2014-11-06T10:41:19-06:00 2013-12-31 454084437 WARREN AVERETT LLC 2500 ACTON ROAD BIRMINGHAM AL 35243 990 2013-01-01 630307306 THE CHILDREN'S HOSPITAL OF ALABAMA CHIL 2056389100 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 DAWN WALTON CFO 2059399100 2014-10-09 1 JC ROUSE P00081132 2059794100 2013 2015-11-30 17:44:51Z WILLIAM MICHAEL WARREN J 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 689758422 0 X WWW.CHILDRENSAL.ORG X 1911 AL SPECIALTY ACUTE-CARE HOSPITAL PROVIDING INPATIENT AND OUTPATIENT MEDICAL SERVICES TO PEDIATRIC PATIENTS. 32 25 4716 1231 0 0 2662935 2807370 562332168 661414935 1810088 11553664 10093502 9023407 576898693 684799376 0 5000000 0 0 245736280 268451345 0 0 0 296977182 363563802 542713462 637015147 34185231 47784229 774438516 807994870 417710863 417976828 356727653 390018042 X THE MISSION OF THE CHILDREN'S HOSPITAL OF ALABAMA (THE HOSPITAL) IS TO PROVIDE THE FINEST PEDIATRIC HEALTH SERVICES TO ALL CHILDREN IN AN ENVIRONMENT THAT FOSTERS EXCELLENCE IN RESEARCH AND MEDICAL EDUCATION. THE HOSPITAL WILL BE AN ADVOCATE FOR ALL CHILDREN AND WORK TO EDUCATE THE PUBLIC ABOUT ISSUES AFFECTING CHILDREN'S HEALTH AND WELL-BEING. 0 0 346451542 408042700 THE HOSPITAL IS THE 3RD LARGEST AND ONE OF THE TOP 10 BUSIEST PEDIATRIC MEDICAL CENTER IN THE UNITED STATES. IT IS THE ONLY PEDIATRIC RENAL CARE CENTER, AND THE LARGEST PEDIATRIC BURN CENTER IN THE SOUTHEAST. CHILDREN'S OPERATES 342 BEDS, WHICH INCLUDES 48 NICU BASSINETS AND 98 CRITICAL CARE BEDS IN THE FOLLOWING UNITS: CARDIOVASCULAR, PEDIATRIC, NEONATAL, SPECIAL CARE, CRITICAL CARE, BURN AND STEM CELL TRANSPLANTS. IN 2013, CHILDREN'S HOSPITAL HAD 13,993 INPATIENT CASES AND 86,502 PATIENT DAYS. INPATIENT SURGERY CASES TOTALED 5,778 FOR 2013. THE CHILDREN'S CRITICAL CARE TRANSPORT TEAM PROVIDES HELICOPTER, JET AND GROUND TRANSPORT FOR CRITICALLY ILL AND INJURED CHILDREN. 179852012 213468125 THE HOSPITAL OPERATES 13 OUTPATIENT SPECIALTY CLINICS THAT HANDLE FOLLOW-UP VISITS FOR PATIENTS AS WELL AS REFERRALS FROM HEALTH DEPARTMENTS ACROSS THE STATE. THESE CLINICS PROVIDE SERVICES IN HEMODIALYSIS, GASTROENTEROLOGY, HEMATOLOGY/ONCOLOGY, ORTHOPEDICS, UROLOGY, OTORINOLARYNGOLOGY, NEUROLOGY, PULMONARY FUNCTION, GENERAL SURGERY, DENTAL, BEHAVIORAL SERVICES, SPEECH AND HEARING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND OTHERS. IN 2013, THESE CLINICS HAD 252,726 VISITS AND 17,159 OUTPATIENT SURGERIES WERE PERFORMED. THE HOSPITAL ALSO PROVIDES A STATEWIDE AND REGIONAL REFERRAL SITE FOR COMPLEX EMERGENCY PATIENTS. THE EMERGENCY DEPARTMENT HAD 55,062 VISITS IN 2013. 42510077 46953702 THE HOSPITAL HAS A NETWORK OF PRIMARY CARE PRACTICES THROUGHOUT THE STATE KNOWN AS PEDIATRIC PRACTICE SOLUTIONS. IT CONSISTS OF 13 PRACTICES SUPPORTING 60 GENERAL PEDIATRICIANS. IN 2013 THESE PRACTICES PROVIDED 334,967 VISITS. 5000000 5000000 0 THE HOSPITAL SUPPORTS THE UNIVERSITY OF ALABAMA AT BIRMINGHAM'S DEPARTMENT OF PEDIATRICS TO ENHANCE THE GROWTH AND DEVELOPMENT OF THE PEDIATRIC ENTERPRISE. 5000000 5000000 573813631 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 297 0 1 4716 1 0 1 CJ 0 0 0 0 0 0 0 0 X 32 25 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X JENNY WAKEFORD 2056386778 1600 7TH AVENUE SOUTH BIRMINGHAM AL 35233 WILLIAM MICHAEL WARREN JR PRESIDENT & CEO 40.00 X X 560089 0 191796 RAYMOND J HARBERT DIRECTOR 0.50 X 0 0 0 C PHILLIP MCWANE CHAIRMAN OF THE BOARD 0.50 X 0 0 0 W CHARLES MAYER TREASURER 0.50 X 0 0 0 SUSAN N HASKELL SECRETARY 0.50 X 0 0 0 RICHARD J BIELEN DIRECTOR 0.50 X 0 0 0 J DAVID BROWN III DIRECTOR 0.50 X 0 0 0 THOMAS N CARRUTHERS JR DIRECTOR 0.50 X 0 0 0 DERROL DAWKINS MD DIRECTOR 0.50 X 0 0 0 DAVID E DIXON MD DIRECTOR 0.50 X 0 0 0 BETH G DUBINA DIRECTOR 0.50 X 0 0 0 DAVID M FIELDS DIRECTOR 0.50 X 0 0 0 RALPH FROHSIN JR DIRECTOR 0.50 X 0 0 0 OB GRAYSON HALL JR DIRECTOR 0.50 X 0 0 0 JOHN O HUDSON III DIRECTOR 0.50 X 0 0 0 DONALD M JAMES DIRECTOR 0.50 X 0 0 0 VIRGINIA WALKER JONES DIRECTOR 0.50 X 0 0 0 PHILIPPE W LATHROP DIRECTOR 0.50 X 0 0 0 JAMES C LEE III VICE CHAIRMAN OF THE BOARD 0.50 X 0 0 0 THOMAS H LOWDER DIRECTOR 0.50 X 0 0 0 ROBERT S MCANNALLY DIRECTOR 0.50 X 0 0 0 L GWALTNEY MCCOLLUM JR DIRECTOR 0.50 X 0 0 0 CHARLES D MCCRARY DIRECTOR 0.50 X 0 0 0 ANN D MCMILLAN DIRECTOR 0.50 X 0 0 0 BEVERLY B MCNEIL DIRECTOR 0.50 X 0 0 0 HUGH J MORGAN JR DIRECTOR 0.50 X 0 0 0 CRAFT O'NEAL DIRECTOR 0.50 X 0 0 0 MARGARET M PORTER DIRECTOR 0.50 X 0 0 0 FREDERICK W RENNEKER III DIRECTOR 0.50 X 0 0 0 BEN RUSSELL DIRECTOR 0.50 X 0 0 0 LEE J STYSLINGER III DIRECTOR 0.50 X 0 0 0 TEMPLE W TUTWILER III DIRECTOR 0.50 X 0 0 0 MARC BRYANT TYSON DIRECTOR 0.50 X 0 0 0 GAYLE CUNNINGHAM DIRECTOR 0.50 X 0 0 0 THOMAS G SHUFFLEBARGER SR VP AND COO 40.00 X 592754 0 121248 DAWN WALTON CHIEF FINANCIAL OFFICER 40.00 X 338406 0 77684 JAMES MICHAEL BURGESS EXITING CHIEF FINANCIAL OFFICER 40.00 X 115572 0 0 MIKE MCDEVITT EXEC VP FACILITIES AND TEC 40.00 X 694088 0 110936 DOUGLAS DEAN CHIEF HUMAN RESOURCE OFFIC 40.00 X 384026 0 81566 DEBORAH M WESLEY SENIOR VP, CHIEF NURSING OFFICER 40.00 X 465715 0 74452 AUDIE WOOLLEY PEDIATRICIAN 40.00 X 927210 0 179726 JIMMY SCOTT HILL PEDIATRICIAN 40.00 X 926050 0 178366 BRIAN WIATRAK PEDIATRICIAN 40.00 X 927833 0 179726 DAVID KELLY PEDIATRICIAN 40.00 X 635210 0 187819 ELIZABETH MROCZEK-MUSULMAN PEDIATRICIAN 40.00 X 619389 0 151929 7186342 0 1535248 273 0 1 0 UNIVERSITY OF ALABAMA HEALTH SERVICES FO 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 SUBSPECIALTY, MOONLIGHTING, AFTER HOURS, 18856109 HOARBE&K JOINT VENTURE TWO METROPLEX DRIVE STE 400 BIRMINGHAM AL 35209 CONSTRUCTION 12508108 UAB DEPARTMENT OF PEDIATRICS 1600 7TH AVENUE SOUTH BIRMINGHAM AL 35233 PROGRAM SUPPORT 10140724 DOSTER CONSTRUCTION COMPANY INC 2100 INTERNATIONAL PARK DR BIRMINGHAM AL 35243 CONSTRUCTION 9320088 UNIVERSITY OF ALABAMA HOSPITAL 619 19TH STREET SOUTH JEFFERSON TO BIRMINGHAM AL 35233 HOSPITAL RESIDENTS 6969269 301 2045515 761855 2807370 PATIENT SERVICE 900099 661405409 661405409 MEDICAID DISPROPORTIONATE SHARE 900099 9526 9526 661414935 11462013 11462013 3141 3141 2277541 4761907 -2484366 -2484366 -2484366 285649 197139 88510 88510 88510 GRADUATE MEDICAL 900099 3998054 3998054 CAFETERIA/VENDING 900099 2987818 2987818 PARKING 900099 1371186 1371186 3150715 3051538 99177 11507773 684799376 668464527 0 13527479 X 5000000 5000000 3150650 2835585 315065 219887268 197898541 21988727 30323778 27291400 3032378 15089649 13580684 1508965 537551 483796 53755 205736 185162 20574 59526466 53573819 5952647 9362286 8426057 936229 3258551 2932696 325855 11333808 10200427 1133381 60901221 54811099 6090122 7928718 7135846 792872 MEDICAL SUPPLIES 45187844 40669060 4518784 PROVIDER TAX 38892801 35003521 3889280 DRUGS 32531186 29278067 3253119 BAD DEBT EXPENSE 12599321 11339389 1259932 81298313 73168482 8129831 637015147 573813631 63201516 0 68874018 94207625 16909131 16912251 40839232 54276832 11512787 13018032 10756549 11844156 1072491106 488188319 600023153 584302787 25523646 33433187 774438516 807994870 45467121 53793798 3438935 3438562 292851574 280507203 75953233 80237265 417710863 417976828 X 356727653 390018042 356727653 390018042 774438516 807994870 X 47784229 -14493840 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 294424 294424 636720723 637015147 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 230070 249541 267916 294424 1041951 250000 250000 250000 250000 1000000 1500000 PART II-B, LINE 1: THE HOSPITAL BELONGS TO CERTAIN ORGANIZATIONS THAT ENGAGE IN LOBBYING ACTIVITIES ON BEHALF OF THEIR HOSPITAL MEMBERS. SINCE THIS IS A NONALLOWABLE EXPENSE, THESE ORGANIZATIONS INFORM THEIR MEMBERS THE PORTION OF THEIR DUES THAT SHOULD BE CONSIDERED APPLICABLE TO LOBBYING EXPENSES SO THAT THE APPROPRIATE ADJUSTMENT CAN BE MADE. IN AN EFFORT TO DETERMINE WHICH DUES INCLUDE LOBBYING EXPENSES, WE REVIEWED THE INVOICES FOR ALL DUES PAYMENTS IN EXCESS OF $10,000 AND SCHEDULED ALL OTHER PAYMENTS WE WERE MADE AWARE OF THROUGH VARIOUS INQUIRY. 4800118 4800118 700818832 246684368 454134464 7893807 5152569 2741238 330802105 236351382 94450723 28176244 28176244 584302787 SALARIES PAYABLE 28816441 ACCRUED INTEREST PAYABLE 984969 PROFESSIONAL LIABILITY ACCRUAL 3519833 EXECUTIVE RETIREMENT PLAN 20822157 DUE TO AFFILIATE 26093865 80237265 X PART X, LINE 2: THE COMPANY IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). THE COMPANY ADHERES TO THE PROVISIONS OF THE ACCOUNTING STANDARDS CODIFICATION RELATING TO UNCERTAINTY IN INCOME TAXES THAT REQUIRES ENTITIES TO ASSESS THEIR UNCERTAIN TAX POSITIONS FOR THE LIKELIHOOD THAT THEY WOULD BE OVERTURNED UPON INTERNAL REVENUE SERVICE (IRS) EXAMINATION OR UPON EXAMINATION BY STATE TAXING AUTHORITIES. THE COMPANY HAS DETERMINED THAT IT DOES NOT HAVE ANY POSITIONS AT DECEMBER 31, 2013, THAT IT WOULD BE UNABLE TO SUBSTANTIATE. THE COMPANY HAS FILED ITS TAX RETURNS THROUGH DECEMBER 31, 2012. THE TAX RETURNS FOR THE YEARS ENDED DECEMBER 31, 2010, AND THEREAFTER ARE SUBJECT TO AUDIT BY THE TAXING AUTHORITIES. 1 1 1 X 250.000000000000 1 X 1 0 1 1 5997526 5997526 0.00940 328422336 324307073 4115263 0.00650 22677096 24532436 -1855340 0.00000 357096958 348839509 8257449 0.01590 12 62878 6504373 1318947 5185426 0.00810 4 4043 12389275 1539841 10849434 0.01700 2 0 6122978 3043175 3079803 0.00480 1 0 273743 273743 0.00040 0 0 19 66921 25290369 5901963 19388406 0.03030 19 66921 382387327 354741472 27645855 0.04620 0 4816720 1292792 2693258 2289916 403342 X 1 0 1 1 CHILDREN'S HOSPITAL OF ALABAMA 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 X X X X X X THE CHILDREN'S HOSPITAL OF ALABAMA 1 1 X X X X X X X X 13 1 0 1 X WWW.CHILDRENSAL.ORG X X 1 0 1 1 250.000000000000 1 400.000000000000 1 X X X X X 1 1 X X X 1 X 1 X X X X 1 X 0 0 THE CHILDREN'S HOSPITAL OF ALABAMA PART V, SECTION B, LINE 3: CHILDREN'S OF ALABAMA INVITED SCHOOL NURSES, PEDIATRICIANS, FAMILY PRACTICE PHYSICIANS, AND COMMUNITY ADVOCATES TO PARTICIPATE IN AN ONLINE SURVEY TO IDENTIFY HEALTH NEEDS FOR CHILDREN IN ALABAMA. IN ADDITION TO THE ONLINE SURVEY TOOL, FACE-TO-FACE AND TELEPHONE INTERVIEWS WERE CONDUCTED IN OCTOBER AND NOVEMBER 2012 WITH ALABAMA'S PUBLIC HEALTH LEADERS AND COMMUNITY ADVOCATES. THEY WERE CHOSEN FOR THEIR KNOWLEDGE OF MEDICALLY AND SOCIALLY UNDERSERVED AREAS, PUBLIC HEALTH, AND PEDIATRIC HEALTH CHALLENGES. INTERVIEWEES WERE ASKED WHAT THEY PERCEIVE AS THE GREATEST HEALTH NEEDS FOR CHILDREN IN THEIR SPECIFIC COMMUNITIES AND IN THE STATE IN GENERAL. THE CHILDREN'S HOSPITAL OF ALABAMA PART V, SECTION B, LINE 14G: THE DETAIL FINANCIAL ASSISTANCE POLICY IS AVAILABLE ON THE HOSPITAL'S WEBSITE AS WELL AS UPON REQUEST. SIGNAGE REFERENCING THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED IN THE EMERGENCY DEPARTMENT, WAITING AND ADMITTING AREAS. IN ADDITION, THERE IS LANGUAGE INCLUDED ON ALL BILLING INVOICES INFORMING THE GUARANTOR OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. THE CHILDREN'S HOSPITAL OF ALABAMA PART V, SECTION B, LINE 18E: SIGNAGE IS POSTED IN THE EMERGENCY DEPARTMENT, WAITING AND ADMITTING AREAS NOTIFYING PATIENTS AND GUARANTORS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. PART I, LINE 7: THE COSTING METHODOLOGY USED TO COMPLETE LINE 7 WAS AN OVERALL COST-TO-CHARGE RATIO COMPUTED USING THE IRS FORM 990 WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES.PART I, LINE 7 COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $12,599,321. PART II, COMMUNITY BUILDING ACTIVITIES: WHILE THE HOSPITAL DID NOT HAVE SYSTEMS IN PLACE TO FORMALLY TRACK COMMUNITY BUILDING ACTIVITIES FOR 2013, HOSPITAL EXECUTIVES AND VICE PRESIDENTS SERVED ON A VARIETY OF COMMUNITY BOARDS INCLUDING MAGIC MOMENTS AND RONALD MCDONALD HOUSE. IN ADDITION, APPROXIMATELY 50 ADMINISTRATIVE INTERNS AND AIDES WERE EDUCATED BY HOSPITAL EMPLOYEES DURING THE YEAR. PART III, LINE 4: RECEIVABLES FROM PATIENTS, INSURANCE COMPANIES AND THIRD-PARTY CONTRACTUAL AGENCIES ARE STATED AT NET REALIZABLE VALUE. THE HOSPITAL EVALUATES THE COLLECTABILITY OF ITS PATIENT ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, HISTORICAL COLLECTION EXPERIENCE, REVIEW OF LARGE BALANCE ACCOUNTS AND TRENDS IN HEALTH CARE INSURANCE PROGRAMS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WITH THIRD-PARTY INSURERS, THE HOSPITAL ESTIMATES CONTRACTUAL ALLOWANCES BASED ON THE TERMS OF THIRD-PARTY INSURED CONTRACTS AND ESTIMATES AN ADDITIONAL ALLOWANCE FOR DOUBTFUL ACCOUNTS ON PATIENT RESPONSIBLE BALANCES AFTER THIRD-PARTY PAYMENTS. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THESE ALLOWANCES ARE RECORDED ON AN ESTIMATED BASIS AND ADJUSTED AS NEEDED IN FUTURE PERIODS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBTS IF SUBSEQUENTLY COLLECTED. PART III, LINE 2: THE COST OF BAD DEBT WRITE-OFFS AND THE RELATED COSTS ON LINE 3 WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF. PART III, LINE 3: BAD DEBTS ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR CHARITY CARE WERE CALCULATED BASED ON THE OUTSTANDING PATIENT BALANCE IN EXCESS OF A REASONABLE AMOUNT THE AVERAGE PERSON COULD PAY WITHOUT CREATING A MEDICAL HARDSHIP. FOR 2013 THIS AMOUNT IS $20,000, WHICH APPROXIMATES THE INCOME LIMIT FOR A FAMILY OF 4 IN THE FEDERAL POVERTY GUIDELINES. CHARITY CARE DETERMINATIONS ARE BASED ON COMPLETING THE REQUIRED APPLICATION AND MEETING DEFINED CRITERIA OF THE HOSPITAL. MANY TIMES PATIENTS FAIL TO COMPLETE PAPERWORK REQUIRED DESPITE EFFORTS TO EDUCATE AND INFORM PATIENTS OF THIS OPTION. HOWEVER BASED ON SOCIO-ECONOMIC AND OTHER KNOWN FACTORS, IT IS HIGHLY LIKELY THAT THESE PATIENTS WOULD MEET ESTABLISHED CHARITY CARE CRITERIA IF THE APPLICATION PROCESS WAS COMPLETED. PART VI, LINE 2: THE HOSPITAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY EVALUATING DISEASE AND INJURY DATA OF PATIENTS THAT ARE SERVED IN THE HOSPITAL'S CLINICS AND THAT PRESENT IN THE EMERGENCY DEPARTMENT, PARTICULARLY AROUND INJURY CARE. IN ADDITION, THE HOSPITAL CONSIDERS INFORMATION PROVIDED BY LOCAL PEDIATRICIANS, THE CENTER FOR DISEASE CONTROL, AND OTHER NATIONAL, STATE, AND LOCAL HEALTHCARE GROUPS. PART VI, LINE 3: EACH PATIENT THAT PRESENTS AS A SELF PAY PATIENT IS DIRECTED TO A FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR EDUCATES PATIENTS AND THEIR FAMILIES ABOUT GOVERNMENT AND FINANCIAL ASSISTANCE PROGRAMS AND ASSISTS WITH RELATED APPLICATIONS. IF A PATIENT IS NOT COUNSELED BY A FINANCIAL COUNSELOR ON THE DATE OF SERVICE, FOLLOW UP ATTEMPTS ARE MADE BY THE FINANCIAL COUNSELORS AND THE BUSINESS OFFICE TO CONTINUE TO INFORM AND EDUCATE PATIENTS RELATED TO AVAILABLE PROGRAMS. IN ADDITION, THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE AND THERE IS SIGNAGE THROUGHOUT THE HOSPITAL INFORMING PATIENTS OF THE AVAILABILITY OF A FINANCIAL ASSISTANCE PROGRAM. PART VI, LINE 4: THE HOSPITAL'S PRIMARY SERVICE AREA IS BIRMINGHAM-HOOVER METROPOLITAN STATISTICAL AREA AS DEFINED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET. THE HOSPITAL'S SECONDARY SERVICE AREA IS DEFINED AS THE REST OF THE STATE, AND WE CARE FOR PATIENTS FROM EVERY COUNTY IN THE STATE. DEMOGRAPHIC DATA INCLUDING RACE, GENDER, AND AGE IS CAPTURED THROUGH THE REGISTRATION PROCESS. FOR 2013, CAUCASIANS, AFRICAN-AMERICANS, HISPANICS, AND OTHER RACES ACCOUNTED FOR 57%, 36%, 5%, AND 2%, RESPECTIVELY, OF THE PATIENTS SERVED WHILE 37%, 37%, AND 26% WERE AGES 0-4, 5-12, AND 13+ YEARS, RESPECTIVELY. ECONOMIC DEMOGRAPHIC DATA IS NOT SPECIFICALLY CAPTURED HOWEVER, IN 2013 GREATER THAN 60% OF THE HOSPITAL'S PATIENTS QUALIFIED FOR GOVERNMENTAL MEANS-TESTED PROGRAMS SUCH AS MEDICAID AND SCHIP. PART VI, LINE 5: THE HOSPITAL IS THE PRIMARY SOURCE OF PEDIATRIC HEALTHCARE AND PEDIATRIC HEALTH EDUCATION IN THE STATE OF ALABAMA THROUGH ITS AFFILIATION WITH THE SCHOOL OF MEDICINE AT THE UNIVERSITY OF ALABAMA AT BIRMINGHAM. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF, HAS A BOARD COMPRISED OF COMMUNITY MEMBERS, AND OPERATES AN OPEN EMERGENCY DEPARTMENT THAT TREATS ALL EMERGENT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL OPERATES THE ONLY LEVEL 1 PEDIATRIC TRAUMA CENTER, THE ONLY PEDIATRIC RENAL CARE CENTER, AND THE ONLY INPATIENT CHILDREN'S PSYCHIATRIC UNIT IN THE STATE. IN ADDITION, THE HOSPITAL OPERATES THE LARGEST PEDIATRIC BURN CENTER IN THE SOUTHEAST. THE HOSPITAL IS EDUCATION AND RESEARCH FOCUSED AND COLLABORATES WITH LOCAL UNIVERSITIES, AS WELL AS THOSE THROUGHOUT THE STATE, TO TRAIN AND EDUCATE FUTURE HEALTHCARE PROFESSIONALS. THIS IS REFLECTED BY THE FACT THAT APPROXIMATELY 50-60% OF THE PEDIATRICIANS PRACTICING IN THE STATE OF ALABAMA TRAINED AT THE HOSPITAL AND THAT THE HOSPITAL TRAINED NURSING STUDENTS FROM 9 DIFFERENT COLLEGES AND UNIVERSITIES DURING 2013. IN ADDITION, THE HOSPITAL PARTICIPATES IN APPROXIMATELY 225 CLINICAL RESEARCH STUDIES ON AN ANNUAL BASIS. 1 UNIVERSITY OF ALABAMA AT BIRMINGHAM 1530 3RD AVENUE SOUTH BIRMINGHAM AL 35294 636005396 GOVERNMENT ORG 5000000 0 N/A N/A ENHANCE PEDIATRIC ENTERPRISE 1 0 PART I, LINE 2: THE HOSPITAL RESTRICTED THE FUNDS GRANTED TO THE UNIVERSITY OF ALABAMA AT BIRMINGHAM TO BE USED EXCLUSIVELY FOR THE SUPPORT OF THE DEPARTMENT OF PEDIATRICS IN ORDER TO ENHANCE THE GROWTH AND DEVELOPMENT OF THE PEDIATRIC ENTERPRISE. X X X X 0 1 0 0 0 0 0 0 0 WILLIAM MICHAEL WARREN JR PRESIDENT & CEO 558676 0 0 0 1413 0 175666 0 16130 0 751885 0 0 0 THOMAS G SHUFFLEBARGER SR VP AND COO 357207 0 143000 0 92547 0 96941 0 24307 0 714002 0 91244 0 DAWN WALTON CHIEF FINANCIAL OFFICER 233982 0 103000 0 1424 0 58893 0 18791 0 416090 0 0 0 MIKE MCDEVITT EXEC VP FACILITIES AND TEC 330674 0 109000 0 254414 0 89999 0 20937 0 805024 0 253014 0 DOUGLAS DEAN CHIEF HUMAN RESOURCE OFFIC 244580 0 82000 0 57446 0 56102 0 25464 0 465592 0 56004 0 DEBORAH M WESLEY SENIOR VP, CHIEF NURSING OFFICER 226276 0 90000 0 149439 0 55360 0 19092 0 540167 0 148015 0 AUDIE WOOLLEY PEDIATRICIAN 516817 0 408946 0 1447 0 78750 0 100976 0 1106936 0 0 0 JIMMY SCOTT HILL PEDIATRICIAN 515658 0 408946 0 1446 0 78750 0 99616 0 1104416 0 0 0 BRIAN WIATRAK PEDIATRICIAN 517441 0 408946 0 1446 0 78750 0 100976 0 1107559 0 0 0 DAVID KELLY PEDIATRICIAN 331309 0 65782 0 238119 0 83449 0 104370 0 823029 0 236733 0 ELIZABETH MROCZEK-MUSULMAN PEDIATRICIAN 272041 0 53656 0 293692 0 67773 0 84156 0 771318 0 292258 0 PART I, LINE 4B WILLIAM MICHAEL WARREN, JR. - $175,666 THOMAS G. SHUFFLEBARGER - $96,941 DAWN WALTON - $58,893 DOUGLAS B. DEAN - $56,102 DEBORAH M. WESLEY - $55,360 MIKE MCDEVITT - $89,999 AUDIE WOOLLEY - $78,750 JIMMY SCOTT HILL - $78,750 BRIAN WIATRACK - $78,750 DAVID KELLY - $83,449 ELIZABETH MROCZEK-MUSULMAN - $67,773 A SPECIAL CARE FACILITIES FINANCING AUTH OF THE CTY OF BHAM - CHILDREN'S HOSP 631005621 090929FV7 2009-09-01 233179363 CONSTRUCT AND EQUIP FACILITY 0 0 0 B SPECIAL CARE FACILITIES FINANCING AUTH OF THE CTY OF BHAM - CHILDREN'S HOSP 631005621 090929FZ8 2012-02-24 26250000 FINANCE EXPANSION FACILITY 0 0 0 C SPECIAL CARE FACILITIES FINANCING AUTH OF THE CTY OF BHAM - CHILDREN'S HOSP 631005621 2012-06-28 74600000 FINANCE EXPANSION FACILITY 0 0 0 A 233179363 15973687 25538118 3480828 4329725 176300761 726331 0 0 1 1 B 26250000 26250000 0 0 1 1 C 74600000 74600000 0 0 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 0 A 0 B 0 C 0 BUFFALO ROCK ENTITY MORE THAN 35% OWNED BY JAMES C. LEE, III, DIRECTOR 210279 VENDING 0 ALABAMA POWER CHARLES D. MCCRARY & DONALD JAMES ARE DIRECTORS OF THE ABOVE ENTITY 5594533 ELECTRICITY PROVIDER 0 ALABAMA GAS CORPORATION ROBERT MCANNALLY IS EMPLOYED BY THE ABOVE ENTITY 995631 GAS UTILITY 0 REGIONS BANK CHARLES D. MCCRARY & LEE STYSLINGER ARE DIRECTORS OF THE ABOVE ENTITY 149465 BANKING SERVICES 0 REGIONS BANK O.B. GRAYSON HALL, JR. IS THE CEO OF THE ABOVE ENTITY 149465 BANKING SERVICES 0 FORM 990, PART VI, SECTION A, LINE 2 THOMAS N. CARRUTHERS, JR. IS OF COUNSEL IN A FIRM WHICH ACTS AS GENERAL COUNSEL FOR THE HOSPITAL AS WELL AS COUNSEL TO THE OBLIGATED GROUP AND BOND COUNSEL. DERROL DAWKINS, M.D. HAS ADMITTING PRIVILEGES TO THE HOSPITAL. O.B. GRAYSON HALL, JR IS THE CEO OF A BANK THAT PROVIDES THE MAJORITY OF THE BANKING SERVICES TO THE HOSPITAL. RAYMOND J. HARBERT OWNS AN INVESTMENT COMPANY THAT MANAGES A HEDGE FUND IN WHICH THE HOSPITAL HAS INVESTED THROUGH A FUND OF FUNDS. DONALD M. JAMES IS A DIRECTOR OF A BANK WHICH WAS AN UNDERWRITER FOR THE HOSPITAL BONDS. MR. JAMES IS ALSO A DIRECTOR FOR THE PARENT COMPANY OF AN ELECTRIC UTILITY THAT PROVIDES UTILITY SERVICES TO THE HOSPITAL. IN ADDITION, MR. JAMES IS A TRUSTEE FOR UAB HEALTH SYSTEM AND UA HEALTH SERVICES FOUNDATION, BOTH OF WHICH HAVE AN AFFILIATION AGREEMENT TO PROVIDE MEDICAL SERVICES TO THE HOSPITAL. VIRGINA WALKER JONES IS EMPLOYED BY A COMPANY THAT PROVIDES CERTAIN VENDING SERVICES TO THE HOSPITAL. IN ADDITION, MARGARET M. PORTER AND THE SPOUSE OF MS. JONES ARE MEMBERS OF AN ADVISORY BOARD FOR A BANK THAT WAS AN UNDERWRITER AND THAT CURRENTLY PROVIDES THE MAJORITY OF THE BANKING SERVICES TO THE HOSPITAL. MARGARET M. PORTER'S SPOUSE HOLDS A MINORITY OWNERSHIP IN A REAL ESTATE CONSULTING FIRM THAT PROVIDES SERVICES TO THE HOSPITAL. JAMES C. LEE, III IS THE OWNER OF A COMPANY THAT PROVIDES VENDING SERVICES TO THE HOSPITAL. THOMAS H. LOWDER SERVES ON THE BOARD OF TWO ORGANIZATIONS THAT MAKE CONTRIBUTIONS TO THE FOUNDATION. ROBERT S. MCANNALLY IS EMPLOYED BY THE PARENT COMPANY OF A GAS UTILITY THAT PROVIDES UTILITY SERVICES TO THE HOSPITAL. CHARLES D. MCCRARY IS THE CEO OF AN ELECTRIC UTILITY WHICH PROVIDES UTILITY SERVICES TO THE HOSPITAL AS WELL AS SERVES AS A BOARD MEMBER FOR A BANK THAT WAS AN UNDERWRITER AND THAT CURRENTLY PROVIDES THE MAJORITY OF THE BANKING SERVICES TO THE HOSPITAL. HE RESIGNED FROM THE CEO POSITION EFFECTIVE 3/1/2014. HUGH MORGAN IS A DIRECTOR OF A COMPANY FROM WHICH THE HOSPITAL PURCHASED MEDICAL EQUIPMENT DURING 2013. BEN RUSSELL IS THE FOUNDER AND CHAIRMAN OF THE BOARD OF A NON-PROFIT ORGANIZATION THAT LEASES SPACE FROM THE HOSPITAL TO PROVIDE FAMILY SERVICE ACTIVITIES TO PATIENTS AND THEIR FAMILIES. LEE J. STYSLINGER, III SERVES AS A BOARD MEMBER FOR A BANK THAT IS AN UNDERWRITER AND THAT CURRENTLY PROVIDES THE MAJORITY OF THE BANKING SERVICES TO THE HOSPITAL. MARC TYSON IS THE CEO OF A COMPANY, WHICH PROVIDED CONCRETE FOR THE EXPANSION FACILITY. THE HOSPITAL BELIEVES THAT ALL BUSINESS WITH SUCH FIRMS AND BUSINESSES IS CONDUCTED ON TERMS AND CONDITIONS NO LESS FAVORABLE TO THE HOSPITAL THAN THAT WITH UNRELATED THIRD PARTIES. FORM 990, PART VI, SECTION B, LINE 11 THE COMPLETED FORM 990 IS REVIEWED IN DETAIL BY THE FINANCE AND AUDIT COMMITTEE, AS WELL AS THE BOARD OF TRUSTEES, PRIOR TO FILING THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. ANNUAL DISCLOSURE REQUESTS ARE SENT AND FOLLOWED UP ON TO ENSURE THAT ALL ARE RETURNED. RETURNED CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER AND COMPLIANCE DEPARTMENT STAFF AS WELL AS OFFICERS OF THE HOSPITAL FOR ACCURACY AND COMPLETENESS. CONFLICT OF INTEREST STATEMENTS ARE MAINTAINED BY THE COMPLIANCE DEPARTMENT. THE COMPLIANCE OFFICER REPORTS ACTIVITY RELATED TO ANY POTENTIAL CONFLICTS OF INTEREST, INCLUDING CHANGES IN PREVIOUSLY REPORTED CONFLICTS TO ADMINISTRATION, THE FINANCE & AUDIT COMMITTEE, AND THE BOARD OF TRUSTEES ON A REGULAR BASIS. FORM 990, PART VI, SECTION B, LINE 15 THE HOSPITAL MAINTAINS OVERSIGHT CONCERNING ALL EXECUTIVE COMPENSATION ACTION. THIS PROCESS IS LED BY THE HOSPITAL BOARD OF TRUSTEES COMPENSATION COMMITTEE, WHICH IS INVOLVED ANNUALLY, AND THROUGHOUT THE YEAR AS NEEDED, IN PROVIDING OVERSIGHT OF ALL EXECUTIVE COMPENSATION. TOTAL COMPENSATION (I.E. BASE SALARY, INCENTIVE COMPENSATION, AND EXECUTIVE BENEFITS) OF OFFICERS, KEY EMPLOYEES, AND OTHER VICE-PRESIDENTS IS APPROVED BY THE COMPENSATION COMMITTEE PRIOR TO SUCH COMPENSATION BEING PAID. THE TOTAL COMPENSATION THAT IS PRESENTED FOR APPROVAL IS DETERMINED BY EVALUATION OF MARKET DATA COMPARISONS ON EXECUTIVE TOTAL COMPENSATION. THIS INDEPENDENT, OBJECTIVE MARKET DATA IS PROVIDED BY THE HOSPITAL'S INDEPENDENT EXECUTIVE COMPENSATION CONSULTING FIRM, MERCER. ALL COMPENSATION COMMITTEE PROCEEDINGS, DECISIONS, AND ACTIONS ARE DOCUMENTED IN COMMITTEE MINUTES THAT ARE MAINTAINED BY THE HOSPITAL. FORM 990, PART VI, SECTION C, LINE 19 THE CONFLICT OF INTEREST POLICY IS SUMMARIZED IN THE CORPORATE CODE OF CONDUCT WHICH IS AVAILABLE ON THE HOSPITAL'S WEBSITE. THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT GENERALLY AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 24E MISCELLANEOUS EXPENSE: PROGRAM SERVICE EXPENSES 10,630,582. MANAGEMENT AND GENERAL EXPENSES 1,181,176. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,811,758. LAB EXPENSE: PROGRAM SERVICE EXPENSES 10,554,429. MANAGEMENT AND GENERAL EXPENSES 1,172,714. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,727,143. MANAGEMENT CONTRACTS: PROGRAM SERVICE EXPENSES 9,666,591. MANAGEMENT AND GENERAL EXPENSES 1,074,066. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,740,657. EQUIPMENT RENTAL AND MAINTENANCE: PROGRAM SERVICE EXPENSES 7,197,052. MANAGEMENT AND GENERAL EXPENSES 799,672. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,996,724. CONSULTING FEES: PROGRAM SERVICE EXPENSES 5,817,691. MANAGEMENT AND GENERAL EXPENSES 646,410. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,464,101. EQUIPMENT RELATED SUPPLIES: PROGRAM SERVICE EXPENSES 4,578,542. MANAGEMENT AND GENERAL EXPENSES 508,727. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,087,269. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 4,528,348. MANAGEMENT AND GENERAL EXPENSES 503,150. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,031,498. MAINTENANCE: PROGRAM SERVICE EXPENSES 4,476,005. MANAGEMENT AND GENERAL EXPENSES 497,334. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,973,339. MINOR MEDICAL EQUIPMENT: PROGRAM SERVICE EXPENSES 3,503,118. MANAGEMENT AND GENERAL EXPENSES 389,235. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,892,353. TRANSPORTATION: PROGRAM SERVICE EXPENSES 3,021,591. MANAGEMENT AND GENERAL EXPENSES 335,732. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,357,323. SUPPLIES: PROGRAM SERVICE EXPENSES 2,248,485. MANAGEMENT AND GENERAL EXPENSES 249,832. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,498,317. TELEPHONE: PROGRAM SERVICE EXPENSES 1,822,639. MANAGEMENT AND GENERAL EXPENSES 202,515. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,025,154. PROFESSIONAL DUES: PROGRAM SERVICE EXPENSES 1,462,961. MANAGEMENT AND GENERAL EXPENSES 162,551. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,625,512. SUBSCRIPTIONS AND PUBLICATIONS: PROGRAM SERVICE EXPENSES 577,852. MANAGEMENT AND GENERAL EXPENSES 64,206. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 642,058. REGISTRATION FEES: PROGRAM SERVICE EXPENSES 570,868. MANAGEMENT AND GENERAL EXPENSES 63,430. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 634,298. BANKING FEES: PROGRAM SERVICE EXPENSES 545,569. MANAGEMENT AND GENERAL EXPENSES 60,619. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 606,188. PRINTING AND PUBLICATIONS: PROGRAM SERVICE EXPENSES 383,454. MANAGEMENT AND GENERAL EXPENSES 42,606. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 426,060. POSTAGE AND SHIPPING: PROGRAM SERVICE EXPENSES 337,919. MANAGEMENT AND GENERAL EXPENSES 37,547. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 375,466. LODGING: PROGRAM SERVICE EXPENSES 315,345. MANAGEMENT AND GENERAL EXPENSES 35,038. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 350,383. COLLECTION FEES: PROGRAM SERVICE EXPENSES 292,090. MANAGEMENT AND GENERAL EXPENSES 32,454. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 324,544. NOVELTIES: PROGRAM SERVICE EXPENSES 266,974. MANAGEMENT AND GENERAL EXPENSES 29,664. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 296,638. MEALS: PROGRAM SERVICE EXPENSES 236,793. MANAGEMENT AND GENERAL EXPENSES 26,310. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 263,103. SPECIAL FUNCTIONS: PROGRAM SERVICE EXPENSES 119,838. MANAGEMENT AND GENERAL EXPENSES 13,315. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 133,153. RECOGNITIONS: PROGRAM SERVICE EXPENSES 13,577. MANAGEMENT AND GENERAL EXPENSES 1,509. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,086. TELETHON EXPENSE: PROGRAM SERVICE EXPENSES 169. MANAGEMENT AND GENERAL EXPENSES 19. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 188. FORM 990, PART XI, LINE 9: TRANSFER TO ALABAMA CHILDREN'S HOSPITAL FOUNDATION -14,493,840. FORM 990, PART XI, LINE 2C: THE HOSPITAL MADE NO CHANGES TO ITS OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE TAX YEAR. ALABAMA CHILDREN'S HOSPITAL FOUNDATION 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 630879471 FUNDRAISING ACTIVITIES AL 501(C)(3) LINE 11B, II THE CHILDREN'S HOSPITAL OF ALABAMA 1 THE CHILDREN'S HOSPITAL AUXILIARY 1600 SEVENTH AVENUE SOUTH BIRMINGHAM AL 35233 630774930 FUNDRAISING ACTIVITIES AL 501(C)(3) LINE 11C, III-FI N/A 0 TCH VENTURES 1600 7TH AVENUE SOUTH BIRMINGHAM AL 35233 630942442 HOLDING COMPANY AL THE CHILDREN'S HOSPITAL OF ALABAMA C 772 1.00000 1 HOLY INNOCENTS INDEMNITY LTD PO BOX 10073 APO GRAND CAYMAN GRAND CAYMAN CJ 980436612 INSURANCE CJ THE CHILDREN'S HOSPITAL OF ALABAMA C 3809216 27150589 1.00000 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 ALABAMA CHILDREN'S HOSPITAL FOUNDATION B 14815500 FAIR MARKET VALUE ALABAMA CHILDREN'S HOSPITAL FOUNDATION E 8099237 FAIR MARKET VALUE HOLY INNOCENTS INDEMNITY LLC E -10012644 FAIR MARKET VALUE HOLY INNOCENTS INDEMNITY LLC R 3340851 FAIR MARKET VALUE ALABAMA CHILDREN'S HOSPITAL FOUNDATION C 321660 FAIR MARKET VALUE TCH VENTURES D 1025 FAIR MARKET VALUE