2012-11-14T11:14:40-06:00 2011-12-31 861065772 DELOITTE TAX LLP 201 E KENNEDY BLVD STE 1200 TAMPA FL 33602 990 2011-01-01 590638499 VARIETY CHILDREN'S HOSPITAL DBA MIAMI CHILDREN'S HOSPITAL VARI 3056666511 3100 SW 62ND AVENUE MIAMI FL 331553009 TIMOTHY BIRKENSTOCK 3056666511 2012-11-13 0 P00648526 8132738355 2011 2016-02-24 21:20:13Z TIMOTHY BIRKENSTOCK 3100 SW 62ND AVENUE MIAMI FL 331553009 488959198 0 X WWW.MCH.COM X 1950 FL THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. 19 14 3198 1590 145177 -625293 2396956 3286047 417422557 453513854 10066481 12305823 15055580 19748432 444941574 488854156 0 0 0 0 234314266 257057663 0 0 0 174189789 187179268 408504055 444236931 36437519 44617225 728858751 767361960 358328167 389514831 370530584 377847129 X THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. 0 0 355389544 453513854 SEE SCHEDULE O: PROGRAM SERVICE ACCOMPLISHMENTS. 355389544 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 X 744 0 1 3198 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 0 X 19 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MIAMI CHILDREN'S HOSPITAL 3056666511 3100 SW 62ND AVENUE MIAMI FL 331553009 X JEFRY BIEHLER MD 39.30 X 370661 0 31448 THOMAS M CORNISH 1.30 X 0 0 0 JARET DAVIS ESQUIRE 1.30 X 0 0 0 MARIA FRANCO MD 1.30 X 0 0 0 MICHAEL FUX 1.30 X 0 0 0 LUIS GONZALEZ-MENDOZA MD 39.30 X 286521 0 18508 GHISLAIN GOURAIGE JR 1.30 X 0 0 0 DEISE GRANADO-VILLAR MD 39.30 X 334372 0 74571 GARY GREGORY 1.30 X 0 0 0 JUAN C MAS 1.30 X 0 0 0 JAY MASSIRMAN 1.30 X 0 0 0 STEVEN MCKEAN 1.30 X 0 0 0 MARIO MURGADO 1.30 X 0 0 0 PHILIP NEWCOMM MD 1.30 X 0 0 0 CARMEN PEREZ 1.30 X 0 0 0 GENE PRESCOTT 1.30 X 0 0 0 ALEX SOTO 1.30 X 0 0 0 KEITH WARD 1.30 X 0 0 0 NARENDRA KINI MD 39.30 X X 737885 0 154351 PEDRO ALFARO 39.30 X 399326 0 83599 SANDEEP DAVE 40.00 X 908776 0 19589 WILLIAM M DECAMPLI MD 40.00 X 1010076 0 24787 REDMOND P BURKE MD 40.00 X 1492515 0 27988 ROBERT L HANNAN MD 40.00 X 1185529 0 27776 JOHN RAGHEB MD 40.00 X 966717 0 31262 7692378 0 493879 283 0 1 0 SQUIRE SANDERS AND DEMPSEY LLP PO BOX 643051 CINCINNATI OH 45264 LEGAL SERVICES 4626059 CERNER CORPORATION PO BOX 412732 KANSAS CITY MO 64141 EQUIPMENT RENTAL 3946942 ANTHONY BARADAT AND ASSOCIATES 1235 CORAL WAY SUITE 200 MIAMI FL 33145 ADVERTISING/MARKETING SVCS. 3719658 LYON FINANCIAL SERVICES INC 1310 MADRID STREET STE 100 MARSHALL MN 56258 COPIER RENTAL 2936455 CHILDREN'S ANESTHESIA ASSOC PA 3100 SW 62ND AVENUE MIAMI FL 33155 ANESTESIA SERVICES 2752952 128 3286047 3286047 PATIENT SERVICE REVENU 621300 436264347 436264347 GRANT REVENUE 900099 16074450 16074450 SEMINAR/WORKSHOPS 621300 1196013 1196013 ORDINARY INCOME PARTNE 621300 -20956 -20956 453513854 12296389 18057 12278332 288587 288587 1271579 0 1271579 1271579 1271579 113444 1032 0 105042 113444 -104010 9434 9434 PHARMACY 446110 3592641 123546 3469095 MANAGEMENT FEES 621990 3451693 3451693 CAFETERIA VENDING 722210 2585212 2585212 8558720 3574 8555146 18188266 488854156 453513854 145177 31909078 7692378 7692378 203669487 169089492 34579995 9026124 7220899 1805225 36461076 29168861 7292215 208598 166878 41720 1719724 1375779 343945 955260 764208 191052 33990102 27192082 6798020 3953810 3163048 790762 59618350 47694680 11923670 21661627 17329302 4332325 2397339 1917871 479468 11460860 9168688 2292172 22000024 17600019 4400005 13538699 10830959 2707740 BAD DEBTS 7022677 5618142 1404535 MEDICAL ASSISTANCE TAX 5101594 4081275 1020319 DUES & SUBSCRIPTIONS 1665229 1332183 333046 MISCELLANEOUS EXPENSES 1445038 1156030 289008 648935 519148 129787 444236931 355389544 88847387 0 0 1847158 34921888 36818765 49849829 50242660 4169730 4768910 5729140 4566708 471101775 227931636 210957435 243170139 325064045 331715088 98166684 94232532 728858751 767361960 59529853 63431702 246585824 242705542 4440000 52212490 78937587 358328167 389514831 X 278387150 287784302 63562282 60865501 28581152 29197326 370530584 377847129 728858751 767361960 X 44617225 -37300680 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 308684 0 1 132293 440977 0 EXPLANATION OF LOBBYING ACTIVITIES: PART II-B, LINE 1: OTHER ACTIVITIES RELATE TO RESEARCH, MONITORING LEGISLATION, AND ATTENDING MEETINGS. 2932156 2932156 250199537 112104895 138094642 4692130 1424383 3267747 152783901 96822540 55961361 60494051 17579818 42914233 243170139 BOND ISSUE COSTS 1948522 BENEFICIAL INTEREST IN MIAMI CHILDREN'S HOSPITAL FNDTN 77416956 DUE FROM AFFILIATED ORGANIZATION 9228863 EXEC LIFE 875285 SELF INSURANCE TRUST 4762906 94232532 OTHER LIABILITIES 16513676 SWAP LIABILITIES 55120302 THIRD PARTY SETTLEMENT PAYABLE 7303609 78937587 488854156 444236931 44617225 -36738739 -538550 -37277289 7339936 442969122 -41676108 -41676108 484645230 4208926 4208926 488854156 435629186 5062296 5062296 430566890 13670041 13670041 444236931 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: PART X, LINE 2: THE HOSPITAL BELIEVES THERE IS NO UNCERTAIN TAX LIABILITY WHICH SHOULD BE RECORDED AS OF DECEMBER 31, 2011. PART XI, LINE 8 - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS -4,502,487. AMOUNTS REPORTED SEPARATELY -1,856,151. NET PAYMENT ON SWAP AGREEMENTS 5,820,088. TOTAL TO SCHEDULE D, PART XI, LINE 8: -538,550. PART XII, LINE 2D - OTHER ADJUSTMENTS: AMOUNTS REPORTED SEPARATELY 2,855,777. BAD DEBT EXPENSE -7,022,677. LOSS ON CONVERSION OF DEBT -32,832. NET UNREALIZED LOSS ON INVESTMENTS -6,220,519. NET PAYMENT ON SWAP AGREEMENTS -5,820,088. LOSS ON CHANGE IN FMV OF SWAP AGREEMENT -24,665,300. UBTI EXPENSES RECORDED ON FORM 990, PART IX -770,469. PART XII, LINE 4B - OTHER ADJUSTMENTS: PARTNERSHIP INCOME -189,551. LOSS ON SALE OF ASSETS -104,010. RESTRICTED CONTRIBUTIONS 4,502,487. PART XIII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON SALE OF ASSETS 104,010. AMOUNTS REPORTED SEPARATELY 4,958,286. PART XIII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 7,022,677. PARTNERSHIP EXPENSE 56,807. NET PAYMENT ON SWAP AGREEMENTS 5,820,088. UBTI EXPENSES RECORDED ON FORM 990, PART IX 770,469. CENTRAL AMERICA/CARIBBEAN 0 0 PROGRAM SERVICES INSURANCE PREMIUM 6859288 0 0 0 0 0 0 6859288 0 6859288 0 0 1 0 0 0 1 1 X 1 X 1 X 401.000000000000 1 1 0 1 1 1860252 1860252 0.00430 260278889 205651589 54627300 0.12490 5412428 3705657 1706771 0.00390 267551569 209357246 58194323 0.13310 1231498 1231498 0.00280 13803670 13803670 0.03160 273659 273659 0.00060 15308827 15308827 0.03500 282860396 209357246 73503150 0.16810 30000 30000 0.00010 30000 30000 0.00010 1 1823184 1240625 1691334 -450709 X 1 0 1 1 MCH - MAIN CAMPUS

3100 SW 62ND AVENUE MIAMI FL 33155

X X X X X X MCH - MAIN CAMPUS 1 1 1 200.000000000000 1 401.000000000000 1 X X X X 1 1 X X X 1 0 1 X 0 0 PART I, L7 COL(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 $7,022,677. PART I, LINE 7 CALCULATED THE COST TO CHARGE RATIO USING THE ALLOWABLE PATIENT CARE OPERATING EXPENSES REPORTED WITH THE FLORIDA COST REPORT AND AFTER ADJUSTING FOR ADDITIONAL BUSINESS EXPENSES NOT INCLUDED IN THE DIRECT PATIENT CARE. MULTIPLY THE GROSS PATIENT CHARGES PER THE ANNUAL PATIENT CLAIM LOG (ALSO USED FOR THE COST REPORT) TIMES THE COST/CHARGE RATIO TO CALCULATE COST OF PROGRAM. PART III, LINE 4 TEXT OF FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE:THE FOLLOWING SUMMARIZES THE ACTIVITY IN THE HOSPITAL'S ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR THE YEAR ENDED DECEMBER 31, 2011:BALANCE - BEGINNING OF THE YEAR 10,909,878PROVISIONS DURING THE YEAR, NET OF RECOVERIES 7,022,677LESS ACCOUNTS WRITTEN OFF (9,142,122) -----------BALANCE - END OF THE YEAR 8,790,433THE HOSPITAL'S ESTIMATION OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS BASED PRIMARILY UPON THE TYPE AND AGE OF THE PATIENT ACCOUNTS RECEIVABLE AND THE EFFECTIVENESS OF THE HOSPITAL'S COLLECTION EFFORTS. THE HOSPITAL'S POLICY IS TO RESERVE A PORTION OF ALL SELF-PAY RECEIVABLES, INCLUDING AMOUNTS DUE FROM THE UNINSURED AND AMOUNTS RELATED TO CO-PAYMENTS AND DEDUCTIBLES, AS THESE CHARGES ARE RECORDED. ON A MONTHLY BASIS, THE HOSPITAL REVIEWS ITS ACCOUNTS RECEIVABLE BALANCES, THE EFFECTIVENESS OF THE HOSPITAL'S RESERVE POLICIES AND VARIOUS ANALYTICS TO SUPPORT THE BASIS FOR ITS ESTIMATES. THESE EFFORTS PRIMARILY CONSIST OF REVIEWING THE FOLLOWING: - HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE USING A HINDSIGHT OR LOOK-BACK APPROACH; - REVENUE AND VOLUME TRENDS BY PAYOR, PARTICULARLY THE SELF-PAY COMPONENTS; - CHANGES IN THE AGING AND PAYOR MIX OF ACCOUNTS RECEIVABLE, INCLUDING INCREASED FOCUS ON ACCOUNTS DUE FROM THE UNINSURED AND ACCOUNTS THAT REPRESENT CO-PAYMENTS AND DEDUCTIBLES DUE FROM PATIENTS; - CASH COLLECTIONS AS A PERCENTAGE OF NET PATIENT REVENUE LESS BAD DEBT EXPENSE; - TRENDING OF DAYS REVENUE IN ACCOUNTS RECEIVABLE AND COLLECTION EXPERIENCE; AND - VARIOUS ALLOWANCE COVERAGE STATISTICS.THE HOSPITAL REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. PART III, LINE 8 BASED ON COST REPORT - ALLOWABLE COSTS. FINANCIAL ASSISTANCE PROGRAM POLICY: PART III, LINE 9B THE HOSPITAL, IN FURTHERANCE OF ITS TAX-EXEMPT PURPOSE, SHALL PROVIDE CHARITY OR DISCOUNTED CARE TO THOSE PATIENTS ("APPLICANT") THAT ARE DETERMINED TO BE ELIGIBLE THROUGH THE HOSPITAL'S EVALUATION PROCESS.THE EVALUATION PROCESS SHALL CONSIDER THE APPLICANT'S ANNUAL INCOME, ELIGIBILITY FOR INSURANCE COVERAGE THROUGH COMMERCIAL OR GOVERNMENTAL SOURCES AND COMPARE THE EXPECTED HEALTHCARE EXPENDITURES AT THE HOSPITAL TO THE APPLICANT'S TOTAL ANNUAL INCOME ( THIS IS COMMONLY REFERRED TO AS "MEDICALLY INDIGENT"). THE HOSPITAL SHALL USE THE CURRENT DEPARTMENT OF HEALTH AND HUMAN SERVICES POVERTY GUIDELINES, WHICH ARE UPDATED ANNUALLY, TO ESTABLISH THE ELIGIBILITY CRITERIA FOR CHARITY OR SELF-PAY DISCOUNTS. THE APPLICANT MUST HAVE EXHAUSTED ALL EFFORTS TO OBTAIN THIRD PARTY HEALTH INSURANCE COVERAGE FROM BOTH COMMERCIAL AND GOVERNMENTAL SOURCES.ACOORDING TO THE FINANCIAL ASSISTANCE PROGRAM POLICY:IF THE COLLECTION SUPERVISOR AND/OR PFS DIRECTOR REVIEW THE APPLICATION FOR FINANCIAL EVALUATION AGANIST THE AHCA CRITERIA AND APPROVE THE REQUEST, THE PATIENT FINANCIAL SERVICES SUPERVISOR WRITES OFF CHARGES TO CHARITY. HOSPITAL FACILITIES PART V, SECTION A MIAMI CHILDREN'S HOSPITAL OPERATES THE FOLLOWING FACILITIES UNDER THE HOSPITAL'S LICENSE IN ADDITION TO THE MAIN CAMPUS:MCH - DAN MARINO CENTEROUTPATIENT AMBULATORY CENTERMCH - MIAMI LAKES REHABILITATION CENTERREHABILITATION CENTERMCH - PALMETTO BAY CENTEROUTPATIENT AMBULATORY CENTERMCH - DORAL CENTEROUTPATIENT AMBULATORY CENTERMCH - WEST KENDALL CENTEROUTPATIENT AMBULATORY CENTEROFFICE OF DR. JOSE VARGASPRIMARY CARE CLINICNICKLAUS CARE CENTER (MOB SPECIALIST PHYSICIAN OFFICE)SPECIALIST PHYSICIAN OFFICE MCH - MAIN CAMPUS PART V, SECTION B, LINE 13G: THE PROCEDURE IS FOR PATIENT/GUARDIAN TO MEET WITH FINANCIAL COUNSELOR AND DETERMINE IF THE PATIENT HAS INSURANCE. IF NOT, PREFORM A FINANCIAL EVALUATION AND DETERMINE IF ELIGIBLE FOR HEALTH KIDS, MEDICAID OR OTHER PROGRAM. IF DETERMINED TO BE A SELF-PAY PATIENT THEN PROVIDE A COPY OF THE CHARITY POLICY AND SEE IF APPLIES. NEEDS ASSESSMENT: UNDER THE DIRECTION OF THE BOARD OF DIRECTORS, MANAGEMENT STRIVES TO PROVIDE HOPE THROUGH ADVANCED CARE FOR OUR CHILDREN AND FAMILIES. THE VISION IS TO BE WHERE THE CHILDREN ARE. THE HOSPITAL USES A QUARTERLY OPERATING CALENDAR TO DEVELOP PROGRAMS AND COMMUNICATE GOALS, ACCOMPLISHMENTS AND GAPS IN PLANS. MIAMI CHILDREN'S HOSPITAL PARTICIPATES IN MANY COMMUNITY ORGANIZATIONS THAT COLLECTIVELY STRIVE TO IMPROVE THE HEALTH STATUS OF CHILDREN. MCH HAS REPRESENTATION ON THE CHILDREN'S TRUST, THE MIAMI DADE COUNTY PUBLIC SCHOOLS WELLNESS COMMITTEE, THE GREATER MIAMI CHAMBER OF COMMERCE'S HEALTH AND BIO-SCIENCE COMMITTEE AND THE HEALTH COUNCIL OF SOUTH FLORIDA. THROUGH OUR INVOLVEMENT WITH THE HEALTH COUNCIL, WE CONSISTENTLY ANALYZE DATA TO IDENTIFY UNMET NEEDS AND SERVE IN AN ADVISORY CAPACITY ASSISTING THE COUNCIL TO ADDRESS HEALTH DISPARITIES. ADDITIONALLY, MCH PROVIDES SCHOOL HEALTH NURSES IN 8 SCHOOLS THROUGH A COMMUNITY GRANT, AND OUR PREVENTIVE MEDICINE PROGRAM DEPLOYS A MEDICAL AND A DENTAL VAN INTO UNDERSERVED AREAS OF THE COMMUNITY. MCH HAS A ROBUST MECHANISM TO ANALYZE HEALTH DATA. WE RECENTLY DEPLOYED SEVERAL PEDIATRIC SUBSPECIALISTS TO SERVE CHILDREN IN PALM BEACH COUNTY AFTER DATA CONFIRMED THAT THERE WAS A SHORTAGE. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: MIAMI CHILDREN'S HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM TO ASSIST PATIENTS THAT ARE UNINSURED OR UNDERINSURED AND TO BE GIVEN THE OPPORTUNITY TO APPLY FOR VARIOUS PROGRAMS. WITH THE PATIENT/FAMILY GENERAL CONSENT FOR TREATMENT FORM, FINANCIAL AGREEMENT FOR PROFESSIONAL SERVICES FORM, AND A COORDINATION OF BENEFITS FORM, PATIENTS/FAMILIES ARE PROVIDED REFERRAL TO AN ELIGIBILITY ASSISTANCE COUNSELOR WHO WILL EXPLAIN VARIOUS PROGRAMS OFFERED. COMMUNITY INFORMATION: MIAMI CHILDREN'S HOSPITAL PRIMARILY SERVES THE COMMUNITIES OF SOUTH FLORIDA INCLUDING WEST PERRINE, GOLDEN GLADES, OPA LOCKA, WYNWOOD SERVICE AREA, BISCAYNE PARK, SWEETWATER WEST DADE, LIBERTY CITY, AND HIALEAH, LITTLE HAVANA SERVICE AREA, HOMESTEAD SERVICE AREA, HALLENDALE, HOLLYWOOD, MARGATE, HALLANDALE/MIRAMAR, WEST PALM BEACH, BOCA RATON, MONROE COUNTY AND MANY OTHERS IN THE SOUTH FLORIDA REGION. COMMUNITY BUILDING ACTIVITIES: MANY COMMUNITY BUILDING ACTIVES ARE CO-SPONSORED BY OTHER INDEPENDENT NON-PROFIT ORGANIZATIONS, SUCH AS NATIONAL CENTER FOR MISSING AND EXPLOITED CHILDREN, BIG BROTHERS BIG SISTERS OF DADE COUNTY, PARENT TO PARENT AND AMERICAN CANCER SOCIETY, WHO PROVIDE EXPERT SPEAKERS AT NO CHARGE TO MIAMI CHILDREN'S HOSPITAL. OTHER INFORMATION: MIAMI CHILDREN'S HOSPITAL HAS AN ACTIVE COMMUNITY EDUCATION PROGRAM, VARIOUS CAMP PROGRAMS INCLUDING ASTHMA CENTER, DIABETES, CANCER CENTER, PSYCHIATRIC PROGRAMS, EARLY INTERVENTION PROGRAM, PREVENTATIVE MEDICINE PROGRAM DENTAL MOBILE PROGRAM, AFTER HOURS PROGRAM, HEALTHY CONNECTIONS PROGRAM, MEDICAL EDUCATION RESIDENCY PROGRAM, PEDIATRIC POST GRADUATE PROGRAM, FELLOWSHIP PROGRAMS, PEDIATRIC ARE CALL PROGRAM, MULTIPLE AMBULATORY CARE CENTERS ALL DESIGNED TO PROMOTE HEALTH IN THE COMMUNITY. X X X X X 0 1 0 0 0 0 0 0 0 JEFRY BIEHLER MD 354315 0 16346 0 0 0 0 0 31448 0 402109 0 0 0 LUIS GONZALEZ-MENDOZA MD 286521 0 0 0 0 0 0 0 18508 0 305029 0 0 0 DEISE GRANADO-VILLAR MD 281891 0 52481 0 0 0 45624 0 28947 0 408943 0 0 0 NARENDRA KINI MD 576999 0 160886 0 0 0 123724 0 30627 0 892236 0 0 0 PEDRO ALFARO 328411 0 70915 0 0 0 50386 0 33213 0 482925 0 0 0 SANDEEP DAVE 469101 0 439675 0 0 0 0 0 19589 0 928365 0 0 0 WILLIAM M DECAMPLI MD 822051 0 188025 0 0 0 0 0 24787 0 1034863 0 0 0 REDMOND P BURKE MD 1315929 0 176586 0 0 0 0 0 27988 0 1520503 0 0 0 ROBERT L HANNAN MD 1080315 0 105214 0 0 0 0 0 27776 0 1213305 0 0 0 JOHN RAGHEB MD 966717 0 0 0 0 0 0 0 31262 0 997979 0 0 0 SUPPLEMENTAL INFORMATION PART III PART I LINE 4(B) THE EXECUTIVES PARTICIPATE IN A SUPPLEMENTAL 457(F) DEFINED CONTRIBUTION RETIREMENT ACCOUNT. THE VALUES ARE REPORTED IN SCEDULE J, PART 11, COLUMN C MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NCF7 2011-08-01 25504962 SEE PART V 0 0 0 MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NCE0 2010-12-22 107784753 SEE PART V 0 0 0 MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NBT8 2008-04-17 55000000 SEE PART V 0 0 0 MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NBS0 2006-12-21 209475000 SEE PART V 0 0 0 25504962 504962 25000000 1 0 1 1 2065000 108048657 47096 1227083 1970838 41925000 62878640 1 0 0 1 25000000 55000000 55000000 1 0 1 1 128025000 146979195 1914159 5553000 3265256 134149101 2097679 0 1 0 1 0 1 1 1 1 1 0.00300 0.00000 0.00300 1 0 1 1 1 1 1 0.00800 0.00000 0.00800 1 0 1 1 1 1 1 0.00300 0.00000 0.00300 1 0 1 1 1 1 1 0.01900 0.00000 0.01900 1 0 0 0 0 0 0 0 1 0 1 BAYERISCHE LANDESBAN 2.000000000000 1 0 0 0 1 0 1 WELLS FARGO BANK 2.200000000000 1 0 0 0 1 1 CITIBANK 35.700000000000 0 0 1 WELLS FARGO BANK 2.200000000000 1 1 0 PART I, LINE A(F) DESCRIPTION OF PURPOSE REFUND ISSUE DATED 4/17/2008 PART I, LINE B(F) DESCRIPTION OF PURPOSE REFUND 2006-B3 DATED 12/21/2006 AND NEW MONEY PROJECT PART I, LINE C(F) DESCRIPTION OF PURPOSE CONVERTED AUCTION RATE SECURITIES (ARS) TO PUT BONDS AFTER THE ARS MARKET COLLAPSED IN 2008; REISSUE OF 12/21/2006 BOND ISSUE PART I, LINE D(F) DESCRIPTION OF PURPOSE PROVIDED BOND PROCEEDS FOR NEW PROJECT AND REFUNDED 6/7/2001 ISSUE PART II, LINE 3 BOND B THE DIFFERENCE BETWEEN THE ISSUE PRICE (LISTED IN PART I) AND TOTAL PROCEEDS (PART II, LINE 3)IS DUE TO INVESTMENT EARNINGS EARNED TO DATE. PART II, LINE 3 BOND D THE DIFFERENCE BETWEEN THE ISSUE PRICE (LISTED IN PART I) AND TOTAL PROCEEDS (PART II, LINE 3)IS DUE TO INVESTMENT EARNINGS EARNED TO DATE AND THE USE OF $70,000,000 OF SALE PROCEEDS TO REDEEM A PORTION OF THE BONDS AFTER A DECISION WAS MADE TO POSTPONE THE NEW MONEY PROJECT. PART IV, LINE 5, COLUMN D SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. PART V THE ORGANIZATION IS CURRENTLY DEVELOPING A POLICY TO ENSURE THAT VIOLATIONS OF FEDERAL TAX REQUIREMENTS ARE TIMELY IDENTIFIED AND CORRECTED. RODOBALDO PEREZ HASSOR SEE PART V 77501 PART V 0 THE BILTMORE HOTEL SEE PART V 117185 PART V 0 PART IV, COLUMN B AND PART IV, COLUMN D RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION RODOBALDO PEREZ HASSOR IS A FAMILY MEMBER OF DEISE GRANADO-VILLAR, A MEMBER OF THE MCH BOARD OF DIRECTORS. DESCRIPTION OF TRANSACTION: COMPENSATIONGENE PRESCOTT IS AN OFFICER OF THE BILTMORE HOTEL AND IS ALSO A MEMBER OF THE MCH BOARD OF DIRECTORS. DESCRIPTION OF TRANSACTION: EVENTS PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A VARIETY CHILDREN'S HOSPITAL, ESTABLISHED IN 1950, OWNS AND OPERATES AND PEDIATRIC SPECIALTY HOSPITAL KNOWN AS MIAMI CHILDREN'S HOSPITAL. THE HOSPITAL IS ONE OF THE LARGEST FREESTANDING PEDIATRIC TEACHING HOSPITALS IN THE SOUTHEASTERN UNITED STATES. IT PROVIDES SPECIALIZED PEDIATRIC HEALTHCARE FOR CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE OR ABILITY TO PAY. THE HOSPITAL HAS 289 LICENSED BEDS. MIAMI CHILDREN'S HOSPITAL SERVES AS A REFERRAL CENTER FOR CHILDREN WITH COMPLEX, CRITICAL OR LIFE-THREATENING ILLNESSES REQUIRING SPECIALIZED CARE. IT HAS A 28-BED PEDIATRIC INTENSIVE CARE UNIT, A 37-BED NEONATAL INTENSIVE CARE UNIT AND A 12-BED CARDIAC INTENSIVE CARE UNIT. IT ALSO A STATE-DESIGNATED PEDIATRIC TRAUMA CENTER. MANY PATIENTS ARE REFERRED BY OTHER HOSPITALS REGARDLESS OF THE EXISTENCE OF FORMAL ARRANGEMENTS. IN 2011, 1,718 PATIENTS WERE TRANSFERRED FROM HOSPITALS THROUGHOUT FLORIDA, CENTRAL AND SOUTH AMERICA AND THE CARIBBEAN. WHEN CHILDREN NEED THE SERVICES OF A SPECIALIST, IT IS IMPORTANT THAT SUCH SERVICES BE PROVIDED BY A PRACTITIONER WITH SPECIFIC TRAINING AND EXPERTISE IN PEDIATRIC CARE. THE CARE OF CHILDREN WITH CERTAIN COMPLEX CHRONIC CONDITIONS, SUCH AS JUVENILE DIABETES, CANCER, OR CYSTIC FIBROSIS IS BEST MANAGED BY A PEDIATRIC SPECIALIST IN ORDER TO ELIMINATE REFERRAL DELAYS AND EXPEDITE POSITIVE TREATMENT. CHILDREN ARE MORE VULNERABLE TO COMPLICATIONS DUE TO DELAYS THAN ADULTS. THEY DEVELOP SERIOUS COMPLICATIONS MORE RAPIDLY THAN ADULTS BECAUSE THEY HAVE LESS PHYSIOLOGICAL RESERVES AND LESS DEVELOPED ORGAN SYSTEMS. THERE ARE PRESENTLY MORE THAN 200 PEDIATRIC SUBSPECIALTY PHYSICIANS GEOGRAPHICALLY LOCATED AT MIAMI CHILDREN'S HOSPITAL. PEDIATRIC SUBSPECIALTY AREAS INCLUDE: ADOLESCENT MEDICINE, ALLERGY/IMMUNOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, CLINICAL GENETICS AND METABOLISM, CRITICAL CARE MEDICINE, DENTISTRY, DERMATOLOGY, EMERGENCY MEDICINE, ENDOCRINOLOGY, GASTROENTEROLOGY, GENERAL PEDIATRICS, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEONATOLOGY, NEPHROLOGY, NEUROLOGY, PREVENTIVE MEDICINE, PSYCHIATRY, PULMONOLOGY, RHEUMATOLOGY, CARDIOVASCULAR SURGERY, NEUROLOGY, NEUROSURGERY, OPHTHALMOLOGY, ORTHOPEDIC SURGERY, OTOLARYNGOLOGY, PEDIATRIC SURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PATHOLOGY, RADIOLOGY, UROLOGY AND ANESTHESIOLOGY. THIS CRITICAL MASS OF PHYSICIANS SIGNIFICANTLY CONTRIBUTES TO THE QUALITY AND RANGE OF PEDIATRIC SERVICES AVAILABLE AT THE HOSPITAL. 2011 STATISTICAL DATA INCLUDES TOTAL INPATIENT DAYS: 66.256 TOTAL INPATIENT ADMISSIONS: 12,172 INPATIENT AVERAGE DAILY CENSUS: 185.4 TOTAL ED VISITS (MAIN CAMPUS): 92,597 MCH PEDIATRIC CARE CENTER VISITS: 11,935 AMBULATORY VISITS: 10,619 PRIVATE OUTPATIENT VISITS (MAIN CAMPUS): 114,753 PRIVATE OUTPATIENT VISITS (AMBULATORY CENTERS): 106,387 TOTAL SURGICAL CASES: 14,148 AVERAGE LENGTH OF STAY: 5.6 DAYS THE HOSPITAL IS INTERNATIONALLY RECOGNIZED FOR CARE EXCELLENCE. MIAMI CHILDREN'S HOSPITAL PROGRAMS WERE RANKED AMONG THE NATION'S BEST IN ALL 10 PEDIATRIC SUBSPECIALTY PROGRAMS SURVEYED BY U.S. NEWS AND WORLD REPORT IN ITS 2012 LISTING OF "AMERICA'S BEST CHILDREN'S HOSPITALS." (RANKINGS ARE BASED ON 2011 DATA). THE HOSPITAL IS THE ONLY ONE IN FLORIDA TO HAVE PROGRAMS RANKED IN ALL CATEGORIES SURVEYED BY U.S. NEWS. THESE PROGRAMS INCLUDE CANCER, CARDIOLOGY AND HEART SURGERY, DIABETES AND ENDOCRINOLOGY, GASTROENTEROLOGY, NEONATOLOGY, NEPHROLOGY, NEUROLOGY ORTHOPEDICS, UROLOGY. IN ADDITION, THE HOSPITAL SYSTEM INCLUDES A NETWORK OF AMBULATORY CENTERS THAT EXTEND CARE THROUGHOUT THE SOUTH FLORIDA REGION. DURING 2011, THESE CENTERS OFFERED OUTPATIENT SERVICES AS FOLLOWS: MCH DAN MARINO OUTPATIENT CENTER: OFFERS COMPREHENSIVE SERVICES FOR CHILDREN WITH NEURODEVELOPMENTAL DISORDERS. SERVICES ON SITE INCLUDE IMAGING AND REHABILITATION. ALSO ON SITE IS A SWIMMING POOL FOR AQUATIC THERAPY. MCH DORAL OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES AND AN AFTER-HOURS URGENT CARE CENTER. MCH PALMETTO BAY OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES AND AN AFTER-HOURS URGENT CARE CENTER. ALSO ON-SITE IS EARLY STEPS SOUTHERNMOST COAST, A RESOURCE FOR CHILDREN UNDER THE AGE OF 3 WHO ARE AT RISK OF DEVELOPMENTAL DELAYS. MCH WEST KENDALL OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, SUBSPECIALTY OFFICE VISITS AND AN AFTER-HOURS URGENT CARE CENTER. MCH NICKLAUS CARE CENTER: OFFERS PEDIATRIC SUBSPECIALTY CONSULTATIONS IN PALM BEACH COUNTY. MCH REHABILITATION SERVICES - MIAMI LAKES: OFFERS COMPREHENSIVE REHABILITATION SERVICES. QUALITY/SAFETY AND ERROR PREVENTION INITIATIVES FROM 2011 THE HOSPITAL IS COMMITTED TO ADVANCING QUALITY AND SAFETY. INITIATIVES FOR 2011 ARE DETAILED BELOW: LEAN INITIATIVES: LEAN IS AN INTERNATIONALLY RECOGNIZED BUSINESS IMPROVEMENT MODEL. IN 2011, THE HOSPITAL CONTINUED TO UTILIZE LEAN METHODS TO IMPROVE PROCESSES THAT ENHANCE SAFETY, EFFICIENCY AND PREVENT ERRORS AT THE HOSPITAL. FROM 2008 TO 2011, THE HOSPITAL HAS SAVED $8 MILLION THROUGH LEAN-BASED EFFICIENCIES. FASTPASS SYSTEM: MIAMI CHILDREN'S WAS ALSO AN EARLY ADOPTER OF FASTPASS VISITOR BADGE IDENTIFICATION TECHNOLOGY. ALL VISITORS MUST PRESENT PHOTO IDENTIFICATION UPON ARRIVAL AND A RECORD IS KEPT OF ALL THOSE ENTERING THE HOSPITAL. THIS SYSTEM CAN IDENTIFY INDIVIDUALS WITH RECORDS OF CHILD ABUSE AND MOLESTATION, HELPING ENHANCE THE SAFETY OF CHILDREN AT THE HOSPITAL. GETWELL NETWORK: SINCE 2009, THE HOSPITAL HAS OFFERED THE GETWELL NETWORK IN ALL MEDICAL SURGICAL ROOMS. THE SYSTEM, ACCESSIBLE THROUGH THE IN-ROOM TELEVISION SCREEN, OFFERS PATIENT EDUCATION INFORMATION THAT CAN SUPPORT ENHANCED PATIENT CARE AS WELL AS A PATIENT FEEDBACK SYSTEM, THROUGH WHICH FAMILIES CAN ADDRESS SAFETY CONCERNS. LIFEWINGS: IN 2010, THE HOSPITAL BEGAN COLLABORATING WITH LIFEWINGS PARTNERS LLC TO TRAIN EMERGENCY DEPARTMENT STAFF, SURGEONS, ANESTHESIOLOGISTS, OR NURSES AND SUPPORT STAFF TO IMPLEMENT AVIATION-BASED SAFETY AND EFFICIENCY MEASURES. IN 2011, THE HOSPITAL WON AN OUTSTANDING INITIATIVE AWARD FROM TRAINING MAGAZINE FOR THIS SAFETY COLLABORATION. EMR: THE HOSPITAL HAS ACQUIRED A STATE-OF-THE-ART SYSTEM THAT WILL CAPTURE ALL PATIENT DATA, INCLUDING COMPREHENSIVE CARE RECORDS (RADIOLOGY, PHARMACY, REHABILITATION, OUTPATIENT AND INPATIENT) AS WELL AS REGISTRATION AND BILLING INFORMATION, ALL IN A COMPREHENSIVE SYSTEM. IN 2011, THE HOSPITAL ACTIVATED TO MAKE THOUSANDS OF SYSTEM DESIGN DECISIONS TO PREPARE FOR A SPRING 2012 GO-LIVE (VERY SUCCESSFUL). PHYSICIANS AND OTHER CAREGIVERS CAN ACCESS ALL MEDICAL DATA THROUGH A SECURE LOGIN SYSTEM FROM ANY PLACE AT ANY TIME, ENABLING THEM TO MAKE INFORMED DECISIONS WITH MAXIMUM EFFICIENCY HUMPTY DUMPTY: MIAMI CHILDREN'S HOSPITAL HAS TAKEN THE LEAD IN DEVELOPING A TOOL TO PREVENT PEDIATRIC FALLS AND THEREBY ENHANCE SAFETY. THIS FALL PREVENTION PROGRAM HAS BEEN IMPLEMENTED, TESTED AND PROVEN TO BE AN EFFECTIVE TOOL IN THE PREVENTION OF UNINTENTIONAL INJURY DUE TO FALLS. THE HUMPTY DUMPTY FALLS PREVENTION PROGRAM[TM] IS A COMPREHENSIVE PROGRAM AIMED AT IDENTIFYING PATIENTS WHO ARE AT RISK FOR FALLS AS WELL AS PREVENTING FALL EVENTS AND INJURIES. THIS PROGRAM WAS DEVELOPED BY AN INTERDISCIPLINARY GROUP OF FALLS EXPERTS DERIVED FROM NURSING, RESEARCH, REHABILITATION, QUALITY IMPROVEMENT, AND RISK MANAGEMENT. PROGRAM MATERIALS INCLUDE A VALIDATED FALLS RISK SCALE, AN INTERVENTION PROTOCOL, AND PATIENT EDUCATION INFORMATION. MORE THAN 400 HOSPITALS AROUND THE GLOBE NOW USE THIS MCH TOOL TO PREVENT PATIENT FALLS. HYGREEN: IMPLEMENTATION OF XHALE INNOVATIONS' HYGREEN(R) HAND HYGIENE SYSTEM IS ANOTHER WAY MIAMI CHILDREN'S HOSPITAL LEADS THE WAY IN PATIENT SAFETY. HYGREEN HELPS PREVENT INFECTIONS BY MONITORING AND REMINDING HEALTHCARE WORKERS TO WASH THEIR HANDS. A SENSOR SCANS NEWLY CLEANED HANDS AND SENDS A WIRELESS "ALL CLEAN" MESSAGE TO A BADGE WORN BY THE CAREGIVER. IN 2011, HYGREEN WAS INTEGRATED INTO THE MCH ONCOLOGY UNIT'S INFECTION CONTROL PROGRAM AND PLANS WERE MADE FOR EXPANSION INTO OTHER HOSPITAL UNITS. COMMUNITY TRAINING OUTREACH PROGRAMS IN ADDITION, THE HOSPITAL SUPPORTS A NUMBER OF PROGRAMS THAT ENHANCE THE SKILLS AND WORK READINESS OF YOUNG PEOPLE AS WELL AS PROMOTE HEALTH AWARENESS. PROJECT VICTORY: THIS PROJECT IS A COOPERATIVE EFFORT BETWEEN MIAMI CHILDREN'S COMMUNITY AND VOLUNTEER RESOURCE PROGRAM AND THE COMMUNITY. TEENS WITH DISABILITIES ARE GIVEN THE OPPORTUNITY TO GAIN LIFE SKILLS THROUGH THE WORLD OF WORK. TWENTY STUDENTS ARE PROVIDED THREE HOURS OF WORK SERVICE PER DAY AT THE HOSPITAL DURING THE COURSE OF THE SCHOOL YEAR. THE STUDENTS GAIN VOCATIONAL EXPERIENCE WORKING IN THE HOSPITAL'S DIETARY DEPARTMENT, MAIL ROOM, VISITOR INFORMATION SERVICE AND OTHER DEPARTMENTS. PROGRAM SERVICE ACCOMPLISHMENTS CONTINUED FORM 990, PART III, LINE 4A MIAMI SENIOR HIGH SCHOOL: MIAMI SENIOR HIGH OFFERS A MEDICAL MAGNET PROGRAM. EACH YEAR, 43 STUDENTS FROM THE PROGRAM HAVE THE OPPORTUNITY TO RECEIVE HANDS-ON EXPERIENCE IN A NURSING/MEDICAL SETTING. THE HOSPITAL OFFERS THE STUDENTS THIS EXPERIENCE AS PART OF ITS SERVICE TO THE COMMUNITY. A TEAM OF 20 NURSES MENTOR THE STUDENTS. KIDS AND THE POWER OF WORK (KAPOW): THIS PROGRAM IS A NATIONAL VOLUNTEER PROGRAM. THE HOSPITAL PARTICIPATES WITH MIAMI-DADE COUNTY PUBLIC SCHOOLS. HOSPITAL STAFF MEMBERS VOLUNTEER TO VISIT STUDENTS AT ONE OF TWO AREA PUBLIC ELEMENTARY SCHOOLS. THEY PRESENT AND PREPARE LESSONS FOR SECOND GRADE STUDENTS TO HELP CREATE A FOUNDATION FOR YOUNG STUDENTS, INTRODUCING THEM TO WORK AND RELATED CONCEPTS. EMPLOYEES DONATE ABOUT 500 HOURS OF TIME TO THE PROGRAM. HEALTHTEACHER: MIAMI CHILDREN'S IS PARTNERING WITH SCHOOL DISTRICTS IN PALM BEACH AND BROWARD COUNTIES TO TEACH CHILDREN HOW TO INCORPORATE HEALTH AND WELLNESS INTO THEIR LIFESTYLES. THE HOSPITAL MAKES AVAILABLE AN ONLINE HEALTH CURRICULUM DEVELOPED BY HEALTHTEACHER. THE PROGRAM IS DESIGNED FOR KINDERGARTEN THROUGH HIGH SCHOOL STUDENTS, WITH TOPICS RANGING FROM GOOD NUTRITION TO BICYCLE SAFETY. THE GOAL IS TO EQUIP CHILDREN WITH THE KNOWLEDGE AND TOOLS NEEDED TO MAKE BETTER CHOICES FOR THEIR HEALTH. FORM 990, PART VI, SECTION B, LINE 11 THE FOLLOWING DESCRIBES MIAMI CHILDREN'S HOSPITAL'S PROCESS FOR PROVIDING IT'S BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE MAILED TO FINANCE COMMITTEE OF MCH BOARD OF DIRECTORS FOR REVIEW AND COMMENT PRIOR TO REGULARLY SCHEDULED MEETING. 2. THE DRAFT TAX FORM 990 WILL BE REVIEWED WITH THE FINANCE COMMITTEE. 3. QUESTIONS WILL BE ANSWERED AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. 4. THE FINAL FORM 990 WILL BE POSTED ON THE MCH BOARD OF DIRECTOR'S WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C ALL MIAMI CHILDREN'S HOSPITAL EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE, ANNUALLY AND WHENEVER A CHANGE IN CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURE FORMS ARE FORWARDED TO THE COMPLIANCE DEPARTMENT BY THE TALENT MANAGEMENT AND EFFECTIVENESS DEPARTMENT. THESE FORMS ARE INITIALLY REVIEWED BY COMPLIANCE DEPARTMENT STAFF. WHEN DEEMED NECESSARY, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT. CONFLICTS OF INTEREST THAT NECESSITATE BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS AND BOARD-DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT THE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE IF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY THE HOSPITAL'S CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION AND COMPENSATION COMMITTEE OF MCH BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, PART VI, SECTION C, LINE 19: DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. AVERAGE HOURS PER WEEK PART VII, LINE 1A, COLUMN B THE OFFICERS LISTED ON PART VII, SECTION A, LINE 1(A), COLUMN B DEVOTED THEIR TIME TO THE ORGANIZATION AND RELATED ORGANIZATIONS AS FOLLOWS: WORKER'S PROFESSIONAL MCH COMPENSATION LIABILITY RESEARCH FOUNDATION TRUST TRUST INSTITUTE INC. JEFRY BIEHLER, MD 0.1 0.1 0.5 0.0 THOMAS M. CORNISH 0.1 0.1 0.5 1.5 JARET DAVIS, ESQUIRE 0.1 0.1 0.5 0.0 MARIA FRANCO, MD 0.1 0.1 0.5 0.0 MICHAEL FUX 0.1 0.1 0.5 0.0 LUIS GONZALEZ-MENDOZA, MD 0.1 0.1 0.5 0.0 GHISLAIN GOURAIGE, JR. 0.1 0.1 0.5 0.0 DEISE GRANADO-VILLAR, MD 0.1 0.1 0.5 0.0 GARY GREGORY 0.1 0.1 0.5 0.5 JUAN C. MAS 0.1 0.1 0.5 0.5 JAY MASSIRMAN 0.1 0.1 0.5 0.0 STEVEN MCKEAN 0.1 0.1 0.5 0.0 MARIO MURGADO 0.1 0.1 0.5 1.5 PHILIP NEWCOMM, MD 0.1 0.1 0.5 0.0 CARMEN PEREZ 0.1 0.1 0.5 0.0 GENE PRESCOTT 0.1 0.1 0.5 0.0 ALEX SOTO 0.1 0.1 0.5 0.0 KEITH WARD 0.1 0.1 0.5 0.0 PEDRO ALFARO 0.1 0.1 0.5 0.0 NARENDRA KINI, MD 0.1 0.1 0.5 0.0 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: RESTRICTED CONTRIBUTIONS -4,502,487. PRIOR PERIOD ADJUSTMENT 262,357. LOSS ON CONVERSION OF DEBT -32,832. LOSS ON CHANGE IN FMV OF SWAP AGREEMENTS -24,665,300. GRANT REVENUE USED FOR PURCHASE OF PP&E 1,626,684. NET UNREALIZED GAINS ON TEMP RESTRICTED ASSETS 4,309,195. CHANGE IN CHARITABLE REMAINDER TRUSTS -72,364. NET ASSETS RELEASED FROM RESTRICTION -1,433,390. CHANGE IN BENEFICIAL INTEREST IN MCHF -4,686,444. AMOUNTS REPORTED SEPARATELY -1,157,003. NET UNREALIZED LOSS ON INVESTMENTS -6,949,096. TOTAL TO FORM 990, PART XI, LINE 5: -37,300,680. EMPLOYEES REPORTED ON W-3 PART V, LINE 2A VARIETY CHILDREN'S HOSPITAL D/B/A MIAMI CHILDREN'S HOSPITAL ("MCH") IS THE APPOINTED PAY AGENT FOR ALL AFFILIATES. AS SUCH, ONLY MCH ISSUES FORM W-3. MCH PEDIATRIC CARDIOLOGY LLC 3100 SW 62ND AVENUE MIAMI FL 33155 651023909 CARDIAC SVC'S FL 6277835 -17863042 N/A MCH RESEARCH INSTITUTE INC 3100 SW 62ND AVENUE MIAMI FL 33155 592602318 RESEARCH FL 501(C)(3) 11B N/A 1 MCH WORKER'S COMPENSATION TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 597021572 WC CLAIMS FL 4947(A)(1) N/A N/A 1 PROFESSIONAL LIABILITY TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 592551434 LIAB. CLAIMS FL 4947(A)(1) N/A N/A 1 MIAMI CHILDREN'S HOSPITAL FND INC 3100 SW 62ND AVENUE MIAMI FL 33155 591720704 FUNDRAISING FL 501(C)(3) 7 N/A 1 MIAMI CHILDREN'S HEALTH SYSTEM INC 3100 SW 62ND AVENUE MIAMI FL 33155 453481327 HEALTHCARE FL 501(C)(3) 11 TYPE II N/A 0 CANAVAN PARTNERS C/O COHEN PO BOX 812170 BOCA RATON FL 334812170 650974245 MED.INTEL.PRO FL N/A RELATED 271564 0 1 0.62500 CHILDREN'S HEALTH SERVICES INC 3100 SW 62ND AVENUE MIAMI FL 33155 650438667 PHYSICIAN SUP FL N/A C -70 1.00000 MIAMI CHILDREN'S INSURANCE CO SPC LTD 720 WEST BAY ROAD PO BOX 69GT B GEORGETOWN CJ 980442086 INSURANCE CJ N/A C 2639232 66493192 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 MIAMI CHILDREN'S HOSPITAL FOUNDATION INC C 3286047 FMV MIAMI CHILDREN'S INSURANCE CO SPC LTD Q 4473892 CHANGE IN BALANCE MIAMI CHILDREN'S INSURANCE CO SPC LTD R 1700000 FMV MIAMI CHILDREN'S HOSPITAL FOUNDATION INC P 223401 FMV