2025-11-14T10:54:19-06:00 2024-12-31 135565207 KPMG LLP 1212 NORTH 96TH STREET SUITE 300 OMAHA NE 68114 990 2024-01-01 470379754 CHILDREN'S HOSPITAL & MEDICAL CENTER CHIL 4029556262 8200 DODGE STREET OMAHA NE 68114 AMY HATCHER CFO 4029556262 2025-11-10 1 0 SOPHIE R KING P02233384 4023481450 2025-11-10 2024 2025-03-06 01:10:19Z CHILDREN'S NEBRASKA CHANDA CHACON 8200 DODGE STREET OMAHA NE 68114 997907215 0 X WWW.CHILDRENSNEBRASKA.ORG X 1948 NE TO IMPROVE THE LIFE OF EVERY CHILD THROUGH EXCEPTIONAL CARE, ADVOCACY, RESEARCH AND EDUCATION 13 11 4298 147 975321 404428 9774507 15336100 605143914 712319163 15217614 28372916 16706751 18449138 646842786 774477317 15934318 20133355 0 0 314891399 349550547 0 0 597 271857751 315413343 602683468 685097245 44159318 89380072 1395470547 1555241618 362259056 349940833 1033211491 1205300785 X TO IMPROVE THE LIFE OF EVERY CHILD - THROUGH EXCEPTIONAL CARE, ADVOCACY, RESEARCH AND EDUCATION. 0 0 563664887 20133355 730153065 THE HOSPITAL OPERATES A 225 LICENSED-BED PEDIATRIC HOSPITAL, WHICH INCLUDES 13 SURGICAL SUITES, TWO HYBRID HEART CATHETERIZATION LABS, AN OUTPATIENT SURGERY CENTER INCLUDING 4 SURGICAL SUITES. CHILDREN'S HAS ACHIEVED THE MAGNET DESIGNATION FOR NURSING EXCELLELNCE, AND ITS PEDIATRIC AND NEONATAL INTENSIVE CARE UNITS HAVE EARNED A BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES, WHICH RECOGNIZES CRITICAL CARE UNITS WITH EXCELLENT PATIENT OUTCOMES THAT EXCEED NATIONAL BENCHMARKS. THE HOSPITAL WAS RECOGNIZED BY U.S. NEWS AND WORLD REPORT IN THE NEPHROLOGY AND PULMONOLOGY & LUNG SURGERY SPECIALTIES. CHILDREN'S SPECIALTY PEDIATRIC CENTER OFFERS MORE THAN 100 OUTPATIENT SPECIALTY AND SUB-SPECIALTY CLINICS, PROVIDING DIAGNOSTICS, TREATMENT, AND THERAPY. IN ADDITION, THE HOSPITAL PROVIDES OUTPATIENT BEHAVIORAL HEALTH AND A FULL ARRAY OF PEDIATRIC HOME HEALTHCARE SERVICES TO CHILDREN AND ADOLESCENTS WHO HAVE IMMEDIATE OR LONG-TERM HEALTHCARE NEEDS. THE HOSPITAL IS HOME TO THE REGION'S ONLY LEVEL IV NEONATAL INTENSIVE CARE UNIT AND THE ONLY DEDICATED PEDIATRIC EMERGENCY DEPARTMENT WITH LEVEL II PEDIATRIC TRAUMA CERTIFICATION. THE HOSPITAL ALSO PROVIDES SPECIALTY PEDIATRIC CARE SERVICES IN COMMUNITIES ACROSS THREE STATES. 563664887 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 276 0 1 4298 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 13 11 0 0 1 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 GA NE X AMY HATCHER 4029556262 8200 DODGE STREET OMAHA NE 68114 CHANDA CHACON PRESIDENT & CEO 40.00 0.00 X X 1757773 0 437688 MARGARET HERSHISER CHAIR 1.00 0.00 X X 0 0 0 STACY SCHOLTZ VICE CHAIR 1.00 0.00 X X 0 0 0 SAMANTHA MOSSER SECRETARY 1.00 0.00 X X 0 0 0 AMY RYAN TREASURER 1.00 0.00 X X 0 0 0 NICOLE BIRGE MEMBER 1.00 0.00 X 0 0 0 DAVE DIAMOND MEMBER 1.00 0.00 X 0 0 0 ROBERT DUNLAY MD MEMBER 1.00 0.00 X 0 0 0 CINDY HEIDER MEMBER 1.00 0.00 X 0 0 0 FARHAN KHAN MEMBER 1.00 0.00 X 0 0 0 STEVE LINDSAY MEMBER 1.00 0.00 X 0 0 0 SUE THADEN MEMBER 1.00 0.00 X 0 0 0 BRYAN WILSON MEMBER 1.00 0.00 X 0 0 0 JONATHAN WEGNER MEMBER 1.00 0.00 X 0 0 0 AMY HATCHER EVP & CFO 39.00 1.00 X 941557 0 122324 KATHY ENGLISH EVP & COO 40.00 0.00 X 900709 0 38083 PAM JOHNSON-CARLSON SVP PCS & CNO 40.00 0.00 X 591471 0 39549 CHRISTOPHER MALONEY MD EVP CHIEF CLINICAL OFFICER 40.00 0.00 X 1066632 0 115587 AMY BONES SVP & GENERAL COUNSEL 40.00 0.00 X 624504 0 32974 JEROLD VUCHAK EVP CHIEF INFO & INNOV OFFICER 40.00 0.00 X 707456 0 101034 JANEL ALLEN EVP & CHIEF PEOPLE OFFICER 40.00 0.00 X 611404 0 102291 ERIN WILLIS-LOUCKS MD PHYSICIAN 40.00 0.00 X 960056 0 52518 8161562 0 1042048 725 0 1 0 CHOICE SOLUTIONS LLC 7015 COLLEGE BLVD OVERLAND PARK KS 66211 IT SERVICES 2060322 SELLERS DORSEY & ASSOCIATES 1635 MARKET ST STE 301 PHILADELPHIA PA 19103 CONSULTING SERVICES 1212089 NODDLE VP1 LLC 2285 S 67TH ST STE 250 OMAHA NE 68106 FACILITIES SERVICES 1035791 SWISTAK ENTERPRISES LLC 4624 CREST RIDGE LOOP BLAIR NE 68008 FACILITIES SERVICES 1034996 UNMC PHYSICIANS 983135 NEBRASKA MEDICAL CENTER OMAHA NE 68198 PATHOLOGY SERVICES 913308 46 14092429 1243671 15336100 NET PATIENT REVENUE 622110 712319163 712319163 712319163 12231340 479668 11751672 615236 0 615236 615236 615236 239571474 223290479 139419 16280995 -139419 16141576 16141576 MANAGEMENT FEE INCOME 541610 9546780 9546780 CAFETERIA INCOME 900099 2611640 2611640 INTERCOMPANY RENTAL 900099 1334410 1334410 4341072 3845419 495653 17833902 774477317 729657412 975321 28508484 3150000 3150000 16983355 16983355 4789186 4789186 266332264 230344481 35987783 16964674 14356834 2607840 43917913 39531823 4386090 17546510 15204422 2342088 636640 633324 3316 478273 478273 103658 103658 53645406 31490259 22155147 2422332 1491 2420841 96107637 94711283 1396354 25326166 24764305 561861 10078495 3204601 6873894 771144 557093 214051 9516655 9516655 56743582 58243432 -1499850 44729859 18699722 26030137 2492855 2492855 BUILDING & GROUND MAINT 4115593 199109 3916484 EQUIPMENT MAINTENANCE 3471713 1120728 2350985 BANK & SERVICE FEES 1773115 268337 1504778 PROF DUES & SUBSCRIPTIO 1096606 540980 555626 1903614 142653 1760364 597 685097245 563664887 121431761 597 8585258 7646844 88516264 80248298 0 0 124263474 186990977 0 0 0 0 0 0 10168746 12271269 13428735 14843391 1001793137 338607015 644678654 663186122 0 0 434533613 515077563 0 0 0 0 71295803 74977154 1395470547 1555241618 82175007 80943557 0 0 21747 1077124 241302478 235857651 0 0 0 0 0 0 0 0 38759824 32062501 362259056 349940833 X 1025210325 1163372683 8001166 41928102 1033211491 1205300785 1395470547 1555241618 X 89380072 31056377 51652845 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 103658 103658 684993587 685097245 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 88360 71561 106423 103658 370002 250000 250000 250000 250000 1000000 1500000 74968429 10048529 965966 290832 11797908 73894184 62985521 17954245 1180899 153425 6998811 74968429 67055688 13279795 488673 55090 17783545 62985521 99960929 12775597 1571110 150207 47101741 67055688 92781994 8659064 650201 133073 1997257 99960929 0.39200 0.15400 0.45400 0 1 1 33192199 33192199 736282750 204528865 531753885 14740692 7984898 6755794 191952122 125676919 66275203 25625374 416333 25209041 663186122 LIMITED PARTNERSHIP INVESTMENT 463455114 F CERTIFICATE OF DEPOSIT 25000000 F PEDIATRIC ENRICHMENT FUND 6552439 F OTHER - BOARD DESIGNATED FUND 20000000 F DEBT SERVICE RESERVE FUNDS 70010 F 515077563 LEASE OBLIGATION - OPERATING 13980698 LEASE OBLIGATION - FINANCING 3496902 DEFERRED COMPENSATION LIABILITY 8542234 INTERCOMPANY PAYABLE 1868981 SWAP LIABILITY 565897 CURRENT PORTION OF LEASE PAYMENTS - OPERATING 2764258 CURRENT PORTION OF LEASE PAYMENTS - FINANCING 843531 32062501 X PART V, LINE 4: THESE FUNDS ARE ADMINISTERED BY THE FOUNDATION ON BEHALF OF AND FOR THE BENEFIT OF THE HOSPITAL. THE FUNDS ARE USED TO SUPPORT PROGRAMS, FUTURE CAPITAL IMPROVEMENTS, AND OPERATIONS OF THE HOSPITAL. PART X, LINE 2: FIN 48 FOOTNOTE THE COMPANY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2024 AND 2023, THE COMPANY DID NOT RECORD ANY AMOUNTS RELATED TO UNCERTAIN TAX POSITIONS OR ANY ACCRUED INTEREST AND PENALTIES. CENTRAL AMERICA AND THE CARIBBEAN INVESTMENTS 42988404 EUROPE (INCLUDING ICELAND AND GREENLAND) INVESTMENTS 17551100 0 0 0 0 0 0 60539504 0 60539504 1 0 0 1 1 0 1 1 X 1 X 1 X 1 1 1 0 1 1 7236174 0 7236174 0.01060 235935693 149671194 86264499 0.12590 243171867 149671194 93500673 0.13650 8966355 1817752 7148603 0.01040 38302093 0 38302093 0.05590 12670313 7502627 5167686 0.00750 12061000 0 12061000 0.01760 190320864 113609900 76710964 0.11200 262320625 122930279 139390346 0.20340 505492492 272601473 232891019 0.33990 32000 32000 0.00000 32000 32000 0.00000 1 4264672 0 216881 1021290 -804409 X 1 1 1 1 CHILDREN'S HOSPITAL & MEDICAL CENTER 8200 DODGE STREET OMAHA NE 68114 WWW.CHILDRENSNEBRASKA.ORG 260005 X X X X X CHILDREN'S HOSPITAL & MEDICAL CENTER 1 0 0 1 X X X X X X X X X 24 1 1 1 1 X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 200.000000000000 400.000000000000 X X 1 1 X X X 1 X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X X 1 X 0 X X X 1 X 0 0 CHILDREN'S HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE 2024 CHILD & ADOLESCENT (PEDIATRIC) COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY CONDUCTED ON BEHALF OF THE HOSPITAL, BOYS TOWN NATIONAL RESEARCH HOSPITAL AND BUILDING HEALTHY FUTURES, KEY INFORMANTS (INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY) WERE CONTACTED BY EMAIL, INTRODUCED TO THE PEDIATRIC COMMUNITY HEALTH NEEDS ASSESSMENT KEY INFORMANT SURVEY AND PROVIDED A LINK TO TAKE THE SURVEY ONLINE. THE SURVEY COLLECTED RESPONSES IN FEBRUARY AND MARCH OF 2024, AND REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. SUPPORTING ORGANIZATIONS FOR THE PCHNA INCLUDED: CHARLES DREW HEALTH CENTER, INC., CREIGHTON UNIVERSITY INSTITUTE FOR POPULATION HEALTH, DOUGLAS COUNTY HEALTH DEPARTMENT, THE LOZIER FOUNDATION, ONE WORLD COMMUNITY HEALTH CENTERS, INC. AND SARPY/CASS HEALTH DEPARTMENT.KEY INFORMANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS AMONG THE FAMILIES AND CHILDREN/ADOLESCENTS WITH WHOM THEY WORK, AS WELL AS THE COMMUNITY OVERALL. IN ALL, 220 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY, REPRESENTING COMMUNITY/BUSINESS LEADERS, PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, SOCIAL SERVICE PROVIDERS AND OTHER HEALTH CARE PROVIDERS. KEY INFORMANTS REPRESENT ORGANIZATIONS THAT WORK WITH LOW-INCOME POPULATIONS, POPULATIONS OF COLOR, MEDICALLY UNDERSERVED POPULATIONS, AND INDIVIDUALS WITH SPECIAL HEALTH CONDITIONS. CHILDREN'S HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 6A: BOYS TOWN NATIONAL RESEARCH HOSPITAL CHILDREN'S HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 6B: BUILDING HEALTHY FUTURES, CHARLES DREW HEALTH CENTER, INC., CREIGHTON UNIVERSITY INSTITUTE FOR POPULATION HEALTH, DOUGLAS COUNTY HEALTH DEPARTMENT, THE LOZIER FOUNDATION, ONE WORLD COMMUNITY HEALTH CENTERS, INC., AND SARPY/CASS HEALTH DEPARTMENT CHILDREN'S HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 11: CHILD HEALTH DATA GALLERY WALKS WERE CONDUCTED IN THE COMMUNITY, SHARING DATA FROM THE 2024 PEDIATRIC COMMUNITY HEALTH NEEDS ASSESSMENT (PCHNA) AND GATHERING INPUT ON CHILDREN'S NEBRASKA'S CHILD HEALTH PRIORITIES FOR THE NEXT THREE YEARS. THREE PRIORITIES WERE IDENTIFIED: ACCESS TO CARE, PEDIATRIC MENTAL HEALTH AND WELLNESS, AND THE SOCIAL DETERMINANTS OF HEALTH. ON NOVEMBER 18, 2024, THE BOARD OF DIRECTORS OF CHILDREN'S, WHICH INCLUDES REPRESENTATIVES FROM THROUGHOUT THE COMMUNITY, MET TO DISCUSS THIS PLAN AND THE INTERNAL AND EXTERNAL PRIORITIZATION INPUT FOR ADDRESSING THE COMMUNITY HEALTH PRIORITIES IDENTIFIED THROUGH THE PCHNA. UPON REVIEW, THE BOARD OF DIRECTORS APPROVED AND ADOPTED THIS PCHNA AND INSTRUCTED CHILDREN'S COMMUNITY HEALTH & ADVOCACY TEAM TO DEVELOP A NEW IMPLEMENTATION STRATEGY PLAN FOR 2025-2027 TO UNDERTAKE MEASURES TO MEET THE HEALTH NEEDS OF THE COMMUNITY.IMPLEMENTATION STRATEGY PLANTHE 2022-2024 IMPLEMENTATION STRATEGY PLAN (ISP) CLOSED WITH EVALUATION DETAILED IN THE 2024 PCHNA. THE 2022-2024 IMPLEMENTATION STRATEGY PLAN WAS APPROVED APRIL 26, 2022 BY THE QUALITY & PATIENT SAFETY COMMITTEE OF THE BOARD OF DIRECTORS OF CHILDREN'S NEBRASKA, WHICH INCLUDES REPRESENTATIVES FROM THROUGHOUT THE COMMUNITY.AS A RESULT OF THE INTERNAL AND EXTERNAL PLANNING CONVERSATIONS UTILIZING THE PCHNA DATA, ALIGNMENT WITH CHILDREN'S FIVE-YEAR STRATEGIC PLAN AND THE DESIRE TO ADDRESS STRATEGIES FOR WHICH COMMUNITY HEALTH IMPROVEMENT IS NEEDED, THE FOLLOWING IMPACT AREAS WERE IDENTIFIED AS PRIORITIES FOR THE ISP:- PEDIATRIC MENTAL WELLNESS- SOCIAL DETERMINANTS OF HEALTH: HEALTHY HOUSING FINANCIAL STABILITY FOOD SECURITYIN ADDITION TO THE IMPACT AREAS, A FOCUS ON UNDERREPRESENTED POPULATIONS AS DEFINED BY NATIONAL INSTITUTES OF HEALTH (NIH), USING EARLY CHILDHOOD SETTINGS AND SCHOOLS AS ACCESS POINTS FOR INTERVENTIONS AND SERVICE DELIVERY, AND UTILIZATION OF CHILDREN'S ACCESS TO CARE FRAMEWORK ADOPTED DURING THE 2019-2021 ISP ARE ALL KEY COMPONENTS OF A SUCCESSFUL 2022-2024 ISP.THE 2022-2024 ISP WAS LARGELY FOCUSED ON DUE DILIGENCE TO BETTER UNDERSTAND CHALLENGES RELATED TO THE IMPACT AREAS. THE 2022-2024 ISP IDENTIFIED THREE KEY AREAS TO BE CARRIED FORWARD OR EXPANDED IN THE 2025-2027 ISP: IDENTIFYING INTERVENTIONS THAT BEST ADDRESS THE NEEDS OF IMPACTED COMMUNITIES AND POPULATIONS, SELECTING COMMUNITY PARTNERS WHO REPRESENT THESE INTERESTS AND ARE POSITIONED TO DRIVE MEANINGFUL CHANGE AND ESTABLISHING BEST PRACTICES FOR COORDINATING EFFORTS BOTH INTERNALLY AND IN COMMUNITY.KEY ACCOMPLISHMENTS OF THE 2022-2024 ISP INCLUDE:DISCOVERY & RESEARCH:SOCIAL DETERMINANTS OF HEALTH- PROMISING PRACTICE RESEARCH WAS COMPLETED DESCRIBING THE WORK IN THE SOCIAL DETERMINANTS OF HEALTH BY PEER HOSPITALS, COMMUNITY ORGANIZATIONS AND BEST PRACTICE.- AN INTERNAL, ANONYMOUS SOCIAL NEEDS SURVEY WAS CONDUCTED WITH CHILDREN'S TEAM MEMBERS TO IDENTIFY WHAT RESOURCES CHILDREN'S NEBRASKA SHOULD INVESTIGATE MAKING AVAILABLE TO TEAM MEMBERS TO ADDRESS THEIR SOCIAL NEEDS. PEDIATRIC MENTAL WELLNESS:- ASSESSED NEED TO INFORM PROGRAMMING: O 80+ NEBRASKA SECONDARY STUDENTS WERE SURVEYED TO HELP IDENTIFY A NEED FOR THE CALM PROJECT - A PROGRAM CONNECTING HEALTH CARE PROVIDERS AND SCHOOLS TO EMPOWER TEENS TO GET NEEDED MENTAL HEALTH HELP AND SUPPORT. O OVER 330 SCHOOL SOCIAL WORKERS AND COUNSELORS WERE SURVEYED TO IDENTIFY THEIR MOST PREVALENT NEEDS IN ADDRESSING THE SOCIAL, EMOTIONAL AND BEHAVIORAL HEALTH NEEDS OF NEBRASKA STUDENTS.- CARING CONTACTS O CHILDREN'S LAUNCHED CARING CONTACTS IN 2020, PROVIDING HAND-WRITTEN NOTES TO CHILDREN BEING SEEN IN THE EMERGENCY DEPARTMENT FOR SUICIDAL IDEATION. SINCE ITS LAUNCH, NEARLY 1,000 CHILDREN AND YOUTH HAVE BEEN ENROLLED. O THE PROGRAM HAS BEEN PEER REVIEWED AND PUBLISHED WITH THE FOLLOWING FINDINGS: - ONLY 7% OF THOSE ENROLLED EXPERIENCE REPEAT INCIDENCE OF SUICIDE IDEATION OR GESTURE COMPARED TO 27% AMONG THIS POPULATION NATIONALLY. - INCREASE IN STAFF SOCIAL WORKER RETENTION. - NO PATIENT DEATHS OF ENROLLED PATIENTS TO-DATE. O A REPLICATION PACKAGE WAS DEVELOPED AND IS BEING DISSEMINATED TO SCHOOLS ACROSS NEBRASKA BY CHILDREN'S SCHOOL HEALTH TEAM IN COLLABORATION WITH CARE COORDINATION. EDUCATION AND TRAINING:SOCIAL DETERMINANTS OF HEALTH:- CHILDREN'S CONDUCTED 10 COMMUNITY LEARNING TOURS TAKING 86 TEAM MEMBERS TO VISIT 21 ORGANIZATIONS WORKING TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH WITH THE GOAL TO INCREASE TEAM MEMBER AWARENESS OF RESOURCES IN THE COMMUNITY AND CHALLENGES FACED BY THOSE WE SERVE.- CHILDREN'S NEBRASKA'S PAID VOLUNTEER TIME OFF PROGRAM, KNOWN AS BEINVOLVED, WAS LAUNCHED IN SUMMER 2022. OVER 4,300 VOLUNTEER HOURS HAVE BEEN COMPLETED BY CHILDREN'S TEAM MEMBERS SINCE PROGRAM INCEPTION.PEDIATRIC MENTAL WELLNESS- WITH A FOCUS ON EDUCATING PROFESSIONALS WITH SKILLS AND SUPPORT: O THE COPE PROGRAM LAUNCHED WITH: - 94 PRIMARY CARE PROVIDERS WHO EACH COMPLETED 20 HOURS OF TRAINING IN THE MANAGEMENT OF MILD TO MODERATE MENTAL HEALTH CONDITIONS WITHIN THEIR PATIENTS. - 1,927 CMES WERE AWARDED THROUGH COPE. O CHILDREN'S NEBRASKA TEAMED UP WITH ESU10 AND THE NEUROSEQUENTIAL NETWORK TO FUND THE NEUROSEQUENTIAL MODEL IN EDUCATION BOOTCAMP TRAINING FOR 2 SCHOOL-BASED MENTAL HEALTH THERAPISTS SERVING THE ESU 10 EDUCATIONAL REGION. O FOLLOWING COMPLETION OF THE FIRST 18-MONTHS OF A LEARNING COLLABORATIVE, THE ZERO SUICIDE PRINCIPLES WERE FULLY SOCIALIZED THROUGHOUT THE ORGANIZATION. SIGNIFICANT PROGRESS WAS MADE REGARDING IMPLEMENTATION AND OPERATIONALIZATION. O TRAUMA INFORMED CARE TRAINING WAS PROVIDED TO OVER 300 TEAM MEMBERS.ADVOCACY:SOCIAL DETERMINANTS OF HEALTH:- COMMUNITY PROGRAM CONTRIBUTIONS WERE MADE TO COMMUNITY ORGANIZATIONS WORKING IN THE IMPACT AREAS.- 10 COMMUNITY IMPACT GRANTS WERE AWARDED TO COMMUNITY ORGANIZATIONS TO FUND PROJECTS ADDRESSING CHILDREN'S IMPACT AREAS.- IMPLEMENTATION WORK BEGAN ON THREE STRATEGIES: O CHILD CARE SURVEY WAS INITIATED AND DISSEMINATED TO CHILDREN'S NEBRASKA TEAM MEMBERS TO UNDERSTAND OUR WORKFORCE'S NEED AND BARRIERS IN THE AREA OF CHILD CARE. O AN INTERNAL GROUP OF STAKEHOLDERS WAS CONVENED, AND A HEALTHY HOUSING PHYSICIAN CHAMPION WAS NAMED IN PARTNERSHIP WITH THE MID-AMERICAN PEDIATRIC ENVIRONMENTAL HEALTH SPECIALTY UNIT (MAPEHSU). O CHILDREN'S BOARD PLACEMENT PROJECT WAS LAUNCHED, PREPARING TEAM MEMBERS FOR PLACEMENT ON COMMUNITY BOARDS AND ASSISTING WITH PLACEMENT.- AN INTERNAL HEALTH EXCELLENCE & OPPORTUNITY STEERING COMMITTEE WAS FORMED INCLUDING A COMMUNITY HEALTH WORKGROUP LED BY COMMUNITY HEALTH & ADVOCACY.- HOSTED A FOOD RESOURCE FAIR HELD IN SPRING 2024 AT THE NEW COMMUNITY WELLNESS CENTER IN PARTNERSHIP WITH NEBRASKA MEDICINE/UNMC. - A PARTNERSHIP WITH HABITAT FOR HUMANITY OMAHA WAS ESTABLISHED TO PROVIDE EDUCATION AND CASE MANAGEMENT FOR CHILDREN'S TEAM MEMBERS TO BECOME MORTGAGE READY.- FINANCIAL LITERACY COURSES WERE PROVIDED TO CHILDREN'S TEAM MEMBERS THROUGH A PARTNERSHIP WITH BRIDGES OUT OF POVERTY.PEDIATRIC MENTAL WELLNESS:- INCREASING ACCESS TO CARE & CAPACITY: O CHILDREN'S BEHAVIORAL HEALTH URGENT CARE OPENED IN THE FALL OF 2024 IN KEARNEY, NEBRASKA, BRINGING GREATER ACCESS TO MENTAL HEALTH CARE AND SUPPORT TO RURAL, CENTRAL NEBRASKA. O CHILDREN'S ANNOUNCED THE OPENING AND BROKE GROUND ON THE BEHAVIORAL HEALTH & WELLNESS CENTER.- STRENGTHENING SCHOOL MENTAL HEALTH PROGRAMS & SERVICES: O INCREASED SCHOOL MENTAL HEALTH INFRASTRUCTURE BY FACILITATING TIER 2 GROUP INTERVENTION TRAINING FOR SCHOOL SOCIAL WORKERS, COUNSELORS, PSYCHOLOGISTS AND OTHER SCHOOL MENTAL HEALTH SERVICE PROVIDERS. APPROXIMATELY 100 SCHOOL-BASED STAFF FROM ACROSS THE STATE WERE TRAINED TO FACILITATE THESE INTERVENTIONS WITH STUDENTS. O PARTNERED WITH THE SCHOOL SOCIAL WORK ASSOCIATION OF NE (SSWAN) AND THE NEBRASKA SCHOOL COUNSELOR ASSOCIATION TO INCREASE MEMBERSHIP AND SUPPORT SCHOOL MENTAL HEALTH TRAINING AND PROFESSIONAL DEVELOPMENT. PROFESSIONAL MEMBERSHIPS FOR 25 NEW MEMBERS OF EACH ASSOCIATION WERE OFFERED THROUGH THE PARTNERSHIP TO ENCOURAGE COLLABORATION AND NETWORK BUILDING TO STRENGTHEN THE PROFESSIONAL WORKFORCE.- REACHING UNDERSERVED STUDENTS: O PARTNERED WITH THE NORTHEAST NEBRASKA PUBLIC HEALTH DEPARTMENT AND NEBRASKA DEPARTMENT OF EDUCATION TO SPONSOR THE NEBRASKA NATIVE YOUTH GATHERING (NNYG) WHICH IS DESIGNED TO ENGAGE 8TH-12TH GRADE NEBRASKA AMERICAN INDIAN STUDENTS. THIS ANNUAL GATHERING AIMS TO ENHANCE THE INDIVIDUAL AND COLLECTIVE UNDERSTANDING OF SPIRITUAL, EMOTIONAL, MENTAL AND PHYSICAL WELLBEING. CHILDREN'S HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 13B: CHILDREN'S RECOGNIZES THAT SOME PATIENTS WILL BE UNRESPONSIVE TO THE FINANCIAL ASSISTANCE APPLICATION PROCESS DUE TO A VARIETY OF REASONS INCLUDING BUT NOT LIMITED TO:1. LACK OF DOCUMENTATION REQUIRED TO COMPLY WITH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION REQUIREMENTS.2. LACK OF THE EDUCATIONAL LEVEL TO UNDERSTAND AND COMPLETE THE FINANCIAL ASSISTANCE APPLICATION.3. FEAR THAT INFORMATION GATHERED DURING THE APPLICATION PROCESS WILL BE USED IN THE COLLECTION PROCESS IN THE EVENT THAT THE APPLICATION IS DENIED.4. OUT OF STATE PATIENTS THAT DO NOT RESPOND TO COMPLETION OF A MEDICAIDAPPLICATION OR FINANCIAL ASSISTANCE APPLICATION.IN THE ABSENCE OF INFORMATION PROVIDED BY THE PATIENT OR IN CASES WHERE THE INFORMATION PROVIDED BY THE PATIENT IS INCOMPLETE, AN ASSESSMENT PROCESS UTILIZING A PREDICTIVE MODEL WILL BE DEPLOYED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. THE PREDICTIVE MODEL INCORPORATES INCOME AND HOUSEHOLD SIZE ESTIMATES, A SOCIO-ECONOMIC NEED FACTOR (WIC, SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM, HUD PROGRAMS), CENSUS BLOCK DATA, AS WELL AS INFORMATION ON HOME OWNERSHIP.THE APPLICATION OF THE PREDICTIVE SCORING PROCESS AND PRESUMPTIVE FINANCIAL ASSISTANCE WILL BE DEPLOYED PRIOR TO BAD DEBT ASSIGNMENT FOR ALL PATIENTS THAT HAVE NOT APPLIED FOR CHARITY CARE. CHILDREN'S IS NOT OBLIGATED TO NOTIFY THE PATIENT THAT THEY HAVE RECEIVED PRESUMPTIVE FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 16J: THE POLICY IS PROVIDED TO THE PUBLIC IN SUMMARY AND THEY ARE DIRECTED TO VISIT THE HOSPITAL'S WEBSITE FOR THE FULL POLICY. CHILDREN'S HOSPITAL & MEDICAL CENTER PART V, SECTION B, LINE 24: AT CHILDREN'S, COMMERCIAL INSURERS, GOVERNMENT PAYORS AND SELF-PAY BILLING PARTIES ARE ALL BILLED THE SAME GROSS CHARGE RATE FOR EACH SPECIFIC PROCEDURE PERFORMED. GROSS CHARGES ON AN FAP-PATIENT BILL ARE THEN DISCOUNTED ACCORDING TO THEIR FPG ELIGIBILITY WHICH REDUCES OR ELIMINATES THE AMOUNT THE PATIENT IS REQUIRED TO PAY. PART V, SECTION B, LINE 11 (CONTINUED) OTHER SIGNIFICANT HEALTH ISSUES NOT ADDRESSEDTHE FOUR IMPACT AREAS FOR THE 2022-2024 ISP WERE SELECTED BASED UPON THE SCOPE AND SEVERITY OF THE PROBLEM, OUR INSTITUTION'S DESIRE TO ADVANCE CHILD HEALTH OUTCOMES FOR ALL CHILDREN AND THE COMMUNITY'S READINESS AND ABILITY TO IMPACT CHANGE. KEY INFORMANTS FROM CHILDREN'S NEBRASKA AND COMMUNITY PARTNERS WORKED TOGETHER TO EVALUATE AND IDENTIFY CHILD HEALTH PRIORITIES. THEY DETERMINED THAT TAKING A MORE TARGETED APPROACH TO FOSTER A COLLABORATIVE INVESTMENT OF TIME AND RESOURCES WILL MAXIMIZE IMPACT AND OUTCOMES FOR CHILDREN. THE 2024 PEDIATRIC COMMUNITY HEALTH NEEDS ASSESSMENT, CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS (PRC), IDENTIFIED 11 KEY AREAS OF OPPORTUNITY RELATED TO SIGNIFICANT CHILD HEALTH ISSUES. CHILDREN'S PLAYS AN ACTIVE ROLE IN ADDRESSING MANY OF THESE ISSUES BY PROVIDING DIRECT SERVICES AND COMMUNITY OUTREACH PROGRAMMING. WHILE CHILDREN'S IS ACTIVE IN ADDRESSING MANY COMMUNITY-WIDE INITIATIVES AND CHILD HEALTH PRIORITIES, IT DOES NOT HAVE THE SCOPE, CAPACITY OR RESOURCES TO ADDRESS ALL OF THEM. PART V, SECTION B, LINE 7A HTTPS://WWW.CHILDRENSNEBRASKA.ORG/COMMUNITY-HEALTH-AND-ADVOCACY/CHILD-AND-COMMUNITY-HEALTH-PRIORITIES PART V, SECTION B, LINE 10A HTTPS://WWW.CHILDRENSNEBRASKA.ORG/COMMUNITY-HEALTH-AND-ADVOCACY/CHILD-AND-COMMUNITY-HEALTH-PRIORITIES PART V, SECTION B, LINE 16A HTTPS://WWW.CHILDRENSNEBRASKA.ORG/BILLING/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16B HTTPS://WWW.CHILDRENSNEBRASKA.ORG/BILLING/FINANCIAL-ASSISTANCE PART V, SECTION B, LINE 16C HTTPS://WWW.CHILDRENSNEBRASKA.ORG/BILLING/FINANCIAL-ASSISTANCE 7 1 - CHILDREN'S NE - WEST OMAHA 20502 ROOSEVELT ST ELKHORN NE 68022 SPECIALTY CLINICS 2 - CHILDREN'S NE REHAB SVCS - LINCOLN 5930 VANDERVOORT DR STE A LINCOLN NE 68516 SPECIALTY CLINICS 3 - CHILDREN'S NE SPECIALTY PEDIATRIC CTR 111 N 84TH ST OMAHA NE 68114 SPECIALTY CLINICS 4 - CNSPC - CASS WEST 8552 CASS ST OMAHA NE 68114 SPECIALTY CLINICS 5 - CNSPC - CASS EAST 8534 CASS ST OMAHA NE 68114 SPECIALTY CLINICS 6 - CNSPC - SIOUX CITY 5500 SERGEANT ROAD STE 100 SIOUX CITY IA 51106 SPECIALTY CLINICS 7 - CNSPC - LINCOLN 2121 S 56TH ST LINCOLN NE 68506 SPECIALTY CLINICS PART I, LINE 3C: FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. FINANCIAL ASSISTANCE IS AVAILABLE FOR MEDICALLY NECESSARY PROCEDURES AND SERVICES. SERVICES NOT ELIGIBLE FOR FINANCIAL ASSISTANCE INCLUDE COSMETIC AND OTHER ELECTIVE SERVICES. CERTIFICATION OR PROOF OF MEDICAID DENIAL IS A REQUIREMENT FOR FINANCIAL ASSISTANCE CONSIDERATION. FINANCIALLY RESPONSIBLE PARTIES WHO SUBMIT A COMPLETE AND VERIFIABLE APPLICATION FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR FREE OR REDUCED ASSISTANCE BASED ON FEDERAL POVERTY GUIDELINES (400% FPL LIMIT). FAMILIES THAT DO NOT QUALIFY FOR INCOME-BASED FINANCIAL ASSISTANCE THAT HAVE VERIFIABLE OUT OF POCKET MEDICAL DEBT GREATER THAN 20% OF GROSS INCOME MAY QUALIFY FOR CATASTROPHIC ASSISTANCE. PRESUMPTIVE ELIGIBILITY IS AVAILABLE IN A VARIETY OF CIRCUMSTANCES INCLUDING THE ABSENCE OF DOCUMENTATION REQUIRED TO COMPLY WITH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION REQUIREMENTS. THE PREDICTIVE MODEL INCORPORATES INCOME AND HOUSEHOLD SIZE ESTIMATES, A SOCIO-ECONOMIC NEED FACTOR, CENSUS BLOCK DATA, AS WELL AS INFORMATION ON HOME OWNERSHIP. PART I, LINE 6A: THE COMMUNITY BENEFIT REPORT IS PREPARED BY THE ORGANIZATION. THE VALUES REPORTED IN THE 2024 COMMUNITY BENEFIT REPORT INCLUDE $7.2 MILLION IN FINANCIAL ASSISTANCE. PART I, LINE 7: EXPLANATION OF THE COSTING METHODOLOGY USED TO CALCULATE SUBSIDIZED HEALTH SERVICES: SUBSIDIZED HEALTH SERVICES WERE CALCULATED USING A COMBINATION OF THE HOSPITAL'S COST ACCOUNTING SYSTEM AND A COST TO CHARGE RATIO CALCULATION SIMILAR TO WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE REPORTED SUBSIDIZED LOSS REPRESENTS THE DIFFERENCE IN NET REVENUE RECEIVED FROM ALL PAYORS LESS TOTAL OPERATING EXPENSES INCLUDING INDIRECT COSTS APPLICABLE TO EACH DEPARTMENT. UNREIMBURSED MEDICAID COSTS REPORTED ON LINE 7B AND OTHER OPERATING EXPENSE APPLICABLE TO THE DEPARTMENT REPORTED ELSEWHERE ON SCHEDULE H AS A COMMUNITY BENEFIT IS EXCLUDED FROM THE OPERATING EXPENSE TOTAL AS ARE BAD DEBT AND NON-PATIENT CARE EXPENSE ASSOCIATED WITH EACH DEPARTMENT. INDIRECT COSTS FOR EACH DEPARTMENT WERE CALCULATED BY APPLYING THE MEDICARE COST REPORT OVERHEAD RATE APPLICABLE TO THAT DEPARTMENT TO THE DEPARTMENT'S TOTAL OPERATING EXPENSES EXCLUDING UNREIMBURSED MEDICAID EXPENSES AND/OR ANY OTHER EXPENSE ALREADY REPORTED ELSEWHERE ON SCHEDULE H AS A COMMUNITY BENEFIT.PART I, LINE 7I:THE ORGANIZATION DID NOT INCLUDE COSTS ATTRIBUTABLE TO PRIMARY CARE PHYSICIAN CLINICS AS CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT.PART II, LINE 2:THE HOSPITAL SUPPORTED ECONOMIC DEVELOPMENT IN ITS SPONSORSHIP DONATIONS TO ORGANIZATIONS SUCH AS THE GREATER OMAHA CHAMBER OF COMMERCE. PART III, LINE 2: DESCRIBE THE METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON LINES 2& 3:BAD DEBT EXPENSE AT 100% CHARGE VALUE WAS MULTIPLIED BY THE 2024 MEDICARECOST TO CHARGE RATIO TO ARRIVE AT AN APPROXIMATE COST VALUE.BAD DEBT EXPENSE AT 100% CHARGE VALUE $10,009,217MEDICARE COST TO CHARGE RATIO X .4261BAD DEBT EXPENSE AT COST $4,264,672 PART III, LINE 3: ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY: THIS PROCESS INCLUDES IDENTIFYING FINANCIAL ASSISTANCE CODES CONGRUENT WITH THE FINANCIAL ASSISTANCE POLICY THAT WERE CHARGED TO BAD DEBT EXPENSE AT 100% CHARGE VALUE. THIS AMOUNT IS $0 FOR 2024 AND REFLECTS THE EFFORTS OF THE HOSPITAL TO ENSURE THAT NO CHILD WITH A MEDICAL NEED IS TURNED AWAY DUE TO INABILITY TO PAY FOR HEALTH CARE.DESCRIBE HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS OR PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE: BAD DEBT EXPENSE IS CREDITED FOR ANY PAYMENT RECEIVED ON ACCOUNTS PREVIOUSLY WRITTEN OFF. PART III, LINE 4: FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE COMPANY DETERMINES THE TRANSACTION PRICE ASSOCIATED WITH SERVICES ON THE BASIS OF CHARGES REDUCED BY IMPLICIT PRICE CONCESSIONS. IMPLICIT PRICE CONCESSIONS INCLUDED IN THE ESTIMATE OF THE TRANSACTION PRICE ARE BASED ON HISTORICAL COLLECTION EXPERIENCE FOR APPLICABLE PATIENT PORTFOLIOS. PATIENTS WHO MEET THE COMPANY'S CRITERIA FOR FREE "CHARITY" CARE ARE PROVIDED WITHOUT CHARGE; SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS DUE TO AUDITS, REVIEWS, OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENTS WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR, AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS NEW INFORMATION BECOMES AVAILABLE OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PART III, LINE 8: MEDICARE2024 MEDICARE CHARGES REPORTED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) IN THE PROVIDER STATISTICAL AND REIMBURSEMENT SYSTEM FOR PROVIDER FYE 12/31 WERE MULTIPLIED BY THE 2024 COST TO CHARGE RATIO TO ARRIVE AT AN APPROXIMATE COST OF CARE RELATED TO THE REIMBURSEMENTPAYMENTS REPORTED ON SCHEDULE H, PART III, LINE 5. PART III, LINE 9B: COLLECTION PRACTICESSELF-PAY ACCOUNTS WITH NO VERIFIABLE INSURANCE AND BALANCE AFTER INSURANCE ACCOUNTS ARE CONSIDERED FOR FINANCIAL ASSISTANCE THROUGHOUT THE COLLECTION PROCESS FOR THOSE GUARANTORS WHO ARE FINANCIALLY UNABLE TO PAY, EITHER THROUGH A GOVERNMENT PROGRAM OR THROUGH THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ALL CORRESPONDENCE, INCLUDING STATEMENTS AND COLLECTION LETTERS STATE THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE. PART VI, LINE 2: CHILDREN'S USES NUMEROUS RESOURCES TO BENCHMARK, ALIGN AND CONDUCT ASSESSMENTS OF THE HEALTH CARE NEEDS OF CHILDREN IN THE COMMUNITIES WE SERVE. THESE RESOURCES INCLUDE FOCUSED STAKEHOLDER INPUT AND PRIORITIZATION, NATIONAL PUBLIC HEALTH (HEALTHY PEOPLE 2030) AND PEDIATRIC CARE STANDARDS. WE ALSO REVIEW DATA FROM THE AMERICAN ACADEMY OF PEDIATRICS, OUR 2024 PEDIATRIC COMMUNITY HEALTH NEEDS ASSESSMENT (PCHNA) REPORT, AND TRENDS AS IDENTIFIED BY CHILDREN'S HOSPITAL ASSOCIATION (CHA).TO SUPPORT THE ORGANIZATION'S HEALTH EXCELLENCE EFFORTS, CHILDREN'S DEVELOPED A SOCIAL DRIVERS OF HEALTH (SDOH) AND DISPARITIES DASHBOARD. THE DASHBOARD ALLOWS OVERSIGHT OF REAL-TIME PATIENT DATA REGARDING KEY PEDIATRIC HEALTH INDICATORS AND MONITORING FOR DISPARITIES ACROSS MULTIPLE FACTORS. THE DASHBOARD DEPLOYED MID-2024 AND REPORTING BEGAN EARLY 2025. CHILDREN'S CONTINUED ITS HEALTH EXCELLENCE & OPPORTUNITY STEERING COMMITTEE, A MULTIDISCIPLINARY TEAM OF APPROXIMATELY 20 LEADERS COMMITTED TO ADDRESSING HEALTH ISSUES IMPACTING OUR WORKFORCE, PATIENTS AND THEIR FAMILIES AND OUR COMMUNITY. PART VI, LINE 3: 3-PATIENT EDUCATION OF ELIGIBILITYFINANCIALLY RESPONSIBLE PARTIES WHO EXPERIENCE DIFFICULTY IN MEETING THEIR FINANCIAL OBLIGATIONS WILL BE ENCOURAGED TO AND ASSISTED IN APPLYING FOR FINANCIAL HELP THROUGH GOVERNMENT PROGRAMS AND OTHER POTENTIAL FUNDING SOURCES OR ALTERNATIVELY QUALIFIED FOR CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS IDEALLY DETERMINED EITHER PRIOR TO SERVICES BEING PROVIDED OR AT THE TIME SERVICES ARE RENDERED AND IS BASED UPON FAMILY/GUARANTOR INCOME, FAMILY SIZE AND OTHER SPECIAL CONSIDERATIONS. THE PRIMARY RESPONSIBILITY TO IDENTIFY FINANCIAL NEED IS WITH THE ACCESS CENTER PATIENT ADVOCATES, CENTRAL BILLING OFFICE AND SOCIAL WORK STAFF. THESE STAFF MEMBERS ARE TRAINED TO IDENTIFY PATIENT NEEDS AND ANSWER FINANCIAL ASSISTANCE QUESTIONS. THERE ARE SEVERAL POINTS IN THE PATIENT EXPERIENCE WHERE FINANCIAL ASSISTANCE RESOURCES ARE OFFERED. THE FIRST OCCURS AT THE PRE-REGISTRATION OF INPATIENT ADMITS ANDOUTPATIENTS PRESENTING THROUGH CARES AND FOR THOSE PATIENTS SCHEDULED INTHE SPECIALTY PEDIATRIC CENTER CLINICS.ELIGIBILITY OF THE INSURED IS VALIDATED ELECTRONICALLY. THE BENEFIT DETAIL INCLUDING DEDUCTIBLE, COPAYMENT AND COINSURANCE AMOUNTS ARE DISCUSSED WITH THE FAMILY. ALL INDIVIDUALS WHO ARE FINANCIALLY UNABLE TO PAY ARE ENCOURAGED TO AND ASSISTED IN APPLYING FOR FINANCIAL HELP THROUGHGOVERNMENT PROGRAMS AND OTHER POTENTIAL FUNDING SOURCES OR ALTERNATIVELY QUALIFIED FOR CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. AT THE TIME OF REGISTRATION, INSURANCE IS DISCUSSED, AND FAMILIES AGAIN ARE OFFERED THE ASSISTANCE OF ACCESS CENTER PATIENT ADVOCATES WHO ARE AVAILABLE MONDAY THROUGH FRIDAY. ALL SELF-PAY FAMILIES ARE ENCOURAGED TO SPEAK TO AN ACCESS CENTER PATIENT ADVOCATE. CARE ESTIMATES OR QUESTIONS REGARDING ESTIMATE OF COST FOR UPCOMING TESTING ARE DIRECTED TO THE PATIENT ADVOCATES AND THESE SERVICES ARE AGAIN OFFERED PRIOR TO ENDING THE CONVERSATION. FINANCIAL ASSISTANCE INFORMATION IS ALSO LOCATED IN THE PATIENT HANDBOOKS. PATIENTSTATEMENTS AND ALL CORRESPONDENCE INCLUDING BILLS, STATEMENTS, AND COLLECTION LETTERS STATE THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE. CHILDREN'S HOSPITAL & MEDICAL CENTER'S INTERNET WEBSITE ALSO OFFERS A FINANCIAL ASSISTANCE LINK THAT INFORMS READERS IF THEY ARE UNINSURED OR HAVE LIMITED INCOME, THEY MAY QUALIFY FOR FINANCIAL ASSISTANCE THROUGH GOVERNMENT PROGRAMS OR CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. THE WEBSITE EXPLAINS THAT DEPENDING ON INCOME LEVEL, ALL OR PART OF THE MEDICAL COSTS MAY BE FUNDED BY MEDICAID, AND, ALTERNATIVELY, IF THEY ARE DETERMINED NOT ELIGIBLE FOR MEDICAID AFTER PROVIDING ALL OF THE REQUIRED DOCUMENTATION, THEY MAY THEN APPLY FOR THE CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. CONTACT NUMBERS FOR THE PATIENT ADVOCATES AND HOURS OF SERVICE ARE PROVIDED. THE WEBSITE INCLUDES COPIES OF CHILDREN'S FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION FORM AND THE PLAIN LANGUAGE SUMMARY IN ENGLISH, ARABIC, FRENCH, KAREN, NEPALI, PASHTO, SOMALI AND SPANISH. THE WEBSITE ALSO INCLUDES AMOUNTS GENERALLY BILLED IN ENGLISH. ALL OTHER BILLING, PAYMENT, AND FINANCIAL RESPONSIBILITY RELATED LINKS ON CHILDREN'S WEBSITE STATE THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE.THE FINANCIAL ASSISTANCE POLICY IS CURRENTLY AVAILABLE ON THE HOSPITAL'S WEBSITE AND IS ALSO AVAILABLE UPON REQUEST. HTTPS://WWW.CHILDRENSNEBRASKA.ORG/BILLING/FINANCIAL-ASSISTANCE PART VI, LINE 4: 4-COMMUNITY INFORMATIONTHE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF DOUGLAS AND SARPY COUNTIES IN NEBRASKA AND POTTAWATTAMIE COUNTY IN IOWA. THE PRIMARY SERVICE AREA HAS A CURRENT AGGREGATE POPULATION OF 897,618. THE HOSPITAL'S SECONDARY SERVICE AREA CONSISTS OF EIGHT SURROUNDING COUNTIES IN NEBRASKA AND NINE SURROUNDING COUNTIES IN IOWA.FOR THE YEAR ENDED DECEMBER 31, 2024, 46.9% OF THE HOSPITAL'S INPATIENTDISCHARGES WERE FROM PATIENTS RESIDING IN THE THREE-COUNTY PRIMARY SERVICE AREA. PATIENTS RESIDING IN THE SEVENTEEN-COUNTY SECONDARY SERVICE AREA ACCOUNTED FOR 19.4% OF TOTAL HOSPITAL INPATIENT DISCHARGES DURING THIS SAME TIME PERIOD. THE REMAINING 33.7% OF TOTAL DISCHARGES WERE FROM PATIENTS RESIDING OUTSIDE THE PRIMARY AND SECONDARY SERVICE AREAS.2024 DEMOGRAPHIC SUMMARYOMAHA METRO MARKET AREA: DOUGLAS, SARPY AND POTTAWATTAMIE COUNTIES SOURCES: ESRI (BASED ON US CENSUS BUREAU), UNITED STATES CENSUS BUREAU AND CHILDREN'S HOSPITAL AND MEDICAL CENTER PATIENT ENCOUNTER DATABASE.COMMUNITIES SERVED - URBAN, SUBURBAN AND RURAL # OF HOSPITALS SERVING COMMUNITY - 12TOTAL POPULATION 897,618PEDIATRIC POPULATION 221,444AVERAGE HOUSEHOLD INCOME $114,047PERCENT OF RESIDENTS BELOW FEDERAL POVERTY LEVELTOTAL POPULATION 10.0%UNDER AGE 18 11.0%PERCENT OF RESIDENTS ON MEDICAID 12.3%AGE POPULATION %OF TOTAL LESS THAN 18 221,444 24.7%18 TO 24 86,207 9.6%25 TO 44 255,766 28.4%45 TO 64 199,838 22.3%65+ 134,363 15.0%TOTAL 897,618 100.0%RACE POPULATION %OF TOTALWHITE 583,452 65.0%HISPANIC 143,619 16.0%BLACK 107,714 12.0%ASIAN/PACIFIC ISLANDER 35,905 4.0%OTHER/2+ RACES 17,952 2.0%AM. IND/ALASKA NAT 8,976 1.0%TOTAL 897,618 100.0%FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREASAPPROXIMATE % OF PATIENTS FROM MEDICALLY UNDERSERVED AREAS: 13.6%COUNTY # OF CENSUS TRACTS* TOTAL CENSUS TRACTS % OF TOTALDOUGLAS 36 156 23.1%SARPY 12 43 27.9%POTTAWATTAMIE 3 30 10.0%TOTAL 51 229 22.2%*CENSUS TRACT IS A GEOGRAPHICAL DIVISION OF 500 TO 3,000 HOUSEHOLDS PART VI, LINE 5: PROUDLY SERVING CHILDREN SINCE 1948, CHILDREN'S MISSION IS TO IMPROVE THE LIFE OF EVERY CHILD THROUGH DEDICATION TO EXCEPTIONAL CLINICAL CARE, RESEARCH, EDUCATION AND ADVOCACY.CHILDREN'S CENTER FOR COMMUNITY HEALTH & ADVOCACY IS A STATEWIDE COMMUNITY OUTREACH HUB OF CHILDREN'S. THE CHILDREN'S CENTER FOR THE CHILD & COMMUNITY WAS LAUNCHED IN 2016 TO SERVE AS THE INFRASTRUCTURE FOR COMMUNITY HEALTH IMPROVEMENT, LEADING BOTH INTERNAL AND EXTERNAL PARTNERSHIPS AROUND PEDIATRICS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PLANNING AND IMPLEMENTATION. A LEADER IN PEDIATRIC HEALTH CARE, CHILDREN'S CONDUCTED MORE THAN 500,000 VISITS IN 2024. CHILDREN'S OFFERS UNIQUE RESOURCES TO CHILDREN ACROSS A THREE-STATE REGION AND BEYOND, AND IS THE ONLY FULL-SERVICE, PEDIATRIC HEALTH CARE CENTER IN NEBRASKA. IN ADDITION TO TRADITIONAL HOSPITAL-BASED SERVICES, SOME OF THE OTHER PROGRAMS AND SERVICES CHILDREN'S OFFERS TO PATIENTS ARE BEHAVIORAL HEALTH, REHAB SERVICES, HOME HEALTH, URGENT CARE, WEIGHT & WELLNESS, AND SPECIALTY CARE CLINICS. IN ADDITION, CHILDREN'S OFFERS PALLIATIVE CARE, FAMILY RESOURCES, CHILD LIFE SPECIALISTS, PASTORAL CARE, SOCIAL WORKERS, NURSE CASE MANAGERS, INTERPRETERS, FINANCIAL COUNSELORS, PATIENT ADVOCATES, AND OTHER PROGRAMS TO ENHANCE THE PATIENT EXPERIENCE.CHILDREN'S HAS ACHIEVED THE MAGNET DESIGNATION FOR NURSING EXCELLENCE, AND ITS PEDIATRIC AND NEONATAL INTENSIVE CARE UNITS HAVE EARNED A BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES, WHICH RECOGNIZES CRITICAL CARE UNITS WITH EXCELLENT PATIENT OUTCOMES THAT EXCEED NATIONAL BENCHMARKS. CHILDREN'S HAS BEEN NAMED BY U.S. NEWS & WORLD REPORT AS ONE OF THE NATION'S BEST CHILDREN'S HOSPITALS, NATIONALLY RANKED IN NEPHROLOGY AND PULMONOLOGY & LUNG SURGERY. U.S. NEWS RECOGNIZES HOSPITALS WITH EXCELLENT SURVIVAL RATES, PATIENT SAFETY, SPECIALIZED STAFF, AND HOSPITAL REPUTATION. ALL OF THE CHILDREN'S PHYSICIANS PRIMARY CARE OFFICES HAVE ACHIEVED THE HIGHEST NCQA PATIENT CENTERED MEDICAL HOME (PCMH) CERTIFICATION. A PEDIATRIC AFFILIATION ESTABLISHED BETWEEN CHILDREN'S AND THE UNIVERSITY OF NEBRASKA MEDICAL CENTER COLLEGE OF MEDICINE (UNMC) SUPPORTS ENHANCEMENTS IN PEDIATRIC EDUCATION, RESEARCH, AND CLINICAL CARE. CHILDREN'S SERVES AS THE PRIMARY ACADEMIC MEDICAL TRAINING LOCATION FOR THE UNMC DEPARTMENT OF PEDIATRICS.IN 2024, CHILDREN'S PROVIDED MORE THAN $232 MILLION IN COMMUNITY BENEFITS, REPRESENTING 34% OF THE HOSPITAL'S OPERATING EXPENSES. TOTAL COMMUNITY BENEFITS PROVIDED IN 2024 INCLUDED THE FOLLOWING:- PROVIDED $7.2 MILLION IN FINANCIAL ASSISTANCE TO FAMILIES UNABLE TO PAY. WITH 47% OF PATIENT CARE REVENUES DEVOTED TO THE CARE OF LOW-INCOME CHILDREN ASSISTED BY MEDICAID, THE FY 2024 SHORTFALL BETWEEN MEDICAID REIMBURSEMENT AND THE COST OF PROVIDING CARE WAS $86.3 MILLION.- CONTRIBUTED $7.1 MILLION TOWARDS COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT OPERATIONS AIMED AT PROMOTING HEALTH AND PREVENTING ILLNESS AND INJURY MADE AVAILABLE THROUGH INJURY PREVENTION, OBESITY PREVENTION, OUTREACH EDUCATIONAL CLASSES, HEALTH FAIRS, AND THE CONSUMER WEBSITE. CHILDREN'S GIVES BACK TO THE COMMUNITY THROUGH ADVOCACY SERVICES WHICH ARE AVAILABLE TO ANYONE SUSPECTING CHILD ABUSE OR NEGLECT, AND LODGING FOR FAMILIES OF OUT-OF-TOWN PATIENTS IS OFFERED AT THE CAROLYN SCOTT RAINBOW HOUSE AT NO COST.- CONTRIBUTED $38.3 MILLION IN PEDIATRIC HEALTH CARE EDUCATION COSTS TO EDUCATE TOMORROW'S HEALERS.- PROVIDED $5.2 MILLION IN SUBSIDIZED HEALTH SERVICES PROVIDING BOTH HOME HEALTH AND BEHAVIORAL HEALTH SERVICES.- CONTRIBUTED $12.1 MILLION IN FUNDING FOR RESEARCH.- PROVIDED $76.7 MILLION IN CASH AND IN-KIND DONATIONS/SPONSORSHIPS TO BENEFIT THE BROADER COMMUNITY. PART VI, LINE 6: THE HOSPITAL IS NOT AFFILIATED WITH A GREATER HEALTH CARE SYSTEM, BUT IS ITS OWN HEALTH CARE SYSTEM WHICH THE HOSPITAL OPERATES THE FOLLOWING RELATED ORGANIZATIONS:- CHILDREN'S HOSPITAL & MEDICAL CENTER FOUNDATION- CHILDREN'S PHYSICIANS- CHILDREN'S HEALTH NETWORK- BRIGHT FOUNDRY, LLC PART VI, LINE 7, REPORTS FILED WITH STATES NE PART VI, LINE 7 THE CHILDREN'S HOSPITAL & MEDICAL CENTER COMMUNITY BENEFIT REPORT IS FILED IN THE STATE OF NEBRASKA THROUGH THE NEBRASKA HOSPITAL ASSOCIATION, AND IS AVAILABLE TO THE PUBLIC ON THE WEBSITE AT:HTTPS://WWW.CHILDRENSNEBRASKA.ORG/COMMUNITY-HEALTH-AND-ADVOCACY/COMMUNITY-BENEFIT-AND-ENGAGEMENT 1 UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE 985520 NE MED CTR OMAHA NE 68198 470049123 501(C)(3) 3000000 0 RESEARCH AND SUPPORT FOR MED SCH CEDARS YOUTH SERVICES INC 6601 PIONEERS BLVD LINCOLN NE 68506 470551975 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY NEBRASKA DIAPER BANK 9100 F ST OMAHA NE 68127 474953614 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY COMPLETELY KIDS 2566 ST MARYS AVE OMAHA NE 68105 275111197 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY NELSON MANDELA ELEMENTARY SCHOOL INC 6316 N 30TH ST OMAHA NE 68111 471348136 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY FOUNDATION FOR LINCOLN PUBLIC SCHOOLS 5905 O ST LINCOLN NE 68501 363490560 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY THE VALLEY CHILD DEVELOPMENT CENTER 500 WEST A AVE RED CLOUD NE 68970 811174755 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY LENDING LINK 4706 S 24TH ST OMAHA NE 68107 832198837 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY BIG BROTHERS BIG SISTERS OF MIDLANDS 1209 HARNEY ST OMAHA NE 68102 470466144 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY LEGAL AID OF NEBRASKA 209 S 19TH ST OMAHA NE 68102 470483506 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY RESTORING DIGNITY 3260 DAVENPORT ST OMAHA NE 68131 824375187 501(C)(3) 15000 0 PREVENTION OF CHILDHOOD OBESITY 11 0 FINANCIAL ASSISTANCE TO PATIENTS IN NEED 4852 16983355 BOOK WRITEOFF PATIENT ACCOUNTS PART I, LINE 2: THE HOSPITAL HAS A WRITTEN FINANCIAL ASSISTANCE/CHARITY CARE POLICY. THE AMOUNT OF FINANCIAL ASSISTANCE AN INDIVIDUAL CAN RECEIVE IS BASED ON THE ANNUAL GROSS INCOME THRESHOLDS USING THE CURRENT FEDERAL POVERTY LEVEL GUIDELINES. GRANTS TO ORGANIZATIONS ARE ONLY DISTRIBUTED TO 501(C)(3) OR GOVERNMENT ORGANIZATIONS BASED ON THE HOSPITAL'S EVALUATION CRITERIA. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 CHANDA CHACON PRESIDENT & CEO 1114762 0 434981 0 208030 0 422331 0 15357 0 2195461 0 160000 0 CHRISTOPHER MALONEY MD EVP CHIEF CLINICAL OFFICER 620218 0 214514 0 231900 0 115155 0 432 0 1182219 0 171777 0 AMY HATCHER EVP & CFO 575887 0 185451 0 180219 0 113775 0 8549 0 1063881 0 128507 0 ERIN WILLIS-LOUCKS MD PHYSICIAN 929713 0 26250 0 4093 0 26850 0 25668 0 1012574 0 0 0 KATHY ENGLISH EVP & COO 589834 0 181130 0 129745 0 30150 0 7933 0 938792 0 0 0 JEROLD VUCHAK EVP CHIEF INFO & INNOV OFFICER 449337 0 129537 0 128582 0 91575 0 9459 0 808490 0 76512 0 JANEL ALLEN EVP & CHIEF PEOPLE OFFICER 409957 0 125872 0 75575 0 86220 0 16071 0 713695 0 41059 0 AMY BONES SVP & GENERAL COUNSEL 409179 0 121742 0 93583 0 23550 0 9424 0 657478 0 0 0 PAM JOHNSON-CARLSON SVP PCS & CNO 402863 0 119438 0 69170 0 30150 0 9399 0 631020 0 0 0 PART I, LINE 1A CHANDA CHACON'S SOCIAL CLUB DUES WERE PAID FOR BY THE ORGANIZATION TO BE USED FOR BUSINESS PURPOSES. PART-I LINE-4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN DURING 2024. THE AMOUNTS OF DEFERRED COMPENSATION DISTRIBUTED AND ACCRUED FOR EACH OF THE INDIVIDUALS DURING 2024 ARE AS FOLLOWS: CHANDA CHACON - $229,000 ACCRUAL, $181,290 PLAN DISTRIBUTION CHRISTOPHER MALONEY - $94,905 ACCRUAL, $197,450 PLAN DISTRIBUTION KATHY ENGLISH - $92,265 ACCRUAL, $93,587 PLAN DISTRIBUTION AMY HATCHER - $90,225 ACCRUAL, $148,424 PLAN DISTRIBUTION AMY BONES - $52,116 ACCRUAL, $54,867 PLAN DISTRIBUTION JEROLD VUCHAK - $71,325 ACCRUAL, $88,108 PLAN DISTRIBUTION JANEL ALLEN - $65,970 ACCRUAL, $46,523 PLAN DISTRIBUTION PAM JOHNSON-CARLSON - $48,672 ACCRUAL, $49,453 PLAN DISTRIBUTION A HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE 521440796 259230KT6 2008-08-12 100881609 REFUND BONDS (6/8/2007) 1 0 0 B HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE 521440796 259230NJ5 2017-03-14 101075067 USED TO CONSTRUCT HUBBARD CENTER FOR CHILDREN 0 0 0 C HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE 521440796 259230KT6 2017-11-28 26885000 REFUND BONDS (8/12/2008) 0 0 0 D HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE 521440796 259230PJ3 2020-05-28 109497288 HUBBARD / REFUND BONDS (9/10/2014) 0 0 0 A 74720000 100892290 751783 24826 2755000 97360681 2008 1 0 1 1 B 104280765 1064167 103216598 2021 0 0 1 1 C 16065000 26885000 305601 26579399 2008 1 0 1 1 D 5455000 109498595 10089 1132344 90024355 18331807 2021 1 0 1 1 A 0 1 1 1 1 1 0.00200 0.00200 0 0 1 B 0 0 0 0 0 0 1 C 0 1 1 1 1 1 0.00200 0.00200 0 0 1 D 0 0 0 0 0 0 1 A 0 0 1 1 1 1 MORGAN STANLEY 25.000000000000 0 0 0 0 1 B 0 0 0 1 0 0 0 0 1 C 0 0 1 1 0 0 0 0 1 D 0 0 1 1 0 0 0 0 1 A 1 B 1 C 1 D 1 PART-II LINE-3 THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN E DUE TO INVESTMENT EARNINGS. PART-IV LINE-2C DATE THE REBATE COMPUTATION WAS PERFORMED: 10/02/2017 (2008 BONDS) DATE THE REBATE COMPUTATION WAS PERFORMED: 02/28/2020 (2017 BONDS) DATE THE REBATE COMPUTATION WAS PERFORMED: 05/28/2018 (2017B BONDS) DATE THE REBATE COMPUTATION WAS PERFORMED: 04/30/2021 (2020A&B BONDS) FORM 990, PART VI, SECTION A, LINE 4 SYNOPSIS OF CHANGES TO THE HOSPITAL'S BYLAWS: 1. ARTICLE V, SECTION 1(A) - ELEVATED STRATEGY COMMITTEE DUTIES TO FULL BOARD. 2. ARTICLE V, SECTION 4(D) - ADDED FLEXIBILITY TO NEW BOARD MEMBER TERM COMMENCEMENT DATE. 3. ARTICLE VIII, SECTION 1(A) - REMOVED SEPARATE STRATEGY COMMITTEE. 4. ARTICLE VIII, SECTION 1(H) - CLARIFIED NON-VOTING STATUS OF QPSC PARENT REPRESENTATIVE. 5. ARTICLE VIII, SECTION 8 - REMOVED SEPARATE STRATEGY COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B GOVERNANCE, MANANGEMENT, AND DISCLOSURE A COMPLETE COPY OF THE FORM 990, EXCLUDING PART VII AND SCHEDULE J - COMPENSATION INFORMATION, IS MADE AVAILABLE TO THE HOSPITAL BOARD OF DIRECTORS VIA THE BOARDVANTAGE BOARD PORTAL PRIOR TO FILING WITH THE IRS. A COMPLETE COPY OF THE FORM 990, INCLUDING PART VII AND SCHEDULE J - COMPENSATION INFORMATION, IS REVIEWED WITH THE COMPENSATION & HUMAN RESOURCES COMMITTEE OF THE HOSPITAL'S BOARD OF DIRECTORS AT ITS NOVEMBER MEETING. FORM 990, PART VI, SECTION B, LINE 12C POLICIES THE CONFLICT OF INTEREST POLICY APPLIES TO ANY PERSON IN A POSITION TO EXERCISE INFLUENCE IN CONNECTION WITH ANY CONTRACT, TRANSACTION OR ARRANGEMENT PRESENTED TO THE BOARD OR A BOARD COMMITTEE FOR APPROVAL (COVERED PERSON). COVERED PERSON INCLUDES (BUT IS NOT LIMITED TO) ANY DIRECTOR, OFFICER, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWER, OR KEY EMPLOYEE/STAFF. ALL COVERED PERSONS MUST ANNUALLY SUBMIT A COMPLETED CONFLICT OF INTEREST QUESTIONNAIRE IN THE FORMAT PRESCRIBED BY THE GOVERNANCE COMMITTEE FROM TIME TO TIME. EACH COVERED PERSON SHALL ANNUALLY ACKNOWLEDGE IN WRITING THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) AGREES TO COMPLY WITH THE POLICY; (D) UNDERSTANDS THAT THE POLICY APPLIES TO THE BOARD AND COMMITTEES; (E) UNDERSTANDS THAT CHILDREN'S IS A NOT-FOR-PROFIT ORGANIZATION THAT MUST ENGAGE PRIMARILY IN EXEMPT ACTIVITIES; (F) AGREES TO PROMPTLY REPORT TO THE CHAIR OF THE GOVERNANCE COMMITTEE, AND CHILDREN'S GENERAL COUNSEL ANY CHANGE TO MATTERS PREVIOUSLY DISCLOSED ON THE CONFLICT OF INTEREST QUESTIONNAIRE; AND (G) STATES THAT THE INFORMATION HE OR SHE WILL PROVIDE IN THE CONFLICT OF INTEREST QUESTIONNAIRE IS TRUE AND ACCURATE TO THE BEST OF HIS OR HER KNOWLEDGE AND BELIEF. A COVERED PERSON HAS A CONTINUING OBLIGATION TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST OR ANY SITUATIONS THAT COULD CREATE AN APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES OR WHENEVER IT INVOLVES A MATTER OF BOARD/COMMITTEE ACTION. DISCLOSURE MEANS PROMPTLY PROVIDING THE MATERIAL FACTS OF AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO THE CHAIR OF THE GOVERNANCE COMMITTEE AND CHILDREN'S GENERAL COUNSEL (IN WRITING IF TIME ALLOWS) OR TO THE BOARD OR BOARD COMMITTEE REVIEWING THE CONTRACT, TRANSACTION OR ARRANGEMENT. THE GOVERNANCE COMMITTEE WILL BE CONVENED TO CONSIDER THE DISCLOSURE. CERTAIN CIRCUMSTANCES, IN ADDITION TO FINANCIAL INTERESTS, COULD GIVE RISE TO A POTENTIAL CONFLICT OF INTEREST, INCLUDING INSTANCES WHERE THE ACTIONS OR ACTIVITIES OF AN INDIVIDUAL ON BEHALF OF CHILDREN'S ALSO INVOLVE OBTAINING A PERSONAL GAIN OR ADVANTAGE, OR COULD HAVE AN ADVERSE EFFECT ON CHILDREN'S INTERESTS. A COVERED PERSON MUST ALSO MAKE A DISCLOSURE WHENEVER HE OR SHE HAS A PERSONAL, NON-FAMILIAL RELATIONSHIP THAT COULD IMPACT, OR APPEAR TO IMPACT, THE BOARD MEMBER'S ABILITY TO EXERCISE THEIR INDEPENDENT JUDGMENT IN CARRYING OUT THE DIRECTOR'S FIDUCIARY RESPONSIBILITIES. ALSO, DISCLOSING OR USING INFORMATION RELATING TO CHILDREN'S BUSINESS FOR THE PERSONAL PROFIT OR ADVANTAGE OF AN INDIVIDUAL OR HIS OR HER FAMILY, OR OTHER COLLEAGUES OF THE DIRECTOR, OR DISCLOSING MATTERS DISCUSSED DURING BOARD OR COMMITTEE MEETINGS, COULD GIVE RISE TO A CLAIM OF CONFLICT AND MUST NOT OCCUR. A POTENTIAL CONFLICT OF INTEREST, OR THE APPEARANCE OF A CONFLICT OF INTEREST, DOES NOT NECESSARILY RISE TO THE LEVEL OF AN ACTUAL CONFLICT OF INTEREST, BUT ONCE RECOGNIZED, IT MUST IN EVERY CASE BE DISCLOSED AND EVALUATED. THE GOVERNANCE COMMITTEE WILL CONSIDER THE FOLLOWING FACTORS, AMONG OTHER RELEVANT FACTS, WHEN DETERMINING WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS: (I) THE PROXIMITY OF THE COVERED PERSON TO THE DECISION-MAKING AUTHORITY OF THE OTHER ENTITY INVOLVED IN THE TRANSACTION OR BUSINESS ARRANGEMENT; (II) THE MAGNITUDE OF THE FINANCIAL INTEREST OR PERSONAL INTEREST; (III) THE DEGREE TO WHICH THE COVERED PERSON MIGHT BENEFIT PERSONALLY IF A PARTICULAR TRANSACTION OR BUSINESS ARRANGEMENT WERE APPROVED; (IV) THE ABILITY OF THE COVERED PERSON TO MAKE AN INDEPENDENT DECISION BASED ONLY ON THE BEST INTEREST OF CHILDREN'S; AND (V) SUCH OTHER FACTORS THAT MAY BE RELEVANT TO THE PARTICULAR MATTER. THE GOVERNANCE COMMITTEE SHALL REVIEW EACH COMPLETED CONFLICT OF INTEREST QUESTIONNAIRE, AND MAY MAKE SUCH FURTHER INVESTIGATION OF POTENTIAL CONFLICTS AS IT MAY DETERMINE APPROPRIATE. THE GOVERNANCE COMMITTEE SHALL MAKE APPROPRIATE REPORTS TO THE BOARD CONCERNING ITS REVIEW, ANY FURTHER INVESTIGATION, AND ITS RECOMMENDATIONS TO THE BOARD REGARDING ANY POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR ANY APPEARANCE OF A CONFLICT OF INTEREST. WHENEVER A COVERED PERSON (OR A PERSON OTHER THAN THE COVERED PERSON) VOLUNTARILY IDENTIFIES OR DISCLOSES A POTENTIAL CONFLICT OF INTEREST, THE GOVERNANCE COMMITTEE SHALL FOLLOW THE SAME PROCEDURE OUTLINED ABOVE. TRANSACTIONS OR BUSINESS ARRANGEMENTS WITH COVERED PERSONS WITH CONFLICTS OF INTEREST MUST BE APPROVED IN ADVANCE BY A MAJORITY OF INDEPENDENT DIRECTORS, AT A MEETING AT WHICH A QUORUM IS PRESENT, THAT THE ARRANGEMENT OR TRANSACTION IS IN CHILDREN'S BEST INTEREST, IS FAIR AND REASONABLE TO CHILDREN'S AND THAT, AFTER REASONABLE INVESTIGATION, THE INDEPENDENT DIRECTORS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. THE CONFLICTED DIRECTOR WILL RECUSE HIMSELF/HERSELF. IN CASES IN WHICH A COVERED PERSON HAS AN INTEREST OR A RELATIONSHIP THAT CALLS INTO QUESTION THE ABILITY OF THE COVERED PERSON TO ACT SOLELY IN CHILDREN'S BEST INTERESTS, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN, AT THE DISCRETION OF THE BOARD OR THE GOVERNANCE COMMITTEE: (A) THE COVERED PERSON WILL BE REQUIRED TO LEAVE THE MEETING FOR THE GENERAL DISCUSSION OF THE MATTER AND THE BOARD VOTE; (B) THE GOVERNANCE COMMITTEE CAN RECOMMEND TO THE BOARD THAT A DIRECTOR OR A MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS BE ASKED TO RESIGN IN THE EVENT A CONFLICT OF INTEREST IS SO SUBSTANTIAL THAT IT WOULD BE INCOMPATIBLE WITH CHILDREN'S BEST INTERESTS TO HAVE SUCH AN INDIVIDUAL ON ITS BOARD/COMMITTEE. IF THE BOARD/COMMITTE BELIEVES A COVERED PERSON HAS FAILED TO COMPLY WITH THIS POLICY, THE BOARD SHALL INFORM THAT PERSON OF THE BASIS FOR ITS BELIEF AND GIVE THAT PERSON AN OPPORTUNITY TO ADDRESS THE ALLEGED FAILURE. AFTER HEARING THE RESPONSE AND CONDUCTING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD/COMMITTEE SHALL DETERMINE WHETHER SUCH PERSON HAS, IN FACT, VIOLATED THE DISCLOUSRE REQUIREMENTS OF THE POLICY. IF THE BOARD DETERMINES THAT THERE HAS BEEN A VIOLATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION WHICH MAY INCLUDE REMOVAL FROM THE BOARD. AT ANY BOARD/COMMITTEE MEETING AT WHICH A CONFLICT OF INTEREST ISSUE IS ADDRESSED, THE MINUTES OF THE BOARD/COMMITEE MEETING SHALL REFLECT THE PROCESS THAT WAS FOLLOWED AND THE ACTIONS TAKEN BY THE BOARD/COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 LINE 15A AND 15B POLICIES EACH YEAR AN INDEPENDENT COMPANY CONDUCTS A MARKET ANALYSIS OF EXECUTIVE COMPENSATION. THIS INFORMATION IS PRESENTED TO THE COMPENSATION COMMITTEE. AN INDEPENDENT COMPANY ISSUES AN ANNUAL REASONABLENESS OPINION LETTER REGARDING THE APPROPRIATENESS OF THE EXECTUTIVE PAY LEVELS. THE COMPENSATION COMMITTEE IS A SUB-COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE REVIEWS BASE PAY RANGES FOR ALL EXECUTIVES, INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, AND VICE PRESIDENTS. THE BOARD OF DIRECTORS RECEIVES A REPORT FROM THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNANCE, MANAGEMENT, AND DISCLOSURE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. THE CHILDREN'S HOSPITAL & MEDICAL CENTER AND AFFILIATES AUDITED FINANCIAL STATEMENTS CAN BE OBTAINED THROUGH PUBLICLY AVAILABLE SOURCES SUCH AS EMMA.MSRB.ORG. FORM 990, PART XI, LINE 9: CAPITAL TRANSFERS FROM THE FOUNDATION 12,240,751. TEMP RESTRICTED CONTRIBUTIONS 33,926,936. CAPITAL TRANSFERS TO CHILDREN'S HEALTH NETWORK -449,993. CONTRIBUTION OF ASSET 5,935,151. 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