2012-08-15T15:37:51-05:00 2011-09-30 MOSS ADAMS LLP 3121 WEST MARCH LANE SUITE 100 STOCKTON CA 952192303 990 2010-10-01 941294954 CHILDREN'S HOSPITAL CENTRAL CALIFORNIA CHIL 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 MICHELE WALDRON 5593533000 2012-08-10 1 TRACY S PAGLIA 2099556100 2010 2016-02-24 21:20:13Z MICHELE WALDRON 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 754060739 0 X WWW.CHILDRENSCENTRALCAL.ORG X 1949 CA PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN 15 11 2918 528 1001231 0 23867645 21770337 343754551 479173553 6102417 4857119 8319875 7470362 382044488 513271371 239584 265040 0 0 211444448 221933180 0 0 0 128644288 170720632 340328320 392918852 41716168 120352519 551109623 697990469 247720377 309774983 303389246 388215486 TO 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. 0 0 29317109 265040 162588250 SEE SCHEDULE O 273102463 0 316585303 SEE SCHEDULE O 302419572 1 1 0 1 0 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 0 0 1 253 0 1 2918 1 1 1 0 0 0 0 0 0 0 0 0 X 15 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MICHELE WALDRON CFO 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 X GORDON ALEXANDER 34.00 X X 421879 0 25128 BRUCE ALBRIGHT 1.00 X 0 0 0 SUSAN BOYD TERM ENDED 1.00 X 0 0 0 GREG COLEMAN 1.00 X X 0 0 0 DR LINDA FRALEY 1.00 X 0 0 0 RICHARD SHEHADEY 1.00 X 0 0 0 STEPHANIE HOULDING 1.00 X 0 0 0 DR GRACIE ESQUIVEL-AGUILAR RESIG 1.00 X 0 0 0 DR DEVONNA KAJI 1.00 X 68333 0 0 DENNIS KELLER RESIGNED 1.00 X 0 0 0 DAVID KRAUSE 1.00 X X 0 0 0 DR ROBERT KUBO 1.00 X 0 0 0 MENDY LAVAL 1.00 X X 0 0 0 JEFF MAYER 1.00 X X 0 0 0 DAVE OLSON 1.00 X 0 0 0 PAT RICCHIUTI 1.00 X 0 0 0 DR CHARLES SMITH 1.00 X 0 0 0 BILL SMITTCAMP 1.00 X 0 0 0 MICHELE R WALDRON 38.00 X 438660 0 187363 TODD SUNTRAPAK 40.00 X 434960 0 169094 DAVID CHRISTENSEN 40.00 X 432851 0 56000 BEVERLY HAYDEN-PUGH 40.00 X 326887 0 148161 JESSIE HUDGINS 40.00 X 302991 0 159908 MARTA BOYER 40.00 X 302909 0 164887 JANE WILLSON 40.00 X 300410 0 133330 DAVID SINGH 40.00 X 272926 0 21440 RICK WOLF 40.00 X 257484 0 61136 WILLIAM F HAUG 40.00 X 726523 0 81181 RANDALL GUERRERO 40.00 X 228589 0 25818 STEPHANIE VANCE 40.00 X 231149 0 26133 JEFFREY LEFORS 40.00 X 224352 0 18848 KAMELA LOO 40.00 X 232294 0 32589 MARK ZIELAZINSKI 40.00 X 101459 0 14678 5304656 0 1325694 391 1 1 0 SPECIALTY MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 SUBSPEC PHYSICIAN SERVICES 10315363 PEDIATRIC ANETHESIA ASSOCIATION 6235 N FRESNO ST STE 103 FRESNO CA 93710 ANETHESIA/CRITICAL CARE 7177200 CROTHALL HEALTHCARE INC 1654 MARTHALER LANE WEST ST PAUL MN 55118 HOUSEKEEPING SERVICES 3865967 MEDQUIST INC PO BOX 102467 ATLANTA GA 30368 TRANSCRIPTION SERVICES 1464587 EMERGENCY PHYSICIANS MEDICAL 3300 DOUGLAS BOULEVARD 200 ROSEVILLE CA 95661 EMERGENCY PHYSICIAN SERVICES 1263772 60 6980041 14289786 500510 162795 21770337 PATIENT SERVICES 900099 478947640 478947640 OUTSIDE LAB SERVICES 900099 225913 225913 479173553 5801727 5801727 863009 863009 115382 78093 37289 37289 37289 238575447 80777 240430518 33323 -1855071 47454 -1807617 -1807617 563046 247434 315612 315612 CAFETERIA REVENUE 900099 2648218 2648218 MANAGEMENT SERVICES 541610 1001231 1001231 3468012 3468012 7117461 513271371 479173553 1001231 11326250 70601 70601 194439 194439 5582713 5582713 416322 416322 151310490 119506393 31804097 7660113 7052646 607467 44286855 33271979 11014876 12676687 9466060 3210627 2337794 81494 2256300 666712 666712 124425 124425 1038313 1038313 26195787 25739624 456163 514084 514084 45247471 38964639 6282832 2792056 2792056 5067354 3479159 1588195 430389 188339 242050 196953 34403 162550 8204504 6287752 1916752 17378557 10631835 6746722 3567117 81490 3485627 HOSPITAL FEE PROGRAM 31297533 31297533 PURCHASED SERVICES 17587433 10204587 7382846 BAD DEBT 4936280 4936280 DUES 1069523 89945 979578 RECRUITMENT 416715 208358 208357 1651632 117932 1533700 392918852 302419572 90499280 0 13958 12928 66636227 83116020 443362 580092 47075250 48997977 4398129 4865891 4210879 12358917 395479286 148234420 234118257 247244866 82642915 135169007 90980874 148422858 868246 998628 19721526 16223285 551109623 697990469 33468678 82493887 163930551 159874416 50321148 67406680 247720377 309774983 X 298209989 383617976 5179257 4597510 303389246 388215486 551109623 697990469 X 120352519 -35526279 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 0 1 72040 1 13794 0 0 85834 0 2188788 2188788 247313756 56817826 190495930 2299393 1929669 369724 119737341 76092801 43644540 23940008 13394124 10545884 247244866 LIMITED PARTNERSHIPS 148422858 F 148422858 MALPRACTICE RESERVE 2076000 ACCRUED PENSION LIABILITY 59698478 457 LIABILITY 1731972 SB 1732 LIABILITY 1070045 OTHER 44444 CONSTRUCTION RETAINS ACCOUNT 2785741 67406680 1 1 1 X 1 X 1 0 1 1 11000 11000 0.00000 273102463 316585302 -43482839 0.00000 6998678 4238110 2760568 0.00710 280112141 320823412 -40711271 0.00710 484530 484530 0.00120 2782197 633482 2148715 0.00550 68500 68500 0.00020 3335227 633482 2701745 0.00690 283447368 321456894 -38009526 0.01400 334 334 0.00000 334 334 1 1741859 0 189397 241969 -52572 X 1 1 2 1 CHILDREN'S HOSPITAL CENTRAL CALIFORNIA

9300 VALLEY CHILDRENS PLACE MADERA CA 936368761

X 2 CHILDREN'S HOSPITAL CENTRAL CA HOME CARE

7555 N DEL MAR AVE FRESNO CA 93711

X NOT APPLICABLE 1 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 2011, THE HOSPITAL RECEIVED APPROXIMATELY $68,478,000 IN NET REVENUE THROUGH THE STATE'S HOSPITAL FEE PROGRAM. BECAUSE THIS NET REVENUE RECOGNIZED IN 2011 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2011, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2011. 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 $ 4936280. PART III, LINE 4: THERE IS NO FINANCIAL STATEMENT FOOTNOTE ON BAD DEBT. 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 2011 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 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 STOCKTON IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE EASTERN SIERRA. THE SERVICE AREA INCLUDES 10 COUNTIES, COVERS OVER 45,000 SQUARE MILES AND IS HOME TO OVER 1.2 MILLION CHILDREN AGES 0-17. IN 2011, CHILDREN'S HOSPITAL HAD 13,270 INPATIENT CASES, 69,006 EMERGENCY DEPARTMENT VISITS AND A COMBINED 173,714 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL BENEFITS COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 64% OF THE OUTPATIENT VISITS AT CHILDREN'S HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 5 YEARS OF AGE OR YOUNGER AND 2/3 WERE AN ETHNICITY OTHER THAN CAUCASIAN. PART VI, LINE 6: 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 2011, CHILDREN'S HOSPITAL PROVIDED 22 SEPARATE CONTINUING MEDICAL EDUCATION PROGRAMS TO A TOTAL OF 285 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 2011 - RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN, 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 75 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2011: 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.AS THE LEAD AGENCY FOR SAFE KIDS CENTRAL VALLEY, CHILDREN'S HOSPITAL LED THE COALITION OF 9 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS TO MEET THE MISSION OF SAFE KIDS IN DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. THE PROGRAM PROVIDED EDUCATION TO OVER 12,330 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,955 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS.IN 2011, CHILDREN'S HOSPITAL INJURY PREVENTION ALSO PROVIDED 23 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 APPLIED FOR AND RECEIVED FUNDING FROM THE CENTRAL VALLEY HEALTH NETWORK TO SERVE 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 IN THE DEVELOPMENT AND IMPLEMENTATION OF KEY WORK PLAN COMPONENTS. AS THE FOUNDER AND NOW A 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 2011. EXAMPLES INCLUDE FORMING A COLLABORATIVE AMONG PEDIATRICIANS AND PAYERS FOR THE PURPOSE OF DESIGNING AND IMPLEMENTING A NEW DELIVERY AND PAYMENT MODEL FOR CHILDHOOD OBESITY TREATMENT AND PREVENTION, AND HOSTING A CONFERENCE FOR PRIMARY CARE PROVIDERS ON OBESITY PREVENTION AND ADVOCACY.CHILDREN'S HOSPITAL ALSO PREPARED AND CONVENED TWO CONTINUING MEDICAL EDUCATION PROGRAMS TITLED "CHILDHOOD OBESITY AND RELATED COMORBIDITIES".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. REPORTS FILED WITH STATES PART VI, LINE 7 CA 1 PRIVATE HEALTH NEWS INC 1776 MENTOR AVE SUITE 210 CINCINNATI OH 45212 300059144 9000 CREATION OF E-HEALTH NEWSLETTER STAYWELL CONTENT SERVICES PO BOX 759 MORRISVILLE PA 190670759 134036258 13395 PROVIDE HEALTH INFORMATION VIA CHCC WEBSITE MARCH OF DIMES 4201W SHAW 105 FRESNO CA 93722 131846366 501(C)(3) 10000 MARCH FOR BABIES SPONSOR UCSF FOUNDATION 155 N FRESNO STREET FRESNO CA 93701 943281661 GOVERNMENT 9600 VALLEY VISION SPONSORSHIP UC MERCED FOUNDATION 5200 NORTH LAKE RAOD MERCED CA 95343 270093858 GOVERNMENT 20000 MEDICAL EDUCATION 3 2 NURSING SCHOLARSHIP 3 4926 EDUCATION SCHOLARSHIP - NEONATAL FOCUS 2 3249 CAFETERIA MEALS 11262 59125 FMV MEAL COUPONS FOR PATIENT FAMILIES AS NEEDED TAXI, BUS AND TRANSIT SERVICES 8579 127139 BOOK SUBSIDATION OF BUS AND TRANSIT SERVICES PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE 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. X X X X X 0 1 0 1 1 1 1 0 0 GORDON ALEXANDER 371364 0 35000 0 15515 0 17673 0 7455 0 447007 0 0 0 MICHELE R WALDRON 368246 0 50234 0 20180 0 172453 0 14910 0 626023 0 0 0 TODD SUNTRAPAK 373283 0 31103 0 30574 0 154184 0 14910 0 604054 0 0 0 DAVID CHRISTENSEN 347363 0 76539 0 8949 0 40469 0 15531 0 488851 0 0 0 BEVERLY HAYDEN-PUGH 276527 0 29084 0 21276 0 140706 0 7455 0 475048 0 0 0 JESSIE HUDGINS 265395 0 17590 0 20006 0 148726 0 11182 0 462899 0 0 0 MARTA BOYER 262014 0 30809 0 10086 0 161160 0 3727 0 467796 0 0 0 JANE WILLSON 258558 0 32634 0 9218 0 125875 0 7455 0 433740 0 0 0 DAVID SINGH 229966 0 34155 0 8805 0 17713 0 3727 0 294366 0 0 0 RICK WOLF 232646 0 24515 0 323 0 46226 0 14910 0 318620 0 0 0 WILLIAM F HAUG 573138 0 132301 0 21084 0 77454 0 3727 0 807704 0 0 0 RANDALL GUERRERO 209236 0 18624 0 729 0 10908 0 14910 0 254407 0 0 0 STEPHANIE VANCE 194923 0 19437 0 16789 0 11223 0 14910 0 257282 0 0 0 JEFFREY LEFORS 197073 0 10032 0 17247 0 15121 0 3727 0 243200 0 0 0 KAMELA LOO 227495 0 0 0 4799 0 25134 0 7455 0 264883 0 0 0 MARK ZIELAZINSKI 66744 0 26289 0 8426 0 10950 0 3728 0 116137 0 0 0 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AND A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. WILLIAM HAUG RECEIVED A DISTRIBUTION FROM THE SERP PLAN DURING THE YEAR ENDING 9/30/2011 IN THE AMOUNT OF $2,395,047. NO AMOUNTS WERE PAID OUT OF THE DEFINED COMPENSATION PLAN DURING THE YEAR. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR THE YEAR ENDING 9/30/2011 ARE AS FOLLOWS: GORDON ALEXANDER - DEFERRED COMPENSATION PLAN $16,500; DEFINED CONTRIBUTION SERP PLAN $9,423 WILLIAM HAUG - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $44,280 MICHELE WALDRON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $145,174 TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $130,094 BEVERLY HAYDEN-PUGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $107,931 JESSIE HUDGINS - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $120,365 MARTA BOYER - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $134,211 DAVID CHRISTENSEN - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $32,219 RICK WOLF - DEFERRED COMPENSATION PLAN $0; CHANGE IN SERP ACTUARIAL VALUE $34,549 JANE WILLSON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $101,789 MARK ZIELAZINSKI - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 DAVID SINGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 STEPHANIE VANCE - DEFERRED COMPENSATION PLAN $16,500; NOT ELIGIBLE FOR SERP JEFFREY LEFORS - DEFERRED COMPENSATION PLAN $16,500; NOT ELIGIBLE FOR SERP PART I, LINE 5 AN 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 6 SEE EXPLANATION FOR LINE 5, ABOVE COUNTY OF MADERA 946000518 556902DN1 2010-02-04 39512854 TO REFUND SERIES 2006 BONDS ISSUED ON 6/26/06. 0 0 0 39512854 4363296 1 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 0 0 0 1 WISHON RADIOLOGY MEDICAL GROUP ENTITY FOR WHICH DR. CHARLES SMITH, DIRECTOR, IS AN OFFICER 848915 DR. SMITH PROVIDES MEDICAL DIRECTOR SERVICES AND TELERADIOLOGIST COVERAGE THROUGH WISHON RADIOLOGY MEDICAL GROUP 0 PRODUCER'S DAIRY FOODS INC ENTITY FOR WHICH RICHARD SHEHADEY, DIRECTOR, IS AN OWNER 103573 PURCHASE OF FOOD PRODUCTS TO BE SOLD IN HOSPITAL CAFETERIA AND FOR PATIENT MEALS 0 X PHARMACY FREEZER 1 4000 COST X HCIN EQUIPMENT 1 146495 COST X FUN CENTERS 2 8500 COST X WHEELCHAIRS 1 3800 COST 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 BRUCE ALBRIGHT, DIRECTOR AND JEFF MAYER, DIRECTOR, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 A 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 12C THE 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 15 AS 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 19 A 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. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: 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 TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 34 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 6 HRS BRUCE ALLBRIGHT, SUSAN BOYD, 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 HR CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -23,116,729. TRADING LOSS INCLUDED IN INVESTMENT INCOME PER AFS -12,373,418. TRANSFER TO ENDOWMENT -36,129. ROUNDING -3. TOTAL TO FORM 990, PART XI, LINE 5: -35,526,279. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE FORM 990 PART III, LINE 4A: I. DESCRIPTION OF PROGRAM SERVICE ONE NEARLY 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, 220 PHYSICIANS AND OVER 2,200 FULL-TIME EQUIVALENT 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. THIS COMMUNITY BENEFITS REPORT SUMMARIZES THE CONTRIBUTIONS PROVIDED BY CHILDREN'S HOSPITAL TO ITS COMMUNITY FOR FISCAL YEAR 2011 (OCTOBER 1, 2010 THRU SEPTEMBER 30, 2011). 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 STOCKTON IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE EASTERN SIERRA. THE SERVICE AREA INCLUDES 10 COUNTIES, COVERS OVER 45,000 SQUARE MILES AND IS HOME TO OVER 1.2 MILLION CHILDREN AGES 0-17. CHILDREN'S HOSPITAL'S PATIENT VOLUME IN 2011, CHILDREN'S HOSPITAL HAD 13,270 INPATIENT CASES, 69,006 EMERGENCY DEPARTMENT VISITS AND A COMBINED 173,714 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 64% OF TOTAL OUTPATIENT VISITS AT THE HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 5 YEARS OF AGE OR YOUNGER AND 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 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.CSUFRESNO.EDU/CCCHHS/INSTITUTES_PROGRAMS/CVHPI/PUBLICATIONS/ * 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. IV. A SNAPSHOT OF COMMUNITY HEALTH NEEDS IN 2010 CHILDREN IN CENTRAL CALIFORNIA ARE DISPROPORTIONATELY DISADVANTAGED WHEN COMPARED TO CHILDREN IN OTHER PARTS OF THE STATE AND NATION. CONSIDER THE STATISTICS BELOW COMPARING THE EIGHT CENTRAL VALLEY COUNTIES (FRESNO, KERN, KINGS, MERCED, MADERA, SAN JOAQUIN, STANISLAUS, AND TULARE) TO CALIFORNIA AS A WHOLE. KEEP IN MIND, THESE COUNTIES MAKE UP A MAJORITY OF THE HOSPITAL'S SERVICE AREA. INDICATOR* DESCRIPTION CENTRAL STATEWIDE VALLEY POVERTY PERCENT OF CHILDREN LIVING 25.50 19.9 IN POVERTY, 2009 CHILD ABUSE SUBSTANTIATED CASES OF CHILD 9.35 8.7 MALTREATMENT PER 1,000 POP, 2010 INFANT AVERAGE NUMBER OF INFANT 6.00 5.2 MORTALITY DEATHS PER 1,000 LIVE BIRTHS UNDER ONE YEAR OF AGE FOR THE THREE YEAR PERIOD 2005-2007 LOW BIRTH PERCENT OF BABIES BORN WEIGHING 6.60 6.8 WEIGHT INFANTS LESS THAN 2500 GRAMS IN 2009 PRENATAL PERCENT OF WOMEN RECEIVING 24.60 18.7 CARE INADEQUATE PRENATAL CARE DURING THE FIRST TRIMESTER OF PREGNANCY IN 2009 TEEN BIRTH RATE FOR MOTHERS AGES 56.30 37.1 PREGNANCY 15-19 PER 1000 LIVE BIRTHS, 2007 ASTHMA PERCENT OF CHILDREN AGES 0-17 16.40 13.0 DIAGNOSED WITH ASTHMA, 2007 IMMUNIZATIONS PERCENT OF CHILDREN WHO HAVE 94.80 91.7 RECEIVED ALL REQUIRED IMMUNIZATIONS AT THE TIME THEY ENTERED KINDERGARTEN, 2008 OBESITY PERCENT OF CHILDREN AGES 0-5 16.50 15.7 OVERWEIGHT FOR AGE IN 2009 PERCENT OF CHILDREN AGES 6-19 23.10 23.1 OVERWEIGHT FOR AGE IN 2009 UNINSURED PERCENT OF CHILDREN AGES 12-17 13.50 9.9 WITH NO HEALTH INSURANCE AT LEAST PART OF THE YEAR, 2007 * DATA SOURCES. - POVERTY: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/CHILD_POVERTY250.ASPX - CHILD ABUSE: CHILD WELFARE DYNAMIC REPORT SYSTEM, HTTP://CSSR.BERKELEY.EDU/UCB_CHILDWELFARE/REFRATES.ASPX - INFANT MORTALITY: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/INFANT_MORTALITY.ASPX - LOW BIRTH WEIGHT: CALIFORNIA DEPARTMENT OF HEALTH SERVICES, CENTER FOR HEALTH STATISTICS, CD-ROM PUBLIC USE BIRTH AND DEATH FILES - PRENATAL CARE: CALIFORNIA DEPARTMENT OF HEALTH SERVICES, CENTER FOR HEALTH STATISTICS, CD-ROM PUBLIC USE BIRTH AND DEATH FILES - TEEN BIRTHS: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/TEEN_BIRTHS.ASPX - ASTHMA: HTTP://WWW.CHIS.UCLA.EDU/ - IMMUNIZATIONS: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/IMMUNIZATIONS-KINDERGARTENERS. - OBESITY: HTTP://WWW.DHCS.CA.GOV/SERVICES/CHDP/DOCUMENTS/PEDNSS/2009/16B0TO5.PDF - UNINSURED: HTTP://WWW.CHIS.UCLA.EDU/ THE SHORT-TERM AND LONG-TERM IMPLICATIONS OF THESE STATISTICS ARE SIGNIFICANT. FOR CHILDREN AND THEIR FAMILIES, IT MEANS CHRONIC ILLNESS ACCOMPANIED BY FREQUENT VISITS TO PHYSICIAN OFFICES, CLINICS OR HOSPITAL EMERGENCY ROOMS, MISSED DAYS AT SCHOOL, AND MISSED DAYS AT WORK. FOR HEALTH CARE PROVIDERS LIKE CHILDREN'S HOSPITAL, IT MEANS ALREADY SCARCE RESOURCES ARE STRETCHED EVEN THINNER TO ADDRESS SIGNIFICANT HEALTH NEEDS. THE OPPORTUNITY IS FOR HEALTH CARE PROVIDERS AND THE BROADER COMMUNITY TO ADDRESS THESE AND OTHER HEALTH CHALLENGES FACING OUR REGION'S CHILDREN THROUGH COLLABORATION AND COMMON CONCERN. 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 2011, CHILDREN'S HOSPITAL DEDICATED IN EXCESS OF $2,681,924 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 2011, THE FIGURE ABOVE DOES NOT INCLUDE THE HOSPITAL'S COSTS ASSOCIATED WITH UNCOMPENSATED MEDI-CAL, WHICH WAS $25,804,563 IN 2011. A SUMMARY OF THE HOSPITAL'S COMMUNITY BENEFITS PROGRAM ACTIVITIES IN 2011 IS PROVIDED BELOW. PLEASE NOTE THAT THESE ACTIVITIES WERE DEVELOPED BASED ON THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2008. THE OUTCOMES OF THE NEEDS ASSESSMENT PROCESS DESCRIBED ABOVE WILL BE USED TO DEVELOP THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM ACTIVITIES FOR 2012-2014. COMMUNITY HEALTH NEEDS 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. SCHOOL NURSES - 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. REFERRING HOSPITALS/COMMUNITY BASED ORGANIZATIONS - 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. PRIMARY CARE PHYSICIANS ($23,071) - IN 2011, CHILDREN'S HOSPITAL PROVIDED 22 SEPARATE CONTINUING MEDICAL EDUCATION PROGRAMS TO A TOTAL OF 285 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 ($10,000) IN SUPPORT OF HEALTHY MOMS AND HEALTHY BABIES. INJURY PREVENTION 2011 - RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN, 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 75 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2011: 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. AS THE LEAD AGENCY FOR SAFE KIDS CENTRAL VALLEY, CHILDREN'S HOSPITAL LED THE COALITION OF 9 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS TO MEET THE MISSION OF SAFE KIDS IN DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. THE PROGRAM PROVIDED EDUCATION TO OVER 12,330 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,955 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS. IN 2011, CHILDREN'S HOSPITAL INJURY PREVENTION ALSO PROVIDED 23 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 APPLIED FOR AND RECEIVED FUNDING FROM THE CENTRAL VALLEY HEALTH NETWORK TO SERVE 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 IN THE DEVELOPMENT AND IMPLEMENTATION OF KEY WORK PLAN COMPONENTS. THE HEAL ZONE PROJECT IS A THREE YEAR (JULY 2011-JUNE 2014), $1 MILLION INITIATIVE FUNDED BY KAISER NORTHERN CALIFORNIA INTENDED TO PROMOTE HEALTHY EATING AND ACTIVE LIVING IN THE CITY OF MADERA THROUGH THE FOLLOWING THREE GOALS. - DECREASING CALORIE CONSUMPTION AND REDUCING THE AVAILABILITY OF SUGARY DRINKS AND UNHEALTHY SNACKS - INCREASING THE CONSUMPTION OF FRUITS AND VEGETABLES - INCREASING PHYSICAL ACTIVITY ADDITIONALLY, AS THE FOUNDER AND NOW A 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 2011. EXAMPLES INCLUDE FORMING A COLLABORATIVE AMONG PEDIATRICIANS AND PAYERS FOR THE PURPOSE OF DESIGNING AND IMPLEMENTING A NEW DELIVERY AND PAYMENT MODEL FOR CHILDHOOD OBESITY TREATMENT AND PREVENTION, AND HOSTING A CONFERENCE FOR PRIMARY CARE PROVIDERS ON OBESITY PREVENTION AND ADVOCACY ($334). CHILDREN'S HOSPITAL ALSO PREPARED AND CONVENED TWO CONTINUING MEDICAL EDUCATION PROGRAMS TITLED "CHILDHOOD OBESITY AND RELATED COMORBIDITIES". POISON CONTROL ($48,195) - THE CENTRAL CALIFORNIA POISON CONTROL CENTER IS LOCATED ON THE CHILDREN'S HOSPITAL CAMPUS AND RECEIVES A DONATION OF OFFICE SPACE AND SUPPLIES. 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. OTHER ($7,809) - CHILDREN'S PROVIDED SUPPORT TO OTHER PROGRAMS THAT TARGET THE NEEDS OF UNDERSERVED CHILDREN OR BROADER COMMUNITY BASED HEALTH ISSUES INCLUDING CAMP TAYLOR (A SUMMER CAMP FOR CHILDREN WITH CANCER AND THEIR FAMILIES), THE AMERICAN HEART ASSOCIATION, FRESNO CENTER FOR NEW AMERICANS, AND THE AMERICAN RED CROSS. HEALTH CARE WORK FORCE DEVELOPMENT CHILDREN'S IS COMMITTED TO PROMOTING AN ADEQUATE SUPPLY OF HIGHLY TRAINED PROFESSIONALS TO MEET OUR REGION'S FUTURE DEMAND FOR PEDIATRIC HEALTH CARE SERVICES. ACTIVITIES SUPPORTED BY THE HOSPITAL IN 2011 INCLUDED THE FOLLOWING. PHYSICIAN EDUCATION: TO HELP ENSURE AN ADEQUATE SUPPLY OF PHYSICIANS IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL SUPPORTED PHYSICIAN EDUCATION IN A NUMBER OF WAYS IN 2011. * CONTRIBUTIONS TO MEDICAL SCHOOLS ($29,600): CHILDREN'S HOSPITAL PROVIDED FINANCIAL SUPPORT TO THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO - FRESNO MEDICAL EDUCATION PROGRAM AND THE UNIVERSITY OF MERCED'S SAN JOAQUIN VALLEY PROGRAM IN MEDICAL EDUCATION PROGRAM. * PEDIATRIC RESIDENCY PROGRAM ($1,736,310) - CHILDREN'S HOSPITAL IS A MAJOR AFFILIATE OF THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO - FRESNO PEDIATRIC RESIDENCY PROGRAM. STRUCTURED AS A THREE-YEAR FULLY ACCREDITED POST-GRADUATE RESIDENCY, THE TRAINING PROGRAM IS HELPING TO ADDRESS THE CRITICAL SHORTAGE OF BOTH PEDIATRICIANS AND PEDIATRIC SUBSPECIALTY PHYSICIANS IN THE CENTRAL VALLEY BY OFFERING ROTATIONS IN GENERAL PEDIATRICS, PEDIATRIC SURGERY, FAMILY PRACTICE, AND EMERGENCY MEDICINE. IN 2011, 31 MEDICAL RESIDENTS RECEIVED TRAINING AT CHILDREN'S HOSPITAL. * PHARMACY RESIDENCY PROGRAM ($352,433) - CHILDREN'S HOSPITAL SUPPORTED A PHARMACY RESIDENCY PROGRAM IN 2011 THAT PROVIDED TRAINING TO 6 RESIDENTS. HEMATOLOGY CLASS ($7,300) - CHILDREN'S HOSPITAL MADE A DONATION TO CALIFORNIA STATE UNIVERSITY - FRESNO FOR A HEMATOLOGY CLASS TAUGHT. HEALTH CAREERS PROMOTION - CHILDREN'S HOSPITAL CONTINUED TO PROMOTE HEALTH CAREERS THROUGH THE HOSPITAL'S JOB SHADOWING PROGRAM THAT OFFERS HIGH SCHOOL AND COLLEGE STUDENTS THE OPPORTUNITY TO SHADOW HOSPITAL PHYSICIANS, EMPLOYEES, AND VOLUNTEERS. ADDITIONALLY, THE HOSPITAL PARTNERED WITH SUNNYSIDE DOCTORS' ACADEMY, CLOVIS NORTH HIGH SCHOOL, AND THE CENTER FOR ADVANCED RESEARCH AND TECHNOLOGY FOR INTERNSHIP ROTATIONS AT THE HOSPITAL. COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH EDUCATION IS A PARAMOUNT PRIORITY TO THE HOSPITAL, WHICH HAS A LONG-STANDING COMMITMENT TO PROVIDING COMMUNITY WELLNESS AND PREVENTION EDUCATION PROGRAMS. CLASSES WERE OFFERED AT THE HOSPITAL AS WELL AS AT OTHER COMMUNITY VENUES. CLASSES WERE TAUGHT BY CHILDREN'S HOSPITAL PROFESSIONALS WHO HAVE SPENT YEARS STUDYING AND GAINING EXPERIENCE IN THEIR CHOSEN FIELDS. CLASSES WERE OPEN TO THE COMMUNITY AT NO COST. EXAMPLES OF CLASSES OFFERED IN 2011 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. CHILDREN'S HOSPITAL ALSO PROVIDED ACCESS TO EDUCATIONAL INFORMATION VIA ITS WEBSITE, INCLUDE THE FOLLOWING TWO SERVICES. E-HEALTH NEWSLETTER ($9,000) - CHILDREN'S HOSPITAL APPRECIATES HOW DIFFICULT IT IS FOR PARENTS TO KEEP UP WITH ALL THE LATEST CHILD HEALTH AND SAFETY INFORMATION. E-HEALTH NEWSLETTER PROVIDES TRUSTED, CREDIBLE CHILD HEALTH AND SAFETY INFORMATION FROM HOSPITAL PEDIATRIC EXPERTS AS WELL AS OTHER EXPERTS FROM AROUND THE COUNTRY. MOST IMPORTANT, FAMILIES ARE ABLE TO CUSTOMIZE THE INFORMATION TO MEET A CHILD'S HEALTH AND SAFETY INFORMATION NEEDS. HEALTH ENCYCLOPEDIA ($13,395) - THE CHILDREN'S 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 FAMILY ASSISTANCE FAMILY CENTERED CARE IS A CORNERSTONE OF CHILDREN'S HOSPITAL. THE HOSPITAL UNDERSTANDS THAT FAMILIES MUST BE GIVEN SUPPORT AND RESOURCES TO EFFECTIVELY PARTICIPATE IN THEIR CHILD'S CARE. 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 2011 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. TRANSPORTATION ($127,138) - 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 IS CONTINUING TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND IN TURN IMPROVE ACCESS TO CARE. CAFETERIA MEALS ($59,125) - 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. FAMILY ASSISTANCE FUND ($41,405) - 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. ENROLLMENT INTO HEALTH INSURANCE - CHILDREN'S HOSPITAL COMMITS SIGNIFICANT RESOURCES IN HELPING FAMILIES FIND HEALTH INSURANCE COVERAGE FOR THEMSELVES AND THEIR UNINSURED CHILDREN. SERVICES PROVIDED BY THE HOSPITAL INCLUDED FINANCIAL COUNSELORS AS WELL AS A CONTRACTED VENDOR WITH EXPERTISE IN ENROLLMENT SERVICES ($203,309). THROUGH THESE SERVICES, CHILDREN'S HOSPITAL SCREENS UNINSURED AND UNDER-INSURED FAMILIES FOR ELIGIBILITY IN MEDI-CAL, HEALTHY FAMILIES, THE CALIFORNIA CHILDREN'S SERVICES PROGRAM, AS WELL AS THE CHILDREN'S HOSPITAL FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY IS DETERMINED, THE HOSPITAL ASSISTS IN THE COMPLETION OF APPLICATIONS, AND SUBMITS APPLICATIONS TO THE APPROPRIATE PROCESSING OR FUNDING AGENCIES. CHILDREN'S HOSPITAL ALSO SUPPORTED OUTREACH AND ENROLLMENT SERVICES OFFERED THROUGH THE FRESNO HEALTHY COMMUNITIES ACTION PROGRAM ($2,500). STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO 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 2011, OF THE HOSPITAL'S 84,322 TOTAL INPATIENT DAYS, 62,777 (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 2011 OF $25,804,563. 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. IN 2011, CHILDREN'S HOSPITAL RECOGNIZED $68,478,000 IN PART ONE PROGRAM REVENUE, 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. RECOGNIZED NET REVENUE FROM PART TWO OF THE PROGRAM FALLS WITHIN THE HOSPITAL'S 2012 FISCAL YEAR AND THEREFORE IS NOT INCLUDED HERE. AS THE HOSPITAL'S HOSPITAL FEE PROGRAM REVENUE RECOGNIZED IN 2011 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2011, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2011. 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 RECENTLY ENACTED 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 2011, CHILDREN'S HOSPITAL PROVIDED $11,000 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. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 942797447 PHILANTHROPY/FUNDRAISING FOR THE HOSPITAL CA 501(C)(3) 11 TYPE I N/A 0 SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 770450620 MEDICAL GROUP CA N/A C 39331832 5059081 1.00000 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION C 6980041 CASH VALUE SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA K 1001231 CASH VALUE SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA L 10715131 CASH VALUE