2011-05-09T15:54:49-05:00 2010-06-30 DELOITTE TAX LLP 1111 BAGBY STREET SUITE 4500 HOUSTON TX 770022591 990 2009-07-01 710236857 ARKANSAS CHILDREN'S HOSPITAL ARKA 5013642555 1 CHILDRENS WAY LITTLE ROCK AR 72202 JONATHAN BATES MD 5013642555 2011-05-09 1 DELOITTE TAX LLP 7139822000 2009 2016-02-24 21:20:13Z JONATHAN BATES MD 1 CHILDRENS WAY LITTLE ROCK AR 72202 513101346 0 X www.archildrens.org X 1912 AR TO PROVIDE CLINICAL SERVICES TO ENHANCE, SUSTAIN AND RESTORE THE HEALTH AND DEVELOPMENT OF CHILDREN. 32 25 4729 3315 0 0 15125746 19339155 458746404 483187652 4477789 5006737 3711837 5543785 482061776 513077329 7439162 8369068 0 225512714 239416113 0 0 210534817 222432859 443486693 470218040 38575083 42859289 622271298 658956210 242066716 232857759 380204582 426098451 In order to enhance, sustain, and restore the health and development of children, Arkansas Children's Hospital provides excellent clinical services, teaching and research. 0 0 400644082 8369068 484352759 Arkansas Children's Hospital (ACH) is a not-for-profit pediatric hospital that serves as the only tertiary health care facility for children in the State of Arkansas. ACH has the only Burn Center in Arkansas and therefore provides services to adults as well as children. During the year ended June 30, 2010, ACH experienced the following: 13,953 admissions with an average stay of 6.20 days; 88,923 patient days; 243.6 average daily census; 316 operating beds, including 142 intensive care beds and 163 medical/surgical beds; 216,336 outpatient visits, excluding ER visits which were 52,128; and 13,333 surgeries including 22 heart transplants, 8 kidney transplants, and 1 liver transplant. In addition to providing charity care, ACH works with the central Arkansas community and organizations throughout the State TO PROVIDE THE FOLLOWING: FREE PHYSICALS; STAFF FOR HEALTH CAMPS; PROGRAMS ON HEALTH CARE TO ELEMENTARY STUDENTS; AND INFORMATION AND LEARNING EXPERIENCES TO CHILDREN AND PARENTS AT HEALTH FAIRS AND SEMINARS. 400644082 1 1 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0 0 0 0 1 0 1 1 1 1 0 0 0 0 1 1 0 0 1 214 0 4729 1 0 0 0 0 0 0 0 0 0 32 25 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 AR X GENA WINGFIELD 5013642555 1 CHILDRENS WAY LITTLE ROCK AR 72202 JONATHAN BATES MD 40.00 X X 493571 0 194576 DORSEY JACKSON 2.00 X X 0 0 0 TOM BAXTER 1.00 X X 0 0 0 J FRENCH HILL 1.00 X X 0 0 0 PAUL R HART 1.00 X X 0 0 0 MARY AITKEN MD 8.00 X 0 0 0 JOHN BALE JR 1.00 X 0 0 0 CHARLES M BOWER MD 1.00 X 0 0 0 PATRICK H CASEY MD 1.00 X 0 0 44246 RON CLARK 0.50 X 0 0 0 HASKELL DICKINSON 0.30 X 0 0 0 EDWARD DRILLING 0.10 X 0 0 0 HARRY C ERWIN III 1.00 X 0 0 0 RHONDA FORRESTER 0.20 X 0 0 0 FRANCIS SKIP FRANTZ 0.10 X 0 0 0 JUDGE MARION HUMPHREY 0.50 X 0 0 0 RICHARD JACOBS MD 8.00 X 0 0 196912 MICHAEL JOSHUA 0.00 X 0 0 0 LISA KIRKPATRICK 0.20 X 0 0 0 DIANE MACKEY 1.00 X 0 0 0 HOLLY MARR 0.50 X 0 0 0 MARK MCCASLIN 1.00 X 0 0 0 PAT MCCLELLAND 1.00 X 0 0 0 BARBARA G MOORE 1.00 X 0 0 0 BEVERLY A MORROW 1.00 X 0 0 0 JEFFREY NOLAN 1.00 X 0 0 0 DANIEL RAHN MD 0.50 X 0 0 0 KATIE RANSDELL 0.50 X 0 0 0 JAMES SKIP RUTHERFORD 0.50 X 0 0 0 MARK SAVIERS 0.50 X 0 0 0 PHILIP W SCHMIDT 0.20 X 0 0 0 ROBERT SHULTS 0.10 X 0 0 0 BONNIE TAYLOR MD 40.00 X X 0 0 215606 EVERETT TUCKER III 0.10 X 0 0 0 RICK WATKINS 0.10 X 0 0 0 CHARLES B WHITESIDE III 1.00 X 0 0 0 I DODD WILSON MD 0.10 X 0 0 0 GENA WINGFIELD 40.00 X 387774 0 38008 CHARLES LARRY BECKIUS 40.00 X 177273 0 18203 DAVID BERRY 40.00 X 382387 0 41561 LORI BROWN 40.00 X 256448 0 5627 SCOTT GORDON 20.00 X 366959 0 175463 CYNTHIA HOLLAND 40.00 X 188608 0 20034 DARRELL LEONHARDT 40.00 X 236754 0 22051 MARY MCDANIEL 40.00 X 159884 0 16025 MARY SALASSI-SCOTTER 40.00 X 157088 0 17778 CAROLE ZYLMAN 40.00 X 211052 0 21785 CARL CHIPMAN 40.00 X 232373 0 22610 SHERRY FURR 40.00 X 211055 0 19505 CHARLES JOHNSON 40.00 X 228859 0 15190 JAMES KOONCE 40.00 X 322059 0 21069 KIRT SIMMONS 40.00 X 222361 0 24431 4234505 0 1130680 16 0 1 1 UNIVERSITY OF ARKANSAS FOR MEDICAL SCIEN 4301 WEST MARKHAM LITTLE ROCK AR 72205 MEDICAL SERVICES 51325180 NABHOLZ CONSTRUCTION CORP PO BOX 2090 CONWAY AR 72033 GENERAL CONSTRUCTION CONTRACTOR 30922525 MUNROE-MEYER INSTITUTE 985450 NEBRASKA MEDICAL CENTER OMAHA NE 68198 LAB SERVICES 2628026 BLUEADVANTAGE ADMINISTRATORS OF ARKANSAS PO BOX 1460 LITTLE ROCK AR 72203 HEALTH INSURANCE PLAN ADMINISTRATOR 1237821 CROMWELL ARCHITECTS ENGINEERS 101 SOUTH SPRING STREET LITTLE ROCK AR 72201 ARCHITECT AND ENGINEER SERVICES 1134082 74 10087592 9251563 19339155 Payments for Med SVCS 900099 483187652 483187652 483187652 4975473 4975473 16489 7512 8977 8977 8977 47769 16505 31264 31264 31264 RENT 900099 1684567 1684567 NUTRITIONAL SERVICES 900099 1572125 1572125 CHILD ENRICHMENT 900099 1144273 1144273 1133843 1133843 5534808 513077329 484352759 0 9385415 8298041 8298041 71027 71027 4084916 1430039 2654877 195594638 164032780 31561858 7455161 6184989 1270172 17351543 15497417 1854126 14929855 12386182 2543673 476477 476477 285177 285177 247286 247286 44383 44383 95137767 88603987 6533780 600837 395747 205090 11704678 6444452 5260226 8033860 3830372 4203488 6101000 5026178 1074822 1463507 1180616 282891 159055 103460 55595 3570041 3570041 17922903 13654234 4268669 1678458 307084 1371374 Medical supplies 64591463 64591463 Other expenses 6207597 5052574 1155023 Minor equipment 2610906 1435116 1175790 Provision for bad debt 1597464 1597464 470218040 400644082 69573958 0 6040 11647 43824289 37381035 51029130 51105818 7744510 7468951 2320629 2740113 411139396 198219137 176856859 212920259 144021416 171364568 445636 443406 702226 701502 195320563 174818911 622271298 658956210 56947379 54784798 185119337 178072961 242066716 232857759 X 368853736 410919546 11350846 15178905 380204582 426098451 622271298 658956210 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 44383 1 0 1 206814 251197 0 Part II-B, Line 1i: Explanation of Other Lobbying Activities: IN ORDER TO EFFECTIVELY ADVOCATE FOR AND ASSIST WITH THE IMPROVEMENT OF CHILDREN'S HEALTH, ARKANSAS CHILDREN'S HOSPITAL HAS AN OFFICE OF GOVERNMENT RELATIONS THAT WORKS WITH OTHER ORGANIZATIONS, ON A STATE AND NATIONAL LEVEL, TO FORMULATE POLICY AND TO ARTICULATE OUR PUBLIC POLICY AGENDA. THE ACH BOARD OF DIRECTORS MUST APPROVE ANY LEGISLATIVE OR PUBLIC ISSUE INVOLVEMENT. in addition, A percentage of dues paid to the American Hospital Association, Association of American Medical Colleges and the National Association of Children's Hospitals was for lobbying. 135770735 7045011 13385881 10633312 145568315 0.82820 0.17180 0 1 1 11667204 11667204 191048642 112647179 78401463 131952522 81092441 50860081 76471028 4479517 71991511 212920259 Funds Held By Trustee Under Bond Agreements 95134073 Estimated 3rd party settlement (MCD) 56350100 UPL Receivable 13426115 GME Receivable 1576512 Other Receivables 2713120 Bond Issue Costs 4254258 Interest Receivable 1364733 174818911 513077329 470218040 42859289 2188417 846163 3034580 45893869 Part V, Line 4: Description of Intended Use of Endowment Funds: EARNINGS FROM ENDOWMENT FUNDS WILL BE USED TO SUPPORT VARIOUS HOSPITAL PROGRAMS. THE FILING ORGANIZATION DOES NOT HOLD ANY ENDOWMENTS; ALL ENDOWMENTS ARE HELD BY ARKANSAS CHILDREN'S HOSPITAL FOUNDATION, A RELATED ORGANIZATION. Part XI, Line 8 - Other Adjustments: DONATED ASSET - MOBILE DENTAL UNIT: 375000. OTHER ADJUSTMENT: 471163. 1 1 X 1 X 1 X 0 1 0 1 1 16809858 16809858 0.03590 249264346 275757015 -26492669 0.00000 266074204 275757015 -9682811 0.03590 12127177 6404519 5722658 0.01220 16625553 8586985 8038568 0.01720 38775178 18842190 19932988 0.04250 8259476 8259476 0.01760 555320 555320 0.00120 76342704 33833694 42509010 0.09070 342416908 309590709 32826199 0.12660 35426 35426 0.00010 1250 1250 0.00000 40000 40000 0.00010 1500 1500 0.00000 26771 26771 0.00010 22100 22100 0.00000 32454 32454 0.00010 83214 83214 0.00020 242715 242715 0.00060 0 1090532 0 2413770 3027260 -613490 X 1 1 Arkansas Children's Hospital

1 Childrens Way little rock AR 72202

X X X X X X Part I, Line 7: Arkansas Children's Hospital (ACH) uses a cost accounting (CA) system as the basis for determining cost for our patients. All patient encounters (inpatient, outpatient, ED, ambulatory surgery) are captured in the CA system for all of our patients (Medicaid, insurance, uninsured) with no differentiation for type of insurance, if any. A brief description of the CA system is below.The cost accounting system at ACH is a detail procedure system. All services performed by patient care staff have been evaluated as to the resources utilized to provide the services including labor, direct materials and equipment. In addition, overhead type costs (building, utilities, payroll, etc.) have also been allocated to these services. The two components direct and indirect costs are combined and represent the total cost to provide that service. This is done on a procedure level basis. As a patient is admitted and incurs services (x-rays, room & board, lab, etc.) that procedure cost is assigned to that patient. At discharge, the costs from the individual procedures that were provided to that patient are added up for a total cost of providing care for that patient. The CA system is updated annually to reflect the current year's expenses. Part I, Line 7g: ACH provides many pediatric and some adult specialized services to our community that are either not available in the community or beyond the capacity of the community to provide the service. Many of these services are provided by ACH at a loss. These losses were obtained from the CA system.In addition, ACH provides pediatric renal services that are not provided in the community. The cost of these services provided to pediatric patients is more expensive due to the specialty nature of the patients. These costs are greater than what is allowed on the Medicare cost report and that loss has been reported here.Similarly, ACH incurs losses from providing pediatric lab services to our Medicare patient population that are reimbursed less than cost. Those losses are included here also. Part I, Line 7f: BAD DEBT EXPENSE OF $1,597,464 IS INCLUDED IN THE TOTAL PRESENTED ON FORM 990, PART IX, LINE 25, COLUMN A. THIS AMOUNT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN F. Part III, Line 4: The bad debt attributable to patient accounts does not include the expense for patients who are likely to qualify for financial assistance. At year end, all accounts written off as bad debt are sent to Trans Union for credit analysis. Those with credit scores of 620 and below are reclassified as charity since these would qualify for financial assistance had the families furnished sufficient information. This amount is added to the other charity adjustments. The percent calculated is applied to the bad debt expense for the year to determine the amount of charity and the remainder is bad debt. For those accounts remaining classified as bad debt, the cost to charge ratio for each account is calculated and applied to the bad debt write off to adjust this amount to cost. Part III, Line 8: The ACH Medicare population is primarily renal pediatric patients and Burn adult patients. ACH is the only certified Burn center in the state and serves both pediatric and adult patients. The cost of providing care for the acute adult patients is typically greater than the reimbursement that Medicare allows on the Medicare cost report. Therefore, the Medicare shortfall should be included as a component of community benefit because the reimbursement is not negotiated and services cannot be provided elsewhere.ACH included ($427,607) from prior year Medicare cost report settlements that was paid back to the Medicare program in fiscal year 10. Part III, Line 9b: Arkansas ChildreN'S HospitaL'S Patient Accounts Department uses its best efforts to assist our patients/guarantors in meeting their financial responsibility for services provided at ACH. The ACH policy is to act with integrity in all endeavors; treating all patients and their families with dignity, respect, and compassion. The standard process includes offering Financial Assistance to eligible families. Notices regarding the Financial Assistance program are posted in English and Spanish in all of our registrations areas. Financial Assistance brochures are available to our families upon request. The guarantor statements and our website contain information about this program. There are financial counselors available to all the registration areas of the hospital to assist in completing Medicaid, CMS, SSI Intents, and Financial Assistance applications. It is our standard practice to use our internal resources which includes our Patient Accounts Department and our collection agency Hospital Finance Corporation (HFC). No extraordinary collection efforts are taken. We do not report to credit bureaus or charge interest or file liens against a patienT'S or familY'S residence to secure payment on patient account balances. Upon receipt of a personal bankruptcy notice, any outstanding self pay balances for the associated patient are written off once all other payments have been received. All self pay collection activity is stopped upon notification of the bankruptcy.Upfront discounts on services for the uninsured are offered. The family can also request a prompt pay discount. Additionally, ACH attempts to accommodate U.S. families who desire to set up reasonable payment plans. Interest is not charged. Our guarantor statements are designed to keep the guarantor updated as to whether the account is still pending resolution by insurance or due from the guarantor. Self pay collection attempts are discontinued once charges are determined to qualify for financial assistance. PART I, LINE 4: ACH does not have a specific financial assistance program for the medically indigent, but we do provide discounted care for individuals with household incomes up to 400% of poverty. We also assist families in applying for Medicaid (including the TEFRA program for disabled children that only considers the chilD'S income), SSI, ChildreN'S Medical Services, as well as our Financial Assistance Program. We also allow interest free payments to be made until the outstanding balance is paid without time constraints. ACH does not report to collection agencies or take other extraordinary collection efforts. PART I, LINES 7B AND 7K, COLUMN F: DUE TO SOFTWARE LIMITATIONS RELATED TO ELECTRONICALLY FILING THIS TAX RETURN, THE CALCULATED AMOUNT ON LINE 7B, COLUMN F SHOULD BE -5.65%, AND THE AMOUNT ON LINE 7K, COLUMN F SHOULD BE 7.01%. However, the software would not accept a negative percentage, and therefore, Line 7B column F is blank, resulting in 12.66% to show on Line 7K column F. Part VI, Line 2: Arkansas ChildreN'S Hospital began OUR formal needs assessment of the status of childreN'S health in Arkansas in 2006. Since ACH serves the entire state of Arkansas, our work in this area encompasses all children in the state vs. a single community or neighborhood. Initially, our efforts included a review of 44 separate datasets, each dealing with some aspect of childreN'S health. Such a comprehensive review had not previously been done in our state. This work culminated in a report to the state published in 2007. This first Natural Wonders report reflected not only the thoughts of ACH, but of the Natural Wonders Partnership Council (NWPC), a group of then 11 organizations and agencies committed to collaborative efforts aimed at improving the status of the health of the children of Arkansas. In 2007 and 2008 we expanded this needs assessment with random telephone interviews with over 2500 families across the state to learn of their highest concerns regarding the status of their childreN'S health. This work wAS supplemented with community forums in 5 cities around the state and numerous focus groups including healthcare professionals, educators, healthcare payers, and academic leaders. This work was published in our second report in February 2009. From this work, nine major areas of need were highlighted, and ACH has taken the lead in addressing four of the areas while playing a supportive role in the remaining areas. The areas in which ACH plays a leading role include injury prevention, oral health, health literacy for children, and expansion/improvement of home visiting programs. Our next report will be published in May 2011. Part VI, Line 3: Arkansas ChildreN'S HospitaL'S Patient Accounts Department uses its best efforts to assist our patients/guarantors in meeting their financial responsibility for services provided at ACH. The ACH policy is to act with integrity in all endeavors; treating all patients and their families with dignity, respect, and compassion. The standard process includes offering Financial Assistance to eligible families. Notices regarding the Financial Assistance program are posted in English and Spanish in all of our registration areas. The guarantor statements and our website contain information about this program. There are financial counselors available to all the registration areas of the hospital to assist in completing Medicaid, CMS, SSI Intents, and Financial Assistance applications. Part VI, Line 4: SINCE ARKANSAS CHILDREN'S HOSPITAL IS THE ONLY pediatric medical center in Arkansas, WE SERVE PATIENTS THROUGHOUT THE STATE AND, ON OCCASION, FROM OTHER STATES AND COUNTRIES. ACH DRAWS APPROXIMATELY 71.1% OF OUR OUTPATIENTS AND 53.3% OF OUR INPATIENTS FROM THE CENTRAL PART OF THE STATE (PULASKI COUNTY AND THE SURROUNDING COUNTIES OF JEFFERSON, LONOKE, FAULKNER, BENTON, AND SALINE), AS WELL AS FROM WHITE COUNTY IN NORTH CENTRAL ARKANSAS AND SEBASTIAN AND WASHINGTON COUNTIES IN THE NORTHWEST CORNER OF THE STATE.ACCORDING TO THE U.S. CENSUS BUREAU, AS OF JULY 1, 2009, THE POPULATION FOR PULASKI COUNTY WAS 381,904. AS OF THIS SAME DATE, THE STATE OF ARKANSAS' POPULATION WAS 2,889,450 WITH APPROXIMATELY 63% BEING IN METROPOLITAN AREAS AND 37% IN RURAL AREAS. THERE ARE APPROXIMATELY 746,200 CHILDREN 18 AND UNDER IN THE STATE OF ARKANSAS.THE UNEMPLOYMENT RATE FOR THE STATE OF ARKANSAS FOR CALENDAR YEAR 2009 WAS 7.3%. BY FEBRUARY 2010, THE UNEMPLOYMENT RATE HAD RISEN TO 8%.ACCORDING TO THE U.S. DEPARTMENT OF COMMERCE, THE PER CAPITA PERSONAL INCOME FOR THE STATE OF ARKANSAS WAS $31,946. THE NUMBER OF CHILDREN LIVING IN POVERTY IN OUR STATE IS 218,300. Part VI, Line 5: ACH participates with a wide variety of programs and agencies across the state to address myriad needs of children. Through our support of organizations dealing with specific disease states or chronic health conditions (cancer, heart problems, diabetes, cystic fibrosis, etc.) or agencies serving children and their families with social, clinical and academic services, ACH is an active partner in building communities better serving the health needs of children. Locally, ACH partners with a variety of community organizations to improve the conditions in which children grow up and become adult members of the community. ACH partners with local agencies, non-government organizations, and institutions to improve the Central Little Rock neighborhood in which our hospital is located. Our work with Arkansas Baptist College (ABC) this year helped to prepare a building in the neighborhood to serve as a child care center for local residents, ABC students and to serve as a laboratory setting for student experiences. ACH has for years provided space for the local Community Development Corporation to use as a base of operations. City Connections, a local non-government organization, used our support to modify housing in our neighborhood to accommodate handicapped children, allowing them to remain at home vs. being placed in residential care facilities. ACH is a major employer in the Downtown Little Rock area and serves as an active member of the business community's work to re-vitalize the area for both commerce and living.ACH collaborates with many providers of services to children and their families to assure a wide range of activity in our community. Included in our partnership efforts is our work with our neighborhood high school, the city Parks and Recreation Department and local police department to encourage healthy events and child safety initiatives for all children in our community. These efforts include safe graduation messages and events, community events in parks, and child safety support in concert with local police programming. Additionally, we partner with various agencies targeting efforts to work with parents of hospitalized children, improving mental health services for children, victims of domestic violence and child abuse as well as statewide science education networks. In each of these activities ACH requires the partner agency to specifically report how our support works to improve the lives of children.ACH has long supported training programs for youth focusing on violence prevention, alternative dispute resolution among students as well as cultural/diversity sensitivity among youth.ACH is a leading member of many coalitions focusing on child safety matters, injury prevention, and enhanced health services for children. ACH supports the development of information and educational efforts to illuminate not only problems in child health & safety but also best practices to improve identified issues. Many of these efforts are targeted to specific issues such as car seat and seatbelt utilization, obesity prevention, avoidance of "risky" behaviors and more general issues such as the impact of nanotechnology on improving the lives of children.ACH provides support to our local University affiliates and others to develop educational programs to address major clinical issues, such as cancer, facing children and others in our community. This year we also targeted support for hospice care information regarding children's needs and efforts to improve healthcare quality.ACH maintains active partnerships through financial support and key staff involvement with our local Universities to encourage student interest in the various areas of professional development and training important to our health system operation. Whether encouraging young women to choose professional careers in science or working with University programs to provide clinical experience for students, ACH is a key player in our community in workforce development.Many ACH staff and leaders contribute expertise and leadership in many community settings in pursuit of our mission to improve the lives of children in Arkansas. Whether we are serving on various boards, committees or advisory groups or spending time with students in support of education and development, ACH is an active corporate partner in our community in many ways. We regard this as an important component of our work in the Little Rock and Arkansas community.ACH is a valued partner in the efforts detailed above and remains a key organization in improving the lives of children, both in Little Rock as well as the entire state. Part VI, Line 6: Arkansas ChildreN'S Hospital is the only pediatric medical center in Arkansas and one of the largest in the United States serving children from birth to age 21. The campus spans 29 city blocks and houses 316 beds, a staff of approximately 500 physicians, 80 residents in pediatrics and pediatric specialties and more than 4,400 employees. The private, nonprofit healthcare facility boasts an internationally renowned reputation for medical breakthroughs and intensive treatments, unique surgical procedures and forward-thinking medical research - all dedicated to fulfilling our mission of enhancing, sustaining and restoring childreN'S health and development. For three years in a row ACH has been ranked on FORTUNE'S "100 Best Companies to Work For" list, most recently at No. 75. IN 2012, ARKANSAS CHILDREN'S HOSPITAL WILL CELEBRATE OUR 100TH ANNIVERSARY.Our physicians are consistently recognized for their outstanding performance and achievement in taking care of our young patients. Doctors from ACH are consistently listed on Best Doctors and Top Doctor lists locally and nationally. In fact, 124 ACH staff physicians were recognized as 2009-2010 Best Doctors in America. ACH serves as the pediatric teaching affiliate of UAMS and is home to the Department of Pediatrics. ACH is the classroom where medical students study the pediatric component of all disciplines. In turn, UAMS shares its current medical breakthroughs and technological advancements. UAMS faculty on the ACH campus are practicing physicians as well as teachers to UAMS students in medicine, nursing, pharmacy and allied health.The goal of ACH is to improve the lives of children by providing the best in well-child care as well as emergency medicine and acute care to restore, enhance and sustain a chilD'S health. Inpatient services include: Infant/Toddler, Cardiovascular Intensive Care, Newborn Intensive Care, Pediatric Intensive Care, Intermediate Care, General Medicine, Orthopedics, Hematology/Oncology, Surgery/Ambulatory Surgery, Neuroscience, Progressive/Rehabilitation, Burn Center, Renal Dialysis, Adolescent & Young Adult, Emergency Medicine, and Extracorporeal Membrane Oxygenation(ECMO).In conjunction with the University of Arkansas for Medical Sciences Department of Pediatrics, ACH offers more than 70 specialty and subspecialty clinics, located on the main campus, AND in West Little Rock, as well as in Northwest Arkansas and other areas of the State. These include: Adolescent & Sports Medicine, Asthma/Allergy, Audiology/Speech Pathology, Genetics, Cardiology, Gastroenterology, High Risk Newborn, Otolaryngology, Cystic Fibrosis/Pulmonary, Ophthalmology, Spina Bifida, and Nutrition Research.In order to enhance, sustain and restore the health and development of children, Arkansas Children's Hospital provides excellent clinical services, teaching and research. ACH is committed to working with others to achieve high quality, cost-effective, fully accessible services for Arkansas' most precious resource - our children, without regard to race, religion or inability to pay.Community Outreach programs are just another way that ACH is striving to make a positive impact on children throughout our state. As Arkansas' only pediatric medical center, ACH has taken a proactive leadership role in reaching children and families with informative and fun health education. We have developed several statewide outreach programs with a focus on wellness, prevention, and health promotion. sOME OF OUR COMMUNITY OUTREACH PROGRAMS ARE AS FOLLOWS:-"Healthy Habits" Classroom Presentations - Last school year, "Healthy HabitS" was presented to over 14,000 children across the state. These fun and informative classroom presentations are geared for children in Kindergarten through 4th grade. As part of each presentation, a short, high-energy DVD is used to teach children the importance of healthy eating and having an active lifestyle to maintain good health. -F.A.N. Club - The F.A.N. Club (Fitness and Nutrition) is a presentation-based program targeting middle school students who will learn the importance of daily physical activity as well as fun AND creative ways to include exercise into an active lifestyle. The program emphasizeS creating positive fitness and nutrition choices for a lifetime of good health.-Child Passenger Safety - nationally certified child passenger safety technicians are available to offer presentations focusing on the correct use of car safety seats, booster seats, and seat belts. Information can be tailored for a variety of groups. -Fire Safety House - The mobile KohL'S Fire Safety House Program at ACH helps teach children how to best respond to a house fire situation. With two training rooms, props, and non-toxic smoke, the house is designed to provide a realistic environment for teaching basic fire prevention and survival skills. -Speaker's Bureau - The ACH Speaker's Bureau consists of hospital employees and medical staff who are available to speak to your organization on a wide-range of topics related to children's health issues such as Childhood Asthma, Angel One Transport, Child Passenger Safety, and Children and Grief. -Babysitting 101 - Babysitting 101 is taught by instructors from ACH, using the Safe Sitter Curriculum. It is a great introduction to the basics of babysitting. In Babysitting 101, participants will learn about child development, what to do in an emergency, how to properly accept a babysitting job, and ensure that the job is safe for them to accept. -ACH Health Fair - For 28 years, the ACH Health Fair has been an annual educational and informational event for children and parents in our community. Children are invited to participate in the event by following a map from booth to booth, such as Picture Yourself a Surgeon and Fingercasting. The booths provide children and families with an excellent learning experience and a chance to interact with ACH professionals in a relaxed environment outside the hospital. -Little Rockers Kids Marathon - ACH is a proud sponsor of the annual Little Rockers Kids Marathon. ACH is thrilled to cheer on hundreds of kids as they train and log their exercise and then sprint the last mile toward the finish line on race day.-Riverfest Kidzone - The Community Outreach Department always has fun in the Kid Zone Area during Little Rock's annual Riverfest. Each year the Outreach Staff can be seen manning the Fingercasting booth and the Fire Safety House.-Summer Cereal Drive - The Community Outreach Department is proud to facilitate ACH'S participation each year in the Summer Cereal Drive, benefiting the Arkansas Food Bank. -King Elementary - Partner in Education - ACH is proud to be a Partner in Education with Martin Luther King Elementary School. ACH employees volunteer as readers for the Reading Renaissance Program, offer programs during the schooL'S Wellness Week, and participate in many other activities with the school.-Arkansas Safe Kids Coalition - ACH is proud to be the lead organization for the Arkansas Safe Kids Coalition. This diverse coalition of organizations and individuals meets bi-monthly in an on-going grass roots effort to raise awareness and increase education regarding preventable injuries in children. -Outreach Video Library - The Community Outreach Department has a video library available as a resource to the community. The topics INCLUDE hygiene, nutrition, fire safety, and many more. -KidsHealth Web Resource - KidsHealth is a terrific resource for medical information that includes interactive games and quizzes. It also provides families with perspective, advice, and comfort about a wide range of physical, emotional, and behavioral issues that affect children and teens.-Centers for Good Mourning - These groups have been offered at ACH since 1995. Good Mourning Grief Support Groups are free educational support groups for young people who have experienced the death of someone close to them. The purpose of the groups is to help young people cope with their feelings of grief and loss in a supportive setting with similar age peers. An optional group for parents and adult caregivers is also available.-Injury Prevention Center (IPC) - Arkansas has one of the highest child and adolescent injury rates in the nation. The IPC at ACH is working to reduce the number of injuries and fatalities to Arkansas children through an aggressive and proactive program. Goals of the IPC are to reduce unintentional injury-related deaths and disability among the children of Arkansas. Strategies include public awareness and education, professional training, and identification of evidence-based policies to promote safety in motor vehicles, in recreation, and in the home. Particular focus areas for Arkansas include increased and proper use of seatbelts and car seats for children, teenage driving initiatives, and the safe operation of all-terrain vehicles. Part VI, Line 7: ACH is not part of an affiliated health care system. ACH and the University of Arkansas for Medical Sciences (UAMS) are involved in an affiliation agreement in the pursuit of professional education, research, and clinical care for children. All pediatric sub-specialty work is conducted on the ACH campus with ACH providing space, supporting staff and services and funding for major educational and clinical expertise.In fiscal year 2010, Arkansas ChildreN'S Hospital Research Institute (ACHRI) researchers received over $22 million in grants and contracts from federal, state, and private agencies, industry sponsors, and philanthropic donations. Over 120 researchers, many who are physicians at ACH, conduct research on the ACH campus. ACHRI has over 190,000 square feet of research space. Physicians at ACH have conducted clinical trials or industry-sponsored research for over 25 years. ACH physicians are leaders in the effort to study newly developed medicines and medical devices that will be used to treat common and rare medical conditions in children. In fiscal year 2010, ACHRI'S total revenue for industry-sponsored projects was over $1 million, and nearly 300 children and adolescents were enrolled in clinical studies. Researchers at ACHRI strive to move discoveries quickly from the laboratory bench to the bedside for the benefit of children receiving care at ACH and throughout the world. Areas of study include: Asthma Research, Unlocking the secrets of autoimmune disease, Food Allergy Research, Injury Prevention Research, birth Defects, Pediatric Pharmacology Research Unit, Influence of Diet in Early Childhood Development, Effects of Eating breakfast on Behavioral Regulation and Brain Activity in Preadolescents, Impact of early diet on reproductive organ development in infants, Effects of Infant formula vs. Breast Feeding on Bone Formation in Neonates, Maternal Overweight Programs Multiple Aspects of Energy Balance in Offspring, Soy protein consumption reduces body fat stores and fatty liver, Early blueberry consumption dramatically increases bone quality, Diet-mediated mechanisms of breast cancer protection, Early fruit consumption and breast health, Rice diet and prevention of atherosclerosis, Blueberry diet and atherosclerosis, and Nursing Research. 1 AMERICAN HEART ASSOCIATION PO BOX 1610 LITTLE ROCK AR 72203 135613797 501(c)(3) 10000 GENERAL SUPPORT ARKANSAS ADVOCATES FOR CHILDREN & FAMILIES 1400 WEST MARKHAM SUITE 306 LITTLE ROCK AR 72201 710492205 501(c)(3) 8150 GENERAL SUPPORT ARKANSAS BAPTIST COLLEGE 1621 MARTIN LUTHER KING DRIVE LITTLE ROCK AR 72202 710298658 501(c)(3) 10000 BUILDING RENOVATION ARKANSAS CENTER FOR HEALTH IMPROVEMENT (UAMS) 1401 W CAPITOL AVE SUITE 300 LITTLE ROCK AR 72201 716046242 GOV'T ENTITY 200000 HEALTH IMPROVEMENT PROGRAMS ARKANSAS CHILDREN'S HOSPITAL FOUNDATION 1 CHILDRENS WAY LITTLE ROCK AR 72202 710568795 501(c)(3) 1625728 GENERAL SUPPORT ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE 13 CHILDRENS WAY LITTLE ROCK AR 72202 710694931 501(c)(3) 6263954 GENERAL SUPPORT ARKANSAS DISCOVERY NETWORK 500 PRESIDENT CLINTON AVE S 150 LITTLE ROCK AR 72201 710391707 501(c)(3) 7500 GENERAL SUPPORT CENTRAL LITTLE ROCK COMMUNITY DEVELOPMENT CENTER 1825 W 13TH STREET LITTLE ROCK AR 72202 710739065 501(c)(3) 12150 FMV PROVIDE OFFICE SPACE GENERAL SUPPORT CITY CONNECTIONS INC 200 RIVER MARKET AVE SUITE 100 LITTLE ROCK AR 72201 263532549 501(c)(3) 10000 GENERAL SUPPORT HOME INSTRUCTION FOR PARENTS OF PRESCHOOL YOUNGSTERS (HIPPY) 1221 BISHOP LITTLE ROCK AR 72202 133672592 501(c)(3) 15000 29175 FMV PROVIDE OFFICE SPACE & PHONE GENERAL SUPPORT LITTLE ROCK MARATHON 500 W MARKHAM SUITE 108 LITTLE ROCK AR 72201 716014465 gOV'T ENTITY 10000 GENERAL SUPPORT LITTLE ROCK POLICE DEPARTMENT 600 W MARKHAM LITTLE ROCK AR 72201 716014465 GOV'T ENTITY 6892 GENERAL SUPPORT NATIONAL INITIATIVE FOR CHILDREN'S HEALTHCARE QUALITY 30 WINTER STREET 6TH FLOOR BOSTON MA 02108 010647374 501(c)(3) 15000 GENERAL SUPPORT RONALD MCDONALD HOUSE CHARITIES 1009 WOLFE STREET LITTLE ROCK AR 72202 710525252 501(c)(3) 12500 GENERAL SUPPORT THE ADVOCACY FOR CHILDREN PO BOX 165815 LITTLE ROCK AR 72216 261086937 501(c)(3) 14992 FMV PROVIDE OFFICE SPACE GENERAL SUPPORT UNIVERSITY OF ARKANSAS AT LITTLE ROCK FOUNDATION 2801 S UNIVERSITY AVENUE LITTLE ROCK AR 72204 716056774 GOV'T ENTITY 16000 GENERAL SUPPORT WOMEN'S FOUNDATION OF ARKANSAS 1202 MAIN STREET SUITE 230 LITTLE ROCK AR 72202 300034070 501(c)(3) 8000 GENERAL SUPPORT 17 Food 3737 173379 FMV Meals for families/lactating Mothers INSURANCE PREMIUMS 40 79582 FMV PAYMENT OF PREMIUMS FOR PATIENT'S FAMILIES ALLOWED BY COBRA TRANSPORTATION COSTS (BUS TOKENS, CAB FARE, GAS CARDS) 1147 31283 Funeral Expenses 27 21468 RENT, MORTGAGE EXPENSE, UTILITIES, LODGING 94 14715 Car seats for infants and children 167 13169 FMV Car seats for infants and children CLOTHING AND BLANKETS 5 817 FMV CLOTHING AND BLANKETS PROVIDED FOR PATIENTS AND FAMILIES DOCTOR'S APPOINTMENTS AND MEDICINE 18 262 GROCERY GIFT CARDS AND OTHER MISC. ASSISTANCE 46 3299 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: The Hospital provides some assistance to indigent families. The Hospital's Social Work department evaluates the need on a case by case basis and provides the appropriate assistance, which is typically food, clothing, shelter or travel vouchers. Cash or cash equivalent assistance is also sometimes provided. The assistance provided is documented by the Hospital's Social Work department. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 JONATHAN BATES MD 440456 0 50000 0 3115 0 187679 0 6897 0 688147 0 0 0 RICHARD JACOBS MD 0 0 0 0 0 0 0 0 0 0 0 0 BONNIE TAYLOR MD 0 0 0 0 0 0 0 0 0 0 0 0 GENA WINGFIELD 351222 0 36000 0 552 0 28450 0 9558 0 425782 0 0 0 CHARLES LARRY BECKIUS 165690 0 11000 0 583 0 12303 0 5900 0 195476 0 0 0 DAVID BERRY 349810 0 32000 0 577 0 32003 0 9558 0 423948 0 0 0 LORI BROWN 231936 0 24000 0 512 0 0 0 5627 0 262075 0 0 0 SCOTT GORDON 337614 0 27000 0 2345 0 165905 0 9558 0 542422 0 0 0 CYNTHIA HOLLAND 174968 0 13000 0 640 0 14050 0 5984 0 208642 0 0 0 DARRELL LEONHARDT 223327 0 12000 0 1427 0 12986 0 9065 0 258805 0 0 0 MARY MCDANIEL 149392 0 10000 0 492 0 11647 0 4378 0 175909 0 0 0 MARY SALASSI-SCOTTER 146825 0 10000 0 263 0 12011 0 5767 0 174866 0 0 0 CAROLE ZYLMAN 192877 0 17000 0 1175 0 15622 0 6163 0 232837 0 0 0 CARL CHIPMAN 222201 0 8903 0 1269 0 10875 0 11735 0 254983 0 0 0 SHERRY FURR 194887 0 14000 0 2168 0 14962 0 4543 0 230560 0 0 0 CHARLES JOHNSON 224490 0 4157 0 212 0 13375 0 1815 0 244049 0 0 0 JAMES KOONCE 317954 0 500 0 3605 0 15875 0 5194 0 343128 0 0 0 KIRT SIMMONS 221267 0 500 0 594 0 15846 0 8585 0 246792 0 0 0 Part I, Line 1a Charter travel is used for staff to travel to a clinic located in Northwest Arkansas. Utilization of charter travel, rather than having staff drive to the location, is OCCASIONALLY deemed the most efficient method of travel. Staff who travel to this location may include employees listed as officers and key employees, as well as physicians, nurses, and other administrative or patient care staff. Part I, Line 4a ARKANSAS CHILDREN'S HOSPITAL HAS SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS TO PROVIDE EXECUTIVES WITH RETIREMENT AND DEATH BENEFITS. THE PLAN IS INTENDED TO CONSTITUTE AN UNFUNDED PLAN FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES WITHIN THE MEANING OF TITLE I OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. DURING THE 2009 TAX YEAR, THE FOLLOWING ACH REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE: JONATHAN BATES, M.D. PRESIDENT/CEO DAVID BERRY SR. VP/COO SCOTT GORDON EXECUTIVE VP GENA WINGFIELD SR. VP/CFO NO LISTED PLAN PARTICIPANT RECEIVED PAYMENTS FROM THE SERP OR ANY OTHER RELATED RETIREMENT PLAN DURING THE 2009 TAX YEAR. Part I, Line 7 A bonus to recognize performance, paid at the discretion of the Board of Directors, was paid based on criteria including performance and period of time worked during the fiscal year. For all employees listed as key employees or officers, the bonus was reviewed and approved by the Compensation Committee. Pulaski County Arkansas 716006487 745392HD5 2009-05-28 109526869 See Schedule O. 0 0 Pulaski County Arkansas 716006487 745392GKO 2005-12-08 33917692 See Schedule O. 0 0 110403860 7409584 77365254 3172529 22456493 0 0 0 1 34659477 1096213 910643 33748834 2006 0 0 1 1 0 0 0 0 1 0.00000 0.00000 0.00000 1 0 0 1 0 1 0.00120 0.00000 0.00120 1 0 0 0 0 0 0 0 0 0 0 0 1 Lori Brown ADVANCED HEALTHCARE EDUCATION X 18075 23250 0 0 1 23250 WINDSTREAM SCHEDULE O STMT - PERFORMANCE OF SERVICES 1416168 SCHEDULE O - TELECOMMUNICATIONS SERVICES DIRECTOR FRANCIS X. FRANTZ IS CHAIRMAN OF THE BOARD OF WINDSTREAM. TRANSACTIONS WITH INTERESTED PERSONS WERE PERFORMED IN ACCORDANCE WITH THE ACH BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY. 0 ALARMCO INC SCHEDULE O STMT - INDIRECT OWNERSHIP 145169 SCHEDULE O - SALES AND INSTALLATION OF EQUIPMENT ALARMCO, INC. IS MORE THAN 35% OWNED BY A FAMILY MEMBER OF DIRECTOR BARBARA MOORE. TRANSACTIONS WITH INTERESTED PERSONS WERE PERFORMED IN ACCORDANCE WITH THE ACH BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY. 0 AT&T SCHEDULE O STMT - PERFORMANCE OF SERVICES 132305 SCHEDULE O - TELECOMMUNICATIONS SERVICES DIRECTOR EDWARD DRILLING IS PRESIDENT OF ARKANSAS AT&T. TRANSACTIONS WITH INTERESTED PERSONS WERE PERFORMED IN ACCORDANCE WITH THE ACH BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY. 0 BALE CHEVROLET SCHEDULE O STMT - PERFORMANCE OF SERVICES 122098 SCHEDULE O - SALE AND SERVICE OF VEHICLES BALE CHEVROLET IS OWNED BY DIRECTOR JOHN BALE. TRANSACTIONS WITH INTERESTED PERSONS WERE PERFORMED IN ACCORDANCE WITH THE ACH BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY. 0 JENNIFER J BECKIUS SCHEDULE O STMT - FAMILY MEMBER 28521 SCHEDULE O - JENNIFER J. BECKIUS IS A FAMILY MEMBER OF KEY EMPLOYEE LARRY BECKIUS; HOWEVER, CONSISTENT WITH ARKANSAS CHILDREN'S HOSPITAL POLICY, SHE DOES NOT WORK WITHIN MR. BECKIUS'S LINE OF AUTHORITY 0 JEFFREY DAVID BERRY SCHEDULE O STMT - FAMILY MEMBER 16489 SCHEDULE O - ACH EMPLOYEE JEFFREY DAVID BERRY IS A FAMILY MEMBER OF KEY EMPLOYEE DAVID BERRY; HOWEVER, CONSISTENT WITH ARKANSAS CHILDREN'S HOSPITAL POLICY, HE DOES NOT WORK WITHIN MR. BERRY'S LINE OF AUTHORITY. 0 X 1 0 1 0 Non Reporting of Revenue: Part I, Line 33: The Hospital received a Mobile Dental Clinic valued at $375,000 which was recorded as donated property. See the item listed on the fund balance reconciliation on Schedule D. Form 990, Part VI, Section A, line 1 The Executive Committee consists of the Chairman of the Arkansas Children's Hospital (ACH) Board of Directors, who serves as the Chairman of the Executive Committee, the Vice-Chairman, the Secretary, the Treasurer, and the immediate past Chairman of the ACH Board of Directors. In addition, the Executive Committee includes the Vice Chairman of the Board of Directors of ACH Foundation, Inc., the Chairman of the Board of Directors of ACH Research Institute, Inc., and three additional members elected by the ACH Board at its annual meeting for the election of Directors. The Medical Director, the Chief of Staff of ACH, the UAMS Chairman of the Department of Pediatrics, and the President/Chief Executive Officer of ACH shall also be ex-officio members of the Executive Committee without vote. The Executive Committee shall have the power to transact all regular business of the Hospital during the period between the meetings of the Board, subject to any prior limitations imposed by the Board and with the understanding that all matters of major importance will be referred to the Board of Directors. The Executive Committee has final oversight of long-range planning activities and is responsible for reviewing legal activities involving the hospital and for intitiating revisions to the hospital bylaws. Minutes of the Executive Committee meetings are submitted to the Board, and its actions are subject to approval or disapproval as soon as practicable at a regular Board meeting. Form 990, Part VI, Section A, line 2 Directors Mary Aitken, Charles Bower, Patrick Casey, Richard Jacobs, Diane Mackey, DANIEL RAHN, Bonnie Taylor, and I. Dodd Wilson, were all employees of the University of Arkansas for Medical Sciences (UAMS) during the tax year. Form 990, Part VI, Section B, line 11 Hospital management reviews the draft Form 990 and reconciles it to the Hospital's internal financials and consolidated audit report. The reviewed draft of the Form 990 is delivered to members of the Board's Finance and Audit Committees prior to a joint Finance and Audit Committee meeting, during which the Form 990 is presented by the external tax return preparers and Hospital management. IF THE REVIEW BY THE COMMITTEES RESULTS IN REVISIONS TO THE FORM 990, THOSE REVISIONS ARE MADE. THE FORM 990 TO BE FILED IS THEN PROVIDED TO THE ENTIRE BOARD PRIOR TO FILING. Form 990, Part VI, Section B, line 12c The Hospital has a Board of Directors Conflict of Interest Policy that is reviewed with all new Board members during their Board orientation. In addition, periodically external Counsel will review the Policy with the full Board during a regular Board meeting. Annual disclosure of potential conflicts or affirmative confirmation that none exist is required of all Board members. The annual disclosures are reviewed and approved by a majority of the disinterested Directors on the Executive Committee. All conflict disclosures are then compiled and listed in the Board book at the next regularly scheduled meeting. Determination of whether a listed conflict is material is determined by the Corporate Compliance Officer, with advice from legal counsel if still uncertain. During the year, while Board members may participate in initial discussion, Board members who have a conflict are prohibited from participating in deliberations and decisions in the related transaction and abstain from voting, which is noted in the minutes. Form 990, Part VI, Section B, line 15 Compensation for the organization's CEO, Senior Vice Presidents, Vice Presidents, and key employees is reviewed by the Compensation Committee which is established through the Bylaws of Arkansas Children's Hospital to discharge the duty of the Board in fulfilling its oversight responsibilities for determining the adequacy and reasonableness of the compensation paid the CEO and other employees that the Committee believes are in a position to exercise a substantial influence over the affairs of the Hospital. The Committee is composed of members who personally receive no compensation, fees, or other benefits from the Hospital or related organizations. The Committee may rely upon reasoned written opinions of qualified legal, accounting, valuation and executive compensation experts. The Committee has the sole authority to retain and terminate any special advisors used to assist in the evaluation of compensation. The Committee contemporaneously, with making its determination of reasonableness with respect to the compensation of Disqualified Persons, documents in a written report to the Executive Committee and the Board, the basis for its decision. Form 990, Part VI, Section C, line 19 The Hospital's governing documents, conflict of interest policy and financial statements are available to the public upon request AS REQUIRED. FORM 990, PART VII, SECTION A, COLUMNS E & F: COMPENSATION REPORTED IN THESE COLUMNS IS ATTRIBUTABLE TO EMPLOYEES' TIME DEVOTED EACH WEEK TO THIS ENTITY AS WELL AS RELATED ORGANIZATIONS, AS FOLLOWS: JONATHAN BATES, M.D.: ARKANSAS CHILDREN'S HOSPITAL - 40 HOURS ARKANSAS CHILDREN'S HOSPITAL FOUNDATION - 3 HOURS ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE - 1 HOUR ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY - .1 HOURS RICHARD JACOBS, M.D.: ARKANSAS CHILDREN'S HOSPITAL - 8 HOURS ARKANSAS CHILDREN'S HOSPITAL FOUNDATION - 1 HOUR ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE - 16 HOURS ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY - .25 HOURS GENA WINGFIELD: ARKANSAS CHILDREN'S HOSPITAL - 40 HOURS ARKANSAS CHILDREN'S HOSPITAL FOUNDATION - 2 HOURS ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE - 2 HOURS ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY - .1 HOURS SCOTT GORDON: ARKANSAS CHILDREN'S HOSPITAL - 20 HOURS ARKANSAS CHILDREN'S HOSPITAL FOUNDATION - 20 HOURS ALL OTHER COMPENSATION LISTED IN COLUMNS E OR F RELATES TO EMPLOYEES' TIME THAT IS DEVOTED TO ARKANSAS CHILDREN'S HOSPITAL. ARKANSAS CHILDREN'S HOSPITAL ACCOUNTING DEPARTMENT MANAGES THE PAYROLL FUNCTION CENTRALLY FOR ARKANSAS CHILDREN'S HOSPITAL AND ALL RELATED ORGANIZATIONS. FORM 990, PART XI, LINE 3B THE CONSOLIDATED ORGANIZATION IS REQUIRED TO UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AND DID UNDERGO THAT REQUIRED AUDIT. Schedule K Supplental Information PART I, LINE A - Description of Purpose. Proceeds will be used to accomplish the Utility Project and the South Wing Project. The Utility Project includes major infrastructure improvements in sewer, oxygen system rework, fire and life safety, electrical, and HVAC, including an expansion of the energy building and thermal link. The South Wing Project is new construction that will add approximately 258,034 square feet that will include a new Emergency Department, additional outpatient clinic areas and a net addition of 54 inpatient beds. SCHEDULE K, SUPPLEMENTAL INFORMATION: PART I, Line B - Description of Purpose. The project generally included the construction of a four story parking deck, construction of a 116,525 square foot office building, the acquisition of two magnetic resonance imaging systems, and the acquisition of operating room equipment. SCHEDULE K, SUPPLEMENTAL INFORMATION: Part II, Line 5, Column A - Of the total amount of $3,172,529, issuance costs were $1,296,277 and credit enhancement fees were $1,876,252. SCHEDULE K, SUPPLEMENTAL INFORMATION: Part II, Line 5, Column B - Of the total amount of $910,643, issuance costs were $307,020 and credit enhancement fees were $603,623. Arkansas Children's Hospital Foundation 1 Childrens Way Little rock AR 72202 710568795 Fundraising AR 501(c)(3) Line 7 Arkansas Children's Hospital Arkansas Children's Hospital Research Institute 13 Childrens Way Little rock AR 72202 710694931 Research AR 501(c)(3) Line 11a, I Arkansas Children's Hospital ARKANSAS CHILDREN'S HOSPITAL Building Research Facility Inc 1 Childrens Way Little rock AR 72202 911940376 Building Management AR 501(c)(3) Line 11a, I Arkansas Children's Hospital Arkansas Children's Hospital Auxiliary 1 Childrens Way Little rock AR 72202 710606585 Fundraising AR 501(c)(3) Line 11a, I Arkansas Children's Hospital Hospital Finance Corporation 1 Childrens Way Little Rock AR 72202 710443671 collections AR Arkansas Children's Hospital C 151320 290036 1.00000 Children's Healthcare System Inc 1 Childrens Way little Rock AR 72202 586304957 Management services AR C -11990 376780 0.50000 Children's Health Network Inc 1 Childrens Way Little Rock AR 72202 710797428 management services AR Arkansas Children's Hospital C -841 36509 1.00000 1 1 1 0 0 0 0 0 1 0 1 1 1 1 0 1 1 1 HOSPITAL FINANCE CORPORATION INC A 2592 ARKANSAS CHILDREN'S HOSPITAL FOUNDATION B 1625728 ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE B 6263954 ARKANSAS CHILDREN'S HOSPITAL FOUNDATION C 10085547 ARKANSAS CHILDREN'S HOSPITAL FOUNDATION L 3956311 CHILDREN'S HEALTHCARE SYSTEM INC L 131250 HOSPITAL FINANCE CORPORATION INC L 375464 ARKANSAS CHILDREN'S HOSPITAL FOUNDATION M 1561626 ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE M 2170522 ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY INC M 52683 ARKANSAS CHILDREN'S HOSPITAL AUXILIARY M 166895 HOSPITAL FINANCE CORPORATION INC N 72138 CHILDREN'S HEALTHCARE SYSTEM INC N 265394 ARKANSAS CHILDREN'S HOSPITAL AUXILIARY N 232079 ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY INC N 116903 ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE N 218455 CHILDREN'S HEALTHCARE SYSTEM INC P 70441 ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE P 1092096 ARKANSAS CHILDREN'S HOSPITAL FOUNDATION P 780435 ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE R 22889918 ARKANSAS CHILDREN'S HOSPITAL FOUNDATION R 2265357 ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY INC R 246647 ARKANSAS CHILDREN'S HOSPITAL AUXILIARY R 1152125 CHILDREN'S HEALTHCARE SYSTEM INC R 74433