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IF APPLICABLE, THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION WOULD BE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE RESOLUTION. CHS DOES NOT BELIEVE ITS CONSOLIDATED FINANCIAL STATEMENTS INCLUDE ANY UNCERTAIN TAX PROVISIONS. SCHEDULE D, PART V ENDOWMENT FUNDS ARE USED ACCORDING TO SPECIFIC WRITTEN REQUESTS OF THE DONOR ENDOWMENT AGREEMENT. IF NO DIRECT REQUESTS ARE MADE, FUNDS ARE USED IN ACCORDANCE WITH THE OVERALL MISSION OF THE ORGANIZATION. 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11783 ROCK LANDING DRIVE NEWPORT NEWS VA 23608

X OUTPATIENT SURGICAL HOSPITAL A 3 CHKD HEALTH AND SURGERY CENTER

2021 CONCERT DRIVE VIRGINIA BEACH VA 23456

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500 DISCOVERY DRIVE CHESAPEAKE VA 23320

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171 KEMPSVILLE ROAD NORFOLK VA 23507

OUTPATIENT SERVICES CHKD HEALTH CENTER AT HARBOUR VIEW

5835 HARBOUR VIEW BLVD SUFFOLK VA 23435

OUTPATIENT SERVICES HEALTH CENTER AT BURNETT'S WAY

152 BURNETTS WAY SUFFOLK VA 23434

OUTPATIENT SERVICES SATELLITE AT MEDICAL TOWER

400 GRESHAM DRIVE NORFOLK VA 23507

OUTPATIENT SERVICES CHKD HEALTH CENTER AT STRAWBRIDGE

2117 MCCOMAS WAY SUITE 105 VIRGINIA BEACH VA 23456

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935 REDGATE AVENUE NORFOLK VA 23507

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119 BULFANTS BLVD WILLIAMSBURG VA 23188

Outpatient Services HEALTH CENTER AT MEDICAL CENTER CAMPUS

850 SOUTHHAMPTON AVENUE NORFOLK VA 23510

Outpatient Services PART 1, LINE 3C N/A PART 1, LINE 6A N/A PART 1, LINE 7(G) THE AMOUNT REPORTED ON PART I, LINE 7(G) INCLUDES $30,928,393 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. PART I, LINE 7(F) THE AMOUNT OF BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) THAT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSE IN PART I, LINE 7, COLUMN (F) IS $4,905,976. PART 1, LINE 7 A HYBRID APPROACH WAS USED FOR DETERMINING COSTS RELATED TO COMMUNITY BENEFIT. ACTUAL COSTS FROM ALL PATIENT SEGMENTS ARE IDENTIFIED BY DEPARTMENT IN THE GENERAL LEDGER AND THEN WERE GROUPED INTO LIKE COMMUNITY BENEFIT PROGRAMS. INDIRECT COSTS WERE ADJUSTED FOR COSTS ATTRIBUTABLE TO UNREIMBURSED MEDICAID COSTS REPORTED ELSEWHERE, MARKETING AND GRANT WRITING EXPENSES. THE MEDICAID COSTS ADJUSTMENT WAS CALCULATED USING A COST TO CHARGE RATIO OF APPLICABLE EXPENSES DIVIDED BY TOTAL APPLICABLE CHARGES APPLIED TO MEDICAID REVENUE. THE REMAINING INDIRECT COSTS WERE ALLOCATED PROPORTIONATELY TO THE DIRECT COSTS REPORTED BY DEPARTMENT. IN ADDITION, EXPENSES WERE CALCULATED AT COST AND THEN COSTS RELATED TO CHARITY CARE, BAD DEBT AND MEDICAID WERE REMOVED BEFORE ARRIVING AT THE AMOUNTS FOR COMMUNITY BENEFIT AT COST. PART II N/A PART III, LINE 2 BAD DEBT REPORTED IN PART III LINE 2 IS BASED ON THE AMOUNT REPORTED AS BAD DEBT IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE AMOUNT DOES NOT INCLUDE DISCOUNTS OR OTHER ADMINISTRATIVE WRITE OFFS. IF A PATIENT ACCOUNT HAS BEEN WRITTEN OFF TO BAD DEBT AND IS SUBSEQUENTLY COLLECTED, BAD DEBT EXPENSE IS REDUCED IN THAT PERIOD BY THE PAYMENT. PART III, LINE 3 THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED OF THE PERCENTAGE OF CHARITY CARE EXPENSES AS A PERCENTAGE OF SELF-PAY REVENUE. CHKD DOES NOT MAINTAIN RECORDS THAT TRACK PATIENTS WHO COULD HAVE QUALIFIED FOR CHARITY CARE. THIS AMOUNT IS AN ESTIMATE OF PATIENTS WHO LIKELY WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO DETERMINE THEIR ELIGIBILITY. THIS AMOUNT IS NOT INCLUDED AS COMMUNITY BENEFIT. PART III, LINE 4 THE AUDITED FINANCIAL STATEMENTS AND RELATED FOOTNOTES FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS DO NOT CONTAIN FOOTNOTES RELATED TO BAD DEBT EXPENSE. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING RECEIVABLES. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE, NET OF PAYMENTS AND DISCOUNTS, AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR THE RECOVERY IS CONSIDERED REMOTE. PART III, LINE 8 AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE SHORTFALL WAS CALCULATED USING THE HOSPITAL'S OVERALL COST TO CHARGE RATIO APPLIED TO MEDICARE GROSS CHARGES. THIS SHORTFALL IS NOT SEPARATELY INCLUDED AS A COMMUNITY BENEFIT AS 100% OF IT HAS ALREADY BEEN CAPTURED IN THE APPROPRIATE CATEGORY ON PART I, LINE 7. PART III, LINE 9B ACCOUNTS WITH AN UNPAID BALANCE OR WITHOUT AN ESTABLISHED PAYMENT PLAN ARE REFERRED TO A COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION EFFORTS. CHKD MAKES REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE/CHARITY CARE BEFORE REFERRING TO A COLLECTION AGENCY OR AN ATTORNEY. REASONABLE EFFORT INCLUDES AND IS NOT LIMITED TO NOTIFICATION ABOUT THE FINANCIAL ASSISTANCE - CHARITY CARE/COLLECTION POLICY POSTED IN ADMISSIONS, EMERGENCY DEPARTMENT OR OTHER DESIGNATED AREAS. THE INFORMATION REGARDING THE POLICY IS INCLUDED IN THE ADMISSION PACKAGE AND ON THE PATIENT BILL. THE HEALTH BENEFITS ANALYST AND CUSTOMER SERVICE REPRESENTATIVE WHO MAY SPEAK WITH THE GUARANTOR BY PHONE PROVIDE THEM WITH FINANCIAL ASSISTANCE INCLUDING CHARITY CARE INFORMATION. THE FINANCIAL ASSISTANCE-CHARITY CARE/COLLECTION POLICY IS AVAILABLE UPON REQUEST AND VIA WWW.CHKD.ORG. CHKD ENSURES ALL COLLECTION PROTOCOLS ARE MET PRIOR TO REFERRAL TO COLLECTIONS AGENCY OR ATTORNEY. APPROVED CHARITY CARE AMOUNT WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES. THE REMAINING BALANCE WILL BE SUBJECT TO CHKD'S STANDARD COLLECTION PROTOCOLS. PART V SECTION B LINE 1J N/A PART V SECTION B LINE 3 IN CONDUCTING THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, INPUT WAS RECEIVED FROM REPRESENTATIVES OF THE COMMUNITY SERVED. A COMMUNITY INSIGHT SURVEY WAS CONDUCTED WITH A GROUP OF COMMUNITY STAKEHOLDERS WHERE SURVEY PARTICIPANTS WERE ASKED TO PROVIDE THEIR VIEWPOINTS ON IMPORTANT HEALTH CONCERNS IN THE COMMUNITY, SIGNIFICANT SERVICES GAPS IN THE COMMUNITY AND ADDITIONAL IDEAS OR SUGGESTIONS FOR IMPROVING COMMUNITY HEALTH. THE SURVEY WAS SENT TO 441 COMMUNITY STAKEHOLDERS WITH A TOTAL OF 95 (22%) RESPONSES. RESPONSES WERE RECEIVED FROM VARIOUS LOCAL SOCIAL SERVICES DEPARTMENTS, POLICE OR OTHER PUBLIC SAFETY OFFICES, PUBLIC SCHOOL DIVISIONS, HOSPITALS, COMMUNITY SERVICES BOARD, FOUNDATIONS, HEALTH ASSOCIATIONS, CITIES & COUNTIES IN THE REGION, UNIVERSITY NURSING PROGRAM, HEALTH DEPARTMENTS, VARIOUS CORPORATE CITIZENS AND OTHER NON-PROFIT ORGANIZATIONS. PART V SECTION B LINE 4 A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR CHKD'S THREE LICENSED FACILITIES LIST IN PART V, SECTION A. PART V SECTION B LINE 5C N/A PART V SECTION B LINE 6I N/A Part V Section B line 7 The following needs were identified in our community health needs assessment but were not addressed in our implementation plan as the services were provided by other community resources: dental health/oral health, substance abuse - illegal and/or prescription drugs, teen pregnancy, crime/violence, tobacco use/exposure, high risk pregnancies and birth outcomes, early intervention services, family planning services, housing services, maternal, infant and child health services, food safety net, respite care services, home health services, public health services, durable medical equipment and assistive devices, long term care services, pharmacy services, hospice services, injury prevention services, mental health services. PART V SECTION B LINE 10 N/A PART V SECTION B LINE 11 N/A PART V SECTION B LINE 12H N/A PART V SECTION B LINE 14G N/A PART V SECTION B LINE 16E N/A PART V SECTION B LINE 17E N/A PART V SECTION B LINE 18E N/A PART V SECTION B LINE 19C N/A PART V SECTION B LINE 19D N/A PART V SECTION B LINE 20D N/A PART V SECTION B LINE 21 N/A PART V SECTION B LINE 22 N/A PART V SECTION B LINE 22 N/A NEEDS ASSESSMENT: CHKD USES A VARIETY OF METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON-PROFIT AND PUBLIC HEALTH AGENCIES AND ORGANIZATIONS AND THROUGH REGIONAL, STATE AND NATIONAL DATA. AS THE ONLY HEALTHCARE PROVIDER IN VIRGINIA DEVOTED EXCLUSIVELY TO THE NEEDS OF CHILDREN, CHKD ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF PEDIATRIC CARE AND THE PROMOTION OF CHILDREN'S HEALTH AND IS TRUSTED THROUGHOUT ITS COMMUNITY AS A RESOURCE READY AND WILLING TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. CHKD'S CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT HTTP://WWW.CHKD.ORG/ABOUT/COMMUNITYBENEFIT/DEFAULT.ASPX PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: CHKDs Charity Care eligibility criteria and procedures for applying are provided to all patients. Patients who are admitted are provided the information by the use of the admission packet; patients who receive outpatient services are provided the information during the registration process. An application for Charity Care, along with a letter explaining the process, shall be sent to any patient or guarantor who requests information on any programs or provisions the hospital may have to help assist patients or guarantors in paying their hospital bill. The Charity Care policy and application is available on the internet at www. chkd.org and at each registration workstation. All billing statements mailed to guarantors include a notice of the availability of charity and how to obtain the information/application. Assistance with the application process is available through the Health Benefits Analyst (HBA). The HBA sends out applications via mail and refers families to the Hospitals website. The unit social worker is available to provide information or referral to the HBA during an inpatient stay. COMMUNITY INFORMATION: CHKD IS THE REGIONAL PEDIATRIC REFERRAL CENTER FOR SOUTHEASTERN VIRGINIA, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA. CHKD SERVES THE FOLLOWING REGIONS IN VIRGINIA: ACCOMACK COUNTY, CHESAPEAKE CITY, FRANKLIN CITY, GLOUCESTER COUNTY, HAMPTON CITY, ISLE OF WIGHT COUNTY, JAMES CITY COUNTY, MATHEWS COUNTY, NEWPORT NEWS CITY, NORFOLK CITY, NORTHAMPTON COUNTY, POQUOSON CITY, PORTSMOUTH CITY, SOUTHAMPTON COUNTY, SUFFOLK CITY, SURRY COUNTY, SUSSEX COUNTY, VIRGINIA BEACH CITY, WILLIAMSBURG CITY AND YORK COUNTY. WITHIN NORTH CAROLINA, CHKD SERVES THE FOLLOWING REGIONS: BERTIE COUNTY, CAMDEN COUNTY, CHOWAN COUNTY, CURRITUCK COUNTY, DARE COUNTY, GATES COUNTY, HERTFORD COUNTY, PASQUOTANK COUNTY AND PERQUIMANS COUNTY. IN 2012, THIS SERVICE REGION INCLUDED 568,367 PERSONS AGE 0-21. COMPARED TO THE COMMONWEALTH OF VIRGINIA AS A WHOLE, THE STUDY REGION IS MORE DENSELY POPULATED, AND PROPORTIONALLY MORE BLACK/AFRICAN AMERICAN. THE REGION ALSO HAS LOWER INCOME LEVELS THAN VIRGINIA AS A WHOLE. MEDICALLY UNDERSERVED AREAS (MUAS) AND MEDICALLY UNDERSERVED POPULATIONS (MUPS) ARE DESIGNATED BY THE U.S. HEALTH RESOURCES AND SERVICES ADMINISTRATION AS BEING AT RISK FOR HEALTH CARE ACCESS PROBLEMS. THE DESIGNATIONS ARE BASED ON SEVERAL FACTORS INCLUDING PRIMARY CARE PROVIDER SUPPLY, INFANT MORTALITY, PREVALENCE OF POVERTY, AND THE PREVALENCE OF SENIORS AGE 65+. TWENTY-SIX OF THE 29 LOCALITIES THAT ENCOMPASS THE STUDY REGION HAVE BEEN FULLY OR PARTIALLY DESIGNATED AS MUAS/MUPS. CHKD'S SERVICE AREA COMPRISES A DIVERSE MIX OF URBAN, SUBURBAN AND RURAL COMMUNITIES, AS WELL AS 10 MILITARY INSTALLATIONS. CHKD IS WELL VERSED IN THE SPECIAL NEEDS OF MILITARY FAMILIES AND HAS ONE OF THE HIGHEST TRICARE PAYOR PERCENTAGES AMONG THE CHILDREN'S HOSPITALS IN THE NATION. PROMOTION OF COMMUNITY HEALTH CHKD plays a unique role in its community by providing pediatric healthcare services available nowhere else in the region and, at the same time, serving as the safety net provider to the region's indigent children. In FY2013, CHKD had 5,177 admissions resulting in 48,816 discharged patient days. Approximately 54 percent of these days, were covered by Medicaid, which is the highest percentage by far of any acute-care hospital in Virginia. CHKD leads the region in efforts to address public health concerns like child abuse and childhood obesity. It is the sole provider of pediatric subspecialty care for children with chronic illnesses like cancer and diabetes and employs the region's only pediatric surgeons. The hospital's vibrant community outreach program coordinates parent, professional and student programs that bring important health, safety and wellness information to thousands of participants. CHKD also takes an active role in the education of pediatricians. Comprehensive information on CHKD's efforts to improve the health of children is available at www.chkd.org/About/CommunityBenefit. AFFILIATED HEALTH CARE SYSTEM: CHKD IS PART OF CHILDREN'S HEALTH SYSTEM, A 501 (C)(3) ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY ARE NOT EMPLOYEES OR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CHKD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS ARE USED TO MEET THE NEEDS OF THE ORGANIZATION AS DETERMINED BY CHKD SENIOR MANAGEMENT AND THE CHS BOARD OF DIRECTORS. HISTORICALLY, SURPLUS FUNDS HAVE BEEN USED FOR A VARIETY OF PURPOSES INCLUDING PATIENT CARE PROGRAMS, CAPITAL IMPROVEMENT NEEDS, RESERVES, ETC. ROLES OF ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED: THE CHILDREN'S HEALTH SYSTEM IS COMPRISED OF SEVERAL ORGANIZATIONS. CHKD PROVIDES INPATIENT AND AMBULATORY CARE SERVICES ACROSS MANY PEDIATRIC SPECIALTIES, INCLUDING A HIGH PERCENTAGE OF NEONATAL AND PEDIATRIC INTENSIVE CARE SERVICES. OTHER ENTITIES UNDER THE CHILDREN'S HEALTH SYSTEM UMBRELLA INCLUDE: * CHILDREN'S HEALTH FOUNDATION, WHICH RAISES FUNDS, MANAGES INVESTMENTS AND FUNDS EDUCATION, RESEARCH AND OTHER PROGRAMS FOR CHILDREN'S HEALTH SYSTEM * CHILDREN'S MEDICAL GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC PHYSICIAN PRACTICES * CMG OF NORTH CAROLINA, INC., A NORTH CAROLINA STOCK CORPORATION, WHICH OWNS AND OPERATES A PEDIATRIC PHYSICIAN PRACTICE IN NORTHEASTERN NORTH CAROLINA * CHILDREN'S SURGICAL SPECIALTY GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC SURGICAL SUBSPECIALTY PRACTICES, INCLUDING PEDIATRIC GENERAL SURGERY, PEDIATRIC UROLOGY, PEDIATRIC CARDIAC SURGERY, PEDIATRIC ORTHOPEDIC SURGERY AND SPORTS AND ADOLESCENT MEDICINE, PEDIATRIC NEUROSURGERY AND PEDIATRIC PLASTIC SURGERY. * CHSIL, A CAPTIVE INSURANCE COMPANY INCORPORATED IN BERMUDA, WHICH PROVIDES COMMERCIAL GENERAL LIABILITY COVERAGE FOR CHS AND ITS SUBSIDIARIES AND MEDICAL PROFESSIONAL LIABILITY COVERAGE FOR NON-PHYSICIAN PRACTITIONERS EMPLOYED BY CHS AND ITS SUBSIDIARIES. STATE FILING OF COMMUNITY BENEFIT REPORT: CHKD FILES A COMMUNITY BENEFIT REPORT IN VIRGINIA. FACILITY REPORTING GROUP(S): FACILITY REPORTING GROUP A INCLUDES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, CHKD HEALTH AND SURGERY CENTER IN NEWPORT NEWS AND CHKD HEALTH AND SURGERY CENTER IN VIRGINIA BEACH. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI VA, true EASTERN VIRGINIA MEDICAL SCHOOL PO BOX 1980 NORFOLK VA 23501 546055378 501(c)(3) 71725 BMI FOR KIDS RESEARCH 1 PROCESS FOR AWARDS AWARDS ARE MADE TO INVESTIGATORS/PHYSICIANS BY CHKD (CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS) FOR SPECIFIC PROJECT OR RESEARCH ENDEAVORS. FUNDING REQUESTS ARE COMPLETED AND SUBMITTED WHERE THEY ARE REVIEWED BY THE FINANCE DEPARTMENT, THE CEO AND THE APPLICABLE BOARD. AFTER AN AWARD IS MADE, THE AWARDEE MUST FILE QUARTERLY FINANCIAL SUMMARIES AND A FINAL REPORT TO BE SUBMITTED TO THE CEO AT THE END OF THE FUNDING PERIOD. X true true X X X X false true false false false false false true false MICHELLE BRENNER MD 0 200506 0 0 0 147 0 8164 0 10080 0 218897 0 0 JAMES D DAHLING 0 814035 0 0 0 105933 0 805578 0 39134 0 1764680 0 55424 DENNIS RYAN 0 422160 0 0 0 43874 0 293445 0 42744 0 802223 0 12753 JOHN HAMILTON 211447 0 0 0 9956 0 46505 0 26240 0 294148 0 0 0 JAMES DICE 142006 0 12289 0 30617 0 6180 0 7053 0 198145 0 0 0 SUZANNE STARLING 193404 0 0 0 1011 0 7934 0 13449 0 215798 0 0 0 THOMAS BERRY 106433 0 9819 0 56532 0 4973 0 15888 0 193645 0 0 0 ARNO ZARITSKY 435326 0 0 0 70469 0 278436 0 24286 0 808517 0 36243 0 DAVID BOWERS 294182 0 0 0 26711 0 368885 0 28331 0 718109 0 9502 0 JO-ANN BURKE 316487 0 0 0 44331 0 127706 0 27216 0 515740 0 24000 0 JOANN ROGERS 324810 0 0 0 49341 0 317106 0 21507 0 712764 0 16842 0 DEBORAH BARNES 0 285988 0 0 0 18106 0 174031 0 35750 0 513875 0 5958 SCHEDULE J, LINE 1: IN CONNECTION WITH A RETIREMENT PROGRAM, TAX GROSS-UP PAYMENTS ARE PROVIDED TO CERTAIN DIRECTORS WHOSE EMPLOYER FUNDED CONTRIBUTIONS ARE IMMEDIATELY TAXABLE, IN ORDER TO PROVIDE THEM WITH BENEFITS THAT ARE TAX-EQUIVALENT TO BENEFITS OF PARTICIPANTS WHOSE CONTRIBUTIONS ARE NOT IMMEDIATELY TAXABLE. SCHEDULE J, LINE 4B: CHILDREN'S HEALTH SYSTEM SPONSORS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("THE PLAN"). THE PLAN IS DESIGNED TO RETAIN EXECUTIVES IN POSITIONS ESSENTIAL TO THE SUCCESS OF CHILDREN'S HEALTH SYSTEM. JAMES DAHLING, DENNIS RYAN, ARNO ZARITSKY, JOANN ROGERS, DAVID BOWERS, DEBORAH BARNES, JOHN HAMILTON AND JO-ANN BURKE PARTICIPATE IN THE PLAN. SCHEDULE J, LINE 7: OFFICERS AND VICE PRESIDENTS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET UP BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. DEPARTMENT DIRECTORS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET BY MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS. A VA Small Business Financing Authority 541300845 000000000 2012-09-09 76400000 REFUNDING OF 1/31/2006 ISSUE false false false A 5558057 0 76400000 0 0 0 0 0 0 0 76400000 0 2007 true false true true A false true true true true true 0.00065 0.00000 0.00065 false false false true A false true true false 0 false 0 false true A true Schedule K, Part II, Line 11 0 ALL PROCEEDS OF THE BOND WERE USED TO CURRENTLY REFUND A PRIOR ISSUE. SCHEDULE K, PART III, LINE 4 0 BOND COUNSEL DUE DILIGENCE SHOWED ONLY $50,000 OF PRIVATE USE THAT WAS NOT EQUITY FINANCED OR DID NOT QUALIFY FOR A REGULATORY SAFE HARBOR. SCHEDULE K, PART IV, LINE 2B 0 6-MONTH SPENDING EXCEPTION APPLIES CHILDREN'S SPECIALTY GROUP FAMILY MEMBER IS DIRECTOR 11557552 PHYSICIAN SERVICES false CHILDREN'S MEDICAL GROUP MEMBERS SERVE CHKD & CMG 2254817 CORPORATE SUPPORT & RENTAL false CHILDREN'S SURGICAL SPECIALTY GROUP MEMBERS SERVE CHKD & CSSG 1581211 CORPORATE SUPPORT & RENTAL false WM JORDAN CO INC MEMBER OWNER 327837 CONSTRUCTION SERVICES false X 22 11980 CASH ON SALE X 33 339697 AVG FMV ON DATE REC X VARIOUS IN-KIND ITEMS 15 49283 AVG FMV ON DATE REC X AMBULANCE PURCHASE 1 359205 VALUE OF PAYMENT false true true Schedule M, Line 32A CHKD PAYS SYR, INC. MANAGEMENT FEES TO MANAGE THRIFT STORES FOR THE BENEFIT OF THE ORGANIZATION. CHKD ALSO PAYS TIDEWATER AUTO AUCTION TO AUCTION CARS FOR THE BENEFIT OF THE ORGANIZATION. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III FOR MORE THAN 50 YEARS, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) HAS BEEN THE ONLY FACILITY OF ITS KIND IN VIRGINIA, SERVING THE MEDICAL AND SURGICAL NEEDS OF CHILDREN THROUGHOUT THE STATE. ITS PRIMARY SERVICE AREA ENCOMPASSES GREATER HAMPTON ROADS, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA, A REGION THAT IS HOME TO APPROXIMATELY 500,000 CHILDREN UNDER THE AGE OF 21. CHKD WAS ESTABLISHED AS AN 88-BED, NOT-FOR-PROFIT HOSPITAL IN 1961 BY THE KING'S DAUGHTERS, A WOMEN'S SERVICE ORGANIZATION DEDICATED TO THE HEALTH AND WELL BEING OF THE COMMUNITY'S INDIGENT CHILDREN. THE HOSPITAL HAS ALWAYS UPHELD THE CHARITABLE MISSION OF ITS FOUNDERS, AND IN FY 2013, 54 PERCENT OF ITS INPATIENT DAYS WERE COVERED BY MEDICAID. OVER THE PAST 50 YEARS, CHKD HAS GROWN INTO A 206-BED TEACHING HOSPITAL THAT IS THE HEART OF AN EXTENSIVE PEDIATRIC HEALTH CARE SYSTEM. TODAY, THAT SYSTEM PROVIDES COMPREHENSIVE MEDICAL CARE TO CHILDREN AT THE HOSPITAL AND MULTI-SERVICE HEALTH CENTERS IN VIRGINIA BEACH, NEWPORT NEWS AND CHESAPEAKE. ITS SERVICES INCLUDE EVERYTHING FROM WELLNESS AND PREVENTION INITIATIVES TO PRIMARY CARE, SURGERY AND REHABILITATION. MANY OF ITS UNIQUE SERVICES AND PROGRAMS ADDRESS PRESSING PUBLIC HEALTH NEEDS THAT WOULD OTHERWISE GO UNMET. AS THE PREMIER PROVIDER OF HEALTHCARE SERVICES TO THE REGION'S CHILDREN, CHKD HAS SECURED A PLACE IN THE HEART OF THE COMMUNITY. THE HOSPITAL IS AN EAGER COLLABORATOR WITH OTHER COMMUNITY ORGANIZATIONS AND INSTITUTIONS THAT SHARE ITS CONCERN FOR THE WELL BEING OF YOUNG PEOPLE AND OFFERS A VARIETY OF EDUCATION, RESEARCH AND HEALTH INITIATIVES TO IMPROVE THE HEALTH AND WELL BEING OF CHILDREN IN THIS COMMUNITY AND BEYOND. THE HEALTH SYSTEM'S PRIMARY SERVICES CENTER ON INPATIENT AND OUTPATIENT CARE, COMMUNITY OUTREACH PROGRAMS AND MEDICAL EDUCATION/RESEARCH. SECTION ONE: INPATIENT CARE CHILDREN WITH A VAST RANGE OF MEDICAL PROBLEMS, INCLUDING LIFE-THREATENING ILLNESSES AND INJURIES TURN TO CHKD FOR INPATIENT CARE. IN FY 2013, CHKD HAD 5,177 ADMISSIONS RESULTING IN 48,816 DISCHARGED PATIENT DAYS. APPROXIMATELY 54 PERCENT OF THESE DAYS, WERE COVERED BY MEDICAID, WHICH IS THE HIGHEST PERCENTAGE BY FAR OF ANY ACUTE-CARE HOSPITAL IN VIRGINIA. CHKD HAS 206 INPATIENT BEDS, AND ALMOST HALF OF THOSE ARE FOR PEDIATRIC INTENSIVE CARE. THE HOSPITAL IS HOME TO THE REGION'S HIGHEST LEVEL NEONATAL INTENSIVE CARE UNIT (NICU), WHERE EACH YEAR CRITICALLY ILL NEWBORNS, SOME AS YOUNG AS 23 WEEKS GESTATION, BENEFIT FROM A UNIQUE COMBINATION OF ADVANCED MEDICAL TECHNOLOGY, DEVELOPMENTAL CARE AND FAMILY SUPPORT. THERE WERE 500 ADMISSIONS TO THE NICU IN FY 2013. THE HOSPITAL ALSO OPERATES A NEONATAL STEP-DOWN UNIT FOR BABIES FROM OUR NICU WHO REQUIRE A TRANSITIONAL PERIOD BEFORE BEING DISCHARGED HOME. THE REGION'S LARGEST AND MOST EXPERIENCED PEDIATRIC INTENSIVE CARE UNIT (PICU) IS AT CHKD. IN THIS UNIT, A FULL-TIME STAFF OF BOARD CERTIFIED PEDIATRIC INTENSIVE CARE PHYSICIANS, CRITICAL CARE NURSES AND RESPIRATORY THERAPISTS PROVIDE EXTREMELY SOPHISTICATED, TECHNOLOGICALLY ADVANCED CARE TO CHILDREN WITH LIFE THREATENING INJURIES AND ILLNESSES. MEDICAL CARE IS SUPPLEMENTED WITH SUPPORT FROM CHILD LIFE SPECIALISTS, SOCIAL WORKERS AND CHAPLAINS WHO HAVE EXTENSIVE EXPERIENCE HELPING FAMILIES THROUGH THE TRAUMA AND STRESS OF A SEVERE ILLNESS OR INJURY IN A CHILD. THERE WERE 1,131 ADMISSIONS TO OUR PICU IN FY 2013. MANY PATIENTS ARE BROUGHT FROM OTHER AREA HOSPITALS TO CHKD BY THE HOSPITAL'S NEONATAL/PEDIATRIC TRANSPORT PROGRAM, WHICH OPERATES OUT OF FOUR FULLY EQUIPPED MOBILE INTENSIVE CARE UNITS. TWO TRANSPORT TEAMS ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO ALL AREA MEDICAL FACILITIES THAT NEED TO SEND SICK OR INJURED CHILDREN TO CHKD. EACH TRANSPORT CALL IS ANSWERED BY A NEONATAL/PEDIATRIC CRITICAL CARE NURSE, A REGISTERED RESPIRATORY THERAPIST AND A CERTIFIED EMT PARAMEDIC TRAINED IN NEONATAL/PEDIATRIC CARE. IN FY 2013, THE TEAM TRANSPORTED 1,058 PATIENTS. OF THOSE, 300 WERE NEWBORNS COMING TO OUR NEONATAL INTENSIVE CARE UNIT. CHKD'S TRANSPORT SERVICE IS ALSO UNDER CONTRACT TO THE NAVAL MEDICAL CENTER, PORTSMOUTH, TO PROVIDE ALL NEONATAL AND PEDIATRIC MILITARY TRANSPORTS IN THE REGION. BESIDES GROUND TRANSPORT, THE TEAM ALERTS FIXED-WING AIR AND HELICOPTER TRANSPORTS WHEN MEDICALLY NECESSARY. CHKD OPERATES THE REGION'S ONLY ACUTE INPATIENT REHABILITATION UNIT EXCLUSIVELY FOR CHILDREN, WHERE YOUNG PATIENTS RECEIVE COMPREHENSIVE REHABILITATION SERVICES NEEDED TO REGAIN SKILLS LOST AFTER ACCIDENTS OR ILLNESSES. PRIOR TO THE OPENING OF THIS UNIT, FAMILIES HAD TO TRAVEL LONG DISTANCES OUTSIDE OF THE AREA TO RECEIVE THIS KIND OF CARE, WHICH USUALLY REQUIRES A HOSPITALIZATION OF SEVERAL WEEKS DURATION. ADMISSIONS TO THE INPATIENT REHABILITATION UNIT RESULTED IN 2,164 PATIENT DAYS IN FY 2013. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CHKD'S TRANSITIONAL CARE UNIT, WHERE TECHNOLOGY DEPENDENT CHILDREN BEGIN THE PROCESS OF MOVING FROM THE HOSPITAL TO THEIR HOMES, PROVIDES DEVELOPMENTAL, EDUCATIONAL AND EMOTIONAL SUPPORT AS WELL AS HIGH ACUITY MEDICAL CARE AND PARENT/CAREGIVER SUPPORT AND EDUCATION. ADMISSIONS TO THIS UNIQUE UNIT RESULTED IN 3,986 PATIENT DAYS IN FY 2013. CHKD OPERATES THE REGION'S ONLY PEDIATRIC SURGERY PROGRAM, OFFERING YOUNG PEOPLE STATE-OF-THE-ART TREATMENT IN A SUPPORTIVE, NON-THREATENING ENVIRONMENT CREATED EXCLUSIVELY TO MEET THEIR NEEDS. IN FY 2013, SURGEONS PERFORMED 13,109 SURGERIES AT CHKD FACILITIES FOR A VAST RANGE OF PROBLEMS, FROM THE SIMPLEST OUTPATIENT PROCEDURES TO COMPLEX ORTHOPEDIC AND GENITOURINARY SURGERIES. (SEE OUTPATIENT SERVICES AND PROGRAMS FOR MORE INFORMATION OF CHKD'S SURGERY PROGRAM). CHKD EMPLOYS DOZENS OF PROFESSIONALS WHO PROVIDE EMOTIONAL, RECREATIONAL, SPIRITUAL AND PRACTICAL SUPPORT TO CHILDREN AND FAMILIES DURING HOSPITALIZATIONS. THE WORK OF THESE PROFESSIONALS COMPLEMENTS OUR EXPERT MEDICAL CARE TO CREATE A UNIQUE TREATMENT AND HEALING ENVIRONMENT FOR CHILDREN AND THEIR FAMILIES. OUR CHAPLAINCY SERVICES PROVIDE EMOTIONAL SUPPORT, PASTORAL CARE, ETHICAL REFLECTION, BEREAVEMENT RESOURCES FOLLOW-UP AND SPIRITUAL GUIDANCE TO PATIENTS, FAMILIES AND STAFF WITH IN-HOSPITAL PRESENCE SEVEN DAYS A WEEK, WITH 24-HOUR ON-CALL AVAILABILITY. THE HOSPITAL EMPLOYS THREE FULL-TIME CHAPLAINS, ONE PART-TIME AND EIGHT PER-DIEM CHAPLAINS WHO REFLECT THE DIVERSITY OF THE COMMUNITY AND ARE PROFESSIONALLY TRAINED TO MEET THE VARIED SPIRITUAL NEEDS OF FAMILIES WITH RESPECT AND COMPASSION. THE CHAPLAINS ALSO FACILITATE EDUCATIONAL PROGRAMS FOR HOSPITAL STAFF AND PHYSICIANS, AS WELL AS PLANNING AND PARTICIPATING IN OUTREACH TO THE COMMUNITY. IN 2013, THE DEPARTMENT COORDINATED ITS ANNUAL BIOETHICS DAY PROGRAM WITH DISTINGUISHED PHYSICIAN AND PRIZE-WINNING AUTHOR SHERRI FINK AS GUEST SPEAKER. THE HOSPITAL EMPLOYS 14 CHILD LIFE STAFF MEMBERS WHO HELP CHILDREN ADJUST AND COPE DURING HOSPITALIZATION. THEIR GOAL IS TO MAKE THE CHILD'S HOSPITAL EXPERIENCE AS NORMAL AS POSSIBLE BY DEVELOPING SUPPORTIVE RELATIONSHIPS WITH PATIENTS AND FAMILIES, PROVIDING AGE-APPROPRIATE PREPARATION FOR MEDICAL PROCEDURES, COPING STRATEGIES AND PLAY OPPORTUNITIES FOR CHILDREN TO RELIEVE STRESS. CHILD LIFE STAFF MEMBERS ALSO SCHEDULE AND FACILITATE COMMUNITY GROUP VISITORS TO THE HOSPITAL AND MANAGE APPROXIMATELY 100 VOLUNTEERS WEEKLY. THERE ARE THREE POPULAR ACTIVITY AREAS THROUGHOUT THE HOSPITAL, PROVIDING HOSPITALIZED CHILDREN OPPORTUNITIES FOR SOCIALIZATION AND CREATIVE PLAY. CHILD LIFE SPECIALISTS WORK WITH CHKD'S VOLUNTEER SERVICES DIVISION TO MANAGE THE HOSPITAL'S POPULAR PET THERAPY PROGRAM, THE BUDDY BRIGADE, WHICH BRINGS VISITS OF DOG/HANDLER TEAMS TO THE HOSPITAL SEVERAL TIMES EACH WEEK. CHILD LIFE STAFFERS COLLABORATE WITH OTHER HOSPITAL STAFF TO PROVIDE A PEDIATRIC INTENSIVE CARE UNIT SUPPORT GROUP FOR PARENTS AND SIBLINGS, AN ANNUAL TEDDY BEAR CLINIC, INPATIENT DEVELOPMENTAL SCREENINGS AND A POPULAR TEEN NIGHT ACTIVITY. CHKD'S DEPARTMENT OF SOCIAL WORK HELPS MEET SOCIAL, EMOTIONAL AND PSYCHOLOGICAL NEEDS THAT MAY ARISE WHEN A CHILD IS HOSPITALIZED OR WHEN AN EMERGENCY ARISES. OUR STAFF INCLUDES 15 LICENSED CLINICAL SOCIAL WORKERS AND 11 MEDICAL SOCIAL WORKERS. SOCIAL WORKERS ALSO WORK WITH CHILDREN IN OUR OUTPATIENT SPECIALTY CLINICS, ESPECIALLY THOSE CATERING TO CHILDREN WITH CHRONIC ILLNESSES. AMONG THE SERVICES OUR SOCIAL WORKERS PROVIDE ARE THE FOLLOWING: * COORDINATE REFERRALS AND ONGOING COMMUNICATIONS TO OTHER COMMUNITY RESOURCES. * FACILITATE SUPPORT GROUPS FOR CHKD FAMILIES DEALING WITH CHRONIC ILLNESS AND LOSS. * CONDUCT PSYCHOSOCIAL HISTORY AND MENTAL HEALTH ASSESSMENTS OF PATIENTS TO AID CAREGIVERS IN DEVELOPING TREATMENT PLANS. * HELP PATIENTS AND FAMILIES DEAL WITH SITUATIONAL CRISES. * WORK WITH FAMILIES AND CHKD'S ELIGIBILITY WORKERS TO COMPLETE APPLICATIONS FOR INSURANCE COVERAGE FOR MEDICAL CARE. * 24-HOUR PER-DIEM COVERAGE FOR NIGHTS, WEEKENDS, HOLIDAYS. SOCIAL WORKERS ALSO FACILITATE A VARIETY OF SUPPORT GROUPS THAT HELP PATIENTS AND FAMILIES CONNECT WITH OTHERS IN THE COMMUNITY WHO SHARE THEIR CHALLENGES. CHKD SPONSORS SUPPORT GROUPS FOR PATIENTS AND THEIR FAMILIES WITH HEART CONDITIONS, DIABETES, TURNER'S SYNDROME, PRADER-WILLI SYNDROME, CANCER AND SICKLE CELL. FAMILIES OF NICU PATIENTS MEET PERIODICALLY TO SHARE INFORMATION; AND OUR RECREATION-BASED GROUP FOR BROTHERS AND SISTERS OF CHILDREN WITH SPECIAL NEEDS, CALLED SIBSHOPS, MEETS REGULARLY TO SUPPORT SIBLINGS. THE DEPARTMENT OF SOCIAL WORK MANAGES THE HALO FUND OF DONATED MONIES TO ASSIST PARENTS AND PATIENTS WITH THE COST OF TRANSPORTATION, MEALS, MEDICATIONS AND SPECIFIC NEEDS AT DISCHARGE. THESE DONATED FUNDS MAY ALSO BE USED IN EMERGENCY SITUATIONS TO ASSIST WITH SPECIAL NEEDS, WHICH HAVE CONSISTED OF PARTIAL OR ONE-TIME PAYMENTS FOR UTILITY SERVICES NEEDED TO ENSURE THAT PATIENTS ARE DISCHARGED TO A HOME WITH A WAY TO SUPPORT THEIR MEDICAL NEEDS ON DISCHARGE. SOME OTHER EXAMPLES OF USAGES FOR THE FUNDS INCLUDE COPAYMENTS FOR PRESCRIPTIONS, CORRECTIVE SHOES, HEARING AIDS OR OTHER ITEMS FOR FAMILIES WHO COULD NOT AFFORD THEM. THIS FUND HELPED MORE THAN 750 FAMILIES IN FY 2013. CHKDs Cultural / Language Services Department employs a full-time manager and a part-time cultural liaison to work with patients who have limited English proficiency and to coordinate the assessment and training of bilingual staff for medical interpretation. Twenty-two dual-role staff members are employed throughout the organization in various positions and voluntarily assist with medical interpretation. Several departments have hired professional staff members who are also able to provide Spanish medical interpretation for their patients and families. CHKD has a contractual relationship with seven American Sign Language interpreters who serve the needs of the deaf/hard of hearing patients and families. These services have improved customer service and consistency of care. When an interpreter is not available onsite, the entire CHKD Health System has access to medical interpretation by phone 24 hours a day. In FY13, CHKD provided over 1,000 hours of face-to-face interpretation for our limited English population through 2,724 documented encounters with Hispanic patients and families and continues the process of adapting to meet The Joint Commission Standards for Patient Centered Communication. AS THE REGIONAL PROVIDER OF PEDIATRIC CARE, CHKD IS AN INTEGRAL PART OF THE COMMUNITY'S NATURAL OR MAN-MADE DISASTER PLANNING EFFORTS. THE HEALTH SYSTEM RECOGNIZES THE IMPORTANCE OF A NATIONAL INCIDENT MANAGEMENT SYSTEM (NIMS) COMMUNITY INTEGRATED, ALL-HAZARD EMERGENCY OPERATIONS PLAN. THIS PLAN IS PREPARED, EXERCISED AND SHARED INTERNALLY AND EXTERNALLY WITH COMMUNITY EMERGENCY RESPONSE AGENTS. IN FY 2013, THE HOSPITAL PARTICIPATED IN AN EXTENSIVE, CAMPUS WIDE EMERGENCY TRAINING DRILL WITH SENTARA, EASTERN VIRGINIA MEDICAL SCHOOL, AND CITY AND STATE FIRST RESPONDERS. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS SECTION TWO: OUTPATIENT SERVICES AND PROGRAMS CHKD ALSO OFFERS THE COMMUNITY MANY IMPORTANT PEDIATRIC SERVICES ON AN OUTPATIENT BASIS. IN 2013, CHILDREN MADE APPROXIMATELY 628,000 OUTPATIENT VISITS TO CHKD, ITS COMMUNITY-BASED HEALTH CENTERS AND AFFILIATED PHYSICIAN PRACTICES. THEY MADE 378,068 VISITS TO THE PRIMARY CARE PEDIATRICIANS OF CHKD'S MEDICAL GROUP, WHICH OFFERS CARE IN 16 PRACTICES WHO HAVE 27 OFFICES THROUGHOUT OUR SERVICE AREA. CHKD'S SURGICAL SPECIALTY GROUP MAKES THE SERVICES OF THE REGION'S ONLY PEDIATRIC GENERAL, UROLOGICAL, CARDIAC, NEUROSURGICAL, PLASTIC AND ORTHOPEDIC SURGEONS AVAILABLE TO THOUSANDS OF CHILDREN WHO MIGHT OTHERWISE HAVE TO TRAVEL OUTSIDE OF THE AREA FOR SURGERY. CHILDREN MADE 42,895 VISITS TO THE SURGICAL GROUP PRACTICES IN FY 2013. THE SURGEONS PERFORMED 5,703 SURGICAL CASES. THE HOSPITAL ALSO PROVIDES CARE TO CHILDREN FACING HEALTH CONDITIONS SUCH AS CANCER, GENETIC DISORDERS, OBESITY, HEART PROBLEMS, DEVELOPMENTAL DISABILITIES, ASTHMA/ALLERGIES AND DIABETES THROUGH MORE THAN 50 OUTPATIENT SPECIALTY CLINICS OFFERING SPECIALIZED PEDIATRIC CARE. IN FY 2013, CHILDREN MADE 144,023 VISITS TO OUR OUTPATIENT CLINICS. CHILDREN'S HOSPITAL WAS FOUNDED ON THE PREMISE THAT ALL CHILDREN DESERVE EQUAL ACCESS TO QUALITY PEDIATRIC CARE. AS OUR POPULATION GREW AND SETTLED INTO THE FAR CORNERS OF OUR BRIDGE AND TUNNEL LACED REGION, TRAVEL TO CHKD'S MAIN FACILITY IN NORFOLK BECAME MORE OF A HARDSHIP FOR FAMILIES. TO EASE THAT BURDEN AND IMPROVE CHILDREN'S ACCESS TO CARE IN EVERY CORNER OF OUR SERVICE AREA, CHKD HAS ESTABLISHED THREE MULTI-SERVICE HEALTH CENTERS AND NINE SATELLITE SITES IN STRATEGIC LOCATIONS. * THE CHKD HEALTH AND SURGERY CENTER AT OYSTER POINT OFFERS FAMILIES WHO LIVE NORTH OF THE HAMPTON ROADS BRIDGE TUNNEL A WEALTH OF IMPORTANT SERVICES IN A CONVENIENT LOCATION. THE CENTER IS HOME TO THE REGION'S FIRST PEDIATRIC AMBULATORY SURGERY CENTER. OTHER SERVICES OFFERED AT THE SITE INCLUDE PRIMARY, SURGICAL AND SUB-SPECIALTY PEDIATRICS, LAB AND RADIOLOGY (INCLUDING ULTRASOUND AND MRI), AUDIOLOGY TESTING AND OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY. SPORTS MEDICINE PHYSICAL THERAPY, AQUATIC THERAPY AND CHILD ABUSE PROGRAM SERVICES ARE ALSO AVAILABLE THERE. * THE CHKD HEALTH CENTER AT OAKBROOKE SERVES FAMILIES IN CHESAPEAKE AND NORTHEASTERN NORTH CAROLINA. IT IS HOME TO A PRIMARY CARE PEDIATRIC PRACTICE, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, X-RAY AND LAB SERVICES, A SPORTS MEDICINE GYM, SLEEP STUDIES UNIT AND THERAPY POOL, AS WELL AS CLINIC SPACE FOR A VARIETY OF PEDIATRIC SPECIALISTS AND SURGEONS PROVIDING EVALUATION, TREATMENT AND FOLLOW-UP. * THE CHKD HEALTH AND SURGERY CENTER AT PRINCESS ANNE SERVES THE GROWING MEDICAL NEEDS OF FAMILIES IN VIRGINIA BEACH. THE CENTER IS HOME TO VIRGINIA BEACH'S FIRST AMBULATORY SURGERY CENTER EXCLUSIVELY FOR CHILDREN. BEACH FAMILIES CAN ALSO FIND PRIMARY CARE PEDIATRICIANS AND IN-HOUSE LAB AND RADIOLOGY SERVICES, INCLUDING MRI, AT THE CENTER. OTHER SERVICES INCLUDE SPECIALTY CARE PEDIATRICS FOR HELP WITH CHRONIC PROBLEMS SUCH AS ASTHMA AND DIABETES, CHKD'S CHILD ABUSE PROGRAM AND PHYSICAL, SPEECH, OCCUPATIONAL AND SPORTS MEDICINE THERAPY. CHKD'S CHILD ABUSE PROGRAM COORDINATES THE REGION'S EFFORTS TO ACCURATELY IDENTIFY, TREAT AND PROTECT CHILDREN WHO HAVE BEEN ABUSED OR NEGLECTED. THE PROGRAM PROVIDES COMPREHENSIVE ASSESSMENT, EVALUATION AND TREATMENT SERVICES TO SUSPECTED VICTIMS OF ABUSE AND NEGLECT. THESE SERVICES INCLUDE FORENSIC INTERVIEWING, MEDICAL EXAMINATIONS AND CONSULTATIONS, WHICH INCLUDE 24/7 COVERAGE OF ACUTE SEXUAL ASSAULTS OF CHILDREN, AND AN ARRAY OF EVIDENCE-BASED MENTAL HEALTH SERVICES. THE PROGRAM ALSO HELPS COORDINATE THE EFFORTS OF INVESTIGATIVE AGENCIES INVOLVED IN THE INVESTIGATION AND PROSECUTION OF ABUSE. CHILDREN MADE 3,151 VISITS TO THE PROGRAM IN FY 2013. SERVICES ARE ALSO AVAILABLE AT CHKD'S OUTPATIENT CENTERS IN VIRGINIA BEACH AND NEWPORT NEWS. THE PROBLEM OF CHILDHOOD OBESITY POSES A SIGNIFICANT THREAT TO THE CURRENT AND FUTURE HEALTH OF OUR CHILDREN. IN RESPONSE TO THIS ALARMING PUBLIC HEALTH CRISIS, THE HOSPITAL PROVIDES A MULTI-DISCIPLINARY PEDIATRIC WEIGHT MANAGEMENT PROGRAM FOR CHILDREN BETWEEN 3 AND 16 YEARS OF AGE CALLED "HEALTHY YOU FOR LIFE". THE PROGRAM OFFERS CLINICAL AND PSYCHOSOCIAL EVALUATION AND PLANNING, ONGOING CLASSES TO HELP OVERWEIGHT YOUTH AND THEIR PARENTS MAKE LIFESTYLE CHANGES AND FOLLOW UP CLINICS FOR UP TO A YEAR. THE EXERCISE COMPONENT OF THE PROGRAM IS STRENGTHENED BY THE ADDITION THIS YEAR OF AN EXERCISE SPECIALIST WHO CONDUCTS PERSONAL TRAINING SESSIONS AS WELL AS GROUP FITNESS CLASSES FOR THE WHOLE FAMILY. EXERCISE OPPORTUNITIES LISTED ON OUR FITNESS CALENDAR ARE AVAILABLE WEEKDAYS AND WEEKENDS AROUND THE HAMPTON ROADS REGION TO ENHANCE A PATIENT'S ABILITY TO EMBRACE A HEALTHIER LIFESTYLE. WE ALSO HAVE A REGIONAL PARTNERSHIP WITH THE YMCA WHICH OFFERS FAMILIES A SIX-WEEK TRIAL MEMBERSHIP ONCE THEY HAVE COMPLETED THE EIGHT-WEEK LIFESTYLE CLASS. THE HEALTHY YOU FOR LIFE PROGRAM OFFERS INDIVIDUAL COUNSELING SESSIONS, USE OF MULTI-MEDIA COMMUNICATION SUCH AS E-MAILS, TEXT MESSAGES AND A FACEBOOK PAGE AS A WAY TO KEEP CONNECTED WITH OUR PATIENTS AND ENCOURAGE POSITIVE LIFESTYLE CHANGES. IN FY 2013, 401 PATIENTS GENERATED 925 CLINIC VISITS. CHKD'S DIABETES EDUCATION PROGRAM HELPS APPROXIMATELY 1,300 LOCAL CHILDREN WHO LIVE WITH THE CHRONIC DISEASE. TWO CERTIFIED DIABETES EDUCATORS, A SOCIAL WORKER, NURSE AND DEPARTMENT COORDINATOR HELP PATIENTS AND FAMILIES AT THE ONSET OF THE DISEASE AND UNTIL ADULTHOOD. THE DIABETES CENTER PROVIDES INPATIENT AND OUTPATIENT CLINICAL MANAGEMENT, DIABETES EDUCATION, SUPPORT GROUPS, AND PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS. A TRANSITION PROGRAM HELPS THE OLDER TEENS AND YOUNG ADULTS BEGIN TRANSFERRING CARE TO ADULT PROVIDERS IN THE COMMUNITY. CHILDREN MADE 552 VISITS TO THE DIABETES CENTER IN FY 2013. THE CHILDREN'S CANCER AND BLOOD DISORDERS CENTER IS ONE OF THE HOSPITAL'S BUSIEST OUTPATIENT SPECIALTY CLINICS WITH 11,185 PATIENT VISITS IN FY 2013. THE PROGRAM PROVIDES CARE TO YOUNG PEOPLE WITH CANCER, SICKLE CELL DISEASE, BLEEDING AND OTHER BLOOD DISORDERS THROUGH TREATMENT PROGRAMS THAT ENCOMPASS CHILDREN'S PHYSICAL, EMOTIONAL AND EDUCATIONAL NEEDS AND INCORPORATES THE WHOLE FAMILY. THE REGION'S ONLY PEDIATRIC EMERGENCY CENTER IS LOCATED AT CHKD. IN 2013, CHILDREN MADE 49,651 VISITS TO OUR EMERGENCY CENTER. CHILDREN'S HOSPITAL OFFERS THE ONLY PEDIATRIC RENAL DIALYSIS SERVICE IN THE AREA. DIALYSIS IS A TIME-CONSUMING PROCESS AND CHILDREN APPRECIATE THE CHANCE TO HAVE THE SERVICE IN A SETTING WHERE THEY CAN MEET WITH FRIENDS THEIR OWN AGES AS WELL AS HOSPITAL SUPPORT STAFF AND SCHOOLTEACHERS. CHILDREN MADE 3,047 RENAL AND DIALYSIS VISITS IN FY 2013. ONE MARK OF CHKD'S DISTINCTIVE PEDIATRIC CARE HAS ALWAYS BEEN CHILD-CENTERED DIAGNOSTIC SERVICES, SUCH AS RADIOLOGY AND LABORATORY. OVER THE PAST SEVERAL YEARS, CHKD HAS WORKED HARD TO MAKE THESE UNIQUE SERVICES MORE ACCESSIBLE TO FAMILIES THROUGHOUT OUR SERVICE REGION. THE HOSPITAL NOW HAS LABORATORIES IN ITS OYSTER POINT, PRINCESS ANNE AND OAKBROOKE HEALTH CENTERS AS WELL AS DRAW SITES AT PEDIATRIC PRACTICES IN NORFOLK AND WILLIAMSBURG. THE LABORATORY ALSO OPERATES A COURIER SERVICE THAT FACILITATES QUICK TURNAROUND OF SPECIMENS. OF THE 720,566 TESTS PERFORMED IN FY 2013, MORE THAN 60 PERCENT WERE FOR OUTPATIENTS. CHKD RADIOLOGY SERVICES ARE ALSO AVAILABLE TO FAMILIES AT OUR CHKD FACILITIES IN NEWPORT NEWS, CHESAPEAKE, SUFFOLK, NORFOLK AND VIRGINIA BEACH. THE RADIOLOGY DEPARTMENT IS A FULLY-INTEGRATED DIGITAL IMAGING CENTER THAT ALLOWS DIAGNOSTIC IMAGES AND REPORTS TO BE TRANSMITTED AND VIEWED ELECTRONICALLY. IN 2013, 88,877 DIAGNOSTIC EXAMS WERE PERFORMED, INCLUDING X-RAYS, FLUOROSCOPIC TESTS, URODYNAMICS AND BONE DENSITY TESTS, CT AND MRI SCANS, ULTRASOUND AND NUCLEAR MEDICINE STUDIES. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CHKD'S REHABILITATIVE THERAPY SERVICES ARE OFFERED IN LOCATIONS THROUGHOUT THE COMMUNITY, INCLUDING NORFOLK, CHESAPEAKE, VIRGINIA BEACH, SUFFOLK AND NEWPORT NEWS. IN ADDITION TO ITS HIGHLY SPECIALIZED PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, THE DEPARTMENT ALSO OFFERS: * AQUATIC THERAPY - PHYSICAL AND OCCUPATIONAL THERAPISTS WORK WITH CHILDREN IN THE WATER TO HELP RELAX TIGHT MUSCULATURE, INCREASE RANGE OF MOTION AND IMPROVE STRENGTH, BALANCE AND ENDURANCE. * ASSISTIVE TECHNOLOGY/AUGMENTATIVE PROGRAM - SERVICES PROVIDED FOR CHILDREN WHO ARE UNABLE TO COMMUNICATE VERBALLY OR THROUGH GESTURES DUE TO VARIOUS MEDICAL CONDITIONS. IN FY 2013, WE DID 193 AUGMENTATIVE COMMUNICATION EVALUATIONS. * CAR SEAT PROGRAM - SPECIALLY TRAINED THERAPISTS OFFER CAR SEAT SAFETY RESTRAINT EVALUATIONS FOR PATIENTS WITH SPECIAL NEEDS. IN FY 2013, WE DID 202 CAR SEAT EVALUATIONS, DISTRIBUTED 291 SPECIAL NEEDS CAR SEATS AND PARTICIPATED IN EIGHT COMMUNITY-BASED CAR SEAT SAFETY CHECKS THROUGH THIS PROGRAM. * WHEELCHAIR CLINIC - CERTIFIED THERAPISTS COMPLETE A COMPREHENSIVE EVALUATION TO DETERMINE AND PRESCRIBE THE APPROPRIATE WHEELCHAIR AND SEATING SYSTEM. CHILDREN MADE ALMOST 542 VISITS TO THIS CLINIC IN FY 2013 FOR EVALUATION AND TECHNICAL ADJUSTMENTS. SECTION THREE: COMMUNITY OUTREACH CHKD REACHED FAMILIES IN THEIR HOMES, DOCTORS' OFFICES, NEIGHBORHOODS AND COMMUNITY CENTERS WITH A WIDE VARIETY OF PROGRAMS AND PUBLICATIONS THAT PROMOTE WELLNESS, PREVENT INJURIES AND STRENGTHEN FAMILIES. OUR COMMUNITY OUTREACH EXPERTS COORDINATED A TOTAL OF 412 PARENT, PROFESSIONAL, AND STUDENT PROGRAMS THAT BROUGHT IMPORTANT HEALTH, SAFETY AND WELLNESS INFORMATION TO MORE THAN 43,021 PARTICIPANTS. 23,696 OF THESE PARTICIPANTS WERE PART OF THE KOHL'S CARES FAMILY PROGRAM WHICH PROVIDED 62 SCHOOL-BASED PROGRAMS AND 149 COMMUNITY PROGRAMS. IN ADDITION, WE LAUNCHED A PILOT KOHL'S STEPS TO FITNESS ASSEMBLY PROGRAM WITH GREAT SUCCESS. CHKD IS A SITE OF THE NATIONAL "REACH OUT AND READ" LITERACY PROGRAM, WHICH ENCOURAGES READING BY DISTRIBUTING FREE BOOKS TO CHILDREN AT THEIR WELL CHILD VISITS TO THEIR PEDIATRICIANS. THROUGH THE DONOR FUNDED PROGRAM, CHKD'S PRIMARY CARE PEDIATRICIANS GAVE MORE THAN 69,300 BOOKS TO CHILDREN IN FY 2013. CHKD'S WEBSITE, WWW.CHKD.ORG, CONTINUES TO BE A POPULAR AND EFFECTIVE METHOD OF COMMUNICATION, AVERAGING OVER 100,000 UNIQUE VISITORS A MONTH FOR FY 2013. CHKD UTILIZED SOCIAL MEDIA OUTLETS SUCH AS FACEBOOK AND TWITTER TO INCREASE DIRECT INTERACTION WITH OUR PATIENTS AND THEIR FAMILIES. THE WEBSITE CONTINUES TO BE A RESOURCE FOR OUR SERVICES AND HEALTH INFORMATION. CHKD IS ONE OF SIX LOCATIONS IN THE STATE FOR THE CARE CONNECTION FOR CHILDREN (CCC), THE STATE FUNDED TITLE V PROGRAM THAT PROVIDES COMPREHENSIVE CARE COORDINATION, INFORMATION AND REFERRAL FOR CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS. THERE ARE APPROXIMATELY 12,000 CHILDREN WITH SPECIAL HEALTHCARE NEEDS IN THE REGION'S PUBLIC HEALTH DISTRICTS. IN FY 2013, CARE CONNECTION ASSISTED WITH 500 INFORMATION AND REFERRAL CALLS AND PROVIDED CASE MANAGEMENT SERVICES TO APPROXIMATELY 524 FAMILIES. FINANCIAL ASSISTANCE WAS PROVIDED FOR 70 CHILDREN WHO WERE UNINSURED OR UNDER INSURED, AND 209 FAMILIES WERE ASSISTED IN APPLYING FOR STATE HEALTH PROGRAMS. THE STAFF AT CCC ALSO PROVIDED SEVERAL TRAINING SESSIONS FOR FAMILIES AND PROVIDERS ON MEDICAID WAIVER SERVICES AND THE EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPSDT) BENEFITS AND EDUCATION FOR PEDIATRIC RESIDENTS WITH THE UNIQUE "FAMILIES AS EDUCATORS" PROGRAM. CHKD'S PHYSICIANS, ADMINISTRATORS AND STAFF MEMBERS LEND THEIR KNOWLEDGE AND TIME AS VOLUNTEERS TO MANY NATIONAL, STATE AND LOCAL ORGANIZATIONS THAT SHARE OUR CONCERN FOR CHILDREN. THESE INCLUDE THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS, THE AMERICAN ACADEMY OF PEDIATRICS, THE CHILDREN'S MIRACLE NETWORK, THE NATIONAL SAFE KIDS CAMPAIGN, THE UNITED WAY, THE VIRGINIA HOSPITAL ASSOCIATION AS WELL AS LOCAL ORGANIZATIONS SUCH AS VOLUNTEER HAMPTON ROADS AND THE AMERICAN RED CROSS. SECTION FOUR: MEDICAL EDUCATION AND RESEARCH CHKD INVESTS IN THE PRESENT AND FUTURE HEALTH OF OUR CHILDREN THROUGH A VARIETY OF RESEARCH PROGRAMS AND EDUCATIONAL ACTIVITIES. CHILDREN'S HOSPITAL IS HOME TO EASTERN VIRGINIA MEDICAL SCHOOL'S (EVMS) PEDIATRIC RESIDENCY PROGRAM, WHERE NEW PHYSICIANS BECOME SPECIALISTS IN THE FIELD OF PEDIATRICS. MANY OF THEM STAY IN THIS COMMUNITY OR IN THE STATE TO PRACTICE PEDIATRICS AFTER THEY COMPLETE THEIR RESIDENCIES. CHKD ALSO SERVES AS THE EXCLUSIVE PEDIATRIC TEACHING SITE FOR RESIDENTS IN FAMILY MEDICINE PRACTICE, EMERGENCY PRACTICE, ENT AND PHYSICIAN ASSISTANTS, AS WELL AS THE EXCLUSIVE SITE FOR SOME 120 THIRD-YEAR MEDICAL SCHOOL STUDENTS FOR THEIR EIGHT WEEK PEDIATRIC ROTATION. CHKD PROVIDES A SETTING FOR MANY CLINICAL RESEARCH TRIALS. HIGHLIGHTS OF THE BASIC SCIENCE RESEARCH INCLUDE PROTECTION OF THE NEWBORN BRAIN FROM THE EFFECTS OF HYPOXIC INJURY, NEW INNOVATIONS TO COMBAT SERIOUS INVASIVE INFECTION, MANAGEMENT OF AUTISM, AND EMERGENCY INTERVENTIONS FOR ASTHMA. IN ADDITION, RESEARCH INCLUDES NEW MEDICATIONS AND OTHER THERAPIES, CLINICAL OUTCOMES ANALYSES AND EPIDEMIOLOGICAL STUDIES SANCTIONED BY THE EASTERN VIRGINIA MEDICAL SCHOOL INSTITUTIONAL REVIEW BOARD (IRB). THERE WERE 159 IRB APPROVED ACTIVE FUNDED STUDIES IN FY 2013. TOPICS OF STUDY INCLUDED HEMATOLOGY/ONCOLOGY, ALLERGY/ASTHMA, INFECTIOUS DISEASE, NEUROLOGY, PEDIATRIC SURGERY, CARDIOLOGY, OTOLARYNGOLOGY, PULMONOLOGY, GASTROENTEROLOGY, CHILD ABUSE, ENDOCRINOLOGY, DERMATOLOGY, NEONATOLOGY AND MENTAL HEALTH. MANY OF THESE STUDIES ARE STAGE THREE CLINICAL TRIALS THAT BRING CUTTING EDGE TREATMENTS TO CHKD PATIENTS YEARS BEFORE THEY ARE AVAILABLE TO THE PUBLIC. IN ADDITION, THERE IS AN INCREASED FOCUS ON REGISTRY STUDIES ACROSS ALL DISCIPLINES. DATA COLLECTED IN THESE REGISTRIES IS INTENDED TO STANDARDIZE OPTIMAL LEVELS OF CARE AND LEAD TO IMPROVED PATIENT OUTCOMES. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS THE NUSS PROCEDURE FOR THE CORRECTION OF PECTUS EXCAVATUM, DEVELOPED AT CHKD MORE THAN 20 YEARS AGO, CONTINUES TO DRAW NATIONAL ATTENTION FROM BOTH PATIENTS AND SURGEONS. IN FY 2013, CHKD'S SURGEONS HOSTED THE 11TH ANNUAL WORKSHOP ON THE SURGICAL PROCEDURE, TEACHING A KINDER, GENTLER CORRECTION FOR THIS COMMON BIRTH DEFECT TO MORE THAN 30 SURGEONS FROM ALL OVER THE UNITED STATES, EUROPE, ASIA AND THE MIDDLE EAST. A NEW FOCUS FOR CORRECTING CHEST WALL DEFORMITY WAS INITIATED AT CHKD WITH A FIRST-IN-THE-U.S. BRACING TREATMENT PERFORMED TO HELP CHILDREN WITH PECTUS CARINATUM, A DEFECT THAT IS THE OPPOSITE OF PECTUS EXCAVATUM. THE HOSPITAL CONTINUED ITS MULTI-SITE RESEARCH STUDY ON THE GENETIC MARKERS OF PECTUS EXCAVATUM. TO DATE, MORE THAN 1,500 SURGICAL PATIENTS HAVE UNDERGONE THE NUSS PROCEDURE AT CHKD. CHKD IS A MEMBER OF CHILDREN'S ONCOLOGY GROUP (COG), AN INTERNATIONAL RESEARCH GROUP THAT CONDUCTS CLINICAL TRIALS FOR CHILDREN WITH CANCER. AS A MEMBER, CHKD HAS ACCESS TO THE LATEST PROTOCOLS FOR TREATMENT OF CHILDHOOD CANCER, PROVIDING THE COMMUNITY AND REGION WITH THE BEST PRACTICES AND TREATMENT RESULTS FROM MORE THAN 240 COG-MEMBER HOSPITALS IN NORTH AMERICA, AUSTRALIA, NEW ZEALAND AND EUROPE. IN FY 2013, CHKD HAD 91 COG STUDIES OPEN TO ENROLLMENT OR UNDERGOING DATA ANALYSIS. SEVERAL OF THESE STUDIES WERE INCLUDED IN COG'S LONG-TERM FOLLOW-UP STUDY, WHICH COLLECTS DATA ON PATIENTS WHO HAVE PARTICIPATED IN STUDIES THAT ARE NO LONGER OPEN TO ENROLLMENT. IN FY 2013, CHKD HOSTED 80 INDIVIDUAL CONTINUING MEDICAL EDUCATION EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE REGION, HELPING CHILD HEALTH EXPERTS IN OUR REGION KEEP UP WITH THEIR SKILLS AND THEIR ACCREDITATION. PART VI, SECTION A LINES 6, 7A, 7B & 11 LINE 6: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED IS A VIRGINIA NON-STOCK CORPORATION WITH A SOLE MEMBER. THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED IS CHILDREN'S HEALTH SYSTEM, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED IS MANAGED BY ITS SOLE MEMBER, CHILDREN'S HEALTH SYSTEM, INC. LINE 7A: CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, MANAGES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. ACCORDINGLY, THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED. AS A VIRGINIA NON-STOCK CORPORATION, CHILDREN'S HEALTH SYSTEM, INC. HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. THE MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. ARE THE CLASS A MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. (I.E., THE THEN CURRENT MEMBERS IN GOOD STANDING OF THE NORFOLK CITY UNION OF THE KING'S DAUGHTERS, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION) AND THE CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM INC. (I.E., THE THEN CURRENT DIRECTORS ON THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC.). LINE7B: THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. LINE 11: THE 990 IS PREPARED USING THE ANNUAL FINANCIAL STATEMENTS THAT ARE REVIEWED BY THE BOARD AND AUDITED ANNUALLY AS A PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC. UPON COMPLETION OF THE DRAFT OF THE RETURN A DETAIL REVIEW IS PERFORMED BY SEVERAL MEMBERS OF STAFF AND MANAGEMENT. PRIOR TO FILING WITH THE IRS, THE BOARD IS PROVIDED A COPY TO REVIEW POLICIES & DISCLOSURE ITEMS 990 PART VI SECTIONS B & C CONFLICT POLICY CONSIDERATIONS: CHKD CONFLICT OF INTEREST POLICY INCLUDES OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES, KEY EMPLOYEES, ALL OTHER EMPLOYEES, PROFESSIONAL STAFF AND SUBSTANTIAL DONORS. ANNUALLY, A QUESTIONNAIRE IS DISTRIBUTED AND COLLECTED FROM OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES AND KEY EMPLOYEES. THE QUESTIONNAIRES ARE REVIEWED BY THE LEGAL DEPARTMENT. FOR KNOWN CONFLICTS, THE PERSON INVOLVED RECUSES HIMSELF OR HERSELF FROM DELIBERATIONS REGARDING THE TRANSACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY ARE REPORTED TO THE CHKD BOARD CHAIR OR THE CHKD COMPLIANCE OFFICER, AS APPLICABLE, AND MAY REQUIRE CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. COMPENSATION PROCESS CONSIDERATIONS: CHILDREN'S HEALTH SYSTEM ESTABLISHES THE COMPENSATION OF THE CEO JAMES DAHLING. CHILDREN'S HEALTH SYSTEM AND CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS USE THE FOLLOWING PROCESS TO ESTABLISH COMPENSATION FOR OFFICERS AND KEY EMPLOYEES: AN INDEPENDENT COMPENSATION CONSULTANT APPROVED AND RETAINED BY THE COMPENSATION COMMITTEE OF THE BOARD ANNUALLY, USUALLY IN APRIL, PROVIDES EDUCATION AND PRESENTS TO THE FULL BOARD COMPARATIVE SALARIES AND SALARY RANGES FROM A DATABASE COMPRISED OF CHILDREN'S HOSPITALS AND OTHER APPLICABLE HOSPITALS FOR OFFICERS & EXECUTIVES FOR THE BOARD TO REVIEW. THE COMPENSATION COMMITTEE WITH THE AID OF THE CONSULTANT REVIEWS AND MAKES DECISIONS AS TO EXECUTIVE SALARIES OF CHKD AND ITS SUBSIDIARIES. THOSE SALARY CHANGES AND APPROVALS ARE DOCUMENTED BY MINUTES MAINTAINED BY THE COMPENSATION COMMITTEE AND SIGNED BY THE CHAIRMAN OF THE BOARD. PART VI, C, LINE 19: FINANCIAL STATEMENTS (PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC.) ALONG WITH GOVERNING DOCUMENTS OF THE ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC THROUGH DIRECT INQUIRY AND REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS IS MADE UP OF TRANSFERS OUT ($14,946,477), UNREALIZED GAIN ON DERIVATIVE $6,798,942 AND OTHER CHANGES OF $27,617. 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