2026-05-13T09:21:01+00:00 2025-06-30 440160260 Forvis Mazars LLP One Oak Plaza Suite 300 Asheville NC 28801 990 2024-07-01 540506321 Children's Hospital of the King's Daughters CHIL 7576687000 601 Childrens Lane Norfolk VA 23507 AMY SAMPSON PRESIDENT 7576687000 2026-05-13 true true Amy Bibby P00445891 8282542254 2026-05-06 2024 2025-03-06 01:10:19Z AMY SAMPSON 601 Childrens Lane Norfolk VA 23507 923129913 false X WWW.CHKD.ORG X 1961 VA SEE SCHEDULE O. 23 19 4228 428 694099 380586 28452760 19027723 621558620 769037056 12396777 30045978 3422561 2851393 665830718 820962150 21295433 20397894 0 0 341951907 366797778 204214 210435 3102839 312540374 338561101 675991928 725967208 -10161210 94994942 1159825174 1270930081 312282221 312581536 847542953 958348545 SEE SCHEDULE O. false false 637189797 20397894 771861263 SEE SCHEDULE O. 637189797 true true false false false false false false false true true false false true true true false true false false false false false true true false true true true false true true false false false false false false false false false true true false false false true true false false false false true 136 0 true 4228 true true true false false false true true true true false false false true false false false X 23 19 false false false false true true true true true false false false true true true true true true false true true true FL GA AL IL KY MD MA MN NJ NY NC OK SC UT VA WI X Kathryn Abshire 7576687000 601 Childrens Lane Norfolk VA 23507 Akhil Jain Chairman/Director 2.0 4.0 X X 0 0 0 Amy Sampson President/CEO/Director 2.0 44.0 X X 0 2286148 972272 Brian Skinner Chair/Vice Chairman/Director 2.0 4.0 X X 0 0 0 Kim Georges Secretary/Director 2.0 4.0 X X 0 0 0 Larry Bernert Secretary/Director 2.0 4.0 X X 0 0 0 Miles Leon Vice Chairman/Director 2.0 4.0 X X 0 0 0 Owen Griffin Treasurer/Director 2.0 4.0 X X 0 0 0 Carl St Remy MD Director 1.0 42.0 X 0 852062 44227 Elly Bradshaw Smith Director 1.0 2.0 X 0 0 0 George Clarke Director 1.0 2.0 X 0 0 0 John R Lawson II Director 1.0 2.0 X 0 0 0 Julia Childress Beck Director 1.0 2.0 X 0 0 0 Katherine Knaus Director 1.0 2.0 X 0 0 0 Katrina Lesher MD Director 1.0 2.0 X 0 0 0 Kevin Murphy Director 1.0 2.0 X 0 0 0 Kieran Poulos Director 1.0 2.0 X 0 0 0 Lemuel Lewis Director 1.0 2.0 X 0 0 0 Leslie Doyle Director 1.0 2.0 X 0 0 0 Mark Compton Director 1.0 2.0 X 0 0 0 Martha Colen Director 1.0 2.0 X 0 0 0 Nicole Legum Director 1.0 2.0 X 0 0 0 Scott Nottingham MD Director 1.0 42.0 X 0 412261 43519 Susan Wynne Director 1.0 2.0 X 0 0 0 Taylor Priest Director 1.0 2.0 X 0 0 0 Kathryn Abshire CFO/Asst Tres./Asst Sec. 1.0 42.0 X 0 1027420 535712 Allison Silva VP - Ancillary Services 40.0 X 626435 0 186962 Christopher Foley Senior VP - Chief Clinical Operations Officer 40.0 X 0 970874 184126 Deborah Barnes VP - IS Operations 40.0 X 0 991934 165374 Donald Barnes Senior VP - Chief People Officer 40.0 X 0 454854 102249 Kimberly Day Senior VP - Chief Legal Officer 40.0 X 0 700226 128648 Kristi McGowin VP - Patient Care Services/CNO 40.0 X 366839 0 80551 Tamika Harris VP - Facilities & Support Services 40.0 X 159224 0 19196 Terrie Pyeatt VP - Finance 40.0 X 0 325155 63821 Dean Cauley Physician 40.0 X 366462 0 27635 John Harrington VP Quality/Safety & Clinical Integration 40.0 X 563278 0 126714 John Warburton VP - Mental Health Service Line 40.0 X 480020 0 97450 Kamil Cak VP - Experience of Care 40.0 X 305667 0 68000 Suzanne Brixey Physician 40.0 X 399736 0 17434 JOHN HARDING FORMER CHIEF OPERATING OFFICER 0.0 0.0 X 0 1174869 0 3267661 9195803 2863890 652 true true false CHILDREN'S SPECIALTY GROUP P O BOX 11049 NORFOLK VA 23517 MEDICAL 42745560 EASTERN VIRGINIA MED SCHOOL P O BOX 1980 NORFOLK VA 235011980 MEDICAL 15114804 COMPASS ONE P O BOX 1022289 ATLANTA GA 30368 CLEANING 12000679 AYA HEALTHCARE INC 5930 CORNERSTONE COURT W SUITE 300 SAN DIEGO CA 92121 TEMP PERSONNEL 7603484 ORACLE AMERICA INC CERNER CORP 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 I/T 7055591 143 70794 37917 1333822 4198186 13387004 2845337 19027723 PATIENT SERVICES 900099 733520614 733520614 OTHER RELATED SERVICES 900099 34822343 34822343 LAB SERVICES 621500 522937 522937 SPORTS RELATED SERVICE 900099 171162 171162 0 0 0 0 769037056 15082036 15082036 844198 8213 1518815 -674617 8213 -666404 -666404 115516031 94350 96938619 3707820 18577412 -3613470 14963942 14963942 2000 37917 2509 -509 -509 GRADUATE MEDICAL ED. 900099 3518306 3518306 0 0 0 0 3518306 820962150 771861263 694099 29379065 20397894 20397894 1307565 899833 407732 302222401 275240006 25100911 1881484 9591778 7890418 1622961 78399 32767497 23017366 9558450 191681 20908537 18963416 1796767 148354 269614 164613 104595 406 10163 10163 21000 21000 210435 210435 555626 555626 64749079 60396867 4322457 29755 360300 74266 270070 15964 2854491 1986315 818198 49978 3173824 2381554 681200 111070 17320417 15022305 2284537 13575 293950 240142 47025 6783 836193 734043 90183 11967 5145577 5112729 32848 37118364 33988048 3086185 44131 3111406 1135919 1975291 196 SUPPLIES 118377018 117690033 656617 30368 EQUIP RENTAL AND MAINT. 33661365 30548979 3020018 92368 PURCHASED SERVICES 21244722 16484533 4727003 33186 UNRELATED BUSINESS INC. 25710 25710 29432282 4820518 24459025 152739 725967208 637189797 85674572 3102839 62691536 144725445 24280753 11794229 148878969 177850116 0 0 13071431 16240241 10954070 11267354 886806752 448021556 449834918 438785196 323550886 332151884 54792771 59997417 0 71769840 78118199 1159825174 1270930081 60250888 66422379 377385 788186 224554965 218589857 0 27098983 26781114 312282221 312581536 X 796050815 907198024 51492138 51150521 847542953 958348545 1159825174 1270930081 X 94994942 14424556 -738293 2124387 X false true true true true X 99087320 88572506 56544790 28452760 19027723 291685099 0 0 99087320 88572506 56544790 28452760 19027723 291685099 0 291685099 7246160 9745593 14401256 19159886 15934447 66487342 392485 240510 206714 152320 380586 1372615 0 0 0 0 0 0 359545056 2932353710 0.81126 0.8375 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 30228626 765320 3306305 1236832 33063419 27987077 715998 2551123 1025572 30228626 26170544 664247 1852435 700149 27987077 29093174 600675 -2262495 1260810 26170544 25741292 482624 3489607 620349 29093174 0.0 1.0 0.0 false false 18417162 18417162 534707890 200186503 334521387 16036783 12521988 3514795 301866244 234926505 66939739 15778673 386560 15392113 438785196 CONTRIBUTION/REMAINDER TRUST 5620599 CASH SURRENDER VALUE LIFE INSURANCE 267288 INTERCOMPANY RECEIVABLES 4235716 INVESTMENT IN SHARED HOSPITAL 313350 RIGHT OF USE ASSETS 15115464 INSURANCE RECOVERABLE 5079814 DERIVATIVE INSTRUMENTS ASSET 43216433 LT - AR SETTLEMENT 4270000 MISCELLANEOUS -465 78118199 Federal Income Taxes INSURANCE IBNR & IBNE 7378161 DERIVATIVE INSTRUMENTS 2417024 CAPITAL LEASE 0 ANNUITY PAYABLE 878134 INTERCOMPANY LIABILITIES 26564 ACCRUED TAIL COVERAGE 33712 OPERATING LEASE OBLIGATIONS 16047519 26781114 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part V, Line 4 Intended uses of endowment funds ENDOWMENT FUNDS ARE USED ACCORDING TO SPECIFIC WRITTEN REQUESTS OF THE DONOR ENDOWMENT AGREEMENT. IF NO DIRECT REQUESTS ARE MADE, FUNDS ARE USED IN ACCORDANCE WITH THE OVERALL MISSION OF THE ORGANIZATION. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote CHS RECOGNIZES ANY BENEFITS FROM AN UNCERTAINTY IN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. IF APPLICABLE, THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION WOULD BE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE RESOLUTION. CHS DOES NOT BELIEVE ANY UNCERTAIN TAX PROVISIONS REQUIRE RECORDING IN ITS CONSOLIDATED FINANCIAL STATEMENTS. X X X X X X X true CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 CONSULTING false 1618179 210435 1407744 1618179 210435 1407744 CA CO CT DC FL GA AL HI IL KS KY LA ME MD MA MI MN MO NV NJ NY NC OH OK PA RI SC TN UT VA AR WA WV WI BREWTIFUL DAY 10/26 39917 37917 2000 2250 250 9 0 0 39917 37917 2000 2250 250 9 2509 -509 true true X true X 175 true X 3383111 3383111 0.00466 331581524 354442843 0 0.0 0 0.0 0 0 334964635 354442843 3383111 0.00466 110518227 14021810 96496417 0.13292 17771348 10242786 7528562 0.01037 80121529 36226843 43894686 0.06046 912620 19331 893289 0.00123 0 0.0 0 0 209323724 60510770 148812954 0.20499 0 0 544288359 414953613 152196065 0.20965 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 false 27357302 11107702 2026430 5199974 -3173544 X true true 3 2 CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS 601 CHILDRENS LANE NORFOLK VA 23507 H1843 X X X X X X MEDICAID DSH HOSPITAL A 1 CHKD HEALTH AND SURGERY CENTER 2021 CONCERT DRIVE VIRGINIA BEACH VA 23456 OH713 X OUTPATIENT SURGICAL HOSPITAL A 3 CHKD HEALTH AND SURGERY CENTER 11783 ROCK LANDING DRIVE NEWPORT NEWS VA 23608 OH694 X OUTPATIENT SURGICAL HOSPITAL A A 3 false false true X X X X X X X X X 24 true true false true X WWW.CHKD.ORG X true 25 true WWW.CHKD.ORG false true X 175.0 400.0 X X X X true true X X X true X WWW.CHKD.ORG X WWW.CHKD.ORG X WWW.CHKD.ORG X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - FACILITY REPORTING GROUP A. CHKD'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED COLLECTING DATA FROM SEVERAL DIFFERENT SOURCES: A COMMUNITY HEALTH SURVEY (IN COLLABORATION WITH OTHER AREA HOSPITAL SYSTEMS), FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS, AND A HEALTH INDICATOR ANALYSIS. TWO VERSIONS OF THE SURVEY, WITH SIMILAR QUESTIONS, WERE CIRCULATED ACROSS CHKD'S SERVICE AREA. BOTH SURVEYS WERE CIRCULATED WIDELY THROUGH PARTNERS AND NOTIFICATIONS VIA SOCIAL MEDIA. THE FIRST VERSION WAS A STAKEHOLDER SURVEY IN WHICH MANY PARTICIPANTS PROVIDED EDUCATIONAL, HEALTH, OR OTHER SUPPORT SERVICES TO ITS MEDICALLY UNDERSERVED COMMUNITY. THERE WERE 289 RESPONSES TO THIS VERSION OF THE SURVEY. THE SECOND VERSION WAS A COMMUNITY SURVEY THAT WAS CIRCULATED MORE BROADLY TO COMMUNITY MEMBERS IN CHKD'S SERVICE AREA. THERE WERE A TOTAL OF 5,197 INDIVIDUALS WHO COMPLETED THE MAJORITY OF THE QUESTIONS IN THIS VERSION OF THE SURVEY. GIVEN THE PREVIOUSLY IDENTIFIED PRIORITY OF MENTAL & BEHAVIORAL HEALTH, PLUS AN INTEREST IN HEARING FROM STAKEHOLDERS FAMILIAR WITH THESE ISSUES FROM ACROSS THE REGION, KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED. A TOTAL OF 28 KEY STAKEHOLDERS WERE INTERVIEWED. KEY STAKEHOLDER INTERVIEWS INCLUDED CORE SERVICE PROVIDERS, AND TARGETED LOCAL PUBLIC HEALTH AND SOCIAL SERVICE DEPARTMENT REPRESENTATIVES, INDIVIDUALS OR ORGANIZATIONS SERVING MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY, SCHOOL NURSES FROM LOCAL SCHOOL SYSTEMS, PARTICULARLY IN RURAL AND PREDOMINANTLY LOW-INCOME AREAS, AND HEALTHCARE AND MENTAL/BEHAVIORAL HEALTHCARE PROVIDERS WHO OFFER SERVICES FOR CHILDREN AND FAMILIES. ORGANIZATIONAL PARTICIPANTS INCLUDED HOSPITALS, COMMUNITY HEALTH CENTERS, SCHOOL SYSTEMS, SOCIAL SERVICES, NON-PROFIT AND OTHER COMMUNITY-BASED ORGANIZATIONS. THERE WERE A TOTAL OF 247 PEOPLE WHO PARTICIPATED IN 27 FOCUS GROUPS. FOCUS GROUPS WERE FACILITATED BY THE CHNA COLLABORATIVE. THE COLLABORATIVE WAS FORMED BY REGIONAL HOSPITAL SYSTEMS AND HEALTH DEPARTMENTS TO PLAN AND IMPLEMENT PARTS OF THE CHNA PROCESS. THIS PROCESS INCLUDED SEEKING INPUT FROM COMMUNITIES SERVED, INCLUDING MEDICALLY UNDERSERVED POPULATIONS, AS WELL AS ORGANIZATIONS WITH INSIGHT INTO THE PUBLIC HEALTH NEEDS OF THE BROADER COMMUNITY AND/OR SPECIFIC NEEDS OF THE MEDICALLY UNDERSERVED COMMUNITIES. THE CHNA COLLABORATIVE USED CHATGPT TO INITIALLY IDENTIFY FOCUS GROUP THEMES. STRONG THEMES EMERGED AND INCLUDED: MENTAL HEALTH; CHRONIC & ACUTE HEALTH CONDITIONS; ACCESS TO HEALTH CARE; ACCESS TO HEALTHY FOODS, NUTRITION, & FOOD SECURITY; IMPACT OF SOCIAL & ENVIRONMENTAL FACTORS; TECHNOLOGY & SOCIAL INTERACTION; AND CULTURAL & TRUST BARRIERS. IN ADDITION TO PRIORITIZING SIGNIFICANT HEALTH NEEDS, FOCUS GROUPS DISCUSSED EXISTING RESOURCES AND ORGANIZATIONS, PROGRAMS, AND PARTNERSHIPS WORKING TO ADDRESS SOME OF THOSE NEEDS IDENTIFIED. IN THE KEY HEALTH INDICATOR ANALYSIS, NATIONAL, STATE, AND PRIVATE DATA SOURCES WERE USED. KEY HEALTH ISSUES WERE IDENTIFIED WHEN DATA FROM CHKD'S SERVICE AREA REVEALED WORSE HEALTH OUTCOMES OR CONDITIONS, COMPARED TO STATE AVERAGES. SIGNIFICANT HEALTH NEEDS WERE ALSO IDENTIFIED BASED ON HEALTH DISPARITIES RELATED TO GEOGRAPHIC LOCATION, GENDER, RACE, OR AGE DIFFERENCES. Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - FACILITY REPORTING GROUP - A. A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR CHKD'S THREE LICENSED FACILITIES LISTED IN PART V, SECTION A. Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - FACILITY REPORTING GROUP - A. AFTER COMPILING THE RESULTS FROM THE COMMUNITY HEALTH SURVEY, KEY STAKEHOLDER INTERVIEWS, FOCUS GROUPS, AND HEALTH INDICATOR ANALYSIS, SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED ACROSS DATA SOURCES. THESE THEMES EITHER AROSE AS PRIORITIES IN AT LEAST TWO OF THE DATA SOURCES OR IF DATA FROM ONE OF THE SOURCES REVEALED OVERWHELMING NEED. THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED: MENTAL HEALTH, ACCESS TO HEALTH CARE, CHRONIC & ACUTE HEALTH CONDITIONS, ACCESS TO HEALTHY FOODS, VIOLENCE IN THE HOME/COMMUNITY, MATERNAL/INFANT HEALTH, ALCOHOL MISUSE, SOCIAL/ENVIRONMENTAL FACTORS, AND AFFORDABLE HOUSING/HOMELESSNESS. CHKD LEADERS REVIEWED RESULTS ACROSS ALL DATA SOURCES, AS WELL AS THE PRIORITIES LISTED PREVIOUSLY, TO DETERMINE PRIORITIES BASED ON SIMILAR CRITERIA USED IN PREVIOUS CHNA PROCESSES, INCLUDING: ALIGNMENT WITH CHKD'S MISSION, GOALS, & SCOPE OF SERVICE; IMPORTANCE AND PRIORITY INDICATED THROUGH COMMUNITY & KEY STAKEHOLDER INPUT; AND THE DEGREE TO WHICH CHKD HAS THE RESOURCES NEEDED TO ADDRESS THE ISSUE. INDIVIDUALS AND GROUPS INVOLVED IN THIS PROCESS INCLUDED THE FOLLOWING: THE HOSPITAL'S SENIOR LEADERSHIP TEAM, WHICH INCLUDES ITS CEO, SENIOR AND VICE PRESIDENTS; CHKD'S PHYSICIAN LEADERS; AND CHKD'S PARENT & FAMILY ADVISORY COUNCIL. BASED ON THE CRITERIA AND GIVEN THE ENORMOUS NEED FOR MENTAL HEALTH SERVICES, THERE WAS A STRONG CONSENSUS THAT CHKD SHOULD CONTINUE TO FOCUS ITS IMPLEMENTATION STRATEGY ON PEDIATRIC MENTAL HEALTH IN ITS 2025 IMPLEMENTATION PLAN STRATEGY. FOR ITS PREVIOUS, 2022-2024 IMPLEMENTATION STRATEGY, CHKD'S SOLE FOCUS WAS MENTAL HEALTH. SINCE 2019, CHKD OPENED THE CHILDREN'S PAVILION, AND HIRED MORE THAN 400 PEDIATRIC MENTAL HEALTH PROVIDERS & SUPPORT STAFF. OTHER STEPS INCLUDED PROVISION OF CLINICAL NEEDS ASSESSMENTS ACROSS THE REGION; TELEHEALTH; EMERGENCY DEPARTMENT SERVICES/CONSULTS; THE PARTIAL HOSPITALIZATION PROGRAM; THE INTENSIVE OUTPATIENT PROGRAM AT LANDSTOWN; THE BRIDGE CRISIS CLINIC FOR INTERIM PSYCHIATRIC SERVICES; THE PAVILION FOR INPATIENT CARE; ACADEMICS & RESEARCH; AND COLLABORATION WITH VARIOUS COMMUNITY PARTNERS. MENTAL HEALTH: 2025 CHNA JOINT IMPLEMENTATION STRATEGY ACTION STEPS INCLUDE WORKFORCE RETENTION & DEVELOPMENT; STRENGTHENING SPECIALIZED SERVICES; AND COMMUNITY OUTREACH AND ENGAGEMENT. * WORKFORCE RETENTION & DEVELOPMENT: INCREASE CHILD/ADOLESCENT PSYCHIATRY FELLOWSHIPS; HIRE ADDITIONAL SUPERVISORS & RESIDENTS; DEVELOP INTERNAL FLOAT & RESOURCE POOL MODELS, RESTRUCTURE THE PAVILION'S NURSING & ADMINISTRATIVE ORGANIZATIONS; REDESIGN THE RECRUITMENT PORTION OF THE WEBSITE, COMMIT RESOURCES TO RAISE THE PROFILE OF THE MENTAL HEALTH SERVICE LINE & STAFF POSITIONS; A SERVICE LINE-SPECIFIC NEWSLETTER; AND INCREASE IN-PERSON MEETINGS WITH LEADERSHIP. * STRENGTHENING SPECIALIZED SERVICES: ADOPT THE NATIONALLY RECOGNIZED CHILD AND ADOLESCENT SERVICE INTENSITY INSTRUMENT (CASII) AND CREATE MORE APPOINTMENT AVAILABILITY AT COMMUNITY BASED HEALTH CENTERS. DUE TO LIMITED SPACE FOR MENTAL HEALTH CARE, CHKD OFFERS MENTAL HEALTH SERVICES AT CHKD HEALTH CENTERS AT LANDSTOWN & CONCERT DRIVE FOR VIRGINIA BEACH; CHKD HEALTH CENTER AND URGENT CARE AT TECH CENTER FOR NEWPORT NEWS, IN ADDITION TO CHKD'S CHILDREN'S PAVILION IN NORFOLK, VIRGINIA. * COMMUNITY OUTREACH AND ENGAGEMENT (CORE): FOSTERS COLLABORATION, PROGRAMS, AND PARTNERSHIPS WITH VARIOUS COMMUNITY-BASED ORGANIZATIONS TO ADDRESS PEDIATRIC MENTAL HEALTH. OTHER SIGNIFICANT HEALTH NEEDS ADDRESSED BY CHKD'S EXISTING EFFORTS INCLUDE ACCESS TO HEALTH CARE, CHRONIC & ACUTE HEALTH CONDITIONS, INFANT CARE, AND VIOLENCE IN THE HOME/COMMUNITY. THESE AREAS ARE ADDRESSED VIA THE NEONATAL INTENSIVE CARE UNIT, CHILD ADVOCACY CENTER (CAP), AND THE SAFER FUTURES PROGRAM. DUE TO RESOURCE CONSTRAINTS, CHKD IS NOT ADDRESSING OTHER SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA, INCLUDING ACCESS TO HEALTHY FOODS, ALCOHOL MISUSE, SOCIAL/ENVIRONMENTAL FACTORS, AND AFFORDABLE HOUSING/HOMELESSNESS. THESE NEEDS ARE ADDRESSED BY OTHER COMMUNITY ORGANIZATIONS. Schedule H, Part V, Section B, Line 13 Facility A, 1 Facility A, 1 - FACILITY REPORTING GROUP - A. PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. STATE-FUNDED PRESCRIPTION PROGRAMS; 2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC; 3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); 4. FOOD STAMP ELIGIBILITY; 5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; 6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN); 7. LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND 8. PATIENT IS DECEASED WITH NO KNOWN ESTATE. 14 CHKD HLTH CTR & URGENT CARE AT LOEHMA 3960 VIRGINIA BEACH BLVD VIRGINIA BEACH VA 23452 URGENT CARE & OUTPATIENT SERVICES CHKD HEALTH CENTER AT OAKBROOKE 500 DISCOVERY DRIVE CHESAPEAKE VA 23320 OUTPATIENT SERVICES CHKD URGENT CARE AT VOLVO 817 VOLVO PARKWAY CHESAPEAKE VA 23320 URGENT CARE & OUTPATIENT SERVICES CHKD HLTH CTR & URGENT CARE AT TECH C 680 OYSTER POINT ROAD NEWPORT NEWS VA 23602 URGENT CARE & OUTPATIENT SERVICES CHKD HLTH CTR & URGENT CARE AT LANDST 1924 LANDSTOWN WAY VIRGINIA BEACH VA 23456 URGENT CARE & OUTPATIENT SERVICES CHKD HEALTH CENTER AT HARBOUR VIEW 5832 HARBOUR VIEW BLVD SUFFOLK VA 23435 OUTPATIENT SERVICES CHKD HEALTH CENTER AT HARBOUR 5834 HARBOUR VIEW BLVD SUFFOLK VA 23435 OUTPATIENT SERVICES CHKD HEALTH CENTER AT LIGHTFOOT 6425 RICHMOND ROAD WILLIAMSBURG VA 23188 OUTPATIENT SERVICES HEALTH CENTER AT MEDICAL CENTER CAMPU 850 SOUTHAMPTON AVENUE NORFOLK VA 23510 OUTPATIENT SERVICES SPORTS MEDICINE IN GHENT 702 WEST 21ST STREET NORFOLK VA 23517 OUTPATIENT SERVICES SATELLITE AT MEDICAL TOWER 400 GRESHAM DRIVE NORFOLK VA 23507 OUTPATIENT SERVICES CHKD CAP 935 REDGATE AVENUE NORFOLK VA 23507 OUTPATIENT SERVICES FORT NORFOLK PLAZA MEDICAL BUILDING 301 RIVERVIEW AVENUE NORFOLK VA 23510 OUTPATIENT SERVICES CHKD HEALTH CENTER AT KEMPSVILLE 171 KEMPSVILLE ROAD NORFOLK VA 23510 OUTPATIENT SERVICES Schedule H, Part I, Line 7e THE AMOUNT REPORTED ON PART I, LINE 7(E) INCLUDES $80,470,900 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. Schedule H, Part I, Line 7f THE AMOUNT OF BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) THAT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSE IN PART I, LINE 7, COLUMN (F) IS $27,357,302. Schedule H, Part VI, Line 7 FACILITY REPORTING GROUP A INCLUDES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, CHKD HEALTH AND SURGERY CENTER IN NEWPORT NEWS AND CHKD HEALTH AND SURGERY CENTER IN VIRGINIA BEACH. Schedule H, Part V, Section B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS - FACILITY 2: CHKD HEALTH AND SURGERY CENTER - FACILITY 3: CHKD HEALTH AND SURGERY CENTER Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance A HYBRID APPROACH WAS USED FOR DETERMINING COSTS RELATED TO COMMUNITY BENEFIT. ACTUAL COSTS FROM ALL PATIENT SEGMENTS ARE IDENTIFIED BY DEPARTMENT IN THE GENERAL LEDGER AND THEN WERE GROUPED INTO LIKE COMMUNITY BENEFIT PROGRAMS. INDIRECT COSTS WERE ADJUSTED FOR COSTS ATTRIBUTABLE TO UNREIMBURSED MEDICAID COSTS REPORTED ELSEWHERE, MARKETING AND GRANT WRITING EXPENSES. THE MEDICAID COSTS ADJUSTMENT WAS CALCULATED USING A COST TO CHARGE RATIO OF APPLICABLE EXPENSES DIVIDED BY TOTAL APPLICABLE CHARGES APPLIED TO MEDICAID REVENUE. THE REMAINING INDIRECT COSTS WERE ALLOCATED PROPORTIONATELY TO THE DIRECT COSTS REPORTED BY DEPARTMENT. IN ADDITION, EXPENSES WERE CALCULATED AT COST AND THEN COSTS RELATED TO CHARITY CARE, BAD DEBT AND MEDICAID WERE REMOVED BEFORE ARRIVING AT THE AMOUNTS FOR COMMUNITY BENEFIT AT COST. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount BAD DEBT REPORTED IN PART III, LINE 2 REFLECTS PATIENT ACCOUNT BALANCES WRITTEN OFF AS UNCOLLECTIBLE BASED ON THE ORGANIZATION'S REVENUE CYCLE POLICIES AND COLLECTION EXPERIENCE. AMOUNTS ARE DERIVED FROM PATIENT-RELATED WRITE-OFFS RECORDED IN THE GENERAL LEDGER AND ARE NOT LIMITED TO GAAP BAD DEBT EXPENSE REPORTED IN THE AUDITED FINANCIAL STATEMENTS. IF AMOUNTS PREVIOUSLY WRITTEN OFF ARE SUBSEQUENTLY COLLECTED, BAD DEBT EXPENSE IS REDUCED IN THE PERIOD COLLECTED. Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED OFF THE PERCENTAGE OF CHARITY CARE EXPENSES AS A PERCENTAGE OF SELF-PAY REVENUE. CHKD DOES NOT MAINTAIN RECORDS THAT TRACK PATIENTS WHO COULD HAVE QUALIFIED FOR CHARITY CARE. THIS AMOUNT IS AN ESTIMATE OF PATIENTS WHO LIKELY WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO DETERMINE THEIR ELIGIBILITY. THIS AMOUNT IS NOT INCLUDED AS COMMUNITY BENEFIT. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote CHKD PRESENTS BAD DEBT PROVISION ON THE FINANCIAL STATEMENTS AS A DEDUCTION FROM NET PATIENT SERVICE REVENUE PER ACCOUNTING STANDARDS UPDATE (ASU) 2011-07. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING RECEIVABLES. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE, NET OF PAYMENTS AND DISCOUNTS, AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR THE RECOVERY IS CONSIDERED REMOTE. FOR ADDITIONAL DETAILS SEE FOOTNOTE 3 ON PAGE 13 OF THE AUDITED FINANCIAL STATEMENTS. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE SHORTFALL WAS CALCULATED USING THE HOSPITAL'S OVERALL COST TO CHARGE RATIO APPLIED TO MEDICARE GROSS CHARGES. THIS SHORTFALL IS NOT SEPARATELY INCLUDED AS A COMMUNITY BENEFIT AS 100% OF IT HAS ALREADY BEEN CAPTURED IN THE APPROPRIATE CATEGORY ON PART I, LINE 7. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance ACCOUNTS WITH AN UNPAID BALANCE OR WITHOUT AN ESTABLISHED PAYMENT PLAN ARE REFERRED TO A COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION EFFORTS. CHKD MAKES REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE/CHARITY CARE BEFORE REFERRING TO A COLLECTION AGENCY OR AN ATTORNEY. REASONABLE EFFORT INCLUDES AND IS NOT LIMITED TO NOTIFICATION ABOUT THE FINANCIAL ASSISTANCE - CHARITY CARE/COLLECTION POLICY POSTED IN ADMISSIONS, EMERGENCY DEPARTMENT OR OTHER DESIGNATED AREAS. THE INFORMATION REGARDING THE POLICY IS INCLUDED IN THE ADMISSION PACKAGE AND ON THE PATIENT BILL. THE HEALTH BENEFITS ANALYST AND CUSTOMER SERVICE REPRESENTATIVE WHO MAY SPEAK WITH THE GUARANTOR BY PHONE PROVIDE THEM WITH FINANCIAL ASSISTANCE INCLUDING CHARITY CARE INFORMATION. THE FINANCIAL ASSISTANCE-CHARITY CARE/COLLECTION POLICY IS AVAILABLE UPON REQUEST AND VIA WWW.CHKD.ORG. CHKD ENSURES ALL COLLECTION PROTOCOLS ARE MET PRIOR TO REFERRAL TO COLLECTIONS AGENCY OR ATTORNEY. APPROVED CHARITY CARE AMOUNT WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES. THE REMAINING BALANCE WILL BE SUBJECT TO CHKD'S STANDARD COLLECTION PROTOCOLS. Schedule H, Part V, Section B, Line 16a FAP website A - CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS: Line 16a URL: WWW.CHKD.ORG; Schedule H, Part V, Section B, Line 16b FAP Application website A - CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS: Line 16b URL: WWW.CHKD.ORG; Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS: Line 16c URL: WWW.CHKD.ORG; Schedule H, Part VI, Line 2 Needs assessment AS THE ONLY HEALTHCARE PROVIDER IN VIRGINIA DEVOTED EXCLUSIVELY TO THE NEEDS OF CHILDREN, CHKD ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF PEDIATRIC CARE AND THE PROMOTION OF CHILDREN'S HEALTH AND IS TRUSTED THROUGHOUT ITS COMMUNITY TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. CHKD USES A VARIETY OF METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON-PROFIT, AND PUBLIC HEALTH AGENCIES AND ORGANIZATIONS AND THROUGH REGIONAL, STATE AND NATIONAL DATA. FROM NOVEMBER 2024 TO APRIL 2025, CHKD CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH SUPPORT FROM TOXCEL, LLC, A GAINESVILLE, VIRGINIA-BASED SCIENCE, ENGINEERING AND HEALTH RESEARCH AND CONSULTING FIRM. THIS JOINT CHNA COVERS ALL THREE LICENSED FACILITIES ASSOCIATED WITHIN THE CHKD HEALTHSYSTEM: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) LOCATED IN NORFOLK AND CHKD'S TWO HEALTH AND SURGERY CENTERS, ONE AT OYSTER POINT IN NEWPORT NEWS AND ONE AT PRINCESS ANNE IN VIRGINIA BEACH. CHKD'S CHNA PROVIDES AN OVERVIEW OF THE PRIMARY AND SECONDARY DATA USED TO IDENTIFY KEY HEALTH ISSUES WITHIN THE CHKD COMMUNITY. IT COMBINES AND COMPARES RESULTS FROM THREE SOURCES: A COMMUNITY HEALTH SURVEY, FOCUS GROUPS, AND KEY STAKEHOLDER INTERVIEWS. CHKD'S CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT WWW.CHKD.ORG/COMMUNITYBENEFIT. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance CHKD'S CHARITY CARE ELIGIBILITY CRITERIA AND PROCEDURES FOR APPLYING ARE PROVIDED TO ALL PATIENTS. CHARITY CARE INFORMATION IS INCLUDED IN EVERY INPATIENT ADMISSION PACKET AND DISTRIBUTED TO THE OUTPATIENT DURING THE OUTPATIENT REGISTRATION PROCESS. AN APPLICATION FOR CHARITY CARE, ALONG WITH A LETTER EXPLAINING THE PROCESS, IS SENT TO ANY PATIENT OR GUARANTOR WHO REQUESTS INFORMATION ON ANY PROGRAMS OR PROVISIONS THE HOSPITAL MAY HAVE TO HELP ASSIST PATIENTS OR GUARANTORS IN PAYING THEIR HOSPITAL BILL. THE CHARITY CARE POLICY AND APPLICATION ARE PROMINENTLY DISPLAYED ON THE MAIN "BILLING" PAGE OF THE HOSPITAL WEBSITE, JUST ONE CLICK FROM THE HOME PAGE, AT WWW.CHKD.ORG/BILLING/FINANCIAL-ASSISTANCE. PRINTED COPIES ARE ALSO AVAILABLE AT EACH REGISTRATION WORKSTATION. ALL BILLING STATEMENTS MAILED TO GUARANTORS INCLUDE A NOTICE OF THE AVAILABILITY OF CHARITY AND HOW TO OBTAIN THE INFORMATION/APPLICATION. ASSISTANCE WITH THE APPLICATION PROCESS IS AVAILABLE THROUGH THE HEALTH BENEFITS ANALYST (HBA). THE HBA SENDS OUT APPLICATIONS VIA MAIL AND REFERS FAMILIES TO THE HOSPITAL'S WEBSITE. THE UNIT SOCIAL WORKER IS AVAILABLE TO PROVIDE INFORMATION OR REFERRAL TO THE HBA DURING AN INPATIENT STAY. Schedule H, Part VI, Line 4 Community information CHKD IS THE REGIONAL PEDIATRIC REFERRAL CENTER FOR SOUTHEASTERN VIRGINIA, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA. CHKD SERVES THE FOLLOWING REGIONS IN VIRGINIA: ACCOMACK COUNTY, CHESAPEAKE CITY, FRANKLIN CITY, GLOUCESTER COUNTY, HAMPTON CITY, ISLE OF WIGHT COUNTY, JAMES CITY COUNTY, MATHEWS COUNTY, NEWPORT NEWS CITY, NORFOLK CITY, NORTHAMPTON COUNTY, POQUOSON CITY, PORTSMOUTH CITY, PRINCE GEORGE COUNTY, SOUTHAMPTON COUNTY, SUFFOLK CITY, SURRY COUNTY, SUSSEX COUNTY, VIRGINIA BEACH CITY, WILLIAMSBURG CITY AND YORK COUNTY. WITHIN NORTH CAROLINA, CHKD SERVES THE FOLLOWING REGIONS: BERTIE COUNTY, CAMDEN COUNTY, CHOWAN COUNTY, CURRITUCK COUNTY, DARE COUNTY, GATES COUNTY, HERTFORD COUNTY, PASQUOTANK COUNTY AND PERQUIMANS COUNTY. AS REFLECTED IN OUR 2025 CHNA, THIS SERVICE REGION INCLUDED 492,179 PERSONS AGE 0-19. CHKD'S SERVICE AREA COMPRISES A DIVERSE MIX OF URBAN, SUBURBAN AND RURAL COMMUNITIES, AS WELL AS 10 MILITARY INSTALLATIONS. CHKD IS WELL VERSED IN THE SPECIAL NEEDS OF MILITARY FAMILIES AND HAS ONE OF THE HIGHEST TRICARE PAYER PERCENTAGES AMONG THE CHILDREN'S HOSPITALS IN THE NATION. Schedule H, Part VI, Line 5 Promotion of community health CHKD PLAYS A UNIQUE ROLE IN ITS COMMUNITY BY PROVIDING PEDIATRIC HEALTHCARE SERVICES AVAILABLE NOWHERE ELSE IN THE REGION AND, AT THE SAME TIME, SERVING AS THE SAFETY NET PROVIDER TO THE REGION'S INDIGENT CHILDREN. IN FY 2025, CHKD HAD 5,790 ADMISSIONS RESULTING IN 55,158 PATIENT DAYS. 56.1 PERCENT OF THESE DAYS WERE COVERED BY MEDICAID, WHICH IS THE HIGHEST PERCENTAGE BY FAR OF ANY ACUTE-CARE HOSPITAL IN VIRGINIA. CHKD LEADS THE REGION IN EFFORTS TO ADDRESS PUBLIC HEALTH CONCERNS LIKE CHILD ABUSE AND CHILDHOOD OBESITY. IT IS THE SOLE PROVIDER OF PEDIATRIC SUBSPECIALTY CARE FOR CHILDREN WITH CHRONIC ILLNESSES LIKE CANCER AND DIABETES AND EMPLOYS THE REGION'S ONLY PEDIATRIC SURGEONS. THE HOSPITAL'S VIBRANT COMMUNITY OUTREACH PROGRAM COORDINATES PARENT, PROFESSIONAL AND STUDENT PROGRAMS THAT BRING IMPORTANT HEALTH, SAFETY AND WELLNESS INFORMATION TO THOUSANDS OF PARTICIPANTS. CHKD ALSO TAKES AN ACTIVE ROLE IN THE EDUCATION OF PEDIATRICIANS. COMPREHENSIVE INFORMATION ON CHKD'S EFFORTS TO IMPROVE THE HEALTH OF CHILDREN IS AVAILABLE AT WWW.CHKD.ORG/COMMUNITYBENEFIT Schedule H, Part VI, Line 6 Affiliated health care system CHKD IS PART OF CHILDREN'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CHKD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS ARE USED TO MEET THE NEEDS OF THE ORGANIZATION AS DETERMINED BY CHKD SENIOR MANAGEMENT AND THE CHS BOARD OF DIRECTORS. HISTORICALLY, SURPLUS FUNDS HAVE BEEN USED FOR A VARIETY OF PURPOSES INCLUDING PATIENT CARE PROGRAMS, CAPITAL IMPROVEMENT NEEDS, RESERVES, ETC. ROLES OF ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED: THE CHILDREN'S HEALTH SYSTEM IS COMPRISED OF SEVERAL ORGANIZATIONS. CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS IS A FREESTANDING CHILDREN'S HOSPITAL THAT PROVIDES A BROAD SPECTRUM OF INPATIENT AND OUTPATIENT CARE SERVICES ACROSS MANY PEDIATRIC SPECIALTIES, INCLUDING EVERYTHING FROM PRIMARY CARE AND WELLNESS INITIATIVES TO NEONATAL AND PEDIATRIC INTENSIVE CARE. OTHER ENTITIES UNDER THE CHILDREN'S HEALTH SYSTEM UMBRELLA INCLUDE: * CHILDREN'S HEALTH FOUNDATION, WHICH MANAGES INVESTMENTS AND FUNDS EDUCATION, RESEARCH AND OTHER PROGRAMS FOR CHILDREN'S HEALTH SYSTEM * CHILDREN'S MEDICAL GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC PHYSICIAN PRACTICES * CMG OF NORTH CAROLINA, INC., A NORTH CAROLINA STOCK CORPORATION, WHICH OWNS AND OPERATES A PEDIATRIC PHYSICIAN PRACTICE IN NORTHEASTERN NORTH CAROLINA * CHILDREN'S SURGICAL SPECIALTY GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC SURGICAL SUBSPECIALTY PRACTICES, INCLUDING PEDIATRIC GENERAL SURGERY, PEDIATRIC UROLOGY, PEDIATRIC CARDIAC SURGERY, PEDIATRIC ORTHOPEDIC SURGERY, PEDIATRIC NEUROSURGERY AND PEDIATRIC PLASTIC SURGERY. * CHILDREN'S HEALTH INSURANCE, LLC, A CAPTIVE INSURANCE COMPANY INCORPORATED IN SOUTH CAROLINA IS A DISREGARDED ENTITY OF CHKD. * CHKD THRIFT STORES, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. * CHILDREN'S REAL ESTATE, LLC, IS A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. * CHILDREN'S RESEARCH HOLDING, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. * CHILDREN'S QUALITY CARE, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. * CHILDREN'S PHARMACY SERVICES, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. Schedule H, Part VI, Line 7 State filing of community benefit report VA true CHILDREN'S HEALTH SYSTEM INC 601 CHILDRENS LANE NORFOLK VA 23507 541278830 501(C)(3) 13500000 CASH GENERAL SUPPORT CHILDREN'S HEALTH FOUNDATION INC 601 CHILDRENS LANE NORFOLK VA 23507 541278865 501(C)(3) 6790106 CASH GENERAL SUPPORT TIDEWATER EMS COUNCIL 1104 MADISON PLAZA STE 101 CHESAPEAKE VA 23320 540977032 501(C)(3) 20000 CASH EMS RESUPPLY SYSTEM PENINSULAS EMS COUNCIL PO BOX 1297 GLOUCESTER VA 23061 541064500 501(C)(3) 5000 CASH EMS RESUPPLY SYSTEM TEXAS TECH UNIVERSITY 3601 4TH STREET LUBBOCK TX 79430 752668014 501(C)(3) 25000 CASH HUMAN MILK BANK EASTERN VIRGINIA MEDICAL SCHOOL PO BOX 1980 NORFOLK VA 23501 546055378 501(C)(3) 14492 CASH RESEARCH STUDY 6 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds AWARDS ARE MADE TO INVESTIGATORS/PHYSICIANS BY CHKD (CHILDREN'S HOSPITAL THE KING'S DAUGHTERS) FOR SPECIFIC PROJECT OR RESEARCH ENDEAVORS. FUNDING REQUESTS ARE COMPLETED AND SUBMITTED WHERE THEY ARE REVIEWED BY THE FINANCE DEPARTMENT, THE CEO AND THE APPLICABLE BOARD. AFTER AN AWARD IS MADE, THE AWARDEE MUST FILE QUARTERLY FINANCIAL SUMMARIES AND A FINAL REPORT TO BE SUBMITTED TO THE CEO AT THE END OF THE FUNDING PERIOD. ADDITIONALLY, CHKD GIVES CONTRIBUTIONS TO ITS PARENT ORGANIZATION, CHILDREN'S HEALTH SYSTEM, AND TO CHILDREN'S HEALTH FOUNDATION. X true true X X X X false true false false false false false true false Amy Sampson President/CEO/Director 0 1144719 0 326859 0 814570 0 930206 0 42066 0 3258420 0 756504 Scott Nottingham MD Director 0 411789 0 0 0 472 0 13800 0 29719 0 455780 0 0 Carl St Remy MD Director 0 851252 0 0 0 810 0 13800 0 30427 0 896289 0 0 Kathryn Abshire CFO/Asst Tres./Asst Sec. 0 555389 0 114459 0 357572 0 497762 0 37950 0 1563132 0 324962 JOHN HARDING FORMER CHIEF OPERATING OFFICER 0 0 0 0 0 1174869 0 0 0 0 0 1174869 0 783026 Allison Silva VP - Ancillary Services 320977 0 52586 0 252872 0 171708 0 15254 0 813397 0 178823 0 Kristi McGowin VP - Patient Care Services/CNO 296912 0 24645 0 45282 0 65264 0 15287 0 447390 0 0 0 Tamika Harris VP - Facilities & Support Services 112488 0 0 0 46736 0 4739 0 14457 0 178420 0 0 0 Christopher Foley Senior VP - Chief Clinical Operations Officer 0 814043 0 144735 0 12096 0 136787 0 47339 0 1155000 0 0 Kimberly Day Senior VP - Chief Legal Officer 0 490396 0 102138 0 107692 0 100590 0 28058 0 828874 0 71060 Donald Barnes Senior VP - Chief People Officer 0 380959 0 63179 0 10716 0 80907 0 21342 0 557103 0 0 Terrie Pyeatt VP - Finance 0 270292 0 44147 0 10716 0 51255 0 12566 0 388976 0 0 Deborah Barnes VP - IS Operations 0 461801 0 78395 0 451738 0 145454 0 19920 0 1157308 0 424585 John Harrington VP Quality/Safety & Clinical Integration 451883 0 74473 0 36922 0 92903 0 33811 0 689992 0 0 0 John Warburton VP - Mental Health Service Line 379178 0 63360 0 37482 0 69223 0 28227 0 577470 0 11593 0 Suzanne Brixey Physician 353575 0 34000 0 12161 0 13800 0 3634 0 417170 0 0 0 Dean Cauley Physician 346012 0 20000 0 450 0 13800 0 13835 0 394097 0 0 0 Kamil Cak VP - Experience of Care 246241 0 41424 0 18002 0 47998 0 20002 0 373667 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments IN CONNECTION WITH A RETIREMENT PROGRAM, TAX GROSS-UP PAYMENTS ARE PROVIDED TO CERTAIN EMPLOYEES WHOSE EMPLOYER FUNDED CONTRIBUTIONS ARE IMMEDIATELY BENEFITS OF PARTICIPANTS WHOSE CONTRIBUTIONS ARE NOT IMMEDIATELY TAXABLE. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan CHILDREN'S HEALTH SYSTEM SPONSORS TWO SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS ("THE PLANS"). THE PLANS ARE DESIGNED TO RETAIN EXECUTIVES IN POSITIONS ESSENTIAL TO THE SUCCESS OF CHILDREN'S HEALTH SYSTEM. DURING THE YEAR, THE FOLLOWING INDIVIDUALS WERE PARTICIPANTS IN ONE OF THE SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AND RECEIVED THE FOLLOWING ANNUAL ACTUARIAL INCREASE OR DEFERRED CONTRIBUTION (INCLUDED IN SCHEDULE J, PART II, COLUMN (C)) AND/OR PAYMENT (INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III)). AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III) MAY DIFFER FROM AMOUNTS PAID DUE TO TIMING DIFFERENCES IN VESTING AND PAYMENTS. NAME: AMY SAMPSON ACT. INCREASE: $829,117 AMT. PAID: $329,049 NAME: KATHRYN ABSHIRE ACT. INCREASE: $463,097 AMT. PAID: $136,327 NAME: ALLISON SILVA ACT. INCREASE: $134,787 AMT. PAID: $819,034 NAME: DEBORAH BARNES ACT. INCREASE: $120,553 AMT. PAID: $2,116,694 NAME: CHRIS FOLEY ACT. INCREASE: $122,987 AMT. PAID: $0 NAME: KIMBERLY DAY ACT. INCREASE: $86,790 AMT. PAID: $80,255 NAME: JOHN HARRINGTON ACT. INCREASE: $79,103 AMT. PAID: $0 NAME: DONALD BARNES ACT. INCREASE: $67,107 AMT. PAID: $0 NAME: KRISTI MCGOWIN ACT. INCREASE: $65,264 AMT. PAID: $0 NAME: JOHN WARBURTON ACT. INCREASE: $55,423 AMT. PAID: $348,867 NAME: TERRIE PYEATT ACT. INCREASE: $38,617 AMT. PAID: $0 NAME: KAMIL CAK ACT. INCREASE: $36,235 AMT. PAID: $0 NAME: JOHN HARDING ACT. INCREASE: $0 AMT. PAID: $1,480,250 Schedule J, Part I, Line 7 Non-fixed payments OFFICERS AND VICE PRESIDENTS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET UP BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. DEPARTMENT DIRECTORS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET BY MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS. A VA SMALL BUSINESS FIN AUTH (2025) 541300845 2025-06-02 90805000 REFINANCE 2015 SERIES BONDS (ISSUED 12/01/2015) AND FINANCING OF HEALTHCARE FACILITIES false false false B VA SMALL BUSINESS FIN AUTH (2020) 541300845 2020-06-10 100000000 FINANCING OF HOSPITAL FACILITIES false false false C VA SMALL BUSINESS FIN AUTH (2021) 541300845 2021-11-09 91958991 REFINANCE 2012 SERIES BONDS (ISSUED 9/19/2012) AND FINANCING OF HOSPITAL FACILITIES false false false A 44494000 44494000 2025 true false true true B 5145000 100000000 100000000 2022 false false true true C 12400000 91958991 91958991 2022 true false true true A false true true true true true 0.0033 0 0.0033 false false 0 false true B false true true true true true 0 0 0.0 false false 0 false true C false true true true true true 0.0059 0 0.0059 false false 0 false true A false true false false true false 0 false false false 0 false false true B false true false false true false 0 false false false 0 false false true C false true false false true false 0 false false false 0 false false true A true B true C true Schedule K, Part II, Line 10 COLUMN C - CAPITAL EXPENDITURES FROM REQUISITIONED PROCEEDS CURRENTLY TOTAL $90,805,000 OF WHICH $46,311,000 WAS ALLOCATED TO CHILDREN'S HEALTH SYSTEM AND $44,494,000 WAS ALLOCATED TO CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS Schedule K, Part III, Line 4 COLUMN B: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.59% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR. COLUMN C: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.33% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR. WM JORDAN CO INC ENTITY MORE THAN 35% OWNED BY JOHN LAWSON II, CURRENT BOARD MEMBER. 5829382 CONSTRUCTION SERVICES false 3 10475 Other - CASH ON SALE 35 2821178 Other - AVG FMV ON DATE REC X OTHER 17 13684 Other - FMV ON DATE REC false true true Schedule M, Part I, Line 32b Third parties used to solicit, process, or sell noncash contributions CHKD PAYS AMERICA'S AA VIRGINIA A FEE TO AUCTION CARS FOR THE BENEFIT OF THE ORGANIZATION Schedule M, Part I Explanations of reporting method for number of contributions Cars and other vehicles - COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS, NOT THE NUMBER OF ITEMS RECEIVED. Securities - Publicly traded - COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS, NOT THE NUMBER OF ITEMS RECEIVED. Other - OTHER COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS, NOT THE NUMBER OF ITEMS RECEIVED. Form 990, Part I, Line 1 DEDICATED TO THE MISSION OF PROVIDING THE BEST POSSIBLE CARE AND SERVICES FOR ALL CHILDREN WHO COME TO US BECAUSE OF SICKNESS AND INJURY. Form 990, Part III, Line 4a For more than six decades, Children's Hospital of The King's Daughters (CHKD) has been the only facility of its kind in Virginia, serving the medical and surgical needs of children throughout the state. Its primary service area encompasses greater Hampton Roads, the Eastern Shore of Virginia, and northeastern North Carolina, a region that is home to approximately 418,000 people under the age of 21. CHKD was established as an 88-bed, not-for-profit hospital in 1961 by The King's Daughters, a women's service organization dedicated to the health and well-being of the community's indigent children. The hospital has always upheld the charitable mission of its founders, and in FY25, 56.1 percent of its inpatient days were covered by Medicaid. Over the past 60 years, CHKD's hospital has grown into an extensive pediatric health care system that offers 266 inpatient beds. Two hundred and six of those beds are in CHKD's acute care facility and sixty are in Children's Pavilion, the organization's new mental health tower. CHKD Health System also offers a variety of outpatient pediatric services at CHKD, Children's Pavilion, and multi-service CHKD Health Centers in Virginia Beach, Newport News, Chesapeake, Hampton, and Suffolk. Its services include everything from wellness and prevention initiatives to primary care, surgery and rehabilitation. Many of CHKD's unique services and programs address pressing public health needs that would otherwise go unmet. As the premier provider of healthcare services to the region's children, CHKD has secured a place in the heart of the community. The Health System is an eager collaborator with other community organizations and institutions that share its concern for the well-being of young people and offers a variety of education, research and health initiatives to improve the health and well-being of children in this community and beyond. The Health System's primary services center on inpatient and outpatient care, community outreach programs and medical education/research. Because the organization's ongoing development of mental health services are so integral to its community benefit, advances of this program are highlighted separately. Section One: Inpatient Care Children with a vast range of medical problems -- including life-threatening illnesses and injuries -- turn to CHKD for inpatient care. In FY25, CHKD had 5,790 admissions resulting in 55,158 patient days. Approximately 56 percent of these days were covered by Medicaid. CHKD's acute care facility has 206 inpatient beds, and almost half of those are for pediatric intensive care. The hospital is home to the region's highest-level Neonatal Intensive Care Unit, where critically ill newborns, some as young as 22 weeks gestation, benefit from a unique combination of advanced medical technology, developmental care, family support, and palliative care. CHKD's NICU has 50 private rooms and 10 semi-private rooms to create a more individualized and family-centered approach, giving families more privacy to bond with their babies. There were 505 discharges from the NICU in FY25. The region's largest and most sophisticated Pediatric Intensive Care Unit is at CHKD. In this unit, a full-time staff of board-certified pediatric intensive care physicians, critical care nurses, and respiratory therapists provide extremely sophisticated, technologically advanced care to children with life-threatening injuries and illnesses. Medical care is supplemented with support from child life specialists, social workers and chaplains who have extensive experience helping families through the trauma and stress of a severe illness or injury in a child. There were 1,004 admissions to our PICU in FY25. Many patients are brought from other area hospitals to CHKD by the hospital's neonatal/pediatric transport program, which operates out of four fully equipped mobile intensive care units. Two EMT certified critical care transport teams are available 24 hours a day, seven days a week to all area medical facilities that need to send sick or injured children to CHKD. CHKD transport teams are equipped and trained to transport all trauma patients under the age of 15 to Children's Hospital of The King's Daughters for specialized pediatric trauma care. Each critical care transport call is answered by a certified EMT-B neonatal/pediatric critical care nurse, a certified EMT-B registered respiratory therapist and a certified EMT-paramedic trained in neonatal/pediatric care. In FY25, the team transported approximately 1,400 patients. Of those, about 350 were newborns in need of neonatal intensive care. CHKD's transport service is also under contract to the Naval Medical Center, Portsmouth, to provide all critical care neonatal and pediatric military transports in the region. Besides ground transports in our Mobile ICUs or acute care transport, the team can respond via fixed wing aircraft or helicopter transport when medically necessary. CHKD transfer center is staffed with paramedics who operate to ensure appropriate dispatch services to the transport team as well as to deliver assistance and support for referral facilities and staff throughout the community. CHKD operates the region's only pediatric surgery program, offering young people state-of-the-art treatment in a supportive, non-threatening environment created exclusively to meet their needs. In FY25, surgeons performed 14,279 cases at CHKD facilities for a vast range of problems, from the simplest outpatient procedures to complex Craniofacial, Orthopedic and Chest Wall surgeries. CHKD's cardiac surgery program is part of a regional collaborative between CHKD and the University of Virginia. CHKD and UVA combine the efforts of pediatric cardiologists, cardiac surgeons, cardiac anesthesiologists, intensive care physicians and cardiac support professionals from both institutions with the goal of improving outcomes for children with complex congenital heart defects. (See outpatient services and programs for more information of CHKD's surgery program.) CHKD employs dozens of professionals who provide emotional, recreational, spiritual and practical support to children and families during hospitalizations. The work of these professionals complements our expert medical care to create a unique treatment and healing environment for children and their families. Our chaplaincy services provide emotional support, spiritual care, ethical reflection, bereavement care/resources/follow-up (including parent support groups), spiritual assessment and guidance to patients, families, and staff with in-hospital presence seven days a week and 24 hours a day. Additionally, a chaplain is assigned to Children's Pavilion to provide for patients on our inpatient mental healthcare floors. Chaplains assist with advance directives, advanced care plans and serve on the trauma team as primary providers of family support. The hospital employs a chaplaincy manager, six full-time chaplains, one full-time Family/Staff Support Coordinator and four per-diem chaplains who reflect the diversity of the community. All chaplains are professionally trained to meet the varied spiritual needs of families and staff with respect and compassion. Chaplaincy services has numerous connections with community clergy to ensure most religious needs can be met. The chaplains provide an annual memorial service to remember and celebrate the lives of the children who have passed on during the previous year. The chaplains also facilitate educational and wellness programs for hospital staff and physicians, as well as planning and participating in outreach to the community. The hospital employs 29 integrative care/child life staff members, including two art therapists and two music therapists, who help children adjust and cope during hospitalization. Their goal is to make the child's hospital experience as normal as possible by developing supportive relationships with patients and families, providing age-appropriate preparation for medical procedures and surgeries, coping strategies and play opportunities for children to relieve stress. Ten members of the department, including certified therapeutic recreation specialists, work on our inpatient mental health units. Form 990, Part III, Line 4a There are four popular activity areas, including a teen room, in the main hospital, providing hospitalized children opportunities for socialization and creative play. And child life assistants work with CHKD's volunteer services division to manage the hospital's popular pet therapy program -- the Buddy Brigade -- which brings visits of dog/handler teams to visit patients several times each week. Child life staff members collaborate with other hospital staff to provide support for parents and siblings, offering an annual Teddy Bear clinic, weekly closed-circuit TV bingo, inpatient developmental screenings, and a Kids as Partners Advisory Council. CHKD's Medical Social Work team provides many services, including the following: -Conduct biopsychosocial and behavioral assessments. -Provide support during hospitalization to CHKD patients and families dealing with trauma, chronic illness, and loss. -Refer to CHKD's eligibility workers to complete applications for insurance coverage for medical care, prescriptions, and medical supplies. -Coordinate referrals and ongoing communication to other community resources for assistance with needs such as housing, mental health counseling, educational advocacy, legal assistance, and much more. -Aid in communication with families with the medical treatment teams by coordinating patient care conferences and team meetings. -Evaluate and report suspicion for child abuse/neglect. -Conducts trauma assessments as required for the coordination of care for patients of a Level 1 pediatric trauma center. In July 2021, a grant was awarded to the medical social work team under the Hospital Violence Intervention Program initiative. This program is now identified as "Safer Futures, is managed by an identified licensed eligible coordinator, and one full-time medical social worker who conduct intake assessments, develop individual service plans, do interval check-ins and provide progress notes for patients and family members affected by violence. Additionally, medical social workers facilitate a variety of support groups in the community that assist patients and families in connecting with others who share similar challenges. Some examples include Sibshops, Healthy Mommy Healthy Baby, and Dine and Discover for NICU families. The Medical Social Work team manages the Halo, Butterfly Blessings, and Sam's Warriors Funds, monetary funds designated to assist patients/families encountering barriers such as transportation needs, meal and medication/prescription assistance, and other discharge-related costs. These donated funds may also be used in emergency situations to assist with special healthcare challenges, lost money due to parent's inability to work during child's inpatient stay, and partial or one-time payments for utilities or rent fees post discharge. The medical social work team is part of CHKD's mental health program, which is covered in more detail in the next section. The cultural/language services department at Children's Hospital of The King's Daughters (CHKD) meets the needs of patients and families with limited English proficiency by coordinating access to language interpretation via face-to-face, over the phone, and video remote interpretation throughout the health system. The program's goal is to improve customer service, consistency of care, and patient safety. We recognize that it is critical to have access to interpreters and caregivers who can provide culturally sensitive and accurate information so they can understand and participate in the child's treatment and discharge process and help prevent potential medical errors. It also contributes to overall family satisfaction, which is vitally important. We meet this goal through the activities described below: CHKD provided interpretation services in 43 different languages for our limited English population through 25,225 outpatient visits during FY25. To meet the needs of these families, hospital staff used Over the Phone Interpretation, Video Remote Interpretation, and 3.83 FTE Spanish medical interpreters in the Language Services department who cover the main hospital and the General Academic Pediatrics (GAP) clinic. Additionally, the CHKD system had 29 dual role bilingual staff who were available to provide medical interpretation in their assigned areas. For written document translation (Spanish), language services staffing relied on the assistance of 2.2 Language Services Spanish interpreters in the department. All CHKD Language Services interpreters assisting with Spanish document translation must have National Certification as Healthcare Interpreters at a minimum. During FY25 the CHKD Language Services department assisted with in person and over the phone interpretation for 12,235 patient encounters at the main hospital and at the GAP clinic, translated 339 documents from English to Spanish, and conducted 22 language proficiency assessments. Language proficiency assessments are conducted by the Language Services Department to ensure bilingual staff throughout the CHKD health system have the skills necessary to communicate effectively with patients and families in Spanish, or before they are allowed to provide medical interpretation in Spanish. As the regional provider of pediatric care, CHKD is an integral part of the community's natural or man-made disaster planning efforts. CHKDHS recognizes the importance of a National Incident Management System (NIMS) community-integrated, all-hazard emergency operations plan. This plan is prepared, exercised and shared internally and externally with community, State and Federal emergency response agents. Section Two: Outpatient Services and Programs CHKD Health System also offers the community many important pediatric services on an outpatient basis. In FY25, children made approximately 659,979 outpatient visits to CHKD pediatricians, surgeons, and subspecialty clinics. They made 376,312 visits to the primary care pediatricians of CHKD's Medical Group, which offers care in 19 practices in 31 offices throughout our service area. CHKD's Surgical Specialty Group makes the services of the region's only pediatric general, urological, cardiac, neurosurgical, plastic, oral maxillofacial, and orthopedic surgeons available to thousands of children who might otherwise have to travel outside of the area for surgery. Children made 50,876 visits to the surgical group practices in FY25. The surgeons performed 5,891 surgical cases. The hospital also provides care to children facing health conditions such as cancer, genetic disorders, obesity, heart problems, developmental disabilities, asthma/allergies, and diabetes through more than 34 outpatient specialty clinics offering specialized pediatric care. In FY25, children made 232,791 visits to our outpatient clinics. Children's Hospital was founded on the premise that all children deserve equal access to quality pediatric care. As our population grew and settled into the far corners of our bridge- and tunnel-laced region, travel to CHKD's main facility in Norfolk became more of a hardship for families. To ease that burden and improve children's access to care in every corner of our service area, CHKD has established multi-service health centers in strategic locations. These include, but are not limited to, the following: * The CHKD Health and Surgery Center at Oyster Point offers families who live north of the Hampton Roads Bridge Tunnel a wealth of important services in a convenient location. The center is home to the region's first pediatric ambulatory surgery center. Other services offered at the site include primary, surgical, and sub-specialty pediatrics; lab and radiology services (including ultrasound and MRI); audiology testing; and occupational, speech, and physical therapy. Aquatic therapy and child abuse program services are also available there. * The CHKD Health Center and Urgent Care at Tech Center is home to the Peninsula's only pediatric urgent care as well as the Center for Pediatric Sleep Medicine, lab and radiology services, physical medicine and rehabilitation, rheumatology, sports medicine primary care, sports medicine physical therapy, mental health, neurology, and performance training. * The CHKD Health Center at Oakbrooke serves families in Chesapeake and northeastern North Carolina. It is home to a primary care pediatric practice; physical, occupational, and speech therapy; lab and radiology services (including ultrasound); a sports medicine gym; sleep studies unit; audiology testing; therapy pool; and clinic space for a variety of pediatric specialists and surgeons providing evaluation, treatment, and follow-up. Form 990, Part III, Line 4a * The CHKD Health and Surgery Center at Concert Drive serves the growing medical needs of families in Virginia Beach. The center is home to Virginia Beach's first ambulatory surgery center exclusively for children. Families can also find primary care pediatricians and in-house lab and radiology services - including MRI - at the center, along with child life specialists. Other services include specialty care pediatrics for help with chronic problems such as diabetes. A third operating room at this location supports the pediatric dental needs of the community. It was built and designed according to input from community dentists. * The CHKD Health Center at Landstown is located just down the road from Concert Drive and offers dedicated Virginia Beach space for specialty services such as sports medicine, dermatology, and gynecology. * The CHKD Health Center and Urgent Care at Loehmann's Plaza serves the northern and middle Virginia Beach region and is home to CHKD Urgent Care; sports medicine (primary care) and therapy; sports performance training; and physical, occupational, and speech therapy. * The CHKD Health Center at Harbour View offers specialized pediatric care to families in Suffolk. The site offers appointments in pediatric dermatology, allergy, gastroenterology, cardiology, gynecology, physical medicine and rehabilitation, lab and radiology services (including ultrasound), nephrology, and developmental pediatrics. * CHKD Sports Medicine & Therapy Services offers sports medicine and therapy services in Suffolk, conveniently located next to the CHKD Health Center at Harbour View. * The CHKD Health Center at Lightfoot offers families in the northern corner of our service area appointments in pediatric cardiology, nephrology, gynecology, physical medicine and rehabilitation, rehabilitative therapies, plastic and oral maxillofacial surgery, sports medicine, and urology. It is also home to the Children's Diagnostic Center. * The CHKD Health Center at Fort Norfolk is located in the Fort Norfolk Plaza building and is home to specialty services including allergy and asthma, adolescent medicine, ophthalmology, and the Cleft and Craniofacial Center. * The CHKD Health Center at Kempsville provides families in Norfolk and Virginia Beach pediatric primary care and orthopedics and sports medicine. * The CHKD Health Center, South Campus is home to CHKD's Neuroscience Center and is located just across Brambleton Avenue to the south of the main hospital. This site offers appointments in mental health, neurology, sleep medicine, and physical medicine and rehabilitation. Children's Hospital of The King's Daughters operates the region's only pediatric urgent care. Parents of children with urgent, but not emergent medical needs, now have access to quality medical care just for kids after-hours, on weekends and holidays. In FY25, children made 98,068 visits to CHKD Urgent Care Centers in Chesapeake, Virginia Beach and Newport News. CHKD's Child Advocacy Center (CAC) coordinates the region's efforts to accurately identify, treat, and support children who are suspected victims of abuse or neglect. In addition to the main program in Norfolk, services are available at CHKD's outpatient centers in Virginia Beach and Newport News. The CAC provides comprehensive assessment, evaluation, and treatment services, including case management and advocacy, an array of evidence-based mental health services, forensic interviewing, forensic medical examinations, and consultations, which include 24/7 coverage of acute sexual assaults of children. The CAC also coordinates efforts among investigative agencies involved in the investigation and prosecution of child maltreatment and facilitates collaboration across 12 multidisciplinary teams (MDTs). These teams discuss each child referred to the program to ensure the best possible outcomes. With strong community support, CHKD's Child Advocacy Center served 2,621 children and families in FY2025 across southeastern Virginia. For over 27 years, investigative agencies across southeastern Virginia have relied on this specialized program for assessment and treatment services when a child is suspected of experiencing any form of maltreatment. In FY2025, the center provided nearly 900 forensic interviews, over 3,800 mental health service visits, more than 1,300 medical service encounters, and almost 14,000 victim and family advocacy encounters to children and families across Hampton Roads. A specialty program within the CAC helps accurately identify and provide assistance and treatment to commercially sexually exploited children (CSEC). Since launching this program and CSEC MDT, the program has seen a sharp increase in the need for these services. The Child Advocacy Center assisted 297 children through the CSEC program this year - a 5% increase from the previous year. The team frequently collaborates with federal and local investigators, as well as juvenile court services, and medical and mental health providers, to best meet the unique needs of each child. The CAC's mental health team recently completed a year-long training to implement the Problematic Sexualized Behavior Cognitive Behavioral Therapy - Young Children (PSB-CBT) treatment modality. Currently unavailable elsewhere in our region, this needed treatment expands our mental health services to address these problematic behaviors. In FY25, our mental health team provided treatment for 29 children who were identified as having problematic sexual behaviors with PSB-CBT or Trauma-Focused Cognitive Behavior therapy with PSB components added. The CAC is also the backbone agency for the Hampton Roads Trauma Informed Community Network (HRTICN), which exists to promote an understanding of how trauma affects individuals and communities, and to advocate practices that help all people reach their full potential. HRTICN worked with the Virginia chapter of the American Academy of Pediatrics this year to train pediatricians on approaches to screening, referral, and follow-up for maternal depression, social determinants of health and social-emotional development during well-child visits. Approximately 14% of children served at our CAC have a military affiliation, supported by a dedicated case manager who is also a decorated veteran. In addition to nine city MTD case review teams, this program also facilitates three multidisciplinary case review teams, covering all military branches, and is focused on meeting the unique needs of these families, linking them to military resources, and providing educational opportunities to our MDT partners. The epidemic of childhood obesity continues to be a concern and focus area for CHKD. To address this critical issue, CHKD offers a comprehensive program called Healthy You for Life that is offered to children ages 3 through 21. Healthy You for Life offers a multidisciplinary team approach that provides clinical and psychological evaluation and treatment planning for individuals either in person or by telemedicine visits. The program's clinical staff includes a physician, nurse practitioner, registered dieticians, a licensed clinical social worker, medical assistants, and an exercise physiologist. The Healthy You for Life program also offers individual counseling sessions. In the 2025 fiscal year, the team conducted 1,502 visits. Moving into the new fiscal year, the team is continuing to use telemedicine to ensure access to all providers, including behavioral health counselor to address psycho-social stressors many patients experience. Middle school and high school group therapy sessions continues via telehealth to help pre-teen and teenagers feel connected and supported. Personal training is also offered for interested patients and group fitness classes resumed with parent and patient enthusiasm. Pursuant to recommendations from the American Academy of Pediatrics, the use of pharmacotherapy has been considered as an additional treatment in conjunction with diet, exercise and lifestyle changes for those children and adolescents at high risk for developing life-threatening comorbidities. Healthy You continues to partner with various community organizations to educate and encourage healthy lifestyles for chronically obese children and their families in Hampton Roads. Our providers also partner with neighboring universities as preceptors, guest lecturers and consultants in nutrition and wellness. Form 990, Part III, Line 4a CHKD's diabetes education program helps approximately 1,600 local children who live with the chronic disease. Three certified diabetes educators, a social worker, a registered dietitian and office coordinator help patients and families at the onset of the disease and until adulthood. The Diabetes Center provides inpatient and outpatient clinical management, diabetes education, support groups, and professional and community education programs. A transition program helps the older teens and young adults begin transferring care to adult providers in the community. Children made 646 visits to the Diabetes Center in FY25. The Children's Cancer and Blood Disorders Center provides care to young people with cancer, sickle cell disease, bleeding and other blood disorders through treatment programs that encompass children's physical, emotional and educational needs and incorporates the whole family. Patients made 8,541 visits to the center in FY25. CHKD is the only Emergency Department and Level 1 Trauma Center exclusively serving children and their families in the southeast region of Virginia. In FY25, children made 60,256 visits to our Emergency Department. We provide care for patients and their families from birth to young adulthood with varied levels of acuity from trauma and resuscitations to urgent care-type patients. Our collaborative team includes pediatric board-certified emergency physicians, nurse practitioners, nurses, ED techs, nursing care partners, behavioral health techs, pharmacists, social workers, child life specialists, chaplains, respiratory therapists and more. Children's Hospital offers the only pediatric renal dialysis service in the area. Dialysis is a time-consuming process and children appreciate the chance to have the service in a setting where they can meet with friends their own ages as well as hospital support staff. During FY25, children made 6,045 visits to the renal clinic. CHKD is a stand-alone pediatric transplant hospital. Since 2005, CHKD has performed more than 100 kidney transplants from living donors as well as deceased donors. Living donation options include a partnership with Sentara Norfolk General Hospital and the National Kidney Registry (nationwide living donor paired-exchange program). One mark of CHKD's distinctive pediatric care has always been child-centered diagnostic services, such as radiology and laboratory. Over the past several years, CHKD has worked hard to make these unique services more accessible to families throughout our service region. In addition to the lab at the main hospital, CHKD now offers lab services at its Oyster Point, Harbour View, Concert Drive, Oakbrook, Loehmann's and Tech Center locations as well as the Volvo Urgent Care Center. The laboratory also operates a courier service that facilitates quick turnaround of specimens. Of the 832,875 lab tests performed in FY25, 558,296 were from outpatients. CHKD radiology services are also available to families at our CHKD facilities in Newport News, Chesapeake, Suffolk, Hampton, Norfolk and Virginia Beach. The radiology department is a fully integrated digital imaging center that allows diagnostic images and reports to be transmitted and viewed electronically. In FY25, 129,448 diagnostic exams were performed including X-rays, fluoroscopic tests, urodynamics and bone density tests, CT, MRI scans, ultrasound, PVL, PET scans, and nuclear medicine studies. Approximately 80 percent were outpatient based. CHKD's rehabilitative therapy services are offered in locations throughout the community, including Norfolk, Chesapeake, Virginia Beach, Suffolk, Newport News, and Williamsburg. In FY 25, CHKD provided 33,965 inpatient and 191,551 outpatient therapy units, which included highly specialized pediatric physical, occupational and speech therapy, as well as: * Aquatic Therapy - Physical and occupational therapists work with children in the water to help relax tight musculature, increase range of motion and improve strength, balance and endurance. * Assistive Technology/Augmentative Program - Services provided for children who are unable to communicate verbally or through gestures due to various medical conditions, thereby allowing them an alternative way to increase their participation and inclusion in daily activities. * Car Seat Program - Specially trained therapists offer car seat safety restraint evaluations for patients with special needs. * Wheelchair Clinic - Certified therapists complete a comprehensive evaluation to determine and prescribe the appropriate wheelchair and seating system. Section Three: Mental Health Services Since 2013, CHKD's Community Health Needs Assessments have indicated that the region's number one need in the children's health arena was improved access to pediatric mental health services. In response, CHKD formally expanded its mission to incorporate children's mental health services and began building a program to answer our children's most pressing mental health needs. Children's Pavilion, a 14-story pediatric psychiatric hospital and outpatient center that comprises 60 of CHKD's 266 licensed inpatient beds, is the hub of CHKD's growing mental health program. Since the launch of the program, CHKD has developed the essential framework of a comprehensive pediatric mental health network, with the goal of providing care in the least restrictive environment possible. Elements of this plan include the following: * Inpatient psychiatric care (1,237 discharges in FY25) * Emergency psychiatric care (3,027 visits to CHKD's Emergency Department were for mental health care in FY25) * Medical-psychiatric care. (682 discharges in FY25) * Partial hospitalization program (2,481 patient days in FY25) * Intensive outpatient program (1,297 patient days in FY25) * Outpatient mental health (48,000 visits in FY25) * Child and adolescent psychiatry fellowship Section Four: Community Outreach CHKD reached 26,316 families through parent education, school-based programs, social media, and publications focused on mental wellness, injury prevention, and family support. Partnering with community organizations, the Community Outreach & Engagement (CORE) program conducted 238 outreach events for 21,770 families. Online resources (blogs, podcasts, and webinars on demand) and I&R contacts reached an additional 4,546 families, covering topics such as mental health, trauma, and social-emotional learning. Community partners supported marketing and collaboration to deliver timely presentations and resources for parents, professionals, and children/students. CHKD is a site of the national "Reach Out and Read" literacy program, which encourages reading by distributing free books to children at their well child visits to their pediatricians. Through the donor-funded program, CHKD primary care pediatricians gave approximately 77,000 books to children in FY25. CHKD also has a "Reach Out and Read" program in our NICU, where 1,838 books were distributed in FY25. In FY25, CHKD's website, www.chkd.org, underwent a major transformation, migrating to new, open-source platform that is easier to manage and navigate. They also streamlined back-end content management and third-party integrations (e.g. scheduling, patient portals, donation tools), reducing maintenance overhead and improving data flow. Post-launch, the new platform delivered measurable gains: search and "provider-finder" tools significantly improved, user engagement rose, and visits to high-value pages (like Find a Provider, Urgent Care, billing, etc.) increased year over year. The site's updated design and info architecture enhanced navigation, making it easier for families and medical professionals to find essential information. Overall, the migration gave CHKD a scalable, secure, and flexible foundation - improving both the patient-facing experience and the internal content management workflow. CHKD continues to utilize social media outlets such as Facebook, LinkedIn, and Instagram to increase direct interaction with our patients and their families. The website continues to be a resource for our services and health information. Form 990, Part III, Line 4a CHKD is one of six locations in the state for the Care Connection for Children, the state-funded Title V program that provides comprehensive care coordination, information and referral for children and youth with special health care needs. There are estimated to be more than 52,000 children with special healthcare needs in the region's public health districts. In FY25, CCC assisted with just under 600 information and referral calls and provided comprehensive case management services to more than 500 families. Close to 20 children who were uninsured or underinsured received a total of $23,597 in financial assistance for equipment, specialty care and medications. More than 40 families were assisted in applying for state health programs, to include Virginia's waiver services. The program provided ongoing bilingual care coordination services to approximately 100 clients/families and assisted them with access to community resources and financial assistance. Care Connections maintains an updated regional database with cataloged resources for all 21 cities and counties in CHKD service area. This resource directory was made available to the health system as well as local agencies and the community. 2024-2025 Highlights: -Developed, implemented, and continue to moderate a list serv for the community on disability topics with more than 500 people registered via GOOGLE GROUPS. Members are patients, parents, caregivers, and providers. -Added a SPANISH language list serv for our Hispanic population. -Collaborated with CHKD, Fortify Clinically Integrated Network and CMG to integrate care coordination activities within the electronic record to improve communication with primary care providers. -Engaged in home visiting collaboration autism collaboratives, Infant Toddler Connection, PEATC, FAPT Teams, SEAC state representative for Medicaid Advisory Group. -Offered a virtual Spanish speaking support group. Other trainings planned, coordinated, and reported on quarterly, based on needs identified through community networks and the Families as Educators group. -Refined intake process to improve enrollment experience for families and improve communication with referral sources. -Researched and updated resources in our community asset mapping tool. Collaborated across the CCC network to identify resources. -Actively engaged with the VDH Intercenter Work Group meetings, trainings, email collaborations and teleconference sessions. This group is resourceful, and members support one another to identify resources to close gaps in services. -Continued to offer Educational Consultant services per VDOE regulations. Provided information and referral services for health system related to educational concerns (IEP/IFSP). -Representatives from team serve on the Medicaid Waiver Task Force and the DMAS Pharmacy and DME provider network to problem solve and identify needs in our region. -Continued our Families as Educators program focused on providing the Pediatric Residents an opportunity to experience the challenges and joys of living in the community with a child with complex medical care needs. Section Five: Medical Education and Research CHKD invests in the present and future health of our children through a variety of research programs and educational activities. Children's Hospital is home to Eastern Virginia Medical School's Department of Pediatrics and its pediatric residency program, where new physicians become specialists in the field of pediatrics. Many of our residents elect to stay and practice pediatrics in this community or in the state of Virginia. CHKD also serves as the exclusive pediatric teaching site for physician assistants and residents in family medicine, emergency medicine, obstetrics-gynecology, ENT, plastic surgery, and general surgery. CHKD participates in the education of all EVMS medical students and is the exclusive site for some 150 third-year medical school students for their six-week pediatric clerkship rotation. CHKD provides a setting for many clinical research trials. Highlights of the basic science research include new gene therapy for neuromuscular disorders, breakthroughs in treatment of cystic fibrosis, innovative therapies in sports medicine, advanced growth hormone treatments, and interventions for disordered sleep. In addition, research includes new medications and other therapies, clinical outcomes analyses, and epidemiological studies sanctioned by the Institutional Review Board of EVMS, part of the Macon and Joan Brock Virginia Health Sciences at ODU. There were 214 IRB-approved active funded studies in FY25. Topics of study included hematology/oncology, allergy/asthma, infectious disease, neurology, pediatric surgery, cardiology, otolaryngology, pulmonology, gastroenterology, child abuse, endocrinology, dermatology, neonatology and mental health. Many of these studies are phase three clinical trials that bring cutting-edge treatments to CHKD patients years before they are available to the public. This fiscal year there were also new phase one trials opened, which allowed our patients the earliest possible access to novel therapies. There is an increased focus on registry studies across all disciplines. Data collected in these registries is intended to standardize optimal levels of care and lead to improved patient outcomes. The Nuss Procedure for the correction of pectus excavatum, developed at CHKD more than 30 years ago, continues to draw national attention from both patients and surgeons. The Children's Surgical Special Group surgeons continue to refine treatment techniques, publish research and outcomes and present their work at national meetings to strengthen the care and understanding of chest wall anomalies world-wide. In addition to surgery, innovative therapies offered through CHKD's Nuss Center include non-surgical, non-invasive modalities such as state-of-the-art bracing for pectus carinatum and vacuum therapy for pectus excavatum. CHKD is a member of Children's Oncology Group, an international research group that conducts clinical trials for children with cancer. As a member, CHKD has access to the latest protocols for treatment of childhood cancer, providing the community and region with the best practices and treatment results from more than 225 COG-member hospitals in North America, Australia, New Zealand, and Saudi Arabia. Our primary goal is to increase participation in clinical trials which we feel will advance the field of pediatric oncology. In FY25, CHKD had approximately 90 COG studies including LTF studies open to enrollment or undergoing data analysis. In all, approximately 200 CHKD patients participated in either open or follow-up COG studies in FY25. The hematology/oncology division had 18 research studies open that were not COG studies. In FY25 CHKD hosted seven continuing medical education events in various locations throughout the region, helping child health experts in our region keep up with their skills and their accreditation. Form 990, Part VI, Line 15a CHILDREN'S HEALTH SYSTEM ESTABLISHES THE COMPENSATION OF THE CEO AMY SAMPSON. Form 990, Part VI, Line 15b CHILDREN'S HEALTH SYSTEM AND CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS USE THE FOLLOWING PROCESS TO ESTABLISH COMPENSATION FOR OFFICERS AND KEY EMPLOYEES: AN INDEPENDENT COMPENSATION CONSULTANT APPROVED AND RETAINED BY THE COMPENSATION COMMITTEE OF THE BOARD ANNUALLY, USUALLY IN APRIL, PROVIDES EDUCATION AND PRESENTS TO THE FULL BOARD COMPARATIVE SALARIES AND SALARY RANGES FROM A DATABASE COMPRISED OF CHILDREN'S HOSPITALS AND OTHER APPLICABLE HOSPITALS FOR OFFICERS & EXECUTIVES FOR THE BOARD TO REVIEW. THE COMPENSATION COMMITTEE WITH THE AID OF THE CONSULTANT REVIEWS AND MAKES DECISIONS AS TO EXECUTIVE SALARIES OF CHKD AND ITS SUBSIDIARIES. THOSE SALARY CHANGES AND APPROVALS ARE CONTEMPORANEOUSLY DOCUMENTED BY MINUTES MAINTAINED BY THE COMPENSATION COMMITTEE AND SIGNED BY THE CHAIRMAN OF THE BOARD. Form 990, Part VI, Line 6 Classes of members or stockholders CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK CORPORATION WITH A SOLE MEMBER. THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS CHILDREN'S HEALTH SYSTEM, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS MANAGED BY ITS SOLE MEMBER, CHILDREN'S HEALTH SYSTEM, INC. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, MANAGES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. ACCORDINGLY, THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED. AS A VIRGINIA NON-STOCK CORPORATION, CHILDREN'S HEALTH SYSTEM, INC., HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. THE MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC., THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. ARE THE CLASS A MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. (I.E., THE THEN CURRENT MEMBERS IN GOOD STANDING OF THE NORFOLK CITY UNION OF THE KING'S DAUGHTERS, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION) AND THE CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM INC. (I.E., THE THEN CURRENT DIRECTORS ON THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC.). Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. Form 990, Part VI, Line 12c Conflict of interest policy CONFLICT POLICY CONSIDERATIONS: CHKD CONFLICT OF INTEREST POLICY INCLUDES OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES, KEY EMPLOYEES, ALL OTHER EMPLOYEES, PROFESSIONAL STAFF AND SUBSTANTIAL DONORS. ANNUALLY, A QUESTIONNAIRE IS DISTRIBUTED AND COLLECTED FROM OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES AND KEY EMPLOYEES. THE QUESTIONNAIRES ARE REVIEWED BY THE LEGAL DEPARTMENT. FOR KNOWN CONFLICTS, THE PERSON INVOLVED RECUSES HIMSELF OR HERSELF FROM DELIBERATIONS REGARDING THE TRANSACTION. VIOLATIONS OF THE CONFLICT OF INTEREST POLICY ARE REPORTED TO THE CHKD BOARD CHAIR OR THE CHKD COMPLIANCE OFFICER, AS APPLICABLE, AND MAY REQUIRE CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. Form 990, Part VI, Line 19 Required documents available to the public FINANCIAL STATEMENTS (PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC.) ALONG WITH GOVERNING DOCUMENTS OF THE ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY, ARE AVAILABLE TO THE PUBLIC THROUGH DIRECT INQUIRY AND REQUEST. Form 990, Part XI, Line 9 Other changes in net assets or fund balances GAIN/LOSS ON DERIVATIVE INVESTMENTS - -1248792; CHANGE IN DONOR RESTRICTED CONTRIBUTIONS - 3373179; Total - 2124387; CHILDREN'S MEDICAL TOWER LLC 601 CHILDRENS LANE NORFOLK VA 23507 452907147 LESSOR VA 132404 9321255 CHKD CHILDREN'S HEALTH SYSTEM INSURANCE LLC 601 CHILDRENS LANE NORFOLK VA 23507 INSURANCE SC 1189933 2896347 CHKD CHILDREN'S HEALTH SYSTEM INC 601 CHILDRENS LANE NORFOLK VA 23507 541278830 HEALTHCARE VA 501(c)(3) Type II NA false CHILDREN'S HEALTH FOUNDATION INC 601 CHILDRENS LANE NORFOLK VA 23507 541278865 SUPP CHKD VA 501(c)(3) Type I CHILDREN'S HEALTH SYSTEM true FORTIFY CHILDREN'S HEALTH LLC 1330 JEFFERSON PARK AVENUE CHARLOTTESVILLE VA 22903 831442745 HEALTHCARE VA NA Related false false REALTA HOLDINGS LLC 601 CHILDRENS LANE NORFOLK VA 23507 823954346 RESEARCH VA NA Related false false CHILDREN'S SURGICAL SPECIALTY GROUP INC 601 CHILDRENS LANE NORFOLK VA 23507 311610834 HEALTHCARE VA NA C Corporation false CHILDREN'S MEDICAL GROUP INC 601 CHILDRENS LANE NORFOLK VA 23507 541778786 HEALTHCARE VA NA C Corporation false CMG OF NORTH CAROLINA INC 601 CHILDRENS LANE NORFOLK VA 23507 561960102 HEALTHCARE NC NA C Corporation false false true true true true false false false false true true true true true true true true false false