2025-11-13T11:37:23+00:00 2024-12-31 350921680 CROWE LLP 401 East Las Olas Blvd Suite 1100 Fort Lauderdale FL 333014230 990 2024-01-01 590638499 Variety Children's Hospital VARI 3056666511 3100 SW 62nd Avenue Miami FL 331553009 Dawn Javersack SVP and CFO 2025-11-13 true Brittney Kocaj P01320603 9542028600 2025-11-13 2024 2025-03-06 01:10:19Z Nicklaus Children's Hospital Matthew A Love 3100 SW 62nd Avenue Miami FL 331553009 1275632893 false X www.nicklauschildrens.org X 1950 FL To inspire hope and promote lifelong health by providing the best care to every child. 12 8 3793 398 79806 0 35265380 45528283 898905067 946079437 24940217 38531230 15447067 12759837 974557731 1042898787 0 0 0 287878757 303693098 0 0 0 530249846 576495590 818128603 880188688 156429128 162710099 1637315414 1774367898 677444446 668371406 959870968 1105996492 TO INSPIRE HOPE AND PROMOTE LIFELONG HEALTH BY PROVIDING THE BEST CARE TO EVERY CHILD. false false 702902953 946079437 VARIETY CHILDREN'S HOSPITAL, ESTABLISHED IN 1950, OWNS AND OPERATES A PEDIATRIC SPECIALTY HOSPITAL NOW KNOWN AS NICKLAUS CHILDREN'S HOSPITAL. THE HOSPITAL IS ONE OF THE LARGEST FREESTANDING PEDIATRIC TEACHING HOSPITALS IN THE SOUTHEASTERN UNITED STATES. IT PROVIDES SPECIALIZED PEDIATRIC HEALTHCARE FOR CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. THE HOSPITAL HAS 307 LICENSED BEDS. NICKLAUS CHILDREN'S HOSPITAL SERVES AS A REFERRAL CENTER FOR CHILDREN WITH COMPLEX, CRITICAL, OR LIFE-THREATENING ILLNESSES REQUIRING SPECIALIZED CARE. IT HAS A STATE-DESIGNATED PEDIATRIC TRAUMA CENTER. MANY PATIENTS ARE REFERRED BY OTHER HOSPITALS REGARDLESS OF THE EXISTENCE OF FORMAL ARRANGEMENTS. (CONTINUED ON SCHEDULE O) 702902953 true true false false false false false false false true true true false true true true false true false false true false false false false false true true false false true true true false false false false false false false true true false false false false false true true true false false true X 0 0 3793 true true true true CJ false false false false false false false false false false X 12 8 true false true false true true true true true false false false true true true true true true false false true true FL X Laurie Levine 3056666511 5301 Blue Lagoon Drive Miami FL 33126 AMY CHARLEY ESQ SECRETARY / DIRECTOR 0.1 0.1 X X 0 0 0 DREW KERN Vice Chairman / Director 0.1 0 X X 0 0 0 JAY MASSIRMAN CHAIRMAN / DIRECTOR 0.1 0.1 X X 0 0 0 MATTHEW LOVE President & CEO 20.0 20.0 X X 0 2255590 315360 PERRY ANN REED SVP/COO NCHS & President NCH 40.0 0.1 X X 852838 0 130657 ALI MANDSAURWALA DIRECTOR 0.1 0 X 0 0 0 BALAGANGADHAR TOTAPALLY MD Director 0.1 0 X 0 0 0 GARY GREGORY EMERITUS DIRECTOR (thru JAN 2024) 0.1 0 X 0 0 0 JACQUES E ORCES Director (8/25/24 - 12/16/24), VP & Chief Medical Officer (as of 8/25/24) 40.0 0 X 166714 0 18899 JENNIFER BOUSSUGE Director 0.1 0 X 0 0 0 JOSEPH NADER Director 0.1 0.1 X 0 0 0 MARCO VALENTINI Director 0.1 0 X 0 0 0 MARCOS A MESTRE MD Dir. (thru 8/24), VP (thru 6/24), CMO (thru 8/24) / NCHS SVP & CCO (6/24) / NCPS Pres (6/24-12/24) 40.0 40.0 X 681854 0 117355 MARIA E FRANCO MD Director/Physician 0.1 0 X 48000 0 0 STEVEN MELNICK PhD MD Director 0.1 0 X 0 0 0 ARIANNA URQUIA VP/CFO Hospital 40.0 0 X 489846 0 46487 DAWN E JAVERSACK SVP/CFO Health System 20.0 20.0 X 0 911422 30343 JODI LAURENCE ESQ SVP and General Counsel 20.0 20.0 X 0 646818 103141 IRIS BERGES VP of Operations 40.0 0 X 401672 0 40727 RANI S GEREIGE Exec Dir Med Ed & DEI Lead 40.0 0 X 360195 0 25909 ROBERT L HANNAN Sr Med Dir Advanced Proj Lab 40.0 0 X 589878 0 19799 RODNEY L BAKER Executive Med Director 40.0 0 X 403460 0 24471 SHANNON M ODELL VP & NCH Chief Nursing Officer 40.0 0 X 454235 0 45838 JEFRY BIEHLER Former Exec Med Director Clinical Ops 0.0 40.0 X 409653 0 37671 JOSE PERDOMO SVP Admin/Special Projects 0.0 40.0 X 0 447786 31488 4858345 4261616 988145 613 true true false PHI AIR MEDICAL LLC 2800 NORTH 44 STREET PHOENIX AZ 85008 FLIGHT HOURS 4402257 MAYO MEDICAL LABORATORIES 200 FIRST STREET SW ROCHESTER MN 55905 Laboratory Services 1685994 A AND S TOTAL CLEANING 3350 NW 53 ST STE 106 FT LAUDERDALE FL 33309 Cleaning Services 1674333 MIAMI ASSOCIATES IN PEDIATRIC 3200 SW 60 CT SUITE 201 MIAMI FL 33155 Physician Services 1496064 KIDZ MEDICAL SERVICES INC 5955 PONCE DE LEON BLVD CORAL GABLES FL 33146 Physician Services 1413774 79 15445189 30025959 57135 45528283 Patient Service Revenue 621300 940179207 940179207 Grant Revenue 900099 5830630 5830630 Seminar Workshops 621300 69600 69600 0 0 0 0 946079437 26406950 3098 26403852 32686 32686 4987455 76708 4987455 76708 5064163 76708 4987455 244059299 604963 231823055 492999 12236244 111964 12124280 12124280 0 0 493090 418052 75038 75038 PHARMACY 456110 3500350 3500350 CAFETERIA/VENDING 722514 2208818 2208818 OTHER REVENUE 900099 1878782 1878782 0 0 0 0 7587950 1042898787 946079437 79806 51211261 X 2552650 2042121 510529 1156752 925402 231350 242717820 194174255 48543565 6037783 4830226 1207557 33369360 26695488 6673872 17858733 14286986 3571747 1559991 1559991 272470427 217976342 54494085 0 48253 38602 9651 8977723 7182178 1795545 1526273 1221018 305255 32158921 25727137 6431784 862166 689733 172433 10114580 8091664 2022916 27420923 21936738 5484185 25005424 20004339 5001085 HOSPITAL ASSESMENT 102243398 81794718 20448680 MEDICAL SUPPLIES 92169232 73735386 18433846 OTHER NON-OPERATING EXP 531730 425384 106346 COURSE EXPENSES 477173 381738 95435 929376 743498 185878 0 880188688 702902953 177285735 0 92774177 139724578 25225088 25101234 181428893 210162212 123038581 112940673 0 0 0 0 14004674 14700487 3974774 2710473 1073611914 532464631 430322392 541147283 444322719 303929049 129586647 222302832 19196456 15120158 173441013 186528919 1637315414 1774367898 56803542 51446679 468250181 457432648 0 0 152390723 159492079 677444446 668371406 X 802712600 937728285 157158368 168268207 959870968 1105996492 1637315414 1774367898 X 162710099 13138193 -29722768 X false true true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 54715114 48584 7609069 2292708 60080059 51284585 42467 5688930 2300868 54715114 58072902 190592 -3972479 3006430 51284585 51847151 1424279 6880578 2079106 58072902 50915312 33028 3318446 2419635 51847151 0.2923 0.7077 0.0 false true 3030156 3030156 620637866 242698062 377939804 47889717 41926756 5962961 330497339 240962606 89534733 71556836 6877207 64679629 541147283 Closely-held equity interests Financial derivatives Alternative Investments 221210170 F Restricted investments 1092662 F 222302832 Beneficial Interest in Miami Childrens Hospital Foundation 150992805 Self Insurance Trust 770760 Other Long Term Assets 1920924 Operating lease right of use assets, net 32039528 Finance Lease right of use assets, net 804902 186528919 Federal Income Taxes Other Liabilities 20574344 Swap Liabilities 2953589 Lease Incentive Obligation 36186069 Intercompany Payable 98973175 Finance Lease Liabilities 804902 159492079 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part V, Line 4 Intended uses of endowment funds The Foundation's endowments are established to fund medical research, education, patient medical, and social services at Nicklaus Children's Hospital. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The System and certain of its affiliated organizations qualify as tax-exempt, nonprofit organizations under Section 501(c)(3) of the Internal Revenue Code (the Code). The Hospital, NCPS and the Foundation are exempt from federal income tax on related income pursuant to Section 501(a) of the Code as described in Section 501(c)(3). These tax-exempt entities had no tax provision for the years ended December 31, 2024 and 2023. The Captive Insurance Company is not subject to income taxes, as no income taxes are levied in the Cayman Islands. The System believes there is no uncertain tax liability which should be recorded as of December 31, 2024 and 2023. Central America and the Caribbean 0 0 Program Services Self-Insurance Funding 5033314 Central America and the Caribbean 0 0 Investments 2529742 0 0 0 0 0 0 7563056 0 7563056 false false true true false false Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEAN-Accrual true true X true X true X 3144729 4591371 0 0.0 507582904 491979172 15603732 0.01773 7364029 2286318 5077711 0.00577 0 0 518091662 498856861 20681443 0.02350 7488706 3007078 4481628 0.00509 35308127 14744763 20563364 0.02336 44340694 13989613 30351081 0.03448 5325741 132320 5193421 0.00590 0 0.0 0 0 92463268 31873774 60589494 0.06884 0 0 610554930 530730635 81270937 0.09233 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 0 0 133990 437608 -303618 X true true MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC SURGERY CENTER 0.5217 0.0 0.4783 1 1 NICKLAUS Children's Hospital 3100 SW 62nd Avenue Miami FL 33155 WWW.NICKLAUSCHILDRENS.ORG 4067 X X X X X NICKLAUS Children's Hospital 1 false false true X X X X X X X X X 22 true false false true X https://www.nicklauschildrens.org/patient-resources/community-outreach/community-health-needs-assess X true 22 true https://www.nicklauschildrens.org/patient-resources/community-outreach/community-health-needs-assess false true X 200.0 400.0 X X X X true true X X X true X SEE PT VI X SEE PT VI X SEE PT VI X X X X X X true X false X X X X X true X false false Schedule H, Part V, Section B, Line 3E The significant health needs are a prioritized description of the significant health needs of the community and identified through the CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Nicklaus Children's Hospital. In 2022, Nicklaus Children's Hospital conducted a Community Health Needs Assessment (CHNA) of the community it serves in South Florida. The purpose of the CHNA was to provide an empirical foundation for future health planning, as well as fulfill the CHNA requirement for non-profit institutions put forth by the Internal Revenue Service (IRS). Nicklaus Children's Hospital hired Health Resources in Action (HRiA), a non-profit public health organization specializing in CHNA development, to collect and analyze data, and to develop the CHNA report. Contributing Stakeholders * Catalyst Miami * Early Learning Coalition of Miami-Dade/Monroe * Feeding South Florida * Florida Department of Health * Florida Health Justice Project * Florida International University * Israeli American Council * Nicklaus Children's Hospital Patient and Family Services * Nicklaus Children's Primary Care * Parent to Parent Miami * Sant La, Haitian Neighborhood Center, Inc. * The Children's Movement * The Children's Trust * YES Institute * Youth Co-Op, Inc Vulnerable/Underserved Populations Addressed by this Implementation Plan * Youth * Low-income children and families * Medically underserved children * Children and families managing mental health and/or behavioral health disorders * Children and families impacted by food insecurity, the cost of health care and medications * Non-English-speaking children and their families The 2022 Nicklaus Children's CHNA was conducted to achieve the following goals: 1. Examine the current health status of children and families in South Florida 2. Identify the current health priorities among children and families, focusing specifically on pediatric health 3. Explore community strengths, resources, and gaps in services in order to guide future planning and programming efforts for Nicklaus Children's Hospital 4. Understand perceptions of - and explore ways to address - health equity in South Florida The 2022 CHNA Report includes data from the seven Florida counties that Nicklaus Children's Hospital considers to be part of its overall service area: Broward, Collier, Lee, Martin, Miami-Dade, Monroe, and Palm Beach Counties. While patients of Nicklaus Children's come from many counties in Florida and around the world, the hospital is in Miami-Dade County and draws roughly 80% of its patient population from Miami-Dade. Therefore, the primary community of focus for this CHNA is defined as Miami-Dade County. METHODS To develop a comprehensive picture of the South Florida region, the assessment team employed quantitative and qualitative data collection methods. To gather quantitative data, the assessment team conducted a review of secondary data sources and administered a community survey to residents in South Florida. Secondary data included existing data from national, state, and local sources. The community survey was administered to residents of Broward, Collier, Lee, Martin, Miami-Dade, Monroe, and Palm Beach Counties. A total of 246 respondents are included in survey analysis. In addition to quantitative data, qualitative data was gathered to develop a more nuanced understanding of the perceptions of the community served by Nicklaus Children's Hospital. Interviews were conducted with 26 service providers representing a range of sectors including public health, community development, social services, early childhood education, and healthcare. Additionally, three discussion groups with 29 residents were conducted with residents of South Florida. One group was conducted with youth, one group with parents of children with complex care needs, and one group with recent immigrants. Participants ranged in age, racial identity, socioeconomic background, length of residence in South Florida, and county of residence, though most resided in Miami-Dade County. Similar to conversations with service providers, discussion groups explored perceptions of South Florida, health concerns, and suggestions for future programming and services to address stated concerns. The assessment team engaged with interview participants either representing or identifying with various populations that are typically underrepresented in data collection (e.g., recent immigrants, young adults, and people of color). The 2022 CHNA report discusses the findings from the 2022 CHNA conducted December 2021 - May 2022. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Nicklaus Children's Hospital. AFTER ENGAGING COMMUNITY ADVISORY BOARD MEMBERS IN A GROUP DISCUSSION AND PRIORITIZATION PROCESS, THE FOLLOWING PRIORITIES WERE IDENTIFIED AND INCLUDED IN NICKLAUS CHILDREN'S IMPLEMENTATION STRATEGY. 1. ACCESS TO SERVICES GOAL: Enhance access to timely, equitable, and comprehensive medical, social, behavioral health, and wellness services for children and their families in both traditional and non-traditional settings. Following a successful pilot, Nicklaus Children's expanded its comprehensive program to address social determinants of health through screenings and referral initiatives for families with health-related social needs. In 2024, 50,128 screenings were conducted, with 26,591 positive results and 102 positive social work interventions. Families screening positive were referred to resources such as Feeding South Florida for food access and benefit enrollment. Screening efforts also addressed housing, transportation, and utilities, ensuring that individuals facing challenges received appropriate support. Bringing the program into community and educational settings has further enhanced access. In 2024, 19,818 free EKGs were provided to children in the community, ensuring early detection of heart-related conditions. Mobile dental services also reached underserved populations, providing essential care and education. 2. HEALTH EDUCATION GOAL: Empower parents and children to lead healthy lifestyles by providing culturally, linguistically, and developmentally tailored education and resources. Specialized initiatives such as Safe Kids focus on injury prevention and child safety, while collaborations with schools expand outreach efforts. In 2024, multiple car seat check events were held, inspecting 229 car seats and educating caregivers on proper fit and installation. Parent safety presentations promoted awareness of safe sleep practices and Sudden Unexpected Infant Death Syndrome (SUIDS). These efforts are designed to improve health literacy and empower families to make informed decisions. The Food for Salud nutrition education and outreach program continued in 2024. Under the tagline "Healthy Food for Healthy Kids", Nicklaus Children's provided fresh monthly content to educate families on nutrition and offer actionable tips and recipes that are healthy, budget-friendly, culturally relevant, and kid-approved. Additionally, 25 live cooking demonstration events were held, engaging children in hands-on nutrition education. Nicklaus Children's Hospital also ensures access to high-quality health information that families can rely on for topics ranging from digital safety to early childhood development. Through social media, newsletters, podcasts, and expert interviews, this trusted content supports health for all children and improves awareness across the community. 3. CHILDREN'S MENTAL HEALTH GOAL: Promote the overall mental wellness of children and adolescents by engaging an ecosystem of support and services for them and their families. Nicklaus Children's recognizes community collaboration as an essential component of mental health. This is a priority both in the hospital's CHNA and in the collaborative, community-level CHNA. Local health systems are working together to address these needs. One example is participation in the NAMI Walk, where each system provided resources and collectively demonstrated their commitment to addressing mental health challenges. The youth-focused ecosystem continues to strengthen as the hospital builds collaborations within the community, raising awareness about vetted providers for patients and families. Nicklaus Children's has also fostered a network among local schools that lacked the full resources of the public school district. This network enables schools to support one another during crises by sharing professional staff. Mental health needs are often identified and addressed within school settings. The School Health Programs team has created Mental Health First Aid Kits, which are used in school clinics and classrooms. These kits, which have been well received and are in high demand, include tools to help students regulate emotions, improve behavior, and enhance academic performance while supporting diverse learning needs. Providing teachers with these kits not only benefits individual students but also fosters a supportive and focused learning environment, enhancing the overall classroom experience. Schedule H, Part V, Section B, Line 20 Facility , 1 Facility , 1 - NICKLAUS CHILDREN'S HOSPITAL. Notified individuals of the financial assistance policy on admission Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals' bills Documented its determination of whether individuals were eligible for financial assistance under the hospital facility's financial assistance policy 29 Nicklaus Children's Doral Outpatient Center 3601 NW 107th Avenue Doral FL 33178 Outpatient / Urgent Care Center Nicklaus Children's Dan Marino Outpatient Center 2900 S Commerce Parkway Weston FL 33331 Outpatient / Urgent Care Center Nicklaus Children's Palm Beach Gardens Outpatient Center 11310 Legacy Avenue Legacy Place Palm Beach Gardens FL 33410 Outpatient / Urgent Care Center Nicklaus Children's Miramar Outpatient Center 12246 Miramar Parkway Miramar Squar e Miramar FL 33025 Outpatient / Urgent Care Center Nicklaus Children's Miami Lakes Outpatient Center 15025 NW 77th Avenue Miami Lakes FL 33014 Outpatient / Urgent Care Center Nicklaus Children's Midtown Outpatient Center 3915 Biscayne Boulevard Miami FL 33137 Outpatient / Urgent Care Center Nicklaus Children's West Kendall Outpatient Center 13400 SW 120th Street Suite 100 Miami FL 33186 Outpatient / Urgent Care Center Nicklaus Children's Palmetto Bay Outpatient Center 17615 SW 97th Avenue Palmetto Bay FL 33157 Outpatient / Urgent Care Center Nicklaus Children's West Bird Outpatient Center 11449 SW 40 St Miami FL 33165 Outpatient / Urgent Care Center Nicklaus Children's Pinecrest Outpatient Center 11521 South Dixie Hwy 1st Fl Pinecrest FL 33156 Specialty Care Center Nicklaus Children's Hialeah Outpatient Center 990 W 49th St Hialeah FL 33012 Outpatient / Urgent Care Center Nicklaus Children's Homestead Outpatient Center 2072 NE 8th St Campbell Shoppes Homestead FL 33033 Outpatient / Urgent Care Center Boynton Beach Care Center 10383 Hagen Ranch Rd Ste 200 Boynton Beach FL 33437 Specialty Care center Sports Health Center (Pinecrest) 11521 South Dixie Hwy 2nd fl Pinecrest FL 33156 Sports rehabilitation NCPS at Coral Springs 9750 NW 33rd Street Ste 109 Coral Springs FL 33065 Specialty Care center NCPS at Palm City 3228 SW Martin Downs Blvd Unit 33 Palm City FL 34990 Specialty Care Center NCPS at Flamingo Park Plaza 4410 West 16th Avenue Bay 60 Hialeah FL 33012 Pediatric Care Center NCPS at Allapattah 3445 NW 7 Street Miami FL 33125 Pediatric Care Center NCPS at Sunset Oaks 9260 SW 72 Street Suite 218 Miami FL 33173 Specialty Care Center. NCPS at Plantation 8430 West Broward Boulevard Plantation FL 33324 Specialty Care Center Nicklaus Children's Pediatric Specialists at Wellington 10111 Forest Hill Boulevard Suite 1 10 Wellington FL 33414 Specialty Care Center Nicklaus Children's Pediatric Specialists at Alton Road 4308 Alton Road Suite 940 Miami Beach FL 33140 Specialty Care Center Nicklaus Children's Pediatric Specialists at Coral Reef 8950 SW 152nd Street Suite 101 Miami FL 33176 Specialty Care Center Nicklaus Children's at Cooper City 11011 Sheridan Street Suite 311 Cooper City FL 33026 Specialty Care Center Nicklaus Children's at Cutler Bay 18557 S Dixie Hwy Miami FL 33157 Specialty Care Center Nicklaus Children's at Galloway 7800 SW 87th Avenue Suite C-350 Miami FL 33173 Specialty Care Center Nicklaus Children's at Pompano Beach 4701 N Federal Hwy Suite 370 Pompano Beach FL 33064 Specialty Care Center Nicklaus Children's at Pembroke Pines 208 N University Drive Pembroke Pines FL 33024 Specialty Care Center Nicklaus Children's at West Pines 18503 Pines Boulevard Suite 212 Pembroke Pines FL 33029 Pediatric Care Center Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE https://www.nicklauschildrens.org/patient-resources/patient-financial-services/financial-assistance-program Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE https://www.nicklauschildrens.org/patient-resources/patient-financial-services/financial-assistance-program Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE https://www.nicklauschildrens.org/patient-resources/patient-financial-services/financial-assistance-program Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE ORGANIZATION UTILIZED IRS WORKSHEET 2 FOR THE CALCULATION OF THE COST TO CHARGE RATIO IN PART I, LINE 7. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, the organization HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDE BAD DEBTS. ACCORDINGLY, BAD DEBTS ARE REFLECTED AS A REDUCTION OF NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15. AS A RESULT, BAD DEBT EXPENSE IS NOT PRESENTED SEPARATELY. Schedule H, Part III, Line 3 Bad Debt Expense Methodology Since the organization has adopted Accounting Standards Update No. 2014-09 (Topic 606), bad debts are reported as implicit price concessions within net patient revenue. Consequently, no bad debt expense is recognized for patients who qualify for free or discounted services under the financial assistance policy. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote Per NOTE 2 of the Audited Financial Statements: The System determines the transaction price based on standard charges for goods and services provided to patients, reduced by contractual adjustments provided to third-party payors, discounts provided to uninsured patients in accordance with the System's policy and/or implicit price concessions. The implicit price concessions included in estimating the transaction price represent the difference between amounts billed to patients and the amounts expected to collect based on the System's collection history with similar class of patients. Subsequent changes to the estimate of the transaction price are generally recorded as adjustments to patient service revenue in the period of the change. Subsequent changes that are determined to be the result of an adverse change in the patient's ability to pay are recorded as bad debt expense. Bad debt expense for the years ended December 31, 2024 and 2023, was not significant. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs NICKLAUS CHILDREN'S HOSPITAL ("NCH") ACCEPTS ALL MEDICARE PATIENTS WITH THE KNOWLEDGE THAT THERE MAY BE SHORTFALLS AND OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. NCH BELIEVES THAT THE MEDICARE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE DOES NOT FULLY REIMBURSE HOSPITALS FOR THE COST OF PROVIDING HOSPITAL CARE TO MEDICARE BENEFICIARIES. IN 2024, NCH INCURRED LOSSES OF $303,618 DUE TO UNDERPAYMENT FOR THE TREATMENT OF MEDICARE PATIENTS. UNREIMBURSED MEDICARE COSTS REPRESENT A SIGNIFICANT VALUE THAT NONPROFIT HOSPITALS PROVIDE TO THE COMMUNITY, AS THE HOSPITAL RELIEVES THE FEDERAL GOVERNMENT OF A FINANCIAL BURDEN WHEN IT PROVIDES ESSENTIAL HEALTHCARE SERVICES TO MEDICARE-COVERED PATIENTS. THE MEDICARE COST REPORT AND THE ORGANIZATION'S COST ACCOUNTING SYSTEM ARE USED TO DETERMINE THE MEDICARE-ALLOWABLE COSTS. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance Hospital patient accounts may be subject to the following collection actions, conducted by the Hospital or an authorized party: 1. Following the initial bill, monthly statements and collection letters are mailed, and phone calls are made in an effort to collect outstanding balances. 2. The patient's responsible portion of an outstanding balance may be transferred to a bad debt collection agency. 3. Payment plan arrangements may be made for patients who indicate they have difficulty paying their balance in a single installment. If an individual submits a complete FAP application and NCH determines the individual is eligible for financial assistance, NCH will refund any excess amount paid by the individual. This includes payments made to the hospital facility or any other party to whom the hospital facility has referred or sold the individual's debt. NCH will also take all necessary measures to reverse any actions taken to obtain payment, such as reversing any external collection agency (ECA) activities. Schedule H, Part V, Section B, Line 16a FAP website - NICKLAUS Children's Hospital: Line 16a URL: SEE PT VI; Schedule H, Part V, Section B, Line 16b FAP Application website - NICKLAUS Children's Hospital: Line 16b URL: SEE PT VI; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - NICKLAUS Children's Hospital: Line 16c URL: SEE PT VI; Schedule H, Part VI, Line 2 Needs assessment Under the direction of the Board of Directors, Nicklaus Children's Hospital (NCH) works to provide hope through advanced care for children and families. In 2024, NCH actively participated in community organizations such as The Children's Trust, the Miami-Dade County Public Schools Wellness Committee, the Greater Miami Chamber of Commerce's Health and Bio-Science Committee, the Consortium for a Healthier Miami-Dade, and the Health Council of South Florida. Through ongoing collaboration with the Health Council, NCH consistently analyzes data to identify unmet needs and address health disparities. NCH also deploys physicians to community health fair events and provides a mobile dental unit to underserved communities as part of its preventive medicine program. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Nicklaus Children's Hospital has a financial assistance program to assist patients who are uninsured or underinsured and to provide them the opportunity to apply for different programs. Using the Patient/Family General Consent Form, the Financial Agreement for Professional Services Form, and a Coordination of Benefits Form, patients/families are referred to an eligibility assistance counselor who will explain the programs available. Patients are also provided pamphlets summarizing the financial assistance policy, and signage is posted at each location indicating that financial counseling is available and that patients may be eligible for financial assistance. Schedule H, Part VI, Line 4 Community information NICKLAUS CHILDREN'S HOSPITAL-THE FLAGSHIP OF NICKLAUS CHILDREN'S HEALTH SYSTEM-PRIMARILY SERVES THE PEDIATRIC POPULATION OF MIAMI-DADE COUNTY. IN 2024, 80% OF CHILDREN LIVING IN MIAMI-DADE COUNTY RECEIVED CARE AT A NICKLAUS CHILDREN'S LOCATION. MIAMI-DADE IS ONE OF THE MOST INTERNATIONALLY DIVERSE COUNTIES IN THE NATION. ACCORDING TO THE MIAMI-DADE COUNTY REPORT, 54% OF THE POPULATION WAS FOREIGN-BORN; 20.2% WERE UNDER AGE 18; 72.9% IDENTIFIED AS HISPANIC OR LATINO; AND 76.2% SPOKE A LANGUAGE OTHER THAN ENGLISH AT HOME. THE MEDIAN HOUSEHOLD INCOME WAS $52,311. ADDITIONALLY, 35.9% OF THE POPULATION HELD A BACHELOR'S DEGREE OR HIGHER, AND 10.5% OF THE POPULATION WAS DISABLED. IN 2024, NICKLAUS CHILDREN'S SERVED PATIENTS FROM EVERY COUNTY IN FLORIDA AND FROM INTERNATIONAL LOCATIONS WORLDWIDE. AT MORE THAN 30 OUTPATIENT AND URGENT CARE CENTERS ACROSS SOUTH FLORIDA, NCH OFFERED SUBSPECIALTY CONSULTATIONS, URGENT CARE, IMAGING, AND REHABILITATION SERVICES. Schedule H, Part VI, Line 5 Promotion of community health NICKLAUS CHILDREN'S HOSPITAL (NCH) IS A NONPROFIT HOSPITAL OPERATED TO SERVE THE PUBLIC INTEREST AND MEETS THE REQUIREMENTS OF REVENUE RULING 69-545. CONTROL OF THE HOSPITAL RESTS WITH ITS BOARD OF DIRECTORS, WHICH IS PRIMARILY COMPOSED OF MEMBERS OF THE LOCAL COMMUNITY WHO ARE NEITHER EMPLOYEES NOR FAMILY MEMBERS. NCH EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE HOSPITAL ACCEPTS PATIENTS COVERED BY MEDICAID AND PROVIDES SERVICES TO ALL CHILDREN REGARDLESS OF THEIR ABILITY TO PAY. EMERGENCY AND SPECIALTY CARE ARE ACCESSIBLE THROUGH HOSPITAL AND OUTPATIENT LOCATIONS THROUGHOUT SOUTH FLORIDA. SURPLUS FUNDS ARE REINVESTED TO ADVANCE COMMUNITY HEALTH, ENHANCE PATIENT CARE, EXPAND FACILITIES, AND SUPPORT MEDICAL TRAINING AND RESEARCH. In 2023, A PILOT STUDY AT NICKLAUS CHILDREN'S HOSPITAL assessed the impact of rapid whole genome sequencing for critically ill children, leading to Florida Medicaid funding. THIS INNOVATIVE TESTING SUPPORTS FASTER DIAGNOSES AND TARGETED CARE FOR UNDIAGNOSED CHILDREN ACROSS SOUTH FLORIDA. THE HOSPITAL ALSO OPENED AN UNDIAGNOSED DISEASE CLINIC, PROVIDING ANSWERS FOR FAMILIES ON A DIAGNOSTIC JOURNEY, AND BECAME THE FIRST IN FLORIDA TO OFFER NEW TREATMENTS FOR DUCHENNE MUSCULAR DYSTROPHY AND ANTERIOR CRUCIATE (ACL) LIGAMENT TEARS. As the South Florida affiliate of Project ADAM, Nicklaus Children's Hospital has collaborated with private, charter, and all Miami-Dade County Public Schools (MDCPS) to prepare school employees to respond quickly and efficiently should students, family members or school staff experience sudden cardiac arrest. To date, there have been 10 lives saved since the inception of the Project ADAM program. IN 2024, NCH CONTINUED TO ADVANCE ITS MISSION TO INSPIRE HOPE AND PROMOTE LIFELONG HEALTH BY PROVIDING THE BEST CARE TO EVERY CHILD. THE COMMITMENT TO ITS COMMUNITY HEALTH NEEDS ASSESSMENT PRIORITIES WAS DEMONSTRATED THROUGH TARGETED OUTREACH AND SERVICES, INCLUDING PEDIATRIC CPR EDUCATION, DIABETES SCREENINGS, AND VENTILATOR ASSISTANCE TRAINING FOR CAREGIVERS. THE HOSPITAL ALSO SUPPORTED ACCESS TO CARE IN UNDERSERVED NEIGHBORHOODS THROUGH MOBILE MEDICAL AND DENTAL UNITS, AND PROVIDED 19,818 FREE EKG SCREENINGS. NCH IS DEDICATED TO IMPROVING HEALTH ACCESS THROUGH HEALTH PROFESSIONS EDUCATION, OFFERING TRAINING OPPORTUNITIES TO RESIDENT AND FELLOW PHYSICIANS, NURSING STUDENTS, AND OTHER ALLIED HEALTH PROFESSIONALS. THESE INITIATIVES ARE GUIDED BY THE REGULAR COMPLETION OF A COMMUNITY HEALTH NEEDS ASSESSMENT, ENSURING NCH REMAINS RESPONSIBLE IN PROMOTING COMMUNITY HEALTH. IN 2024, NCH HAD 126 RESIDENTS AND FELLOWS AND OFFERED 61,189 STUDENT HOURS OF CLINICAL TRAINING TO ALLIED HEALTH PROFESSIONALS AND NURSES, STRENGTHENING THE FUTURE PEDIATRIC WORKFORCE IN THE REGION. Schedule H, Part VI, Line 6 Affiliated health care system NICKLAUS CHILDREN'S HEALTH SYSTEM PRIMARILY SERVES THE PEDIATRIC POPULATION OF MIAMI-DADE COUNTY AND IS A LEADING PROVIDER OF HEALTHCARE SERVICES FOR MEDICALLY NEEDY CHILDREN. IN ADDITION, NICKLAUS CHILDREN'S HOSPITAL IS THE LARGEST PROVIDER OF PEDIATRIC MEDICAL EDUCATION IN THE SOUTHEASTERN UNITED STATES. THE NICKLAUS CHILDREN'S HOSPITAL PROVIDES PRIMARY CARE AND A MEDICAL HOME TO THE MEDICAID POPULATION THROUGH ITS PEDIATRIC CARE CENTER LOCATED ON THE HOSPITAL'S MAIN CAMPUS. THE HOSPITAL provides care for half a million children annually - offering nearly every pediatric specialty and the latest innovative therapies. true true false false false false false false false PERRY ANN REED SVP/COO NCHS & President NCH 603139 0 162885 0 86814 0 114563 0 16094 0 983495 0 57906 0 MATTHEW LOVE President & CEO 0 1306062 0 631453 0 318075 0 288011 0 27349 0 2570950 0 290140 MARCOS A MESTRE MD Dir. (thru 8/24), VP (thru 6/24), CMO (thru 8/24) / NCHS SVP & CCO (6/24) / NCPS Pres (6/24-12/24) 571598 0 102646 0 7610 0 90397 0 26958 0 799209 0 5013 0 JACQUES E ORCES Director (8/25/24 - 12/16/24), VP & Chief Medical Officer (as of 8/25/24) 141671 0 25000 0 43 0 15686 0 3213 0 185613 0 0 0 JEFRY BIEHLER Former Exec Med Director Clinical Ops 363567 0 45380 0 706 0 19796 0 17875 0 447324 0 0 0 JOSE PERDOMO SVP Admin/Special Projects 0 315704 0 79020 0 53062 0 13453 0 18035 0 479274 0 47374 DAWN E JAVERSACK SVP/CFO Health System 0 646881 0 159169 0 105372 0 19575 0 10768 0 941765 0 95425 JODI LAURENCE ESQ SVP and General Counsel 0 457965 0 115876 0 72977 0 87727 0 15414 0 749959 0 68330 ARIANNA URQUIA VP/CFO Hospital 360631 0 104506 0 24709 0 46161 0 326 0 536333 0 23944 0 RODNEY L BAKER Executive Med Director 362378 0 40782 0 300 0 16614 0 7857 0 427931 0 0 0 IRIS BERGES VP of Operations 314382 0 66049 0 21241 0 40444 0 283 0 442399 0 19930 0 RANI S GEREIGE Exec Dir Med Ed & DEI Lead 304258 0 39424 0 16513 0 18040 0 7869 0 386104 0 0 0 ROBERT L HANNAN Sr Med Dir Advanced Proj Lab 114430 0 32162 0 443286 0 13230 0 6569 0 609677 0 0 0 SHANNON M ODELL VP & NCH Chief Nursing Officer 366445 0 71443 0 16347 0 45508 0 330 0 500073 0 12275 0 Schedule J, Part I, Line 4a Severance or change-of-control payment The following employee received a severance payment. ROBERT L HANNAN $382,151 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan The organization maintains a nonqualified deferred compensation plan under section 457(f) available to highly compensated employees. Under the plan, each participant accrues an annual benefit equal to a percentage of base salary, which vests after three years of service or upon reaching age 60. Benefits are paid in a lump sum upon vesting, subject to forfeiture if the executive leaves before vesting. For 2024, ten Executives contributed $743,578 under this plan, and $477,538 of distributions were made during the year. The following contributions were made to a Section 457(f) plan during the year - MATTHEW LOVE $270,001 JODI LAURENCE $69,170 PERRY ANN REED $97,653 MARCOS A MESTRE $70,488 ARIANNA URQUIA $27,980 SHANNON M ODELL $28,554 IRIS BERGES $24,479 JACQUES E ORCES $12,453 THE FOLLOWING DISTRIBUTIONS WERE MADE FROM A SECTION 457(F) PLAN DURING THE YEAR - MATTHEW LOVE $290,140 JODI LAURENCE $68,331 PERRY ANN REED $57,906 MARCOS A MESTRE $5,013 ARIANNA URQUIA $23,944 SHANNON M ODELL $12,275 IRIS BERGES $19,930 DAWN E JAVERSACK $95,425 JOSE PERDOMO $47,374 Schedule J, Part I, Line 3 METHODS USED BY RELATED ORGANIZATION TO ESTABLISH CEO'S COMPENSATION The organization relied on the methods of establishing compensation for the organization's CEO employed by Nicklaus Children's Health System (EIN: 45-3481327). Nicklaus Children's Health System uses the following methods to establish such compensation: (1) Compensation Committee; (2) Independent Compensation Consultant; (3) Compensation survey or study; and (4) Approval by the Board or Compensation Committee. A Miami-Dade County Health Facilities Authority 521293036 59334NDY5 2017-04-27 162534870 SEE PART VI false false false B Miami-Dade County Health Facilities Authority 521293036 59334NFC1 2021-11-10 184436567 SEE PART VI false false false C Miami-Dade County Health Facilities Authority 521293036 59334NBW1 2017-05-01 62225000 SEE PART VI false false false A 2980000 0 162560891 0 0 0 1931562 0 0 100026021 60603308 0 2017 false true true true B 7540000 0 184436567 0 0 0 1560795 0 0 160106289 9531955 13237528 true false false false C 4345000 62225000 62225000 2017 true false true false A false true true true true true 0.0118 0.0004 0.0122 false false 0 false true B false true true true true true 0.004 0.0 0.004 false false 0 false true C false true true true true true 0.024 0.001 0.025 false false 0 false true A false false true false false false 0 false false false 0 false true true B false true false false false false 0 false false false 0 false true true C false false true false true false 0 false false false 0 false false true A true B true C true Schedule K, Part II, Line 3 Columns A and B The difference between the Issue Prices listed in Part I, Column (E), Lines A and B, and the total proceeds of the issue listed in Part II, Line 3, Columns A and B is due to investment earnings. Schedule K, Part I, Column (f) Line A Partially Refund bonds issued on 12/22/2010 and 08/01/2011; acquire, construct, and equip hospital facilities. Schedule K, Part I, Column (f) Line B Refund bonds issued on 12/22/2010; acquire, construct, and equip hospital facilities. Schedule K, Part I, Column (f) Line C REFUND BONDS ISSUED ON 12/15/2010 Children's Critical Care Specialists PA Balagandahar Totapally, director, is a greater than 35% owner 639099 Payment for medical services rendered by Children's Critical Care Specialists, PA false NANCY LYNN PERDOMO SPOUSE OF JOSE PERDOMO - DIRECTOR 70329 COMPENSATION & BENEFITS false JOANNA E PERDOMO DAUGHTER OF JOSE PERDOMO - DIRECTOR 199545 COMPENSATION & BENEFITS false Form 990, Part III, Line 4a CONTINUED PROGRAM DESCRIPTION (CONTINUED FROM PART III) In 2024: 3,801 PATIENTS WERE TRANSFERRED FROM HOSPITALS THROUGHOUT FLORIDA, CENTRAL AND SOUTH AMERICA, AND THE CARIBBEAN. WHEN CHILDREN NEED THE SERVICES OF A SPECIALIST, IT IS IMPORTANT THAT SUCH SERVICES BE PROVIDED BY A PRACTITIONER WITH SPECIFIC TRAINING AND EXPERTISE IN PEDIATRIC CARE. THE CARE OF CHILDREN WITH CERTAIN COMPLEX CHRONIC CONDITIONS, SUCH AS JUVENILE DIABETES, CANCER, OR CYSTIC FIBROSIS, IS BEST MANAGED BY A PEDIATRIC SPECIALIST IN ORDER TO ELIMINATE REFERRAL DELAYS AND EXPEDITE POSITIVE TREATMENT. CHILDREN ARE MORE VULNERABLE TO COMPLICATIONS DUE TO DELAYS THAN ADULTS. THEY DEVELOP SERIOUS COMPLICATIONS MORE RAPIDLY THAN ADULTS BECAUSE THEY HAVE LESS PHYSIOLOGICAL RESERVES AND LESS DEVELOPED ORGAN SYSTEMS. OPENED THE TENTH PEDIATRIC CARE CENTER (PCC) IN WEST PINES, OFFERING APPOINTMENTS WITH BOARD-CERTIFIED PEDIATRICIANS WHO SERVE AS PRIMARY CARE PROVIDERS (PCPS) FOR BABIES, CHILDREN, AND TEENS. REPLACED THE EXISTING MAGNETIC RESONANCE IMAGING MACHINE AT THE WEST KENDALL OUTPATIENT CENTER WITH A NEW MRI SYSTEM (Philips 1.5T Ambition), TRANSFORMING HEALTHCARE DELIVERY FOR CHILDREN. OPENED THE KENNETH C. GRIFFIN SURGICAL TOWER, EQUIPPED WITH 12 ADVANCED AND FULLY INTEGRATED OPERATING SUITES FOR PERFORMING THE MOST COMPLEX PEDIATRIC SURGERIES, INCLUDING TRAUMA CARE, SURGICAL CANCER INTERVENTIONS, AND PEDIATRIC PLASTIC AND RECONSTRUCTIVE SURGERIES, SUCH AS CLEFT LIP-AND-PALATE, ORTHOPEDIC AND SPINE, BRAIN, AND HEART SURGERIES. THE KENNETH C. GRIFFIN SURGICAL TOWER IS CONSIDERED ONE OF THE MOST INNOVATIVE PEDIATRIC SURGICAL FACILITIES IN THE UNITED STATES AND COMBINES LEADING-EDGE TECHNOLOGY WITH A FOCUS ON DELIVERING A COMPASSIONATE PATIENT EXPERIENCE. BECAME THE FIRST CHILDREN'S HOSPITAL IN SOUTH FLORIDA TO OFFER IN-HOUSE PHARMACOGENOMICS TESTING AS PART OF NICKLAUS'S COMMITMENT TO PRECISION MEDICINE. NICKLAUS ACQUIRED THE BIOSYSTEMS PHARMACOSCAN SOLUTION AND GENETITAN MC FAST SCAN INSTRUMENT, WHICH COMBINES PHARMACOGENOMICS TEST RESULTS WITH OTHER INFORMATION SUCH AS A PATIENT'S OVERALL HEALTH, LIFESTYLE FACTORS, AND FAMILY HISTORY TO HELP DETERMINE A PERSONALIZED TREATMENT PLAN FOR EACH PATIENT. LAUNCHED HOSPITAL SAFETY FOR ALL, AN INTEGRATED SAFETY AND QUALITY FRAMEWORK, DESIGNED TO PREVENT HARM TO PATIENTS, STAFF, AND VISITORS. THROUGH THIS INITIATIVE, TEAMS ACROSS THE HEALTH SYSTEM COLLABORATE TO CONTINUOUSLY IMPROVE WORKFLOWS AND IMPLEMENT PROCESSES FOCUSED ON ACHIEVING QUALITY IMPROVEMENT MILESTONES. DUE TO THESE EFFORTS, THE HOSPITAL EXPERIENCED A SIGNIFICANT REDUCTION IN PREVENTABLE SAFETY INCIDENTS AND A DECREASE IN ALREADY RARE HEALTHCARE-ACQUIRED INFECTIONS. ESTABLISHED ONLINE SCHEDULING TO IMPROVE ACCESSIBILITY AND CONVENIENCE FOR CHILDREN AND FAMILIES IN SOUTH FLORIDA, GIVING FAMILIES THE OPTION TO SELF-SCHEDULE APPOINTMENTS WITH BOARD-CERTIFIED SPECIALISTS AND PRIMARY CARE PROVIDERS. ATTAINED MAGNET RECOGNITION BY THE AMERICAN NURSES CREDENTIALING CENTER'S MAGNET RECOGNITION PROGRAM FOR THE FIFTH CONSECUTIVE TERM. NICKLAUS CHILDREN'S IS ONE OF ONLY FIVE CHILDREN'S HOSPITALS IN THE NATION TO HAVE RECEIVED A FIFTH MAGNET DESIGNATION AND JOINED THE RANKS OF ONLY ONE PERCENT OF HOSPITALS NATIONWIDE THAT HAVE ATTAINED THIS FIFTH-TERM MAGNET MILESTONE. THE MAGNET RECOGNITION PROGRAM DISTINGUISHES HEALTHCARE ORGANIZATIONS THAT MEET RIGOROUS STANDARDS FOR NURSING EXCELLENCE AND IS THE HIGHEST AND MOST REGARDED HONOR AN ORGANIZATION CAN RECEIVE FOR PROFESSIONAL NURSING PRACTICE. NICKLAUS CHILDREN'S WAS THE FIRST PEDIATRIC HOSPITAL IN FLORIDA AND THE FIFTH PEDIATRIC HOSPITAL IN THE NATION TO ACHIEVE ANCC MAGNET DESIGNATION IN 2004. WAS NAMED A TOP CHILDREN'S HOSPITAL BY THE LEAPFROG GROUP. 2,400 HOSPITALS WERE CONSIDERED FOR THE AWARD THIS YEAR. AMONG THOSE, NICKLAUS CHILDREN'S IS ONE OF ONLY EIGHT HOSPITALS TO ACHIEVE A TOP CHILDREN'S DISTINCTION. WAS RECOGNIZED BY THE NATIONAL SAFE SLEEP HOSPITAL AS A "GOLD CERTIFIED" HOSPITAL FOR ITS COMMITMENT TO BEST PRACTICES AND EDUCATION ON INFANT SAFE SLEEP. WAS INCLUDED IN NEWSWEEK'S LIST OF AMERICA'S BEST CHILDREN'S HOSPITALS 2024. NICKLAUS CHILDREN'S WAS RECOGNIZED WITH THE MOST PROGRAMS RANKED WITHIN THE STATE OF FLORIDA, WITH DISTINCTIONS IN GASTROENTEROLOGY, NEONATOLOGY, NEUROLOGY, AND ENDOCRINOLOGY. 2024 STATISTICAL DATA INCLUDES - TOTAL INPATIENT DAYS: 60,426 TOTAL INPATIENT ADMISSIONS: 10,695 INPATIENT AVERAGE DAILY CENSUS: 189.3 TOTAL OUTPATIENT VISITS (MAIN CAMPUS): 182,009 TOTAL OUTPATIENT VISITS (AMBULATORY CENTERS): 348,219 TOTAL AMBULATORY URGENT CARE VISITS: 210,276 TOTAL SURGICAL CASES: 9,893 AVERAGE LENGTH OF STAY: 5.6 DAYS Nicklaus Children's Hospital completed the ISO 9001 Quality Management System certification by DNV GL. Nicklaus Children's is the second freestanding children's hospital in the nation to obtain this certification. Since the hospital's initial DNV GL accreditation in 2016, Nicklaus Children's and its network of outpatient centers have participated in annual accreditation site visit evaluations to ensure steady progression toward ISO 9001 certification. ISO 9001 sets forth criteria for quality management that include a strong customer focus, engagement of top management, a process approach, and continual improvement. The ultimate impact of ISO within hospitals is the reduction or elimination of variation, so that critical work processes are done consistently, and the "best ideas" are not by one person or department, but are ingrained in the organization itself. Nicklaus Children's Hospital's Quality Program is data driven and dedicated to the development and implementation of consistency in the service we provide. Our quality measures are based on national standards and are formed around the patient-centered framework put forth by the Institute for Healthcare Improvement (IHI) which aligns to the principles of safety, equity, effectiveness, timeliness, and efficiency. Using industry benchmarks, internal standards, and the resources of national survey and compliance services, we seek to constantly improve our pediatric care. The quality department serves as a vital part of improvement and resource management throughout the institution. Our team of dedicated physicians, nurses, quality and accreditation specialists, and data analysts are working to achieve customer care excellence, standardization of practice, transparency in performance, a Just Culture for improvement, and assurance to ourselves and the patients and families we serve that we are delivering the best possible pediatric care. Nicklaus monitors internal performance in real time and formally on a monthly basis using an extensive, metric driven, nationally benchmarked scorecard. Improvement opportunities and action planning are addressed using a structured, collaborative, multidisciplinary approach in which quality becomes the interest and responsibility of every employee. Quality performance and action planning are monitored at a monthly cadence through the multidisciplinary Performance Improvement Council with regular oversight by the Quality Committee of the System Board. FAST PASS VISITOR SYSTEM REQUIRES ALL VISITORS AT THE MAIN HOSPITAL TO PRESENT PHOTO IDENTIFICATION UPON ARRIVAL AND A RECORD IS KEPT OF ALL THOSE ENTERING THE HOSPITAL. THIS SYSTEM CAN IDENTIFY INDIVIDUALS WITH RECORDS OF CHILD ABUSE AND MOLESTATION; HELPING ENHANCE THE SAFETY OF CHILDREN AT THE HOSPITAL. GETWELL NETWORK IS IN ALL MEDICAL SURGICAL ROOMS. THE SYSTEM, ACCESSIBLE THROUGH THE IN-ROOM TELEVISION SCREEN, OFFERS PATIENT EDUCATION INFORMATION THAT CAN SUPPORT ENHANCED PATIENT CARE AS WELL AS A PATIENT FEEDBACK SYSTEM, THROUGH WHICH FAMILIES CAN ADDRESS SAFETY CONCERNS. EMR, A STATE-OF-THE-ART SYSTEM, WHICH CAPTURES ALL PATIENT DATA, INCLUDING COMPREHENSIVE CARE RECORDS (RADIOLOGY, PHARMACY, REHABILITATION, OUTPATIENT AND INPATIENT) AS WELL AS REGISTRATION AND BILLING INFORMATION, ALL IN A COMPREHENSIVE SYSTEM. HUMPTY DUMPTY, A TOOL TO PREVENT PEDIATRIC FALLS AND THEREBY ENHANCE SAFETY. AS OF 12/31/2024, THE TOOL WAS IN USE IN 1,800 HOSPITALS (1,519 IN THE US AND 281 OUTSIDE THE US), INCLUDING FACILITIES IN VIRTUALLY EVERY U.S. STATE AS WELL AS IN EUROPE, THE MIDDLE EAST, HONG KONG, INDONESIA, JAPAN, THE PHILIPPINES, BERMUDA, CANADA, CARIBBEAN, US VIRGIN ISLANDS, CAYMAN ISLANDS, BRAZIL, AUSTRALIA, NEW ZEALAND, AND SOUTH AFRICA. THE PROGRAM IS ALSO IN USE BY EVERY BRANCH OF OUR U.S. MILITARY HOSPITALS THROUGHOUT THE WORLD. Form 990, Part III, Line 4a CONTINUED PROGRAM DESCRIPTION COMMUNITY TRAINING OUTREACH PROGRAMS: The hospital supports a number of programs that enhance the skills and work readiness of young professionals as well as promote health awareness. This includes: Pediatric Residency Training Program- Nicklaus Children's is an established teaching hospital and is one of the largest freestanding pediatric teaching hospitals in the southeastern United States. The Pediatric Residency Training Program is structured in accordance with the American Board of Pediatrics' requirement of three core years in general pediatrics, and is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME). All facets of pediatric care are encompassed in the training program from the complex intensive care to the office practice of general pediatrics. Each year, medical students and scholars from all parts of the United States, and around the world apply for acceptance to the hospital's Pediatric Residency Training Program, which has been in operation for over 40 years. The program has a formal affiliation with Florida International University's College of Medicine. Other participating institutions include Jackson Memorial Hospital, Cleveland Clinic Florida Center, University of Florida Jacksonville, Mount Sinai Medical Center of Florida, and Nova Southeastern University. Fellowship Training Programs- Nicklaus Children's Hospital offers quality, nationally recognized fellowships in a wide range of pediatric subspecialties. Fellowships are accredited by the Accreditation Council for Graduate Medical Education (ACGME). Available programs include Adolescent Medicine, Allergy and Immunology, Child & Adolescent Psychiatry, Clinical Biochemical Genetics, Clinical Neurophysiology, Craniofacial Surgery (Plastic Surgery), Pediatric Critical Care Medicine, Pediatric Emergency Medicine, Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Hematology Oncology Fellowship, Pediatric Hospitalist, Pediatric Radiology, Pediatric Urology, Pediatric Cardiology, and Pediatric Surgery. The Horizon Nurse Residency Program- The Horizon Nurse Residency (Horizon) Program is an American Nurses Credentialing Center accredited, evidence-based nurse residency program. It is designed to guide new graduate nurses by bridging the divide between nursing education and nursing practice. The program offers training within hospital units including the ICU setting, hematology-oncology, Emergency Department, and the ICU Float Pool, with the duration varying by unit of hire. The Horizon Nurse Residency Program was honored with ANCC PTAP National Accreditation with distinction in 2017. Practice Transition Accreditation Program (PTAP) sets the global standard for residency programs that transition nurses into new practice settings. Achieving this accreditation elevates the standards of the Horizon Nurse Residency Program at Nicklaus Children's Health System with ANCC evidence-based criteria, demonstrating excellence in the transitioning nurses from novice to proficient. The Horizon Nurse Residency Program was further developed in 2014 and has transitioned over 682 nurses with a 1% first year turnover, since the inception of the program. The Student Nurse Intern Program (SNIP)- The Student Nurse Intern Program (SNIP) provides nursing students the opportunity to be hired as care assistants to gain insight into the field of nursing. Based on availability, this program supports a smooth transition from nursing student to registered nurse by providing paid hours of mentorship in Emergency, Surgical, Medical-Surgical, or Critical Care areas. Students work alongside other care assistants while under orientation with the goal of completing a list of required competencies. Upon completion of orientation, the intern works alongside an RN and/or under the direct supervision of an RN performing delegatory-type tasks as well as patient-care skilled tasks in different pediatric areas of the hospital. Form 990, Part V, Line 1a Number in Box 3 of Form 1096 THE TOTAL NUMBER FROM BOX 3 OF FORM 1096 IS REPORTED BY NICKLAUS CHILDREN'S HEALTH SYSTEM, INC., A RELATED ORGANIZATION THAT PROCESSES FORMS 1099 FOR ITS AFFILIATES. SUCH REPORTING ALIGNS THE FORM 1096, BOX 3 REPORTING TO THE ISSUING ORGANIZATION. Form 990, Part VI, Line 15a Process for determininig compensation for the organization's CEO The CEO is paid by Nicklaus CHILDREN'S HEALTH SYSTEM, INC., a related organization. Therefore, this has been answered no, in accordance with the instructions. THE ORGANIZATION AND COMPENSATION COMMITTEE OF Nicklaus CHILDREN'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD. PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION AGREEMENT ARE CONTEMPORANEOUS DOCUMENTED. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. Form 990, Part VI, Line 15b Process for determining compensation for other officers or key employees NCH RELIED ON THE METHODS OF ESTABLISHING COMPENSATION USED BY Nicklaus CHILDREN'S HEALTH SYSTEM, INC. THE ORGANIZATION AND COMPENSATION COMMITTEE OF Nicklaus CHILDREN'S HEALTH SYSTEM, INC.'S BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD. PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE ARE NOT INVOLVED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION AGREEMENT ARE CONTEMPORANEOUS DOCUMENTED. THIS PROCESS IS COMPLETED IN THE FIRST QUARTER EACH YEAR. Form 990, Part VI, Line 2 FAMILY/BUSINESS RELATIONSHIPS AMONGST INTERESTED PERSONS Dawn Javersack, Jodi Laurence, Matthew A. Love, and Joseph Nader have a business relationship due to serving on the board of directors or serving as an officer of Children's Health Ventures. Form 990, Part VI, Line 1a EXECUTVE COMMITTEE There shall be an Executive Committee of the Board of Directors composed of at least three (3) Directors elected by the Board of Directors, one of whom must be the Chair of the Board. No non-Director members shall serve on the Executive Committee. A majority of the members of the Executive Committee present and voting shall constitute a quorum for the transaction of business. The Executive Committee shall have and exercise the authority of the Board of Directors in the management of the Hospital, except that it shall not take any action with respect to (a) the election of Officers; (b) the filling of vacancies in the Board of Directors; or (c) the adoption, amendment, or repeal of these Bylaws. The Executive Committee shall report to the Board of Directors any action taken by the Executive Committee at the next meeting of the Board of Directors. Members of the Executive Committee may be removed at any regular or special meeting of the Board of Directors. Form 990, Part VI, Line 4 Significant changes to organizational documents ON DECEMBER 16, 2024, THE ORGANIZATION MODIFIED THE BYLAWS TO REMOVE EX-OFFICIO NON-VOTING MEMBERS IN ALL AREAS MENTIONED THROUGHOUT THE BYLAWS AND REMOVED THE CHIEF MEDICAL OFFICER OF THE HOSPITAL AS AN EX-OFFICIO VOTING MEMBER Form 990, Part VI, Line 6 Classes of members or stockholders The organization's sole member is Nicklaus Children's Health System, Inc. The sole member has the authority to elect members to the board of directors and approve decisions of the board. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body The elected members of the Board shall be elected by Nicklaus Children's Health System (the sole member), after taking into consideration any recommendations of the Board. The number of Directors of the Hospital shall be established by resolution of the Board of Directors of the sole member; provided that there shall be no fewer than 7 and no more than 20 Directors. Any Director may be removed from office by action of the sole Member or the elected members of the Board so permitted to vote, for any cause or reason deemed sufficient by the Member or the elected members of the Board so permitted to vote. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders The Board shall not take any action with respect to the following without the approval of Nicklaus Children's Health System (the sole Member): a) Modify the mission, purpose, or scope of the hospital, or materially change the location, size, or scope of services, programs, operations, or educational or medical school affiliations of the hospital or related agreements; b) Create any entity in which the hospital is the sole member or sole shareholder, or any entity in which the hospital has a direct or indirect oversight role, which may include not-for-profit, for profit, limited liability companies, or any other legal entity; c) Sell, lease, purchase, create, dissolve, convey, mortgage, grant a security interest, or otherwise dispose of any affiliated, controlled, or joint venture entity, any real or personal property or other assets (or any interest in any of the foregoing), or incur debt for money borrowed or guarantee the debt of another, not in the ordinary course of business; d) Approve annual operating or capital budgets, strategic and long-range plans, major fund-raising programs, physician compensation or other agreements, managed care contracts or other financial commitments or material deviations from such budgets, plans, agreements, or commitments; and e) Approve financial, accounting, human resource, employee benefit, compliance policies or procedures, medical staff bylaws (including amendments) or other policies and procedures, or the appointment or engagement of auditors, legal counsel, and consultants, which are in any way contrary to the policies and procedures adopted from time to time by the Member. Form 990, Part VI, Line 11b Review of form 990 by governing body THE FOLLOWING DESCRIBES NICKLAUS CHILDREN'S HOSPITAL'S PROCESS FOR PROVIDING ITS BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE EMAILED TO THE AUDIT AND COMPLIANCE COMMITTEE CHAIR FOR REVIEW AND COMMENTS PRIOR TO FILING. 2. THE PAID TAX PREPARER WILL PRESENT A SUMMARY OF THE INFORMATION TO THE FINANCE COMMITTEE OF THE BOARD. 3. QUESTIONS WILL BE ANSWERED, AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. THE CHAIR WILL APPROVE THE FORM 990. 4. THE FINAL FORM 990 WILL BE POSTED ON THE BOARD WEB PORTAL PRIOR TO FILING. Form 990, Part VI, Line 12c Conflict of interest policy ALL NICKLAUS CHILDREN'S HOSPITAL (NCH) EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL, OR PERCEIVED CONFLICTS OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE AND WHENEVER CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURES ARE MANAGED BY THE COMPLIANCE DEPARTMENT AND REVIEWED BY THE NCHS CONFLICT OF INTEREST COMMITTEE, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT, AND DISCLOSURES THAT NECESSITATES BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE NCHS BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. ANY POTENTIALLY CONFLICTED BOARD MEMBERS ARE RECUSED FROM BOARD DELIBERATIONS AND VOTING ON ITEMS IN WHICH THEY HAVE A POTENTIAL CONFLICT. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS AND BOARD DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT-OF-INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) HAS AGREED TO COMPLY WITH THE POLICY; AND (D) UNDERSTANDS THAT THE HOSPITAL IS A CHARITABLE ORGANIZATION, AND THAT, IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY THE HOSPITAL'S NCHS CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. Form 990, Part VI, Line 19 Required documents available to the public Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. Form 990, Part IX, Line 11g Other Fees CASUAL LABOR - Total Expense: 1864821, Program Service Expense: 1491857, Management and General Expenses: 372964, Fundraising Expenses: ; Medical fees - Total Expense: 46092563, Program Service Expense: 36874050, Management and General Expenses: 9218513, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 11159020, Program Service Expense: 8927216, Management and General Expenses: 2231804, Fundraising Expenses: ; INSPECTIONS - Total Expense: 6575, Program Service Expense: 5260, Management and General Expenses: 1315, Fundraising Expenses: ; ARTWORK, GRAPHICS - Total Expense: 43143, Program Service Expense: 34514, Management and General Expenses: 8629, Fundraising Expenses: ; DESIGN, PROTOTYPE - Total Expense: 120, Program Service Expense: 96, Management and General Expenses: 24, Fundraising Expenses: ; STORAGE FEES - Total Expense: 353647, Program Service Expense: 282918, Management and General Expenses: 70729, Fundraising Expenses: ; CLEANING SERVICES - Total Expense: 1601891, Program Service Expense: 1281513, Management and General Expenses: 320378, Fundraising Expenses: ; LABORATORY SERVICES - Total Expense: 6467911, Program Service Expense: 5174329, Management and General Expenses: 1293582, Fundraising Expenses: ; CONSULTANTS - Total Expense: 2152946, Program Service Expense: 1722357, Management and General Expenses: 430589, Fundraising Expenses: ; COLLECTION SERVICES - Total Expense: 172534, Program Service Expense: 138027, Management and General Expenses: 34507, Fundraising Expenses: ; MANAGEMENT FEE EXPENSE - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 40511051, Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances Net payments on swap agreements - 97443; Gain from subsidiaries - 11162702; Net change in fair value of swaps - 2359949; Change in value of charitable remainder trusts held by others - 136109; Change in beneficial interest in NCHF - 11075045; Equity transfer with affiliate - 3635003; Distribution to noncontrolling interest - -1309957; Guarantee of affiliate losses - -56779447; Release from restrictions for Capital - -99615; Total - -29722768; MIAMI CHILDREN'S HEALTH SYSTEM INC 3100 SW 62ND AVENUE MIAMI FL 33155 453481327 HEALTHCARE FL 501(c)(3) Type II NA false MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC 800 SW 108TH AVENUE SUITE 200 MIAMI FL 33174 463406805 SURGERY CENTER FL VCH Related 2470231 false true 0.5217 MIAMI CHILDREN'S HEALTH PLAN LLC 3100 SW 62ND AVE MIAMI FL 33155 823111550 INSURANCE FL VCH Related -953 false true 0.75 MIAMI CHILDREN'S INSURANCE CO SPC LTD 720 WEST BAY ROAD PO BOX 69GT BUCKINGHAM SQUARE GEORGETOWN GRAND CAYMAN CJ 980442086 INSURANCE CJ VCH C Corporation 8303000 138728036 1 true CHILDREN'S HEALTH VENTURES INC & SUBS 3100 SW 62ND AVENUE MIAMI FL 331553009 454541147 MERCHANT WHOLESALE FL NA C Corporation false false false true false false false false false false true false true true true true false false true true MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC S 1429044 FMV