICTS AND INTERESTS ARE NOTED. THE CHILDREN'S HOSPITAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY GOVERNING POLICIES FORM 990, PART VI, LINES 13 & 14 CHILDREN'S HOSPITAL IS GOVERNED BY THE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL MEDICAL CENTER ("CNMC"). THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. Process for Determining Compensation Form 990, Part VI, Line 15a THE EXECUTIVE COMPENSATION COMMITTEE OF THE CNMC BOARD OF DIRECTORS IS COMPRISED WHOLLY OF DISINTERESTED, INDEPENDENT BOARD MEMBERS. THE COMMITTEE HAS RETAINED INDEPENDENT OUTSIDE CONSULTANTS EXPERT ON COMPENSATION MATTERS. THE COMMITTEE DETERMINES ADJUSTMENTS IN COMPENSATION, INCLUDING BASE PAY, INCENTIVES, AND OTHER FORMS OF COMPENSATION FOR EACH PERSON DEEMED BY THE COMPENSATION COMMITTEE TO BE A "DISQUALIFIED PERSON" AS THAT TERM IS USED IN THE INTERMEDIATE SANCTION REGULATIONS OF THE IRS. THE COMMITTEE IS INFORMED IN ITS DECISION-MAKING BY COMPENSATION STUDIES AND COMPARISONS DONE BY THE INDEPENDENT CONSULTANT, AND RELIES UP "REASONABLENESS" OPINIONS FOR SUCH CONSULTANTS PRIOR TO OR CONTEMPORANEOUS WITH MAKING COMPENSATION DECISIONS. THE COMMITTEE MEETS 4-6 TIMES PER YEAR TO CONSIDER SUCH MATTERS. How Documents are Made Available to the Public Form 990, Part VI, Line 19 CHILDREN'S HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED ON REQUEST. OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CP&A Partnership Capital Account Adjustment - $182,498 (Difference Between Income and Change in Capital Account per Schedule K-1). 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