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PAYABLE 1683528 ACCRUED TAIL COVERAGE 35216 LONG TERM CAPITAL LEASE-SIEMENS 237850 INTERCO PAYABLE 35289 21470119 ASC 740 Footnote from Consolidated Audit Report CHS RECOGNIZES ANY BENEFITS FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. IF APPLICABLE, THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION WOULD BE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE RESOLUTION. CHS DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY UNCERTAIN TAX POSITIONS. SCHEDULE D, PART V ENDOWMENT FUNDS ARE USED ACCORDING TO SPECIFIC WRITTEN REQUESTS OF THE DONOR ENDOWMENT AGREEMENT. IF NO DIRECT REQUESTS ARE MADE, FUNDS ARE USED IN ACCORDANCE WITH THE OVERALL MISSION OF THE ORGANIZATION. 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OUTPATIENT SERVICES PART 1, LINE 3C N/A PART 1, LINE 6A N/A PART 1, LINE 7(G) THE AMOUNT REPORTED ON PART I, LINE 7(G) INCLUDES $27,766,354 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LINE 7(F) THE AMOUNT OF BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) THAT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSE IN PART I, LINE 7, COLUMN (F) IS $7,023,667. PART 1, LINE 7 A HYBRID APPROACH WAS USED FOR DETERMINING COSTS RELATED TO COMMUNITY BENEFIT. ACTUAL COSTS FROM ALL PATIENT SEGMENTS ARE IDENTIFIED BY DEPARTMENT IN THE GENERAL LEDGER AND THEN WERE GROUPED INTO LIKE COMMUNITY BENEFIT PROGRAMS. INDIRECT COSTS WERE ADJUSTED FOR COSTS ATTRIBUTABLE TO UNREIMBURSED MEDICAID COSTS REPORTED ELSEWHERE, MARKETING AND GRANT WRITING EXPENSES. THE MEDICAID COSTS ADJUSTMENT WAS CALCULATED USING A COST TO CHARGE RATIO OF APPLICABLE EXPENSES DIVIDED BY TOTAL APPLICABLE CHARGES APPLIED TO MEDICAID REVENUE. THE REMAINING INDIRECT COSTS WERE ALLOCATED PROPORTIONATELY TO THE DIRECT COSTS REPORTED BY DEPARTMENT. IN ADDITION, EXPENSES WERE CALCULATED AT COST AND THEN COSTS RELATED TO CHARITY CARE, BAD DEBT AND MEDICAID WERE REMOVED BEFORE ARRIVING AT THE AMOUNTS FOR COMMUNITY BENEFIT AT COST. PART III, LINE 4 BAD DEBT REPORTED IN PART III, SECTION A IS CALCULATED BASED ON THE HOSPITAL'S OVERALL COST TO CHARGE RATIO. THE RATIO WAS CALCULATED BY DIVIDING APPLICABLE CHARGES RECORDED FOR ALL PATIENTS INTO APPLICABLE EXPENSES REQUIRED TO PROVIDE THAT CARE. CHKD DOES NOT MAINTAIN RECORDS THAT TRACK PATIENTS WHO COULD HAVE QUALIFIED FOR CHARITY CARE. THE AMOUNT REPORTED IN PART III LINE 3 WAS CALCULATED USING A COST TO CHARGE RATIO. THIS AMOUNT IS AN ESTIMATE OF PATIENTS WHO LIKELY WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO DETERMINE THEIR ELIGIBILITY. THE AUDITED FINANCIAL STATEMENTS AND RELATED FOOTNOTES FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS DO NOT CONTAIN FOOTNOTES RELATED TO BAD DEBT EXPENSE. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING RECEIVABLES. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE, NET OF PAYMENTS AND DISCOUNTS, AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR THE RECOVERY IS CONSIDERED REMOTE. PART III, LINE 8 AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE SHORTFALL WAS CALCULATED USING THE HOSPITAL'S OVERALL COST TO CHARGE RATIO APPLIED TO MEDICARE GROSS CHARGES. THIS SHORTFALL IS NOT SEPARATELY INCLUDED AS A COMMUNITY BENEFIT AS 100% OF IT HAS ALREADY BEEN CAPTURED IN THE APPROPRIATE CATEGORY ON PART I, LINE 7. PART III, LINE 9B ACCOUNTS WITH AN UNPAID BALANCE OR WITHOUT AN ESTABLISHED PAYMENT PLAN ARE REFERRED TO A COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION EFFORTS. CHKD MAKES REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE/CHARITY CARE BEFORE REFERRING TO A COLLECTION AGENCY OR AN ATTORNEY. REASONABLE EFFORT INCLUDES AND IS NOT LIMITED TO NOTIFICATION ABOUT THE FINANCIAL ASSISTANCE - CHARITY CARE/COLLECTION POLICY POSTED IN ADMISSIONS, EMERGENCY DEPARTMENT OR OTHER DESIGNATED AREAS. THE INFORMATION REGARDING THE POLICY IS INCLUDED IN THE ADMISSION PACKAGE AND ON THE PATIENT BILL. THE HEALTH BENEFITS ANALYST AND CUSTOMER SERVICE REPRESENTATIVE WHO MAY SPEAK WITH THE GUARANTOR BY PHONE PROVIDE THEM WITH FINANCIAL ASSISTANCE INCLUDING CHARITY CARE INFORMATION. THE FINANCIAL ASSISTANCE-CHARITY CARE/COLLECTION POLICY IS AVAILABLE UPON REQUEST AND VIA WWW.CHKD.ORG. CHKD ENSURES ALL COLLECTION PROTOCOLS ARE MET PRIOR TO REFERRAL TO COLLECTIONS AGENCY OR ATTORNEY. APPROVED CHARITY CARE AMOUNT WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES. THE REMAINING BALANCE WILL BE SUBJECT TO CHKD'S STANDARD COLLECTION PROTOCOLS. NEEDS ASSESSMENT: CHKD USES A VARIETY OF METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON-PROFIT AND PUBLIC HEALTH AGENCIES AND ORGANIZATIONS AND THROUGH REGIONAL, STATE AND NATIONAL DATA. AS THE ONLY HEALTHCARE PROVIDER IN VIRGINIA DEVOTED EXCLUSIVELY TO THE NEEDS OF CHILDREN, CHKD ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF PEDIATRIC CARE AND THE PROMOTION OF CHILDREN'S HEALTH AND IS TRUSTED THROUGHOUT ITS COMMUNITY AS A RESOURCE READY AND WILLING TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CHKD'S CHARITY CARE ELIGIBILITY CRITERIA AND PROCEDURES FOR APPLYING ARE PROVIDED TO ALL PATIENTS. PATIENTS WHO ARE ADMITTED ARE PROVIDED THE INFORMATION BY THE USE OF THE ADMISSION PACKET; PATIENTS WHO RECEIVE OUTPATIENT SERVICES ARE PROVIDED THE INFORMATION DURING THE REGISTRATION PROCESS. AN APPLICATION FOR CHARITY CARE, ALONG WITH A LETTER EXPLAINING THE PROCESS, SHALL BE SENT TO ANY PATIENT OR GUARANTOR WHO REQUESTS INFORMATION ON ANY PROGRAMS OR PROVISIONS THE HOSPITAL MAY HAVE TO HELP ASSIST PATIENTS OR GUARANTORS IN PAYING THEIR HOSPITAL BILL. THE CHARITY CARE POLICY AND APPLICATION IS AVAILABLE ON THE INTERNET AT WWW. CHKD.ORG AND AT EACH REGISTRATION WORKSTATION. ALL BILLING STATEMENTS MAILED TO GUARANTORS INCLUDE A NOTICE OF THE AVAILABILITY OF CHARITY AND HOW TO OBTAIN THE INFORMATION/APPLICATION. ASSISTANCE WITH THE APPLICATION PROCESS IS AVAILABLE THROUGH THE HEALTH BENEFITS ANALYST (HBA). THE HBA SENDS OUT APPLICATIONS VIA MAIL AND REFERS FAMILIES TO THE HOSPITAL'S WEBSITE. THE UNIT SOCIAL WORKER IS AVAILABLE TO PROVIDE INFORMATION OR REFERRAL TO THE HBA DURING AN INPATIENT STAY. COMMUNITY INFORMATION: CHKD IS THE REGIONAL PEDIATRIC REFERRAL CENTER FOR SOUTHEASTERN VIRGINIA, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA--A SERVICE AREA OF NEARLY 2 MILLION PEOPLE, APPROXIMATELY 460,000 OF WHOM ARE UNDER THE AGE OF 19. THIS SERVICE AREA COMPRISES A DIVERSE MIX OF URBAN, SUBURBAN AND RURAL COMMUNITIES, AS WELL AS 10 MILITARY INSTALLATIONS. CHKD IS WELL-VERSED IN THE SPECIAL NEEDS OF MILITARY FAMILIES AND HAS ONE OF THE HIGHEST TRICARE PAYOR PERCENTAGES AMONG THE CHILDREN'S HOSPITALS IN THE NATION. THE SOUTHEASTERN VIRGINIA REGION IS MADE UP OF EIGHT CITIES COLLECTIVELY KNOWN AS HAMPTON ROADS: NORFOLK, VIRGINIA BEACH, CHESAPEAKE, HAMPTON, NEWPORT NEWS, PORTSMOUTH, SUFFOLK AND WILLIAMSBURG. HAMPTON ROADS IS THE 39TH-MOST POPULOUS REGION IN THE COUNTRY, ACCORDING TO THE 2010 CENSUS. MORE THAN 35 PERCENT OF THE REGION'S HOUSEHOLDS HAVE CHILDREN AND APPROXIMATELY 30 PERCENT OF THE POPULATION IS UNDER THE AGE OF 19. THE POVERTY RATE IN HAMPTON ROADS WAS 11.7 PERCENT IN 2011, UP FROM 10.6 PERCENT IN 2010. BASED ON FEDERAL GUIDELINES, 17.4 PERCENT OF CHILDREN IN CHKD'S SERVICE AREA LIVE BELOW THE POVERTY LEVEL. THE UNEMPLOYMENT RATE WAS APPROXIMATELY 6.83 PERCENT IN HAMPTON ROADS. PROMOTION OF COMMUNITY HEALTH CHKD PLAYS A UNIQUE ROLE IN ITS COMMUNITY BY PROVIDING PEDIATRIC HEALTHCARE SERVICES THAT NO ONE ELSE OFFERS AND, AT THE SAME TIME, SERVING AS THE SAFETY NET PROVIDER TO THE REGION'S INDIGENT CHILDREN. IN 2012, 56 PERCENT OF CHKD'S INPATIENT DAYS WERE COVERED BY MEDICAID. THE VIRGINIA HOSPITAL WITH THE SECOND-LARGEST MEDICAID PATIENT LOAD WEIGHS IN UNDER 30 PERCENT. AFFILIATED HEALTH CARE SYSTEM: CHKD IS PART OF CHILDREN'S HEALTH SYSTEM, A 501 (C)(3) ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CHKD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS ARE USED TO MEET THE NEEDS OF THE ORGANIZATION AS DETERMINED BY CHKD SENIOR MANAGEMENT AND THE CHS BOARD OF DIRECTORS. HISTORICALLY, SURPLUS FUNDS HAVE BEEN USED FOR A VARIETY OF PURPOSES INCLUDING PATIENT CARE PROGRAMS, CAPITAL IMPROVEMENT NEEDS, RESERVES, ETC. ROLES OF ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED: THE CHILDREN'S HEALTH SYSTEM IS COMPRISED OF SEVERAL ORGANIZATIONS. CHKD PROVIDES INPATIENT AND AMBULATORY CARE SERVICES ACROSS MANY PEDIATRIC SPECIALTIES, INCLUDING A HIGH PERCENTAGE OF NEONATAL AND PEDIATRIC INTENSIVE CARE SERVICES. OTHER ENTITIES UNDER THE CHILDREN'S HEALTH SYSTEM UMBRELLA INCLUDE: * CHILDREN'S HEALTH FOUNDATION, WHICH RAISES FUNDS, MANAGES INVESTMENTS AND FUNDS EDUCATION, RESEARCH AND OTHER PROGRAMS FOR CHILDREN'S HEALTH SYSTEM * CHILDREN'S MEDICAL GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC PHYSICIAN PRACTICES * CMG OF NORTH CAROLINA, INC., A NORTH CAROLINA STOCK CORPORATION, WHICH OWNS AND OPERATES A PEDIATRIC PHYSICIAN PRACTICE IN NORTHEASTERN NORTH CAROLINA * CHILDREN'S SURGICAL SPECIALTY GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC SURGICAL SUBSPECIALTY PRACTICES, INCLUDING PEDIATRIC GENERAL SURGERY, PEDIATRIC UROLOGY, PEDIATRIC CARDIAC SURGERY, PEDIATRIC ORTHOPEDIC SURGERY AND SPORTS AND ADOLESCENT MEDICINE, PEDIATRIC NEUROSURGERY AND PEDIATRIC PLASTIC SURGERY. * CHSIL, A CAPTIVE INSURANCE COMPANY INCORPORATED IN BERMUDA, WHICH PROVIDES COMMERCIAL GENERAL LIABILITY COVERAGE FOR CHS AND ITS SUBSIDIARIES AND MEDICAL PROFESSIONAL LIABILITY COVERAGE FOR NON-PHYSICIAN PRACTITIONERS EMPLOYED BY CHS AND ITS SUBSIDIARIES. STATE FILING OF COMMUNITY BENEFIT REPORT: CHKD FILES A COMMUNITY BENEFIT REPORT IN VIRGINIA. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI VA, X true true X X X X false true false false false false false true false MICHELLE BRENNER MD 0 187093 0 0 0 129 0 7557 0 6508 0 201287 0 0 JAMES D DAHLING 0 715387 0 242000 0 116154 0 629184 0 38132 0 1740857 0 47105 SUZANNE STARLING 189886 0 0 0 15897 0 7799 0 13164 0 226746 0 0 0 JOHN HAMILTON 187878 0 39790 0 9366 0 17311 0 23546 0 277891 0 0 0 JAMES DICE 133214 0 11949 0 30968 0 5955 0 20095 0 202181 0 0 0 MICHAEL FACKELMANN 167686 0 0 0 7013 0 5934 0 6992 0 187625 0 0 0 ARNO ZARITSKY 400392 0 82800 0 17150 0 168303 0 22422 0 691067 0 0 0 DAVID BOWERS 260022 0 53820 0 23015 0 295846 0 27168 0 659871 0 5898 0 JO-ANN BURKE 262294 0 55200 0 67217 0 116251 0 20887 0 521849 0 20600 0 JOANN ROGERS 299522 0 61870 0 27106 0 269579 0 20856 0 678933 0 13117 0 DENNIS RYAN 0 386519 0 91000 0 41193 0 212036 0 40817 0 771565 0 27176 JOSEPH HOOKS 128334 0 12880 0 28309 0 5920 0 16837 0 192280 0 0 0 MARTIN CASEY 0 0 0 0 176076 0 0 0 0 0 176076 0 0 0 SCHEDULE J, LINE 1: IN CONNECTION WITH A RETIREMENT PROGRAM, TAX GROSS-UP PAYMENTS ARE PROVIDED TO CERTAIN DIRECTORS WHOSE EMPLOYER FUNDED CONTRIBUTIONS ARE IMMEDIATELY TAXABLE, IN ORDER TO PROVIDE THEM WITH BENEFITS THAT ARE TAX-EQUIVALENT TO BENEFITS OF PARTICIPANTS WHOSE CONTRIBUTIONS ARE NOT IMMEDIATELY TAXABLE. SCHEDULE J, LINE 4B: CHILDREN'S HEALTH SYSTEM SPONSORS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("THE PLAN"). THE PLAN IS DESIGNED TO RETAIN EXECUTIVES IN POSITIONS ESSENTIAL TO THE SUCCESS OF CHILDREN'S HEALTH SYSTEM. JAMES DAHLING, DENNIS RYAN, ARNO ZARITSKY, JOANN ROGERS, DAVID BOWERS, JOHN HAMILTON AND JO-ANN BURKE PARTICIPATE IN THE PLAN. SCHEDULE J, LINE 7: OFFICERS AND VICE PRESIDENTS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET UP BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. DEPARTMENT DIRECTORS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET BY MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS. VA Small Business Financing Authority 541300845 928104KD9 2006-01-01 78000000 Revenue & Refunding Bonds false false false 1600 0 78904564 0 0 55467069 689744 0 0 22747751 0 0 2007 true false true true 0 true true false 0 false 0 false false Schedule K, Part II, Line 3 0 INVESTMENT EARNINGS ON PROJECT FUND ADDED $904,564 IN PROCEEDS WHICH ARE REFLECTED IN PART II, LINE 3, BUT ARE NOT A COMPONENT OF "ISSUE PRICE" UNDER THE DEFINITION OF SUCH TERMS IN THE TREASURY REGULATIONS. CHILDREN'S SPECIALTY GROUP FAMILY MEMBER IS DIRECTOR 10366498 PHYSICIAN SERVICES false CHILDREN'S MEDICAL GROUP MEMBERS SERVE CHKD & CMG 3295363 CORPORATE SUPPORT & RENTAL false CHILDREN'S SURGICAL SPECIALTY GROUP MEMBERS SERVE CHKD & CSSG 1697407 CORPORATE SUPPORT & RENTAL false X 60 46170 CASH ON SALE X 29 130626 AVG FMV ON DATE REC X VARIOUS IN-KIND ITEMS 1 1500 AVG FMV ON DATE REC X DOWN-PAYMENT ON AMBULANCE PURCHASE 1 40000 VALUE OF PAYMENT false true true Schedule M, Line 32A CHKD PAYS SYR, INC. MANAGEMENT FEES TO MANAGE THRIFT STORES FOR THE BENEFIT OF THE ORGANIZATION. CHKD ALSO PAYS TIDEWATER AUTO AUCTION TO AUCTION CARS FOR THE BENEFIT OF THE ORGANIZATION. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III FOR MORE THAN 50 YEARS, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) HAS BEEN THE ONLY FACILITY OF ITS KIND IN VIRGINIA, SERVING THE MEDICAL AND SURGICAL NEEDS OF CHILDREN THROUGHOUT THE STATE. ITS PRIMARY SERVICE AREA ENCOMPASSES GREATER HAMPTON ROADS, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA, A REGION THAT IS HOME TO APPROXIMATELY 460,000 CHILDREN. CHKD WAS ESTABLISHED AS AN 88-BED, NOT-FOR-PROFIT HOSPITAL IN 1961 BY THE KING'S DAUGHTERS, A WOMEN'S SERVICE ORGANIZATION DEDICATED TO THE HEALTH AND WELL BEING OF THE COMMUNITY'S INDIGENT CHILDREN. THE HOSPITAL HAS ALWAYS UPHELD THE CHARITABLE MISSION OF ITS FOUNDERS, AND IN FY 2012, 56 PERCENT OF ITS INPATIENT DAYS WERE COVERED BY MEDICAID. OVER THE PAST 50 YEARS, CHKD HAS GROWN INTO A 206-BED TEACHING HOSPITAL THAT IS THE HEART OF AN EXTENSIVE PEDIATRIC HEALTH CARE SYSTEM. TODAY, THAT SYSTEM PROVIDES COMPREHENSIVE MEDICAL CARE TO CHILDREN AT THE HOSPITAL AND MULTI-SERVICE HEALTH CENTERS IN VIRGINIA BEACH, NEWPORT NEWS AND CHESAPEAKE. ITS SERVICES INCLUDE EVERYTHING FROM WELLNESS AND PREVENTION INITIATIVES TO PRIMARY CARE, SURGERY AND REHABILITATION. MANY OF ITS UNIQUE SERVICES AND PROGRAMS ADDRESS PRESSING PUBLIC HEALTH NEEDS THAT WOULD OTHERWISE GO UNMET. AS THE PREMIER PROVIDER OF HEALTHCARE SERVICES TO THE REGION'S CHILDREN, CHKD HAS SECURED A PLACE IN THE HEART OF THE COMMUNITY. THE HOSPITAL IS AN EAGER COLLABORATOR WITH OTHER COMMUNITY ORGANIZATIONS AND INSTITUTIONS THAT SHARE ITS CONCERN FOR THE WELL BEING OF YOUNG PEOPLE AND OFFERS A VARIETY OF EDUCATION, RESEARCH AND HEALTH INITIATIVES TO IMPROVE THE HEALTH AND WELL BEING OF CHILDREN IN THIS COMMUNITY AND BEYOND. THE HEALTH SYSTEM'S PRIMARY SERVICES CENTER ON INPATIENT AND OUTPATIENT CARE, COMMUNITY OUTREACH PROGRAMS AND MEDICAL EDUCATION/RESEARCH. SECTION ONE: INPATIENT CARE CHILDREN WITH A VAST RANGE OF MEDICAL PROBLEMS, INCLUDING LIFE-THREATENING ILLNESSES AND INJURIES -- TURN TO CHKD FOR INPATIENT CARE. IN FY 2012, CHKD HAD 5,399 ADMISSIONS RESULTING IN 48,521 PATIENT DAYS. APPROXIMATELY 56 PERCENT OF THESE DAYS, WERE COVERED BY MEDICAID, WHICH IS THE HIGHEST PERCENTAGE BY FAR OF ANY ACUTE-CARE HOSPITAL IN VIRGINIA. CHKD HAS 206 INPATIENT BEDS, AND ALMOST HALF OF THOSE ARE FOR PEDIATRIC INTENSIVE CARE. THE HOSPITAL IS HOME TO THE REGION'S HIGHEST LEVEL NEONATAL INTENSIVE CARE UNIT (NICU), WHERE EACH YEAR CRITICALLY ILL NEWBORNS, SOME AS YOUNG AS 23 WEEKS GESTATION, BENEFIT FROM A UNIQUE COMBINATION OF ADVANCED MEDICAL TECHNOLOGY, DEVELOPMENTAL CARE AND FAMILY SUPPORT. THERE WERE 502 ADMISSIONS TO THE NICU IN FY 2012. THE HOSPITAL ALSO OPERATES A NEONATAL STEP-DOWN UNIT FOR BABIES FROM OUR NICU WHO REQUIRE A TRANSITIONAL PERIOD BEFORE BEING DISCHARGED HOME. THE REGION'S LARGEST AND MOST EXPERIENCED PEDIATRIC INTENSIVE CARE UNIT (PICU) IS AT CHKD. IN THIS UNIT, A FULL-TIME STAFF OF BOARD-CERTIFIED PEDIATRIC INTENSIVE CARE PHYSICIANS, CRITICAL CARE NURSES AND RESPIRATORY THERAPISTS PROVIDE EXTREMELY SOPHISTICATED, TECHNOLOGICALLY ADVANCED CARE TO CHILDREN WITH LIFE-THREATENING INJURIES AND ILLNESSES. MEDICAL CARE IS SUPPLEMENTED WITH SUPPORT FROM CHILD LIFE SPECIALISTS, SOCIAL WORKERS AND CHAPLAINS WHO HAVE EXTENSIVE EXPERIENCE HELPING FAMILIES THROUGH THE TRAUMA AND STRESS OF A SEVERE ILLNESS OR INJURY IN A CHILD. THERE WERE 1,182 ADMISSIONS TO OUR PICU IN FY 2012. MANY PATIENTS ARE BROUGHT FROM OTHER AREA HOSPITALS TO CHKD BY THE HOSPITAL'S NEONATAL/PEDIATRIC TRANSPORT PROGRAM, WHICH OPERATES OUT OF FOUR FULLY EQUIPPED MOBILE INTENSIVE CARE UNITS. TWO TRANSPORT TEAMS ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO ALL AREA MEDICAL FACILITIES THAT NEED TO SEND SICK OR INJURED CHILDREN TO CHKD. EACH TRANSPORT CALL IS ANSWERED BY A NEONATAL/PEDIATRIC CRITICAL CARE NURSE, A REGISTERED RESPIRATORY THERAPIST AND A CERTIFIED EMT PARAMEDIC TRAINED IN NEONATAL/PEDIATRIC CARE. IN FY 2012, THE TEAM TRANSPORTED 1,005 PATIENTS. OF THOSE, 338 WERE NEWBORNS COMING TO OUR NEONATAL INTENSIVE CARE UNIT. CHKD'S TRANSPORT SERVICE IS ALSO UNDER CONTRACT TO THE NAVAL MEDICAL CENTER, PORTSMOUTH, TO PROVIDE ALL NEONATAL AND PEDIATRIC MILITARY TRANSPORTS IN THE REGION. BESIDES GROUND TRANSPORT, THE TEAM ALERTS FIXED-WING AIR AND HELICOPTER TRANSPORTS WHEN MEDICALLY NECESSARY. CHKD OPERATES THE REGION'S ONLY ACUTE INPATIENT REHABILITATION UNIT EXCLUSIVELY FOR CHILDREN, WHERE YOUNG PATIENTS RECEIVE COMPREHENSIVE REHABILITATION SERVICES NEEDED TO REGAIN SKILLS LOST AFTER ACCIDENTS OR ILLNESSES. PRIOR TO THE OPENING OF THIS UNIT, FAMILIES HAD TO TRAVEL LONG DISTANCES OUTSIDE OF THE AREA TO RECEIVE THIS KIND OF CARE, WHICH USUALLY REQUIRES A HOSPITALIZATION OF SEVERAL WEEKS DURATION. ADMISSIONS TO THE INPATIENT REHABILITATION UNIT RESULTED IN 2,030 PATIENT DAYS IN FY 2012. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CHKD'S TRANSITIONAL CARE UNIT, WHERE TECHNOLOGY-DEPENDENT CHILDREN BEGIN THE PROCESS OF MOVING FROM THE HOSPITAL TO THEIR HOMES, PROVIDES DEVELOPMENTAL, EDUCATIONAL AND EMOTIONAL SUPPORT AS WELL AS HIGH ACUITY MEDICAL CARE AND PARENT/CAREGIVER SUPPORT AND EDUCATION. ADMISSIONS TO THIS UNIQUE UNIT RESULTED IN 3,340 PATIENT DAYS IN FY 2012. CHKD OPERATES THE REGION'S ONLY PEDIATRIC SURGERY PROGRAM, OFFERING YOUNG PEOPLE STATE-OF-THE-ART TREATMENT IN A SUPPORTIVE, NON-THREATENING ENVIRONMENT CREATED EXCLUSIVELY TO MEET THEIR NEEDS. IN FY 2012, SURGEONS PERFORMED 13,110 SURGERIES AT CHKD FACILITIES FOR A VAST RANGE OF PROBLEMS, FROM THE SIMPLEST OUTPATIENT PROCEDURES TO COMPLEX ORTHOPEDIC AND GENITOURINARY SURGERIES. (SEE OUTPATIENT SERVICES AND PROGRAMS FOR MORE INFORMATION OF CHKD'S SURGERY PROGRAM). CHKD EMPLOYS DOZENS OF PROFESSIONALS WHO PROVIDE EMOTIONAL, RECREATIONAL, SPIRITUAL AND PRACTICAL SUPPORT TO CHILDREN AND FAMILIES DURING HOSPITALIZATIONS. THE WORK OF THESE PROFESSIONALS COMPLEMENTS OUR EXPERT MEDICAL CARE TO CREATE A UNIQUE TREATMENT AND HEALING ENVIRONMENT FOR CHILDREN AND THEIR FAMILIES. OUR CHAPLAINCY SERVICES PROVIDE EMOTIONAL SUPPORT, PASTORAL CARE, ETHICAL REFLECTION, BEREAVEMENT RESOURCES/FOLLOW-UP AND SPIRITUAL GUIDANCE TO PATIENTS, FAMILIES AND STAFF WITH IN-HOSPITAL PRESENCE SEVEN DAYS A WEEK, WITH 24-HOUR ON-CALL AVAILABILITY. THE HOSPITAL EMPLOYS THREE FULL-TIME CHAPLAINS, ONE PART-TIME AND EIGHT PER-DIEM CHAPLAINS WHO REFLECT THE DIVERSITY OF THE COMMUNITY AND ARE PROFESSIONALLY TRAINED TO MEET THE VARIED SPIRITUAL NEEDS OF FAMILIES WITH RESPECT AND COMPASSION. THE CHAPLAINS ALSO FACILITATE EDUCATIONAL PROGRAMS FOR HOSPITAL STAFF AND PHYSICIANS, AS WELL AS PLANNING AND PARTICIPATING IN OUTREACH TO THE COMMUNITY. IN 2012, THE DEPARTMENT COORDINATED ITS ANNUAL BIOETHICS DAY PROGRAM WITH DISTINGUISHED PHYSICIAN, BEST-SELLING AUTHOR DR. ABRAHAM VERGHESE AS GUEST SPEAKER. THE HOSPITAL EMPLOYS 14 CHILD LIFE STAFF MEMBERS WHO HELP CHILDREN ADJUST AND COPE DURING HOSPITALIZATION. THEIR GOAL IS TO MAKE THE CHILD'S HOSPITAL EXPERIENCE AS NORMAL AS POSSIBLE BY DEVELOPING SUPPORTIVE RELATIONSHIPS WITH PATIENTS AND FAMILIES, PROVIDING AGE-APPROPRIATE PREPARATION FOR MEDICAL PROCEDURES, COPING STRATEGIES AND PLAY OPPORTUNITIES FOR CHILDREN TO RELIEVE STRESS. CHILD LIFE STAFF MEMBERS ALSO SCHEDULE AND FACILITATE COMMUNITY GROUP VISITORS TO THE HOSPITAL AND MANAGE APPROXIMATELY 100 VOLUNTEERS WEEKLY. THERE ARE FOUR POPULAR ACTIVITY AREAS THROUGHOUT THE HOSPITAL, PROVIDING HOSPITALIZED CHILDREN OPPORTUNITIES FOR SOCIALIZATION AND CREATIVE PLAY. CHILD LIFE SPECIALISTS WORK WITH CHKD'S VOLUNTEER SERVICES DIVISION TO MANAGE THE HOSPITAL'S POPULAR PET THERAPY PROGRAM, THE BUDDY BRIGADE, WHICH BRINGS VISITS OF DOG/HANDLER TEAMS TO THE HOSPITAL SEVERAL TIMES EACH WEEK. THEY ALSO MANAGE OUR VERY POPULAR DAVID WRIGHT VIDEO LIBRARY, WHICH PROVIDES HUNDREDS OF GAMES AND ENTERTAINMENT VIDEOS FOR HOSPITALIZED CHILDREN. CHILD LIFE STAFFERS COLLABORATE WITH SOCIAL WORKERS TO PROVIDE A PEDIATRIC INTENSIVE CARE UNIT SUPPORT GROUP FOR PARENTS AND SIBLINGS, AN ANNUAL INPATIENT TEDDY BEAR CLINIC, INPATIENT DEVELOPMENTAL SCREENINGS AND A POPULAR TEEN NIGHT ACTIVITY. CHKD'S DEPARTMENT OF SOCIAL WORK HELPS MEET SOCIAL, EMOTIONAL AND PSYCHOLOGICAL NEEDS THAT MAY ARISE WHEN A CHILD IS HOSPITALIZED OR WHEN AN EMERGENCY ARISES. OUR 24 LICENSED SOCIAL WORKERS ALSO WORK WITH CHILDREN IN OUR OUTPATIENT SPECIALTY CLINICS, ESPECIALLY THOSE CATERING TO CHILDREN WITH CHRONIC ILLNESSES. AMONG THE SERVICES OUR SOCIAL WORKERS PROVIDE ARE THE FOLLOWING: * COORDINATE REFERRALS AND ONGOING COMMUNICATIONS TO OTHER COMMUNITY RESOURCES. * FACILITATE SUPPORT GROUPS FOR CHKD FAMILIES DEALING WITH CHRONIC ILLNESS AND LOSS. * CONDUCT PSYCHOSOCIAL HISTORY AND MENTAL HEALTH ASSESSMENTS OF PATIENTS TO AID CAREGIVERS IN DEVELOPING TREATMENT PLANS . * HELP PATIENTS AND FAMILIES DEAL WITH SITUATIONAL CRISES. * WORK WITH FAMILIES AND CHKD'S ELIGIBILITY WORKERS TO COMPLETE APPLICATIONS FOR INSURANCE COVERAGE FOR MEDICAL CARE. * 24-HOUR PER-DIEM COVERAGE FOR NIGHTS, WEEKENDS, HOLIDAYS. SOCIAL WORKERS ALSO FACILITATE A VARIETY OF SUPPORT GROUPS THAT HELP PATIENTS AND FAMILIES CONNECT WITH OTHERS IN THE COMMUNITY WHO SHARE THEIR CHALLENGES. CHKD SPONSORS SUPPORT GROUPS FOR PATIENTS AND THEIR FAMILIES WITH HEART CONDITIONS, DIABETES, TURNER'S SYNDROME, PRADER-WILLI SYNDROME, CANCER AND SICKLE CELL. FAMILIES OF NICU PATIENTS MEET PERIODICALLY TO SHARE INFORMATION; AND OUR RECREATION-BASED GROUP FOR BROTHERS AND SISTERS OF CHILDREN WITH SPECIAL NEEDS, CALLED SIBSHOPS, MEETS REGULARLY TO SUPPORT SIBLINGS. THE DEPARTMENT OF SOCIAL WORK MANAGES THE HALO FUND OF DONATED MONIES TO ASSIST PARENTS AND PATIENTS WITH THE COST OF TRANSPORTATION, MEALS, MEDICATIONS AND SPECIFIC NEEDS AT DISCHARGE. THESE DONATED FUNDS MAY ALSO BE USED IN EMERGENCY SITUATIONS TO ASSIST WITH SPECIAL NEEDS, WHICH HAVE CONSISTED OF PARTIAL OR ONE-TIME PAYMENTS FOR UTILITY SERVICES NEEDED TO ENSURE THAT PATIENTS ARE DISCHARGED TO A HOME WITH A WAY TO SUPPORT THEIR MEDICAL NEEDS ON DISCHARGE. SOME OTHER EXAMPLES OF USAGES FOR THE FUNDS INCLUDE CORRECTIVE SHOES, HEARING AIDS OR OTHER ITEMS FOR FAMILIES WHO COULD NOT AFFORD THEM. THIS FUND HELPED MORE THAN 700 FAMILIES IN FY 2012. CHKD'S MEDICAL INTERPRETER PROGRAM EMPLOYS A PART-TIME CULTURAL LIAISON TO WORK WITH PATIENTS WHO HAVE LIMITED ENGLISH PROFICIENCY AND TO COORDINATE THE ASSESSMENT AND TRAINING OF MEDICAL INTERPRETERS. ELEVEN VOLUNTEER MEDICAL INTERPRETERS WHO ARE EMPLOYED IN VARIOUS POSITIONS THROUGHOUT THE ORGANIZATION ASSIST WITH TRANSLATIONS, AND SEVERAL DEPARTMENTS HAVE HIRED PROFESSIONAL STAFF MEMBERS WHO CAN ALSO FUNCTION AS INTERPRETERS IN THEIR AREAS. THIS HAS IMPROVED CUSTOMER SERVICE AND CONSISTENCY OF CARE. WHEN AN INTERPRETER IS NOT AVAILABLE ONSITE, THE ENTIRE CHKD HEALTH SYSTEM HAS ACCESS TO MEDICAL INTERPRETATION BY PHONE 24 HOURS A DAY. IN FY 2012, CHKD PROVIDED INTERPRETATION SERVICES FOR OUR LIMITED ENGLISH POPULATION THROUGH 3,565 ENCOUNTERS WITH PATIENTS AND FAMILIES AND BEGAN THE PROCESS OF ADAPTING TO MEET NEW JOINT COMMISSION STANDARDS FOR PATIENT CENTERED COMMUNICATION, CREATING A LANGUAGE SERVICES DEPARTMENT AND REVISING TRAINING AND PROFICIENCY TESTING METHODS AND STANDARDS FOR MEDICAL INTERPRETERS. AS THE REGIONAL PROVIDER OF PEDIATRIC CARE, CHKD IS AN INTEGRAL PART OF THE COMMUNITY'S NATURAL OR MAN-MADE DISASTER PLANNING EFFORTS. THE HEALTH SYSTEM RECOGNIZES THE IMPORTANCE OF A NATIONAL INCIDENT MANAGEMENT SYSTEM (NIMS) COMMUNITY INTEGRATED, ALL-HAZARD EMERGENCY OPERATIONS PLAN. THIS PLAN IS PREPARED, EXERCISED AND SHARED INTERNALLY AND EXTERNALLY WITH COMMUNITY EMERGENCY RESPONSE AGENTS. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS SECTION TWO: OUTPATIENT SERVICES AND PROGRAMS CHKD ALSO OFFERS THE COMMUNITY MANY IMPORTANT PEDIATRIC SERVICES ON AN OUTPATIENT BASIS. IN 2012, CHILDREN MADE MORE THAN 654,500 OUTPATIENT VISITS TO CHKD, ITS COMMUNITY-BASED HEALTH CENTERS AND AFFILIATED PHYSICIAN PRACTICES. THEY MADE 415,935 VISITS TO THE PRIMARY CARE PEDIATRICIANS OF CHKD'S MEDICAL GROUP, WHICH OFFERS CARE IN 25 LOCATIONS THROUGHOUT OUR SERVICE AREA. CHKD'S SURGICAL SPECIALTY GROUP MAKES THE SERVICES OF THE REGION'S ONLY PEDIATRIC GENERAL, UROLOGICAL, CARDIAC, NEUROSURGICAL, PLASTIC AND ORTHOPEDIC SURGEONS AVAILABLE TO THOUSANDS OF CHILDREN WHO MIGHT OTHERWISE HAVE TO TRAVEL OUTSIDE OF THE AREA FOR SURGERY. CHILDREN MADE 40,047 VISITS TO THE SURGICAL GROUP PRACTICES IN FY 2012. THE SURGEONS PERFORMED 5,481 SURGICAL CASES. THE HOSPITAL ALSO PROVIDES CARE TO CHILDREN FACING HEALTH CONDITIONS SUCH AS CANCER, GENETIC DISORDERS, OBESITY, HEART PROBLEMS, DEVELOPMENTAL DISABILITIES, ASTHMA/ALLERGIES AND DIABETES THROUGH MORE THAN 50 OUTPATIENT SPECIALTY CLINICS OFFERING SPECIALIZED PEDIATRIC CARE. IN FY 2012, CHILDREN MADE 150,511 VISITS TO OUR OUTPATIENT CLINICS. CHILDREN'S HOSPITAL WAS FOUNDED ON THE PREMISE THAT ALL CHILDREN DESERVE EQUAL ACCESS TO QUALITY PEDIATRIC CARE. AS OUR POPULATION GREW AND SETTLED INTO THE FAR CORNERS OF OUR BRIDGE AND TUNNEL-LACED REGION, TRAVEL TO CHKD'S MAIN FACILITY IN NORFOLK BECAME MORE OF A HARDSHIP FOR FAMILIES. TO EASE THAT BURDEN AND IMPROVE CHILDREN'S ACCESS TO CARE IN EVERY CORNER OF OUR SERVICE AREA, CHKD HAS ESTABLISHED THREE MULTI-SERVICE HEALTH CENTERS AND EIGHT SATELLITE SITES IN STRATEGIC LOCATIONS. * THE CHKD HEALTH AND SURGERY CENTER AT OYSTER POINT OFFERS FAMILIES WHO LIVE NORTH OF THE HAMPTON ROADS BRIDGE TUNNEL A WEALTH OF IMPORTANT SERVICES IN A CONVENIENT LOCATION. THE CENTER IS HOME TO THE REGION'S FIRST PEDIATRIC AMBULATORY SURGERY CENTER. OTHER SERVICES OFFERED AT THE SITE INCLUDE PRIMARY, SURGICAL AND SUB-SPECIALTY PEDIATRICS, LAB AND RADIOLOGY (INCLUDING ULTRASOUND AND MRI), AUDIOLOGY TESTING AND OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY. SPORTS MEDICINE PHYSICAL THERAPY, AQUATIC THERAPY AND CHILD ABUSE PROGRAM SERVICES ARE ALSO AVAILABLE THERE. * THE CHKD HEALTH CENTER AT OAKBROOKE SERVES FAMILIES IN CHESAPEAKE AND NORTHEASTERN NORTH CAROLINA. IT IS HOME TO A PRIMARY CARE PEDIATRIC PRACTICE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, X-RAY AND LAB SERVICES, A SPORTS MEDICINE GYM, SLEEP STUDIES UNIT AND THERAPY POOL, AS WELL AS CLINIC SPACE FOR A VARIETY OF PEDIATRIC SPECIALISTS AND SURGEONS PROVIDING EVALUATION, TREATMENT AND FOLLOW-UP. * THE CHKD HEALTH AND SURGERY CENTER AT PRINCESS ANNE SERVES THE GROWING MEDICAL NEEDS OF FAMILIES IN VIRGINIA BEACH. THE CENTER IS HOME TO VIRGINIA BEACH'S FIRST AMBULATORY SURGERY CENTER EXCLUSIVELY FOR CHILDREN. BEACH FAMILIES CAN ALSO FIND PRIMARY CARE PEDIATRICIANS AND IN-HOUSE LAB AND RADIOLOGY SERVICES, INCLUDING MRI, AT THE CENTER. OTHER SERVICES INCLUDE SPECIALTY CARE PEDIATRICS FOR HELP WITH CHRONIC PROBLEMS SUCH AS ASTHMA AND DIABETES, CHKD'S CHILD ABUSE PROGRAM AND PHYSICAL, SPEECH, OCCUPATIONAL AND SPORTS MEDICINE THERAPY. CHKD'S CHILD ABUSE PROGRAM COORDINATES THE REGION'S EFFORTS TO ACCURATELY IDENTIFY, TREAT AND PROTECT CHILDREN WHO HAVE BEEN ABUSED OR NEGLECTED. THE PROGRAM PROVIDES COMPREHENSIVE ASSESSMENT, EVALUATION AND TREATMENT SERVICES TO SUSPECTED VICTIMS OF ABUSE AND NEGLECT. THESE SERVICES INCLUDE FORENSIC INTERVIEWING, MEDICAL EXAMINATIONS AND CONSULTATIONS, WHICH INCLUDE 24/7 COVERAGE OF ACUTE SEXUAL ASSAULTS OF CHILDREN, AND AN ARRAY OF EVIDENCE-BASED MENTAL HEALTH SERVICES. THE PROGRAM ALSO HELPS COORDINATE THE EFFORTS OF INVESTIGATIVE AGENCIES INVOLVED IN THE INVESTIGATION AND PROSECUTION OF ABUSE. THE PROGRAM, WHICH IS ACCREDITED BY THE NATIONAL CHILDREN'S ALLIANCE, PROVIDED SERVICES TO 960 CHILDREN IN FY 2012. SERVICES ARE ALSO AVAILABLE AT CHKD'S OUTPATIENT CENTERS IN VIRGINIA BEACH AND NEWPORT NEWS. THE PROBLEM OF CHILDHOOD OBESITY POSES A SIGNIFICANT THREAT TO THE CURRENT AND FUTURE HEALTH OF OUR CHILDREN. IN RESPONSE TO THIS ALARMING PUBLIC HEALTH CRISIS, THE HOSPITAL PROVIDES A MULTI-DISCIPLINARY PEDIATRIC WEIGHT MANAGEMENT PROGRAM FOR CHILDREN BETWEEN 3 AND 16 YEARS OF AGE CALLED "HEALTHY YOU FOR LIFE". THE PROGRAM OFFERS CLINICAL AND PSYCHOSOCIAL EVALUATION AND PLANNING, ONGOING CLASSES TO HELP OVERWEIGHT YOUTH AND THEIR PARENTS MAKE LIFESTYLE CHANGES AND FOLLOW UP CLINICS FOR UP TO A YEAR. THE EXERCISE COMPONENT OF THE PROGRAM IS STRENGTHENED BY THE ADDITION THIS YEAR OF AN EXERCISE SPECIALIST WHO CONDUCTS PERSONAL TRAINING SESSIONS AS WELL AS GROUP FITNESS CLASSES FOR THE WHOLE FAMILY. EXERCISE OPPORTUNITIES LISTED ON OUR FITNESS CALENDAR ARE AVAILABLE WEEKDAYS AND WEEKENDS AROUND THE HAMPTON ROADS REGION TO ENHANCE A PATIENT'S ABILITY TO EMBRACE A HEALTHIER LIFESTYLE. WE ALSO HAVE A REGIONAL PARTNERSHIP WITH THE YMCA WHICH OFFERS FAMILIES A SIX-WEEK TRIAL MEMBERSHIP ONCE THEY HAVE COMPLETED THE EIGHT-WEEK LIFESTYLE CLASS. THE HEALTHY YOU FOR LIFE PROGRAM OFFERS INDIVIDUAL COUNSELING SESSIONS, USE OF MULTI-MEDIA COMMUNICATION SUCH AS E-MAILS AND TEXT MESSAGES AND NEW THIS FISCAL YEAR, WE HAVE INCLUDED A FACEBOOK PAGE AS A WAY TO KEEP CONNECTED WITH OUR PATIENTS AND ENCOURAGE POSITIVE LIFESTYLE CHANGES. ALMOST 750 CLINIC PATIENTS AND THEIR PARENTS PARTICIPATED IN THE PROGRAM IN FY 2012. CHKD'S DIABETES EDUCATION PROGRAM HELPS APPROXIMATELY 1,300 LOCAL CHILDREN WHO LIVE WITH THE CHRONIC DISEASE. TWO CERTIFIED DIABETES EDUCATORS, A SOCIAL WORKER, NURSE AND DEPARTMENT COORDINATOR HELP PATIENTS AND FAMILIES AT THE ONSET OF THE DISEASE AND UNTIL ADULTHOOD. THE DIABETES CENTER PROVIDES INPATIENT AND OUTPATIENT CLINICAL MANAGEMENT, DIABETES EDUCATION, SUPPORT GROUPS, AND PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS. A TRANSITION PROGRAM HELPS THE OLDER TEENS AND YOUNG ADULTS BEGIN TRANSFERRING CARE TO ADULT PROVIDERS IN THE COMMUNITY. THE CHILDREN'S CANCER AND BLOOD DISORDERS CENTER IS ONE OF THE HOSPITAL'S BUSIEST OUTPATIENT SPECIALTY CLINICS WITH 10,170 PATIENT VISITS IN FY 2012. THE PROGRAM PROVIDES CARE TO YOUNG PEOPLE WITH CANCER, SICKLE CELL DISEASE, BLEEDING AND OTHER BLOOD DISORDERS THROUGH TREATMENT PROGRAMS THAT ENCOMPASS CHILDREN'S PHYSICAL, EMOTIONAL AND EDUCATIONAL NEEDS AND INCORPORATES THE WHOLE FAMILY. THE REGION'S ONLY PEDIATRIC EMERGENCY CENTER IS LOCATED AT CHKD. IN 2012, CHILDREN MADE 47,998 VISITS TO OUR EMERGENCY CENTER. CHILDREN'S HOSPITAL OFFERS THE ONLY PEDIATRIC RENAL DIALYSIS SERVICE IN THE AREA. DIALYSIS IS A TIME-CONSUMING PROCESS AND CHILDREN APPRECIATE THE CHANCE TO HAVE THE SERVICE IN A SETTING WHERE THEY CAN MEET WITH FRIENDS THEIR OWN AGES AS WELL AS HOSPITAL SUPPORT STAFF AND SCHOOLTEACHERS. ONE MARK OF CHKD'S DISTINCTIVE PEDIATRIC CARE HAS ALWAYS BEEN CHILD-CENTERED DIAGNOSTIC SERVICES, SUCH AS RADIOLOGY AND LABORATORY. OVER THE PAST SEVERAL YEARS, CHKD HAS WORKED HARD TO MAKE THESE UNIQUE SERVICES MORE ACCESSIBLE TO FAMILIES THROUGHOUT OUR SERVICE REGION. THE HOSPITAL NOW HAS LABORATORIES IN ITS OYSTER POINT, PRINCESS ANNE AND OAKBROOKE HEALTH CENTERS AS WELL AS DRAW SITES AT PEDIATRIC PRACTICES IN NORFOLK AND WILLIAMSBURG. THE LABORATORY ALSO OPERATES A COURIER SERVICE THAT FACILITATES QUICK TURNAROUND OF SPECIMENS. OF THE 1,129,997 TESTS PERFORMED IN FY 2012, MORE THAN 63 PERCENT WERE FOR OUTPATIENTS. CHKD RADIOLOGY SERVICES ARE ALSO AVAILABLE TO FAMILIES AT OUR CHKD FACILITIES IN NEWPORT NEWS, CHESAPEAKE, SUFFOLK, NORFOLK AND VIRGINIA BEACH. THE RADIOLOGY DEPARTMENT IS A FULLY-INTEGRATED DIGITAL IMAGING CENTER THAT ALLOWS DIAGNOSTIC IMAGES AND REPORTS TO BE TRANSMITTED AND VIEWED ELECTRONICALLY. IN 2012, 86,438 DIAGNOSTIC EXAMS WERE PERFORMED, INCLUDING X-RAYS, FLUOROSCOPIC TESTS, URODYNAMICS AND BONE DENSITY TESTS, CT AND MRI SCANS, ULTRASOUND AND NUCLEAR MEDICINE STUDIES. WE INSTALLED A NEW 3T FIXED MRI WITH THE FIRST PATIENT USE IN NOVEMBER 2012. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CHKD'S REHABILITATIVE THERAPY SERVICES ARE OFFERED IN LOCATIONS THROUGHOUT THE COMMUNITY, INCLUDING NORFOLK, CHESAPEAKE, VIRGINIA BEACH, SUFFOLK AND NEWPORT NEWS. IN ADDITION TO ITS HIGHLY SPECIALIZED PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, THE DEPARTMENT ALSO OFFERS: * AQUATIC THERAPY - PHYSICAL AND OCCUPATIONAL THERAPISTS WORK WITH CHILDREN IN THE WATER TO HELP RELAX TIGHT MUSCULATURE, INCREASE RANGE OF MOTION AND IMPROVE STRENGTH, BALANCE AND ENDURANCE. * ASSISTIVE TECHNOLOGY/AUGMENTATIVE PROGRAM - SERVICES PROVIDED FOR CHILDREN WHO ARE UNABLE TO COMMUNICATE VERBALLY OR THROUGH GESTURES DUE TO VARIOUS MEDICAL CONDITIONS. IN FY 2012, WE DID 238 AUGMENTATIVE COMMUNICATION EVALUATIONS. * CAR SEAT PROGRAM - SPECIALLY TRAINED THERAPISTS OFFER CAR SEAT SAFETY RESTRAINT EVALUATIONS FOR PATIENTS WITH SPECIAL NEEDS. IN FY 2012, WE DID 286 CAR SEAT EVALUATIONS, DISTRIBUTED 431 SPECIAL NEEDS CAR SEATS AND PARTICIPATED IN EIGHT COMMUNITY-BASED CAR SEAT SAFETY CHECKS THROUGH THIS PROGRAM. * WHEELCHAIR CLINIC - CERTIFIED THERAPISTS COMPLETE A COMPREHENSIVE EVALUATION TO DETERMINE AND PRESCRIBE THE APPROPRIATE WHEELCHAIR AND SEATING SYSTEM. CHILDREN MADE ALMOST 1,116 VISITS TO THIS CLINIC IN FY 2012 FOR EVALUATION AND TECHNICAL ADJUSTMENTS. SECTION THREE: COMMUNITY OUTREACH CHKD REACHED FAMILIES IN THEIR HOMES, DOCTORS' OFFICES, NEIGHBORHOODS AND COMMUNITY CENTERS WITH A WIDE VARIETY OF PROGRAMS AND PUBLICATIONS THAT PROMOTE WELLNESS, PREVENT INJURIES AND STRENGTHEN FAMILIES. OUR COMMUNITY OUTREACH EXPERTS COORDINATED A TOTAL OF 389 PARENT, PROFESSIONAL, AND STUDENT PROGRAMS THAT BROUGHT IMPORTANT HEALTH, SAFETY AND WELLNESS INFORMATION TO MORE THAN 46,143 PARTICIPANTS. 28,797 OF THESE PARTICIPANTS WERE PART OF THE KOHL'S CARES FAMILY PROGRAM WHICH PROVIDED 57 SCHOOL-BASED PROGRAMS AND 122 COMMUNITY PROGRAMS. IN ADDITION, WE LAUNCHED A PILOT KOHL'S STEPS TO FITNESS ASSEMBLY PROGRAM WITH GREAT SUCCESS. CHKD IS A SITE OF THE NATIONAL "REACH OUT AND READ" LITERACY PROGRAM, WHICH ENCOURAGES READING BY DISTRIBUTING FREE BOOKS TO CHILDREN AT THEIR WELL CHILD VISITS TO THEIR PEDIATRICIANS. THROUGH THE DONOR FUNDED PROGRAM, CHKD'S PRIMARY CARE PEDIATRICIANS GAVE MORE THAN 70,000 BOOKS TO CHILDREN IN FY 2012. CHKD'S WEBSITE, WWW.CHKD.ORG, CONTINUES TO BE A POPULAR AND EFFECTIVE METHOD OF COMMUNICATION, AVERAGING OVER 62,000 UNIQUE VISITORS A MONTH FOR FY 2012. CHKD UTILIZED SOCIAL MEDIA OUTLETS SUCH AS FACEBOOK AND TWITTER TO INCREASE DIRECT INTERACTION WITH OUR PATIENTS AND THEIR FAMILIES. THE WEBSITE CONTINUES TO BE A RESOURCE FOR OUR SERVICES AND HEALTH INFORMATION. CHKD IS ONE OF SIX LOCATIONS IN THE STATE FOR THE CARE CONNECTION FOR CHILDREN (CCC), THE STATE FUNDED TITLE V PROGRAM THAT PROVIDES COMPREHENSIVE CARE COORDINATION, INFORMATION AND REFERRAL FOR CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS. THERE ARE APPROXIMATELY 12,000 CHILDREN WITH SPECIAL HEALTHCARE NEEDS IN THE REGION'S PUBLIC HEALTH DISTRICTS. IN FY 2012, CARE CONNECTION ASSISTED WITH 556 INFORMATION AND REFERRAL CALLS AND PROVIDED CASE MANAGEMENT SERVICES TO APPROXIMATELY 620 FAMILIES. FINANCIAL ASSISTANCE WAS PROVIDED FOR 86 CHILDREN WHO WERE UNINSURED OR UNDER INSURED, AND 204 FAMILIES WERE ASSISTED IN APPLYING FOR STATE HEALTH PROGRAMS. THE STAFF AT CCC ALSO PROVIDED SEVERAL TRAINING SESSIONS FOR FAMILIES AND PROVIDERS ON MEDICAID WAIVER SERVICES AND THE EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPSDT) BENEFITS AND EDUCATION FOR PEDIATRIC RESIDENTS WITH THE UNIQUE "FAMILIES AS EDUCATORS" PROGRAM. CHKD'S PHYSICIANS, ADMINISTRATORS AND STAFF MEMBERS LEND THEIR KNOWLEDGE AND TIME AS VOLUNTEERS TO MANY NATIONAL, STATE AND LOCAL ORGANIZATIONS THAT SHARE OUR CONCERN FOR CHILDREN. THESE INCLUDE THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS, THE AMERICAN ACADEMY OF PEDIATRICS, THE CHILDREN'S MIRACLE NETWORK, THE NATIONAL SAFE KIDS CAMPAIGN, THE UNITED WAY, THE VIRGINIA HOSPITAL ASSOCIATION AS WELL AS LOCAL ORGANIZATIONS SUCH AS VOLUNTEER HAMPTON ROADS AND THE AMERICAN RED CROSS. SECTION FOUR: MEDICAL EDUCATION AND RESEARCH CHKD INVESTS IN THE PRESENT AND FUTURE HEALTH OF OUR CHILDREN THROUGH A VARIETY OF RESEARCH PROGRAMS AND EDUCATIONAL ACTIVITIES. CHILDREN'S HOSPITAL IS HOME TO EASTERN VIRGINIA MEDICAL SCHOOL'S (EVMS) PEDIATRIC RESIDENCY PROGRAM, WHERE NEW PHYSICIANS BECOME SPECIALISTS IN THE FIELD OF PEDIATRICS. MANY OF THEM STAY IN THIS COMMUNITY OR IN THE STATE TO PRACTICE PEDIATRICS AFTER THEY COMPLETE THEIR RESIDENCIES. CHKD ALSO SERVES AS THE EXCLUSIVE PEDIATRIC TEACHING SITE FOR RESIDENTS IN FAMILY MEDICINE PRACTICE, EMERGENCY PRACTICE, ENT AND PHYSICIAN ASSISTANTS, AS WELL AS THE EXCLUSIVE SITE FOR SOME 120 THIRD-YEAR MEDICAL SCHOOL STUDENTS FOR THEIR EIGHT WEEK PEDIATRIC ROTATION. CHKD PROVIDES A SETTING FOR MANY CLINICAL RESEARCH TRIALS. HIGHLIGHTS OF THE BASIC SCIENCE RESEARCH INCLUDE PROTECTION OF THE NEWBORN BRAIN FROM THE EFFECTS OF HYPOXIC INJURY, NEW INNOVATIONS TO COMBAT SERIOUS INVASIVE INFECTION, MANAGEMENT OF AUTISM, AND EMERGENCY INTERVENTIONS FOR ASTHMA. IN ADDITION, RESEARCH INCLUDES NEW MEDICATIONS AND OTHER THERAPIES, CLINICAL OUTCOMES ANALYSES AND EPIDEMIOLOGICAL STUDIES SANCTIONED BY THE EASTERN VIRGINIA MEDICAL SCHOOL INSTITUTIONAL REVIEW BOARD (IRB). THERE WERE 185 IRB APPROVED ACTIVE FUNDED STUDIES IN FY 2012. TOPICS OF STUDY INCLUDED HEMATOLOGY/ONCOLOGY, ALLERGY/ASTHMA, INFECTIOUS DISEASE, NEUROLOGY, PEDIATRIC SURGERY, CARDIOLOGY, OTOLARYNGOLOGY, PULMONOLOGY, GASTROENTEROLOGY, CHILD ABUSE, ENDOCRINOLOGY, DERMATOLOGY, NEONATOLOGY AND MENTAL HEALTH. MANY OF THESE STUDIES ARE STAGE THREE CLINICAL TRIALS THAT BRING CUTTING EDGE TREATMENTS TO CHKD PATIENTS YEARS BEFORE THEY ARE AVAILABLE TO THE PUBLIC. IN ADDITION, THERE IS AN INCREASED FOCUS ON REGISTRY STUDIES ACROSS ALL DISCIPLINES. DATA COLLECTED IN THESE REGISTRIES IS INTENDED TO STANDARDIZE OPTIMAL LEVELS OF CARE AND LEAD TO IMPROVED PATIENT OUTCOMES. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS OUR DIVISION OF COMMUNITY HEALTH AND RESEARCH HAS FOCUSED ON CONDITIONS AND ISSUES IMPACTING CHILDREN'S HEALTH WITH AN EMPHASIS ON HEALTH DISPARITIES IN THE CITIES OF THE HAMPTON ROADS REGION, WESTERN TIDEWATER, AND THE RURAL EASTERN SHORE. CURRENT AREAS OF EMPHASIS INCLUDE CHILDHOOD OBESITY, ASTHMA, IMMUNIZATION, INFANT AND CHILD PASSENGER SAFETY, TEEN ALCOHOL ABUSE AND AUTISM. DURING THE 2011-2012 ACADEMIC YEAR, APPROXIMATELY $1.43 MILLION IN EXTRAMURAL GRANTS SUPPORTED THIS WORK WITH ADDITIONAL FUNDING FROM CHKD AND EVMS. THE NUSS PROCEDURE FOR THE CORRECTION OF PECTUS EXCAVATUM, DEVELOPED AT CHKD MORE THAN 20 YEARS AGO, CONTINUES TO DRAW NATIONAL ATTENTION FROM BOTH PATIENTS AND SURGEONS. IN FY 2012, CHKD'S SURGEONS HOSTED THE 10TH ANNUAL WORKSHOP ON THE SURGICAL PROCEDURE, TEACHING A KINDER, GENTLER CORRECTION FOR THIS COMMON BIRTH DEFECT TO MORE THAN 30 SURGEONS FROM ALL OVER THE UNITED STATES, EUROPE, ASIA AND THE MIDDLE EAST. A NEW FOCUS FOR CORRECTING CHEST WALL DEFORMITY WAS INITIATED AT CHKD WITH A FIRST-IN-THE-U.S. BRACING TREATMENT PERFORMED TO HELP CHILDREN WITH PECTUS CARINATUM, A DEFECT THAT IS THE OPPOSITE OF PECTUS EXCAVATUM. THE HOSPITAL CONTINUED ITS MULTI-SITE RESEARCH STUDY ON THE GENETIC MARKERS OF PECTUS EXCAVATUM. TO DATE, MORE THAN 1,380 SURGICAL PATIENTS HAVE UNDERGONE THE NUSS PROCEDURE AT CHKD. CHKD IS A MEMBER OF CHILDREN'S ONCOLOGY GROUP (COG), AN INTERNATIONAL RESEARCH GROUP THAT CONDUCTS CLINICAL TRIALS FOR CHILDREN WITH CANCER. AS A MEMBER, CHKD HAS ACCESS TO THE LATEST PROTOCOLS FOR TREATMENT OF CHILDHOOD CANCER, PROVIDING THE COMMUNITY AND REGION WITH THE BEST PRACTICES AND TREATMENT RESULTS FROM MORE THAN 240 COG-MEMBER HOSPITALS IN NORTH AMERICA, AUSTRALIA, NEW ZEALAND AND EUROPE. IN FY 2012, CHKD HAD 89 COG STUDIES OPEN TO ENROLLMENT OR UNDERGOING DATA ANALYSIS. SEVERAL OF THESE STUDIES WERE INCLUDED IN COG'S LONG-TERM FOLLOW-UP STUDY, WHICH COLLECTS DATA ON PATIENTS WHO HAVE PARTICIPATED IN STUDIES THAT ARE NO LONGER OPEN TO ENROLLMENT. IN ALL, APPROXIMATELY 220 CHKD PATIENTS PARTICIPATED IN EITHER OPEN OR FOLLOW-UP COG STUDIES IN FY 2012. IN FY 2012, CHKD HOSTED 62 INDIVIDUAL CONTINUING MEDICAL EDUCATION EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE REGION, HELPING CHILD HEALTH EXPERTS IN OUR REGION KEEP UP WITH THEIR SKILLS AND THEIR ACCREDITATION. AND THE HOSPITAL HELD ITS 10TH SUMMER NURSE EXTERNSHIP, INTRODUCING 10 NURSING STUDENTS TO OUR HOSPITAL FOR SUMMER EMPLOYMENT. PART VI, SECTION A LINES 6, 7A, 7B & 11 LINE 6: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED IS A VIRGINIA NON-STOCK CORPORATION WITH A SOLE MEMBER. THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED IS CHILDREN'S HEALTH SYSTEM, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED IS MANAGED BY ITS SOLE MEMBER, CHILDREN'S HEALTH SYSTEM, INC. LINE 7A: CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, MANAGES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. ACCORDINGLY, THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED. AS A VIRGINIA NON-STOCK CORPORATION, CHILDREN'S HEALTH SYSTEM, INC. HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. THE MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. ARE THE CLASS A MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. (I.E., THE THEN CURRENT MEMBERS IN GOOD STANDING OF THE NORFOLK CITY UNION OF THE KING'S DAUGHTERS, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION) AND THE CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM INC. (I.E., THE THEN CURRENT DIRECTORS ON THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC.). LINE7B: THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. LINE 11: THE 990 IS PREPARED USING THE ANNUAL FINANCIAL STATEMENTS THAT ARE REVIEWED BY THE BOARD AND AUDITED ANNUALLY AS A PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC. UPON COMPLETION OF THE DRAFT OF THE RETURN A DETAIL REVIEW IS PERFORMED BY SEVERAL MEMBERS OF STAFF AND MANAGEMENT. PRIOR TO FILING WITH THE IRS, THE BOARD IS PROVIDED A COPY TO REVIEW POLICIES & DISCLOSURE ITEMS 990 PART VI SECTIONS B & C CONFLICT POLICY CONSIDERATIONS: CHKD CONFLICT OF INTEREST POLICY INCLUDES OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES, KEY EMPLOYEES, ALL OTHER EMPLOYEES, PROFESSIONAL STAFF AND SUBSTANTIAL DONORS. ANNUALLY, A QUESTIONNAIRE IS DISTRIBUTED AND COLLECTED FROM OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES AND KEY EMPLOYEES. THE QUESTIONNAIRES ARE REVIEWED BY THE LEGAL DEPARTMENT. FOR KNOWN CONFLICTS, THE PERSON INVOLVED RECUSES HIMSELF OR HERSELF FROM DELIBERATIONS REGARDING THE TRANSACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY ARE REPORTED TO THE CHKD BOARD CHAIR OR THE CHKD COMPLIANCE OFFICER, AS APPLICABLE, AND MAY REQUIRE CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. COMPENSATION PROCESS CONSIDERATIONS: CHILDREN'S HEALTH SYSTEM ESTABLISHES THE COMPENSATION OF THE CEO JAMES DAHLING. CHILDREN'S HEALTH SYSTEM AND CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS USE THE FOLLOWING PROCESS TO ESTABLISH COMPENSATION FOR OFFICERS AND KEY EMPLOYEES: AN INDEPENDENT COMPENSATION CONSULTANT APPROVED AND RETAINED BY THE COMPENSATION COMMITTEE OF THE BOARD ANNUALLY, USUALLY IN APRIL, PROVIDES EDUCATION AND PRESENTS TO THE FULL BOARD COMPARATIVE SALARIES AND SALARY RANGES FROM A DATABASE COMPRISED OF CHILDREN'S HOSPITALS AND OTHER APPLICABLE HOSPITALS FOR OFFICERS & EXECUTIVES FOR THE BOARD TO REVIEW. THE COMPENSATION COMMITTEE WITH THE AID OF THE CONSULTANT REVIEWS AND MAKES DECISIONS AS TO EXECUTIVE SALARIES OF CHKD AND ITS SUBSIDIARIES. THOSE SALARY CHANGES AND APPROVALS ARE DOCUMENTED BY MINUTES MAINTAINED BY THE COMPENSATION COMMITTEE AND SIGNED BY THE CHAIRMAN OF THE BOARD. PART VI, C, LINE 19: FINANCIAL STATEMENTS (PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC.) ALONG WITH GOVERNING DOCUMENTS OF THE ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC THROUGH DIRECT INQUIRY AND REQUEST. FORM 990, PART VII THE FOLLOWING INDIVIDUALS WORK FOR MULTIPLE RELATED ORGANIZATIONS AS INDICATED BELOW: MICHELLE BRENNER - 1 HOUR CHS AND 40 HOURS CMG JIM DAHLING - 40 HOURS CHS AND 1 HOUR CHF DENNIS RYAN - 40 HOURS CHS AND 1 HOUR CHF. FORM 990, PART XI OTHER CHANGES IN NET ASSETS IS MADE UP OF TRANSFERS OUT ($6,111,819), UNREALIZED LOSS ON INVESTMENTS ($1,412,989), UNREALIZED LOSS ON DERIVATIVE ($9,816,197) AND OTHER CHANGES OF ($585,355). 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