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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW HARDWICK MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>HELEN JONES-KELLEY</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>TIFFANY KELLNER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>ANTHONY R KENNEY</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>LAURENCE KLABEN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS KRZMARZICK MD</PersonNm>
        <TitleTxt>TRUSTEE (UNTIL 7/01/2020)</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JAMIE MCGREGOR</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DAVID C MELIN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>LESLIE C MILLER</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TODD PLEIMAN</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CHRISTINE SOWARD</PersonNm>
        <TitleTxt>TRUSTEE (UNTIL 09/01/2020)</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GREGORY TOUSSAINT MD</PersonNm>
        <TitleTxt>TRUSTEE</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>CHRIS BERGMAN</PersonNm>
        <TitleTxt>CFO</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CINDY BURGER</PersonNm>
        <TitleTxt>VP &amp; CHIEF EXPERIENCE OFFICER</TitleTxt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>CHARLES KIDWELL</PersonNm>
        <TitleTxt>CHIEF LEGAL OFFICER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>BENJAMIN GOODSTEIN</PersonNm>
        <TitleTxt>VP &amp; CHIEF AMBULATORY OFFICER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>KELLY KAVANAUGH</PersonNm>
        <TitleTxt>VP &amp; CHIEF STRATEGY OFFICER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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      <Form990PartVIISectionAGrp>
        <PersonNm>JAYNE GMEINER</PersonNm>
        <TitleTxt>VP &amp; CHIEF NURSING OFFICER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>WRIGHT STATE PHYSICIANS</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>725 UNIVERSITY BLVD</AddressLine1Txt>
            <CityNm>FAIRBORN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45324</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHYSICIAN SERVICES</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>PORTER WRIGHT MORRIS &amp; ARTHUR LLP</BusinessNameLine1Txt>
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        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>41 SOUTH HIGH ST</AddressLine1Txt>
            <CityNm>COLUMBUS</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>43215</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LEGAL SERVICES</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>STERIS INSTRUMENT MANAGEMENT SERVICES</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>PO BOX 531809</AddressLine1Txt>
            <CityNm>ATLANTA</CityNm>
            <StateAbbreviationCd>GA</StateAbbreviationCd>
            <ZIPCd>30353</ZIPCd>
          </USAddress>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>CHILDREN'S EMERGENCY SERVICES INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1 CHILDRENS PLAZA</AddressLine1Txt>
            <CityNm>DAYTON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45404</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PHYSICIAN SERVICES</ServicesDesc>
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      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>OHLMANN GROUP INC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1605 NORTH MAIN STREET</AddressLine1Txt>
            <CityNm>DAYTON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45405</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>ADVERTISING SERVICES</ServicesDesc>
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      <CntrctRcvdGreaterThan100KCnt>36</CntrctRcvdGreaterThan100KCnt>
      <RelatedOrganizationsAmt>12113995</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>13572384</GovernmentGrantsAmt>
      <TotalContributionsAmt>25686379</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PATIENT SERVICE REVENUE</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>274195022</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>274195022</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEDICARE/MEDICAID</Desc>
        <BusinessCd>624100</BusinessCd>
        <TotalRevenueColumnAmt>190542304</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>190542304</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>RELATED ORG RENT</Desc>
        <BusinessCd>532000</BusinessCd>
        <TotalRevenueColumnAmt>144648</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>144648</RelatedOrExemptFuncIncomeAmt>
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        <TotalRevenueColumnAmt>7679401</TotalRevenueColumnAmt>
        <ExclusionAmt>7679401</ExclusionAmt>
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      <NetRentalIncomeOrLossGrp>
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        <ExclusionAmt>818812</ExclusionAmt>
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      <NetGainOrLossInvestmentsGrp>
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        <ExclusionAmt>19147826</ExclusionAmt>
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        <Desc>CAFETERIA</Desc>
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        <ManagementAndGeneralAmt>4730529</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>147354536</ProgramServicesAmt>
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        <ProgramServicesAmt>13633529</ProgramServicesAmt>
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        <ProgramServicesAmt>20808484</ProgramServicesAmt>
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        <ProgramServicesAmt>11660455</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>1063007</ManagementAndGeneralAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>430650</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>117714</ProgramServicesAmt>
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        <ManagementAndGeneralAmt>1026027</ManagementAndGeneralAmt>
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        <ManagementAndGeneralAmt>1047354</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>7327537</ProgramServicesAmt>
        <ManagementAndGeneralAmt>7634070</ManagementAndGeneralAmt>
        <FundraisingAmt>260801</FundraisingAmt>
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        <ProgramServicesAmt>10059888</ProgramServicesAmt>
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        <ProgramServicesAmt>3428905</ProgramServicesAmt>
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        <FundraisingAmt>17572</FundraisingAmt>
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        <ProgramServicesAmt>251806</ProgramServicesAmt>
        <ManagementAndGeneralAmt>375128</ManagementAndGeneralAmt>
        <FundraisingAmt>20481</FundraisingAmt>
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        <ManagementAndGeneralAmt>1329352</ManagementAndGeneralAmt>
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        <ProgramServicesAmt>35849734</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2474263</ManagementAndGeneralAmt>
        <FundraisingAmt>158966</FundraisingAmt>
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        <ManagementAndGeneralAmt>460956</ManagementAndGeneralAmt>
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        <Desc>MEDICAL SUPPLIES AND DR</Desc>
        <TotalAmt>68879139</TotalAmt>
        <ProgramServicesAmt>67176442</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1695982</ManagementAndGeneralAmt>
        <FundraisingAmt>6715</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>BAD DEBT EXPENSE</Desc>
        <TotalAmt>14870310</TotalAmt>
        <ProgramServicesAmt>14870310</ProgramServicesAmt>
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      <OtherExpensesGrp>
        <Desc>STATE HOSPITAL ASSESSME</Desc>
        <TotalAmt>13582261</TotalAmt>
        <ManagementAndGeneralAmt>13582261</ManagementAndGeneralAmt>
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      <OtherExpensesGrp>
        <Desc>REPAIRS AND MAINTENANCE</Desc>
        <TotalAmt>1244286</TotalAmt>
        <ProgramServicesAmt>1134747</ProgramServicesAmt>
        <ManagementAndGeneralAmt>108018</ManagementAndGeneralAmt>
        <FundraisingAmt>1521</FundraisingAmt>
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        <TotalAmt>427855592</TotalAmt>
        <ProgramServicesAmt>344400478</ProgramServicesAmt>
        <ManagementAndGeneralAmt>80280992</ManagementAndGeneralAmt>
        <FundraisingAmt>3174122</FundraisingAmt>
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        <EOYAmt>199366</EOYAmt>
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        <EOYAmt>240337</EOYAmt>
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        <EOYAmt>10415000</EOYAmt>
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        <EOYAmt>92020416</EOYAmt>
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        <EOYAmt>282398046</EOYAmt>
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        <EOYAmt>990108024</EOYAmt>
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        <EOYAmt>1272506070</EOYAmt>
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      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>125877570</ReconcilationRevenueExpnssAmt>
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      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
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        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
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        <ContributorBusinessName>
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        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
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      <PublicationsOrBroadcastInd>0</PublicationsOrBroadcastInd>
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      <OtherActivitiesAmt>30000</OtherActivitiesAmt>
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        <FormAndLineReferenceDesc>PART II-B, LINE 1:</FormAndLineReferenceDesc>
        <ExplanationTxt>LINE 1F: OHIO HOSPITAL ASSOCIATION $5,067 OHIO CHILDREN'S HOSPITAL ASSOCIATION $47,574 CHILDREN'S HOSPITAL ASSOCIATION $22,451 DAYTON DEV COALITION $12,300 DAYTON AREA CHAMBER OF COMMERCE $322 TOTAL $87,714 LINE 1G: MANAGEMENT TIME $30,513 DAYTON CHILDREN'S HOSPITAL SPENDS TIME TRACKING SPECIFIC LEGISLATION THAT IS OF INTEREST TO PEDIATRIC HEALTH ISSUES. IT PROVIDES SUGGESTIONS AND FEEDBACK TO LOCAL, STATE AND FEDERAL LEGISLATURES. THE MAIN FOCUS CONCERNS MEDICAID, CHILDREN'S SPECIFIC HEALTH ISSUES AND MEDICAL EDUCATION FUNDING. LINE 1H: CONSULTING EXPENSE FOR GOVERNMENT ADVOCACY TO STATE AND FEDERAL AGENCIES TO BENEFIT CHILDREN'S HOSPITALS: $30,000 TOTAL LINE 1J : $148,227</ExplanationTxt>
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        <GrantsOrScholarshipsAmt>80760</GrantsOrScholarshipsAmt>
        <EndYearBalanceAmt>1520634</EndYearBalanceAmt>
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        <InvestmentEarningsOrLossesAmt>640717</InvestmentEarningsOrLossesAmt>
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        <EndYearBalanceAmt>1601373</EndYearBalanceAmt>
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        <ContributionsAmt>106014</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>22473043</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>6271797</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>10372</OtherExpendituresAmt>
        <EndYearBalanceAmt>183912987</EndYearBalanceAmt>
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        <Amt>26986997</Amt>
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        <Desc>OTHER LIABILITIES</Desc>
        <Amt>1652265</Amt>
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        <Desc>CAPITAL LEASE PAYABLE</Desc>
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        <ExplanationTxt>THE ENDOWMENTS ARE HELD BY DAYTON CHILDREN'S HOSPITAL FOUNDATION, A SUPPORTING ORGANIZATION OF DAYTON CHILDREN'S HOSPITAL. THE FUNDS ARE USED EXCLUSIVELY TO SUPPORT DAYTON CHILDREN'S HOSPITAL AND ITS SUBSIDIARIES. THE INTENDED USE OF THE FUNDS IS TO COVER EXPENSES FOR THE CARE AND COMFORT PROGRAM.</ExplanationTxt>
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      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
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      <AccountActivitiesOutsideUSGrp>
        <RegionTxt>NORTH AMERICA</RegionTxt>
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      </TotalCommuntityBuildingActyGrp>
      <BadDebtExpenseReportedInd>0</BadDebtExpenseReportedInd>
      <BadDebtExpenseAmt>10190370</BadDebtExpenseAmt>
      <ReimbursedByMedicareAmt>458799</ReimbursedByMedicareAmt>
      <CostOfCareReimbursedByMedcrAmt>458799</CostOfCareReimbursedByMedcrAmt>
      <CostingMethodologyUsedGrp>
        <OtherInd>X</OtherInd>
      </CostingMethodologyUsedGrp>
      <WrittenDebtCollectionPolicyInd>1</WrittenDebtCollectionPolicyInd>
      <FinancialAssistancePrvsnInd>1</FinancialAssistancePrvsnInd>
      <HospitalFacilitiesCnt>1</HospitalFacilitiesCnt>
      <HospitalFacilitiesGrp>
        <FacilityNum>1</FacilityNum>
        <BusinessName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </BusinessName>
        <USAddress>
          <AddressLine1Txt>1 CHILDRENS PLAZA</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>454041815</ZIPCd>
        </USAddress>
        <WebsiteAddressTxt>WWW.CHILDRENSDAYTON.ORG</WebsiteAddressTxt>
        <StateLicenseNum>020035650</StateLicenseNum>
        <LicensedHospitalInd>X</LicensedHospitalInd>
        <GeneralMedicalAndSurgicalInd>X</GeneralMedicalAndSurgicalInd>
        <ChildrensHospitalInd>X</ChildrensHospitalInd>
        <TeachingHospitalInd>X</TeachingHospitalInd>
        <EmergencyRoom24HrsInd>X</EmergencyRoom24HrsInd>
      </HospitalFacilitiesGrp>
      <HospitalFcltyPoliciesPrctcGrp>
        <HospitalFacilityName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </HospitalFacilityName>
        <FacilityNum>1</FacilityNum>
        <FirstLicensedCYOrPYInd>0</FirstLicensedCYOrPYInd>
        <TaxExemptHospitalCYOrPYInd>0</TaxExemptHospitalCYOrPYInd>
        <CHNAConductedInd>1</CHNAConductedInd>
        <CommunityDefinitionInd>X</CommunityDefinitionInd>
        <CommunityDemographicsInd>X</CommunityDemographicsInd>
        <ExistingResourcesInd>X</ExistingResourcesInd>
        <HowDataObtainedInd>X</HowDataObtainedInd>
        <CommunityHealthNeedsInd>X</CommunityHealthNeedsInd>
        <OtherHealthIssuesInd>X</OtherHealthIssuesInd>
        <CommunityHlthNeedsIdProcessInd>X</CommunityHlthNeedsIdProcessInd>
        <ConsultingProcessInd>X</ConsultingProcessInd>
        <PriorCHNAImpactInd>X</PriorCHNAImpactInd>
        <CHNAConductedYr>19</CHNAConductedYr>
        <TakeIntoAccountOthersInputInd>1</TakeIntoAccountOthersInputInd>
        <CHNAConductedWithOtherFcltsInd>0</CHNAConductedWithOtherFcltsInd>
        <CHNAConductedWithNonFcltsInd>0</CHNAConductedWithNonFcltsInd>
        <CHNAReportWidelyAvailableInd>1</CHNAReportWidelyAvailableInd>
        <RptAvailableOnOwnWebsiteInd>X</RptAvailableOnOwnWebsiteInd>
        <OwnWebsiteURLTxt>SEE PART V, SECTION C</OwnWebsiteURLTxt>
        <OtherWebsiteInd>X</OtherWebsiteInd>
        <OtherWebsiteURLTxt>HTTP://WWW.HCNO.ORG/COMMUNITY-SERVICES/COMMUNITY-HEALTH-ASSESSMENTS/</OtherWebsiteURLTxt>
        <PaperCopyPublicInspectionInd>X</PaperCopyPublicInspectionInd>
        <ImplementationStrategyAdoptInd>1</ImplementationStrategyAdoptInd>
        <ImplementationStrategyAdptYr>20</ImplementationStrategyAdptYr>
        <StrategyPostedWebsiteInd>1</StrategyPostedWebsiteInd>
        <StrategyWebsiteURLTxt>SEE PART V, SECTION C</StrategyWebsiteURLTxt>
        <OrganizationIncurExciseTaxInd>0</OrganizationIncurExciseTaxInd>
        <EligCriteriaExplainedInd>1</EligCriteriaExplainedInd>
        <FPGFamilyIncmLmtFreeDscntInd>X</FPGFamilyIncmLmtFreeDscntInd>
        <FPGFamilyIncmLmtFreeCarePct>100.000000000000</FPGFamilyIncmLmtFreeCarePct>
        <FPGFamilyIncmLmtDscntCarePct>400.000000000000</FPGFamilyIncmLmtDscntCarePct>
        <InsuranceStatusCriteriaInd>X</InsuranceStatusCriteriaInd>
        <ResidencyCriteriaInd>X</ResidencyCriteriaInd>
        <ExplainedBasisInd>1</ExplainedBasisInd>
        <AppFinancialAsstExplnInd>1</AppFinancialAsstExplnInd>
        <DescribedInfoInd>X</DescribedInfoInd>
        <DescribedSuprtDocInd>X</DescribedSuprtDocInd>
        <ProvidedHospitalContactInd>X</ProvidedHospitalContactInd>
        <ProvidedNonprofitContactInd>X</ProvidedNonprofitContactInd>
        <IncludesPublicityMeasuresInd>1</IncludesPublicityMeasuresInd>
        <FAPAvailableOnWebsiteInd>X</FAPAvailableOnWebsiteInd>
        <FAPAvailableOnWebsiteURLTxt>SEE PART V, SECTION C</FAPAvailableOnWebsiteURLTxt>
        <FAPAppAvailableOnWebsiteInd>X</FAPAppAvailableOnWebsiteInd>
        <FAPAppAvailableOnWebsiteURLTxt>SEE PART V, SECTION C</FAPAppAvailableOnWebsiteURLTxt>
        <FAPSummaryOnWebsiteInd>X</FAPSummaryOnWebsiteInd>
        <FAPSummaryOnWebsiteURLTxt>SEE PART V, SECTION C</FAPSummaryOnWebsiteURLTxt>
        <FAPAvlblOnRequestNoChargeInd>X</FAPAvlblOnRequestNoChargeInd>
        <FAPAppAvlblOnRequestNoChrgInd>X</FAPAppAvlblOnRequestNoChrgInd>
        <FAPSumAvlblOnRequestNoChrgInd>X</FAPSumAvlblOnRequestNoChrgInd>
        <NotifiedFAPCopyBillDisplayInd>X</NotifiedFAPCopyBillDisplayInd>
        <CommuntityNotifiedFAPInd>X</CommuntityNotifiedFAPInd>
        <FAPTranslatedInd>X</FAPTranslatedInd>
        <FAPActionsOnNonpaymentInd>1</FAPActionsOnNonpaymentInd>
        <PermitNoActionsInd>X</PermitNoActionsInd>
        <CollectionActivitiesInd>0</CollectionActivitiesInd>
        <ProvidedWrittenNoticeInd>X</ProvidedWrittenNoticeInd>
        <MadeEffortOrallyNotifyInd>X</MadeEffortOrallyNotifyInd>
        <ProcessedFAPApplicationInd>X</ProcessedFAPApplicationInd>
        <MadePresumptiveEligDetermInd>X</MadePresumptiveEligDetermInd>
        <NondisEmergencyCarePolicyInd>1</NondisEmergencyCarePolicyInd>
        <LookBackMedicaidMedcrPrvtInd>X</LookBackMedicaidMedcrPrvtInd>
        <AmountsGenerallyBilledInd>0</AmountsGenerallyBilledInd>
        <GrossChargesInd>0</GrossChargesInd>
      </HospitalFcltyPoliciesPrctcGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>DAYTON CHILDREN'S HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 5: PURSUING THE OPTIMAL HEALTH OF ALL CHILDREN IS THE MISSION OF DAYTON CHILDREN'S HOSPITAL. TO HELP DEVELOP MEANINGFUL AND IMPACTFUL COMMUNITY ENGAGEMENT AND CHILD HEALTH PROGRAMS, DAYTON CHILDREN'S EVALUATES THE STATUS OF OUR REGION'S PEDIATRIC HEALTH EVERY THREE YEARS THROUGH OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). DAYTON CHILDREN'S SERVES 20 OHIO COUNTIES AND EASTERN INDIANA, HOWEVER FOR THE PURPOSES OF DETERMINING THE COMMUNITY COVERED BY THIS COMMUNITY HEALTH NEEDS ASSESSMENT THE HOSPITAL CHOSE TO INCLUDE OUR PRIMARY SERVICE AREA WHERE 75 PERCENT OF OUR PATIENT POPULATION COMES FROM. THIS PRIMARY SERVICE AREA COVERS ZIP CODES IN MONTGOMERY, MIAMI, GREENE, CLARK AND WARREN COUNTIES. THESE COUNTIES REPRESENT URBAN, RURAL AND SUBURBAN COMMUNITIES. OUR HEALTH ASSESSMENT FOCUSED ON THE PEDIATRIC POPULATION LIVING IN THESE COUNTIES. SPECIAL ATTENTION HAS BEEN GIVEN TO THE CITY OF DAYTON IN MONTGOMERY COUNTY WHERE DAYTON CHILDREN'S PHYSICALLY IS LOCATED AND HEALTH DISPARITIES FOR CHILDREN ARE MOST CHALLENGING. APPROXIMATELY 29.4% OF DAYTON CITY RESIDENTS WERE BELOW THE POVERTY LINE, ACCORDING TO THE 2018 AMERICAN COMMUNITY SURVEY 1-YEAR ESTIMATES. FOR THIS REASON, DATA IS BROKEN DOWN BY INCOME (LESS THAN $25,000 AND GREATER THAN $25,000) THROUGHOUT THE REPORT TO SHOW DISPARITIES. WHERE POSSIBLE, DATA IS ALSO BROKEN DOWN BY RACE AND AGE TO BETTER UNDERSTAND WHERE HEALTH DISPARITIES EXIST. THIS COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS WAS COMMISSIONED BY DAYTON CHILDREN'S HOSPITAL. MULTIPLE SECTORS, INCLUDING THE GENERAL PUBLIC, WERE ASKED TO PARTICIPATE IN THE VARIOUS PHASES OF THE PROJECT. OVER 25 COMMUNITY PARTNER AGENCIES INCLUDING HEALTH DEPARTMENTS PARTICIPATED IN CHOOSING QUESTIONS FOR THE SURVEY, REVIEWING INITIAL DATA, AND IDENTIFYING AND PRIORITIZING NEEDS. OVER 300 FAMILIES TOOK THE PARENT PERCEPTION SURVEY DURING JANUARY-MARCH 2020. THE FINDINGS ARE BASED ON SELF-ADMINISTERED SURVEYS USING A STRUCTURED QUESTIONNAIRE. THE QUESTIONS WERE MODELED AFTER THE SURVEY INSTRUMENTS USED BY THE NATIONAL SURVEY OF CHILDREN'S HEALTH (NSCH) DEVELOPED BY THE CHILD AND ADOLESCENT HEALTH MEASUREMENT INITIATIVE. DAYTON CHILDREN'S HOSPITAL MET MULTIPLE TIMES TO COMPLETE THE 2020-2023 DAYTON CHILDREN'S IMPLEMENTATION PLAN (IP). DAYTON CHILDREN'S HOSPITAL USED THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS, WHICH IS A COMMUNITY-DRIVEN STRATEGIC PLANNING PROCESS FOR IMPROVING COMMUNITY HEALTH. THIS FRAMEWORK HELPS COMMUNITIES APPLY STRATEGIC THINKING TO PRIORITIZE HEALTH ISSUES AND IDENTIFY RESOURCES TO ADDRESS THEM. DAYTON CHILDREN'S CONTRACTED WITH THE HOSPITAL COUNCIL OF NORTHWEST OHIO, A NEUTRAL NON-PROFIT REGIONAL HOSPITAL ASSOCIATION, TO FACILITATE THE PROCESS. DAYTON CHILDREN'S THEN INVITED KEY COMMUNITY LEADERS TO PARTICIPATE IN AN ORGANIZED PROCESS OF STRATEGIC PLANNING TO IMPROVE THE HEALTH OF CHILDREN OF THE GREATER DAYTON AREA. THEN AN INTERNAL TEAM OF DAYTON CHILDREN'S LEADERS REFINED THE PRIORITIES TO ENSURE ALIGNMENT WITH HOSPITAL STRATEGY AND INVESTMENT. DETAILS OF THIS PROCESS AND ITS RESULTS CAN BE FOUND ON THE DAYTON CHILDREN'S HOSPITAL WEBSITE. DAYTON CHILDREN'S HOSPITAL IS FOCUSED ON THE FOLLOWING PRIORITY HEALTH OUTCOMES: MENTAL HEALTH AND ADDICTION, CHRONIC DISEASE, AND MATERNAL AND INFANT HEALTH. DAYTON CHILDREN'S HOSPITAL WILL ALSO FOCUS ON THE FOLLOWING PRIORITY FACTORS TO ADDRESS MOST, IF NOT ALL, PRIORITY AREAS: COMMUNITY CONDITIONS, AND ACCESS TO CARE.AMID THE PLANNING PROCESS AND AFTER INITIAL CHNA DATA COLLECTION, THE GREATER DAYTON COMMUNITY WAS STRUCK BY COVID-19 ALONG WITH THE REST OF THE COUNTRY. IMMEDIATELY, ISSUES INCLUDING FOOD INSECURITY, UNSTABLE HOUSING, MENTAL HEALTH AND ACCESS TO CARE BECAME MORE PRONOUNCED. COMMUNITY LEADERS EXPRESSED GREAT CONCERN OVER THE IMPACT OF COVID-19 ON THE GREATER DAYTON COMMUNITY AND THEREFORE THIS IMPLEMENTATION PLAN CONSIDERS THE CHANGING AND UNKNOWN ENVIRONMENT BROUGHT ABOUT BY COVID-19.THE HOSPITAL FACILITY ALSO CONSULTED WITH THE FOLLOWING COMMUNITY PARTNERS:ADAMHS BOARD MONTGOMERY COUNTY COMMUNITY DEVELOPMENT, CITY OF DAYTON COMMUNITY HEALTH CENTERS OF GREATER DAYTON DAYTON FOOD BANK HEALTH SERVICES DAYTON PUBLIC SCHOOLS ECHO (EMPOWERING CHILDREN WITH HOPE AND OPPORTUNITY) FIVE RIVERS HEALTH CENTERS FIVE RIVERS METROPARKS GREATER DAYTON AREA HOSPITAL ASSOCIATION GREENE COUNTY PUBLIC HEALTH MIAMI COUNTY PUBLIC HEALTH MIAMI VALLEY CHILD DEVELOPMENT CENTERS MIAMI VALLEY REGIONAL PLANNING COMMISSION MONTGOMERY COUNTY HUMAN SERVICES PLANNING AND DEVELOPMENTMONTGOMERY COUNTY STRATEGIC INITIATIVESMONTGOMERY COUNTY JOB &amp; FAMILY SERVICES/CHILDREN SERVICES MONTGOMERY COUNTY EDUCATIONAL SERVICES CENTER PRESCHOOL PROMISE PUBLIC HEALTH--DAYTON &amp; MONTGOMERY COUNTY UNITED REHABILITATION SERVICES UNITED WAY OF GREATER DAYTON WARREN COUNTY HEALTH DISTRICT WRIGHT STATE UNIVERSITY DEPARTMENT OF PEDIATRICS STATE UNIVERSITY DEPARTMENT OF POPULATION AND PUBLIC HEALTH SCIENCES YMCA OF GREATER DAYTON</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>DAYTON CHILDREN'S HOSPITAL</FormAndLineReferenceDesc>
        <ExplanationTxt>PART V, SECTION B, LINE 11: THE HOSPITAL'S 2020-2023 CHNA AND CORRESPONDING IMPLEMENTATION STRATEGY WAS ADOPTED BY DAYTON CHILDREN'S HOSPITAL BOARD OF TRUSTEES IN JUNE 2020. IN RESPONSE TO THE 2020 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL'S IMPLEMENTATION STRATEGY PLAN OUTLINES HOW THE HOSPITAL WILL WORK TO ADDRESS THE PRIORITIES IDENTIFIED. THE STRATEGIES WERE CHOSEN BASED ON EVIDENCE-BASED GUIDELINES, THE ABILITY TO ADDRESS HEALTH DISPARITIES AND ALIGNMENT WITH REGIONAL AND STATEWIDE AREAS OF FOCUS. TO WORK TOWARD IMPROVING MENTAL HEALTH AND ADDICTION OUTCOMES, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. LAUNCH AND SPREAD THE ON OUR SLEEVE MOVEMENT THROUGHOUT THE DAYTON REGION 2. INTEGRATE BEHAVIORAL HEALTH THROUGHOUT PRIMARY CARE 3. DEVELOP A COMPREHENSIVE SCHOOL-BASED PROGRAM4. ADOPT AND EMBED A COMPREHENSIVE APPROACH TO SUICIDE CARE (ZERO-SUICIDE)5. DEVELOP AND LAUNCH PARTIAL HOSPITALIZATION AND INTENSIVE OUTPATIENT THERAPY SERVICES6. IMPLEMENT THE OAAP STORE IT SAFE PROGRAM7. IMPLEMENT THE ROADMAP PROJECTTO WORK TOWARD IMPROVING CHRONIC DISEASE OUTCOMES, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. IMPLEMENT HEALTHY FOOD INITIATIVES 2. IMPLEMENT SAFE ROUTES TO SCHOOL 3. ENHANCE THE DAYTON ASTHMA ALLIANCE 4. EXPAND THE FOOD INSECURITY AND REFERRAL PROGRAM5. CONTINUE TO ENHANCE THE "FOOD PHARM" PROGRAM 6. INCREASE PHYSICAL ACTIVITY OPPORTUNITIES AMONG FAMILIES 7. IMPLEMENT LEAD PREVENTION QUALITY IMPROVEMENT PROJECT TO WORK TOWARD IMPROVING MATERNAL AND INFANT HEALTH OUTCOMES, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. INCREASE THE USE OF SAFE SLEEP PRACTICES 2. INCREASE BREASTFEEDING AND PROVIDE BREASTFEEDING SUPPORT3. INCREASE PARENTING RESOURCES AND SUPPORTTO WORK TOWARD IMPROVING COMMUNITY CONDITIONS, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. EXPAND SCREENINGS TO ADDRESS SOCIAL NEEDS 2. SUPPORT AND EXPAND STRATEGIES TO IMPROVE KINDERGARTEN READINESS TO WORK TOWARD IMPROVING ACCESS TO CARE, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. PROMOTE PREVENTIVE HEALTH CARE2. FURTHER INTEGRATE COMMUNITY HEALTH WORKERS INTO CLINICAL SERVICES 3. PROVIDE CULTURAL COMPETENCY TRAINING FOR HEALTH CARE PROFESSIONALS</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINE 7A:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CHNA REPORT IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/ADVOCACY-AND-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B, LINES 16A-16C:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/PATIENTS-VISITORS/AFTER-YOUR-VISIT/ BILLING/FINANCIAL-ASSISTANCE</ExplanationTxt>
      </SupplementalInformationGrp>
      <SupplementalInformationGrp>
        <FormAndLineReferenceDesc>PART V, SECTION B LINE 10A:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE IMPLEMENTATION STRATEGY IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/ADVOCACY-AND-OUTREACH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT</ExplanationTxt>
      </SupplementalInformationGrp>
      <FacilityNum>19</FacilityNum>
      <OthHlthCareFcltsNotHospitalGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>1 - SPRINGBORO SOUTH URGENT CARE &amp; OP CARE C</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3333 WEST TECH ROAD</AddressLine1Txt>
            <CityNm>MIAMISBURG</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45342</ZIPCd>
          </USAddress>
          <FacilityTxt>URGENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>2 - HUBER HEIGHTS OUTPATIENT TESTING CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>8501 OLD TROY PIKE</AddressLine1Txt>
            <CityNm>HUBER HEIGHTS</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45424</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>3 - SPRINGFIELD SPECIALTY CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>30 W MCCREIGHT AVENUE</AddressLine1Txt>
            <CityNm>SPRINGFIELD</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45504</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>4 - BEAVERCREEK OUTPATIENT TESTING CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1425 NORTH FAIRFIELD ROAD</AddressLine1Txt>
            <CityNm>BEAVERCREEK</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45432</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>5 - VANDALIA OUTPATIENT TESTING CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>810 FALLS CREEK DRIVE SUITE A</AddressLine1Txt>
            <CityNm>VANDALIA</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45377</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>6 - WARREN COUNTY SPECIALTY CARE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>100 CAMPUS LOOP ROAD SUITE A</AddressLine1Txt>
            <CityNm>FRANKLIN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45005</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>7 - KETTERING OUTPATIENT TESTING CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>4475 FAR HILLS AVENUE</AddressLine1Txt>
            <CityNm>KETTERING</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45429</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>8 - KIDS EXPRESS SPRINGBORO</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>662 N MAIN STREET</AddressLine1Txt>
            <CityNm>SPRINGBORO</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45066</ZIPCd>
          </USAddress>
          <FacilityTxt>EXPRESS CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>9 - TROY OUTPATIENT TESTING CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>865 W MARKET STREET</AddressLine1Txt>
            <CityNm>TROY</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45373</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>10 - CHILD HEALTH PAVILION</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1010 VALLEY STREET</AddressLine1Txt>
            <CityNm>DAYTON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45404</ZIPCd>
          </USAddress>
          <FacilityTxt>PEDIATRIC CARE CLINICS AND COMMUNITY CONNECTIONS</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>11 - KIDS EXPRESS MASON</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>8809 WILKENS BOULEVARD</AddressLine1Txt>
            <CityNm>MASON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45040</ZIPCd>
          </USAddress>
          <FacilityTxt>EXPRESS CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>12 - KIDS EXPRESS WEST CHESTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>7787 COX LANE</AddressLine1Txt>
            <CityNm>WEST CHESTER</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45069</ZIPCd>
          </USAddress>
          <FacilityTxt>EXPRESS CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>13 - COVID TETING LAB - SOUTH CAMPUS</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3300 WEST TECH</AddressLine1Txt>
            <CityNm>MIAMISBURG</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45432</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>14 - HOPE CENTER</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>212 CHESTNUT STREET</AddressLine1Txt>
            <CityNm>MARYSVILLE</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>43040</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>15 - KIDS EXPRESS BEAVERCREEK</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>3301 DAYTON-XENIA ROAD SUITE 200</AddressLine1Txt>
            <CityNm>BEAVERCREEK</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45432</ZIPCd>
          </USAddress>
          <FacilityTxt>EXPRESS CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>16 - BEHAVIORAL HEALTH CENTER SOUTH</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>76 REMICK BOULEVARD</AddressLine1Txt>
            <CityNm>SPRINGBORO</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45066</ZIPCd>
          </USAddress>
          <FacilityTxt>BEHAVIORAL HEALTH CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>17 - BEHAVIORAL HEALTH CENTER DAYTON</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>700 E 1ST STREET</AddressLine1Txt>
            <CityNm>DAYTON</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45402</ZIPCd>
          </USAddress>
          <FacilityTxt>BEHAVIORAL HEALTH CARE</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>18 - MICHAELS HOUSE</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>1016 RAINBOW COURT</AddressLine1Txt>
            <CityNm>FAIRBORN</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45324</ZIPCd>
          </USAddress>
          <FacilityTxt>CHILD ADVOCACY CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
        <OthHlthCareFcltsGrp>
          <BusinessName>
            <BusinessNameLine1Txt>19 - LIMA CLINIC</BusinessNameLine1Txt>
          </BusinessName>
          <USAddress>
            <AddressLine1Txt>730 WEST HIGH STREET</AddressLine1Txt>
            <CityNm>LIMA</CityNm>
            <StateAbbreviationCd>OH</StateAbbreviationCd>
            <ZIPCd>45801</ZIPCd>
          </USAddress>
          <FacilityTxt>OUTPATIENT DIAGNOSTIC CENTER</FacilityTxt>
        </OthHlthCareFcltsGrp>
      </OthHlthCareFcltsNotHospitalGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3C:</FormAndLineReferenceDesc>
        <ExplanationTxt>IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS AND RESIDENCY TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING COSTING METHODOLOGIES WERE USED IN PREPARATION OF SCHEDULE H, PART I, LINE 7:- CHARITY CARE AT COST WAS CALCULATED USING THE COST TO CHARGE RATIO. - UNREIMBURSED MEDICAID WAS CALCULATED USING THE COST TO CHARGE RATIO. - COMMUNITY HEALTH IMPROVEMENT SERVICES WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION. - HEALTH PROFESSIONS EDUCATION COSTS WERE DETERMINED USING THE FACILITY'S MEDICARE COST REPORTED, SUPPLEMENTED BY THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. - SUBSIDIZED HEALTH SERVICES COSTS WERE DETERMINED USING THE FACILITY'S INTERNAL COST ACCOUNTING SYSTEM. THE COST OF THESE SERVICES INCLUDES DIRECT COSTS ATTRIBUTABLE TO HEALTH SERVICES OPERATIONS, TOGETHER WITH AN ALLOCATION OF FACILITY DIRECT AND INDIRECT OVERHEAD USING A COST FINDING METHODOLOGY PATTERNED AFTER THE MEDICARE COST REPORT. - CASH AND IN KIND CONTRIBUTIONS WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7G:</FormAndLineReferenceDesc>
        <ExplanationTxt>DAYTON CHILDREN'S INCLUDED $52,152,970 OF PHYSICIAN CLINIC COSTS IN THE SUBSIDIZED HEALTH SERVICES CATEGORY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART II, COMMUNITY BUILDING ACTIVITIES:</FormAndLineReferenceDesc>
        <ExplanationTxt>AS THE ONLY CHILDREN'S HOSPITAL IN THE REGION, WE TAKE OUR PEDIATRIC EXPERTISE INTO THE COMMUNITY TO SOLVE PROBLEMS AND CREATE A HEALTHY COMMUNITY FOR OUR CHILDREN. OUR COMMUNITY RELATIONSHIPS DEMONSTRATE OUR COMMITMENT TO DAYTON AND THE SURROUNDING COMMUNITY - A COMMUNITY WE HAVE CALLED HOME FOR OVER 50 YEARS. DAYTON CHILDREN'S IS COMMITTED TO WORKING WITH OUR MANY VALUED PARTNERS TO HELP ENSURE DAYTON REMAINS A GREAT CITY FOR CHILDREN TO LIVE, LEARN, GROW AND PLAY.THE DAVINCI PROJECTTHE DAVINCI PROJECT IS A COMPREHENSIVE STRATEGY FOR NEIGHBORHOOD REVITALIZATION SUPPORTED IN THE OLD NORTH DAYTON AND MCCOOK FIELD NEIGHBORHOODS AND THE BUSINESS COMMUNITY AROUND IT INCLUDING DAYTON CHILDREN'S. DAYTON CHILDREN'S LEADS THIS EFFORT AND IS JOINED BY PARTNERS INCLUDING THE CITY OF DAYTON, GREATER OLD NORTH DAYTON BUSINESS ASSOCIATION, THE SALVATION ARMY KROC CENTER, THE UNIVERSITY OF DAYTON FITZ CENTER OF LEADERSHIP IN COMMUNITY, ST. MARY'S COMMUNITY DEVELOPMENT CORP. AND CITYWIDE DEVELOPMENT. THE DAVINCI PROJECT IS WORKING ON EFFORTS TO DEMOLISH NUISANCE BUILDINGS, REALIGN STREETS, BUILD A CHILDREN'S GARDEN, REVITALIZE BUS STOPS, IMPROVE WAYFINDING, AND BEAUTIFY THE NEIGHBORHOOD SO IT CONTINUES TO BE ATTRACTIVE TO FAMILIES AND BUSINESSES. THIS PROJECT IS IMPORTANT TO DAYTON CHILDREN'S, NOT ONLY BECAUSE WE WANT TO BE AN ACTIVE PARTICIPANT IN OUR COMMUNITY, WE WANT PATIENTS, STAFF, VOLUNTEERS AND VISITORS TO FEEL WELCOME WHEN THEY ENTER THE OLD NORTH DAYTON A NEIGHBORHOOD THAT WE ARE PROUD TO CALL HOME.COMMUNITY LEADERSHIPBEYOND PARTICIPATION IN ORGANIZATIONS THAT DIRECTLY IMPACT CHILDREN AND CHILDREN'S HEALTH, DAYTON CHILDREN'S STAFF AND LEADERSHIP SERVE ON VARIOUS COALITIONS TO IMPROVE THE ECONOMIC AND SOCIAL HEALTH OF OUR COMMUNITY INCLUDING THE PRESCHOOL PROMISE, THE FAMILY AND CHILDREN FIRST COUNCIL, DAYTON DEVELOPMENT COALITION, AND THE HOPE CENTER. THROUGH THESE ACTIVITIES, DAYTON CHILDREN'S STRIVES TO CREATE A COMMUNITY THAT IS A PLACE WHERE ALL CHILDREN AND FAMILIES GROW AND THRIVE. IN ADDITION, TO ADDRESS EFFORTS OF HEALTH EQUITY, DIVERSITY AND INCLUSION DAYTON CHILDREN'S SUPPORTS ORGANZATIONS INCLUDING THE NAACP AND THE NATIONAL CONFERENCE FOR COMMUNITY AND JUSTICE.DAYTON CHILDREN'S IS AN INDISPENSABLE RESOURCE TO OUR COMMUNITY BECAUSE WE: -SERVE AS THE COMMUNITY'S SAFETY NET HOSPITAL BY CARING FOR ALL CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, WHILE PROVIDING AND SUBSIDIZING HOSPITAL AND COMMUNITY-BASED SERVICES THAT ARE EITHER LIMITED OR UNAVAILABLE ELSEWHERE IN OUR COMMUNITY.-SERVE AS A VOICE FOR CHILDREN THROUGH PUBLIC POLICY ADVOCACY TO CHANGE LAWS, POLICIES, OR SYSTEMS LEADING TO THE IMPROVEMENT OF HEALTH AND SAFETY FOR CHILDREN AND FAMILIES.-JOIN WITH COMMUNITY PARTNERS AND LEND SUPPORT THROUGHOUT OUR REGION TO IMPROVE THE LIVES OF CHILDREN AND THEIR FAMILIES.-TRAIN FUTURE DOCTORS AND HEALTH CARE PROVIDERS TO BECOME THE NEXT GENERATION OF HIGH QUALITY, PROFESSIONAL PEDIATRIC EXPERTS, OFTEN AT A FINANCIAL LOSS TO THE HOSPITAL.AS A TEACHING HOSPITAL, DAYTON CHILDREN'S IS DEDICATED TO TRAINING THE NEXT GENERATION OF PEDIATRICIANS AND PEDIATRIC SPECIALISTS. EACH YEAR, DAYTON CHILDREN'S HOSTS MEDICAL RESIDENTS FROM THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE. IN ADDITION, DAYTON CHILDREN'S HOUSES THIS COUNTRY'S ONLY CIVILIAN/MILITARY INTEGRATED PEDIATRIC RESIDENCY PROGRAM WITH WRIGHT-PATTERSON AIR FORCE BASE. PHYSICIANS TRAINED AT DAYTON CHILDREN'S ARE CARING FOR CHILDREN IN OUR REGION AND THROUGHOUT THE WORLD. IN ADDITION, WE WORK WITH NUMEROUS COLLEGES AND UNIVERSITIES TO HELP TRAIN STUDENTS IN MULTIPLE DISCIPLINES INCLUDING NURSING, PUBLIC HEALTH, SOCIAL WORK, AND MANY MORE AREAS REQUIRED BY MODERN HEALTHCARE. TRAINING INVOLVES SIGNIFICANT COSTS FAR BEYOND THOSE USUALLY ASSOCIATED WITH PATIENT CARE. HOWEVER, WE RECOGNIZE TRAINING THE NEXT GENERATION OF HEALTH CARE WORKERS IS ESSENTIAL TO THE OVERALL HEALTH OF OUR COMMUNITY. DAYTON CHILDREN'S JOINS WITH OTHER CHILDREN'S HOSPITALS ACROSS THE COUNTRY TO ADDRESS ISSUES UNIQUE TO THE POPULATION WE SERVE. WE WORK WITH THE CHILDREN'S HOSPITAL ASSOCIATION, THE OHIO CHILDREN'S HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION TO ENSURE CHILDREN HAVE A VOICE IN POLICY MATTERS. DAYTON CHILDREN'S FURTHER SUPPORTS COMMUNITY EFFORTS TO IMPROVE THE HEALTH AND SAFETY OF CHILDREN THROUGHOUT THE REGION THROUGH DONATIONS AND SPONSORSHIPS MADE TO PROGRAMS THAT SUPPORT, HELP AND IMPROVE THE HEALTH STATUS OF CHILDREN AND IMPROVE THE QUALITY OF LIFE FOR CHILDREN AND THEIR FAMILIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE OF SELF-PAY ACCOUNTS RECEIVABLE INCLUDING THOSE BALANCES AFTER INSURANCE PAYMENTS AND NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR BAD DEBTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENTS THEMSELVES HAVE BEEN EXHAUSTED, THE HOSPITAL MAY PLACE CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE HOSPITAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTING METHODOLOGY USED IN PREPARATION OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS IS THE COST TO CHARGE RATIO, RATIO OF PATIENT COST-TO-CHARGE. THE DAYTON CHILDREN'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE. A PROVISION FOR BAD DEBT EXPENSE IS SHOWN ON THE PROFIT AND LOSS STATEMENT. THE CALCULATION FOR BAD DEBT EXPENSE IS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES REQUIRING MANAGEMENT TO MAKE ESTIMATES AND ASSUMPTIONS BASED ON HISTORICAL DATA THAT AFFECT THE REPORTED AMOUNTS OF REVENUE AND EXPENSES DURING THE REPORTED PERIOD. LIKEWISE, AN ALLOWANCE FOR BAD DEBT IS SHOWN ON THE BALANCE SHEET UNDER THE SAME PRINCIPLE AFFECTING THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES DURING THE REPORTED PERIOD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 8:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COSTS REPORTED FOR SERVICES PROVIDED TO MEDICARE PATIENTS COME FROM SCHEDULE E OF THE FACILITY'S COST REPORT AS FILED. SINCE DAYTON CHILDREN'S IS REIMBURSED FOR MEDICARE SERVICES UNDER A TEFRA METHODOLOGY, THERE IS NORMALLY NO SHORTFALL, AS ALLOWED COSTS AND PAYMENTS DUE ARE EQUAL.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART III, LINE 9B:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE IN OUR FINANCIAL ASSISTANCE POLICY POSTED UNDER PATIENTS &amp; VISITORS &gt; AFTER YOU VISIT &gt; BILLING &gt; FINANCIAL ASSISTANCE. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT AND OTHER FINANCIAL ASSISTANCE PROGRAMS UP FRONT BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS. EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE-TO-FACE INTERVIEWS. THESE FINANCIAL ASSISTANCE COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE PROGRAMS IF DESIRED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>IN ADDITION TO OUR CHNA, DAYTON CHILDREN'S ASSESSES THE NEEDS OF OUR COMMUNITY IN A VARIETY OF WAYS. WE SERVE AS A KEY COMMUNITY PARTNER ON MANY LOCAL INITIATIVES WHICH ALLOWS US TO BETTER UNDERSTAND COMMUNITY NEEDS AND TRENDS. SPECIFICALLY, WE PARTNER WITH PUBLIC HEALTH DAYTON AND MONTGOMERY COUNTY ON THEIR COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLAN. KEY AREAS WE WORK ON TOGETHER INCLUDE HEALTHY LIFESTYLES AND INFANT MORTALITY. WE ALSO HAVE SEVERAL OTHER COMMUNITY BASED PROGRAMS WHICH ALLOW FOR FEEDBACK ABOUT THE COMMUNITY. CENTER FOR COMMUNITY HEALTH AND ADVOCACYIN FALL 2017, DAYTON CHILDREN'S CREATED THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY TO REALIGN AND ELEVATE CLINICAL PROGRAMS PROVIDING A GREATER FOCUS ON PRIMARY AND PREVENTATIVE CARE AND COMMUNITY ENGAGEMENT PROGRAMS AIMED AT IMPROVING THE HEALTH OF CHILDREN BEYOND THE WALLS OF THE HOSPITAL. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY INTEGRATED OUR PRIMARY CARE CLINIC, DAYTON CHILDREN'S PEDIATRICS, FOSTER/KINSHIP CARE PROGRAMS, COMPLEX CARE CLINIC AND HEALTHY ME CLINIC WITH PROGRAMS ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH INCLUDING THE FAMILY RESOURCE CONNECTION, THE DAYTON ASTHMA ALLIANCE, INJURY PREVENTION PROGRAMS AND OTHER COMMUNITY BASED PROGRAMS TO ENSURE CHILDREN HAVE HEALTHY AND SAFE PLACES FOR ALL CHILDREN TO LIVE, LEARN AND PLAY. THE WORK OF THE CENTER IS DIRECTLY TIED TO THE NEEDS IDENTIFIED THROUGH OUR COMMUNITY HEALTH NEEDS ASSESSMENT. IN SPRING 2019, THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY FOUND A NEW HOME IN THE NEWLY BUILT CHILD HEALTH PAVILION. TO ENSURE THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY CONTINUOUSLY OBTAINS FEEDBACK FROM THE COMMUNITY, A COMMUNITY ADVISORY BOARD OF COMMUNITY LEADERS REPRESENTING KEY CHILD SERVING AGENCIES WAS ASSEMBLED IN SPRING 2019 AND A PATIENT FAMILY ADVISORY BOARD BEGAN IN FALL 2019.IN FISCAL YEAR 2020-2021, AS A STRATEGY IDENTIFIED THROUGH THE CEO'S TASK FORCE ON RACISM, WORK BEGAN TO REFOCUS THE WORK OF THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY TO HAVE A GREATER FOCUS ON HEALTH EQUITY. DAYTON ASTHMA ALLIANCETHE DAYTON ASTHMA ALLIANCE AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, FOCUSING ON THE MOST AT-RISK POPULATIONS. USING THE COLLECTIVE IMPACT FRAMEWORK, THE ALLIANCE ENGAGES LOCAL PARTNER ORGANIZATIONS TO COLLABORATIVELY IMPLEMENT A VARIETY OF STRATEGIC ACTIONS TO IMPROVE OUTCOMES FOR CHILDREN WITH ASTHMA. TO HAVE THE GREATEST IMPACT AND TO ENSURE ALL CHILDREN WITH ASTHMA HAVE OPTIMAL HEALTH OUTCOMES, THE ALLIANCE IDENTIFIED THREE STRATEGIC FOCUS AREAS FOR THEIR WORK 1) ENSURE ASTHMA-FRIENDLY ENVIRONMENTS; 2) ENHANCE ACCESS TO HIGH QUALITY HEALTHCARE AND SUPPORTIVE SOCIAL SERVICES THROUGH CLINICAL-COMMUNITY LINKAGES; AND 3) EDUCATE AND EQUIP CHILDREN, FAMILIES AND THE COMMUNITY FOR ASTHMA WELLNESS. TO SUPPORT WORK IN THESE AREAS, DAYTON CHILDREN'S SERVES AS THE BACKBONE ORGANIZATION CONVENING THE GROUP OF COMMITTED STAKEHOLDERS AND SUPPORTING THE ALLIANCE WITH STAFF AND RESOURCES. THE ALLIANCE IS GOVERNED BY ENTITIES WITH A COMMON PURPOSE TO IMPROVE HEALTH OUTCOMES FOR CHILDREN WITH ASTHMA IN THE DAYTON REGION. THE ALLIANCE CONSULTS WITH ADDITIONAL ORGANIZATIONS TO GATHER DATA AND RESEARCH, ASCERTAIN BEST PRACTICES, AND TO IDENTIFY COMMUNITY RESOURCES TO SUPPORT CHILDREN WITH ASTHMA AND TO INFORM THE STRATEGIC FOCUS AREAS. THIS WORK COULD NOT BE DONE WITHOUT ALIGNMENT WITH A VARIETY OF COMMUNITY STAKEHOLDERS. IN ADDITION TO STAFF AND PERSONNEL FROM DAYTON CHILDREN'S CENTER FOR CHILD HEALTH AND WELLNESS AND DAYTON CHILDREN'S PULMONARY CLINIC, PARTNERS IN THE DAYTON ASTHMA ALLIANCE INCLUDE COMMUNITY PRIMARY CARE PHYSICIANS, COMMUNITY ALLERGISTS, CARESOURCE, COMMUNITY HEALTH CENTERS OF GREATER DAYTON, DAYTON PUBLIC SCHOOLS, GREATER DAYTON PREMIER MANAGEMENT, LEGAL AID OF WESTERN OHIO (MEDICAL-LEGAL PARTNERSHIP), PUBLIC HEALTH - DAYTON &amp; MONTGOMERY COUNTY, MIAMI VALLEY CHILD DEVELOPMENT CENTERS, AND THINK TV. ADDITIONAL PARTNERS AND COLLABORATORS ARE CONTINUALLY INVITED TO JOIN THE ALLIANCE AS THE NEEDS OR INTEREST ARISE.FAMILY RESOURCE CONNECTIONWHEN PATIENTS AND THEIR FAMILIES SEEK MEDICAL CARE, THEY ARE OFTEN FACING ADDITIONAL CRITICAL CHALLENGES IN THEIR LIVES - THEY MAY HAVE LITTLE FOOD, THEY MAY NOT HAVE A JOB, OR THEY STRUGGLE TO KEEP UP WITH BILLS FOR UTILITIES. UNFORTUNATELY, THESE CHALLENGES OFTEN AFFECT THEIR HEALTH. THE FAMILY RESOURCE CONNECTION USES A PATIENT'S VISIT TO THE DOCTOR AS AN OPPORTUNITY TO ADDRESS THE NON-MEDICAL ISSUES THAT HAVE AN IMPACT ON HEALTH. THIS PROGRAM SCREENS PATIENT FAMILIES FOR SOCIAL NEEDS. IDENTIFIED FAMILIES THEN ARE REFERRED TO AN ADVOCATE WORKING IN THE DAYTON CHILDREN'S HOSPITAL FAMILY RESOURCE CONNECTION FOR RESOURCE CONNECTION AND FOLLOW-UP. THE FAMILY RESOURCE CONNECTION IS MODELED AFTER THE WELL-KNOWN AND RESPECTED HEALTH LEADS PROGRAM.IN FISCAL YEAR 2020-2021, THE FAMILY RESOURCE CONNECTION HAS PROVEN OUTCOMES IN CONNECTING PATIENT FAMILIES TO RESOURCES. IN THE PAST YEAR, 2,150 FAMILIES ENGAGED IN THE PROGRAM AND OVER 1,013 RESOURCE CONNECTIONS WERE MADE. THE GREATEST NEEDS IDENTIFIED IN THE FAMILY RESOURCE CONNECTION CONTINUE TO BE FOOD AND COMMODITIES INCLUDING DIAPERS, CRIBS AND BEDS, SCHOOL SUPPLIES AND CLOTHING.IN ADDITION TO PROVIDING POSITIVE OUTCOMES FOR FAMILIES, THE FAMILY RESOURCE CONNECTION HELPS TO TRAIN THE NEXT GENERATION OF THE HEALTHCARE WORKFORCE. OVER THE LAST YEAR, 33 STUDENT ADVOCATES FROM MULTIPLE COLLEGES AND UNIVERSITIES IN A VARIETY OF PROGRAMS AND MAJORS ENGAGED WITH THE PROGRAM. THE STUDENTS HAVE RANGED FROM CERTIFICATE PROGRAMS, ASSOCIATE, BACHELOR TO MASTER'S DEGREES WITH A VARIETY OF PROGRAMS AND MAJORS WHICH HAVE INCLUDED PRE-MEDICAL, SOCIAL WORK, HEALTH CARE ADMINISTRATION, PUBLIC HEALTH, SOCIAL SERVICES AND HEALTH CARE NAVIGATOR. IN THE SPRING OF 2021, DAYTON CHILDREN'S HOSPITAL PARTNERED WITH MONTGOMERY COUNTY TO PARTICIPATE IN THE EARNED INCOME TAX ASSISTANCE (EITC) PROGRAM TO HELP PATIENT FAMILIES AND STAFF PREPARE AND FILE THEIR 2020 TAXES. THIS PROGRAM, RUN THROUGH THE VOLUNTEER INCOME TAX ASSISTANCE (VITA) GRANT, IS AN IRS INITIATIVE DESIGNED TO SUPPORT FREE TAX PREPARATION SERVICES TO THE UNDERSERVED. THE FAMILY RESOURCE CONNECTION STAFF AND STUDENTS WERE IRS TRAINED AND PREPARED 51 TAX RETURNS WITH 10 OF THEM RECEIVING THE EARNED INCOME TAX CREDIT TOTALING $21,290.RONALD MCDONALD HOUSEAS MORE COMPLEX CARE MOVES TO AN OUTPATIENT SETTING, THE NEED FOR FAMILIES TO BE CLOSE TO THE HOSPITAL FOR TREATMENT CONTINUES TO GROW. THIS FISCAL YEAR, DAYTON CHILDRENS PROVIDED A SIGNIFICANT GIFT TO SUPPORT THE EXPANSION OF THE LOCAL RONALD MCDONALD HOUSE. THE EXPANDED RONALD MCDONALD HOUSE WILL PROVIDE LODGING FOR MORE PATIENTS AND THEIR FAMILIES DURING MULTI-DAY TREATMENTS IN THE OUTPATIENT CLINIC AS WELL AS MORE CASES REQUIRING INPATIENT STAYS WITH SPECIALISTS AT DAYTON CHILDREN'S. THE RONALD MCDONALD HOUSE ALSO SERVES PATIENT FAMILIES FROM ALL LOCAL HOSPITALS. KISER NEIGHBORHOOD SCHOOLS CENTERDAYTON CHILDREN'S IS THE NONPROFIT COMMUNITY PARTNER TO KISER NEIGHBORHOOD SCHOOLS CENTER, AS PART OF THE DAYTON PUBLIC SCHOOL'S NEIGHBORHOOD SCHOOL CENTER PROGRAM. NEIGHBORHOOD SCHOOL CENTERS ARE DAYTON PUBLIC SCHOOLS THAT ARE CENTERED ON THEIR NEIGHBORHOODS, SERVING AS HEALTHY PLACES OF LEARNING FOR CHILDREN AND FAMILIES. THEY SEEK TO IMPROVE STUDENT PERFORMANCE, REALIGN COMMUNITY RESOURCES TO SUPPORT YOUTH ACHIEVEMENT AND IMPROVE QUALITY OF LIFE IN THE NEIGHBORHOOD. FOCUSED ON COMMUNITY LEADERSHIP, NEIGHBORHOOD SCHOOL CENTERS BRING TOGETHER PARTNERS TO OFFER A RANGE OF OPPORTUNITIES TO CHILDREN, FAMILIES, AND COMMUNITIES. TO AID IN THIS PARTNERSHIP, A GRANT-FUNDED DAYTON CHILDREN'S STAFF MEMBER SERVES AS A FAMILY RESOURCE COORDINATOR IN THE SCHOOL. IN ADDITION TO MANAGING THE DUTIES OF THE FAMILY RESOURCE COORDINATOR, DAYTON CHILDREN'S OFFERS VARIOUS SERVICES AND RESOURCES TO CHILDREN AT KISER INCLUDING TUTORS. THIS IS A KEY PARTNERSHIP AS KISER NEIGHBORHOOD SCHOOLS CENTER IS IN OUR BACKYARD, THE GREATER OLD NORTH DAYTON.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE UNDER THE "BILLING" TAB. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT, AND OTHER FINANCIAL ASSISTANCE PROGRAMS BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE-TO-FACE INTERVIEWS. THESE FINANCIAL COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 4:</FormAndLineReferenceDesc>
        <ExplanationTxt>DAYTON CHILDREN'S HOSPITAL IS LOCATED IN OLD NORTH DAYTON, NORTHEAST OF DOWNTOWN DAYTON AND THE URBAN CORE, IN MONTGOMERY COUNTY IN SOUTHWESTERN OHIO. THE HOSPITAL'S ROOTS CAN BE TRACED BACK TO 1919, WHEN PHILANTHROPIST AND ACTIVIST ANNA BARNEY GORMAN PLANNED A NORTH DAYTON COMMUNITY CENTER TO OFFER HEALTH SERVICES, EDUCATION AND RECREATION. THE BARNEY COMMUNITY CENTER LATER DEVELOPED INTO THE BARNEY CONVALESCENT HOSPITAL, WHICH CARED FOR POLIO VICTIMS. IN 1967 A FULL-SERVICE CHILDREN'S HOSPITAL, THE BARNEY CHILDREN'S MEDICAL CENTER, OPENED. THE NAME WAS CHANGED IN 1970 TO THE CHILDREN'S MEDICAL CENTER OF DAYTON. IN SPRING 2013, THE HOSPITAL CHANGED ITS NAME ONCE AGAIN TO DAYTON CHILDREN'S HOSPITAL. THE HOSPITAL CELEBRATED ITS 50-YEAR ANNIVERSARY IN 2017. DAYTON CHILDREN'S NOW SERVES INFANTS, CHILDREN AND TEENS FROM 20 OHIO COUNTIES, WITH 75 PERCENT OF PATIENTS COMING FROM MONTGOMERY, GREENE, CLARK, MIAMI AND NORTHERN WARREN COUNTIES. THE SERVICE AREA SPANS 9,000 SQUARE MILES WITH A 2.1 MILLION PEDIATRIC POPULATION THAT INCLUDES POOR URBAN AND RURAL AREAS. DAYTON CHILDREN'S IS THE ONLY PEDIATRIC HEALTH CARE PROVIDER AND THE LARGEST PROVIDER OF MEDICAL CARE TO LOW-INCOME CHILDREN IN THE REGION. CURRENTLY, THE HOSPITAL SERVES A DISPROPORTIONATE SHARE OF CHILDREN FROM LOW-INCOME FAMILIES. OVER 55 PERCENT OF THE PATIENTS AT DAYTON CHILDREN'S ARE COVERED BY MEDICAID. IN ADDITION, DAYTON CHILDREN'S SERVES AS THE PEDIATRIC RESOURCE FOR MILITARY FAMILIES STATIONED AT NEARBY WRIGHT-PATTERSON AIR FORCE BASE. DAYTON CHILDREN'S HAS ALWAYS BELIEVED THAT INFANTS, CHILDREN AND TEENS NEED TO BE CARED FOR BY PEDIATRIC SPECIALISTS. WITH IMPROVED ACCESS TO PEDIATRIC SPECIALTY SERVICES, THE HOSPITAL PROVIDES EXPERT CARE TO 382,391 CHILDREN IN ITS 20-COUNTY REGION. OUTPATIENT AND ALTERNATIVE SERVICES INCLUDE PEDIATRIC LABORATORY AND IMAGING WHICH COMPLEMENT THE HOSPITAL'S INPATIENT SERVICES. MANY PROGRAMS HAVE RECEIVED CERTIFICATIONS AND ACCREDITATIONS FROM ORGANIZATIONS SETTING THE STANDARDS OF QUALITY CARE; THE HOSPITAL'S SCORES FROM THE JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATIONS ARE CONSISTENTLY AMONG THE HIGHEST IN THE NATION: IN NOVEMBER 2019 THE AMERICAN COLLEGE OF SURGEONS NAMED DAYTON CHILDREN'S AS A LEVEL 1 PEDIATRIC TRAUMA CENTER. THE TRAUMA DEPARTMENT SAW OVER 1,000 PATIENTS IN 2019/2020. IN JUNE 2019, DAYTON CHILDREN'S RANKED IN THE TOP 50 CHILDREN'S HOSPITALS IN THE COUNTRY FOR CARE IN PULMONOLOGY IN U.S. NEWS AND WORLD REPORT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 5:</FormAndLineReferenceDesc>
        <ExplanationTxt>IN AN EFFORT TO BETTER ALIGN AND FOCUS ON OUR COMMUNITY ENGAGEMENT AND COMMUNITY HEALTH EFFORTS, IN FALL 2017, DAYTON CHILDREN'S FORMALLY ESTABLISHED THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY REALIGNS AND ELEVATES CLINICAL PROGRAMS PROVIDING A GREATER FOCUS ON PRIMARY AND PREVENTATIVE CARE AND COMMUNITY ENGAGEMENT PROGRAMS AIMED AT IMPROVING THE HEALTH OF CHILDREN BEYOND THE WALLS OF THE HOSPITAL. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY PUTS OUR CHILDREN'S HEALTH AGENDA IN FOCUS EMPHASIZING OUR COMMITMENT TO IMPROVING THE HEALTH STATUS OF ALL CHILDREN AND UNDERSCORING OUR COMMITMENT TO MOST VULNERABLE POPULATIONS AND HEALTH DISPARITIES.HAVE YOU HEARD THE PHRASE "A PERSON'S HEALTH IS DETERMINED MORE BY ZIP CODE THAN GENETIC CODE?" THAT PHRASE HAS BECOME POPULAR BECAUSE WE NOW KNOW THAT AT THE MAJORITY OF WHAT CONTRIBUTES TO A CHILD'S WELLNESS IS RELATED TO THE FAMILY WITH WHOM THEY LIVE AND THE ENVIRONMENT IN WHICH THEY ARE RAISED. CONSIDER A CHILD WITH ASTHMA WHO MAY RECEIVE MEDICATION AND EDUCATION FROM A PEDIATRICIAN HOWEVER LIVES IN A HOME WITH MOLD, PESTS AND SECONDHAND SMOKE WHICH CAUSE HIS OR HER ASTHMA TO BE UNCONTROLLED. THERE EXIST SOCIAL DETERMINANTS OF HEALTH SUCH AS POVERTY, LACK OF QUALITY AFFORDABLE HOUSING, EXPOSURE TO VIOLENCE AND NEGLECT, AND FOOD INSECURITY THAT ARE CRITICAL TO DETRACTING FROM A CHILD'S HEALTH AND WELLBEING. WE KNOW CHILDREN LIVE IN THE CONTEXT OF THEIR FAMILY AND COMMUNITY AND CLINICAL-COMMUNITY LINKAGES ARE ESSENTIAL TO IMPROVE CHILDREN'S HEALTH.AT DAYTON CHILDREN'S WE ARE PART OF THE TRANSFORMATION OF HEALTH CARE. JUST AS WE HAVE STATE-OF-THE-ART SERVICES FOR CHILDREN WHO ARE UNWELL DUE TO MEDICAL ISSUES, SO TOO DO WE NEED A STATE-OF-THE-ART RESPONSE FOR CHILDREN THAT ARE UNWELL BECAUSE OF THE ENVIRONMENT IN WHICH THEY ARE RAISED AND THE SOCIAL DETERMINANTS OF HEALTH WHICH THEY EXPERIENCE. DAYTON CHILDREN'S CENTER FOR COMMUNITY HEALTH AND ADVOCACY IS THE FIRST STEP IN THAT RESPONSE AND WILL WORK TO INTEGRATE CLINICAL SERVICES AND COMMUNITY-BASED PROGRAMS TO SUPPORT CHILDREN AND THEIR FAMILIES. THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY IS RESPONSIBLE FOR THE PLANNING AND EXECUTION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN ALONG WITH MANY OTHER COMMUNITY BENEFIT PROGRAMS. PROGRAMS AND SERVICES ALIGNED UNDER THE CENTER FOR COMMUNITY HEALTH AND ADVOCACY-DAYTON CHILDREN'S PEDIATRICS IS A PRIMARY CARE PATIENT-CENTERED MEDICAL HOME PROVIDING COMPREHENSIVE WELL-CHILD SERVICES, TREATMENT FOR ILLNESSES AND MEDICAL CONDITIONS, AND REFERRALS FOR SPECIALTY CARE. DAYTON CHILDREN'S PEDIATRICS IS ALSO THE HOME OF PRIMARY CARE TRAINING FOR MANY OF THE PEDIATRIC MEDICINE RESIDENTS AT THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE.-A SPECIALTY MEDICAL HOME TO SUPPORT CHILDREN WITH DISPARATE MEDICAL AND BEHAVIORAL HEALTH CARE NEEDS, INCLUDING CHILDREN IN FOSTER/KINSHIP CARE AND CHILDREN WITH MEDICAL COMPLEXITIES. PATIENTS IN THESE PROGRAMS BENEFIT FROM DEDICATED CARE COORDINATION, SOCIAL WORK, AND COMMUNITY HEALTH WORKER SUPPORT.-THE DIVISION OF CHILD ADVOCACY INCLUDING THREE CHILD ADVOCACY CENTERS: CARE HOUSE, MICHAEL'S HOUSE, AND THE WARREN COUNTY CHILD ADVOCACY CENTER. THE DIVISION PROVIDES COMPREHENSIVE ASSESSMENTS FOR CHILDREN WHO ARE SUSPECTED VICTIMS OF ALL FORMS OF CHILD MALTREATMENT, INCLUDING PHYSICAL AND SEXUAL ABUSE. -A CONSULTATIVE SERVICE TO SUPPORT CHILDREN DEALING WITH ISSUES RELATED TO WEIGHT MANAGEMENT AND HEALTHY LIFESTYLES. THIS PROGRAM PROVIDES MULTIDISCIPLINARY SUPPORT INCLUDING RECOMMENDATIONS ON HEALTHY EATING, EXERCISE, AND DIAGNOSIS AND MANAGEMENT OF COMPLICATIONS RELATED TO OBESITY. -A COMMUNITY HEALTH WORKER PROGRAM WHEREBY NAVIGATORS INTEGRATE INTO CLINICS WHILE PROVIDING COMMUNITY SUPPORTS FOR CHILDREN AND FAMILIES.-COMMUNITY ENGAGEMENT PROGRAMS OUTLINED WITHIN THE CHNA IMPLEMENTATION PLAN INCLUDING THE FAMILY RESOURCE CONNECTION, THE DAYTON ASTHMA ALLIANCE, WHICH AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, THE SAFE KIDS GREATER DAYTON COALITION AND OTHER INJURY PREVENTION PROGRAMMING. WHILE THE CENTER EXTENDS WELL BEYOND THE WALLS OF THE HOSPITAL AND OUR CAMPUS ON VALLEY STREET, THE NEW HOME OF THE CENTER'S ADMINISTRATION WILL BE AT OUR NEW CHILD HEALTH PAVILION ON THE CORNER OF VALLEY AND STANLEY STREETS. CONSTRUCTION FOR THE CHILD HEALTH PAVILION BEGAN IN FISCAL YEAR 2017-2018 WITH A TENTATIVE OPENING IN SPRING 2019. INJURY PREVENTIONDAYTON CHILDREN'S CONTINUES OUR WORK TO PREVENT CHILDHOOD INJURIES AS UNINTENTIONAL INJURY IS A LEADING CAUSE OF DEATH AND DISABILITY FOR CHILDREN ACROSS THE COUNTY AND REGIONALLY. DAYTON CHILDREN'S WORKS WITH PARTNERS SUCH AS THE OHIO INJURY PREVENTION PARTNERSHIP, OHIO OCCUPANT PROTECTION REGIONAL COORDINATOR PROGRAM, AND THE MONTGOMERY COUNTY CHILD FATALITY REVIEW BOARD TO ADDRESS SOME OF THE KEY UNINTENTIONAL INJURIES TO CHILDREN IN OUR COMMUNITY, SUCH AS MOTOR VEHICLE ACCIDENTS, PEDESTRIAN ACCIDENTS, AND UNSAFE SLEEP PRACTICES. DAYTON CHILDREN'S IS THE LEAD AGENCY OF SAFE KIDS GREATER DAYTON, WHICH IS OUR REGION'S LEADER IN CHILDHOOD INJURY PREVENTION PROGRAMMING. THE SAFE KIDS GREATER DAYTON COALITION ADDRESSES KEY PEDIATRIC SAFETY ISSUES WITH COMMUNITY PROGRAMMING INCLUDING CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, HOME/FIRE SAFETY, MEDICATION POISONING PREVENTION, WATER SAFETY AND BICYCLE HELMET EDUCATION. DUE TO THE COVID-19 PANDEMIC ALL SAFE KIDS GREATER DAYTON PROGRAMMING WAS VIRTUAL THIS YEAR. PROGRAMMING INCLUDED VIRTUAL BIKE AND PEDESTRIAN SAFETY EDUCATION AND VIRTUAL HOME SAFETY EDUCATION TO SEVEN AREA SCHOOLS. DAYTON CHILDREN'S RECEIVED FUNDING FROM THE OHIO DEPARTMENT OF TRANSPORTATION TO IMPLEMENT SAFE ROUTES TO SCHOOLS PROGRAMING FOR THE DAYTON PUBLIC SCHOOLS IN JULY 2020. SUCCESSES INCLUDED CREATING BLOGS, SOCIAL MEDIA POSTS AND BILLBOARD TO PROMOTE A PEDESTRIAN SAFETY CAMPAIGN. ADDITIONALLY, THE SAFE ROUTES TO SCHOOL PROGRAM COMPLETED A PARENT SURVEY AND PROVIDED A VIRTUAL BIKE SAFETY COURSE CALLED GIRLS IN GEAR WITH 11 GIRLS COMPLETING THE PROGRAM.DAYTON CHILDREN'S RECEIVED FUNDING FROM THE OHIO CHILDREN'S TRUST FUND TO IMPLEMENT AN EARLY CHILDHOOD SAFETY INIATIVE. THIS FUNDING ALLOWED DAYTON CHILDREN'S TO EDUCATE AND PROVIDE NEEDED SAFETY EQUIPMENT TO 81 ELIGIBLE FAMILIES. EDUCATION COVERED HOME SAFETY FOR CHILDREN AGES ZERO TO THREE AND EQUIPMENT RECEIVED BY FAMILIES INCLUDED CRIBS, TODDLER BEDS, STOLLERS, HIGHCHAIRS, SAFETY GATES AND CHILDPROOFING EQUIPMENT.DAYTON CHILDREN'S HOSPITAL HAS ADDITIONAL OUTREACH PROGRAMS TO PREVENT INJURY THAT EDUCATE PROFESSIONALS TO UNDERSTAND THE UNIQUE PHYSIOLOGY OF CHILDREN. THESE PROGRAMS INCLUDE EMS OUTREACH AND EDUCATION, THE NURSING LIAISON PROGRAM AND SPORTS MEDICINE. DAYTON CHILDREN'S EMS OUTREACH COORDINATORS TRAINED THE STAFF AT 20 FIRE DEPARTMENTS ON SPECIFIC PEDIATRIC TRAUMA CASES AS WELL AS CHILDREN WITH SPECIFIC HEALTH CARE NEEDS. BY COVERING TOPICS RANGING FROM SEIZURES TO RESPIRATORY, TO HIDDEN HAZARDS (POISON), THE EMS OUTREACH COORDINATORS ENSURE EMTS ARE EDUCATED IN VARIOUS PEDIATRIC HEALTH ISSUES. THE EMS OUTREACH COORDINATORS ENSURE DAYTON CHILDREN'S NURSE LIAISONS PROVIDE CONTINUING EDUCATION TO COMMUNITY AND SCHOOL NURSES IN MONTGOMERY AND CLARK COUNTIES. COMMUNITY AND SCHOOL NURSES RECEIVED TRAINING ON SEIZURES, SCHOOL AVOIDANCE, USE OF NARCAN, AND OTHER PERTINENT TOPICS. DAYTON CHILDREN'S SPORTS MEDICINE PROGRAM PROVIDED SERVICES AT SPORTING TOURNAMENTS AND PROVIDED FREE BASELINE CONCUSSION SCREENINGS TO CHILDREN AGES 11 AND OVER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 7, REPORTS FILED WITH STATES</FormAndLineReferenceDesc>
        <ExplanationTxt>OH</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART VI, LINE 2 CONTINUED:</FormAndLineReferenceDesc>
        <ExplanationTxt>AMERICORPS CORPS FOR RURAL AND URBAN SUCCESS IN HEALTH (CRUSH) THE AMERICORPS CORPS FOR RURAL AND URBAN SUCCESS IN HEALTH (CRUSH) IS A PROGRAM DAYTON CHILDREN'S SUPPORTS IN PARTNERSHIP WITH THE BOONSHOFT SCHOOL OF MEDICINE AND JOHN CARROLL UNIVERSITY. THROUGH THIS PROGRAM, HIGH SCHOOL AND COLLEGE STUDENT LOOK AT HEALTH DISPARITIES WITHIN THEIR COMMUNITY AND DESIGN GRASSROOTS PROJECTS CENTERED ON IMPACTING THOSE ISSUES. STUDENT GROUPS PARTICIPATING IN THIS PROGRAM HAVE COMPLETED PROJECTS ADDRESSING KEY ISSUES INCLUDING TEEN HOMELESSNESS, MENTAL HEALTH, DIABETES, NUTRITION, IMMIGRANT INCLUSION AND MORE. THE GOAL OF HPAC IS NOT ONLY TO GIVE THESE STUDENTS AN OPPORTUNITY TO MAKE A POSITIVE CHANGE IN THEIR COMMUNITY, BUT TO ENCOURAGE THEM TO THINK ABOUT CHOOSING A CAREER IN HEALTH CARE, WHICH IN TURN CREATES A MORE DIVERSE WORKFORCE.MONTGOMERY COUNTY IMAGINATION LIBRARY IN DECEMBER 2019, DAYTON CHILDREN'S HOSPITAL PARTNERED WITH MONTGOMERY COUNTY AND OTHER LOCAL ORGANIZATIONS TO LAUNCH THE OHIO GOVERNOR'S IMAGINATION LIBRARY INITIATIVE TO PROVIDE FREE BOOKS TO LOCAL CHILDREN FOUR YEARS OLD AND YOUNGER, THROUGH A PARTNERSHIP WITH DOLLY PARTON'S IMAGINATION LIBRARY. THE PROGRAM IS AIMED AT INCREASING LITERACY AND EARLY LEARNING OPPORTUNITIES FOR CHILDREN THROUGHOUT MONTGOMERY COUNTY, AND WILL BE PROVIDED FREE OF CHARGE TO LOCAL FAMILIES. THIS PROGRAM ADDRESSES A KEY NEED IN OUR COMMUNITY AROUND KINDERGARTEN READINESS A BUILDING BLOCK FOR A HEALTHY COMMUNITY AND STRONG WORKFORCE.CENTRAL STATE SERVICE WORKS SCHOLARS PROGRAMDAYTON CHILDREN'S PARTNERED WITH CENTRAL STATE UNIVERSITY THROUGH THE CENTRAL STATES SERVICE WORKS SCHOLAR PROGRAM, WHICH PROVIDES STUDENTS FROM THIS HISTORICALLY BLACK UNIVERSITY A PAID INTERNSHIP IN THEIR AREA OF STUDY. INTERNS RECEIVE RELEVANT WORK EXPERIENCE, NETWORKING OPPORTUNITIES, AND POTENTIAL EMPLOYMENT AFTER GRADUATION WHILE REDUCING PERSONAL DEBT. THIS ALIGNS WITH DAYTON CHILDREN'S MISSION TO PROMOTE OUR DIVERSITY AND INCLUSION INITIATIVES. IN THE 2020-2021 ONE (1) STUDENT SPENT 15 HOURS EACH WEEK IN THIS PAID INTERNSHIP FOR ONE SEMEMESTER. THE PROGRAM DID NOT RUN THE FULL YEAR BECAUSE CENTRAL STATE UNIVERSITY CONDUCTED ITS CLASSES VIRTUALLY DUE TO COVID-19.IN FISCAL YEAR 2020, DAYTON CHILDREN'S CREATED A COMMUNITY CONTRIBUTION PROGRAM TO PROVIDE SUPPORT COMMUNITY PROGRAMS THAT FOCUS ON IMPROVING HEALTH OUTCOME FOR CHILDREN. ORGANIZATIONS ARE ASKED TO SUBMIT AN APPLICATION TO ENSURE FUNDING ALIGNS WITH COMMUNITY BENEFIT REQUIREMENTS AND STRATEGIES. THE HOSPITAL LOOKS AT THE FOLLOWING ITEMS WHEN FUNDING PROPOSALS. - SOCIAL CORRELATES OF HEALTH THROUGH UPSTREAM APPROACHES: WE KNOW A CHILD'S HEALTH IS GREATLY RELATED TO THE ENVIRONMENT IN WHICH HE OR SHE LIVES. THE SOCIAL CORRELATES OF HEALTH ARE ALL THE ENVIRONMENTAL FACTORS THAT INFLUENCE HEALTH, INCLUDING EARLY CHILDHOOD DEVELOPMENT, EMPLOYMENT OPPORTUNITIES, FOOD INSECURITY, AIR AND WATER QUALITY, TRANSPORTATION, EDUCATIONAL ATTAINMENT, PUBLIC SAFETY, AND HOUSING.- HEALTH EQUITY &amp; DISPARITIES: HEALTH DISPARITIES ARE THE DIFFERENCES IN HEALTH OUTCOMES BASED ON RACE, ETHNICITY, SEXUAL ORIENTATION, AND/OR SOCIO-ECONOMIC STATUS. HEALTH EQUITY IS ACHIEVED WHEN CHARACTERISTICS SUCH AS RACE, GENDER, SEXUAL IDENTITY, AND MORE ARE NOT CORRELATED TO HIGHER RATES OF ADVERSE HEALTH OUTCOMES.- COLLABORATION AND PARTNERSHIP: PROGRAMS THAT VALUE PARTNERSHIPS AND ALIGN THE PRACTICES AND PERSPECTIVES OF COMMUNITIES, HEALTH SYSTEMS AND PUBLIC HEALTH UNDER A SHARED VISION HELP FACILITATE STRONG COLLABORATION AND PARTNERSHIPS. PROGRAMS THAT DRAW UPON THE STRENGTHS OF EACH PARTNER TO HAVE A GREATER COLLECTIVE IMPACT.- COMMUNITY-INFORMED DECISION MAKING: PROGRAMS THAT ENGAGE NEIGHBORHOOD RESIDENTS AND COMMUNITY LEADERS AS KEY VOICES THROUGHOUT ALL STAGES OF PLANNING AND IMPLEMENTATION HONOR THE UNIQUE EXPERIENCE OF THOSE IMPACTED BY THE INTERVENTION. - DATA-DRIVEN AND EVIDENCE-BASED INTERVENTIONS: PROGRAMS THAT USE DATA FROM BOTH CLINICAL AND COMMUNITY SOURCES AS A TOOL TO IDENTIFY KEY NEEDS, MEASURE MEANINGFUL CHANGE, AND CREATE TRANSPARENCY AMONGST STAKEHOLDERS. IDENTIFYING PROVEN STRATEGIES THAT HAVE TANGIBLE RESULTS. - ALIGNED WITH REGIONAL, STATEWIDE AND NATIONAL STRATEGIES: PROGRAMS THAT ARE ALIGNED WITH THE AMERICAN ACADEMY OF PEDIATRICS, HEALTHY PEOPLE 2020, THE STATE HEALTH IMPROVEMENT PLAN AND OTHER REGIONAL HEALTH IMPROVEMENT PLANS TO CONTRIBUTE TO A GREATER IMPACT ON CHILDREN'S HEALTH.THE FOLLOWING ORGANIZATIONS RECEIVED FUNDING IN FISCAL YEAR 2021: GOODWILL EASTER SEALS, ARTEMIS CENTER, AMERICAN CANCER SOCIETY, BIG BROTHERS AND BIG SISTERS, GIRLS ON THE RUN, CHRIST CHILD SOCIETY, BOYS AND GIRLS CLUB OF DAYTON, DAYBREAK, DAYTON METRO LIBRARY, GEM CITY MARKET, AND THE YWCA OF DAYTON.IN ADDITION, THE HOSPITAL FINANCIALLY SUPPORTED VARIOUS COMMUNITY AGENCIES INCLUDING CULTUREWORKS, JUVENILE DIABETES RESEARCH FOUNDATION, MARCH OF DIMES, UNITED REHABILITATION SERVICES, THE UNITED WAY AND COMMUNITY YOUTH SPORTS TEAMS TO ENSURE LOCAL CHILDREN HAVE ACCESS TO HEALTHY ACTIVITIES. THE HOSPITAL'S RESPONSE TO THE NEEDS OF THE COMMUNITY RELATED TO THE COVID-19 PANDEMIC, ALLOWS ADDITIONAL CONSIDERATIONS FOR COMMUNITY BENEFIT REPORTING OF PROGRAMS AND ACTIVITIES FOR FISCAL YEAR 2020. COMMUNITY BENEFIT ACTIVITIES OR PROGRAMS SEEK TO ACHIEVE A COMMUNITY BENEFIT OBJECTIVE INCLUDING IMPROVING ACCESS TO HEALTH SERVICES, ENHANCING PUBLIC HEALTH, ADVANCING INCREASED GENERAL KNOWLEDGE, AND RELIEF OF A GOVERNMENT BURDEN TO IMPROVE HEALTH. MANY OF THESE PRINCIPLES ALIGN WITH REPORTING COVID-19 RELATED EXPENSES THAT WERE INCURRED IN OUR RESPONSE TO THE PANDEMIC. IN FISCAL YEAR 2021, THE HOSPITAL INCIDENT COMMAND SYSTEM (HICS) WAS ENGAGED AND OUR STAFF WORKED WITH PROFESSIONALS FROM ACROSS THE COMMUNITY TO ADDRESS NEEDS AROUND PERSONAL PROTECTION EQUIPMENT (PPE), SUPPORTING FAMILIES WITH INJURY PREVENTION, MENTAL HEALTH AND PUBLIC HEALTH INFORMATION, PROVIDING A NURSE HOTLINE TO ANSWER QUESTIONS FROM THE PUBLIC, PROVIDING PPE FOR AREA FIRST RESPONDERS, AND PROVIDING CLINICAL EXPERTISE TO SUPPORT AREA MEDICAL PROFESSIONALS. AT DAYTON CHILDREN'S, WE BELIEVE THAT ALL CHILDREN IN OUR REGION DESERVE A GREAT CHILDREN'S HOSPITAL CLOSE TO HOME. WE ARE DEDICATED TO ADDRESSING THE HEALTH AND WELLNESS NEEDS OF CHILDREN BOTH THROUGH CLINICAL PRACTICE AS WELL AS OUR COMMUNITY BENEFIT ACTIVITIES.</ExplanationTxt>
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          <AddressLine1Txt>130 WEST SECOND STREET SUITE 700</AddressLine1Txt>
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          <AddressLine1Txt>110 N MAIN STREET STE 165</AddressLine1Txt>
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          <AddressLine1Txt>605 S PATTERSON BOULEVARD</AddressLine1Txt>
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          <BusinessNameLine1Txt>DAYTON FOUNDATION DEPOSITORY INC - GEM CITY MARKET</BusinessNameLine1Txt>
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          <AddressLine1Txt>1401 S MAIN STREET SUITE 100</AddressLine1Txt>
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        </RecipientBusinessName>
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          <AddressLine1Txt>1401 S MAIN STREET SUITE 100</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45409</ZIPCd>
        </USAddress>
        <RecipientEIN>311044298</RecipientEIN>
        <IRCSectionDesc>501 (C) (3)</IRCSectionDesc>
        <CashGrantAmt>30000</CashGrantAmt>
        <PurposeOfGrantTxt>PROGRAM DONATION</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>DAYTON METRO LIBRARY FOUNDATION</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>215 E THIRD STREET</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <RecipientEIN>352511884</RecipientEIN>
        <IRCSectionDesc>501 (C) (3)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <PurposeOfGrantTxt>PROGRAM DONATION</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>GIRLS ON THE RUN OF DAYTON INC</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>PO BOX 752105</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45475</ZIPCd>
        </USAddress>
        <RecipientEIN>272528377</RecipientEIN>
        <IRCSectionDesc>501 (C) (3)</IRCSectionDesc>
        <CashGrantAmt>7500</CashGrantAmt>
        <PurposeOfGrantTxt>PROGRAM DONATION</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>GOODWILL EASTER SEALS MIAMI VALLEY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>660 SOUTH MAIN STREET</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <RecipientEIN>310537112</RecipientEIN>
        <IRCSectionDesc>501 (C) (3)</IRCSectionDesc>
        <CashGrantAmt>7500</CashGrantAmt>
        <PurposeOfGrantTxt>PROGRAM DONATION</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>JOHN CARROLL UNIVERSITY HEALTH PROFESSIONS AFFINITY COMMUNITY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1 JOHN CARROLL BOULEVARD</AddressLine1Txt>
          <CityNm>UNIVERSITY HEIGHTS</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>44118</ZIPCd>
        </USAddress>
        <RecipientEIN>340714681</RecipientEIN>
        <IRCSectionDesc>501 (C) (3)</IRCSectionDesc>
        <CashGrantAmt>14279</CashGrantAmt>
        <PurposeOfGrantTxt>PROGRAM DONATION</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>LEUKEMIA AND LYMPHOMA SOCIETY</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3085 WOODMAN DR SUITE 211</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45420</ZIPCd>
        </USAddress>
        <RecipientEIN>135644916</RecipientEIN>
        <IRCSectionDesc>501 (C) (3)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <PurposeOfGrantTxt>PROGRAM DONATION</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>UNITED WAY OF THE GREATER DAYTON AREA</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>33 W FIRST STREET STE 500</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45402</ZIPCd>
        </USAddress>
        <RecipientEIN>310536658</RecipientEIN>
        <IRCSectionDesc>501 (C) (3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <PurposeOfGrantTxt>CORPORATE PLEDGE</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>16</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCE COMMITTEE AND COMMUNITY RELATIONS MANAGER APPROVE ALL GRANTS AND CHARITABLE DONATIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <CompensationSurveyInd>X</CompensationSurveyInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>1</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ADAM MEZOFF MD</PersonNm>
        <TitleTxt>CMO</TitleTxt>
        <BaseCompensationFilingOrgAmt>625112</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>429704</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>1275730</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15867</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>2346413</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>400000</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DEBORAH FELDMAN</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>861151</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>40257</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>943793</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7730</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>1852931</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CINDY BURGER</PersonNm>
        <TitleTxt>VP &amp; CHIEF EXPERIENCE OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>246269</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>50894</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>224540</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>19494</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>541197</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHRIS BERGMAN</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>481641</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>11000</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>16120</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22424</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>531185</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>CHARLES KIDWELL</PersonNm>
        <TitleTxt>CHIEF LEGAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>399287</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>8064</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13769</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>25174</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>446294</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>BENJAMIN GOODSTEIN</PersonNm>
        <TitleTxt>VP &amp; CHIEF AMBULATORY OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>323006</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>25000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>6637</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>16365</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>23924</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>394932</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KELLY KAVANAUGH</PersonNm>
        <TitleTxt>VP &amp; CHIEF STRATEGY OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>295117</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>9261</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>64140</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>22147</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>390665</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>JAYNE GMEINER</PersonNm>
        <TitleTxt>VP &amp; CHIEF NURSING OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>315055</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>9188</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>15312</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>9236</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>348791</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND THE FOLLOWING ARE THE INCREASES IN THE ACTUARIAL VALUE DURING THE YEAR: DEBORAH FELDMAN - $929,643 CINDY BURGER - $213,140 KELLY KAVANAUGH - $52,740 ADAM MEZOFF - $1,258,730 THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DEBORAH FELDMAN - $23,193 CHRIS BERGMAN - $2,936 CINDY BURGER - $5,018 KELLY KAVANAUGH - $1,767 BENJAMIN GOODSTEIN - $3,305 ADAM MEZOFF - $14,686</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>BONUSES ARE DISCRETIONARY AND ARE BASED ON AN INCENTIVE PROGRAM APPROVED BY SENIOR MANAGEMENT.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="RetDoc1053100001">
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COUNTY OF MONTGOMERY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>316000172</BondIssuerEIN>
        <CUSIPNum>000000000</CUSIPNum>
        <BondIssuedDt>2016-10-13</BondIssuedDt>
        <IssuePriceAmt>30000000</IssuePriceAmt>
        <PurposeDesc>HOSPITAL RENOVATION</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COUNTY OF MONTGOMERY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>316000172</BondIssuerEIN>
        <CUSIPNum>000000000</CUSIPNum>
        <BondIssuedDt>2015-11-20</BondIssuedDt>
        <IssuePriceAmt>12675000</IssuePriceAmt>
        <PurposeDesc>HOSPITAL RENOVATION</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsIssuesGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <IssuerName>
          <BusinessNameLine1Txt>COUNTY OF MONTGOMERY</BusinessNameLine1Txt>
        </IssuerName>
        <BondIssuerEIN>316000172</BondIssuerEIN>
        <CUSIPNum>000000000</CUSIPNum>
        <BondIssuedDt>2014-08-19</BondIssuedDt>
        <IssuePriceAmt>117055000</IssuePriceAmt>
        <PurposeDesc>HOSPITAL RENOVATION</PurposeDesc>
        <DefeasedInd>0</DefeasedInd>
        <OnBehalfOfIssuerInd>0</OnBehalfOfIssuerInd>
        <PoolFinancingInd>0</PoolFinancingInd>
      </TaxExemptBondsIssuesGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <TotalProceedsAmt>30000000</TotalProceedsAmt>
        <OtherSpentProceedsAmt>30000000</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2017</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <TotalProceedsAmt>12675000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>40000</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>12635000</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2017</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsProceedsGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <RetiredAmt>7247196</RetiredAmt>
        <TotalProceedsAmt>117055000</TotalProceedsAmt>
        <IssuanceCostsFromProceedsAmt>400070</IssuanceCostsFromProceedsAmt>
        <OtherSpentProceedsAmt>116654930</OtherSpentProceedsAmt>
        <SubstantialCompletionYr>2017</SubstantialCompletionYr>
        <RefundingTaxExemptBondsInd>0</RefundingTaxExemptBondsInd>
        <RefundingTaxableBondsInd>0</RefundingTaxableBondsInd>
        <FinalAllocationMadeInd>0</FinalAllocationMadeInd>
        <AdequateBooksAndRecMaintInd>1</AdequateBooksAndRecMaintInd>
      </TaxExemptBondsProceedsGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsPrivateBusUseGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedPropertyInd>0</OwningBondFinancedPropertyInd>
        <AnyLeaseArrangementsInd>0</AnyLeaseArrangementsInd>
        <MgmtContractBondFincdPropInd>0</MgmtContractBondFincdPropInd>
        <AnyResearchAgreementsInd>0</AnyResearchAgreementsInd>
        <BondIssMeetPrvtSecPymtTestInd>0</BondIssMeetPrvtSecPymtTestInd>
        <ChangeInUseBondFinancedPropInd>0</ChangeInUseBondFinancedPropInd>
        <ProcsNonqualifiedBondRemdtdInd>0</ProcsNonqualifiedBondRemdtdInd>
      </TaxExemptBondsPrivateBusUseGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>1</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>0</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <TaxExemptBondsArbitrageGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiledInd>0</Form8038TFiledInd>
        <RebateNotDueYetInd>0</RebateNotDueYetInd>
        <ExceptionToRebateInd>0</ExceptionToRebateInd>
        <NoRebateDueInd>1</NoRebateDueInd>
        <VariableRateIssueInd>1</VariableRateIssueInd>
        <HedgeIdentifiedInBksAndRecInd>0</HedgeIdentifiedInBksAndRecInd>
        <GrossProceedsInvestedInGICInd>0</GrossProceedsInvestedInGICInd>
        <GrossProceedsInvestedInd>0</GrossProceedsInvestedInd>
        <WrittenProcToMonitorReqsInd>0</WrittenProcToMonitorReqsInd>
      </TaxExemptBondsArbitrageGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>A</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>B</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
      <ProceduresCorrectiveActionGrp>
        <BondReferenceCd>C</BondReferenceCd>
        <ProceduresCorrectiveActionInd>0</ProceduresCorrectiveActionInd>
      </ProceduresCorrectiveActionGrp>
    </IRS990ScheduleK>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CFO REVIEWS KEY DISCLOSURES WITH APPROPRIATE COMMITTEES OF THE BOARD OF TRUSTEES. THEN PRIOR TO FILING, THE FORM 990 IS ELECTRONICALLY LOADED TO A SECURE WEBSITE FOR THE ENTIRE BOARD OF TRUSTEES TO REVIEW. AN EMAIL IS SENT TO ALL MEMBERS NOTIFYING THEM THAT THE FORM IS AVAILABLE FOR THEIR REVIEW AND THAT IT WILL BE FILED ON OR BEFORE THE EXTENDED DUE DATE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>AT THE BEGINNING OF EACH MEETING, THE CHAIRMAN OF THE BOARD ASKS EACH MEMBER TO IDENTIFY AND DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST BASED ON THE AGENDA OR ANY CHANGES IN THEIR BUSINESS PRACTICE THAT MIGHT BE RELEVANT. IF THERE ARE ANY CONFLICTS, THE MEMBER(S) RECUSE THEMSELVES AND DO NOT PARTICIPATE IN THE DISCUSSION AND DO NOT VOTE ON THE ITEM. THIS THEN IS NOTED IN THE MINUTES OF THAT MEETING. BOARD MEMBERS ANNUALLY AGREE TO ABIDE BY WRITTEN CONFLICT OF INTEREST AND CONFIDENTIALITY POLICIES. BOARD MEMBERS ALSO WORK TO REPRESENT AND BALANCE THE INTERESTS OF DAYTON CHILDREN'S HOSPITAL'S MANY CONSTITUENTS. THE BOARD ANNUALLY EVALUATES ITS OWN PERFORMANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE COMMITTEE USED A TOTAL COMPENSATION PHILOSOPHY TO GUIDE ALL DECISIONS RELATED TO EXECUTIVE COMPENSATION AT DAYTON CHILDREN'S HOSPITAL (DCH), AND AS SUCH DETERMINES AND APPROVES ALL ASPECTS OF THE CEO'S TOTAL COMPENSATION PACKAGE, INCLUDING BENEFITS AND EXPENSE ALLOWANCES. THESE ARE DETAILED IN A WRITTEN EMPLOYMENT AGREEMENT FOR THE CEO. THE COMMITTEE USES AN OUTSIDE CONSULTANT TO CONDUCT PERIODIC REVIEWS OF THE EXECUTIVE COMPENSATION LEVELS OF THE ORGANIZATION VERSUS THOSE OF SIMILARLY SIZED AND SITUATED ORGANIZATIONS USING PUBLISHED SURVEYS. THESE SURVEY RESULTS ARE USED BY THE COMMITTEE IN SETTING EXECUTIVE LEVELS AND THE CEO'S COMPENSATION IN PARTICULAR. THE COMMITTEE FOLLOWS A FORMAL CALENDAR OF MEETINGS AND THE CHAIRMAN OF THE COMMITTEE REPORTS TO THE BOARD OF TRUSTEES AT LEAST ANNUALLY ON THE COMMITTEE'S ACTIVITIES AND ON DETAILS OF THE CEO'S COMPENSATION AND BENEFITS PACKAGE. THE COMMITTEE ALSO REVIEWS AND APPROVES DISCLOSURES RELATED TO EXECUTIVE COMPENSATION MADE AS PART OF IRS FORM 990. CONTEMPORANEOUS MINUTES WERE KEPT OF THE COMMITTEE PROCEEDINGS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FINANCIAL STATEMENTS, ORGANIZING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE GENERAL PUBLIC UPON WRITTEN OR VERBAL REQUEST TO DAYTON CHILDREN'S HOSPITAL, FOR THE SAME PERIOD OF TIME AS SET FORTH IN THE INTERNAL REVENUE CODE SECTION 6104(D).</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>CHANGE IN PENSION BENEFIT OBLIGATION 20,478,459.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdDisregardedEntitiesGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CENTER FOR COMMUNITY HEALTH AND ADVOCACY</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>ONE CHILDRENS PLAZA</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45404</ZIPCd>
        </USAddress>
        <EIN>824391789</EIN>
        <PrimaryActivitiesTxt>NEW MARKETS TAX CREDIT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <TotalIncomeAmt>-42802</TotalIncomeAmt>
        <EndOfYearAssetsAmt>9689170</EndOfYearAssetsAmt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
      </IdDisregardedEntitiesGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S HOME CARE OF DAYTON</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>18 CHILDRENS PLAZA</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45404</ZIPCd>
        </USAddress>
        <EIN>311356037</EIN>
        <PrimaryActivitiesTxt>HOME CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 10</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>ONE CHILDRENS PLAZA</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45404</ZIPCd>
        </USAddress>
        <EIN>311045247</EIN>
        <PrimaryActivitiesTxt>SUPPORT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PEDIATRIC ASSURANCE COMPANY LTD</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>BUTTERFIELD BANK BLDG 6TH FL 65 FRO</AddressLine1Txt>
          <CityNm>HAMILTON HM</CityNm>
          <CountryCd>BD</CountryCd>
        </ForeignAddress>
        <EIN>980478183</EIN>
        <PrimaryActivitiesTxt>SELF-INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>BD</LegalDomicileForeignCountryCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ShareOfTotalIncomeAmt>4228169</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>19728816</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S SPECIALTY PHYSICIANS</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>ONE CHILDRENS PLAZA</AddressLine1Txt>
          <CityNm>DAYTON</CityNm>
          <StateAbbreviationCd>OH</StateAbbreviationCd>
          <ZIPCd>45404</ZIPCd>
        </USAddress>
        <EIN>311411364</EIN>
        <PrimaryActivitiesTxt>SPEC PHYS GRO</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>OH</LegalDomicileStateCd>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ShareOfTotalIncomeAmt>18540036</ShareOfTotalIncomeAmt>
        <ShareOfEOYAssetsAmt>30642237</ShareOfEOYAssetsAmt>
        <OwnershipPct>1.00000</OwnershipPct>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>1</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>1</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>1</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>1</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>1</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CHILDREN'S HOME CARE OF DAYTON</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>B</TransactionTypeTxt>
        <InvolvedAmt>76840</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>138969</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S SPECIALTY PHYSICIANS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>1056555</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CHILDREN'S HOME CARE OF DAYTON</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>P</TransactionTypeTxt>
        <InvolvedAmt>6830727</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S SPECIALTY PHYSICIANS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>11272901</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PEDIATRIC ASSURANCE COMPANY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>Q</TransactionTypeTxt>
        <InvolvedAmt>543000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>3084383</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>DAYTON CHILDREN'S SPECIALTY PHYSICIANS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>73525000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>PEDIATRIC ASSURANCE COMPANY</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>R</TransactionTypeTxt>
        <InvolvedAmt>543000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CHILDREN'S HOME CARE OF DAYTON</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>S</TransactionTypeTxt>
        <InvolvedAmt>14000000</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>CASH</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
