2024-05-15T09:34:18-05:00 2023-06-30 861065772 DELOITTE TAX LLP 111 MONUMENT CIRCLE SUITE 4200 INDIANAPOLIS IN 46204 990 2022-07-01 951690977 CHILDREN'S HOSPITAL LOS ANGELES CHIL 3236602450 4650 SUNSET BOULEVARD LOS ANGELES CA 900270982 SCOTT LIEBERENZ SVP & CHIEF FINANCIAL OFFICER 3236602450 2024-05-14 1 SCOTT LIEBERENZ 999009999 0 SHAWNA M JANSONS P01222873 3174648600 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z PAUL S VIVIANO 4650 SUNSET BOULEVARD LOS ANGELES CA 900270982 1853370391 0 X WWW.CHLA.ORG X 1901 CA PROMOTION AND ADVANCEMENT OF CHILDREN'S HEALTH THROUGH PATIENT CARE, RESEARCH, AND EDUCATION. 16 12 7947 449 45557 5689 265364863 255482276 1156935400 1299165942 37331036 36869628 15692189 18421787 1475323488 1609939633 2251232 3286772 0 0 763094721 879864435 0 0 22712619 679834432 769778237 1445180385 1652929444 30143103 -42989811 2607463497 2696953883 871839461 954996735 1735624036 1741957148 X SEE SCHEDULE O. 0 0 1066384709 3286772 1255347934 MEDICAL CARE PROVIDED TO CHILDREN: IT IS THE POLICY OF THE HOSPITAL TO STRIVE TO MAINTAIN QUALITY HEALTH CARE DELIVERY IN A MANNER THAT RESPECTS THE DIGNITY OF THE INDIVIDUAL AND FAMILY, REGARDLESS OF THE ABILITY TO PAY. UNDER THE HOSPITAL'S POLICY, MEDICAL CARE MAY BE PROVIDED WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PEOPLE WHO ARE UNINSURED OR UNDERINSURED AND CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE. THE HOSPITAL PROVIDES ADDITIONAL COMMUNITY SUPPORT BY PROVIDING CARE TO PATIENTS WHO PARTICIPATE IN PROGRAMS, LIKE MEDI-CAL, THAT DO NOT PAY FULL CHARGES. APPROXIMATELY THREE-FOURTHS OF THE HOSPITAL'S PATIENTS ARE COVERED BY MEDI-CAL PROGRAMS. 67628582 25553583 GRADUATE MEDICAL EDUCATION PROVIDES TRAINING AND EDUCATION TO MEDICAL STUDENTS IN LOS ANGELES COUNTY WHO, IN TURN, PROVIDE SERVICES TO PATIENTS AT THE HOSPITAL. ALSO, INCLUDES EDUCATION REVENUE FROM THE RESIDENCY AND FELLOWSHIP PROGRAMS AT CHLA. THE HOSPITAL SUBSIDIZES A LARGE PART OF THE COST OF TRAINING PHYSICIANS, ALLIED HEALTH PROFESSIONALS, AND OTHER HEALTH CARE WORKERS IN ITS EMERGENCY ROOM, CLINICS, INPATIENT AREAS, AND OTHER PARTS OF ITS FACILITIES. 161504761 18264425 RESEARCH REVENUES FURTHER THE EXEMPT PURPOSE OF CHLA BY PROVIDING THE PATIENTS OF CHLA ACCESS TO NEW TECHNOLOGIES, DISCOVERIES AND MEDICATIONS FOR TREATMENT. RESULTS OF THIS RESEARCH IS DISSEMINATED THROUGH PUBLICATIONS IN SCIENTIFIC JOURNALS AND PRESENTATIONS BY THE PRINCIPAL INVESTIGATORS. THE HOSPITAL SUBSIDIZES A LARGE PART OF THE COST OF MEDICAL RESEARCH TAKING PLACE IN ITS FACILITIES. 4396334 4733049 OTHER PROGRAM SERVICE REVENUES ALSO INCLUDE RESIDENTS HOUSING AND MISCELLANEOUS TUITION AND EDUCATION INCOME. 4396334 4733049 1299914386 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 942 0 1 7947 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 1 0 X 16 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 AL AR CA FL GA HI IL KS KY MA MD MI MN MS NC NH NJ NM NY OR PA RI SC TN UT VA WI WV X JUDITH M KLINE 3233617865 4650 SUNSET BLVD MS 1 LOS ANGELES CA 900270980 PAUL S VIVIANO DIRECTOR, PRESIDENT AND CEO 55.00 0.00 X X 2041701 0 39178 MARK D KRIEGER MD DIRECTOR, FACULTY PHYSICIAN 20.00 0.00 X 818751 0 0 MATTHEW MATT KEEFER MD DIRECTOR, FACULTY PHYSICIAN 28.00 0.00 X 392207 0 0 ROBERT BOB E SHADDY MD DIRECTOR, FACULTY PHYSICIAN 10.00 0.00 X 233375 0 0 KEVIN H BROGAN DIRECTOR,CHAIR OF BOARD(START 07/22) 2.00 0.00 X X 0 0 0 ALIA TUTOR DIRECTOR 1.00 0.00 X 0 0 0 BURT LEVITCH DIRECTOR 1.00 0.00 X 0 0 0 BYRON H POLLITT JR DIRECTOR 1.00 0.00 X 0 0 0 CHERYL KUNIN FAIR DIRECTOR 1.00 0.00 X 0 0 0 CHRISTOPHER C MARTIN FAIA DIRECTOR 1.00 0.00 X 0 0 0 DIANA M BONTA RN DRPH DIRECTOR 1.00 0.00 X 0 0 0 EUGENE MITCH MITCHELL DIRECTOR 1.00 0.00 X 0 0 0 GEORGE H BROWN DIRECTOR 1.00 0.00 X 0 0 0 KIMBERLY KIM SHEPHERD DIRECTOR 1.00 0.00 X 0 0 0 LAURENCE LARRY E PAUL MD DIRECTOR 1.00 0.00 X 0 0 0 SHERI SANI DIRECTOR 1.00 0.00 X 0 0 0 M SCOTT LIEBERENZ SVP, CHIEF FINANCIAL OFFICER 55.00 0.00 X 924651 0 131394 JUDITH M KLINE CORPORATE SECRETARY 55.00 0.00 X 263442 0 19294 ALEXANDRA CARTER SVP, CHIEF DEVELOPMENT OFFICER 55.00 0.00 X 1199727 0 100774 GRACE OH SVP, GENERAL COUNSEL 55.00 0.00 X 951570 0 131175 NANCY LEE SVP, CHIEF CLINICAL OFFICER 55.00 0.00 X 1044635 0 13744 LARA KHOURI SVP, CHIEF STRATEGY OFFICER 55.00 0.00 X 905099 0 152587 JAMES STEIN MD SVP, CHIEF MEDICAL OFFICER 55.00 0.00 X 877994 0 92526 MAMOON SYED SVP, CHIEF PEOPLE OFFICER 55.00 0.00 X 641291 0 105892 CONRAD BAND SVP, CHIEF INFORMATION OFFICER 55.00 0.00 X 481200 0 93806 DEBORAH BRAIDIC VP,CHIEF COMM OFF&SPC PROJECTS 55.00 0.00 X 432446 0 65085 HANNA SONG SVP, CHIEF DIVERSITY OFFICER 55.00 0.00 X 357866 0 69541 RUTH M AREVALO VP, HEALTH SYSTEM DEV & INTEG 55.00 0.00 X 480152 0 80990 PAT R LEVITT MD FACULTY PHYSICIAN 55.00 0.00 X 815875 0 0 MICHAEL GORAN MD FACULTY PHYSICIAN 28.00 0.00 X 477348 0 0 JODI SHIRLYN OGDEN RIVERA VP, RESEARCH OPERATIONS 55.00 0.00 X 473960 0 78134 MARILYN HO CHIEF OF STAFF (END 02/22) 55.00 0.00 X 447936 0 3179 14261226 0 1177299 2296 0 1 1 AMN HEALTHCARE INC 12400 HIGH BLUFF DR SAN DIEGO CA 92130 HEALTHCARE WORKFORCE MANAGEMENT 24424732 SODEXO INC & AFFILIATES 9801 WASHINGTON BLVD GAITHERSBURG MD 20878 FOOD AND HOUSEKEEPING SERVICES 20942833 PCAM LLC 3165 GARFIELD AVE LOS ANGELES CA 90040 PARKING SERVICES 5526300 UNIVERSAL BUILDING MAINTENANCE LLC 161 WASHINGTON STREET SUITE 600 CONSHOHOCKEN PA 19428 JANITORIAL SERVICES 4187346 BRASCIA BUILDERS INC 100 E WARDLOW ROAD LONG BEACH CA 90807 CONSTRUCTION SERVICES 3597555 180 5845458 86177900 163458918 1724840 255482276 PATIENT REVENUE 621110 1255347934 1255347934 RESEARCH REVENUE 900099 18264425 18264425 GRADUATE MEDICAL EDU. 900099 17917971 17917971 EDUCATION REVENUE 900099 7635612 7635612 1299165942 32059346 45557 32013789 2048173 2048173 3416788 1087059 2329729 2329729 2329729 244246881 239415848 20751 4831033 -20751 4810282 4810282 69117 5845458 2907100 -2837983 -2837983 CAFETERIA 722514 4587302 4587302 JV INCOME 900099 3926450 3926450 PARKING GARAGE 812930 3407740 3407740 4960376 806599 4153777 16881868 1609939633 1303898991 45557 50512809 X 3286772 3286772 11852244 3029440 7882401 940403 737148059 578227335 148840990 10079734 13494209 10848380 2406018 239811 71034371 53136069 16796288 1102014 46335552 37341265 8238734 755553 3344686 3344686 2316036 163083 2152953 482779 482779 358901 358901 1069881 1069881 262086023 171753996 84580951 5751076 3424151 3241829 182322 229700728 215313322 13917879 469527 41432294 34620952 6137582 673760 348849 348849 20975514 18228013 2743499 4002 2752274 1706257 857914 188103 3768337 2497912 666187 604238 19685036 18809120 875916 69680298 66623752 3056546 8486995 6959090 1461054 66851 QUALITY ASSURANCE FEES 62630948 62630948 0 0 LEASE EXPENSE 11359894 4260379 7099515 0 DUES AND SUBSCRIPTIONS 5154186 791524 3060519 1302143 TAXES AND LICENSES 3333153 588130 2744955 68 17387274 5507969 11526291 353014 1652929444 1299914386 330302439 22712619 9200 9250 71706472 41216048 111740446 83796123 252747517 294302695 0 0 500000 500000 16054558 15978207 13125821 12479112 2093780848 1089003589 1015256726 1004777259 858165115 848345593 5760355 6051188 262397287 389498408 2607463497 2696953883 218665778 267462558 19511917 15853435 453871287 442851552 179790479 228829190 871839461 954996735 X 1175779719 1143085307 559844317 598871841 1735624036 1741957148 2607463497 2696953883 X -42989811 45475515 3847408 X 0 1 X 1 1 1 X 195381505 165853687 159208727 234853900 253502299 1008800118 195381505 165853687 159208727 234853900 253502299 1008800118 87760294 921039824 12516139 19608331 17230369 31615448 37478750 118449037 28268 36607 64875 12321947 46214471 14984184 12625801 16881868 103028271 1230342301 0.74860 0.80050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 358901 358901 0 PART II-B, LINE 1: 1. NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH) - MEMBERSHIP DUES 2. HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) - MEMBERSHIP DUES 3. CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION (CCHA) - MEMBERSHIP DUES 4. CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS) - MEMBERSHIP DUES 5. THE MARGOLIN GROUP, INC. - STATE LOBBYING ACTIVITY 6. ASSOCIATION OF AMERICAN MEDICAL COLLEGES (AAMC) - MEMBERSHIP DUES 7. CALIFORNIA ADVOCACY LLC - STATE LOBBYING ACTIVITY PART II-B: CHILDREN'S HOSPITAL LOS ANGELES DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS), ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 664222760 103163226 57259567 108267665 716377888 752519746 65433713 -68342348 85388351 664222760 650266946 58919128 114386968 71053296 752519746 613593715 79575519 18292383 61194671 650266946 607373502 59730321 13083122 66593230 613593715 0.56190 0.43810 0 0 138422121 138422121 1157818078 547985128 609832950 677879320 541018461 136860859 119661329 119661329 1004777259 HOSPITAL FEE PROGRAM RECEIVABLE 293956470 CAPITAL ACCUMULATION ACCOUNT 5087416 RECEIVABLES UNDER GOVERNMENT PROGRAM 29438431 RIGHT-OF-USE ASSET 46960013 MEDI-CAL COST REPORT SETTLEMENT 13208360 OTHER 847718 389498408 HOSPITAL FEE PROGRAM LIABILITY 68391119 LIABILITY UNDER UNITRUST AGREEMENTS 1722683 INTEREST RATE SWAP 3896096 LEASE LIABILITY - LONG TERM 34836534 PAYABLES UNDER GOVERNMENT PROGRAMS 19573085 LINE OF CREDIT 50000000 OTHER NONCURRENT LIABILITIES 50409673 228829190 X PART V, LINE 4: ENDOWMENT FUNDS ARE INTENDED TO BE USED ACCORDING TO THE DONOR'S WISHES WHICH VARY FROM ONGOING PROGRAM SUPPORT, TO SPECIFIC RESEARCH, TO BUILDING OR ASSET ACQUISITION, OR SUPPORT OF ACADEMIC CHAIRS WITHIN THE ORGANIZATION. PART X, LINE 2: THE HOSPITAL IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS CHARITABLE ORGANIZATIONS QUALIFYING UNDER SECTION 501(C)(3) AND SIMILAR CALIFORNIA STATUTES. INCOME FROM THE HOSPITAL'S LIMITED LIABILITY CORPORATIONS, CHLA ESBT AND CHLA MEDICAL FOUNDATION (C CORPORATION), ARE TAXABLE TO CHLA. THE INCOME TAX PROVISION IS RECORDED IN OTHER EXPENSES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS AND IS IMMATERIAL FOR THE YEARS ENDED JUNE 30, 2023 AND 2022. THE HOSPITAL ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH ASC 740, INCOME TAXES. IT IS THE HOSPITAL'S POLICY TO CLASSIFY THE EXPENSE RELATED TO INTEREST AND PENALTIES, IF ANY, TO BE PAID ON UNDERPAYMENTS OF INCOME TAXES WITHIN OTHER EXPENSES. THE HOSPITAL HAS EVALUATED ITS UNCERTAIN TAX POSITIONS, AND THERE WERE NO MATERIAL PENALTIES OR INTEREST RECOGNIZED FOR THE YEARS ENDED JUNE 30, 2023 AND 2022. THE HOSPITAL'S INCOME TAX RETURNS FOR THE YEARS ENDED JUNE 30, 2019, THROUGH JUNE 30, 2023, ARE SUBJECT TO EXAMINATION BY BOTH THE FEDERAL AND STATE TAX JURISDICTIONS. WALK & PLAY LA 492997 492997 0 9938 114869 278 21853 81415 GALA 5421578 5352461 69117 0 0 1292448 512844 750723 122732 5914575 5845458 69117 9938 1407317 513122 772576 204147 2907100 -2837983 1 1 X 1 X 400.000000000000 1 X 600.000000000000 1 1 0 1 1 1 352 414302 0 414302 0.00030 5 261876 446862446 380710638 66151808 0.04000 6 262228 447276748 380710638 66566110 0.04030 14 694724 11602027 0 11602027 0.00700 8 8456 74944141 36910999 38033142 0.02300 1 2649 1915247 0 1915247 0.00120 1 0 163756837 99057948 64698889 0.03910 2 200 962700 0 962700 0.00060 26 706029 253180952 135968947 117212005 0.07090 32 968257 700457700 516679585 183778115 0.11120 1 61 63014 63014 0.00000 2 150000 777847 237000 540847 0.00030 2 32 609380 0 609380 0.00040 5 150093 1450241 237000 1213241 0.00070 1 49243335 0 3720321 2514172 1206149 X 1 1 1 1 CHILDREN'S HOSPITAL LOS ANGELES 4650 SUNSET BLVD LOS ANGELES CA 900270982 WWW.CHLA.ORG 930000032 X X X X X X CHILDREN'S HOSPITAL LOS ANGELES 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V, SECTION C, SUPPLEMENTAL INFORMATION X 1 21 1 SEE PART V, SECTION C, SUPPLEMENTAL INFORMATION 0 1 X 400.000000000000 600.000000000000 X X 1 1 X X X X 1 X HTTPS://WWW.CHLA.ORG/BILLING-AND-INSURANCE-PAYING-CARE X HTTPS://WWW.CHLA.ORG/BILLING-AND-INSURANCE-PAYING-CARE X HTTPS://WWW.CHLA.ORG/BILLING-AND-INSURANCE-PAYING-CARE X X X X X X 1 X 0 X X X X 1 X 0 0 CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 5: THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY THE CENTER FOR NONPROFIT MANAGEMENT (CNM) AND THE OFFICE OF COMMUNITY AFFAIRS AT CHILDREN'S HOSPITAL LOS ANGELES IN COLLABORATION WITH OTHER INSTITUTIONS, ORGANIZATIONS AND AGENCIES AS WELL AS MEMBERS OF THE CHILDREN'S HOSPITAL COMMUNITY BENEFIT ADVISORY COMMITTEE.THE CNM TEAM HAS EXTENSIVE EXPERIENCE THROUGH BEING INVOLVED IN AND CONDUCTING MORE THAN 30 CHNAS FOR HOSPITALS THROUGHOUT LOS ANGELES COUNTY AND SAN DIEGO COUNTY. THE CNM TEAM CONDUCTED 2019 CHNAS FOR CITRUS VALLEY HEALTH PARTNERS, THE GLENDALE HOSPITALS COLLABORATIVE, CITY OF HOPE, HUNTINGTON HOSPITAL IN PASADENA, CA, AND TWO OF THE LOCAL HOSPITALS WITHIN THE PROVIDENCE HEALTH SYSTEM, AS WELL AS CHLA'S PREVIOUS 2016 & 2019 CHNAS.CHLA HAS CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN AN EFFORT TO UNDERSTAND THE HEALTH AND SOCIAL NEEDS OF THE COMMUNITY AND AS REQUIRED BY STATE AND FEDERAL LAW. THE CHNA IS A PRIMARY TOOL USED BY THE HOSPITAL TO DETERMINE ITS COMMUNITY BENEFIT PLAN. THIS ASSESSMENT INCORPORATES COMPONENTS OF PRIMARY DATA COLLECTION AND SECONDARY DATA ANALYSIS THAT FOCUS ON THE HEALTH AND SOCIAL NEEDS OF THE SERVICE AREA. SOURCES OF DATA INCLUDE THE U.S. CENSUS 2020 DECENNIAL CENSUS AND AMERICAN COMMUNITY SURVEY, CALIFORNIA HEALTH INTERVIEW SURVEY, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, CALIFORNIA EMPLOYMENT DEVELOPMENT DEPARTMENT, LOS ANGELES COUNTY HEALTH SURVEY, LOS ANGELES HOMELESS SERVICES AUTHORITY, CDC NATIONAL HEALTH STATISTICS, NATIONAL CANCER INSTITUTE, U.S. DEPARTMENT OF EDUCATION, AND OTHERS. WHEN PERTINENT, THESE DATA SETS ARE PRESENTED IN THE CONTEXT OF CALIFORNIA STATE. THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT METHODOLOGY AND PROCESS INVOLVED THE COLLECTION OF BOTH SECONDARY DATA AND PRIMARY DATA. APPROXIMATELY 300 SECONDARY DATA INDICATORS ON A VARIETY OF HEALTH, SOCIAL, ECONOMIC, AND ENVIRONMENTAL TOPICS WERE COLLECTED BY ZIP CODE, SERVICE PLANNING AREA (SPA), COUNTY, AND STATE LEVELS (AS AVAILABLE). IN ADDITION, PRIMARY DATA COLLECTION INCLUDED AN ONLINE SURVEY, A YOUTH-LED PHOTOVOICE PROJECT WITH YOUTH AND YOUNG ADULT REPRESENTATION FROM ALL OVER LOS ANGELES COUNTY AND A COMMUNITY FORUM WITH INDIVIDUALS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. ADDITIONALLY, INPUT WAS OBTAINED FROM LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH OFFICIALS. FOR THE COMMUNITY FORUM, COMMUNITY STAKEHOLDERS IDENTIFIED BY KEY DEPARTMENTS AT CHILDREN'S HOSPITAL LOS ANGELES WERE CONTACTED AND ASKED TO PARTICIPATE IN THE PRIORITIZATION OF NEEDS PROCESS. PARTICIPANTS INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS, OR REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY.A NUMBER OF INSTITUTIONS, ORGANIZATIONS, AND DEPARTMENTS CONTRIBUTED TIME AND RESOURCES TO ASSIST WITH THE ASSESSMENT. THIS LIST WHICH INCLUDED THE LA COUNTY DEPARTMENT OF PUBLIC HEALTH IS FOUND IN APPENDIX C OF THE 2022 CHNA FOUND ON WWW.CHLA.ORG/COMMUNITY. CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 11: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), HEALTH AND SOCIAL NEEDS WERE IDENTIFIED THROUGH AN EXAMINATION OF PRIMARY AND SECONDARY DATA AND THEN PRIORITIZED THROUGH A STRUCTURED PROCESS USING THE RELATIVE WORTH METHOD. THE FOLLOWING PRIORITIZED HEALTH NEEDS WERE IDENTIFIED: MENTAL HEALTH, HOMELESSNESS/HOUSING, ECONOMIC SECURITY/POVERTY, COMMUNICABLE/INFECTIOUS DISEASES (INCLUDING COVID-19), PATIENT/FAMILY-CENTERED HEALTH CARE, HEALTH SERVICES COMMUNICATION, OBESITY, AND FOOD SECURITY.TO ADDRESS THESE NEEDS, WE OPERATE THROUGH THE FOLLOWING DOMAINS: 1) HEALTH ACCESS, 2) ECONOMIC ADVANCEMENT AND 3) COMMUNITY GROWTH. 1) HEALTH ACCESS DOMAIN:MENTAL HEALTH:-CHLA'S BEHAVIORAL HEALTH INSTITUTE, DEPARTMENT OF PSYCHOLOGY, DIVISION OF DEVELOPMENTAL-BEHAVIORAL PEDIATRICS, DEVELOPMENTAL AND BEHAVIORAL OUTPATIENT CENTER AND OTHER PROGRAMS WILL CONTINUE ADVANCING INITIATIVES THAT IMPROVE THE BEHAVIORAL AND DEVELOPMENTAL HEALTH OF CHILDREN.PATIENT/FAMILY-CENTERED HEALTH CARE:-WE PLAN TO CONTINUE WORKING WITH COMMUNITY HEALTH PROMOTION ORGANIZATIONS AND COMMUNITY HEALTH PROMOTERS TO PARTNER AND CONCEPTUALIZE MODELS THAT INTEGRATE NAVIGATION OF COMMUNITY RESOURCES AND SERVICES INTO THE HEALTH CARE SYSTEM.COMMUNICABLE/INFECTIOUS DISEASES (INCLUDING COVID-19): -CHLA WILL CONTINUE TO HOST ANNUAL COMMUNITY VACCINATION CLINICS FOR INFLUENZA AND WILL CONTINUE TO EXPLORE PARTNERSHIP OPPORTUNITIES TO CONTINUE THIS EFFORT.HEALTH SERVICES COMMUNICATION:-WE PLAN TO CONTINUE DEEPENING RELATIONS AND INCREASING PARTNERSHIPS TO EXTEND THE PROVISION OF HEALTH PROMOTION AND RESOURCE INFORMATION TO COMMUNITY MEMBERS AND COMMUNITY ORGANIZATIONS THROUGH MULTIPLE PLATFORMS.OBESITY:-CHLA PLANS TO CONTINUE TO EXPLORE OPPORTUNITIES TO APPLY ITS CLINICAL EXPERTISE AND INITIATIVES TO EXTEND ITS PROGRAMS AND SERVICES TO THE COMMUNITY, INCLUDING BUT NOT LIMITED TO, NUTRITION PROGRAMS, RESEARCH WITHIN THE CHLA DIABETES AND OBESITY PROGRAM TO DEVELOP STRATEGIES TO REDUCE THE BURDEN OF OBESITY AND DIABETES IN CHILDREN AND OTHER CHLA WEIGHT MANAGEMENT PROGRAMS AND CLINICS. 2) ECONOMIC ADVANCEMENT DOMAIN:ECONOMIC SECURITY/POVERTY:-WE CONTINUE TO PROVIDE WORKFORCE DEVELOPMENT OPPORTUNITIES TO YOUTH IN DIVERSE COMMUNITIES THROUGH PROGRAMS, INCLUDING BUT NOT LIMITED TO: LATINO AND AFRICAN AMERICAN HIGH SCHOOL INTERNSHIP PROGRAM (LA HIP) STEM AND HEALTH RESEARCH INTERNSHIPS, PROJECT SEARCH JOB-READINESS PROGRAM FOR YOUTH WITH DEVELOPMENTAL DISABILITIES, CAMP CHLA- HIGH-SCHOOL HEALTH CAREER EXPLORATION PROGRAM AND CAREERS IN HEALTH AND MENTORSHIP (CHAMP) HEALTHCARE ADMINISTRATION FOCUSED INTERNSHIP PROGRAM.-WE ARE CONTINUING OUR SUCCESSFUL CAREERS IN HEALTH AND MENTORSHIP (CHAMP) PROGRAM TO INCREASE THE SCOPE OF THE TRAINING PROVIDED FOR INTERNS TO MAXIMIZE THEIR ABILITY TO GAIN EMPLOYMENT FOLLOWING PARTICIPATION IN THE PROGRAM. -WE CONTINUE TO PROVIDE WORKFORCE DEVELOPMENT OPPORTUNITIES TO YOUTH IN DIVERSE COMMUNITIES THROUGH PROGRAMS SUCH AS: LATINO AND AFRICAN AMERICAN HIGH SCHOOL INTERNSHIP PROGRAM (LA HIP) STEM AND HEALTH RESEARCH INTERNSHIPS, PROJECT SEARCH JOB-READINESS PROGRAM FOR YOUTH WITH DEVELOPMENTAL DISABILITIES AND CAMP CHLA- HIGH-SCHOOL HEALTH CAREER EXPLORATION PROGRAM. -THE HOSPITAL IS WORKING TO ADVANCE CURRENT EFFORTS TO EXPAND INTERNSHIPS, MENTORSHIPS AND WORK EXPERIENCE OPPORTUNITIES FOR YOUNG ADULTS AND UNEMPLOYED INDIVIDUALS AND WILL COLLABORATE WITH COMMUNITY AND CIVIC STAKEHOLDERS TO MAXIMIZE ECONOMIC OPPORTUNITY STRATEGIES THAT ADDRESS HEALTH DISPARITIES AND THE SOCIAL DETERMINANTS OF HEALTH.3) COMMUNITY GROWTH DOMAIN:FOOD SECURITY: -WE AIM TO ADDRESS FOOD INSECURITY BY SUPPORTING FOOD RECLAMATION, FRESH PRODUCE DISTRIBUTION AND MEAL PROGRAMS FOR FAMILIES IN NEED, CONDUCTED IN PARTNERSHIP WITH COMMUNITY STAKEHOLDERS. -WE SUPPORT THE DEVELOPMENT OF COMMUNITY GARDENS AND GREEN SPACES. -WE PROVIDE SUPPORT TO LOCAL NONPROFITS ENGAGING IN WORK TO ADVANCE HEALTH EQUITY IN OUR COMMUNITIES. WHILE "HOMELESSNESS/HOUSING" WAS ANOTHER HEALTH AND SOCIAL NEED IDENTIFIED IN PRIORITIZED LIST, THERE ARE OTHER LOCAL AND REGIONAL COMMUNITY ORGANIZATIONS WHOSE MISSION AND RESOURCES ARE WELL-ALIGNED TO ADDRESS THIS NEED THAT HAVE BEEN IDENTIFIED. CHLA WILL STILL CONTINUE TO EXPLORE FUTURE OPPORTUNITIES TO PARTNER OR COLLABORATE REGARDING THIS NEED. PART V, SECTION B, LINE 7A: THE COMMUNITY HEALTH NEEDS ASSESSMENT ("CHNA") OF THE HOSPITAL CAN BE LOCATED AT THE FOLLOWING WEB ADDRESS: HTTPS://WWW.CHLA.ORG/COMMUNITY-IMPACT-REPORTS-AND-PUBLICATIONS PART V, SECTION B, LINE 10A: THE IMPLEMENTATION STRATEGY OF THE HOSPITAL CAN BE LOCATED AT THE FOLLOWING WEB ADDRESS: HTTPS://WWW.CHLA.ORG/COMMUNITY-IMPACT-REPORTS-AND-PUBLICATIONS 7 1 - ARCADIA 468 E SANTA CLARA ST ARCADIA CA 91006 OUTPATIENT CLINIC 2 - SOUTH BAY 3440 TORRANCE BLVD SUITE 100 TORRANCE CA 90503 OUTPATIENT CLINIC 3 - WILSHIRE 3250 WILSHIRE BLVD LOS ANGELES CA 90010 UNIVERSITY CENTER FOR EXCELLENCE IN DEVELOPMENTAL DISABILITIES CLINIC 4 - SANTA MONICA 1419 19TH ST SANTA MONICA CA 90404 OUTPATIENT CLINIC 5 - VALENCIA 23838 VALENCIA BLVD SUITE 140 VALENCIA CA 91355 OUTPATIENT CLINIC 6 - ENCINO 5363 BALBOA BLVD SUITE 121 ENCINO CA 91316 OUTPATIENT CLINIC 7 - BAKERSFIELD 9500 STOCKDALE HWY 104 BAKERSFIELD CA 93311 OUTPATIENT CLINIC PART I, LINE 6A: CHLA HAS PREPARED A COMMUNITY IMPACT REPORT AND IT CAN BE FOUND ON OUR WEBSITE AT THE FOLLOWING LINK: HTTPS://WWW.CHLA.ORG/COMMUNITY-IMPACT-REPORTS-AND-PUBLICATIONS PART I, LINE 7: THE ORGANIZATION USES THE COST-TO-CHARGE RATIO METHODOLOGY TO DETERMINE UNREIMBURSED COST OF CARE PROVIDED TO MEDI-CAL PATIENTS. ALL OTHER COSTS ARE ACCOUNTED FOR USING AN INTERNAL SOFTWARE CALLED CBISA (COMMUNITY BENEFIT INVENTORY FOR SOCIAL ACCOUNTABILITY), WHICH FEATURES A BLEND OF BOTH STATISTICAL AND NARRATIVE INFORMATION. IN OCTOBER 2010, CMS APPROVED LEGISLATION ENACTED BY THE STATE OF CALIFORNIA THAT PROVIDED FOR SUPPLEMENTAL MEDI-CAL PAYMENTS TO BE PAID TO CERTAIN HOSPITALS FROM FUNDS COLLECTED FROM PARTICIPATING HOSPITALS UNDER THE STATE'S QUALITY ASSURANCE FEE PROGRAM. SUCH AMOUNTS WERE ALLOCATED AND PAID TO CHLA BASED ON PRIOR YEAR PATIENT DATA, WHICH INCLUDES MEDI-CAL PATIENTS. PART II, COMMUNITY BUILDING ACTIVITIES: THE HOSPITAL SPONSORS VARIOUS COMMUNITY SERVICES TO BENEFIT THE PHYSICALLY, MENTALLY, AND GENETICALLY DISABLED AS PART OF ITS CHARITABLE MISSION. THESE SERVICES INCLUDE PARENTAL COUNSELING, EDUCATIONAL SEMINARS, FAMILY SUPPORT GROUPS, AND AN OUTREACH ORGANIZATION FOR FAMILIES ADMINISTERED BY THE HOSPITAL IN AN AGENCY RELATIONSHIP AND FUNDED BY THE STATE OF CALIFORNIA. ADDITIONALLY, A LARGE NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, TELEPHONE INFORMATION SERVICES, AND PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY. CHILDREN'S HOSPITAL LOS ANGELES OFFERS MANY COMMUNITY SERVICES AND PROGRAMS IN RESPONSE TO THE NEEDS OF CHILDREN, YOUTH AND FAMILIES. COMMUNITY BENEFIT SERVICES AND ACTIVITIES ARE DESIGNED TO PROVIDE TREATMENT AND PROMOTE HEALTH AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. OUR OBJECTIVES ARE TO IMPROVE ACCESS TO HEALTH CARE SERVICES, ENHANCE PUBLIC HEALTH OF THE COMMUNITY, ADVANCE MEDICAL OR HEALTH CARE KNOWLEDGE THAT PROVIDES PUBLIC BENEFIT, AND RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS.THE CHLA COMMUNITY HEALTH OUTREACH NETWORK - DUE TO CHANGING COVID-19 RESTRICTIONS, CHLA COMMUNITY HEALTH OUTREACH NETWORK IN-PERSON OUTREACH HAS BEEN LIMITED AND HAS REMAINED PRIMARILY IN A VIRTUAL FORMAT. CHLA'S OFFICE OF COMMUNITY AFFAIRS CONTINUED TO UTILIZE THE COMMUNITY IMPACT VIRTUAL SERIES TO VIRTUALLY PROVIDE HEALTH EDUCATION AND HEALTH PROMOTION INFORMATION TO THE COMMUNITY ORGANIZATION AND COMMUNITY MEMBERS INCLUDING TOPICS SUCH AS NUTRITION FOR HEALTHY KIDS, HOW TO TALK TO OUR KIDS ABOUT TRAUMATIC EVENTS, THE DANGERS OF FENTANYL, SCHOOL IMMUNIZATIONS REACHING OVER 400 INDIVIDUALS INCLUDING REPRESENTATIVES FROM COMMUNITY ORGANIZATIONS, COMMUNITY MEMBERS AND FAMILIES VIA 13 VIRTUAL SESSIONS.CAREERS IN HEALTH AND MENTORSHIP PROGRAM (CHAMP) CHLA'S CHAMP PROVIDES UNDERREPRESENTED ADULTS FROM THE LOS ANGELES COMMUNITY THE OPPORTUNITY TO PARTICIPATE IN A SERIES OF COMPREHENSIVE JOB READINESS AND LEADERSHIP DEVELOPMENT WORKSHOPS THAT ARE LED BY CHLA STAFF AND HOSPITAL PARTNERS. SINCE ITS INCEPTION, OVER 250 YOUNG ADULTS ENTERED THE CHLA CHAMP. AFTER SUCCESSFULLY COMPLETING THE WORKSHOP SERIES, "CHAMPERS" ARE PLACED IN NONCLINICAL, PROJECT-BASED INTERNSHIPS IN PARTICIPATING HOSPITAL DEPARTMENTS. STUDENTS ENGAGED WITH MANY DEPARTMENTS INCLUDING INNOVATIONS, COMMUNITY AFFAIRS, THE SABAN RESEARCH INSTITUTE, DIVERSITY, EQUITY & INCLUSION AND PATIENT EXPERIENCE.CAMP CHLA, A HEALTH CAREERS EXPLORATION PROGRAM, PROVIDES HIGH SCHOOL STUDENTS A FIRSTHAND LOOK INTO THE DAILY LIVES OF HEALTH CARE PROFESSIONALS. SINCE ITS INCEPTION IN 2006, OVER 2,000 STUDENTS FROM OUR COMMUNITY HAVE HAD THE OPPORTUNITY TO: JOB-SHADOW HEALTH CARE PROFESSIONALS, PARTICIPATE IN HANDS-ON SKILLS LABS, GAIN EXPOSURE TO DIFFERENT HEALTH CAREER PATHS AND SHARE THEIR EXPERIENCES WITH OTHER CAMPERS. TWO SESSIONS OF 60 STUDENTS RETURNED TO AN IN-PERSON FORMAT. STUDENTS ENGAGED WITH MANY PEDIATRIC DEPARTMENTS INCLUDING GENERAL PEDIATRICS, ED, NEONATOLOGY, HEMATOLOGY/ONCOLOGY, ORTHOPEDICS, SURGERY AND REHABILITATION.CHLA CONTINUES TO DEEPEN ITS COMMITMENT TO THE COMMUNITY AT LARGE THROUGH THE INNOVATION AND IMPLEMENTATION OF ITS COMMUNITY SERVICES AND PROGRAMS TO IMPROVE THE COMMUNITY'S HEALTH AND SAFETY. THROUGH OUR COMMUNITY BENEFIT PROCESS WE WILL GAIN A BETTER UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH; AND INNOVATE AND IMPLEMENT SERVICES AND PROGRAMS TO IMPROVE THE HEALTH AND SAFETY OF THE COMMUNITY. PART III, LINE 2: THE HOSPITAL RECOGNIZES PATIENT SERVICE REVENUE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED FOR THOSE PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). PATIENTS COVERED BY INSURANCE, BUT REQUIRED TO PAY DEDUCTIBLES OR COPAYMENTS, ARE CONSIDERED TO BE UNINSURED FOR THOSE PORTIONS. BASED ON HISTORICAL EXPERIENCE, THE HOSPITAL BELIEVES THAT A SIGNIFICANT PORTION OF ITS PATIENT ACCOUNTS WILL BE UNCOLLECTIBLE. THUS, IT RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO PATIENT ACCOUNTS IN THE PERIOD THE SERVICES ARE PROVIDED. BAD DEBTS ARE NOT INCLUDED AS COMMUNITY BENEFITS AND CONTAIN -0- CHARITY COST. BAD DEBTS ARE CALCULATED BASED ON UNCOLLECTIBLE ACCOUNTS NET OF CONTRACTUALS. THE METHODOLOGY USED TO ARRIVE AT THE BAD DEBT REPORTED FOR THE FISCAL YEAR IS DERIVED FROM INCREMENTAL RESERVE INCREASES BASED ON THE AGE OF BILLED ACCOUNTS, PAYOR, AND PATIENT TYPE. PART III, LINE 3: THE HOSPITAL RECOGNIZES PATIENT SERVICE REVENUE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED FOR THOSE PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). PATIENTS COVERED BY INSURANCE, BUT REQUIRED TO PAY DEDUCTIBLES OR COPAYMENTS, ARE CONSIDERED TO BE UNINSURED FOR THOSE PORTIONS. BASED ON HISTORICAL EXPERIENCE, THE HOSPITAL BELIEVES THAT A SIGNIFICANT PORTION OF ITS PATIENT ACCOUNTS WILL BE UNCOLLECTIBLE. THUS, IT RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO PATIENT ACCOUNTS IN THE PERIOD THE SERVICES ARE PROVIDED. BAD DEBTS ARE NOT INCLUDED AS COMMUNITY BENEFITS AND CONTAIN -0- CHARITY COST. BAD DEBTS ARE CALCULATED BASED ON UNCOLLECTIBLE ACCOUNTS NET OF CONTRACTUALS. PART III, LINE 4: FOOTNOTE 1:NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS, INCLUDING ESTIMATED VARIABLE CONSIDERATION FOR RETROACTIVE ADJUSTMENTS DUE TO TERMS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS, SETTLEMENT OF AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE ESTIMATED AND ACCRUED IN THE PERIOD IN WHICH THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED.THE HOSPITAL DETERMINES PERFORMANCE OBLIGATIONS BASED ON THE NATURE OF THE SERVICES PROVIDED. PATIENT SERVICE REVENUE IS RECOGNIZED FOR PERFORMANCE OBLIGATIONS SATISFIED OVER TIME BASED ON ACTUAL CHARGES INCURRED IN RELATION TO TOTAL EXPECTED CHARGES. THE HOSPITAL BELIEVES THAT THIS METHOD PROVIDES A FAITHFUL DEPICTION OF THE TRANSFER OF SERVICES OVER THE TERM OF PERFORMANCE OBLIGATIONS BASED ON THE INPUTS NEEDED TO SATISFY THE OBLIGATIONS. GENERALLY, PERFORMANCE OBLIGATIONS SATISFIED OVER TIME RELATE TO PATIENTS IN THE HOSPITAL RECEIVING INPATIENT ACUTE CARE SERVICES. PERFORMANCE OBLIGATIONS ARE MEASURED FROM ADMISSION TO THE POINT WHEN THERE ARE NO FURTHER SERVICES REQUIRED FOR THE PATIENT, WHICH IS GENERALLY THE TIME OF DISCHARGE. REVENUE IS RECOGNIZED FOR PERFORMANCE OBLIGATIONS SATISFIED AT A POINT IN TIME, WHICH GENERALLY RELATE TO PATIENTS RECEIVING OUTPATIENT SERVICES, WHEN (1) SERVICES ARE PROVIDED AND (2) THE HOSPITAL DOES NOT BELIEVE THE PATIENT REQUIRES ADDITIONAL SERVICES. BECAUSE THE PATIENT SERVICE PERFORMANCE OBLIGATIONS RELATE TO CONTRACTS WITH A DURATION OF LESS THAN ONE YEAR, THE HOSPITAL HAS ELECTED TO APPLY THE OPTIONAL EXEMPTION PROVIDED IN FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC) 606-10-50-14(A), REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606), AND, THEREFORE, THE HOSPITAL IS NOT REQUIRED TO DISCLOSE THE AGGREGATE AMOUNT OF THE TRANSACTION PRICE ALLOCATED TO PERFORMANCE OBLIGATIONS THAT ARE UNSATISFIED OR PARTIALLY UNSATISFIED AT THE END OF THE REPORTING PERIOD. THE UNSATISFIED OR PARTIALLY UNSATISFIED PERFORMANCE OBLIGATIONS REFERRED TO ABOVE ARE PRIMARILY RELATED TO INPATIENT ACUTE CARE SERVICES AT THE END OF THE REPORTING PERIOD. THE PERFORMANCE OBLIGATIONS FOR THESE CONTRACTS ARE GENERALLY COMPLETED WHEN THE PATIENTS ARE DISCHARGED, WHICH GENERALLY OCCURS WITHIN DAYS OR WEEKS OF THE END OF THE REPORTING PERIOD, EXCEPT FOR CERTAIN PATIENTS WHO MAY HAVE MUCH LONGER LENGTHS OF STAY.THE HOSPITAL DETERMINES THE TRANSACTION PRICE, WHICH INVOLVES SIGNIFICANT ESTIMATES AND JUDGMENT, BASED ON GROSS CHARGES UTILIZING STANDARD BILLING RATES FOR SERVICES PROVIDED, REDUCED BY CONTRACTUAL ADJUSTMENTS PROVIDED TO THIRD-PARTY PAYERS, DISCOUNTS PROVIDED TO UNINSURED PATIENTS, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO UNINSURED OR UNDERINSURED PATIENTS. THE HOSPITAL DETERMINES ITS ESTIMATES OF CONTRACTUAL ADJUSTMENTS AND DISCOUNTS BASED ON CONTRACTUAL AGREEMENTS, ITS DISCOUNT POLICY, AND HISTORICAL EXPERIENCE. THE HOSPITAL DETERMINES ITS ESTIMATE OF IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE WITH THESE CLASSES OF PATIENTS USING A PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO ACCOUNT FOR PATIENT CONTRACTS AS COLLECTIVE GROUPS RATHER THAN ON AN INDIVIDUAL CONTRACT BASIS. THE FINANCIAL STATEMENT EFFECTS OF USING THIS PRACTICAL EXPEDIENT ARE NOT MATERIALLY DIFFERENT FROM AN INDIVIDUAL CONTRACT APPROACH.REVENUES UNDER THE TRADITIONAL FEE-FOR-SERVICE MEDICAID PROGRAMS, INCLUDING CALIFORNIA'S MEDICAID PROGRAM ("MEDI-CAL"), ARE BASED PRIMARILY ON PROSPECTIVE PAYMENT SYSTEMS, PLUS AN OUTLIER PAYMENT FOR INDIVIDUAL PATIENTS WHOSE MEDICAL CONDITIONS ARE COSTLIER TO TREAT THAN THOSE OF PATIENTS WITH THE SAME DIAGNOSIS.SETTLEMENTS WITH THIRD-PARTY PAYERS FOR RETROACTIVE REVENUE ADJUSTMENTS DUE TO AUDITS, REVIEWS, OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENT WITH THE PAYER, CORRESPONDENCE FROM THE PAYER, AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN (THAT IS, NEW INFORMATION BECOMES AVAILABLE), OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, OR INVESTIGATIONS.REVENUES UNDER MANAGED CARE PLANS ARE BASED PRIMARILY ON PAYMENT TERMS INVOLVING PREDETERMINED RATES PER DIAGNOSIS, PER DIEM RATES, DISCOUNTED FEE-FOR-SERVICE RATES, AND/OR OTHER SIMILAR CONTRACTUAL ARRANGEMENTS. THESE REVENUES ARE ALSO SUBJECT TO REVIEW AND POSSIBLE AUDIT BY THE PAYERS, WHICH CAN TAKE SEVERAL YEARS BEFORE THEY ARE COMPLETELY RESOLVED. THE PAYERS ARE BILLED FOR PATIENT SERVICES ON AN INDIVIDUAL PATIENT BASIS. AN INDIVIDUAL PATIENT'S BILL IS SUBJECT TO ADJUSTMENT ON A PATIENT-BY-PATIENT BASIS IN THE ORDINARY COURSE OF BUSINESS BY THE PAYERS FOLLOWING THEIR REVIEW AND ADJUDICATION OF EACH PARTICULAR BILL. THE HOSPITAL ESTIMATES THE DISCOUNTS FOR CONTRACTUAL ALLOWANCES. AT THE END OF EACH MONTH, THE HOSPITAL ESTIMATES ITS EXPECTED REIMBURSEMENT FOR PATIENTS OF MANAGED CARE PLANS BASED ON THE APPLICABLE CONTRACT TERMS. CONTRACTUAL ALLOWANCE ESTIMATES ARE PERIODICALLY REVIEWED FOR ACCURACY BY TAKING INTO CONSIDERATION KNOWN CONTRACT TERMS, AS WELL AS PAYMENT HISTORY. THE HOSPITAL BELIEVES THAT THE ESTIMATION AND REVIEW PROCESS ENABLES THEM TO IDENTIFY INSTANCES ON A TIMELY BASIS WHERE SUCH ESTIMATES NEED TO BE REVISED. THE HOSPITAL DOES NOT BELIEVE THERE WERE ANY ADJUSTMENTS TO ESTIMATES OF PATIENT BILLS THAT WERE MATERIAL TO REVENUES.GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYERS ARE RESPONSIBLE FOR RELATED COPAYS, COINSURANCE, AND DEDUCTIBLES, WHICH VARY IN AMOUNT. THE HOSPITAL ALSO PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS UNINSURED PATIENTS A DISCOUNT FROM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH COPAYS, COINSURANCE, AND DEDUCTIBLES AND FOR THOSE WHO ARE UNINSURED BASED ON HISTORICAL COLLECTION EXPERIENCE AND CURRENT MARKET CONDITIONS. UNDER THE HOSPITAL'S UNINSURED DISCOUNT PROGRAMS, THE DISCOUNT OFFERED TO CERTAIN UNINSURED PATIENTS IS RECOGNIZED AS A POLICY DISCOUNT, WHICH REDUCES NET OPERATING REVENUES AT THE TIME THE SELF-PAY ACCOUNTS ARE RECORDED. THE UNINSURED PATIENT ACCOUNTS, NET OF POLICY DISCOUNTS RECORDED, ARE FURTHER REDUCED TO THEIR NET REALIZABLE VALUE AT THE TIME THEY ARE RECORDED THROUGH IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION TRENDS FOR SELF-PAY ACCOUNTS AND OTHER FACTORS THAT AFFECT THE ESTIMATION PROCESS. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO NET PATIENT SERVICE REVENUES IN THE PERIOD OF THE CHANGE. ALTHOUGH OUTCOMES VARY, THE HOSPITAL'S POLICY IS TO ATTEMPT TO COLLECT AMOUNTS DUE FROM PATIENTS, INCLUDING COPAYS, COINSURANCE, AND DEDUCTIBLES DUE FROM PATIENTS WITH INSURANCE, AT THE TIME OF SERVICE WHILE COMPLYING WITH ALL FEDERAL AND STATE STATUTES AND REGULATIONS. PART III, LINE 8: CHLA IS NOT INCLUDING ANY MEDICARE SHORTFALL AS PART OF ITS COMMUNITY BENEFIT. FURTHER, CHLA USES FEDERAL MEDICARE COST ALLOCATION METHODOLOGY, AS REPORTED IN ITS MEDICARE COST REPORT, TO DETERMINE THE ALLOWABLE COSTS OF CARE RELATING TO MEDICARE PAYMENTS RECEIVED. PART III, LINE 9B: THE HOSPITAL'S POLICY STATES THAT IF THE PATIENT/GUARANTOR IS UNABLE TO PAY FOR SERVICES DUE TO THEIR CURRENT FINANCIAL SITUATION, THEY COULD BE ELIGIBLE FOR UNCOMPENSATED OR DISCOUNTED CARE, IN WHICH CASE THE HOSPITAL'S APPLICABLE POLICY AND PROCEDURE IS FURTHER REFERENCED. IF THE PATIENT/GUARANTOR DOES NOT QUALIFY, THE HOSPITAL FOLLOWS ALL APPLICABLE FEDERAL AND STATE GUIDELINES FOR DEBT COLLECTION, INCLUDING THE REQUIREMENT OF FAIR TREATMENT, THE PROHIBITION OF MAKING FALSE STATEMENTS AND RESTRICTIONS ON THE TIME OF DAY THAT DEBT COLLECTORS MAY CONTACT THE DEBTOR. PART VI, LINE 2: CHLA CONTINUES ITS COMMITMENT TO THE CHILDREN AND FAMILIES OF THE LOS ANGELES AREA THROUGH ITS COMMUNITY BENEFIT ACTIVITIES WHICH ENSURE THAT OUR HOSPITAL WILL REMAIN RESPONSIVE TO THE NEEDS OF THE COMMUNITY. CHILDREN'S HOSPITAL LOS ANGELES STRIVES TO ACCOMPLISH OUR GOALS THROUGH OUR STRATEGIC PLAN, DEVELOPED IN ACCORDANCE WITH THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT. 2022 COMMUNITY HEALTH NEEDS ASSESSMENT GOALS INCLUDE: -EXPAND ACCESS TO PEDIATRIC HEALTH, BEHAVIORAL HEALTH, AND PREVENTATIVE SERVICES -INCREASE AWARENESS OF PEDIATRIC AND FAMILY HEALTH CARE RESOURCES AND INFORMATION -EXPAND WORKFORCE PIPELINE PROGRAMS FOR YOUTH AND YOUNG ADULTS -EXPAND SUPPORT OF LOCAL ECONOMIC INCLUSION INITIATIVES -SPUR LOCAL ECONOMIC GROWTH AND CHAMPION ENVIRONMENTAL SUSTAINABILITY. CHLA COMPLETED 2022 COMMUNITY HEALTH NEEDS ASSESSMENT AND CONTINUES TO STRENGTHEN ITS COMMITMENT TO UNDERSTANDING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. PART VI, LINE 3: EVERY PATIENT OR HIS OR HER REPRESENTATIVE SHALL, UPON ADMISSION AS AN INPATIENT, RECEIVE A WRITTEN NOTICE CONTAINING INFORMATION ABOUT THE AVAILABILITY OF CHARITY CARE AND DISCOUNT CARE. THE NOTICE SHALL INCLUDE INFORMATION ABOUT THIS POLICY, AS WELL AS CONTACT INFORMATION FOR A HOSPITAL EMPLOYEE OR OFFICE FROM WHICH THE PATIENT OR REPRESENTATIVE MAY OBTAIN FURTHER INFORMATION ABOUT THIS POLICY. THIS SAME NOTICE SHALL BE GIVEN TO PATIENTS WHO RECEIVE EMERGENCY OR OUTPATIENT CARE, AND WHO MAY RECEIVE A BILL FOR SUCH CARE, BUT WHO WERE NOT ADMITTED. THE NOTICE SHALL BE PROVIDED IN ENGLISH AND IN THE LANGUAGE SPOKEN BY THE PATIENT'S FAMILY IF AVAILABLE. NOTICES REGARDING THIS POLICY WILL BE CLEARLY AND CONSPICUOUSLY POSTED IN LOCATIONS VISIBLE TO THE PUBLIC INCLUDING, BUT NOT LIMITED TO, ALL OF THE FOLLOWING: THE EMERGENCY DEPARTMENT, BILLING OFFICE, ADMISSIONS OFFICE, AND OUTPATIENT SETTINGS. THESE POSTED NOTICES WILL EXPLAIN THAT CHLA HAS A VARIETY OF OPTIONS AVAILABLE, INCLUDING FINANCIAL ASSISTANCE, TO INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED. THESE NOTICES WILL INCLUDE A CONTACT OFFICE AND TELEPHONE NUMBER AN INDIVIDUAL CAN CALL TO OBTAIN MORE INFORMATION ABOUT THIS FINANCIAL ASSISTANCE POLICY AND TO APPLY FOR FINANCIAL ASSISTANCE. PART VI, LINE 4: OUR HOSPITAL SERVICES REACH THOUSANDS ACROSS SOUTHERN CALIFORNIA, WITH A PRIMARY SERVICE AREA OF LOS ANGELES COUNTY--A REGION THAT SPANS 4,057 SQUARE MILES AND INCLUDES VAST URBAN COMMUNITIES, SUBURBAN AREAS AND RURAL NEIGHBORHOODS AND INCLUDES 8 SERVICE PLANNING AREAS (SPAS) AS DESIGNATED BY THE LOS ANGELES COUNTY HEALTH DEPARTMENT. APPROXIMATELY 87% OF THE HOSPITAL'S PATIENTS ORIGINATE FROM L.A. COUNTY. LOS ANGELES COUNTY IS HOME TO MORE THAN 10 MILLION RESIDENTS. IT IS THE MOST POPULOUS COUNTY IN THE NATION, AND ONE OF THE MOST ETHNICALLY AND RACIALLY DIVERSE AS WELL.CHILDREN (AGES 0-14) REPRESENTED 18.2% OF THE POPULATION IN LOS ANGELES COUNTY, WHILE ADOLESCENTS (AGES 15-17) REPRESENTED 3.8%. LOS ANGELES COUNTY IS VERY DIVERSE. APPROXIMATELY HALF OF THE POPULATIONIDENTIFIES AS HISPANIC OR LATINO (50%); A LITTLE OVER A QUARTER IDENTIFIED AS WHITE (26.2%); 13.3% IDENTIFIED AS ASIAN, AND 7.9% IDENTIFIED AS BLACK OR AFRICAN AMERICAN. IN LA COUNTY, 57% OF THE POPULATION SPEAKS A LANGUAGE OTHER THAN ENGLISH AT HOME AND 22% ARE LINGUISTICALLY ISOLATED. IN LOS ANGELES COUNTY, 16.7% OF THE POPULATION LIVED AT OR BELOW 100% OF THE FPL. FURTHERMORE, IN LOS ANGELES COUNTY, 16.7% OF CHILDREN, UNDER AGE 18 YEARS, LIVED IN POVERTY. PART VI, LINE 5: CHILDREN'S HOSPITAL LOS ANGELES PROVIDES A RANGE OF COMMUNITY BENEFIT AND COMMUNITY IMPACT SERVICES AND PROGRAMS TAILORED TO ADDRESS THE NEEDS OF CHILDREN, YOUTH, AND FAMILIES. EMPHASIZING THE VITAL ROLE OF FAMILIES AND COMMUNITIES IN A CHILD'S LIFE, OUR PROGRAMS STRIVE TO BE FAMILY-CENTERED AND ROOTED IN THE COMMUNITY.-COMMUNITY VACCINATIONS AND HEALTH INFORMATION:CHILDREN'S HOSPITAL LOS ANGELES HOSTED COMMUNITY WELLNESS EVENTS IN VARIOUS NEIGHBORHOODS, PROVIDING VACCINES AND ESSENTIAL HEALTH INFORMATION. AMID THE PANDEMIC, CHLA BECAME AN OFFICIAL COUNTY 'POINT OF DISPENSING' FOR COVID-19 VACCINES, OPERATING BY APPOINTMENT THROUGH CALIFORNIA'S MY TURN WEBSITE. COLLABORATING WITH LOS ANGELES COUNTY AND COMMUNITY ORGANIZATIONS, THE HOSPITAL IDENTIFIED UNDERSERVED AREAS AND GROUPS, ENSURING ACCESS TO FLU AND COVID-19 VACCINES ALONGSIDE RELEVANT HEALTH EDUCATION.-FALL INTO WELLNESS FAMILY HEALTH FAIR IN SOUTH LA:THE FALL INTO WELLNESS FAMILY HEALTH FAIR WAS HOSTED BY MACEDONIA BAPTIST CHURCH IN COLLABORATION WITH THE MACEDONIA COMMUNITY DEVELOPMENT CORPORATION, CHARLES DREW UNIVERSITY AND CHILDREN'S HOSPITAL LOS ANGELES TO ADDRESS ECONOMIC, HEALTH AND SOCIAL DISPARITIES IN THE WATTS COMMUNITY OF LOS ANGELES.THE FAMILY HEALTH FAIR WELCOMED THE PUBLIC, AND PROVIDED FREE IMMUNIZATIONS, HEALTH SCREENINGS AND A FESTIVE FAMILY ATMOSPHERE WITH FOOD, MUSIC AND BOOTHS STAFFED BY COMMUNITY AND HOSPITAL VOLUNTEERS FEATURING EVERYTHING FROM ART AND EDUCATIONAL ACTIVITIES FOR KIDS TO FIRST AID TRAINING AND JOB OPPORTUNITIES FOR ADULTS.CHLA HAS A LONGSTANDING RELATIONSHIP WITH FAMILIES IN SOUTH LOS ANGELES. OVER THE PAST THREE YEARS, THE HOSPITAL HAS SEEN MORE THAN 61,000 UNIQUE PATIENTS AND MANAGED MORE THAN 243,000 PATIENT VISITS FROM THE COMMUNITY.-MQS COMMUNITY WELLNESS FAIR:SINCE 2020, CHILDREN'S HOSPITAL LOS ANGELES HAS PARTNERED WITH MANOS QUE SOBREVIVEN (MQS) IN MAKING A DIFFERENCE IN THE COMMUNITY. MANOS QUE SOBREVIVEN, WHICH TRANSLATES TO "HANDS THAT SURVIVE," IS A NONPROFIT BASED IN NORTHEAST LOS ANGELES DEDICATED TO PROMOTING HEALTHY BODIES AND MINDS FOR FAMILIES WITH CHILDREN WHO HAVE SPECIAL NEEDS.LAST OCTOBER, CHLA'S OFFICE OF COMMUNITY AFFAIRS SPONSORED THE 2022 MANOS QUE SOBREVIVEN COMMUNITY WELLNESS FAIR. THE ANNUAL EVENT IS AN OPPORTUNITY FOR LOCAL FAMILIES TO LEARN ABOUT OPTIMIZING THEIR HEALTH AND WELLNESS AND TO RECEIVE FOOD BOXES AND OTHER ESSENTIAL ITEMS AT NO COST.DURING THE FOUR-HOUR EVENT, MORE THAN 800 FAMILIES ACCESSED SERVICES INCLUDING FREE HEALTH AND DENTAL SCREENINGS, AND COVID-19 VACCINES, AS WELL AS FOOD DISTRIBUTION PROVIDED BY THE L.A. REGIONAL FOODBANK. MORE THAN 300 FAMILIES IN VEHICLES PARTICIPATED IN DRIVE-THROUGH FOOD DISTRIBUTION. IN ADDITION, REPRESENTATIVES FROM LOCAL HEALTH AGENCIES, SCHOOLS AND OTHER COMMUNITY ORGANIZATIONS WERE ON HAND TO EDUCATE THE PUBLIC ABOUT RESOURCES AVAILABLE TO SUPPORT THEM.-COMMUNITY HEALTH BUZZ:CHILDREN'S HOSPITAL LOS ANGELES' OFFICE OF COMMUNITY AFFAIRS ESTABLISHED THE COMMUNITY HEALTH BUZZ, A VIRTUAL EDUCATIONAL SERIES THAT LAUNCHED AMIDST THE COVID-19 PANDEMIC. THE AIM WAS TO MAINTAIN CONNECTIONS WITH FAMILIES AND OFFER RELIABLE HEALTH AND WELLNESS INFORMATION WHILE IN-PERSON SESSIONS WERE NOT FEASIBLE.FOR THREE YEARS, COMMUNITY HEALTH BUZZ CONDUCTED FREE ENGLISH AND SPANISH WEBINARS, DELVING INTO VARIOUS ESSENTIAL TOPICS. THESE SESSIONS FEATURED CHLA FACULTY FROM DIVERSE PROGRAMS, COVERING SUBJECTS SUCH AS PARENTING TIPS, STRESS RELIEF, NUTRITION, AND ADDRESSING CRITICAL ISSUES LIKE FENTANYL DANGERS AND SCHOOL SHOOTINGS.CHLA CLINICAL EXPERTS LED IMPACTFUL SESSIONS DISCUSSING CRUCIAL TOPICS LIKE TRAUMA, CHILD ABUSE SIGNS, AND MENTAL HEALTH STIGMA. THE SERIES ALSO PROVIDED CRUCIAL UPDATES ON COVID-19 MYTHS, OMICRON, AND ITS EVOLVING LANDSCAPE.AS IN-PERSON EVENTS RESUME, COMMUNITY HEALTH BUZZ HAS EXPANDED AND PARTNERED WITH THE LOS ANGELES UNIFIED SCHOOL DISTRICT (LAUSD), TO AMPLIFY ITS REACH AND TO EMPOWER FAMILIES THROUGH THEIR "FAMILY ACADEMY" PROGRAM. COLLABORATIONS LIKE THE RECENT WEBINAR ON SUICIDE PREVENTION SIGNIFY THE EXPANSION'S IMPACT THROUGHOUT SOUTHERN CALIFORNIA.-SAMUELS FAMILY LATINO AND AFRICAN AMERICAN HIGH SCHOOL INTERNSHIP PROGRAM (LA-HIP):THE OVERALL GOAL OF THE SAMUELS FAMILY LA-HIP IS TO PROVIDE LATINO AND AFRICAN-AMERICAN PUBLIC HIGH SCHOOL STUDENTS THAT HAVE A GENUINE INTEREST IN SCIENCE, TECHNOLOGY, ENGINEERING AND MATH (STEM) WITH THE OPPORTUNITY TO LEARN HANDS-ON LABORATORY-BASED RESEARCH AND TO SUPPORT THEM IN THEIR QUEST TO BECOME SCIENTISTS OR PHYSICIAN SCIENTISTS. LA-HIP WAS FOUNDED 18 YEARS AGO AND HAS TRAINED OVER 200 HIGH SCHOOL STUDENTS FROM THE LOS ANGELES AREA. LA-HIP IS A COMPREHENSIVE YEARLONG INTERNSHIP PROGRAM THAT COMBINES BIOMEDICAL RESEARCH WITH COLLEGE READINESS WORKSHOPS, ACADEMIC ENHANCEMENT, AND SAT PREPARATORY CURRICULUM. THIS 2023 CLASS OF 24 OUTSTANDING STUDENTS IN THE PROGRAM, ALL OF WHOM UNDERTOOK ORIGINAL RESEARCH PROJECTS WORKING WITH FACULTY, FELLOWS, AND GRADUATE STUDENT MENTORS IN THE SABAN RESEARCH INSTITUTE.-CAREERS IN HEALTH AND MENTORSHIP PROGRAM (CHAMP):CAREERS IN HEALTH AND MENTORSHIP PROGRAM (CHAMP) CHLA'S CHAMP PROVIDES UNDERREPRESENTED ADULTS FROM THE LOS ANGELES COMMUNITY THE OPPORTUNITY TO PARTICIPATE IN A SERIES OF COMPREHENSIVE JOB READINESS, LEADERSHIP DEVELOPMENT WORKSHOPS AND INTERNSHIPS. OVER 300 YOUNG ADULTS LIVING WITHIN THE LOS ANGELES COMMUNITY HAVE BEEN PROVIDED THE OPPORTUNITY TO STRENGTHEN THEIR CAREER PATHWAYS BY GAINING UNIQUE WORK EXPERIENCES AND MENTORSHIP BY OUR HOSPITAL'S LEADERS THAT ARE AFFILIATED WITH NON-CLINICAL SYSTEMS. THE STUDENTS APPLYING CAME FROM VARIOUS EDUCATIONAL INSTITUTIONS INCLUDING TRADE TECHS, COMMUNITY COLLEGES, UNIVERSITIES (UNDERGRADUATE AND GRADUATE), AND PRIVATE PROFESSIONAL ORGANIZATIONS, MANY FROM UNDERSERVED AREAS IN LOS ANGELES COUNTY AND ACROSS THE COUNTRY. CHAMPERS ARE PAIRED WITH DEPARTMENTS ACROSS THE ORGANIZATION THAT HAVE INCLUDED AREAS SUCH AS AMBULATORY OPERATIONS, FOUNDATION, IT, RESEARCH, FACILITIES, ACADEMIC AFFAIRS, ETC. APPROXIMATELY 50% HAVE BEEN OFFERED A POSITION, IN A HEALTHCARE SETTING INCLUDING BUT NOT LIMITED TO CHLA, CEDARS SINAI, THE UCLA HEALTH SYSTEM, THE KAISER SYSTEM, AND USC AND MORE THAN 75% OF THE STUDENTS WENT ON TO CONTINUE TO PURSUE HIGHER EDUCATION INCLUDING PROGRAMS FOR DEGREES SUCH AS MASTERS IN BUSINESS ADMINISTRATION (MBA), MASTERS IN PUBLIC HEALTH (MPH), MASTERS IN HEALTH ADMINISTRATION (MHA), TO NAME A FEW.-PROJECT SEARCH:CHILDREN'S HOSPITAL LOS ANGELES IS A TRAINING SITE OF THE NATIONALLY RECOGNIZED PROJECT SEARCH PROGRAM IN COLLABORATION WITH THE LOS ANGELES UNIFIED SCHOOL DISTRICT, PATHPOINT, LANTERNMAN REGIONAL CENTER, AND SOUTH-CENTRAL LOS ANGELES REGIONAL CENTER THIS YEAR. THIS PROGRAM PROVIDES INTERNSHIP OPPORTUNITIES TO PREPARE YOUNG PEOPLE WITH SIGNIFICANT DISABILITIES FOR SUCCESS IN INTEGRATED, COMPETITIVE EMPLOYMENT. ITS FIRST INAUGURAL PROJECT SEARCH COHORT AT CHILDREN'S HOSPITAL LOS ANGELES INCLUDED FOUR YOUNG ADULT INTERNS PLACED THROUGHOUT VARIOUS DEPARTMENTS AT CHLA. THE PROGRAM PROVIDES REAL-LIFE WORK EXPERIENCE COMBINED WITH SKILLS TRAINING, CAREER EXPLORATION, AND INDEPENDENT-LIVING SKILLS. THIS YEAR WE RECRUITED 4 NEW STUDENTS FOR THE 2023 PROJECT SEARCH COHORT AND HIRED A PROJECT SEARCH GRADUATE FROM THE 2022 COHORT FOR A POSITION AT OUR HOSPITAL. PART VI, LINE 7, REPORTS FILED WITH STATES CA SCHEDULE H, PART V, SECTION B, SUPPLEMENTAL INFORMATION CHILDREN'S HOSPITAL LOS ANGELES (THE HOSPITAL) PERIODICALLY CONDUCTS REVIEWS OF ITS INTERNAL REVENUE CODE (IRC) SECTION 501(R) AND RELATED TREASURY REGULATIONS COMPLIANCE BOTH INTERNALLY AND WITH EXTERNAL ADVISORS. DURING THE HOSPITAL'S MOST RECENT REVIEW THAT BEGAN IN 2022 AND WAS CONCLUDED IN EARLY 2023, IT WAS DETERMINED THAT CERTAIN INFORMATION IN THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP), PLAIN LANGUAGE SUMMARY (PLS), AND BILLING AND COLLECTION POLICY (BCP) REQUIRED CLARIFICATION OR CORRECTION AND THAT THE HOSPITAL HAD NOT YET TAKEN CERTAIN STEPS TO WIDELY PUBLICIZE ITS FAP. THE FOLLOWING DISCLOSURE IS IN ACCORDANCE WITH SECTION 7 OF REV. PROC. 2015-21. EACH OF THE ITEMS IDENTIFIED BELOW CONSTITUTE MINOR, INADVERTENT DEFICIENCIES AND EACH OF THESE ITEMS WERE CORRECTED EXPEDIENTLY ONCE IDENTIFIED.(1) THE HOSPITAL'S FAP DID NOT INCLUDE A COMPLETE LIST OF PROVIDERS OTHER THAN THE HOSPITAL DELIVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IN THE HOSPITAL SPECIFYING WHICH OF THOSE PROVIDERS ARE AND WHICH ARE NOT COVERED BY THE FAP. THE FAP WAS REVISED TO INCLUDE THIS INFORMATION AND ADOPTED BY AN AUTHORIZED BODY OF THE HOSPITAL ON MARCH 1, 2023.(2) NEITHER THE HOSPITAL'S FAP NOR ITS SEPARATE BCP (I) DESCRIBED THE ACTIONS THE HOSPITAL MAY TAKE RELATED TO OBTAINING PAYMENT FOR A MEDICAL BILL, (II) DESCRIBED THE PROCESS AND TIME FRAMES THE HOSPITAL USES IN TAKING ACTIONS TO COLLECT PAYMENT, INCLUDING THE EFFORTS IT TAKES TO DETERMINE WHETHER AN INDIVIDUAL IS FAP-ELIGIBLE BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS, OR (III) DESCRIBED THE OFFICE OR DEPARTMENT WITH FINAL AUTHORITY FOR DETERMINING THAT THE HOSPITAL HAD MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL WAS FAP-ELIGIBLE BEFORE ENGAGING IN EXTRAORDINARY COLLECTION ACTIONS. THE FAP WAS REVISED TO INCLUDE THIS INFORMATION AND ADOPTED BY AN AUTHORIZED BODY OF THE HOSPITAL ON MARCH 1, 2023.(3) THE HOSPITAL'S PLS DID NOT INCLUDE THE DIRECT WEBSITE ADDRESS AND PHYSICAL LOCATION WHERE AN INDIVIDUAL COULD OBTAIN COPIES OF THE FAP AND FAP APPLICATION FORM. THE PLS WAS REVISED TO INCLUDE THIS INFORMATION, AND TO CONFORM TO THE UPDATED FAP, AFTER THE FAP'S ADOPTION ON MARCH 1, 2023.(4) THE HOSPITAL HAD NOT TAKEN THE FOLLOWING STEPS TO WIDELY PUBLICIZE ITS FAP: (I) POSTED A COMPLETE AND CURRENT VERSION OF THE FAP AND APPENDICES, FAP APPLICATION AND PLS ON ITS WEBSITE (MOST INFORMATION WAS AVAILABLE ON THE HOSPITAL'S WEBSITE IN SOME FORM, BUT NOT EVERYTHING NOTED ABOVE); (II) PUBLICIZED HOW INDIVIDUALS COULD OBTAIN THESE SPECIFIC DOCUMENTS ON THE WEBSITE, IN PERSON OR BY MAIL (FINANCIAL ASSISTANCE INFORMATION OVERALL WAS COMMUNICATED BY FINANCIAL COUNSELORS AND THEY WERE ABLE TO PROVIDE COPIES IF REQUESTED); AND (III) TRANSLATED THE FAP, FAP APPLICATION AND PLS INTO THE PRIMARY LANGUAGES SPOKEN BY ALL POPULATIONS WITH LIMITED ENGLISH PROFICIENCY (LEP) MAKING UP THE LESSER OF 1,000 INDIVIDUALS OR 5% OF THE COMMUNITY (THE HOSPITAL PROVIDED TRANSLATIONS INTO THE LANGUAGES OF LARGE LEP POPULATIONS, BUT NOT ALL LANGUAGES MEETING THE THRESHOLD SPECIFIED BY THE REGULATIONS) . THE HOSPITAL HAS NOW TRANSLATED ITS UPDATED FAP, FAP APPLICATION AND PLS INTO THE REQUIRED LANGUAGES, POSTED THESE DOCUMENTS ON ITS WEBSITE, AND PROVIDED INFORMATION IN THE DOCUMENTS, ON THE WEBSITE, AND IN THE HOSPITAL ON HOW TO OBTAIN COPIES OF THESE DOCUMENTS. (5) THE HOSPITAL HAD NOT FULLY DOCUMENTED ITS MEASURES TO NOTIFY AND INFORM MEMBERS OF THE COMMUNITY IT SERVES ABOUT ITS FAP IN A MANNER REASONABLY CALCULATED TO REACH THOSE MEMBERS WHO ARE MOST LIKELY TO REQUIRE FINANCIAL ASSISTANCE. IT IS NOW DOCUMENTING THOSE MEASURES AND TAKING ADDITIONAL MEASURES INCLUDING PROVIDING COPIES OF THE FAP, FAP APPLICATION AND PLS IN THE HOSPITAL'S COMMUNITY OUTREACH TOOLKIT THAT IS PROVIDED TO ALL DEPARTMENTS CONDUCTING OUTREACH AT COMMUNITY EVENTS.THE HOSPITAL HAS CONTINUOUSLY MAINTAINED A FINANCIAL ASSISTANCE PROGRAM FOR PATIENTS AND THE COMMUNITY, INCLUDING POSTING INFORMATION IN THE HOSPITAL, OFFERING SESSIONS WITH FINANCIAL ASSISTANCE COUNSELORS, AND PERFORMING COMMUNITY OUTREACH SO THAT THE AVAILABILITY OF FINANCIAL ASSISTANCE IS WIDELY PUBLICIZED. THE HOSPITAL'S PATIENT AND COMMUNITY OUTREACH DID NOT IDENTIFY ANY INDIVIDUALS AFFECTED BY THE OMISSIONS NOTED ABOVE. ALL ITEMS WERE IDENTIFIED BY THE HOSPITAL AND ITS ADVISORS, NOT PATIENTS OR THE COMMUNITY. THEREFORE, THE HOSPITAL BELIEVES THERE WERE NO INDIVIDUALS ADVERSELY AFFECTED OR DOLLAR AMOUNTS NOT PROVIDED IN FINANCIAL ASSISTANCE.IN AN EFFORT TO BE FULLY TRANSPARENT, THE HOSPITAL HAS CHOSEN TO PROACTIVELY DISCLOSE THESE MINOR AND INADVERTENT OMISSIONS AND ERRORS ON THIS FORM 990. ADDITIONALLY, THE HOSPITAL HAS ADOPTED PROCEDURES THAT REQUIRE THE HOSPITAL TO REVIEW, ON A REGULAR BASIS, THE HOSPITAL'S POLICIES AND PROCEDURE TO ENSURE COMPLIANCE WITH THE REQUIREMENTS OF SECTION 501(R) AND THE REGULATIONS ISSUED THEREUNDER. 1 CALIFORNIA HEALTH FOUNDATION AND TRUST 1215 K STREET SUITE 800 SACRAMENTO CA 95814 941498687 501(C)(3) 2314072 0 SUPPORT CHARITABLE ACTIVITIES AT HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA RONALD MCDONALD HOUSE CHARITIES OF SOUTHERN CALIFORNIA 4650 FOUNTAIN AVENUE LOS ANGELES CA 90029 953167869 501(C)(3) 510000 0 DONATION/SPONSORSHIP OF GALA EVENT - HEROES FOR THE HEALING NATIONAL MEDICAL FELLOWSHIPS INC 347 FIFTH AVENUE SUITE 510 NEW YORK NY 10016 010963657 501(C)(3) 210000 0 PRIMARY CARE LEADERSHIP PROGRAM SUPPORT PARTNERS IN CARE FOUNDATION INC 732 MOTT STREET SUITE 150 SAN FERNANDO CA 91340 953954057 501(C)(3) 25000 0 23RD ANNUAL TRIBUTE DINNER THE UCLA FOUNDATION 10889 WILSHIRE BLVD SUITE 1500 LOS ANGELES CA 90024 952250801 501(C)(3) 25000 0 UCLA HPMAA ANNUAL AWARDS DINNER 2023 CANCER SUPPORT COMMUNITY LOS ANGELES 1990 SOUTH BUNDY DRIVE SUITE 100 LOS ANGELES CA 90025 330287070 501(C)(3) 25000 0 SPONSORSHIP - 40TH ANNIVERSARY GALA GREATER LOS ANGELES AFRICAN AMERICAN 5120 W GOLDLEAF CIRCLE SUITE 230 LOS ANGELES CA 90056 954357302 501(C)(6) 20000 0 ANNUAL ECONOMICS AWARDS DINNER LOS ANGELES AREA CHAMBER OF COMMERCE 350 S BIXEL ST NO 201 LOS ANGELES CA 90017 950947860 501(C)(6) 20000 0 2023 INAUGURAL DINNER SPONSORSHIP NATIONAL FORUM FOR LATINO HEALTHCARE EXEC 2800S IH 35 SUITE 155 AUSTIN TX 78704 262033192 501(C)(6) 15000 0 SPONSORSHIP LOS ANGELES CITY COLLEGE FOUNDATION 855 N VERMONT AVENUE LOS ANGELES CA 90029 956207819 501(C)(3) 10000 0 SPONSORSHIP MAKE-A-WISH FOUNDATION GREATER LOS ANGELES 11390 OLYMPIC BLVD STE 300 LOS ANGELES CA 90064 954107024 501(C)(3) 10000 0 SPONSORSHIP FRIENDS OF THE LOS ANGELES FREE CLINIC 8405 BEVERLY BLVD LOS ANGELES CA 90048 953433824 501(C)(3) 10000 0 ANNUAL DINNER GALA HATHAWAY-SYCAMORES CHILD & FAMILY SVCS 100 W WALNUT STREET SUITE 375 PASADENA CA 91124 951691005 501(C)(3) 10000 0 2023 SPRING GALA JVS SOCAL 6505 WILSHIRE BLVD SUITE 200 LOS ANGELES CA 90048 951643388 501(C)(3) 10000 0 JVS TABLE SPONSORSHIP HOLLYWOOD CHAMBER OF COMMERCE COMMUNITY 6255 SUNSET BLVD SUITE 150 HOLLYWOOD CA 90028 954557923 501(C)(3) 8000 0 SPONSORSHIP NICOLE PARKER FOUNDATION FOR CHILDREN 16461 SHERMAN WAY SUITE 100 VAN NUYS CA 91406 953822577 501(C)(3) 8000 0 SPONSORSHIPS BOYS & GIRLS CLUBS OF METRO LOS ANGELES 5029 S VERMONT AVE LOS ANGELES CA 90037 810851473 501(C)(3) 7500 0 2022 BGCMLA HOMECOMING GALA AMERICAN DIABETES ASSOCIATION 2451 CRYSTAL DRIVE SUITE 900 ARLINGTON VA 22202 131623888 501(C)(3) 7500 0 SPONSORSHIP VALLEY PRESBYTERIAN HOSPITAL 15107 VANOWEN ST VAN NUYS CA 91405 951945832 501(C)(3) 6000 0 2022 GOLF CLASSIC SPONSORSHIP 16 3 PART I, LINE 2: CHLA AWARDS GRANTS TO VARIOUS ORGANIZATIONS FOR PURPOSES THAT ARE CONSISTENT WITH OUR MISSION AND VALUES. IN ADDITION, DUE DILIGENCE IS PERFORMED TO ENSURE THE FUNDS ARE USED FOR THEIR INTENDED PURPOSES. X X X 1 1 0 0 0 0 0 1 0 PAUL S VIVIANO DIRECTOR, PRESIDENT AND CEO 1238126 0 507100 0 296475 0 9150 0 30028 0 2080879 0 266223 0 ALEXANDRA CARTER SVP, CHIEF DEVELOPMENT OFFICER 488583 0 602800 0 108344 0 85425 0 15349 0 1300501 0 64130 0 GRACE OH SVP, GENERAL COUNSEL 537998 0 310943 0 102629 0 89029 0 42146 0 1082745 0 73749 0 NANCY LEE SVP, CHIEF CLINICAL OFFICER 570461 0 133281 0 340893 0 8700 0 5044 0 1058379 0 316816 0 LARA KHOURI SVP, CHIEF STRATEGY OFFICER 624763 0 164200 0 116136 0 107670 0 44917 0 1057686 0 94733 0 M SCOTT LIEBERENZ SVP, CHIEF FINANCIAL OFFICER 671319 0 139402 0 113930 0 109519 0 21875 0 1056045 0 88068 0 JAMES STEIN MD SVP, CHIEF MEDICAL OFFICER 594136 0 136824 0 147034 0 91245 0 1281 0 970520 0 121856 0 MARK D KRIEGER MD DIRECTOR, FACULTY PHYSICIAN 818751 0 0 0 0 0 0 0 0 0 818751 0 0 0 PAT R LEVITT MD FACULTY PHYSICIAN 815875 0 0 0 0 0 0 0 0 0 815875 0 0 0 MAMOON SYED SVP, CHIEF PEOPLE OFFICER 428173 0 114200 0 98918 0 77659 0 28233 0 747183 0 57339 0 CONRAD BAND SVP, CHIEF INFORMATION OFFICER 397605 0 80500 0 3095 0 70091 0 23715 0 575006 0 0 0 RUTH M AREVALO VP, HEALTH SYSTEM DEV & INTEG 338418 0 57215 0 84519 0 59943 0 21047 0 561142 0 64019 0 JODI SHIRLYN OGDEN RIVERA VP, RESEARCH OPERATIONS 335677 0 54312 0 83971 0 57366 0 20768 0 552094 0 61466 0 DEBORAH BRAIDIC VP,CHIEF COMM OFF&SPC PROJECTS 317185 0 50320 0 64941 0 51709 0 13376 0 497531 0 48225 0 MICHAEL GORAN MD FACULTY PHYSICIAN 477348 0 0 0 0 0 0 0 0 0 477348 0 0 0 MARILYN HO CHIEF OF STAFF (END 02/22) 32431 0 0 0 415505 0 1056 0 2123 0 451115 0 52009 0 HANNA SONG SVP, CHIEF DIVERSITY OFFICER 289338 0 64777 0 3751 0 50700 0 18841 0 427407 0 0 0 MATTHEW MATT KEEFER MD DIRECTOR, FACULTY PHYSICIAN 392207 0 0 0 0 0 0 0 0 0 392207 0 0 0 JUDITH M KLINE CORPORATE SECRETARY 261413 0 500 0 1529 0 6764 0 12530 0 282736 0 0 0 ROBERT BOB E SHADDY MD DIRECTOR, FACULTY PHYSICIAN 233375 0 0 0 0 0 0 0 0 0 233375 0 0 0 PART I, LINE 4A: THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE IN CALENDAR YEAR 2022, WHICH WAS TREATED AS TAXABLE COMPENSATION: MARILYN HO - $329,887 PART I, LINE 4B: THE FOLLOWING INDIVIDUALS PARTICIPATED IN CHLA'S 457(F) PLAN FOR EXECUTIVE DEFERRED COMPENSATION (EDCP), A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. AMOUNTS DEFERRED UNDER SECTION 457(F) PLAN ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WILL BE REPORTED AS COMPENSATION FOR THE YEAR PAID. AMOUNTS RECOGNIZED AS TAXABLE COMPENSATION ON THE EMPLOYEES 2021 FORM W-2 (EXCEPT PAUL VIVIANO - DEFERRED COMPENSATION) REFLECT PAYMENTS RECEIVED BY THE EMPLOYEE DURING CALENDAR YEAR 2022 THAT WERE PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEAR FORM 990S: PAUL S. VIVIANO - $266,223 M. SCOTT LIEBERENZ - $88,068 ALEXANDRA CARTER - $64,130 LARA KHOURI - $94,733 NANCY LEE - $316,816 GRACE OH - $73,749 JAMES STEIN, M.D. - $121,856 MAMOON SYED - $57,339 JODI SHIRLYN ODEN RIVERA - $61,466 RUTH AREVALO - $64,019 DEBORAH BRAIDIC - $48,225 MARILYN HO - $52,009 PART I, LINE 7 CHLA MAINTAINS AN ENTERPRISE INCENTIVE PROGRAM (THE PLAN) THAT AWARDS INCENTIVE COMPENSATION BASED UPON ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES AS DETERMINED ANNUALLY BY THE BOARD OF DIRECTORS. ALTHOUGH THE AMOUNT OF INCENTIVE THAT EACH PARTICIPANT MAY BE AWARDED IS BASED ON A FIXED FORMULA, THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND BOARD OF DIRECTORS HAS THE FULL DISCRETION AND AUTHORITY TO DETERMINE QUESTIONS CONCERNING THE INTERPRETATION OR ADMINISTRATION OF THE PLAN, INCLUDING, WITHOUT LIMITATION, ALL QUESTIONS RELATING TO PLAN ELIGIBILITY, FINANCIAL FUNDING, PERFORMANCE GOALS AND RESULTS, AND APPROPRIATE PAYMENTS, AND THE DETERMINATIONS OF THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND BOARD OF DIRECTORS IS CONCLUSIVE AND BINDING AS TO ALL PERSONS AND FOR ALL PURPOSES. FORM 990, PART VII, SECTION A, LINE 5: PURSUANT TO THE AFFILIATE AGREEMENT WITH THE UNIVERSITY OF SOUTHERN CALIFORNIA (USC), AN UNRELATED ORGANIZATION, THE FOLLOWING COMPENSATION AMOUNTS WERE PAID TO THE FOLLOWING LISTED INDIVIDUALS BY USC. USC WAS SUBSEQUENTLY REIMBURSED BY CHLA FOR THE AMOUNTS: MARK D. KRIEGER, M.D. - $818,751 PAT R. LEVITT, M.D. - $815,875 MICHAEL GORAN, M.D. - $477,348 MATTHEW KEEFER, M.D. - $392,207 ROBERT E. SHADDY, M.D. - $233,375 JAMES STEIN, M.D. - $67,337 A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UNH7 2017-06-06 295974620 SEE PART VI 0 0 0 B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UNJ3 2017-06-06 52180000 SEE PART VI 0 0 0 C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 000000000 2022-08-31 103420000 SEE PART VI 0 0 0 A 296181141 2528240 33225192 260427710 1 1 1 1 B 52180000 494240 51685760 1 0 1 1 C 103420000 789320 102630680 1 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 0 1 0 1 1 GOLDMAN SACHS 12.000000000000 0 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 SCHEDULE K, PART I, BOND ISSUES: PART I(F): THE SERIES 2017A BONDS WERE ISSUED TO FINANCE HOSPITAL PROJECTS; THE ADVANCE REFUNDING OF THE BORROWER'S SERIES 2010A BONDS (ISSUED ON 05/20/2010); AND THE CURRENT REFUNDING OF THE BORROWER'S SERIES 2007 BONDS (ISSUED ON 04/24/2007) AND SERIES 2012B BONDS (ISSUED ON 08/15/2012). SCHEDULE K, PART I, BOND ISSUES: PART I(F): THE CURRENT REFUNDING OF THE SERIES 2007 BONDS (ISSUED ON 04/24/2007) AND THE SERIES 2010 BONDS (ISSUED ON 05/24/2010). PART IV, LINE 2B, COLUMN A: BOND A: THE 2012 BONDS MET THE 6 MONTH EXCEPTION TO REBATE. PART IV, LINE 6, COLUMN B: THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD-RESTRICTED ADVANCE REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS. PART VI: DIFFERENCES BETWEEN THE ISSUE PRICE (PART I) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS. SCHEDULE K, PART I, BOND ISSUES: PART I(F): THE CURRENT REFUNDING OF THE SERIES 2012A BONDS (ISSUED ON 08/15/2012). X 243404 FAIR MARKET VALUE X 83 1326491 COST OR SELLING PRICE X 5 17985 FAIR MARKET VALUE X OTHER IN-KIND 27 95820 FAIR MARKET VALUE X AIRLINE TICKETS 1 24000 FAIR MARKET VALUE X GIFT CARDS 12 13380 FAIR MARKET VALUE X INFANT CPR KITS 1 3760 FAIR MARKET VALUE 1 0 1 0 PART I, COLUMN (B): THE HOSPITAL IS REPORTING THE NUMBER OF CONTRIBUTIONS. FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: WE CREATE HOPE AND BUILD HEALTHIER FUTURES. AS A LEADING ACADEMIC CHILDREN'S HOSPITAL, WE FULFILL OUR MISSION BY: CARING FOR CHILDREN, ADOLESCENTS, YOUNG ADULTS, FAMILIES AND EACH OTHER; ADVANCING KNOWLEDGE; PREPARING FUTURE GENERATIONS; BUILDING OUR FINANCIAL STRENGTH. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY DELOITTE TAX LLP, WORKING IN CONJUNCTION WITH CHLA'S FINANCE DEPARTMENT. CHLA'S DIRECTOR OF FINANCE AND CONTROLLER HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE CHIEF FINANCIAL OFFICER. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY AND/OR KNOWLEDGE ABOUT THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE CHIEF FINANCIAL OFFICER AND GENERAL COUNSEL, IN PARTICULAR, REVIEW THE FORM 990 AND ENSURE ACCURACY OF DESCRIPTIONS AND THAT DISCLOSURE IS COMPLETE. THE DRAFT FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF CHLA, ACTING ON BEHALF OF THE BOARD OF DIRECTORS OF CHLA. ONCE THE DRAFT FORM 990 HAS BEEN REVIEWED AND DISCUSSED BY THE AUDIT COMMITTEE, ANY CHANGES RESULTING FROM THEIR REVIEW IS INCORPORATED INTO THE FINAL DRAFT OF THE FORM 990. THE FINAL DRAFT OF THE FORM 990 IS THEN DISTRIBUTED TO THE BOARD OF DIRECTORS VIA A SECURE WEB SITE FOR THEIR REVIEW AND COMMENTS PRIOR TO THE FILING OF THE FORM 990. FORM 990, PART VI, SECTION B, LINE 12C CHLA MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS TO BE ANSWERED BY MEMBERS OF ITS BOARD OF DIRECTORS AND BOARD OF TRUSTEES, OFFICERS, MEDICAL STAFF MEMBERS, AND CERTAIN KEY EMPLOYEES. FURTHERMORE, INDIVIDUALS COVERED BY THE POLICY ARE REQUIRED TO DISCLOSE ANY PERSONAL INTERESTS THAT COULD CREATE A CONFLICT OF INTEREST ON A CONTINUOUS BASIS THROUGHOUT THE YEAR. ANY DISCLOSURES PRESENTING A CONFLICT OF INTEREST ARE EVALUATED BY A COMBINATION OF CHLA'S CONFLICT OF INTEREST COMMITTEE, GENERAL COUNSEL, CHIEF COMPLIANCE OFFICER, CHIEF EXECUTIVE OFFICER, CHIEF MEDICAL OFFICER, RESEARCH COMPLIANCE AND INTEGRITY OFFICER, AND BOARD OF DIRECTORS AND ITS AUDIT COMMITTEE, DEPENDING ON THE INDIVIDUAL MAKING THE DISCLOSURE. DISCLOSURES WILL BE INITIALLY ASSESSED BY CHLA'S OFFICE OF COMPLIANCE AND PRIVACY AND, IF A CONFLICT EXISTS, IT WILL BE REFERRED TO CHLA'S CONFLICT OF INTEREST COMMITTEE FOR FURTHER EVALUATION. IF A CONFLICT EXISTS INVOLVING A CHLA BOARD MEMBER, THE BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING THE CONFLICT AND DETERMINING THE CONFLICT RESOLUTION, WHICH MAY INCLUDE, BUT IS NOT LIMITED TO, A CONFLICT MANAGEMENT STIPULATION REQUIRING THE BOARD MEMBER'S RECUSAL FROM CERTAIN CHLA MATTERS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF CHLA IS CONDUCTED BY THE BOARD OF DIRECTORS OF CHLA. IN DETERMINING THE CHIEF EXECUTIVE OFFICER'S COMPENSATION DURING THE TAX PERIOD OF THIS INFORMATION RETURN THE BOARD WORKED WITH AND RELIED UPON THE COUNSEL AND EXPERTISE OF SULLIVAN, COTTER AND ASSOCIATES, INC., A FIRM WITH EXPERIENCE AND EXPERTISE IN THE AREA OF NON-PROFIT ORGANIZATION EXECUTIVE COMPENSATION. SULLIVAN COTTER PROVIDED REPORTS TO THE BOARD, WHICH FURNISHED THE BASIS FOR THE ESTABLISHMENT OF THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE. THEIR REPORTS WERE BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF HOSPITALS AND HEALTHCARE SYSTEMS THAT ARE CONSIDERED COMPARABLE TO CHLA BASED ON VARIOUS METRICS SUCH AS HOSPITAL TYPE AND REVENUE. THE BOARD DELIBERATED ON THE ISSUE OF THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE IN LIGHT OF THESE REPORTS AND SULLIVAN COTTER WERE AVAILABLE TO ANSWER ANY QUESTIONS REGARDING SUCH REPORTS AND OTHER RELEVANT MATTERS. BASED ON SUCH DELIBERATIONS, BOARD NEGOTIATED A WRITTEN CONTRACT WITH THE CHIEF EXECUTIVE OFFICER. THE PROCESS FOR DETERMINING THE COMPENSATION OF OFFICERS AND OTHER KEY EMPLOYEES OF CHLA IS CONDUCTED BY THE BOARD OF DIRECTORS OF CHLA, WITH SUPPORT AND GUIDANCE FROM THE CHIEF EXECUTIVE OFFICER AND HUMAN RESOURCES DEPARTMENT. IN DETERMINING SUCH EMPLOYEE'S COMPENSATION, DURING THE COMPENSATION SEASON THE HUMAN RESOURCES DEPARTMENT AND THE BOARD WORKED WITH AND RELIED UPON THE COUNSEL AND EXPERTISE OF SULLIVAN COTTER, A FIRM WITH EXPERIENCE AND EXPERTISE IN THE AREA OF NON-PROFIT ORGANIZATION EXECUTIVE COMPENSATION, INCLUDING PEDIATRIC SYSTEMS. SULLIVAN COTTER PROVIDED AN EXECUTIVE COMPENSATION REPORT TO THE HUMAN RESOURCES DEPARTMENT AND THE BOARD WHICH FURNISHED THE BASIS FOR THE ESTABLISHMENT OF SUCH EMPLOYEE'S COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. SULLIVAN COTTERS REPORT WAS BASED ON A REVIEW OF EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF HOSPITALS AND HEALTHCARE SYSTEMS THAT ARE CONSIDERED COMPARABLE TO CHLA BASED ON VARIOUS METRICS SUCH AS HOSPITAL TYPE AND REVENUE. IN ADDITION, THE CHIEF EXECUTIVE OFFICER MADE A RECOMMENDATION TO THE BOARD WITH RESPECT TO EACH OF SUCH EMPLOYEE'S COMPENSATION PACKAGE IN LIGHT OF THE SULLIVAN COTTER REPORT AND IN LIGHT OF THE EXECUTIVE'S PERFORMANCE. AT THE BOARD MEETING ADDRESSING SUCH MATTERS, SULLIVAN COTTER WERE AVAILABLE TO ANSWER ANY QUESTIONS REGARDING SUCH REPORT AND OTHER RELEVANT MATTERS, AND RECOMMENDATIONS FROM THE CHIEF EXECUTIVE OFFICER WERE REQUESTED BY AND PROVIDED TO THE BOARD. BASED ON SUCH DELIBERATIONS, THE BOARD MADE A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR. BASED ON THE APPROVED COMPENSATION, SULLIVAN COTTER OPINED THAT CHLA'S CHIEF EXECUTIVE'S TOTAL COMPENSATION IS REASONABLE AND DEFENSIBLE FROM A REGULATORY PERSPECTIVE UNDER ALL SCENARIOS. THIS OPINION OF REASONABLENESS ALSO APPLIES WITH RESPECT TO THE CALIFORNIA NONPROFIT INTEGRITY ACT OF 2004. BASED ON THE APPROVED COMPENSATION, SULLIVAN COTTER OPINED THAT CHLA'S OFFICER AND KEY EXECUTIVE TOTAL COMPENSATION IS REASONABLE AND DEFENSIBLE FROM A REGULATORY PERSPECTIVE UNDER ALL SCENARIOS. THIS OPINION OF REASONABLENESS ALSO APPLIES WITH RESPECT TO THE CALIFORNIA NONPROFIT INTEGRITY ACT OF 2004. FORM 990, PART VI, SECTION C, LINE 19 CHLA DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. CHLA'S FINANCIAL STATEMENTS ARE CONTAINED IN ITS FORM 990, WHICH IS AVAILABLE FOR PUBLIC INSPECTION DURING BUSINESS HOURS. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 130,470,333. MANAGEMENT AND GENERAL EXPENSES 33,093,653. FUNDRAISING EXPENSES 564,558. TOTAL EXPENSES 164,128,544. MEDICAL-RELATED SERVICES: PROGRAM SERVICE EXPENSES 12,201,856. MANAGEMENT AND GENERAL EXPENSES 640,863. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,842,719. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 29,081,807. MANAGEMENT AND GENERAL EXPENSES 50,846,435. FUNDRAISING EXPENSES 5,186,518. TOTAL EXPENSES 85,114,760. FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS 537,110. TRANSFERS AND OTHERS 610,451. CHANGE IN SWAP MARK TO MARKET 2,699,847. 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