FURP.ORG / PUBLIC DATA EXPLORER

VALLEY CHILDRENS HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
VALLEY CHILDRENS HOSPITAL (EIN 94-1294954)
Tax period
2011-10-01 to 2012-09-30
Filed
2013-08-14
IRS object ID
201342269349304314
Schema version
2011v1.5
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-08-14T18:26:27-05:00Timestamp
Tax Period End Date2012-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN910189318EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13121 WEST MARCH LANE SUITE 100AddressLine1
CitySTOCKTONCity
StateCAState
ZIP Code952192303ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941294954EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL CENTRAL CALIFORNIABusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone5593533000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line19300 VALLEY CHILDRENS PLACEAddressLine1
CityMADERACity
StateCAState
ZIP Code936368761ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMICHELE WALDRONName
TitleCFOTitle
Phone5593533000Phone
Date Signed2013-08-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTRACY S PAGLIAName
PTINP00366884PTIN
Phone2099556100Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMICHELE WALDRONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line19300 VALLEY CHILDRENS PLACEAddressLine1
CityMADERACity
StateCAState
ZIP Code936368761ZIPCode
FieldValueIRS element (for citing)
Gross Receipts599315465GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CHILDRENSCENTRALCAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1949YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionPROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDRENActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees3013TotalNbrEmployees
Total Nbr Volunteers490TotalNbrVolunteers
Total Gross UBI1110164TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year21770337ContributionsGrantsPriorYear
Contributions Grants Current Year21751379ContributionsGrantsCurrentYear
Program Service Revenue Prior Year479173553ProgramServiceRevenuePriorYear
Program Service Revenue CY493001475ProgramServiceRevenueCY
Investment Income Prior Year4857119InvestmentIncomePriorYear
Investment Income Current Year15550021InvestmentIncomeCurrentYear
Other Revenue Prior Year7470362OtherRevenuePriorYear
Other Revenue Current Year12152362OtherRevenueCurrentYear
Total Revenue Prior Year513271371TotalRevenuePriorYear
Total Revenue Current Year542455237TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year265040GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY385407GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year221933180SalariesEtcPriorYear
Salaries Etc Current Year233968321SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year170720632OtherExpensePriorYear
Other Expenses Current Year182439576OtherExpensesCurrentYear
Total Expenses Prior Year392918852TotalExpensesPriorYear
Total Expenses Current Year416793304TotalExpensesCurrentYear
Revenues Less Expenses Prior Year120352519RevenuesLessExpensesPriorYear
Revenues Less Expenses CY125661933RevenuesLessExpensesCY
Total Assets BOY697990469TotalAssetsBOY
Total Assets EOY824282671TotalAssetsEOY
Total Liabilities BOY309774983TotalLiabilitiesBOY
Total Liabilities EOY307355485TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY388215486NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY516927186NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HIGH QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense47873017Expense
Grants385407Grants
Revenue158828055Revenue
DescriptionSEE SCHEDULE ODescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense274389642Expense
Grants0Grants
Revenue334173420Revenue
DescriptionSEE SCHEDULE ODescription
FieldValueIRS element (for citing)
Total Program Service Expense322262659TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art1DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096260NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3013NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MICHELE WALDRON CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5593533000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19300 VALLEY CHILDRENS PLACEAddressLine1
CityMADERACity
StateCAState
ZIP Code93636ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
GORDON ALEXANDER
FORMER CEO, TERMED 11/13/1134.00XX767496016613
TODD SUNTRAPAK
FORMER COO, CEO EFF. 7/19/1234.00XX525558089988
BRUCE ALBRIGHT
BOARD MEMBER1.00X000
GREG COLEMAN
FORMER BOARD CHAIRMAN1.00XX000
DR LINDA FRALEY
BOARD MEMBER1.00X000
RICHARD SHEHADEY
FOUNDATION CHAIRMAN OF BOARD1.00X000
STEPHANIE HOULDING TERM 1211
FR. GUILD. COOR. COUNCIL CHR1.00X000
DR DEVONNA KAJI TERM ENDED
FORMER CHIEF OF STAFF, EFF. 1/31/121.00X7500055272334376
DAVID KRAUSE
BOARD VICE CHAIRMAN1.00XX000
DR ROBERT KUBO
BOARD SECRETARY, EFF. 1/1/121.00XX000
MENDY LAVAL RESIGNED
BOARD SECRETARY, EFF. 12/31/111.00XX000
JEFF MAYER
BOARD CHAIRMAN1.00XX000
DAVE OLSON
BOARD MEMBER1.00X000
PAT RICCHIUTI
BOARD MEMBER1.00X000
DR CHARLES SMITH
BOARD MEMBER1.00X000
BILL SMITTCAMP
BOARD TREASURER1.00XX000
DR TIM HANSEN
CHIEF OF STAFF, EFF. 2/1/121.00X000
RILEY WALTER
BOARD MEMBER1.00X000
NANCY MASICH
GUILD COOR. COUNCIL CHR, EFF. 1/1/121.00X000
MICHELE R WALDRON
CFO38.00X510194093614
DAVID CHRISTENSEN
VP, MEDICAL AFFAIRS & CMO40.00492195045299X
BEVERLY HAYDEN-PUGH
VP, CHIEF NURSING OFFICER40.00343239093378X
JESSIE HUDGINS
VP, FACILITIES40.00328066094111X
MARTA BOYER
FORMER VP, HR, TERMED 5/4/1240.00332104030960X
JANE WILLSON
VP, CORPORATE DEVELOPMENT40.00315515065458X
DAVID SINGH
VP, REVENUE CYCLE MANAGEMENT40.00283946017687X
RICK WOLF
VP, GENERAL COUNCIL40.00288528029881X
KIRK LARSON
VP AND CIO40.00238612012189X
RANDALL GUERRERO
EXECUTIVE DIRECTOR, CRITICAL CARE40.00226197023074X
STEPHANIE VANCE
EXECUTIVE DIRECTOR, FINANCE40.00243623024030X
JEFFREY LEFORS
EXECUTIVE DIRECTOR, PROF SVRS & CHG MGMT40.00238751015887X
KAMELA LOO
NEONATAL NURSE PRACTITIONER40.00245761033938X
DANIEL DAVIS
EXECUTIVE DIR., ACUTE/PT CARE SUP40.00230171024446X
WILLIAM F HAUG
STRATEGIC ADVISOR, TERMED 3/31/201134.002663377028442X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8348333TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs552723TotalReportableCompFrmRltdOrgs
Total Other Compensation773371TotalOtherCompensation
Number Individuals GT100 K448NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SPECIALTY MEDICAL GROUP
9300 VALLEY CHILDRENS PLACEMADERACA93636SUBSPEC PHYSICIAN SERVICES11501912
PEDIATRIC ANETHESIA ASSOCIATION
6235 N FRESNO ST STE 103FRESNOCA93710ANETHESIA/CRITICAL CARE8135427
CROTHALL HEALTHCARE INC
1654 MARTHALER LANEWEST ST PAULMN55118HOUSEKEEPING SERVICES3288434
EMERGENCY PHYSICIANS MEDICAL
3300 DOUGLAS BOULEVARD 200ROSEVILLECA95661EMERGENCY PHYSICIAN SERVICES1329861
MEDQUIST INC
PO BOX 102467ATLANTAGA30368TRANSCRIPTION SERVICES1087427
FieldValueIRS element (for citing)
Number Of Contractors GT100 K69NumberOfContractorsGT100K
Related Organizations2651665RelatedOrganizations
Government Grants18269618GovernmentGrants
All Other Contributions830096AllOtherContributions
Noncash Contributions47969NoncashContributions
Total Contributions21751379TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICES900099492778657492778657
OUTSIDE LAB SERVICES900099222818222818
FieldValueIRS element (for citing)
Total Program Service Revenue493001475TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column7102857TotalRevenueColumn
Exclusion$7,102,857ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column862738TotalRevenueColumn
Exclusion$862,738ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real118466Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real81370Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real37096Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column37096TotalRevenueColumn
Exclusion$37,096ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities64060255Securities
Other13241Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities56475213Securities
Other13857Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities7585042Securities
Other-616Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column7584426TotalRevenueColumn
Exclusion$7,584,426ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory594225GrossSalesOfInventory
Cost Of Goods Sold289788CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column304437TotalRevenueColumn
Exclusion$304,437ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA REVENUE9000992597788$2,597,788
MANAGEMENT SERVICES54161011101641110164

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column8102877TotalRevenueColumn
Exclusion$8,102,877ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue11810829TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column542455237TotalRevenueColumn
Related Or Exempt Function Income493001475RelatedOrExemptFunctionIncome
Unrelated Business Revenue1110164UnrelatedBusinessRevenue
Exclusion$26,592,219ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total157262Total
Program Services157262ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total228145Total
Program Services228145ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total5869692Total
Program Services31250ProgramServices
Management And General5838442ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total157336574Total
Program Services125512605ProgramServices
Management And General31823969ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total10228746Total
Program Services8023343ProgramServices
Management And General2205403ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total47295442Total
Program Services34469175ProgramServices
Management And General12826267ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total13237867Total
Program Services9954769ProgramServices
Management And General3283098ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2994475Total
Program Services30589ProgramServices
Management And General2963886ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1908175Total
Management And General1908175ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total188494Total
Management And General188494ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1436431Total
Management And General1436431ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total29467375Total
Program Services28979383ProgramServices
Management And General487992ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total467493Total
Program Services467493ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total48246305Total
Program Services42021052ProgramServices
Management And General6225253ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3223901Total
Management And General3223901ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4396244Total
Program Services3143558ProgramServices
Management And General1252686ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total445639Total
Program Services195336ProgramServices
Management And General250303ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total244505Total
Program Services35987ProgramServices
Management And General208518ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total8746659Total
Program Services6653266ProgramServices
Management And General2093393ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total20097620Total
Program Services12373451ProgramServices
Management And General7724169ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2172361Total
Program Services98133ProgramServices
Management And General2074228ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
HOSPITAL FEE PROGRAM3315882733158827
PURCHASED SERVICES16515810108629335652877
BAD DEBT52451615245161
DUES11509511015281049423

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2333150Total
Program Services519413ProgramServices
Management And General1813737ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total416793304Total
Program Services322262659ProgramServices
Management And General94530645ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY12928BOY
EOY13245EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY83116020BOY
EOY117087017EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY580092BOY
EOY898869EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY48997977BOY
EOY55256332EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4865891BOY
EOY5725563EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY12358917BOY
EOY3903203EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis420526575LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec165699774LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY247244866BOY
EOY254826801EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY135169007BOY
EOY154238769EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY148422858BOY
EOY162903837EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY998628BOY
EOY1240746EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY16223285BOY
EOY68188289EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY697990469BOY
EOY824282671EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY82493887BOY
EOY60933380EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY159874416BOY
EOY155549710EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY67406680BOY
EOY90872395EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY309774983BOY
EOY307355485EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY383617976BOY
EOY511187675EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4597510BOY
EOY5739511EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY388215486BOY
EOY516927186EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY697990469BOY
EOY824282671EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses125661933ReconcilationRevenueExpenses
Reconcilation Other Changes3049767ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$57,177GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$13,773DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB70950TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART IV, SUPPLEMENTAL INFORMATION:Identifier
ExplanationCHILDREN'S HOSPITAL CENTRAL CALIFORNIA HAS HAD DIRECT CONTACT WITH AND HAS ENCOURAGED OTHERS TO HAVE DIRECT CONTACT WITH LOCAL, STATE AND FEDERAL LEGISLATORS REGARDING CHILDREN'S HEALTH CARE PUBLIC POLICY. THESE CONTACTS HAVE PROVIDED INFORMATION REGARDING THE PROVISION OF HEALTH CARE SERVICES TO CHILDREN, THE ANTICIPATED EFFECT ON CHILDREN'S HEALTH OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING CURRENT STATE AND FEDERAL FUNDING LEVELS FOR MEDI-CAL AND OTHER PUBLIC PROGRAMS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $13,773 ASSOCIATION DUES RELATED TO LOBBYING NACH 13,080 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 23,363 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIF. 20,734 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $70,950Explanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3214538OtherCostOrOtherBasis
Book Value3214538BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis258499957OtherCostOrOtherBasis
Depreciation63704285Depreciation
Book Value194795672BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2299393OtherCostOrOtherBasis
Depreciation2059302Depreciation
Book Value240091BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis132415808OtherCostOrOtherBasis
Depreciation85258785Depreciation
Book Value47157023BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis24096879OtherCostOrOtherBasis
Depreciation14677402Depreciation
Book Value9419477BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings254826801TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionLIMITED PARTNERSHIPSDescription
Book Value162903837BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities162903837TotalOfBookValueSecurities

Other Assets OtherAssets (7 entries)

DescriptionDescriptionBook ValueBookValue
UNAMORTIZED BOND ISSUE COSTS3560132
DISPROPORTIONATE SHARE FUNDS RECEIVABLE11719752
INSURANCE RECEIVABLE6034014
PROVIDER FEE RECEIVABLE43627238
457 TRUST FUNDS1702438
RESTRICTED CASH1187060
OTHERS357655
FieldValueIRS element (for citing)
Total Book Value Other Assets68188289TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
MALPRACTICE RESERVE$2,376,000
ACCRUED PENSION LIABILITY$73,430,336
457 LIABILITY$1,702,438
1732 LIABILITY$895,525
OTHER$31,111
CONSTRUCTION RETAINS ACCOUNT$1,641,985
WORKERS COMP$6,453,540
INS LIABILITY$4,341,460
FieldValueIRS element (for citing)
Total Of Amounts90872395TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent350XPcent350
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care0AmountsBudgetedForCharityCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense102000TotalCommunityBenefitExpense
Net Community Benefit Expense102000NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense274389642TotalCommunityBenefitExpense
Direct Offsetting Revenue334173420DirectOffsettingRevenue
Net Community Benefit Expense-59783778NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense8577714TotalCommunityBenefitExpense
Direct Offsetting Revenue5116127DirectOffsettingRevenue
Net Community Benefit Expense3461587NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense283069356TotalCommunityBenefitExpense
Direct Offsetting Revenue339289547DirectOffsettingRevenue
Net Community Benefit Expense-56220191NetCommunityBenefitExpense
Percent Of Total Expense0.00860PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense588897TotalCommunityBenefitExpense
Net Community Benefit Expense588897NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2579500TotalCommunityBenefitExpense
Direct Offsetting Revenue644650DirectOffsettingRevenue
Net Community Benefit Expense1934850NetCommunityBenefitExpense
Percent Of Total Expense0.00470PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense178272TotalCommunityBenefitExpense
Net Community Benefit Expense178272NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3346669TotalCommunityBenefitExpense
Direct Offsetting Revenue644650DirectOffsettingRevenue
Net Community Benefit Expense2702019NetCommunityBenefitExpense
Percent Of Total Expense0.00650PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense286416025TotalCommunityBenefitExpense
Direct Offsetting Revenue339934197DirectOffsettingRevenue
Net Community Benefit Expense-53518172NetCommunityBenefitExpense
Percent Of Total Expense0.01510PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense5000TotalCommunityBuildingExpense
Net Community Building Expense5000NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense5000TotalCommunityBuildingExpense
Net Community Building Expense5000NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,778,690BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare204682AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare409178CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-204496MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeChildrens HospitalChildrensHospital
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
19300 VALLEY CHILDRENS PLACEMADERACA936368761X
CHILDREN'S HOSPITAL CENTRAL CA HOME CARE
27555 N DEL MAR AVEFRESNOCA93711X

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelOther FactorsOtherFactorsExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesPosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestOther PublicityOtherPublicityActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
111200.0000000000001350.0000000000001XX11XXXXXXX101X01
CHILDREN'S HOSPITAL CENTRAL CA HOME CARE
211200.0000000000001350.0000000000001XX11XXXXXXX101X01

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7: CHARITY CARE AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE DECISION SUPPORT SYSTEM WAS USED TO CALCULATE COST-TO-CHARGE FOR DETERMINING UNREIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THIS DECISION SUPPORT SYSTEM ADDRESSES ALL PATIENT SEGMENTS (I.E INPATIENT, OUTPATIENT, ETC.). IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING CHILDREN'S HOSPITAL CENTRAL CALIFORNIA, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. IN 2012, THE HOSPITAL RECEIVED APPROXIMATELY $80,397,000 IN NET REVENUE THROUGH THE STATE'S HOSPITAL FEE PROGRAM. BECAUSE THIS NET REVENUE RECOGNIZED IN 2012 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2012, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2012. WHILE THE PROGRAM'S PAYMENTS HAVE PLAYED AN IMPORTANT ROLE IN OFFSETTING SOME OF THE HOSPITAL'S LOSSES, THE PROGRAM'S LIMITED DURATION MEANS THAT IT WILL NOT SERVE AS A LONG-TERM SOLUTION TO THE HOSPITAL'S CHRONIC MEDI-CAL PAYMENT SHORTFALLS.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5245161.
PART III, LINE 4: FOOTNOTE DESCRIBING BAD DEBT EXPENSE:THE HOSPITAL ANALYZES ITS COLLECTION HISTORY AND IDENTIFIES TRENDS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS FOR PATIENTS WITHOUT THIRD PARTY COVERAGE. THE ALLOWANCE IS RECORDED IN THE PERIOD IN WHICH SERVICES ARE PROVIDED. FOR PATIENTS WITH THIRD-PARTY COVERAGE, THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY, FOR AMOUNTS THAT ARE THE PATIENT'S RESPONSIBILITY, INCLUDING DEDUCTIBLES AND COPAYMENTS. IN ADDITION, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS WOULD BE ESTABLISHED FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA TO EVALUATE THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS APPROXIMATELY 60 PERCENT OF SELF-PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2012 AND 2011. THE HOSPITAL HAS NOT CHANGED ITS UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2011 OR 2012 BUT MODIFIED ITS CHARITY CARE POLICY IN 2011 TO INCLUDE A BROADER RANGE OF INDIVIDUALS. THE HOSPITAL DOES NOT MAINTAIN AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITEOFFS FROM THIRD-PARTY PAYORS.COSTING METHODOLOGY:ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND REVIEW OF LARGE BALANCE SELF-PAY ACCOUNTS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBT IF SUBSEQUENTLY COLLECTED. THE COST OF BAD DEBT WRITE-OFFS WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF.
PART III, LINE 8: MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2012 MEDICARE COST REPORT. MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE SERVICES. ADDITIONALLY, THE MAJORITY OF THE HOSPITAL'S MEDICARE PATIENTS WOULD BE COVERED BY MEDI CAL IF THEY DID NOT FALL UNDER THE MEDICARE COVERAGE OPTION.
PART III, LINE 9B: COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE; INSURANCE COLLECTION ATTEMPTS CONTINUE AS APPROPRIATE.
PART V, SECTION B, LINE 11H: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS.CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
PART V, SECTION B, LINE 11H: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS.CHILDREN'S HOSPITAL CENTRAL CA HOME CARE
PART V, SECTION B, LINE 13G: ADDITIONALLY THE POLICY IS SENT BY US POSTAL SERVICE TO COMMUNITY AGENCIES TO BE DISTRIBUTED.CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
PART V, SECTION B, LINE 19D: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS.CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
PART V, SECTION B, LINE 19D: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS.CHILDREN'S HOSPITAL CENTRAL CA HOME CARE
PART V, SECTION B, LINE 21: IF A PATIENT DID NOT QUALIFY FOR FULL CHARITABLE DISCOUNT, LOW INCOME DISCOUNT, HIGH MEDICAL COST DISCOUNT OR 25% PROMPT PAY DISCOUNT THEN THEY COULD BE CHARGED GROSS CHARGES FOR THEIR SERVICES.CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
PART V, SECTION B, LINE 21: IF A PATIENT DID NOT QUALIFY FOR FULL CHARITABLE DISCOUNT, LOW INCOME DISCOUNT, HIGH MEDICAL COST DISCOUNT OR 25% PROMPT PAY DISCOUNT THEN THEY COULD BE CHARGED GROSS CHARGES FOR THEIR SERVICES.CHILDREN'S HOSPITAL CENTRAL CA HOME CARE
PART VI, LINE 2: NEEDS ASSESSMENT: CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS ESTABLISHED BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT. CONSISTENT WITH STATE LAW, CHILDREN'S HOSPITAL COMPLETES A FORMAL ASSESSMENT OF UNMET PEDIATRIC HEALTH CARE NEEDS IN THE COMMUNITY EVERY THREE YEARS. THE HOSPITAL'S MOST RECENT ASSESSMENT WAS COMPLETED IN AUGUST 2011 AND INCLUDED THE FOLLOWING ACTIVITIES: * REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT - UNDER THE AUSPICES OF THE CENTRAL VALLEY HEALTH POLICY INSTITUTE, CALIFORNIA STATE UNIVERSITY, FRESNO, CHILDREN'S HOSPITAL PARTNERED WITH OTHER HOSPITALS IN A FOUR COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. SOURCES OF DATA INCLUDED KEY STAKEHOLDER INTERVIEWS AS WELL PUBLISHED HEALTH STATUS INDICATOR DATA. * SUPPLEMENTAL STAKEHOLDER INTERVIEWS - IN ADDITION TO THE INTERVIEWS CONDUCTED AS PART OF THE NEEDS ASSESSMENT DESCRIBED ABOVE, CHILDREN'S HOSPITAL STAFF CONDUCTED ADDITIONAL INTERVIEWS TO EXPLORE MORE THOROUGHLY THE ISSUES AS THEY RELATE TO CHILDREN. INTERVIEWS WERE CONDUCTED WITH OVER A DOZEN KEY ORGANIZATIONS, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS, SCHOOL DISTRICTS, FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, AND A VARIETY OF COMMUNITY-BASED NONPROFIT AGENCIES SERVING LOW INCOME, NEEDY CHILDREN AND FAMILIES. PARTICULAR AREAS OF INTEREST INCLUDED CHRONIC DISEASE MANAGEMENT (ASTHMA, OBESITY, DIABETES), SERVICES FOR CHILDREN WITH, OR AT RISK FOR DEVELOPMENTAL DELAYS, ACCESS TO PRIMARY AND PREVENTATIVE SERVICES, CHILD ABUSE AND UNINTENTIONAL INJURY PREVENTION, MENTAL HEALTH, AND CAPACITY OF COMMUNITY-BASED PROVIDERS TO MANAGE KIDS WITH COMPLEX MEDICAL CONDITIONS.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: EACH PATIENT THAT PRESENTS AS A SELF PAY PATIENT IS DIRECTED TO A FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR EDUCATES PATIENTS AND THEIR FAMILIES ABOUT GOVERNMENT AND CHARITY CARE PROGRAMS AND ASSISTS WITH RELATED APPLICATIONS. IF A PATIENT IS NOT COUNSELED BY A FINANCIAL COUNSELOR ON THE DATE OF SERVICE, FOLLOW UP ATTEMPTS ARE MADE BY THE COUNSELORS AND THE BUSINESS OFFICE TO CONTINUE TO INFORM AND EDUCATE PATIENTS OF AVAILABLE PROGRAMS. IN ADDITION, THE CHARITY CARE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE AND THERE IS SIGNAGE THROUGHOUT THE HOSPITAL INFORMING PATIENTS OF THE AVAILABILITY OF THE CHARITY CARE PROGRAM.
PART VI, LINE 4: COMMUNITY INFORMATION: AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL'S PRIMARY SERVICE AREA EXTENDS FROM MODESTO IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE SIERRA NEVADA. THE SERVICE AREA INCLUDES 9 COUNTIES AND IS HOME TO OVER 1.2 MILLION CHILDREN AGES 0-17. IN 2012, CHILDREN'S HOSPITAL HAD 12,791 INPATIENT CASES, 77,994 EMERGENCY DEPARTMENT VISITS AND A COMBINED 181,853 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL BENEFITS COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 66% OF THE OUTPATIENT VISITS AT CHILDREN'S HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 4 YEARS OF AGE OR YOUNGER AND OVER 2/3 WERE AN ETHNICITY OTHER THAN CAUCASIAN.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: CHILDREN'S HOSPITAL PARTNERS WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING THE FOLLOWING. CHILD ABUSE PREVENTION - PREVENTING AND PROTECTING CHILDREN FROM ABUSE AND NEGLECT FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH A NUMBER OF PRIVATE AND PUBLIC AGENCIES, THE PROGRAM PROVIDED EDUCATION, LEADERSHIP, AND DIRECT SERVICES FOR CHILDREN WHO WERE VICTIMS OF ABUSE AND TO PARENTS AND COMMUNITY-BASED ORGANIZATIONS TO HELP PREVENT ABUSE.CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN - CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. TO HELP ENSURE THESE CHILDREN RECEIVE MEDICALLY APPROPRIATE CARE AT SCHOOL, CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO REFERRING HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. TOPICS COVERED INCLUDED CARE FOR HIGH RISK NEWBORNS, HYPOTHERMIA, PEDIATRIC TRAUMA AND CHILD MALTREATMENT, PEDIATRIC LABORATORY SKILLS, SHAKEN BABY SYNDROME, TO NAME A FEW. IN 2012, CHILDREN'S HOSPITAL PROVIDED 20 SEPARATE CONTINUING MEDICAL EDUCATION PROGRAMS TO NEARLY 250 PRIMARY CARE PROVIDERS. PEDIATRIC SUBSPECIALTY PHYSICIANS FROM CHILDREN'S HOSPITAL SERVED AS THE FEATURED FACULTY, PROVIDING COMMUNITY BASED PHYSICIANS WITH GUIDANCE ON HOW TO MANAGE A WIDE ARRAY OF COMPLEX PEDIATRIC MEDICAL CONDITIONS IN A NUMBER OF TOPICAL AREAS INCLUDING OBESITY AND DIABETES, ONCOLOGY, GASTROENTEROLOGY AND GENETICS. PROGRAMS WERE PROVIDED AT LOCATIONS THROUGHOUT THE HOSPITAL'S SERVICE AREA, INCLUDING BAKERSFIELD, MADERA, MERCED, MODESTO AND SAN LUIS OBISPO. DEVELOPMENTAL DISABILITIES - CHILDREN'S HOSPITAL PROVIDED EDUCATION TO PROVIDERS AND FAMILIES IN A NUMBER OF WAYS, INCLUDING THROUGH THE HOSTING OF SEVERAL CONFERENCES AND WORKING WITH BIRTHING HOSPITALS IN FRESNO AND TULARE COUNTIES AS PART OF THE HOSPITAL'S NEONATAL STABILIZATION PROJECT. THE HOSPITAL CONTINUED TO PARTICIPATE IN COALITIONS FOCUSED ON IMPROVING CARE COORDINATION FOR INFANTS AND CHILDREN WITH, OR AT RISK FOR, DEVELOPMENTAL DELAYS, INCLUDING KERN COUNTY'S MEDICALLY VULNERABLE INFANT WORK GROUP INITIATIVE, AND FIRST 5 FRESNO'S MODEL OF CARE PARTNERSHIP OVERSIGHT COMMITTEE AND SYSTEMS OF CARE COMMITTEE. ALSO, THE HOSPITAL EXPANDED EDUCATION AND TECHNICAL ASSISTANCE OFFERED THROUGH ITS HIGH RISK INFANT FOLLOW UP PROGRAM TO OTHER PROVIDERS AND COMMUNITY BASED AGENCIES REGARDING SCREENING AND ASSESSMENT FOR DEVELOPMENTAL DELAYS IN HIGH RISK INFANTS. LAST, CHILDREN'S HOSPITAL MAINTAINED ITS STRONG PARTNERSHIP WITH THE MARCH OF DIMES IN SUPPORT OF HEALTHY MOMS AND HEALTHY BABIES.INJURY PREVENTION 2012 - RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN AGES 1-14, CHILDREN'S HOSPITAL OPERATES AN UNINTENTIONAL INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. SUPPORTED BY A CAST OF 90 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2012: DISTRACTED & RECKLESS TEEN DRIVING, PEDIATRIC TRAUMA, WATER SAFETY, WHEELED SPORTS SAFETY, CHILD PASSENGER SAFETY, THE CHOKING GAME, SPORTS INJURIES, LITHIUM (BUTTON) BATTERY INGESTION, CHILD MALTREATMENT, MUNCHAUSEN SYNDROME BY PROXY, AND ABUSIVE HEAD TRAUMA.CHILDREN'S HOSPITAL CHAIRED SAFE KICK CENTRAL VALLEY AND LED THE COALITION OF 16 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS FOCUSED ON DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. THE PROGRAM PROVIDED EDUCATION TO OVER 14,600 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,376 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS.IN 2012, CHILDREN'S HOSPITAL INJURY PREVENTION ALSO PROVIDED 31 TELEVISION INTERVIEWS AND MEDIA EVENTS TO ADDRESS CHILD SAFETY ISSUES. THE HOSPITAL NOW PROVIDES A MONTHLY CHILD SAFETY SEGMENT ON TWO LOCAL NEWS PROGRAMS BROADCAST THROUGHOUT THE CENTRAL VALLEY. OBESITY PREVENTION - CHILDREN'S HOSPITAL SERVES AS THE ADVOCACY COORDINATOR FOR THE KAISER HEAL ZONE PROJECT IN THE CITY OF MADERA. IN ITS ROLE AS BOTH ADVOCACY COORDINATOR AND CHAIR OF THE MADERA HEAL ZONE PARTNERSHIP COMMITTEE, CHILDREN'S HOSPITAL PROVIDED CONSIDERABLE SUPPORT OF INCREASED ACCESS TO HEALTHY FOODS AND PHYSICAL ACTIVITY.AS THE FOUNDER AND ONGOING ACTIVE MEMBER OF THE CHILDHOOD OBESITY PREVENTION TASK FORCE OF FRESNO AND MADERA COUNTIES, CHILDREN'S HOSPITAL PLAYED A LEAD ROLE IN SUPPORTING THE TASK FORCE'S ACTIVITIES IN 2012. EXAMPLES INCLUDE FACILITATING EDUCATION PROGRAMS FOR PRIMARY CARE PROVIDERS AND PREVENTING AND MANAGING OBESITY AS WELL AS PROMOTING A HIGHER LEVEL OF SUPPORT BY HEALTH PLANS FOR PRIMARY CARE BASED OBESITY PREVENTION OR MANGEMENT SERVICES.THE MISSION OF CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND IS AN INDEPENDENT NON PROFIT ORGANIZATION GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES WHICH IS THEREFORE ACCOUNTABLE TO OUR COMMUNITY AND ONLY OUR COMMUNITY.
CAREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantIRC SectionIRCSection
STAYWELL CONTENT SERVICES
PO BOX 759MORRISVILLEPA19067075913403625812062PROVIDE HEALTH INFORMATION VIA CHCC WEBSITE
MARCH OF DIMES
4201W SHAW 105FRESNOCA9372213184636610650MARCH FOR BABIES SPONSOR501(C)(3)
EASTER SEALS OF CENTRAL CA
9010 SOQUEL DRAPTOSCA95003941497580100000DONATION501(C)(3)
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants2TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (4 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
NURSING SCHOLARSHIP921470
EDUCATION SCHOLARSHIP - RCP FOCUS23238
CAFETERIA MEALS1250665657FMVMEAL COUPONS FOR PATIENT FAMILIES AS NEEDED
TAXI, BUS AND TRANSIT SERVICES744137780BOOKSUBSIDIATION OF BUS AND TRANSIT SERVICES

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: NURSING SCHOLARSHIPS ARE DESIGNED TO HELP EMPLOYEES MEET FINANCIAL NEEDS THAT ARE NOT COVERED BY OTHER TUITION REIMBURSEMENT PROGRAMS. A SCHOLARSHIP COMMITTEE REVIEWS APPLICATIONS BI-ANNUALLY BASED ON CERTAIN CRITERIA. RECIPIENTS ARE CHOSEN BY THE COMMITTEE AND THE CHIEF NURSING OFFICER APPROVES THE SELECTIONS. ALL RECIPIENTS ARE EMPLOYEES OF THE HOSPITAL AND THE HOSPITAL IS MADE AWARE WHEN THE RECIPIENT COMPLETES THEIR EDUCATION. OTHER SERVICES PROVIDED ARE PURCHASED FROM VARIOUS VENDORS AND ARE SUPPLIED TO PATIENTS AND THEIR FAMILIES. THE RECORDS FOR THESE PURCHASED SERVICES ARE MAINTAINED BY THE HOSPITAL.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org1CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs1CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org1CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs1CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
GORDON ALEXANDER
6420160243620101118015409012040784109000
TODD SUNTRAPAK
4643600455080156900742330157550615546000
DR DEVONNA KAJI TERM ENDED
7500055272300000208250135517500058709900
MICHELE R WALDRON
446747053619098280817970118170603808000
DAVID CHRISTENSEN
407750074873095720295440157550537494000
BEVERLY HAYDEN-PUGH
314444017984010811089439039390436617000
JESSIE HUDGINS
284760033047010259086233078780422177000
MARTA BOYER
282562038575010967027021039390363064000
JANE WILLSON
27974702628909479061519039390380973000
DAVID SINGH
227452033695022799017687000301633000
RICK WOLF
26722802088304170180640118170318409000
KIRK LARSON
229516000909608250039390250801000
RANDALL GUERRERO
21530101014307530112570118170249271000
STEPHANIE VANCE
2036550223630176050122130118170267653000
JEFFREY LEFORS
2276100982301318015887000254638000
KAMELA LOO
2370660359105104026060078780279699000
DANIEL DAVIS
21942601024205030126290118170254617000
WILLIAM F HAUG
17644408100002405933028442000269181908348100

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINES 4A-BPART I, LINES 4A-B: PART I, LINES 4A: SEVERANCE PAYMENTS TOTALLING $81,346 WERE MADE TO GORDON ALEXANDER, FORMER CEO DURING THE CALENDAR YEAR AND ARE INCLUDED IN PART II, COLUMN B(III). THE SEVERANCE AGREEMENT IS SUBJECT TO A CONFIDENTIALITY CLAUSE. TERMS AND CONDITIONS OF THE AGREEMENT WILL BE PROVIDED TO THE IRS UPON REQUEST. PART I, LINES 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AND A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. MARTA BOYER RECEIVED A DISTRIBUTION FROM THE SERP PLAN DURING THE YEAR ENDING 9/30/2012 IN THE AMOUNT OF $287,287. NO AMOUNTS WERE PAID OUT OF THE DEFERRED COMPENSATION PLAN DURING THE YEAR. RANDALL GUERRERO, JEFFREY LEFORS AND DANIEL DAVIS ARE ELIGIBLE TO CONTRIBUTE BUT NO CONTRIBUTION WAS MADE. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR THE YEAR ENDING 9/30/2012 ARE AS FOLLOWS: GORDON ALEXANDER - DEFERRED COMPENSATION PLAN $14,596; DEFINED CONTRIBUTION SERP PLAN $0 WILLIAM HAUG - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 MICHELE WALDRON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $53,767 TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $49,472 BEVERLY HAYDEN-PUGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $56,337 JESSIE HUDGINS - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $57,564 MARTA BOYER - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 DAVID CHRISTENSEN - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $13,698 RICK WOLF - DEFERRED COMPENSATION PLAN $0; CHANGE IN SERP ACTUARIAL VALUE $5,508 JANE WILLSON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $37,103 DAVID SINGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 STEPHANIE VANCE - DEFERRED COMPENSATION PLAN $16,500; NOT ELIGIBLE FOR SERP KIRK LARSEAN - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 IN FISCAL YR 2012, THE HOSPITAL ESTABLISHED A NON CONTRIBUTORY, NON QUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT, CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EXEC RETIREMENT PLAN (DC SERP). AMOUNTS CONTRIBUTED TO THE PLAN ARE NOT VESTED FOR 5 YRS. NO PAYMENTS FROM THE PLAN HAVE BEEN MADE.
PART I, LINE 5AN EXECUTIVE INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON BOTH ORGANIZATION-WIDE AND INDIVIDUAL GOALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING REVENUE, OPERATIONAL AND QUALITY RESULTS OF THE HOSPITAL AND FOUNDATION. THE INCENTIVE PLAN HAS BEEN APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE COMMITTEE REVIEWS THE FORECASTED PAYOUTS AT THE END OF EACH YEAR BASED ON THE FINANCIAL AND OPERATING RESULTS.
PART I, LINE 6SEE EXPLANATION FOR LINE 5, ABOVE

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1COUNTY OF MADERABusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN946000518IssuerEIN
CUSIP Number556902DN1CUSIPNumber
Date Issued2010-02-04DateIssued
Issue Price39512854IssuePrice
Description Of PurposeTO REFUND SERIES 2006 BONDS ISSUED ON 6/26/06.DescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds39512854TotalProceeds
Amount In Reserve Fund4319911AmountInReserveFund
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate1ExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WISHON RADIOLOGY MEDICAL GROUP
ENTITY FOR WHICH DR. CHARLES SMITH, DIRECTOR, IS AN OFFICER649209DR. SMITH PROVIDES MEDICAL DIRECTOR SERVICES AND TELERADIOLOGIST COVERAGE THROUGH WISHON RADIOLOGY MEDICAL GROUP0
PRODUCER'S DAIRY FOODS INC
ENTITY FOR WHICH RICHARD SHEHADEY, DIRECTOR, IS AN OWNER112227PURCHASE OF FOOD PRODUCTS TO BE SOLD IN HOSPITAL CAFETERIA AND FOR PATIENT MEALS0

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9908200NoncashContribsRptdF990
Method Of Determining RevenuesCOSTMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable (4 entries)

Non Cash CheckboxNonCashCheckboxDescriptionDescriptionNumber Of ContributionsNumberOfContributionsNoncash Contribs Rptd F990NoncashContribsRptdF990Method Of Determining RevenuesMethodOfDeterminingRevenues
XIPADS63219COST
XCOUGH ASSIST MACHINE11500COST
XFUN CENTERS521250COST
XCLUBCAR IV113600COST
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2BRUCE ALBRIGHT, DIRECTOR AND JEFF MAYER, DIRECTOR, HAVE A BUSINESS RELATIONSHIP. IN ADDITION, GREG COLEMAN, DIRECTOR AND PAT RICCHIUTI, DIRECTOR, HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. THE CFO PRESENTS HIGHLIGHTS OF KEY SECTIONS OF THE FORM 990 AT THE FINANCE COMMITTEE MEETING THAT IS HELD BEFORE THE FILING DATE AND ANSWERS QUESTIONS OR ADDRESSES ANY CONCERNS AT THIS MEETING. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS.
FORM 990, PART VI, SECTION B, LINE 15AS PROVIDED BY THE HOSPITAL BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE HOSPITAL AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE
FORM 990, PART VI, SECTION C, LINE 19A COPY OF CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF CHILDREN'S HOSPITAL CENTRAL CALIFORNIA IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE HOSPITAL PREPARES ANNUAL FINANCIAL STATEMENTS WHICH ARE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM PRIOR TO SUBMITTAL TO RELEVANT STATE AGENCIES.
FORM 990, PART VII, SECTION A, COLUMN B:MICHELE WALDRON'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 38 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 2 HRS GORDON ALEXANDER'S'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 34 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 6 HRS TODD SUNTRAPAK'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 34 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 6 HRS BRUCE ALLBRIGHT, DR. ROBERT KUBO, JEFF MAYER, DAVE OLSON, RICHARD SHEHADEY AND BILL SMITTCAMP DIVIDE THEIR TIME AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 1 HR CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 1 HRHOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS:
FORM 990, PART XI, LINE 5:PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -19,826,241. TRADING GAIN INCLUDED IN INVESTMENT INCOME PER AFS 22,906,033. TRANSFER TO ENDOWMENT -30,026. ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: 3,049,767.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990 PART III, LINE 4A:I. DESCRIPTION OF PROGRAM SERVICE ONE 60 YEARS AGO, OUR FOUNDING MOTHERS HAD A DREAM TO CARE FOR CHILDREN IN A HOSPITAL AS SPECIAL AS ITS PATIENTS. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA HAS FLOURISHED EVER SINCE, CARING FOR HUNDREDS OF THOUSANDS OF CHILDREN. OUR MISSION GUIDES US AS WE TRAVEL THE ROAD TO OUR FUTURE ALONGSIDE STAFF, PHYSICIANS, CHILDREN, FAMILIES, OUR COMMUNITY AND OUR PARTNERS THROUGHOUT THE REGION. MISSION THE MISSION OF CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. VISION OUR VISION CAPTURES THE PATH WE'VE TRAVELED AND SHOWCASES OUR COMMITMENT AND PASSION TO BE THE BEST. OUR CLEAR FOCUS IS TO CONTINUE TO PROVIDE THE BEST CARE AND THE BEST QUALITY PEDIATRIC SERVICES AVAILABLE ANYWHERE WITH A VISION TO BECOME THE NATION'S BEST CHILDREN'S HOSPITAL. CORE VALUES THE FOLLOWING CORE ORGANIZATIONAL VALUES GUIDE THE INVESTMENTS AND SUPPORT PROVIDED BY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM. EXCELLENCE - WE DEPEND ON EXCEPTIONAL PEOPLE TO PROVIDE EXCEPTIONAL QUALITY HEALTH CARE AND SERVICES THROUGHOUT CHILDREN'S HOSPITAL. WE SET HIGH STANDARDS AND WE SUPPORT EACH OTHER AS WE STRIVE TO ACHIEVE THEM. WE INVEST IN EACH OTHER AND WE VALUE THE INDIVIDUAL AND CULTURAL DIFFERENCES THAT MAKE US STRONG. WE ARE PROUD OF OUR SUPERIOR SERVICES AS MEASURED BY QUALITY OUTCOMES. COMPASSIONATE CARE - WE TREAT EVERY CHILD, EVERY FAMILY, EACH OTHER, OUR VISITORS AND OUR VENDORS WITH RESPECT, KINDNESS, HOPE, JOY AND GOOD HUMOR. WE DISPLAY OUR HELPFUL, HEALING, FAMILY-CENTERED SPIRIT AT EVERY OPPORTUNITY. WE RECOGNIZE THE IMPORTANCE OF PLAYFULNESS IN HUMAN INTERACTION AND IN THE HEALTH OF CHILDREN. WE LOOK FOR WAYS TO EASE SUFFERING AND PROVIDE COMFORT. INTEGRITY - WE ARE HONEST, ETHICAL AND RESPONSIBLE IN OUR WORK AND IN THE WAY WE DEAL WITH OTHERS. WE KEEP OUR PROMISES AND ADMIT OUR MISTAKES. WE KNOW OURSELVES AND WE AVOID HIDDEN AGENDAS. BY THE WAY WE LIVE OUR LIVES EVERYDAY, WE ARE WORTHY OF THE TRUST PEOPLE PLACE IN US. INNOVATION - WE EMBRACE CHANGE, CREATIVITY, CONTINUOUS LEARNING AND PERSONAL GROWTH. WE INCORPORATE NEW IDEAS, TECHNOLOGY AND METHODS TO IMPROVE THE HEALTH CARE AND SERVICES WE PROVIDE. WE ANTICIPATE FUTURE TRENDS AND WE CREATE STRATEGIC PLANS TO INSURE FUTURE GROWTH AND CONTINUED VITALITY. COLLABORATION - WE BUILD ENDURING INTERNAL AND EXTERNAL RELATIONSHIPS, JOINING WITH COLLEAGUES ACROSS ORGANIZATIONAL BOUNDARIES TO IMPROVE THE CARE AND SERVICES WE PROVIDE. WE ENCOURAGE AND REWARD BOTH INDIVIDUAL AND TEAM ACHIEVEMENTS. WE PUT THE COMMON GOOD AHEAD OF NARROW INTERESTS. STEWARDSHIP - WE ARE RESOURCEFUL, ADAPTABLE AND RESILIENT. WE HAVE A "CAN DO" ATTITUDE THAT GETS THE JOB DONE. WE ARE FISCALLY RESPONSIBLE AND EFFICIENT WITH OUR TIME. WE PROTECT OUR RESERVES AND MANAGE OUR OPERATING COSTS IN ORDER TO INVEST IN OUR FUTURE. WE ARE EACH PERSONALLY DEDICATED TO MAKING CHILDREN'S HOSPITAL BETTER BECAUSE WE WERE HERE. COMMITMENT TO THE COMMUNITY AS A NOT-FOR-PROFIT ORGANIZATION GOVERNED BY ITS OWN BOARD OF TRUSTEES, CHILDREN'S HOSPITAL IS SOLELY COMMITTED TO ADDRESSING THE MEDICAL NEEDS OF OUR REGION'S SICKEST CHILDREN. WITH 348 BEDS, CLOSE TO 600 PHYSICIANS AND APPROXIMATELY 2,800 TOTAL EMPLOYEES, CHILDREN'S HOSPITAL OFFERS ACCESSIBILITY TO OVER 40 FETAL, NEONATAL AND PEDIATRIC SUBSPECIALTIES, ALL COMMITTED TO PROVIDING THE HIGHEST LEVEL OF QUALITY CARE POSSIBLE. EXAMPLES INCLUDE THE HOSPITAL'S NEONATAL AND PEDIATRIC INTENSIVE CARE UNITS THAT MAINTAIN LOW MORTALITY RATES, WHEN COMPARED NATIONALLY, WHILE TREATING SOME OF THE SICKEST CHILDREN. WHILE PROVIDING EXCEPTIONAL CARE IS THE SINGLE GREATEST CONTRIBUTION THE HOSPITAL MAKES FOR OUR CHILDREN AND THEIR FAMILIES, THE HOSPITAL ALSO APPRECIATES THAT IT IS UNIQUELY POSITIONED TO SUPPORT THE NEEDS OF CHILDREN IN OTHER WAYS AS WELL. AS AN EXTENSION OF THE HOSPITAL'S MISSION AND VISION, THE GOAL OF CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS TO ADVANCE THE HEALTH AND WELLBEING OF UNDERSERVED, MEDICALLY NEEDY CHILDREN THROUGH COLLABORATION AND COMMON CONCERN. THE COMMUNITY BENEFITS PROGRAM IS OVERSEEN BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE. II. SERVICE AREA DEMOGRAPHICS AND PATIENT VOLUME SERVICE AREA DEMOGRAPHICS AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL'S PRIMARY SERVICE AREA EXTENDS FROM MODESTO IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE SIERRA NEVADA. THE SERVICE AREA INCLUDES 9 COUNTIES AND IS HOME TO OVER 1.1 MILLION CHILDREN AGES 0-17. CHILDREN'S HOSPITAL'S PATIENT VOLUME IN 2012, CHILDREN'S HOSPITAL HAD 12,791 INPATIENT CASES, 77,994 EMERGENCY DEPARTMENT VISITS AND A COMBINED 181,853 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 66% OF TOTAL OUTPATIENT VISITS AT THE HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 4 YEARS OF AGE OR YOUNGER AND OVER 2/3 WERE AN ETHNICITY OTHER THAN CAUCASIAN. III. ASSESSING AND UNDERSTANDING COMMUNITY NEEDS CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS ESTABLISHED BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT. CONSISTENT WITH STATE AND FEDERAL LAW, CHILDREN'S HOSPITAL COMPLETES A FORMAL ASSESSMENT OF UNMET PEDIATRIC HEALTH CARE NEEDS IN THE COMMUNITY EVERY THREE YEARS. THE HOSPITAL'S MOST RECENT ASSESSMENT WAS COMPLETED IN AUGUST 2011 AND INCLUDED THE FOLLOWING ACTIVITIES. FORMAL NEEDS ASSESSMENT PROCESS * REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT - UNDER THE AUSPICES OF THE CENTRAL VALLEY HEALTH POLICY INSTITUTE, CALIFORNIA STATE UNIVERSITY, FRESNO, CHILDREN'S HOSPITAL PARTNERED WITH OTHER HOSPITALS IN A FOUR COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. SOURCES OF DATA INCLUDED KEY STAKEHOLDER INTERVIEWS AS WELL PUBLISHED HEALTH STATUS INDICATOR DATA. FOR A COPY OF THE NEEDS ASSESSMENT, VISIT THE FOLLOWING LINK. HTTP://WWW.FRESNOSTATE.EDU/CHHS/CVHPI/DOCUMENTS/2011-COMMUNITY-NEEDS. PDF *SUPPLEMENTAL STAKEHOLDER INTERVIEWS - IN ADDITION TO THE INTERVIEWS CONDUCTED AS PART OF THE NEEDS ASSESSMENT DESCRIBED ABOVE, CHILDREN'S HOSPITAL STAFF CONDUCTED ADDITIONAL INTERVIEWS TO EXPLORE MORE THOROUGHLY THE ISSUES AS THEY RELATE TO CHILDREN. INTERVIEWS WERE CONDUCTED WITH OVER A DOZEN KEY ORGANIZATIONS, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS, SCHOOL DISTRICTS, FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, AND A VARIETY OF COMMUNITY-BASED NONPROFIT AGENCIES SERVING LOW INCOME, NEEDY CHILDREN AND FAMILIES. PARTICULAR AREAS OF INTEREST INCLUDED CHRONIC DISEASE MANAGEMENT (ASTHMA, OBESITY, DIABETES), SERVICES FOR CHILDREN WITH, OR AT RISK FOR DEVELOPMENTAL DELAYS, ACCESS TO PRIMARY AND PREVENTATIVE SERVICES, CHILD ABUSE AND UNINTENTIONAL INJURY PREVENTION, MENTAL HEALTH, AND CAPACITY OF COMMUNITY-BASED PROVIDERS TO MANAGE KIDS WITH COMPLEX MEDICAL CONDITIONS.STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE
IV. COMMUNITY BENEFITS PROGRAM A COMMUNITY BENEFIT IS GENERALLY DEFINED AS A CLINICAL OR NON-CLINICAL PROGRAM OR SERVICE THAT - PROVIDES TREATMENT AND/OR PROMOTES HEALTH AND HEALING IN RESPONSE TO AN IDENTIFIED COMMUNITY HEALTH NEED OR SERVICE GAP IDENTIFIED THROUGH THE COMMUNITY NEEDS ASSESSMENT PROCESS, - IS INTENDED TO BENEFIT THE COMMUNITY AS OPPOSED TO THE HOSPITAL, AND - RESULTS IN A LOW OR NEGATIVE FINANCIAL MARGIN FOR THE HOSPITAL. ALSO INCLUDED IN THE DEFINITION IS THE PROVISION OF CHARITY CARE AND THE UNREIMBURSED COST OF PROVIDING HEALTH CARE SERVICES TO THOSE ENROLLED IN PUBLIC PROGRAMS, INCLUDING MEDI-CAL. FOR FY 2012, CHILDREN'S HOSPITAL DEDICATED IN EXCESS OF $2,776,284 IN COMMUNITY BENEFITS THAT CONTINUE THE HOSPITAL'S LONG TRADITION OF BEING AN ACTIVE AND INTEGRAL PART OF CENTRAL CALIFORNIA. DUE TO THE HOSPITAL'S RECEIPT OF HOSPITAL FEE PROGRAM REVENUE IN 2012, THE FIGURE ABOVE DOES NOT INCLUDE THE HOSPITAL'S COSTS ASSOCIATED WITH UNCOMPENSATED MEDI-CAL, WHICH WAS $21,418,838 IN 2012. A SUMMARY OF THE HOSPITAL'S COMMUNITY BENEFITS PROGRAM ACTIVITIES IN 2012: COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH EDUCATION CLASSES OFFERED BY THE HOSPITAL REFLECT THE HOSPITAL'S LONG-STANDING COMMITMENT TO SUPPORTING COMMUNITY WELLNESS AND DISEASE PREVENTION. CLASSES, WHICH ARE OFFERED AT THE HOSPITAL AT NO COST TO PARTICIPANTS, ARE TAUGHT BY CHILDREN'S HOSPITAL STAFF AND A COMMUNITY BASED VENDOR, BOTH OF WHICH HAVE SPENT YEARS STUDYING AND GAINING EXPERIENCE IN THEIR CHOSEN FIELDS. EXAMPLES OF CLASSES OFFERED IN 2012 INCLUDE THE FOLLOWING. ASTHMA BASICS THIS CLASS PROVIDED INFORMATION ABOUT CONTROLLING ASTHMA; PROPER USE OF MEDICATIONS; PEAK FLOW METERS; METER DOSE INHALERS AND SPACERS; RECOGNIZING EARLY WARNING SIGNS OF ASTHMA; ENVIRONMENTAL CONTROL AND WHAT TRIGGERS AN ASTHMA ATTACK. CPR FOR FAMILY AND FRIENDS OFFERED TO FAMILIES WHO WERE TAKING A CHILD HOME FROM CHILDREN'S HOSPITAL, THIS CLASS PRESENTED INFORMATION ON THE AMERICAN HEART ASSOCIATION'S (AHA) PEDIATRIC CHAIN OF SURVIVAL, SIGNS OF CHOKING, PREVENTION OF SUDDEN INFANT DEATH SYNDROME, AND PREVENTION OF THE MOST COMMON FATAL INJURIES IN INFANTS AND CHILDREN. THE COURSE ALSO PRESENTED INFORMATION ABOUT THE AHA ADULT CHAIN OF SURVIVAL AND SIGNS OF CARDIAC ARREST, HEART ATTACK, STROKE AND CHOKING IN ADULTS. HEALTH ENCYCLOPEDIA ($12,062) CHILDREN'S HOSPITAL ALSO PROVIDED ACCESS TO ON LINE EDUCATIONAL INFORMATION VIA THE HEALTH ENCYCLOPEDIA LINK ON ITS WEBSITE. HEALTH ENCYCLOPEDIA CONTAINS THOUSANDS OF PAGES OF INFORMATION ON PEDIATRIC DISEASES, CONDITIONS AND TREATMENTS, AS WELL AS SECTIONS ON HOW TO KEEP KIDS HEALTHY. THE ENCYCLOPEDIA IS AVAILABLE IN ENGLISH AND SPANISH. HEALTH CARE SUPPORT SERVICES HEALTH CARE SUPPORT SERVICES ARE PROVIDED BY THE HOSPITAL TO HELP ADDRESS THE HEALTH CARE NEEDS OF CHILDREN AND THEIR FAMILIES WHILE AT THE HOSPITAL, AT HOME, AND IN THE COMMUNITY. CAFETERIA MEALS ($65,656) MEAL COUPONS WERE PROVIDED TO BREAST-FEEDING MOMS WHOSE INFANTS WERE IN THE HOSPITAL. SOCIAL WORKERS ALSO PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. CANCER SURVIVORSHIP PROGRAM THE CHILDHOOD CANCER SURVIVORSHIP PROGRAM AT CHILDREN'S HOSPITAL PROVIDES SPECIALIZED, HIGH-QUALITY CARE TO HELP SURVIVORS OF CHILDHOOD CANCER LIVE HEALTHIER, HAPPIER LIVES. THE PROGRAM INCLUDES AN ANNUAL ASSESSMENT OF THE SURVIVOR'S HEALTH, ACADEMIC AND SOCIAL DEVELOPMENT, AND AN INDIVIDUALIZED ACTION PLAN TO ADDRESS LONG-TERM EFFECTS FROM CANCER TREATMENT. CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY-BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. A. SCHOOL NURSES - CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. B. HOSPITALS / COMMUNITY BASED ORGANIZATIONS - CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. TOPICS COVERED INCLUDED CARE FOR HIGH RISK NEWBORNS, HYPOTHERMIA, PEDIATRIC TRAUMA AND CHILD MALTREATMENT, PEDIATRIC LABORATORY SKILLS, SHAKEN BABY SYNDROME, TO NAME A FEW. CHILD ABUSE PREVENTION PREVENTING AND PROTECTING CHILDREN FROM MALTREATMENT, INCLUDING BUT NOT LIMITED TO, PHYSICAL ABUSE, SEXUAL ABUSE, COMMERCIAL SEXUAL EXPLOITATION, DRUG EXPOSURE AND NEGLECT, FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH COMMUNITY BASED ORGANIZATIONS, PARENTS, PRIVATE AND PUBLIC AGENCIES, THE CENTER PROVIDED EDUCATION, PREVENTION, LEADERSHIP, AND DIRECT SERVICES FOR THE COMMUNITY, CHILDREN AND THEIR FAMILIES TO HELP PREVENT FUTURE ABUSE. CULTURALLY COMPETENT HEALTH CARE WITH A SERVICE AREA THAT IS HOME TO OVER 100 DOCUMENTED LANGUAGES AND 37 DISTINCT CULTURES, CHILDREN'S HOSPITAL IS COMMITTED TO MEETING THE NEEDS OF A VERY DIVERSE PATIENT POPULATION. AS IT HAS DONE FOR YEARS, THE HOSPITAL IN 2012 PROVIDED LANGUAGE ASSISTANT 24 HOURS A DAY, SEVEN DAYS A WEEK. CHILDREN'S HOSPITAL ALSO WORKED WITH A VARIETY OF ETHNIC GROUPS TO ENSURE THAT THE HOSPITAL WAS PROVIDING CARE IN AS CULTURALLY SENSITIVE A MANNER AS POSSIBLE. DEVELOPMENTAL DISABILITIES CHILDREN'S HOSPITAL PROVIDED EDUCATION TO PROVIDERS AND FAMILIES IN A NUMBER OF WAYS, INCLUDING THROUGH THE HOSTING OF SEVERAL CONFERENCES AND WORKING WITH BIRTHING HOSPITALS IN FRESNO AND TULARE COUNTIES AS PART OF THE HOSPITAL'S NEONATAL STABILIZATION PROJECT. THE HOSPITAL ALSO HOSTED A CONFERENCE AS PART OF ITS PARTICIPATION IN THE CALIFORNIA PERINATAL QUALITY CARE COLLABORATIVE (CPQCC). THE GOAL OF CPQCC IS TO IMPROVE AND OPTIMIZE THE DELIVERY ROOM RESUSCITATION AND STABILIZATION PRACTICES FOR ALL INFANTS WHOM CHILDREN'S TRANSPORT OR RESUSCITATION TEAM WERE PRESENT FOR DELIVERY. THE HOSPITAL ALSO CONTINUED TO PARTICIPATE IN COALITIONS FOCUSED ON IMPROVING CARE COORDINATION FOR INFANTS AND CHILDREN WITH, OR AT RISK FOR, DEVELOPMENTAL DELAYS, INCLUDING KERN COUNTY'S MEDICALLY VULNERABLE INFANT WORK GROUP INITIATIVE, AND FIRST 5 FRESNO'S MODEL OF CARE PARTNERSHIP OVERSIGHT COMMITTEE AND SYSTEMS OF CARE COMMITTEE. ALSO, THE HOSPITAL CONTINUED TO PROVIDE EDUCATION AND TECHNICAL ASSISTANCE OFFERED THROUGH ITS HIGH RISK INFANT FOLLOW UP PROGRAM TO OTHER PROVIDERS AND COMMUNITY BASED AGENCIES REGARDING SCREENING AND ASSESSMENT FOR DEVELOPMENTAL DELAYS IN HIGH RISK INFANTS. LAST, CHILDREN'S HOSPITAL MAINTAINED ITS STRONG PARTNERSHIP WITH THE MARCH OF DIMES ($10,650) IN SUPPORT OF HEALTHY MOMS AND HEALTHY BABIES.
ENROLLMENT INTO HEALTH INSURANCE CHILDREN'S HOSPITAL COMMITTED SIGNIFICANT RESOURCES TO HELP FAMILIES FIND HEALTH INSURANCE COVERAGE FOR THEMSELVES AND THEIR UNINSURED CHILDREN, INCLUDING FINANCIAL COUNSELORS AS WELL AS A CONTRACTED VENDOR WITH EXPERTISE IN ENROLLMENT SERVICES (APPROXIMATELY $286,900). WITH THESE RESOURCES, THE HOSPITAL IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM, OR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, THE HOSPITAL AND/OR THE CONTRACTED VENDOR ASSISTED THE FAMILY WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. CHILDREN'S HOSPITAL ALSO SUPPORTED OUTREACH AND ENROLLMENT SERVICES OFFERED THROUGH THE FRESNO HEALTHY COMMUNITIES ACTION PROGRAM ($1,000). FAMILY ASSISTANCE FUND ($48,764) WHEN SUPPORT FOR SERVICES WERE NOT AVAILABLE THROUGH A COMMUNITY PROGRAM OR ANOTHER FUNDING SOURCE, SOCIAL WORKERS WERE ABLE TO ACCESS THESE HOSPITAL FUNDS TO HELP PATIENTS AND FAMILIES OBTAIN ITEMS NEEDED UPON RETURN HOME OR ASSIST WITH TRANSPORTATION FOR FOLLOW UP CARE. INJURY PREVENTION RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN AGES 1-14, CHILDREN'S HOSPITAL OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. SUPPORTED BY A CAST OF OVER 90 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2012: DISTRACTED & RECKLESS TEEN DRIVING, PEDIATRIC TRAUMA, WATER SAFETY, WHEELED SPORTS SAFETY, CHILD PASSENGER SAFETY, THE CHOKING GAME, SPORTS INJURIES, LITHIUM (BUTTON) BATTERY INGESTION, AIR POWERED GUN INJURIES, TOY SAFETY, CHILD MALTREATMENT, MUNCHAUSEN SYNDROME BY PROXY, AND ABUSIVE HEAD TRAUMA. THE PROGRAM PROVIDED EDUCATION TO OVER 14,600 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY-BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,376 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS. THE PROGRAM ALSO PROVIDED 31 TELEVISION INTERVIEWS AND MEDIA EVENTS TO ADDRESS CHILD SAFETY ISSUES. THE HOSPITAL NOW PROVIDES A MONTHLY CHILD SAFETY SEGMENT ON TWO LOCAL NEWS PROGRAMS BROADCAST THROUGHOUT THE CENTRAL VALLEY. CHILDREN'S HOSPITAL ALSO CHAIRED SAFE KIDS CENTRAL VALLEY, LEADING THE COALITION OF 16 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS FOCUSED ON DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. LITERACY PROGRAM LITERACY, WHICH IS DEFINED AS THE ABILITY TO READ AND WRITE, IS ESSENTIAL TO FULLY DEVELOPING A SENSE OF WELL-BEING AND CITIZENSHIP. EXPERTS ESTIMATE THAT NEARLY 40 PERCENT OF U.S. 4TH GRADERS DO NOT ACHIEVE BASIC LEVELS OF READING PROFICIENCY. READING DIFFICULTIES AND ILLITERACY CONTRIBUTE TO INCREASED SCHOOL ABSENTEEISM, SCHOOL DROP-OUTS, JUVENILE DELINQUENCY, INCREASED CRIME, TEEN PREGNANCY, DRUG USE AND OTHER PROBLEMS THAT IMPACT OUR COMMUNITY. STUDIES SHOW THE EASIEST WAY TO INCREASE LITERACY AMONG PRE-SCHOOL AND SCHOOL AGE CHILDREN IS TO SIMPLY READ TO THEM. TO MAKE A MEANINGFUL CONTRIBUTION TO LITERACY IN OUR COMMUNITY, CHILDREN'S HOSPITAL'S LITERACY PROGRAM PROMOTES AND ENCOURAGES CHILDREN AND THEIR FAMILIES TO BECOME LIFELONG READERS. THE HOSPITAL'S "BOOK BUDDIES" INITIATIVE SPECIFICALLY FOCUSES ON DEVELOPING READING READINESS AND EARLY READING SKILLS FOR OUR YOUNG PATIENTS. HOSPITAL VOLUNTEERS BRING BOOKS TO THE CHILDREN, READ THEM STORIES AND ENGAGE THEM IN ACTIVITIES THAT COORDINATE WITH THE STORIES. SEPARATE FROM "BOOK BUDDIES", HOSPITAL VOLUNTEERS VISIT OUTPATIENT PRACTICE WAITING ROOMS TO READ TO CHILDREN, SHOWING PARENTS AND CHILDREN THE PLEASURES AND TECHNIQUES OF LOOKING AT BOOKS TOGETHER. ADDITIONALLY, BOOKS ARE AVAILABLE IN HOSPITAL CLINICS AND DEPARTMENTS, AND FAMILIES ARE ENCOURAGED TO TAKE THEM HOME TO USE WITH THEIR CHILDREN. IN 2012, CHILDREN'S HOSPITAL DISTRIBUTED OVER 14,000 BOOKS TO PATIENTS AND FAMILIES. OBESITY PREVENTION CHILDREN'S HOSPITAL SUPPORTED A NUMBER OF EFFORTS AIMED AT ADDRESSING THE ISSUE OF CHILDHOOD OBESITY IN OUR COMMUNITY. THE HOSPITAL CONTINUED TO SERVE AS THE ADVOCACY COORDINATOR FOR THE KAISER HEAL ZONE PROJECT IN THE CITY OF MADERA BY FACILITATING ADVOCACY IN SUPPORT OF INCREASED ACCESS TO HEALTHY FOODS AND PHYSICAL ACTIVITY. ADDITIONALLY, AS THE FOUNDER AND ONGOING ACTIVE MEMBER OF THE CHILDHOOD OBESITY PREVENTION TASK FORCE FOR FRESNO AND MADERA COUNTIES, CHILDREN'S HOSPITAL PLAYED A LEAD ROLE IN SUPPORTING THE TASK FORCE'S ACTIVITIES IN 2012. EXAMPLES INCLUDED FACILITATING EDUCATION PROGRAMS FOR PRIMARY CARE PROVIDERS ON PREVENTING AND MANAGING OBESITY, AS WELL AS PROMOTING A HIGHER LEVEL OF SUPPORT BY HEALTH PLANS FOR PRIMARY CARE BASED OBESITY PREVENTION OR MANAGEMENT SERVICES. POISON CONTROL ($50,122) THE CENTRAL CALIFORNIA POISON CONTROL CENTER IS LOCATED ON THE CHILDREN'S HOSPITAL CAMPUS AND RECEIVED A DONATION OF OFFICE SPACE. THE CENTRAL CALIFORNIA DIVISION OF THE CALIFORNIA POISON CONTROL CENTER ANSWERS CALLS FROM THROUGHOUT THE REGION AND PROVIDES EXPERT ADVICE AND INFORMATION REGARDING EXPOSURE TO POTENTIALLY HARMFUL SUBSTANCES. THE PHONES ARE STAFFED 24 HOURS A DAY, 7 DAYS A WEEK. IN ADDITION TO PROVIDING EMERGENCY TELEPHONE ADVICE REGARDING POISON EXPOSURES, THE POISON CONTROL CENTER OPERATES SEVERAL PROGRAMS CRITICAL TO A CULTURALLY DIVERSE, AGRICULTURALLY BASED COMMUNITY LIKE THE CENTRAL VALLEY. THE CENTER HAS BEEN EXPRESSLY RESPONSIVE TO THE GROWING AND LARGELY UNDERSERVED LATINO POPULATION BY DEVELOPING SPECIALIZED TEACHING TOOLS AND PROGRAM INTERVENTIONS IN SPANISH, AND PROVIDING CUSTOMIZED TRAININGS FOR COMMUNITY HEALTH WORKERS IN SPANISH. ALSO, THE CENTER CONTRACTS WITH THE STATE DEPARTMENT OF PESTICIDE REGULATION (DPR) TO ASSIST PHYSICIANS IN COMPLYING WITH MANDATORY REPORTING REQUIREMENTS FOR PESTICIDE EXPOSURES. THE POISON CONTROL CENTER ALSO PROVIDES THE STATE DPR WITH CASE DATA AND INFORMATION ON THE HEALTH ISSUES RELATED TO PESTICIDE EXPOSURE IN CALIFORNIA. REINTEGRATION CHILDREN'S HOSPITAL SUPPORTS A NUMBER OF PROGRAMS OR INITIATIVES DESIGNED TO HELP CHILDREN WHO SUFFER FROM PERMANENT OR LONG-TERM DISABILITIES REINTEGRATE AS EASILY AS POSSIBLE INTO REGULAR DAILY ACTIVITIES. CHILDREN'S HOSPITAL'S ADAPTIVE SPORTS PROGRAM PROVIDES RECREATIONAL AND ATHLETIC EXPERIENCES FOR CHILDREN WITH DISABILITIES. EXPERIENCES OFFERED IN 2012 INCLUDED WATER SKIING, SNOW SKIING, ROCK CLIMBING AND ICE HOCKEY. OPEN TO ALL AGES, THE PROGRAM IS THE ONLY ONE OF ITS KIND IN THE CENTRAL VALLEY. IT'S DESIGNED FOR INDIVIDUALS WITH PHYSICAL AND HEALTH IMPAIRMENTS AND CONDITIONS RANGING FROM CEREBRAL PALSY TO SPINAL CORD INJURIES. THROUGH HARD WORK AND DETERMINATION, PARTICIPANTS LEARN THAT IT'S POSSIBLE FOR THEM, TOO, TO TAKE PART IN ATHLETIC ACTIVITIES, EXCEED EXPECTATIONS AND ACHIEVE THEIR DREAMS. CHILDREN'S HOSPITAL ALSO WORKS TO ENSURE A SMOOTH TRANSITION FOR CHILDREN RETURNING TO SCHOOL BY COORDINATING A SERIES OF VISITS WITH SCHOOL STAFF AND STUDENTS. IN 2012, VISITS INCLUDED A TOUR OF THE CAMPUS TO REORIENT CHILDREN TO THE SCHOOL AND TO IDENTIFY AND ADDRESS ANY POTENTIAL ACCESS ISSUES. VISITS ALSO INCLUDED CONFERENCES WITH SCHOOL STAFF TO MAKE SURE THEY WERE AWARE OF THE CHILDREN'S DISABILITIES AND TO ENSURE STAFF COULD ACCOMMODATE THE CHILDREN'S HEALTH CARE NEEDS AS BEST AS POSSIBLE. ADDITIONALLY, THE HOSPITAL CONVENED 'CIRCLE OF FRIENDS' MEETINGS BETWEEN CHILDREN AND THEIR FRIENDS TO GIVE THEM A CHANCE TO SEE AND TALK ABOUT THE CHILDREN'S DISABILITIES. TRANSPORTATION ($137,779) CHILDREN'S HOSPITAL'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING TAXI VOUCHERS AND BUS TOKENS. IN ADDITION, CHILDREN'S HOSPITAL SUBSIDIZED BUS AND TRANSIT SERVICES FROM FRESNO AND THE KINGS COUNTY RURAL AREAS. PUBLIC TRANSPORTATION HAS BEEN A PROBLEM IN THE CENTRAL VALLEY FOR YEARS AND THUS CHILDREN'S HOSPITAL CONTINUES TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND ACCESS TO CARE.
PART III, LINE 4B:COMMITMENT TO MEDI-CAL CHILDREN'S HOSPITAL'S COMMITMENT TO SERVING ITS COMMUNITY IS EVIDENCED BY THE LARGE NUMBER OF PATIENTS ITS SERVES THAT ARE COVERED BY MEDI-CAL. IN 2012, OF THE HOSPITAL'S 79,699 TOTAL INPATIENT DAYS, 59,503 (75%) WERE COVERED BY MEDI-CAL. THE HOSPITAL HAS HISTORICALLY BEEN ABLE TO NEGOTIATE INCREASES TO ITS MEDI-CAL INPATIENT REIMBURSEMENT. THESE INCREASES, HOWEVER, HAVE NOT OFFSET THE RISING COST OF CARE FOR THESE PATIENTS AND IN RECENT YEARS, ADDITIONAL RATES FREEZES AND CUTBACKS IN GOVERNMENT FUNDING CONTINUE TO PUT PRESSURE ON THE HOSPITAL'S ABILITY TO PROVIDE CARE. IN ADDITION, THE MEDI-CAL OUTPATIENT FEE SCHEDULE REIMBURSEMENT REMAINS SIGNIFICANTLY BELOW COST. THE COMBINED NET EFFECT OF TOTAL MEDI-CAL REIMBURSEMENT AND DISPROPORTIONATE SHARE FUNDING IN RELATION TO THE COST OF THESE SERVICES RESULTED IN A NET LOSS TO THE HOSPITAL IN 2012 OF $21,418,838. THIS FIGURE IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS, AND ALSO EXCLUDES THE REVENUE AND EXPENSES ASSOCIATED WITH THE HOSPITAL FEE PROGRAM, WHICH IS DESCRIBED IN MORE DETAIL BELOW. HOSPITAL FEE PROGRAM - IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING CHILDREN'S HOSPITAL CENTRAL CALIFORNIA, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. THE PROGRAM WAS FUNDED BY A QUALITY ASSURANCE FEE PAID BY HOSPITALS THAT THE STATE THEN USED TO COLLECT ADDITIONAL FEDERAL FUNDING. HOSPITAL FEE PROGRAMS LIKE CALIFORNIA'S ARE ALLOWABLE UNDER FEDERAL LAW, AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROVED CALIFORNIA'S PROGRAM. CALIFORNIA'S PROGRAM WAS IMPLEMENTED IN TWO PARTS, WITH PART ONE COVERING THE PERIOD APRIL 1, 2009 THROUGH DECEMBER 31, 2010, AND PART TWO COVERING THE PERIOD JANUARY 1, 2011 THROUGH JUNE 30, 2011. CALIFORNIA SUBSEQUENTLY ENACTED A THIRTY-MONTH QUALITY ASSURANCE PROGRAM FOR THE PERIOD OF JULY 1, 2011 THROUGH DECEMBER 31, 2013. AS OF SEPTEMBER 30, 2012, THE MANAGED CARE PORTION OF THE 30 MONTH PROGRAM HAD NOT BEEN APPPROVED. IN 2012, CHILDREN'S HOSPITAL RECOGNIZED PROGRAM REVENUE OF $80,897,470, NET OF THE HOSPITAL'S QUALITY ASSURANCE FEE AND HOSPITAL CONTRIBUTIONS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT). CHFT WAS ESTABLISHED UNDER THE PROGRAM FOR THE PURPOSE OF SUPPORTING CHARITABLE ACTIVITIES. THE NET REVENUE RECOGNIZED IN 2012 INCLUDES PART TWO OF THE PROGRAM AND 15 MONTHS OF THE FEE-FOR-SERVICE COMPONENT OF THE THIRTY-MONTH PROGRAM. AS THE HOSPITAL'S HOSPITAL FEE PROGRAM REVENUE RECOGNIZED IN 2012 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2012, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2012. FOR DECADES, CALIFORNIA HAS BEEN UNABLE TO REIMBURSE HOSPITALS LIKE CHILDREN'S FOR MEDI-CAL SERVICES AT LEVELS WHICH COVER COSTS. THE FUTURE LOOKS EVEN WORSE GIVEN MEDI-CAL FUNDING CUTS AT BOTH THE STATE AND FEDERAL LEVELS, ALONG WITH THE PRESSURE THAT ONGOING GOVERNMENT BUDGET DEFICITS WILL PLAY ON REDUCING MEDI-CAL FUNDING EVEN FURTHER. WHILE THE PROGRAM'S PAYMENTS HAVE PLAYED AN IMPORTANT ROLE IN OFFSETTING SOME OF THE HOSPITAL'S LOSSES, THE PROGRAM'S LIMITED DURATION MEANS THAT IT WILL NOT SERVE AS A LONG-TERM SOLUTION TO THE HOSPITAL'S CHRONIC MEDI-CAL PAYMENT SHORTFALLS. CHARITY CARE IN KEEPING WITH OUR MISSION, CHILDREN'S HOSPITAL CONTINUES TO ACCEPT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2012, CHILDREN'S HOSPITAL PROVIDED $102,000 IN CHARITY CARE. THE AMOUNT REPRESENTS COSTS ASSOCIATED WITH PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES IN RELATION TO THE COST OF THESE SERVICES. CHARITY CARE INCLUDES COUNTY INDIGENT AND FREE CARE, WHICH IS BASED ON THE PATIENT'S INABILITY TO PAY FOR SERVICES. IN ORDER TO ASSIST FAMILIES WITH ONGOING CARE NEEDS, CHILDREN'S HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES PATIENT FAMILIES TO APPLY FOR APPROPRIATE GOVERNMENT FUNDING IN CONJUNCTION WITH APPLYING FOR FINANCIAL ASSISTANCE (CHARITY CARE). AS A RESULT, MANY FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS AND DO NOT ULTIMATELY REQUIRE CHARITY CARE. THE HOSPITAL'S CHARITY CARE AMOUNT IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS.STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19300 VALLEY CHILDRENS PLACEAddressLine1
CityMADERACity
StateCAState
ZIP Code93636ZIPCode
FieldValueIRS element (for citing)
EIN942797447EIN
Primary ActivitiesPHILANTHROPY/FUNDRAISING FOR THE HOSPITALPrimaryActivities
Legal Domicile StateCALegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status11 TYPE IPublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIABusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line19300 VALLEY CHILDRENS PLACEAddressLine1
CityMADERACity
StateCAState
ZIP Code93636ZIPCode
FieldValueIRS element (for citing)
EIN770450620EIN
Primary ActivityMEDICAL GROUPPrimaryActivity
Legal Domicile StateCALegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
Share Of Total Income41862362ShareOfTotalIncome
Share Of EOY Assets5931391ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION
C2651665CASH VALUE
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA
K1114664CASH VALUE
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA
L14099527CASH VALUE