2017-11-13T14:16:00-07:00 2016-12-31 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2016-01-01 590634433 THE NEMOURS FOUNDATION NEMO 9046974100 10140 Centurion Parkway North Jacksonville FL 32256 Rodney McKendree SR VP and CFO 9046975847 2017-11-15 1 KPMG LLP P00008888 3362753394 2017-11-15 199.207.253.101 2016 2017-02-10 21:41:12Z David Bailey President and CEO 10140 Centurion Parkway North Jacksonville FL 32256 1515794434 0 8516 X www.nemours.org X 1936 FL Nemours mission is to provide leadership, institutions, and services to restore and improve the health of children through care and programs not readily available, with one high standard of quality and distinction regardless of the recipient's financial status. 12 11 7925 1360 -10032725 -10145421 163939442 163989596 932989586 1072981101 12176333 25408220 30451301 35914790 1139556662 1298293707 1141167 1656603 0 0 696610695 745159476 0 0 3132231 400932772 441486493 1098684634 1188302572 40872028 109991135 1837196442 1951297349 746432226 795751122 1090764216 1155546227 Nemours mission is to provide leadership, institutions, and services to restore and improve the health of children through care and programs not readily available, with one high standard of quality and distinction regardless of the recipient's financial status. 0 0 906300825 1656603 1106271209 See Schedule H, Part VI 0 0 0 906300825 1 1 0 1 0 0 0 1 0 1 1 0 0 0 1 0 0 1 0 0 1 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 1 1 1 0 0 1 758 1 1 7925 1 1 1 1 CJ 0 0 1 1 1 1 0 0 0 0 X 12 11 1 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 AK AL AR CA CT DC DE FL GA HI IL KS KY MA MD ME MI MN MS NC ND NH NJ NM OH OK OR PA RI SC TN UT VA WA WI WV X Rodney McKendree Sr VP and CFO 9046974100 10140 Centurion Parkway North Jacksonville FL 32256 Brian P Anderson Chairman of the Board 10 0 X 105135 0 0 Geoffrey M Rogers Former Member Director (termed 11/10/2016) 2.5 0 X 37920 68413 0 Hugh M Durden Former Member Director (termed 11/10/2016) 10 25 X 0 148858 0 J Michael Mcginnis Director 2.5 0 X 49820 0 0 James S Hunt Director 3 0 X 0 0 0 John F Porter Former Member Director (termed 11/10/2016) 20 15 X 0 119623 0 John S Lord Former Member Director (termed 1/27/2016) 25 10 X 0 136826 0 Leonard Berry Phd Director 3 0 X 39675 0 0 Linda D Norman Director 2.5 0 X 0 0 0 Marc Probst Director 0.5 0 X 0 0 0 Richard Christopher Former Member (termed 6/1/2016). Director. 15 1.5 X 19400 68413 0 Robert Riney Director 3.5 0 X 53230 0 0 Rosa Hakala Director 2.5 0 X 40785 0 0 Terri L Kelly Director 3 0 X 37920 0 0 Toni Jennings Director 3 0.15 X 45510 0 0 Valerie Montgomery Rice Director 0.5 0 X 0 0 0 Bernard E Rice Ent VP Chief Information Officer 40 0 X 295151 0 39106 Brent R King MD Ent VP CMO Physician Practices, DE 40 0 X 701780 0 80910 Cameron S Morrow Assistant Treasurer 40 0 X 96160 0 20715 Dana N Bledsoe Ent VP, President NCH 40 0 X 518280 0 90473 David J Bailey MD President/CEO 40 0 X 1527860 0 402506 Deborah Chang Sr VP Children's Health Policy & Prevention 40 0 X 336783 0 33134 Deborah Platz Ent VP and General Counsel 40 0 X 374111 0 31234 Diane C Goin Secretary to the President CEO 40 0 X 77586 0 8429 Gina Altieri Sr VP Chief Strategy Integration 40 0 X 468777 0 53625 Mariane Stefano Sr VP Chief Experience Officer 40 0 X 352388 0 30033 Martha G McGill ENT VP Chief Network Ops FL 40 0.5 X 418250 0 76352 Marylynn Girouard Exec Coordinator BOD/General Counsel 40 0 X 74631 0 10598 Nancy E Stephenson Ent VP Chief Compliance Officer 40 0 X 291516 0 32229 Paul Kempinski OVP Chief Operating Officer, AIDHC 40 0 X 560085 0 86203 R J Cummings MD Ent VP Chief Medical Officer FL 40 0 X 733751 0 23614 Robert D Bridges EVP Chief Executive FL Operations 40 7 X 890222 0 172755 Rodney A McKendree Sr VP and CFO 40 4 X 543791 0 114726 Roger A Oxendale Former President NCH (termed 1/1/2016) 40 0 X 977934 0 1514 Roy Proujansky EVP Chief Executive DE Operations 40 1 X 994396 0 155726 Stephen Lawless Sr VP Chief Clinical Officer 40 0.5 X 564355 0 71514 Steven R Sparks Former Sr VP General Counsel (termed 7/11/2016) 40 0 X 649343 0 10141 Theresa M Young Sr VP Human Resources 40 0 X 418580 0 52773 William W Higginbotham II Ent VP Finance & Cost Containment 40 7 X 296568 0 43804 Arabinda K Choudhary MD Dept of Medical Imaging Chair, AIDHC 40 0 X 543907 0 39035 Carlos Archilla MD Dept of Anesthesiology Chair, NCCO 40 0 X 495154 0 29620 Carolyn F Bannister MD Physician, Department Chair 40 0 X 496003 0 27216 Christian Pizarro MD Director of Nemours Cardiac Center 40 0 X 1899013 0 31826 Daniel J Podberesky MD Dept of Radiology Chief, NCCO 40 0 X 594712 0 35465 Debbie J Merinbaum MD Dept of Radiology Chair, NCCJ 40 0 X 592450 0 21219 Eric A Loveless MD Division Chief, Orthopaedics, NCCJ 40 0 X 605406 0 18894 Gary D Josephson MD Dept of Otolaryngology/ENT Chair, NCCJ 40 0 X 590639 0 28545 Jay S Greenspan MD Dept of Pediatrics Chair, AIDHC 40 0 X 493552 0 26338 Jeffrey Campbell MD Director Neuroscience Center, NCCW 40 0 X 721664 0 21126 Julie L Wei MD Surgeon in Chief, NCCO 40 0 X 530041 0 31094 Mary B Mehta MD Medical Director, NCCP 40 0.5 X 407664 0 26214 Michael J Erhard MD Chief Medical Officer, NCCJ 40 0 X 657614 0 26879 Paul A Pitel MD Dept of Pediatrics Chair, NCCJ 40 0 X 369325 0 20324 Peter D Wearden MD Cardiothoracic Surgeon, NCCO 40 0 X 1150035 0 32996 Stefanie F Schrum MD Division Chief, Anesthesiology, NCCJ 40 0 X 377073 0 7734 Stephen Dunn MD Dept of Surgery Chair, AIDHC 40 0 X 552724 0 18606 Terri Finkel MD Dept of Pediatrics Chair, NCH 40 0 X 573024 0 28028 Tetsu Uejima MD Dept of Anesthesiology/Critical Care Chair, NCCW 40 0 X 554895 0 35465 William G Mackenzie MD Dept of Orthopaedics Chair, AIDHC 40 0 X 757901 0 20144 John F Lovejoy MD Dept of Orthopaedics Chair, NCCO 40 0 X 603913 0 40991 Joseph H Piatt Jr MD Dept of Neurosurgery, Division Chief, NCCW 40 0 X 623839 0 29951 Peter G Gabos MD Orthopaedic Surgeon, NCCW 40 0 X 640713 0 28818 Suken A Shah MD Dept of Orthopaedics, Surgeon, AIDHC 40 0 X 897591 0 29593 Todd A Maugans MD Dept of Neurosurgery, Division Chief, NCH 40 0 X 758124 0 31287 Barbara D Meeks Chief Nurse Executive, NCH 40 0 X 406481 0 13672 Leslie Grissom MD Dept of Radiology, Radiologist, AIDHC 40 0 X 438819 0 23071 Salvatore R Goodwin MD Dept of Anesthesiology Chair, NCCJ 40 0 X 218090 0 22863 Steven Frick MD Dept of Orthopaedics Chair, NCH 40 0 X 731509 0 26624 W L Thornton Member Director 0 10 X 0 127297 0 W T Thompson Member Director 0 0 X 0 142379 0 30873568 811809 2415752 1398 1 1 0 HSC Builders and Construction Manager 340 New Mill Lane Exton PA 19341 Building & Construction 14571003 Sodexo Inc and Affiliates PO Box 905374 Charlotte NC 282905374 Facilities Management 10779457 Whiting Turner Contracting 131 Continental Drive Suite 404 Newark DE 19713 Building & Construction 12997396 Thomas Jefferson University 1025 Walnut Street Philadelphia PA 19107 Residency Program Expenses 5786557 J Smith Lanier PO Box 162080 Atlanta GA 30321 Insurance Broker 3923474 137 0 0 1135430 155880487 0 6973679 92133 163989596 Net patient service revenue 900099 1040623850 1040623850 0 0 Net research grants 900099 29883595 29883595 0 0 Electronic health record revenue 900099 2473656 2473656 0 0 0 0 0 0 1072981101 7726040 0 -10032725 17758765 0 0 0 0 2430160 0 0 2430160 454669 0 102657 0 352012 0 352012 0 0 352012 234436980 0 216754800 0 17682180 0 17682180 0 0 17682180 483280 1135430 643270 -159990 0 -159990 2500 0 2500 0 0 2500 0 0 Specialized services 900099 25271409 25271409 0 0 Graduate medical education funding 900099 4123348 4123348 0 0 Continuing medical education 900099 1390219 1390219 0 0 2505132 2505132 0 0 33290108 1298293707 1106271209 -10032725 38065627 1354104 1354104 302499 302499 0 0 0 0 27453696 0 27453696 0 2150805 0 2150805 0 565959034 444128968 119702275 2127791 39127207 30997128 7957894 172185 73590166 58290743 15053798 245625 36878568 29290547 7445782 142239 0 0 0 0 4358439 2301331 2042364 14744 455031 241803 213228 0 212485 0 212485 0 0 0 411906 218886 193020 0 71442260 51637759 19761499 43002 8469266 5754649 2698308 16309 126880437 113222669 13560569 97199 21747515 11174265 10542654 30596 0 0 0 0 38425191 26544325 11860167 20699 6344417 4198911 2084192 61314 0 0 0 0 3095948 2278623 779571 37754 10888448 10888448 0 0 0 0 0 0 76510189 52470688 24039501 0 6259686 6101538 157117 1031 Provision for bad debts 43653163 43653163 0 0 Subscriptions (mags & db), books 4146779 3792479 337963 16337 Maintenance contracts - misc 6130271 1898545 4231726 0 Repairs and maintenance 6344008 1964170 4379268 570 5711054 3594584 2011634 104836 1188302572 906300825 278869516 3132231 221746462 307091129 31436629 34214028 10297367 12623660 127092777 142022390 0 0 0 5428484 4981692 14523918 13267106 1661840612 674461352 970998696 987379260 361244571 342417019 80672417 91154835 0 0 5322677 6380758 8432444 9765472 1837196442 1951297349 118678730 132653004 0 0 5763039 3309956 305394769 297052870 0 0 0 0 99370000 98225000 0 0 217225688 264510292 746432226 795751122 X 875340458 930601259 207169439 218032359 8254319 6912609 1090764216 1155546227 1837196442 1951297349 X 109991135 -5162063 0 0 0 -40047061 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2000 341047 343047 1187959525 1188302572 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 431429 400329 509282 343047 1684087 250000 250000 250000 250000 1000000 1500000 2000 2000 2000 2000 8000 Schedule C, Part II-A, Line 1a Nemours is not affiliated with any groups and did not exceed either the lobbying or grass roots expenditure ceiling. 0 3386733 0 0 X X X 0 213014884 4694650 12401609 0 10010223 163896 219937024 238322440 7762065 -1214069 0 31699683 155869 213014884 258479551 5586259 11563115 0 37116978 189507 238322440 279439880 5135534 31381744 0 57205064 272543 258479551 384535863 8086876 29080079 0 142011164 251774 279439880 0 0.022 0.978 0 0 106095 103983771 104089866 0 831653527 282961941 548691586 0 30786643 14935683 15850960 0 656691416 376563728 280127688 0 38619160 0 38619160 987379260 0 Self-insurance reserves 55620153 Liabilities for pension benefits 208890139 264510292 X 1255232751 -1927702 0 0 -17510940 -19438642 1274671393 0 23622314 23622314 1298293707 1168895315 0 0 0 -19243372 -19243372 1188138687 0 163885 163885 1188302572 Schedule D, Part III, Line 4 The Nemours mansion is the 300-acre country estate of the late industrialist and philanthropist Alfred I. DuPont. The mansion is located on the grounds of the renowned Alfred I. DuPont Hospital for Children in Wilmington, Delaware. It derives its name from the town in France represented by Mr. Dupont's great-great-grandfather, Pierre Samuel DuPont de Nemour. The mansion was built from 1909 to 1910 and is a fine example of a French chateau in the style of Louis XVI. The 47,000 sq. ft. mansion looms over the surrounding formal gardens and is furnished with fine antiques, famous works of art, beautiful tapestries, and other treasures. The grounds surrounding the mansion extend for one third of a mile along the main vista from the house, and are among the finest examples of French-style gardens in the United States. The mansion and gardens are open for tours between May and December. Tour groups are kept small and include expert commentary by guides familiar with the DuPont family history. Schedule D, Part V, Line 4 Nemours' endowments have been established for a variety of purposes including ophthalmology, orthopaedic, dental and research. Schedule D, Part X, Line 2 Nemours is exempt from federal income taxes on related income under Section 501(a) of the Internal Revenue Code as an organization described in Section 501(c)(3), and is also exempt from state income taxes. Management believes that the unrelated business income generated by Nemours is not material to the combined financial statements. Schedule D, Part XI, Line 2d Net assets released from restriction - Ed Ball $6,678,029 plus net assets released from restriction - donations $1,620,449 plus NJPP (subsidiary) total revenue $7,321,276 plus PMSI (subsidiary) total revenue $11,873,288 less Nemours bad debt expense $43,653,163 less NJPP bad debt expense $888,053 less PMSI bad debt expense $462,766 equals (17,510,940). Schedule D, Part XI, Line 4b Temp restricted contributions and pledges $7,293,720 plus temp restricted investment income $2,434,066 plus temp restricted realized gains $13,201,900 less rental expenses $102,657 less fundraising expenses $643,270 plus PMSI (subsidiary) management fee $1,438,555 equals $23,622,314 Schedule D, Part XII, Line 2d Rental expenses $102,657 less bad debt expense $45,003,982 plus fundraising expenses $643,270 less PMSI (subsidiary) management fee $1,438,555 plus NJPP (subsidiary) operating expenses $9,293,016 plus PMSI (subsidiary) operating expenses $17,160,222 equals ($19,243,372). Schedule D, Part XII, Line 4b Temp restricted investment expenses $161,538 plus temp restricted occupancy expenses $2,347 equals $163,885. East Asia and the Pacific 0 0 Investments 756199 Europe (including Iceland and Greenland) 0 0 Investments 5594632 North America (including Canada and Mexico, but not the United States) 0 0 Investments 1787897 South America 0 0 Investments 315755 0 0 8454483 1 0 1 1 1 0 Delaware Gala 432170 206095 226075 0 0 133060 114295 8250 6789 Orlando Gala 404484 268320 136164 0 0 62998 69533 32777 22612 13 782056 661015 121041 0 0 28802 58349 74764 31041 1618710 1135430 483280 0 0 224860 242177 115791 60442 643270 -159990 1 1 X 1 X 2.50 1 X 1 0 1 1 0 0 9402475 1889821 7512654 0.0064 0 0 515569185 442228875 73340310 0.0627 0 0 0 0 0 0 0 0 524971660 444118696 80852964 0.0691 0 0 30051541 9948903 20102638 0.0172 0 0 8527062 4967182 3559880 0.003 0 0 0 0 0 0 0 0 36053865 16686138 19367727 0.0166 0 0 1892274 0 1892274 0.0016 0 0 76524742 31602223 44922519 0.0384 0 0 601496402 475720919 125775483 0.1075 1 16188660 0 1897504 2427006 -529502 X 1 1 2 1 ALFRED I DUPONT HOSPITAL FOR CHILDREN 1600 ROCKLAND ROAD WILMINGTON DE 19803 HSPTL-003 X X A 2 NEMOURS CHILDREN'S HOSPITAL 13535 NEMOURS PARKWAY ORLANDO FL 32827 4509 X X A A 0 0 1 X X X X X X X X X 16 1 0 0 1 X www.nemours.org/community X 1 16 1 https://www.nemours.org/about/community-health-needs.html 0 0 1 X 250 300 X 1 1 X X X X 1 X See Section C, Line 16 X See Section C, Line 16 X See Section C, Line 16 X X X X 1 X 0 1 X 0 0 Schedule H, Part V, Section B, Line 1-Group A Nemours conducted a Child & Adolescent Community Health Needs Assessment (CHNA) in 2016. The CHNA report can be found at https://www.nemours.org/about/community-health-needs.html. Schedule H, Part V, Section B, Line 5-Group A As part of the Child & Adolescent Community Health Needs Assessment (CHNA), Nemours solicited information from multiple key informants: physicians, other health professionals, social service providers, business leaders, public health representatives and other community leaders. A list of these key informants can be found in the Nemours CHNA. Schedule H, Part V, Section B, Line 11-Group A See the implementation plan and progress reports located at https://www.nemours.org/about/community-health-needs.html Schedule H, Part V, Section B, Line 14-Group A Brochures regarding the Nemours Financial Assistance Program are made available at a number of locations throughout AIDHC, NCH, and the physician practices, as well as on-line at https://www.nemours.org/patientfamily/financialassistance.html . Personnel throughout each facility are instructed to direct families that may be having financial concerns or difficulty to one of the Financial Counselors. Schedule H, Part V, Section B, Line 16-Group A http://www.nemours.org/patientfamily/financialassistance.html Schedule H, Part V, Section B, Line 18e-Group A Nemours utilizes its own internal collections department in order to address non-payment by patients who have not been qualified for financial assistance in a sensitive manner. 55 NEMOURS DUPONT PEDIATRICS WILMINGTON 1600 ROCKLAND ROAD WILMINGTON DE 19803 PEDIATRIC SPECIALTY CARE CLINIC AND CARDIAC CENTER NEMOURS CHILDREN'S SPECIALITY CARE JACKSONVILLE 807 CHILDRENS WAY JACKSONVILLE FL 32207 PEDIATRIC SPECIALTY CARE CLINIC INCLUDING BRIGHTSTART DYSLEXIA INITIATIVE Nemours Childrens Specialty Care Brunswick Southeast Georgia Health System 3025 Shrine Road Suite 350 Brunswick GA 31520 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS CHILDREN'S SPECIALITY CARE DAYTONA BEACH 1219 DUNN AVE DAYTONA BEACH FL 32114 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS CHILDREN'S SPECIALITY CARE FLEMING ISLAND 2300 PARK AVENUE SUITE 206 ORANGE PARK FL 32073 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS CHILDREN'S SPECIALITY CARE JACKSONVILLE SOUTH 14785 OLD ST AUGUSTINE ROAD SUITE 200 JACKSONVILLE FL 32258 CHILDREN'S CLINIC SPECIALTY CARE Nemours Children's Specialty Care Lake City 164 NW Madison St Suite 201 Lake City FL 32055 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS CHILDREN'S SPECIALITY CARE ORLANDO DOWNTOWN 1717 SOUTH ORANGE AVENUE SUITE 100 ORLANDO FL 32806 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS CHILDREN'S SPECIALITY CARE LAKE MARY 3300 WEST LAKE MARY BLVD SUITE 100 LAKE MARY FL 32746 CHILDREN'S CLINIC SPECIALTY CARE Nemours Children's Specialty Care Lake Nona 9368 Narcoossee Road Suite 105 - S Orlando FL 32827 PEDIATRIC SPECIALTY CARE CLINIC Nemours Children's Specialty Care Miramar Beach 7720 U S Highway 98 W Suite 260 Miramar Beach FL 32550 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS CHILDRENS URGENT CARE ORLANDO DR PHILLIPS 5018 DR PHILLIPS BOULEVARD ORLANDO FL 32819 PEDIATRIC URGENT CARE Nemours Children's Specialty Care Wesley Chapel 2020 Ashley Oaks Circle Suite 102 Wesley Chapel FL 33544 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS CHILDREN'S CLINIC PENSACOLA 5153 NORTH 9TH AVENUE PENSACOLA FL 32504 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS CHILDRENS CLINIC BONIFAY 2600 HOSPITAL DRIVE BONIFAY FL 32425 PEDIATRIC SPECIALITY CARE CLINIC Nemours Children's Specialty Care Tallahassee-Phillips Childrens Medical Services Bldg 2390 Phillips Road Tallahassee FL 32308 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS DUPONT PEDIATRICS BRYN MAWR 130 SOUTH BRYN MAWR AVENUE BRYN MAWR PA 19010 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS DUPONT PEDIATRICS SEAFORD 49 FALLON AVENUE SEAFORD DE 19973 PEDIATRIC PRIMARY, SPECIALITY CARE AND DYSLEXIA INITIATIVE CLINIC NEMOURS DUPONT PEDIATRICS MIDDLETOWN 200 CLEAVER FARM ROAD SUITE 201 MIDDLETOWN DE 19709 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS FOULK ROAD 910 FOULK ROAD SUITE 101 WILMINGTON DE 19809 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS ST FRANCIS 700 NORTH CLAYTON STREET SUITE 400 WILMINGTON DE 19805 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS NEWTOWN SQUARE 3855 WEST CHESTER PIKE SUITE 280 NEWTOWN SQUARE PA 19073 PEDIATRIC SPECIALITY CARE CLINIC NEMOURS DUPONT PEDIATRICS NEWARK 1400 PEOPLES PLAZA SUITE 300 NEWARK DE 19702 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS MEDIA 1098 W BALTIMORE PIKE SUITE 3403 MEDIA PA 19063 PEDIATRICS PRIMARY CARE NEMOURS DUPONT PEDIATRICS JESSUP STREET 1602 JESSUP STREET WILMINGTON DE 19802 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS VILLANOVA 789 EAST LANCASTER AVENUE SUITE 10 VILLANOVA PA 19085 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS VOORHEES 443 LAUREL OAK ROAD SUITE 200 VOORHEES NJ 08043 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS DUPONT PEDIATRICS DOVER 102 WEST WATER STREET SUITE 1 DOVER DE 19904 PEDIATRIC PRIMARY AND SPECIALITY CARE NEMOURS DUPONT PEDIATRICS COLLEGEVILLE 599 ARCOLA ROAD Collegeville PA 19426 CHILDREN'S CLINIC SPECIALTY CARE AND PRIMARY CARE NEMOURS DUPONT PEDIATRICS VINELAND 2950 COLLEGE DRIVE SUITE 2B VINELAND NJ 08360 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS DUPONT PEDIATRICS BECKS WOODS 141 BECKS WOODS DRIVE BEAR DE 19701 PEDIATRIC PRIMARY AND SPECIALITY CARE CLINIC NEMOURS DUPONT PEDIATRICS PIKE CREEK 5500 SKYLINE DRIVE SUITE 4 WILMINGTON DE 19808 PEDIATRIC PRIMARY AND SPECIALITY CARE CLINIC NEMOURS CHILDRENS URGENT CARE WATERFORD LAKES 651 NORTH ALAFAYA TRAIL ORLANDO FL 32828 PEDIATRIC URGENT CARE CLINIC NEMOURS DUPONT PEDIATRICS MILFORD TEAL CREEK PLAZA 703 NORTH DUPONT BOULEVARD MILFORD DE 19963 PEDIATRIC PRIMARY AND SPECIALITY CARE CLINIC NEMOURS CHILDRENS URGENT CARE ORLANDO KISSIMMEE 4101 TOWN CENTER BOULEVARD ORLANDO FL 32837 PEDIATRIC URGENT CARE CLINIC NEMOURS DUPONT PEDIATRICS GLEN MILLS 101 APPLIED BANK BLVD SUITE 11 GLEN MILLS PA 19342 PEDIATRIC SPECIALTY CARE CLINIC Nemours duPont Pediatrics Wayne 110 W Lancaster Ave Wayne PA 19087 PEDIATRICS PRIMARY CARE NEMOURS DUPONT PEDIATRICS EXTON 101 ARRANDALE BLVD SUITE 103 EXTON PA 19341 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS PAOLI 1676 LANCASTER AVE PAOLI PA 19301 PEDIATRIC PRIMARY CARE NEMOURS CHILDRENS URGENT CARE SANFORD 1481 WP BALL BOULEVARD SANFORD FL 32771 PEDIATRIC URGENT CARE CLINIC Nemours duPont Pediatrics Concordville 1020 Baltimore Pike Suite 300 Glen Mills PA 19342 PEDIATRICS PRIMARY CARE NEMOURS SENIORCARE WILMINGTON 1600 ROCKLAND ROAD WILMINGTON DE 19803 HEALTH CLINIC Nemours duPont Pediatrics Deptford 1280 Almonesson Road Deptford NJ 08096 PEDIATRIC SPECIALTY CARE CLINIC and Surgery Center NEMOURS DUPONT PEDIATRICS LANCASTER 2128 EMBASSY DRIVE LANCASTER PA 17603 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS SENIORCARE MILFORD 915 NORTH DUPONT BOULEVARD MILFORD DE 19963 HEALTH CLINIC Nemours Children's Specialty Care Lakeland Lakeland Regional Health Center Gr 3030 Harden Blvd Lakeland FL 33803 PEDIATRIC SPECIALTY CARE CLINIC Nemours Children's Specialty Care Davenport 410 Lionel Way Davenport FL 33837 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS DUPONT PEDIATRICS UPLAND CROZER CHESTER MEDICAL CENTER ONE MEDICAL CENTER BLVD SUITE 443 UPLAND PA 19013 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS CHILDRENS URGENT CARE ALTAMONTE SPRINGS 745 ORIENTA AVENUE SUITE 1011 ALTAMONTE SPRINGS FL 32701 PEDIATRIC URGENT CARE CLINIC NEMOURS DUPONT PEDIATRICS SEAFORD - SHIPLEY 411 N Shipley St Seaford DE 19973 PEDIATRICS PRIMARY CARE Nemours Children's Specialty Care Titusville The Childrens Center of Parrish Med 5650 S Washington Ave Titusville FL 32780 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS BRIGHTSTART 9145 NARCOOSEE ROAD ORLANDO FL 32827 DYSLEXIA INITIATIVE NEMOURS CHILDRENS URGENT CARE MELBOURNE 1270 NORTH WICKHAM ROAD Melbourne FL 32935 PEDIATRIC URGENT CARE CLINIC NEMOURS HEALTH AND PREVENTION SERVICES 49 FALLON AVENUE SEAFORD DE 19973 PREVENTION SERVICES NEMOURS DUPONT PEDIATRICS PHILADELPHIA 833 CHESTNUT STREET SUITE 300 PHILADELPHIA PA 19107 PEDIATRIC PRIMARY CARE AND SPECIALITY CARE CLINIC Schedule H, Part I, Line 6a Schedule H, Part I, Line 6a - The Nemours 2016 Report to Our Communities entitled, "What is Health?" can be found at https://www.nemours.org/about/financial-benefit-to-the-community.html Schedule H, Part I, Line 7 Nemours calculated the amounts included in Part I, Lines 7a-b utilizing the methodology provided in the various worksheets included in the instructions for Schedule H of Form 990. These worksheets include Worksheet 1, Charity Care at Cost, Worksheet 2, Ratio of Patient Care Cost-to-Charges and Worksheet 3, Unreimbursed Medicaid and Other Means-Tested Government Programs. Schedule H, Part I, Line 7, Column f Nemours included provision for bad debt (bad debt expense) in Form 990, Part IX, line 24 of $43,653,163. Such amount was subtracted from total expense of $1,188,302,572 for purposes of determining percent of total expense calculations. Schedule H, Part I, Line 7a Financial Assistance At Cost - Nemours' mission is to "provide leadership, institutions, and services to restore and improve the health of children through care and programs not readily available, with one high standard of quality and distinction regardless of the recipient's financial status." Community Health Improvement Services and Community Benefit Operations: During 2016, Nemours continued to focus on leadership and programs dealing with not just health care, but also areas of children's health promotion and disease prevention. Through Nemours Health & Prevention Services, Nemours Center for Children's Health Media, Nemours Brightstart! and others, Nemours subsidized prevention and children's health programs totaling nearly $16.0 million. Nemours provided a variety of community health services for more than 6,200 of Delaware's low-income senior citizens of approximately $4 .2 million.. These outpatient health care services included dental care, eye examinations and eyeglasses, as well as hearing tests and hearing aids at the Nemours Senior Care. Research Nemours continues to improve children's lives through the power of discovery. However, new discoveries are not enough. We are integrating research findings at the bedside and exam room where it has the greatest impact on children. In total, Nemours subsidized health research by over $19.3 million during 2016 with more than 450 research projects under the direction of more than 100 Nemours physician-scientists. Education & Training of Health Professionals Nemours continues to train the next generation of pediatric specialists through affiliations with Thomas Jefferson University, the Mayo Clinic Medical College and others. In 2016, Nemours hosted 695 residents and 724 medical students and provided fellowship rotations for 103 physicians. Nemours supported education and training programs for health professionals of more than $3.6 million. Uncompensated Medical Care: Nemours' services classified as "charity care" or where the recipient could not afford services or lacked adequate health insurance, was nearly $7.5 million in 2016. Nemours also covers the costs in excess of government payments for services provided to Medicaid and other public health beneficiaries of nearly $73.3 million with an additional $45.0 million in uncollected patient care charges written off by Nemours during the same period. All totaled, uncompensated care for 2016 approximates $125.8 million. Schedule H, Part III, Section A, Line 4 In the Alfred I. duPont Hospital for Children and Nemours Children's Hospital audited financial statements, see footnote 1e located on pages 9 and 28, respectively, for a description of bad debt expense. The source of the Medicare allowable costs comes from the 2016 Medicare Cost Reports. Schedule H, Part III, Section B, Line 8 The entire shortfall related to Medicare reported on line 7 should be considered a community benefit. Nemours is bearing the burden of providing care in excess of our costs to those Medicare patients. The source of the Medicare allowable costs comes from the 2016 Medicare Cost Reports. Schedule H, Part III, Section C, Line 9b The Nemours financial assistance policy applies to all of the facilities that it operates. Debt collection is not pursued against patients who qualify for the financial assistance program. Schedule H, Part VI, Line 2 Nemours assesses the healthcare needs of these communities using various methods. For example, Nemours community relations team is active at all sites to identify specific community needs for children. At Nemours, we seek to understand the health needs of the families who live in the communities we serve. Nemours has clinical operations in communities in Delaware, southeastern Pennsylvania and southern New Jersey (referred to as the Delaware Valley), Maryland and Florida. Nemours is committed to improving the health of children, even those who never enter our doors. To do this effectively, Nemours conducts community health needs assessments (CHNAs) then explores potential strategies to influence them. The CHNA can be found at https://www.nemours.org/about/community-health-needs.html . The "areas of opportunity" listed below represent the significant health needs of children and adolescents in the communities our hospitals serve. Areas of opportunity in the Delaware Valley: access to health services, alcohol, tobacco and other drugs, health education, mental and emotional health, nutrition, physical activity and weight, prenatal and infant health, sexual activity. Areas of opportunity in Central Florida: access to health services, health education injury and safety, mental and emotional health, nutrition, physical activity and weight, prenatal and infant health, vision, hearing and speech. Nemours seeks to educate families about children's health and parenting through its Center for Children's Health Media (KidsHealth.org). KidsHealth helps families by enabling parents, kids and teens to better understand and take mastery of their own health. Nemours creates integrated suites of physician reviewed, family-friendly, engaging media that provide families with knowledge, perspective, advice and comfort. Schedule H, Part VI, Line 3 All of Nemours hospital and clinic locations share the same practice of educating patients and their families in the eligibility process. Information regarding financial assistance can be found on our website at https://www.nemours.org/patientfamily/financialassistance.html . Nemours employs financial counselors, as well as engages independent firms (collectively referred to as Financial Counselors) to assist in determining Medicaid eligibility. The Financial Counselors, some of whom are multi-lingual, work with families, educate and assist them with form completion regarding any program for which they might be eligible, including programs in the state of residence. Patients that arrive for an appointment at one of our practices, or admitted to or present to the emergency room at AIDHC or NCH as "self pay" are screened for Medicaid eligibility. The Financial Counselors follow up directly with the respective State regarding their decision/determination. Certain Financial Counselors may go to the family's home, if necessary. In some instances, certain Financial Counselors will ask for and receive limited power of attorney, in an effort to assist the family with the Medicaid eligibility process. To benefit from Nemours Financial Assistance Program, a family must participate in the Medicaid eligibility process described above. Through that process, Nemours assesses eligibility for our charity care program, which is based on Federal Poverty Guidelines as indicated in Schedule H, Part I, lines 3a and b. Eligibility for the Nemours Financial Assistance Program is completed by the Financial Counselors. Personnel at AIDHC have also established the Family Advisory Council (FAC), a group of parents whose children have had services at AIDHC. The purpose of the FAC is to obtain feedback from families about additional ways Nemours can assist with financial eligibility issues. Nemours' representatives have participated in the Robert Wood Johnson Foundation funded "Children's Hospital Eligibility Process Improvement Collaborative", an effort about educating providers regarding eligibility best practices. The collaborative touched on topics from literacy and how to write and share a brochure in a way that the family can understand, to assessing what an appropriate staffing level should be. In an effort to perform proactive outreach in the Delaware Valley, Nemours' Financial Counselors go to our various locations, as well as local Community Health Center facilities. Both types of places represent a source from which families come to Nemours. Such visits focus on educating families about the various funding sources for which they might be eligible. Schedule H, Part VI, Line 4 Nemours' clinical operations include two children's hospitals and multiple outpatient clinics. In Wilmington, Delaware, Nemours operates specialty and primary care children's clinics and a health clinic for the elderly. Nemours' service area includes 27 counties throughout Delaware, southeastern Pennsylvania, and southern New Jersey. In 2011, an estimated 204,208 children and youth under the age of 18 lived in Delaware, (US Census Bureau, 2011) comprising approximately 22.7 % of the area's total population. Currently, Delaware's children and youth population is comprised primarily of 61% White and 25.7% African American compared to 68.2% White and 14.3% African American, nationally. (US Census Bureau, 2011) Household income level can have a significant impact on the health status of children living in the household. Overall, a smaller percentage of children and youth in Delaware (17.5%) live below 100% of the Federal Poverty Level (FPL) when compared to the national rate of children in poverty (22.5%) (US Census Bureau, 2011). Approximately, 63.9% of the area's children and youth live in households with incomes at or above 200 percent of the poverty level (US Census Bureau, 2011). The vast majority of children and youth in the Delaware (96.4%) have health insurance coverage (NSCH, 2011), either through a private source or a public health insurance program such as Medicaid. Nemours' clinical operations in Florida include a children's hospital in Orlando, and a statewide physician practice with campuses in Jacksonville, Pensacola and Orlando. The majority of children and youth in Florida are white (67.6%) while African American children make up 21% of the population (US Census Bureau, 2011). A slightly larger number of children and youth in Florida (24.9%) live below 100% of the FPL when compared to the national rate of children in poverty (22.5%). Based on the US Census bureau (2011), children in Florida are more likely to be uninsured or publicly insured (53.1%), and less likely to be privately insured (59.1%) than children and youth nationally (44.7% and 66.2%, respectively). The majority of children and youth in Florida are covered through private, largely employer-sponsored, health insurance. About 32.1% of children and youth in Florida are covered by public health insurance (us census bureau, 2011), a percentage which is slightly lower than the national average (29.5%). Finally, a greater proportion of children and youth are uninsured in Florida than nationally (21% vs. 15.2%) (US Census Bureau, 2011). For more information about the communities Nemours serves, please see our CHNA at https://www.nemours.org/about/why/healthequityinclusion.html Schedule H, Part VI, Line 5 The Alfred I. duPont Hospital for Children and the Alfred I. duPont Hospital for Children Surgery Center, Bryn Mawr have open model medical staffs. Criteria for membership and clinical privileges are outlined in the Medical Staff Bylaws. Certain areas of practice are only open to practitioners employed by or under contract with Nemours and are eligible for privileges in their respective areas. Schedule H, Part VI, Line 6 Nemours is not a part of an affiliated health care system. However, Nemours works in tandem with numerous community resources in the communities it serves. Schedule H, Part VI, Line 7 Nemours is not required to file its Community Benefit report with the state of Delaware or Florida. However, Nemours is happy to provide access to its community report on the internet at https://www.nemours.org/about/financial-benefit-to-the-community.html. 1 ACADEMY HEALTH 1150 17TH STREET NW SUITE 600 WASHINGTON DC 20036 521260918 501(c)(3) 12500 0 FMV Donation AM HEART ASSOCIATION GREAT RIVERS AFFILIATE PO BOX 50065 PRESCOTT AZ 85304 135613797 501(c)(3) 25000 0 FMV Donation BOY SCOUTS OF AM CENTRAL FL 1951 S ORANGE BLOSSOM TRAIL SUITE 102 APOPKA FL 32703 590624376 501(c)(3) 10000 0 FMV Donation CAMP BOGGY CREEK 2871 N FEDERAL HIGHWAY EUSTIS FL 32736 593012889 501(c)(3) 10000 0 FMV Donation CATHOLIC CHARITIES 2601 W 4TH STREET WILMINGTON DE 19805 510065685 501(c)(3) 10000 0 FMV Donation Center for Excellence HEALTH CARE JOURNALISM 10 NEFF HALL COLUMBIA MO 65211 411908032 501(c)(3) 14143 0 FMV Donation CHILD CANCER FUND 4720 SALISBURY RD JACKSONVILLE FL 32256 593359840 501(c)(3) 10000 0 FMV Donation COMMUNITY HOSPICE FOUNDATION 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 593583920 501(c)(3) 6000 0 FMV Donation CONSCIOUS CONNECTIONS 8047 RUGBY STREET UNIT 2 PHILADELPHIA PA 19150 450570816 501(c)(3) 7400 0 FMV Donation CURESEARCH 200 S TRYON STREET BETHESDA MD 20814 954132414 501(c)(3) 7500 0 FMV Donation JACKSONVILLE ZOO 370 ZOO PARKWAY JACKSONVILLE FL 32218 591319010 501(c)(3) 7000 0 FMV Donation JDRF INTERNATIONAL 370 CENTER POINT CIRCLE SUITE 1154 ALTAMONTE SPRINGS FL 32701 231907729 501(c)(3) 6500 0 FMV Donation LAKE NONA INSTITUTE INC 6900 TAVISTOCK LAKES BLVD ORLANDO FL 32827 273346737 501(c)(3) 25000 0 FMV Donation LAKE NONA SCHOOL 445 WEST AMELIA STREET 12500 NARCOOSSEE RD ORLANDO FL 32832 596000771 501(c)(3) 5040 0 FMV Donation LEUKEMIA RESEARCH FOUNDATION 91 LUKENS DRIVE SUITE F NEW CASTLE DE 19720 261215347 501(c)(3) 10000 0 FMV Donation MARCH OF DIMES 5620 KIRKWOOD HIGHWAY WILMINGTON DE 19808 131846366 501(c)(3) 10000 0 FMV Donation MARCH OF DIMES FULLFILMENT CENTER 555 WINDERLEY PLACE STE 105 MAITLAND FL 32751 131846366 501(c)(3) 8850 0 FMV Donation NATIONAL ACADEMY OF SCIENCES 500 5TH STREET NW ROOM 805 WASHINGTON DC 20001 530196932 501(c)(3) 25000 0 FMV Donation Orange County Board of County Commissioners 201 South Rosalind Avenue Orlando FL 32829 999999999 GOVT 60592 0 FMV Donation ORANGE COUNTY PUBLIC SCHOOLS 445 W AMELIA ST ORLANDO FL 32801 592788435 501(c)(3) 22500 0 FMV Donation RONALD MCDONALD HOUSE 1901 ROCKLAND RD WILMINGTON DE 19803 593211250 501(c)(3) 88770 0 FMV Donation RONALD MCDONALD HOUSE 1030 N ORANGE AVENUE SUITE 105 ORLANDO FL 32801 593211250 501(c)(3) 21600 0 FMV Donation RONALD MCDONALD HOUSE 824 CHILDRENS WAY JACKSONVILLE FL 32207 593211250 501(c)(3) 526985 0 FMV Donation RONALD MCDONALD HOUSE OF THE PHILADELPHIA REGION 200 SOUTH BROAD STREET 10TH FL PHILADELPHIA PA 19102 593211250 501(c)(3) 15000 0 FMV Donation SPECIAL OLYMPICS FLORIDA INC 1915 DON WICKHAM DR CLERMONT FL 34711 237181560 501(c)(3) 20000 0 FMV Donation TIDES FOUNDATION PO BOX 29903 SAN FRANCISCO CA 94129 510198509 501(c)(3) 10000 0 FMV Donation TRACK SHACK FITNESS CLUB INC EVENT MARKETING AND MANAGEMENT 1013 MONTANA STREET ORLANDO FL 32803 263361402 501(c)(3) 10078 0 FMV Donation WOLFSON CHILDRENS HOSPITAL THE WOMENS BOARD 1325 SAN MARCO BLVD SUITE 802 JACKSONVILLE FL 32207 590747311 501(c)(3) 30000 0 FMV Donation YMCA OF GREATER BRANDYWINE 1 E CHESTNUT STREET WEST CHESTER PA 19380 231365994 501(c)(3) 27500 0 FMV Donation TOM COUGHLIN JAY FOUNDATION CELEBRITY GOLF CLASSIC PO BOX 50798 JACKSONVILLE BEACH FL 322400798 593426937 501(c)(3) 15000 0 FMV TRANSPLANT FOUNDATION 401 N 3RD STREET PHILADELPHIA PA 191234101 311481798 501(c)(3) 15000 0 FMV UNIVERSITY OF DELAWARE KIDS COUNT IN DE 298 K GRAHAM HALL NEWARK DE 197167350 516000297 501(c)(3) 6000 0 FMV CHILDREN AND FAMILIES FIRST 2005 BAYNARD BOULEVARD WILMINGTON DE 198023999 510065731 501(c)(3) 10000 0 FMV CENTER FOR LEARNING GARDEN STATE DISCOVERY MUSEUM 2040 SPRINGDALE RD STE 100 CHERRY HILL NJ 08003 223410864 501(c)(3) 7000 0 FMV INSPIRA HEALTH NETWORK FOUNDATION CUMBERLAND/ SALEM 2950 COLLEGE DR STE 1F VINELAND NJ 08360 223746758 501(c)(3) 6500 0 FMV INSPIRA MED CENTER WOODBURY 509 NORTH BROAD STREET WOODBURY NJ 08096 221820210 501(c)(3) 6200 0 FMV COOPER FOUNDATION 2 AQUARIUM DRIVE SUITE 146 CAMDEN NJ 08103 222213715 501(c)(3) 5500 0 FMV MARCH OF DIMES PO BOX 343 VOORHEES NJ 08043 131846366 501(c)(3) 5425 0 FMV 33 0 Aggregate Employee Relief Fund Donations 4 3275 0 FMV Aggregate Research Patient Participation Payment 472 299224 0 FMV Schedule I, Part I, Line 2 The grants made by Nemours were made to public charities for use in their respective exempt missions. Accordingly, Nemours expects the organization to use the funds for proper purposes, and as such, does not subsequently monitor these grants. X 1 1 X X X X 1 1 0 0 0 0 0 1 0 R J Cummings MD Ent VP Chief Medical Officer FL 550268 0 178539 0 4944 0 10611 0 13003 0 757365 0 0 0 Roy Proujansky EVP Chief Executive DE Operations 695031 0 179217 0 120148 0 142553 0 13173 0 1150122 0 0 0 Stephen Lawless Sr VP Chief Clinical Officer 424330 0 71772 0 68253 0 60870 0 10644 0 635869 0 0 0 Mariane Stefano Sr VP Chief Experience Officer 269066 0 55845 0 27477 0 29823 0 210 0 382421 0 0 0 Gina Altieri Sr VP Chief Strategy Integration 373198 0 62347 0 33232 0 53415 0 210 0 522402 0 0 0 David J Bailey MD President/CEO 855493 0 249451 0 422916 0 390378 0 12128 0 1930366 0 0 0 Robert D Bridges EVP Chief Executive FL Operations 625486 0 161212 0 103524 0 158628 0 14127 0 1062977 0 0 0 Bernard E Rice Ent VP Chief Information Officer 260853 0 33938 0 360 0 27759 0 11347 0 334257 0 0 0 Rodney A McKendree Sr VP and CFO 455001 0 88238 0 552 0 93019 0 21707 0 658517 0 0 0 Theresa M Young Sr VP Human Resources 307773 0 65735 0 45072 0 41972 0 10801 0 471353 0 0 0 William W Higginbotham II Ent VP Finance & Cost Containment 262152 0 34056 0 360 0 27587 0 16217 0 340372 0 0 0 Paul Kempinski OVP Chief Operating Officer, AIDHC 447754 0 71951 0 40380 0 65784 0 20419 0 646288 0 0 0 Deborah Chang Sr VP Children's Health Policy & Prevention 286880 0 49351 0 552 0 32924 0 210 0 369917 0 0 0 Nancy E Stephenson Ent VP Chief Compliance Officer 269109 0 20826 0 1581 0 16180 0 16049 0 323745 0 0 0 Deborah Platz Ent VP and General Counsel 308280 0 65472 0 359 0 8894 0 22340 0 405345 0 0 0 Brent R King MD Ent VP CMO Physician Practices, DE 521652 0 111858 0 68270 0 52950 0 27960 0 782690 0 0 0 Dana N Bledsoe Ent VP, President NCH 446735 0 46273 0 25272 0 54815 0 35658 0 608753 0 0 0 Martha G McGill ENT VP Chief Network Ops FL 391206 0 24920 0 2124 0 43010 0 33342 0 494602 0 0 0 Roger A Oxendale Former President NCH (termed 1/1/2016) 1819 0 116389 0 859726 0 0 0 1514 0 979448 0 0 0 Steven R Sparks Former Sr VP General Counsel (termed 7/11/2016) 193527 0 79515 0 376301 0 0 0 10141 0 659484 0 0 0 Paul A Pitel MD Dept of Pediatrics Chair, NCCJ 317531 0 48746 0 3048 0 7151 0 13173 0 389649 0 0 0 Stefanie F Schrum MD Division Chief, Anesthesiology, NCCJ 366533 0 9508 0 1032 0 6860 0 874 0 384807 0 0 0 William G Mackenzie MD Dept of Orthopaedics Chair, AIDHC 657813 0 98504 0 1584 0 6778 0 13366 0 778045 0 0 0 Eric A Loveless MD Division Chief, Orthopaedics, NCCJ 543196 0 60626 0 1584 0 6766 0 12128 0 624300 0 0 0 Debbie J Merinbaum MD Dept of Radiology Chair, NCCJ 520606 0 70812 0 1032 0 6707 0 14512 0 613669 0 0 0 Michael J Erhard MD Chief Medical Officer, NCCJ 537334 0 66478 0 53802 0 6460 0 20419 0 684493 0 0 0 Christian Pizarro MD Director of Nemours Cardiac Center 1726804 0 171177 0 1032 0 6286 0 25540 0 1930839 0 0 0 Jay S Greenspan MD Dept of Pediatrics Chair, AIDHC 400168 0 92352 0 1032 0 6247 0 20091 0 519890 0 0 0 Stephen Dunn MD Dept of Surgery Chair, AIDHC 482838 0 65802 0 4084 0 6224 0 12382 0 571330 0 0 0 Gary D Josephson MD Dept of Otolaryngology/ENT Chair, NCCJ 519397 0 70690 0 552 0 6137 0 22408 0 619184 0 0 0 Carlos Archilla MD Dept of Anesthesiology Chair, NCCO 423104 0 71498 0 552 0 0 0 29620 0 524774 0 0 0 Mary B Mehta MD Medical Director, NCCP 361170 0 45452 0 1042 0 5795 0 20419 0 433878 0 0 0 Jeffrey Campbell MD Director Neuroscience Center, NCCW 635734 0 85378 0 552 0 5750 0 15376 0 742790 0 0 0 Terri Finkel MD Dept of Pediatrics Chair, NCH 484224 0 66816 0 21984 0 0 0 28028 0 601052 0 0 0 Julie L Wei MD Surgeon in Chief, NCCO 491335 0 38346 0 360 0 0 0 31094 0 561135 0 0 0 Tetsu Uejima MD Dept of Anesthesiology/Critical Care Chair, NCCW 481058 0 72253 0 1584 0 0 0 35465 0 590360 0 0 0 Arabinda K Choudhary MD Dept of Medical Imaging Chair, AIDHC 479449 0 64098 0 360 0 0 0 39035 0 582942 0 0 0 Daniel J Podberesky MD Dept of Radiology Chief, NCCO 522972 0 71500 0 240 0 0 0 35465 0 630177 0 0 0 Carolyn F Bannister MD Physician, Department Chair 435689 0 58730 0 1584 0 0 0 27216 0 523219 0 0 0 Peter D Wearden MD Cardiothoracic Surgeon, NCCO 1098483 0 51000 0 552 0 0 0 32996 0 1183031 0 0 0 Peter G Gabos MD Orthopaedic Surgeon, NCCW 639161 0 1000 0 552 0 6410 0 22408 0 669531 0 0 0 Suken A Shah MD Dept of Orthopaedics, Surgeon, AIDHC 876553 0 20678 0 360 0 6222 0 23371 0 927184 0 0 0 Joseph H Piatt Jr MD Dept of Neurosurgery, Division Chief, NCCW 614902 0 7353 0 1584 0 0 0 29951 0 653790 0 0 0 Todd A Maugans MD Dept of Neurosurgery, Division Chief, NCH 686171 0 70921 0 1032 0 0 0 31287 0 789411 0 0 0 John F Lovejoy MD Dept of Orthopaedics Chair, NCCO 553563 0 49990 0 360 0 0 0 40991 0 644904 0 0 0 Leslie Grissom MD Dept of Radiology, Radiologist, AIDHC 415171 0 20600 0 3048 0 9898 0 13173 0 461890 0 0 0 Salvatore R Goodwin MD Dept of Anesthesiology Chair, NCCJ 212522 0 3008 0 2560 0 5046 0 17817 0 240953 0 0 0 Barbara D Meeks Chief Nurse Executive, NCH 0 0 30070 0 376411 0 0 0 13672 0 420153 0 0 0 Steven Frick MD Dept of Orthopaedics Chair, NCH 552220 0 98171 0 81118 0 0 0 26624 0 758133 0 0 0 Schedule J, Part I, Line 1a Nemours has established a policy for the reimbursement of travel and related expenses incurred by its employees. All transportation and travel arrangements shall be the most economical under the circumstances. Excursion or coach fares shall be ordered whenever available. Approval of a vice president shall be required for any other class of travel. Each department has the right to limit travel expenditures based on budgetary restrictions and may limit coverage to certain categories of travel expense. First class travel may occur in situations for Nemours employees wherein other fares are not available or travel is for a long period of time or overseas. Board members also have the option of traveling first class. Effective, January 1, 2009, Nemours instituted a written policy regarding such travel. Schedule J, Part I, Line 4 The Nemours Foundation maintained a supplemental employee benefit plan ("SEBP") for most of the members of The Nemours executive team as determined by the Board of Directors. The SEBP provides each participant an employer provided annual "flexible" benefit allowance in the form of dollar credits which the participant may apply to any of the benefits offered under the plan which include individual long-term disability insurance, and unfunded nonqualified deferred compensation benefits subject to IRC section 457(f). Under the plan, each of the participants makes an annual election allocating his or her flexible benefit allowance for the upcoming year among the component benefits. The amount of the flexible benefit allowance may vary among the participants as determined by Nemours and Nemours may discontinue the flexible benefit allowances at any time. Contributions to the plan are disclosed in Form 990, Part VII, Column F and Schedule J, Part II, Column (C). The following associates received severance payments in 2016. Steven Sparks ($288,625 ), Roger Oxendale ($841,751) and Barbara Meeks ($340,715). Schedule J, Part I, Line 7 Certain employees of Nemours are eligible for incentive compensation. This compensation is based on qualitative and quantitative organizational goals and the achievement of such goals by the organization, its division and individuals. A Orange County Health Facililties Authority 521035390 6845036W0 2009-10-15 326242302 See Part V 0 0 0 A 26750000 0 326242302 0 0 24350000 1834712 0 0 300057590 0 0 1 0 1 1 A 0 1 1 1 0 0.01018 0 0.01018 1 0 1 A 0 0 0 1 1 0 0 0 0 A 1 Schedule K, Part I, Column a-10/15/2009 326,242,302 Orange County Health A portion of the proceeds of these bonds were used to refund on a current basis all of the outstanding Jacksonville Health Facility Authority Revenue Bonds (The Nemours Foundation Project), Series 2007, originally issued on October 3, 2007. The proceeds were used to finance the cost of the acquisition, construction, installation and equipping of a new administrative facility located in Jacksonville, Florida, and owned and operated by Nemours, and related fixtures, furnishings and equipment. The remaining portion of the proceeds of these bonds were used for the purpose of providing funds which, together with other available funds, were used to finance a portion of the cost of the acquisition, construction, installation and equipping of a pediatric healthcare facility owned and operated by Nemours, including a 95-bed freestanding children's hospital known as Nemours Children's Hospital and Outpatient Clinic, and related facilities, equipment, fixtures and furnishings, located in Orlando, Florida. Schedule K, Part III, Line 4-10/15/2009 326,242,302 Orange County Health For the year ended December 31, 2016, private use disclosed in Schedule K, Part III Line 4 Column A is 1.018%. Included in the private use calculation is space leased for Home Office Cafeteria, a casting and a pharmacy vendor located in Nemours Children's Hospital Schedule K, Part IV, Line 2c-10/15/2009 326,242,302 Orange County Health Calculation last performed on 12/6/2012. Substantial Contributor Service Provider 14980325 Independent Contractor 0 Substantial Contributor Service Provider 14573204 Independent Contractor 0 Substantial Contributor Service Provider 13479194 Independent Contractor 0 Substantial Contributor Service Provider 6071565 Independent Contractor 0 Substantial Contributor Service Provider 5497722 Independent Contractor 0 Substantial Contributor Service Provider 4092027 Independent Contractor 0 Substantial Contributor Service Provider 3780104 Independent Contractor 0 Substantial Contributor Service Provider 2612472 Independent Contractor 0 Substantial Contributor Service Provider 1481803 Independent Contractor 0 Substantial Contributor Service Provider 411021 Independent Contractor 0 Substantial Contributor Service Provider 375830 Independent Contractor 0 Substantial Contributor Service Provider 337730 Independent Contractor 0 Substantial Contributor Service Provider 318710 Independent Contractor 0 Substantial Contributor Service Provider 255766 Independent Contractor 0 Substantial Contributor Service Provider 183148 Independent Contractor 0 Substantial Contributor Service Provider 116107 Independent Contractor 0 Jacob Schrum MD Family Member of Stefanie F. Schrum 216112 Employment Compensation 0 Bryan Oxendale Family Member of Roger Oxendale 76988 Employment Compensation 0 Holly Oxendale Family Member of Roger Oxendale 45283 Employment Compensation 0 Richard Finkel MD Family Member of Terri Finkel 341697 Employment Compensation 0 Kelsey Bridges Family Member of Robert Bridges 53938 Employment Compensation 0 X 3 1900 Cost or sales price X 249997 Cost or sales price X 12 92133 Fair market value X 5 3549 Cost or sales price X Other - electronics 20 15645 Cost or sales price X Other - books 1 10000 Cost or sales price X Other - decorations 3 5300 Cost or sales price 0 0 1 0 Schedule M, Part I Nemours reports the number of contributions received and not by the number of items. Form 990, Part VI, Section A, Line 2 Mr. Durden , Mr. Porter, Mr. Lord, Mr. Thornton, and Mr. Christopher have a shared business relationship. These individuals serve as trustees of the Alfred I. DuPont Testamentary Trust, of which Nemours is the only charitable beneficiary and who are some of the members of Nemours. Form 990, Part VI, Section A, Line 4 During 2016 Nemours streamlined its governance structure. Previously, some members also served on the Nemours Board of Directors. Subsequent to the governing document changes, the Trustees of Alfred I. DuPont Testamentary Trust (the Trust) served as members of Nemours, but they no longer served on the Nemours Board of Directors. Their responsibility is to appoint the Members of the Nemours Board of Directors. No changes were made to the clauses in the governing documents related to Nemours' charitable purpose, the general powers of the Board of Directors, the size of the Board of Directors, the dissolution clause, or the committee structure. Form 990, Part VI, Section A, Line 6 The Nemours Foundation (Nemours) organizational documents include members who constitute a portion of the governing body. Specifically, the members are those individuals who also serve as trustees of the Alfred I. DuPont Testamentary Trust (the Trust). The Trust's primary purpose is to provide funding for Nemours' charitable activities in the communities it serves. As trustees of the Trust, these individuals are appointed as members of Nemours. The members have certain general oversight rights and some limited retained powers. After changes were made to the Articles of Incorporation and Bylaws of Nemours as discussed above, the Board of Directors is made up of directors who are selected by the members of Nemours. The Board of Directors has full governance over the activities of Nemours. Form 990, Part VI, Section A, Line 7a See answer on Form 990, Part IV, Section A, Line 6. Form 990, Part VI, Section A, Line 7b See answer on Form 990, Part IV, Section A, Line 6. Form 990, Part VI, Section B, Line 11b During November 2017, management distributed a draft of the 2016 Form 990 to the Audit and Finance committee prior to the scheduled board of directors meeting in November of 2017. During the course of the board of directors meeting, management presented an overview of Form 990 to the Audit and Finance committee and gave the committee members an opportunity to provide comments and ask questions with respect to the draft. Based on feedback provided from the committee members, management updated the draft Form 990. Upon finalization of the return, management provided a final copy of the return via e-mail to the board of directors. Form 990, Part VI, Section B, Line 12c The Nemours Foundation (Nemours) has established a conflict of interest policy which has been reviewed and approved by the board of directors. Nemours is committed to the belief that sound business practices start with an absolute commitment from each employee to act ethically in carrying out Nemours business, and to comply with the laws and regulations that impact its business, thus Nemours' employees must avoid participating in activities that create or appear to create a conflict of interest. Nemours has specifically identified the following areas in its policy to be potential conflicts of interest: financial interest, outside employment, paid faculty arrangements, consultant or research contracts, acceptance of gifts, gratuities, business courtesies, travel, lodging and entertainment, misuse of resources or assets, personal gain using undue influence, direct dealings with vendors, use of confidential information, and an individual's support of political causes. Nemours' policy requires certain individuals to disclose participation in activities or circumstances that may present a conflict of interest on an annual basis or if at any time such individual becomes aware of circumstances that may present a conflict of interest. These disclosures are reviewed by the Audit and Finance Committee as necessary. Form 990, Part VI, Section B, Line 15 The Nemours Foundation's (Nemours) Board of Directors designated the People, Compensation and Reputation Committee (PCRC) to serve as the committee responsible for establishing compensation practices which are reasonable and do not violate the private inurement prohibition . The practices and processes are designed to avoid any claim for intermediate sanctions and to satisfy the requirements to obtain the rebuttable presumption. The PCRC annually reviews, in consultation with an independent executive compensation consulting firm specializing in healthcare and the not-for-profit industry, independently sourced benchmark market data to establish the compensation of our officers, senior leadership and key employees and to ensure reasonableness in comparison with peer practices. The Board of Directors reviews and sets forth the compensation for the CEO using the same process as the PCRC. Nemours' compensation philosophy across the board targets the market median for base salaries for all Nemours' Associates, including officers, senior leadership and key employees. Total cash compensation is also generally targeted to be at the median of Nemours' peers. Form 990, Part VI, Section C, Line 19 Generally, the Nemours Foundation (Nemours) does not make its governing documents or its conflict of interest policy available to the public. However, Nemours' articles of incorporation are publicly available through Florida's secretary of state website www.sunbiz.org . Additionally, Nemours' audited financial statements can be accessed through Digital Assurance Certification LLC, website www.dacbond.com. Form 990, Part XI, Line 9 Pension liability adjustment $40,047,061. Cruden Bay Risk Retention Group Inc 2386 Airport Road Barre VT 05641 270057453 Risk Retention VT 501(C)(3) 509(A)(3) The Nemours Foundation 1 Pediatric Medical Services of Florida Inc 9145 Narcoossee Road Suite A203 Orlando FL 32827 453584225 Health Care FL 501(C)(3) 509(A)(2) The Nemours Foundation 1 Nemours New Jersey Physician Practice PC 1801 Rockland Road Wilmington DE 19803 463160718 Health Care NJ 501(c)(3) 509(a)(2) The Nemours Foundation 1 Dornoch Sutherland Assurance LTD PO Box 1085 GT Grand Cayman CJ KY1-1102 980404800 Captive Insurance CJ The Nemours Foundation C 15269586 48379682 1 1 Alfred I duPont Testamentary Trust 510 Alfred Dupont Place Jacksonville FL 32202 590226560 Charity Investment FL N/A T 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 Dornoch Sutherland Assurance LTD m 1250000 Dornoch Sutherland Assurance LTD l 13850000 Cruden Bay Risk Retention Group Inc l 2000000 Cruden Bay Risk Retention Group Inc m 260000 Cruden Bay Risk Retention Group Inc q 531539 Pediatric Medical Services of Florida Inc r 5597281 Nemours New Jersey Physician Practice PC r 1869036 The Return is being filed on a timely basis. Nemours filed extensions on a timely basis, manually with the IRS. The tax return software system used to efile the return generates a reasonable cause statement if extensions are not filed in that system. Accordingly, the return was properly extended and is now being filed timely by its extended due date of November 15, 2017.