2016-11-11T16:18:23-07:00 2015-12-31 KPMG LLP 300 North Greene Street Suite 400 Greensboro NC 27401 990 2015-01-01 590634433 THE NEMOURS FOUNDATION NEMO 9046974100 10140 Centurion Parkway North Jacksonville FL 32256 Rodney McKendree Sr VP and CFO 9046975847 2016-11-15 1 KPMG LLP P00008888 3362753394 2016-11-15 2015 2017-02-10 21:41:12Z David Bailey President and CEO 10140 Centurion Parkway North Jacksonville FL 32256 1306715237 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 12 8976 1840 -8953152 -8953152 154420130 163939442 869413806 932989586 19222300 12176333 30098696 30451301 1073154932 1139556662 2965634 1141167 0 0 630953519 696610695 0 0 4579116 404103842 400932772 1038022995 1098684634 35131937 40872028 1746257353 1837196442 769235610 746432226 977021743 1090764216 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 833638559 1141167 960729546 See Schedule H, Part VI 0 0 0 833638559 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 0 0 1 0 0 0 0 1 1 1 0 0 1 707 1 1 8976 1 1 1 1 CJ 0 0 1 1 1 1 0 0 0 0 X 12 12 1 0 0 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 0 AK AL AR AZ CO CT DC FL GA HI IL KS KY MA MD ME MI MS NC ND NH NJ NM NY 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 78505 0 0 Hugh M Durden Member Director 10 25 X 0 148930 0 J Michael Mcginnis Director 2.5 0 X 52860 0 0 John F Porter Member Director 20 10.5 X 0 119623 0 John S Lord Member Director 25 2 X 0 145829 0 Leonard Berry Phd Director 3 0 X 67070 0 0 Richard Christopher Vice Chairman and Member Director 15 1.5 X 12500 136898 0 Robert Riney Director 3.5 0 X 56280 0 0 Rosa Hakala Director 2.5 0 X 68060 0 0 Terri L Kelly Director 3 0 X 67990 0 0 Toni Jennings Director 3 0.15 X 80680 0 0 Geoffrey M Rogers Director 2.5 0 X 17043 0 0 R J Cummings MD Ent VP North Florida 40 0 X 662808 0 22245 Roy Proujansky EVP Chief Executive DE Operations 40 1 X 967687 0 96959 Stephen Lawless Ent VP Quality and Safety 40 0.5 X 533142 0 52637 Mariane Stefano Ent VP Operational Excellence 40 0 X 333885 0 21063 Gina Altieri Ent VP Corporate Services 40 0 X 471749 0 48800 David J Bailey MD President/CEO 40 0 X 1462038 0 162782 Robert D Bridges EVP Chief Executive FL Operations 40 2 X 861102 0 109060 Rodney A McKendree Sr Vice President and CFO 40 4 X 478056 0 72428 Theresa M Young Sr VP Human Resources 40 0 X 402603 0 32489 Steven R Sparks Sr VP General Counsel 40 0 X 496785 0 -5803 William W Higginbotham II Oper VP Corporate Finance/Treasurer 40 7 X 283820 0 26882 Deborah Chang Ent VP Policy and Prevention 40 0 X 328241 0 28387 Roger A Oxendale President NCH 40 0.5 X 1162285 0 29187 Brent R King MD Ent VP Chief Medical Officer Physician Practices 40 0 X 718266 0 93928 Diane C Goin Secretary to the President CEO 40 0 X 75915 0 12341 Marylynn Girouard Exec Coordinator BOD/General Counsel 40 0 X 70497 0 15118 Cameron S Morrow Assistant Treasurer 40 0 X 93497 0 26433 Dana N Bledsoe President NCH 40 0 X 465677 0 40769 Martha G McGill ENT VP Chief Network Ops FL 40 0.5 X 168824 0 17520 Paul A Pitel MD Dept of Pediatrics Chair, NCCJ 40 0 X 354726 0 20278 Stefanie F Schrum MD Division Chief, Anesthesiology, NCCJ 40 0 X 404201 0 7574 William G Mackenzie MD Dept of Orthopaedics Chair, AIDHC 40 0 X 732707 0 19905 Eric A Loveless MD Division Chief, Orthopaedics, NCCJ 40 0 X 594239 0 19893 Debbie J Merinbaum MD Dept of Radiology Chair, NCCJ 40 0 X 573962 0 20274 Kevin P Sheahan MD Dept of Pediatrics Chief, NCCW 40 0 X 283880 0 28238 Michael J Erhard MD Chief Medical Officer, NCCJ 40 0 X 592063 0 30355 Christian Pizarro MD Director of Nemours Cardiac Center 40 0 X 2696876 0 30678 Jay S Greenspan MD Dept of Pediatrics Chair, AIDHC 40 0 X 493181 0 26233 Stephen Dunn MD Dept of Surgery Chair, AIDHC 40 0 X 554780 0 19351 Gary D Josephson MD Dept of Otolaryngology/ENT Chair, NCCJ 40 0 X 564756 0 24000 Carlos Archilla MD Dept of Anesthesiology Chair, NCCO 40 0 X 473355 0 29144 Paul Kempinski OVP Chief Operating Officer, AIDHC 40 0 X 480701 0 70208 Mary B Mehta MD Medical Director, NCCP 40 0 X 364512 0 25879 Randall W Hartley OVP Chief Operating Officer, NCH 40 0.5 X 356700 0 15362 Terri Finkel MD Dept of Pediatrics Chair, NCH 40 0 X 535555 0 25774 Steven Frick MD Dept of Orthopaedics Chair, NCH 40 0 X 808513 0 29487 Tetsu Uejima MD Dept of Anesthesiology/Critical Care Chair, NCCW 40 0 X 550732 0 34657 Arabinda K Choudhary MD Dept of Medical Imaging Chair, AIDHC 40 0 X 506646 0 38566 Daniel J Podberesky MD Dept of Radiology Chief, NCCO 40 0 X 568192 0 38559 Helen M Case Oper VP NCH & FL 40 0 X 125314 0 5764 Jeffrey Campbell MD Director Neuroscience Center, NCCW 40 0 X 664359 0 17779 Carolyn F Bannister MD Physician, Department Chair 40 0 X 465789 0 25097 Jane M Mericle Oper VP CNE AIDHC 40 0 X 298166 0 22702 Suken A Shah MD Dept of Orthopaedics, Surgeon, AIDHC 40 0 X 710291 0 26890 Todd A Maugans MD Dept of Neurosurgery, Division Chief, NCH 40 0 X 752780 0 30747 Joseph H Piatt Jr MD Dept of Neurosurgery, Division Chief, NCCW 40 0 X 620980 0 30920 Christopher Iobst MD Orthopaedic Surgeon 40 0 X 586447 0 33396 Peter G Gabos MD Orthopaedic Surgeon, NCCW 40 0 X 588656 0 26987 Leslie Grissom MD Dept of Radiology, Radiologist, AIDHC (former) 40 0 X 431290 0 22090 James S Reilly MD Dept of Otolaryngology/ENT Chair, AIDHC (former) 40 0 X 375120 0 21314 Salvatore R Goodwin MD Dept of Anesthesiology Chair, NCCJ (former) 40 0 X 246039 0 22843 Barbara D Meeks Chief Nurse Executive, NCH (former) 40 0 X 342053 0 29187 Lane F Donnelly MD Ent VP Chief Medical Officer, NCH (former) 40 0 X 1081436 0 0 W L Thornton Member Director (former) 3 10 X 0 127539 0 W T Thompson Member Director (former) 0 0 X 0 142829 0 30316862 821648 1773356 1127 1 1 0 Skanska USA Building Inc 4030 Boy Scout Boulevard Suite 200 Tampa FL 33607 Building & Construction 13709774 Sodexo Inc And Affiliates PO Box 905374 Charlotte NC 282905374 Facilities Management 17694639 Whiting Turner Contracting 131 Continental Drive Suite 404 Newark DE 19713 Building & Construction 10091188 Thomas Jefferson University 1025 Walnut Street Philadelphia PA 19107 Residency Program Expenses 5896311 RC Stevens Construction 28 S Main Street Winter Garden FL 34787 Building & Construction 3963780 189 0 0 1312823 157407640 0 5218979 144320 163939442 Net Patient Service Revenue 900099 900222981 900222981 0 0 Net Research Grant Revenue 900099 29293049 29293049 0 0 Electronic Health Record Revenue 900099 3473556 3473556 0 0 0 0 0 0 932989586 8486025 0 -8953152 17439177 0 0 0 0 2476038 0 0 2476038 493384 0 81096 0 412288 0 412288 0 0 412288 170027575 0 166337267 0 3690308 0 3690308 0 0 3690308 559427 1312823 740212 -180785 0 -180785 3800 0 3800 0 0 3800 0 0 0 0 0 0 Specialized Services 900099 21623289 21623289 0 0 Graduated Medical Education Funding 900099 3161986 3161986 0 0 Continuing Medical Education 900099 886866 886866 0 0 2067819 2067819 0 0 27739960 1139556662 960729546 -8953152 23840826 868812 868812 272355 272355 0 0 0 0 26290751 0 26290751 0 0 0 0 0 518220648 406524701 109490659 2205288 55720330 44203466 11308438 208426 62607878 49448279 12796576 363023 33771088 26791371 6818382 161335 0 0 0 0 4274562 2253965 2003059 17538 510612 271339 239273 0 265929 0 265929 0 0 0 427359 227098 200261 0 61081159 43194378 17631825 254956 6835307 4294825 2177729 362753 109911416 97255417 12371422 284577 24493307 13519975 10956592 16740 0 0 0 0 42796968 30489641 12272626 34701 6750476 4451549 2210224 88703 0 0 0 0 3206826 1893189 806162 507475 9740508 9740508 0 0 0 0 0 0 76007937 52126243 23881694 0 9082581 8853115 227972 1494 Provision for bad debts 28147384 28147384 0 0 Subscriptions (mags & db), books 3498550 3190457 285132 22961 Maintenance contracts- Miscel 5099519 1579321 3520198 0 Repairs and Maintenance 4426295 1370824 3055471 0 4376077 2670347 1656584 49146 1098684634 833638559 260466959 4579116 85708358 221746462 166898512 31436629 10834542 10297367 108912116 127092777 0 0 0 0 0 0 4906467 5428484 9562888 14523918 1580700019 609701323 973866581 970998696 189955493 361244571 184203178 80672417 0 0 4135434 5322677 7273784 8432444 1746257353 1837196442 113084930 118678730 0 0 3631528 5763039 351704707 305394769 0 0 0 0 0 99370000 0 0 300814445 217225688 769235610 746432226 X 734899705 875340458 236021876 207169439 6100162 8254319 977021743 1090764216 1746257353 1837196442 X 40872028 -11079582 0 0 0 83950027 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2000 507282 509282 1098175352 1098684634 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 439812 431429 400329 509282 1780852 250000 250000 250000 250000 1000000 1500000 3881 2000 2000 2000 9881 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 0 3386733 0 0 X X X 0 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 392975995 4406956 -581412 0 11968151 297525 384535863 0 0.016 0.984 0 0 106095 101628933 101735028 0 807858040 261591530 546266510 0 22818761 12825399 9993362 0 612271512 335284394 276987118 0 36016678 0 36016678 970998696 0 F 0 F Partnerships 24865759 F Private Equity Funds 26934071 F Hedge Funds 18383410 F Real Estate 10489177 F 80672417 Self-insurance reserves 61214897 Liabilities for Pension Benefits 156010791 217225688 X 1140156048 -4236445 0 0 17336009 13099564 1127056484 0 12500178 12500178 1139556662 1093049829 0 0 0 -5478935 -5478935 1098528764 0 155870 155870 1098684634 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 $6,895,238 + net assets released from restriction - donations $2,871,675 plus special distributions $20,000,000 plus PMSI (subsidiary) total revenue $10,569,746 plus NNJPP total revenue $6,031,095 less bad debt expense ($29,031,745) equals $17,336,009. Schedule D, Part XI, Line 4b Temp restricted contributions and pledges $6,371,341 plus temp restricted investment income $1,813,881 plus temp restricted realized gains $3,815,186 plus PMSI management fee $1,321,080 less rental expenses ($81,097) less fundraising expenses ($740,213) equals $12,500,178. Schedule D, Part XII, Line 2d Bad debt expense ($29,031,745) plus rental expenses $81,097 plus fundraising expenses $740,213 less PMSI management fee ($1,321,080) plus PMSI (subsidiary) operating expenses $15,909,817 plus NNJPP operating expenses $8,142,763 equals ($5,478,935). Schedule D, Part XII, Line 4b Temp restricted investment expenses $153,469 plus temp restricted occupancy expenses $2,401 equals $155,870. East Asia and the Pacific 0 0 Investments 7617791 Europe (including Iceland and Greenland) 0 0 Investments 11392739 Middle East and North Africa 0 0 Investments 836367 North America (including Canada and Mexico, but not the United States) 0 0 Investments 3449599 Russia and the newly independent States 0 0 Investments 216429 South America 0 0 Investments 1568697 South Asia 0 0 Investments 0 Sub-Saharan Africa 0 0 Investments 823800 0 0 25905422 1 0 1 1 1 0 Delaware Gala 462327 202133 260194 0 0 91592 269022 9463 9575 Orlando Gala 489765 341735 148030 0 0 60549 1721 10300 87748 13 923958 772755 151203 0 0 60877 41867 14875 82623 1876050 1316623 559427 0 0 213018 312610 34638 179946 740212 -180785 1 1 X 1 X 2.50 1 X 1 0 1 1 6682211 0 6682211 0.0061 461268148 349276977 111991171 0.1025 0 0 0 0 0 0 467950359 349276977 118673382 0.1086 0 0 33761116 10120731 23640385 0.0216 0 0 8474806 4517751 3957055 0.0036 0 0 0 0 0 0 0 0 35115210 16745622 18369588 0.0168 0 0 954826 0 954826 0.0009 0 0 78305958 31384104 46921854 0.0429 0 0 546256317 380661081 165595236 0.1515 1 11617992 0 1278429 1206505 71924 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 X 13 1 0 0 1 X www.nemours.org/community X 1 15 1 http://www.nemours.org/about/community-health-needs.html 0 0 1 X 250 300 X 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 X 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 2013. The CHNA report can be found at http://www.nemours.org/about/community-health-needs.html Schedule H, Part V, Section B, Line 3-Group A As part of the Child & Adolescent Community Health Needs Assessment, various focus groups were held. Focus group participants included 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 Nemours CHNA. Schedule H, Part V, Section B, Line 5-Group A As part of the Child & Adolescent Community Health Needs Assessment, various focus groups were held. Focus group participants included 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 Nemours CHNA. Schedule H, Part V, Section B, Line 11-Group A See the implementation plan and progress reports located at http://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 www.nemours.org. 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 18d-Group A Nemours utilizes an internal collections department in order to address non-payment by patients who have not been qualified for financial assistance in a sensitive manner. Schedule H, Part V, Section B, Line 22d-Group A Nemours offers financial assistance to all eligible individuals who do not have insurance covering emergency or other medically necessary care. All patients of Nemours receive a statement relative to care provided, which constitutes a bill for services. This statement provides patients with the amount of gross charges less discounts. Discounts are based upon eligibility criteria including family income, family size, federal poverty guideline levels or other eligibility criteria. 44 NEMOURS DUPONT PEDIATRICS WILMINGTON 1600 ROCKLAND ROAD WILMINGTON DE 19803 PEDIATRIC SPECIALTY CARE CLINIC AND CARDIAC CENTER NEMOURS DUPONT PEDIATRICS BECKS WOODS 141 BECKS WOODS DRIVE BEAR DE 19701 PEDIATRIC PRIMARY AND SPECIALITY CARE CLINIC NEMOURS DUPONT PEDIATRICS DOVER 102 WEST WATER STREET SUITE 1 DOVER DE 19904 PEDIATRIC PRIMARY AND SPECIALITY CARE NEMOURS DUPONT PEDIATRICS MILFORD TEAL CREEK PLAZA 703 NORTH DUPONT BOULEVARD MILFORD DE 19963 PEDIATRIC PRIMARY AND SPECIALITY 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 NEWARK 1400 PEOPLES PLAZA SUITE 300 NEWARK DE 19702 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS ST FRANCIS 700 NORTH CLAYTON STREET SUITE 400 WILMINGTON DE 19805 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS JESSUP STREET 1602 JESSUP STREET WILMINGTON DE 19802 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS FOULK ROAD 910 FOULK ROAD SUITE 101 WILMINGTON DE 19809 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS PIKE CREEK 5500 SKYLINE DRIVE SUITE 4 WILMINGTON DE 19808 PEDIATRIC PRIMARY AND SPECIALITY CARE CLINIC NEMOURS DUPONT PEDIATRICS VOORHEES 443 LAUREL OAK ROAD SUITE 200 VOORHEES NJ 08043 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS DUPONT PEDIATRICS VINELAND 2950 COLLEGE DRIVE SUITE 2B VINELAND NJ 08360 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS DUPONT PEDIATRICS BRYN MAWR 130 SOUTH BRYN MAWR AVENUE BRYN MAWR PA 19010 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS DUPONT PEDIATRICS COLLEGEVILLE 599 ARCOLA ROAD COLLEGEVILLE PA 19426 CHILDREN'S CLINIC SPECIALTY CARE AND PRIMARY CARE NEMOURS DUPONT PEDIATRICS LANCASTER 2128 EMBASSY DRIVE LANCASTER PA 17603 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS DUPONT PEDIATRICS NEWTOWN SQUARE 3855 WEST CHESTER PIKE SUITE 280 NEWTOWN SQUARE PA 19073 PEDIATRIC SPECIALITY CARE CLINIC NEMOURS DUPONT PEDIATRICS PHILADELPHIA 833 CHESTNUT STREET SUITE 300 PHILADELPHIA PA 19107 PEDIATRIC PRIMARY CARE AND SPECIALITY CARE CLINIC NEMOURS DUPONT PEDIATRICS BRYN MAWR AIDHC FOR CHILDREN SURGERY CENTER BRYN MAWR MEDICAL ARTS PAVILION 825 OLD LANCASTER ROAD SUITE 250 BRYN MAWR PA 19010 PEDIATRIC SURGERY CENTER NEMOURS DUPONT PEDIATRICS VILLANOVA 789 EAST LANCASTER AVENUE SUITE 10 VILLANOVA PA 19085 PEDIATRIC PRIMARY CARE NEMOURS SENIORCARE WILMINGTON 1600 ROCKLAND ROAD WILMINGTON DE 19803 HEALTH CLINIC NEMOURS SENIORCARE MILFORD 915 NORTH DUPONT BOULEVARD MILFORD DE 19963 HEALTH CLINIC NEMOURS BRIGHTSTART 9145 NARCOOSEE ROAD ORLANDO FL 32827 DYSLEXIA INITIATIVE NEMOURS HEALTH AND PREVENTION SERVICES 49 FALLON AVENUE SEAFORD DE 19973 PREVENTION SERVICES NEMOURS CHILDRENS CLINIC BONIFAY 2600 HOSPITAL DRIVE BONIFAY FL 32425 PEDIATRIC SPECIALITY CARE CLINIC NEMOURS CHILDREN'S CLINIC DESTIN 7720 US HIGHWAY 98 WEST SUITE 260 DESTIN FL 32550 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 807 CHILDRENS WAY JACKSONVILLE FL 32207 PEDIATRIC SPECIALTY CARE CLINIC INCLUDING BRIGHTSTART DYSLEXIA INITIATIVE 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 SPECIALITY CARE LAKE MARY 3300 WEST LAKE MARY BLVD SUITE 100 LAKE MARY FL 32746 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS CHILDREN'S SPECIALITY CARE ORLANDO DOWNTOWN 1717 SOUTH ORANGE AVENUE SUITE 100 ORLANDO FL 32806 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS CHILDREN'S CLINIC PENSACOLA 5153 NORTH 9TH AVENUE PENSACOLA FL 32504 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS CHILDRENS URGENT CARE ALTAMONTE SPRINGS 745 ORIENTA AVENUE SUITE 1011 ALTAMONTE SPRINGS FL 32701 PEDIATRIC URGENT CARE CLINIC NEMOURS CHILDRENS URGENT CARE ORLANDO DR PHILLIPS 5018 DR PHILLIPS BOULEVARD ORLANDO FL 32819 PEDIATRIC URGENT CARE NEMOURS CHILDRENS URGENT CARE ORLANDO KISSIMMEE 4101 TOWN CENTER BOULEVARD ORLANDO FL 32837 PEDIATRIC URGENT CARE CLINIC NEMOURS CHILDRENS URGENT CARE MELBOURNE 1270 NORTH WICKHAM ROAD MELBOURNE FL 32935 PEDIATRIC URGENT CARE CLINIC NEMOURS CHILDRENS URGENT CARE SANFORD 1481 WP BALL BOULEVARD SANFORD FL 32771 PEDIATRIC URGENT CARE CLINIC NEMOURS CHILDRENS URGENT CARE WATERFORD LAKES 651 NORTH ALAFAYA TRAIL ORLANDO FL 32828 PEDIATRIC URGENT CARE CLINIC NEMOURS CHILDREN'S SPECIALITY CARE DAYTONA BEACH 1219 DUNN AVE DAYTONA BEACH FL 32114 CHILDREN'S CLINIC SPECIALTY CARE NEMOURS DUPONT PEDIATRICS GLEN MILLS 101 APPLIED BANK BLVD SUITE 11 GLEN MILLS PA 19342 PEDIATRIC SPECIALITY CARE NEMOURS DUPONT PEDIATRICS UPLAND CROZER CHESTER MEDICAL CENTER ONE MEDICAL CENTER BLVD SUITE 443 UPLAND PA 19013 PEDIATRIC SPECIALTY CARE CLINIC NEMOURS DUPONT PEDIATRICS PAOLI 1676 LANCASTER AVE PAOLI PA 19301 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS EXTON 101 ARRANDALE BLVD SUITE 103 EXTON PA 19341 PEDIATRIC PRIMARY CARE NEMOURS DUPONT PEDIATRICS MEDIA 1098 W BALTIMORE PIKE SUITE 3403 MEDIA PA 19063 PEDIATRICS PRIMARY CARE Schedule H, Part I, Line 6a The Nemours 2015 Report to Our Communities entitled, "Shared Guardians of Children's Health and Joy," can be found at https://www.nemours.org/content/dam/nemours/wwwv2/filebox/about/2015-report-to-our-communities.pdf 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 $28,147,384. Such amount was subtracted from total expense of $1,098,684,634 for purposes of determining percent of total expense calculations. Schedule H, Part I, Line 7a 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." At Nemours, our plan to do that begins before illness or injury with our integrated model of care. We begin with education through the Nemours Center for Children's Health Media and Kidshealth. Then, add prevention in our communities with the perspective of Nemours Health & Prevention Services and literacy aided by our Brightstart! Dyslexia initiative. In the center are health operations, research and education-staples of an academic environment providing the right combination of evidence-based health services. Two more ingredients enable Nemours to energize this powerful mix: innovation and technology. Our model of care has gained definition from our families and experts in the field who sought the "ideal" combination of services throughout Nemours. The model is family-centered and incorporates what we have found to work in guarding the healthy, joyful life experience of a child. Whether hospitalized or visiting for a check-up, children and families find a centralized, pleasant reception area where the same nurses, physicians and therapists greet them. Patient families also find advice and can report progress electronically from a remote location. Our eye is on the best health and quality outcomes, measured and monitored according to established benchmarks and satisfaction as reported by the children and families who have helped define the model. Nemours children's clinic locations provide services at several primary and satellite locations ranging from primary care to sub-specialty care in the Delaware Valley, and sub-specialty care in Florida. These locations are listed in Schedule H, Part V, and Section D. Community Benefit: Nemours is unique among pediatric health care systems, providing treatment, care, health information and prevention services that form a continuum of care aimed at achieving our vision of freedom from disabling conditions. Alfred I. Dupont envisioned a world where all children could receive top-notch medical care, especially children disabled in some way. At Nemours, we demonstrate sound stewardship by staying true to Mr. DuPont's vision. In 2015, Nemours cared for more than 390,000 unique patients who experienced nearly 1,600,000 encounters, nearly 775,000 clinic and outpatient visits. Nemours saw approximately 150,000 new patients during 2015. During 2015, Nemours provided care and services totaling more than $900 million for our communities throughout the Delaware Valley, Florida and beyond. Community Health Improvement Services and Community Benefit Operations: During 2015, 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 in excess of $18.6 million. Nemours provided a variety of community health services for Delaware's low-income senior citizens of approximately $5.0 million through more than 29,900 encounters of care. 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 $18.0 million during 2015 with nearly 382 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 2015, Nemours hosted 743 residents and 633 medical students and provided fellowship rotations for 115 physicians. Nemours supported education and training programs for health professionals in nearly $4.0 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 $6.7 million in 2015. Nemours also covers the costs in excess of government payments for services provided to Medicaid and other public health beneficiaries of nearly $112.0 million with an additional $29.0 million in uncollected patient care charges written off by Nemours during the same period. All totaled, uncompensated care for 2015 approximates $147.7 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 10 and 31, respectively, for a description of bad debt expense. 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 2015 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 www.nemours.org/community. 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 www.nemours.org/patientfamily/payment/financialassistance.htm. 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 presents 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 families 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 live in Delaware, (US Census Bureau, 2011) comprising approximately 22.7 % of the area's total population. Nationally, an estimated 73,650,025 children and youth under 18 make up 23.8% of the total population (US Census Bureau, 2011). While Americans' overall health status has been improving, disparities remain in the prevalence of illness and death experienced by minority populations, as compared to the U.S. population as a whole. These disparities affect children as well as adults. 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. For example, children living in low-income households may not have adequate health insurance or access to primary care. 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). Children who have health insurance typically have better access to preventive services, such as vaccinations, routine screenings, and medical treatment. 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. In 2011, 3,980,766 children and youth under the age of 18 years are living in Florida (US Census Bureau, 2011). Children under the age of 18 make up 21.1% of Florida's total population compared to 23.8% of the total population nationally (US Census Bureau, 2011). 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 www.nemours.org/community 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. The Board of Managers of Delaware Valley, through approval of these Medical Staff Bylaws, has identified several services or departments that are closed, meaning that only practitioners employed by or under contract with Nemours are eligible for privileges in that area. The closed services or departments include anesthesiology, critical care including pediatric critical care, neonatology, cardiac critical care, emergency medicine, pathology, medical imaging, hospitalist service, and the Nemours Cardiac Center. The Nemours Children's Hospital has an open model medical staff. Criteria for membership and clinical privileges are outlined in the Medical Staff Bylaws. The Board of Managers of Florida, through approval of these Medical Staff Bylaws has identified the following restricted services or departments. The restricted services or departments include anesthesiology, critical care including pediatric critical care and neonatology, emergency medicine, pathology, radiology, cardiology and hospitalist services. 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/content/dam/nemours/wwwv2/filebox/about/community-benefit-report-2015.pdf 1 TRACK SHACK FITNESS CLUB INC EVENT MARKETING AND MANAGEMENT 1013 MONTANA STREET ORLANDO FL 32803 263361402 501(c)(3) 10785 0 FMV Donation RUNWAY TO HOPE 7411 INTERNATIONAL DRIVE ORLANDO FL 32819 273272616 501(c)(3) 7250 0 FMV Donation AM HEART ASSOCIATION GREAT RIVERS AFFILIATE PO BOX 4002907 DES MOINES IA 50340 135613797 501(c)(3) 40000 0 FMV Donation AM HEART ASSOCIATION GREATER SOUTHEAST AFFILIATE PO BOX 50015 PRESCOTT AZ 86304 135613797 501(c)(3) 10000 0 FMV Donation GIVE KIDS THE WORLD INC 210 SOUTH BASS ROAD KISSIMMEE FL 34746 592654440 501(c)(3) 7000 0 FMV Donation YMCA YMCA STRONG KIDS CAMPAIGN 100 W 10 STREET SUITE 1100 WILMINGTON DE 19810 510065748 501(c)(3) 10000 0 FMV Donation LAKE NONA INSTITUTE INC 6900 TAVISTOCK LAKES BLVD STE 200 ORLANDO FL 32827 273346737 501(c)(3) 25000 0 FMV Donation YMCA OF GREATER BRANDYWINE 1 E CHESTNUT STREET WEST CHESTER PA 19380 231365994 501(c)(3) 27500 0 FMV Donation PUBLIC HEALTH MANAGEMENT CORPORATION CENTRE SQUARE EAST 1500 MARKET ST SUITE 1500 PHILADELPHIA PA 19102 237221025 501(c)(3) 7000 0 FMV Donation WOLFSON CHILDRENS HOSPITAL THE WOMENS BOARD 1325 SAN MARCO BLVD SUITE 802 JACKSONVILLE FL 32207 590747311 501(c)(3) 15000 0 FMV Donation MARCH OF DIMES FULLFILMENT CENTER PO BOX 1657 WILKES BARRE PA 18703 131846366 501(c)(3) 7500 0 FMV Donation MARCH OF DIMES 5620 KIRKWOOD HIGHWAY WILMINGTON DE 19808 131846366 501(c)(3) 10000 0 FMV Donation PHILLIES CHARITIES INC CITIZENS BANK PARK ONE CITIZENS BANK WAY PHILADELPHIA PA 19148 231994699 501(c)(3) 175000 0 FMV Donation CAMP BOGGY CREEK 2871 N FEDERAL HIGHWAY FT LAUDERDALE FL 33306 593012889 501(c)(3) 25000 0 FMV Donation RONALD MCDONALD HOUSE 1901 ROCKLAND RD WILMINGTON DE 19803 593211250 501(c)(3) 59710 0 FMV Donation RONALD MCDONALD HOUSE 1030 N ORANGE AVENUE SUITE 105 ORLANDO FL 32801 593211250 501(c)(3) 20000 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 BOY SCOUTS OF AM CENTRAL FL 1951 S ORANGE BLOSSOM TRAIL SUITE 102 APOPKA FL 32703 590624376 501(c)(3) 10000 0 FMV Donation SPECIAL OLYMPICS FLORIDA INC 1915 DON WICKHAM DR CLERMONT FL 34711 237181560 501(c)(3) 12500 0 FMV Donation COMMUNITY HOSPICE FOUNDATION 4266 SUNBEAM ROAD JACKSONVILLE FL 32257 593583920 501(c)(3) 6000 0 FMV Donation Orange County Board of County Commissioners 201 South Rosalind Avenue Orlando FL 32829 999999999 GOVT 60592 0 FMV Donation MARCH OF DIMES 3012 MAIN ST VOORHEES NJ 08043 131846366 501(c)(3) 5350 FMV 22 0 Aggregate Employee Relief Fund Donations 5 5000 0 FMV Aggregate Research Patient Participation Payment 562 269340 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 North Florida 538626 0 121134 0 3048 0 9321 0 12924 0 685053 0 Roy Proujansky EVP Chief Executive DE Operations 680233 0 181648 0 105806 0 83672 0 13287 0 1064646 0 Stephen Lawless Ent VP Quality and Safety 407809 0 73548 0 51785 0 41961 0 10676 0 585779 0 Mariane Stefano Ent VP Operational Excellence 263790 0 46891 0 23203 0 20854 0 210 0 354948 0 Gina Altieri Ent VP Corporate Services 357344 0 63175 0 51231 0 48589 0 210 0 520549 0 David J Bailey MD President/CEO 855666 0 258027 0 348345 0 150257 0 12524 0 1624819 0 Robert D Bridges EVP Chief Executive FL Operations 610731 0 164985 0 85386 0 92823 0 16237 0 970162 0 Rodney A McKendree Sr Vice President and CFO 403078 0 74426 0 552 0 52947 0 19482 0 550485 0 Theresa M Young Sr VP Human Resources 298893 0 66640 0 37070 0 21813 0 10676 0 435092 0 Steven R Sparks Sr VP General Counsel 360142 0 80610 0 56032 0 -22040 0 16237 0 490981 0 William W Higginbotham II Oper VP Corporate Finance/Treasurer 249326 0 34139 0 355 0 5478 0 21404 0 310702 0 Deborah Chang Ent VP Policy and Prevention 278871 0 48818 0 552 0 28177 0 210 0 356628 0 Roger A Oxendale President NCH 560537 0 600165 0 1584 0 0 0 29187 0 1191473 0 Brent R King MD Ent VP Chief Medical Officer Physician Practices, DE 509291 0 108200 0 100776 0 66092 0 27835 0 812194 0 Dana N Bledsoe President NCH 257438 0 200000 0 8239 0 15031 0 25737 0 506445 0 Martha G McGill ENT VP Chief Network Ops FL 143633 0 25000 0 191 0 3854 0 13666 0 186344 0 Paul A Pitel MD Dept of Pediatrics Chair, NCCJ 313671 0 38007 0 3048 0 6992 0 13287 0 375005 0 Stefanie F Schrum MD Division Chief, Anesthesiology, NCCJ 353014 0 50635 0 552 0 6700 0 874 0 411775 0 William G Mackenzie MD Dept of Orthopaedics Chair, AIDHC 645567 0 85556 0 1584 0 6618 0 13287 0 752612 0 Eric A Loveless MD Division Chief, Orthopaedics, NCCJ 534077 0 59130 0 1032 0 6606 0 13287 0 614132 0 Debbie J Merinbaum MD Dept of Radiology Chair, NCCJ 520818 0 52112 0 1032 0 6547 0 13727 0 594236 0 Kevin P Sheahan MD Dept of Pediatrics Chief, NCCW 249493 0 33835 0 551 0 8093 0 20146 0 312118 0 Michael J Erhard MD Chief Medical Officer, NCCJ 527551 0 63960 0 552 0 6301 0 24055 0 622419 0 Christian Pizarro MD Director of Nemours Cardiac Center 1695665 0 1000179 0 1032 0 6126 0 24552 0 2727554 0 Jay S Greenspan MD Dept of Pediatrics Chair, AIDHC 391999 0 100150 0 1032 0 6087 0 20146 0 519414 0 Stephen Dunn MD Dept of Surgery Chair, AIDHC 475674 0 62522 0 16584 0 6065 0 13287 0 574132 0 Gary D Josephson MD Dept of Otolaryngology/ENT Chair, NCCJ 507459 0 56745 0 552 0 5439 0 18561 0 588756 0 Carlos Archilla MD Dept of Anesthesiology Chair, NCCO 425129 0 47866 0 360 0 0 0 29144 0 502499 0 Paul Kempinski OVP Chief Operating Officer, AIDHC 406783 0 72886 0 1032 0 50062 0 20146 0 550909 0 Mary B Mehta MD Medical Director, NCCP 320494 0 43456 0 562 0 5262 0 20617 0 390391 0 Randall W Hartley OVP Chief Operating Officer, NCH 309093 0 46022 0 1584 0 2589 0 12774 0 372062 0 Terri Finkel MD Dept of Pediatrics Chair, NCH 474912 0 59059 0 1584 0 0 0 25773 0 561328 0 Steven Frick MD Dept of Orthopaedics Chair, NCH 711760 0 96201 0 552 0 0 0 29487 0 838000 0 Tetsu Uejima MD Dept of Anesthesiology/Critical Care Chair, NCCW 486565 0 62522 0 1645 0 0 0 34656 0 585388 0 Arabinda K Choudhary MD Dept of Medical Imaging Chair, AIDHC 459366 0 46920 0 360 0 0 0 38566 0 545212 0 Daniel J Podberesky MD Dept of Radiology Chief, NCCO 513928 0 54024 0 240 0 0 0 38559 0 606751 0 Jeffrey Campbell MD Director Neuroscience Center, NCCW 623807 0 40000 0 552 0 5238 0 12541 0 682138 0 Carolyn F Bannister MD Physician, Department Chair 424337 0 40000 0 1452 0 0 0 25097 0 490886 0 Jane M Mericle Oper VP CNE AIDHC 264558 0 32597 0 1011 0 0 0 22702 0 320868 0 Suken A Shah MD Dept of Orthopaedics, Surgeon, AIDHC 682740 0 27191 0 360 0 5483 0 21407 0 737181 0 Todd A Maugans MD Dept of Neurosurgery, Division Chief, NCH 695976 0 56252 0 552 0 0 0 30747 0 783527 0 Joseph H Piatt Jr MD Dept of Neurosurgery, Division Chief, NCCW 614387 0 5009 0 1584 0 0 0 30920 0 651900 0 Christopher Iobst MD Orthopaedic Surgeon 537087 0 49000 0 360 0 0 0 33396 0 619843 0 Peter G Gabos MD Orthopaedic Surgeon, NCCW 568114 0 19990 0 552 0 5580 0 21407 0 615643 0 Leslie Grissom MD Dept of Radiology, Radiologist, AIDHC (former) 415178 0 13064 0 3048 0 8804 0 13287 0 453381 0 James S Reilly MD Dept of Otolaryngology/ENT Chair, AIDHC (former) 370176 0 0 0 4944 0 8027 0 13287 0 396434 0 Salvatore R Goodwin MD Dept of Anesthesiology Chair, NCCJ (former) 235645 0 7468 0 2926 0 5352 0 17491 0 268882 0 Barbara D Meeks Chief Nurse Executive, NCH (former) 300731 0 39737 0 1584 0 0 0 29187 0 371239 0 Lane F Donnelly MD Ent VP Chief Medical Officer, NCH (former) 0 0 0 0 1081436 0 0 0 0 0 1081436 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). 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 Delaware Health Facilities Authority 510272458 246388NE8 2005-01-26 50950000 See Part V 0 0 0 B Orange County Health Facililties Authority 521035390 6845036W0 2009-10-15 326242302 See Part V 0 0 0 A 50950000 0 50950000 0 0 0 483143 0 0 50466857 0 0 2007 0 0 1 1 B 19805000 0 326242302 0 0 24350000 1834712 0 0 300057590 0 0 2012 1 0 1 1 A 0 1 0 1 1 0.0251 0 0.0251 1 0 1 B 0 0 1 1 0 0.0089 0 0.0089 1 0 1 A 0 0 0 1 1 0 1 XL Asset Funding 1.5 1 0 0 B 0 0 0 1 1 0 0 0 0 A 1 B 1 Schedule K, Part I, Column a-01/26/2005 50,950,000 Delaware Health The proceeds of these bonds were used to finance the cost of the acquisition, construction, and installation of certain health care facilities used in connection with the Alfred I. Dupont hospital located in Wilmington, DE. These facilities include improvements to an existing two-story building and multi-level parking structure; construction of a multi-level parking structure on the grounds of the hospital; the acquisition and installation of medical equipment, furnishings and other capital improvements at the hospital. In June 2015, the bonds' principal balance was retired. Schedule K, Part I, Column b-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 4-01/26/2005 50,950,000 Delaware Health For the year ended December 31, 2015, private use disclosed in Schedule K, Part III Line 4 Column A is 2.51%. Included in the private use calculation is space leased pursuant to a lease agreement with a local healthcare provider ("Lease") which represents all private use for the noted bond issue in 2012. The Lease will expire June 30, 2015 and management does not anticipate renewing the Lease. Assuming the Lease is not renewed, the adjusted private business use amount relating to the Lease over the life of the 2005 Delaware Bonds is 1.1205%. For the year ended December 31, 2015, private use disclosed in Schedule K, Part III Line 4 Column B is 0.89371%. Schedule K, Part III, Line 4-10/15/2009 326,242,302 Orange County Health For the year ended December 31, 2015, private use disclosed in Schedule K, Part III Line 4 Column B is 0.89371%. Included in the private use calculation is space leased for Home Office Cafeteria and casting vendor located in Nemours Children's Hospital. Schedule K, Part IV, Line 2c-01/26/2005 50,950,000 Delaware Health (A) Delaware Health Facilities Authority - No calculation performed as funds spent In 2007. (B) Orange County Healthy Facilities Authority - calculation performed 12/6/2012. Schedule K, Part IV, Line 2c-10/15/2009 326,242,302 Orange County Health (A) Delaware Health Facilities Authority - No calculation performed as funds spent In 2007. (B) Orange County Healthy Facilities Authority - calculation performed 12/6/2012. X 1 17000 cost or sales price X 218520 cost or sales price X 15 144320 FMV X 2 1300 cost or sales price X Miscellaneous 18 41974 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 directors serve as trustees of the Alfred I. DuPont Testamentary Trust, of which Nemours is the only charitable beneficiary. 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. The board of directors, made up of member directors (those members that opt to also serve on the board of directors) and non-member 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 2016, management distributed a draft of the 2015 Form 990 to the Audit and Finance committee prior to the scheduled board of directors meeting on November 8, 2016. 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 liabilty adjustment $83,950,027. 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 9292524 34713734 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 1 1 0 0 0 1 1 0 Dornoch Sutherland Assurance LTD m 3000000 FMV Dornoch Sutherland Assurance LTD l 10000000 FMV Cruden Bay Risk Retention Group Inc l 3000000 FMV Cruden Bay Risk Retention Group Inc m 500000 FMV Cruden Bay Risk Retention Group Inc q 446040 FMV Pediatric Medical Services of Florida Inc r 4969125 FMV Nemours New Jersey Physician Practice PC r 1817860 FMV 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 2016.