2019-11-15T12:26:51-06:00 2018-12-31 ERNST & YOUNG US LLP 2 N CENTRAL AVE SUITE 2300 PHOENIX AZ 85004 990 2018-01-01 840166760 CHILDREN'S HOSPITAL COLORADO % JEFFREY HARRINGTON CHIL 7207771234 13123 East 16TH AVENUE AURORA CO 80045 Jeffrey Harrington SVP and CFO 7207771234 2019-11-14 true PATRICK SHIELDS P01508556 6023223000 164.57.159.254 86597020193195000025 2019-11-15 P C1FB216E02A8E0FF4B10C7F1585D3311BD03F0CC 9D5EEB42429821CBACA628CB88EB15E2B93F9A36 2018 2020-03-31 21:24:44Z JENA HAUSMANN 13123 EAST 16TH AVENUE AURORA CO 80045 1229507027 false X WWW.CHILDRENSCOLORADO.ORG X 1908 CO TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY. 28 27 8195 3127 4816248 806515 45374318 15421891 1027947219 1197640060 7540339 10559773 979525 5885303 1081841401 1229507027 847231 632600 0 0 533464125 576951334 0 0 0 477235081 537936873 1011546437 1115520807 70294964 113986220 1618767354 1763582517 901516967 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RECEIVABLES 25430392 SELF INSURANCE TRUST LT REC. 7425000 INTERCOMPANY OTHER AFFILIATES 7323118 457 ASSETS 6226653 OTHER NON CURRENT ASSETS 4391508 ENTERO TRACK NOTE RECEIVABLE 1556383 93632350 0 VALUE OF FINANCIAL SWAP 22235899 SELF INSURANCE TRUST PAYABLE 21235816 CURRENT PORTION LT DEBT 8530350 457 LIABILITIES 6264002 LEASE TENANT IMPROVEMENT 2068888 DEFERRED RENT 1525639 DEFERRED COMP ESCROW 438692 62299286 X SCHEDULE D, PART V, LINE 4 THE HOSPITAL IS THE INCOME BENEFICIARY OF THE H.H. TAMMEN TRUST, A PERPETUAL TRUST UNDER WHICH THE HOSPITAL HAS THE IRREVOCABLE RIGHT TO RECEIVE THE INCOME EARNED ON THE TRUST ASSETS IN PERPETUITY. FUNDS ARE USED TO SUPPORT HOSPITAL ACTIVITIES. SCHEDULE D, PART X, LINE 2 MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. true true X true X true X true true true false true true 3462481 1158180 2304301 0.00210 438243168 317930175 120312993 0.10790 441705649 319088355 122617294 0.11000 18229081 3767894 14461187 0.01300 28611192 9392754 19218438 0.01720 48091191 40224719 7866472 0.00710 28932753 11483008 17449745 0.01560 539846 539846 0.00050 124404063 64868375 59535688 0.05340 566109712 383956730 182152982 0.16340 41014 41014 0.00000 42079 19849 22230 59487 59487 0.00000 17575 17575 0.00000 1260326 116000 1144326 0.00100 1420481 135849 1284632 0.00100 true 4254898 450000 1623361 2833126 -1209765 X true true 3 1 CHILDREN'S HOSPITAL CO - ANSCHUTZ 13123 EAST 16TH AVENUE AURORA CO 80045 WWW.CHILDRENSCOLORADO.ORG 010417 X X X X X A 2 CHILDREN'S HOSPITAL COLORADO - SOUTH 1811 PLAZA DRIVE HIGHLANDS RANCH CO 80129 WWW.CHILDRENSCOLORADO.ORG 01F105 X X X X X A 3 CHCO - At Parker Adventist Hospital 9395 Crown Crest Blvd Parker CO 80138 WWW.CHILDRENSCOLORADO.ORG 132405 X X X Hospital Unit or Hospital-Within a Hospital A A 13 false false true X X X X X X X X X 18 true true false true X WWW.CHILDRENSCOLORADO.ORG X X true 19 true WWW.CHILDRENSCOLORADO.ORG false true X 200. 400. X X X X true true X X X X true X www.childrenscolorado.org X www.childrenscolorado.org X www.childrenscolorado.org X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B A SINGLE SCHEDULE H, PART V, SECTION B WAS COMPLETED FOR FACILITY REPORTING GROUP A. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED IN FACILITY REPORTING GROUP A: (1) CHILDREN'S HOSPITAL COLORADO (2) CHILDREN'S HOSPITAL COLORADO - SOUTH (3) CHILDREN'S HOSPITAL COLORADO - AT PARKER ADVENTIST HOSPITAL Schedule H, Part V, Section B, Line 3e THE TOP FIVE IDENTIFIED CHNA NEEDS ARE NOT PRIORITIZED AND ALL RECEIVED EQUAL WEIGHT IN THE IMPLEMENTATION PLAN AND ON-GOING PROGRAMING. Schedule H, Part V, Section B, Line 5 THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 5 APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: PRIOR TO LAUNCHING OUR 2018 ASSESSMENT, CHILDREN'S COLORADO SOLICITED INTERNAL AND EXTERNAL FEEDBACK ON OUR PREVIOUS ASSESSMENT, WHICH WAS CONDUCTED IN 2015. WE WERE INTERESTED IN LEARNING ABOUT AND IMPROVING BOTH THE PROCESS THAT WAS USED PREVIOUSLY AND THE CONCLUSIONS THAT WERE DRAWN IN THAT ASSESSMENT. A TOTAL OF SEVEN EXTERNAL EVALUATORS PROVIDED DETAILED WRITTEN FEEDBACK ON THE 2015 ASSESSMENT. THEY INCLUDED REPRESENTATIVES FROM PUBLIC HEALTH, NONPROFIT ORGANIZATIONS, HEALTH ADVOCACY ORGANIZATIONS AND HEALTH CARE PROVIDERS. REVIEWERS WERE ASKED TO IDENTIFY KEY STRENGTHS AND WEAKNESSES OF THE PREVIOUS ASSESSMENTS. FOR THE PURPOSES OF THE ASSESSMENT, WE USED FOUR QUALITATIVE DATA COLLECTION METHODS: KEY STAKEHOLDER INTERVIEWS WITH COMMUNITY AND HEALTH LEADERS. A TOTAL OF 44 INTERVIEWS WERE COMPLETED WITH INDIVIDUALS WHO REPRESENTED PUBLIC HEALTH, GOVERNMENT, PUBLIC SAFETY, DIRECT SERVICE, PUBLIC EDUCATION AND ADVOCACY ORGANIZATIONS. INTERVIEWEES ALSO REPRESENTED A RANGE OF GEOGRAPHIC AREAS AND ALL FOUR COUNTIES IN OUR COMMUNITY WERE WELL REPRESENTED. 7 OF THE INTERVIEWS WERE WITH STAFF MEMBERS OF THE TRI-COUNTY HEALTH DEPARTMENT, WHICH IS ONE OF THE LARGEST PUBLIC HEALTH DEPARTMENTS IN THE STATE AND COVERS ADAMS, ARAPAHOE AND DOUGLAS COUNTIES. THE LIST OF ORGANIZATIONS INTERVIEWED IS IDENTIFIED IN THE CHNA AND THE NAMES OF THE INTERVIEWEES ARE ON FILE. FOCUS GROUPS IN EACH OF THE FOUR COUNTIES IN OUR COMMUNITY. WE FOCUSED ON RECRUITING LOW-INCOME AND VULNERABLE POPULATIONS TO THE FOCUS GROUPS THAT WE CONDUCTED. WE CONDUCTED 6 FOCUS GROUPS AND HAD A TOTAL OF 48 PARTICIPANTS. WE CONDUCTED 2 GROUPS IN DENVER COUNTY, 1 IN DOUGLAS COUNTY, AND 3 IN LOCATIONS WHERE BOTH ADAMS AND ARAPAHOE COUNTY RESIDENTS COULD PARTICIPATE. PARENT SURVEY IN BOTH ENGLISH AND SPANISH. OUR SURVEY TARGETED PARENTS AND CAREGIVERS OF CHILDREN AGES 0-17 WHO LIVE IN THEIR HOME. PARTICIPANTS WERE RECRUITED VIA CHILDREN'S HOSPITAL EMAIL LISTS AND SOCIAL MEDIA AND THROUGH EMAIL CAMPAIGNS WITH OUR PARTNERS. ADDITIONALLY, WE WORKED CLOSELY WITH THE COMMUNITY CAMPUS PARTNERSHIP (CCP), A NONPROFIT ORGANIZATION THAT FOSTERS COLLABORATIONS BETWEEN THE ANSCHUTZ MEDICAL CAMPUS AND THE SURROUNDING AURORA COMMUNITY NEIGHBORHOODS TO IMPROVE THE HEALTH AND ECONOMIC WELL-BEING OF THE AURORA COMMUNITY. MEMBERS OF THE CCP'S RESIDENT LEADERSHIP COUNCIL, WHO ALL RESIDE NEAR THE MAIN CAMPUS, WEre RECRUITED TO CONDUCT THE SURVEYS IN ADDITIONAL LANGUAGES AND TRANSLATE THE RESPONSES. THEY GREATLY EXPANDED OUR ACCESS TO NON-ENGLISH SPEAKERS WHO RESIDE IN THE THREE ZIP CODES CLOSE TO THE HOSPITAL. IN 2018, ADDITIONAL DEMOGRAPHIC QUESTIONS WERE ADDED TO THE PARENT SURVEY. THIS ALLOWED US TO ANALYZE THE RESULTS IN A MORE IN-DEPTH MANNER. FIRST, AN ANALYSIS OF THE TOP-RATED ISSUES/CONCERNS WAS PERFORMED WITH DIFFERENCES NOTED BETWEEN THE ENGLISH LANGUAGE AND SPANISH LANGUAGE SURVEY RESPONSES. NEXT, WE SORTED RESULTS BY COUNTY AS WELL AS BY INCOME LEVELS TO DETERMINE SIGNIFICANT VARIATIONS IN THE ISSUES IDENTIFIED AS TOP CONCERNS. THIS APPROACH PERMITTED THE TEAM TO GAIN INSIGHT INTO A LARGE CROSS SECTION OF THE POPULATION. IN ALL, 582 RESIDENTS OF OUR FOUR-COUNTY COMMUNITY RESPONDED TO THE SURVEY; 409 IN ENGLISH AND 173 IN SPANISH. THE FOUR COUNTIES WERE FAIRLY EQUALLY REPRESENTED IN THE TOTAL RESPONSES. ONLINE PROVIDER SURVEY. THE PROVIDER SURVEY WAS A NEW ADDITION TO OUR DATA COLLECTION EFFORTS THIS YEAR AND ALLOWED US TO HEAR DIRECTLY FROM HEALTH CARE WORKERS ABOUT THE COMMUNITY NEEDS THEY ARE SEEING IN THEIR PRACTICES. WE HAD 108 PROVIDER RESPONSES FROM PHYSICIANS, SCHOOL NURSES AND OTHER HEALTH CARE PROVIDERS. UNDERSERVED POPULATION INPUT. AS PART OF THIS ASSESSMENT, WE PRIORITIZED GETTING INPUT FROM UNDERSERVED POPULATIONS INCLUDING LOW-INCOME AND MINORITY GROUPS AND GROUPS WHOSE PRIMARY LANGUAGE IS NOT ENGLISH. STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH LEADERS OF ORGANIZATIONS THAT SERVE AND/OR ADVOCATE FOR UNDERSERVED GROUPS. SPECIFIC ORGANIZATIONS IDENTIFIED IN THE CHNA. THE TEAM WORKED WITH COMMUNITY PARTNERS TO ENSURE THAT THE PARENT SURVEY REACHED A SOCIO-ECONOMICALLY AND ETHNICALLY DIVERSE POPULATION. 60% OF OUR RESPONDENTS HAVE A HOUSEHOLD INCOME THAT IS LESS THAN THE STATE'S AVERAGE HOUSEHOLD INCOME OF $75,000 AND 21% HAVE HOUSEHOLD INCOMES OF LESS THAN $25,000. 65% OF OUR RESPONDENTS ARE ETHNIC MINORITIES. ADDITIONAL DETAILS AVAILABLE IN THE CHNA. SCHEDULE H, PART V, SECTION B, LINE 6A THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 6A APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: DUE TO THE PROXIMITY OF GEOGRAPHIC LOCATIONS in 2018 CHILDREN'S HOSPITAL COLORADO CONDUCTED A JOINT CHNA FOR ITS LICENSED HOSPITAL FACILITIES, WHICH INCLUDED MAIN CAMPUS, SOUTH CAMPUS AND PARKER ADVENTIST (HOSPITAL UNIT LICENSE). THE IRS ALLOWS HOSPITAL FACILITIES TO PRODUCE A JOINT CHNA REPORT IF THE FACILITIES USE THE SAME DEFINITIONS OF COMMUNITY AND CONDUCT A JOINT CHNA PROCESS. WE HAVE FOLLOWED THOSE REQUIREMENTS FOR THE 2018 CHNA. WHILE OUR NETWORK SERVES CHILDREN IN A SEVEN-STATE REGION, FOR THE PURPOSES OF THE 2018 CHNA WE DEFINED COMMUNITY AS ALL CHILDREN LIVING IN THE FOUR-COUNTY AREA FROM WHICH MOST OF OUR PATIENT POPULATION IS DRAWN AND IN WHICH WE HAVE FACILITIES. THIS INCLUDES DENVER, DOUGLAS, ADAMS AND ARAPAHOE COUNTIES. LOCATED WITHIN A 50 MILE RADIUS OF EACH OTHER. IN 2018, WE HAD MORE THAN 15,000 INPATIENT ADMISSIONS, approximately 600,000 OUTPATIENT VISITS, AND MORE THAN 160,000 EMERGENCY DEPARTMENT AND URGENT CARE VISITS. 60% OF ALL VISITS FOR ALL LOCATIONS WERE FROM PATIENTS WHO RESIDE IN DENVER, DOUGLAS, ADAMS AND ARAPAHOE COUNTIES. SCHEDULE H, PART V, SECTION B, LINE 7D THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 7D APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: IN ADDITION TO POSTING THE CHNA ON THE HOSPITALS EXTERNAL-FACING WEBSITE AND MAKING THE REPORT AVAILABLE UPON REQUEST, OVER 500 PHYSICAL COPIES HAVE BEEN DISTRIBUTED TO THE COMMUNITY SINCE DECEMBER 2018. AS PART OF THE CHNA COMMUNICATION PLAN CHILDRENS CHILD HEALTH ADVOCACY INSTITUTE (CHAI) STAFF PRESENTED THE CHNA FINDINGS TO SEVERAL STAKEHOLDER GROUPS. CHAI STAFF ALSO ROUTINELY SHARE CHNA FINDINGS IN MEETINGS WITH COMMUNITY PARTNERS, WITH THE GOAL OF IDENTIFYING OPPORTUNITIES TO ENGAGE IN COLLABORATIVE EFFORTS TO ADDRESS THE AREAS OF NEED. WITH THE GOAL OF MAKING THE CHNA MORE ACCESSIBLE TO THE LARGER COMMUNITY, UPON THE COMPLETION OF THE IMPLEMENTATION STRATEGY, ADDITIONAL MATERIALS WILL BE MADE AVAILABLE IN VARIOUS FORMATS TO SUMMARIZE BOTH THE CHNA AND ACCOMPANYING PLAN. 2018 CHNA: https://www.childrenscolorado.org/community/community-health/community-hea lth-needs-assessment/ SCHEDULE H, PART V, SECTION B, LINE 11 THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: THE COMMUNITY HEALTH ACTION PLAN (CHAP) OF 2016-2019 SERVED AS A FOUNDATION AND ROAD MAP FOR CHILDRENS COLORADOS POPULATION HEALTH WORK. SINCE THE START OF CHAP IN 2016, THE HOSPITALS COMMUNITY HEALTH TEAM AND ITS PARTNERS ENGAGED IN A VARIETY OF INITIATIVES TO PROMOTE HEALTH AND PREVENT ILLNESS IN THE SURROUNDING COMMUNITY. CHILDRENS COLORADO FOCUSED ON THE SIX HEALTH PRIORITY AREAS THAT WERE IDENTIFIED IN THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND LED OR COLLABORATED WITH PARTNERS ON INITIATIVES WITHIN THE HOSPITAL, IN THE COMMUNITY AND ACROSS THE STATE. THESE INITIATIVES INCLUDED EDUCATION AND PUBLIC AWARENESS, TRAININGS, SCREENINGS AND IMPROVING ACCESS TO CARE, POLICY AND ADVOCACY EFFORTS AND EXPANSION OF THE WORKFORCE IN COMMUNITY HEALTH. THE ANNUAL EVALUATION SUMMARIZES THE IMPACT OF THE WORK OUTLINED IN THE 2016 CHAP, AS WELL AS ONGOING AND FUTURE INITIATIVES TO ADDRESS SOCIAL DETERMINANTS OF HEALTH AND IMPROVE THE HEALTH AND LIVES OF CHILDREN AND FAMILIES IN THE COMMUNITY. THE ANNUAL EVALUATION CAN BE FOUND AT: HTTPS://WWW.CHILDRENSCOLORADO.ORG/GLOBALASSETS/COMMUNITY/2016-2018-ACTION- PLAN-EVALUATION-REPORT.PDF CHILDRENS COLORADO WILL CONTINUE TO FOCUS ITS EFFORTS IN THE COMMUNITY TO PROMOTE HEALTH AND REDUCE ILLNESS IN OUR COMMUNITY AND FOCUSING ON NEW AND EXISTING COMMUNITY PARTNERSHIPS TO DEVELOP A SUSTAINABLE MODEL TO ADDRESS POPULATION HEALTH. IN 2018, AS PART OF OUR COMMITMENT TO BE AN ACTIVE PARTNER IN THE COMMUNITY THAT GOES WELL BEYOND THE PROVISION OF PATIENT CARE, WE CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT. THE GOAL OF THE ASSESSMENT WAS TO BETTER UNDERSTAND THE CONCERNS AND PRIORITIES OF THE FAMILIES WE SERVE, THE COMMUNITY ORGANIZATIONS WE PARTNER WITH, AND THE PROVIDERS WHO WORK WITH OUR PATIENTS. THE 2018 COMMUNITY NEEDS HEALTH ASSESSMENT, WHICH SUMMARIZES THESE FINDINGS, CAN BE FOUND AT CHILDRENSCOLORADO.ORG/GLOBALASSETS/COMMUNITY/CHILDRENS-HOSPITAL-COLORADO-2 018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF. THE CHNA WAS APPROVED BY THE CHCO BOARD OF DIRECTORS IN DECEMBER 2018. THROUGH OUR 2018 NEEDS ASSESSMENT, WE IDENTIFIED FIVE PRIORITY AREAS THAT WILL BE THE FOCUS OF OUR COMMUNITY HEALTH IMPROVEMENT WORK FOR THE NEXT THREE YEARS (2019-2022): MENTAL HEALTH/BEHAVIORAL HEALTH, INJURY PREVENTION, PREMATURITY, OBESITY/NUTRITION/PHYSICAL ACTIVITY, AND ASTHMA/RESPIRATORY CARE. CHCO IS ACTIVELY WORKING ON THE DEVELOPMENT OF OUR THREE-YEAR IMPLEMENTATION PLAN TO ADDRESS THE FIVE COMMUNITY HEALTH PRIORITY AREAS. THE PLAN IS SCHEDULED TO BE COMPLETED AND APPROVED BY THE BOARD IN MAY 2019. TO DEVELOP THE IMPLEMENTATION PLAN, CHILDRENS HOSPITAL COLORADO IS UTILIZING THE INFORMATION GATHERED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT AS THE MAJOR SOURCE OF INFORMATION AND INCORPORATED ADDITIONAL INSIGHTS FROM PLANNING DISCUSSIONS WITH COMMUNITY PARTNERS. WE PLAN TO CONVENE A SERIES OF STRATEGY SESSIONS WITH PROVIDERS, COMMUNITY HEALTH STRATEGISTS AND ADMINISTRATORS. EACH OF THESE SESSIONS WILL FOCUS ON ONE OF THE FIVE PRIORITY AREAS THAT HAD BEEN SELECTED THROUGH THE NEEDS ASSESSMENT. WITH THE HELP OF AN OUTSIDE FACILITATOR, TEAMS WILL VISION STATEMENTS, GOALS AND OBJECTIVES FOR EACH PRIORITY. THE OBJECTIVES SELECTED WILL ALL BE QUANTIFIABLE AND TIME-LIMITED, WHICH WILL ALLOW FOR EFFECTIVE EVALUATION OF OUR EFFORTS IN THE FUTURE. 12 CHILDREN'S HOSPITAL COLORADO-NORTH 469 WEST STATE HIGHWAY 7 BROOMFIELD CO 80023 UC,SPECIALTY CARE,observation, REHAB & SPORT THERAPY licensed cmty clinic 18F110 CHILDREN'S HOSPITAL CO OP SPECIALTY CARE 4125 BRIARGATE PKWY COLORADO SPRINGS CO 80920 SPECIALTY CARE, Oncology CLINICS, URGENT CARE CHILDREN'S HOSPITAL COLORADO-UPTOWN 1830 FRANKLIN ST DENVER CO 80218 EMERGENCY CARE, UC, OP SPCLTY, DIAGNOSTIC, observation, licensed cmty clinic 18M127 CHILDREN'S HOSPITAL CO THERAPY CARE 8401 ARISTA PLACE BROOMFIELD CO 80021 OT/PT, SPEECH & AUDIOLOGY SERVICES KIDSTREET 3615 MARTIN LUTHER KING BLVD DENVER CO 80205 REHABILITATION & THERAPY SERVICES CHILDREN'S HOSPITAL CO THERAPY CARE PRINTERS PARK MEDICAL PLAZA COLORADO SPRINGS CO 80910 OT/PT, SPEECH & AUDIOLOGY SERVICES CHILDREN'S HOSPITAL CO Therapy Care 19284 COTTONWOOD DRIVE PARKER CO 80138 OT/PT, SPEECH & AUDIOLOGY SERVICES CHILDREN'S HOSPITAL CO Therapy Care 9139 S RIDGELINE BLVD 100 HIGHLANDS RANCH CO 80129 REHABILITATION & THERAPY SERVICES CHILDREN'S HOSPITAL CO UC & OP CARE 3455 LUTHERAN PKWY WHEATRIDGE CO 80033 URGENT CARE, SPECIALIST CARE, SPORTS MEDICINE CHILDREN'S HOSPITAL CO THERAPY CARE 704 FORTINO BLVD STE A PUEBLO CO 81008 SPEECH THERAPY, LEARNING DISABILITIES CHILDREN'S HOSPITAL CO SPECIALTY CARE 9399 CROWN CREST BLVD PARKER CO 80138 SPECIALTY CARE, SPORTS MEDICINE CHILDREN'S HOSPITAL CO ORTHOPEDIC CARE 9094 E MINERAL AVE SUITE 110 CENTENNIAL CO 80112 ORTHOPEDIC ARE, RADIOLOGY SERVICES, SPORTS MEDICINE SCHEDULE H, PART I, LINE 6A CHILDRENS COLORADO PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT. THE 2018 REPORT WILL BE PUBLISHED AFTER THE FINALIZATION OF THE 2018 SCHEDULE H 990 REPORTING. THE 2017 REPORT CAN BE FOUND AT HTTPS://WWW.CHILDRENSCOLORADO.ORG/COMMUNITY/COMMUNITY-HEALTH/. PRIOR TO THE COMPLETION OF THE REPORT A DISTRIBUTION LIST OF COMMUNITY MEMBERS, PARTNERS AND STATE AND LOCAL OFFICIALS IS DEVELOPED, AND THE REPORT IS DISTRIBUTED UPON COMPLETION. COINCIDING WITH THE PHYSICAL DISTRIBUTION THE REPORT IS THEN PUBLISHED ON THE CHCO WEBSITE. SCHEDULE H, PART I, LINE 7 IN 2018, CHILDRENS HOSPITAL COLORADO PROVIDED $182,152,982 OR 16.34% OF TOTAL OPERATING EXPENSES, IN BENEFIT TO THE COMMUNITY. MEDICAID AT CHILDRENS HOSPITAL COLORADO ACCOUNTED FOR $120,312,993 OF NET COMMUNITY BENEFIT EXPENSE OR 10.79% OF TOTAL OPERATING EXPENSES WITH $2,304,301 IN FINANCIAL ASSISTANCE OR 0.21% OF TOTAL EXPENSE. OTHER BENEFITS ACCOUNTED FOR $59,535,688 IN NET COMMUNITY BENEFIT EXPENSE OR 5.34% OF TOTAL EXPENSE. OF THAT $14,461,187 IN COMMUNITY HEALTH IMPROVEMENT, $19,218,438 IN HEALTH PROFESSION EDUCATION, $7,866,472 IN SUBSIDIZED HEALTH SERVICES, $17,449,745 IN RESEARCH AND $539,846 IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT. INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THOSE WHICH CHILDRENS HOSPITAL COLORADO PROVIDES TO ITS PATIENT POPULATION AT A LOSS. IN 2018, PROGRAMS ASSOCIATED WITH THESE LOSSES ARE REHABILITATION, DERMATOLOGY AND MENTAL HEALTH. THE NUMBER REFLECTED IN SUBSIDIZED HEALTH SERVICES EXCLUDES BAD DEBT, MEDICAID AND OTHER MEANS TESTED PROGRAMS SHORTFALLS AND FINANCIAL ASSISTANCE. CHILDRENS HOSPITAL COLORADO IS COMMITTED TO SERVING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. SCHEDULE H, PART II IN 2018, CHILDRENS HOSPITAL COLORADO PROVIDED $1,284,632 IN COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE DESIGNED TO PROMOTE THE HEALTH OF THE BROADER COMMUNITY. WE CONTINUE TO BUILD ON OUR LONG AND STRONG RECORD OF COLLABORATION WITH COMMUNITY GROUPS, BUSINESSES, ACADEMIC INSTITUTIONS AND GOVERNMENTAL AND NON-GOVERNMENTAL ORGANIZATIONS, WITH THE GOAL OF IMPROVING HEALTH OUTCOMES AND REDUCING HEALTH DISPARITIES FOR CHILDREN AND THEIR FAMILIES. ADDITIONALLY, SIGNIFICANT RESOURCES WERE ALLOCATED IN 2018 TO SUPPORT EFFORTS TO ENGAGE COMMUNITY MEMBERS IN ADVOCATING FOR ACCESS TO HEALTH CARE AS WELL AS PROVIDING EDUCATIONAL SESSIONS FOR BOTH POLICYMAKERS AND ADVOCATES ON CHILD HEALTH ISSUES OF IMPORTANCE. IMPROVING THE HEALTH OF THE COMMUNITY THROUGH ENVIRONMENTAL EFFORTS WAS ALSO A PRIORITY, INCLUDING LONG-STANDING RECYCLING AND RETRO COMMISSIONING EFFORTS. FINALLY, THE HOSPITAL CONTRIBUTED SUBSTANTIAL RESOURCES TO PROGRAMS, SUCH AS OUR HIRE LOCAL PROGRAM, THAT PROVIDE A PIPELINE FOR AT-RISK HIGH SCHOOL STUDENTS, AND UNDERSERVED COMMUNITY MEMBERS TO PURSUE HEALTHCARE SPECIFIC CAREERS. SELECTED COMMUNITY BUILDING ACTIVITIES ARE HIGHLIGHTED BELOW. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS AND SAFETY. DURING THE 2018 COLORADO LEGISLATIVE SESSION, THE CHILDRENS HOSPITAL COLORADO GOVERNMENT AFFAIRS TEAM WORKED WITH INTERNAL AND EXTERNAL PARTNERS TO KEEP KIDS OUT OF THE HOSPITAL BY SUPPORTING LAWS THAT WOULD IMPROVE KIDS' HEALTH-AND DEFENDING AGAINST THOSE THAT WOULD NOT. WE BUILT PARTNERSHIPS WITH OUR ALLIES AND ADVOCATES ACROSS THE STATE, ENGAGED OUR HEALTHCARE PROFESSIONALS AND OTHER TEAM MEMBERS AND GAVE A VOICE TO OUR PATIENTS AND FAMILIES. TOGETHER, WE ADVANCED A NUMBER OF POLICY AND ADVOCACY GOALS THAT HAVE THE POTENTIAL TO LIFT THE TRAJECTORY OF A CHILDS LIFE. FOR EXAMPLE: MODERNIZING NEWBORN SCREENING: COLORADOS NEWBORN SCREENING PROGRAM AIMS TO ENSURE EVERY COLORADO BABY RECEIVES A GENETIC, METABOLIC AND HEARING SCREENING UPON BIRTH. THESE SCREENINGS HELP IDENTIFY POTENTIALLY LIFE-THREATENING CONDITIONS, AS WELL AS HEARING LOSS. IF THESE CONDITIONS ARENT IDENTIFIED VERY EARLY IN LIFE, THEY CAN LEAD TO SEVERE HEALTH CONSEQUENCES AND DEVELOPMENTAL DELAYS OR EVEN DEATH. HOWEVER, THAT LAW DATES BACK TO THE 1990S AND DID NOT INCLUDE SCREENING FOR MANY CONDITIONS THAT ARE STANDARD IN OTHER STATES. COLORADO'S SCREENING PROGRAM AIMS TO ENSURE EVERY ONE OF THE 67,000 BABIES BORN EACH YEAR IN THE STATE RECEIVES A SCREENING FOR POTENTIALLY LIFE-THREATENING MEDICAL CONDITIONS AND HEARING PROBLEMS. HOUSE BILL 18-1006 MAKES THE NEWBORN SCREENING PROGRAM MORE COMPREHENSIVE, ENSURES TIMELINESS OF SCREENING RESULTS AND OFFERS AN ENHANCED PROGRAM FOR THE 2,000 BABIES EACH YEAR WHO FAIL THEIR HEARING SCREENING. THE SCREENING ENSURES THAT BABIES AND FAMILIES ARE SWIFTLY CONNECTED TO CARE IF THERE IS A RISK FOR A MEDICAL CONDITION OR HEARING LOSS THAT NEEDS FURTHER EVALUATION. CLINICIANS AT CHILDRENS HOSPITAL COLORADO, INCLUDING PULMONOLOGISTS, APPROACHED OUR GOVERNMENT AFFAIRS TEAM WITH CONCERNS ABOUT THESE GAPS. WITH HELP FROM COMMUNITY PARTNERS, WE ADVOCATED TO MODERNIZE COLORADOS NEWBORN SCREENING PROGRAM BY EXPANDING TESTING TO COVER NEW DISEASES, IMPROVING THE FOLLOW-UP PROCESS FOR BABIES NEEDING ADDITIONAL TESTING, AND ENSURING ADEQUATE PROGRAM RESOURCES. PULMONARY FACULTY MEMBERS PROVIDED GUIDANCE ON BILL DEVELOPMENT AND TESTIMONY AT THE COLORADO LEGISLATURE. THIS BILL WAS SIGNED INTO LAW ON JUNE 8, 2018. FOOD INSECURITY: DURING THE 2018 STATE LEGISLATIVE SESSION, WE JOINED A COALITION OF ANTI-HUNGER ORGANIZATIONS TO SUPPORT SENATE BILL 13, WHICH EXPANDS THE STATE COVERAGE FOR FREE LUNCHES THROUGH THE NATIONAL SCHOoL LUNCH PROGRAM FOR MIDDLE SCHOOL STUDENTS. SB13 PASSED BOTH HOUSES OF THE LEGISLATURE AND WAS SIGNED INTO LAW. WE ALSO COLLABORATED WITH PARTNERS INVOLVED IN THE COLORADO BLUEPRINT TO END HUNGER INITIATIVE TO PASS A COLORADO STATE BOARD OF HUMAN SERVICES RULE CHANGE. ONE OF OUR PEDIATRICIANS TESTIFIED BEFORE THE STATE HUMAN SERVICES BOARD IN SUPPORT OF THE CHANGE TO INCREASE THE SNAP INCOME ELIGIBILITY THRESHOLD FOR ALL COLORADOANS TO 200% OF THE FEDERAL POLICY LEVEL. THIS CHANGE PROTECTS CHILDREN AND LOW-INCOME FAMILIES FROM LOSING SNAP BENEFITS BY BEING SLIGHTLY OVER THE PREVIOUS ELIGIBILITY THRESHOLD, WITH EXPANDED ACCESS TO THESE CRITICAL BENEFITS FOR OUR FAMILIES. ADDITONALLY, THROUGH OUR GRASSROOTS ADVOCACY NETWORK, CHILD HEALTH CHAMPIONS, WE HARNESS THE POWER OF OUR MEMBERS ACROSS COLORADO TO PUSH FOR BETTER CHILD HEALTH THROUGH PUBLIC POLICY. THIS LEGISLATIVE SESSION, WE ADDED 707 NEW MEMBERS TO THE NETWORK, INCREASING OUR TOTAL NUMBER OF ADVOCATES TO OVER 7,000. MORE THAN 1,200 OF THESE ADVOCATES WROTE EMAILS TO THEIR LAWMAKERS ON POLICY ISSUES THAT IMPACT KIDS AND FAMILIES. WE ALSO CO-HOSTED THE SEVENTH ANNUAL SPEAK UP FOR KIDS DAY AT THE CAPITOL, TRAINING 190 NEW ADVOCATES FROM ACROSS THE STATE AT AN INTENSIVE, INSPIRING AND HANDS-ON EVENT THAT CONNECTS THEM WITH THEIR LOCAL LEGISLATORS TO HAVE CONVERSATIONS ABOUT PENDING KIDS HEALTH LEGISLATION. PARTNERSHIPS ARE AN ESSENTIAL COMPONENT TO CHILDRENS COMMUNITY HEALTH WORK. THE HOSPITAL HAS PARTNERED WITH AN ARRAY OF LOCAL, STATE AND NATIONAL ORGANIZATIONS TO COORDINATE, COLLABORATE AND SHARE KEY FINDINGS AND LESSONS LEARNED IN IMPROVING HEALTH AND QUALITY OF LIFE FOR CHILDREN IN COLORADO. BELOW ARE A FEW EXAMPLES OF CHILDRENS COLLABORATIONS ADDRESSING COMMUNITY BUILDING AND HEALTH IMPROVEMENT. COALITION BUILDING. IN 2016, CHILDRENS HOSPITAL COLORADO JOINED FORCES WITH EIGHT OTHER STATEWIDE HEALTH AND EDUCATION ORGANIZATIONS TO FORM THE COLORADO ALLIANCE FOR SCHOOL HEALTH (THE "ALLIANCE"). THE ALLIANCE AIMS TO TRANSFORM HOW HEALTH CARE AND EDUCATION PARTNERS COLLABORATE TO CREATE SUSTAINABLE SYSTEMS THAT RESULT IN HEALTH EQUITY AMONG ALL COLORADO STUDENTS. OVER THE PAST YEAR, THE ALLIANCE IDENTIFIED ADVOCACY PRIORITIES THAT INCLUDE FUNDING FOR SCHOOL HEALTH SERVICES, ACCESS TO INTEGRATED CARE FOR STUDENTS AND FAMILIES, AND EFFORTS TO DEVELOP A COMMON, COMPREHENSIVE, APPROACH TO SHARING DATA ACROSS SYSTEMS TO INFORM PLANNING, DOCUMENT PROGRESS, AND ULTIMATELY IMPROVE THE HEALTH, DEVELOPMENT, LEARNING, AND SUCCESS OF CHILDREN AND THEIR SCHOOL COMMUNITIES. IN 2018, THE ALLIANCE ESTABLISHED THEIR ADVOCACY AGENDA, PUBLISHING A CALL TO ACTION IN EARLY 2019; ITS INTENT IS TO DEFINE SCHOOL HEALTH SERVICES, ELEVATE THE IMPORTANCE OF THESE SERVICES, OUTLINE OPPORTUNITIES FOR HEALTH AND EDUCATION TO WORK TOGETHER TO MEET THE HEALTHCARE NEEDS OF EVERY STUDENT AND IDENTIFY ACTIONS WE CAN TAKE RIGHT NOW TO IMPROVE THE HEALTH OF ALL COLORADO STUDENTS. PHYSICAL IMPROVEMENTS AND HOUSING. AT CHILDRENS COLORADO, WE SERVE A DIVERSE PATIENT POPULATION WHOSE EXPERIENCES WITH SOCIAL DETERMINANTS OF HEALTH VARY GREATLY. TO BETTER UNDERSTAND THESE EXPERIENCES, WE HAVE BEGUN SYSTEMATICALLY SCREENING PATIENTS FOR BARRIERS TO WELLNESS AND UTILIZING PATIENT NAVIGATORS TO HELP FAMILIES ADDRESS THESE BARRIERS. OUR PSYCHOSOCIAL SCREENING PROGRAM WAS PILOTED IN OUR CHILD HEALTH CLINIC, A PRIMARY CARE CLINIC FOR CHILDREN FROM BIRTH TO ADOLESCENCE, AND HAS BEEN EXPANDED TO ADDITIONAL CLINICAL AREAS, INCLUDING SPECIFIC INPATIENT UNITS AND OUR PRIMARY CARE CLINIC FOR CHILDREN WITH COMPLEX HEALTHCARE NEEDS. IN 2018, 14,878 SCREENINGS OCCURRED WITH 8,548 UNIQUE PATIENTS. HOUSING WAS THE SIXTH MOST FREQUENTLY REPORTED CONCERN, WITH 10.5% OF PATIENTS SCREENED BEING REFERRED TO A NAVIGATOR FOR ASSISTANCE WITH HOUSING. AS A NON-PROFIT HOSPITAL, WE COMPLETE A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS TO ENSURE THAT OUR PATIENTS, FAMILIES, AND COMMUNITY PARTNERS ARE ABLE TO GUIDE OUR POPULATION HEALTH EFFORTS. OUR MOST RECENT NEEDS ASSESSMENT WAS COMPLETED IN DECEMBER 2018 AND INCLUDED INPUT FROM MORE THAN 40 PARTNER ORGANIZATIONS AND NEARLY 600 COMMUNITY MEMBERS. IN THIS PROCESS, STAKEHOLDERS WERE ASKED TO PRIORITIZE THE MOST "CRITICAL HEALTH NEEDS"OTHER CRITICAL NEEDS" IN THEIR COMMUNITY. HOUSING, IDENTIFIED AS AN "OTHER CRITICAL NEED" BECAUSE IT IS NOT CONDITION-SPECIFIC, WAS RATED AS THE SIXTH MOST IMPORTANT NEED IN THE COMMUNITIES CHILDREN'S COLORADO SERVES. WE HAVE ALSO BEEN APPROACHED BY SEVERAL ADVOCACY PARTNERS ON HOUSING-RELATED MEASURES AT THE STATE AND FEDERAL LEVELS, INCLUDING EFFORTS TO IMPROVE TENANT RIGHTS, ESTABLISH A STATEWIDE EVICTION PREVENTION FUND, AND ASSESS THE HEALTH IMPACT OF MILITARY HOUSING. AS A RESULT OF FEEDBACK FROM COMMUNITY PARTNERS AND RESIDENTS, CHILDRENS COLORADO IS ALSO WORKING WITH THE UNIVERSITY OF COLORADO DENVER TO CONDUCT AN ENVIRONMENTAL NEEDS ASSESSMENT OF LIVING CONDITIONS IN THE COMMUNITY IMMEDIATELY SURROUNDING OUR AURORA HOSPITAL. THIS PROJECT, FUNDED BY PHILANTHROPIC DONATIONS TO CHILDRENS COLORADO, WILL PROVIDE HYPERLOCAL DATA ON HOUSING CONDITIONS AND THE RELATED HEALTH IMPACTS ON CHILDREN AND FAMILIES; OUR INTENTION IS TO PROVIDE THE RESULTS TO COMMUNITY MEMBERS TO USE IN THEIR OWN ADVOCACY AND PROGRAMMATIC EFFORTS. THE DEVELOPMENT O SCHEDULE H, PART III, LINE 2 The Organization adopted ASC 606 on January 1, 2018, using the modified retrospective method to all patient contracts at the date of initial application. The adoption of ASC 606 resulted in changes to the presentation for net patient services revenue related to uninsured or underinsured patients. Prior to the adoption of ASC 606, a significant portion of the Hospitals provision for bad debts related to self-pay patients, as well as co-pay and deductibles owed by patients with insurance. Under ASC 606, the estimated uncollectable amounts due from these patients are generally considered implicit price concessions that are a direct reduction to net patient service revenue, rather than as a provision for bad debts. Other than these changes in presentation, the adoption of ASC 606 did not have a material impact on the overall financial statements of the Organization. Expanded disclosures required by ASC 606 are included within Note 4, Net Patient Services Revenue. SCHEDULE H, PART III, LINE 3 CHILDREN'S HOSPITAL INACTIVATES AR BALANCES BETWEEN 150-175 DAYS AFTER THE FIRST BILLING CYCLE. ACCOUNTS ARE REFERRED TO COLLECTION AGENCIES FOR RECOVERY. THE HOSPITAL DOES NOT REPORT ANY BAD DEBT AMOUNT IN COMMUNITY BENEFIT. SCHEDULE H, PART III, LINE 4 The Organization adopted ASC 606 on January 1, 2018, using the modified retrospective method to all patient contracts at the date of initial application. The adoption of ASC 606 resulted in changes to the presentation for net patient services revenue related to uninsured or underinsured patients. Prior to the adoption of ASC 606, a significant portion of the Hospital's provision for bad debts related to self-pay patients, as well as co-pay and deductibles owed by patients with insurance. Under ASC 606, the estimated uncollectable amounts due from these patients are generally considered implicit price concessions that are a direct reduction to net patient service revenue, rather than as a provision for bad debts. Other than these changes in presentation, the adoption of ASC 606 did not have a material impact on the overall financial statements of the Organization. Expanded disclosures required by ASC 606 are included within Note 4, Net Patient Services Revenue. SCHEDULE H, PART III, LINE 8 THE SHORTFALL REPORTED IN LINE 7 REPRESENTS MEDICARE SHORTFALLS FOR HIGH NEED PEDIATRIC PATIENTS SERVED BY CHILDREN'S HOSPITAL COLORADO. IF CHILDREN'S HOSPITAL COLORADO DID NOT SUBSIDIZE THE HIGHLY SPECIALIZED CARE, ACCESS FOR THIS POPULATION WOULD BE LIMITED, THUS WE VIEW THIS CARE AS COMMUNITY BENEFIT. THE HOSPITAL UTILIZED COST TO CHARGE RATIO METHODOLOGY TO ARRIVE AT THIS NUMBER. THE AMOUNT INCLUDES ALL COSTS LESS ALL PAYMENTS RECEIVED. SCHEDULE H, PART III, LINE 9B YES, THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. PRIOR TO DEBT REFERRALS, ACCOUNTS ARE REVIEWED FOR ALL THIRD-PARTY PAYER ELIGBILITY PRIOR TO QUALIFYING FOR ANY CHARITY CARE OR FINANCIAL ASSISTANCE. ONCE THE PATIENT'S RESPONSIBILITY IS VALIDATED, THE HOSPITAL PROVIDES SLIDING SCALE DISCOUNTS BASED ON INCOME AND/OR EXPENSES. PARENTS WHOSE CHILDREN DO NOT QUALIFY FOR MEDICAID CAN ALSO APPLY FOR THIS DISCOUNT PLAN. THE HOSPITAL HAS A DEDICATED FINANCIAL COUNSELING/SERVICES DEPARTMENT WHO WORK CLOSELY WITH PARENTS TO ESTABLISH PAYMENT PLANS. SCHEDULE H, PART VI, LINE 2 IN ADDITION TO THE CHNA, CHILDRENS HOSPITAL COLORADO REGULARLY ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY WE SERVE. ACROSS THE HOSPITAL, NUMEROUS INTERNAL AND EXTERNAL DATA SOURCES ARE REGULARLY MONITORED AND UTILIZED TO IDENTIFY TRENDS AND OPPORTUNITIES TO IMPACT CHILD HEALTH. ADDITIONALLY, HOSPITAL STAFF DEDICATES SIGNIFICANT TIME TO SERVING ON COMMUNITY BOARDS AND OTHER COMMUNITY GROUPS THAT ASSESS HEALTH NEEDS OF THE COMMUNITY AND PROACTIVELY PARTICIPATES IN THE HEALTH IMPROVEMENT EFFORTS LED BY THESE PARTNERS. IN 2018, CHCO FORMALIZED A POPULATION HEALTH STRATEGY. DELIVERING CARE TO KIDS ISN'T A ONE-SIZE-FITS-ALL MODEL. CONSIDERING THEIR DIFFERENT BARRIERS TO WELLNESS IS NECESSARY TO CHANGE THE WAY WE DELIVER HEALTHCARE, AND EMPOWERING COMMUNITIES TO FOCUS ON PREVENTION IS KEY. WE CALL THIS APPROACH POPULATION HEALTH. OUR ADVOCACY TEAM IS WORKING WITHIN OUR COMMUNITIES, EMPOWERING THEM TO FOCUS ON PREVENTION AND IMPLEMENTING PROGRAMMING THAT KEEPS KIDS OUT OF OUR DOORS. WE ARE CHARTING NEW TERRITORY TO FURTHER OUR REACH AND IMPACT AND SUPPORT THE WHOLE PICTURE OF A CHILD'S HEALTH AND WELLBEING. EXAMPLES OF RESPONDING TO THE NEEDS OF THE COMMUNITY: RESPIRATORY HEALTH. BASED ON FEEDBACK CHILDRENS COLORADO RECEIVED FROM COMMUNITY PARTNERS IN 2017, WE BEGAN A HEALTH IMPACT ASSESSMENT OF THE HOUSING IMMEDIATELY SURROUNDING OUR MAIN CAMPUS IN AURORA. THIS PROJECT, FUNDED BY CHILDRENS COLORADO PREVENTION AND WELLNESS FUND, IS COMPARING CHILD AND CAREGIVER EXPOSURES TO INDOOR ENVIRONMENTAL HAZARDS AND ASSOCIATED HEALTH OUTCOMES BY HOUSING TYPE (E.G., MOTEL, MULTIUNIT HOUSING, AND SINGLE-FAMILY HOMES). IN 2018, WE CONVENED A COMMUNITY ADVISORY BOARD TO HELP SHAPE RECRUITMENT AND DATA COLLECTION, RECEIVED INSTITUTIONAL REVIEW BOARD APPROVAL, RECRUITED AND TRAINED TEAM MEMBERS, AND BEGAN DATA COLLECTION. FUTURE EFFORTS WILL FOCUS ON COMPLETING DATA COLLECTION AND ANALYSIS, DISSEMINATING FINDINGS, AND PLANNING APPROPRIATE INTERVENTIONS. SCHOOL HEALTH: AIMING TO INCREASE ACCESS OF TYPE 1 DIABETES-SPECIFIC PROFESSIONAL DEVELOPMENT OPPORTUNITIES FOR COLORADO SCHOOL NURSES, WHILE ALSO BUILDING PROFESSIONAL NETWORKS, THE SCHOOL HEALTH PROGRAM AT CHILDREN'S HOSPITAL COLORADO (CHCO) PARTNERED WITH EXTENSION FOR COMMUNITY HEALTH OUTCOMES (ECHO) COLORADO TO ENVISION, DESIGN, AND EVALUATE A "SCHOOL NURSES MANAGING DIABETES CARE" ECHO LEARNING SERIES. FIELD EXPERTS FROM THE CHCO SCHOOL HEALTH PROGRAM, BARBARA DAVIS CENTER FOR CHILDHOOD DIABETES, AND ECHO COLORADO CAME TOGETHER TO DEVELOP A MULTI-COHORT, FOUR-WEEK EDUCATIONAL ECHO SERIES, WHICH LAUNCHED IN FEBRUARY AND APRIL 2018, AND INCLUDED THE FOLLOWING CURRICULUM: 1) PATHOPHYSIOLOGY OF DIABETES; 2) INSULIN TECHNOLOGY; 3) INSULIN MANAGEMENT; AND, 4) DEVELOPMENTALLY-APPROPRIATE CARE FOR SCHOOL-AGED CHILDREN. TWENTY-NINE PARTICIPANTS ATTENDED THE FIRST DIABETES CARE ECHO LEARNING SERIES. DIFFERENT FROM WEBINAR FORMAT, ECHO SERIES ARE PROVIDED VIA A VIDEOCONFERENCING PLATFORM, WHICH CREATES AN INTERACTIVE, ENGAGING FORUM FOR THE CONSISTENT DISSEMINATION OF SCHOOL NURSING BEST PRACTICE AND EVIDENCE-BASED STANDARDS OF CARE. THIS ECHO SERIES ALLOWED SCHOOL NURSES TO OBTAIN EDUCATION FROM CONTENT MATTER EXPERTS, SHARE PEER-TO-PEER KNOWLEDGE AND EXPERTISE, COLLABORATE WITH COLLEAGUES, AND BUILD A SENSE OF COMMUNITY REGARDING THE MANAGEMENT OF DIABETES IN SCHOOLS. SCHOOL NURSES WERE RECRUITED THROUGHOUT COLORADO, INCLUDING URBAN AND RURAL SETTINGS, AND A TOTAL OF FORTY-EIGHT SCHOOL NURSES ATTENDED COHORTS 1 AND 2 OF THE SERIES. EVALUATION FINDINGS SHOWED THAT THE SERIES IS A PROMISING APPROACH TO INCREASE THE SELF-EFFICACY OF SCHOOL NURSES FOR MANAGING DIABETES CARE, REDUCE PROFESSIONAL ISOLATION, AND IMPROVE CARE OF STUDENTS. AS A RESULT OF THE IMPACTS OF THIS SERIES, THE FOLLOWING TOOK PLACE: 1) A "SCHOOL NURSES MANAGING NEUROLOGICAL CONDITIONS" ECHO LEARNING SERIES WAS DEVELOPED, IMPLEMENTED AND EVALUATED IN OCTOBER, 2018, WITH TWENTY-TWO SCHOOL NURSES IN ATTENDANCE; 2) A MONTHLY ECHO COMMUNITY OF PRACTICE SERIES FOR COLORADO SCHOOL NURSE LEADERS WAS DEVELOPED AND LAUNCHED IN OCTOBER, 2018; 3) TWO MORE COHORTS OF THE "SCHOOL NURSE MANAGING DIABETES CARE" HAVE BEEN SCHEDULED FOR 2019, AND 4) ONE MORE COHORT OF THE "SCHOOL NURSES MANAGING NEUROLOGICAL CONDITIONS" HAS BEEN SCHEDULED FOR 2019. AS SCHOOL NURSES CONTINUE TO SERVE AS POPULATION HEALTH LEADERS, PROVIDING HIGHLY COMPLEX COORDINATED CARE TO INCREASING NUMBERS OF CHILDREN IN EDUCATIONAL SETTINGS, THE NEED FOR ONGOING CONTINUING EDUCATION OFFERINGS IN COLLABORATIVE PEER-TO-PEER LEARNING ENVIRONMENTS IS CRITICAL TO ENSURING THEIR ABILITIES TO SUPPORT THE HEALTH OF CHILDREN IN SCHOOLS. THE ECHO MODEL PROVIDES A PROMISING WAY TO SUPPORT SCHOOL NURSES ACROSS ALL GEOGRAPHIES IN GAINING THE NECESSARY INFORMATION, SKILLS, AND SUPPORT TO EFFECTIVELY CARE FOR STUDENTS AND STAY INFORMED ABOUT UP-TO-DATE CLINICAL INFORMATION, SO STUDENTS HAVE THE OPPORTUNITY TO SUCCEED IN SCHOOL. ADDRESSING SOCIAL DETERMINANTS OF HEALTH. IN 2016, CHILDRENS COLORADO EXPANDED ITS WORKFORCE TO INCLUDE, FOR THE FIRST TIME, COMMUNITY HEALTH NAVIGATORS CHN TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. THE CHN WORKFORCE DIFFERS FROM THE CLINICALLY BASED FAMILY NAVIGATORS IN THAT THEY WORK WITH FAMILIES IN PRIMARY CARE CLINICS, COMMUNITY BASED-SETTINGS AND CONDUCT HOME VISITS TO ENSURE THE MAXIMUM SUPPORT TO OUR FAMILIES. CHNS PROVIDE ASSISTANCE TO PATIENTS AND FAMILIES WITH BARRIERS TO CARE AND RESOURCE NEEDS. THE RELATIONSHIP BETWEEN SOCIAL DETERMINANTS OF HEALTH AND HEALTH OUTCOMES IS WELL DOCUMENTED. ADDRESSING SOCIAL DETERMINANTS OF HEALTH IS IMPORTANT FOR IMPROVING HEALTH OUTCOMES AND REDUCING HEALTH DISPARITIES. SINCE 2016, THE TEAM HAS EXPANDED FROM 6 NAVIGATORS IN THREE UNIQUE SETTINGS TO 13 NAVIGATORS IN 9 SETTINGS. THE POPULATION SERVED IS PRIMARILY MEDICAID OR UNINSURED FAMILIES WITH A SIGNIFICANT NUMBER OF NON-ENGLISH-SPEAKING FAMILIES. IN 2018, THE TEAM PROVIDED SUPPORT TO 5,135 PATIENTS/FAMILIES. TOP NEEDS INCLUDE: FINANCIAL ASSISTANCE, PUBLIC BENEFIT ASSISTANCE, FOOD INSECURITY, HOUSING AND ASSISTANCE FINDING A PRIMARY CARE PROVIDER FOR THE CAREGIVER. THIS INITIATIVE ALSO PROVED AN OPPORTUNITY TO EXPAND OUR PARTNERSHIP WITH PUBLIC HEALTH. IN 2016, TWO NAVIGATORS WERE PLACED IN A TRI-COUNTY HEALTH DEPARTMENT WIC OFFICE. THIS FEDERAL PROGRAM PROVIDES SUPPLEMENTAL NUTRITIONAL SUPPORT FOR WOMEN, INFANTS AND CHILDREN (WIC) FOR LOW-INCOME PREGNANT, BREASTFEEDING, AND NON-BREASTFEEDING POSTPARTUM WOMEN AND TO INFANTS AND CHILDREN UP TO THE AGE OF FIVE WHO ARE AT NUTRITIONAL RISK. IN 2018, THE NAVIGATORS PROVIDED RESOURCE SUPPORT TO 590 FAMILIES AND EXPANDED TO A SECOND WIC OFFICE. ADDITIONALLY, THROUGH COMMUNITY ENGAGEMENT EFFORTS THE NAVIGATION TEAM DISCOVERED THAT MANY OF THE NON-ENGLISH SPEAKING AND REFUGEE FAMILIES DID NOT UNDERSTAND HOW TO UTILIZE THEIR FAMILIES WIC BENEFITS. THIS STARTED A NEW COMPONENT OF THE PROGRAM WHERE NAVIGATORS WILL TAKE FAMILIES TO THE GROCERY STORE 1-2 TIMES TO ASSIST THEM WITH WHAT FOODS IN WHAT QUANTITIES THEY WERE ELIGIBLE TO PURCHASE THROUGH THE WIC BENEFITS. SCHEDULE H, PART VI, LINE 3 CHILDREN'S HOSPITAL COLORADO HAS A PROCESS FOR INFORMING AND EDUCATING FAMILIES ABOUT HOW THEY MAY BE BILLED FOR PATIENT CARE AND THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL COLORADO'S FULL TIME PATIENT FINANCIAL COUNSELORS ARE DEDICATED TO WORKING WITH FAMILIES TO PROVIDE GUIDANCE REGARDING AVAILABLE FINANCIAL ASSISTANCE WHICH ENSURES THAT ITS PATIENT POPULATION RECEIVES THE CRITICAL CARE IT NEEDS. ADDITIONALLY, CHILDREN'S HOSPITAL COLORADO PROVIDES PATIENT ASSISTANCE TO HELP IDENTIFY COMMUNITY-BASED RESOURCES, FACILITATE SERVICES AND PROVIDE APPROPRIATE REFERRAL ASSISTANCE TO HELP WITH CONTINUITY OF CARE. INPATIENT PROCESS: THIS PROCESS APPLIES TO PATIENTS WHO ARE BEING ADMITTED FOR OBSERVATION, SURGERY OR OTHER INPATIENT SERVICES. IF THE PATIENT IS PRE-SCHEDULED, CHILDREN'S HOSPITAL COLORADO PATIENT ACCESS WORKS TO CONTACT THE FAMILY PRIOR TO ADMISSION TO ARRANGE FOR A FINANCIAL SCREENING APPOINTMENT. REGARDLESS OF WHETHER AN APPOINTMENT IS SET PRIOR TO ADMISSION, THE PATIENT FINANCIAL COUNSELING TEAM WORKS WITH THE FAMILY TO DETERMINE THEIR SELF-PAY STATUS (EITHER NON-COMMERCIAL OR GOVERNMENT INSURANCE) AND SUBSEQUENTLY WORKS WITH THEM TO SCREEN FOR FINANCIAL ASSISTANCE OPTIONS. OUTPATIENT PROCESS: WHEN A PATIENT SCHEDULES A NON-EMERGENT OR URGENT OUTPATIENT CLINIC VISIT, THEY WILL IDENTIFY THEMSELVES AS SELF-PAY IF THEY DO NOT HAVE EITHER COMMERCIAL OR GOVERNMENT INSURANCE. AT THIS POINT, THEY ARE GIVEN TWO OPTIONS: (1) PAY A $200 DEPOSIT AT THE TIME OF APPOINTMENT AND BE BILLED ANY REMAINING BALANCE OR (2) SCHEDULE TIME WITH PATIENT FINANCIAL COUNSELING FOR ASSISTANCE. IF THE PATIENT WAS SEEN IN THE EMERGENCY DEPARTMENT OR URGENT CARE WITHOUT THE PRE-SCREEN, THEY STILL CAN APPLY FOR FINANCIAL ASSISTANCE WITH THE PATIENT FINANCIAL COUNSELING OFFICE. ALL SELF-PAY FAMILIES ARE AUTOMATICALLY GIVEN A 35 PERCENT DISCOUNT. CHILDREN'S HOSPITAL COLORADO HAS A FORMAL POLICY REGARDING ELIGIBILITY CRITERIA FOR CHARITY CARE. THE DECISION TO PROVIDE CHARITY CARE WILL BE, IN ALL CASES, BASED ON A REVIEW OF THE INCOME, ASSETS AND LIABILITIES OF THE FAMILY AT THE TIME OF ADMISSION TO THE HOSPITAL OR CLINIC. THE LEVELS OF CHARITY CARE AND FINANCIAL ASSISTANCE PROVIDED BY CHILDREN'S HOSPITAL COLORADO WILL BE DETERMINED BASED ON FEDERAL POVERTY GUIDELINES WHICH MAY BE ADJUSTED UP TO 200 PERCENT AND REVISED FROM TIME TO TIME. FAMILIES WITH ADJUSTED GROSS INCOME BETWEEN 200 PERCENT AND 400 PERCENT OF FEDERAL POVERTY GUIDELINES MAY ALSO BE CONSIDERED FOR CHARITY CARE WITH A CAP FOR OUT-OF-POCKET RESPONSIBILITY. DETERMINATION OF ELIGIBILITY WILL BE EFFECTIVE FOR SIX MONTHS AND APPLY TO ALL PATIENTS REGARDLESS OF IMMIGRATION STATUS. CHILDREN'S COLORADO WORKS TO PROVIDE NECESSARY HOSPITAL-RELATED SERVICES CONSISTENT WITH ITS MISSION, ITS STATUS AS A NONPROFIT HOSPITAL AND ITS STEWARDSHIP RESPONSIBILITY TO ITS DONORS. CHILDRENS HOSPITAL COLORADOS FINANCIAL ASSISTANCE PUBLIC POLICY AND PLAIN LANGUAGE SUMMARY ARE LISTED ON THE ORGANIZATIONS HOMEPAGE WWW.CHILDRENSCOLORADO.ORG. SCHEDULE H, PART VI, LINE 4 CHILDRENS COLORADO PROVIDES COMPREHENSIVE MEDICAL CARE FOR KIDS FROM BIRTH THROUGH ADOLESCENCE. CHILDRENS COLORADO SERVES A SEVEN-STATE REGION; HOWEVER, MOST OF OUR PATIENTS COME FROM COLORADO AND SPECIFICALLY THE DENVER METRO AREA. ADDITIONALLY, CHILDRENS HOSPITAL COLORADO IS THE ONLY LEVEL 1 PEDIATRIC TRAUMA CENTER IN OUR SEVEN-STATE REGION. DEMOGRAPHICALLY, CHILDREN SERVED COME FROM DIVERSE CULTURAL AND ETHNIC BACKGROUNDS. NORTHWEST AURORA, SURROUNDING THE MAIN CAMPUS IS ONE OF THE MOST DIVERSE AREAS IN THE STATE. MORE THAN HALF OF AURORAS 350,000 RESIDENTS BELONG TO A MINORITY POPULATION, AND OVER 100 LANGUAGES ARE SPOKEN IN AURORA PUBLIC SCHOOLS. ALONG WITH ITS DIVERSITY, AURORA FACES CHALLENGES WITH HEALTH DISPARITIES, LOWER INCOME AND EMPLOYMENT LEVELS AND OTHER SOCIAL DETERMINANTS OF HEALTH AND ECONOMIC WELL-BEING AS COMPARED TO OTHER PARTS OF AURORA, THE METRO DENVER AREA AND THE STATE OF COLORADO. IN RESPONSE TO OUR DIVERSE POPULATION, CHILDRENS COLORADO TRANSLATES MEDICAL CARE AND EDUCATION INSTRUCTIONS INTO 65 + LANGUAGES, INCLUDING SIGN LANGUAGE, TO DELIVER CULTURALLY SENSITIVE, HIGH-QUALITY PEDIATRIC HEALTH CARE. MOST PATIENTS SPEAK ENGLISH, FOLLOWED BY A SIGNIFICANT NUMBER OF FAMILIES WHO SPEAK SPANISH, ARABIC, BURMESE, VIETNAMESE, SOMALIAN, RUSSIAN AND KOREAN. THE PAYER MIX OF THE POPULATION SERVED IS 44.9% MEDICIAID, 48.8% MANAGED CARE/COMMERCIAL, 4.4% OTHER GOVERNMENT AND 1.9% SELF-PAY AND INDIGENT. SCHEDULE H, PART VI, LINE 5 IN 2018, CHILDRENS HOSPITAL COLORADO PROVIDED $14,461,187 IN COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT OPERATIONS. CHCO IS COMMITTED TO IMPROVING THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY. CHILDRENS HOSPITAL COLORADO WORKS TO DELIVER ON THIS MISSION NOT ONLY IN THE DENVER METRO AREA AND IN THE STATE OF COLORADO, BUT ALSO THROUGHOUT THE ROCKY MOUNTAIN REGION. THERE ARE EXTENSIVE EFFORTS LED BY CHILDRENS HOSPITAL COLORADO THAT POSITIVELY IMPACT THE HEALTH AND SAFETY OF CHILDREN IN THE COMMUNITY. THROUGHOUT 2018, THE HOSPITALS CHILD HEALTH ADVOCACY INSTITUTE AND ITS PARTNERS ENGAGED IN EXTENSIVE EFFORTS TO PROMOTE HEALTH AND PREVENT ILLNESS, IN ACCORDANCE WITH THE CHILDRENS HOSPITAL COLORADO (CHILDRENS COLORADO) 2016-2018 COMMUNITY HEALTH ACTION PLAN (CHAP). IN THE CHAP, CHILDRENS COLORADO FOCUSED ON SIX HEALTH PRIORITY AREAS THAT WERE IDENTIFIED IN THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND LED OR COLLABORATED WITH PARTNERS ON INITIATIVES WITHIN THE HOSPITAL, IN THE COMMUNITY AND ACROSS THE STATE. THESE INITIATIVES INCLUDED EDUCATION AND PUBLIC AWARENESS, TRAININGS, SCREENINGS, DIRECT SERVICES, ACCESS TO CARE, AS WELL AS POLICY AND ADVOCACY EFFORTS. ADDITIONALLY, CHILDRENS COLORADO PRIORITIZED ADDRESSING SOCIAL DETERMINANTS OF HEALTH THAT IMPACT HEALTH OUTCOMES THROUGH DEVELOPMENT OF COMMUNITY PARTNERSHIPS TO ENHANCE REFERRALS AND CONNECTIONS FOR FAMILIES, ALONG WITH CONTINUED EXPANSION OF THE WORKFORCE IN COMMUNITY HEALTH. AS PART OF OUR EFFORTS IN ADDRESSING CHNA PRIORITY AREAS, THE TEAM EPIDEMIOLOGIST CONDUCTS A COMPREHENSIVE ANNUAL EVALUATION OF THE ACTIVITIES IDENTIFIED IN THE 2016-2018 COMMUNITY HEALTH ACTION PLAN. THE EVALUATION PLAN IS AVAILABLE ON-LINE: HTTPS://WWW.CHILDRENSCOLORADO.ORG/COMMUNITY/COMMUNITY-HEALTH/COMMUNITY-HEA LTH-NEEDS-ASSESSMENT/ HIGHLIGHTS OF THIS WORK IN 2018 INCLUDE: MENTAL HEALTH: MENTAL HEALTH IS A TOP CONCERN FOR YOUTH AND FAMILIES, AS IDENTIFIED IN THE CHILDRENS COLORADO COMMUNITY HEALTH NEEDS ASSESSMENT, AS WELL AS ASSESSMENTS CONDUCTED BY NUMEROUS OTHER HOSPITALS, LOCAL PUBLIC HEALTH DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS. IN LOOKING FOR WAYS TO ADDRESS MENTAL HEALTH EDUCATION AND DE-STIGMATIZATION, THE CHILDRENS COLORADO PEDIATRIC MENTAL HEALTH INSTITUTE, REVIEWED EXISTING PROGRAMS TARGETING STIGMA REDUCTION AMONG YOUTH AND TURNED TO THE WORK OF OUR MENTAL HEALTH YOUTH ACTION BOARD (YAB). THE YAB WAS CREATED IN 2013 TO GENERATE SOCIAL ACTION AROUND MENTAL HEALTH. EACH YEAR A GROUP OF 15 TEENS FROM ACROSS THE DENVER METRO AREA CREATE AN ARTS-BASED PROJECT TO SHARE WITH THE COMMUNITY TO HELP INCREASE CONVERSATIONS REGARDING THE SPECTRUM OF MENTAL AND EMOTIONAL EXPERIENCES. TWO OF THE YABS GOALS DIRECTLY ADDRESS CHILDRENS COLORADO DESIRE TO SERVE THE COMMUNITY IN THESE WAYS: 1. RAISE AWARENESS OF CHILD AND ADOLESCENT MENTAL HEALTH ISSUES IN THE COMMUNITIES WE SERVE BY CREATING A PROJECT EACH YEAR THAT WILL SUPPORT SOCIAL CHANGE, 2. DEVELOP THE LEADERSHIP AND ADVOCACY SKILLS OF OUR YOUTH. IN 2018, THE TEAM TRANSFORMED THE YAB PROJECTS INTO A TOOLKIT THAT CAN BE USED WITH GROUPS OF YOUTH IN THE COMMUNITY BY TEACHERS, YOUTH PROGRAM LEADERS AND OTHER YOUTH SERVING PROFESSIONALS. THE TOOLKIT WAS COMPLETED IN APRIL 2018, WITH OVER 1000 COPIES DISTRIBUTED TO SCHOOLS AND COMMUNITY-BASED ORGANIZATIONS. PHYSICAL ACTIVITY, NUTRITION AND OBESITY: IN 2018, 72 CHILDREN WERE ENROLLED IN CAMP CHAMPIONS, A CAMP PROGRAM FOR LOW-INCOME, UNDERSERVED YOUTH WHO ARE OVERWEIGHT OR OBESE. CAMP CHAMPIONS AIMS TO IMPROVE HEALTHY LIFESTYLES THROUGH EDUCATION AND ACTIVITIES, DURING WHICH CAMPERS INCREASED THEIR DAILY VIGOROUS PHYSICAL ACTIVITY BY AN AVERAGE OF 27 MINUTES AND INCREASED THEIR DAILY STEP COUNT EXCEEDING RECOMMENDATIONS BY AN AVERAGE OF 3,000 STEPS. ORAL HEALTH: IN PARTNERSHIP WITH AURORA PUBLIC SCHOOLS (APS), CHILDRENS COLORADO WORKED TO ADVANCE THE ORAL HEALTH OF CHILDREN IN THE COMMUNITY THROUGH EDUCATION, SCREENING, AND PREVENTIVE SERVICES. IN 2018, 501 CHILDREN UNDER THE AGE OF 5 ENROLLED IN APS EARLY CHILDHOOD EDUCATION SITES PARTICIPATED IN A LEARNING ACTIVITY ABOUT ORAL HEALTH, AND 216 CHILDREN WERE SCREENED FOR ORAL HEALTH NEEDS AND RECEIVED FLUORIDE VARNISH. ADDITIONALLY, PARENTS OF YOUNG CHILDREN, INCLUDING 24 TEEN PARENTS, WERE ALSO ENGAGED IN EDUCATIONAL SESSIONS AND PROVIDED RESOURCES RELATED TO ORAL HEALTH FOR BOTH THEM AND THEIR CHILD. PREMATURITY AND EARLY CHILDHOOD: IN 2016, CHILDRENS COLORADO LAUNCHED A UNIVERSAL PSYCHOSOCIAL SCREENING PROGRAM IN THE CHILD HEALTH CLINIC TO IDENTIFY FAMILIES WITH PSYCHOSOCIAL NEEDS AND PROVIDE THEM WITH APPROPRIATE LEVELS OF INTERVENTION. IN 2017, NEARLY 8,000 PSYCHOSOCIAL SCREENINGS WERE COMPLETED IN THE CHILD HEALTH CLINIC AND 68% OF FAMILIES WITH PATIENTS UNDER AGE 2 WERE SCREENED. IN 2018 THAT NUMBER CLIMBED TO ALMOST 14,000 SCREENINGS; 63% WERE AGE 2 OR YOUNGER. THROUGH THIS WORK, CHILDRENS COLORADO HAS LEARNED ABOUT THE EVOLVING PSYCHOSOCIAL AND SOCIAL DETERMINANTS OF HEALTH THAT OUR FAMILIES FACE. PEDIATRIC ASTHMA: AS A RESULT OF THE PREVIOUSLY CONDUCTED NEEDS ASSESSMENT FOCUSED ON HIGH RISK ASTHMA PATIENTS SEEN AT CHILDRENS HOSPITAL COLORADO, THE BREATHING INSTITUTE CREATED A HOME VISIT PROGRAM FOR PATIENTS WITH DIFFICULT-TO-CONTROL ASTHMA IN 2016. THE FIRST TWO YEARS WERE FOCUSED ON PROGRAM DEVELOPMENT, HIRING AND TRAINING STAFF, AND CONDUCTING QUARTERLY PDSA QUALITY IMPROVEMENT CYCLES. IN 2018, WE CONCLUDED OUR PILOT PHASE AND INCORPORATED HOME VISITS INTO OUR CLINICAL OPERATIONS AS STANDARD OF CARE FOR HIGH RISK ASTHMA PATIENTS. WE CONDUCTED 116 HOME VISITS WITH 44 PATIENTS. THESE VISITS WERE CONDUCTED BY A NURSE AND COMMUNITY HEALTH NAVIGATORS AND FOCUSED ON ASTHMA EDUCATION, BARRIER IDENTIFICATION AND PATIENT NAVIGATION, HOME ENVIRONMENTAL ASSESSMENT AND TRIGGER REMEDIATION. SUPPORT PROVIDED TO EACH FAMILY VARIES BASED ON BARRIERS IDENTIFIED BUT COMMONLY INCLUDES MEDICATION DEVICE TECHNIQUE TEACHING, HELP WITH APPLICATIONS FOR BENEFITS (E.G., MEDICAID AND WIC PAPERWORK), AND REMEDIATION SUPPLIES SUCH AS HEPA-FILTER VACUUMS, SAFE CLEANING SUPPLIES, AND PEST EXTERMINATION SERVICES. DURING THE PILOT PHASE THAT ENDED IN 2018, WE SAW A 41% REDUCTION IN READMISSIONS/EMERGENCY DEPARTMENT REVISITS FOR ASTHMA IN THE SIX MONTHS FOLLOWING PARTICIPATION IN THE HOME VISIT PROGRAM. INJURY PREVENTION: IN 2018 OUR CONTINUED COLLABORATION WITH COMMUNITY-BASED ORGANIZATIONS, AND PARTNERSHIPS WITH LOCAL AND STATE GOVERNMENT LED TO OVER 700 CHILD RESTRAINT INSPECTIONS AND NEARLY 500 CAR SEAT DISTRIBUTIONS TO LOW-INCOME FAMILIES QUALIFYING FOR FEDERAL ENTITLEMENT PROGRAMS AND RESIDING IN TARGETED NEIGHBORHOODS. THE CPS PROGRAM CONTINUED ITS PARTNERSHIP WITH THE WOMEN, INFANTS, AND CHILDREN (W.I.C.) PROGRAM AT TRI-COUNTY HEALTH DEPARTMENT, WHERE W.I.C CLIENTS IDENTIFIED IN NEED OF SAFE TRANSPORTATION FOR THEIR INFANTS, TODDLERS, AND YOUNG CHILDREN ARE ELIGIBLE TO RECEIVE A SUBSIDIZED-COST CAR SEAT. THIS PARTNERSHIP WITH LOCAL W.I.C. OFFICES REPRESENTS A UNIQUE EXAMPLE IN COLORADO WHERE A PRIVATE, NON-PROFIT HOSPITAL DEDICATES STAFF RESOURCES TO SERVE THE SAFE TRANSPORTATION NEEDS OF FAMILIES ENROLLED IN FEDERALLY-FUNDED SAFETY NET PROGRAM. THROUGH OUR "CRIBS FOR KIDS" INFANT SAFE SLEEP AWARENESS AND EDUCATION PROGRAM, COMMUNITY HEALTH NAVIGATORS PROVIDED EDUCATION AND ANTICIPATORY GUIDANCE TO MOTHERS RECEIVING PRIMARY CARE SERVICES AT CHILDRENS COMMUNITY HEALTH CLINICS. IN ADDITION TO HIGHLIGHTING THIS PRIORITY ISSUE WITH PARENTS, THE NAVIGATORS PROVIDED PORTABLE CRIBS TO 34 MOTHERS WHOSE INFANTS WERE IDENTIFIED AS BEING AT HIGH RISK FOR SUDDEN UNEXPLAINED INFANT DEATH (SUID). IN ADDITION TO CHILDRENS COLORADOS HEALTH PRIORITY AREAS, THERE WERE KEY MILESTONES ACHIEVED IN OUR PARTNERSHIPS, COMMUNITY HEALTH AND POLICY AND ADVOCACY EFFORTS. BELOW ARE SOME HIGHLIGHTS OF THOSE EFFORTS. PARTNERSHIP DEVELOPMENT: IN 2018, CHILDRENS COLORADO MADE A CONCERTED EFFORT TO ENHANCE PARTNERSHIPS WITH OTHER SYSTEMS AND SECTORS SERVING CHILDREN AND FAMILIES IN THE COMMUNITY TO IMPROVE COORDINATION OF EFFORTS RELATED TO OUR SHARED POPULATION, AS WELL AS IDENTIFY OPPORTUNITIES TO ENHANCE OUR COLLECTIVE IMPACT ON THE HEALTH AND WELLBEING OF CHILDREN LIVING IN OUR COMMUNITY. SHARED GOALS, INTEGRATED STAFFING MODELS, COLLABORATIVE FUNDING PROPOSALS, AND DATA/INFORMATION SHARING ARE SOME OF THE KEY COMPONENTS OF THIS WORK. CHILDRENS COLORADO INTENDS TO PILOT THESE INNOVATIVE COLLABORATIONS WITH PARTNERS IN THE COMMUNITY IMMEDIATELY SURROUNDING THE HOSPITALS MAIN CAMPUS. KEY PARTNERS INCLUDE THE LOCAL PUBLIC HEALTH DEPARTMENT, THE LOCAL PUBLIC-SCHOOL DISTRICT, CITY PARKS AND RECREATION DIVISION, AND PRIMARY CARE CLINICS SERVING MEDICAID FAMILIES. MANY OTHER COMMUNITY BASED ORGANIZATIONS WILL BE CRITICAL STAKEHOLDERS IN THIS WORK GOING FORWARD AS WELL. MEDICAL FACULTY PROFILE: CHILDRENS HOSPITAL COLORADO HAS AN OPEN MEDICAL STAFF, MEANING COMMUNITY PRACTITIONERS CAN HOLD PRIVILEG SCHEDULE H, PART VI, LINE 7 THERE ARE NO FILING REQUIREMENTS IN THE STATE OF COLORADO. CHCO DOES PROVIDE THE ANNUAL COMMUNITY BENEFIT REPORT TO THE COLORADO HOSPITAL ASSOCIATION AND SELECTIVE GOVERNMENTAL ENTITIES. true Denver Botanic Gardens 1007 York St Denver CO 80206 840440359 501(c)(3) 7500 0 GENERAL PROGRAM St Anthony Foundation 116000 W 2nd Pl Lakewood CO 80228 840902211 501(c)(3) 8500 0 GENERAL PROGRAM Rocky Mountain Butterfly Consortium 6252 W 104th Ave Westminister CO 80020 841155029 501(c)(3) 9600 0 GENERAL PROGRAM American Academy of Pediatrics 141 NW Pt Elk Groove Village IL 60007 362275597 501(c)(3) 10000 0 GENERAL PROGRAM Colorado Children's Campaign 1580 Lincoln St 420 Denver CO 80203 742374672 501(c)(3) 10000 0 GENERAL PROGRAM SPONSORSHIP Ronald McDonald House Charities 110 North Carpenter St Chicago IL 60607 841013843 501(c)(3) 10000 0 GENERAL PROGRAM Colorado College 14 Cace La poudre CO Springs CO 80903 840402510 501(c)(3) 10500 0 GENERAL PROGRAM Columbine lakewood Colorado Soccer 8101 S Shaffer Parkway Littleton CO 80127 841411827 501(c)(3) 15000 0 GENERAL PROGRAM Young Americans Center for Financial 3550 E First Ave Denver CO 80206 841564936 501(c)(3) 15000 0 GENERAL PROGRAM Denver Museum of Nature & Science 2001 Colorado Bvld Denver CO 80205 840518447 501(c)(3) 17500 0 GENERAL PROGRAM Douglas County Soccer Assoc 8200 S Akron St 122 Centennial CO 80112 742392779 501(c)(3) 30000 0 GENERAL PROGRAM Colorado High School Activities 14855 E 2nd Ave Aurora CO 80011 840427063 501(c)(3) 37500 0 GENERAL PROGRAM Childrens Museum of Denver 2121 Childrens Museum Dr Denver CO 80211 840658142 501(c)(3) 40000 GENERAL PROGRAM Support Gold Grown Foundation 1743 Wazee St 300 Denver CO 80202 742422126 501(c)(3) 45000 0 GENERAL PROGRAM Ronald Mc Donald House Colorado 1300 E 21st Ave Denver CO 80205 362934689 501(c)(3) 150000 0 GENERAL PROGRAM Young Men's Christian Association 316 N Tejon St Colorado Springs CO 80903 840404266 501(c)(3) 175000 0 GENERAL PROGRAM American Cancer Society 10065 Ek Harvard Ave 400 Denver CO 80231 131788491 501(c)(3) 10000 0 GENERAL PROGRAM Global Down Syndrome Foundation 3300 E 1st Aven Suite 390 Denver CO 80206 264431001 501(c)(3) 11500 0 GENERAL PROGRAM 18 0 SCHEDULE I, PART I, LINE 2 CHILDREN'S HOSPITAL COLORADO RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT EXEMPT ORGANIZATIONS TO MONITOR THE USE OF FUNDS AS INTENDED. X X X X true true false false false false false true false JENA HAUSMANN President and CEO 920513 0 520940 0 138861 0 249877 0 23401 0 1853592 0 136521 0 JERROD MILTON VP Operations 264679 0 62796 0 53081 0 76768 0 17972 0 475296 0 50213 0 GREGORY RAYMOND Colorado Springs COO 255756 0 59075 0 19918 0 73173 0 20883 0 428805 0 18083 0 MICHELLE LUCERO Chief Legal Officer 421686 0 137775 0 70743 0 109178 0 15050 0 754432 0 63772 0 DAVID BIGGERSTAFF EVP and COO 553680 0 225979 0 3953 0 163846 0 23401 0 970859 0 0 0 SUZANNE JAEGER SVP Experience and Access 301249 0 101524 0 68830 0 59000 0 20883 0 551486 0 0 0 JEFFREY HARRINGTON SVP and CFO 533839 0 210516 0 92498 0 151154 0 20884 0 1008891 0 87169 0 RAPHE SCHWARTZ SVP AND CHIEF STRATEGY OFFICER 357334 0 60000 0 2687 0 94217 0 17404 0 531642 0 0 0 PATRICIA GIVENS SVP Patient Care SVCS & CNO 315438 0 98799 0 60288 0 40500 0 18 0 515043 0 0 0 CATHERINE DAL SANTO VP Finance 281970 0 82688 0 48803 0 59500 0 8369 0 481330 0 0 0 CHARLOTTE ISOLINE VP Marketing 226787 0 65333 0 40065 0 0 0 18390 0 350575 0 0 0 DANA MOORE SVP and CIO 427047 0 94533 0 7464 0 133376 0 23401 0 685821 0 0 0 SCHEDULE J, PART I, LINE 4b THE FOLLOWING INDIVIDUALS RECEIVED PAYOUTS FROM A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: SUZANNE JAEGER $ 63,306 JERROD MILTON $ 50,213 GREGORY RAYMOND $ 18,083 JEFFREY HARRINGTON $ 87,169 JENA HAUSMANN $136,521 PATRICIA GIVENS $ 52,145 MICHELLE LUCERO $ 63,772 CATHERINE DAL SANTO $ 41,431 CHARLOTTE ISOLINE $ 33,930 Schedule J, Part I, Line 7 CERTAIN INDIVIDUALS ARE ELIGIBLE TO PARTICIPATE IN THE INCENTIVE PLAN FOR CHILDREN'S COLORADO, THE COMPONENTS OF WHICH INCLUDE ACHIEVEMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE GOALS. BECAUSE THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS RESERVES THE RIGHT TO CHANGE, AMEND OR TERMINATE THIS PLAN AT ANY TIME, FOR ANY REASON, AT ITS SOLE DISCRETION AND BECAUSE OF CERTAIN OTHER CONDITIONS OF THE PLAN, LINE 7 REGARDING "NON-FIXED PAYMENTS" IS ANSWERED YES. NOTE THAT PRIOR TO THE PAYMENT OF ANY AMOUNTS TO AN INDIVIDUAL WHO IS CONSIDERED A DISQUALIFIED PERSON, THE COMPENSATION COMMITTEE SHALL CERTIFY IN WRITING THE EXTENT TO WHICH THE PERFORMANCE FACTORS ESTABLISHED BY THE COMPENSATION COMMITTEE HAVE BEEN SATISFIED AND SHALL APPROVE THE PAYMENT OF SUCH BONUSES TO SUCH INDIVIDUALS. SEE PART VI, LINES 15A AND 15B FOR ADDITIONAL INFORMATION ON EXECUTIVE COMPENSATION. A CITY OF AURORA CO 846000564 05155XBT5 2008-06-06 258814487 SERIES 2008 - SEE PART VI false false false B CITY OF AURORA CO 846000564 05155XBX6 2010-05-25 59999130 SERIES 2010A - SEE PART VI false false false C COLORADO HEALTH FACILITIES AUTHORITY 840752932 1964BAL52 2013-08-04 309252566 SERIES 2013 - SEE PART VI false false false D COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648A7J8 2016-05-24 200724807 SERIES 2016A & 2016C - SEE PART VI false false false A 140430000 0 258814487 0 0 0 2381234 183253 0 0 256250000 0 2008 true false true true B 0 0 59999130 0 0 0 709432 0 0 59289698 0 0 2012 false false true true C 1040000 0 309252566 0 0 0 1844600 0 0 197052966 110355000 0 2013 true false true true D 1484500 0 200724807 0 0 0 1519986 0 0 59414950 119204821 20585050 false true false A false false false true true 0 false false false true B false false false false 0 false false false true C false false false false 0 false false false true D false false false false 0 false false false true A false false false true true false 0 false 0 false true B false false false true false false 0 false 0 false true C false false false true true true JP MORGAN 24.9 true false false 0 false true D false true false false false false 0 false 0 false true A true B true C true D true SCHEDULE K, PART I, COLUMN (F) BOND A - HOSPITAL REVENUE BONDS SERIES 2008 THE PURPOSE OF THIS BOND ISSUE was TO REFUND BONDS THAT WERE PREVIOUSLY ISSUED ON 1/22/04 AND 4/7/08. THE REMAINING WEIGHTED AVERAGE MATURITY OF THE BONDS CURRENTLY REFUNDED is 11.8929 YEARS. BOND B - HOSPITAL REVENUE BONDS SERIES 2010A THE PURPOSE OF THIS BOND ISSUE was TO PAY FOR THE CONSTRUCTION OF A NEW TEN-STORY ADDITION TO THE EXISTING FACILITY, EQUIPMENT FOR THAT ADDITION, AND EXPANSION OF AN EXISTING PARKING GARAGE. BOND C - HOSPITAL REVENUE BONDS SERIES 2013 THE PURPOSE OF THIS BOND ISSUE was TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2008B AND 2008C BONDS. BOND D - HOSPITAL REVeNUE BONDS SERIES 2016A & 2016C THE PURPOSE OF THIS BOND ISSUE was TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2004C AND 2004D BONDS. BOND A (2) HOSPITAL REVENUE BONDS SERIES 2016B THE PURPOSE OF THIS BOND ISSUE was TO FINANCE LONG-TERM PROJECTS. SCHEDULE K, PART IV, LINE 2C BOND A - HOSPITAL REVENUE BONDS SERIES 2008 JULY 31, 2018 BOND B - HOSPITAL REVENUE BONDS SERIES 2010A - OCTOBER 12, 2016 BOND C - HOSPITAL REVENUE BONDS SERIES 2013 MAY 23, 2018 A COLORADO HEALTH FACILITIES AUTHORITY 840752932 19648A8D0 2016-05-24 70300000 SERIES 2016B - SEE PART VI false false false A 0 0 70300000 0 0 0 300000 0 0 62045693 0 7954307 false false false A false false false false 0 false false false true A false true false false true true JP Morgan 2.7 true false false 0 false true A true FORM 990, PART I, LINE 6 FROM TEENAGERS TO GREAT GRANDPARENTS, FROM HOMEMAKERS TO PROFESSIONAL ATHLETES, CHILDREN'S HOSPITAL COLORADO VOLUNTEERS ENCOMPASS ALL WALKS OF LIFE AND ALL INCOME LEVELS, EACH VOLUNTEER WITH SOMETHING UNIQUE TO OFFER. OUR DIVERSE GROUP OF VOLUNTEERS HAS ONE THING IN COMMON, HOWEVER, THE DESIRE TO HELP SICK CHILDREN AND THEIR FAMILIES. CHILDREN'S HOSPITAL COLORADO IS FORTUNATE TO HAVE HUNDREDS OF DEDICATED VOLUNTEERS WHO WORK REGULARLY, FROM SEVERAL HOURS A YEAR TO SEVERAL HOURS A WEEK, TO PROVIDE BETTER CARE FOR THE CHILDREN OF CHILDREN'S HOSPITAL COLORADO. THE ASSOCIATION OF VOLUNTEERS THE VOLUNTEERS AT CHILDREN'S HOSPITAL COLORADO ARE ALL PART OF A GROUP CALLED CHILDREN'S HOSPITAL COLORADO ASSOCIATION OF VOLUNTEERS (AOV). THE AOV COORDINATES PLACEMENTS FOR VOLUNTEERS AND ENSURES THAT COMPLETE ORIENTATION AND TRAINING IS PROVIDED TO ALL VOLUNTEERS. OUR VOLUNTEER'S SKILLS AND INTERESTS ARE ALL SO APPRECIATED AND WE TRY TO PLACE EVERYONE IN A ROLE THAT SUITS THEM AND OUR NEEDS. THE EXAMPLES BELOW ARE JUST SOME OF THE WAYS THAT OUR VOLUNTEERS CONTRIBUTE: - VOLUNTEERS ARE ACTIVE AT THE HOSPITAL ON THE ANSCHUTZ MEDICAL CAMPUS, THE SOUTH CAMPUS, HIGHLANDS RANCH THERAPY CARE CENTER, BRIARGATE, AND THE NORTH CAMPUS. - VOLUNTEERS SPEND TIME WITH OUR PATIENTS BY HOLDING, COMFORTING, PLAYING WITH THEM AND MAKING THEM LAUGH. - VOLUNTEERS BRING SPECIALLY-SCREENED DOGS TO PROVIDE ANIMAL-ASSISTED THERAPY FOR THE PRESCRIPTION PET PROGRAM. - SPECIALLY TRAINED VOLUNTEERS SERVE AS AMBASSADORS WITH THE WELCOME PROGRAM. VOLUNTEERS GREET NEWLY ADMITTED PATIENT FAMILIES UPON THEIR ARRIVAL AND INTRODUCE THEM TO THE HOSPITAL'S MANY AMENITIES. THE GOAL IS TO PROVIDE A WARM AND WELCOMING ENVIRONMENT AND TO ANSWER ANY NON-MEDICAL QUESTIONS. - THE WINE EVENT IS THE ASSOCIATION OF VOLUNTEERS' SIGNATURE EVENT. THE SPECIAL EVENING FEATURES A SILENT AND LIVE AUCTION OF FINE WINES AND EXPERIENCES WITH ALL PROCEEDS BENEFITING THE MATERNAL FETAL MEDICINE PROGRAM. - MANY GROUPS OF VOLUNTEERS DO NOT SPEND TIME DIRECTLY WITH OUR PATIENTS, BUT PERFORM MORE ADMINISTRATIVE DUTIES, WHICH CAN BE JUST AS IMPORTANT TO THE DAY-TO-DAY OPERATIONS OF CHILDREN'S HOSPITAL COLORADO. - TEENAGERS BETWEEN 13 AND 18 YEARS OF AGE PARTICIPATE IN THE JUNIOR VOLUNTEER PROGRAM. THEY SUPPORT THE HOSPITAL BY WORKING IN SEVERAL DEPARTMENTS AS WELL AS SUPPORTING FUNDRAISING ACTIVITIES. - VOLUNTEERS ALSO ASSIST IN FUNDRAISING BY STAFFING CHILDREN'S HOSPITAL COLORADO GIFT SHOP AND LA CACHE. - CHAPTER VOLUNTEERS IN THE COMMUNITY ARE VERY ACTIVE IN FUNDRAISING EVENTS THROUGHOUT THE YEAR THAT HELP TO FUND SPECIAL EQUIPMENT, FACILITIES AND PROGRAMS FOR THE PATIENTS OF CHILDREN'S HOSPITAL COLORADO. FORM 990, PART III, LINE 4A RESPIRATORY CARE At Childrens Hospital Colorado, Respiratory Care is part of the Breathing Institute service line. This department cares for a diverse patient population from around the United States, ranging in age from birth to early adulthood. We provide care at three inpatient facilities, four emergency departments, seven outpatient clinic locations, and three outreach clinics in addition to our growing telemedicine outreach. In 2018, we cared for 48% of patients from birth to age 18 hospitalized for respiratory disease in Colorado and 79% of those hospitalized with the most severe respiratory disease. The Respiratory Care team includes 27 Pediatric Pulmonologists (9.23 clinical FTEs), 7 Pediatric Sleep Medicine Physicians (3.45 clinical FTEs), 2 Allergists (0.19 clinical FTEs), 16 Advanced Practice Providers (12.5 clinical FTEs), and 21.73 outpatient RN FTEs. The multidisciplinary care team also includes respiratory therapists, social workers, registered dieticians, physical and speech therapists, psychologists, and health navigators. In 2018, the Breathing Institute had 18,658 outpatient visits (9% increase from 2017), 3,621 inpatient discharges (2% increase from 2017) performed 357 bronchoscopies (19% increase from 2017), 22 laryngoscopies (8% decrease from 2017), and 4,131 sleep studies (2.8% increase from 2017). In 2018, the Respiratory Care team dedicated focused resources to quality improvement, advocacy, and healthcare provider education. Four of those projects have yielded strong results and are described below as our 2018 accomplishments. Quality Initiative: Home Visits for Pediatric Asthma Patients As a result of a previously conducted needs assessment focused on high risk asthma patients seen at Childrens Hospital Colorado, the Breathing Institute created a home visit program for patients with difficult-to-control asthma in 2016. The first two years were focused on program development, hiring and training staff, and conducting quarterly PDSA quality improvement cycles. In 2018, we concluded our pilot phase and incorporated home visits into our clinical operations as standard of care for high risk asthma patients. We conducted 116 home visits with 44 patients. These visits were conducted by a nurse and community health navigators and focused on asthma education, barrier identification and patient navigation, home environmental assessment and trigger remediation. Support provided to each family varies based on barriers identified but commonly includes medication device technique teaching, help with applications for benefits (e.g., Medicaid and WIC paperwork), and remediation supplies such as HEPA-filter vacuums, safe cleaning supplies, and pest extermination services. During the pilot phase that ended in 2018, we saw a 41% reduction in readmissions/emergency department revisits for asthma in the six months following participation in the home visit program. Healthcare Advocacy: Updating Colorados Newborn Screening Law Colorados newborn screening program aims to ensure every Colorado baby receives a genetic, metabolic and hearing screening upon birth. These screenings help identify potentially life-threatening conditions, as well as hearing loss. If these conditions arent identified very early in life, they can lead to severe health consequences and developmental delays or even death. However, that law dates back to the 1990s and did not include screening for many conditions that are standard in other states. Clinicians at Childrens Hospital Colorado, including pulmonologists, approached our Government Affairs team with concerns about these gaps. With help from community partners, we advocated to modernize Colorados newborn screening program by expanding testing to cover new diseases, improving the follow-up process for babies needing additional testing, and ensuring adequate program resources. Pulmonary faculty members provided guidance on bill development and testimony at the Colorado legislature. This bill was signed into law on June 8, 2018. Quality Initiative: Improving Care for Patients with Obstructive Sleep Apnea by Leveraging Electronic Medical Records Since the original description of positive airway pressure (PAP) therapy for treatment of Obstructive Sleep Apnea (OSA) in 1980, the science and evidence of its effectiveness has expanded. Clinical applications of PAP therapy, along with the evolution of improved medical devices using this technology, has outpaced the medical communitys ability to supply and monitor patients who would benefit from PAP therapy. In 2015, the American Academy of Sleep Medicine (AASM) published "Quality Measures for the Care of Pediatric Patients with Obstructive Sleep Apnea" but did not provide specific means to accomplish the outcomes and processes. Improving access to PAP therapy became a quality care, high priority issue at our institution. The increased numbers of patients needing to be assessed and treated overwhelmed our work flow. To effectively capture the ever-growing PAP patient population, a customized report was created to extract data within EMR system to track all new PAP patients from completion of their PAP titration sleep study to subsequent clinic visit. A process map was created to identify communication gaps and 100% of new PAP patients received a call to schedule a follow up visit. Through three quality improvement cycles, the team increased sleep study follow-up clinic visits from 61% at baseline to 88%. Quality Initiative: Simulation Training for Families of Children with Long-term Mechanical Ventilation Preparing families of children requiring long-term mechanical ventilation (LTMV) to manage medical emergencies at home is challenging. Opportunities for family caregivers to rehearse crisis management in a controlled setting before discharge are limited. We created a multimodal discharge preparedness curriculum, incorporating high-fidelity simulation training, to prepare family caregivers of children with complex medical conditions requiring LTMV. We also sought to determine which curricular elements were most helpful and whether this curriculum impacted the rate of readmissions within 7 days of hospital discharge. The curriculum included instructional videos, printed handouts, cardiopulmonary resuscitation training, and two mandatory high fidelity simulation scenarios depicting tracheostomy- and ventilator-related emergencies. Teams of one to three family caregivers per patient managed each scenario. A video-based debriefing focused on identifying and closing performance gaps. Participants rated their perceptions regarding each curricular element and its relative impact on their preparedness for discharge. Eighty-seven family caregivers completed the curriculum. Simulation-enhanced curriculum was well-received by participants. Participants reported that post-simulation debriefing was the most beneficial component. We observed a trend toward reduced readmissions within 7 days of discharge since implementation of our revised curriculum: from 15% 7-day readmission rate (n=20) to 7.9% 7-day readmission rate (n=38). Simulation training can be incorporated into discharge training for families of children requiring LTMV. Rehearsal of emergency management in a simulated clinical setting increases caregiver confidence and preparation to assume care for their ventilator-dependent child at home. Neuroscience Institute Childrens Hospital Colorados (CHCO) Neuroscience Institute (NSI) has one of the best pediatric developmental pediatrics, neurology, and neurosurgery programs in the country. We have consistently ranked among the Top 15 programs by US News & World Report. The NSI provides evaluation and treatment of neurological disorders, parent and patient education, and inpatient and outpatient treatments, therapies and procedures. Our neurology team is specially trained to diagnose and treat disorders of the brain and nervous system, caring for kids with conditions like stroke, neuromuscular disorders, movement disorders, neurometabolic disorders, epilepsy, and migraines. Our neurosurgery team provides surgical treatment for all types of disorders affecting the brain, spinal cord and skull including epilepsy, hydrocephalus, traumatic injury, brain tumors, spina bifida, and facial and skull deformities. Our Developmental Pediatrics team sees children with a variety of developmental and neurobehavioral differences such as autism spectrum disorders, X&Y chromosome variations, fragile X and developmental delays. FORM 990, PART III, LINE 4A CONTINUED The NSI clinical care team is comprised of Neonatologists, Neonatal Nurse Practitioners, specially trained nurses, respiratory therapists, pharmacists, physical, speech and occupational therapists, lactation specialists, neonatal nutrition, social work, chaplains and case managers. Specialty consultants include neurology, pulmonology, genetics, gastroenterology, nutrition, metabolic, endocrinology, hematology, cardiology and cardiovascular surgery, general pediatric surgery, renal, ophthalmology, orthopedics and ear, nose and throat specialists. NSI includes 50 physicians, 24 advanced practice providers, 27 psychologists across 8 Childrens sites as well as 7 outreach sites across Colorado and a growing telemedicine practice. Our Childrens sites include Anschutz, COS/Briargate, North/Broomfield, Parker, Uptown, Wheatridge, South, Highlands Ranch Therapy. The NSI treated 37,622 patient visits in 2018, serving the Colorado community and our 7-state region. Our Anschutz facility location alone saw 22,260 visits, and we see patients at eight of CHCOs network sites. NSI tripled the number of telemedicine visits in 2018, to 182, and saw almost 500 patient visits in eight outreach clinics across Colorado. Due to the high demand for NSIs services, we have focused on expanding our outreach and telemedicine efforts to better serve patients across Colorado and the 7-state region. Increasing access to care for NSIs specialized services is our high priority to enable our families live healthier lives. NSI Inpatient had 6,822 patient days recorded in 2018. There was a total of 1,236 inpatient discharges in 2018. National/Regional Presence: NSI has an outreach program reaching from Montana to New Mexico with extensive presence in Colorado. We host over 100 Neurology outreach clinics annually across Colorado, in Alamosa, Durango, Ft. Morgan, Grand Junction, Montrose, Pueblo and Sterling. Our Neurologists provide EEG reading services for 8 hospitals/medical centers in Colorado, Nebraska and Montana. Our Developmental Pediatrics team travels throughout the state to train PCPs on best practices in diagnosing and managing patients with autism. In 2018 we expanded our telemedicine efforts significantly, seeing an increase of over 200% in the number of visits. We were successful in arranging physician licensing, credentialing, and contracts in Montana. We are also working to expand our regional partnerships in 2019 we expect to host an outreach and telemedicine clinics in Casper, WY. NSI is acknowledged by the National Association of Epilepsy Centers as a Level 4 Epilepsy Center. We are recognized by the International Foundation for CDKL5 Research as Center of Excellence for Rett patients, drawing patients nationally to be treated by Dr. Tim Benke, an international expert in this area. Our Neurology Complex Drugs Program draw patients from around the region to be treated for complex neurodegenerative diseases, and the program has been recognized as model for care for these treatments. Our faculty offer local and regional CMEs and organize an annual Rett Symposium and regular Seizure Safety Schools for parents and families. Quality Improvement: The NSI is committed to developing quality improvement as a core clinical strategy by continually advancing the effectiveness, efficiency, safety, experience and coordination of the care it provides to its patients. Our Quality Improvement committee meets monthly to review quality and safety metrics and initiatives and has representatives from all three sections. NSI has numerous active Quality & Process Improvement initiatives underway in 2018 (and continuing into 2019), including the following: - A QSRS review that resulted in establishment of medication safety task force impacting prescription practices and improving parental compliance with Rx orders. - Restructured monthly M&M conferences for faculty and trainees to make them more outcome oriented and to facilitate follow-up on progress toward agreed upon goals. - Established clinical pathways for headache, pediatric arterial ischemic stroke, infantile spasms, neonatal seizures after acquired brain injury, traumatic brain injury, neuromuscular disorders, and status epilepticus. - Established dedicated appointments within the infusion center for status migrainosis patients. - Implemented and trained inpatient nurses specifically to neuroscience patient care improving patient outcomes such as unplanned RRT/Codes related to seizures. - Established dedicated inpatient Neurology service and separate Neurocritical Care (for PICU, CICU, NICU) and Neurohospitalist (ED and regular inpatient units) consultative services. - Care team optimization completed to fully integrate medical assistants into clinic practice. - Piloted RN bookend model in our Developmental Pediatrics clinic to increase access - Redesigned our autism intake model to better serve patients As a result of ongoing Quality & Process Improvement initiatives, NSI has seen the following outcomes: - Decreased utilization of free text only sigs used when writing prescriptions by 25% - 50% decrease in EEG lead pressure injuries - 30% improvement in rate of medication reconciliation during telephone encounters - Greater than 90% rate of responding to over 54K annual patient telephone and MyChart encounters within 2 days. - Decreased headache patient visits through the ED, decreased cost to hospital and increased patient access and satisfaction. - Improved referring physician satisfaction with timeliness and quality of input from inpatient Neurology consultations CENTER FOR CANCER AND BLOOD DISORDERS Childrens Hospital Colorados (CHCO) Center for Cancer and Blood Disorders (CCBD) has one of the best pediatric hematology, oncology and bone marrow transplant programs in the country. The CHC CCBD has been ranked in the Top 10 programs by US News & World Report each year. The CCBD treated 34,848 patient visits in 2018, in an effort to serve the Colorado community, as well as our 7-state region. Our Anschutz facility location alone saw 22,914 visits, with our infusion center volume making up 8,632 (38%) of those visits. Our Network of Care sites in Highlands Ranch, Colorado Springs, and our Hemophilia Thrombosis Center on the Anschutz campus serviced 11,934 patient visits in 2018, 3,507 of which were infusions (29%). Because of the depth and breadth of CCBD outpatient services, a large number of our clinic and infusion visits mean that many children can be cared for on an outpatient basis instead of being admitted to the hospital. Limiting hospitalization when possible is our high priority to enable our families live healthier lives. CCBD Inpatient had 11,592 patient days recorded in 2018. The inpatient unit had a total of 8,228 inpatient Hematology and Oncology patient days and 3,158 BMT patient days recorded. There was a total of 1,722 admissions to the inpatient unit in 2016. National/Regional Presence: CCBD has an outreach program reaching from Montana to New Mexico with extensive presence in Colorado. Our outreach clinics in Grand Junction bring Hematology sub-specialty expertise to the Western slope. Our Hemophilia & Thrombosis Center (HTC) provides comprehensive care clinics throughout the region. We host bi-weekly Bone Marrow Transplant teleconferences with cancer programs in New Mexico. Our CCBD nursing program travels throughout the region to train other hospital nurse staff on best practices in chemotherapy administration. CCBD also hosts regional private practice physicians through our Visiting Provider program, inviting them to our Anschutz location to share best care practices with our community partners first hand, and giving them educational materials and strategies to bring home. In 2018 we expanded our telemedicine efforts. We were successful in arranging physician licensing, credentialing, and contracts in Montana and New Mexico. Our HTC faculty successfully treated rural out of state patients via telemedicine in 2018, and they have set the stage for expanding this platform for 2019 and beyond. We are also working to expand our regional partnerships in 2019 we fully expect to host an outreach clinic in Cheyenne, WY. CCBD is acknowledged by Optum as a Center of Excellence for both our Cancer Care as well as our Bone Marrow Transplant program. We are the only pediatric Foundation for the Accreditation of Cellular Therapy (FACT) program in a 16-state region, which brings us the capacity to deliver the most sophisticated stem cell transplant and chimeric antigen receptor T (CAR-T) cell immunotherapy. Our Neuro-Oncology and Experimental Therapeutics programs draw patients nationally and internationally for treatment and clinical trials available in only a few centers in the world. FORM 990, PART III, LINE 4A CONTINUED CCBD Fellowship Program: Each year we select 4 new fellows to join our highly selective 3-year Accreditation Council of Graduate Medical Education-sanctioned Fellowship Program. Our fellows train in all aspects of sub-specialty care of children, adolescents and young adults with blood and cancer disorders in preparation for a career in academic medicine. We emphasize excellence in clinical care and research, developing fellows in the physician-scientist model with numerous mentors among the faculty such that our graduates acquire the skills and strategies needed for a career as life-long learners, educators, and influential leaders. We have successfully prepared subspecialty pediatricians that provide comprehensive, patient- and family-centered care with particular focus on excellent communication skills, as well as safety and quality improvement. Almost 90% of our graduates go on to prestigious academic positions with leadership positions across the country. Access: CCBD is privileged to have a dedicated Wellness program. This interdisciplinary team is comprised of specialists in Social Work, Psychology, Child Life, Family Navigation, Creative Arts Therapy, Chaplaincy, and Learning Specialists. The Wellness program benefits families and patients by integrating and coordinating clinical services to meet every familys needs at the individual level and increases possibilities for prevention/intervention and on-going care and connection. The CCBD is a home for multiple sub-programs within Oncology, Hematology and BMT. Our Vascular Anomalies Center is a less commonly known program that is a national and regional leader. This interdisciplinary team evaluates and treats vascular anomalies in children. The team includes specialists from Otolaryngology (ear, nose and throat), Plastic Surgery, Dermatology, Hematology, Pediatric General Surgery and Interventional Radiology. This program exemplifies our priority to put the patient first. Our specialists coordinate their care in one patient appointment to minimize the number of visits needed to evaluate and treat the patients condition. Quality Improvement: The CCBD is committed to developing quality improvement as a core clinical strategy by continually advancing the effectiveness, efficiency, safety, experience and coordination of the care it provides to its patients. The Clinical Effectiveness Collaborative (CEC) supports data driven improvement work on clinical effectiveness, operational excellence and value throughout the CCBD, CHC, and the University of Colorado Anschutz Medical Campus with multidisciplinary standing membership drawn from individuals within the CCBD who can provide meaningful review and guidance to projects shared and supported by the CEC. The CEC is broadly representative, multidisciplinary and guides the range of activities and initiatives through which the CCBD is pursuing its clinical, operational, value-driven, and financial improvement goals. One primary function of the CEC is to review and provide feedback related to clinical and operational improvement projects, including measures, PI methods, and project alignment across the CCBD and CHC. The Collaboratives members help guide clinical and operational improvement initiatives, spread successful interventions, identify and recommend strategies to overcome barriers/challenges, and serve as enthusiastic advocates for, participants and leaders of continuous learning and improvement in their respective areas and across the CCBD. The CCBD has several active Quality & Process Improvement initiatives underway in 2018 (and continuing into 2019) to include: - The CCBD outpatient infusion center on the Anschutz Medical Campus significantly surpassed the Childrens Hospital Colorado patient satisfaction goal for 2018. - Standardizing an approach to screening for transfusion-associated iron overload increasing the number of patients identified and treated for this complication and preventing long-term toxicities. - Decreasing length of stay of high-dose methotrexate admissions resulting in more time outside the hospital for children with leukemia and osteosarcoma. - Preventing blood stream infections in patients with a central line/catheter (tube). - Improving time to administration of pain medications with Sickle Cell patients in acute pain. - Decreasing the rate of clostridium difficile infections resulting in decreased mortality, decreased length of inpatient hospital stay and decreased cost for both community and hospital onset. - Effective clinical management: Quality & Strategy Team at the HTC developed a transitions of care program for patients and is beginning to address transition of care for care givers. Their processes are now being used in HTCs throughout Region VIII of the federal HTC network. - Successful Foundation for the Accreditation of Cellular Therapy (FACT) re-accreditation. FACT accreditation is a threshold for excellence in cellular therapy within the bone marrow or cord blood transplant (BMT) patient population. - Reorganizing the program to a "Door to Door model" providing patients and families a single point of contact to facilitate providing high quality patient care. - Evaluating and changing the Bone Marrow Harvest process to reduce the positive sterility rate of products collected by CHCO providers. FORM 990, PART VI, LINE 1A CHILDREN'S HOSPITAL COLORADO'S EXECUTIVE COMMITTEE CONSISTS OF THE BOARD CHAIR, CHAIR ELECT, CHIEF EXECUTIVE OFFICER, SECRETARY, BOARD TREASURER, CORPORATE TREASURER, IMMEDIATE PAST CHAIR, THE CHAIR OF THE CHILDREN'S HOSPITAL COLORADO FOUNDATION, THE CHANCELLOR (OR DESIGNEE) AND UP TO TWO (2) ADDITIONAL SEATS TO BE FILLED BY THE BOARD CHAIR. THE EXECUTIVE COMMITTEE HAS ALL THE POWERS OF THE BOARD OF DIRECTORS, EXCEPT AS LIMITED BY LAW, DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD. FORM 990, PART VI, LINE 6 CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL COLORADO. FORM 990, PART VI, LINE 7A THE WRITTEN CONSENT OF CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS REQUIRED TO APPROVE THE BOARD OF DIRECTORS OF CHILDREN'S HOSPITAL COLORADO. FORM 990, PART VI, LINE 7B CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM AS THE SOLE MEMBER HAS CERTAIN APPROVAL POWERS AS DESCRIBED IN THE AMENDED AND RESTATED BYLAWS DATED SEPTEMBER 22, 2011 AND AMENDED MOST RECENTLY IN FEBRUARY 2017. FORM 990, PART VI, Line 11B CHILDREN'S HOSPITAL COLORADO'S FINANCE DEPARTMENT WORKS CLOSELY WITH HUMAN RESOURCES, CORPORATE COMPLIANCE, LEGAL AND PUBLIC RELATIONS TO GATHER ALL THE DATA REQUIRED TO COMPLETE THE FORM 990. THE VP OF FINANCE AND THE DIRECTOR OF ACCTG. & REPORTING CONDUCT A REVIEW WITH THE CFO PRIOR TO THE DRAFT BEING DISTRIBUTED TO THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE MADE, THE FORM IS SIGNED BY THE CFO, REVIEWED BY THE AUDIT COMMITTEE, AND A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS VIA A SECURED WEBSITE. FORM 990, PART VI, LINE 12C BOARD MEMBERS ARE REQUIRED TO DISCLOSE, ON AN ANNUAL BASIS, POTENTIAL CONFLICTS OF INTEREST PURSUANT TO THE WRITTEN POLICIES OF CHILDREN'S HOSPITAL COLORADO (CHCO) AND CHILDREN'S HOSPITAL COLORADO FOUNDATION (CHCF). ALL EMPLOYEES AND BOARD MEMBERS MUST PROMPTLY PROVIDE A WRITTEN DESCRIPTION OF MATERIAL FACTS OF AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO CORPORATE COMPLIANCE AND/OR GENERAL COUNSEL ON THE APPROPRIATE DISCLOSURE FORM. SUCH DISCLOSURE WILL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF THE CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. POLICIES AND PROCEDURES FOR DISCLOSING CONFLICTS OF INTEREST ARE TO BE FOLLOWED ACCORDING TO THE INDIVIDUAL'S FUNCTION, IN COMPLIANCE WITH STATE AND FEDERAL REGULATIONS. COMPLETED DISCLOSURE FORMS ARE SUBJECT TO AUDIT REVIEW BY LEGAL, THE CORPORATE COMPLIANCE PROGRAM, AND THE COMPLIANCE AND BUSINESS ETHICS COMMITTEE OF THE BOARD OF DIRECTORS. FAILURE TO COMPLY WITH CONFLICT OF INTEREST POLICIES MAY LEAD TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR WORKING RELATIONSHIP WITH THE CHILDREN'S HOSPITAL COLORADO. ONCE THE COMPLIANCE AND BUSINESS ETHICS (CABE) COMMITTEE HAS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WITH RESPECT TO AN AGREEMENT/CONTRACT THEN: 1. THE (CABE) COMMITTEE WILL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER CHILDREN'S HOSPITAL COULD OBTAIN A MORE ADVANTAGEOUS AGREEMENT/CONTRACT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES AND, IF APPROPRIATE, WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT. 2. IN CONSIDERING WHETHER TO ENTER THE PROPOSED AGREEMENT/CONTRACT, THE CABE COMMITTEE MAY APPROVE SUCH CONTRACT, TRANSACTION OR ARRANGEMENT ONLY IF THE DISINTERESTED PERSON OR COMMITTEE DETERMINE BY A MAJORITY VOTE THAT: - THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT IS IN CHILDREN'S COLORADOS BEST INTERESTS AND FOR COLORADO CHILDREN'S OWN BENEFIT; AND - THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO CHILDREN'S HOSPITAL COLORADO (CHCO), CONSIDERING, AMONG OTHER RELEVANT FACTORS, WHETHER CHCO COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. FORM 990, PART VI, LINES 15A AND 15B CHILDREN'S HOSPITAL COLORADO HAS AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS THAT REVIEWS AND APPROVES ANY PROPOSED INCREASES RELATED TO ANY OFFICERS AND KEY EMPLOYEES OF THE COMPANY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE ALONG WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EACH YEAR. ONCE A CHANGE IN COMPENSATION IS APPROVED, FORMAL DOCUMENTS ARE COMPLETED AND MINUTES OF THE MEETING ARE PREPARED, REVIEWED AND APPROVED. REVIEW PROCESS INCLUDES: - REVIEW MARKET RATIO - SHOULD FALL BETWEEN 80% TO 120% OF MARKET - REVIEW 25TH, 50TH, AND 75TH PERCENTILE - BASE SALARY - INDIVIDUAL QUALIFICATIONS AND PERFORMANCE DETERMINES MARKET POSITION. BASE SALARY FOR EACH INDIVIDUAL IS TARGETED AT THE MEDIAN (50TH PERCENTILE) OF THE PEER GROUP. - VARIABLE PAY - LEADERSHIP INCENTIVE IS IN PLACE WHICH REWARDS FOR ORGANIZATIONAL PERFORMANCE WITH A COMPONENT ALSO BASED ON INDIVIDUAL PERFORMANCE. THE INCLUSION OF VARIABLE PAY WILL PLACE TOTAL CASH COMPENSATION (E.G., BASE SALARY AND VARIABLE PAY) BETWEEN THE 50TH AND 75TH PERCENTILE FOR EACH INDIVIDUAL. - AWARDS ARE BASED ON ACHIEVEMENT OF PRE-ESTABLISHED CHILDREN'S COLORADO GOALS WHICH SUPPORT THE STRATEGIC PLAN - BENEFITS - TARGETED AT THE "MIDDLE OF MARKET" DECISION FACTORS IN EXECUTIVE COMPENSATION DECISIONS: - MARKET DATA FROM INDEPENDENT COMPENSATION SURVEYS THAT REFLECT FUNCTIONALLY COMPARABLE POSITIONS IN ORGANIZATIONS OF SIMILAR SIZE AND SCOPE - DIFFICULTIES IN RECRUITING AND RETAINING EXECUTIVES - SKILLS, EXPERIENCE AND PERFORMANCE HISTORY OF INDIVIDUAL EXECUTIVES - CRITICAL BUSINESS OR STRATEGIC ISSUES THAT THE ORGANIZATION MAY FACE - UTILIZED APPROVED PEER GROUP FROM JANUARY 2018 MEETING - ON POSITIONS WITH INSUFFICIENT DATA (LESS THAN 10 MATCHES) - USED EXPANDED PEER GROUP OF ALL ACUTE CARE ORGANIZATIONS - BENCHMARKED BASE PAY, TOTAL CASH COMPENSATION, AND BENEFITS 2018 CUSTOM PEER GROUP - ATLANTA - BOSTON - CHICAGO - CINCINNATI - COLUMBUS - DALLAS - FORT WORTH - HOUSTON - KANSAS CITY - LOS ANGELES - MILWAUKEE - MINNEAPOLIS - ORANGE - PALO ALTO - PHILADELPHIA - SAN DIEGO - SEATTLE - WASHINGTON, DC THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2018. FORM 990, PART VI, LINE 19 THESE DOCUMENTS ARE MADE AVAILABLE UPON REASONABLE REQUEST. Form 990, Part IX, Line 11g PHYSICIAN SERVICES $ 112,343,732 PURCHASED SERVICES $ 26,647,847 CONSULTING FEES $ 4,920,199 OTHER $ 21,371,387 ------------- TOTAL $ 165,283,165 ============= FORM 990, PART XI, LINE 9 EQUITY TRANSFER FROM CHCHS $ 6,996,209 EQUITY TRANSFER FROM FOUNDATION $ 29,700,130 CHANGE IN PERPETUAL TRUST ($ 3,524,702) OTHER CHANGES IN NET ASSETS $ 573,476 ------------- TOTAL $ 33,745,113 ============= Children's North Surgery Cntr 469 state highway 7 suite 2 broomfield CO 80023 262394578 O/P surgery CO 0 0 CH-Colorado CHILDREN'S HOSPITAL COLORADO HLTH SYSTEM 13123 EAST 16TH AVE AURORA CO 80045 454182666 HEALTHCARE CO 501(c)(3) 12c, iii-fi NA false CHILD HEALTH MANAGEMENT SERVICES INC 13123 EAST 16TH AVE AURORA CO 80045 742266667 IT SERVICES CO 501(c)(3) 3 CH-COLORADo true THE CHILDREN'S HOSPITAL FOUNDATION 13123 EAST 16TH AVE AURORA CO 80045 840813462 FOUNDATION CO 501(c)(3) 7 CHCHS true CHILDREN'S HEALTH CORPORATION 13123 EAST 16TH AVE AURORA CO 80045 742235572 SUPPORTING CO 501(c)(3) 12A-I CH-COLORADo true Children's north surgery cntr 469 state highway 7 suite 2 broomfield CO 80023 262394578 Outpatient Surg CO CH-COLORADO Related 293645 1624332 false false RMCHS MANAGEMENT SERVICES INC 13123 EAST 16TH AVE AURORA CO 80045 840957415 BILLING CO CH-COLORADO C Corp 4608430 115486 1.00000 true PEDIATRIC CARE NETWORK CHCH LLC 13123 EAST 16TH AVE AURORA CO 80045 813554450 HEALTHCARE CO CH-COLORADO C Corp 923672 2438423 1.00000 true PERPETUAL TRUST HOSPITAL SUPPORT CO CH-COLORADO true true true true true false false false false false false true true true true true false false false false THE CHILDREN'S HOSPITAL FOUNDATION c 7203103 accrual Schedule R, Part III, Column (A) Children's North Surgery Center LLC EIN: 26-2394578 Address: 469 State Highway 7, Suite 2, Broomfield, CO 80023