2019-11-11T13:30:10-06:00 2018-12-31 350921680 CROWE LLP 401 East Las Olas Blvd Suite 1100 Fort Lauderdale FL 333014230 990 2018-01-01 590638499 Variety Children's Hospital VARI 3056666511 3100 SW 62nd Avenue Miami FL 331553009 Matthew A Love President and CEO 2019-11-11 true Brittney Kocaj P01320603 9542028600 2018 2020-03-31 21:24:44Z Nicklaus Children's Hospital Matthew A Love 3100 SW 62nd Avenue Miami FL 331553009 702286240 false X www.nicklauschildrens.org X 1950 FL THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. 17 15 4102 1145 19512 8113325 11045555 618929319 606214652 24069053 15631131 23086904 25091580 674198601 657982918 0 0 272181948 274713335 0 0 341378814 332104611 613560762 606817946 60637839 51164972 1240624215 1165532000 498120778 442199702 742503437 723332298 TO INSPIRE HOPE AND PROMOTE LIFELONG HEALTH BY PROVIDING THE BEST CARE TO EVERY CHILD. false false 485454282 620525018 VARIETY CHILDREN'S HOSPITAL, ESTABLISHED IN 1950, OWNS AND OPERATES A PEDIATRIC SPECIALTY HOSPITAL NOW KNOWN AS NICKLAUS CHILDREN'S HOSPITAL. THE HOSPITAL (FORMERLY MIAMI CHILDREN'S HOSPITAL) WAS RENAMED IN 2015 IN RECOGNITION OF A GENEROUS PLEDGE FROM THE NICKLAUS CHILDREN'S HEALTH CARE FOUNDATION. THE HOSPITAL IS ONE OF THE LARGEST FREESTANDING PEDIATRIC TEACHING HOSPITALS IN THE SOUTHEASTERN UNITED STATES. IT PROVIDES SPECIALIZED PEDIATRIC HEALTHCARE FOR CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE OR ABILITY TO PAY. THE HOSPITAL HAS 309 LICENSED BEDS CONSISTING OF 289 GENERAL ACUTE-CARE BEDS AND 20 PSYCHIATRIC BEDS. NICKLAUS CHILDREN'S HOSPITAL SERVES AS A REFERRAL CENTER FOR CHILDREN WITH COMPLEX, CRITICAL OR LIFE-THREATENING ILLNESSES REQUIRING SPECIALIZED CARE. IT HAS A STATE-DESIGNATED PEDIATRIC TRAUMA CENTER. MANY PATIENTS ARE REFERRED BY OTHER HOSPITALS REGARDLESS OF THE EXISTENCE OF FORMAL ARRANGEMENTS.. (CONTINUED ON SCHEDULE O) 485454282 true true false false false false false false true true true false true true true false true false false true false false false false false true true false false true true true false false false false false false false false false false false false false true true true true false false true 492 0 true 4102 true true true false false false false false true false false false false false X 17 15 true false false false true true true true true false false true true true true true true false false true false FL X Ramon Coto 3056666511 5301 Blue Lagoon Drive Miami FL 33126 Jaret Davis Chairman 0.1 1.3 X X 0 0 0 Jodi Laurence Esq Vice Chairman 0.1 0.3 X X 0 0 0 Narendra M Kini MD CEO/DIRECTOR 20.0 20.5 X X 0 2186311 263462 Jefry Biehler MD Secretary 40.0 0.3 X X 326830 0 31123 Ravneet Chowdhury Esq Director 0.1 1.4 X 0 0 0 Maria Franco Director 0.1 0.3 X 0 0 0 Jorge Gonzalez Director 0.1 0.3 X 0 0 0 Drew Kern Director 0.1 0.4 X 0 0 0 Marcelo Laufer MD Director 0.1 0.3 X 0 0 0 Jay Massirman Director 0.1 1.3 X 0 0 0 Judge Fred Moreno Director 0.1 0.3 X 0 0 0 Mario Murgado Director 0.1 1.3 X 0 0 0 Joseph Nader Director 0.1 0.3 X 0 0 0 Phillip Newcomm Director 0.1 0.3 X 0 0 0 John L Nielsen Director 0.1 0.3 X 0 0 0 Alex Soto Director 0.1 1.4 X 0 0 0 Keith Ward Director 0.1 0.3 X 0 0 0 Timothy L Birkenstock Treasurer 20.0 20.5 X 0 979128 82617 Michael L Harrington President 40.0 0.4 X 491345 0 87200 Matthew Love SVP & CFO (partial year) 20.0 20.5 X 0 93638 3818 Beatriz M Cunill De Sautu MD Director Ped Residency 40.0 0 X 223656 0 30912 Rani S Gereige MD Director Medical Education 40.0 0 X 251436 0 14817 Jacqueline L Gonzalez SVP/Chief Nursing Officer 40.0 0 X 386831 0 77699 Andrea Maggioni MD Director Hospitalist 40.0 0 X 335406 0 32218 Jorge Ojito Manager Perfusion Services 40.0 0 X 234334 0 29149 Deise Granado-Villar MD DIRECTOR/ SVP/ CHIEF ACADEMIC OFFICER 40.0 0.3 X 334123 0 0 2583960 3259077 653016 293 true true false PHI AIR MEDICAL LLC 2800 NORTH 44 STREET SUITE 800 Phoenix AZ 85008 Air medical services 4217597 CHILDRENS ANESTHESIA ASSOC INC 3100 SW 623 AVE Miami FL 33155 Teaching Services 2806794 ONEBLOOD INC po Box 628342 Orlando FL 32862 Medical Supplies 2090810 NBBJ PO Box 101800 Pasadena CA 911891800 Architects 1280874 HILL-ROM COMPANY INC 1069 STATE ROUTE 46 E Batesville IN 47006 Provider Medical technologies 1183048 104 X 10443730 48300 553525 11045555 Patient Service Revenue 621300 586537414 586537414 Grant Revenue 900099 19407079 19407079 Seminar Workshops 621300 270159 270159 0 0 0 0 606214652 11228943 19512 11209431 2696720 2696720 0 2696720 2696720 48705510 44303322 4402188 0 4402188 4402188 1247426 1247426 1247426 Cafeteria Vending 722210 3477434 3477434 Shared Services 561000 14310366 14310366 Pharmacy 446110 707609 707609 2652025 0 0 2652025 21147434 657982918 620525018 19512 26392833 X 936498 749198 187300 213369470 170695575 42673895 10340516 8272413 2068103 35288420 28230736 7057684 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true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2926860 64751 2991611 231560 2695300 2926860 0 231560 231560 0 0 0 0 0.0 1.0 0.0 false true 27714599 27714599 488985218 181419085 307566133 53448467 25876694 27571773 333320346 212232489 121087857 86543369 3827107 82716262 566656624 Alternative Investments 235471562 F Corporate Debt Securities Restricted investments 6668075 F 242139637 Beneficial Interest in Miami Childrens Hospital Foundation Beneficial Interest in Miami Childrens Health System Foundation Self Insurance Trust Charitable Remainder Trust Other Long Term Assets Exec Life Intercompany Receivables beneficial interest in Nicklaus Children's Hospital Foundation 90410546 Self Insurance Trust 397649 Charitable Remainder Trust 942061 Other Long Term Assets 496372 Exec Life 337961 92584589 Other Liabilities Swap Liabilities Third Party Settlement Payable Lease Incentive Obligation Intercompany Payable Line of Credit Other Liabilities 9169792 Swap Liabilities 24223866 Third Party Settlement Payable 9882633 Lease Incentive Obligation 18205407 Intercompany Payable 17086175 Line of Credit 78567873 X Schedule D, Part V, Line 4 Intended uses of endowment funds The Foundation's endowments are established to fund medical research, education, patient medical, and social services at Nicklaus Children's Hospital. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote VARIETY CHILDREN'S HOSPITAL'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF NICKLAUS CHILDREN'S HEALTH SYSTEM (NCHS), A RELATED ORGANIZATION. MCHS' FIN 48 (ASC 740) FOOTNOTE FOR THE YEAR ENDED DECEMBER 31, 2018, READS AS FOLLOWS: "THE SYSTEM AND CERTAIN OF ITS AFFILIATED ORGANIZATIONS QUALIFY AS TAX-EXEMPT, NONPROFIT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). THE HOSPITAL, PSA, NCHF AND THE RESEARCH INSTITUTE ARE EXEMPT FROM FEDERAL INCOME TAX ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE AS DESCRIBED IN SECTION 501(C)(3). THESE TAX EXEMPT ENTITIES HAD NO TAX PROVISION FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017. THE CAPTIVE INSURANCE COMPANY IS NOT SUBJECT TO INCOME TAXES, AS NO INCOME TAXES ARE LEVIED IN THE CAYMAN ISLANDS. THE SYSTEM BELIEVES THERE IS NO UNCERTAIN TAX LIABILITY WHICH SHOULD BE RECORDED AS OF DECEMBER 31, 2018 AND 2017. THE HEALTH PLAN IS A LIMITED LIABILITY COMPANY WHICH IS TAXED AS A PARTNERSHIP AND THEREFORE IS GENERALLY NOT A TAXPAYING ENTITY FOR FEDERAL OR STATE INCOME TAX PURPOSES. IN LIEU OF CORPORATE INCOME TAXES, THE MEMBERS ARE TAXED ON THE HEALTH PLAN'S TAXABLE INCOME. THEREFORE, NO PROVISION OR LIABILITY FOR INCOME TAXES HAS BEEN INCLUDED IN THESE FINANCIAL STATEMENTS." Central America and the Caribbean 0 0 Program Services Self-Insurance Funding 3484000 Central America and the Caribbean 0 0 Investments 5578000 0 0 0 0 0 0 9062000 0 9062000 true false true true false false true true X true X false true true false true true 47987 47987 0.0001 372479246 273362867 99116379 0.1648 4046311 3580731 465580 0.0008 0 0 376573544 276943598 99629946 0.1656 1996155 59119 1937036 0.0032 11296633 9427310 1869323 0.0031 0 0.0 770350 145647 624703 0.0010 0 0.0 0 0 14063138 9632076 4431062 0.0074 0 0 390636682 286575674 104061008 0.1730 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 1738849 0 989985 1446784 -456799 X true true MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC SURGERY CENTER 0.5275 0.0 0.4725 1 1 NICKLAUS Children's Hospital 3100 SW 62nd Avenue Miami FL 33155 WWW.NICKLAUSCHILDRENS.ORG 4067 X X X X X NICKLAUS Children's Hospital 1 false false true X X X X X X X X X 18 true false false true X https://www.nicklauschildrens.org/NCH/media/docs/pdf/2018-PRC-Child-Adolescent-Health-Needs-Assessme X true 18 true https://www.nicklauschildrens.org/NCH/media/docs/pdf/Nicklaus-Children-s-Implementation-Plan_In-resp false true X 200.0 X X X true true X X X true X See Part VI X See Part VI X See Part VI X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The significant health needs are a prioritized description of the significant health needs of the community and identified through the CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - NIcklaus Children's Hospital. Focus Group: External and Internal This assessment was conducted by Professional Research Consultants, Inc. (PRC) on behalf of Nicklaus Children's Hospital (renamed in March 2015, and the flagship for Nicklaus Children's Health System). PRC is a nationally-recognized healthcare consulting firm with extensive experience conducting Community Health Needs Assessments in hundreds of communities across the United States since 1994. This 2018 PRC Child & Adolescent Health Needs assessment is a follow up to a similar study conducted in 2015 and incorporates data from both quantitative and qualitative sources. Quantitative data input includes primary research and secondary research (vital statistics and other existing health-related data); these quantitative components allow for comparison to benchmark data at the state and national levels. Qualitative data input includes primary research gathered through an Online Key Informant Survey. A precise and carefully executed methodology is critical in asserting the validity of the results gathered in the PRC Child & Adolescent Survey. Thus, to ensure the best representation of the population surveyed, a telephone interview methodology - one that incorporates both landline and cell phone interviews - was employed. The primary advantages of telephone interviewing are timeliness, efficiency and random-selection capabilities. In addition, these telephone interviews were supplemented with surveys among families in the total service area requested to participate in the study via a questionnaire completed online. The sample design used for this effort consisted of a stratified random sample of 1,372 parents of children under 18 in the Nicklaus Children's Hospital Service Area. By geography, a total of 408 surveys were conducted in Miami-Dade County, 359 in Broward County, 301 in Palm Beach County, 153 in Lee County and 50 in Monroe County. Once the interviews were completed, these were weighted in proportion to the actual child population distribution so as to appropriately represent the Nicklaus Children's Hospital Service Area as a whole. All administration of the surveys, data collection and data analysis was conducted by Professional Research Consultants, Inc. (PRC). To solicit input from key informants, those individuals who have a broad interest in the health of the community, an Online Key Informant Survey was also implemented as part of this process. A list of recommended participants was provided by the sponsors of this study; this list included names and contact information for physicians, public health representatives, other health professionals, social service providers, and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns among the families and children/adolescents with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. In all, 108 community stakeholders took part in the Online Key Informant Survey. Final participation included representatives of the organizations outlined below. Allergy & Immunology Care Center of South Florida Alvis Pediatrics Barry University College of Nursing and Health Sciences Boys & Girls Clubs of Miami-Dade Branches, Inc. Carrollton Children's Urology Associates, South Florida City of Hialeah Fire Rescue Department Cuban American National Council, Inc. Early Learning Coalition-Early Head Start Miami-Dade Fire Rescue Florida Department of Health Florida Department of Health in Miami-Dade County Greater Miami Jewish Federation Gulliver School Jehovah's Witnesses Jupiter Medical Center Miami Dade Pediatrics Miami Pediatric Care, LLC Midway Pediatrics Moreh and Associates Nicklaus Children's Hospital Nicklaus Children's Hospital, Department of Anesthesia Nicklaus Children's Hospital, Division of Hematology/Oncology Nicklaus Children's Health System Pediatric Professional Associates Physicians to Children Progressive Behavioral Science Publix Pharmacy South Florida Hispanic Chamber of Commerce The Children's Trust University of Miami School of Nursing and Health Studies Wellington Regional Medical Center West Coast University Through this process, input was gathered from several individuals whose organizations work with low-income, minority populations (including adopted children, African-Americans, Albanians, American Indians, Asians, biologically and socially at-risk infants and children, Caribbean people, Central Americans, children with autism, children with chronic medical problems, children with special needs, Cubans, the disabled, Dominicans, Europeans, foster children, grandparents raising grandchildren, Haitians, Hispanics, the homeless, immigrants, inner-city youth, international, children with lack of parental involvement, LGBT community, those with low education, low income residents, Medicare/Medicaid beneficiaries, the mentally ill, people of Middle Eastern decent, non-English speaking persons, Non-Whites, school-aged children, single parents, South Americans, the undocumented, the unemployed, the uninsured/underinsured, victims of human trafficking, people from the Virgin Islands), or other medically underserved populations (including African-Americans, children with autism, children with chronic medical problems, children with special needs, children with substance abuse issues, the disabled, family and individual counseling centers, foster children, Haitians, Hispanics, the homeless, immigrants, persons that lack dental care, persons that lack transportation, LGBT community, low income residents, Medicare/Medicaid beneficiaries, the mentally ill, the undocumented, the uninsured/underinsured). In the online survey, key informants were asked to rate the degree to which various children's health issues are a problem in their own community. Follow-up questions asked them to describe why they identify problem areas as such, and how these might be better addressed. Results of their ratings, as well as their verbatim comments, are included throughout this report as they relate to the various other data presented. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - NICKLAUS CHILDREN'S HOSPITAL. Mental & Emotional Health- Nicklaus, in collaboration with community partners, is committed to significantly grow our mental health program with more services and more types of services to facilitate greater prevention, treatment, and management. Access to Healthcare - Of the tested access barriers, inconvenient office hours impacted the greatest share of Total Service Area children (25.1%). Nicklaus has begun offering evening and weekend appointments for select sub-specialties in its physician group practice, Pediatric Specialists of America (PSA). This is an ongoing and high priority initiative for the PSA; and NCHS looks for the collaboration of affiliated private groups to do the same within their offices. * PSA created open access slots for patients with a STAT diagnosis and/or as recommended by the PCP/referring provider. * NCHS will be adding more formal structure to support multidisciplinary clinics and programs - centralizing dedicated resources and where possible allowing for global billing. * Nicklaus Children's continues to grow subspecialty and ancillary services throughout the ambulatory network to 'be where the children are'. * Almost a quarter of children in South Florida were reported to have a lapse in insurance coverage in the past year (vs. 13.0% nationally). NCHS intends to work with the Florida legislature to pass some form of 'auto-enrollment' so children are not left without insurance. * Nicklaus Children's School Health Program currently services 74 schools. The program is actively looking to expand to more schools, and has recently added or is working to add specific programming around weight management, mental health counseling, incorporating parents and guardians for training and guidance, and various targeted violence prevention and health promotion initiatives. Nutrition, Physical Activity & Weight - #GiveMe5 is a multidisciplinary, training, educational and marketing tool to encourage the consumption of fruits and vegetables among children of all different ethnic and cultural backgrounds in South Florida. Since the program's launch, in response to the 2015 CHNA, fruit and vegetable consumption went from significantly below to being in line with rates reported across the US. Based on the success of the program, NCHS and our community partners are committed to continued support for community nutrition and the #GiveMe5 campaign. #GiveMe5 is made possible with the generous support of Kohl's Cares. * NCHS strives to work with payors to cover outpatient nutrition therapy. Most plans list outpatient nutrition as a covered benefit, but it largely remains an out-of-pocket service. This is a carry-over from the prior Implementation Plan. * The Nicklaus Children's Pinecrest Sports Health Center offers a suite of services to enhance performance and facilitate safe play. Programmatic growth targeted around wellness, concussion, and other areas. * NCHS is exploring building out more enhanced programming specifically focused on obesity medicine. Prenatal & Infant Health - The Fetal Care Center at Nicklaus Children's is devoted to the care of high risk fetal patients with medical needs requiring intervention at birth. The special delivery unit for healthy women who are anticipating a baby with medical/surgical needs is set to open in 2019. Nicklaus Children's Fetal Care Center, in partnership with OBs, MFMs, and other community organizations are working together to improve prenatal health though quality collaboratives and joint outreach. * NCHS is exploring the development of a neurodevelopmental clinic and other programs for NICU graduates. Diabetes - Nicklaus is expanding diabetes care into the community. The Diabetes program now offers services in NCHS's West Kendall and Doral outpatient centers; plans are also underway for growth in Martin County. * The Diabetes program has increased the number of Certified Diabetes Educators and is working with psychology to provide more counseling services. * NCHS is developing a roadmap to create a Diabetes Center of Excellence with best-in-class evidenced-based structure, process, and outcomes. Asthma & Other Respiratory Conditions - 2018 CHNA findings suggest in South Florida the prevalence of asthma, ED/Urgent Care utilization for asthma, and asthma related inpatient admissions are all above the rest of the country and comparatively worse than the CHNA findings from 2015. The Division of Pulmonology is exploring ways to support PCPs and families in the community to reinforce critical asthma management education. Injury & Safety - Nicklaus Children's Safe Kids - Buckle Up program provides car seat inspections / installation appointments; presentations at community events; and offers courses. NCHS is committed to injury prevention in the community and looks for ways to reach more families with these services. * The School Health Program offers health education in every school where we operate, touching on a range of health, safety, and injury prevention topics. A sample of planed projects include a distracted driving/impaired driving pilot, stop the bleed training, and a drowning prevention initiative. Substance Abuse - Adolescent Medicine physicians counsel patients on high risk behaviors including sexual activity, alcohol and drug use. NCHS endeavors to reach more patients needing this service. Sexual Health - Within the Division of Adolescent Medicine several initiatives are underway to improve HIV screening rates in accordance with national guidelines, use of long-acting reversible contraceptives, and to improve rates of screening for sexual abuse. Potentially Disabling Conditions - NCHS is scheduled to open a Gait and Motion Analysis Laboratory to aid in the targeted treatment of orthopedic, neurological, and muscular conditions. * NCHS is exploring the development of a complex chronic / stabilization / NICU graduate clinic or program to centralize and coordinate care for the most medically involved pediatric patients in our community. * The Personalized Medicine Initiative (PMI) at Nicklaus Children's is one of the nation's first programs focused on the development and delivery of precision and personalized approaches for children's medical care, health and wellness. The PMI offers a comprehensive approach to tailoring medical management to each child's individual characteristics, needs, and preferences from prevention, diagnosis, treatment, and follow up. The PMI serves as the innovation hub for genomics, immunotherapies, 3D printing, imaging innovation, and biobanking. PMI is closely linked to various programs across NCHS including the Brain Institute, the Heart Program, the Center for Cancer & Blood Disorders, Orthopedics and Sports Medicine, the Victor Center for Prevention of Jewish Genetic Diseases, and the Fetal Care Program. The team is actively engaged with community partners to build capacity and support efforts in science and STEM/STEAM education with an emphasis on genetics and genomics. Areas for targeted growth include pharmacogenomics, health economics and augmented and virtual reality. Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - NICKLAUS CHILDREN'S HOSPITAL. Notified individuals of the financial assistance policy on admission Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals' bills Documented its determination of whether individuals were eligible for financial assistance under the hospital facility's financial assistance policy 18 Nicklaus Children's Doral Outpatient Center 3601 NW 107th Avenue Doral FL 33178 Outpatient / Urgent Care Center Nicklaus Children's Dan Marino Outpatient Center 2900 S Commerce Parkway Weston FL 33331 Outpatient Center Nicklaus Children's Palm Beach Gardens Outpatient Center 11310 Legacy Avenue Legacy Place Palm Beach Gardens FL 33410 Outpatient / Urgent Care Center Nicklaus Children's Miramar Outpatient Center 12246 Miramar Parkway Miramar Squar e Miramar FL 33025 Outpatient / Urgent Care Center Nicklaus Children's Miami Lakes Outpatient Center 15025 NW 77th Avenue Miami Lakes FL 33014 Outpatient / Urgent Care Center Nicklaus Children's Midtown Outpatient Center 3915 Biscayne Boulevard Miami FL 33137 Outpatient / Urgent Care Center Nicklaus Children's West Kendall Outpatient Center 13400 SW 120th Street Suite 100 Miami FL 33186 Outpatient / Urgent Care Center Nicklaus Children's Palmetto Bay Outpatient Center 17615 SW 97th Avenue Palmetto Bay FL 33157 Outpatient / Urgent Care Center Nicklaus Children's West Bird Outpatient Center 11449 SW 40 St Miami FL 33165 Outpatient / Urgent Care Center Nicklaus Children's Pinecrest Outpatient Center 11521 South Dixie Hwy 1st Fl Pinecrest FL 33156 Outpatient/Urgent Care Center Nicklaus Children's Hialeah Outpatient Center 990 W 49th St Hialeah FL 33012 Outpatient/Urgent Care Center Nicklaus Children's Homestead Outpatient Center 2072 NE 8th St Campbell Shoppes Homestead FL 33033 Outpatient/Urgent Care Center Aventura Care Center 20295 NE 29th Place Ste 300 Aventura FL 33180 specialty care center Boynton Beach Care Center 10383 Hagen Ranch Rd Ste 200 Boynton Beach FL 33437 Specialty Care center Coconut Creek Care Center 6370 North State Road 7 Ste 100 Coconut Creek FL 33073 Specialty Care center Coral Springs Care Center 9750 NW 33rd Street Ste 109 Coral Springs FL 33065 Specialty Care center Palm City Care Center 3270 SW Martin Downs Blvd Palm City FL 34990 Specialty Care Center Pinecrest Care Center 11521 South Dixie Hwy Ste 201 2nd f l Pinecrest FL 33156 Specialty Care Center Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE https://www.nicklauschildrens.org/patient-resources/patient-financial-services/financial-assistance-program Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE https://www.nicklauschildrens.org/patient-resources/patient-financial-services/financial-assistance-program Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE https://www.nicklauschildrens.org/patient-resources/patient-financial-services/financial-assistance-program Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation 5319780 Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE ORGANIZATION USES THE COST TO CHARGE RATIO IN IRS WORKSHEET 2 TO DETERMINE THE COST OF COMMUNITY BENEFITS AND FINANCIAL ASSISTANCE. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount Bad debt expense is reported at cost using the cost to charge ratio Schedule H, Part III, Line 3 Bad Debt Expense Methodology THE HOSPITAL IS UNABLE TO ESTIMATE ACCURATELY THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FREE SERVICES UNDER THE FINANCIAL ASSISTANCE POLICY. ALTHOUGH A PORTION OF BAD DEBT EXPENSES MAY RELATE TO PATIENTS WHO WOULD QUALIFY FOR CHARITY CARE, A REPORTABLE FIGURE CANNOT BE REASONABLY ESTIMATED. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The System's estimation of the allowance for bad debts is based primarily upon the type and age of the patient accounts receivable and the effectiveness of the System s collection efforts. As a policy, the System reserves for all balances over 180 days old. Certain third-party payors with increased volume are slow payors or are in negotiations to resolve outstanding balances, increasing reserves recorded in 2018. In addition, the System has forgiven balances due from patients which, while they do form as a basis to assist families with their financial obligations, do not qualify as charity care and must be recognized as bad debt. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs VARIETY CHILDREN'S HOSPITAL ("VCH") ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. VCH BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY COMPENSATE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES. VCH EXPERIENCED LOSSES ($456,799 FOR 2018) DUE TO UNDERPAYMENT FOR THE TREATMENT OF MEDICARE PATIENTS. UNREIMBURSED MEDICARE COSTS REPRESENT A SIGNIFICANT VALUE THAT NONPROFIT HOSPITALS PROVIDE TO THE COMMUNITY AS THE HOSPITAL RELIEVES THE FEDERAL GOVERNMENT OF A FINANCIAL BURDEN WHEN IT PROVIDES ESSENTIAL HEALTHCARE SERVICES TO MEDICARE COVERED PATIENTS. THE MEDICARE COST REPORT AND THE ORGANIZATION'S COST ACCOUNTING SYSTEM ARE USED TO DETERMINE THE MEDICARE ALLOWABLE COSTS. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Hospital patient accounts may be subject to the following collection actions to be conducted by the Hospital or an authorized party thereof: 1. Following the initial bill, monthly statements and collection letters are mailed and phone calls are completed in an effort to collect all outstanding balances due. 2. The patient responsible portion of an outstanding balance may be transferred to a bad debt collection agency. 3. Payment plan arrangements may be made for patients who indicate they may have difficulty paying their balance in a single installment. Schedule H, Part V, Section B, Line 16a FAP website - NICKLAUS Children's Hospital: Line 16a URL: See Part VI; Schedule H, Part V, Section B, Line 16b FAP Application website - NICKLAUS Children's Hospital: Line 16b URL: See Part VI; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - NICKLAUS Children's Hospital: Line 16c URL: See Part VI; Schedule H, Part VI, Line 2 Needs assessment Under direction of the Board of Directors, management strives to provide hope through advanced care for our children and families. The vision is to be where the children are. The hospital uses a quarterly operating calendar to develop programs and communicate goals, accomplishments and gaps in plans. Nicklaus Children's Hospital participates in many community organizations that collectively strive to improve the health status of children. NCH has representation on The Children's Trust, the Miami Dade County Public Schools Wellness Committee, the Greater Miami Chamber of Commerce's Health and Bio-Science Committee and the Health Council of South Florida. Through our involvement with the Health Council, we consistently analyze data to identify unmet needs and serve in an advisory capacity assisting the Council to address health disparities. Additionally, our Preventive Medicine Program deploys a medical and dental van into underserved areas of the community. NCH has a robust mechanism to analyze health data. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Nicklaus Children's Hospital has a financial assistance program to assist patients that are uninsured or underinsured and to be given the opportunity to apply for various programs. With the patient/family general consent form, financial agreement for professional services form, and a coordination of benefits form, patients/families are provided referral to an eligibility assistance counselor who will explain various programs offered. The patients are provided pamphlets of the financial assistance policy summary and signage is posted at each location indicating that financial counseling is available and that they may be eligible for financial assistance Schedule H, Part VI, Line 4 Community information Nicklaus Children's Hospital - the flagship of Nicklaus Children's Health System - primarily serves the pediatric population of Miami-Dade County. In 2018, 65 percent of the health system's patient population was funded by Medicaid. Miami-Dade is comprised of a diverse mixture of residents and visitors, making it one of the most international communities in the nation. According to the 2010 census, 51.1 percent was foreign born, 21.9 percent were under the age of 18, 65 percent of the population comprised of individuals of Latin or Hispanic descent and 72 percent spoke a language other than English at home. The hospital also serves children from all over the United States and throughout Florida (patients from every county in the state have been served by the hospital). In 2018, the hospital served international patients from 69 countries. The health system, through its network of 12 outpatient centers, also provides services within Broward, Palm Beach, Lee and Martin counties. The ambulatory centers offer subspecialty physician consultations, urgent care, imaging and outpatient rehabilitation services. Schedule H, Part VI, Line 5 Promotion of community health A majority of the Board of Directors is comprised of persons who live in Miami-Dade County, who are neither employees nor independent contractors of the Hospital, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in the community and applies surplus funds to improvements in patient care, medical education and research. In addition, NICKLAUS Children's Hospital has an active community education program, various camp programs including asthma, diabetes, cancer center, psychiatric programs, early intervention program, preventative medicine program, dental mobile program, after hours program, healthy connections program, medical education residency program, pediatric post graduate program, fellowship programs, pediatric care call program, multiple ambulatory care centers all designed to promote health in the community. Schedule H, Part VI, Line 6 Affiliated health care system Nicklaus Children's Hospital - the flagship of Nicklaus Children's Health System - primarily serves the pediatric population of Miami-Dade County and is a leading provider of healthcare services for medically needy children. In addition, the hospital is proud to be the largest provider of pediatric medical education in the southeastern United States. NICKLAUS Children's Hospital provides primary care and a medical home to the Medicaid population through its Pediatric Care Center located on the hospital's main campus. The hospital also provides dental services through its Pediatric Dental Residency program. NICKLAUS Children's Hospital also houses Early Steps Southernmost Coast, an early intervention program for children at risk of developmental delays. The program evaluates over 2,000 children annually. NICKLAUS Children's offers primary care services to needy children through the Health Connect in Our Schools program. The hospital provides nursing staff for school-based clinics situated in high-risk communities to ensure that children have access to care. NICKLAUS Children's Hospital's Brain Institute is the first and largest pediatric neuroscience collaboration in the nation. The program is recognized for excellence in treatment of children with brain tumors, intractable epilepsy and other brain anomalies, and offers the latest minimally invasive methods, including Visualase, an image-guided laser technique for epilepsy surgery in children. The Heart Program at NICKLAUS Children's Hospital provides care for more children with congenital heart disorders than any other hospital in Florida. It is consistently ranked among the best programs in the nation for cardiology and heart surgery. NICKLAUS Children's Hospital's Cancer Center is the largest provider of pediatric cancer services in the region. The center participates in research protocols, offering the latest interventions for children receiving treatment for all forms of cancer and blood disorders. NICKLAUS Children's LifeFlight Critical Care Transport team provides transport of critically ill children from referring hospitals to NICKLAUS Children's Hospital critical care units. X true true true true false false false false false false false Deise Granado-Villar MD DIRECTOR/ SVP/ CHIEF ACADEMIC OFFICER 0 0 0 0 334123 0 0 0 0 0 334123 0 0 0 Narendra M Kini MD CEO/DIRECTOR 0 2029253 0 126713 0 30345 0 236948 0 26514 0 2449774 0 0 Jefry Biehler MD Secretary 324564 0 968 0 1298 0 8250 0 22873 0 357953 0 0 0 Timothy L Birkenstock Treasurer 0 737250 0 126658 0 115220 0 62891 0 19726 0 1061745 0 76356 Michael L Harrington President 423810 0 38778 0 28757 0 78502 0 8699 0 578545 0 0 0 Beatriz M Cunill De Sautu MD Director Ped Residency 223104 0 244 0 308 0 6943 0 23968 0 254567 0 0 0 Rani S Gereige MD Director Medical Education 237565 0 529 0 13342 0 7587 0 7230 0 266252 0 0 0 Jacqueline L Gonzalez SVP/Chief Nursing Officer 235356 0 78138 0 73337 0 57306 0 20393 0 464530 0 56726 0 Andrea Maggioni MD Director Hospitalist 315679 0 529 0 19198 0 8250 0 23968 0 367625 0 0 0 Jorge Ojito Manager Perfusion Services 232068 0 968 0 1298 0 6715 0 22434 0 263484 0 0 0 Schedule J, Part I, Line 3 METHODS USED BY RELATED ORGANIZATION TO ESTABLISH CEO'S COMPENSATION The organization relied on the methods of establishing compensation for the organization's CEO employed by Nicklaus Children's Health System (EIN: 45-3481327). Nicklaus Children's Health System uses the following methods to establish such compensation: - Compensation Committee - Independent Compensation Consultant - Compensation survey or study - Approval by the Board or Compensation Committee. Schedule J, Part I, Line 1a Tax indemnification and gross-up payments All of the compensated individuals listed on Part VII received tax gross-up payments during the year. The gross-up payment was treated as taxable compensation to them. Schedule J, Part I, Line 4a Severance or change-of-control payment Deise Granado-Villar - $334,123 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The following contributions were made to a Section 457(f) plan during the year - Narendra Kini - $228,698 Timothy Birkenstock - $54,641 Michael Harrington- $70,252 Jacqueline Gonzalez - $49,518 The following distributions were made from a Section 457(f) plan during the year - Jacqueline Gonzalez - $56,726 Timothy Birkenstock - $76,356 A Miami-Dade County Health Facilities Authority 521293036 59334NCE0 2010-12-22 107784753 Refund 2006 bond issue and new project true false false B Miami-Dade County Health Facilities Authority 521293036 59334NDD1 2013-08-01 107788754 Refund 2006 and 2008 bond issues false false false C Miami-Dade County Health Facilities Authority 521293036 59334NDY5 2017-04-27 162534870 Partially refund 2010A Fully refund 2011 New Projects false false false A 9750000 26120000 108410552 9 0 1227083 0 0 65258469 41925000 0 2015 true false true true B 11165000 0 107788754 0 0 0 1488754 0 0 0 106300000 0 2013 true false true true C 162560891 29 56171626 1931562 100026021 4431682 2017 false true true true A false true true true false 0.007 0.0 0.007 false false true B false true true true false 0.03 0.0 0.03 false false true C false true true true false 0.005 0.0 0.005 false false true A false false false true true false true Bayerische Landesbank 2.0 true true true B false false true false false false false 0.0 false true C false true false false false false false true true A true B true C true Schedule K, Part II, Line 3 Columns A and C The difference between the issue price (listed in Part I) and the total proceeds (Part II, Line 3) is due to the investment earnings. Schedule K, Part IV, Line 6 Column A Such amounts were appropriately yield restricted Schedule K, Part IV, Line 6 Available Temporary Period Proceeds that were deposited in the advance refunding escrow were invested beyond their temporary period. Schedule K, Part IV, Line 2c COLUMN A Issuer name: Miami-Dade County Health Facilities Authority The calculation for computing no rebate due was performed on 01/12/2016 Form 990, Part III, Line 4a CONTINUED PROGRAM DESCRIPTION (CONTINUED FROM PART III) IN 2018, 4,876 PATIENTS WERE TRANSFERRED FROM HOSPITALS THROUGHOUT FLORIDA, CENTRAL AND SOUTH AMERICA AND THE CARIBBEAN. WHEN CHILDREN NEED THE SERVICES OF A SPECIALIST, IT IS IMPORTANT THAT SUCH SERVICES BE PROVIDED BY A PRACTITIONER WITH SPECIFIC TRAINING AND EXPERTISE IN PEDIATRIC CARE. THE CARE OF CHILDREN WITH CERTAIN COMPLEX CHRONIC CONDITIONS, SUCH AS JUVENILE DIABETES, CANCER, OR CYSTIC FIBROSIS IS BEST MANAGED BY A PEDIATRIC SPECIALIST IN ORDER TO ELIMINATE REFERRAL DELAYS AND EXPEDITE POSITIVE TREATMENT. CHILDREN ARE MORE VULNERABLE TO COMPLICATIONS DUE TO DELAYS THAN ADULTS. THEY DEVELOP SERIOUS COMPLICATIONS MORE RAPIDLY THAN ADULTS BECAUSE THEY HAVE LESS PHYSIOLOGICAL RESERVES AND LESS DEVELOPED ORGAN SYSTEMS. IN 2018 THE HOSPITAL HAD APPROXIMATELY 262 PROVIDERS TO SUPPORT THE ONGOING FUNCTIONS OF NICKLAUS CHILDREN'S HEALTH SYSTEM AND NICKLAUS CHILDREN'S HOSPITAL IN THE FOLLOWING SUB-SPECIALTIES: ADOLESCENT MEDICINE, ALLERGY/IMMUNOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, CLINICAL GENETICS AND METABOLISM, CRITICAL CARE MEDICINE, DENTISTRY, EMERGENCY MEDICINE, ENDOCRINOLOGY, GASTROENTEROLOGY, GENERAL PEDIATRICS, INFECTIOUS DISEASES, MATERNAL FETAL, NEPHROLOGY, NEUROPSYCHOLOGY, NEUROSURGERY, NUTRITION, OPHTHALMOLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, PLASTIC AND RECONSTRUCTIVE SURGERY, PSYCHIATRY AND PSYCHOLOGY, RADIOLOGY/SEDATION AND RHEUMATOLOGY.THIS CRITICAL MASS OF PHYSICIANS SIGNIFICANTLY CONTRIBUTES TO THE QUALITY AND RANGE OF PEDIATRIC SERVICES AVAILABLE AT THE HOSPITAL. 2018 STATISTICAL DATA INCLUDES TOTAL INPATIENT DAYS: 65,841 TOTAL INPATIENT ADMISSIONS: 10,215 INPATIENT AVERAGE DAILY CENSUS: 180.39 TOTAL OUTPATIENT VISITS (MAIN CAMPUS): 185,846 TOTAL OUTPATIENT VISITS (AMBULATORY CENTERS): 186,375 TOTAL AMBULATORY URGENT CARE VISITS: 141,021 TOTAL SURGICAL CASES: 10,743 AVERAGE LENGTH OF STAY: 6.5 DAYS THE HOSPITAL IS INTERNATIONALLY RECOGNIZED FOR CARE EXCELLENCE. NICKLAUS CHILDREN'S HOSPITAL PROGRAMS WERE RANKED AMONG THE NATION'S BEST IN SIX PEDIATRIC SUB-SPECIALTY PROGRAMS SURVEYED BY U.S. NEWS AND WORLD REPORT IN ITS 2018-2019 LISTING OF "AMERICA'S BEST CHILDREN'S HOSPITALS." THE HOSPITAL HAD MORE RANKED PEDIATRIC PROGRAMS THAN ANY OTHER HOSPITAL IN FLORIDA. In 2018 Six Nicklaus Children's Hospital specialty programs were again identified among the best in the nation, according to U.S.News & World Report's 2018-19 "Best Children's Hospitals" rankings, posted online today. No other hospital in Florida has more ranked pediatric programs. Nicklaus Children's 2018-19 rankings are as follows o Cardiology & Heart Surgery,Neonatology, Neurology and Neurosurgery, Orthopedics,Pulomonology and Urology. Nicklaus Children's Hospital becomes the only facility in South Florida verified as a Level 1 Pediatric Trauma Center.Verification as a pediatric facility by the ACS demonstrates our continued commitment to delivering the highest quality care to the children and families we serve. Nicklaus Children's Hospital was awarded DNV GL Healthcare's Innovation of the Year award for the development and implementation of an automated crash cart management solution that has dramatically enhanced patient care and efficiency at the 309-bed freestanding children's hospital and its network of outpatient centers. Nicklaus Children's Hospital become the first children's hospital in the nation to acquire the OmniTom mobile CT scanner from NeuroLogica, a subsidiary of Samsung Electronics Co., Ltd. The OmniTom is the world's first medical device delivering high quality non-contrast CT scans at the patients' bedside with omni-directional wheels, collecting real-time data on pediatric patients. AS PART OF THE PROCESS TO IMPROVE SERVICES THE HOSPITAL ACQUIRED: THE LATEST DA VINCI X SURGICAL SYSTEM (2015) TO SUPPORT SURGICAL SAFETY. TRAINED PEDIATRIC GENERAL SURGEONS AND UROLOGICAL SURGEONS ON THE MEDICAL STAFF USE THE EQUIPMENT TO ENHANCE SURGICAL PRACTICE. BENEFITS INCLUDE SHORTER HOSPITAL STAYS, REDUCED BLOOD LOSS, REDUCED COMPLICATIONS, REDUCED NEED FOR NARCOTIC PAIN MEDICINE, FASTER RECOVERY AND REDUCED SCARRING. A XENEX GERM-ZAPPING ROBOT (2015), THE MOST ADVANCED DISINFECTION TECHNOLOGY AVAILABLE TO ENHANCE THE CLEANLINESS OF THE OPERATING ROOMS. THE EQUIPMENT USES PULSED XENON ULTRAVIOLET LIGHT TO ELIMINATE HARMFUL SUPERBUGS IN THE OR. AN INTRAOPERATIVE MRI (2016) TO ENHANCE SAFETY AND OPTIMIZE SURGICAL RESULTS FOR CHILDREN WITH BRAIN TUMORS OR THOSE UNDERGOING SURGERY FOR MEDICALLY RESISTANT EPILEPSY. THE LAND AND BUILDING (INCLUDNG THE EQUIPMENT) (2017 2018) FORMERLY OCCUPIED BY THE MIAMI MEDICAL CENTER (TMMC). THE PROPERTY HAS A CAPACITY FOR 65 INPATIENT BEDS. THE HOSPITAL OPENED ITS NEW 213,000-SQUARE-FOOT ADVANCED PEDIATRIC CARE PAVILION (2016), OFFERING THE LATEST EQUIPMENT AND SPACIOUS FAMILY-CENTERED CARE SPACES FOR FAMILIES. COMMUNITY TRAINING OUTREACH PROGRAMS: IN ADDITION, THE HOSPITAL SUPPORTS A NUMBER OF PROGRAMS THAT ENHANCE THE SKILLS AND WORK READINESS OF YOUNG PEOPLE AS WELL AS PROMOTE HEALTH AWARENESS. PROJECT VICTORY: THIS PROJECT IS A COOPERATIVE EFFORT BETWEEN NICKLAUS CHILDREN'S COMMUNITY AND VOLUNTEER RESOURCE PROGRAM AND THE COMMUNITY. TEENS WITH DISABILITIES ARE GIVEN THE OPPORTUNITY TO GAIN LIFE SKILLS THROUGH THE WORLD OF WORK. TWENTY STUDENTS ARE PROVIDED THREE HOURS OF WORK SERVICE PER DAY AT THE HOSPITAL DURING THE COURSE OF THE SCHOOL YEAR. THE STUDENTS GAIN VOCATIONAL EXPERIENCE WORKING IN THE HOSPITAL'S DIETARY DEPARTMENT, MAIL ROOM, VISITOR INFORMATION SERVICE AND OTHER DEPARTMENTS. HONORS AND EXECUTIVE INTERNSHIP PROGRAM, MIAMI DADE COUNTY PUBLIC SCHOOLS EACH YEAR, MEDICAL STUDENTS AND SCHOLARS FROM ALL PARTS OF THE UNITED STATES AND AROUND THE WORLD APPLY FOR ACCEPTANCE TO THE HOSPITAL'S PEDIATRIC RESIDENCY TRAINING PROGRAM, WHICH HAS BEEN IN OPERATION FOR OVER 50 YEARS. THE PEDIATRIC RESIDENCY PROGRAM IS AFFILIATED WITH THE FLORIDA INTERNATIONAL UNIVERSITY (FIU) HEBERT WERTHEIM COLLEGE OF MEDICINE. THE PROGRAM'S ACADEMIC ACCOMPLISHMENTS INCLUDE EXCELLENT BOARD EXAM PASS RATES, FELLOWSHIP MATCHES AT TOP SUBSPECIALTY PROGRAMS ACROSS THE NATION, AND RESEARCH PRESENTATIONS AT WELL-ESTABLISHED REGIONAL/NATIONAL PEDIATRIC AND PEDIATRIC SUBSPECIALTY MEETINGS AND CONFERENCES. Form 990, Part III, Line 4a CONTINUED PROGRAM DESCRIPTION KIDS AND THE POWER OF WORK (KAPOW): THIS PROGRAM IS A NATIONAL VOLUNTEER PROGRAM. THE HEALTH SYSTEM PARTICIPATES WITH MIAMI-DADE COUNTY PUBLIC SCHOOLS. HEALTH SYSTEM STAFF MEMBERS VOLUNTEER TO VISIT STUDENTS AT ONE OF TWO AREA PUBLIC ELEMENTARY SCHOOLS. THEY PRESENT AND PREPARE LESSONS FOR SECOND GRADE STUDENTS TO HELP CREATE A FOUNDATION FOR YOUNG STUDENTS, INTRODUCING THEM TO WORK AND RELATED CONCEPTS. EMPLOYEES DONATE ABOUT 200 HOURS OF TIME TO THE PROGRAM. Form 990, Part VI, Line 15a Process for determininig compensation for the organization's CEO THE ORGANIZATION AND COMPENSATION COMMITTEE OF Nicklaus CHILDREN'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. The CEO is paid by Nicklaus CHILDREN'S HEALTH SYSTEM, INC., a related organization, therefore this has been answered no in accordance with the instructions. Form 990, Part VI, Line 15b Process for determining compensation for other officers or key employees THE ORGANIZATION AND COMPENSATION COMMITTEE OF Nicklaus CHILDREN'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. NCH RELIED ON THE METHODS OF ESTABLISHING COMPENSATION USED BY Nicklaus CHILDREN'S HEALTH SYSTEM, INC. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee of the Board of Directors is composed of three (3) Directors elected by the Board of Directors, one of whom must be the Chair of the Board. No non-Director members shall serve on the Executive Committee. A majority of the members of the Executive Committee present and voting shall constitute a quorum for the transaction of business. The Executive Committee shall have and exercise the authority of the Board of Directors in the management of the Corporation. The Executive Committee shall report to the Board of Directors any action taken by the Executive Committee at the next meeting of the Board of Directors. Members of the Executive Committee may be removed at any regular or special meeting of the Board of Directors. Form 990, Part VI, Line 2 Family/business relationships amongst interested persons NARENDRA KINI, JAY MASSIRMAN, MARIO MURGADO, MATTHEW A. LOVE, AND TIMOTHY BIRKENSTOCK - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders The organization's sole member is Nicklaus Children's Health System, Inc. The sole member has the authority to elect members to the board of directors and approve decisions of the board. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The elected members of the Board shall be elected by Nicklaus Children's Health System (the sole member), after taking into consideration any recommendations of the Board. The number of Directors of the Hospital shall be established by resolution of the Board of Directors of the sole member; provided that there shall be no fewer than 7 and no more than 20 Directors. Any Director may be removed from office by action of the sole Member or the elected members of the Board so permitted to vote, for any cause or reason deemed sufficient by the Member or the elected members of the Board so permitted to vote. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The Board shall not take any action with respect to the following without the approval of Nicklaus Children's Health System (the sole Member): a) Modify the mission, purpose or scope of the hospital, or materially change the location, size or scope of services, programs, operations or educational or medical school affiliations of the hospital or related agreements; b) Create any entity in which the hospital is the sole member or sole shareholder, or any entity in which the hospital has a direct or indirect oversight role, which may include not-for-profit, for profit, limited liability companies, or any other legal entity; c) Sell, lease, purchase, create, dissolve, convey, mortgage, grant a security interest or otherwise dispose of any affiliated, controlled, or joint venture entity, any real or personal property or other assets (or any interest in any of the foregoing), or incur debt for money borrowed or guarantee the debt of another, not in the ordinary course of business; d) Approve annual operating or capital budgets, strategic and long-range plans, major fund-raising programs, physician compensation or other agreements, managed care contracts or other financial commitments or material deviations from such budgets, plans, agreements or commitments; and e) Approve financial, accounting, human resource, employee benefit, compliance policies or procedures, medical staff bylaws (including amendments) or other policies and procedures, or the appointment or engagement of auditors, legal counsel and consultants, which are in any way contrary to the policies and procedures adopted from time to time by the Member. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FOLLOWING DESCRIBES NICKLAUS CHILDREN'S HOSPITAL'S PROCESS FOR PROVIDING ITS BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE EMAILED TO THE AUDIT AND COMPLIANCE COMMITTEE CHAIR FOR REVIEW AND COMMENT. 2. THE PAID TAX PREPARER WILL PRESENT A SUMMARY OF THE INFORMATION TO THE FINANCE COMMITTEE OF THE BOARD. 3. QUESTIONS WILL BE ANSWERED AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. THE CHAIR WILL APPROVE THE FORM 990. 4. THE FINAL FORM 990 WILL BE POSTED ON THE BOARD WEB PORTAL. Form 990, Part VI, Line 12c Conflict of interest policy ALL NICKLAUS CHILDREN'S HOSPITAL EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE, ANNUALLY AND WHENEVER A CHANGE IN CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURE FORMS ARE FORWARDED TO THE COMPLIANCE DEPARTMENT BY THE TALENT MANAGEMENT AND EFFECTIVENESS DEPARTMENT. THESE FORMS ARE INITIALLY REVIEWED BY COMPLIANCE DEPARTMENT STAFF. WHEN DEEMED NECESSARY, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT. CONFLICTS OF INTEREST THAT NECESSITATE BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS AND BOARD-DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT THE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY THE HOSPITAL'S CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. Form 990, Part VI, Line 19 Required documents available to the public Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue Royalties - Total Revenue: 13283, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 13283; Vending Machine Commission - Total Revenue: 63963, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 63963; Child Care - Total Revenue: 400031, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 400031; Lab Revenues - Total Revenue: 30536, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 30536; Purch Discounts - Total Revenue: 13250, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 13250; OTHER REVENUE - Total Revenue: 1135, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1135; RECEIPT WRITE-OFF-NON-STOCK - Total Revenue: 1077355, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 1077355; RECEIPT-WRITEOFF-INVENTORY - Total Revenue: 362570, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 362570; ACCRETION EXPENSE - Total Revenue: 689902, Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 689902; Form 990, Part IX, Line 11g Other Fees Laboratory Services - Total Expense: 4030511, Program Service Expense: 3224409, Management and General Expenses: 806102, Fundraising Expenses: ; FEES- PHYSICIANS - Total Expense: 8152226, Program Service Expense: 6521781, Management and General Expenses: 1630445, Fundraising Expenses: ; COLLECTION SERVICES - Total Expense: 571832, Program Service Expense: 457466, Management and General Expenses: 114366, Fundraising Expenses: ; SCANNING - Total Expense: 605635, Program Service Expense: 484508, Management and General Expenses: 121127, Fundraising Expenses: ; CONSULTANTS - Total Expense: 2312001, Program Service Expense: 1849601, Management and General Expenses: 462400, Fundraising Expenses: ; Transcription Services - Total Expense: 327721, Program Service Expense: 262177, Management and General Expenses: 65544, Fundraising Expenses: ; Management Fees - Total Expense: XXX-XX-XXXX, Program Service Expense: 91028577, Management and General Expenses: 22757144, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 10408681, Program Service Expense: 8326945, Management and General Expenses: 2081736, Fundraising Expenses: ; INSPECTIONS - Total Expense: 4760, Program Service Expense: 3808, Management and General Expenses: 952, Fundraising Expenses: ; STORAGE FEES - Total Expense: 10774, Program Service Expense: 8619, Management and General Expenses: 2155, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Settlement on Swap Agreements - -2940559; Loss from subsidiaries - -8474911; Gain on net change in fair value of swap agreements - 6459754; Change in value of charitable remainder trusts held by others - -153386; Change in beneficial interest in NCHF - -3748533; Transfer to Affiliate - -31340983; Other changes in Net Assets - -1701869; Loss on TMMC support/guarantee - -7003742; MCH PEDIATRIC CARDIOLOGY LLC 3100 SW 62ND AVENUE MIAMI FL 33155 651023909 CARDIAC SERVICES FL 0 0 VCH MIAMI CHILDREN'S HOSPITAL PRPG LLC 3100 SW 62ND AVENUE MIAMI FL 33155 760724684 INSURANCE FL 0 0 VCH MIAMI CHILDREN'S HEALTH SYSTEM INC 3100 SW 62ND AVENUE MIAMI FL 33155 453481327 HEALTHCARE FL 501(c)(3) Type II NA false MCH RESEARCH INSTITUTE INC 3100 SW 62ND AVENUE MIAMI FL 33155 592602318 RESEARCH FL 501(c)(3) 3 VCH true MCH WORKER'S COMPENSATION TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 597021572 WC CLAIMS FL 4947 (a)(1) VCH true VARIETY CHILDREN'S HOSPITAL PROFESSIONAL LIABILITY TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 592551434 LIAB. 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