2016-05-14T14:15:13-05:00 2015-06-30 Grant Thornton LLP 2010 CORPORATE RIDGE SUITE 400 MCLEAN VA 22102 990 2014-07-01 530196580 Children's Hospital % CORPORATE OFFICERS CHIL 3015723502 111 Michigan Avenue NW Washington DC 20010 larry ragel cfo 3015726283 2016-05-13 true Mary Torretta P00847851 7038477500 2014 2016-08-17 19:52:53Z KURT DOUGLAS NEWMAN MD 111 Michigan Avenue NW WASHINGTON DC 20010 1133554138 false X www.childrensnational.org X 1870 DC see schedule o. 17 13 7649 1451 1312160 -848 15746236 25722100 964559428 998090371 2726062 3896652 522306 48408925 983554032 1076118048 2415133 0 0 0 565408241 569837910 0 0 0 372391003 387422290 940214377 957260200 43339655 118857848 1012567155 1063426405 559761603 494022488 452805552 569403917 X see schedule o. false false 698988025 1040402932 CHILDREN'S HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER (CNMC) IS THE PARENT COMPANY OF THE HOSPITAL. CNMC AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE O FOR COMPLETE FY15 COMMUNITY BENEFIT REPORT. 698988025 true true false true false false false false false false true true false true true true false true false true true true false false false false true true false false true true false true false false false true false false false false false false false false true true true true false false true 858 0 true 7649 true true true false false false false false false false false false X 17 13 false false false false true true true true true false false true true true true true true true true false DC X CORPORATE OFFICERS 3015723502 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 CAROLYN A THORNELL BOARD CHAIRMAN 2.0 1.0 X X 0 0 0 DEBRA L FRIEDMAN - 123114 BOARD VICE CHAIRMAN 2.0 0.0 X X 0 0 0 KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 39.0 16.0 X X 1851520 0 328884 DEIDRE ADKINS BOARD MEMBER 1.0 0.0 X 0 0 0 KATHRYN D BARKER BOARD MEMBER 1.0 1.0 X 0 0 0 SCHONAY BARNETT-JONES BOARD MEMBER 1.0 0.0 X 0 0 0 DENICE CORA-BRAMBLE MD BRD MEMBER/CMO 51.0 4.0 X 915460 0 151705 DARYL DAVIS BOARD MEMBER 1.0 0.0 X 0 0 0 ELIZABETH DUGGAL BOARD MEMBER 1.0 0.0 X 0 0 0 IVY WAFFORD DUKE BOARD MEMBER 1.0 0.0 X 0 0 0 ALBERTO GOMEZ BOARD MEMBER 1.0 0.0 X 0 0 0 MAE H GRENNAN BOARD MEMBER 1.0 1.0 X 0 0 0 DAVID STOCKWELL MD Board MEMBER 55.0 0.0 X 175429 0 3379 MARY HELEN THOMPSON BOARD MEMBER 1.0 0.0 X 0 0 0 CAROLINE VAN VLECK MD BOARD MEMBER 1.0 0.0 X 0 0 0 CHERYL WEINER BOARD MEMBER 1.0 1.0 X 0 0 0 DAVID WESSEL MD BRD MEMBER/CMO 52.0 3.0 X 978828 0 153109 DAVID WHISTON DDS BOARD MEMBER 1.0 0.0 X 0 0 0 DOUGLAS MYERS CHIEF FINANCIAL OFFICER 44.0 11.0 X 1008946 0 129503 MARK BATSHAW MD PHY IN CHIEF / CAO 9.0 46.0 X 1285578 0 335849 ELIZABETH FLURY CHIEF STRATEGY OFFICER 51.0 4.0 X 847741 0 125977 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 54.0 1.0 X 820828 0 111649 MARY ANNE HILLIARD CHIEF RISK OFFICER 54.0 1.0 X 555094 0 91756 BRIAN JACOBS MD CHIEF INFORMATION OFFICER 54.0 1.0 X 513869 0 71151 RICHARD JONAS MD CHIEF OF CARDIOLOGY 54.0 1.0 X 1864158 0 139231 PAM KING SAMS CHIEF DEVELOPMENT OFFICER 5.0 50.0 X 604235 0 176762 GERARD MARTIN MD SVP CENTER OF EXCELLENCE 53.0 2.0 X 900708 0 113285 MICHELLE MCGUIRE VP & CHIEF OF STAFF 43.0 12.0 X 294954 0 35990 MARY OTTOLINI MD PHD VICE CHAIR MED. EDUCATION 54.0 1.0 X 374598 0 17641 ROGER PACKER MD SVP CENTER OF EXCELLENCE 43.0 12.0 X 798726 0 132967 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 44.0 11.0 X 983717 0 139864 RAYMOND S SCZUDLO CHIEF LEGAL OFFICER 51.0 4.0 X 857774 0 108634 LINDA TALLEY CHIEF NURSING OFFICER 54.0 1.0 X 329865 0 23076 MENDeL TUCHMAN MD CHIEF RESEARCH OFFICER 25.0 30.0 X 632896 0 116850 DARRYL VARNADO CHIEF PEOPLE OFFICER 54.0 1.0 X 500275 0 104300 ROBERT KEATING MD CHIEF OF NEUROSURGERY 55.0 0.0 X 926517 0 110353 PETER KIM MD VP SHEIKH ZAYED INSTITUTE 55.0 0.0 X 902955 0 34403 H GIL RUSHTON MD CHIEF OF UROLOGY 55.0 0.0 X 660966 0 96236 JOHN MYSEROS MD NEUROSURGEON 55.0 0.0 X 734905 0 36037 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 55.0 0.0 X 806712 0 32805 NELLIE ROBINSON - 63014 EVP NURSING PHILANTHROPHY 0.0 0.0 X 372283 0 4964 JOSEPH WRIGHT MD - 63014 SVP CENTER OF EXCELLENCE 0.0 0.0 X 760466 0 141702 DAVID SPARKS INTERIM TRANSITION DIR. FIN. 55.0 0.0 X 454772 0 39823 RAHUL K SHAH MD FORMER BOARD MEMBER 55.0 0.0 X 465564 0 26670 23180339 0 3134555 1012 true true false CERNER CORPORATION 2800 ROCKCREEK PARKWAY NORTH KANSAS CITY MO 64117 IT SERVICES 23551930 CARDINAL HEALTH 7000 CARDINAL PLACE DUBLIN OH 43017 SUPPLY DISTRIBUTION 16097783 FTI CONSULTING INC 909 COMMERCE ROAD ANNAPOLIS MD 21401 CONSULTING 6079136 ATLANTIC SERVICES GROUP 2131 K STREET NW STE 200 WASINGTON DC 20037 SHUTTLE SERVICE 3808224 COLONIAL PARKING 1050 THOMAS JEFFERSON ST NW STE 10 WASHINGTON DC 20007 PARKING SERVICES 3494697 276 15473029 7268871 2980200 25722100 NET PATIENT REVENUE 621400 917239376 917239376 ALL OTHER PROGRAM SERVICES REVENUE 900099 80850995 80850995 998090371 3069394 3069394 0 0 0 0 0 53006070 5257278 53034689 4401401 -28619 855877 827258 827258 0 0 0 EQUITY AND PARTNERSHIP GAIN 621110 42312561 42312561 PARKING 812930 4784204 4784204 LAB FEES 621500 1312160 1312160 48408925 1076118048 1040402932 1312160 8680856 0 0 0 0 16608507 16608507 0 471211481 357947185 113264296 15403077 11302301 4100776 33966586 24923628 9042958 32648259 23956281 8691978 0 3580570 2627312 953258 984937 984937 456337 456337 0 0 52704316 38766282 13938034 3186579 2338213 848366 9251395 6788387 2463008 41176300 30213892 10962408 0 21805225 15999998 5805227 2826612 2074080 752532 0 825092 605427 219665 26500085 19444941 7055144 0 59269886 43490405 15779481 24658048 18093311 6564737 MEDICAL SUPPLIES 86253607 63290223 22963384 BAD DEBT EXPENSE 25409620 25409620 REPAIRS AND MAINTENANCE 15967613 11716539 4251074 OVERHEAD 2908910 2908910 9657158 9657158 957260200 698988025 258272175 0 0 0 80288535 114829265 7994785 7959219 175456200 171500657 360000 120000 0 0 0 0 7410283 8587583 11035619 12901610 1049434319 567736981 519797175 481697338 132304887 149965068 35582245 74782199 0 0 20000 0 42317426 41083466 1012567155 1063426405 154860336 141897536 0 0 15025591 22630573 406619378 383871996 0 0 0 0 75257136 75452247 0 0 -92000838 -129829864 559761603 494022488 X 452805552 569403917 0 0 0 0 452805552 569403917 1012567155 1063426405 X 118857848 -2400130 140647 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 408260 false true 48077 456337 false Paid Staff or Management Schedule C, Part II-B, Line 1b FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS. Direct Contact Schedule C, Part II-B, Line 1g THE LOBBYING ACTIVITIES ENGAGED IN BY CHILDREN'S HOSPITAL FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS. THOSE LOBBYING ACTIVITIES INCLUDE CONTINUAL MONITORING OF LEGISLATION VIA DISCUSSIONS WITH LEGISLATIVE STAFF, HOSTING EDUCATIONAL BRIEFING SESSIONS FOR MEMBERS OF CONGRESS, EXECUTIVE BRANCH, STATE AND LOCAL OFFICIALS/STAFF REGARDING CHILD HEALTH ISSUES, AND COORDINATING THE SUBMISSION OF CORRESPONDENCE/WRITTEN COMMENTS ON PROPOSED LEGISLATION AND REGULATIONS, AS WELL AS THE PRESENTATION OF TESTIMONY BEFORE LEGISLATIVE COMMITTEES. CHILDREN'S HOSPITAL ALSO DEVELOPS POLICY POSITIONS IN RESPONSE TO PROBLEMS AND OPPORTUNITIES IN THE PUBLIC SECTOR. EXPENSES TOTALED $408,260. OTHER ACTIVITIES SCHEDULE C, PART II-B, LINE 1i THE HOSPITAL IS A MEMBER OF THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH). NACH HAS CHILD ADVOCACY AND LEGISLATIVE ADVOCACY PROGRAMS. 1440758 1440758 85041607 73484431 11557176 775683408 375734986 399948422 185051641 117098590 67953051 2216905 1418974 797931 481697338 INVESTMENT IN BEARACUDA 35539061 F INVESTMENT IN PSV 9182621 F DEBT RESERVE FUND 29948621 F CHCA/CHIC PARTNERSHIP 45919 F OTHER INVESTMENTS 65977 F 74782199 0 CAPITAL LEASE OBLIGATIONS 4744104 RESERVE FOR CLAIMS 47687992 OTHER LIABILITIES 49344848 SETTLEMENTS TO THIRD PARTY PAY 7015493 DUE TO AFFILIATES -238622301 -129829864 X Liability for Uncertain Tax Position (ASC 740) Schedule D, Part X, Line 2 FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (MEDICAL CENTER), OF WHICH CHILDREN'S HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: The Medical Center is a not-for-profit corporation as described in Section 501(c)(3) of the Internal Revenue Code and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. On such basis, the exempt entities will not incur any liability for federal income taxes, except for possible unrelated business income. The Medical Center evaluates uncertain tax positions using a two-step approach for recognizing and measuring tax benefits taken or expected to be taken in an unrelated business activity tax return and disclosures regarding uncertainties in tax positions. There was no impact on the Medical Centers financial statements during the years ended June 30, 2015 and 2014. Middle East and North Africa 1 Program Services PATIENTS REFFERALS 523080 Central America and the Caribbean Program Services INSURANCE PREMIUMS 13735561 1 1 14258641 14258641 true false false false false false true true X true X 350. true X true true true false true true 7856988 7856988 0.00850 55827718 55827718 0.06130 63684706 63684706 0.06980 50 143859 22933629 20670174 2263455 0.00240 23 3036 34821026 8474689 26346337 0.02570 9 19221600 14930600 4291000 0.00460 1 10882216 10882216 0.01170 17 1208 554422 10928 543494 0.00060 100 148103 88412893 44086391 44326502 0.04500 100 148103 152097599 44086391 108011208 0.11480 5 25 13845 13845 2 21338 1000 20338 1 4 39728 4500 35228 8 29 74911 5500 69411 true 12568156 1817602 1905667 -88065 X true true 1 1 CHILDREN'S HOSPITAL 111 MICHIGAN AVE NW WASHINGTON DC 20010 www.childrensnational.org HFD01-0208 X X X X X X X X Children's Hospital false false true X X X X X X X X X X 13 true true true true X www.childrensnational.org X www.dchealthmatters.org X X true 13 true www.childrensnational.org false false true X 350. 350. X X X X true true X X X true X www.childrensnational.org X www.childrensnational.org X X X X X true X false X X X X true X false false Childrens Hospital - Facility Information Schedule H, Part V, Section B, Line 3J The community health needs assessment also includes illustrative maps/figures of assets and vulnerabilities related to specific health metrics, including but not limited to major outlet fast food locations per ward of the District, hospitals and primary care centers in the District, medically underserved areas in the District, and locations of primary care and mental health professionals shortage areas in the District. Providing this information will assist in overall data analysis, program planning and inform decision making on important health related issues affecting the residents of Washington, DC. Schedule H, Part V, Section B, Line 5 In conducting the most recent CHNA, input was received via four focus groups conducted with key stakeholders who are advocates or providers of health and social services. Two of the groups focused on health and health service issues. The other two groups focused on social determinants and related social service issues that impact health. There was a total of 30 focus group participants including hospital patient advocates, case managers, Department of Health officials, and community-based health and social service stakeholders. Stakeholders were queried about a number of major issues, including what they viewed as priority health and social services needs for the city in general, the particular needs that were relevant to the populations they serve, and their specific recommendations for concrete steps that could be implemented to improve overall health and social services for residents. Social scientists from RAND developed the script for the focus groups. The focus group guide included additional questions geared towards gaining pertinent information from focus group participants. The questions aligned with the health needs identified through the quantitative analyses, and were analyzed as part of the qualitative component of the community health needs assessment. In addition, RAND spearheaded the recruitment efforts of the focus groups to ensure representation of the community as a whole. RAND has record and access to all focus group participants' name along with the focus group guide on file and is available upon request from RAND. Schedule H, Part V, Section B, Line 6a & 6b Children's National, through its membership in the DC Healthy Communities Collaborative, conducted the CHNA in participation with three non-profit hospitals: Howard University Hospital, Providence Hospital, Sibley Memorial Hospital. The DC Healthy Communities Collaborative (DCHCC) works to eliminate health disparities and create health equity for all communities in the District of Columbia to realize one healthy Capital city. With the unique perspectives of each hospital and community health center, DCHCC members provided guidance and feedback respective to populations and neighborhoods served. As part of the DC Healthy Communities Collaborative, three community health centers, two of which are federally qualified health centers, Bread for the City, Community of Hope, and Unity Health Care, Inc. also worked to conduct the FY 2013 CHNA. Another community health center, Mary's Center joined the DC Healthy Families Collaborative after the needs assessment was conducted and participated in the community health improvement plan development process. Schedule H, Part V, Section B, Line 7d In addition to the broad distribution via the hospital's website and the DCHCC's DC Health Matters (DCHM) web portal, Children's Hospital also participated in community-based meetings and forums to disseminate the CHNA report findings. Part of the launch of the DCHM, we distributed a news release was distributed with URL information for viewing the CHNA report. Additionally, each DCHCC member organization has an electronic copy of the CHNA report on their website. Schedule H, Part V, Section B, Line 8 Children's Hospital adopted an implementation strategy, referred to as the Community Health Improvement Plan (CHIP) that addresses four of the six priority community health needs identified through the citywide CHNA. The CHIP is available online at: HTTP://CHILDRENSNATIONAL.ORG/~/MEDIA/CNHS-SITE/FILES/ABOUT/ADVOCACY/FINAL_ CHILDRENS_NATIONAL_CHIP_FY_20142016.ASHX Schedule H, Part V, Section B, Line 11 The DCHCC accepted the six top health issues -- Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, Asthma, Access to Care, and Stress-Related Conditions - that emerged through analyses of quantitative data sources (including the Behavioral Risk Factor Survey, Youth Behavioral Risk Survey, hospital discharge data, American Community Survey, and US Census data) and qualitative data (input from community representatives obtained during stakeholder focus groups). Members of the DCHCC deliberated and decided access to care and stress-related conditions should not be addressed as independent priority issues as they are systemic issues that impact all of the other priority health areas. Thus, the implementation strategy (Community Health Improvement Plan) addresses the remaining four priority issues: Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, and Asthma. In preparation for developing the implementation strategy, Children's Hospital conducted a series of internal meetings with experts to assess its capacity to address and prioritize the identified health areas based on organizational strategy. With the organizational capacity identified and sanctioned, Children's Hospital reconvened as part of the DCHCC process to develop the implementation strategy (Community Health Improvement Plan) as follows: conducted Gap and Strength, Weaknesses, Opportunities, and Threats (SWOT) analyses (for each health priority); prioritization of issues (to rank the health issues); creation of action plan; and monitoring of the action plan. DCHCC members included in their individual organization's implementation strategy (community health improvement plan) additional health issues that support their organization's mission, including but not limited to, access to care and stress-related conditions. Each DCHCC member organization received approval of the implementation strategy (community health improvement plan) by their Board of Directors/Trustees. Children's Hospital received approval by its Board on May 23, 2013. By the close of FY15, DCHCC addressed community health improvement in the areas of Mental Health/Substance Abuse, Obesity/Overweight, Asthma, and Sexual/Reproductive Health. The Collaborative offered continuing educational programs for clinicians on programmatic best practices in the areas of sexual health, mental health and asthma. The collaborative also created asset maps showcasing citywide resources in the four priority areas. The Collaborative is moving forward with the second community health needs assessment and health improvement plan. EXAMPLES OF WAYS THE DCHCC IS ADDRESSING THE NEEDS OF THE WASHINGTON, DC COMMUNITY. The DCHCC accepted the six top health issues -- Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, Asthma, Access to Care, and Stress-Related Conditions - that emerged through analyses of quantitative data sources (including the Behavioral Risk Factor Survey, Youth Behavioral Risk Survey, hospital discharge data, American Community Survey, and US Census data) and qualitative data (input from community representatives obtained during stakeholder focus groups). Members of the DCHCC deliberated and decided access to care and stress-related conditions should not be addressed as independent priority issues as they are systemic issues that impact all of the other priority health areas. Thus, the implementation strategy (Community Health Improvement Plan) addresses the remaining four priority issues: Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, and Asthma. In preparation for developing the implementation strategy, Children's Hospital conducted a series of internal meetings with experts to assess its capacity to address and prioritize the identified health areas based on organizational strategy. With the organizational capacity identified and sanctioned, Children's Hospital reconvened as part of the DCHCC process to develop the implementation strategy (Community Health Improvement Plan) as follows: conducted Gap and Strength, Weaknesses, Opportunities, and Threats (SWOT) analyses (for each health priority); prioritization of issues (to rank the health issues); creation of action plan; and monitoring of the action plan. DCHCC members included in their individual organization's implementation strategy (community health improvement plan) additional health issues that support their organization's mission, including but not limited to, access to care and stress-related conditions. Each DCHCC member organization received approval of the implementation strategy (community health improvement plan) by their Board of Directors/Trustees. 19 CHILDREN'S OUTPATIENT CTR OF MONTGOMERY SHADY GROVE MEDICAL PARK ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 8501 ARLINGTON BOULEVARD STE 200 FAIRFAX VA 22031 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR IN LAUREL 13922 BALTIMORE AVE LAUREL MD 20707 REGIONAL OUTPATIENT CENTER CHILDREN'S HEALTH CENTER - ADAMS MORGAN 1630 EUCLID STREET NW WASHINGTON DC 20009 HEALTH CENTERS CHILDREN'S HEALTH CENTER - GOOD HOPE RD 2501 GOOD HOPE ROAD SE WASHINGTON DC 20020 HEALTH CENTERS CHILDREN'S HEALTH CENTER - MLK JR AVE 3029 MARTIN LUTHER KING JR AVE SE WASHINGTON DC 20032 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR - UPR MARLBORO 9440 PENNSYLVANIA AVENUE UPPER MARLBORO MD 20772 REGIONAL OUTPATIENT CENTER MOBILE VAN - HEALTH CARE N/A NA DC 20010 MOBILE HEALTH CARE CHILDREN'S OUTPATIENT CTR IN ANNAPOLIS 888 BESTGATE ROAD STE 320 ANNAPOLIS MD 21401 REGIONAL OUTPATIENT CENTER CHILDREN'S HEALTH CENTER - SHAW 2220 11TH STREET NW WASHINGTON DC 20001 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR SPRING VALLEY 4900 MASSACHUSETTS AVENUE NW WASHINGTON DC 20016 REGIONAL OUTPATIENT CENTER CHILDREN'S NAT'L AMBULATORY SURGERY CTR 9850 KEY WEST AVENUE ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR IN FREDERICK 5910 FREDERICK CROSSING LANE STE 1 FREDERICK MD 21704 REGIONAL OUTPATIENT CENTER MOBILE VAN - DENTAL N/A NA DC 20010 MOBILE HEALTH CARE CHILDREN'S HEALTH CENTER AT THEARC 1901 MISSISSIPPI AVE SE WASHINGTON DC 20020 HEALTH CENTERS CHILDREN'S OUTPATIENT CTR MONTGOMERY CTY 15245 SHADY GROVE ROAD STE 350 ROCKVILLE MD 20858 REGIONAL OUTPATIENT CENTER CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 8501 ARLINGTON BLVD STE 450 FAIRFAX VA 22031 REGIONAL OUTPATIENT CENTER CHILDREN'S NATIONAL IMGAGING CENTER 9850 KEY WEST AVENUE Suite 110 ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER CHILDREN'S NATIONAL SPECIALISTS OF VIRGI 3023 HAMAKER COURT SUITE 500 FAIRFAX VA 22031 HEALTH CENTER Criteria for Free or Discounted Care Schedule H, Part I, Line 3c Children's Hospital and its parent, Childrens National Medical Center, are committed to provide quality pediatric health care for all patients regardless of their ability to meet the associated financial obligations and without discrimination on the grounds of race, color, national origin or creed. CHILDREN'S NATIONAL MEDICAL CENTER ANNUAL REPORT Schedule H, Part I, Line 6 Children's National prepares an annual community benefit report. For mass public distribution, the report is posted to our website. In addition, an executive summary including the link to the report is distributed to the hospital's key internal and external stakeholders. Children's National is dedicated to fulfilling its vision of setting the standard in excellence in pediatric care, advocacy, research, and education, here in the nation's capital, around the country, and throughout the world. As part of our commitment to our community, below are some of the programs that were implemented in FY 2015: -DC Collaborative for Mental Health in Pediatric Primary Care The DC Collaborative for Mental Health in Pediatric Primary Care (DC Collaborative), founded in 2012, aims to improve the integration of mental health in pediatric primary care for children and youth in the District of Columbia. This public-private partnership consists of a working group that is responsible for the planning, implementation and evaluation of all activities of the DC Collaborative; a community advisory board that includes parents, community stakeholders, and over 25 diverse organizations; and a project team comprised of Children's National staff that provide the day-to-day support for the work of the DC Collaborative. The DC Collaborative supports and implements initiatives focused on supporting primary care practices and clinicians; supporting families; integrating mental health services into primary care; and engaging in related policy and advocacy efforts. As of June 2015, over 150 providers and 16 practices completed mental health screening training through a 15 month learning collaborative model. 100% of providers reported that they felt somewhat or very prepared to identify mental health issues of their patients. Another component of the DC Collaborative is DC MAP (Mental Health Access in Pediatrics), which offers pediatric primary care providers increased access to child mental health experts. The DC MAP team of child mental health experts offers telephone consultation, community resource referral, and training to pediatric practices in an effort to help with the management of mental health concerns of patients and families. The program launched city-wide in September 2015. -Safe Kids DC Car Seat Inspection Station Safe Kids DC works to prevent childhood accidents in the District, the leading cause of death and disability in children ages one to 19. As part of Safe Kids DC, the Car Seat Inspection Program aims to raise awareness of preventable injuries as a result of motor vehicle crashes. The desired outcome is to reduce preventable injury during a crash due to proper child restraint techniques. Parents and caregivers are provided education on child passenger safety including how to correctly install car seats and position the child in the seat, how to identify the proper seat for the child's age, weight and height as well as how to determine if the car seat is expired or recalled. The car seat inspection station is operated by nationally certified child passenger safety technicians. In addition to the education and installation services provided, the child passenger safety technicians also connect families to resources for obtaining child safety seats at reduced rates. Through partnerships with the District Department of Transportation, Metropolitan Police Department, and DC Department of Motor Vehicles, areas in the city that are most in need of education and outreach efforts are identified. The Car Seat Inspection Station Program provided 705 people services in FY 2015. -IMPACT DC Asthma is the most common chronic childhood disease and has become considerably more prevalent and severe in the United States during the last 40 years. In recent years, the number of children diagnosed with asthma has dramatically increased. In Washington, DC, more than one in ten children currently have asthma, which is well above the national average. IMPACT DC is a pediatric asthma program in Washington, DC, dedicated to improving asthma care and outcomes for children through clinical care, education, research, and advocacy. One of the program's main goals is to educate patients and families about ways to manage asthma and connect with valuable resources in the community in an effort to lessen the need for emergency room visits and hospital stays. In an effort to increase asthma awareness, community education and outreach is an important component of IMPACT DC. Staff of IMPACT DC provide evidence-based educational outreach through health fairs, school-based programs, and other educational and advocacy events. There is a particular focus on early childhood providers since most children spend most of their day in school or daycare, where asthma can have a tremendous impact on their attendance, ability to learn, and participation in normal activities. IMPACT DC staff work closely with school nurses, teachers, parents, and other caregivers to better identify, assess, and manage asthma in these settings. Program staff also assist these individuals with reducing common triggers in these environments. In FY 2015, health education was provided to 199 early childhood educators who serve over 3,000 children. -HEALTHY GENERATIONS PROGRAM Adolescent pregnancy is a significant issue in the District of Columbia. With a primary goal of reducing repeat pregnancies, the Healthy Generations Program provides primary care and case management support to adolescent parents and their children. The program has maintained a repeat pregnancy rate of under 10% which is significantly lower than the average repeat pregnancy rate for adolescents in the District of Columbia. The Healthy Generations Program also strives to provide parenting, mental health and social work support to these young families. The parents are also educated about the prevention of sexually transmitted infections, problem-solving skills, safety and nutrition, and connected to necessary resources. The Healthy Generations Program also helps adolescent parents get the support needed to finish high school. Seventy percent of the program's participants are enrolled in High School/GED programs or have completed such programs. The program also provides mental health screenings and referrals as needed to all participants. Sixty percent of program participants have completed a mental health screening. 849 adolescents and their children were served through the Healthy Generations Program in FY 2015. Costing Methodology Schedule H, Part I, Line 7 bad debt write-offs adjusted by the irs cost to charge ratio were UTILIZED TO CALCULATE AMOUNTS REPORTED IN THE TABLE IN PART I, LINE 7A-D. THE AMOUNTS WERE PULLED FROM FINANCIAL DATABASES MANAGED BY THE CHILDREN'S NATIONAL ACCOUNTING AND FINANCE DEPARTMENT. DetermiNATIOn of net commnuity benefit expenses Schedule H, Part I, Line 7 IT IS IMPORTANT TO NOTE THAT THE NET COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF CHILDREN'S HOSPITAL'S TOTAL EXPENSES IS BASED ON A TOTAL EXPENSES OF $957,260,200 RESULTING FROM SUBTRACTING CHILDREN'S HOSPITAL'S BAD DEBT EXPENSES, $25,409,620, FROM CHILDREN'S HOSPITAL'S TOTAL FUNCTIONAL EXPENSES, $957,260,200, AS REPORTED ON FORM 990 PART IX LINE 25. Charity at Cost Schedule H, Part I, Line 7A Hospital & Physician Charity amounts from the respective income statements adjusted to cost using the IRS adjusted ratio of cost to charges. Medicaid Schedule H, Part I, Line 7B Hospital & Physician Gross Patient Revenue from Trendstar and the Physician Business Office report adjusted to cost using the IRS adjusted ratio of cost to charges. Claims payments were derived from the same source. Medicaid GME add-on payments were excluded as they are reported in the Health Education section. CHGME IME payments were included as per 990 instructions. Health Education Schedule H, Part I, Line 7f Interns and Residents total cost from the FY15 Submitted Medicare cost report. Specific medical student/training programs were identified by the GME Office and added as Health Education costs. Education payments and resident funding amounts offset the expense. DC Medicaid GME payments were calculated (rate x volume) and deducted from total Medicaid payments to be reported under health education. Subsidized Health Services Schedule H, Part I, Line 7G Physician claims report by department received from physician accounting team. Total charges were adjusted to cost using the IRS cost to charge ratio and claims payments netted against the cost. Departments with a loss were then compared to hospital claims report by department (also netted down to cost and adjusted for profitability). The combined service lines for programs in underserved areas with losses were reported as Subsidized Health Services. Cost Attributable to a Physical Clinic AS DESCRIBED BY DEFINITION, SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. THE SERVICES ARE PROVIDED DESPITE THE FINANCIAL LOSS TO MEET THE NEEDS OF THE COMMUNITY. IF THE SERVICES WERE NOT PROVIDED, THEY WOULD NOT BE AVAILABLE TO THE AREA OR WOULD RESULT IN THE GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION PROVIDING THE SERVICES. THE SUBSIDIZED HEALTH SERVICES AMOUNT IN PART I, LINE 7G INCLUDES $4,291,000 WHICH IS ATTRIBUTED TO THE PRIMARY CLINICAL SERVICES PROVIDED VIA CHILDREN'S NATIONAL. CHILDREN'S HEALTH CENTERS PROVIDE PROGRAMS AND INITIATIVES INCLUDING COMPREHENSIVE AND HIGH QUALITY PREVENTIVE SERVICES, IMPROVEMENT OF IMMUNIZATION RATES, AND COORDINATION OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THE AMOUNT INCLUDES SALARY, FRINGE, DIRECT, AND INDIRECT COSTS EXPENDED TO PROVIDE THE CLINICAL SERVICES. OUR CHILDREN'S HEALTH CENTERS ARE ESTABLISHING BEST PRACTICES IN COMMUNITY HEALTH. Research Schedule H, Part I, Line 7H The hospital research (not CRI) was obtained from the FY15 general ledger and adjusted for grants from taxable entities. Other benefits Schedule H, Part I, Line 7 e & i In calculating the amounts reported in the Table in Part I relating to Other Benefits (e - i), we use an accountability and eligibility system based on the community benefit definition and guidelines for determining where programs fit into each community benefit category. Program financials are provided by program staff through Children's National financial software system. Direct supervisors of the program staff verify the accuracy of the financials and sign off on the submission. Community Benefit staff then analyze financials submitted to ensure consistency in reporting and confirm with program staff the accuracy of the financials. The Community Benefit staff also works with the Accounting & Finance department to verify the accuracy of submitted financials. The financials for grant funded programs is received from the Office of Grants and Contracts. See the below community benefit report for narratives related to programs within the community benefit categories. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, PART II Part II includes the costs incurred for activities and programs to protect or improve the community's health or safety. As reported and defined in Part II, community-building activities include programs that address the root causes of health problems, such as homelessness, poverty, and environmental problems. Each program included in Part II meets the definition of community benefit including meeting one or more of the community benefit objectives: improving access to health services, enhancing health, advancing generalizable knowledge, or relief of government burden. Programs accounted for as community building activities fall into the subcategories of community support, coalition building, and workforce development. Children's National is dedicated to engaging and providing opportunities of learning and development to students with an interest in health professions. With our involvement with the Princeton Internship program we provide hands on learning through an immersion into the academic practices of pediatric surgical care, modeling many of the day to day activities of an academic surgeon. Students interning are also able to gain skills in areas such as research. For example, students working in the Trauma and Burn department at Children's National participated in medical research, developing skills such as data collection, use of statistics for data analysis and authorship. Children's National also engages in city-wide emergency preparedness activities, one in which a citywide hazard vulnerability analysis was developed and incorporated into the District's Emergency Management Plan. Also, as part of our injury prevention efforts, the Injury Prevention Alliance was created. The Alliance, comprised of various community-based organizations, is developing their action plan that focuses on advocacy and public policy efforts needed to adequately address identified areas of injury prevention. The number of persons served by the community building activities were not tracked for all programs throughout the course of the year. Bad Debt Expense Schedule H, Part III, Lines 2-4 BAD DEBT IS ACCOUNTED FOR IN THE FOOTNOTES FOR ACCOUNTS RECEIVABLE IN THE ORGANIZATION'S FINANCIAL STATEMENTS. Children's Hospital reports $25,409,620 on its Statement of Functional Expenses for its bad debt; however, in this section, the reporting of the $12,568,156 is appropriate because it reflects the value of the bad debt at cost. Financial Services Footnote ACCOUNTS RECEIVABLE FOR PATIENT SERVICES CONSISTS OF AMOUNTS DUE DIRECTLY FROM PATIENTS OR PATIENTS' THIRD PARTY PAYORS SUCH AS INSURANCE COMPANIES, MANAGED CARE PROGRAMS, AND MEDICAID PROGRAMS FOR SERVICES RENDERED. PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE FINANCIAL STATEMENTS OF THE ORGANIZATION IS SHOWN NET OF RECOVERIES ON AMOUNTS PREVIOUSLY WRITTEN OFF. THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTIMATED BASED ON PRIOR EXPERIENCE AND MANAGEMENT'S JUDGMENT AND IS, THEREFORE, SUSCEPTIBLE TO CHANGE. THE PROCESS OF DETERMINING BAD DEBT MAY ALSO INCLUDE THE REDUCTION OF AN ACCOUNT BASED ON PROCEDURES ASSOCIATED WITH INSURANCE CONTRACTUAL AGREEMENTS, GUARANTOR CHARITY EVALUATION, AND GUARANTOR BAD DEBT EVALUATION. THE COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINES 2 AND 3. BAD DEBT IS NOT INCLUDED IN CHILDREN'S HOSPITAL'S COMMUNITY BENEFIT DETERMINATION. Costing methodology used to determine the amount reported on Line 6 Schedule H, Part III, Line 8 SHORTFALLS ARE NOT INCLUDED AS COMMUNITY BENEFIT. ANY SHORTFALL IS EVENTUALLY PAID IN FULL BY MEDICARE AS SETTLEMENT. THERE IS THEREFORE NO SHORTFALL. Collection Practices Schedule H, Part III, Line 9b THE COLLECTION POLICY DOES NOT CONTAIN SPECIFIC PROVISIONS FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY. ALL PATIENTS ARE TREATED THE SAME. CHILDREN'S NATIONAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS WHILE MAINTAINING RESPONSIBLE AND EFFECTIVE FINANCIAL PROGRAMS WHICH ENSURE THAT THIS COMMITMENT CAN CONTINUE. CHILDREN'S NATIONAL SUPPORTS FAMILIES IN CARRYING OUT THEIR RESPONSIBILITY FOR OBTAINING MEDICAL CARE FOR THEIR CHILDREN. CHILDREN'S HOSPITAL, THEREFORE, WILL ASSIST FAMILIES IN VERIFYING THEIR ABILITY TO MEET THEIR FINANCIAL OBLIGATIONS TO THE HOSPITAL OR IN SECURING THE RESOURCES NECESSARY TO DO SO. THE PURPOSE OF THIS POLICY IS TO ESTABLISH GUIDELINES FOR EFFECTIVE AND RESPONSIBLE FISCAL PROGRAMMING, WHICH ASSURES THE FINANCIAL VIABILITY OF THE INSTITUTION AND MAINTAINS THE DIGNITY OF THE FAMILY. COLLECTION EFFORTS ARE THEREFORE THE SAME FOR ALL PATIENT RESPONSIBLE BALANCES ONCE THE APPROVED CHARITY ADJUSTMENT HAS BEEN MADE. Children's Hospital does not engage in any extraordinary collection activities. Community Health Care Needs Assessment Schedule H, Part V, Lines 5 and 6 SCHEDULE H, PART VI, LINE 2 CHILDREN'S NATIONAL COMMITS TO CONDUCTING A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) EVERY THREE YEARS TO UNDERSTAND THE HEALTH AND HEALTH CARE STATUS OF THE PEDIATRIC POPULATION IN OUR COMMUNITY. THE ASSESSMENT WILL GUIDE THE HOSPITAL IN TARGETING ITS RESOURCES TO ACHIEVE THE GREATEST IMPACT ON CHILD HEALTH AND WELLNESS AT A POPULATION-LEVEL. OUR MOST RECENT CITYWIDE CHNA WAS RELEASED IN JUNE 2013 (FY 2013), IN COLLABORATION WITH THE DC HEALTHY COMMUNITIES COLLABORATIVE (DCHCC). THE DCHCC IS AN ALLIANCE OF DC HOSPITALS AND COMMUNITY HEALTH CENTERS THAT HAVE PARTNERED TO DEVELOP A CITYWIDE CHNA AND IMPLEMENTATION STRATEGY THAT IS RESPONSIVE TO NEEDS IDENTIFIED BY THE CHNA. THE DCHCC WORKS TO ELIMINATE HEALTH DISPARITIES AND CREATE HEALTH EQUITY FOR ALL COMMUNITIES IN THE DISTRICT OF COLUMBIA TO REALIZE ONE HEALTHY CAPITAL CITY. THE MISSION OF THE DCHCC IS TO MERGE THE TWO FACES OF THE CAPITAL CITY INTO ONE HEALTHY AND THRIVING COMMUNITY THAT HOLDS THE SAME PROMISE FOR ALL RESIDENTS. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS A UNIQUE BLEND OF BOTH QUANTITATIVE DATA AND QUALITATIVE COMMUNITY PERSPECTIVES THAT PROVIDE A COMPREHENSIVE AND GRASSROOTS VIEW OF THE STATE OF HEALTH IN THE DISTRICT. IN RESPONSE TO THE FINDINGS OF THE NEEDS ASSESSMENT, THE DCHCC, WITH INPUT FROM COMMUNITY STAKEHOLDERS DEVELOPED AN IMPLEMENTATION STRATEGY. THE STRATEGY PROVIDES A TARGETED AND COORDINATED APPROACH TO ADDRESSING THE PRIORITY AREAS - MENTAL HEALTH AND SUBSTANCE ABUSE, ASTHMA, OBESITY/OVERWEIGHT, AND SEXUAL HEALTH WITH THE ULTIMATE GOAL OF IMPROVING LOCAL HEALTH AND QUALITY OF LIFE FOR DC RESIDENTS. AS THE ONLY PEDIATRIC FOCUSED MEMBER OF THE DCHCC, CHILDREN'S NATIONAL IDENTIFIED TWO ADDITIONAL HEALTH PRIORITIES-ORAL HEALTH AND INJURY PREVENTION. USING THE DCHCC CITYWIDE IMPLEMENTATION STRATEGY AS A BASIS, CHILDREN'S NATIONAL DEVELOPED A COMMUNITY HEALTH IMPROVEMENT PLAN APPROVED AND ADOPTED BY THE CHILDREN'S NATIONAL MEDICAL CENTER BOARD OF DIRECTORS. THE CHNA AND THE IMPLEMENTATION STRATEGY ARE HOUSED ON THE DC HEALTH MATTERS WEBSITE. DC HEALTH MATTERS PROVIDES A ONE-STOP RESOURCE FOR ON-LINE ACCESS TO COMMUNITY HEALTH INDICATORS AND RELATED RESOURCES THAT IMPACT THE HEALTH OF DC COMMUNITIES. THE SITE CONTAINS COMMUNITY HEALTH MEASURES, EVIDENCE-BASED PROMISING PRACTICES, LOCAL RESOURCES, AND FUNDING OPPORTUNITIES. DC HEALTH MATTERS WILL BE USED AS A PLATFORM TO TRACK PROGRESS OF THE IMPLEMENTATION STRATEGY. INTERNALLY, ONGOING EVALUATION AND MONITORING OF THE IMPLEMENTATION STRATEGY WILL TAKE PLACE BY THE ADVOCACY AND COMMUNITY AFFAIRS AND CHILD HEALTH DATA LAB DEPARTMENTS OF CHILDREN'S NATIONAL. In addition to the hospital's community health needs assessment, to help inform community health improvement programming, hospital and community programming staff also conducts significant analysis on the health care needs as it relates to their population. For example, the hospital asthma program reviews data and receives input from the community to inform the programming logistics. The hospital's active role in these and similar community needs activities serve as a catalyst for identification and prioritization of community health needs. An updated CHNA has been completed, awaiting Board Review and Approval, and expected to be released June 30, 2016. PUBLICLY AVAILABLE CHNA PART V, LINE 7 THE 2013 CHNA IS AVAILABLE ONLINE AT: http://childrensnational.org/~/media/cnhs-site/files/about/advocacy/distri ct_of_columbia_community_health_needs_assessment_2013_final.ashx PUBLICLY AVAILABLE IMPLEMENTATION PLAN PART V, LINE 10 IMPLEMENTATION PLAN IS AVAILABLE ONLINE AT: http://childrensnational.org/~/media/cnhssite/files/about/advocacy/final_c hildrens_national_chip_fy_20142016.ashx Children's Hospital is in the process of reviewing and addressing internally and with external advisors to update their policies in light of the enactment of IRC Section 501(r). These policies will ensure Children's National Medical System and Children's Hospital are fully in compliance with the new laws on a timely basis. Eligibility Education Schedule H, Part VI, Line 3 THE FOLLOWING PROCESSES TAKE PLACE FOR FAMILIES WHO DO NOT HAVE INSURANCE OR WHO CANNOT PAY. 1. AN APPLICATION IS MADE FOR MEDICAL ASSISTANCE AND FINANCIAL ASSISTANCE PROGRAM (FAP) STAFFED BY CONTRACTED COMPANIES, MED LAW & DECO IN THE FINANCIAL INFORMATION CENTER (FIC). ELIGIBILITY IS CONSIDERED FOR ALL APPROPRIATE PUBLIC PROGRAMS. WE WOULD LIKE THIS PROCESS TO TAKE PLACE PRIOR TO THE MEDICAL VISIT. FAP APPLICATIONS ARE MAILED TO SELF PAY PATIENTS WHEN THEY MAKE AN APPOINTMENT. 2. WHILE THE APPLICATION IS IN PROCESS, THE PATIENT IS REGISTERED AS MEDICAID PENDING AND THE MEDICAL VISIT TAKES PLACE (CITIZENS ONLY). NON CITIZENS ARE REGISTERED AS SELF PAY. 3. IF MEDICAID ELIGIBLE, THE PATIENT REGISTRATION IS CONVERTED TO THE MEDICAID PLAN. 4. IF NOT ELIGIBLE, THE PATIENT'S CHARITY CARE APPLICATION IS FURTHER EVALUATED FOR CN CHARITY CARE BY CNMC CUSTOMER SERVICE IN THE FIC. 5. IF FAP IS APPROVED, ACCOUNT NOTES ARE UPDATED AND THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. THE ACCOUNTS ARE MANAGED BY CUSTOMER SERVICE STAFF. ONLY EXPECTED BALANCES REMAIN ON THE ACCOUNT AND FAMILIES RECEIVE STATEMENTS SHOWING THEIR RESPONSIBILITY. 6. IF FAP IS NOT APPROVED, ACCOUNTS NOTES ARE UPDATED AND THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. FAMILIES CAN SET UP PAYMENT PLANS TO RESOLVE THEIR ACCOUNT BALANCES 7. FOR INSURED FAMILIES: MEDICALLY INDIGENT STATUS CAN APPLY. THIS STATUS CAN BE EVALUATED AT ANY TIME IF A FAMILY'S REMAINING BALANCE (EXCLUDING ANY DEDUCTIBLES) AFTER 3RD PARTY PAYER IS GREATER THAN 30% OF ANNUAL INCOME LESS HOUSING EXPENSES. - WHENEVER APPLICABLE, IT IS ENCOURAGED THAT FAMILIES REVIEW THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE THE APPOINTMENT DATE. APPOINTMENTS ARE TYPICALLY MADE WITH THE FIC OFFICE WHEN FAMILIES MAKE THEIR MEDICAL APPOINTMENTS. THEY CAN GO DIRECTLY TO THE FIC OFFICE AT CN AT ANY OTHER TIME. - FAMILIES ARE ENCOURAGED TO COOPERATE WITH OUR STAFF BY SUPPLYING ALL NECESSARY INFORMATION FOR THE MEDICAID AND FAP APPLICATIONS. Description of Community Served Schedule H, Part VI, Line 4 As the only exclusive provider of pediatric care in the Nation's capital, Children's National has the privilege of serving a diverse and broad community, spanning from the District of Columbia to Maryland and Virginia and beyond. Our community has broad ethnic diversity and vibrant cultures. According to the U.S. Census Bureau, population figures for the region are estimated at 658,893 for the District of Columbia; nearly 6 million in Maryland; and a little over 8 million in Virginia. The social demographics for the District of Columbia, Maryland and Virginia, according to the U.S. Census, are as follows: District of Columbia: about 49% Black; 43.6% White; 10.4% Latino; 4% Asian and 0.6% American Indian/Alaska Native; Maryland: approximately 60% White; 30% Black; 9% Hispanic; 6.4% Asian and 0.6% American Indian/Alaska Native and Virginia: 70.5% White, 19.7% Black; 8.9% Hispanic; 6.3% Asian and 0.5% American Indian/Alaska Native. In the District of Columbia, children 18 years old and under make up about 18 percent of the population with the highest in Wards 7 and 8, 3.14% and 3.30%, respectively. In both Maryland and Virginia about 23 percent of the population are children 18 years and under. Children age five and under make up approximately 6 percent of the population in the District of Columbia, Maryland, and Virginia. In the District of Columbia about 16 percent and in Virginia about 15 percent of the population age five and older report speaking a language other than English at home while in Maryland the percentage is slightly higher at nearly 17 percent. The U.S. Census reports median household income at approximately $65,830 in the District with the highest income in Ward 3 and lowest in WardS 7 and 8. In Maryland the median household income is $73,538 in Maryland; including $73,623 in Prince George's County and $98,221 and $63,907 in Virginia. The percentage of persons living below the poverty line is reported at 18.6% for the District of Columbia, 11.3% in Virginia, and 9.8% in Maryland; with 9.4% in Prince George's County and 6.7% in Montgomery County. The Centers for Medicare and Medicaid Services (CMS) reports total Medicaid and CHIP enrollment figures based on enrollment data as of January 2015 at 69,975,289. The breakdown for total Medicaid and CHIP enrollment based on October figures from CMS for the District of Columbia Medicaid and CHIP enrollment was 256,383; 1,152,248 in Maryland; and 968,216 in Virginia. In 2014, the percentage of hospital inpatients receiving Medicaid was 76 percent from the District of Columbia, 28 percent from Virginia, and 31 percent from the state of Maryland. Serving children for more than 140 years, Children's National is a proven leader in developing and providing innovative new treatments for childhood illness and injury. We care for more than 35,000 children through our health centers each year, as the largest non-government provider of primary care in the District of Columbia. About 56 percent of our patients live in Maryland. We also offer families a link to quality pediatric care through our mobile medical program and at community centers. Our team averages more than 460,000 outpatient visits each year at health clinics in the District of Columbia, affiliated centers in Maryland and Virginia, and at the Sheikh Zayed Campus in Washington, D.C. On average, that equals nearly 1,000 patient visits in one day to one of Children's National's 30 locations in the District of Columbia and throughout the metropolitan area. In 2015, we performed 17,449 surgical procedures, 122,485 diagnostic imaging procedures, and more than 1 million laboratory tests. Promoting the Health of the Community Schedule H, Part VI, Line 5 For more than 140 years, Children's National has been committed to serving the community by promoting and improving the health of children and supporting the health improvements in their homes, schools, neighborhoods, and broader community. This commitment is evidenced through its governing boards to community health initiatives, and the development of DC Healthy Communities Collaborative (DCHCC). Children's National, the 501 (c)(3) not-for-profit organization, is governed by board of directors representing the diversity of the local, regional, national, and international communities that we serve. The majority of our board of directors resides within the primary service area of the Washington, DC metropolitan area, including the District of Columbia, Maryland, and Virginia. Children's National is a pioneer in innovative programs that move beyond awareness to targeted interventions that improve the lives of children and their families, locally, regionally, nationally, and internationally. The Children's National Advocacy and Public Policy, Inc. (CNAPPI) governs the Advocacy component of our care, advocacy, research, and education (CARE) mission as a charitable organization. The CNAPPI is comprised of leaders from throughout the region with experience in policy, advocacy, leadership and strategic planning. With this capacity, the CNAPPI serves as a platform for the Children's National to reach beyond the boundaries of the institution; advocate for all children regardless of their circumstance or location; and prioritize and guide official policy statements and action, government relations, community benefit outreach and other relevant issues. Over the past 20 years, Children's Health Board has awarded approximately $5 million in grants to more than 200 Children's National Medical Center programs. The grants have turned early ideas into proven models that have attracted support from leading investors in improved health outcomes for children nationwide. The Community Affairs Department established a partnership with the Children's Health Board, a service affiliate of Children's National, that works to advance the health and well-being of children in the Washington, DC metropolitan community, especially those most in need, through advocacy, education, prevention and early intervention. Beginning in FY 2014, the Children's Health Board implemented an updated grant making strategy which includes the Community Benefit Grant Program. Through the Community Benefit Grant Program the Children's Health Board focuses its grant making on supporting the Children's National Community Health Improvement Plan (implementation strategy), in an effort to improve community health demonstrated by measurable outcomes. In 2013, the community benefit team worked with the Children's Health Board to establish this new grant process and will engage in the grant application review process to review grant applications for community benefit program alignment. Grant awardees are now required to report their programs/initiatives as Community Benefit and will be included in the Community Benefit Report. Affiliated Health Care System Roles Schedule H, Part VI, Line 6 CHILDREN'S HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING ENTITIES: - CHILDREN'S NATIONAL MEDICAL CENTER - 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBLITY FOR HEALTH CARE SYSTEM - CHILDREN'S HOSPITAL FOUNDATION - 501(C)(3), FUNDRAISING - CHILDREN'S RESEARCH INSTITUTE - 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS - SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN - BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN - CHILDREN'S NATIONAL ADVOCACY & PUBLIC POLICY INC - 501(C)(3), ADVOCATING FOR CHILDREN'S HEALTH ISSUES - CHILDREN'S HOSPITAL SELF-INSURANCE TRUST - 501(C)(3), PROVISION OF INSURANCE TO SYSTEM EACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL MEDICAL CENTER'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 DC X X X X X true true X X X X X false true false false false false false true true true KURT D NEWMAN MD PRESIDENT / CEO (CNMC) 843178 0 981964 0 26378 0 292525 0 36359 0 2180404 0 0 0 DENICE CORA-BRAMBLE MD BRD MEMBER/CMO 521281 0 372587 0 21592 0 95502 0 56203 0 1067165 0 0 0 DAVID STOCKWELL MD Board MEMBER 116842 0 17350 0 41237 0 2597 0 782 0 178808 0 0 0 DAVID WESSEL MD BRD MEMBER/CMO 522922 0 391393 0 64513 0 95502 0 57607 0 1131937 0 0 0 DOUGLAS MYERS CHIEF FINANCIAL OFFICER 504890 0 452042 0 52014 0 92501 0 37002 0 1138449 0 0 0 MARK BATSHAW MD PHY IN CHIEF / CAO 596516 0 621303 0 67759 0 263000 0 72849 0 1621427 0 0 0 ELIZABETH FLURY CHIEF STRATEGY OFFICER 490881 0 354355 0 2505 0 88002 0 37975 0 973718 0 0 0 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 459979 0 341981 0 18868 0 84251 0 27398 0 932477 0 0 0 MARY ANNE HILLIARD CHIEF RISK OFFICER 270453 0 250719 0 33922 0 57446 0 34310 0 646850 0 0 0 BRIAN JACOBS MD CHIEF INFORMATION OFFICER 371298 0 120001 0 22570 0 34246 0 36905 0 585020 0 0 0 RICHARD JONAS MD CHIEF OF CARDIOLOGY 1080179 0 747960 0 36019 0 101551 0 37680 0 2003389 0 0 0 PAM KING SAMS CHIEF DEVELOPMENT OFFICER 316181 0 262255 0 25799 0 145461 0 31301 0 780997 0 0 0 GERARD MARTIN MD SVP CENTER OF EXCELLENCE 479248 0 396139 0 25321 0 62033 0 51252 0 1013993 0 0 0 MICHELLE MCGUIRE VP & CHIEF OF STAFF 226466 0 67498 0 990 0 11899 0 24091 0 330944 0 0 0 MARY OTTOLINI MD PHD VICE CHAIR MED. EDUCATION 256999 0 109645 0 7954 0 13000 0 4641 0 392239 0 0 0 ROGER PACKER MD SVP CENTER OF EXCELLENCE 404336 0 363351 0 31039 0 77584 0 55383 0 931693 0 0 0 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 581344 0 399565 0 2808 0 73000 0 66864 0 1123581 0 0 0 RAYMOND S SCZUDLO CHIEF LEGAL OFFICER 438307 0 387266 0 32201 0 58003 0 50631 0 966408 0 0 0 LINDA TALLEY CHIEF NURSING OFFICER 253467 0 74880 0 1518 0 10925 0 12151 0 352941 0 0 0 MENDeL TUCHMAN MD CHIEF RESEARCH OFFICER 316964 0 287077 0 28855 0 65139 0 51711 0 749746 0 0 0 DARRYL VARNADO CHIEF PEOPLE OFFICER 274390 0 205370 0 20515 0 58003 0 46297 0 604575 0 0 0 ROBERT KEATING MD CHIEF OF NEUROSURGERY 746056 0 179687 0 774 0 88697 0 21656 0 1036870 0 0 0 PETER KIM MD VP SHEIKH ZAYED INSTITUTE 641187 0 260250 0 1518 0 13000 0 21403 0 937358 0 0 0 H GIL RUSHTON MD CHIEF OF UROLOGY 473748 0 172122 0 15096 0 60499 0 35737 0 757202 0 0 0 JOHN MYSEROS MD NEUROSURGEON 601824 0 131563 0 1518 0 13000 0 23037 0 770942 0 0 0 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 591184 0 214010 0 1518 0 11483 0 21322 0 839517 0 0 0 NELLIE ROBINSON - 63014 EVP NURSING PHILANTHROPHY 46657 0 247482 0 78144 0 2539 0 2425 0 377247 0 0 0 JOSEPH WRIGHT MD - 63014 SVP CENTER OF EXCELLENCE 179144 0 515455 0 65867 0 105460 0 36242 0 902168 0 0 0 DAVID SPARKS INTERIM TRANSITION DIR. FIN. 275033 0 154000 0 25739 0 13000 0 26823 0 494595 0 0 0 RAHUL K SHAH MD FORMER BOARD MEMBER 276629 0 186344 0 2591 0 13000 0 13670 0 492234 0 0 0 First-class or charter travel Schedule J, Part I, Line 1a FIRST CLASS OR CHARTER TRAVEL/TRAVEL FOR COMPANIONS THE CEO PER HIS EMPLOYMENT CONTRACT IS ENTITLED TO USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS, AND HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL. TRAVEL FOR COMPANION SCHEDULE J, PART I, LINE 1A THE CEO MAY TAKE HIS SPOUSE ON UP TO 7 TRIPS PER YEAR FOR CONFERENCES WHERE HER PRESENCE BENEFITS THE HOSPITAL AND ITS BUSINESS RELATIONS. IN ADDITION, UPON PRIOR APPROVAL OF THE CEO, AND IN LIMITED CIRCUMSTANCES, TRAVEL FOR AN EXECUTIVE'S SPOUSE MAY BE AUTHORIZED WHERE HER PRESENCE BENEFITS THE HOSPITAL AND ITS BUSINESS RELATIONS. Tax indemnification and gross-up payments Schedule J, Part I, Line 1a TWO KEY EMPLOYEES AND ONE FORMER KEY EMPLOYEE RECEIVED CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS, UPON APPROVAL OF THE COMPENSATION COMMITTEE, WHICH ARE INCREASED BY A TAX EQUALIZATION AMOUNT, WHICH IS SIGNIFICANTLY LESS THAN THE AMOUNT THAT WOULD BE DETERMINED BY A TAX GROSS UP OR INDEMNIFICATION METHOD. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. Health or social club dues or initiation fees Schedule J, Part I, Line 1a CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR HEALTH CLUB OR SOCIAL CLUB DUES. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. Personal services Schedule J, Part I, Line 1a CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. THERE ARE NO EXPENDITURES FOR MAIDS, CHAUFFEURS OR CHEFS. Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AS PART OF DEFERRED COMPENSATION: KURT D. NEWMAN, MD - $279,525 MARK L. BATSHAW, MD - $250,000 DOUGLAS MYERS - $79,501 ANTHONY SANDLER, MD - $60,000 DAVID WESSEL, MD - $82,502 DENICE CORA-BRAMBLE, MD - $82,502 GERARD MARTIN, MD - $49,033 RAYMOND S. SCZUDLO - $45,003 ELIZABETH FLURY - $75,002 KATHLEEN CHAVANU GORMAN - $71,251 ROGER PACKER, MD - $64,584 JOSEPH WRIGHT, MD - $95,499 MENDeL TUCHMAN, MD - $52,139 PAM KING SAMS - $132,461 MARY ANNE HILLIARD - $44,446 BRIAN JACOBS, MD - $21,246 DARRYL VARNADO - $45,003 RICHARD JONAS, MD - $88,551 ROBERT KEATING, MD - $75,697 H. GIL RUSHTON, MD - $47,499 Non-fixed payments Schedule J, Part I, Line 7 THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT. Initial contract exception Schedule J, Part I, Line 8 Certain individuals hired during the year have employment contracts which meet the initial contract exceptions described in the Treasury Regulations. A DISTRICT OF COLUMBIA 536001131 254764GN7 2005-10-26 50000000 CONSTRUCT AND RENOVATE FACILITIES false false false B DISTRICT OF COLUMBIA 536001131 254764GP2 2005-10-26 50000000 CONSTRUCT AND RENOVATE FACILITIES false false false C DISTRICT OF COLUMBIA 536001131 254764GQ0 2005-10-26 50000000 CONSTRUCT AND RENOVATE FACILITIES false false false D DISTRICT OF COLUMBIA 536001131 254764GX5 2008-04-10 3555193 CONSTRUCT AND RENOVATE FACILITIES false false false A 0 0 50000000 3738181 12645266 0 889291 2909809 0 29817453 0 0 2009 false false true true B 0 0 50000000 3738181 12645267 0 889291 2909809 0 29817453 0 0 2009 false false true true C 0 0 50000000 3738181 12645267 0 889291 2909809 0 29817453 0 0 2009 false false true true D 0 0 3555193 233255 511928 0 63310 198654 0 2548046 0 0 2009 false false false true A false false false false 0.00000 0.00000 0.00000 true false false true B false false false false 0.00000 0.00000 0.00000 true false false true C false false false false 0.00000 0.00000 true false false true D false false false false 0.00000 0.00000 0.00000 true false false true A false true true UBS 29.75 true false false 0 false true B false true true UBS 29.75 true false false 0 false true C false true true UBS 29.75 true false false 0 false true D false false false 0 false false 0 false true A true B true C true D true A DISTRICT OF COLUMBIA 536001131 254764GY3 2008-04-10 3854679 CONSTRUCT AND RENOVATE FACILITIES false false false B DISTRICT OF COLUMBIA 536001131 254764GZ0 2008-04-10 10931252 CONSTRUCT AND RENOVATE FACILITIES false false false C DISTRICT OF COLUMBIA 536001131 254764HA4 2008-04-10 73663982 CONSTRUCT AND RENOVATE FACILITIES false false false D DISTRICT OF COLUMBIA 536001131 254764HB2 2008-04-10 149516148 CONSTRUCT AND RENOVATE FACILITIES false false false A 0 0 3854679 252904 555053 0 68643 215388 0 2762691 0 0 2012 false false true true B 0 0 10931252 717196 1574040 0 194661 610806 0 7834550 0 0 2012 false false true true C 0 0 73663982 4833070 10607208 0 1311788 4116123 0 52795794 0 0 2012 false false true true D 0 0 149516148 9809706 21529502 0 2662542 8354514 0 107159883 0 0 2012 false false true true A false false false false 0.00000 0.00000 0.00000 true false false true B false false false false 0.00000 0.00000 0.00000 true false false true C false false false false 0.00000 0.00000 0.00000 true false false true D false false false false 0.00000 0.00000 0.00000 true false false true A false false false 0 false false false 0 false true B false false false 0 false false false 0 false true C false false false 0 false false false 0 false true D false false false 0 false false false 0 false true A true B true C true D true DAVID WESSEL MD DIRECTOR HOUSING LOAN - COMP X 200000 120000 false true true 120000 ORGANIZATION'S MISSION FORM 990, Part I, Line 1 TO IMPROVE HEALTH OUTCOMES FOR CHILDREN; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH, TO MEET NEEDS OF CHILDREN AND THEIR FAMILIES. Form 990, Part III, Line 1 TO IMPROVE HEALTH OUTCOMES FOR CHILDREN REGIONALLY, NATIONALLY, AND INTERNATIONALLY; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH, AND EDUCATION TO MEET UNIQUE NEEDS OF CHILDREN, ADOLESCENTS, AND THEIR FAMILIES. Program Services Part III, Line 4a Children's Mission Statement As the nation's children's hospital, the mission of Children's National Medical Center is to excel in Care, Advocacy, Research and Education. We accomplish this through: - Providing a quality health care experience for our patients and families. - Improving health outcomes for children regionally, nationally, and internationally. - Leading the creation of innovative solutions to pediatric health challenges. Children's Vision Statement As the nation's children's hospital, we will set the standard of excellence for the care of children. - We will serve as the voice for the most vulnerable among us: our children. - We will lead the quest to cure some of childhood's most devastating diseases. - We will prepare the nation's future leaders in child health. - We will be the children's hospital against which all others are measured. Children's Child-Centered Vision By incorporating feedback from our families, we have developed our first child-centered vision, which looks at the hospital experience through a child's eyes. Healing a child's body, mind and spirit takes more than medicine: it takes a team to fulfill a family's dream. - My hospital is a bright and happy place that feels like home. - My providers, my family, and I are a team, and everyone's job is important. - The way my hospital works is built around me. - My providers don't all look alike. - My hospital is my family's connection to everything I need for my health, whether they provide it or blaze trail it. About Children's National Children's National Medical Center is the premier provider of pediatric care in the Washington, DC, metropolitan area and is the only freestanding children's hospital between Philadelphia, Pittsburgh, Norfolk, and Atlanta. Serving the nation's children for 140 years, Children's National is a proven leader in the development and application of innovative new treatments for childhood illness and injury. Children's internationally recognized team of pediatric healthcare professionals care for more than 360,000 patients each year who come from throughout the region, nation and world. Serving as an advocate for all children, Children's is the largest non-governmental provider of pediatric care in the District of Columbia, providing more than $50 million in uncompensated care. In addition, Children's serves as the regional referral center for pediatric emergency, trauma, cancer, cardiac and critical care as well as neonatology, orthopedic surgery, neurology, and neurosurgery. Children's National is proudly ranked consistently among the best pediatric hospitals in America by US News & World Report and the Leapfrog Group, and has received Magnet designation by the ANCC. At Children's National Medical Center, we stand for children! Our vision of advancing the health and wellbeing of children has been the motivation behind a number of forward-focused initiatives aimed at creating a lasting standard for prevention and community education, coupled with top-notch treatment and continuous improvement. As always, the vision is carried out through a cadre of nationally recognized healthcare professionals, staff, and administrators who tirelessly serve the unique and diverse medical needs of the residents of the Washington, DC, metropolitan area and the broader community. Their work provides a unique perspective of the health improvements important for all children, in every family. With this in mind, the hospital is committed to building a universal blueprint for improving healthcare that can be replicated in health systems, hospitals, and clinics in communities across the country. The programs highlighted in this report provide a snapshot of the important work being done at Children's National every day to improve the health and wellbeing of kids and our communities. Every member of our team is committed to giving children and our communities the best chance for a healthy future, it's all we do. Children's National is dedicated to fulfilling its vision of setting the standard in excellence in pediatric care, advocacy, research , and education, here in the nation's capital, around the country, and throughout the world. As part of our commitment to our community, below are some of the programs that were implemented in FY 2015: -DC Collaborative for Mental Health in Pediatric Primary Care The DC Collaborative for Mental Health in Pediatric Primary Care (DC Collaborative), founded in 2012, aims to improve the integration of mental health in pediatric primary care for children and youth in the District of Columbia. This public-private partnership consists of a working group that is responsible for the planning, implementation and evaluation of all activities of the DC Collaborative; a community advisory board that includes parents, community stakeholders, and over 25 diverse organizations; and a project team comprised of Children's National staff that provide the day-to-day support for the work of the DC Collaborative. The DC Collaborative supports and implements initiatives focused on supporting primary care practices and clinicians; supporting families; integrating mental health services into primary care; and engaging in related policy and advocacy efforts. As of June 2015, over 150 providers and 16 practices completed mental health screening training through a 15 month learning collaborative model. 100% of providers reported that they felt somewhat or very prepared to identify mental health issues of their patients. Another component of the DC Collaborative is DC MAP (Mental Health Access in Pediatrics), which offers pediatric primary care providers increased access to child mental health experts. The DC MAP team of child mental health experts offers telephone consultation, community resource referral, and training to pediatric practices in an effort to help with the management of mental health concerns of patients and families. The program launched city-wide in September 2015. -Safe Kids DC Car Seat Inspection Station Safe Kids DC works to prevent childhood accidents in the District, the leading cause of death and disability in children ages one to 19. As part of Safe Kids DC, the Car Seat Inspection Program aims to raise awareness of preventable injuries as a result of motor vehicle crashes. The desired outcome is to reduce preventable injury during a crash due to proper child restraint techniques. Parents and caregivers are provided education on child passenger safety including how to correctly install car seats and position the child in the seat, how to identify the proper seat for the child's age, weight and height as well as how to determine if the car seat is expired or recalled. The car seat inspection station is operated by nationally certified child passenger safety technicians. In addition to the education and installation services provided, the child passenger safety technicians also connect families to resources for obtaining child safety seats at reduced rates. Through partnerships with the District Department of Transportation, Metropolitan Police Department, and DC Department of Motor Vehicles, areas in the city that are most in need of education and outreach efforts are identified. The Car Seat Inspection Station Program provided 705 people services in FY 2015. -IMPACT DC Asthma is the most common chronic childhood disease and has become considerably more prevalent and severe in the United States during the last 40 years. In recent years, the number of children diagnosed with asthma has dramatically increased. In Washington, DC, more than one in ten children currently have asthma, which is well above the national average. IMPACT DC is a pediatric asthma program in Washington, DC, dedicated to improving asthma care and outcomes for children through clinical care, education, research, and advocacy. One of the program's main goals is to educate patients and families about ways to manage asthma and connect with valuable resources in the community in an effort to lessen the need for emergency room visits and hospital stays. In an effort to increase asthma awareness, community education and outreach is an important component of IMPACT DC. Staff of IMPACT DC provide evidence-based educational outreach through health fairs, school-based programs, and other educational and advocacy events. There is a particular focus on early childhood providers since most chil Form 990 Review Process Form 990, Part VI, Line 11b THE RELEVANT COMMITTEES OF THE ORGANIZATION AND ITS PARENT ORGANIZATION, CNMC, REVIEW APPLICABLE PORTIONS OF THE FORM 990: The legal affairs and audit committee reviews the financial disclosures, the CNAPPI board reviews the public benefit sections, and the executive compensation committee reviews the compensation disclosures. The full board reviewed the entire Form 990. The completed Form 990 is made available to the board of Children's National Medical Center before filing. Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c CHILDREN'S HOSPITAL REQUIRES THAT EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE COMPLETE A CONFLICT OF INTEREST FORM AT LEAST EVERY YEAR. IN ADDITION, EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS INSTRUCTED AND REQUIRED TO AMEND THE CONFLICT OF INTEREST FORM IMMEDIATELY UPON A CHANGE IN STATUS OF ANY OF THE QUESTIONS ON THE FORM. THESE FORMS ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND CONFLICTS AND INTERESTS ARE NOTED. THE CHILDREN'S HOSPITAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY. GOVERNING POLICIES FORM 990, PART VI, LINES 13 & 14 CHILDREN'S HOSPITAL IS GOVERNED BY THE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL MEDICAL CENTER ("CNMC"). THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. Process for Determining Compensation Form 990, Part VI, Line 15a & 15b THE EXECUTIVE COMPENSATION COMMITTEE OF THE CNMC BOARD OF DIRECTORS IS COMPRISED WHOLLY OF DISINTERESTED, INDEPENDENT BOARD MEMBERS. THE COMMITTEE HAS RETAINED INDEPENDENT OUTSIDE CONSULTANTS EXPERT ON COMPENSATION MATTERS. THE COMMITTEE DETERMINES ADJUSTMENTS IN COMPENSATION, INCLUDING BASE PAY, INCENTIVES, AND OTHER FORMS OF COMPENSATION FOR EACH PERSON DEEMED BY THE COMPENSATION COMMITTEE TO BE A "DISQUALIFIED PERSON" AS THAT TERM IS USED IN THE INTERMEDIATE SANCTION REGULATIONS OF THE IRS. THE COMMITTEE IS INFORMED IN ITS DECISION-MAKING BY COMPENSATION STUDIES AND COMPARISONS DONE BY THE INDEPENDENT CONSULTANT, AND RELIES UP "REASONABLENESS" OPINIONS FOR SUCH CONSULTANTS PRIOR TO OR CONTEMPORANEOUS WITH MAKING COMPENSATION DECISIONS. THE COMMITTEE MEETS 4-6 TIMES PER YEAR TO CONSIDER SUCH MATTERS. How Documents are Made Available to the Public Form 990, Part VI, Line 19 CHILDREN'S HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED ON REQUEST. Other Changes in Net Assets Form 990, Part XI, Line 9 CP&A Partnership Capital Account Adjustment $140,647 (DIFFERENCE BETWEEN INCOME AND CHANGE IN CAPITAL ACCOUNT PER SCHEDULE K-1). 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