2018-05-14T13:08:22-05:00 2017-06-30 Grant Thornton LLP 1000 WILSON BLVD SUITE 1400 ARLINGTON VA 22209 990 2016-07-01 530196580 Children's Hospital % CORPORATE OFFICERS CHIL 3015723502 111 Michigan Avenue NW Washington DC 20010 ALEC KING CFO 3015723502 2018-05-11 true MARY TORRETTA P00847851 7038477500 2016 2022-09-23 18:48:47Z KURT DOUGLAS NEWMAN MD 111 Michigan Avenue NW Washington DC 20010 1241414690 false X www.childrensnational.org X 1870 DC TO IMPROVE HEALTH OUTCOMES FOR CHILDREN; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH. SEE SCHEDULE O. 16 13 7850 1513 1279074 -4272 27288703 87200911 1045077116 1089195010 2064148 2764801 -12194542 -6150154 1062235425 1173010568 0 0 0 0 603898678 624798020 0 0 0 485714127 432580911 1089612805 1057378931 -27377380 115631637 1305368482 1421366300 771318094 794934106 534050388 626432194 X SEE SCHEDULE O. false false 689042681 1077555160 CHILDREN'S HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER (CNMC) IS THE SOLE MEMBER OF THE HOSPITAL. CNMC AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE H, PART VI FOR COMPLETE FY17 COMMUNITY BENEFIT REPORT. 689042681 true true false true false false false false false false true false false true true true false true false true true true false false false false true true false false true true false true false false false true false false false false true false false false true true true true false false true 875 0 true 7850 true true true false false false false false false false false false X 16 13 false false false false true true true true true false false true true true true true true true true false DC X CORPORATE OFFICERS 3015723502 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 X CAROLYN A THORNELL BOARD CHAIRMAN TO 12/2016 2.0 1.0 X X 0 0 0 SCHONAY BARNETT-JONES BOARD CHAIRMAN 1.0 1.0 X X 0 0 0 DAVID WHISTON DDS BOARD SECRETARY/TREASURER 1.0 0.0 X X 0 0 0 KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 45.0 10.0 X X 2266277 0 298687 DIEDRE ADKINS BOARD MEMBER 1.0 0.0 X 0 0 0 DARYL DAVIS BOARD MEMBER 1.0 0.0 X 0 0 0 ELIZABETH 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PACKER MD SVP CENTER OF EXCELLENCE 36.0 19.0 X 916299 0 141807 MARY ANNE HILLIARD CHIEF LEGAL OFFICER 54.0 1.0 X 703636 0 121446 BRIAN JACOBS MD CHIEF INFORMATION OFFICER 54.0 1.0 X 559572 0 79813 DARRYL VARNADO CHIEF PEOPLE OFFICER 54.0 1.0 X 629808 0 113140 MARY OTTOLINI MD PHD VICE CHAIR MEDICAL EDUCATION 54.0 1.0 X 376110 0 17346 LINDA TALLEY CHIEF NURSING OFFICER 54.0 1.0 X 388785 0 23315 MICHELLE M MCGUIRE VP & CHIEF OF STAFF 54.0 1.0 X 312140 0 33068 MARK L BATSHAW MD EVP & CHIEF ACADEMIC OFFICER 28.0 27.0 X 1310915 0 363306 RICHARD JONAS MD CHIEF OF CARDIOLOGY 52.0 3.0 X 2209001 0 171679 ROBERT KEATING MD CHIEF OF NEUROSURGERY 55.0 0.0 X 997350 0 115683 PETER KIM MD VP SHEIKH ZAYED INSTITUTE 51.0 4.0 X 970729 0 35253 MATTHEW OETGEN MD CHIEF OF ORTHO & SPORTS MED 55.0 0.0 X 742407 0 35216 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 54.0 1.0 X 894249 0 35042 JOHN MYSEROS MD NEUROSURGEON 55.0 0.0 X 827477 0 34386 RAHUL K SHAH MD FORMER BOARD MEMBER to 6/2014 0.0 0.0 X 506586 0 14857 DAVID SPARKS FORMER VP FIN/CONTR. to 6/2014 0.0 0.0 X 352701 0 27072 David Stockwell Former Board Member to 6/2016 0.0 0.0 X 193110 0 6065 DOUGLAS MYERS FORMER CFO to 12/2015 0.0 0.0 X 879032 0 151314 GERARD MARTIN MD FMR SVP CENTER OF EXCELLENCE 0.0 1.0 X 506880 0 94603 PAM KING SAMS Former CDO to 06/2016 0.0 0.0 X 724518 0 65624 23848076 0 2901344 1695 true true false CERNER CORPORATION 2800 ROCKCREEK PARKWAY N KANSAS CITY MO 64117 IT 38875968 ATLANTIC SERVICES GROUP 2131 K STREET NW STE 200 WASHINGTON DC 20037 SHUTTLE 3566292 COLONIAL PARKING 1050 THOMAS JEFFERSON ST NW STE WASHINGTON DC 20007 PARKING 3367821 RP3 LLC 7316 WISCONSIN AVENUE 450 BETHESDA MD 20814 ADVERTISING 1940977 QUEST DIAGNOSTICS CLINICAL LAB INC 1201 S COLLEGEVILLE ROAD COLLEGEVILLE PA 19426 LAB TEST WORK 1640936 192 17278912 64558773 5363226 45400000 87200911 PATIENT REVENUE 621400 1017456032 1017456032 ALL OTHER PROGRAM SERVICES 900099 71738978 71738978 1089195010 2946140 2946140 0 0 0 0 0 68222783 68404122 -181339 -181339 -181339 0 0 0 0 0 0 0 0 0 PARKING 812930 4210622 4210622 LAB FEES 621500 1279074 1279074 EQUITY AND PARTNERSHIP LOSS 621110 -11639850 -11639850 -6150154 1173010568 1077555160 1279074 6975423 0 0 0 0 24084775 15414256 8670519 0 514949556 329601350 185348206 18643283 11931701 6711582 31734312 20309960 11424352 35386094 22647100 12738994 0 4403468 2818220 1585248 1009785 1009785 546675 546675 0 0 72135777 46483135 25652642 5479671 3506989 1972682 10975124 7024079 3951045 48566004 31082243 17483761 0 23310498 14918719 8391779 3539107 2265028 1274079 0 1095278 700978 394300 22023408 14094981 7928427 0 59907948 38341087 21566861 22193501 14203841 7989660 MEDICAL SUPPLIES 94228147 60306014 33922133 BAD DEBT EXPENSE 37239025 37239025 REPAIRS AND MAINTENANCE 18274499 11695679 6578820 OTHER EXPENSES 7652996 4458296 3194700 1057378931 689042681 368336250 0 0 0 125627814 133413285 6703912 6687896 163175659 192455209 80000 40000 0 0 0 0 8867399 8814638 13029110 42120937 1210561474 680209518 484886042 530351956 168789111 164458807 39386824 6195670 0 0 0 0 294822611 336827902 1305368482 1421366300 147858391 145157604 0 0 7137079 8740569 406330452 397204503 0 0 0 0 75255531 75105304 0 0 134736641 168726126 771318094 794934106 X 534050388 626432194 0 0 0 0 534050388 626432194 1305368482 1421366300 115631637 12289230 -35539061 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true true false true false false true 434539 false true 112136 546675 false VOLUNTEERS SCHEDULE C, PART II-B, LINE 1A COORDINATED THE PARTICIPATION OF THE PATIENT FAMILIES IN THE CHILDREN'S HOSPITAL ASSOCIATION FAMILY ADVOCACY DAY FOCUSED PRIMARILY ON PROTECTING HEALTH CARE SERVICES FOR CHILDREN. PAID STAFF OR MANAGEMENT SCHEDULE C, PART II-B, LINE 1B FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS. MAILING TO MEMBERS SCHEDULE C, PART II-B, LINE 1D Childrens National participated in an online email campaign sponsored by the Childrens Hospital Association (CHA). We invited our staff to log onto a CHA web portal that allowed the individual to send a message to their congressional representative asking the representative to protect the Childrens Health Insurance Program. DIRECT CONTACT SCHEDULE C, PART II-B, LINE 1G THE LOBBYING ACTIVITIES ENGAGED IN BY CHILDREN'S HOSPITAL FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS. THOSE LOBBYING ACTIVITIES INCLUDE CONTINUAL MONITORING OF LEGISLATION VIA DISCUSSIONS WITH LEGISLATIVE STAFF, HOSTING EDUCATIONAL BRIEFING SESSIONS FOR MEMBERS OF CONGRESS, EXECUTIVE BRANCH, STATE AND LOCAL OFFICIALS/STAFF REGARDING CHILD HEALTH ISSUES, AND COORDINATING THE SUBMISSION OF CORRESPONDENCE/WRITTEN COMMENTS ON PROPOSED LEGISLATION AND REGULATIONS, AS WELL AS THE PRESENTATION OF TESTIMONY BEFORE LEGISLATIVE COMMITTEES. CHILDREN'S HOSPITAL ALSO DEVELOPS POLICY POSITIONS IN RESPONSE TO PROBLEMS AND OPPORTUNITIES IN THE PUBLIC SECTOR. OTHER ACTIVITIES SCHEDULE C, PART II-B, LINE 1I THE HOSPITAL IS A MEMBER OF THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH) AND DISTRICT OF COLUMBIA HOSPITAL ASSOCIATION (DCHA). NACH AND DCHA HAVE CHILD ADVOCACY AND LEGISLATIVE ADVOCACY PROGRAMS. 13340758 13340758 168575641 76309576 92266065 806442296 449812299 356629997 218997546 152302430 66695116 3205233 1785213 1420020 530351956 DUE FROM AFFILIATES 312407671 DEFERRED COMPENSATION PLAN 24420231 336827902 0 RESERVE FOR CLAIMS 89540810 OTHER LIABILITIES 69611879 CAPITAL LEASE OBLIGATIONS 5546492 SETTLEMENTS TO THIRD PARTY PAY 2832279 DUE TO AFFILIATIES 1194666 168726126 X LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) SCHEDULE D, PART X, LINE 2 FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (MEDICAL CENTER), OF WHICH CHILDREN'S HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ON SUCH BASIS, THE EXEMPT ENTITIES WILL NOT INCUR ANY LIABILITY FOR FEDERAL INCOME TAXES, EXCEPT FOR POSSIBLE UNRELATED BUSINESS INCOME. THE FINANCIAL ACCOUNTING STANDARDS BOARD'S ("FASB") GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES CLARIFIES THE ACCOUNTING FOR UNCERTAINTY OF INCOME TAX POSITIONS. THE GUIDANCE DEFINES THE THRESHOLD FOR RECOGNIZING TAX RETURN POSITIONS IN THE COMBINED FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON TECHNICAL MERITS. THE MEDICAL CENTER EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THERE was no impact on the medical center's financial statements during the year ended june 30, 2017 and 2016 as the medical center has no uncertain tax positions. Middle East and North Africa 1 Program Services patients refferals 753909 Central America and the Caribbean Program Services insurance premiums 11601962 1 1 12355871 12355871 true false false false false false ACCOUNTING METHOD USED SCHEUDLE F, PART I, LINE 3, COLUMN F THE EXPENDITURES, PER REGION, ARE PRESENTED ON THE ACCRUAL BASIS OF ACCOUNTING. true true true X 400. true X true true true false true true 9562260 9562260 0.00900 61923287 61923287 0.05860 71485547 71485547 0.06760 65486 6728895 2684440 4044455 0.00380 3307 47288861 6567171 40721690 0.03850 7061774 7061774 0.00670 4652603 4652603 0.00440 3841 750977 4025 746952 0.00070 72634 66483110 9255636 57227474 0.05410 72634 137968657 9255636 128713021 0.12170 8075 12981 12981 100 52142 52142 84765 0.00010 51 1091911 26136 1065775 0.00100 8226 1241799 26136 1130898 0.00110 true 34532733 1600000 2008057 2120476 -112419 X true true 1 1 CHILDREN'S HOSPITAL 111 MICHIGAN AVE NW WASHINGTON DC 20010 www.childrensnational.org HFD01-0208 X X X X X X X X Children's Hospital false false true X X X X X X X X X X 15 true true true true X www.childrensnational.org X www.dchealthmatters.org X true 16 true www.childrensnational.org false true X 400. 400. X X X X true true X X X true X www.childrensnational.org X www.childrensnational.org X www.childrensnational.org X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 3 THE COMMUNITY HEALTH NEEDS ASSESSMENT ALSO INCLUDES ILLUSTRATIVE MAPS/FIGURES OF ASSETS AND VULNERABILITIES RELATED TO SPECIFIC HEALTH METRICS, INCLUDING BUT NOT LIMITED TO MAJOR OUTLET FAST FOOD LOCATIONS PER WARD OF THE DISTRICT, HOSPITALS AND PRIMARY CARE CENTERS IN THE DISTRICT, MEDICALLY UNDERSERVED AREAS IN THE DISTRICT, AND LOCATIONS OF PRIMARY CARE AND MENTAL HEALTH PROFESSIONALS SHORTAGE AREAS IN THE DISTRICT. PROVIDING THIS INFORMATION WILL ASSIST IN OVERALL DATA ANALYSIS, PROGRAM PLANNING AND INFORM DECISION MAKING ON IMPORTANT HEALTH RELATED ISSUES AFFECTING THE RESIDENTS OF WASHINGTON, DC. SCHEDULE H, PART V, SECTION B, LINE 5 CHILDRENS NATIONAL HEALTH SYSTEM (CHILDREN'S NATIONAL) SPEARHEADED THE 2016 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ON BEHALF OF THE DISTRICT OF COLUMBIA HEALTHY COMMUNITIES COLLABORATIVE (DCHCC), A GROUP OF WASHINGTON, DC HOSPITALS AND FEDERALLY QUALIFIED HEALTH CENTERS. THE DCHCC ALSO INCLUDES PARTICIPATION FROM THE DC PRIMARY CARE ASSOCIATION, THE DC HOSPITAL ASSOCIATION, AND THE DC DEPARTMENT OF HEALTH. CHILDRENS NATIONAL ALSO LED THE RECRUITMENT OF THE FOCUS GROUPS TO ENSURE FULL REPRESENTATION OF THE COMMUNITY. INPUT WAS RECEIVED VIA SEVERAL KEY INFORMANT INTERVIEWS, FOCUS GROUPS, TOWN HALLS, AND ONLINE SURVEYS. THESE GROUPS CONSISTED OF COMMUNITY RESIDENTS, MEMBERS FROM THE LOCAL HEALTH CARE COMMUNITY, AND COMMUNITY AND GOVERNMENT AGENCIES REPRESENTING THE SOCIAL DETERMINANTS OF HEALTH SUCH AS THE DEPARTMENT OF HOUSING, ECONOMICS, DEPARTMENT OF HEALTH CARE FINANCE, DEPARTMENT OF TRANSPORTATION, AND THE DEPARTMENT OF BEHAVIORAL HEALTH. THE STAKEHOLDER INTERVIEWS TOOK PLACE WITHIN 60 ORGANIZATIONS AND INCLUDED 31 KEY INFORMANT INTERVIEWS, 113 ONLINE SURVEYS, 40 FOCUS GROUP PARTICIPANTS, 80 COMMUNITY FORUMS ATTENDEES, 6 COUNCIL MEMBERS, 11 GOVERNMENT AGENCIES, AND 15 HOSPITALS AND CLINICS. STAKEHOLDERS PROVIDED INPUT ON SEVERAL QUESTIONS RELATED TO OVERALL HEALTH AND THE COMPONENTS OF A HEALTHY COMMUNITY. PARTICIPANTS ALSO COMMENTED ON WAYS TO IMPROVE THE STATUS OF HEALTH IN THE CITY, DISCUSSED WHAT PROGRAMS/SYSTEMS WERE WORKING, AND PROVIDED INSIGHT INTO ADDITIONAL RESOURCES NEEDED TO ADVANCE HEALTH IN THE DISTRICT OF COLUMBIA. MEMBERS OF THE DCHCC CONDUCTED KEY INFORMANT INTERVIEWS WITH LOCAL CEO'S AS WELL AS DIRECTORS OF GOVERNMENT AGENCIES. SCHEDULE H, PART V, SECTION B, LINES 6A & 6B CHILDRENS NATIONAL, THROUGH ITS MEMBERSHIP IN THE DC HEALTHY COMMUNITIES COLLABORATIVE (DCHCC), CONDUCTED THE CHNA IN PARTICIPATION WITH THREE ADDITIONAL NON-PROFIT HOSPITALS: HOWARD UNIVERSITY HOSPITAL, PROVIDENCE HOSPITAL, AND SIBLEY MEMORIAL HOSPITAL. THE DCHCC ALSO CONSISTS OF FOUR COMMUNITY HEALTH CENTERS: BREAD FOR THE CITY, COMMUNITY OF HOPE, MARYS CENTER, AND UNITY HEALTH CARE, INC. THE DCHCC WORKS TO ELIMINATE HEALTH DISPARITIES AND CREATE HEALTH EQUITY FOR ALL COMMUNITIES IN DC TO REALIZE ONE HEALTHY CAPITAL CITY. WITH THE UNIQUE PERSPECTIVES OF EACH HOSPITAL AND COMMUNITY HEALTH CENTER, DCHCC MEMBERS PROVIDED GUIDANCE AND FEEDBACK RESPECTIVE TO POPULATIONS AND NEIGHBORHOODS SERVED. SCHEDULE H, PART V, SECTION B, LINE 7D THE CHNA REPORT IS LOCATED ON THE HOSPITAL'S WEBSITE AND THE DCHCC'S DC HEALTH MATTERS WEB PORTAL. CHILDREN'S NATIONAL ALSO PARTICIPATED IN A PRESS BRIEFING AND ISSUED A PRESS RELEASE TO DISSEMINATE THE CHNA REPORT FINDINGS TO THE PUBLIC. IN ADDITION, SEVERAL SOCIAL MEDIA PLATFORMS WERE USED TO DISTRIBUTE THE FINDINGS FROM THE CHNA. EACH DCHCC MEMBER ORGANIZATION HAS AN ELECTRONIC COPY OF THE CHNA REPORT ON THEIR WEBSITE. CHILDREN'S NATIONAL PARTICIPATED IN SEVERAL COMMUNITY FORUMS TO DISCUSS THE RESULTS OF THE CHNA AND THE IMPLEMENTATION STRATEGY. COPIES OF THE CHNA WERE DISTRIBUTED TO FORUM ATTENDEES. PARTICIPANTS WERE ALSO REFERRED TO THE DC HEALTH MATTERS WEB PORTAL TO ACCESS THE CHNA ELECTRONICALLY. Children's National, as a member of the DC Healthy Communities Collaborative, has met with community stakeholders, like community health alliances, government agencies, and faith-based organizations, to provide an overview of the CHNA and the four priority needs. In addition to providing an overview the CHNA, it has engaged new members in its community health improvement strategies. Children's National has also provided numerous trainings on the DC Health Matters website that includes the community health needs assessment and community health improvement plan. SCHEDULE H, PART V, SECTION B, LINE 8 CHILDREN'S HOSPITAL ADOPTED AN IMPLEMENTATION STRATEGY, REFERRED TO AS THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) THAT ADDRESSES FOUR OF THE SIX PRIORITY COMMUNITY HEALTH NEEDS IDENTIFIED THROUGH THE CITYWIDE CHNA. THE CHIP IS AVAILABLE ONLINE AT: https://childrensnational.org/advocacy-and-outreach/child-health-advocacy- institute/the-data-lab SCHEDULE H, PART V, SECTION B, LINE 11 THE DCHCC IS ADDRESSING THE FOLLOWING SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA MENTAL HEALTH, HEALTH LITERACY, PLACE-BASED CARE, AND CARE COORDINATION. WHILE THE COMMUNITY IDENTIFIED NINE HEALTH NEEDS, THE COLLABORATIVE SELECTED FOUR OF THE NINE PRIORITY NEEDS USING A STRUCTURED PRIORITIZATION PROCESS. THE PRIORITIZATION PROCESS SCORED EACH OF THE NEEDS ACCORDING TO 1) IMPORTANCE TO OUR COMMUNITY, 2) CAPACITY TO ADDRESS (AVAILABILITY OF FINANCIAL AND OTHER RESOURCES), 3) ALIGNMENT WITH ORGANIZATIONAL AND CITYWIDE MISSION AND 4) STRENGTH OF EXISTING INTERVENTION/COLLABORATIONS. A DESCRIPTION OF HOW CHILDRENS NATIONAL AND DCHCC ARE ADDRESSING THE FOUR SELECTED NEEDS IS DETAILED IN OUR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). IT IS IMPORTANT TO NOTE THAT THESE FOUR PRIORITIZED COMMUNITY NEEDS CUT ACROSS NEARLY ALL CLINICAL CONDITIONS AND OFTEN CONTRIBUTE TO POOR HEALTH OUTCOMES. THE QUANTITATIVE DATA PRESENTED IN THE REPORT HELPED GUIDE THE COLLABORATIVE IN DECIDING WHICH OF THE PRIORITY AREAS TO INVEST OUR RESOURCES FOR THE GREATEST IMPACT. FURTHERMORE, BECAUSE THE COLLABORATIVE IS COMPRISED OF HEALTH CARE ORGANIZATIONS, IT WAS IMPORTANT TO ALIGN THE PRIORITY AREAS ON HEALTH RELATED MATTERS VERSUS SOME OF THE NON-HEALTH AREAS IN ORDER TO BRING ABOUT THE GREATEST OPPORTUNITY TO AFFECT CHANGE. IN PREPARATION FOR DEVELOPING THE CHIP, CHILDRENS NATIONAL ALONG WITH DCHCC MEMBERS PARTICIPATED IN AN EXTENSIVE TRAINING TO ASSESS CAPACITY AND ORGANIZATIONAL ABILITY TO ADDRESS THE PRIORITY AREAS. MEMBERS DEVELOPED LOGIC MODELS FOR EACH OF THE PRIORITY AREAS AND IDENTIFIED THOSE ORGANIZATIONS THAT WOULD LEAD, COLLABORATE, OR SERVE IN A SUPPORTIVE ROLE BASED ON ORGANIZATIONAL CAPACITY. EACH DCHCC MEMBER ORGANIZATION RECEIVED APPROVAL OF THE CHIP BY THEIR BOARD OF DIRECTORS/TRUSTEES. CHILDRENS NATIONAL RECEIVED APPROVAL BY ITS BOARD ON NOV. 15, 2016. 18 CHILDREN'S OUTPATIENT CTR OF MONTGOMERY SHADY GROVE MEDICAL PARK ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 8501 ARLINGTON BOULEVARD STE 200 FAIRFAX VA 22031 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR IN LAUREL 13922 BALTIMORE AVE LAUREL MD 20707 REGIONAL OUTPATIENT CENTER CHILDREN'S HEALTH CENTER - ADAMS MORGAN 1630 EUCLID STREET NW WASHINGTON DC 20009 HEALTH CENTERS CHILDREN'S HEALTH CENTER - ANACOSTIA 2101 Martin Luther King Jr Ave SE WASHINGTON DC 20020 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR - UPR MARLBORO 9440 PENNSYLVANIA AVENUE UPPER MARLBORO MD 20772 REGIONAL OUTPATIENT CENTER MOBILE VAN - HEALTH CARE N/A NA DC 20010 MOBILE HEALTH CARE CHILDREN'S OUTPATIENT CTR IN ANNAPOLIS 888 BESTGATE ROAD STE 320 ANNAPOLIS MD 21401 REGIONAL OUTPATIENT CENTER CHILDREN'S HEALTH CENTER - SHAW 2220 11TH STREET NW WASHINGTON DC 20001 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR SPRING VALLEY 4900 MASSACHUSETTS AVENUE NW WASHINGTON DC 20016 REGIONAL OUTPATIENT CENTER CHILDREN'S NAT'L AMBULATORY SURGERY CTR 9850 KEY WEST AVENUE ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR IN FREDERICK 5910 FREDERICK CROSSING LANE STE 1 FREDERICK MD 21704 REGIONAL OUTPATIENT CENTER MOBILE VAN - DENTAL N/A NA DC 20010 MOBILE HEALTH CARE CHILDREN'S HEALTH CENTER AT THEARC 1901 MISSISSIPPI AVE SE WASHINGTON DC 20020 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR MONTGOMERY CTY 15245 SHADY GROVE ROAD STE 350 ROCKVILLE MD 20858 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 3023 Hamaker Court Suite 300 FAIRFAX VA 22031 REGIONAL OUTPATIENT CENTER CHILDREN'S NATIONAL IMGAGING CENTER 9850 KEY WEST AVENUE Suite 110 ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S NATIONAL SPECIALISTS OF VIRGI 3023 HAMAKER COURT SUITE 500 FAIRFAX VA 22031 HEALTH CENTER ELIGIBILITY FOR CHARITY CARE PROGRAM SCHEDULE H, PART I, LINE 3C CHILDRENS NATIONAL USED THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR ITS CHARITY CARE PROGRAM. ELIGIBILITY WAS INCOME BASED AND NOT ASSET BASED. CHILDREN'S NATIONAL MEDICAL CENTER ANNUAL REPORT SCHEDULE H, PART I, LINE 6 CHILDRENS NATIONAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. FOR MASS PUBLIC DISTRIBUTION, THE REPORT IS POSTED TO OUR WEBSITE AND HARD COPIES ARE MADE AVAILABLE AND DISTRIBUTED TO THE HOSPITALS KEY INTERNAL AND EXTERNAL STAKEHOLDERS. COMMUNITY BENEFIT REPORT CHILDRENS NATIONAL IS DEDICATED TO FULFILLING ITS VISION OF SETTING THE STANDARD IN EXCELLENCE IN PEDIATRIC CARE, ADVOCACY, RESEARCH, AND EDUCATION, HERE IN THE NATIONS CAPITAL, AROUND THE COUNTRY, AND THROUGHOUT THE WORLD. AS PART OF OUR COMMITMENT TO OUR COMMUNITY, BELOW ARE SOME OF THE PROGRAMS AND ACTIVITIES THAT WERE CONDUCTED IN FY 2017. - DC Collaborative for Mental Health in Pediatric Primary Care and DC Mental Health Access in Pediatrics Founded in 2012, the DC Collaborative for Mental Health in Pediatric Primary Care (DC Collaborative) aims to improve the integration of mental health in pediatric primary care for youth in the District of Columbia. This public-private partnership includes an interdisciplinary Working Group, a Community Advisory Board and a Childrens National Project Team. During the course of the reporting period, the Collaborative has been particularly focused on: 1) educating and supporting pediatric primary care providers (PPCPs) in the implementation of universal, annual mental health screening at well-child visits; 2) engaging in comprehensive planning process to bring a child behavioral health access program to the District of Columbia which would provide PPCPs with real-time phone consultation with child mental health experts; brief, time-limited follow-up services; mental health education and training; resource guide maintenance; and psychotropic medication reviews for children in the citys system of care. With this mission in mind, the DC Collaborative for Mental Health in Pediatric Primary Care created the DC Mental Health Access in Pediatric (DC MAP) Program. DC MAP was launched in the District in 2015 (piloted in May 2015, launched city-wide in September 2015) following several years of planning by stakeholders. Key to planning efforts has been the DC Collaborative for Mental Health in Pediatric Primary Care (DC Collaborative), a public-private partnership that includes Childrens National Health System, MedStar Georgetown University Hospital, the Childrens Law Center, the DC Chapter of the American Academy of Pediatrics and the DC Departments of Health, Behavioral Health and Health Care Finance, as well as a community advisory board with representation from more than 25 child-serving organizations, parents and community groups. DC MAP is modeled after a highly successful program started in Massachusetts (Massachusetts Child Psychiatry Access Program) and it joins a long list of other access programs across the country that are part of the National Network of Child Psychiatry Access Programs. These programs offer pediatric primary care providers with increased access to child mental health experts and have led to significant improvements in providers feeling better able to address their patient's. DC MAP provides the following services: Primary care clinician telephone consultation with child mental health specialists, Community resource referrals and face-to-face consultations as clinically indicated, mental health education and training in primary care, Child mental health resource guide maintenance, and quarterly medication reviews flagged by the Psychotropic Monitoring Group. DC MAP aims to improve the integration of mental health in pediatric primary care for children in the District of Columbia. We are committed to addressing the mental health needs of diverse children and their families through culturally competent, family-focused initiatives. We acknowledge that the unmet mental health needs of young children, especially those who have not yet entered school, are great. Thus, although we aim to address the mental health needs of all children and youths, we are particularly focused on infants, toddlers, and preschoolers. In FY2017, DC MAP fielded approximately 500 calls from primary care providers in the DC metro area, an increase of 213% in call volume from last year. All primary care providers who utilized the DC MAP hotline service were connected with a psychiatrist within one hour of calling, typically allowing them expert consultation while patients were still in the office. One pediatrician at the Childrens National ARC said of the program, "DC MAP empowers me to provide the best care for my patients. It is an integral part of my medical practice." - Engaging East End Communities in Health Outcomes (E3CHO) The Engaging East End Communities in Health Outcomes (E3CHO) work group seeks to explore both the views of parents/caregivers who use the emergency department (ED) for low acuity conditions as well as the views of clinical staff in order to develop actionable items that will encourage appropriate health care utilization and improvement of accessible health care services in east end Washington, DC. The work group most recently conducted focus groups with parents/caregivers of children who have used the Children's National Emergency Department at United Medical Center (UMC ED) 4 or more times between July 2016 and June 2017 for low acuity conditions, and with clinical staff at the UMC ED and the two Goldberg Center primary care clinics in Wards 7 and 8. The team conducted 5 focus groups for parents/caregivers with 31 participants and 5 focus groups for clinical staff, including 48 physicians, nurses, physician extenders, and other clinical staff. The work group is currently reviewing and collating a report of focus groups findings. The findings will be used to understand why families choose the ED for low acuity conditions and what resources are needed in primary care to make primary care clinics more accessible. Additionally, the work group will evaluate interventions that aim to increase appropriate health care utilization for families in Wards 7 and 8 in Washington, DC. Some of these interventions include increased health education within the ED, professional education for ED providers, and the expansion of hours and services for community clinics. - School based health centers Approximately 18 percent of the DC population is comprised of children ages 0-17 and 50 percent live in Wards 4, 7, and 8, which have some of the greatest health disparities in the city. These health disparities are perpetuated by the social determinants of health, conditions in the places where people live, learn, work, and play. About one third of DC children live below the federal poverty level, which is more prevalent among Black children and exacerbates poor health outcomes. School attendance has also been a chronic challenge in DC public schools with 32 percent of all students in pre-kindergarten through high school missing more than 10 days without a valid excuse in 2014. Given Children's National Health System's proven capacity to serve the community via school-health programs, and the necessity of reaching pediatric populations in school, there is an identified need for collaboration and intentional in the school-setting. Children's National's School-Based Health Centers provide a primary care home to students at Ballou, Dunbar, and Coolidge High schools in Washington, D.C. During FY17, these school-based health centers staffed with RN's, Nurse Practitioners, Medical Doctors, and mental health experts, provided over 1,000 visits. A SBHC can serve as a student's primary health care provider or supplement the services they would normally receive. Each SBHC offers medical, oral, social and mental health services, and education to enrolled students and to the children of enrolled students. SBHC staff can also provide referrals to specialty care, community providers and other programs to ensure every student receives the care they need to lead healthier lives. - District of Columbia Healthy Communities Collaborative and DC Health Matters Children's National is a founding member and ongoing leader in the District of Columbia Healthy Communities Collaborative (DCHCC). The DCHCC is a data-driven Collaborative of four local DC hospitals and four federally-qualified health centers that share a common goal of reducing health disparities and increasing healthy equity for the most vulnerable DC populations. The mission of the DCHCC is to merge the two faces of the capital city into one healthy and thriving community that holds the same promise for all residents. With these goals in mind, the DCHCC launched DC Health Matters, an online web resource that brings non-biased data, local resources, and a wealth of information in one, accessible, user-friendly location. DC Health Matters (www.dchealthmatters.org) is an innovative, community-driven health dashboard that provides useful data of local health metrics and related resources for the Washington, DC community. The intent is to give our community the tools needed to read, COSTING METHODOLOGY - CHARITY AT COST SCHEDULE H, PART I, LINE 7A HOSPITAL AND PHYSICIAN CHARITY AMOUNTS REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS. - MEDICAID SCHEDULE H, PART I, LINE 7B HOSPITAL AND PHYSICIAN GROSS PATIENT REVENUE AND PAYMENT FROM FINANCIAL DECISION SUPPORT SYSTEMS WERE ADJUSTED TO COST USING THE COST TO CHARGES RATIO PER THE IRS INSTRUCTIONS. MEDICAID GRADUATE MEDICAL EDUCATION (GME) ADD-ON PAYMENTS WERE EXCLUDED AS THEY ARE REPORTED ON THE HEALTH EDUCATION LINE. CHILDRENS' NATIONAL GME INDIRECT MEDICAL EDUCATION (IME) PAYMENTS WERE INCLUDED AS PER 990 INSTRUCTIONS. - HEALTH EDUCATION SCHEDULE H, PART I, LINE 7F THE HEALTH EDUCATION COST INCLUDES THE TOTAL COST OF INTERNS AND RESIDENTS FROM THE FY17 SUBMITTED MEDICARE COST REPORT AS WELL AS SPECIFIC MEDICAL STUDENT/TRAINING PROGRAMS THAT WERE IDENTIFIED BY THE GME OFFICE. THE SPECIFIC MEDICAL STUDENT/TRAINING PROGRAM COSTS WERE CALCULATED BASED ON THE HOURS REPORTED BY EACH DEPARTMENT AND THE WAGE RELATED COSTS OF THE STAFF WHO PROVIDED THE TRAINING. EDUCATION PAYMENTS AND RESIDENT FUNDING AMOUNTS OFFSET THE REPORTED EXPENSE. DC MEDICAID GME PAYMENTS WERE CALCULATED AND DEDUCTED FROM TOTAL MEDICAID PAYMENTS TO BE REPORTED ON THE LINE FOR HEALTH EDUCATION (PART I, LINE 7B). - SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I, LINE 7G THE HOSPITAL AND PHYSICIAN COMBINED SERVICE LINES FOR PROGRAMS IN UNDERSERVED AREAS WITH LOSSES WERE REPORTED AS SUBSIDIZED HEALTH SERVICES. TOTAL CHARGES WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO BASED ON THE IRS INSTRUCTIONS. THE CLAIMS PAYMENTS WERE NETTED AGAINST THE COST. COSTS ATTRIBUTABLE TO A PHYSICAL CLINIC AS DESCRIBED BY DEFINITION, SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. THE SERVICES ARE PROVIDED DESPITE THE FINANCIAL LOSS TO MEET THE IDENTIFIED AND UNMET NEEDS OF THE COMMUNITY. IF THE SERVICES WERE NOT PROVIDED, THEY WOULD NOT BE AVAILABLE TO THE AREA OR WOULD RESULT IN THE GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION PROVIDING THE SERVICES. THE SUBSIDIZED HEALTH SERVICES AMOUNT IN PART I, LINE 7G INCLUDES $7,061,774 WHICH IS ATTRIBUTED TO THE PRIMARY CLINICAL SERVICES PROVIDED VIA CHILDREN'S HOSPITAL. CHILDREN'S HEALTH CENTERS PROVIDE PROGRAMS AND INITIATIVES INCLUDING COMPREHENSIVE AND HIGH QUALITY PREVENTIVE SERVICES, IMPROVEMENT OF IMMUNIZATION RATES, AND COORDINATION OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THE AMOUNT INCLUDES SALARY, FRINGE, DIRECT, AND INDIRECT COSTS EXPENDED TO PROVIDE THE CLINICAL SERVICES. OUR CHILDREN'S HEALTH CENTERS ARE ESTABLISHING BEST PRACTICES IN COMMUNITY HEALTH. - OTHER BENEFITS SCHEDULE H, PART I, LINES 7 E & I IN CALCULATING THE AMOUNTS REPORTED IN THE TABLE IN PART I RELATING TO OTHER BENEFITS (E - I), WE USE AN ACCOUNTABILITY AND ELIGIBILITY SYSTEM BASED ON THE COMMUNITY BENEFIT DEFINITION AND GUIDELINES FOR DETERMINING WHERE PROGRAMS FIT INTO EACH COMMUNITY BENEFIT CATEGORY. TIME SPENT ON PROGRAMS/ACTIVITIES AND PROGRAM FUNDING IS PROVIDED BY PROGRAM STAFF. AVERAGE SALARY RATES ARE USED TO CALCULATE SALARY EXPENSES AND A FRINGE RATE IS ATTACHED AS NECESSARY. THE COMMUNITY BENEFIT STAFF ANALYZES THE FINANCIALS SUBMITTED TO ENSURE CONSISTENCY IN REPORTING AND CONFIRM WITH PROGRAM STAFF THE ACCURACY OF THE FINANCIALS. THE COMMUNITY BENEFIT STAFF ALSO WORKS WITH THE ACCOUNTING & FINANCE DEPARTMENT TO VERIFY THE ACCURACY OF SUBMITTED FINANCIALS. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II Coalition Building: As part of our injury prevention efforts, the DC Injury Prevention Alliance, created in 2016 has continued in FY2017. The Alliance, comprised of various community-based organizations, participated in a prioritization process and identified bullying and child abuse as areas of focus. On May 30, 2017, in response to intense local and national attention regarding DC's alarming rate of missing youth, Children's National Health System's Child Health Advocacy Institute (CHAI) convened Ward 7 and 8 residents, public officials, and hospital staff at the R.I.S.E. Demonstration Center to begin an important conversation to address Washington D.C.'s missing youth crisis. Community Conversations: D.C. Missing Youth Town Hall, hosted by DJ Quicksilva, was spearheaded by CHAI to present solutions on how the hospital can work collectively with residents and community-based organizations to keep youth safe, especially during the summer months when they are most at risk. The evening consisted of a series of expert led panels/presentations related to information, prevention, and potential interventions surrounding D.C.'s current missing youth crisis. Children's National is also a member of the DC Emergency Health and Medical Coalition, where we participate in disaster planning with the CDC and FEMA. As part of oral health efforts, Childrens National leads the DC Pediatric Oral Health Coalition. The Coalition provided oral health literacy training sessions to community based organization and saw an increase by 10% in knowledge among trainees. Community Health Improvement Advocacy: Our Government Affairs team serves as a voice for children at the local, state, and federal levels by bringing attention to and rallying support for public policies that protect the interest of childrens health, aim to eliminate health disparities, and support medical and research innovation. In 2017, the team educated policy makers on childrens health issues and worked with expert physicians and researchers to testify on a bill and/or provide written statements on issues such as expansion of CHIP/Medicaid, Sickle Cell Disease Advocacy, research funding for rare diseases, the effects of the opioid crisis on infants, and later school start time. The team also coordinated advocacy efforts with other community organizations and advocates on a local and national level. Workforce Development: Children's National is dedicated to engaging in and providing opportunities of learning and development to students with the hope that students will want to serve long-term in the District of Columbia locality. We work with many local high schools, colleges and universities to provide learning opportunities for students interested in health professions. Through the Urban Alliance internship program, Children's National provides internships to local high school students. Interns spend part of their school year and the summer interning in one of the departments at Children's National developing professional skills, supporting departmental efforts, and learning about healthcare. Students are paired with a mentor ensuring their success. The vast majority of youth interning at Children's National through Urban Alliance are from DC's most under-resourced neighborhoods. Children's National also supports the Child Care Technician program which allows university students interested in nursing to shadow two pediatric nurses during a summer internship. These students work closely with a preceptor and supervisor learning the skills and techniques of a pediatric nurse. BAD DEBT EXPENSE SCHEDULE H, PART III, LINES 2-4 THE HOSPITAL AND PHYSICIAN BAD DEBT WRITE-OFF REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS. DISCOUNTS AND PAYMENTS REDUCE THE PATIENTS ACCOUNT BALANCE PRIOR TO SENDING THE PATIENT A STATEMENT FOR ANY REMAINING BALANCES DUE TO CHILDRENS HOSPITAL. FINANCIAL ASSISTANCE ELIGIBLE PATIENTS RECEIVE A 100% DISCOUNT ON THE BALANCE DUE. PAYMENT PLANS ARE ALSO AVAILABLE FOR PATIENT BALANCES DUE. ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER COLLECTION EFFORTS (BILLING STATEMENTS AND PHONE CALLS) ARE UNSUCCESSFUL. BAD DEBT IS NOT INCLUDED IN CHILDRENS NATIONAL'S COMMUNITY BENEFIT. A DEMOGRAPHIC ANALYSIS BASED ON ZIP CODES WAS COMPLETED TO ESTIMATE THE AMOUNT OF BAD DEBT THAT COULD HAVE BEEN ATTRIBUTED TO PATIENTS WITH A LIKELIHOOD OF QUALIFYING FOR FINANCIAL ASSISTANCE HAD SUFFICIENT INFORMATION BEEN OBTAINED TO DETERMINE THEIR ELIGIBILITY. BASED ON THE ANALYSIS, APPROXIMATELY $1.6M, OF BAD DEBT COULD HAVE BEEN ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. CHILDREN'S HOSPITAL REPORTS ITS APPLICABLE BAD DEBT ($34.5 MILLION) AMOUNT ON PAGES 6 AND 8 OF THE AUDITED FINANCIAL STATEMENTS. THERE IS NO SPECIFIC FOOTNOTE FOR BAD DEBT IN THE STATEMENTS. COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 SCHEDULE H, PART III, LINE 8 MEDICARE SHORTFALLS ARE NOT INCLUDED AS A COMMUNITY BENEFIT AS ANY SHORTFALL DETERMINATION FROM THE MEDICARE COST REPORT IS EVENTUALLY PAID AS A SETTLEMENT. COLLECTION PRACTICES SCHEDULE H, PART III, LINES 9A AND 9B CHILDRENS HOSPITAL HAS A WRITTEN financial assistance POLICY. THE POLICY IS APPLIED UNIFORMLY TO ALL PATIENTS. CHILDREN'S HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS WHILE MAINTAINING RESPONSIBLE AND EFFECTIVE FINANCIAL PROGRAMS WHICH ENSURE THAT THIS COMMITMENT CAN CONTINUE. CHILDRENS HOSPITAL SUPPORTS FAMILIES IN CARRYING OUT THEIR RESPONSIBILITY FOR OBTAINING MEDICAL CARE FOR THEIR CHILDREN. CHILDRENS HOSPITAL, THEREFORE WILL ASSIST FAMILIES IN VERIFYING THEIR ABILITY TO MEET THEIR FINANCIAL OBLIGATION TO THE HOSPITAL OR IN SECURING THE RESOURCES NECESSARY TO DO SO. THE PURPOSE OF THIS POLICY IS TO ESTABLISH GUIDELINES FOR THE EFFECTIVE AND RESPONSIBLE FISCAL PROGRAMMING, WHICH ASSURES THE FINANCIAL VIABILITY OF THE INSTITUTION AND MAINTAINS THE DIGNITY OF THE FAMILY. COLLECTION EFFORTS ARE THEREFORE THE SAME FOR ALL PATIENTS. ONCE THE APPROVED CHARITY ADJUSTMENT HAS BEEN DETERMINED, THE ACCOUNT BALANCE IS WRITTEN OFF TO CHARITY AND COLLECTION EFFORTS CEASE. FOR PATIENT BALANCES THAT ARE NOT FINANCIAL ASSISTANCE ELIGIBLE, CHILDRENS OFFERS PAYMENT PLANS. BILLING STATEMENTS WILL BE SENT TO GUARANTORS FOR OUTSTANDING BALANCES. ATTEMPTS TO CONTACT THE GUARANTORS VIA PHONE WILL ALSO OCCUR. ACCOUNTS WITH BALANCES AND NO RESPONSE FROM GUARANTORS AFTER REPEATED STATEMENTS AND PHONE CALLS WILL BE WRITTEN OFF TO BAD DEBT. AN EXTERNAL AGENCY WILL THEN ATTEMPT TO REACH THE PATIENT FOR PAYMENT. IF THE PATIENT SUBSEQUENTLY PAYS, THE BAD DEBT ADJUSTMENT WILL BE REVERSED AND PAYMENT POSTED TO THE PATIENTS ACCOUNT. IF THE EXTERNAL AGENCYS EFFORTS, PROVE TO BE INEFFECTIVE THE ACCOUNT WILL BE CLOSED WITH THE AGENCY AND THEIR EFFORTS WILL CEASE. CHILDRENS HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES, E.G. CREDIT REPORTING, WAGE GARNISHMENTS, LIENS, ETC. COMMUNITY HEALTH CARE NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 CHILDRENS NATIONAL, IN CONJUNCTION WITH THE DC HEALTHY COMMUNITIES COLLABORATIVE, CONDUCTS A COMMUNITY-WIDE CHNA EVERY THREE YEARS IN ORDER TO TRULY INVEST IN COMMUNITY HEALTH INITIATIVES THAT ADDRESS COMMUNITY NEEDS WITH THE ULTIMATE GOAL OF CREATING A CULTURE OF HEALTH AND IMPROVING HEALTH AND WELLNESS. IN ADDITION TO THE COMMUNITY-WIDE ASSESSMENT, THE HOSPITAL ALSO ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES WE SERVE THROUGH ADDITIONAL AND SPECIFIC EFFORTS LED ACROSS THE HOSPITAL ORGANIZATION. CHILDREN'S NATIONAL IS AWARE THAT CERTAIN SPECIALIZED, PEDIATRIC NEEDS EXIST IN THE COMMUNITY SERVED. TO ASCERTAIN THE NEEDS OF THOSE SPECIFIC POPULATIONS, ADDITIONAL COMMUNITY NEEDS ASSESSMENTS ARE CONDUCTED. FOR EXAMPLE, THE CHILDRENS NATIONAL ASTHMA PROGRAM CALLED IMPACT DC HAS ANALYZED ON AN ANNUAL BASIS EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS FOR ASTHMA TO ALL NON-MILITARY HOSPITAL EMERGENCY DEPARTMENTS IN DC. THIS HAS ALLOWED THE HOSPITAL TO TRACK TRENDS OVER TIME AND ACROSS ZIP CODES IN DC. THE HOSPITAL ALSO HAS CONDUCTED A NUMBER OF STUDIES TO IDENTIFY BARRIERS TO CARE, INTERVENTION PREFERENCES, AND PARENT CONCERNS ABOUT ASTHMA. IN 2017-2018, THE HOSPITAL HAD FUNDING FROM THE NIH TO SPECIFICALLY CONDUCT A COMMUNITY NEEDS ASSESSMENT FOCUSED ON ASTHMA AND THE HOSPITAL WAS ABLE TO PRODUCE REPORTS USING BOTH QUANTITATIVE AND QUALITATIVE METHODS. THE HOSPITAL SUBSEQUENTLY SUBMITTED ANOTHER NIH GRANT TO REFINE AND STUDY AN ASTHMA INTERVENTION THAT IS HIGHLY RESPONSIVE TO THE FINDINGS. SIMILARLY, THE HOSPITAL CONDUCTED A RESOURCE AND GAP ANALYSIS TO EXAMINE DCS EARLY CHILDHOOD MENTAL HEALTH WORKFORCE CAPACITY AND TO DETERMINE HOW THE HOSPITAL-LED DC COLLABORATIVE FOR MENTAL HEALTH IN PEDIATRIC PRIMARY CARE AND CHILDRENS NATIONAL CAN PLAY A ROLE IN IMPROVING THE ACCESS TO MENTAL HEALTH SERVICES FOR CHILDREN UNDER THE AGE OF 6. THE RESOURCE AND GAP ANALYSIS IS DIVIDED INTO FOUR SECTIONS: BACKGROUND, LANDSCAPE, OTHER STATE STRATEGIES AND POLICIES, AND RECOMMENDATIONS. FOR THE PURPOSE OF THIS ANALYSIS, DATA WAS GATHERED AND COLLECTED FROM A NUMBER OF SOURCES: INTERVIEWS, ANNUAL REPORTS, NATIONAL RESEARCH, AND LOCAL REPORTED STATISTICS. THE ANALYSIS INCLUDED REVIEW OF LOCAL STATISTICS ABOUT THE POPULATION AT RISK, THE NUMBER OF LOCAL EDUCATION AND TRAINING PROGRAMS OFFERED FOR INFANT AND TODDLER MENTAL HEALTH PROFESSIONALS, AND THE CAPACITY OF EARLY CHILDHOOD MENTAL PROGRAMS AND SERVICES. MORE SPECIFICALLY, OUR RESEARCH AND FINDINGS INCLUDED: -CLINICAL PSYCHOLOGY, SOCIAL WORK AND CERTIFICATE PROGRAMS OFFERED AT LOCAL UNIVERSITIES AND IF THEY OFFER INFANT MENTAL HEALTH SPECIALIZATION; -EARLY INTERVENTION PROFESSIONAL DEVELOPMENT OPPORTUNITIES WITHIN THE SCHOOL SYSTEM; -CAPACITY AND REACH OF EARLY CHILDHOOD MENTAL HEALTH CONSULTATION; -OVERVIEW AND CAPACITY OF HOME VISITING PROGRAMS, SERVICES AVAILABLE FOR YOUNG CHILDREN THROUGH THE DEPARTMENT OF BEHAVIORAL HEALTH, SOCIAL-EMOTIONAL HEALTH EMPHASIS IN EARLY LEARNING THROUGH QUALITY IMPROVEMENT NETWORKS, AND SERVICES AVAILABLE AT NEIGHBORHOOD COLLABORATIVES. FINALLY, TO SUPPORT CONTINUOUS ASSESSMENT OF THE NEEDS OF OUR COMMUNITY, THE HOSPITAL HAS ESTABLISHED THE CHILD HEALTH DATA LAB WHERE DATA SCIENTIST USE EVIDENCE-BASED APPROACHES TO IDENTIFY AND TRACK TRENDS IN POPULATION HEALTH USING BIG DATA ANALYSIS, DEVELOPING INTERACTIVE MAPS, AND COLLECTING COMMUNITY INPUT. ELIGIBILITY EDUCATION SCHEDULE H, PART VI, LINE 3 CHILDRENS HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY (FAP) THAT PROVIDES ELIGIBLE PATIENTS WITH DISCOUNTED EMERGENCY OR OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES PROVIDED BY CHILDRENS HOSPITAL. CHILDRENS WILL PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. CHILDRENS HOSPITAL PROHIBITS ANY ACTIONS THAT WOULD DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE. FINANCIAL ASSISTANCE INFORMATION, INCLUDING THE POLICY AND PLAIN LANGUAGE GUIDES, AND APPLICATION FORM, IS AVAILABLE ON CHILDRENS PUBLIC WEBSITE and a copy of the FAP is provided to patients during intake procedures. FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND VIA PHONE. THE COUNSELORS CONTACT INFORMATION IS PUBLICIZED ON THE WEBSITE. CUSTOMER SERVICE CONTACT INFORMATION IS ALSO PROVIDED ON THE WEBSITE AS WELL AS BILLING STATEMENTS. SIGNAGE ALERTING PATIENTS TO THE AVAILABILITY OF FINANCIAL AID IS POSTED AT REGISTRATION AREAS AND APPLICATIONS ARE READILY AVAILABLE. CHILDRENS ALSO WORKS WITH EXTERNAL VENDORS WHO ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE APPLICATION AS WELL AS APPLYING FOR STATE MEDICAID AND OTHER FEDERAL AND LOCAL PROGRAMS. THE FOLLOWING PROCESSES TAKE PLACE FOR FAMILIES WHO DO NOT HAVE INSURANCE OR WHO CANNOT PAY. 1. THROUGH OUR CONTRACTED COMPANIES (MEDLAW AND DECO) WHO RESIDE IN OUR FINANCIAL INFORMATION CENTER (FIC), AN APPLICATION IS MADE FOR MEDICAL ASSISTANCE AND OUR FINANCIAL ASSISTANCE PROGRAM (FAP). ELIGIBILITY IS CONSIDERED FOR ALL APPROPRIATE PUBLIC PROGRAMS. IN AN EFFORT TO HAVE THIS PROCESS TO TAKE PLACE PRIOR TO THE MEDICAL VISIT. FAP APPLICATIONS ARE MAILED TO SELF-PAY PATIENTS WHEN THEY MAKE AN APPOINTMENT. 2. WHILE THE APPLICATION IS IN PROCESS, THE PATIENT IS REGISTERED AS MEDICAID PENDING AND THE MEDICAL VISIT TAKES PLACE (CITIZENS ONLY). NON-CITIZENS ARE REGISTERED AS SELF-PAY. 3. IF THE PATIENT IS DETERMINED TO BE MEDICAID ELIGIBLE, THE PATIENT REGISTRATION IS CONVERTED TO THE MEDICAID PLAN. 4. IF NOT ELIGIBLE, THE PATIENT'S CHARITY CARE APPLICATION IS FURTHER EVALUATED FOR CHARITY CARE BY CHILDRENS CUSTOMER SERVICE STAFF IN THE FIC. 5. IF FAP IS APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. THE ACCOUNTS ARE MANAGED BY CUSTOMER SERVICE STAFF. ONLY EXPECTED BALANCES REMAIN ON THE ACCOUNT AND FAMILIES RECEIVE STATEMENTS SHOWING THEIR RESPONSIBILITY. 6. IF FAP IS NOT APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. FAMILIES CAN SET UP PAYMENT PLANS TO RESOLVE THEIR ACCOUNT BALANCES. 7. MEDICALLY INDIGENT STATUS CAN APPLY FOR INSURED FAMILIES. THIS STATUS CAN BE EVALUATED AT ANY TIME IF A FAMILY'S REMAINING BALANCE (EXCLUDING ANY DEDUCTIBLES) AFTER THIRD PARTY PAYER PAYMENT IS GREATER THAN 30% OF ANNUAL INCOME LESS HOUSING EXPENSES. - WHENEVER APPLICABLE, IT IS ENCOURAGED THAT FAMILIES REVIEW THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE THE APPOINTMENT DATE. APPOINTMENTS ARE TYPICALLY MADE WITH THE FIC OFFICE WHEN FAMILIES MAKE THEIR MEDICAL APPOINTMENTS. THEY CAN GO DIRECTLY TO THE FIC OFFICE AT CHILDRENS HOSPITAL AT ANY OTHER TIME. - FAMILIES ARE ENCOURAGED TO COOPERATE WITH OUR STAFF BY SUPPLYING ALL NECESSARY INFORMATION FOR THE MEDICAID AND FAP APPLICATIONS. DESCRIPTION OF COMMUNITY SERVED SCHEDULE H, PART VI, LINE 4 AS THE ONLY EXCLUSIVE PROVIDER OF PEDIATRIC CARE IN THE NATIONS CAPITAL, CHILDRENS NATIONAL HAS THE PRIVILEGE OF SERVING A DIVERSE AND BROAD COMMUNITY, SPANNING FROM THE DISTRICT OF COLUMBIA TO MARYLAND AND VIRGINIA AND BEYOND. ACCORDING TO THE U.S. CENSUS BUREAU, POPULATION FIGURES FOR THE REGION ARE ESTIMATED AT 672,228 FOR THE DISTRICT OF COLUMBIA, NEARLY 6 MILLION IN MARYLAND, AND A LITTLE OVER 8 MILLION IN VIRGINIA. THE SOCIAL DEMOGRAPHICS FOR THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA, ACCORDING TO THE U.S. CENSUS, ARE AS FOLLOWS: DISTRICT OF COLUMBIA: ABOUT 48.3% BLACK; 44.1% WHITE; 10.6% LATINO; 4.2% ASIAN AND 0.6% AMERICAN INDIAN/ALASKA NATIVE; MARYLAND: APPROXIMATELY 60% WHITE; 31% BLACK; 10% HISPANIC; 6.5% ASIAN AND VIRGINIA 70.5% WHITE, 19.7% BLACK, 9.0% HISPANIC, 6.5% ASIAN, AND 0.5% AMERICAN INDIAN/ALASKA NATIVE. SINCE 2010, THE LARGEST POPULATION GROWTH OF 33% HAS BEEN IN THE HISPANIC GROUP WHILE THE PORTION OF BLACK POPULATION HAS BEEN DECREASING. IN THE DISTRICT OF COLUMBIA, CHILDREN 18 YEARS OLD AND YOUNGER MAKE UP ABOUT 18 PERCENT OF THE POPULATION WITH THE HIGHEST IN WARDS 7 AND 8, 3.14% AND 3.30% RESPECTIVELY. IN BOTH MARYLAND AND VIRGINIA ABOUT 23 PERCENT OF THE POPULATION IS CHILDREN 18 YEARS OLD AND YOUNGER. CHILDREN AGE FIVE AND YOUNGER MAKE UP APPROXIMATELY 6 PERCENT OF THE POPULATION IN THE DISTRICT OF COLUMBIA, MARYLAND, AND VIRGINIA. ACCORDING TO OUR 2016 COMMUNITY HEALTH NEEDS ASSESSMENT, THE DC POPULATION HAS GROWN 11% FROM 2010 TO 2015. THE LARGEST POPULATION GROWTH IS FROM CHILDREN (20% INCREASE) AND OLDER ADULTS (18% INCREASE). IN THE DISTRICT OF COLUMBIA AND MARYLAND, APPROXIMATELY 17 PERCENT OF THE POPULATION AGE FIVE AND OLDER REPORT SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME, WHILE IN VIRGINIA THE PERCENTAGE IS APPROXIMATELY 15. THE U.S. CENSUS REPORTS MEDIAN HOUSEHOLD INCOME AT APPROXIMATELY $70,848 IN THE DISTRICT WITH THE HIGHEST INCOME IN WARD 3 AND LOWEST IN WARDS 7 AND 8. IN MARYLAND THE MEDIAN HOUSEHOLD INCOME IS $74,551 AND THE MEDIAN HOUSEHOLD INCOME IN VIRGINIA IS $65,015. THE PERCENTAGE OF PERSONS LIVING BELOW THE POVERTY LINE IS REPORTED AT 17.3% FOR THE DISTRICT OF COLUMBIA, 11.2% IN VIRGINIA, AND 9.7% IN MARYLAND. THE CENTERS OF MEDICARE AND MEDICAID SERVICES (CMS) REPORTS TOTAL MEDICAID AND CHIP ENROLLMENT FIGURES BASED ON ENROLLMENT DATA AS OF JUNE 2016 AT 73,467,427. THE BREAKDOWN FOR TOTAL MEDICAID AND CHIP ENROLLMENT BASED ON AUGUST FIGURES FROM THE CMS FOR THE DISTRICT OF COLUMBIA MEDICAID AND CHIP ENROLLMENT WAS 225,491; 1,240,791 IN MARYLAND; 970,438 IN VIRGINIA. IN 2014, THE PERCENTAGE OF HOSPITAL INPATIENTS RECEIVING MEDICAID WAS 76 PERCENT FROM THE DISTRICT OF COLUMBIA, 28 PERCENT FROM VIRGINIA, AND 31 PERCENT FROM THE STATE OF MARYLAND. THE DISTRICT OF COLUMBIA HAS 17 HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) AND MEDICALLY UNDERSERVED AREA/POPULATION (MUA/P) DESIGNATIONS. THERE ARE A TOTAL OF 51 CENSUS TRACTS THAT ARE DESIGNATED AS PRIMARY CARE SHORTAGE AREAS, 7 CENSUS TRACTS THAT ARE MENTAL HEALTH SHORTAGE AREAS, AND 48 CENSUS TRACTS THAT ARE DESIGNATED AS DENTAL SHORTAGE AREAS. SERVING CHILDREN FOR MORE THAN 145 YEARS, CHILDRENS HOSPITAL IS A PROVEN LEADER IN DEVELOPING AND PROVIDING INNOVATIVE NEW TREATMENTS FOR CHILDHOOD ILLNESS AND INJURY. CHILDRENS HOSPITAL IS LOCATED IN AN URBAN COMMUNITY WHERE THERE ARE SEVERAL LARGE ACADEMIC AND COMMUNITY HOSPITALS LOCATED. HOWEVER, WE SERVE A MAJORITY OF THE CHILDREN IN DC. WE CARE FOR MORE THAN 35,000 CHILDREN THROUGH OUR HEALTH CENTERS EACH YEAR, AS THE LARGEST NON-GOVERNMENT PROVIDER OF PRIMARY CARE IN THE DISTRICT OF COLUMBIA. Maryland residents accounted for 56% of Childrens National patients, and Childrens National is the largest provider of pediatric care for residents of Northern Virginia as well. The needs of the population served in MD and Northern Virginia are similar to the District of Columbia. We also offer families a link to quality pediatric care through our mobile medical program and at community centers. Our team averages more than 530,000 outpatient visits each year at health clinics in the District of Columbia, affiliated centers in Maryland and Virginia, and at the Sheikh Zayed Campus in Washington, D.C. On average, that equals nearly 1,400 patient visits in one day to one of Childrens Nationals 30 locations in the District of Columbia and throughout the metropolitan area. In Fiscal Year 2017, we performed 17,535 surgical procedures, 123,911 diagnostic imaging procedures, and more than 1 million laboratory tests. PROMOTING THE HEALTH OF THE COMMUNITY SCHEDULE H, PART VI, LINE 5 For more than 145 years, Children's National has been committed to serving the community by promoting and improving the health of children and supporting the health improvements in their homes, schools, neighborhoods, and broader community. As a leader in pediatric health in the region, children come to Childrens National with numerous health challenges, many of which are preventable. In order to advance our four-part "CARE" missionto improve health and wellness and increase health equity through Clinical Care, Advocacy, Research, and Educationand be advocates for all children, our efforts need to move beyond the walls of the hospital, target the social determinants of health, and bridge effective partnerships. Childrens National recognizes that to create a healthier society will require health professionals and healthcare institutions to collaborate with others outside of the traditional medical community. To further the advocacy part of the CARE mission, Childrens National founded the Child Health Advocacy Institute (CHAI) over ten years ago. CHAI champions policies that save childrens lives and improve access to quality care. Staff works in partnership with the community to advance policies that impact and improve pediatric health outcomes. Through advocacy, CHAI looks for new ideas and new ways of serving all of the regions children, especially those experiencing health inequities. CHAI leads initiatives that improve the health of the community, with a focus on programs, policies, and systems that impact the determinants of health and populations that experience health inequities. Additionally, CHAI uses data and evidence to develop a coordinated approach to improving population and health outcomes. Childrens National is committed to building a brighter, healthier future for all children, not just the ones who come through our hospital doors. Childrens National is committed to investing in the health and wellness of the communities we serve through providing Community Benefit programming. Through the Community Benefit program facilitated by CHAI, we collaborate with community-based organizations, government agencies, and other public health professionals to implement programs that address the prioritized health needs identified in the community health needs assessment (CHNA). Partnerships are vital to the success of our programming. We partner with the community through coalitions and alliances, such as our DC Pediatric Oral Health Coalition and Injury Prevention Alliance. One example of our hospital-led community partnerships is the DC Collaborative for Mental Health in Pediatric Primary Care ("the Collaborative"). The Collaborative aims to improve the integration of mental health in primary pediatric care for children of all ages. Since 2001, Childrens National has operated the District of Columbia school nurses program, has engaged in dozens of school-based programs throughout the DC metropolitan area, and has advocated for policy changes to foster healthy school environments. Childrens National faculty and nursing staff is committed to improving the health of the community by representing Childrens National on a number of boards and in local organizations. Staff supports boards and organizations on a city, state, and national level that focus on breastfeeding, adolescent health, behavioral health and eye disease. This commitment to the community is also evidenced through its governing boards dedicated to community health initiatives, and the development of DC Healthy Communities Collaborative (DCHCC). Childrens National, the 501 (c)(3) not-for-profit organization, is governed by board of directors representing the diversity of the local, regional, national, and international communities that we serve. The majority of our board of directors resides within the primary service area of the Washington, DC metropolitan area, including the District of Columbia, Maryland, and Virginia. Childrens National is a pioneer in innovative programs that move beyond awareness to targeted interventions that improve the lives of children and their families, locally, regionally, nationally, and internationally. The Childrens National Advocacy and Public Policy, Inc. (CNAPPI) governs the Advocacy component of our care, advocacy, research, and education (CARE) mission as a charitable organization. The CNAPPI is comprised of leaders from throughout the region with experience in policy, advocacy, leadership and strategic planning. With this capacity, the CNAPPI serves as a platform for the Childrens National to reach beyond the boundaries of the institution; advocate for all children regardless of their circumstance or location; and prioritize and guide official policy statements and action, government relations, community benefit outreach and other relevant issues. Over the past 20 years, Childrens Health Board has awarded approximately $5 million in grants to more than 200 Childrens programs. The grants have turned early ideas into proven models that have attracted support from leading investors in improved health outcomes for children nationwide. The Community Affairs Department established a partnership with the Childrens Health Board, a service affiliate of Childrens National, that works to advance the health and well-being of children in the Washington, DC metropolitan community, especially those most in need, through advocacy, education, prevention and early intervention. Beginning in FY 2014, the Childrens Health Board implemented an updated grant making strategy which includes the Community Benefit Grant Program. Through the Community Benefit Grant Program the Childrens Health Board focuses its grant making on supporting the Childrens National Community Health Improvement Plan (implementation strategy), in an effort to improve community health demonstrated by measurable outcomes. In 2013, the community benefit team worked with the Childrens Health Board to establish this new grant process and has engaged in the grant application review process to review grant applications for community benefit program alignment. Grant awardees are now required to report their programs/initiatives as Community Benefit and will be included in the Community Benefit Report. For the 2017 grants, preference will be given to proposals directed towards the CHNA priority areas - Mental Health, Place-Based Care, Care Coordination, and Health Literacy. AFFILIATED HEALTH CARE SYSTEM ROLES SCHEDULE H, PART VI, LINE 6 CHILDREN'S HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING TAX-EXEMPT ENTITIES: - CHILDREN'S NATIONAL MEDICAL CENTER - 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBLE FOR HEALTH CARE SYSTEM - CHILDREN'S HOSPITAL FOUNDATION - 501(C)(3), FUNDRAISING - CHILDREN'S RESEARCH INSTITUTE - 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS - SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN - BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN - CHILDREN'S NATIONAL ADVOCACY & PUBLIC POLICY INC. - 501(C)(3), ADVOCATING FOR CHILDREN'S HEALTH ISSUES - CHILDREN'S HOSPITAL SELF-INSURANCE TRUST - 501(C)(3), PROVISION OF INSURANCE TO SYSTEM EACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL MEDICAL CENTER'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS. - Children's School Services - 501(c)(3), School nursing services STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 DC X X X true true X X X X true true false false false false false true true true KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 1088989 0 1080000 0 97288 0 175250 0 123437 0 2564964 0 0 0 DAVID WESSEL MD BOARD MEMBER/CMO 560842 0 428723 0 67758 0 97727 0 73380 0 1228430 0 0 0 DENICE CORA-BRAMBLE MD BOARD MEMBER/CMO 558678 0 423670 0 56206 0 97730 0 68672 0 1204956 0 0 0 ALEC KING EVP/CFO 281537 0 75000 0 24744 0 0 0 19617 0 400898 0 0 0 CHARLES WEINSTEIN CHIEF REAL ESTATE OFFICER 225458 0 115000 0 456 0 0 0 8925 0 349839 0 0 0 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 669630 0 454588 0 42486 0 66000 0 65800 0 1298504 0 0 0 GERARD MARTIN MD FMR SVP CENTER OF EXCELLENCE 353806 0 143848 0 9226 0 49300 0 45303 0 601483 0 0 0 ELIZABETH FLURY CHIEF STRATEGIC OFFICER 497063 0 375010 0 3183 0 88252 0 76903 0 1040411 0 0 0 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 555966 0 405457 0 54804 0 94099 0 48642 0 1158968 0 0 0 ROGER PACKER MD SVP CENTER OF EXCELLENCE 463736 0 357264 0 95299 0 70747 0 71060 0 1058106 0 0 0 PAM KING SAMS Former CDO to 06/2016 189596 0 335335 0 199587 0 45324 0 20300 0 790142 0 0 0 MARY ANNE HILLIARD CHIEF LEGAL OFFICER 365398 0 278722 0 59516 0 69500 0 51946 0 825082 0 0 0 BRIAN JACOBS MD CHIEF INFORMATION OFFICER 406498 0 110367 0 42707 0 43851 0 35962 0 639385 0 0 0 DARRYL VARNADO CHIEF PEOPLE OFFICER 320021 0 251208 0 58579 0 49499 0 63641 0 742948 0 0 0 MARY OTTOLINI MD PHD VICE CHAIR MEDICAL EDUCATION 288990 0 78773 0 8347 0 13250 0 4096 0 393456 0 0 0 LINDA TALLEY CHIEF NURSING OFFICER 291061 0 79079 0 18645 0 11330 0 11985 0 412100 0 0 0 MICHELLE M MCGUIRE VP & CHIEF OF STAFF 243705 0 67445 0 990 0 7735 0 25333 0 345208 0 0 0 MARK L BATSHAW MD EVP & CHIEF ACADEMIC OFFICER 665941 0 507588 0 137386 0 263250 0 100056 0 1674221 0 0 0 RICHARD JONAS MD CHIEF OF CARDIOLOGY 1465308 0 604761 0 138932 0 104457 0 67222 0 2380680 0 0 0 ROBERT KEATING MD CHIEF OF NEUROSURGERY 772778 0 154158 0 70414 0 91218 0 24465 0 1113033 0 0 0 PETER KIM MD VP SHEIKH ZAYED INSTITUTE 669209 0 252086 0 49434 0 13250 0 22003 0 1005982 0 0 0 MATTHEW OETGEN MD CHIEF OF ORTHO & SPORTS MED 534082 0 191440 0 16885 0 13250 0 21966 0 777623 0 0 0 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 630121 0 236421 0 27707 0 13250 0 21792 0 929291 0 0 0 JOHN MYSEROS MD NEUROSURGEON 648663 0 126131 0 52683 0 13250 0 21136 0 861863 0 0 0 RAHUL K SHAH MD FORMER BOARD MEMBER to 6/2014 359769 0 98924 0 47893 0 13250 0 1607 0 521443 0 0 0 DOUGLAS MYERS FORMER CFO to 12/2015 0 0 0 0 879032 0 92751 0 58563 0 1030346 0 0 0 DAVID SPARKS FORMER VP FIN/CONTR. to 6/2014 241642 0 50786 0 60273 0 13154 0 13918 0 379773 0 0 0 MENDEL TUCHMAN MD CHIEF RESEARCH OFFICER 363100 0 267986 0 73149 0 67997 0 48878 0 821110 0 0 0 David Stockwell Former Board Member to 6/2016 182667 0 10034 0 409 0 5346 0 719 0 199175 0 0 0 FIRST-CLASS OR CHARTER TRAVEL SCHEDULE J, PART I, LINE 1A THE CEO PER HIS EMPLOYMENT CONTRACT IS ENTITLED TO USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS. HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS SCHEDULE J, PART I, LINE 1A TWO KEY EMPLOYEES AND ONE FORMER KEY EMPLOYEE RECEIVED CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS, UPON APPROVAL OF THE COMPENSATION COMMITTEE, ARE INCREASED BY A TAX EQUALIZATION AMOUNT, WHICH IS SIGNIFICANTLY LESS THAN THE AMOUNT THAT WOULD BE DETERMINED BY A TAX GROSS UP OR INDEMNIFICATION METHOD. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. HEALTH OR SOCIAL CLUB DUES OR INITIATION FEES SCHEDULE J, PART I, LINE 1A HEALTH CLUB AND SOCIAL CLUB DUES REIMBURSEMENT IS NO LONGER OFFERED TO INCOMING EXECUTIVES. PERSONAL SERVICES SCHEDULE J, PART I, LINE 1A CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. SEVERANCE SCHEDULE J, PART 1, LINE 4A THE FOLLOWING FORMER OFFICERS AND KEY EMPLOYEES RECEIVED A SEVERENCE PAYMENT. THE SEVERENCE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF OTHER REPORTABLE COMPENSATION: DOUGLAS MYERS - $879,032 DAVID SPARKS - $34,344 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AS PART OF DEFERRED COMPENSATION: MARK L. BATSHAW, MD $250,000 KURT D. NEWMAN, MD $162,000 RICHARD JONAS $ 91,207 DENICE CORA-BRAMBLE, MD $ 84,480 DAVID WESSEL, MD $ 84,477 KATHLEEN CHAVANU GORMAN $ 80,849 DOUGLAS MYERS $ 79,501 ROBERT KEATING $ 77,968 ELIZABETH FLURY $ 75,002 ANTHONY SANDLER, MD $ 66,000 ROGER PACKER, MD $ 57,497 MENDAL TUCHMAN, MD $ 54,747 DARRYL VARNADO $ 49,499 MARY ANNE HILLIARD $ 42,250 PAM KING SAMS $ 35,709 BRAIN JACOBS, MD $ 30,601 GERARD MARTIN, MD $ 26,350 NON-FIXED PAYMENTS SCHEDULE J, PART I, LINE 7 THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT. INITIAL CONTRACT EXCEPTION SCHEDULE J, PART I, LINE 8 CERTAIN INDIVIDUALS HIRED DURING THE YEAR HAVE EMPLOYMENT CONTRACTS WHICH MEET THE INITIAL CONTRACT EXCEPTIONS DESCRIBED IN THE TREASURY REGULATIONS. A DISTRICT OF COLUMBIA 536001131 254764KB8 2015-09-17 413728662 SEE PART IV false false false A 0 0 413728662 0 0 410562146 3166515 0 0 0 0 0 2015 false true true true A false false true true true true 0 true false false true A false false false 0 false 0 false true A true DESCRIPTION OF PURPOSE SCHEDULE K, PART I, LINE A, COLUMN (F) ADV REFUND BONDS ISSUED 10.26.05 & 4.10.08 DAVID WESSEL MD HOUSING LOAN - COMP HOUSING LOAN - COMP X 200000 40000 false true true 40000 LOANS TO AND/OR FROM INTERESTED PERSONS SCHEDULE L, PART II THE HOUSING LOAN TO DR. WESSEL WAS APPROVED IN ADVANCE BY INDEPENDENT PERSONS SERVING ON THE BOARD OF DIRECTORS. THE LOAN IS DOCUMENTED BY A SIGNED WRITTEN AGREEMENT BETWEEN THE PARTIES, AND THE ORGANIZATION BELIEVES THE AGREEMENT MEETS THE INCOME TAX DEFINITION OF A LOAN. DR. WESSEL IS CURRENTLY IN COMPLIANCE WITH ALL TERMS OF THE AGREEMENT. X 1 45400000 FMV false true false Number of Contributions Schedule M, Part I, Line 9, Column (B) The organization is reporting the number of contributions in column (B). Walter Reed Contribution Schedule M, Part I, Line 16 In November 2016, the federal government conveyed through quitclaim deed, certain land and buildings to Children's National Walter Reed to be used for the protection of public health, including research. The property, which was recorded as Federal Grants in the Schedule of Contributions at fair market value during the year ended June 30, 2017, consisted of land and buildings valued at $11.9 million and $33.5 million, respectively. ORGANIZATION MISSION FORM 990, PART I, LINE 1 AND PART III, LINE 1 AS THE NATION'S CHILDREN'S HOSPITAL, THE MISSION OF CHILDREN'S NATIONAL MEDICAL CENTER IS TO EXCEL IN CARE, ADVOCACY, RESEARCH AND EDUCATION. WE ACCOMPLISH THIS THROUGH: - PROVIDING A QUALITY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND FAMILIES. - IMPROVING HEALTH OUTCOMES FOR CHILDREN REGIONALLY, NATIONALLY, AND INTERNATIONALLY. - LEADING THE CREATION OF INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES. MEMBERS OR STOCKHOLDERS FORM 990, PART VI, LINE 6, 7A AND 7B CHILDREN'S NATIONAL MEDICAL CENTER ("CNMC") IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL AND HAS THE RIGHT TO ELECT DIRECTORS OF CHILDREN'S HOSPITAL. THE ARTICLES AND BY-LAWS OF CHILDREN'S HOSPITAL DESCRIBE CERTAIN RIGHTS RESERVED TO THE SOLE MEMBER. FORM 990 REVIEW PROCESS FORM 990, PART VI, LINE 11B THE RELEVANT COMMITTEES OF THE ORGANIZATION REVIEW APPLICABLE PORTIONS OF THE 990 (FOR EXAMPLE, THE CNAPPI BOARD REVIEWS THE PUBLIC BENEFIT SECTIONS). THE FORM 990 IS REVIEWED AND APPROVED BY THE CHAIRPERSON OF THE AUDIT COMMITTEE OF CNMC, AS WELL AS, THE CHAIRMAN OF THE BOARD OF CNMC, PRIOR TO FILING WITH IRS. THE COMPLETED FORM 990 IS ALSO MADE AVAILABLE TO THE BOARD OF CHILDREN'S NATIONAL MEDICAL CENTER BEFORE FILING. CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT FORM 990, PART VI, LINE 12C CHILDREN'S HOSPITAL asks THAT EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE COMPLETE A CONFLICT OF INTEREST FORM AT LEAST EVERY YEAR. IN ADDITION EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS INSTRUCTED TO AMEND THE CONFLICT OF INTEREST FORM IMMEDIATELY UPON A CHANGE IN STATUS OF ANY OF THE QUESTIONS ON THE FORM. THESE FORMS ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND CONFLICTS AND INTERESTS ARE NOTED. THE CHILDREN'S HOSPITAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY. GOVERNING POLICIES FORM 990, PART VI, LINES 13 & 14 CHILDREN'S HOSPITAL IS GOVERNED BY THE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL MEDICAL CENTER. THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15A & 15B THE EXECUTIVE COMPENSATION COMMITTEE OF THE CNMC BOARD OF DIRECTORS IS COMPRISED WHOLLY OF DISINTERESTED, INDEPENDENT BOARD MEMBERS. THE COMMITTEE HAS RETAINED INDEPENDENT OUTSIDE CONSULTANTS EXPERT ON COMPENSATION MATTERS. THE COMMITTEE DETERMINES ADJUSTMENTS IN COMPENSATION, INCLUDING BASE PAY, INCENTIVES, AND OTHER FORMS OF COMPENSATION FOR EACH PERSON DEEMED BY THE COMPENSATION COMMITTEE TO BE A "DISQUALIFIED PERSON" AS THAT TERM IS USED IN THE intermediate SANCTIONS REGULATIONS OF THE IRS. THE COMMITTEE IS INFORMED IN ITS DECISION-MAKING BY COMPENSATION STUDIES AND COMPARISONS DONE BY THE INDEPENDENT CONSULTANT, AND RELIES UP "REASONABLENESS" OPINIONS FOR SUCH CONSULTANTS, PRIOR TO OR CONTEMPORANEOUS WITH MAKING COMPENSATION DECISIONS. THE COMMITTEE MEETS 4-6 TIMES PER YEAR TO CONSIDER SUCH MATTERS. HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC FORM 990, PART VI, LINE 19 CHILDREN'S HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED ON REQUEST. 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