CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: CHILDRENS HOSPITAL OF THE KINGS DAUGHTERS INC (EIN 54-0506321)
Tax period: 2019-07-01 to 2020-06-30
Filed: 2021-05-14
IRS object ID: 202141349349301854
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule F
Schedule G
Schedule H
Schedule I
Schedule J
Schedule K
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-05-14T08:03:02-05:00	ReturnTs
Tax Period End	2020-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	8350 Broad Street Suite 900	AddressLine1Txt
City	McLean	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	22102	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	540506321	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DENNIS RYAN	InCareOfNm
Business Name Control	CHIL	BusinessNameControlTxt
Phone	7576687000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	601 CHILDRENS LANE	AddressLine1Txt
City	NORFOLK	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	23507	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DENNIS RYAN	PersonNm
Person Title	CFO/ASST TREAS/SECR	PersonTitleTxt
Phone	7576687000	PhoneNum
Signature	2021-05-12	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JG WHITE	PreparerPersonNm
PTIN	P01498698	PTIN
Phone	7032868000	PhoneNum
Preparation	2021-05-11	PreparationDt

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JAMES D DAHLING	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	601 CHILDRENS LANE	AddressLine1Txt
City	NORFOLK	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	23507	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$543,497,242	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CHKD.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1961	FormationYr
Legal Domicile State	VA	LegalDomicileStateCd
Activity Or Mission	DEDICATED TO THE MISSION OF PROVIDING THE BEST POSSIBLE CARE AND SERVICES FOR ALL CHILDREN WHO COME TO US BECAUSE OF SICKNESS AND INJURY.	ActivityOrMissionDesc
Voting Members Governing Body	21	VotingMembersGoverningBodyCnt
Voting Members Independent	17	VotingMembersIndependentCnt
Total Employee	3284	TotalEmployeeCnt
Total Volunteers	667	TotalVolunteersCnt
Total Gross UBI	$697,389	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$397,998	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$15,669,332	PYContributionsGrantsAmt
CY Contributions Grants	$46,947,279	CYContributionsGrantsAmt
PY Program Service Revenue	$460,320,039	PYProgramServiceRevenueAmt
CY Program Service Revenue	$444,916,296	CYProgramServiceRevenueAmt
PY Investment Income	$9,188,170	PYInvestmentIncomeAmt
CY Investment Income	$9,115,220	CYInvestmentIncomeAmt
PY Other Revenue	$3,394,737	PYOtherRevenueAmt
CY Other Revenue	$2,777,693	CYOtherRevenueAmt
PY Total Revenue	$488,572,278	PYTotalRevenueAmt
CY Total Revenue	$503,756,488	CYTotalRevenueAmt
PY Grants And Similar Paid	$24,184,664	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$13,564,952	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$193,086,467	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$204,014,176	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$356,432	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$455,799	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$2,670,232	CYTotalFundraisingExpenseAmt
PY Other Expenses	$211,412,651	PYOtherExpensesAmt
CY Other Expenses	$223,783,170	CYOtherExpensesAmt
PY Total Expenses	$429,040,214	PYTotalExpensesAmt
CY Total Expenses	$441,818,097	CYTotalExpensesAmt
PY Revenues Less Expenses	$59,532,064	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$61,938,391	CYRevenuesLessExpensesAmt
Total Assets BOY	$680,638,976	TotalAssetsBOYAmt
Total Assets EOY	$805,448,811	TotalAssetsEOYAmt
Total Liabilities BOY	$169,332,698	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$243,917,851	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$511,306,278	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$561,530,960	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	SEE SCHEDULE O	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$385,393,526	ExpenseAmt
Grant	$13,564,952	GrantAmt
Revenue	$447,164,391	RevenueAmt
Desc	SEE SCHEDULE O	Desc
Total Program Service Expenses	$385,393,526	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (true)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	Yes (true)	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	Yes (true)	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	Yes (true)	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (true)	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	114	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	3284	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	Yes (true)	NondeductibleContributionsInd
Nondeductible Contri Discl	Yes (true)	NondeductibleContriDisclInd
Quid Pro Quo Contributions	Yes (true)	QuidProQuoContributionsInd
Quid Pro Quo Contri Discl	Yes (true)	QuidProQuoContriDisclInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form1098 C Filed	Yes (true)	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	21	GoverningBodyVotingMembersCnt
Independent Voting Member	17	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
States Where Copy Of Return Is Fld	AL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	FL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	GA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	KY	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MD	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	MN	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NJ	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	NC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	OK	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	SC	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	UT	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	VA	StatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is Fld	WI	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DENNIS RYAN	PersonNm
Phone	7576687000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	601 CHILDRENS LANE	AddressLine1Txt
City	NORFOLK	CityNm
State Abbreviation	VA	StateAbbreviationCd
ZIP	23507	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
James D Dahling
President/Director	1.0	42.0	Yes (X)	Yes (X)	$0	$8,782,799	$134,256
Dennis Ryan
CFO/Asst Treas/Assist Secr	1.0	42.0		Yes (X)	$0	$2,903,667	$483,944
Deborah Barnes
VP - IS Operations	0.0	40.0			$0	$1,121,596	$218,583	Yes (X)
Karen Mitchell
VP- Patient Care Services	40.0	0.0			$700,015	$0	$186,719	Yes (X)
John Harding
Chief Operating Officer	0.0	40.0			$0	$677,910	$85,492	Yes (X)
Robert Obermeyer MD
Director	1.0	41.0	Yes (X)		$0	$654,762	$36,988
Allison Silva
VP - Ancillary Services	40.0	0.0			$428,791	$0	$124,566	Yes (X)
Sandip Godambe MD
VP - Quality & Patient Safety	40.0	0.0			$453,214	$0	$75,930		Yes (X)
Jalana McCasland
VP Physician Practice Manageme	40.0	0.0			$331,400	$0	$71,418	Yes (X)
Kathryn Abshire
VP Finance	0.0	40.0			$0	$269,971	$122,157	Yes (X)
Tamika Harris
VP - Facilities & Support Serv	40.0	0.0			$251,455	$0	$84,031	Yes (X)
Suzanne Brixey
Physician	40.0	0.0			$278,322	$0	$15,514		Yes (X)
Michelle Brenner MD
Director	1.0	41.0	Yes (X)		$0	$220,216	$27,003
James Dice
Director Pharmacy	40.0	0.0			$200,777	$0	$20,462		Yes (X)
Adam Campbell
Director Clinical Improvements	40.0	0.0			$191,587	$0	$29,486		Yes (X)
David Kushner
Physician	40.0	0.0			$213,280	$0	$656		Yes (X)
Buffy Barefoot
Treasurer/Director	2.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
Edward A Heidt Jr
Director	1.0	1.0	Yes (X)		$0	$0	$0
F Blair Wimbush
Vice Chairman/Director	2.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
Akhil Jain
Secretary/Director	2.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
Christine Neikirk
Chairman/Director	2.0	2.0	Yes (X)	Yes (X)	$0	$0	$0
Edward Whitmore
Director	1.0	1.0	Yes (X)		$0	$0	$0
Elly Bradshaw Smith
Director	1.0	1.0	Yes (X)		$0	$0	$0
John R Lawson II
Director	1.0	1.0	Yes (X)		$0	$0	$0
Julia Childress Beck
Director	1.0	1.0	Yes (X)		$0	$0	$0
Kathryn M Van Buren
Director	1.0	1.0	Yes (X)		$0	$0	$0
Kim Georges
Director	1.0	1.0	Yes (X)		$0	$0	$0
Marta Satin-Smith
Director	1.0	1.0	Yes (X)		$0	$0	$0
Martha Colen
Director	1.0	1.0	Yes (X)		$0	$0	$0
Miles Leon
Director	1.0	1.0	Yes (X)		$0	$0	$0
R Justin Fulton
Director	1.0	1.0	Yes (X)		$0	$0	$0
Susan R Einhorn
Director	1.0	1.0	Yes (X)		$0	$0	$0
Svinder S Toor MD
Director	1.0	1.0	Yes (X)		$0	$0	$0
Kieran Poulos
Director	1.0	1.0	Yes (X)		$0	$0	$0
Stacey Vellines
Director	1.0	1.0	Yes (X)		$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$3,048,841	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$14,630,921	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,717,205	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	181	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
CHILDREN'S SPECIALTY GROUP
PO BOX 11049	NORFOLK	VA	23517	MEDICAL	$23,613,839
EASTERN VIRGINIA MED SCHOOL
PO BOX 1980	NORFOLK	VA	235011980	MEDICAL	$12,323,230
W M JORDAN CO INC
11010 JEFFERSON AVE	NEWPORT NEWS	VA	23601	Construction	$17,367,173
CERNER CORPORATION
PO BOX 959156	ST LOUIS	MO	63195	I/T SUPPORT	$5,132,967
COMPASS ONE
PO BOX 1022289	ATLANTA	GA	30368	FOOD SERVICES	$6,878,545

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	142	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$207,612	FederatedCampaignsAmt
Fundraising	$179,282	FundraisingAmt
Related Organizations	$8,800,000	RelatedOrganizationsAmt
Government Grants	$11,357,244	GovernmentGrantsAmt
All Other Contributions	$26,403,141	AllOtherContributionsAmt
Noncash Contributions	$1,946,517	NoncashContributionsAmt
Total Contributions	$46,947,279	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
PATIENT SERVICES	900099	$424,323,733	$424,323,733
OTHER RELATED SERVICES	900099	$19,895,174	$19,895,174
LAB SERVICES	621500	$594,660		$594,660
SPORTS RELATED SERVICES	900099	$102,729		$102,729

Field	Value	IRS element (for citing)
Total Program Service Revenue	$444,916,296	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$6,694,245	TotalRevenueColumnAmt
Exclusion	$6,694,245	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$3,351,557	RealAmt
Personal	$24,630	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$3,529,507	RealAmt
Personal	$3,068	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$177,950	RealAmt
Personal	$21,562	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$156,388	TotalRevenueColumnAmt
Exclusion	-$156,388	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$38,477,404	SecuritiesAmt
Other	$82,577	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$34,990,657	SecuritiesAmt
Other	$1,148,349	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$3,486,747	SecuritiesAmt
Other	-$1,065,772	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,420,975	TotalRevenueColumnAmt
Exclusion	$2,420,975	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$57,770	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$179,282	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$69,173	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$11,403	TotalRevenueColumnAmt
Exclusion	-$11,403	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	GRADUATE MEDICAL EDUCATION	Desc
Business	900099	BusinessCd
Total Revenue Column	$2,945,484	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,945,484	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$2,945,484	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$503,756,488	TotalRevenueColumnAmt
Related Or Exempt Func Income	$447,164,391	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$697,389	UnrelatedBusinessRevenueAmt
Exclusion	$8,947,429	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$13,564,952	TotalAmt
Program Services	$13,564,952	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,573,047	TotalAmt
Program Services	$1,252,874	ProgramServicesAmt
Management And General	$320,173	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$172,187,823	TotalAmt
Program Services	$157,608,073	ProgramServicesAmt
Management And General	$13,288,743	ManagementAndGeneralAmt
Fundraising	$1,291,007	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,165,794	TotalAmt
Program Services	$3,733,620	ProgramServicesAmt
Management And General	$1,393,440	ManagementAndGeneralAmt
Fundraising	$38,734	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$13,277,559	TotalAmt
Program Services	$11,828,956	ProgramServicesAmt
Management And General	$1,333,584	ManagementAndGeneralAmt
Fundraising	$115,019	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$11,809,953	TotalAmt
Program Services	$10,746,351	ProgramServicesAmt
Management And General	$962,986	ManagementAndGeneralAmt
Fundraising	$100,616	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$60,000	TotalAmt
Management And General	$60,000	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$19,256	TotalAmt
Program Services	$5,391	ProgramServicesAmt
Management And General	$13,865	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$40,400	TotalAmt
Management And General	$40,400	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$455,799	TotalAmt
Fundraising	$455,799	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$43,460,291	TotalAmt
Program Services	$41,098,705	ProgramServicesAmt
Management And General	$2,298,918	ManagementAndGeneralAmt
Fundraising	$62,668	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$198,540	TotalAmt
Program Services	$26,888	ProgramServicesAmt
Management And General	$164,548	ManagementAndGeneralAmt
Fundraising	$7,104	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,794,349	TotalAmt
Program Services	$1,807,112	ProgramServicesAmt
Management And General	$895,405	ManagementAndGeneralAmt
Fundraising	$91,832	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$2,338,016	TotalAmt
Program Services	$1,809,801	ProgramServicesAmt
Management And General	$487,396	ManagementAndGeneralAmt
Fundraising	$40,819	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$14,984,221	TotalAmt
Program Services	$13,398,653	ProgramServicesAmt
Management And General	$1,561,844	ManagementAndGeneralAmt
Fundraising	$23,724	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$274,295	TotalAmt
Program Services	$240,251	ProgramServicesAmt
Management And General	$29,803	ManagementAndGeneralAmt
Fundraising	$4,241	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$1,359,377	TotalAmt
Program Services	$826,181	ProgramServicesAmt
Management And General	$526,954	ManagementAndGeneralAmt
Fundraising	$6,242	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$3,845,118	TotalAmt
Program Services	$3,319,447	ProgramServicesAmt
Management And General	$525,671	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$22,958,227	TotalAmt
Program Services	$21,202,694	ProgramServicesAmt
Management And General	$1,633,462	ManagementAndGeneralAmt
Fundraising	$122,071	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$2,661,403	TotalAmt
Program Services	$547,998	ProgramServicesAmt
Management And General	$2,112,333	ManagementAndGeneralAmt
Fundraising	$1,072	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
SUPPLIES	$68,320,723	$67,938,960	$359,052	$22,711
EQUIP RENTAL AND MAINT	$20,593,132	$18,655,326	$1,856,784	$81,022
CORPORATE SUPPORT	$20,285,824		$20,285,824
PURCHASED SERVICES	$16,213,957	$13,566,436	$2,624,942	$22,579

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$3,376,041	TotalAmt
Program Services	$2,214,857	ProgramServicesAmt
Management And General	$978,212	ManagementAndGeneralAmt
Fundraising	$182,972	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$441,818,097	TotalAmt
Program Services	$385,393,526	ProgramServicesAmt
Management And General	$53,754,339	ManagementAndGeneralAmt
Fundraising	$2,670,232	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$42,730,560	BOYAmt
EOY	$82,255,207	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$2,918,579	BOYAmt
EOY	$16,309,113	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$89,376,178	BOYAmt
EOY	$80,107,050	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$9,396,603	BOYAmt
EOY	$10,408,519	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$5,602,048	BOYAmt
EOY	$9,385,650	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$604,546,243	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$296,233,296	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$237,237,021	BOYAmt
EOY	$308,312,947	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$261,391,303	BOYAmt
EOY	$258,921,689	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$25,777,426	BOYAmt
EOY	$27,075,234	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$6,209,258	BOYAmt
EOY	$12,673,402	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$680,638,976	BOYAmt
EOY	$805,448,811	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$44,139,771	BOYAmt
EOY	$55,686,150	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,923,150	BOYAmt
EOY	$1,527,375	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$104,830,878	BOYAmt
EOY	$129,293,278	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$18,438,899	BOYAmt
EOY	$57,411,048	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$169,332,698	BOYAmt
EOY	$243,917,851	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$479,454,320	BOYAmt
EOY	$510,511,507	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$31,851,958	BOYAmt
EOY	$51,019,453	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$511,306,278	BOYAmt
EOY	$561,530,960	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$680,638,976	BOYAmt
EOY	$805,448,811	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$61,938,391	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$988,780	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	-$528,859	DonatedServicesAndUseFcltsAmt
Other Changes In Net Assets	-$10,196,070	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd
IRS Written Determination	Yes (X)	IRSWrittenDeterminationInd

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$11,517,067	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$12,513,662	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$15,064,465	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$15,669,332	CurrentTaxYearMinus1YearAmt
Current Tax Year	$46,947,279	CurrentTaxYearAmt
Total	$101,711,805	TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$11,517,067	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$12,513,662	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$15,064,465	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$15,669,332	CurrentTaxYearMinus1YearAmt
Current Tax Year	$46,947,279	CurrentTaxYearAmt
Total	$101,711,805	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$280,169	SubstantialContributorsTotAmt
Public Support Total170	$101,431,636	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$6,591,606	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$7,348,692	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$8,097,824	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$10,139,234	CurrentTaxYearMinus1YearAmt
Current Tax Year	$10,070,432	CurrentTaxYearAmt
Total	$42,247,788	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$305,636	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$473,903	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$363,689	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$349,255	CurrentTaxYearMinus1YearAmt
Current Tax Year	$397,998	CurrentTaxYearAmt
Total	$1,890,481	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$145,850,074	TotalSupportAmt
Gross Receipts Rltd Activities	$2,086,097,827	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.69545	PublicSupportCY170Pct
Public Support PY170	0.60450	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
Incl Escrow Custodial Acct Liab	false	InclEscrowCustodialAcctLiabInd

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$25,731,316	BeginningYearBalanceAmt
Contributions	$322,831	ContributionsAmt
Investment Earnings Or Losses	$754,876	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,067,731	OtherExpendituresAmt
End Year Balance	$25,741,292	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$25,265,775	BeginningYearBalanceAmt
Contributions	$546,670	ContributionsAmt
Investment Earnings Or Losses	$1,056,618	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,137,747	OtherExpendituresAmt
End Year Balance	$25,731,316	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$25,040,857	BeginningYearBalanceAmt
Contributions	$359,017	ContributionsAmt
Investment Earnings Or Losses	$992,800	InvestmentEarningsOrLossesAmt
Other Expenditures	$1,126,899	OtherExpendituresAmt
End Year Balance	$25,265,775	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$23,954,985	BeginningYearBalanceAmt
Contributions	$117,553	ContributionsAmt
Investment Earnings Or Losses	$1,700,191	InvestmentEarningsOrLossesAmt
Other Expenditures	$731,872	OtherExpendituresAmt
End Year Balance	$25,040,857	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$24,211,713	BeginningYearBalanceAmt
Contributions	$56,826	ContributionsAmt
Investment Earnings Or Losses	-$171,891	InvestmentEarningsOrLossesAmt
Other Expenditures	$141,663	OtherExpendituresAmt
End Year Balance	$23,954,985	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Prmnnt Endowment Balance EOY	0.92190	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.07810	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	false	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$18,417,162	OtherCostOrOtherBasisAmt
Book Value	$18,417,162	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$265,530,555	OtherCostOrOtherBasisAmt
Depreciation	$120,712,767	DepreciationAmt
Book Value	$144,817,788	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$13,331,687	OtherCostOrOtherBasisAmt
Depreciation	$5,230,978	DepreciationAmt
Book Value	$8,100,709	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$214,201,725	OtherCostOrOtherBasisAmt
Depreciation	$170,092,181	DepreciationAmt
Book Value	$44,109,544	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$93,065,114	OtherCostOrOtherBasisAmt
Depreciation	$197,370	DepreciationAmt
Book Value	$92,867,744	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$308,312,947	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
DERIVATIVE INSTRUMENTS	$27,685,211
LINE OF CREDIT	$12,000,000
CAPITAL LEASE	$10,449,369
INSURANCE IBNR & IBNE	$5,579,213
ANNUITY PAYABLE	$1,664,927
ACCRUED TAIL COVERAGE	$32,328

Field	Value	IRS element (for citing)
Total Liability	$57,411,048	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE D, PART X, LINE 2

ASC 740 FOOTNOTE FROM CONSOLIDATED AUDIT REPORT CHS RECOGNIZES ANY BENEFITS FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. IF APPLICABLE, THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION WOULD BE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE RESOLUTION. CHS DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY UNCERTAIN TAX PROVISIONS.

SCHEDULE D, PART V

ENDOWMENT FUNDS ARE USED ACCORDING TO SPECIFIC WRITTEN REQUESTS OF THE DONOR ENDOWMENT AGREEMENT. IF NO DIRECT REQUESTS ARE MADE, FUNDS ARE USED IN ACCORDANCE WITH THE OVERALL MISSION OF THE ORGANIZATION.

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

Field	Value	IRS element (for citing)
Region	Central America and the Caribbean	RegionTxt
Type Of Activities Conducted	Investments	TypeOfActivitiesConductedTxt
Region Total Expenditures	$27,075,234	RegionTotalExpendituresAmt

Field	Value	IRS element (for citing)
Subtotal Spent	$27,075,234	SubtotalSpentAmt
Total Spent	$27,075,234	TotalSpentAmt
Transfer To Foreign Corp	false	TransferToForeignCorpInd
Interest In Foreign Trust	false	InterestInForeignTrustInd
Foreign Corp Ownership	Yes (true)	ForeignCorpOwnershipInd
Passive Foreign Investmest Co	Yes (true)	PassiveForeignInvestmestCoInd
Foreign Partnership	false	ForeignPartnershipInd
Boycott Countries	false	BoycottCountriesInd

Schedule G IRS990ScheduleG

Field	Value	IRS element (for citing)
Mail Solicitations	Yes (X)	MailSolicitationsInd
Email Solicitations	Yes (X)	EmailSolicitationsInd
Phone Solicitations	Yes (X)	PhoneSolicitationsInd
In Person Solicitations	Yes (X)	InPersonSolicitationsInd
Solicitation Of Non Govt Grants	Yes (X)	SolicitationOfNonGovtGrantsInd
Solicitation Of Govt Grants	Yes (X)	SolicitationOfGovtGrantsInd
Special Fundraising Events	Yes (X)	SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty	Yes (true)	AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	ActivityActivityTxt	Fundraiser Control Of FundsFundraiserControlOfFundsInd	Gross ReceiptsGrossReceiptsAmt	Retained By ContractorRetainedByContractorAmt	Net To OrganizationNetToOrganizationAmt
CHILDREN'S MIRACLE NETWORK
205 west 700 south	salt lake city	UT	84101	CONSULTING	false	$2,012,361	$208,628	$1,803,733
HEALTH GIVING
3966 N HAMPTON DRIVE	POWELL	OH	43065	CONSULTING	false		$43,005	$0
STEPHANIE SWEEL
199 APPALACHIAN LANE	ZION CROSSROADS	VA	22942	CONSULTING	false		$21,217	$0

Field	Value	IRS element (for citing)
Total Gross Receipts	$2,012,361	TotalGrossReceiptsAmt
Total Retained By Contractors	$272,850	TotalRetainedByContractorsAmt
Total Net To Organization	$1,803,733	TotalNetToOrganizationAmt
Licensed States	AL	LicensedStatesCd
Licensed States	AR	LicensedStatesCd
Licensed States	CA	LicensedStatesCd
Licensed States	CO	LicensedStatesCd
Licensed States	CT	LicensedStatesCd
Licensed States	DC	LicensedStatesCd
Licensed States	FL	LicensedStatesCd
Licensed States	GA	LicensedStatesCd
Licensed States	HI	LicensedStatesCd
Licensed States	IL	LicensedStatesCd
Licensed States	KS	LicensedStatesCd
Licensed States	KY	LicensedStatesCd
Licensed States	LA	LicensedStatesCd
Licensed States	ME	LicensedStatesCd
Licensed States	MD	LicensedStatesCd
Licensed States	MA	LicensedStatesCd
Licensed States	MI	LicensedStatesCd
Licensed States	MN	LicensedStatesCd
Licensed States	MO	LicensedStatesCd
Licensed States	NV	LicensedStatesCd
Licensed States	NJ	LicensedStatesCd
Licensed States	NY	LicensedStatesCd
Licensed States	NC	LicensedStatesCd
Licensed States	OH	LicensedStatesCd
Licensed States	OK	LicensedStatesCd
Licensed States	PA	LicensedStatesCd
Licensed States	RI	LicensedStatesCd
Licensed States	SC	LicensedStatesCd
Licensed States	TN	LicensedStatesCd
Licensed States	VA	LicensedStatesCd
Licensed States	WA	LicensedStatesCd
Licensed States	WV	LicensedStatesCd
Licensed States	WI	LicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	David Wright	Event1Nm
Gross Receipts Event1	$237,052	GrossReceiptsEvent1Amt
Charitable Contri Event1	$179,282	CharitableContriEvent1Amt
Gross Revenue Event1	$57,770	GrossRevenueEvent1Amt
Cash Prizes Event1	$2,172	CashPrizesEvent1Amt
Rent Facility Costs Event1	$3,828	RentFacilityCostsEvent1Amt
Food And Beverage Event1	$29,086	FoodAndBeverageEvent1Amt
Entertainment Event1	$6,775	EntertainmentEvent1Amt
Other Direct Expenses Event1	$27,312	OtherDirectExpensesEvent1Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$237,052	GrossReceiptsTotalAmt
Charitable Contributions Tot	$179,282	CharitableContributionsTotAmt
Gross Revenue Total Events	$57,770	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$2,172	CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$3,828	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$29,086	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$6,775	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$27,312	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$69,173	DirectExpenseSummaryEventsAmt
Net Income Summary	-$11,403	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	175.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,667,606	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,667,606	NetCommunityBenefitExpnsAmt
Total Expense	0.00600	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$204,462,289	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$164,096,567	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$40,365,722	NetCommunityBenefitExpnsAmt
Total Expense	0.09140	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$207,129,895	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$164,096,567	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$43,033,328	NetCommunityBenefitExpnsAmt
Total Expense	0.09740	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$79,073,736	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,396,305	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$69,677,431	NetCommunityBenefitExpnsAmt
Total Expense	0.15770	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$13,988,306	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,700,449	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,287,857	NetCommunityBenefitExpnsAmt
Total Expense	0.01650	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$57,777,584	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$25,210,086	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$32,567,498	NetCommunityBenefitExpnsAmt
Total Expense	0.07370	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$341,311	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$50,299	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$291,012	NetCommunityBenefitExpnsAmt
Total Expense	0.00070	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$151,180,937	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$41,357,139	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$109,823,798	NetCommunityBenefitExpnsAmt
Total Expense	0.24860	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$358,310,832	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$205,453,706	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$152,857,126	NetCommunityBenefitExpnsAmt
Total Expense	0.34600	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReportedInd
Bad Debt Expense	$6,571,297	BadDebtExpenseAmt
Bad Debt Expense Attributable	$2,989,144	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$3,388,228	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$9,187,169	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$5,798,941	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	3	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (3 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Research FacilityResearchFacilityInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc	Facility Reporting GroupFacilityReportingGroupCd
CHILDREN'S HOSPITAL OF THE KING'S DAU
1	601 CHILDRENS LANE	NORFOLK	VA	23507	H1843	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	MEDICAID DSH HOSPITAL	A
CHKD HEALTH AND SURGERY CENTER
2	2021 CONCERT DRIVE	VIRGINIA BEACH	VA	23456	OH713	Yes (X)						OUTPATIENT SURGICAL HOSPITAL	A
CHKD HEALTH AND SURGERY CENTER
3	11783 ROCK LANDING DRIVE	Newport News	VA	23608	OH694	Yes (X)						OUTPATIENT SURGICAL HOSPITAL	A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	A	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	3	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	18	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	WWW.CHKD.ORG	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	WWW.CHKD.ORG	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	175.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	WWW. CHKD.ORG	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	WWW. CHKD.ORG	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	WWW. CHKD.ORG	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V SECTION B LINE 5:	CHKD'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED COLLECTING DATA FROM SEVERAL DIFFERENT SOURCES: A COMMUNITY HEALTH SURVEY (IN COLLABORATION WITH OTHER AREA HOSPITAL SYSTEMS), FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS AND HEALTH INDICATOR ANALYSIS. TWO VERSIONS OF THE SURVEY WITH SIMILAR QUESTIONS WERE CIRCULATED ACROSS CHKD'S SERVICE AREA. THE FIRST VERSION WAS A STAKEHOLDER SURVEY IN WHICH PARTICIPANTS PROVIDED (OR HAD KNOWLEDGE OF) HEALTH, PREVENTIVE AND SUPPORT SERVICES, INCLUDING FOR MANY LOW INCOME AND MINORITY RESIDENTS. THE SECOND VERSION WAS A COMMUNITY SURVEY THAT WAS CIRCULATED MORE BROADLY TO COMMUNITY MEMBERS. THERE WERE A TOTAL OF 768 PARTICIPANTS WHO COMPLETED ALL OF THE REQUIRED QUESTIONS, INCLUDING 329 RESPONSES TO THE STAKEHOLDER SURVEY AND 439 RESPONSES TO THE COMMUNITY SURVEY. GIVEN THE PREVIOUSLY IDENTIFIED PRIORITY OF MENTAL AND BEHAVIORAL HEALTH AND AN INTEREST IN HEARING FROM STAKEHOLDERS FROM ACROSS THE REGION WHO WERE FAMILIAR WITH THESE ISSUES, TWO FOCUS GROUPS WERE CONDUCTED. ONE OF THE FOCUS GROUPS WAS FACILITATED WITH MENTAL AND BEHAVIORAL HEALTH SERVICE PROVIDERS IN THE HAMPTON ROADS AREA. THE OTHER FOCUS GROUP WAS FACILITATED DURING ONE OF THE MONTHLY MEETINGS OF A NETWORK OF AGENCIES AND ORGANIZATIONS THAT COME TOGETHER TO ENSURE THAT THE HAMPTON ROADS COMMUNITY HAS ACCESS TO QUALITY PARENTING EDUCATION. KEY STAKEHOLDER INTERVIEWS TARGETED SCHOOL NURSES AND OTHER CORE SERVICE PROVIDERS THAT SERVE MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS. ORGANIZATIONAL PARTICIPANTS INCLUDED HOSPITALS, SCHOOL SYSTEMS, SOCIAL SERVICES, CHKD'S CARE CONNECTION, A COMMUNITY-BASED NETWORK OF EARLY CARE AND EDUCATION SPECIALISTS, DEPRESSION AND SUICIDE EDUCATION AWARENESS SPECIALISTS, A NON-PROFIT BEHAVIORAL HEALTH SYSTEM AND OTHER COMMUNITY-BASED ORGANIZATIONS. NATIONAL, STATE AND PRIVATE DATA SOURCES WERE USED IN THE HEALTH INDICATOR ANALYSIS. KEY HEALTH ISSUES WERE IDENTIFIED WHEN MULTIPLE LOCALITIES HAD WORSE RATES OR PERCENTAGES IN COMPARISON TO STATE AVERAGES.
PART V SECTION B LINE 6A:	A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR CHKD'S THREE LICENSED FACILITIES LISTED IN PART V, SECTION A.
PART V SECTION B LINE 11:	AFTER COMPILING ALL OF THE RESULTS FROM THE STAKEHOLDER AND COMMUNITY SURVEYS, FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS AND HEALTH INDICATOR ANALYSIS, COMMON THEMES AND SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED ACROSS DATA SOURCES. THESE THEMES EITHER AROSE AS PRIORITIES IN AT LEAST TWO OF THE DATA SOURCES OR IF DATA FROM ONE OF THE SOURCES REVEALED OVERWHELMING NEED. THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED: MENTAL/BEHAVIORAL HEALTH, OBESITY, CHILD ABUSE, ASTHMA, SEXUALLY TRANSMITTED INFECTIONS, TEEN PREGNANCY, ALCOHOL/SUBSTANCE ABUSE, AND SOCIAL DETERMINANTS, INCLUDING POVERTY, UNEMPLOYMENT, AND COMMUNITY VIOLENCE. CHKD LEADERS REVIEWED RESULTS FROM ALL THREE DATA SOURCES TO BETTER UNDERSTAND THE SIGNIFICANT HEALTH NEEDS AND PRIORITIES TO DETERMINE THE BEST FOCUS FOR ITS IMPLEMENTATION PLAN. INDIVIDUALS AND GROUPS INVOLVED IN THIS PROCESS INCLUDED THE FOLLOWING: THE HOSPITAL'S SENIOR LEADERSHIP TEAM, WHICH INCLUDES ITS CEO, PRESIDENT AND VICE PRESIDENTS; CHKD PHYSICIAN LEADERS; AND CHKD'S PARENT AND FAMILY ADVISORY COUNCIL. GIVEN THE SCOPE AND DEPTH OF THE NEED FOR MENTAL HEALTH CARE AND THE SIGNIFICANT RESOURCES CHKD PLANS TO DEVOTE TO EXPANDING ITS MENTAL HEALTH SERVICES, CHKD IS FOCUSING SOLELY ON THIS ISSUE IN ITS IMPLEMENTATION PLAN STRATEGY FROM 2019 TO 2021. ADDRESSING PEDIATRIC MENTAL/BEHAVIORAL HEALTH WOULD HAVE A POSITIVE EFFECT ON PEDIATRIC HEALTH AND WELL-BEING OVERALL, AFFECTING MULTIPLE OTHER IDENTIFIED HEALTH NEEDS, SUCH AS VIOLENCE, CRIME, SUBSTANCE ABUSE AND, AS OUR PEDIATRIC POPULATION GROWS OLDER, CHILD ABUSE AND NEGLECT AND CHILDHOOD OBESITY. MENTAL/BEHAVIORAL HEALTH: CHILDREN AND ADOLESCENTS IN MENTAL HEALTH CRISIS CONTINUE TO SEEK CARE 24/7 THROUGH CHKD'S EMERGENCY DEPARTMENT. FACED WITH AN ONGOING SHORTAGE OF INPATIENT PLACEMENTS FOR THESE PATIENTS, CHKD SOUGHT AND RECEIVED STATE APPROVAL TO ADD 60 INPATIENT MENTAL HEALTH BEDS TO ITS NORFOLK CAMPUS. THIS PROJECT WILL ALSO INCLUDE PARTIAL HOSPITALIZATION/DAY TREATMENT AND AFTERCARE PROGRAMS FOR PEDIATRIC MENTAL HEALTH PATIENTS. ALL MENTAL HEALTH PROGRAMMING WILL BE DESIGNED SPECIFICALLY TO MEET THE NEEDS OF OUR REGION'S MOST UNDERSERVEDMENTAL HEALTH PATIENTS: CHILDREN UNDER AGE 5, CHILDREN WITH CO-OCCURRING MEDICAL AND MENTAL HEALTH NEEDS, CHILDREN WITH DEVELOPMENTAL AND MENTAL HEALTH CHALLENGES AND CHILDREN WITH EATING DISORDERS. CHKD ALSO CONTINUES TO EXPAND ITS OUTPATIENT MENTAL HEALTH PROGRAM WITH ADDITIONAL THERAPISTS IN MORE LOCATIONS. CHKD PLANS TO CONTINUE TO COMMIT PROGRAMMING AND RESOURCES TO ITS ONGOING INITIATIVES TO ADDRESS OBESITY, CHILD ABUSE AND SOCIAL DETERMINANTS OF HEALTH. OTHER SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA ARE NOT BEING SPECIFICALLY ADDRESSED IN THE CURRENT IMPLEMENTATION ARE ASTHMA, SEXUALLY TRANSMITTED INFECTIONS, TEEN PREGNANCY, AND ALCOHOL/SUBSTANCE USE DISORDER, THESE ARE ALL CONDITIONS THAT CHKD EITHER CURRENTLY PROVIDES CARE FOR AND/OR COLLABORATES WITH OTHER COMMUNITY AGENCIES TO ADDRESS. CHKD REGULARLY AND ROUTINELY OFFERS ITS EXPERTISE AND ASSISTANCE, SEEKS TO COLLABORATE AND DEDICATES COMMUNITY RESOURCES TO ADDRESS A BROAD RANGE OF ISSUES RELATING TO THE HEALTH AND WELFARE OF CHILDREN.
PART V SECTION B LINE 13:	PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE: 1. STATE-FUNDED PRESCRIPTION PROGRAMS; 2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC; 3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC); 4. FOOD STAMP ELIGIBILITY; 5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY; 6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT ARE UNFUNDED (E.G., MEDICAID SPEND-DOWN); 7. LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND 8. PATIENT IS DECEASED WITH NO KNOWN ESTATE.

Field	Value	IRS element (for citing)
Facility	16	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (16 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CHKD HEALTH CENTER AT OAKBROOKE
500 DISCOVERY DRIVE	CHESAPEAKE	VA	23320	OUTPATIENT SERVICES
CHKD HLTH CTR & URGENT CARE AT TECH CNTR
680 OYSTER POINT ROAD	NEWPORT NEWS	VA	23602	URGENT CARE & OUTPATIENT SERVICES
CHKD HLTH CTR & URGENT CARE AT LOEHMAN'S
3960 VIRGINIA BEACH BLVD	VIRGINIA BEACH	VA	23452	URGENT CARE & OUTPATIENT SERVICES
HEALTH CENTER AT MEDICAL CENTER CAMPUS
850 SOUTHAMPTON AVENUE	NORFOLK	VA	23510	OUTPATIENT SERVICES
CHKD URGENT CARE AT VOLVO
817 VOLVO PARKWAY	CHESAPEAKE	VA	23320	URGENT CARE & OUTPATIENT SERVICES
CHKD HLTH CTR & URGENT CARE AT LANDSTOWN
1924 LANDSTOWN WAY	VIRGINIA BEACH	VA	23456	URGENT CARE & OUTPATIENT SERVICES
CHKD AT BUTLER FARM ROAD
421 BUTLER FARM ROAD	HAMPTON	VA	23666	OUTPATIENT SERVICES
SATELLITE AT MEDICAL TOWER
400 GRESHAM DRIVE	NORFOLK	VA	23507	OUTPATIENT SERVICES
SPORTS MEDICINE IN GHENT
702 WEST 21ST STREET	NORFOLK	VA	23517	OUTPATIENT SERVICES
CHKD HEALTH CENTER AT HARBOUR VIEW
5835 HARBOUR VIEW BLVD	SUFFOLK	VA	23435	OUTPATIENT SERVICES
HEALTH CENTER AT BURNETT'S WAY
152 BURNETTS WAY	SUFFOLK	VA	23456	OUTPATIENT SERVICES
CHKD HEALTH CENTER AT LIGHTFOOT
6425 RICHMOND ROAD	WILLIAMSBURG	VA	23188	OUTPATIENT SERVICES
CHKD CAP
935 REDGATE AVENUE	NORFOLK	VA	23507	OUTPATIENT SERVICES
CHKD HEALTH CENTER AT HARBOUR VIEW NORTH
7021 HARBOUR VIEW BLVD	SUFFOLK	VA	23435	OUTPATIENT SERVICES
FORT NORFOLK PLAZA MEDICAL BUILDING
301 RIVERVIEW AVENUE	NORFOLK	VA	23510	OUTPATIENT SERVICES
CHKD HEALTH CENTER AT KEMPSVILLE
171 KEMPSVILLE ROAD	NORFOLK	VA	23507	OUTPATIENT SERVICES

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7(E)	THE AMOUNT REPORTED ON PART I, LINE 7(E) INCLUDES $48,595,574 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LINE 7(F) THE AMOUNT OF BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) THAT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSE IN PART I, LINE 7, COLUMN (F) IS $6,571,297.
PART I, LINE 7	A HYBRID APPROACH WAS USED FOR DETERMINING COSTS RELATED TO COMMUNITY BENEFIT. ACTUAL COSTS FROM ALL PATIENT SEGMENTS ARE IDENTIFIED BY DEPARTMENT IN THE GENERAL LEDGER AND THEN WERE GROUPED INTO LIKE COMMUNITY BENEFIT PROGRAMS. INDIRECT COSTS WERE ADJUSTED FOR COSTS ATTRIBUTABLE TO UNREIMBURSED MEDICAID COSTS REPORTED ELSEWHERE, MARKETING AND GRANT WRITING EXPENSES. THE MEDICAID COSTS ADJUSTMENT WAS CALCULATED USING A COST TO CHARGE RATIO OF APPLICABLE EXPENSES DIVIDED BY TOTAL APPLICABLE CHARGES APPLIED TO MEDICAID REVENUE. THE REMAINING INDIRECT COSTS WERE ALLOCATED PROPORTIONATELY TO THE DIRECT COSTS REPORTED BY DEPARTMENT. IN ADDITION, EXPENSES WERE CALCULATED AT COST AND THEN COSTS RELATED TO CHARITY CARE, BAD DEBT AND MEDICAID WERE REMOVED BEFORE ARRIVING AT THE AMOUNTS FOR COMMUNITY BENEFIT AT COST. PART III, LINE 2 BAD DEBT REPORTED IN PART III, LINE 2 IS BASED ON THE AMOUNT REPORTED AS BAD DEBT IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE AMOUNT DOES NOT INCLUDE DISCOUNTS OR OTHER ADMINISTRATIVE WRITE OFFS. IF A PATIENT ACCOUNT HAS BEEN WRITTEN OFF TO BAD DEBT AND IS SUBSEQUENTLY COLLECTED, BAD DEBT EXPENSE IS REDUCED IN THAT PERIOD BY THE PAYMENT. PART III, LINE 3 THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED OFF THE PERCENTAGE OF CHARITY CARE EXPENSES AS A PERCENTAGE OF SELF-PAY REVENUE. CHKD DOES NOT MAINTAIN RECORDS THAT TRACK PATIENTS WHO COULD HAVE QUALIFIED FOR CHARITY CARE. THIS AMOUNT IS AN ESTIMATE OF PATIENTS WHO LIKELY WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO DETERMINE THEIR ELIGIBILITY. THIS AMOUNT IS NOT INCLUDED AS COMMUNITY BENEFIT.
PART III, LINE 4	CHKD PRESENTS BAD DEBT PROVISION ON THE FINANCIAL STATEMENTS AS A DEDUCTION FROM NET PATIENT SERVICE PER ACCOUNTING STANDARDS UPDATE (ASU) 2011-07. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING RECEIVABLES. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE, NET OF PAYMENTS AND DISCOUNTS, AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR THE RECOVERY IS CONSIDERED REMOTE. FOR ADDITIONAL DETAILS SEE FOOTNOTE 17 ON PAGE 35 OF AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8	AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE SHORTFALL WAS CALCULATED USING THE HOSPITAL'S OVERALL COST TO CHARGE RATIO APPLIED TO MEDICARE GROSS CHARGES. THIS SHORTFALL IS NOT SEPARATELY INCLUDED AS A COMMUNITY BENEFIT AS 100% OF IT HAS ALREADY BEEN CAPTURED IN THE APPROPRIATE CATEGORY ON PART I, LINE 7.
PART III, LINE 9B	ACCOUNTS WITH AN UNPAID BALANCE OR WITHOUT AN ESTABLISHED PAYMENT PLAN ARE REFERRED TO A COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION EFFORTS. CHKD MAKES REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE/CHARITY CARE BEFORE REFERRING TO A COLLECTION AGENCY OR AN ATTORNEY. REASONABLE EFFORT INCLUDES AND IS NOT LIMITED TO NOTIFICATION ABOUT THE FINANCIAL ASSISTANCE - CHARITY CARE/COLLECTION POLICY POSTED IN ADMISSIONS, EMERGENCY DEPARTMENT OR OTHER DESIGNATED AREAS. THE INFORMATION REGARDING THE POLICY IS INCLUDED IN THE ADMISSION PACKAGE AND ON THE PATIENT BILL. THE HEALTH BENEFITS ANALYST AND CUSTOMER SERVICE REPRESENTATIVE WHO MAY SPEAK WITH THE GUARANTOR BY PHONE PROVIDE THEM WITH FINANCIAL ASSISTANCE INCLUDING CHARITY CARE INFORMATION. THE FINANCIAL ASSISTANCE-CHARITY CARE/COLLECTION POLICY IS AVAILABLE UPON REQUEST AND VIA WWW.CHKD.ORG. CHKD ENSURES ALL COLLECTION PROTOCOLS ARE MET PRIOR TO REFERRAL TO COLLECTIONS AGENCY OR ATTORNEY. APPROVED CHARITY CARE AMOUNT WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES. THE REMAINING BALANCE WILL BE SUBJECT TO CHKD'S STANDARD COLLECTION PROTOCOLS.
NEEDS ASSESSMENT:	AS THE ONLY HEALTHCARE PROVIDER IN VIRGINIA DEVOTED EXCLUSIVELY TO THE NEEDS OF CHILDREN, CHKD ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF PEDIATRIC CARE AND THE PROMOTION OF CHILDREN'S HEALTH AND IS TRUSTED THROUGHOUT ITS COMMUNITY TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. CHKD USES A VARIETY OF METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON PROFIT AND PUBLIC HEALTH AGENCIES AND ORGANIZATIONS AND THROUGH REGIONAL, STATE AND NATIONAL DATA. FROM NOVEMBER 2018 TO APRIL 2019, CHKD CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH SUPPORT FROM TOXCEL, LLC, A GAINESVILLE, VIRGINIA-BASED SCIENCE, ENGINEERING AND HEALTH RESEARCH AND CONSULTING FIRM. THIS JOINT CHNA COVERS ALL THREE LICENSED FACILITIES ASSOCIATED WITHIN THE CHKD HEALTH SYSTEM: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) LOCATED IN NORFOLK AND CHKD'S TWO HEALTH AND SURGERY CENTERS, ONE AT OYSTER POINT IN NEWPORT NEWS AND ONE AT PRINCESS ANNE IN VIRGINIA BEACH. CHKD'S CHNA PROVIDES AN OVERVIEW OF THE PRIMARY AND SECONDARY DATA USED TO IDENTIFY KEY HEALTH ISSUES WITHIN THE CHKD COMMUNITY. IT COMBINES AND COMPARES RESULTS FROM THREE SOURCES: A COMMUNITY HEALTH SURVEY, KEY STAKEHOLDER INTERVIEWS, AND HEALTH INDICATOR ANALYSES. CHKD'S CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT WWW.CHKD.ORG/COMMUNITYBENEFIT.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:	CHKD'S CHARITY CARE ELIGIBILITY CRITERIA AND PROCEDURES FOR APPLYING ARE PROVIDED TO ALL PATIENTS. CHARITY CARE INFORMATION IS INCLUDED IN EVERY INPATIENT ADMISSION PACKET AND DISTRIBUTED TO THE OUTPATIENT DURING THE OUTPATIENT REGISTRATION PROCESS. AN APPLICATION FOR CHARITY CARE, ALONG WITH A LETTER EXPLAINING THE PROCESS, IS SENT TO ANY PATIENT OR GUARANTOR WHO REQUESTS INFORMATION ON ANY PROGRAMS OR PROVISIONS THE HOSPITAL MAY HAVE TO HELP ASSIST PATIENTS OR GUARANTORS IN PAYING THEIR HOSPITAL BILL. THE CHARITY CARE POLICY AND APPLICATION ARE PROMINENTLY DISPLAYED ON THE MAIN "BILLING" PAGE OF THE HOSPITAL WEBSITE, JUST ONE CLICK FROM THE HOME PAGE, AT WWW.CHKD.ORG/BILLING/FINANCIAL-ASSISTANCE. PRINTED COPIES ARE ALSO AVAILABLE AT EACH REGISTRATION WORKSTATION. ALL BILLING STATEMENTS MAILED TO GUARANTORS INCLUDE A NOTICE OF THE AVAILABILITY OF CHARITY AND HOW TO OBTAIN THE INFORMATION/APPLICATION. ASSISTANCE WITH THE APPLICATION PROCESS IS AVAILABLE THROUGH THE HEALTH BENEFITS ANALYST (HBA). THE HBA SENDS OUT APPLICATIONS VIA MAIL AND REFERS FAMILIES TO THE HOSPITAL'S WEBSITE. THE UNIT SOCIAL WORKER IS AVAILABLE TO PROVIDE INFORMATION OR REFERRAL TO THE HBA DURING AN INPATIENT STAY.
COMMUNITY INFORMATION:	CHKD IS THE REGIONAL PEDIATRIC REFERRAL CENTER FOR SOUTHEASTERN VIRGINIA, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA. CHKD SERVES THE FOLLOWING REGIONS IN VIRGINIA: ACCOMACK COUNTY, CHESAPEAKE CITY, FRANKLIN CITY, GLOUCESTER COUNTY, HAMPTON CITY, ISLE OF WIGHT COUNTY, JAMES CITY COUNTY, MATHEWS COUNTY, NEWPORT NEWS CITY, NORFOLK CITY, NORTHAMPTON COUNTY, POQUOSON CITY, PORTSMOUTH CITY, PRINCE GEORGE COUNTY, SOUTHAMPTON COUNTY, SUFFOLK CITY, SURRY COUNTY, SUSSEX COUNTY, VIRGINIA BEACH CITY, WILLIAMSBURG CITY AND YORK COUNTY. WITHIN NORTH CAROLINA, CHKD SERVES THE FOLLOWING REGIONS: BERTIE COUNTY, CAMDEN COUNTY, CHOWAN COUNTY, CURRITUCK COUNTY, DARE COUNTY, GATES COUNTY, HERTFORD COUNTY, PASQUOTANK COUNTY AND PERQUIMANS COUNTY. AS REFLECTED IN OUR 2019 CHNA, THIS SERVICE REGION INCLUDED 553,054 PERSONS AGE 0-21. APPROXIMATELY 18 PERCENT OF ALL FAMILIES WITH CHILDREN UNDER THE AGE OF 18 HAVE INCOMES BELOW THE FEDERAL POVERTY LEVEL. FOR FAMILIES HEADED BY SINGLE MOTHERS, THAT PERCENTAGE INCREASES TO 38 PERCENT. CHKD'S SERVICE AREA COMPRISES A DIVERSE MIX OF URBAN, SUBURBAN AND RURAL COMMUNITIES, AS WELL AS 10 MILITARY INSTALLATIONS. CHKD IS WELL VERSED IN THE SPECIAL NEEDS OF MILITARY FAMILIES AND HAS ONE OF THE HIGHEST TRICARE PAYER PERCENTAGES AMONG THE CHILDREN'S HOSPITALS IN THE NATION.
PROMOTION OF COMMUNITY HEALTH	CHKD PLAYS A UNIQUE ROLE IN ITS COMMUNITY BY PROVIDING PEDIATRIC HEALTHCARE SERVICES AVAILABLE NOWHERE ELSE IN THE REGION AND, AT THE SAME TIME, SERVING AS THE SAFETY NET PROVIDER TO THE REGION'S INDIGENT CHILDREN. IN FY 2020, CHKD HAD 5,099 ADMISSIONS RESULTING IN 46,611 PATIENT DAYS. APPROXIMATELY 56 PERCENT OF THESE DAYS, WERE COVERED BY MEDICAID, WHICH IS THE HIGHEST PERCENTAGE BY FAR OF ANY ACUTE-CARE HOSPITAL IN VIRGINIA. CHKD LEADS THE REGION IN EFFORTS TO ADDRESS PUBLIC HEALTH CONCERNS LIKE CHILD ABUSE AND CHILDHOOD OBESITY. IT IS THE SOLE PROVIDER OF PEDIATRIC SUBSPECIALTY CARE FOR CHILDREN WITH CHRONIC ILLNESSES LIKE CANCER AND DIABETES AND EMPLOYS THE REGION'S ONLY PEDIATRIC SURGEONS. THE HOSPITAL'S VIBRANT COMMUNITY OUTREACH PROGRAM COORDINATES PARENT, PROFESSIONAL AND STUDENT PROGRAMS THAT BRING IMPORTANT HEALTH, SAFETY AND WELLNESS INFORMATION TO THOUSANDS OF PARTICIPANTS. CHKD ALSO TAKES AN ACTIVE ROLE IN THE EDUCATION OF PEDIATRICIANS. COMPREHENSIVE INFORMATION ON CHKD'S EFFORTS TO IMPROVE THE HEALTH OF CHILDREN IS AVAILABLE AT WWW.CHKD.ORG/COMMUNITYBENEFIT.
AFFILIATED HEALTH CARE SYSTEM:	CHKD IS PART OF CHILDREN'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CHKD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS ARE USED TO MEET THE NEEDS OF THE ORGANIZATION AS DETERMINED BY CHKD SENIOR MANAGEMENT AND THE CHS BOARD OF DIRECTORS. HISTORICALLY, SURPLUS FUNDS HAVE BEEN USED FOR A VARIETY OF PURPOSES INCLUDING PATIENT CARE PROGRAMS, CAPITAL IMPROVEMENT NEEDS, RESERVES, ETC. ROLES OF ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED: THE CHILDREN'S HEALTH SYSTEM IS COMPRISED OF SEVERAL ORGANIZATIONS. CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS IS A FREESTANDING CHILDREN'S HOSPITAL THAT PROVIDES A BROAD SPECTRUM OF INPATIENT AND OUTPATIENT CARE SERVICES ACROSS MANY PEDIATRIC SPECIALTIES, INCLUDING EVERYTHING FROM PRIMARY CARE AND WELLNESS INITIATIVES TO NEONATAL AND PEDIATRIC INTENSIVE CARE. OTHER ENTITIES UNDER THE CHILDREN'S HEALTH SYSTEM UMBRELLA INCLUDE: * CHILDREN'S HEALTH FOUNDATION, WHICH MANAGES INVESTMENTS AND FUNDS EDUCATION, RESEARCH AND OTHER PROGRAMS FOR CHILDREN'S HEALTH SYSTEM * CHILDREN'S MEDICAL GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC PHYSICIAN PRACTICES. * CMG OF NORTH CAROLINA, INC., A NORTH CAROLINA STOCK CORPORATION, WHICH OWNS AND OPERATES A PEDIATRIC PHYSICIAN PRACTICE IN NORTHEASTERN NORTH CAROLINA. * CHILDREN'S SURGICAL SPECIALTY GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC SURGICAL SUBSPECIALTY PRACTICES, INCLUDING PEDIATRIC GENERAL SURGERY, PEDIATRIC UROLOGY, PEDIATRIC CARDIAC SURGERY, PEDIATRIC ORTHOPEDIC SURGERY, PEDIATRIC NEUROSURGERY AND PEDIATRIC PLASTIC SURGERY. * CHILREN'S HEALTH INSURANCE, LLC, A CAPTIVE INSURANCE COMPANY INCORPORATED IN SOUTH CAROLINA IS A DISREGARDED ENTITY OF CHKD. * CHKD THRIFT STORES, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. * CHILDREN'S REAL ESTATE, LLC, IS A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. * CHILDREN'S RESEARCH HOLDING, LLC, A DISREGARDED ENTITY ORGANINZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM. * CHILDREN'S QUALITY CARE, LLC, A DISREGARDED ENTITY ORGANINZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.
FACILITY REPORTING GROUP(S):	FACILITY REPORTING GROUP A INCLUDES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, CHKD HEALTH AND SURGERY CENTER IN NEWPORT NEWS AND CHKD HEALTH AND SURGERY CENTER IN VIRGINIA BEACH. STATE FILING OF COMMUNITY BENEFIT REPORT VA,

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (4 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Valuation Method UsedValuationMethodUsedDesc	Purpose Of GrantPurposeOfGrantTxt
CHILDREN'S HEALTH FOUNDATION INC
601 CHILDRENS LANE	NORFOLK	VA	23507	541278865	501(C)(3)	$6,423,185	CASH	GENERAL SUPPORT
CHILDREN'S HEALTH SYSTEM INC
601 CHILDRENS LANE	NORFOLK	VA	23507	541278830	501(C)(3)	$7,000,000	CASH	GENERAL SUPPORT
OLD DOMINION UNIVERSITY RESEARCH FOUNDATION
PO BOX 6369	NORFOLK	VA	23508	546068198	501(C)(3)	$55,604	CASH	CHEST WALL STUDY
CHILDREN'S SURGICAL SPECIALTY GROUP INC
601 CHILDRENS LANE	NORFOLK	VA	23507	311610834		$20,604	CASH	CHEST WALL & PECTUS

Field	Value	IRS element (for citing)
Total501c3 Org	3	Total501c3OrgCnt
Total Other Org	1	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE I, PART I, LINE 2	FormAndLineReferenceDesc
Explanation	PROCESS FOR AWARDS AWARDS ARE MADE TO INVESTIGATORS/PHYSICIANS BY CHKD (CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS) FOR SPECIFIC PROJECT OR RESEARCH ENDEAVORS. FUNDING REQUESTS ARE COMPLETED AND SUBMITTED WHERE THEY ARE REVIEWED BY THE FINANCE DEPARTMENT, THE CEO AND THE APPLICABLE BOARD. AFTER AN AWARD IS MADE, THE AWARDEE MUST FILE QUARTERLY FINANCIAL SUMMARIES AND A FINAL REPORT TO BE SUBMITTED TO THE CEO AT THE END OF THE FUNDING PERIOD. ADDITIONALLY, CHKD GIVES CONTRIBUTIONS TO ITS PARENT ORGANIZATION, CHILDREN'S HEALTH SYSTEM, AND TO CHILDREN'S HEALTH FOUNDATION. CHILDREN'S HEALTH SYSTEM, AND TO CHILDREN'S HEALTH FOUNDATION.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Other Compensation Filing OrgOtherCompensationFilingOrgAmt
James D Dahling
President/Director	$1,015,004	$75,000	$7,692,795	$0	$98,773	$0	$35,483	$0	$8,917,055	$0	$6,894,858
Michelle Brenner MD
Director	$219,847	$0	$369	$0	$9,063	$0	$17,940	$0	$247,219	$0	$0
Robert Obermeyer MD
Director	$634,698	$19,621	$443	$0	$11,200	$0	$25,788	$0	$691,750	$0	$0
Dennis Ryan
CFO/Asst Treas/Assist Secr	$520,697	$26,301	$2,356,669	$0	$437,291	$0	$46,653	$0	$3,387,611	$0	$2,339,373	$0	$0	$0
Allison Silva
VP - Ancillary Services	$0	$0	$0	$109,772	$0	$14,794	$0	$553,357	$0	$130,278	$0	$270,914	$13,500	$144,377
Deborah Barnes
VP - IS Operations	$387,965	$19,250	$714,381	$0	$192,154	$0	$26,429	$0	$1,340,179	$0	$699,329	$0	$0	$0
Jalana McCasland
VP Physician Practice Manageme				$33,099	$0	$38,319	$0	$402,818	$0	$18,372	$0	$282,869	$14,060	$34,471
John Harding
Chief Operating Officer	$553,380	$26,982	$97,548	$0	$48,024	$0	$37,468	$0	$763,402	$0	$81,617	$0	$0	$0
Karen Mitchell
VP- Patient Care Services	$0	$0	$0	$171,531	$0	$15,188	$0	$886,734	$0	$234,012	$0	$327,699	$15,930	$356,386
Kathryn Abshire
VP Finance	$239,737	$12,000	$18,234	$0	$80,628	$0	$41,529	$0	$392,128	$0	$4,200
Tamika Harris
VP - Facilities & Support Serv				$50,029	$0	$34,002	$0	$335,486	$0	$15,056	$0	$212,241	$10,935	$28,279
James Dice
Director Pharmacy				$7,951	$0	$12,511	$0	$221,239	$0	$0	$0	$180,892	$12,822	$7,063
Sandip Godambe MD
VP - Quality & Patient Safety	$0	$0	$0	$25,057	$0	$50,873	$0	$529,144	$0	$8,410	$0	$411,584	$19,725	$21,905
Suzanne Brixey
Physician				$11,200	$0	$4,314	$0	$293,836	$0	$0	$0	$278,052		$270
David Kushner
Physician				$0	$0	$656	$0	$213,936	$0	$0	$0	$212,348		$932
Adam Campbell
Director Clinical Improvements				$3,542	$0	$25,944	$0	$221,073	$0	$0	$0	$156,410	$11,424	$23,753

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE J, LINE 1:	IN CONNECTION WITH A RETIREMENT PROGRAM, TAX GROSS-UP PAYMENTS ARE PROVIDED TO CERTAIN EMPLOYEES WHOSE EMPLOYER FUNDED CONTRIBUTIONS ARE IMMEDIATELY TAXABLE, IN ORDER TO PROVIDE THEM WITH BENEFITS THAT ARE TAX-EQUIVALENT TO BENEFITS OF PARTICIPANTS WHOSE CONTRIBUTIONS ARE NOT IMMEDIATELY TAXABLE.
SCHEDULE J, LINE 4B:	CHILDREN'S HEALTH SYSTEM SPONSORS TWO SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS ("THE PLANS"). THE PLANS ARE DESIGNED TO RETAIN EXECUTIVES IN POSITIONS ESSENTIAL TO THE SUCCESS OF CHILDREN'S HEALTH SYSTEM. DURING THE YEAR, THE FOLLOWING INDIVIDUALS WERE PARTICIPANTS IN ONE OF THE SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AND RECEIVED THE FOLLOWING ANNUAL ACTUARIAL INCREASE OR DEFERRED CONTRIBUTION (INCLUDED IN SCHEDULE J, PART II, COLUMN (C)) AND/OR PAYMENT (INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III)). AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III) MAY DIFFER FROM AMOUNTS PAID DUE TO TIMING DIFFERENCES IN VESTING AND PAYMENTS. A CHANGE TO ONE OF THESE PLANS HAS RESULTED IN A CHANGE TO A NUMBER OF THE PREVIOUS ESTIMATED ACCRUALS. ACT. INCREASE AMT. PAID ------------ ---------- KAREN MITCHELL: $ 135,302 $ 142,376 ALLISON SILVA: $ 79,363 $ 51,547 JOHN HARDING: $ 0 $ 21,592 DEBORAH BARNES: $ 163,836 $ 308,279 KATHY ABSHIRE: $ 65,541 $ 0 TAMIKA HARRIS: $ 22,160 $ 0 JAMES DAHLING: $ 0 $ 7,582,367 DENNIS RYAN: $ 397,799 $ 1,045,501
SCHEDULE J, LINE 7:	OFFICERS AND VICE PRESIDENTS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET UP BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. DEPARTMENT DIRECTORS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET BY MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	CUSIPCUSIPNum	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd
VA Small Business Financing Authority
A	541300845	000000000	2012-09-19	$76,400,000	REFUNDING OF 1/31/2006 ISSUE	false	false	false
VA SMALL BUSINESS FINANCING AUTHORITY
B	541300845	000000000	2015-12-01	$100,000,000	FINANCING OF HEALTH CARE FACILITIE	false	false	false
VA SMALL BUSINESS FINANCING AUTHORITY
C	541300845	000000000	2020-06-10	$100,000,000	FINANCING OF HOSPITAL FACILITIES	false	false	false

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Refunding Tax Exempt BondsRefundingTaxExemptBondsInd	Refunding Taxable BondsRefundingTaxableBondsInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$21,941,009	$0	$76,400,000	$0	$0	$0	$0	$0	$0	$0	$76,400,000	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
B	$1,285,713	$0	$48,650,000	$0	$0	$0	$0	$0	$0	$48,650,000	$0	$0	2018	false	false	Yes (true)	Yes (true)
C	$0	$0	$27,470,000	$0	$0	$0	$0	$0	$0	$27,470,000	$0	$0		false	false	false	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCd	Owning Bond Financed PropertyOwningBondFinancedPropertyInd	Any Lease ArrangementsAnyLeaseArrangementsInd	Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd	Engage Bond Counsel ContractsEngageBondCounselContractsInd	Any Research AgreementsAnyResearchAgreementsInd	Engage Bond Counsel ResearchEngageBondCounselResearchInd	Private Bus Use By OthersPrivateBusUseByOthersPct	Total Private Business UseTotalPrivateBusinessUsePct	Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd	Change In Use Bond Financed PropChangeInUseBondFinancedPropInd	Remedial Action TakenRemedialActionTakenInd	Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (true)	0.00586	0.00586	false	false	false	Yes (true)
B	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (true)	0.00326	0.00326	false	false	false	Yes (true)
C	false	Yes (true)	Yes (true)	Yes (true)	Yes (true)	Yes (true)	0		false	false	false	Yes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Exception To RebateExceptionToRebateInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Business Name Line1GICProviderName/BusinessNameLine1Txt	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	Rebate Not Due YetRebateNotDueYetInd
0
A	false	Yes (true)	Yes (true)	false	false	0	false	Yes (true)
0
B	false		Yes (true)	false	false	0	false	Yes (true)	false
0
C	false		Yes (true)	false	false	0	false	Yes (true)	false

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)
C	Yes (true)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART II, LINE 11, COLUMN A:	ALL PROCEEDS OF THE BOND WERE USED TO CURRENTLY REFUND A PRIOR ISSUE.
PART II, LINE 10, COLUMN B:	LINE 10 - CAPITAL EXPENDITURES FROM PROCEEDS ALLOCATED CURRENTLY TOTAL $99,950,000, OF WHICH $51,300,000 WAS ALLOCATED TO CHILDREN'S HEALTH SYSTEM AND $48,650,000 WAS ALLOCATED TO CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. Part II, Lines 3 and 10, Column C: Line 3 Funds will be drawn by childrens hospital of the kings daughters from the total issue price of the bond. Final proceeds will be $100,000,000. Line 10 Capital expenditures from proceed currently total $27,470,000.
PART III, LINE 4:	COLUMN A: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.5863% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR. COLUMN B: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.3264% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR.
PART IV, LINE 2B, COLUMN A:	THE 6-MONTH SPENDING EXCEPTION APPLIES TO THE BOND. OBLIGATED GROUP PNC BANK, NATIONAL ASSOCIATION AND BANK OF AMERICA, N.A., EACH HOLD PARITY NOTES OF CHKD'S OBLIGATED GROUP (INCLUDING CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED; CHILDREN'S HEALTH SERVICES, INC.; AND CHILDREN'S HEALTH FOUNDATION, INC.) ISSUED UNDER THE MASTER TRUST INDENTURE. ACCORDINGLY, PNC AND BANK OF AMERICA HAVE THE BENEFIT, ON A PARITY BASIS, OF A VALID AND PERFECTED, FIRST PRIORITY SECURITY INTEREST HELD BY THE MASTER TRUSTEE IN THE TOTAL REVENUES PLEDGED UNDER THE MASTER TRUST INDENTURE AND IN ANY OTHER SECURITY INTEREST GRANTED BY THE MASTER TRUST INDENTURE. THE MASTER TRUST INDENTURE AND THE FINANCING DOCUMENTS WITH PNC AND BANK OF AMERICA PLACE CERTAIN RESTRICTIONS UPON CHKD'S OBLIGATED GROUP RELATIVE TO OPERATING RATIOS, INCURRENCE OF ADDITIONAL INDEBTEDNESS, MAINTENANCE OF TAX-EXEMPT STATUS AND FINANCIAL REPORTING REQUIREMENTS.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Field	Value	IRS element (for citing)
Person	WM JORDAN CO INC	PersonNm

Field	Value	IRS element (for citing)
Relationship Description	ENTITY MORE THAN 35% OWNED BY JOHN LAWSON II, CURRENT BOARD MEMBER	RelationshipDescriptionTxt
Transaction	$39,219,428	TransactionAmt
Transaction	CONSTRUCTION SERVICES	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART V - SUPPLEMENTAL INFORMATION	FormAndLineReferenceDesc
Explanation	All transactions with the company were negotiated at arm's length.	ExplanationTxt

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArtGrp
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp
Clothing And Household Goods		ClothingAndHouseholdGoodsGrp

Cars And Other Vehicles CarsAndOtherVehiclesGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	10	ContributionCnt
Noncash Contributions Rpt F990	$6,375	NoncashContributionsRptF990Amt
Method Of Determining Revenues	CASH ON SALE	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp

Securities Publicly Traded SecuritiesPubliclyTradedGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	30	ContributionCnt
Noncash Contributions Rpt F990	$1,801,657	NoncashContributionsRptF990Amt
Method Of Determining Revenues	AVG FMV ON DATE REC	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp
Real Estate Commercial		RealEstateCommercialGrp
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	OTHER	Desc
Contribution	179	ContributionCnt
Noncash Contributions Rpt F990	$138,485	NoncashContributionsRptF990Amt
Method Of Determining Revenues	AVG FMV ON DATE REC	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	Yes (true)	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE M, PART I, LINE 32A:	FormAndLineReferenceDesc
Explanation	CHKD PAYS ABC VIRGINIA AUTO AUCTION, LLC A FEE TO AUCTION CARS FOR THE BENEFIT OF THE ORGANIZATION.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	PART I: DEDICATED TO THE MISSION OF PROVIDING THE BEST POSSIBLE CARE AND SERVICES FOR ALL CHILDREN WHO COME TO US BECAUSE OF SICKNESS AND INJURY. PART III: FOR MORE THAN 50 YEARS, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) HAS BEEN THE ONLY FACILITY OF ITS KIND IN VIRGINIA, SERVING THE MEDICAL AND SURGICAL NEEDS OF CHILDREN THROUGHOUT THE STATE. ITS PRIMARY SERVICE AREA ENCOMPASSES GREATER HAMPTON ROADS, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA, A REGION THAT IS HOME TO APPROXIMATELY 553,000 CHILDREN UNDER THE AGE OF 21. CHKD WAS ESTABLISHED AS AN 88-BED, NOT-FOR-PROFIT HOSPITAL IN 1961 BY THE KING'S DAUGHTERS, A WOMEN'S SERVICE ORGANIZATION DEDICATED TO THE HEALTH AND WELL BEING OF THE COMMUNITY'S INDIGENT CHILDREN. THE HOSPITAL HAS ALWAYS UPHELD THE CHARITABLE MISSION OF ITS FOUNDERS, AND IN FY2020, OVER 56 PERCENT OF ITS INPATIENT DAYS WERE COVERED BY MEDICAID. OVER THE PAST 59 YEARS, CHKD HAS GROWN INTO A 206-BED TEACHING HOSPITAL THAT IS THE HEART OF AN EXTENSIVE PEDIATRIC HEALTH CARE SYSTEM. TODAY, THAT SYSTEM PROVIDES COMPREHENSIVE MEDICAL CARE TO CHILDREN AT THE HOSPITAL AND MULTI-SERVICE HEALTH CENTERS IN VIRGINIA BEACH, NEWPORT NEWS, CHESAPEAKE, HAMPTON, SUFFOLK, NORFOLK AND WILLIAMSBURG. ITS SERVICES INCLUDE EVERYTHING FROM WELLNESS AND PREVENTION INITIATIVES TO PRIMARY CARE, SURGERY AND REHABILITATION. MANY OF ITS UNIQUE SERVICES AND PROGRAMS ADDRESS PRESSING PUBLIC HEALTH NEEDS THAT WOULD OTHERWISE GO UNMET. LIKE HOSPITALS EVERYWHERE, CHKD SPENT MUCH OF 2020 FOCUSED ON RESPONSE TO THE COVID-19 PANDEMIC, SWIFTLY RAMPING UP TESTING FOR COVID-19, TRACKING DOWN PERSONAL PROTECTIVE EQUIPMENT, CONSTRUCTING SCREENING AREAS, AND ESTABLISHING TREATMENT AND INFECTION CONTROL PROTOCOLS. THE HOSPITAL ALSO EXPANDED ITS TELEHEALTH OPTIONS, AND CONTINUED IMPORTANT WORK ON FACILITY IMPROVEMENTS, SUCH AS RENOVATION OF ITS 70-BED NEONATAL INTENSIVE CARE UNIT. THE HOSPITAL ALSO CONTINUED CONSTRUCTION OF A $224 MILLION MENTAL HEALTH FACILITY, WHICH IS EXPECTED TO OPEN 2022. THE 14-STORY MENTAL HEALTH CENTER WILL HAVE 60 INPATIENT BEDS, INDOOR AND OUTDOOR EXERCISE AREAS, AND ROOMS FOR OUTPATIENT SERVICES. AS THE PREMIER PROVIDER OF HEALTHCARE SERVICES TO THE REGION'S CHILDREN, CHKD HAS SECURED A PLACE IN THE HEART OF THE COMMUNITY. THE HOSPITAL IS AN EAGER COLLABORATOR WITH OTHER COMMUNITY ORGANIZATIONS AND INSTITUTIONS THAT SHARE ITS CONCERN FOR THE WELL-BEING OF YOUNG PEOPLE AND OFFERS A VARIETY OF EDUCATION, RESEARCH AND HEALTH INITIATIVES TO IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN IN THIS COMMUNITY AND BEYOND. THE HEALTH SYSTEM'S PRIMARY SERVICES CENTER ON INPATIENT AND OUTPATIENT CARE, COMMUNITY OUTREACH PROGRAMS AND MEDICAL EDUCATION/RESEARCH. SECTION ONE: INPATIENT CARE CHILDREN WITH A VAST RANGE OF MEDICAL PROBLEMS - INCLUDING LIFE-THREATENING ILLNESSES AND INJURIES -- TURN TO CHKD FOR INPATIENT CARE. IN FY20, CHKD HAD 5,099 ADMISSIONS RESULTING IN 46,611 PATIENT DAYS. APPROXIMATELY 56 PERCENT OF THESE DAYS WERE COVERED BY MEDICAID. CHKD HAS 206 INPATIENT BEDS, AND ALMOST HALF OF THOSE ARE FOR PEDIATRIC INTENSIVE CARE. THE HOSPITAL IS HOME TO THE REGION'S HIGHEST LEVEL NEONATAL INTENSIVE CARE UNIT, WHERE EACH YEAR CRITICALLY ILL NEWBORNS, SOME AS YOUNG AS 22 WEEKS GESTATION, BENEFIT FROM A UNIQUE COMBINATION OF ADVANCED MEDICAL TECHNOLOGY, DEVELOPMENTAL CARE, FAMILY SUPPORT, AND PALLIATIVE CARE. IN SEPTEMBER 2020, A RENOVATION OF THE NICU WAS COMPLETED CREATING 50 PRIVATE ROOMS AND 10 SEMI-PRIVATE ROOMS TO CREATE A MORE INDIVIDUALIZED AND FAMILY-CENTERED APPROACH, GIVING FAMILIES MORE PRIVACY TO BOND WITH THEIR BABIES. THERE WERE APPROXIMATELY 478 ADMISSIONS TO THE NICU IN FY20. THE REGION'S LARGEST AND MOST EXPERIENCED PEDIATRIC INTENSIVE CARE UNIT IS AT CHKD. IN THIS UNIT, A FULL-TIME STAFF OF BOARD-CERTIFIED PEDIATRIC INTENSIVE CARE PHYSICIANS, CRITICAL CARE NURSES AND RESPIRATORY THERAPISTS PROVIDE EXTREMELY SOPHISTICATED, TECHNOLOGICALLY-ADVANCED CARE TO CHILDREN WITH LIFE-THREATENING INJURIES AND ILLNESSES. MEDICAL CARE IS SUPPLEMENTED WITH SUPPORT FROM CHILD LIFE SPECIALISTS, SOCIAL WORKERS AND CHAPLAINS WHO HAVE EXTENSIVE EXPERIENCE HELPING FAMILIES THROUGH THE TRAUMA AND STRESS OF A SEVERE ILLNESS OR INJURY IN A CHILD. THERE WERE 1,413 ADMISSIONS TO OUR PICU IN FY20. MANY PATIENTS ARE BROUGHT FROM OTHER AREA HOSPITALS TO CHKD BY THE HOSPITAL'S NEONATAL/PEDIATRIC TRANSPORT PROGRAM, WHICH OPERATES OUT OF FOUR FULLY-EQUIPPED MOBILE INTENSIVE CARE UNITS. TWO CRITICAL CARE TRANSPORT TEAMS ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO ALL AREA MEDICAL FACILITIES THAT NEED TO SEND SICK OR INJURED CHILDREN TO CHKD. CHKD TRANSPORT TEAMS ARE EQUIPPED AND TRAINED TO TRANSPORT ALL TRAUMA PATIENTS UNDER THE AGE OF 15 TO CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS FOR SPECIALIZED PEDIATRIC TRAUMA CARE. ONE ACUTE CARE TRANSPORT TEAM IS STAFFED DAILY WITH TWO PARAMEDICS TO PROVIDE TRANSPORT TO PEDIATRIC PATIENTS THROUGHOUT THE COMMUNITY, SERVING URGENT CARE FACILITIES AS WELL AS EMERGENCY ROOMS WITHIN THE TIDEWATER REGION. EACH CRITICAL CARE TRANSPORT CALL IS ANSWERED BY A NEONATAL/PEDIATRIC CRITICAL CARE NURSE, A REGISTERED RESPIRATORY THERAPIST AND A CERTIFIED EMT PARAMEDIC TRAINED IN NEONATAL/PEDIATRIC CARE. IN FY20, THE TEAM TRANSPORTED 1,808 PATIENTS. OF THOSE, 243 WERE NEWBORNS COMING TO OUR NEONATAL INTENSIVE CARE UNIT. CHKD'S TRANSPORT SERVICE IS ALSO UNDER CONTRACT TO THE NAVAL MEDICAL CENTER, PORTSMOUTH, TO PROVIDE ALL NEONATAL AND PEDIATRIC MILITARY TRANSPORTS IN THE REGION. BESIDES GROUND TRANSPORTS IN OUR MOBILE ICUS OR ACUTE CARE TRANSPORT, THE TEAM CAN RESPOND VIA FIXED WING AIRCRAFT OR HELICOPTER TRANSPORT WHEN MEDICALLY NECESSARY. CHKD TRANSFER CENTER IS STAFFED WITH PARAMEDICS WHO OPERATE TO ENSURE APPROPRIATE DISPATCH SERVICES TO THE TRANSPORT TEAM AS WELL AS TO DELIVER ASSISTANCE AND SUPPORT FOR REFERRAL FACILITIES AND STAFF THROUGHOUT THE COMMUNITY.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	CHKD OPERATES THE REGION'S ONLY PEDIATRIC SURGERY PROGRAM, OFFERING YOUNG PEOPLE STATE-OF-THE-ART TREATMENT IN A SUPPORTIVE, NON-THREATENING ENVIRONMENT CREATED EXCLUSIVELY TO MEET THEIR NEEDS. IN FY20, SURGEONS PERFORMED 12,556 SURGERIES AT CHKD FACILITIES FOR A VAST RANGE OF PROBLEMS, FROM THE SIMPLEST OUTPATIENT PROCEDURES TO COMPLEX CRANIOFACIAL, ORTHOPEDIC AND CHEST WALL SURGERIES. CHKD'S CARDIAC SURGERY PROGRAM IS PART OF A REGIONAL COLLABORATIVE BETWEEN CHKD AND THE UNIVERSITY OF VIRGINIA. CHKD AND UVA COMBINE THE EFFORTS OF PEDIATRIC CARDIOLOGISTS, CARDIAC SURGEONS, CARDIAC ANESTHESIOLOGISTS, INTENSIVE CARE PHYSICIANS AND CARDIAC SUPPORT PROFESSIONALS FROM BOTH INSTITUTIONS WITH THE GOAL OF IMPROVING OUTCOMES FOR CHILDREN WITH COMPLEX CONGENTIAL HEART DEFECTS. (SEE OUTPATIENT SERVICES AND PROGRAMS FOR MORE INFORMATION OF CHKD'S SURGERY PROGRAM.) CHKD EMPLOYS DOZENS OF PROFESSIONALS WHO PROVIDE EMOTIONAL, RECREATIONAL, SPIRITUAL AND PRACTICAL SUPPORT TO CHILDREN AND FAMILIES DURING HOSPITALIZATIONS. THE WORK OF THESE PROFESSIONALS COMPLEMENTS OUR EXPERT MEDICAL CARE TO CREATE A UNIQUE TREATMENT AND HEALING ENVIRONMENT FOR CHILDREN AND THEIR FAMILIES. OUR CHAPLAINCY SERVICES PROVIDE EMOTIONAL SUPPORT, PASTORAL CARE, ETHICAL REFLECTION, BEREAVEMENT RESOURCES/FOLLOW-UP (INCLUDING PARENT AND CHILD SUPPORT GROUP), SPIRITUAL ASSESSMENT AND GUIDANCE TO PATIENTS, FAMILIES AND STAFF WITH IN-HOSPITAL PRESENCE SEVEN DAYS A WEEK AND WITH 24-HOUR ON-CALL AVAILABILITY. CHAPLAINS ASSIST WITH ADVANCE DIRECTIVES AND SERVE ON THE TRAUMA TEAM AS PRIMARY PROVIDERS OF FAMILY SUPPORT. THE HOSPITAL EMPLOYS A CHAPLAINCY MANAGER, THREE FULL-TIME CHAPLAINS, ONE FULL-TIME FAMILY/STAFF SUPPORT COORDINATOR, AND FOUR PER-DIEM CHAPLAINS WHO REFLECT THE DIVERSITY OF THE COMMUNITY AND ARE PROFESSIONALLY TRAINED TO MEET THE VARIED SPIRITUAL NEEDS OF FAMILIES AND STAFF WITH RESPECT AND COMPASSION. THE CHAPLAINS ALSO FACILITATE EDUCATIONAL PROGRAMS FOR HOSPITAL STAFF AND PHYSICIANS, AS WELL AS PLANNING AND PARTICIPATING IN OUTREACH TO THE COMMUNITY. THE HOSPITAL EMPLOYS 16 CHILD LIFE STAFF MEMBERS, INCLUDING AN ART AND MUSIC THERAPIST, WHO HELP CHILDREN ADJUST AND COPE DURING HOSPITALIZATION. THEIR GOAL IS TO MAKE THE CHILD'S HOSPITAL EXPERIENCE AS NORMAL AS POSSIBLE BY DEVELOPING SUPPORTIVE RELATIONSHIPS WITH PATIENTS AND FAMILIES, PROVIDING AGE-APPROPRIATE PREPARATION FOR MEDICAL PROCEDURES, COPING STRATEGIES AND PLAY OPPORTUNITIES FOR CHILDREN TO RELIEVE STRESS. BEFORE THE CORONAVIRUS PANDEMIC CHILD LIFE STAFF MEMBERS ALSO SCHEDULE AND FACILITATE COMMUNITY GROUP VISITORS TO THE HOSPITAL AND MANAGE APPROXIMATELY 100 VOLUNTEERS WEEKLY. ONCE THE PANDEMIC SET IN, WE TEMPORARILY SUSPENDED IN HOSPITAL VOLUNTEERS AND CONTINUE TO HAVE COMMUNITY MEMBER VISITS ON HOLD. THERE ARE THREE POPULAR ACTIVITY AREAS THROUGHOUT THE HOSPITAL, PROVIDING HOSPITALIZED CHILDREN OPPORTUNITIES FOR SOCIALIZATION AND CREATIVE PLAY. CHILD LIFE ASSISTANTS WORK WITH CHKD'S VOLUNTEER SERVICES DIVISION TO MANAGE THE HOSPITAL'S POPULAR PET THERAPY PROGRAM -- THE BUDDY BRIGADE -- WHICH BRINGS VISITS OF DOG/HANDLER TEAMS TO THE HOSPITAL SEVERAL TIMES EACH WEEK. THE BUDDY BRIGADE VISITS WENT TO A VIRTUAL PLATFORM DURING THE PANDEMIC, WHICH ACTUALLY ALLOWED INCREASED ACCESSIBILITY TO ALL HOSPITALIZED PATIENTS NO MATTER DIAGNOSIS, ISOLATION, OR FEVER STATUS. CHILD LIFE STAFF MEMBERS COLLABORATE WITH OTHER HOSPITAL STAFF TO PROVIDE SUPPORT FOR PARENTS AND SIBLINGS, OFFERING AN ANNUAL TEDDY BEAR CLINIC, WEEKLY CLOSED-CIRCUIT TV BINGO, INPATIENT DEVELOPMENTAL SCREENINGS, AND A KIDS-AS-PARTNERS ADVISORY COUNCIL.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	CHKD'S MENTAL HEALTH SERVICE LINE IS COMPRISED OF ONE MANAGER, ONE OFFICE SUPERVISOR, 16 FULL-TIME MEDICAL SOCIAL WORKERS AND TWO PER DIEM SOCIAL WORKERS. ALL OF THE MEDICAL SOCIAL WORKERS HOLD MASTER'S DEGREES IN SOCIAL WORK. THERE ARE TWO LICENSED CLINICAL SOCIAL WORKERS IN THE DEPARTMENT. THIRTEEN SOCIAL WORKERS ARE IN SUPERVISION WORKING TOWARD CLINICAL LICENSURE. THE PRIMARY FOCUS OF THE MEDICAL SOCIAL WORK TEAM IS BIOPSYCHOSOCIAL EVALUATION, SUPPORT TO FAMILIES, CRISIS INTERVENTION, CONNECTION TO RESOURCES AND SUPPORTING ADJUSTMENT TO ILLNESSES AND HELPING TO MITIGATE THE STRESS OF HOSPITALIZATION. THE MEDICAL SOCIAL WORK TEAM PROVIDES MANY SERVICES, INCLUDING: * CONDUCT BIOPSYCHOSOCIAL AND BEHAVIORAL ASSESSMENTS. * PROVIDE SUPPORT DURING HOSPITALIZATION TO CHKD PATIENTS AND FAMILIES DEALING WITH TRAUMA, CHRONIC ILLNESS AND LOSS. * REFER TO CHKD'S ELIGIBILITY WORKERS TO COMPLETE APPLICATIONS FOR INSURANCE COVERAGE FOR MEDICAL CARE, PRESCRIPTIONS, AND MEDICAL SUPPLIES. * COORDINATE REFERRALS AND ONGOING COMMUNICATIONS TO OTHER COMMUNITY RESOURCES FOR ASSISTANCE WITH NEEDS SUCH AS HOUSING, MENTAL HEALTH COUNSELING, EDUCATIONAL ADVOCACY, LEGAL ASSISTANCE AND MUCH MORE. * AID IN COMMUNICATION WITH FAMILIES WITH THE MEDICAL TREATMENT TEAMS BY COORDINATING PATIENT CARE CONFERENCES AND TEAM MEETINGS. * EVALUATE AND REPORT SUSPICION FOR CHILD ABUSE/NEGLECT. MEDICAL SOCIAL WORKERS ALSO FACILITATE A VARIETY OF SUPPORT GROUPS THAT HELP PATIENTS AND FAMILIES CONNECT WITH OTHERS IN THE COMMUNITY WHO SHARE THEIR CHALLENGES. SOME EXAMPLES ARE SIBSHOPS, HEALTHY MOMMY HEALTHY BABY, DINE AND DISCOVER FOR NICU FAMILIES. THE MEDICAL SOCIAL WORK TEAM MANAGES THE HALO FUND AND BUTTERFLY BLESSINGS FUND WHICH ASSIST PATIENTS AND PARENTS WITH COSTS ASSOCIATED WITH TRANSPORTATION, MEALS, MEDICATIONS AND OTHER DISCHARGE-RELATED NEEDS. THESE DONATED FUNDS MAY ALSO BE USED IN EMERGENCY SITUATIONS TO ASSIST WITH SPECIAL HEALTHCARE NEEDS, LIKE PARTIAL OR ONE-TIME PAYMENTS FOR UTILITIES NECESSARY TO SUPPORT A PATIENT IN THE HOME FOLLOWING A DISCHARGE. THESE FUNDS HELPED MORE THAN 2,600 FAMILIES IN FY20. THE MENTAL HEALTH THERAPY TEAM PROVIDES OUTPATIENT AND HOSPITAL SUPPORT TO PATIENTS WHO PRESENT TO OUR ED OR WHO ARE ADMITTED FOR MEDICAL REASONS BUT ALSO HAVE CONCURRENT MENTAL HEALTH CONCERNS. IN ADDITION, WE PROVIDE OUTPATIENT EVIDENCE BASED THERAPY AT SEVEN LOCATIONS IN VIRGINIA BEACH, CHESAPEAKE, NORFOLK, AND NEWPORT NEWS. THREE NEW CHILD AND ADOLESCENT PSYCHIATRISTS (CAPS) WERE ADDED TO THE MENTAL HEALTH TEAM DURING FY20 AND EARLY FY21 BRINGING OUR TOTAL NUMBER OF CAPS TO EIGHT. ALSO, IN SEPTEMBER OF 2019, WE BROKE GROUND FOR A 14-STORY MEDICAL BUILDING WHICH WILL PROVIDE 60 INPATIENT BEDS FOR ACUTE MENTAL HEALTH CARE, EXPANDED OUTPATIENT SERVICES, INCLUDING PARTIAL HOSPITALIZATION PROGRAMS AND INTENSIVE OUTPATIENT SERVICES WHEN THE BUILDING OPENS IN 2022. WE ARE OPERATING A COMPREHENSIVE CONSULT SERVICE AT THE MAIN HOSPITAL FOR MEDICALLY COMPROMISED CHILDREN WITH A MENTAL HEALTH DIAGNOSIS. IN MARCH OF 2020, WE OPENED AN OUTPATIENT CRISIS "BRIDGE" CLINIC TO EXTEND OUR SERVICES TO KIDS WHO ARE NOT CONNECTED TO A PROVIDER AS THEY ARE WAITING TO CONNECT TO OUTPATIENT SERVICES. WE EXPANDED OUR OUTPATIENT WORKFORCE BY ADDING ADDITIONAL PSYCHOLOGISTS AND MENTAL HEALTH THERAPISTS. IN FY20, WE HIRED A DIRECTOR OF NURSING FOR MENTAL HEALTH, A CHIEF AND VICE CHIEF OF PSYCHIATRY, AND A VICE PRESIDENT OF MENTAL HEALTH OPERATIONS TO ROUND OUT OUR GROWING TEAM. WE HAVE PLANS TO OPEN INTENSIVE OUTPATIENT PROGRAMS IN THE FALL OF 2021 IN VIRGINIA BEACH AND NEWPORT NEWS PENDING LICENSURE APPLICATIONS. WE CONTINUE TO TRAIN AND EDUCATE OUR TEAM ON EVIDENCE-BASED RESEARCH AND SUPPORTED-CARE DELIVERY. WE'VE ADDED DIALECTICAL BEHAVIOR THERAPY IN ADDITION TO TRAINING SEVERAL MORE CLINICIANS IN OTHER EVIDENCE-BASED TREATMENTS. WE HAVE ALSO PARTNERED WITH OUR COMMUNITY ON SEVERAL FOUNDATION GRANTS TO SUPPORT SCHOOLS, HOUSING REDEVELOPMENTS, AND PEDIATRIC INTEGRATION OF CARE FOR EARLY CHILDHOOD CONSULTATION. WE ARE THE EASTERN REGION'S PARTNER FOR THE VIRGINIA MENTAL HEALTH ACCESS PROGRAM, WHICH WAS FULLY FUNDED THROUGH THE STATE BUDGET. THE TEAM COLLABORATES WITH THE CHILD'S PEDIATRICIAN, PSYCHIATRIC PROVIDER, SPECIALIST AND FAMILY TO ENSURE THE CHILD RECEIVES COMPREHENSIVE AND INTEGRATED SUPPORT. AMONG THE SERVICES OUR MENTAL HEALTH TEAM PROVIDES ARE THE FOLLOWING: * CONDUCT PSYCHOSOCIAL HISTORY AND MENTAL HEALTH ASSESSMENTS OF PATIENTS: OUTPATIENT, ED, AND IN-HOUSE. * UTILIZE EVIDENCE-BASED PRACTICES TO OFFER BRIEF THERAPY TO IN-HOUSE PATIENTS BY PHYSICIAN REFERRAL TO ADDRESS ACUTE OR CHRONIC MENTAL HEALTH ISSUES. * OFFER INDIVIDUALIZED BEHAVIOR PLANS FOR CHILDREN WITH MEDICAL AND BEHAVIORAL ISSUES ADMITTED TO CHKD FOR THEIR MEDICAL CONDITION. * PROVIDE OUTPATIENT MENTAL HEALTH SERVICES UTILIZING EVIDENCE-BASED TREATMENT (COGNITIVE BEHAVIORAL THERAPY, PARENT CHILD INTERACTION THERAPY, TRAUMA-FOCUSED COGNITIVE BEHAVIORAL THERAPY, FAMILY BASED THERAPY FOR ANOREXIA NERVOSA, BEHAVIORAL THERAPY FOR CHILDREN WITH AUTISM SPECTRUM DISORDER AND OTHER NEURODEVELOPMENTAL CONDITIONS, EMDR, AND A GROUP THERAPY CALLED SPARCS (STRUCTURE PSYCHOTHERAPY FOR ADOLOSCENTS RESPONDING TO CHRONIC STRESS) INCLUDING INDIVIDUAL, FAMILY AND GROUP. * HELP PATIENTS AND FAMILIES DEAL WITH SITUATIONAL CRISES RESULTING FROM ACCIDENT, ILLNESS OR TRAUMA. * 24-HOUR COVERAGE BY A LICENSED CLINICIAN OR SUPERVISEE FOR NIGHTS, WEEKENDS AND HOLIDAYS. THE CHKD'S CULTURAL/LANGUAGE SERVICES DEPARTMENT MEETS THE NEEDS OF PATIENTS AND FAMILIES WITH LIMITED ENGLISH PROFICIENCY BY COORDINATING ACCESS TO LANGUAGE INTERPRETATION VIA FACE-TO-FACE, OVER THE PHONE AND VIDEO REMOTE INTERPRETATION THROUGHOUT THE HEALTH SYSTEM. IN FY20, CHKD PROVIDED INTERPRETATION SERVICES IN 50 DIFFERENT LANGUAGES FOR OUR LIMITED ENGLISH POPULATION THROUGH 15,597 OUTPATIENT VISITS, A 17% INCREASE FROM THE PREVIOUS YEAR. ON AVERAGE, 88% OF OUR LIMITED ENGLISH PROFICIENT PATIENTS AND FAMILIES SPEAK SPANISH. TO MEET THIS DEMAND, IN ADDITION TO OVER THE PHONE INTERPRETATION AND VIDEO REMOTE INTERPRETATION AVAILABLE THROUGHOUT CHKDHS, THE LANGUAGE SERVICES DEPARTMENT CONSISTS OF 3 SPANISH MEDICAL INTERPRETERS AT THE MAIN HOSPITAL. ADDITIONALLY, THE HEALTH SYSTEM RELIED ON THE ASSISTANCE OF 17 DUAL ROLE BILINGUAL STAFF WHO PROVIDED MEDICAL INTERPRETATION IN THEIR ASSIGNED AREAS. DURING FY20 LANGUAGE SERVICES STAFF DIRECTLY ASSISTED IN 7,480 PATIENT ENCOUNTERS AT THE MAIN HOSPITAL AND 63 DOCUMENT TRANSLATIONS. AS THE REGIONAL PROVIDER OF PEDIATRIC CARE, CHKD IS AN INTEGRAL PART OF THE COMMUNITY'S NATURAL OR MAN-MADE DISASTER PLANNING EFFORTS. CHKDHS RECOGNIZES THE IMPORTANCE OF A NATIONAL INCIDENT MANAGEMENT SYSTEM(NIMS) COMMUNITY-INTEGRATED, ALL-HAZARD EMERGENCY OPERATIONS PLAN. THIS PLAN IS PREPARED, EXERCISED AND SHARED INTERNALLY AND EXTERNALLY WITH COMMUNITY, STATE AND FEDERAL EMERGENCY RESPONSE AGENTS.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS	SECTION TWO: OUTPATIENT SERVICES AND PROGRAMS CHKD ALSO OFFERS THE COMMUNITY MANY IMPORTANT PEDIATRIC SERVICES ON AN OUTPATIENT BASIS. IN FY20, CHILDREN MADE APPROXIMATELY 607,744 OUTPATIENT VISITS TO CHKD PEDIATRICIANS, SURGEONS AND SPECIALTY CLINICS. THEY MADE 387,561 VISITS TO THE PRIMARY CARE PEDIATRICIANS OF CHKD'S MEDICAL GROUP, WHICH OFFERS CARE IN 20 PRACTICES AND 31 OFFICES THROUGHOUT OUR SERVICE AREA. CHKD'S SURGICAL SPECIALTY GROUP MAKES THE SERVICES OF THE REGION'S ONLY PEDIATRIC GENERAL, UROLOGICAL, CARDIAC, NEUROSURGICAL, PLASTIC AND ORTHOPEDIC SURGEONS AVAILABLE TO THOUSANDS OF CHILDREN WHO MIGHT OTHERWISE HAVE TO TRAVEL OUTSIDE OF THE AREA FOR SURGERY. CHILDREN MADE 41,083 VISITS TO THE SURGICAL GROUP PRACTICES IN FY20. THE SURGEONS PERFORMED 5,154 SURGICAL CASES. THE HOSPITAL ALSO PROVIDES CARE TO CHILDREN FACING HEALTH CONDITIONS SUCH AS CANCER, GENETIC DISORDERS, OBESITY, HEART PROBLEMS, DEVELOPMENTAL DISABILITIES, ASTHMA/ALLERGIES AND DIABETES THROUGH MORE THAN 50 OUTPATIENT SPECIALTY CLINICS OFFERING SPECIALIZED PEDIATRIC CARE. IN FY20, CHILDREN MADE 179,100 VISITS TO OUR OUTPATIENT CLINICS. CHILDREN'S HOSPITAL WAS FOUNDED ON THE PREMISE THAT ALL CHILDREN DESERVE EQUAL ACCESS TO QUALITY PEDIATRIC CARE. AS OUR POPULATION GREW AND SETTLED INTO THE FAR CORNERS OF OUR BRIDGE-AND TUNNEL-LACED REGION, TRAVEL TO CHKD'S MAIN FACILITY IN NORFOLK BECAME MORE OF A HARDSHIP FOR FAMILIES. TO EASE THAT BURDEN AND IMPROVE CHILDREN'S ACCESS TO CARE IN EVERY CORNER OF OUR SERVICE AREA, CHKD HAS ESTABLISHED MULTI-SERVICE HEALTH CENTERS IN STRATEGIC LOCATIONS. THESE INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: * THE CHKD HEALTH AND SURGERY CENTER AT OYSTER POINT OFFERS FAMILIES WHO LIVE NORTH OF THE HAMPTON ROADS BRIDGE TUNNEL A WEALTH OF IMPORTANT SERVICES IN A CONVENIENT LOCATION. THE CENTER IS HOME TO THE REGION'S FIRST PEDIATRIC AMBULATORY SURGERY CENTER. OTHER SERVICES OFFERED AT THE SITE INCLUDE PRIMARY, SURGICAL AND SUB-SPECIALTY PEDIATRICS; LAB AND RADIOLOGY (INCLUDING ULTRASOUND AND MRI), AUDIOLOGY TESTING AND OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY. AQUATIC THERAPY AND CHILD ABUSE PROGRAM SERVICES ARE ALSO AVAILABLE THERE. * THE CHKD HEALTH CENTER AND URGENT CARE AT TECH CENTER IS HOME TO THE PENINSULA'S ONLY PEDIATRIC URGENT CARE AS WELL AS THE CENTER FOR PEDIATRIC SLEEP MEDICINE, X-RAY, LAB, PHYSICAL MEDICINE AND REHABILITATION, RHEUMATOLOGY, AND SPORTS MEDICINE PRIMARY CARE, PHYSICAL THERAPY, AND PERFORMANCE TRAINING. * THE CHKD HEALTH CENTER AT OAKBROOKE SERVES FAMILIES IN CHESAPEAKE AND NORTHEASTERN NORTH CAROLINA. IT IS HOME TO A PRIMARY CARE PEDIATRIC PRACTICE; PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY; X-RAY AND LAB SERVICES, A SPORTS MEDICINE GYM, SLEEP STUDIES UNIT AND THERAPY POOL, AS WELL AS CLINIC SPACE FOR A VARIETY OF PEDIATRIC SPECIALISTS AND SURGEONS PROVIDING EVALUATION, TREATMENT AND FOLLOW-UP. * THE CHKD HEALTH AND SURGERY CENTER AT PRINCESS ANNE SERVES THE GROWING MEDICAL NEEDS OF FAMILIES IN VIRGINIA BEACH. THE CENTER IS HOME TO VIRGINIA BEACH'S FIRST AMBULATORY SURGERY CENTER EXCLUSIVELY FOR CHILDREN. BEACH FAMILIES CAN ALSO FIND PRIMARY CARE PEDIATRICIANS AND IN-HOUSE LAB AND RADIOLOGY SERVICES - INCLUDING MRI - AT THE CENTER. OTHER SERVICES INCLUDE SPECIALTY CARE PEDIATRICS FOR HELP WITH CHRONIC PROBLEMS SUCH AS DIABETES. THIS YEAR, A THIRD OPERATING ROOM WAS ADDED TO THIS LOCATION TO SUPPORT THE PEDIATRIC DENTAL NEEDS OF THE COMMUNITY. IT WAS BUILT AND DESIGNED ACCORDING TO THE INPUT FROM COMMUNITY DENTISTS. * THE CHKD HEALTH CENTER AND URGENT CARE AT LANDSTOWN IS LOCATED JUST DOWN THE ROAD FROM CONCERT DRIVE AND OFFERS DEDICATED VIRGINIA BEACH SPACE FOR CHKD URGENT CARE AND ADOLESCENT SERVICES SUCH AS SPORTS MEDICINE, DERMATOLOGY AND GYNECOLOGY. * THE CHKD HEALTH CENTER AND URGENT CARE AT LOEHMANN'S SERVES THE NORTHERN AND MIDDLE VIRGINIA BEACH REGION AND IS HOME TO CHKD URGENT CARE, SPORTS MEDICINE (PRIMARY CARE) AND THERAPY, SPORTS PERFORMANCE TRAINING AND PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. * THE CHKD HEALTH CENTER AT BUTLER FARM OFFERS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, AND SPORTS MEDICINE PHYSICAL THERAPY TO CHILDREN AND TEENS ON THE PENNISULA. DEVELOPMENTAL PEDIATRICS ALSO HOSTS A WHEELCHAIR CLINIC AT THIS LOCATION. * THE CHKD HEALTH CENTER AT HARBOUR VIEW NORTH OFFERS SPECIALIZED PEDIATRIC CARE TO FAMILIES IN SUFFOLK. THE SITE OFFERS APPOINTMENTS IN PEDIATRIC DERMATOLOGY, ALLERGY, GASTROENTEROLOGY, CARDIOLOGY AND NEPHROLOGY, AS WELL AS DEVELOPMENTAL PEDIATRICS. * THE CHKD HEALTH CENTER AT LIGHTFOOT OFFERS FAMILIES IN THE NORTHERN CORNER OF OUR SERVICE AREA APPOINTMENTS IN PEDIATRIC CARDIOLOGY, NEPHROLOGY, GYNECOLOGY, PHYSICAL MEDICINE AND REHABILITATION, REHABILITATIVE THERAPIES, SPORTS MEDICINE AND UROLOGY. CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS OPERATES THE REGION'S ONLY PEDIATRIC URGENT CARE. PARENTS OF CHILDREN WITH URGENT, BUT NOT EMERGENT MEDICAL NEEDS, NOW HAVE ACCESS TO QUALITY MEDICAL CARE JUST FOR KIDS AFTER-HOURS, ON WEEKENDS AND HOLIDAYS. IN FY20, CHILDREN MADE 78,044 VISITS TO CHKD URGENT CARE CENTERS IN CHESAPEAKE, VIRGINIA BEACH AND NEWPORT NEWS. CHKD'S CHILD ABUSE PROGRAM COORDINATES THE REGION'S EFFORTS TO ACCURATELY IDENTIFY, TREAT AND PROTECT SUSPECTED VICTIMS OF ABUSE AND NEGLECT. THE PROGRAM PROVIDES COMPREHENSIVE ASSESSMENT, EVALUATION AND TREATMENT SERVICES, INCLUDING CASE MANAGEMENT, AN ARRAY OF EVIDENCE-BASED MENTAL HEALTH SERVICES, FORENSIC INTERVIEWING, MEDICAL EXAMINATIONS AND CONSULTATIONS, WHICH INCLUDE 24/7 COVERAGE OF ACUTE SEXUAL ASSAULTS OF CHILDREN. THE PROGRAM ALSO HELPS COORDINATE THE EFFORTS OF INVESTIGATIVE AGENCIES INVOLVED IN THE INVESTIGATION AND PROSECUTION OF ABUSE. OVER FOUR YEARS AGO WE STARTED A PROGRAM TO HELP ACCURATELY IDENTIFY AND PROVIDE ASSISTANCE AND TREATMENT TO COMMERCIALLY SEXUALLY EXPLOITED CHILDREN (CSEC). SINCE LAUNCHING OUR PROGRAM AND CSEC MDT WE HAVE SEEN A SHARP INCREASE IN THE NEED FOR SERVICES FOR THIS POPULATION. WE HAVE CREATED A SURVIVOR-LEAD MENTORING PROGRAM, AND OUR TEAM OFTEN COORDINATES WITH FEDERAL AND LOCAL INVESTIGATORS AS WELL AS JUVENILE COURT SERVICES AND MEDICAL AND MENTAL HEALTH PROVIDERS. IN JANUARY 2020, THE PROGRAM BECAME THE BACKBONE AGENCY FOR THE HAMPTON ROADS TRAUMA INFORMED COMMUNITY NETWORK (HRTICN). THE NETWORK EXISTS TO PROMOTE AN UNDERSTANDING OF HOW TRAUMA AFFECTS INDIVIDUALS AND COMMUNITIES, AND TO ADVOCATE PRACTICES THAT HELP ALL PEOPLE REACH THEIR FULL POTENTIAL. DURING FY20, PROFESSIONALS AT THE PROGRAM PROVIDED SERVICES FOR 1,544 CHILDREN AND THEIR FAMILIES. COMMUNITY PARTNERS CONTINUE TO INCREASE THEIR REFERRALS TO OUR PROGRAM DUE TO HAVING POSITIVE OUTCOMES FOR THEIR INVESTIGATIONS AND KNOWING CHILDREN RECEIVE APPROPRIATE TREATMENT. IN ADDITION TO THE MAIN CENTER IN NORFOLK, SERVICES ARE ALSO AVAILABLE AT CHKD'S OUTPATIENT CENTERS IN VIRGINIA BEACH AND NEWPORT NEWS. TO ACCURATELY REFLECT OUR MISSION AND SERVICES, ALIGN WITH CHKD AND OUR ACCREDITING BODY, THE NATIONAL CHILDREN'S ALLIANCE, AND REDUCE THE STIGMA OF SEEKING HELP FOR ABUSE, ON JANUARY 1, 2021, THE CHILD ABUSE PROGRAM WILL OFFICIALLY CHANGE ITS NAME TO CHKD CHILD ADVOCACY CENTER. THE EPIDEMIC OF CHILDHOOD OBESITY CONTINUES TO BE A CONCERN AND FOCUS AREA FOR CHKD. IN ORDER TO ADDRESS THIS CRITICAL ISSUE, IN 2001, CHKD ESTABLISHED A COMPREHENSIVE PROGRAM CALLED HEALTHY YOU FOR LIFE THAT IS OFFERED TO CHILDREN AGES 3 THROUGH HIGH SCHOOL. HEALTHY YOU FOR LIFE OFFERS A MULTIDISCIPLINARY TEAM APPROACH THAT PROVIDES CLINICAL AND PSYCHOLOGICAL EVALUATION AND TREATMENT PLANNING FOR INDIVIDUALS EITHER IN PERSON OR BY TELEMEDICINE VISITS. THE PROGRAM'S STAFF INCLUDES PHYSICIANS, NURSE PRACTITIONERS, REGISTERED DIETITIANS, LICENSED CLINICAL SOCIAL WORKERS AND EXERCISE PHYSIOLOGIST. THE HEALTHY YOU FOR LIFE PROGRAM ALSO OFFERS INDIVIDUAL COUNSELING SESSIONS. IN FY20 THE TEAM CONDUCTED NEARLY 2,000 VISITS COVERING 90 ZIP CODES. MOVING INTO THE NEW FISCAL YEAR, THE TEAM IS CONTINUING TO USE TELEMEDICINE AS A WAY TO IMPROVE ACCESS TO A BEHAVIORAL HEALTH COUNSELOR TO ADDRESS PSYCHO-SOCIAL STRESSORS MANY PATIENTS EXPERIENCE. MIDDLE SCHOOL AND HIGH SCHOOL GROUP THERAPY SESSIONS HAVE BEEN INITATED VIA TELEHEALTH TO HELP PRE-TEEN AND TEENAGERS FEEL CONNECTED AND SUPPORTED DURING THE PANDEMIC. PERSONAL TRAINING IS ALSO OFFERED FOR INTERESTED PATIENTS. HEALTHY YOU CONTINUES TO PARTNER WITH VARIOUS COMMUNITY ORGANZIATIONS TO EDUCATE AND ENCOURAGE HEALTHY LIFESTYLES FOR CHRONICALLY OBESE CHILDREN AND THEIR FAMILIES IN HAMPTON ROADS.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS (CONT'D)	CHKD'S DIABETES EDUCATION PROGRAM HELPS APPROXIMATELY 1,300 LOCAL CHILDREN WHO LIVE WITH THE CHRONIC DISEASE. THREE CERTIFIED DIABETES EDUCATORS, A SOCIAL WORKER, A REGISTERED DIETITIAN AND OFFICE COORDINATOR HELP PATIENTS AND FAMILIES AT THE ONSET OF THE DISEASE AND UNTIL ADULTHOOD. THE DIABETES CENTER PROVIDES INPATIENT AND OUTPATIENT CLINICAL MANAGEMENT, DIABETES EDUCATION, SUPPORT GROUPS, AND PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS. A TRANSITION PROGRAM HELPS THE OLDER TEENS AND YOUNG ADULTS BEGIN TRANSFERRING CARE TO ADULT PROVIDERS IN THE COMMUNITY. CHILDREN MADE 716 VISITS TO THE DIABETES CENTER IN FY20. THE CHILDREN'S CANCER AND BLOOD DISORDERS CENTER PROVIDES CARE TO YOUNG PEOPLE WITH CANCER, SICKLE CELL DISEASE, BLEEDING AND OTHER BLOOD DISORDERS THROUGH TREATMENT PROGRAMS THAT ENCOMPASS CHILDREN'S PHYSICAL, EMOTIONAL AND EDUCATIONAL NEEDS AND INCORPORATES THE WHOLE FAMILY. PATIENTS MADE 8,293 VISITS TO THE CENTER IN FY20. CHKD IS THE ONLY EMERGENCY DEPARTMENT AND LEVEL 1 TRAUMA CENTER EXCLUSIVELY SERVING CHILDREN AND THEIR FAMILIES IN THE SOUTHEAST REGION OF VIRGINIA. IN FY20, CHILDREN MADE 48,288 VISITS TO OUR EMERGENCY CENTER. CHKD PROVIDES CARE FOR PATIENTS AND THEIR FAMILIES FROM BIRTH TO YOUNG ADULTHOOD WITH VARIED LEVELS OF ACUITY FROM TRAUMA AND RESUSCITATIONS TO URGENT CARE TYPE PATIENTS. OUR COLLABORATIVE TEAM INCLUDES PEDIATRIC BOARD-CERTIFIED EMERGENCY PHYSICIANS, NURSE PRACTITIONERS, NURSES, ED TECHS, NURSING CARE PARTNERS, BEHAVIORAL HEALTH TECHS, PHARMACISTS, SOCIAL WORKERS, CHILD LIFE SPECIALISTS, CHAPLAINS, RESPIRATORY THERAPISTS AND MORE. CHKD OFFERS THE ONLY PEDIATRIC RENAL DIALYSIS SERVICE IN THE AREA. DIALYSIS IS A TIME-CONSUMING PROCESS AND CHILDREN APPRECIATE THE CHANCE TO HAVE THE SERVICE IN A SETTING WHERE THEY CAN MEET WITH FRIENDS THEIR OWN AGES AS WELL AS HOSPITAL SUPPORT STAFF AND SCHOOL TEACHERS. CHILDREN MADE 3,016 CHRONIC AND ACUTE DIALYSIS VISITS IN FY20, AND 4,617 VISITS TO THE RENAL CLINIC. SINCE 2005, CHKD HAS PERFORMED 84 KIDNEY TRANSPLANTS FROM LIVING DONORS AS WELL AS DECEASED DONORS. LIVING DONATION OPTIONS INCLUDE A PARTNERSHIP WITH SENTARA NORFOLK GENERAL HOSPITAL AND THE NATIONAL KIDNEY REGISTRY (NATIONWIDE LIVING DONOR PAIRED-EXCHANGE PROGRAM). ONE MARK OF CHKD'S DISTINCTIVE PEDIATRIC CARE HAS ALWAYS BEEN CHILD-CENTERED DIAGNOSTIC SERVICES, SUCH AS RADIOLOGY AND LABORATORY. OVER THE PAST SEVERAL YEARS, CHKD HAS WORKED HARD TO MAKE THESE UNIQUE SERVICES MORE ACCESSIBLE TO FAMILIES THROUGHOUT OUR SERVICE REGION. IN ADDITION TO THE LAB AT THE MAIN HOSPITAL, CHKD NOW HAS LAB SERVICES AT ITS OYSTER POINT, PRINCESS ANNE, OAKBROOKE, BURNETT'S WAY, LANDSTOWN, LOEHMANN'S AND TECH CENTER LOCATIONS AS WELL AS THE VOLVO URGENT CARE CENTER. THE LABORATORY ALSO OPERATES A COURIER SERVICE THAT FACILITATES QUICK TURNAROUND OF SPECIMENS. OF THE 762,641 LAB TESTS PERFORMED IN FY20, APPROXIMATELY 66 PERCENT WERE FOR OUTPATIENTS. CHKD RADIOLOGY SERVICES ARE ALSO AVAILABLE TO FAMILIES AT OUR CHKD FACILITIES IN NEWPORT NEWS, CHESAPEAKE, SUFFOLK, HAMPTON, NORFOLK AND VIRGINIA BEACH. THE RADIOLOGY DEPARTMENT IS A FULLY-INTEGRATED DIGITAL IMAGING CENTER THAT ALLOWS DIAGNOSTIC IMAGES AND REPORTS TO BE TRANSMITTED AND VIEWED ELECTRONICALLY. IN FY20, 99,217 DIAGNOSTIC EXAMS WERE PERFORMED, INCLUDING X-RAYS, FLUOROSCOPIC TESTS, URODYNAMICS AND BONE DENSITY TESTS, CT AND MRI SCANS, ULTRASOUND, PVL AND NUCLEAR MEDICINE STUDIES. APPROXIMATELY 80 PERCENT WERE OUTPATIENT BASED. CHKD'S REHABILITATIVE THERAPY SERVICES ARE OFFERED IN LOCATIONS THROUGHOUT THE COMMUNITY, INCLUDING NORFOLK, CHESAPEAKE, VIRGINIA BEACH, SUFFOLK, HAMPTON AND NEWPORT NEWS. IN ADDITION TO ITS HIGHLY-SPECIALIZED PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, THE DEPARTMENT ALSO OFFERS: * AQUATIC THERAPY - PHYSICAL AND OCCUPATIONAL THERAPISTS WORK WITH CHILDREN IN THE WATER TO HELP RELAX TIGHT MUSCULATURE, INCREASE RANGE OF MOTION AND IMPROVE STRENGTH, BALANCE AND ENDURANCE. * ASSISTIVE TECHNOLOGY/AUGMENTATIVE PROGRAM - SERVICES PROVIDED FOR CHILDREN WHO ARE UNABLE TO COMMUNICATE VERBALLY OR THROUGH GESTURES DUE TO VARIOUS MEDICAL CONDITIONS. IN FY20, WE DID 210 AUGMENTATIVE COMMUNICATION EVALUATIONS. * CAR SEAT PROGRAM - SPECIALLY TRAINED THERAPISTS OFFER CAR SEAT SAFETY RESTRAINT EVALUATIONS FOR PATIENTS WITH SPECIAL NEEDS. IN FY20, WE DID 263 CAR SEAT EVALUATIONS, DISTRIBUTED 125 SPECIAL NEEDS CAR SEATS DURING THOSE EVALUATIONS, DISTRIBUTED AN ADDITIONAL 131 STANDARD CAR SEATS, AND PARTICIPATED IN 6 COMMUNITY-BASED CAR SEAT SAFETY CHECKS THROUGH THIS PROGRAM. * WHEELCHAIR CLINIC - CERTIFIED THERAPISTS COMPLETE A COMPREHENSIVE EVALUATION TO DETERMINE AND PRESCRIBE THE APPROPRIATE WHEELCHAIR AND SEATING SYSTEM. CHILDREN MADE ALMOST 9,450 VISITS TO THIS CLINIC IN FY20 FOR EVALUATION AND TECHNICAL ADJUSTMENTS. SECTION THREE: COMMUNITY OUTREACH CHKD REACHED FAMILIES IN THEIR HOMES, DOCTORS' OFFICES, SCHOOLS, NEIGHBORHOODS AND COMMUNITY CENTERS WITH A WIDE VARIETY OF PROGRAMS, SOCIAL MEDIA AND PUBLICATIONS THAT PROMOTE WELLNESS, PREVENT INJURIES, AND STRENGTHEN FAMILIES. THE COVID-19 PANDEMIC CAUSED RESTRICTIONS ON OUR COMMUNITY OUTREACH AND ENGAGEMENT (CORE) ACTIVITIES IN THE LAST PART OF FY20. HOWEVER, DESPITE THOSE RESTRICTIONS, CORE CONDUCTED 359 OUTREACH EVENTS REACHING 29,380 FAMILIES. WE ALSO COMPLETED THE COMMUNITY NEEDS HEALTH ASSESSMENT AND IMPLEMENTATION PLAN. EFFORTS FOCUSED ON MENTAL HEALTH, TRAUMA, AND SOCIAL EMOTIONAL LEARNING FOR BOTH PARENTS AND PROFESSIONALS. THE MENTAL HEALTH VIRTUAL DOCUMENTARIES WERE VIEWED BY AN ESTIMATED 1,000 PARENTS, STUDENTS, AND PROFESSIONALS. OUR COMMUNITY PARTNERS, ESPECIALLY DURING THE PANDEMIC, WERE INSTRUMENTAL IN DISSEMINATING INFORMATION TO FAMILIES ABOUT OUR VIRTUAL PROGRAMS AND RESOURCES. CHKD IS A SITE OF THE NATIONAL "REACH OUT AND READ" LITERACY PROGRAM, WHICH ENCOURAGES READING BY DISTRIBUTING FREE BOOKS TO CHILDREN AT THEIR WELL CHILD VISITS TO THEIR PEDIATRICIANS. THROUGH THE DONOR-FUNDED PROGRAM, CHKD PRIMARY CARE PEDIATRICIANS GAVE APPROVIMATELY 75,194 BOOKS TO CHILDREN IN FY20. IN FY20 CHKD'S WEBSITE, WWW.CHKD.ORG, CONTINUES TO BE A POPULAR AND EFFECTIVE METHOD OF COMMUNICATION. IN FY20, CHKD.ORG HAD MORE THAN 2.6 MILLION VISITS. MORE THAN 1.5 MILLION NEW AND RETURNING VISITORS VIEWED 5,021,762 PAGES ON OUR SITE. THE CONTENT MANAGEMENT SYSTEM THAT IS IN PLACE ALLOWS MULTIPLE USERS TO CREATE AND UPDATE CONTENT AS NEEDED. CHKD.ORG IS A RESPONSIVE DESIGN SITE AND AUTOMATICALLY FORMATS ITSELF TO ANY DEVICE (PC, TABLET OR SMARTPHONE)- NO APP NEEDED. CLICKABLE PHONE NUMBERS AND INTERACTIVE MAPS MAKE IT EASY FOR OUR PATIENTS TO CALL OR FIND ANY PRACTICE, AND FAMILIES HAVE EASY ACCESS TO TEST RESULTS, SHOT RECORDS, AND CAN EVEN REQUEST PRESCRIPTION REFILLS AND MAKE APPOINTMENTS ONLINE STRAIGHT FROM THE HOMEPAGE BY ACCESSING THE MYCHKD PATIENT PORTAL. ENHANCED PHYSICIAN PROFILES, INCLUDING CLICKABLE PHONE NUMBERS, INTERACTIVE MAPS, BIOGRAPHICAL INFORMATION AND A LINK TO THE PHYSICIAN'S PRACTICE MAKE IT EASIER THAN EVER TO CHOOSE THE DOCTOR THAT'S RIGHT FOR YOU. CHKD CONTINUES TO UTILIZE SOCIAL MEDIA OUTLETS SUCH AS FACEBOOK, TWITTER, LINKEDIN, PINTEREST AND INSTAGRAM TO INCREASE DIRECT INTERACTION WITH OUR PATIENTS AND THEIR FAMILIES. THE WEBSITE CONTINUES TO BE A RESOURCE FOR OUR SERVICES AND HEALTH INFORMATION. CHKD IS ONE OF SIX LOCATIONS IN THE STATE FOR THE CARE CONNECTION FOR CHILDREN (CCC), THE STATE-FUNDED TITLE V PROGRAM THAT PROVIDES COMPREHENSIVE CARE COORDINATION, INFORMATION AND REFERRAL FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. THERE ARE APPROXIMATELY 12,000 CHILDREN WITH SPECIAL HEALTH CARE NEEDS IN THE REGION'S PUBLIC HEALTH DISTRICTS. IN FY20, CCC ASSISTED WITH 614 INFORMATION AND REFERRAL CALLS AND PROVIDED COMPREHENSIVE CASE MANAGEMENT SERVICES TO 600 FAMILIES. FINANCIAL ASSISTANCE WAS PROVIDED FOR 28 CHILDREN AND YOUTH WHO WERE UNINSURED OR UNDERINSURED AND 145 FAMILIES WERE ASSISTED IN APPLYING FOR STATE HEALTH PROGRAMS, TO INCLUDE VIRGINIA'S WAIVER SERVICES. THE PROGRAM PROVIDED ONGOING BILINGUAL CARE COORDINATION SERVICES TO 105 CLIENTS AND FAMILY MEMBERS AND ASSISTED THEM WITH ACCESS TO COMMUNITY RESOURCES AND FINANCIAL ASSISTANCE. WE MAINTAINED AN UPDATED LOCAL AND REGIONAL COMMUNITY DATABASE WITH CATALOGED RESOURCES FOR ALL 21 CITIES AND COUNTIES IN OUR REGION. THIS RESOURCE DIRECTORY WAS MADE AVAILABLE TO THE HEALTH SYSTEM AS WELL AS LOCAL AGENCIES AND THE COMMUNITY. THE PARENT EDUCATORS FROM THE FAMILIES AS EDUCATORS PROGRAM PROVIDED COMMUNITY BASED EXPERIENCES TO 9 RESIDENTS FOR THE PURPOSE OF SHARING THEIR CHALLENGES AND POSITIVE EXPERIENCES IN RAISING CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS IN THE COMMUNITY. (IN FY20 THE PROGRAM WAS FURLOUGHED FROM FEB. 25 - JUN 30 BECAUSE OF COVID-19.) WE MAINTAINED A SPECIAL NEEDS LISTSERV WITH OVER 500 SUBSCRIBERS.
SECTION FOUR: MEDICAL EDUCATION AND RESEARCH	CHKD INVESTS IN THE PRESENT AND FUTURE HEALTH OF OUR CHILDREN THROUGH A VARIETY OF RESEARCH PROGRAMS AND EDUCATIONAL ACTIVITIES. CHILDREN'S HOSPITAL IS HOME TO EASTERN VIRGINIA MEDICAL SCHOOL'S PEDIATRIC RESIDENCY PROGRAM, WHERE NEW PHYSICIANS BECOME SPECIALISTS IN THE FIELD OF PEDIATRICS. MANY OF THEM STAY IN THIS COMMUNITY OR IN THE STATE TO PRACTICE PEDIATRICS AFTER THEY COMPLETE THEIR RESIDENCIES. CHKD ALSO SERVES AS THE EXCLUSIVE PEDIATRIC TEACHING SITE FOR RESIDENTS IN FAMILY MEDICINE PRACTICE, EMERGENCY PRACTICE, ENT AND PHYSICIAN ASSISTANTS, AS WELL AS THE EXCLUSIVE SITE FOR SOME 150 THIRD-YEAR MEDICAL SCHOOL STUDENTS FOR THEIR SIX-WEEK PEDIATRIC ROTATION. CHKD PROVIDES A SETTING FOR MANY CLINICAL RESEARCH TRIALS. HIGHLIGHTS OF THE BASIC SCIENCE RESEARCH INCLUDE NEW GENE THERAPY FOR NEUROMUSCULAR DISORDERS, BREAKTHROUGHS IN TREATMENT OF CYSTIC FIBROSIS, INNOVATIVE THERAPIES IN SPORTS MEDICINE, ADVANCE GROWTH HORMONE TREATMENTS, AND INTERVENTIONS FOR DISORDERED SLEEP. IN ADDITION, RESEARCH INCLUDES NEW MEDICATIONS AND OTHER THERAPIES, CLINICAL OUTCOMES ANALYSES AND EPIDEMIOLOGICAL STUDIES SANCTIONED BY THE EASTERN VIRGINIA MEDICAL SCHOOL INSTITUTIONAL REVIEW BOARD. THERE WERE 241 IRB-APPROVED ACTIVE FUNDED STUDIES IN FY20. TOPICS OF STUDY INCLUDED HEMATOLOGY/ONCOLOGY, ALLERGY/ASTHMA, INFECTIOUS DISEASE, NEUROLOGY, PEDIATRIC SURGERY, CARDIOLOGY, OTOLARYNGOLOGY, PULMONOLOGY, GASTROENTEROLOGY, CHILD ABUSE, ENDOCRINOLOGY, DERMATOLOGY, NEONATOLOGY AND MENTAL HEALTH. MANY OF THESE STUDIES ARE STAGE THREE CLINICAL TRIALS THAT BRING CUTTING-EDGE TREATMENTS TO CHKD PATIENTS YEARS BEFORE THEY ARE AVAILABLE TO THE PUBLIC. THIS FISCAL YEAR THERE WERE ALSO NEW PHASE ONE TRIALS OPENED, WHICH ALLOWED OUR PATIENTS THE EARLIEST POSSIBLE ACCESS TO NOVEL THERAPIES. THERE IS AN INCREASED FOCUS ON REGISTRY STUDIES ACROSS ALL DISCIPLINES. DATA COLLECTED IN THESE REGISTRIES IS INTENDED TO STANDARDIZE OPTIMAL LEVELS OF CARE AND LEAD TO IMPROVED PATIENT OUTCOMES. THERE HAVE ALSO BEEN OPPORTUNITIES TO STUDY THE EFFECTS OF VARIOUS TELEHEALTH/TELEMEDICINE INTERVENTIONS, NOT ONLY TO ADAPT TO THE COVID-19 PANDEMIC, BUT TO BE ABLE TO REACH SUBJECTS WHO CANNOT TRAVEL TO THE SITE, SUCH AS SUBJECTS WHO ARE HOMEBOUND OR IN HOSPICE CARE. THE NUSS PROCEDURE FOR THE CORRECTION OF PECTUS EXCAVATUM, DEVELOPED AT CHKD MORE THAN 30 YEARS AGO, CONTINUES TO DRAW NATIONAL ATTENTION FROM BOTH PATIENTS AND SURGEONS. THE NUSS CENTER OFFERS NON-SURGICAL TREATMENT THERAPIES AS WELL. THE COMPRESSION BRACE INITIATED IN 2009 HAS HELPED MORE THAN 461 PATIENTS WITH OVER 80% OF THOSE PATIENTS EXPERIENCING A CORRECTION TO THEIR DEFORMITY. IN ADDITION, THE VACUUM BELL TREATMENT FIRST OFFERED IN 2012 HAS HELPED OVER 295 PATIENTS. IN JUNE 2016, CHKD OPENED THE NEW NUSS CENTER, OFFERING A SPACE DEDICATED TO THE EVALUATION AND TREATMENT OF CHEST WALL CONDITIONS. THE HOSPITAL CONTINUES ITS ENDEAVORS ON MULTIPLE RESEARCH STUDIES IN AN EFFORT TO FURTHER UNDERSTAND CHEST WALL DEFORMITIES. TO DATE, MORE THAN 2,480 SURGICAL PATIENTS HAVE UNDERGONE THE NUSS PROCEDURE AT CHKD AND OVER 5,738 PATIENTS HAVE BEEN EVALUATED FOR CHEST WALL CONDITIONS. CHKD IS A MEMBER OF CHILDREN'S ONCOLOGY GROUP (COG), AN INTERNATIONAL RESEARCH GROUP THAT CONDUCTS CLINICAL TRIALS FOR CHILDREN WITH CANCER. AS A MEMBER, CHKD HAS ACCESS TO THE LATEST PROTOCOLS FOR TREATMENT OF CHILDHOOD CANCER, PROVIDING THE COMMUNITY AND REGION WITH THE BEST PRACTICES AND TREATMENT RESULTS FROM MORE THAN 250 COG-MEMBER HOSPITALS IN NORTH AMERICA, AUSTRALIA, NEW ZEALAND, AND EUROPE. OUR PRIMARY GOAL IS TO INCREASE PARTICIPATION IN CLINICAL TRIALS WHICH WE FEEL WILL ADVANCE THE FIELD OF PEDIATRIC ONCOLOGY. IN FY20, CHKD HAD 114 COG STUDIES INCLUDING LTF STUDIES OPEN TO ENROLLMENT OR UNDERGOING DATA ANALYSIS. SEVERAL OF THESE STUDIES WERE INCLUDED IN COG'S LONG-TERM FOLLOW-UP STUDY, WHICH COLLECTS DATA ON PATIENTS WHO HAVE PARTICIPATED IN STUDIES THAT ARE NO LONGER OPEN TO ENROLLMENT. IN ALL, APPROXIMATELY 200 CHKD PATIENTS PARTICIPATED IN EITHER OPEN OR FOLLOW-UP COG STUDIES IN FY20.THE HEMATOLOGY/ONCOLOGY DIVISION HAD 15 RESEARCH STUDIES OPEN THAT WERE NOT COG STUDIES. IN FY20, CHKD HOSTED 7 CONTINUING MEDICAL EDUCATION EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE REGION. HELPING CHILD HEALTH EXPERTS IN OUR REGION KEEP UP WITH THEIR SKILLS AND THEIR ACCREDITATION. (FOUR CONFERENCES WERE CANCELED DUE TO COVID-19.) THERE WERE SEVEN REGULARLY SCHEDULED SERIES (CHKD LECTURE SERIES TOPICS IN SPORTS MEDICINE AND CHKD TRAUMA M&M) FOR A TOTAL OF 81 ACTIVITIES. PART VI, SECTION A, LINES 6, 7A, 7B & 11: LINE 6: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK CORPORATION WITH A SOLE MEMBER. THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS CHILDREN'S HEALTH SYSTEM, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS MANAGED BY ITS SOLE MEMBER, CHILDREN'S HEALTH SYSTEM, INC. PART VI, SECTION A, LINE 7A: LINE 7A: CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, MANAGES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. ACCORDINGLY, THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED. AS A VIRGINIA NON-STOCK CORPORATION, CHILDREN'S HEALTH SYSTEM, INC., HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. THE MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC., THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. ARE THE CLASS A MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. (I.E., THE THEN CURRENT MEMBERS IN GOOD STANDING OF THE NORFOLK CITY UNION OF THE KING'S DAUGHTERS, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION) AND THE CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM INC. (I.E., THE THEN CURRENT DIRECTORS ON THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC.). LINE 7B: THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. LINE 11: THE 990 IS PREPARED USING THE ANNUAL FINANCIAL STATEMENTS THAT ARE REVIEWED BY THE BOARD AND AUDITED ANNUALLY AS A PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC. UPON COMPLETION OF THE DRAFT OF THE RETURN A DETAIL REVIEW IS PERFORMED BY SEVERAL MEMBERS OF STAFF AND MANAGEMENT. PRIOR TO FILING WITH THE IRS, THE BOARD IS PROVIDED A COPY TO REVIEW.
POLICIES & DISCLOSURE ITEMS	PART VI, SECTION B, LINE 12: CONFLICT POLICY CONSIDERATIONS: CHKD CONFLICT OF INTEREST POLICY INCLUDES OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES, KEY EMPLOYEES, ALL OTHER EMPLOYEES, PROFESSIONAL STAFF AND SUBSTANTIAL DONORS. ANNUALLY, A QUESTIONNAIRE IS DISTRIBUTED AND COLLECTED FROM OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES AND KEY EMPLOYEES. THE QUESTIONNAIRES ARE REVIEWED BY THE LEGAL DEPARTMENT. FOR KNOWN CONFLICTS, THE PERSON INVOLVED RECUSES HIMSELF OR HERSELF FROM DELIBERATIONS REGARDING THE TRANSACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY ARE REPORTED TO THE CHKD BOARD CHAIR OR THE CHKD COMPLIANCE OFFICER, AS APPLICABLE, AND MAY REQUIRE CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. PART VI, SECTION B, LINES 15A-15B LINE 15A: COMPENSATION PROCESS CONSIDERATIONS: CHILDREN'S HEALTH SYSTEM ESTABLISHES THE COMPENSATION OF THE CEO JAMES DAHLING. LINE 15B: CHILDREN'S HEALTH SYSTEM AND CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS USE THE FOLLOWING PROCESS TO ESTABLISH COMPENSATION FOR OFFICERS AND KEY EMPLOYEES: AN INDEPENDENT COMPENSATION CONSULTANT APPROVED AND RETAINED BY THE COMPENSATION COMMITTEE OF THE BOARD ANNUALLY, USUALLY IN APRIL, PROVIDES EDUCATION AND PRESENTS TO THE FULL BOARD COMPARATIVE SALARIES AND SALARY RANGES FROM A DATABASE COMPRISED OF CHILDREN'S HOSPITALS AND OTHER APPLICABLE HOSPITALS FOR OFFICERS & EXECUTIVES FOR THE BOARD TO REVIEW. THE COMPENSATION COMMITTEE WITH THE AID OF THE CONSULTANT REVIEWS AND MAKES DECISIONS AS TO EXECUTIVE SALARIES OF CHKD AND ITS SUBSIDIARIES. THOSE SALARY CHANGES AND APPROVALS ARE CONTEMPORANEOUSLY DOCUMENTED BY MINUTES MAINTAINED BY THE COMPENSATION COMMITTEE AND SIGNED BY THE CHAIRMAN OF THE BOARD. PART VI, SECTION C, LINES 19: FINANCIAL STATEMENTS (PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC.) ALONG WITH GOVERNING DOCUMENTS OF THE ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC THROUGH DIRECT INQUIRY AND REQUEST.
FORM 990, PART XI, LINE 9	OTHER CHANGES IN NET ASSETS IS MADE UP OF: GAIN/LOSS ON DERIVATIVE INVESTMENTS ($ 14,614,226) CHANGE IN DONOR RESTRICTED CONTRIBUTIONS $ 4,418,156 ________________________________________________________ TOTAL ($ 10,196,070)

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Total IncomeTotalIncomeAmt	End Of Year AssetsEndOfYearAssetsAmt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
CHILDREN'S MEDICAL TOWER LLC
601 CHILDRENS LANE	NORFOLK	VA	23507	452907147	LESSOR	VA	$1,753,675	$23,339,278	CHILDREN'S H
CHILDREN'S HEALTH SYSTEM INSURANCE LLC
601 CHILDRENS LANE	NORFOLK	VA	23507		INSURANCE	SC	$779,399	$2,571,123	CHILDREN'S H

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CHILDREN'S HEALTH SYSTEM INC
601 CHILDRENS LANE	NORFOLK	VA	23507	541278830	HEALTHCARE	VA	501(C)(3)	12B	NA	false
CHILDREN'S HEALTH FOUNDATION INC
601 CHILDRENS LANE	NORFOLK	VA	23507	541278865	SUPP CHKD	VA	501(C)(3)	12A	NA	false

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
FORTIFY CHILDREN'S HEALTH LLC
1330 JEFFERSON PARK AVENUE	CHA	VA	23507	HEALTHCARE	VA	NA
REALTA HOLDINGS LLC 82-354346
601 CHILDRENS LANE	NORFOLK	VA	23507	RESEARCH	VA	NA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd
CHILDREN'S SURGICAL SPECIALTY GROUP INC
601 CHILDRENS LANE	NORFOLK	VA	23507	311610834	HEALTHCARE	VA	NA	C CORP	false
CHILDREN'S MEDICAL GROUP INC
601 CHILDRENS LANE	NORFOLK	VA	23507	541778786	HEALTHCARE	VA	NA	C CORP	false
CMG OF NORTH CAROLINA INC
601 CHILDRENS LANE	NORFOLK	VA	23507	561960102	HEALTHCARE	NC	NA	C CORP	false

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (16 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
CHILDREN'S SURGICAL SPECIALTY GROUP INC
j	$968,379	BOOK VALUE
CHILDREN'S MEDICAL GROUP INC
j	$447,009	BOOK VALUE
CHILDREN'S HEALTH SYSTEM INC
p	$20,285,824	BOOK VALUE
CHILDREN'S HEALTH SYSTEM INC
e	$237,808	BOOK VALUE
CMG OF NORTH CAROLINA
q	$202,003	BOOK VALUE
CHILDREN'S MEDICAL GROUP INC
q	$4,944,828	BOOK VALUE
CMG OF NORTH CAROLINA
d	$136,946	BOOK VALUE
CHILDREN'S HEALTH FOUNDATION INC
b	$6,423,185	BOOK VALUE
CHILDREN'S SURGICAL SPECIALTY GROUP INC
d	$1,429,803	BOOK VALUE
CHILDREN'S MEDICAL GROUP INC
d	$1,406,014	BOOK VALUE
CHILDREN'S HEALTH SYSTEM INC
b	$7,000,000	BOOK VALUE
CHILDREN'S HEALTH SYSTEM INC
c	$8,800,000	BOOK VALUE
CHILDREN'S HEALTH SYSTEM INC
l	$526,265	BOOK VALUE
CHILDREN'S HEALTH SYSTEM INC
k	$3,003,882	BOOK VALUE
CHILDREN'S SURGICAL SPECIALTY GROUP INC
q	$778,638	BOOK VALUE
CHILDREN'S HEALTH FOUNDATION INC
p	$99,669	BOOK VALUE