2015-11-12T19:01:32-06:00 2014-12-31 350921680 CROWE HORWATH LLP 401 East Las Olas Blvd Suite 1100 Fort Lauderdale FL 33301 990 2014-01-01 590638499 Variety Children's Hospital VARI 3056666511 3100 SW 62nd Avenue Miami FL 331553009 Timothy Birkenstock SVP & CFO 2015-11-12 true Cindy Kushner P00739493 9542028600 2014 2016-04-25 22:37:26Z Nicklaus Children's Hospital Narendra Kini MD 3100 SW 62nd Avenue Miami FL 331553009 909496177 false X www.nicklauschildrens.org X 1950 FL THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. 17 12 3975 1814 45913 -68054 13232648 17936291 522636121 551976767 17135133 34211631 16484863 13968180 569488765 618092869 0 0 0 0 284998874 301573016 0 0 0 222631709 239464484 507630583 541037500 61858182 77055369 917641210 961678086 381340508 386206414 536300702 575471672 THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. false false 429565047 559561728 VARIETY CHILDREN'S HOSPITAL, ESTABLISHED IN 1950, OWNS AND OPERATES A PEDIATRIC SPECIALTY HOSPITAL KNOWN AS NICKLAUS CHILDREN'S HOSPITAL. THE HOSPITAL IS ONE OF THE LARGEST FREESTANDING PEDIATRIC TEACHING HOSPITALS IN THE SOUTHEASTERN UNITED STATES. IT PROVIDES SPECIALIZED PEDIATRIC HEALTHCARE FOR CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE OR ABILITY TO PAY. THE HOSPITAL HAS 289 LICENSED BEDS. NICKLAUS CHILDREN'S HOSPITAL SERVES AS A REFERRAL CENTER FOR CHILDREN WITH COMPLEX, CRITICAL OR LIFE-THREATENING ILLNESSES REQUIRING SPECIALIZED CARE. IT HAS A 28-BED PEDIATRIC INTENSIVE CARE UNIT, A 37-BED NEONATAL INTENSIVE CARE UNIT AND A 12-BED CARDIAC INTENSIVE CARE UNIT. IT IS ALSO A STATE-DESIGNATED PEDIATRIC TRAUMA CENTER. MANY PATIENTS ARE REFERRED BY OTHER HOSPITALS REGARDLESS OF THE EXISTENCE OF FORMAL ARRANGEMENTS. (CONTINUED IN SCHEDULE O) 429565047 true true false true false false false false false true true false true true false false true false false true false false false false false true true false false true true false false false false false false false false false false false false false true true true true false false true 713 0 true 3975 true true true true CJ EI false false false false false false false false X 17 12 false false false false true true true true true false false true true true true true true true true true false X Michael Durr 3056666511 3100 SW 62nd Avenue Miami FL 331553009 Alex Soto Chairman / Director 1.50 3.70 X X 0 0 0 Jaret Davis Esquire Vice Chairman / Director 1.50 0.20 X X 0 0 0 Jefry Biehler MD Secretary / Director 40.00 0.20 X X 335260 0 34636 Narendra Kini MD President and CEO 40.00 3.20 X X 1327025 0 190035 Deise Granado-Villar MD Director and CMO 40.00 0.20 X X 443325 0 70678 Maria Franco MD Director 1.50 0.20 X 0 0 0 Michael Fux Director 1.50 1.20 X 0 0 0 Ghislain Gouraige Jr Director 1.50 0.20 X 0 0 0 Gary Gregory Director 1.50 0.20 X 0 0 0 Juan C Mas Director 1.50 1.20 X 0 0 0 Jay Massirman Director 1.50 0.20 X 0 0 0 Steven McKean Director 1.50 0.20 X 0 0 0 Marcos Mestre MD Physician / Director 40.00 0.20 X 281233 0 31928 Lucy Morillo-Agnetti Foundation President / Director 1.50 40.20 X 0 298703 27137 Mario Murgado Director 1.50 1.70 X 0 0 0 Phillip Newcomm MD Director 1.50 0.20 X 0 0 0 Keith Ward Director 1.50 0.20 X 0 0 0 Timothy Birkenstock Senior VP and CFO 40.00 1.70 X 461277 0 86890 Martha McGill Executive VP and COO 40.00 0 X 561236 0 106919 Redmond P Burke MD Cardiovascular Surgery Director 40.00 0 X 1673860 0 40260 Sandeep P Dave MD Attending Physician 40.00 0 X 870271 0 16624 Robert L Hannan MD Cardiovascular Surgeon 40.00 0 X 990218 0 40558 John Ragheb MD Attending Physician 40.00 1.00 X 1122386 0 34815 Harry Shufflebarger MD Orthopaedic Surgeon 40.00 0 X 1138706 0 42557 9204797 298703 723037 387 false true true Cerner Corporation PO Box 412732 Kansas City MO 64141 IT Equipment and Services 16220771 Turner-Arellano Joint Venture 1000 NW 57 Court Miami FL 33126 Construction Contracts 7223763 Anthony Baradat and Associates 1235 Coral Way Suite 200 Miami FL 33145 Advertising 3801785 PHI Air Medical LLC 2800 North 44th Street Suite 800 Phoenix AZ 85008 Helicopter Operations 3792815 Xtend Healthcare LLC 500 W MAIN STREET SUITE 14 HENDERSONVILLE TN 37075 Collection Service 2692716 92 X 10470085 7466206 17936291 PATIENT SERVICE REVENUE 621300 545792215 545792215 GRANT REVENUE 900099 5827798 5827798 SEMINAR/WORKSHOPS 621300 356754 356754 0 0 0 0 551976767 6903773 -84717 6988490 32422 32422 1423058 1423058 0 1423058 1423058 318271078 440088 290965914 437394 27305164 2694 27307858 27307858 CAFETERIA VENDING 722210 2902109 2902109 PHARMACY 446110 3871595 3813009 58586 ANTENNA REVENUE 900099 72044 72044 5666952 3771952 0 1895000 12512700 618092869 559561728 45913 40548937 0 0 3930442 3930442 236037052 189750119 46286933 4837051 4172522 664529 41377181 33237441 8139740 15391290 12313032 3078258 972012 777610 194402 411990 411990 358450 358450 0 0 1117458 1117458 50763790 40641697 10122093 0 4519325 3615460 903865 60891429 48713143 12178286 28478826 22783061 5695765 1231643 985314 246329 12402586 9922069 2480517 35305419 28244335 7061084 12888264 10310611 2577653 BAD DEBTS 18536842 14829474 3707368 MEDICAL ASSISTANCE TAX 6446064 5156851 1289213 DUES & SUBSCRIPTIONS 1844889 1475911 368978 RECRUITMENT 1023804 819043 204761 2271693 1817354 454339 0 541037500 429565047 111472453 0 -2632370 45555507 48199555 33340134 71143054 77975815 0 0 5167346 5537784 6303225 3615033 646678317 304443909 328592174 342234408 221565312 148653774 133157618 212476928 0 106145296 92288703 917641210 961678086 78615373 82821695 236975193 235424360 0 2664000 888000 63085942 67072359 381340508 386206414 X 437135079 481756882 68999838 62923183 30165785 30791607 536300702 575471672 917641210 961678086 X 77055369 -20573809 -17310590 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true true 23000 false false false true 221500 false true 131654 376154 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY The organization conducts lobbying activities including research, monitoring legislation and attending meetings. In addition the organization pays dues to American Hospital Association and a portion of those dues are reported as lobbying expenditures. 2932156 2932156 281626551 138577105 143049446 26652915 9108271 17544644 280596421 156758533 123837888 54870274 0 54870274 342234408 ALTERNATIVE INVESTMENTS 86066173 F FIXED INCOME BOND FUND 98773474 F CORPORATE DEBT SECURITIES 10831976 F EQUITY SECURITIES 16805305 F 212476928 BOND ISSUE COSTS 2862863 BENEFICIAL INTEREST IN MIAMI CHILDREN'S HOSPITAL FOUNDATION 87439816 EXEC LIFE 391150 SELF INSURANCE TRUST 652083 Charitable Remainder Trust 942791 92288703 OTHER LIABILITIES 17874924 SWAP LIABILITIES 37770259 THIRD PARTY SETTLEMENT PAYABLE 6203964 LEASE INCENTIVE OBLIGATION 5223212 67072359 565292567 -20573809 8535905 -12037904 577330471 1117458 39644940 40762398 618092869 521380506 0 0 521380506 1117458 18539536 19656994 541037500 Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 CHANGE IN VALUE OF CHARITABLE REMAINDER TRUSTS - 1677289 CHANGE IN BENEFICIAL INTEREST OF HOSPITAL FOUNDATION - 6858616 Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements GAIN ON SALE OF FIXED ASSETS - 2694 BAD DEBT EXPENSE - 18536842 LOSS ON CHANGE IN VALUE OF SWAP AGREEMENT - 12352160 CHANGE IN BENEFICIAL INTEREST OF SYSTEM FOUNDATION - 8753244 Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statements Bad Debt Expense - 18536842 Gain on Sale of Fixed Asset - 2694 Central America and the Caribbean 0 0 Program Services Self-Insurance Funding 5467207 Central America and the Caribbean 0 0 Investments 62504431 Europe (Including Iceland and Greenland) 0 0 Investments 21758772 0 0 0 0 0 0 89730410 0 89730410 true false true false false false true true X true X true X true true false true true 419306 0 419306 0.0008 297110133 216153430 80956703 0.1496 5502223 4109163 1393060 0.0026 0 0 303031662 220262593 82769069 0.1530 1651552 105253 1546299 0.0029 13027993 8605471 4422522 0.0082 0 0 0 0.0 286263 207197 79066 0.0001 0 0 0 0.0 0 0 14965808 8917921 6047887 0.0112 0 0 317997470 229180514 88816956 0.1642 true 6511582 0 555750 929741 -373991 X true true MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC SURGERY CENTER 0.5435 0.0 0.4565 1 1 NICKLAUS Children's Hospital 3100 SW 62nd Avenue Miami FL 33155 WWW.NICKLAUSCHILDRENS.ORG 4067 X X X X X NICKLAUS Children's Hospital 1 false false true X X X X X X X X X 12 true false false true X WWW.NICKLAUSCHILDRENS.ORG X true 12 true https://www.nicklauschildrens.org/news-and-events/publications/community-health-needs-assessment.asp false false true X 2.0 4.0 X X X X true true X X true X X X true false X X X true X false false Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - NICKLAUS Children's Hospital. Focus Groups: External and Internal To ensure unbiased feedback when conducting the assessment, NCH engaged the Health Council of South Florida (HCSF) to coordinate a series of focus groups and surveys with both internal and external stakeholders. These stakeholders were chosen by their ability to prioritize community health needs and provide invaluable feedback to the hospital about how NCH is viewed in terms of its current strengths, weaknesses, any perceived barriers to providing care, as well as any potential or emerging opportunities for NCH to improve health outcomes for Miami-Dade County children. Four focus groups were conducted and two online surveys implemented to gauge perceptions of the role of NICKLAUS Children's Hospital in the community and to collect qualitative data from diverse individuals representing internal and external NICKLAUS Children's Hospital stakeholders. During each focus group, the same set of questions was asked to allow participants to express their position regarding children's health issues. All of these elements were considered in the prioritization of local pediatric health need. The groups were presented with Pediatric Health Care Indicators and asked to rank them in order of importance. Focus group discussion topics included: * Health Promotion and Prevention * Disease Prevention * Healthcare and Disease management * Navigation of the Healthcare System * Children's Quality of Life Issues To identify focus group participants whose feedback and recommendations would be most relevant to NCH's CHNA, the group worked to identify key community stakeholders and partners. Internal Stakeholders Focus Group: Eight (8) individuals participated in NCH's Internal Stakeholders Focus Group. The group was comprised of hospital administrative leaders, department representatives and members of the NCH Board of Directors. External Stakeholders Focus Group: Thirteen (13) organizations participated in the External Stakeholders Focus Group. The stakeholders included representatives of public, private and nonprofit organizations that play critical roles in the health and human services arena in Miami-Dade County. Community Leaders In addition to focus groups, the organization consulted with the following community leaders: -American Cancer Society: Berta Rios, PhD (Attended May 10, 2012 Focus Group) -Director of Disparity Outreach with a focus on patient services, early detection and prevention activities -American Heart Association: Chad Buschell (via online survey) -Executive Director and Vice President focusing on improving cardiovascular health in Greater Miami C-atholic Health Services: J. Abilio Rodriguez, PhD (Attended May 10, 2012 Focus Group) -Program Administrator for Catholic Health Services Centro Mater West Child Care Services -The Children's Trust: Modesto Abety (via online survey) -President and CEO with extensive experience in advocacy on behalf of children and families in South Florida -Collins Center for Public Policy: Leda M. Perez, PhD (via online survey) -Vice President of Health Initiatives and Director of the Florida Transparency Project -Dade Association of School Administrators: Delio Diaz (Attended May 10, 2012 Focus Group) -Executive Director of DASA with 35 years of services to Miami-Dade County Public Schools -Dan Marino Foundation: Susan Morantes (Attended May 10, 2012 Focus Group) -Vice President of Disability Services with focus on enhancing services available to children with special needs -Epilepsy Foundation: Karen Basha Egozi (via online survey) -Chief Executive Officer and tireless advocate of increased epilepsy awareness and funding -Florida Heart Research Institute: Tori Gabriel (via online survey) -Education and Prevention Director with a passion for cardiovascular morbidity and mortality prevention -Health Foundation of South Florida: Peter Wood (Attended May 10, 2012 Focus Group) -Vice President of Programs and Community Investments focused on primary care, oral health and prevention -March of Dimes: Marla Wilson (Attended May 10, 2012 Focus Group) -Executive Director and leader for Miami-Dade and Monroe County district -Miami-Dade County Health Department: Karen Weller (Attended May 10, 2012 Focus Group) -Chronic Disease Prevention Director overseeing health, worksite wellness, tobacco prevention, Healthy Start -Miami-Dade County Public Schools: Wilma Steiner and Deborah Montilla (Attended May 10, 2012 Focus Group) District Director, Comprehensive Health Services and District Director, Student Services -Miami-Dade Fire Rescue: Tyler Garcia (Attended May 10, 2012 Focus Group) -Emergency Medical Technician and advocate for improved health, wellness and greater access for children -Our Kids: Rebecca Linda (Attended May 10, 2012 Focus Group and distributed online survey to foster parents) -Advocating safe and permanent families for at-risk children in Miami-Dade and Monroe Counties Parents The third and fourth external focus groups were made up of a broad cross-section of parents that participate in Parent Advisory Groups of community-based organizations throughout South Florida, including the World Literacy Crusade's Girl Power program of Liberty City, the United Way's Center for Excellence in Early Education and Our Kids, Inc. Group demographics included: * Parents of both middle class and low-income children * Parents of children who are uninsured * Minority groups Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NICKLAUS Children's Hospital. Maternal and Infant Health - NCH will build a cutting-edge Advanced Pediatric Care Pavilion that will allow for more efficient and effective use of space on the NICKLAUS Children's Hospital campus, thereby enhancing the hospital's capability to serve the growing demands for pediatric subspecialty care in South Florida's only licensed specialty hospital setting and freestanding Level 1 Trauma Center for children. The Pavilion will include the Neonatal Intensive Care Unit (NICU) with 36 private rooms. The support will support parent rooming-in as well as full surgical support for pediatric specialties. The design is based on recognized practices for best outcomes in infants born with very low birth weights. Immunizations - NICKLAUS Children's Hospital provides influenza and other vaccines to twelve (12) Miami-Dade County Public Schools through the Health Connect in Our Schools (HCiOS) Program in collaboration with the Miami-Dade County Health Department. NCH provides vaccinations to special needs children referred by specialist health care providers. NCH has traditionally worked with impoverished communities to provide vaccination services to all children. NCH also provides vaccinations to children in order to comply with the Center for Disease Control's (CDC) Recommended Immunization Schedule for school entry. Hospital pediatricians participate in media programming via local television to promote the importance of getting vaccinated and the benefits of the Flu vaccine. NCH is collaborating with the Department of Health, Miami-Dade County Public Schools and the Children's Trust to find innovative ways to provide all children with necessary vaccinations and immunizations. Childhood Obesity Prevention and Nutrition Promotion - NCH believes in having a comprehensive plan to prevent chronic disease by focusing on nutrition and healthy lifestyles from birth through school age children. The EAT WELL TO STAY WELL program provides prevention and screening to teach children and parents the importance of good nutrition and health lifestyle. Entire families need to be involved in the raising of a child and this includes healthy nutrition for the whole family. Additionally, various hospital departments encourage healthy lifestyle initiatives. The Community Education Department offers community programming such as "Healthy Summer Snacks." This course provides instruction on how to create tasty summer snacks that are easy to prepare and healthy for the whole family. Samples of snacks as well as take-home materials with tips and recipes are available to participants. The Preventive Medicine Department through the Health Connect in Our Schools (HCiOS) Program provides obesity screenings for twelve (12) Miami-Dade County Public Schools. All children who are deemed to be overweight are invited to participate in an obesity and nutrition program. School nurses oversee the program, which encompasses physical activity, nutrition education and counseling. The NCH Health and Wellness Department promotes employee health and wellness by providing nutritional "lunch & learn" courses, a cardiovascular and strength training facility, personal training and massage therapy for stress relief. NCH has partnered with the YMCA to introduce an interactive gaming and sports program to enhance health and wellness through a multi-disciplinary methodology in a community base setting. The combined approach intervention includes a group of activities including interactive gaming, physical exercise, musculoskeletal assessment and psychological, behavioral and nutritional education. The program seeks to engage participants in learning and practicing behaviors that promote wellness and health. Pediatric Asthma - NCH is committed to improving discharge planning for asthma patients seen in the emergency room and urgent care centers to emphasize the importance of maintenance and follow-up, and also address potential household asthma triggers. The Urgent Care Centers within the Miami Children's Health-System are located in the communities to serve children with asthma. Evaluation of asthmatic episodes with associated treatment and plans of care are provided by Board Certified Pediatrics. Evaluation of continued need and effectiveness of rescue-reliever as well as controller medications is determined at time of visit. Anti-inflammatory medications are associated evaluated for benefit and relief of the acute strained respiratory air exchange during asthmatic exacerbations. Educational instructions to promote wellness including reduced exposure to environmental triggers such as pest control, chemical exposures and air quality emphasizing the elimination of second hand tobacco smoke exposure is provided. Additionally, the Health Connect in Our Schools (HCiOS) Program provides students with an interdisciplinary team of providers in Health-suites and classrooms to support and provide medical services to students with asthma. A Board Certified Pediatrician is on-staff who oversees the delivery of evaluation and care by Advanced Registered Nurse Practitioners for the formulation of individualized Asthma Care Plans and Asthma Action Plan tailored to meet the unique needs of the students. Upon identification of an asthmatic student, the nurse contacts the parent to determine if medications are prescribed, frequency of use and if medications will be administered during school hours. The nurses will review with the parents and students, known triggers and methods to eliminating or reducing exposure to asthma triggers; appropriate use of medications; access to medical care to ensure that the student is receiving appropriate and ongoing medical care; and referral to additional community resources as indicated. The Emergency Department at NCH is also committed to coordinated care for children affected by Asthma. The Emergency Department is trialing a new device for aerosolized nebulizers called the AeroEclipse II Breath Actuated Nebulizer (BAN). Current nebulizer devices administer a dosage of medication in approximately 15-20 minutes per 3 ml and the patient receives approximately 2% of the total dosage. The new system will approximately deliver 20% of the medication in about a 3 minute period. The use of this system will help with patient outcomes, decrease ambient loss of medication, decrease amount of time in the ED, and reduce admissions related to Asthma exacerbations. Insurance and Access to Care - NICKLAUS Children's Hospital is committed to ensuring that all children, regardless of their ability to pay, receive access to the best in pediatric care. The Eligibility Assistance Unit (EAU) is dedicated to coordinating services for uninsured and underserved children. The department has played a crucial role in helping children in the community obtain medical coverage. On a monthly basis the department helps 500+ children apply for an array of government funded programs; Medicaid, Medicaid SOC, Emergency Medicaid, Florida Healthy Kids. In partnership with the Centers for Medicare and Medicaid Services, (CMS) Connecting Kids to Coverage initiative, NCH actively works to ensure that families are given the opportunity to enroll children in government sponsored programs. NCH also provides school-based health and dental services to uninsured and underinsured children through the Health on Wheels program and Health Connect in Our Schools (HCiOS). The mobile dental and medical units visit Miami-Dade County Public Schools, Head Start Centers and various community sites. The goal of these programs is to reach the underserved children and establish a "medical home" for them, allowing for regular access to healthcare. NCH has invested $2.5 million dollars in a robust TeleHealth program. Over the next three years, we will be investing $6 million to the program that will integrate innovative TeleHealth technology, a global telemedicine command center with video-enabled mobile equipment, and mobile devices with an effective outreach strategy, in order to extend NCH's high-quality pediatric care beyond the hospital's walls. Focusing on promoting easier access and better care and with more effective management, NCH's TeleHealth project is expected to reduce the overall cost of care, ultimately resulting in healthier adults, lower long-term morbidity and mortality risks and a reduction in overall demand on the U.S. healthcare system. Project benefits are countless including: providing access to care in remote areas, improving access to specialists, keeping financial resources in local communities, improving home health care and remote monitoring, savings in time and travel related costs, improving collaboration among providers, improving accuracy of diagnoses/reduction of errors, and better access to medical education/training. Schedule H, Part V, Section B, Line 22 Facility , 1 Facility , 1 - Miami Children's Hospital. The PFS department will determine which patients are charity/uncompensated care patients by a verifiable process (as described briefly below). All insurance reimbursement is to be exhausted (i.e. apply for Medicaid) before charity care can be considered. No patient will be considered a charity/uncompensated care patient whose family income as applicable for the 12 months preceding the determination exceeds 200 percent of the current Federal Poverty Guidelines (published in the Federal Register) unless the amount of hospital charges due for the patient exceeds 25% of the annual family income. However, in no case shall the hospital charges for a patient whose family exceeds 4 (four) times the federal poverty level for a family of four to be considered charity. In order to determine if a patient qualifies under the above guidelines published by the Agency for Healthcare Administration (AHCA), an application for financial evaluation form must be completed and signed by the guarantor. For patients who qualify for financial assistance, amounts charged will not exceed the Amounts Generally Billed according to the organization's financial assistance policy. 8 Doral Outpatient Center 3601 NW 107th Avenue Doral FL 33178 Outpatient Center Dan Marino Outpatient Center 2900 S Commerce Parkway Weston FL 33331 Outpatient Center Palm Beach Gardens Outpatient Center 11310 Legacy Avenue Palm Beach Gardens FL 33410 Outpatient Center Miramar Outpatient Center 12246 Miramar Parkway Miramar FL 33025 Outpatient Center Miami Lakes Outpatient Center 15025 NW 77th Avenue3 Miami Lakes FL 33014 Outpatient Center Midtown Outpatient Center 3915 Biscayne Boulevard Miami FL 33137 Outpatient Center West Kendall Outpatient Center 13400 SW 120th Street Miami FL 33186 Outpatient Center Palmetto Bay Outpatient Center 17615 SW 97th Avenue Palmetto Bay FL 33157 Outpatient Center Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance The organization uses the cost to charge ratio in IRS Worksheet 2 to determine the cost of community benefits and financial assistance. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt expense is reported at cost using the cost to charge ratio. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization's financial statements do not include a footnote on "bad debt expense" or "allowance for doubtful accounts". The following summarizes the activity in the Hospital's allowance for bad debts for the year ended December 31, 2014: Balance at beginning of the year 8,182,858 Provision during the year 18,536,841 Accounts written off, net of recoveries (12,596,283) Balance at end of year 14,123,416 The Hospital's estimation of the allowance for bad debts is based primarily upon the type and age of the patient accounts receivable and the effectiveness of the Hospital's collection efforts. In addition, the Hospital provided charity care in the amounts of $298,000 and $605,000 for the years ended December 21, 2014 and 2013, respectively. Refer to the Hospital's annual report for all community benefits provided in addition to the foregoing. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs VARIETY CHILDREN'S HOSPITAL ("VCH") ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. VCH BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES. VCH EXPERIENCED LOSSES ($373,991 FOR 2014) DUE TO UNDERPAYMENT FOR THE TREATMENT OF MEDICARE PATIENTS. UNREIMBURSED MEDICARE COSTS REPRESENT A SIGNIFICANT VALUE THAT NONPROFIT HOSPITALS PROVIDE TO THE COMMUNITY AS THE HOSPITAL RELIEVES THE FEDERAL GOVERNMENT OF A FINANCIAL BURDEN WHEN IT PROVIDES ESSENTIAL HEALTHCARE SERVICES TO MEDICARE COVERED PATIENTS. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance The Hospital, in furtherance of its tax-exempt purpose, shall provide charity or discounted care to those patients ("Applicant") that are determined to be eligible through the Hospital's evaluation process. The evaluation process shall consider the Applicant's annual income, eligibility for insurance coverage through commercial or governmental sources and compare the expected healthcare expenditures at the Hospital to the Applicant's total annual income (This is commonly referred to as "medically indigent".). The Hospital shall use the current Department of Health and Human Services Poverty Guidelines, which are updated annually, to establish the eligibility criteria for charity or self-pay discounts. Eligibility will be determined through an evaluation process that will be completed without regard to the applicant's race, religion, ethnicity, national origin, citizenship, sex, pre-existing condition, physical and/or mental disabilities and will be accomplished in a HIPAA compliant manner. The applicant must have exhausted all efforts to obtain third party health insurance coverage from both commercial and governmental sources. Schedule H, Part VI, Line 2 Needs assessment Under direction of the Board of Directors, management strives to provide hope through advanced care for our children and families. The vision is to be where the children are. The hospital uses a quarterly operating calendar to develop programs and communicate goals, accomplishments and gaps in plans. NICKLAUS Children's Hospital participates in many community organizations that collectively strive to improve the health status of children. NCH has representation on The Children's Trust, the Miami Dade County Public Schools Wellness Committee, the Greater Miami Chamber of Commerce's Health and Bio-Science Committee and the Health Council of South Florida. Through our involvement with the Health Council, we consistently analyze data to identify unmet needs and serve in an advisory capacity assisting the Council to address health disparities. Additionally, our Preventive Medicine Program deploys a medical and dental van into underserved areas of the community. NCH has a robust mechanism to analyze health data. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance NICKLAUS Children's Hospital has a financial assistance program to assist patients that are uninsured or underinsured and to be given the opportunity to apply for various programs. With the patient/family general consent form, financial agreement for professional services form, and a coordination of benefits form, patients/families are provided referral to an eligibility assistance counselor who will explain various programs offered. Signage is posted at each location instructing patients/families to contact Patient Financial Services to facilitate their payment. Financial counselors from the Patient Financial Services Department are available to process billing to insurance carriers when applicable, and explain statements and charges to the financially responsible parties. Schedule H, Part VI, Line 4 Community information NICKLAUS Children's Hospital - the flagship of Miami Children's Health System - primarily serves the pediatric population of Miami-Dade County. Approximately 587,000 people under the age of 18 reside within the county. In 2014, 72 percent of the health system's patient population was funded by Medicaid. Miami-Dade is comprised of a diverse mixture of residents and visitors, making it one of the most international communities in the nation. According to the 2010 census, the county led the nation in foreign-born residents, at 52 percent, with 66 percent of the population comprised of individuals of Latin or Hispanic descent and 71 percent reporting a language other than English spoken in the home. Classifying the hospital's inpatient population using Experian's MOSAIC segmentation tool, 35 percent of the customer base fits into the Group I: Family Union profile: predominantly Hispanic families living in middle-class comfort within the tri-county area. The hospital also serves children from throughout Florida (patients from the 67 counties in the state have been served by the hospital) and the southeast who come seeking subspecialty expertise, as well as international patients from 75 countries. The health system, through its network of eight outpatient centers, also provides services within Broward and Palm Beach counties. The three Broward/Palm Beach centers offer subspecialty physician consultations, urgent care, imaging and outpatient rehabilitation services. According to the latest drive-time trade area analysis conducted in 2013, average drive time to the main hospital was 35 minutes, with a maximum drive-time of two hours for subspecialty care. Schedule H, Part VI, Line 5 Promotion of community health A majority of the Board of Directors is comprised of persons who live in Miami-Dade County , who are neither employees nor independent contractors of the Hospital, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in the community and applies surplus funds to improvements in patient care, medical education and research. In addition, NICKLAUS Children's Hospital has an active community education program, various camp programs including asthma, diabetes, cancer center, psychiatric programs, early intervention program, preventative medicine program, dental mobile program, after hours program, healthy connections program, medical education residency program, pediatric post graduate program, fellowship programs, pediatric care call program, multiple ambulatory care centers all designed to promote health in the community. Schedule H, Part VI, Line 6 Affiliated health care system nicklaus Children's Hospital - the flagship of Miami Children's Health System - primarily serves the pediatric population of Miami-Dade County and is a leading provider of healthcare services for medically needy children. In addition, the hospital is proud to be the largest provider of pediatric medical education in the southeastern United States. NICKLAUS Children's Hospital provides primary care and a medical home to the Medicaid population through its Pediatric Care Center located on the hospital's main campus. The hospital also provides dental services through its Pediatric Dental Residency program. NICKLAUS Children's Hospital also houses Early Steps Southernmost Coast, an early intervention program for children at risk of developmental delays. The program evaluates over 2,000 children annually. NICKLAUS Children's offers primary care services to needy children through the Health Connect in Our Schools program. The hospital provides nursing staff for school-based clinics situated in high-risk communities to ensure that children have access to care. NICKLAUS Children's Hospital's Brain Institute is the first and largest pediatric neuroscience collaboration in the nation. The program is recognized for excellence in treatment of children with brain tumors, intractable epilepsy and other brain anomalies, and offers the latest minimally invasive methods, including Visualase, an image-guided laser technique for epilepsy surgery in children. The Heart Program at NICKLAUS Children's Hospital provides care for more children with congenital heart disorders than any other hospital in Florida. It is consistently ranked among the best programs in the nation for cardiology and heart surgery. NICKLAUS Children's Hospital's Cancer Center is the largest provider of pediatric cancer services in the region. The center participates in research protocols, offering the latest interventions for children receiving treatment for all forms of cancer and blood disorders. NICKLAUS Children's LifeFlight Critical Care Transport team provides transport of critically ill children from referring hospitals to NICKLAUS Children's Hospital critical care units. X true true X X X X false true false false false false false false false Jefry Biehler MD Secretary / Director 317987 0 14981 0 2292 0 7491 0 27145 0 369896 0 0 0 Narendra Kini MD President and CEO 728809 0 469952 0 128264 0 158537 0 31498 0 1517060 0 0 0 Deise Granado-Villar MD Director and CMO 322265 0 113640 0 7420 0 56863 0 13815 0 514003 0 0 0 Marcos Mestre MD Physician / Director 200566 0 64442 0 16225 0 6199 0 25729 0 313161 0 0 0 Lucy Morillo-Agnetti Foundation President / Director 0 261878 0 19250 0 17575 0 7800 0 19337 0 325840 0 0 Timothy Birkenstock Senior VP and CFO 376824 0 63764 0 20689 0 66672 0 20218 0 548167 0 0 0 Martha McGill Executive VP and COO 421642 0 117112 0 22482 0 75040 0 31879 0 668155 0 0 0 Redmond P Burke MD Cardiovascular Surgery Director 1485247 0 186398 0 2215 0 7800 0 32460 0 1714120 0 0 0 Sandeep P Dave MD Attending Physician 387585 0 464841 0 17845 0 7800 0 8824 0 886895 0 0 0 Robert L Hannan MD Cardiovascular Surgeon 986511 0 0 0 3707 0 7800 0 32758 0 1030776 0 0 0 John Ragheb MD Attending Physician 1121042 0 0 0 1344 0 7800 0 27015 0 1157201 0 0 0 Harry Shufflebarger MD Orthopaedic Surgeon 1135459 0 0 0 3247 0 7800 0 34757 0 1181263 0 0 0 Schedule J, Part I, Line 1a Housing allowance or residence for personal use An allowance was provided to the President and CEO, Narendra Kini, for moving and housing expenses. The benefit was treated as taxable compensation to him. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The following contributions were made to a Section 457(f) plan during the year - Narendra Kini - $150,737 Timothy Birkenstock - $58,872 Deise Granado-Villar - $49,063 Martha McGill - $67,240 A Miami-Dade County Health Facilities Authority 521293036 59334NCF7 2011-08-01 25504962 Refund issue dated 4/17/2008 false false false B Miami-Dade County Health Facitilites Authority 521293036 59334NCE0 2010-12-22 107784753 Refund 2006 bond issue and new project false false false C Miami-Dade County Health Facilities Authority 521293036 59334NDD1 2013-08-01 107788754 Refund 2006 and 2008 bond issues false false false A 0 0 25504962 0 0 0 504962 0 0 0 25000000 0 2011 true false true true B 5090000 108381821 1 0 0 2155695 0 0 17397265 41925000 46903861 true false false true C 1000000 0 107788754 0 0 0 1488754 0 0 0 106300000 0 2013 true false true true A false true true true false 0.011 0.0 0.011 false false 0.0 true B false true true true false 0.006 0.0 0.006 false false 0.0 true C false true true true false 0.026 0.0 0.026 false false 0.0 true A false true false false false false 0.0 false 0.0 false true B false true false false true false 0.0 true Bayerische Landesbank 2.0 true false true C false true false false false false 0.0 false 0.0 false true A true B true C true Schedule K, Part II, Line 3 Column B The difference between the issue price (listed in Part I) and the total proceeds (Part II, Line 3) is due to the investment earnings. Schedule K, Part IV, Line 6 Column B Such amounts were appropriately yield restricted. Schedule K, Part I, Column (f) Description Of Purpose Issuer name: Miami-Dade County Health Facitilites Authority Refund 2006 bond issue and new project Form 990, Part III, Line 4a CONTINUED PROGRAM DESCRIPTION (CONTINUED FROM PART III) IN 2014, 3,100 PATIENTS WERE TRANSFERRED FROM HOSPITALS THROUGHOUT FLORIDA, CENTRAL AND SOUTH AMERICA AND THE CARIBBEAN. WHEN CHILDREN NEED THE SERVICES OF A SPECIALIST, IT IS IMPORTANT THAT SUCH SERVICES BE PROVIDED BY A PRACTITIONER WITH SPECIFIC TRAINING AND EXPERTISE IN PEDIATRIC CARE. THE CARE OF CHILDREN WITH CERTAIN COMPLEX CHRONIC CONDITIONS, SUCH AS JUVENILE DIABETES, CANCER, OR CYSTIC FIBROSIS IS BEST MANAGED BY A PEDIATRIC SPECIALIST IN ORDER TO ELIMINATE REFERRAL DELAYS AND EXPEDITE POSITIVE TREATMENT. CHILDREN ARE MORE VULNERABLE TO COMPLICATIONS DUE TO DELAYS THAN ADULTS. THEY DEVELOP SERIOUS COMPLICATIONS MORE RAPIDLY THAN ADULTS BECAUSE THEY HAVE LESS PHYSIOLOGICAL RESERVES AND LESS DEVELOPED ORGAN SYSTEMS. THERE ARE PRESENTLY MORE THAN 200 PEDIATRIC SUBSPECIALTY PHYSICIANS GEOGRAPHICALLY LOCATED AT NICKLAUS CHILDREN'S HOSPITAL. PEDIATRIC SUBSPECIALTY AREAS INCLUDE: ADOLESCENT MEDICINE, ALLERGY/IMMUNOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, CLINICAL GENETICS AND METABOLISM, CRITICAL CARE MEDICINE, DENTISTRY, DERMATOLOGY, EMERGENCY MEDICINE, ENDOCRINOLOGY, GASTROENTEROLOGY, GENERAL PEDIATRICS, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEONATOLOGY, NEPHROLOGY, NEUROLOGY, PREVENTIVE MEDICINE, PSYCHIATRY, PULMONOLOGY, RHEUMATOLOGY, CARDIOVASCULAR SURGERY, NEUROLOGY, NEUROSURGERY, OPHTHALMOLOGY, ORTHOPEDIC SURGERY, OTOLARYNGOLOGY, PEDIATRIC SURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PATHOLOGY, RADIOLOGY, UROLOGY AND ANESTHESIOLOGY. THIS CRITICAL MASS OF PHYSICIANS SIGNIFICANTLY CONTRIBUTES TO THE QUALITY AND RANGE OF PEDIATRIC SERVICES AVAILABLE AT THE HOSPITAL. 2014 STATISTICAL DATA INCLUDES TOTAL INPATIENT DAYS: 60,359 TOTAL INPATIENT ADMISSIONS: 10,899 INPATIENT AVERAGE DAILY CENSUS: 165.4 TOTAL ED VISITS (MAIN CAMPUS): 91,465 NCH GENERAL CLINIC VISITS: 11,471 AMBULATORY VISITS: 85,526 PRIVATE OUTPATIENT VISITS (MAIN CAMPUS): 107,320 PRIVATE OUTPATIENT VISITS (AMBULATORY CENTERS): 150,951 TOTAL SURGICAL CASES: 14,817 AVERAGE LENGTH OF STAY: 5.5 DAYS THE HOSPITAL IS INTERNATIONALLY RECOGNIZED FOR CARE EXCELLENCE. NICKLAUS CHILDREN'S HOSPITAL PROGRAMS WERE RANKED AMONG THE NATION'S BEST IN NINE PEDIATRIC SUBSPECIALTY PROGRAMS SURVEYED BY U.S. NEWS AND WORLD REPORT IN ITS 2014-2015 LISTING OF "AMERICA'S BEST CHILDREN'S HOSPITALS." (RESULTS WERE RELEASED IN 2014.) THE HOSPITAL HAD MORE RANKED PEDIATRIC PROGRAMS THAN ANY OTHER HOSPITAL IN FLORIDA. CATEGORIES IN WHICH THE HOSPITAL WAS RANKED IN 2014 INCLUDE CARDIOLOGY AND HEART SURGERY; DIABETES AND ENDOCRINOLOGY; GASTROENTEROLOGY, NEONATOLOGY, NEPHROLOGY, NEUROLOGY/NEUROSURGERY, PULMONOLOGY, ORTHOPEDICS, UROLOGY. IN ADDITION, THE HOSPITAL SYSTEM INCLUDES A NETWORK OF AMBULATORY CENTERS THAT EXTEND CARE THROUGHOUT THE SOUTH FLORIDA REGION. DURING 2014, THESE CENTERS OFFERED OUTPATIENT SERVICES AS FOLLOWS: NCH DAN MARINO OUTPATIENT CENTER: OFFERS COMPREHENSIVE SERVICES FOR CHILDREN WITH NEURODEVELOPMENTAL DISORDERS. SERVICES INCLUDE IMAGING AND REHABILITATION. ALSO ON SITE IS A SWIMMING POOL FOR AQUATIC THERAPY. NCH DORAL OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. NCH MIDTOWN OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. NCH MIRAMAR OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. NCH PALMETTO BAY OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. ALSO ON-SITE IS EARLY STEPS SOUTHERNMOST COAST, A RESOURCE FOR CHILDREN UNDER THE AGE OF 3 WHO ARE AT RISK OF DEVELOPMENTAL DELAYS. NCH WEST KENDALL OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. NCH NICKLAUS OUTPATIENT CENTER (PALM BEACH GARDENS): OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. NCH MIAMI LAKES OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. Form 990, Part III, Line 4a CONTINUED PROGRAM DESCRIPTION QUALITY/SAFETY AND ERROR PREVENTION INITIATIVES FROM 2014 - THE HOSPITAL IS COMMITTED TO ADVANCING QUALITY AND SAFETY. INITIATIVES FOR 2014 ARE DETAILED BELOW: LEAN INITIATIVES: LEAN IS AN INTERNATIONALLY RECOGNIZED BUSINESS IMPROVEMENT MODEL. IN 2014, THE HOSPITAL CONTINUED TO UTILIZE LEAN METHODS TO IMPROVE PROCESSES THAT ENHANCE SAFETY, EFFICIENCY AND PREVENT ERRORS AT THE HOSPITAL. FROM 2008 TO 2014, THE HOSPITAL HAS SAVED $ 8.9 MILLION THROUGH LEAN-BASED EFFICIENCIES. FASTPASS SYSTEM: NICKLAUS CHILDREN'S HOSPITAL WAS ALSO AN EARLY ADOPTER OF FASTPASS VISITOR BADGE IDENTIFICATION TECHNOLOGY. ALL VISITORS MUST PRESENT PHOTO IDENTIFICATION UPON ARRIVAL AND A RECORD IS KEPT OF ALL THOSE ENTERING THE HOSPITAL. THIS SYSTEM CAN IDENTIFY INDIVIDUALS WITH RECORDS OF CHILD ABUSE AND MOLESTATION, HELPING ENHANCE THE SAFETY OF CHILDREN AT THE HOSPITAL. GETWELL NETWORK: SINCE 2009, THE HOSPITAL HAS OFFERED THE GETWELL NETWORK IN ALL MEDICAL SURGICAL ROOMS. THE SYSTEM, ACCESSIBLE THROUGH THE IN-ROOM TELEVISION SCREEN, OFFERS PATIENT EDUCATION INFORMATION THAT CAN SUPPORT ENHANCED PATIENT CARE AS WELL AS A PATIENT FEEDBACK SYSTEM, THROUGH WHICH FAMILIES CAN ADDRESS SAFETY CONCERNS. S.O.A.R. (FORMERLY LIFEWINGS): IN 2010, THE HOSPITAL BEGAN COLLABORATING WITH LIFEWINGS PARTNERS LLC TO TRAIN EMERGENCY DEPARTMENT STAFF, SURGEONS, ANESTHESIOLOGISTS, OR NURSES AND SUPPORT STAFF TO IMPLEMENT AVIATION-BASED SAFETY AND EFFICIENCY MEASURES AND CONTINUES TO DO SO. THE HOSPITAL WON AN OUTSTANDING INITIATIVE AWARD FROM TRAINING MAGAZINE FOR THIS SAFETY COLLABORATION AND CONTINUES TO USE THIS PROGRAM TO ENHANCE SAFETY AND QUALITY. CRITICAL CARE EXCELLENCE RECOGNITION: THE NICKLAUS CHILDREN'S HOSPITAL NEONATAL INTENSIVE CARE UNIT (NICU) AND PEDIATRIC INTENSIVE CARE UNIT (PICU) IN 2012 EACH RECEIVED A GOLD BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES (AACN). IN ADDITION, THE HOSPITAL'S CARDIAC INTENSIVE CARE UNIT (CICU) RECEIVED AACN'S SILVER BEACON AWARD FOR EXCELLENCE. NCH IS ONE OF ONLY THREE CHILDREN'S HOSPITALS IN THE NATION TO BE AWARDED GOLD- AND SILVER-LEVEL BEACON AWARDS FOR ALL OF ITS ICUS AND THE ONLY CHILDREN'S HOSPITAL IN FLORIDA TO RECEIVE THIS DISTINCTION. THIS RECOGNITION PUTS NCH AMONG THE TOP CHILDREN'S HOSPITALS IN THE COUNTRY AND DEMONSTRATES ORGANIZATIONAL COMMITMENT TO CRITICAL CARE EXCELLENCE. EMR: THE HOSPITAL HAS ACQUIRED A STATE-OF-THE-ART SYSTEM THAT WILL CAPTURE ALL PATIENT DATA, INCLUDING COMPREHENSIVE CARE RECORDS (RADIOLOGY, PHARMACY, REHABILITATION, OUTPATIENT AND INPATIENT) AS WELL AS REGISTRATION AND BILLING INFORMATION, ALL IN A COMPREHENSIVE SYSTEM. IN 2012, THE HOSPITAL WENT LIVE WITH THE NEW SYSTEM WHICH PROVIDES PHYSICIANS AND CAREGIVERS WITH ACCESS TO ALL MEDICAL DATA THROUGH A SECURE LOGIN SYSTEM FROM ANY PLACE AT ANY TIME, ENABLING THEM TO MAKE INFORMED DECISIONS WITH MAXIMUM EFFICIENCY. HUMPTY DUMPTY: NICKLAUS CHILDREN'S HOSPITAL HAS TAKEN THE LEAD IN DEVELOPING A TOOL TO PREVENT PEDIATRIC FALLS AND THEREBY ENHANCE SAFETY. AS OF 2014, THE TOOL WAS IN USE IN 1,130 HOSPITALS, INCLUDING FACILITIES IN EVERY U.S. STATE AS WELL AS IN EUROPE, THE MIDDLE EAST, HONG KONG, INDONESIA, JAPAN, THE PHILIPPINES, BERMUDA, CANADA, CARIBBEAN, US VIRGIN ISLANDS, CAYMAN ISLANDS, BRAZIL, AUSTRALIA AND NEW ZEALAND. THE PROGRAM IS ALSO IN USE BY EVERY BRANCH OF OUR U.S. MILITARY HOSPITALS THROUGHOUT THE WORLD. THIS FALL PREVENTION PROGRAM HAS BEEN IMPLEMENTED, TESTED AND PROVEN TO BE AN EFFECTIVE TOOL IN THE PREVENTION OF UNINTENTIONAL INJURY DUE TO FALLS. THE HUMPTY DUMPTY FALLS PREVENTION PROGRAM(TM) IS A COMPREHENSIVE PROGRAM AIMED AT IDENTIFYING PATIENTS WHO ARE AT RISK FOR FALLS AS WELL AS PREVENTING FALL EVENTS AND INJURIES. THIS PROGRAM WAS DEVELOPED BY AN INTERDISCIPLINARY GROUP OF FALLS EXPERTS DERIVED FROM NURSING, RESEARCH, REHABILITATION, QUALITY IMPROVEMENT, AND RISK MANAGEMENT. PROGRAM MATERIALS INCLUDE A VALIDATED FALLS RISK SCALE, AN INTERVENTION PROTOCOL, AND PATIENT EDUCATION INFORMATION. HYGREEN: IMPLEMENTATION OF XHALE INNOVATIONS' HYGREEN HAND HYGIENE SYSTEM IS ANOTHER WAY NICKLAUS CHILDREN'S HOSPITAL LEADS THE WAY IN PATIENT SAFETY. HYGREEN HELPS PREVENT INFECTIONS BY MONITORING AND REMINDING HEALTHCARE WORKERS TO WASH THEIR HANDS. A SENSOR SCANS NEWLY CLEANED HANDS AND SENDS A WIRELESS "ALL CLEAN" MESSAGE TO A BADGE WORN BY THE CAREGIVER. IN 2013, HYGREEN CONTINUED TO BE INTEGRATED INTO THE INFECTION CONTROL PROGRAM AND WAS IN USE IN MOST HOSPITAL UNITS. COMMUNITY TRAINING OUTREACH PROGRAMS. IN ADDITION, THE HOSPITAL SUPPORTS A NUMBER OF PROGRAMS THAT ENHANCE THE SKILLS AND WORK READINESS OF YOUNG PEOPLE AS WELL AS PROMOTE HEALTH AWARENESS. PROJECT VICTORY: THIS PROJECT IS A COOPERATIVE EFFORT BETWEEN NICKLAUS CHILDREN'S COMMUNITY AND VOLUNTEER RESOURCE PROGRAM AND THE COMMUNITY. TEENS WITH DISABILITIES ARE GIVEN THE OPPORTUNITY TO GAIN LIFE SKILLS THROUGH THE WORLD OF WORK. TWENTY STUDENTS ARE PROVIDED THREE HOURS OF WORK SERVICE PER DAY AT THE HOSPITAL DURING THE COURSE OF THE SCHOOL YEAR. THE STUDENTS GAIN VOCATIONAL EXPERIENCE WORKING IN THE HOSPITAL'S DIETARY DEPARTMENT, MAIL ROOM, VISITOR INFORMATION SERVICE AND OTHER DEPARTMENTS. HONORS AND EXECUTIVE INTERNSHIP PROGRAM, MIAMI DADE COUNTY PUBLIC SCHOOLS: HONORS AND EXECUTIVE INTERNSHIP PROGRAM, MIAMI DADE COUNTY PUBLIC SCHOOLS: EACH YEAR THE HOSPITAL ACCEPTS SEVEN STUDENTS WHO ARE SELECTED BY MIAMI-DADE COUNTY PUBLIC SCHOOLS TO PARTICIPATE IN HEALTHCARE INTERNSHIPS FOR ADVANCED STUDENTS. STUDENTS ARE PAIRED WITH A STAFF MEMBER AT THE HOSPITAL WHO MENTORS AND PROVIDES OVERSIGHT TO THE STUDENT. EACH STUDENT IS ASSIGNED A PROJECT TO BENEFIT A HOSPITAL DEPARTMENT AND RECEIVES A GRADE FROM THE SCHOOL SYSTEM FOR HIS OR HER WORK. KIDS AND THE POWER OF WORK (KAPOW): THIS PROGRAM IS A NATIONAL VOLUNTEER PROGRAM. THE HOSPITAL PARTICIPATES WITH MIAMI-DADE COUNTY PUBLIC SCHOOLS. HOSPITAL STAFF MEMBERS VOLUNTEER TO VISIT STUDENTS AT ONE OF TWO AREA PUBLIC ELEMENTARY SCHOOLS. THEY PRESENT AND PREPARE LESSONS FOR SECOND GRADE STUDENTS TO HELP CREATE A FOUNDATION FOR YOUNG STUDENTS, INTRODUCING THEM TO WORK AND RELATED CONCEPTS. EMPLOYEES DONATE ABOUT 200 HOURS OF TIME TO THE PROGRAM. IN 2011, THE HOSPITAL LAUNCHED A FREE EKG SCREENING PROGRAM AIMED AT PREVENTING SUDDEN CARDIAC DEATH AMONG STUDENT ATHLETES. SINCE THE PROGRAM'S INCEPTION, THE CARDIAC TEAM HAS PROVIDED MORE THAN 3,750 SCREENINGS AND IDENTIFIED SEVERAL CHILDREN WHO WERE AT RISK OF DEATH DURING SPORTS ACTIVITY DUE TO HIDDEN HEART DEFECTS. THE HOSPITAL ALSO MAKES AVAILABLE TO THE COMMUNITY FREE HEALTH INFORMATION THROUGH CONTRACTS WITH KIDSHEALTH AND ADAM, WHICH SUPPLY HEALTH CONTENT ON THE HOSPITAL'S WEBSITE. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee of the Board of Directors is composed of three (3) Directors elected by the Board of Directors, one of whom must be the Chair of the Board. No non-Director members shall serve on the Executive Committee. A majority of the members of the Executive Committee present and voting shall constitute a quorum for the transaction of business. The Executive Committee shall have and exercise the authority of the Board of Directors in the management of the Corporation. The Executive Committee shall report to the Board of Directors any action taken by the Executive Committee at the next meeting of the Board of Directors. Members of the Executive Committee may be removed at any regular or special meeting of the Board of Directors. Form 990, Part VI, Line 6 Classes of members or stockholders The organization's sole member is Miami Children's Health System, Inc. The sole member has the authority to elect members to the board of directors and approve decisions of the board. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The elected members of the Board shall be elected by Miami Children's Health System (the sole member), after taking into consideration any recommendations of the Board. The number of Directors of the Hospital shall be established by resolution of the Board of Directors of the sole member; provided that there shall be no fewer than 7 and no more than 20 Directors. Any Director may be removed from office by action of the sole Member or the elected members of the Board so permitted to vote, for any cause or reason deemed sufficient by the Member or the elected members of the Board so permitted to vote. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The Board shall not take any action with respect to the following without the approval of Miami Children's Health System (the sole Member): a) Modify the mission, purpose or scope of the hospital, or materially change the location, size or scope of services, programs, operations or educational or medical school affiliations of the hospital or related agreements; b) Create any entity in which the hospital is the sole member or sole shareholder, or any entity in which the hospital has a direct or indirect oversight role, which may include not-for-profit, for profit, limited liability companies, or any other legal entity; c) Sell, lease, purchase, create, dissolve, convey, mortgage, grant a security interest or otherwise dispose of any affiliated, controlled, or joint venture entity, any real or personal property or other assets (or any interest in any of the foregoing), or incur debt for money borrowed or guarantee the debt of another, not in the ordinary course of business; d) Approve annual operating or capital budgets, strategic and long-range plans, major fund-raising programs, physician compensation or other agreements, managed care contracts or other financial commitments or material deviations from such budgets, plans, agreements or commitments; and e) Approve financial, accounting, human resource, employee benefit, compliance policies or procedures, medical staff bylaws (including amendments) or other policies and procedures, or the appointment or engagement of auditors, legal counsel and consultants, which are in any way contrary to the policies and procedures adopted from time to time by the Member. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FOLLOWING DESCRIBES NICKLAUS CHILDREN'S HOSPITAL'S PROCESS FOR PROVIDING IT'S BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE MAILED TO FINANCE COMMITTEE OF NCH BOARD OF DIRECTORS FOR REVIEW AND COMMENT PRIOR TO REGULARLY SCHEDULED MEETING. 2. THE DRAFT TAX FORM 990 WILL BE REVIEWED WITH THE FINANCE COMMITTEE. 3. QUESTIONS WILL BE ANSWERED AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. 4. THE FINAL FORM 990 WILL BE POSTED ON THE NCH BOARD OF DIRECTOR'S WEB PORTAL. Form 990, Part VI, Line 12c Conflict of interest policy ALL NICKLAUS CHILDREN'S HOSPITAL EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE, ANNUALLY AND WHENEVER A CHANGE IN CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURE FORMS ARE FORWARDED TO THE COMPLIANCE DEPARTMENT BY THE TALENT MANAGEMENT AND EFFECTIVENESS DEPARTMENT. THESE FORMS ARE INITIALLY REVIEWED BY COMPLIANCE DEPARTMENT STAFF. WHEN DEEMED NECESSARY, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT. CONFLICTS OF INTEREST THAT NECESSITATE BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS AND BOARD-DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT THE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY THE HOSPITAL'S CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. Form 990, Part VI, Line 15a Process to establish compensation of top management official THE ORGANIZATION AND COMPENSATION COMMITTEE OF NCH BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. Form 990, Part VI, Line 15b Process to establish compensation of other employees THE ORGANIZATION AND COMPENSATION COMMITTEE OF NCH BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. Form 990, Part VI, Line 19 Required documents available to the public Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Miscellaneous - Total Revenue: 5666952, Related or Exempt Function Revenue: 3771952, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1895000; Form 990, Part XI, Line 9 Other changes in net assets or fund balances LOSS ON CHANGE IN FMV OF SWAP AGREEMENTS - -12352160; CHANGE IN CHARITABLE REMAINDER TRUSTS - 1677289; CHANGE IN BENEFICIAL INTEREST IN HOSPITAL FOUNDATION - 6858616; CHANGE IN BENEFICIAL INTEREST IN HEALTH SYSTEM FOUNDATION - -8753244; TRANSFER TO AFFILIATES - -4741091; MCH PEDIATRIC CARDIOLOGY LLC 3100 SW 62ND AVENUE MIAMI FL 33155 651023909 CADIAC SVC'S FL 3593571 -26005392 VCH MIAMI CHILDREN'S HOSPITAL PRPG LLC 3100 SW 62ND AVENUE MIAMI FL 33155 760724684 INSURANCE FL 0 0 VCH MIAMI CHILDREN'S HEALTH SYSTEM INC 3100 SW 62ND AVENUE MIAMI FL 33155 453481327 HEALTHCARE FL 501(c)(3 Type II N/A false MIAMI CHILDREN'S HOSPITAL FOUNDATION INC 3100 SW 62ND AVENUE MIAMI FL 33155 591720704 FUNDRAISING FL 501(c)(3 7 VCH false MCH RESEARCH INSTITUTE INC 3100 SW 62ND AVENUE MIAMI FL 33155 592602318 RESEARCH FL 501(c)(3 3 VCH true MCH WORKER'S COMPENSATION TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 597021572 WC CLAIMS FL 4947 (a)(1 VCH true VARIETY CHILDREN'S HOSPITAL PROFESSIONAL LIABILITY TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 592551434 LIAB. CLAIMS FL 4947 (a)(1 VCH true PEDIATRIC SPECIALTY GROUP INC 3100 SW 62ND AVENUE MIAMI FL 33155 453756071 EMPLOYED PHYSICIANS FL 501(c)(3 3 MCHS false MIAMI CHILDREN'S HEALTH SYSTEM FOUNDATION INC 3100 SW 62ND AVENUE MIAMI FL 33155 461784918 FOUNDATION FL 501(c)(3 7 MCHS false CANAVAN PARTNERS PO BOX 812170 BOCA RATON FL 334812170 650974245 MED. INTEL. PRO FL VCH Related 104000 0 false true 0.625 MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC 3100 SW 62ND AVENUE MIAMI FL 33155 463406805 SURGERY CENTER FL VCH Related 0 2671341 false 0 true 0.5435 MIAMI CHILDREN''S INSURANCE CO SPC LTD 720 WEST BAY ROAD PO BOX 69GT BUCKINGHAM SQUARE GEORGETOWN GRAND CAYMAN CJ 980442086 INSURANCE CJ VCH C Corporation 4700847 55041702 1 true CHILDREN''S HEALTH VENTURES INC & SUBS 3100 SW 62ND AVENUE MIAMI FL 331553009 454541147 MERCHANT WHOLESALE FL MCHS C Corporation false false false true false false false false false false false false true true true true false false true false