2017-11-09T16:24:07-06:00 2016-12-31 KPMG LLP 4200 Wells Fargo Ctr 90 S 7th Minneapolis MN 55402 990 2016-01-01 411754276 Children's Health Care % Rebecca Woitalewicz Int CF CHIL 6128136000 2525 Chicago Avenue South Minneapolis MN 554041844 REBECCA WOITALEWICZ Interim CFO 2017-11-09 true Monroe J Gierl P01413237 6123055000 2017-11-09 167.68.102.5 41438720173135000003 2017-11-09 P CBDCF8A62BCD6705D428F3975F29828786D22771 30031D5E7EADAC179FA13A5C3B90D0218042D0DA 2016 2021-01-29 14:40:06Z Children's Hospitals & Clinics of MN Rebecca Woitalewicz Int CFO 2525 Chicago Avenue South Minneapolis MN 554041844 1289735705 false X www.childrensmn.org X 1995 MN Children's Hospitals and Clinics of MN Champions the special needs of children. 17 13 5536 1992 -1013541 -1120021 28809464 30780597 745071505 786609931 23922259 23083502 3723330 3148388 801526558 843622418 4093487 2596223 0 0 425221492 461588940 0 0 0 298923912 323680240 728238891 787865403 73287667 55757015 1136462629 1217253842 387458232 387129955 749004397 830123887 X Children's Hospitals and Clinics of Minnesota champions the special health needs of children and their families. We are committed to improving children's health by providing family centered pediatric services. We advance these efforts through research and education. false false 665149454 2596223 780167970 Hospital program services: Families look to Children's Hospitals and Clinics of Minnesota for the finest in pediatric care. With two pediatric hospital facilities and 430 staffed beds, we champion the special health needs of children and their families and are committed to providing high-quality, family centered pediatric services. The Leapfrog Group's annual list of top hospitals named Children's Hospitals and Clinics of Minnesota's Minneapolis and St. Paul hospitals as two of the top ten pediatric hospitals in the country for quality and efficiency. See Schedule O. 3785899 1289712 Education: Many efforts to improve the health and well-being of children and youth require long-term investment in their future. Children's provides education and training programs for providers, health care students, and other health professionals in the following areas: 1) Community medical education for community physicians: During the 2016 calendar year, Children's provided training to 393 affiliated residents and fellows, and hosted 287 medical student rotations at Children's Minneapolis, Children's St Paul, or both locations. See Schedule O. 4116774 5489 Research: Children's has 456 open research studies, of which 252 are actively recruiting clinical trials. In 2016 Children's received about $32 million from industry contacts and federal state andfoundation sponsors. Types of studies and trials conducted at Children's are investigator-initiated studies, external multi-center trials, observational studies, registries, and supportive services such as Case Management. Children's had ongoing research in Emergency/trauma, Cystic fibrosis, Diabetes andendocrinology, Cardiovascular and critical care, Pain and palliative care, Integrative medicine, Genetics, Cancer and blood disorders, and Neonatology ENT and Rehab. See Schedule O. 673052127 true true false true false false false false false true true true false true true true false true false false true false false false false false true true true true true true false false false false false false false false false true true false false false false true true true false false true 451 0 true 5536 true true true true CJ false false false false false false false false X 17 13 false false false false false false false true true false false true true true true true true true true true false MN X Rebecca Woitalewicz Int CF 6128136129 2525 Chicago Avenue South Minneapolis MN 55404 X Robert Bonar JR Chief Executive Officer 48.0 2.0 X X 1296845 0 199973 Stephen Nelson Staff Physician 50.0 0.0 X 334522 0 69922 J Hayes Batson Board Chair 1.0 2.0 X X 0 0 0 Martin L Bassett Vice Chair 1.0 1.0 X X 0 0 0 Bruce P Shay Treasurer 1.0 1.0 X X 0 0 0 Russell Becker Board Member 1.0 2.0 X 0 0 0 Matt Furman Board Member 1.0 1.0 X 0 0 0 Greg Goven Board Member 1.0 2.0 X 0 0 0 Sharon Jaeger Board Member 1.0 0.0 X 0 0 0 Mary L Jeffries Board Member 1.0 0.0 X 0 0 0 Paul H Marvin Board Member 1.0 0.0 X 0 0 0 John McNamara MD Board Member 1.0 1.0 X 0 0 0 Richard Migliori MD Board Member 1.0 0.0 X 0 0 0 John Mulligan Board Member 1.0 0.0 X 0 0 0 Richard T Murphy JR Board Member 1.0 0.0 X 0 0 0 Lenny Snellman MD Board Member 1.0 1.0 X 55000 0 0 Tom Teft Board Member 1.0 1.0 X 0 0 0 David Overman President & COO 50.0 0.0 X 1044663 0 79028 Todd Ostendorf VP, Finance & CFO - April 2016 47.0 3.0 X 288694 0 61544 Phil Kibort VP Medical Affairs and CMO 49.0 1.0 X 759807 0 43001 Maria Christu Chief Legal Officer 49.0 1.0 X 530354 0 86897 Roxanne Fernandes CNO, VP Patient Care Svcs 50.0 0.0 X 513151 0 72834 Jeffrey Young Chief Information Officer 50.0 0.0 X 457856 0 77030 Carol Wilcox VP Diagnostic/Therapeutic SVCS 50.0 0.0 X 297258 0 44836 Bjorn Gunnerud VP, Marketing & Communications 50.0 0.0 X 331215 0 65272 Samantha Hanson CHRO 50.0 0.0 X 422231 0 77505 Jennifer Olson VP Business Dev. & Strategy 50.0 0.0 X 371699 0 65972 Trevor Sawallish Chief Ambulatory Officer 49.0 1.0 X 334839 0 69606 Emily Chapman Vice Chief Medical Officer 50.0 0.0 X 254290 0 49948 Rabindra Tambyraja Chief Medical Info Officer 50.0 0.0 X 126487 0 15691 Michael Morrey VP Ops Mother Baby Clin Svc 50.0 0.0 X 187236 0 19433 Rebecca Woitalewicz Interim CFO through April 2016 47.0 3.0 X 228363 0 36211 Claudia Hines Sr Dir Clin Svcs - Pediatrics 50.0 0.0 X 144606 0 27420 Gloria Drake Sr Dir Clin Svcs - Periop 49.0 1.0 X 234958 45426 40834 Alice Chernich Sr Dir Clinical Serv - Neonata 50.0 0.0 X 204202 0 23805 Anupam Kharbanda Chief of Critical Care Service 50.0 0.0 X 379660 0 32854 Theresa Pesch President, Foundation 5.0 45.0 X 47293 425630 84714 Kathleen Penson Sr Dir Clin SVCS - Pediatrics 50.0 0.0 X 198696 0 23411 Joseph Petronio Surgical Dir, Peds Neurosurg 50.0 0.0 X 957464 0 81075 Meysam Kebriaei Staff Physician 50.0 0.0 X 757159 0 68849 Frank Rimell Staff Physician 50.0 0.0 X 732725 0 65865 James Engels Staff Physician 50.0 0.0 X 575454 0 76622 Barbara Malone Medical Director 50.0 0.0 X 639879 0 59736 12706606 471056 1719888 866 false true false Cerner Corporation PO Box 412702 Kansas City MO 64141 Hardware/Software 8310325 Sodexo Inc Affiliates 4880 Paysphere Circle Chicago IL 60674 Nutrition & Envi Svr 5216921 Children's Heart Clinic PA 2530 Chicago Ave S Suite 500 Minneapolis MN 55404 Physician Services 5141926 Children's Respiratory Critical C 2530 Chicago Ave S Suite 400 Minneapolis MN 55404 Physician Services 4341540 Conifer Health Solutions LLC 1500 South Douglas Road Anaheim CA 92806 Patient Billing 3833065 123 18509235 12271362 1079567 30780597 Patient Service Revenue 621400 501040791 501040791 Medicare/Medicaid payment 621400 242688275 242688275 Pharmacy Revenue 621400 1555572 1555572 Parking 812930 3435054 73890 3361164 Lab Revenue 621500 37401453 37245319 156134 488786 488786 786609931 16548236 -1243565 17791801 0 0 2028687 1617227 411460 0 411460 411460 450534095 497231 444418425 77635 6115670 419596 6535266 6535266 0 0 0 0 0 0 0 0 0 Cafeteria 722514 2310229 2310229 Marketplace 453220 373983 373983 Vending machines 722514 25947 25947 26769 26769 2736928 843622418 781463171 -1013541 32392191 X 527915 527915 2068308 2068308 0 0 12684614 7396132 5288482 0 349387421 309484890 39902531 28386176 22608640 5777536 46955661 40905365 6050296 24175068 21446665 2728403 3432243 2804973 627270 780303 34389 745914 256243 256243 160215 160215 0 4471757 4471757 84775689 71566345 13209344 3572314 204649 3367665 10215162 7916123 2299039 16472379 16472379 0 13952094 13196766 755328 1931873 1490940 440933 0 2114646 1892337 222309 9531075 9531075 0 41741948 30030765 11711183 1335232 1335232 Medical Supplies 72291749 72291749 MNCare Tax 14714616 14714616 Medicaid Surcharge 9762660 9762660 Temp Labor 8327756 7147198 1180558 23840286 20222638 3617648 787865403 673052127 114813276 0 14565775 9845476 5533060 16796988 1298214 926072 115710800 113968230 0 0 0 0 0 0 5851597 6474706 10677628 10012116 748382399 376326450 380422583 372055949 463694958 376638108 29757244 170150019 19772171 19599253 0 0 89178599 120786925 1136462629 1217253842 108405397 110089270 0 0 2188265 2378932 245437278 228854368 0 0 0 0 229236 187934 0 0 31198056 45619451 387458232 387129955 X 676847001 760463884 0 0 72157396 69660003 749004397 830123887 1136462629 1217253842 X 55757015 24321752 1040723 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 130137 false true 30078 160215 false Form Sch C Part II-B Line 1a Children's retains a lobbyist to assist directly with lobbying efforts at the state level. Children's Public Policy Director is also responsible for lobbying activities on the city, state, and federal level. Those responsibilities include providing testimony at the State Capitol, maintaining relationships, educating legislators and staff, and working with our regulatory agencies. With respect to federal lobbying efforts, Children's Senior Director of Child Health Policy, Public Policy Director, and CEO will occasionally travel to Washington to meet with federal lawmakers. This is generally done in a collaboration with industry organizations, such as NACHRI, who indirectly provide federal lobbying support on behalf of Children's. Children's is a member of the Children's Hospital Association (CHA). $10,911 of membership dues paid to CHA relate to lobbying activities. false false 39136928 100571581 6528600 1502571 144734538 41329339 211366 -1037098 1366679 39136928 39959574 1216110 1904157 1750502 41329339 33578504 1416216 5959789 994935 39959574 30285804 421789 3955151 1084240 33578504 0.71000 0.21000 0.08000 true true true 0 15260701 15260701 0 434123792 171014325 263109467 0 16042432 1690815 14351617 0 277532836 198358494 79174342 0 5422638 5262816 159822 372055949 INVESTMENTS IN LIMITED PSHIPS 170150019 F 170150019 EXECUTIVE BENEFIT PLANS 7636771 PHYSICIAN RELOCATION LOANS REC 76585 PHARMACEUTICAL SERVICE DEPOSIT 2112815 FACILITY DEPOSIT 123255 UNITED SHARED SERVICE ARRNGMT 13465834 INVESTMENT IN MOTHER/BABY 26570924 OTHER 1439541 BENEFICIAL INT IN NA OF FDTN 69361200 120786925 0 RSVP RETIREMENT PLAN 11727922 EXECUTIVE BENEFITS LIABILITY 5260070 MN CARE TAX PAYABLE 3297219 POST-RETIREMENT BENEFITS 3275666 WORKERS COMP LIABILITY 2019580 SELF-INSURANCE RESERVE 284417 ACCRUAL VERP 175826 INTERCOMPANY PAYABLE 7993336 LONG TERM DEFERRED REVENUE 10822696 OTHER 762719 45619451 X Form Sch D Part V Line 4 Effective November 1, 2016, the Childrens Board of Directors designated $100 million of unrestricted investments for endowment to support programs at Children's Health Care. The majority of permanent endowment funds are held by Children's Health Care Foundation, a related organization. The intended use of the funds is to support the programs at Children's Health Care. There are also two endowment funds that are held and administered by US Bank, an unrelated organization, which are also used to support the programs at Children's Health Care. Refer to Part III, Line 4 for a description of the programs of Children's Health Care. Form Sch D Part X Line 2 The IRS has determined that Children's and its subsidiaries are exempt organizations as described in Section 501(c)(3) of the IRC. Children's believes that it continues to meet the requirements of the IRC to sustain its tax-exempt status. In accordance with ASC Subtopic 740-10, Income Taxes Overall, Children s recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than 50% likely of being realized. Changes in recognition or measurement are reflected in the period in which the change in judgment occurs. There are no federal income tax expenses, penalties, or interest recognized in the consolidated statements of operations and changes in net assets and no unrecognized tax benefits for the years ended December 31, 2016 and 2015. Children's is not subject to an income tax examination for years before 2013. Central America and the Caribbean Program Services Self Insurance 122668 Central America and the Caribbean Investments N/A 9426961 Europe (Including Iceland and Greenland) Investments N/A 4720322 Central America and the Caribbean Investments N/A 5286628 Central America and the Caribbean Investments N/A 2815994 Central America and the Caribbean Investments N/A 969995 Central America and the Caribbean Investments N/A 5610475 Central America and the Caribbean Investments N/A 1773848 30726891 30726891 true false true true true false true true X true X 275. true X true true false true true 945420 945420 0.00120 336945040 254963548 81981492 0.10490 337890460 254963548 82926912 0.10610 13640371 2595782 11044589 0.01410 7190663 2542262 4648401 0.00590 69738834 49616313 20122521 0.02570 4152622 3151858 1000764 0.00130 125630 125630 0.00020 94848120 57906215 36941905 0.04720 432738580 312869763 119868817 0.15330 5400 5400 13700 13700 55500 55500 0.00010 74600 74600 0.00010 true 6005834 1501459 130901 269520 -138619 X true true 1 1 Children's Health Care 2525 Chicago Avenue South Minneapolis MN 55404 http://www.childrensmn.org/ 356144 X X X X X X Children's Health Care 1 false false true X X X X X X X X X 16 true false false true X http://www.childrensmn.org/community X true 16 true http://www.childrensmn.org/community false false true X 275. 350. X X X true true X X X X true X www.childrensmn.org/your-visit/af X www.childrensmn.org/your-visit/after X www.childrensmn.org/your-vis X X X X X X true X false X X X X true X false false Form Sch H Part V Line 5 Over the course of 2016, we heard from people within and outside of Children's about their perspectives on health and well-being, including: more than 800 people at community events and primary care clinics; 42 community stakeholders, and 195 Children's Minnesota employees and clinicians. Building off of the data and process used for our 2013 CHNA, the entire assessment process was guided by the Community Advisory Committee (CAC), a diverse group of community stakeholders, including local advocates and representatives of community organizations and systems serving children and families. Health topics considered through this assessment process were expanded to include community conditions and other factors that contribute to health, such as poverty, education and housing. The top health priorities were determined through criteria recommended by the CAC that valued quantitative data and drew on the experience and expertise of committee members. A more detailed description of our Community Health Needs Assessment process and stakeholders interviewed is available in the full CHNA report at https://www.childrensmn.org/support-childrens/community-health-engagement/ community-health-needs-assessment/ In addition, Children's actively participates in several community health coalitions and maintains ongoing contact with many of these representatives. Form Sch H Part V Line 11 The 2016 CHNA identified six issues as being the most important for Children's Minnesota to focus in order to support the health and well-being if children and their families. The identified focus areas include both health status indicators such as asthma and mental health and well-being, as well as social determinants of health including: access to resources; income and employment; education; and structural racism. As implementation strategies are developed to address these priorities, the Children's Advisory Committee and Children's MN will consider the intersectionality of these topics, as well as how they contribute to disparities. Children's continued to provide the following services to address the significant needs identified in its CHNA, including: Access to care: - Interpreter Services: Overall, the total number of interpreting encounters for 2016 was 90,598 in a total of 78 languages. The top three languages interpreted at Children's are: Spanish, Somali and Hmong. - Food Pantry: In 2016, the Family Resource Center provided 9,603 meals, which served 741 children and 2,752 adults. - Family Resource Center: The total number of visits to Children's Family Resource Centers in St Paul and Minneapolis in 2016 was 38,416. Staff mediated encounters were 16,717 which include the number of amenity disbursements (meal tickets, parking vouchers, cab vouchers, bus passes, personal care items, etc), consumer health research/reference requests, notary transactions, technology support, etc. - Financial Counseling: Children's Financial Resource Center helped 3,109 patients in 2016 apply and receive approval for Minnesota Medical Assistance (Medicaid). - Portico Healthnet: To help expand access to coverage, Children's continued providing financial support to Portico Healthnet, a non-profit organization that assists uninsured Minnesotans in accessing affordable health coverage and care. - Sibling Play Area: The Sibling Play Area is a creative space especially designed for the brothers and sisters of patients. It provides siblings of patients a unique place to play during appointment and wait times, surgeries or procedures. In 2016, the Sibling Play Area was used by 6,274 kids in Minneapolis and 3,049 in St Paul. - Children's Immunization Project: Kohl's Cares and Children's Flu Prevention Project administered 6,558 flu vaccinations at 101 school vaccination clinics through funding and support from Kohl's. We visited 16 schools and provided an educational program on influenza prevention including hand hygiene and providing and reading a book to 2,860 students in grades K-2. - Health equity: The Children's Minnesota Minneapolis campus is located in the heart of one of the largest and most vibrant urban communities in the country. Recognizing the critical role culture and traditions play in a child's health and well-being, we've partnered with community organizations to help provide a more culturally responsive and respectful approach to health care. - The First Gift Initiative grows as a transformative program approach that connects traditional knowledge, community healing, positive storytelling/narratives, to promote healthy American Indian babies. Traditionally, The First Gift is a pair of moccasins given to a baby. Children's Minnesota, in partnership with the local American Indian community, gather to make and distribute moccasins to American Indian babies in the Special Care Nursery (SCN) and the Neonatal Intensive Care Unit. In 2016 the First Gift project gave 20 families at Children's and in the community their First Gift. The American Indian Volunteer Cohort has trained over 10 volunteers. This cohort is specifically aimed to recruit American Indian Community members to come to Children's to hold babies in our SCN. This cohort was designed to create a more inclusive, representative, and culturally aware environment. Maternal and child health - Minnesota Sudden Infant Death (SID) Center: The Minnesota SID Center served 90 families in 2016 and provided 15 professional education trainings. The SID Center conducted 1100 public health nurse visits and sent 17,000 informational mailings. - Perinatal HIV Prevention: Children's served 138 clients in the Perinatal HIV Prevention program, including providing care coordination to 40 HIV-positive pregnant women. Children's provided case management for 44 HIV-positive patients in addition to surveillance for 54 HIV-exposed infants. Mental health: - The Midwest Children's Resource Center (MCRC) at Children's is a hospital-based program that provides clinical evaluations and services to children who have been abused or neglected. MCRC brings subspecialty medical consultation, skilled case management and expert psychological services to communities throughout the region, and promotes and delivers expert service in child abuse response. In 2016, MCRC treated 1,318 children for suspected abuse. Achieving optimal outcomes in maltreated children requires close collaboration with community partners in law enforcement, child protection, advocacy, medicine, and mental health. Services include medical evaluations and health assessments; psychological assessments; professional consultations; and prevention programs on shaken baby syndrome, teen parenting programs and child sexual abuse. The MCRC also functions as one of four Regional Children's Advocacy Centers across the nation, providing training and technical assistance to child abuse professionals across the Midwest and nation. Morbidity and mortality (focus on obesity and asthma): - Healthy Kids Partnership: Children's continued its collaboration with HealthPartners and a variety of community-based organizations and health clinics to address childhood obesity at the community level. Through three neighborhood or city specific initiatives, the partnership is testing diverse approaches toward creating healthier environments for children in our communities. - HealthTeacher: Children's financially sponsored the HealthTeacher program for school districts in Hennepin and Ramsey counties. HealthTeacher, Inc. provides web-based health education curriculum and interactive physical activity breaks related resources focused on health improvement and physical activity. These tools provide schools and teachers important resources to help children lead healthy lives. - Public health and policy coalitions: In order to address the policies, systems and environments that impact child health, Children's actively participated in several broad based coalitions, including: the Minnesota Prematurity Task Force, Minnesota Healthy Kids coalition, MinneMinds, Generation Next, the Saint Paul Promise Neighborhood health committee, the Mental Health Legislative Network, and the Community Health Improvement Partnership collaborations in Hennepin and Ramsey counties. These coalitions address a variety of health issues in our community, including improved birth outcomes, childhood weight status, early childhood development, access to health care, social connectedness, and community health overall. Social and economic factors: - School re-entry program: When a child is forced to miss school for a prolonged period of time due to an illness, the school re-entry program helps him or her prepare for a return to the classroom. In 2016, Children's conducted 88 school visits which served 2,640 children. - Child and Family Services: The Families as Partners program worked with 206 families that volunteered 2.914 hours of service in 2016. There were 21 individuals who served on the Family Advisory Council and 20 youth who served on the Youth Advisory Council. Form Sch H Part V Line 15e Children's Hospitals written financial assistance policy. The policy outlines the guidelines, scope of services covered, availability of information, how to apply, the patient/guarantor's responsibility for providing information and the hospitals responsibility for review and communication of determination. The policy is based on the federal poverty guidelines, updated annually with a differentiation for those families with insurance and those without and includes an exception process. Amounts generally billed is defined and Children's has chosen the look back method inclusive of all claims. Form Sch H Part V Line 16J Children's Hospitals and Clinics has a written financial assistance policy and a Plain Language Summary of our policy. Our policy is posted on our website as well as available at all registration areas throughout the hospital and our clinics. A copy of the plain language summary of our policy is provided to any patient without insurance at each visit and annually to all patients. The policy and Plain language Summary is currently available in English, Spanish, Somali, Hmong, Russian and Vietnamese. We also have posters identifying key points of our policy displayed in all registration areas. In addition, we have a financial assistance calculator on our website where families are able to key in their income and family size to assess whether they may meet our policy guidelines. Form Sch H Part V Line 22B CHILDREN'S FINANCIAL ASSISTANCE POLICY IS BASED ON THE FEDERAL POVERTY GUIDELINES. FOR FAMILIES WITH NO INSURANCE AND INCOME LESS THAN 275% OF THE FPL, THE CARE PROVIDED TO THE FAMILY IS FREE. FOR FAMILIES WITH INCOME GREATER THAN 275% OF THE FPL BUT LESS THAN 350% OF THE FPL, THE FAMILY WILL BE CHARGED NOT MORE THAN AMOUNTS GENERALLY BILLED. CHILDREN'S HAS CHOSEN TO USE THE LOOK BACK METHOD AND INCLUDING ALL CLAIM PAYMENTS FOR THE PREVIOUS 12 MONTH PERIOD. 8 Children's Clinics - Woodwinds 1825 Woodwinds Drive Suite 400 Woodbury MN 55125 Specialty and Rehabilitation Clinic Children's - Maple Grove 7767 Elm Creek Blvd Suite 300 Maple Grove MN 55369 Specialty and Rehabilitation Clinic Children's Rehab Clinic 5950 Clearwater Drive Suite 500 Minnetonka MN 55343 ENT and Rehabilitation Clinic Children's - Roseville 1835 W County Rd C Roseville MN 55113 Specialty and Rehabilitation Clinic Children's - Minnetonka 6060 Clearwater Drive Suite 204 Minnetonka MN 55343 Specialty Clinic - Diabetes and Endocrinology Children's Sleep Center 310 North Smith Ave Suite 480 St Paul MN 55404 Specialty Clinic- Sleep Disorders Center for the Treatment of Eating Dsrdr 910 E 26th Street Suite 410 Minneapolis MN 55404 Specialty Clinic - Eating Disorders Children's Specialty Clinic 360 Sherman Street St Paul MN 55102 Specialty Clinic - Psychological Services Form Sch H Part I Line 3c Federal Poverty Guidelines are the primary measurement used to determine eligibility for financial assistance. However, policy exceptions may be granted for families who have medical debt exceeding 10 percent of their income or have other specific documented needs where they are not able to pay all or a portion of their balance. Medicaid eligibility may also be used to determine eligibility. Form Sch H Part I Line 6a Children's includes information on community benefit expenditures in the organization's annual report. The report is available online at https://www.childrensmn.org/support-childrens/giving-to-childrens/annual-r eport/. Community benefit numbers, as well as community health needs assessment information, are also available on the community health section of the website: http://www.childrensmn.org/community. Form Sch H Part I Line 7g Subsidized health services benefits include the following programs: ECMO (extracorporeal membrane oxygenation) is a lifesaving treatment for the most critically ill babies, children and teens. ECMO takes over temporarily with a mechanical blood pump and artificial lung when a childs heart or lung is not functioning. The ECMO program at Children's Hospitals and Clinics of Minnesota is the largest and oldest in the state: $1,518,128. The Infant Apnea Program includes pediatric specialists who understand the science behind a baby's breathing process. Our team of pulmonary, neonatology and nurse experts provides comprehensive evaluations, family education, ongoing management and support to families of infants diagnosed with apnea or gastroesophageal reflux (GER), a regurgitation of food that can interfere with breathing: $512,267. The Hospitalist Program is a team on the general medical/surgical units 24/7 that are among the first faces a child sees. The hospitalists confer with the referring doctor and the patient's pediatrician to gather information and plan for first-rate care: $2,791,505. The Minneapolis General Pediatrics clinic is located within the Minneapolis hospital location and serves babies, toddlers, children, teens and young adults in the Phillips neighborhood: $660,451. The Integrative Medicine Program combines the best of complementary and conventional medical therapies to develop holistic solutions for children with chronic illness, acute and chronic pain, side effects from medical treatments, and emotional challenges such as depression and anxiety: $456,757. The Eating Disorders Clinic uses leading evidence-based treatments to patients of all ages and with all types of eating disorders. The Center for the Treatment of Eating Disorders is the only hospital-based program in the Twin Cities to offer immediate access for medical stabilization: $572,441. The Cleft and Craniofacial Clinic is one of the premier programs in the region dedicated exclusively to diagnosing and treating cleft and craniofacial disorders in babies, children, adolescents and young adults. They treat a wide range of conditions, from cleft lips to abnormal head shapes, using state-of-the-art technologies for 21st century care: $2,467,009. The Development Pediatric Clinic addresses concerns about your childs developmental, behavioral, social or learning challenges. The program approaches behavioral and developmental conditions, such as autism and Down syndrome, from all angles: $351,932. Psychological Services meets with children for outpatient therapy, psychological and neuropsychological assessments, and consultation to outpatient and inpatient medical service: $2,006,667. Home Health Care allows kids to receive these services not at a hospital bedside, but at home with their families. Education is also a big part of a home care nurses' role and they are always available to answer any questions or provide assistance: $1,329,760. Midwest Childrens Resources Center (MCRC) offers medical evaluations and case management in alleged child abuse cases, serious neglect and witness to violence. Every year, more than 1,100 children ages 0 to 18 visit us. MCRC receives referrals from law enforcement, emergency departments, primary physicians, child protection services, parents, self-referrals and a variety of community agencies: $69,363. The Genetics Clinic helps families understand genetic conditions, like chromosomal disorders and single-gene disorders. With one of the largest genetics programs in the region, we see more than 2,000 children and teens every year and we are the only genetics clinic in Minnesota that focuses entirely on caring for kids with genetic conditions: $1,491,843. The Neurology Clinic provides expert diagnosis and treatment for kids' brain and nervous system conditions like brain tumors, epilepsy, head trauma, cerebral palsy and others: $515,656. The Neurosurgery Clinic uses cutting edge surgical techniques and technology to treat tumors, epilepsy and other brain and nervous system conditions. We perform hundreds of surgeries each year on babies, kids and teens. That makes us one the most experienced pediatric neurosurgery centers anywhere: $1,193,063. The Rheumatology Clinic uses advanced tools to diagnose these complex conditions, alleviate pain and restore function in kids and teens: $220,082. Psychiatric Services provides assessment and consultation to children. They can also prescribe and manage medications used to treat emotional and behavioral problems: $588,951. The Sedation and Procedural Services (SPS) unit provides a broad range of scheduled and unscheduled services including, non-surgical procedures, diagnostic testing, minimal, moderate, and deep sedation, nurse-only visits, and vascular access services for the hospital sites. The SPS units admit scheduled and unscheduled medical and surgical observation status patients and care for inpatient overflow volume in times of high census: $1,860,868. The Gynecology clinic knows that common or rare gynecological conditions can indeed affect teens, tweens, girls or even infants. When they do, our specially trained experts provide evaluations and breakthrough treatments: $84,663. Our Cancer and Blood Disorders clinic offers advanced, individualized care for newly diagnosed children, teens and young adults with cancers and blood disorders. We also provide innovative treatment for rare, relapsed and recurrent cancers: $1,431,115. Form Sch H Part II Community building activities: Children's provided the following community building activities in 2016: Career Readiness: -Achieve Step-Up: Step-Up is Minneapolis' largest training program which provides job opportunities to youth. Since 2006 Children's Minnesota has hired Step-Up summer interns. The students work in a variety of areas to gain knowledge in patient care and non-patient care departments. Many of the Children's Step-Up students attend or will be attending higher education institutions. Students may return to their positions during breaks in a casual capacity while attending school or volunteer. The program at Children's focuses on immersing and integrating students in the hospital work environment to assist with building skills and competitive employment in healthcare. In 2016, Children's employed 10 Step-Up interns. -Cristo Rey Jesuit High School: Children's is one of the pioneer organizations in the Twin Cities that is involved in the Cristo Rey School Initiative. This program provides college preparatory schooling to inner city minority students as well as targeted work-study opportunities. Children's has provided work-study and mentor opportunities to students since 2007. The goal of this initiative is to provide real-life work experiences that will broaden our minority talent pool while allowing students to earn a portion of the cost of their education. In 2016, Children's assisted 8 students. -Project SEARCH: Children's partnered with the Minneapolis Public Schools Transitions Plus program to launch Project SEARCH in 2011. We are the first healthcare organization to launch Project SEARCH in the 5 state areas. PS is a unique business-led transition program for students with disabilities to work, explore careers and develop transferable job skills, with the goal of working in a competitive environment. Designed as an unpaid internship program, Project SEARCH places students in real situations where they learn all aspects of gaining and maintaining a job. This process of immersion facilitates the teaching and learning of new work skills on-site. Individualized job development and placement occurs based on the student's experiences, strengths, and skills. A series of job rotations allow students to find positions that best suit their preferences. Students receive support with accommodations, adaptations, and on-the-job coaching via Minneapolis school employees. Children's worked with 8 PRoject Search students in 2016. -Project for Pride in Living: PPL helps low-income people achieve self-sufficiency through housing, employment training, support services and education. Children's partners with and provides financial support to PPL in their Train to Work initiative, which has trained hundreds of people to meet entry-level staffing needs of Children's and other major area healthcare partners. Train to Work offers training in healthcare-specific details, such as medical terminology and electronic health records, as well as a job shadowing internship that has been essential component of the program's success. The internship gives participants hands-on experience in healthcare and gives employers and opportunity to observe potential employees. In 2016, Children's sponsored 5 PPL interns. -Community Support: Children's supports the Midtown Safety Center in the Phillips neighborhood where the Minneapolis hospital campus is located. The Midtown Safety Center acts as a hub for connecting police and community in important ways. -Community Support: Children's provided a number of donations to community based organizations in 2016 to support their work in supporting community health through their mission. The work of these organizations varied, both in scope and specific focus, but broadly worked to address the many social conditions that impact health. Form Sch H Part III Line 2 Bad debt is defined as the unpaid obligation for care provided to patients who have been determined to be able to pay, but have not demonstrated a willingness to pay. The amounts attributable to patients eligible under the organizations financial assistance policy are determined by a patient's willingness to pay with a documented inability to pay per measures established by our policy. Bad Debt is estimated by applying the ratio of patient care cost to charges, as calculated on Form 990, Schedule H, Worksheet 2, to the actual patient charges. Form Sch H Part III Line 3 The organization estimates that twenty-five percent of bad debt expenses are attributable to patients who likely would qualify for financial assistance under the organization's charity care policy (but were either unwilling or unable to provide sufficient information to make a determination of their eligibility while in our care). The estimate of twenty-five percent is based on a review of accounts classified as bad debt and management judgment. Form Sch H Part III Line 4 Footnote from 2016 audited financials: Patient accounts receivable represent amounts due from federal and state agencies, managed healthcare plans, commercial insurance companies, employers, and patients. Children s grants credit to patients, most of whom are insured under third-party payor agreements, without collateral or any other security to support amounts due. Children s determines an allowance for doubtful accounts by considering a number of factors, including, but not limited to, the length of time accounts receivable are past due, previous loss history, the existence of a third-party payor, reimbursement trends, and other collection indicators. Accounts are written off when all reasonable internal and external collection efforts have been performed and payments subsequently received on such receivables are credited to the allowance. At December 31, 2016 and 2015, the allowance for uncollectible accounts was $10,330 and $9,517, respectively. Bad debt write-offs totaled approximately $12,740 and $8,066 for the years ended December 31, 2016 and 2015, respectively. Children's recognizes that revenue and receivables from third-party payors, including governmental agencies, are significant to its operations, but does not believe there are significant credit risks associated with these organizations. In 2016, the top four third-party payors accounted for 28%, 28%, 17%, and 12% of net patient service revenue. In 2015, the top four third-party payors accounted for 30%, 27%, 18%, and 10% of net patient service revenue. Form Sch H Part III Line 8 The organization primarily serves pediatric patients and does not generate significant Medicare revenues. The organization files a Medicare cost report annually. Form 990, Schedule H, Worksheet 3 - Unreimbursed Medicaid and Other Means-Tested Government Programs was used to calculate the costs associated with Medicare charges reported in Part III, Line 6. The organization does not report any amounts from Part III, Line 7 as community benefit. Form Sch H Part III Line 9b When collecting medical debt, Children's Hospitals and Clinics of Minnesota treats its patient families with honor, dignity, and respect; demonstrates compassion; and are good stewards of health care resources. There is a zero tolerance for abusive, harassing, oppressive, false, deceptive, or misleading language or collections conduct by Children's employees and contractors who collect medical debt from patient families. This policy applies broadly to all patient families we serve. Components of Children's collection policy include: During the pre-registration, registration, or admission process, Children's attempts to identify and inform patient families who may be eligible for financial assistance or discounted care through the uninsured discount or financial assistance policy. IN ADDITION, ALL FAMILIES ARE PROVIDED WITH A PLAIN LANGUAGE SUMMARY OF OUR FINANCIAL ASSISTANCE POLICY AT REGISTRATION. INFORMATION ON OUR FINANCIAL ASSISTANCE POLICY IS POSTED IN EACH CLINIC AND REGISTRATION AREA, OUR WELCOME CENTER AND ON OUR WEBSITE. All Children's employees and contracted staff who have direct contact with patients are educated on an annual basis of Children's financial assistance policies. The education informs staff of programs available and how a patient family may obtain more information and submit an application for financial assistance. A FINANCIAL ASSISTANCE APPLICATION AND COPY OF THE FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY IS sent with the initial hospital patient statement explaining the process for obtaining financial assistance to all self-pay patient families. Reference to financial assistance is included on all subsequent statements. If a patient family indicates the need for financial assistance during the registration process or throughout the collection process, financial assistance information is provided to the family by staff. All patients who are registered as self-pay are offered the financial assistance information at the time of registration. ALL CORRESPONDENCE SEEKING COLLECTION OF MEDICAL DEBTS CONTAIN A REFERENCE TO THE AVAILABILITY OF FINANCIAL ASSISTANCE AND THE FINAL NOTICE PRIOR TO BAD DEBT PLACEMENT INCLUDE THE REQUIRED LANGUAGE RELATED TO EXTRAORDINARY COLLECTION EFFORTS. Minnesota hospital providers have jointly developed consistent collection guidelines set out in formal agreements with the Minnesota Attorney General's Office. This agreement is consistent with Children's collection policy. The Audit Committee of our Board of Directors annually reviews this policy and all policies concerning collection of medical debt, uninsured discount, and charity care. The Audit Committee also reviews the results of an annual audit related to these areas in accordance with the Minnesota Attorney General's Agreement. Form Sch H Part VI Line 2 In 2016, Children's completed its second community health needs assessment, as required under the Patient Protection and Affordable Care Act of 2010 ("PPACA"). The CHNA and accompanying implementation strategy were approved by the Children's Board of Directors at its board meeting. The complete documents are available to the public at http://www.childrensmn.org/community. In conducting the assessment, Children's considered the following topics and data: demographics; economic issues that affect children; community issues; health status indicators; health access indicators; health disparities indicators and availability of healthcare facilities and resources. In addition to the CHNA process, Children's also regularly assesses the health care needs of the community in the following ways: a. Board of Directors: the organization's governing body, comprised primarily of community members who reside locally, provides governance oversight and input on the health care services Children's provides to the local community. b. Children's employed physicians, independent physicians who provide care at Children's, and numerous clinical care providers assess community needs daily through the pediatric care provided throughout the community. c. Community partnerships/relationships: Children's Advocacy and Health Policy department has developed a core strategy based on active and substantive engagement of the community, in its varying forms. This includes collaboration with community-based organizations and leaders, aligned non-profits, service delivery agencies and associations. We also engage in local and state government-driven initiatives around child health issues. Through these partnerships Children's gains insight and supports progress on a number of key issues impacting children, including: early childhood development, childhood obesity, premature birth, tobacco control, equity and the social conditions that impact health. d. The Family Advisory Council: this diverse group of families whose children are present or past patients of Children's regularly provides input on the services provided at Children's. Council members represent a wide range of inpatient and outpatient experiences to help enhance the quality of child and family care experiences at Children's. Council responsibilities include: - Develop, implement and evaluate service and facility standards. - Communicate with management about the recommendations and concerns expressed by parents, family members, parent associations and others. - Advise on policy review, promote family-centered care and support program development. e. Youth Advisory Council: This is a dedicated group of patients; ages 10 to 18, who help hospital staff, leaders, clinicians and parents understand what is important to children, teens and siblings during hospital stays, clinic visits and emergency care. The YAC brings a valuable perspective and voice to Children's by participating in activities that promote discussion and thought about health care services for pediatric and young adult patients. The council also brings great perspective to let other children know how to make their stay at Children's a more comfortable and positive experience. f. Other methods include and are not limited to partnerships and projects with third party-payers and other community physicians and hospitals, monitoring and reporting of infectious disease data, disaster readiness efforts, research and education, support groups, and others. Form Sch H Part VI Line 3 Components of Children's collection policy include: During the pre-registration, registration, or admission process, Children's will attempt to identify and inform patient families who may be eligible for charity care or discounted care through the uninsured discount or charity care policy. All Children's employees and contracted staff who have direct contact with patients will be educated on an annual basis of Children's financial assistance policies. The education will inform staff of programs available and how a patient family may obtain more information and submit an application for financial assistance. A financial assistance application will be sent with the initial letter explaining the process for obtaining financial assistance to all self-pay patient families. If a patient family indicates the need for financial assistance during the registration process, financial assistance information is provided to the family by the registration staff. All correspondence seeking collection of medical debts will contain a reference to the availability of financial assistance. Minnesota hospital providers have jointly developed consistent collection guidelines set out in formal agreements with the Minnesota Attorney General's Office. This agreement is consistent with Children's collection policy. The Board of Directors (Audit Committee) performs an annual review of this policy and all policies concerning collection of medical debt, uninsured discount, and charity care. The Audit Committee shall also review the results of an annual audit related to these areas in accordance with the Minnesota Attorney General's Agreement. Form Sch H Part VI Line 4 Children's Hospitals and Clinics of Minnesota serves the five state area of the upper Midwest (Minnesota, North Dakota, South Dakota, Iowa, and Wisconsin). In 2016, Children's served patients from 100 percent of Minnesota counties and 62 percent of the total counties in the five state area. In support of a highly diverse patient population, Children's provided interpreter services for 78 languages with the most frequent languages being Spanish, Somali and Hmong. Children's also serves a disproportionate share of economically disadvantaged patients with 43 percent of net patient revenues from government programs. The Minneapolis campus is located within the Phillips-Powderhorn neighborhood (MUA), home to one of the most ethnically diverse communities in Minnesota. Form Sch H Part VI Line 5 As a tax-exempt organization, Children's maintains an open medical staff and is governed by a volunteer, community board. Children's provides a broad spectrum of benefits to the communities it serves that would otherwise be unavailable or insufficient to meet patient demand. Children's does this for the express purpose of improving the health status of children in the community. These services and donations account for a measurable portion of the hospital's costs and help to promote healthy lifestyles, community development, health education and affordable access to care. Example programs include: - Portico Healthnet: Children's is one of the local hospitals and health plans in the Twin Cities that advises Portico Healthnet on issues related to program services and also provides funding for medical services to participants. Portico Healthnet is a nonprofit health and human services organization that serves the community by assisting children, parents and individuals who are uninsured with applications to health care programs and by offering a primary and preventive health care access program for people ineligible for public programs. - HealthTeacher: Children's financially sponsors the HealthTeacher program for school districts in Hennepin and Ramsey counties. HealthTeacher, Inc. provides web-based health education curriculum and related resources focused on health improvement and physical activity. These tools provide schools and teachers important resources to help kids lead healthy lives. - The EMSC Resource Center provides technical assistance to agencies to improve pediatric emergency care. The EMSC works to reduce child morbidity and mortality due to trauma and critical illness and is the only statewide program that focuses on improving pediatric components of medical care. - The Minnesota Sudden Infant Death (SID) Center: Children's houses the Minnesota SID Center, which provides support to families and promotes awareness within both the medical and lay communities of SIDS and other causes of sudden infant death. The center works to identify causes of sudden, unexpected infant death throughout Minnesota; reaches out with information and support to families; educates professionals and the public; and participates in research. - The Simulation Center is a motor coach outfitted with simulation equipment and staffed with Children's trainers that travels throughout the Midwest to train staff from hospitals in the best practices when responding to pediatric or neonatal medical emergencies. - Healthy Kids Partnership: HealthPartners and Children's Hospital and Clinics of Minnesota are collaborating with community stakeholders to help promote childhood health and prevent obesity. Physician champions in three clinics are connecting with schools, community centers, local businesses and public health. By working in partnership, we hope to promote and sustain change in the places our kids live, learn and play. - Children's Immunization Project: To increase rates of vaccination among children, particularly in low-income and underserved areas, Children's provides outreach and education on vaccinations. The program's current focus is on influenza prevention, and activities include vaccination clinics and educational outreach. - Perinatal HIV Prevention Program: Optimal prenatal care for women with HIV is essential in preventing transmission of the disease to infants. Children's Infection Prevention department works with HIV positive pregnant women to help them get this care by building relationships with medical providers throughout the state to refer expecting mothers into the program. - The Advocacy and Health Policy Department at Children's promotes the health of the community to build partnerships that can support the health and well-being of children in Minnesota. Form Sch H Part VI Line 7 List of States Receiving Community Benefit Report: MN true Cristo Rey Jesuit High School 2924 4th Ave S Minneapolis MN 55408 204548714 501(c)(3) 30500 N/A N/A Sponsorship - Corporate Work Study Healthteacher Inc 209 10th Ave S Suite 350 Nashville TN 37203 000000000 N/A 58333 N/A N/A Classroom-based PE curriculum GoNoodle Program March of Dimes 5233 Edina Industrial Blvd Edina MN 55439 131846366 501(c)(3) 12500 N/A N/A Sponsorship - Nurse of the Year Phillips West Neighborhood Org 2400 Park Ave S Suite 152 Minneapolis MN 55404 900122796 501(c)(3) 5400 N/A N/A Sponsorship - Midtown Safety , NNO Portico Healthnet 2610 University Ave W Suite 550 St Paul MN 55114 411814659 501(c)(3) 37547 N/A N/A Assist families in obtaining insurance Project for Pride in Living 1035 E Franklin Ave Minneapolis MN 55406 237232208 501(c)(3) 25000 N/A N/A Health career job training MN Wild Foundation 317 Washington Street St Paul MN 55102 900518400 501(c)(3) 18500 N/A N/A Health Career Program Wild about Children's Event Ronald McDonald House - Upper Midwest 818 Fulton Street NE Suite 1200 Minneapolis MN 55414 411313107 501(c)(3) 17925 N/A N/A Sponsorship - Golf, Brew Love, Gala CycleHealth 6545 Flying Cloud Drive Suite 202 Eden Prairie MN 55344 463077108 501(c)(3) 20000 N/A N/A Program Education Camp Odaytin PO Box 2068 Stillwater MN 55082 412014358 501(c)(3) 7500 N/A N/A Event sponsorship Children's Surgery International 825 Nicollet Mall Suite 706 Minneapolis MN 55402 412013739 501(c)(3) 5075 N/A N/A Phillips Neighborhood revitalization Sponsorship - Gala and Memorial Greater Mpls Council of Churches 1100 East Lake St Minneapolis MN 55407 410693933 501(c)(3) 10000 N/A N/A 'Wild about Children's' Event Sponsorship - LEAP, Comm Baby Showers Little Earth Residents Assoc Inc 2495 18th Ave S Minneapolis MN 55404 363309894 501(c)(3) 6000 N/A N/A Operational support and sponsorship Youth mental health and NNO Nexus Community Partners 2314 University Ave W Suite 18 St Paul MN 55114 300658898 501(c)(3) 10000 N/A N/A The Green Zone Community Advisory Comm Reach Out and Read 89 South St Suite 201 Boston MA 02111 043481253 501(c)(3) 6500 N/A N/A Sponsorships - Breakfast Event Spare Key 101 East 5th St Suite 1100 St Paul MN 55101 411888767 501(c)(3) 10000 N/A N/A Sponsorships - Groove Galas Women's Health Leadership Trust 1000 Westgate Dr Suite 252 St Paul MN 55114 000000000 N/A 13950 N/A N/A Sponsorship 15 2 Charity Care Assistance to Individuals 1307 2068308 Cost Charity Care to Indv Form Sch I Part I Line 2 From time to time, children's grants monies to other organizations Conducting programs and/or research that will benefit the children that Children's serves. Children's also occasionally provides monetary support To organizations that promote careers in the health care field and Community organizations that support the economic development of the area Surrounding the children's minneapolis campus. Children's receives Periodic updates regarding the use of the funds. X true false X X X X X true true false false false false false false false Robert Bonar JR Chief Executive Officer 827671 403224 65950 182092 0 17881 0 1496818 0 0 0 David Overman President & COO 285065 191314 568284 71577 0 7451 0 1123691 0 273708 0 Todd Ostendorf VP, Finance & CFO - April 2016 286339 2355 46301 0 15243 0 350238 0 0 0 Phil Kibort VP Medical Affairs and CMO 493342 147750 118715 24400 0 18601 0 802808 0 83965 0 Maria Christu Chief Legal Officer 369695 109138 51521 64650 0 22247 0 617251 0 41281 0 Roxanne Fernandes CNO, VP Patient Care Svcs 332518 96998 83635 55392 0 17442 0 585985 0 77899 0 Jeffrey Young Chief Information Officer 319193 95609 43054 56678 0 20352 0 534886 0 36301 0 Carol Wilcox VP Diagnostic/Therapeutic SVCS 209564 61125 26569 42427 0 2409 0 342094 0 22936 0 Bjorn Gunnerud VP, Marketing & Communications 226728 67598 36889 44644 0 20628 0 396487 0 25609 0 Samantha Hanson CHRO 310056 92153 20022 55920 0 21585 0 499736 0 18113 0 Jennifer Olson VP Business Dev. & Strategy 287765 75063 8871 50672 0 15300 0 437671 0 0 0 Trevor Sawallish Chief Ambulatory Officer 324922 9917 48192 0 21414 0 404445 0 0 0 Emily Chapman Vice Chief Medical Officer 220389 16605 17296 28584 0 21364 0 304238 0 14160 0 Michael Morrey VP Ops Mother Baby Clin Svc 179523 7713 6231 0 13202 0 206669 0 0 0 Rebecca Woitalewicz Interim CFO through April 2016 171932 53374 3057 16880 0 19331 0 264574 0 0 0 Claudia Hines Sr Dir Clin Svcs - Pediatrics 123535 15216 5855 13687 0 13733 0 172026 0 0 0 Kathleen Penson Sr Dir Clin SVCS - Pediatrics 163613 30142 4941 5725 0 17686 0 222107 0 0 0 Gloria Drake Sr Dir Clin Svcs - Periop 187223 45426 46324 1411 27640 0 13194 0 275792 45426 0 0 Alice Chernich Sr Dir Clinical Serv - Neonata 164992 39210 9778 0 14027 0 228007 0 0 0 Joseph Petronio Surgical Dir, Peds Neurosurg 805241 51277 100946 57337 0 23738 0 1038539 0 38461 0 Meysam Kebriaei Staff Physician 616229 110002 30928 46409 0 22440 0 826008 0 29870 0 Frank Rimell Staff Physician 515388 189880 27457 42127 0 23738 0 798590 0 24014 0 James Engels Staff Physician 508621 26360 40473 53688 0 22934 0 652076 0 36567 0 Barbara Malone Medical Director 510473 98955 30451 41628 0 18108 0 699615 0 25015 0 Stephen Nelson Staff Physician 241214 41943 51365 48541 0 21381 0 404444 0 47897 0 Anupam Kharbanda Chief of Critical Care Service 298561 67627 13472 29862 0 2992 0 412514 0 12555 0 Theresa Pesch President, Foundation 34984 314859 7596 68355 4713 42416 6185 55663 2287 20579 55765 501872 3916 35250 Form Sch J Part I Line 1a ROBERT BONAR IS REIMBURSED FOR HIS MEMBERSHIP FEES FOR THE MINNEAPOLIS CLUB, WHICH IS USED SOLELY FOR BUSINESS PURPOSES. Form Sch J Part I Line 4a 2016 Severance Payment: David Overman: $294,329 Form Sch J Part I Line 4b Certain employees of Children's Health Care, parent of Children's Clinic Network, are provided the opportunity to participate in the 457(f) Deferral Plan (the Deferral Plan). The Deferral Plan requires that the employee is a physician or executive and is a .5 FTE or more in order to be eligible to participate in the Deferral Plan. Payments from the Deferral Plan occur at vesting and are based on percentage of salary. The following amounts represent the amount paid under the Deferral Plan in 2016: David Overman - $273,708 Phil Kibort - $83,965 Maria Christu - $41,281 Roxanne Fernandes - $77,899 Jeffrey Young - $36,301 Carol Wilcox - $22,936 Bjorn Gunnerud - $25,609 Samantha Hanson - $18,113 Emily Chapman - $14,160 Anupam Kharbanda - $12,555 Joseph Petronio - $38,461 Meysam Kebriaei - $29,870 Frank Rimell - $24,014 James Engels - $36,567 Barbara Malone - $25,015 Stephen Nelson - $47,897 Theresa Pesch - $39,166 Form Sch J Part II The Children's Foundation President participates in a long-term incentive plan with payout based on various performance measures. The payout received in 2016 was $53,975. A 1995B2004A - See Part VI 416005375 603695FG7 2004-08-24 77550000 HEALTHCARE EQUIP & BLDG & REF BOND false false false B 2004B - See Part VI 416005375 603695FH5 2005-05-25 51550000 Refunding of taxable bond false false false C 2007A - See Part VI 416005375 603695FP7 2007-11-15 103000000 Facility expansion and upgrade false false false D 1995B2004A-12010A - See Part VI 416005375 603695GQ4 2010-03-25 97051274 Facility expns & upgrd & ref bond false false false A 58475000 0 77550000 0 0 0 810064 1239936 0 50000000 25500000 0 2004 true false true true B 24625000 0 51550000 0 0 0 0 0 0 0 51550000 0 true false true true C 11800000 0 106148383 0 0 0 862000 1582951 0 103703432 0 0 2009 true false true true D 30810000 0 97071507 0 0 0 0 0 0 51120684 45950823 0 2011 true false true true A true false true true true true 0.00010 0.00010 false false false true B false false true true true true 0.00000 0.00000 0.00000 false false false true C false false true true true true 0.00010 0.00010 false false false true D false false true true true true 0.00010 0.00010 false false false true A false false true false true true Piper Jaffray 27.2 false false false 0 false true B false false true false true true Piper Jaffray 17.2 false false false 0 false true C false false true false true true Piper Jaffray 24.8 false false false 0 false true D false false true false false false 0 false 0 false true A true B true C true D true Supplemental Information: The report periods selected for all four bond issues recorded on Schedule K are not the same as the fiscal year end for the rest of the Form 990. Schedule K uses the bond year ending of August 15, 2017. Part I, Column (g): Although these bonds are not defeased, a portion of the bonds was currently refunded by a reissuance on 3/25/2010. Schedule K, Part I, Line 1 Column A Health Care Facilities Revenue Bonds 1995B/2004A - Issuer of the bond is City of Minneapolis, MN (41-6005375) and Housing and Redevelopment Authority of the City of St Paul, MN (41-6005521). Schedule K, Part I, Line 2 Column A Health Care Facilities Revenue Bonds 2004B - Issuer of the bond is City of Minneapolis, MN (41-6005375) and Housing and Redevelopment Authority of the City of St Paul, MN (41-6005521). Schedule K, Part I, Line 3 Column A Health Care Facilities Revenue Bonds 2007A - Issuer of the bond is City of Minneapolis, MN (41-6005375) and Housing and Redevelopment Authority of the City of St Paul, MN (41- 6005521). Schedule K, Part I, Line 4 Column A Health Care Facilities Revenue Bonds 1995B/2004A-1/2010A - Issuer of the bond is City of Minneapolis, MN (41-6005375) and Housing and Redevelopment Authority of the City of St Paul, MN (41-6005521). Sch K, Part II, Line 3 Differences between Part I, Column (e) and Part II, Line 3 are due to investment earnings. Sch K, Part II, Line 13 Year of Substantial Completion - B As this bond issue consists entirely of refunding bonds, it is Children's understanding that the concept of "year of substantial completion" does not apply to this issue. John McNamara MD Board Member 4341540 Children's Resp. & Crit. Care false Patrick Ryan Board Member 9585081 Ryan Companies US, Inc false Form Sch L Part IV Business transactions involving interested persons: (a) Name of interested person: John McNamara, MD (b) Description of transaction: board member of children's respiratory & Critical care specialists pa (c) name of interested person: Patrick Ryan (d) description of transaction: board member of ryan companies us inc. X 145741 Cost/Selling Price X 673702 Cost/Selling Price X 157 139905 Cost/Selling Price X Entertainment 107 83039 Cost/Selling Price X Electronics 3 37180 Cost/Selling Price 0 false true false Form 990 Part III Line 4a Program Service Accomplishments: Children's - St. Paul has been named a 2015 Top Hospital by the Leapfrog Group. While more than 1,600 hospitals reported safety and quality information to the Leapfrog Group, only 6 percent were recognized this year for their high marks for quality and efficiency. We're one of only 12 pediatric hospitals across the U.S. that has earned this honor and the only one recognized in the Upper Midwest. This is the eighth time that Children's (Minneapolis, St. Paul or both) has been recognized by the Leapfrog Group since 2006. For the tenth year, U.S. News & World Report has named Children's as one of America's Best Children's Hospitals, with our pulmonology program ranking 33rd and our diabetes and endocrinology program ranking 49th in the nation for 2016-2017. We are Minnesota's largest provider of care to children with complex surgical conditions, heart disease, cancer, diabetes, and extreme pre-maturity. In 2016, Children's cared for 14,588 inpatient admissions representing 106,163 patient days, performed 24,591 surgical cases, treated 96,443 emergency room visits and cared for 447,731 outpatient clinic visits, many of which provided to inner city Minneapolis and St. Paul residents. Children's continues to serve a diverse population with 90,598 family encounters for language interpretation in 78 different languages. Children's considers certain major programs as destination programs, which are sought out due to their high quality outcomes. These programs meet rigorous criteria for excellence, including outstanding use of evidence-based practices, clinical research, and advanced technologies. - Cardiovascular - Children's pediatric cardiovascular program is one of the largest in the region with some of the most impressive outcomes in the U.S. Team members care for thousands of the region's sickest children with heart conditions, including fetuses, newborns, infants, children, adolescents, and adult, long-term patients with pediatric cardiovascular conditions. - Neonatal Intensive Care - Children's specializes in caring for multiples, babies with congenital anomalies, very premature and very low birth weight babies, and infants born with other complex diagnoses. We offer exceptional tertiary and quaternary care for babies, with survival outcomes among the best in the world. Children's neonatal program is one of the nation's largest programs with 153 staffed beds and more than 41,000 patient days. Our neonatal team includes highly-trained and experienced professionals from a full spectrum of medical specialties. We have our Mother Baby Center at Abbott & Children's Minneapolis and in 2015 we opened our second and third Mother Baby Centers at Mercy Hospital in Coon Rapids and United Hospital and Children's - St. Paul. - Hematology/Oncology - The hematology/oncology program at Children's is the largest in the upper Midwest with treatment outcomes that consistently rank Children's as one of the top ten programs in the U.S. In our nationally unique model, your child's or teen's care is spearheaded and coordinated by a board-certified hematologist/oncologist, who leads a highly experienced team of multidisciplinary professionals. - Cystic Fibrosis - The Cystic Fibrosis (CF) Center at Children's of Minnesota diagnoses and treats children in all stages of CF. Our dedication to family-centered care and education helps children and their families learn to live with CF. Care at Children's for patients with CF ranks among the top 10 programs nationally in key outcomes measured by the National Cystic Fibrosis Registry. Children's provides a continuum of care through coordinated inpatient and outpatient services, from diagnosis through long-term follow-up. The Cystic Fibrosis Center of Children's provides state-of-the art comprehensive care for children with CF. - Diabetes/Endocrinology - The McNeely Pediatric Diabetes Center is the only diabetes center in the region to specialize in working solely with children and teens. The staff provides expert health care to help maintain a child's targeted blood sugar ranges. Most children seen in the diabetes center have Type 1 diabetes. A small but growing number have Type 2. In addition to diabetes, the clinic provides diagnostic services and treatment for children with disorders of growth, advanced or delayed sexual development, pituitary disorders, thyroid abnormalities, disorders of calcium balance, adrenal disorders, and hypoglycemia. The McNeely Pediatric Diabetes Center has received recognition for its diabetes education program from the American Diabetes Association, by meeting the association's high educational standards. - Children's provides other high quality programs such as Surgery. Children's surgery teams deliver next-generation care in an award-winning environment that is exclusively dedicated to pediatrics. Health professionals of many disciplines work together to provide children with the best possible surgery experience. Children's bodies are different than adults. For example, they often require specially-sized surgical equipment. They react differently to anesthesia and to pain. Their bodies respond differently to illness and treatment, in part because they are still growing. That's why children benefit from our highly accomplished, pediatric-specific surgery teams. At Children's, over 20,000 surgeries are performed each year on fetuses, newborns, children, adolescents, and young adults from throughout the Upper Midwest. Surgical treatment results rank Children's among the top hospitals in the U.S. in pediatric surgical care. Children's has some of the lowest rates in the U.S. of post-surgery complications and some of the highest rates of patient and family satisfaction. Additional destination programs include Neurosciences, ENT and facial plastic surgery, and Trauma care. As a charitable organization, Children's Hospitals & Clinics of Minnesota also provides a broad spectrum of benefits to the communities we serve. These services and donations account for a measureable portion of the hospitals' costs and help to promote healthy lifestyles, community development, health education, and affordable access to care. Please see IRS Form 990, Schedule H for a summary of these community benefits. Form 990 Part III Line 4b Program Service Accomplishments: We continue to participate in multiple prestigious national collaborations and clinical trials. We are also generating landmark investigator-initiated research, aimed at novel ways to deliver life-saving treatments, manage pain and symptoms and develop new methods for preventing or treating childhood diseases. Every day, Children's researchers express their commitment to building better outcomes for our children. These outcomes will have both immediate and lasting impact for children receiving state of the science care at our specialty centers. Children with cardiac disease, cancer, genetic and blood disorders, diabetes, cystic fibrosis, and other life-impacting conditions all have benefited from research at Children's. The vision and strategic innovation of our research leaders have brought us to impressive milestones in the past year. We continue to take steps toward advancing our research and committed to thriving into the future with our children and families. Form 990 Part III Line 4c Program Service Accomplishments: The rotations were performed in Children's Emergency Department, inpatient medical/surgical, PICU and neonatal inpatient care units, surgery and anesthesia, ENT surgery, urology, and subspecialty clinics. In addition, Children's offered 34 continuing medical education courses, and produced 134 peer reviewed publications. Cultivating medical leaders ensures that we continue our mission - championing the special health needs of children and their families. 2) Education and training of health care and other providers of services to children: i) The Midwest Regional Children's Advocacy Center at Children's is a leader in improving the care of abused and neglected children whose goal is to improve services for abused children in local communities throughout the region. The Center offers information, consultation, technical assistance, and training to physicians, nurses, and non-medical members of community child abuse teams, including law enforcement personnel, attorneys and child protection workers. ii) Recognized, as the nation's leader in palliative care education, Children's Institute for Palliative Care (CIPC) developed a model for a regional training and consultation center. CIPC develops and leads training seminars using recognized curriculum for pediatric palliative care, provides hospital-based consultation to children who are in need of hospice or palliative care while they are hospitalized, offers a regional 24/7 telephone consultation program providing education, support, and guidance to families and professional providers, and serves as a resource center for pediatric palliative care. iii) The Minnesota Sudden Infant Death Syndrome (SID) Center is a statewide program that provides information, counseling, and support to anyone experiencing a sudden and unexpected infant death from any cause. The SID Center is the state's resource for information on Sudden Infant Death Syndrome (SIDS) and SIDS risk reduction. The Center conducts training and educational programs for health care providers, child-care workers, and other professional and community groups. The Center also tracks and reports infant mortality trends in Minnesota and participates in local, state, and national initiatives to reduce the risk of sudden, unexpected infant death. The Minnesota SID Center collaborates with the Minnesota Department of Health, county public health nurses, and medical examiners in every county throughout Minnesota. iv) The Emergency Medical Services for Children (EMSC) Resource Center housed at Children's creates awareness regarding the special needs of children in emergency medical situations. EMSC educational programs are designed to train pre-hospital personnel, first responders, physicians, nurses, and school nurses in the unique needs of infants and children in emergency situations. The EMSC Resource Center also provides technical assistance, participates in statewide pediatric emergency/disaster preparedness planning, develops and disseminates pediatric emergency are guidelines, and conducts mortality reviews and research. Education and employment - Because disparities in child health are so closely associated with low educational attainment and poor job skills, Children's is engaged in several key community partnerships to improve educational success and earning potential among youth and adults. Examples include the Roosevelt High School and Cristo Rey Jesuit High School Health Careers Program that provides students interested in health care careers the opportunity to receive health care specific education and obtain internships with health care organizations, the Achieve Minneapolis/Step-up Summer Jobs Program that places youth in supervised summer internships at participating companies and organizations, and a partnership with Project for Pride in Living that recognizes that a healthy, sustainable community requires residents with well-paying jobs. Form 990 Part VI Line 11a Children's senior management reviews the draft Form 990 with the Audit and Compliance Committee of the governing body prior to filing of the Form. This review includes an overview of the Form and discussion related to key sections. Copies of the final Form 990 are made available to members of the Committee and all directors prior to the Form being filed. The Audit and Compliance Committee has been delegated the authority to oversee the completion and filing of the Form 990 by the full board, and the Committee reports the results of its review and approval to the full board at a regularly scheduled board meeting. Form 990 Part VI Line 12c Management of Children's ensure that conflict of interest disclosure forms are completed by all members of the governing body and board committees at least annually. Forms are completed at the beginning of the year, and directors and committee members are instructed to provide additional disclosures if necessary during the course of the year. The Governance Committee of the governing body, along with senior management (CEO and General Counsel) review all disclosures provided by governing board members. The results of this review and any concerns, limitations, etc., are reported by the Governance Committee to the full board. If conflicts are identified, the Governance Committee and management work to ensure that directors do not participate in discussion or voting on the affected matter. Form 990 Part VI Line 15a Children's follows the requirements set forth in the IRS rebuttable presumption of reasonableness in determining compensation for the CEO and other officers and executive leaders of Children's. This function is performed by the Compensation Committee of the governing board, which is composed of only independent directors. The process includes review of comparability data, retention of an outside compensation consultant and contemporaneous substantiation of the deliberation and decision through detailed minutes of the Compensation Committee and full board meetings where executive compensation is considered. Form 990 Part VI Line 16a Currently Children's does not have any joint ventures with a taxable entity that are mission related or joint ventures that are not mission related. Within the context of their investment portfolio, the organization has invested in a number of limited partnership opportunities. Form 990 Part VI Line 19 Children's makes financial statement information public through a summary of financial performance in its annual report. In addition, financial statements are provided publicly through Digital Assurance Certification, a dissemination agent, who therefore make this information publicly available. Children's governing documents and conflict of interest policy are not available to the public. Form 990 Part XI Line 9 Changes in Net Assets: RSVP Retirement plan-related changes (492,293) Change in value of interest rate swap valuation 4,087,270 Change in beneficial interest of net assets of Foundation (2,554,226) Other Changes in net assets (28) Total to Form 990, Part XI, Line 9 1,040,723 FORM 990 PART IX LINE 11G DESCRIPTION:Medical Residents - Pediatrics TOTAL FEES:3633484 FORM 990 PART IX LINE 11G DESCRIPTION:Consulting Fees TOTAL FEES:7312907 FORM 990 PART IX LINE 11G DESCRIPTION:Security TOTAL FEES:63352 FORM 990 PART IX LINE 11G DESCRIPTION:Linen TOTAL FEES:1598386 FORM 990 PART IX LINE 11G DESCRIPTION:Purchased Services TOTAL FEES:64647948 FORM 990 PART IX LINE 11G DESCRIPTION:Stipends and Honorariums TOTAL FEES:294068 FORM 990 PART IX LINE 11G DESCRIPTION:Leased Equipment TOTAL FEES:1991741 FORM 990 PART IX LINE 11G DESCRIPTION:Maintenance/Service Contracts TOTAL FEES:3904336 FORM 990 PART IX LINE 11G DESCRIPTION:EQUIPMENT REPAIR & MAINTENANCE TOTAL FEES:1329467 Children's HC SVCS Inc DBA MINNETonka 2525 Chicago Ave S Minneapolis MN 55404 411756478 Healthcare MN 501(c)(3) Line 3 NA true Children's Health Care Foundation 2525 Chicago Ave S Minneapolis MN 55404 411814223 Healthcare MN 501(c)(3) Line 7 NA true Children's Clinic Network 2525 Chicago Ave S Minneapolis MN 55404 453765330 Healthcare MN 501(c)(3) Line 3 NA true Mother Baby Facility LLC 2525 Chicago Ave S Minneapolis MN 55404 454078371 Healthcare MN 501(c)(3) Line 12A NA true Children's Health Insurance Network Ltd PO Box 30600 Grand Cayman MN 55404 463226418 Insurance CJ NA C Corp 488228 9426961 1.00000 true Children's Health Network 910 East 26th Street Suite 330 Minneapolis MN 55404 Medical Services MN NA C Corp -643617 535042 1.00000 true false false true false false false false false false false false true false false true true true true true Children's Health Care Foundation c 20617552 accrual Children's Health Care Foundation l 7693597 accrual Children's Health Care Foundation o 4780472 accrual Children's Health Care Foundation r 16115307 accrual Children's Health Care Services Inc l 783467 accrual Children's Health Care Services Inc o 314898 accrual Children's Health Care Services Inc q 11757448 accrual Children's Health Care Services Inc p 6414156 accrual Children's Clinic Network l 1270207 accrual Children's Clinic Network o 89998 accrual Children's Clinic Network p 2477442 accrual Children's Clinic Network q 49488703 accrual Children's Clinic Network r 48838048 accrual Children's Clinic Network s 138573 accrual