2014-11-13T16:16:38-06:00 2013-12-31 861065772 DELOITTE TAX LLP 201 E KENNEDY BLVD STE 1200 TAMPA FL 33602 990 2013-01-01 590638499 VARIETY CHILDREN'S HOSPITAL DBA MIAMI CHILDREN'S HOSPITAL VARI 3056666511 3100 SW 62ND AVENUE MIAMI FL 331553009 TIMOTHY BIRKENSTOCK SENIOR VP AND CFO 3056666511 2014-11-07 0 STEVEN E ROVNER P00648526 8132738355 2013 2015-11-30 17:44:51Z TIMOTHY BIRKENSTOCK 3100 SW 62ND AVENUE MIAMI FL 331553009 569506520 0 X WWW.MCH.COM X 1950 FL SEE SCHEDULE O 16 13 3915 1695 122277 -54087 5383169 13232648 476934503 522636121 21076949 17135133 17946534 16484863 521341155 569488765 0 0 0 0 249130533 284998874 0 0 0 223790506 222631709 472921039 507630583 48420116 61858182 835671954 917641210 398585445 381340508 437086509 536300702 X THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. 0 0 406104465 522636121 SEE SCHEDULE O: PROGRAM SERVICE ACCOMPLISHMENTS. 406104465 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 752 0 1 3915 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 16 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MIAMI CHILDREN'S HOSPITAL 3056666511 3100 SW 62ND AVENUE MIAMI FL 331553009 JEFRY BIEHLER MD DIRECTOR 39.50 0.50 X 319275 0 23255 ANSELMO CEPERO MD DIRECTOR 1.50 0.50 X 0 0 0 THOMAS M CORNISH DIRECTOR 1.50 0.50 X 0 0 0 JARET DAVIS ESQUIRE DIRECTOR 1.50 0.50 X 0 0 0 MARIA FRANCO MD DIRECTOR 1.50 0.50 X 0 0 0 MICHAEL FUX DIRECTOR 1.50 0.50 X 0 0 0 GHISLAIN GOURAIGE JR DIRECTOR 1.50 0.50 X 0 0 0 GARY GREGORY CHAIRMAN 1.50 0.60 X 0 0 0 JUAN C MAS CHAIRMAN 1.50 0.60 X 0 0 0 JAY MASSIRMAN DIRECTOR 1.50 0.50 X 0 0 0 STEVEN MCKEAN DIRECTOR 1.50 0.50 X 0 0 0 MARIO MURGADO VICE CHAIRMAN 1.50 0.50 X 0 0 0 PHILLIP NEWCOMM MD DIRECTOR 1.50 0.50 X 0 0 0 ALEX SOTO DIRECTOR 1.50 0.50 X 0 0 0 KEITH WARD SECRETARY 1.50 0.50 X 0 0 0 NARENDRA KINI MD PRESIDENT AND CEO 40.00 0.10 X X 1141286 0 169379 TIMOTHY BIRKENSTOCK SENIOR VP AND CFO 40.00 0.10 X 452256 0 74468 MARTHA MCGILL EXECUTIVE VP/COO 40.00 0.00 X 538704 0 90958 SANJIV BHATIA MD ATTENDING PHYSICIAN 40.00 0.00 X 788564 0 0 HARRY SHUFFLEBARGER MD ORTHOPAEDIC SURGEON 40.00 0.00 X 1138565 0 26369 REDMOND P BURKE MD CARDIOVASCULAR SURGERY DIR 40.00 0.00 X 1794986 0 26562 ROBERT L HANNAN MD CARDIOVASCULAR SURGEON 40.00 0.00 X 990152 0 25349 JOHN RAGHEB MD ATTENDING PHYSICIAN 40.00 0.00 X 1060928 0 24542 PEDRO ALFARO FORMER OFFICER 0.00 0.00 X 261077 0 0 8485793 0 460882 400 1 1 0 CERNER CORPORATION PO BOX 412732 KANSAS CITY MO 64141 EQUIPMENT RENTAL 19644729 TURNER-ARELLANO JOINT VENTURE 1000 NW 57TH COURT STE 200 MIAMI FL 33126 CONSTRUCTION CONTRACTS 14759805 GERRITS CONSTRUCTION PO BOX 810813 BOCA RATON FL 334810813 CONSTRUCTION CONTRACTS 6146583 PRESIDIO NETWORKED SOLUTIONS INC 10 SIXTH ROAD WOBURN MA 01801 IT MAINTENANCE 2510284 PHI AIR MEDICAL LLC 2800 NORTH 44TH STREET STE 800 PHOENIX AZ 85008 HELICOPTER OPERATIONS 2343953 116 12186187 1046461 13232648 PATIENT SERVICE REVENU 621300 509409248 509409248 GRANT REVENUE 900099 12262884 12262884 SEMINAR/WORKSHOPS 621300 971563 971563 ORDINARY INCOME PARTNE 621300 -7574 10997 -18571 522636121 16359302 16359302 208856 208856 1466028 0 1466028 1466028 1466028 793586 0 17755 793586 -17755 775831 775831 CAFETERIA VENDING 722210 2834785 2834785 PHARMACY 446110 2788981 71114 2717867 ANTENNA REVENUE 900099 69734 69734 9116479 9116479 14809979 569488765 522654692 122277 33479148 8485793 8485793 222532592 184814708 37717884 53980489 43184391 10796098 635878 508702 127176 860318 688254 172064 45080116 36064093 9016023 4546588 3637270 909318 58778856 47023085 11755771 23312728 18650182 4662546 1521510 1217208 304302 11516416 9213133 2303283 29950294 23960235 5990059 20657958 16526366 4131592 BAD DEBTS 12707280 10165824 2541456 MEDICAL ASSISTANCE TAX 6162721 4930177 1232544 CHARITY CARE 2327847 1862278 465569 DUES & SUBSCRIPTIONS 1850599 1480479 370120 2722600 2178080 544520 507630583 406104465 101526118 0 422950 -2632370 21950266 48199555 60952164 71143054 5188885 5167346 5400090 6303225 608002999 279410825 293679296 328592174 350347446 354722930 97730857 106145296 835671954 917641210 80033763 78615373 239248505 236975193 3552000 2664000 75751177 63085942 398585445 381340508 X 344207776 437135079 63229135 68999838 29649598 30165785 437086509 536300702 835671954 917641210 X 61858182 13145115 262910 23947986 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 312228 0 1 133812 446040 0 PART II-B, LINE 1: OTHER ACTIVITIES RELATE TO RESEARCH, MONITORING LEGISLATION, AND ATTENDING MEETINGS. 2932156 2932156 270655387 128743450 141911937 25169020 6369121 18799899 211662574 124108523 87554051 97583862 20189731 77394131 328592174 BOND ISSUE COSTS 3029525 BENEFICIAL INTEREST IN MIAMI CHILDREN'S HOSPITAL FNDTN 81811997 DUE FROM AFFILIATED ORGANIZATION 17150848 EXEC LIFE 391150 SELF INSURANCE TRUST 3761776 106145296 OTHER LIABILITIES 25903971 SWAP LIABILITIES 25418099 THIRD PARTY SETTLEMENT PAYABLE 7717056 LEASE INCENTIVE OBLIGATION 4046816 63085942 X 581945777 20409186 20409186 561536591 7952174 7952174 569488765 490430007 3566855 3566855 486863152 20767431 20767431 507630583 PART X, LINE 2: EXPLANATION: THE HOSPITAL BELIEVES THERE IS NO UNCERTAIN TAX LIABILITY WHICH SHOULD BE RECORDED AS OF DECEMBER 31, 2013 AND 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: AMOUNTS REPORTED SEPARATELY 2,396,133. NET UNREALIZED GAIN ON INVESTMENTS 14,124,290. NET PAYMENT ON SWAP AGREEMENTS -5,490,862. BAD DEBT EXPENSE -12,707,280. GAIN ON FMV OF SWAP AGREEMENTS 22,710,933. CHARITY CARE -2,327,847. UBTI EXPENSES RECORDED ON FORM 990, PART IX -176,364. LOSS ON CONVERSION OF DEBT -119,603. PRIOR YEAR CONTRIBUTIONS RELEASED FROM RESTRICTIONS 1,999,786. PART XI, LINE 4B - OTHER ADJUSTMENTS: PARTNERSHIP INCOME -612,086. LOSS ON SALE OF ASSETS -17,755. RESTRICTED CONTRIBUTIONS 8,582,015. PART XII, LINE 2D - OTHER ADJUSTMENTS: AMOUNTS REPORTED SEPARATELY 3,549,100. LOSS ON SALE OF ASSETS 17,755. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 12,707,280. CHARITY CARE 2,327,847. PARTNERSHIP EXPENSE 65,078. NET PAYMENT ON SWAP AGREEMENTS 5,490,862. UBTI EXPENSES RECORDED ON FORM 990, PART IX 176,364. CENTRAL AMERICA/CARIBBEAN 0 0 PROGRAM SERVICES INSURANCE PREMIUM 5535900 0 0 0 0 0 0 5535900 0 5535900 1 0 1 1 0 0 PART IV, LINE 4 VARIETY CHILDREN'S HOSPITAL D/B/A MIAMI CHILDREN'S HOSPITAL IS NOT REQUIRED TO FILE FORM 8621 FOR THEIR INDIRECT OWNERSHIP IN A QUALIFIED ELECTING FUND, AS FORM 8621 HAS ALREADY BEEN FILED ON THEIR BEHALF. 1 1 X 1 X 1 X 401.000000000000 1 1 0 1 1 580736 580736 0.00120 178893474 144464049 34429425 0.06960 4047494 3043364 1004130 0.00200 183521704 147507413 36014291 0.07280 1447995 1447995 0.00290 12342638 12342638 0.02490 539638 539638 0.00110 14330271 14330271 0.02890 197851975 147507413 50344562 0.10170 1 3170127 462124 656100 -193976 X 1 0 1 1 MCH - MAIN CAMPUS 3100 SW 62ND AVENUE MIAMI FL 33155 X X X X X MCH - MAIN CAMPUS 1 1 X X X X X X X X X 12 1 0 1 X WWW.MCH.COM X X X 1 0 1 1 200.000000000000 1 401.000000000000 1 X X X X 1 0 1 0 1 X 0 0 MCH - MAIN CAMPUS PART V, SECTION B, LINE 3: FOCUS GROUPS:EXTERNAL AND INTERNALTO ENSURE UNBIASED FEEDBACK WHEN CONDUCTING THE ASSESSMENT, MCH ENGAGED THE HEALTH COUNCIL OF SOUTH FLORIDA (HCSF) TO COORDINATE A SERIES OF FOCUS GROUPS AND SURVEYS WITH BOTH INTERNAL AND EXTERNAL STAKEHOLDERS. THESE STAKEHOLDERS WERE CHOSEN BY THEIR ABILITY TO PRIORITIZE COMMUNITY HEALTH NEEDS AND PROVIDE INVALUABLE FEEDBACK TO THE HOSPITAL ABOUT HOW MCH IS VIEWED IN TERMS OF ITS CURRENT STRENGTHS, WEAKNESSES, ANY PERCEIVED BARRIERS TO PROVIDING CARE, AS WELL AS ANY POTENTIAL OR EMERGING OPPORTUNITIES FOR MCH TO IMPROVE HEALTH OUTCOMES FOR MIAMI-DADE COUNTY CHILDREN.FOUR FOCUS GROUPS WERE CONDUCTED AND TWO ONLINE SURVEYS WERE IMPLEMENTED TO GAUGE PERCEPTIONS OF THE ROLE OF MIAMI CHILDREN'S HOSPITAL IN THE COMMUNITY AND TO COLLECT QUALITATIVE DATA FROM DIVERSE INDIVIDUALS REPRESENTING INTERNAL AND EXTERNAL MIAMI CHILDREN'S HOSPITAL STAKEHOLDERS.DURING EACH FOCUS GROUP, THE SAME SET OF QUESTIONS WERE ASKED TO ALLOW PARTICIPANTS TO EXPRESS THEIR POSITION REGARDING CHILDREN'S HEALTH ISSUES. ALL OF THESE ELEMENTS WERE CONSIDERED IN THE PRIORITIZATION OF LOCAL PEDIATRIC HEALTH NEED. THE GROUPS WERE PRESENTED WITH PEDIATRIC HEALTH CARE INDICATORS AND ASKED TO RANK THEM IN ORDER OF IMPORTANCE. FOCUS GROUP DISCUSSION TOPICS INCLUDED:- HEALTH PROMOTION AND PREVENTION- DISEASE PREVENTION- HEALTHCARE AND DISEASE MANAGEMENT- NAVIGATION OF THE HEALTHCARE SYSTEM- CHILDREN'S QUALITY OF LIFE ISSUESTO IDENTIFY FOCUS GROUP PARTICIPANTS WHOSE FEEDBACK AND RECOMMENDATIONS WOULD BE MOST RELEVANT TO MCH'S CHNA, THE GROUP WORKED TO IDENTIFY KEY COMMUNITY STAKEHOLDERS AND PARTNERS.INTERNAL STAKEHOLDERS FOCUS GROUP: EIGHT (8) INDIVIDUALS PARTICIPATED IN MCH'S INTERNAL STAKEHOLDERS FOCUS GROUP. THE GROUP WAS COMPRISED OF HOSPITAL ADMINISTRATIVE LEADERS, DEPARTMENT REPRESENTATIVES AND MEMBERS OF THE MCH BOARD OF DIRECTORS.EXTERNAL STAKEHOLDERS FOCUS GROUP: THIRTEEN (13) ORGANIZATIONS PARTICIPATED IN THE EXTERNAL STAKEHOLDERS FOCUS GROUP.THE STAKEHOLDERS INCLUDED REPRESENTATIVES OF PUBLIC, PRIVATE AND NONPROFIT ORGANIZATIONS THAT PLAY CRITICAL ROLES IN THE HEALTH AND HUMAN SERVICES ARENA IN MIAMI-DADE COUNTY.FOCUS GROUPSEXTERNAL:COMMUNITY LEADERS- AMERICAN CANCER SOCIETY: BERTA RIOS, PHD (ATTENDED MAY 10, 2012 FOCUS GROUP)- DIRECTOR OF DISPARITY OUTREACH WITH A FOCUS ON PATIENT SERVICES, EARLY DETECTION AND PREVENTION ACTIVITIES- AMERICAN HEART ASSOCIATION: CHAD BUSCHELL (VIA ONLINE SURVEY)- EXECUTIVE DIRECTOR AND VICE PRESIDENT FOCUSING ON IMPROVING CARDIOVASCULAR HEALTH IN GREATER MIAMI- CATHOLIC HEALTH SERVICES: J. ABILIO RODRIGUEZ, PHD (ATTENDED MAY 10, 2012 FOCUS GROUP)- PROGRAM ADMINISTRATOR FOR CATHOLIC HEALTH SERVICES CENTRO MATER WEST CHILD CARE SERVICES- THE CHILDREN'S TRUST: MODESTO ABETY (VIA ONLINE SURVEY)- PRESIDENT AND CEO WITH EXTENSIVE EXPERIENCE IN ADVOCACY ON BEHALF OF CHILDREN AND FAMILIES IN SOUTH FLORIDA- COLLINS CENTER FOR PUBLIC POLICY: LEDA M.PEREZ, PHD (VIA ONLINE SURVEY)- VICE PRESIDENT OF HEALTH INITIATIVES AND DIRECTOR OF THE FLORIDA TRANSPARENCY PROJECT- DADE ASSOCIATION OF SCHOOL ADMINISTRATORS: DELIO DIAZ (ATTENDED MAY 10, 2012 FOCUS GROUP)- EXECUTIVE DIRECTOR OF DASA WITH 35 YEARS OF SERVICES TO MIAMI-DADE COUNTY PUBLIC SCHOOLS- DAN MARINO FOUNDATION: SUSAN MORANTES (ATTENDED MAY 10, 2012 FOCUS GROUP)- VICE PRESIDENT OF DISABILITY SERVICES WITH FOCUS ON ENHANCING SERVICES AVAILABLE TO CHILDREN WITH SPECIAL NEEDS- EPILEPSY FOUNDATION: KAREN BASHA EGOZI (VIA ONLINE SURVEY)- CHIEF EXECUTIVE OFFICER AND TIRELESS ADVOCATE OF INCREASED EPILEPSY AWARENESS AND FUNDING- FLORIDA HEART RESEARCH INSTITUTE: TORI GABRIEL (VIA ONLINE SURVEY)- EDUCATION AND PREVENTION DIRECTOR WITH A PASSION FOR CARDIOVASCULAR MORBIDITY AND MORTALITY PREVENTION- HEALTH FOUNDATION OF SOUTH FLORIDA: PETER WOOD (ATTENDED MAY 10, 2012 FOCUS GROUP)- VICE PRESIDENT OF PROGRAMS AND COMMUNITY INVESTMENTS FOCUSED ON PRIMARY CARE, ORAL HEALTH AND PREVENTION- MARCH OF DIMES: MARLA WILSON (ATTENDED MAY 10, 2012 FOCUS GROUP)- EXECUTIVE DIRECTOR AND LEADER FOR MIAMI-DADE AND MONROE COUNTY DISTRICT- MIAMI-DADE COUNTY HEALTH DEPARTMENT: KAREN WELLER (ATTENDED MAY 10, 2012 FOCUS GROUP)- CHRONIC DISEASE PREVENTION DIRECTOR OVERSEEING HEALTH, WORKSITE WELLNESS, TOBACCO PREVENTION, HEALTHY START- MIAMI-DADE COUNTY PUBLIC SCHOOLS: WILMA STEINER AND DEBORAH MONTILLA (ATTENDED MAY 10, 2012 FOCUS GROUP)- DISTRICT DIRECTOR, COMPREHENSIVE HEALTH SERVICES AND DISTRICT DIRECTOR, STUDENT SERVICES- MIAMI-DADE FIRE RESCUE: TYLER GARCIA (ATTENDED MAY 10, 2012 FOCUS GROUP)- EMERGENCY MEDICAL TECHNICIAN AND ADVOCATE FOR IMPROVED HEALTH, WELLNESS AND GREATER ACCESS FOR CHILDREN- OUR KIDS: REBECCA LINDA (ATTENDED MAY 10, 2012 FOCUS GROUP AND DISTRIBUTED ONLINE SURVEY TO FOSTER PARENTS)- ADVOCATING SAFE AND PERMANENT FAMILIES FOR AT-RISK CHILDREN IN MIAMI-DADE AND MONROE COUNTIESPARENTSTHE THIRD AND FOURTH EXTERNAL FOCUS GROUPS WERE MADE UP OF A BROAD CROSS-SECTION OF PARENTS THAT PARTICIPATE IN PARENT ADVISORY GROUPS OF COMMUNITY-BASED ORGANIZATIONS THROUGHOUT SOUTH FLORIDA, INCLUDING THE WORLD LITERACY CRUSADE'S GIRL POWER PROGRAM OF LIBERTY CITY, THE UNITED WAY'S CENTER FOR EXCELLENCE IN EARLY EDUCATION AND OUR KIDS, INC.GROUP DEMOGRAPHICS INCLUDED:- PARENTS OF BOTH MIDDLE CLASS AND LOW-INCOME CHILDREN- PARENTS OF CHILDREN WHO ARE UNINSURED- MINORITY GROUPSINTERNAL:- NANCY HUMBERT, SVP OF STRATEGIC BUSINESS PLANNING AND PUBLIC AFFAIRS- JOSE PERDOMO, SVP OF ETHICS AND COMPLIANCE- DEISE GRANADO-VILLAR, MD, CHIEF MEDICAL OFFICER- MARCIA DIAZ DE VILLEGAS, ADMINISTRATIVE DIRECTOR OF MARKETING, OUTREACH AND PUBLIC RELATIONS- JOSEFA DIAZ, REGIONAL DIRECTOR- MILKA ALEGRIA, DIRECTOR OF PREVENTIVE MEDICINE- LANI VALIDO, DIRECTOR OF PUBLIC POLICY AND EXTERNAL AFFAIRS - GENEVIEVE CARUNCHO, DIRECTOR OF STRATEGIC PLANNING - DEBORAH VAIDYA, DIRECTOR OF FINANCE AND ACCOUNTING - ESTEBAN BOVO, COMMUNITY CONSULTANT- GLORIA RIEFKOHL, MD, ATTENDING PHYSICIAN, PREVENTIVE MEDICINE- JOSE ROSA-OLIVARES, MD, MEDICAL DIRECTOR OF THE PEDIATRIC CARE CENTER & AFTER HOURS PROGRAM PART I, LN 7 COL(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 $12,707,280. PART I, LINE 7 CALCULATED THE COST TO CHARGE RATIO USING THE ALLOWABLE PATIENT CARE OPERATING EXPENSES REPORTED WITH THE FLORIDA COST REPORT AND AFTER ADJUSTING FOR ADDITIONAL BUSINESS EXPENSES NOT INCLUDED IN THE DIRECT PATIENT CARE. MULTIPLY THE GROSS PATIENT CHARGES PER THE ANNUAL PATIENT CLAIM LOG (ALSO USED FOR THE COST REPORT) TIMES THE COST/CHARGE RATIO TO CALCULATE COST OF PROGRAM. PART III, LINE 4: BAD DEBT AT COST WAS CALCULATED FOR SCHEDULE H PURPOSES BY APPLYING THE COST TO CHARGE PERCENTAGE AGAINST BAD DEBT EXPENSE REPORTED ON THE AUDITED FINANCIAL STATEMENTS. PART III, LINE 8: THE ORGANIZATION DOES NOT REPORT ANY AMOUNTS FROM PART III, LN 7 AS A COMMUNITY BENEFIT. PART III, LINE 4 TEXT OF FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS THAT DESCRIBES BAD DEBT EXPENSE:THE FOLLOWING SUMMARIZES THE ACTIVITY IN THE HOSPITAL'S ALLOWANCE FOR BAD DEBTS FOR THE YEAR ENDED DECEMBER 31, 2013:BALANCE - BEGINNING OF THE YEAR 6,525,502PROVISIONS DURING THE YEAR 12,707,280ACCOUNTS WRITTEN OFF, NET OF RECOVERIES (11,049,924) -----------BALANCE - END OF THE YEAR 8,182,858THE HOSPITAL'S ESTIMATION OF THE ALLOWANCE FOR BAD DEBTS IS BASED PRIMARILY UPON THE TYPE AND AGE OF THE PATIENT ACCOUNTS RECEIVABLE AND THE EFFECTIVENESS OF THE HOSPITAL'S COLLECTION EFFORTS. PART III, LINE 8 BASED ON COST REPORT - ALLOWABLE COSTS. PART III, LINE 9B FINANCIAL ASSISTANCE PROGRAM POLICY:THE HOSPITAL, IN FURTHERANCE OF ITS TAX-EXEMPT PURPOSE, SHALL PROVIDE CHARITY OR DISCOUNTED CARE TO THOSE PATIENTS ("APPLICANT") THAT ARE DETERMINED TO BE ELIGIBLE THROUGH THE HOSPITAL'S EVALUATION PROCESS. THE EVALUATION PROCESS SHALL CONSIDER THE APPLICANT'S ANNUAL INCOME, ELIGIBILITY FOR INSURANCE COVERAGE THROUGH COMMERCIAL OR GOVERNMENTAL SOURCES AND COMPARE THE EXPECTED HEALTHCARE EXPENDITURES AT THE HOSPITAL TO THE APPLICANT'S TOTAL ANNUAL INCOME (THIS IS COMMONLY REFERRED TO AS "MEDICALLY INDIGENT"). THE HOSPITAL SHALL USE THE CURRENT DEPARTMENT OF HEALTH AND HUMAN SERVICES POVERTY GUIDELINES, WHICH ARE UPDATED ANNUALLY, TO ESTABLISH THE ELIGIBILITY CRITERIA FOR CHARITY OR SELF-PAY DISCOUNTS. THE APPLICANT MUST HAVE EXHAUSTED ALL EFFORTS TO OBTAIN THIRD PARTY HEALTH INSURANCE COVERAGE FROM BOTH COMMERCIAL AND GOVERNMENTAL SOURCES.ACCORDING TO THE FINANCIAL ASSISTANCE PROGRAM POLICY:IF THE COLLECTION SUPERVISOR AND/OR PFS DIRECTOR REVIEW THE APPLICATION FOR FINANCIAL EVALUATION AGANIST THE AHCA CRITERIA AND APPROVE THE REQUEST, THE PATIENT FINANCIAL SERVICES SUPERVISOR WRITES OFF CHARGES TO CHARITY. PART V, SECTION A HOSPITAL FACILITIES:MIAMI CHILDREN'S HOSPITAL OPERATES THE FOLLOWING FACILITIES UNDER THE HOSPITAL'S LICENSE IN ADDITION TO THE MAIN CAMPUS:MCH - DAN MARINO CENTEROUTPATIENT AMBULATORY CENTERMCH - MIAMI LAKES REHABILITATION CENTERREHABILITATION CENTERMCH - PALMETTO BAY CENTEROUTPATIENT AMBULATORY CENTERMCH - DORAL CENTEROUTPATIENT AMBULATORY CENTERMCH - WEST KENDALL CENTEROUTPATIENT AMBULATORY CENTERMCH - MIRAMAR CENTEROUTPATIENT AMBULATORY CENTERMCH - MIDTOWN CENTEROUTPATIENT AMBULATORY CENTERMCH - NICKLAUS CENTEROUTPATIENT AMBULATORY CENTEROFFICE OF DR. JOSE VARGASPRIMARY CARE CLINICNICKLAUS CARE CENTER (MOB SPECIALIST PHYSICIAN OFFICE)SPECIALIST PHYSICIAN OFFICE PART VI, LINE 2: NEEDS ASSESSMENT:UNDER THE DIRECTION OF THE BOARD OF DIRECTORS, MANAGEMENT STRIVES TO PROVIDE HOPE THROUGH ADVANCED CARE FOR OUR CHILDREN AND FAMILIES. THE VISION IS TO BE WHERE THE CHILDREN ARE. THE HOSPITAL USES A QUARTERLY OPERATING CALENDAR TO DEVELOP PROGRAMS AND COMMUNICATE GOALS, ACCOMPLISHMENTS AND GAPS IN PLANS. MIAMI CHILDREN'S HOSPITAL PARTICIPATES IN MANY COMMUNITY ORGANIZATIONS THAT COLLECTIVELY STRIVE TO IMPROVE THE HEALTH STATUS OF CHILDREN. MCH HAS REPRESENTATION ON THE CHILDREN'S TRUST, THE MIAMI DADE COUNTY PUBLIC SCHOOLS WELLNESS COMMITTEE, THE GREATER MIAMI CHAMBER OF COMMERCE'S HEALTH AND BIO-SCIENCE COMMITTEE AND THE HEALTH COUNCIL OF SOUTH FLORIDA. THROUGH OUR INVOLVEMENT WITH THE HEALTH COUNCIL, WE CONSISTENTLY ANALYZE DATA TO IDENTIFY UNMET NEEDS AND SERVE IN AN ADVISORY CAPACITY ASSISTING THE COUNCIL TO ADDRESS HEALTH DISPARITIES. ADDITIONALLY, MCH PROVIDES SCHOOL HEALTH NURSES IN 8 SCHOOLS THROUGH A COMMUNITY GRANT, AND OUR PREVENTIVE MEDICINE PROGRAM DEPLOYS A MEDICAL AND A DENTAL VAN INTO UNDERSERVED AREAS OF THE COMMUNITY. MCH HAS A ROBUST MECHANISM TO ANALYZE HEALTH DATA. WE RECENTLY DEPLOYED SEVERAL PEDIATRIC SUBSPECIALISTS TO SERVE CHILDREN IN PALM BEACH COUNTY AFTER DATA CONFIRMED THAT THERE WAS A SHORTAGE. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:MIAMI CHILDREN'S HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM TO ASSIST PATIENTS THAT ARE UNINSURED OR UNDERINSURED AND TO BE GIVEN THE OPPORTUNITY TO APPLY FOR VARIOUS PROGRAMS. WITH THE PATIENT/FAMILY GENERAL CONSENT FOR TREATMENT FORM, FINANCIAL AGREEMENT FOR PROFESSIONAL SERVICES FORM, AND A COORDINATION OF BENEFITS FORM, PATIENTS/FAMILIES ARE PROVIDED REFERRAL TO AN ELIGIBILITY ASSISTANCE COUNSELOR WHO WILL EXPLAIN VARIOUS PROGRAMS OFFERED. PART VI, LINE 4: COMMUNITY INFORMATION:MIAMI CHILDREN'S HOSPITAL PRIMARILY SERVES THE COMMUNITIES OF SOUTH FLORIDA INCLUDING WEST PERRINE, GOLDEN GLADES, OPA LOCKA, WYNWOOD SERVICE AREA, BISCAYNE PARK, SWEETWATER WEST DADE, LIBERTY CITY, AND HIALEAH, LITTLE HAVANA SERVICE AREA, HOMESTEAD SERVICE AREA, HALLENDALE, HOLLYWOOD, MARGATE, HALLANDALE/MIRAMAR, WEST PALM BEACH, BOCA RATON, MONROE COUNTY AND MANY OTHERS IN THE SOUTH FLORIDA REGION. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:MIAMI CHILDREN'S HOSPITAL HAS AN ACTIVE COMMUNITY EDUCATION PROGRAM, VARIOUS CAMP PROGRAMS INCLUDING ASTHMA CENTER, DIABETES, CANCER CENTER, PSYCHIATRIC PROGRAMS, EARLY INTERVENTION PROGRAM, PREVENTATIVE MEDICINE PROGRAM, DENTAL MOBILE PROGRAM, AFTER HOURS PROGRAM, HEALTHY CONNECTIONS PROGRAM, MEDICAL EDUCATION RESIDENCY PROGRAM, PEDIATRIC POST GRADUATE PROGRAM, FELLOWSHIP PROGRAMS, PEDIATRIC CARE CALL PROGRAM, MULTIPLE AMBULATORY CARE CENTERS ALL DESIGNED TO PROMOTE HEALTH IN THE COMMUNITY. X X X X X 1 1 0 0 0 0 0 0 0 JEFRY BIEHLER MD DIRECTOR 317726 0 0 0 1549 0 0 0 23255 0 342530 0 0 0 NARENDRA KINI MD PRESIDENT AND CEO 702298 0 415186 0 23802 0 0 0 169379 0 1310665 0 0 0 TIMOTHY BIRKENSTOCK SENIOR VP AND CFO 373284 0 54858 0 24114 0 0 0 74468 0 526724 0 0 0 MARTHA MCGILL EXECUTIVE VP/COO 422485 0 108425 0 7794 0 0 0 90958 0 629662 0 0 0 SANJIV BHATIA MD ATTENDING PHYSICIAN 766858 0 30 0 21676 0 0 0 0 0 788564 0 0 0 HARRY SHUFFLEBARGER MD ORTHOPAEDIC SURGEON 1136059 0 0 0 2506 0 0 0 26369 0 1164934 0 0 0 REDMOND P BURKE MD CARDIOVASCULAR SURGERY DIR 1485847 0 306863 0 2276 0 0 0 26562 0 1821548 0 0 0 ROBERT L HANNAN MD CARDIOVASCULAR SURGEON 987111 0 0 0 3041 0 0 0 25349 0 1015501 0 0 0 JOHN RAGHEB MD ATTENDING PHYSICIAN 1055786 0 0 0 5142 0 0 0 24542 0 1085470 0 0 0 PEDRO ALFARO FORMER OFFICER 0 0 87026 0 174051 0 0 0 0 0 261077 0 0 0 PART I, LINES 4A-B PEDRO ALFARO, FORMER OFFICER, RECEIVED A SEVERANCE PAYMENT OF $261,077 IN 2013. PART I, LINE 4(B) THE EXECUTIVES PARTICIPATE IN A SUPPLEMENTAL 457(F) DEFINED CONTRIBUTION RETIREMENT ACCOUNT. THE VALUES ARE REPORTED IN SCHEDULE J, PART II, COLUMN C. A MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NCF7 2011-08-01 25504962 SEE PART VI 0 0 0 B MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NCE0 2010-12-22 107784753 SEE PART VI 0 0 0 C MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NDD1 2013-08-01 107788754 SEE PART VI 0 0 0 A 25504962 6 504962 25000000 1 0 1 1 B 4040000 108349445 38 1227083 14089155 41925000 51108207 1 0 0 1 C 107788754 3928 1488754 106300000 1 0 1 1 A 0 1 1 1 1 1 0.00300 0.00300 0 0 1 B 0 1 1 1 1 1 0.00700 0.00700 0 0 1 C 0 1 1 1 1 1 0.02900 0.02900 0 0 1 A 0 1 0 0 0 0 0 0 1 B 0 1 0 0 1 0 1 BAYERISCHE LANDESBANK 2.000000000000 1 1 1 C 0 1 0 0 0 0 0 0 1 A 1 B 1 C 1 PART I, LINE A, COLUMN F DESCRIPTION OF PURPOSE REFUND ISSUE DATED 4/17/2008 PART I, LINE B, COLUMN F DESCRIPTION OF PURPOSE REFUND 2006-B3 DATED 12/21/2006 AND NEW MONEY PROJECT PART I, LINE C, COLUMN F DESCRIPTION OF PURPOSE REFUND ISSUE DATED 12/21/2006 AND 4/17/2008 PART II, LINE 3, COLUMN B THE DIFFERENCE BETWEEN THE ISSUE PRICE (LISTED IN PART I) AND THE TOTAL PROCEEDS (PART II, LINE 3) IS DUE TO THE INVESTMENT EARNINGS. PART IV, LINE 6, COLUMN B SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. FORM 990, PART I, LINE 1 THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. FORM 990, PART III, LINE 4A VARIETY CHILDREN'S HOSPITAL, ESTABLISHED IN 1950, OWNS AND OPERATES A PEDIATRIC SPECIALTY HOSPITAL KNOWN AS MIAMI CHILDREN'S HOSPITAL. THE HOSPITAL IS ONE OF THE LARGEST FREESTANDING PEDIATRIC TEACHING HOSPITALS IN THE SOUTHEASTERN UNITED STATES. IT PROVIDES SPECIALIZED PEDIATRIC HEALTHCARE FOR CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE OR ABILITY TO PAY. THE HOSPITAL HAS 289 LICENSED BEDS. MIAMI CHILDREN'S HOSPITAL SERVES AS A REFERRAL CENTER FOR CHILDREN WITH COMPLEX, CRITICAL OR LIFE-THREATENING ILLNESSES REQUIRING SPECIALIZED CARE. IT HAS A 28-BED PEDIATRIC INTENSIVE CARE UNIT, A 37-BED NEONATAL INTENSIVE CARE UNIT AND A 12-BED CARDIAC INTENSIVE CARE UNIT. IT ALSO A STATE-DESIGNATED PEDIATRIC TRAUMA CENTER. MANY PATIENTS ARE REFERRED BY OTHER HOSPITALS REGARDLESS OF THE EXISTENCE OF FORMAL ARRANGEMENTS. IN 2013, 3,056 PATIENTS WERE TRANSFERRED FROM HOSPITALS THROUGHOUT FLORIDA, CENTRAL AND SOUTH AMERICA AND THE CARIBBEAN. WHEN CHILDREN NEED THE SERVICES OF A SPECIALIST, IT IS IMPORTANT THAT SUCH SERVICES BE PROVIDED BY A PRACTITIONER WITH SPECIFIC TRAINING AND EXPERTISE IN PEDIATRIC CARE. THE CARE OF CHILDREN WITH CERTAIN COMPLEX CHRONIC CONDITIONS, SUCH AS JUVENILE DIABETES, CANCER, OR CYSTIC FIBROSIS IS BEST MANAGED BY A PEDIATRIC SPECIALIST IN ORDER TO ELIMINATE REFERRAL DELAYS AND EXPEDITE POSITIVE TREATMENT. CHILDREN ARE MORE VULNERABLE TO COMPLICATIONS DUE TO DELAYS THAN ADULTS. THEY DEVELOP SERIOUS COMPLICATIONS MORE RAPIDLY THAN ADULTS BECAUSE THEY HAVE LESS PHYSIOLOGICAL RESERVES AND LESS DEVELOPED ORGAN SYSTEMS. THERE ARE PRESENTLY MORE THAN 200 PEDIATRIC SUBSPECIALTY PHYSICIANS GEOGRAPHICALLY LOCATED AT MIAMI CHILDREN'S HOSPITAL. PEDIATRIC SUBSPECIALTY AREAS INCLUDE: ADOLESCENT MEDICINE, ALLERGY/IMMUNOLOGY, CARDIOLOGY, CARDIOVASCULAR SURGERY, CLINICAL GENETICS AND METABOLISM, CRITICAL CARE MEDICINE, DENTISTRY, DERMATOLOGY, EMERGENCY MEDICINE, ENDOCRINOLOGY, GASTROENTEROLOGY, GENERAL PEDIATRICS, HEMATOLOGY/ONCOLOGY, INFECTIOUS DISEASES, NEONATOLOGY, NEPHROLOGY, NEUROLOGY, PREVENTIVE MEDICINE, PSYCHIATRY, PULMONOLOGY, RHEUMATOLOGY, CARDIOVASCULAR SURGERY, NEUROLOGY, NEUROSURGERY, OPHTHALMOLOGY, ORTHOPEDIC SURGERY, OTOLARYNGOLOGY, PEDIATRIC SURGERY, PLASTIC AND RECONSTRUCTIVE SURGERY, PATHOLOGY, RADIOLOGY, UROLOGY AND ANESTHESIOLOGY. THIS CRITICAL MASS OF PHYSICIANS SIGNIFICANTLY CONTRIBUTES TO THE QUALITY AND RANGE OF PEDIATRIC SERVICES AVAILABLE AT THE HOSPITAL. 2013 STATISTICAL DATA INCLUDES TOTAL INPATIENT DAYS: 63,140 TOTAL INPATIENT ADMISSIONS: 11,272 INPATIENT AVERAGE DAILY CENSUS: 173.0 TOTAL ED VISITS (MAIN CAMPUS): 89,907 MCH GENERAL CLINIC VISITS: 12,749 AMBULATORY VISITS: 54,669 PRIVATE OUTPATIENT VISITS (MAIN CAMPUS): 116,275 PRIVATE OUTPATIENT VISITS (AMBULATORY CENTERS): 143,795 TOTAL SURGICAL CASES: 14,917 AVERAGE LENGTH OF STAY: 5.6 DAYS THE HOSPITAL IS INTERNATIONALLY RECOGNIZED FOR CARE EXCELLENCE. MIAMI CHILDREN'S HOSPITAL PROGRAMS WERE RANKED AMONG THE NATION'S BEST IN ALL 10 PEDIATRIC SUBSPECIALTY PROGRAMS SURVEYED BY U.S. NEWS AND WORLD REPORT IN ITS 2013-2014 LISTING OF "AMERICA'S BEST CHILDREN'S HOSPITALS." (RESULTS WERE RELEASED IN 2013.) THE HOSPITAL WAS THE ONLY FACILITY IN FLORIDA TO HAVE PROGRAMS RANKED IN ALL CATEGORIES SURVEYED BY U.S. NEWS. THESE PROGRAMS INCLUDE CANCER, CARDIOLOGY AND HEART SURGERY, DIABETES AND ENDOCRINOLOGY, GASTROENTEROLOGY, NEONATOLOGY, NEPHROLOGY, NEUROLOGY/NEUROSURGERY, PULMONOLOGY, ORTHOPEDICS, UROLOGY. IN ADDITION, THE HOSPITAL SYSTEM INCLUDES A NETWORK OF AMBULATORY CENTERS THAT EXTEND CARE THROUGHOUT THE SOUTH FLORIDA REGION. DURING 2013, THESE CENTERS OFFERED OUTPATIENT SERVICES AS FOLLOWS: MCH DAN MARINO OUTPATIENT CENTER: OFFERS COMPREHENSIVE SERVICES FOR CHILDREN WITH NEURODEVELOPMENTAL DISORDERS. SERVICES INCLUDE IMAGING AND REHABILITATION. ALSO ON SITE IS A SWIMMING POOL FOR AQUATIC THERAPY. MCH DORAL OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. MCH MIDTOWN OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. MCH MIRAMAR OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. MCH PALMETTO BAY OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. ALSO ON-SITE IS EARLY STEPS SOUTHERNMOST COAST, A RESOURCE FOR CHILDREN UNDER THE AGE OF 3 WHO ARE AT RISK OF DEVELOPMENTAL DELAYS. MCH WEST KENDALL OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. MCH NICKLAUS OUTPATIENT CENTER (PALM BEACH GARDENS): OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE CENTER AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. MCH MIAMI LAKES OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES, AN AFTER-HOURS URGENT CARE AND OUTPATIENT SUBSPECIALTY OFFICE VISITS. THIS NEW FACILITY OPENED IN 2013, REPLACING THE MCH REHABILITATION SERVICES MIAMI LAKES AND OFFERING EXPANDED SERVICES. FORM 990, PART III, LINE 4A QUALITY/SAFETY AND ERROR PREVENTION INITIATIVES FROM 2013 THE HOSPITAL IS COMMITTED TO ADVANCING QUALITY AND SAFETY. INITIATIVES FOR 2013 ARE DETAILED BELOW: LEAN INITIATIVES: LEAN IS AN INTERNATIONALLY RECOGNIZED BUSINESS IMPROVEMENT MODEL. IN 2013, THE HOSPITAL CONTINUED TO UTILIZE LEAN METHODS TO IMPROVE PROCESSES THAT ENHANCE SAFETY, EFFICIENCY AND PREVENT ERRORS AT THE HOSPITAL. FROM 2008 TO 2012, THE HOSPITAL HAS SAVED $ 8.9 MILLION THROUGH LEAN-BASED EFFICIENCIES. FASTPASS SYSTEM: MIAMI CHILDREN'S WAS ALSO AN EARLY ADOPTER OF FASTPASS VISITOR BADGE IDENTIFICATION TECHNOLOGY. ALL VISITORS MUST PRESENT PHOTO IDENTIFICATION UPON ARRIVAL AND A RECORD IS KEPT OF ALL THOSE ENTERING THE HOSPITAL. THIS SYSTEM CAN IDENTIFY INDIVIDUALS WITH RECORDS OF CHILD ABUSE AND MOLESTATION, HELPING ENHANCE THE SAFETY OF CHILDREN AT THE HOSPITAL. GETWELL NETWORK: SINCE 2009, THE HOSPITAL HAS OFFERED THE GETWELL NETWORK IN ALL MEDICAL SURGICAL ROOMS. THE SYSTEM, ACCESSIBLE THROUGH THE IN-ROOM TELEVISION SCREEN, OFFERS PATIENT EDUCATION INFORMATION THAT CAN SUPPORT ENHANCED PATIENT CARE AS WELL AS A PATIENT FEEDBACK SYSTEM, THROUGH WHICH FAMILIES CAN ADDRESS SAFETY CONCERNS. LIFEWINGS: IN 2010, THE HOSPITAL BEGAN COLLABORATING WITH LIFEWINGS PARTNERS LLC TO TRAIN EMERGENCY DEPARTMENT STAFF, SURGEONS, ANESTHESIOLOGISTS, OR NURSES AND SUPPORT STAFF TO IMPLEMENT AVIATION-BASED SAFETY AND EFFICIENCY MEASURES AND CONTINUES TO DO SO. THE HOSPITAL WON AN OUTSTANDING INITIATIVE AWARD FROM TRAINING MAGAZINE FOR THIS SAFETY COLLABORATION AND CONTINUES TO USE THIS PROGRAM TO ENHANCE SAFETY AND QUALITY. CRITICAL CARE EXCELLENCE RECOGNITION: THE MIAMI CHILDREN'S HOSPITAL NEONATAL INTENSIVE CARE UNIT (NICU) AND PEDIATRIC INTENSIVE CARE UNIT (PICU) IN 2012 EACH RECEIVED A GOLD BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL-CARE NURSES (AACN). IN ADDITION, THE HOSPITAL'S CARDIAC INTENSIVE CARE UNIT (CICU) RECEIVED AACN'S SILVER BEACON AWARD FOR EXCELLENCE. MCH IS ONE OF ONLY THREE CHILDREN'S HOSPITALS IN THE NATION TO BE AWARDED GOLD- AND SILVER-LEVEL BEACON AWARDS FOR ALL OF ITS ICUS AND THE ONLY CHILDREN'S HOSPITAL IN FLORIDA TO RECEIVE THIS DISTINCTION. THIS RECOGNITION PUTS MCH AMONG THE TOP CHILDREN'S HOSPITALS IN THE COUNTRY AND DEMONSTRATES ORGANIZATIONAL COMMITMENT TO CRITICAL CARE EXCELLENCE. EMR: THE HOSPITAL HAS ACQUIRED A STATE-OF-THE-ART SYSTEM THAT WILL CAPTURE ALL PATIENT DATA, INCLUDING COMPREHENSIVE CARE RECORDS (RADIOLOGY, PHARMACY, REHABILITATION, OUTPATIENT AND INPATIENT) AS WELL AS REGISTRATION AND BILLING INFORMATION, ALL IN A COMPREHENSIVE SYSTEM. IN 2012, THE HOSPITAL WENT LIVE WITH THE NEW SYSTEM WHICH PROVIDES PHYSICIANS AND CAREGIVERS WITH ACCESS TO ALL MEDICAL DATA THROUGH A SECURE LOGIN SYSTEM FROM ANY PLACE AT ANY TIME, ENABLING THEM TO MAKE INFORMED DECISIONS WITH MAXIMUM EFFICIENCY. HUMPTY DUMPTY: MIAMI CHILDREN'S HOSPITAL HAS TAKEN THE LEAD IN DEVELOPING A TOOL TO PREVENT PEDIATRIC FALLS AND THEREBY ENHANCE SAFETY. AS OF 2013, THE TOOL WAS IN USE IN 933 HOSPITALS, INCLUDING FACILITIES IN VIRTUALLY EVERY U.S. STATE AS WELL AS IN EUROPE, THE MIDDLE EAST, HONG KONG, INDONESIA, THE PHILIPPINES, BERMUDA AND AUSTRALIA. THE PROGRAM IS ALSO IN USE BY EVERY BRANCH OF OUR U.S. MILITARY HOSPITALS THROUGHOUT THE WORLD. THIS FALL PREVENTION PROGRAM HAS BEEN IMPLEMENTED, TESTED AND PROVEN TO BE AN EFFECTIVE TOOL IN THE PREVENTION OF UNINTENTIONAL INJURY DUE TO FALLS. THE HUMPTY DUMPTY FALLS PREVENTION PROGRAM(TM) IS A COMPREHENSIVE PROGRAM AIMED AT IDENTIFYING PATIENTS WHO ARE AT RISK FOR FALLS AS WELL AS PREVENTING FALL EVENTS AND INJURIES. THIS PROGRAM WAS DEVELOPED BY AN INTERDISCIPLINARY GROUP OF FALLS EXPERTS DERIVED FROM NURSING, RESEARCH, REHABILITATION, QUALITY IMPROVEMENT, AND RISK MANAGEMENT. PROGRAM MATERIALS INCLUDE A VALIDATED FALLS RISK SCALE, AN INTERVENTION PROTOCOL, AND PATIENT EDUCATION INFORMATION. HYGREEN: IMPLEMENTATION OF XHALE INNOVATIONS' HYGREEN(R) HAND HYGIENE SYSTEM IS ANOTHER WAY MIAMI CHILDREN'S HOSPITAL LEADS THE WAY IN PATIENT SAFETY. HYGREEN HELPS PREVENT INFECTIONS BY MONITORING AND REMINDING HEALTHCARE WORKERS TO WASH THEIR HANDS. A SENSOR SCANS NEWLY CLEANED HANDS AND SENDS A WIRELESS "ALL CLEAN" MESSAGE TO A BADGE WORN BY THE CAREGIVER. IN 2013, HYGREEN CONTINUED TO BE INTEGRATED INTO THE INFECTION CONTROL PROGRAM AND WAS IN USE IN MOST HOSPITAL UNITS. COMMUNITY TRAINING OUTREACH PROGRAMS IN ADDITION, THE HOSPITAL SUPPORTS A NUMBER OF PROGRAMS THAT ENHANCE THE SKILLS AND WORK READINESS OF YOUNG PEOPLE AS WELL AS PROMOTE HEALTH AWARENESS. PROJECT VICTORY: THIS PROJECT IS A COOPERATIVE EFFORT BETWEEN MIAMI CHILDREN'S COMMUNITY AND VOLUNTEER RESOURCE PROGRAM AND THE COMMUNITY. TEENS WITH DISABILITIES ARE GIVEN THE OPPORTUNITY TO GAIN LIFE SKILLS THROUGH THE WORLD OF WORK. TWENTY STUDENTS ARE PROVIDED THREE HOURS OF WORK SERVICE PER DAY AT THE HOSPITAL DURING THE COURSE OF THE SCHOOL YEAR. THE STUDENTS GAIN VOCATIONAL EXPERIENCE WORKING IN THE HOSPITAL'S DIETARY DEPARTMENT, MAIL ROOM, VISITOR INFORMATION SERVICE AND OTHER DEPARTMENTS. MIAMI SENIOR HIGH SCHOOL: MIAMI SENIOR HIGH OFFERS A MEDICAL MAGNET PROGRAM. EACH YEAR, 43 STUDENTS FROM THE PROGRAM HAVE THE OPPORTUNITY TO RECEIVE HANDS-ON EXPERIENCE IN A NURSING/MEDICAL SETTING. THE HOSPITAL OFFERS THE STUDENTS THIS EXPERIENCE AS PART OF ITS SERVICE TO THE COMMUNITY. A TEAM OF 20 NURSES MENTORS THE STUDENTS. HONORS AND EXECUTIVE INTERNSHIP PROGRAM, MIAMI DADE COUNTY PUBLIC SCHOOLS: EACH YEAR THE HOSPITAL ACCEPTS SEVEN STUDENTS WHO ARE SELECTED BY MIAMI-DADE COUNTY PUBLIC SCHOOLS TO PARTICIPATE IN HEALTHCARE INTERNSHIPS FOR ADVANCED STUDENTS. STUDENTS ARE PAIRED WITH A STAFF MEMBER AT THE HOSPITAL WHO MENTORS AND PROVIDES OVERSIGHT TO THE STUDENT. EACH STUDENT IS ASSIGNED A PROJECT TO BENEFIT A HOSPITAL DEPARTMENT AND RECEIVES A GRADE FROM THE SCHOOL SYSTEM FOR HIS OR HER WORK. KIDS AND THE POWER OF WORK (KAPOW): THIS PROGRAM IS A NATIONAL VOLUNTEER PROGRAM. THE HOSPITAL PARTICIPATES WITH MIAMI-DADE COUNTY PUBLIC SCHOOLS. HOSPITAL STAFF MEMBERS VOLUNTEER TO VISIT STUDENTS AT ONE OF TWO AREA PUBLIC ELEMENTARY SCHOOLS. THEY PRESENT AND PREPARE LESSONS FOR SECOND GRADE STUDENTS TO HELP CREATE A FOUNDATION FOR YOUNG STUDENTS, INTRODUCING THEM TO WORK AND RELATED CONCEPTS. EMPLOYEES DONATE ABOUT 500 HOURS OF TIME TO THE PROGRAM. HEALTHTEACHER: MIAMI CHILDREN'S IS PARTNERING WITH SCHOOL DISTRICTS IN PALM BEACH AND BROWARD COUNTIES TO TEACH CHILDREN HOW TO INCORPORATE HEALTH AND WELLNESS INTO THEIR LIFESTYLES. THE HOSPITAL MAKES AVAILABLE AN ONLINE HEALTH CURRICULUM DEVELOPED BY HEALTHTEACHER. THE PROGRAM IS DESIGNED FOR KINDERGARTEN THROUGH HIGH SCHOOL STUDENTS, WITH TOPICS RANGING FROM GOOD NUTRITION TO BICYCLE SAFETY. THE GOAL IS TO EQUIP CHILDREN WITH THE KNOWLEDGE AND TOOLS NEEDED TO MAKE BETTER CHOICES FOR THEIR HEALTH. FORM 990, PART VI, SECTION B, LINE 11 THE FOLLOWING DESCRIBES MIAMI CHILDREN'S HOSPITAL'S PROCESS FOR PROVIDING IT'S BOARD OF DIRECTORS WITH A COPY OF THE FORM 990 AND REVIEWING IT: 1. THE DRAFT TAX FORM 990 WILL BE MAILED TO FINANCE COMMITTEE OF MCH BOARD OF DIRECTORS FOR REVIEW AND COMMENT PRIOR TO REGULARLY SCHEDULED MEETING. 2. THE DRAFT TAX FORM 990 WILL BE REVIEWED WITH THE FINANCE COMMITTEE. 3. QUESTIONS WILL BE ANSWERED AND IF NECESSARY, TAX FORMS WILL BE ADJUSTED. 4. THE FINAL FORM 990 WILL BE POSTED ON THE MCH BOARD OF DIRECTOR'S WEB PORTAL. FORM 990, PART VI, SECTION B, LINE 12C ALL MIAMI CHILDREN'S HOSPITAL EMPLOYEES ARE INFORMED UPON HIRE, AND ON AN ANNUAL BASIS THEREAFTER, THAT THEY HAVE AN AFFIRMATIVE DUTY TO DISCLOSE ANY ACTUAL, POTENTIAL OR PERCEIVED CONFLICT OF INTEREST. THEY ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM UPON HIRE, ANNUALLY AND WHENEVER A CHANGE IN CIRCUMSTANCES WARRANTS. CONFLICT OF INTEREST DISCLOSURE FORMS ARE FORWARDED TO THE COMPLIANCE DEPARTMENT BY THE TALENT MANAGEMENT AND EFFECTIVENESS DEPARTMENT. THESE FORMS ARE INITIALLY REVIEWED BY COMPLIANCE DEPARTMENT STAFF. WHEN DEEMED NECESSARY, THE COMPLIANCE DEPARTMENT COLLABORATES WITH THE LEGAL DEPARTMENT. CONFLICTS OF INTEREST THAT NECESSITATE BOARD AWARENESS AND ACTION ARE PRESENTED TO THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD FOR RESOLUTION AND IMPOSITION OF SANCTIONS, IF WARRANTED. IN ADDITION, ON AN ANNUAL BASIS, BOARD MEMBERS, PRINCIPAL OFFICERS AND BOARD-DELEGATED COMMITTEE MEMBERS SIGN A STATEMENT WHICH AFFIRMS THAT EACH INDIVIDUAL: (A) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY (C) HAS AGREED TO COMPLY WITH THE POLICY, AND (D) UNDERSTANDS THAT THE HOSPITAL IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF IT'S TAX-EXEMPT PURPOSES. A PROCESS IS IN PLACE FOR MANAGING SITUATIONS IN WHICH IT IS DISCOVERED THAT AN INDIVIDUAL WHO IS COVERED BY THE HOSPITAL'S CONFLICT OF INTEREST POLICY FAILED TO PROPERLY DISCLOSE A POTENTIAL CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION AND COMPENSATION COMMITTEE OF MCH BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTANT TO OBTAIN MARKET SURVEYS FOR THE CEO AND OTHER EXECUTIVES. THE CONSULTANT ASSISTS THE ORGANIZATION AND COMPENSATION COMMITTEE IN ESTABLISHING A COMPENSATION PROGRAM FOR THE CEO AND OTHER EXECUTIVES. SURVEY RESULTS AND COMPENSATION BEST PRACTICES ARE SHARED WITH THE ORGANIZATION AND COMPENSATION COMMITTEE OF THE BOARD AND USED IN ESTABLISHING EXECUTIVE SALARY AND BENEFITS PROGRAMS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: PARTNERSHIP INCOME EXCLUDED FOR F/S PURPOSES 677,164. RESTRICTED CONTRIBUTIONS -8,582,015. GAIN ON CHANGE IN FMV OF SWAP AGREEMENTS 22,710,933. CHANGE IN CHARITABLE REMAINDER TRUSTS 1,176,808. NET ASSETS RELEASED FROM RESTRICTION -6,155,238. CHANGE IN BENEFICIAL INTEREST IN MCHF 692,769. AMOUNTS REPORTED SEPARATELY -1,256,379. LOSS ON CONVERSION OF DEBT -119,603. NET UNREALIZED GAINS ON TEMP RESTRICTED ASSETS 12,358,260. NET ASSETS RELEASED FOR PP&E 445,500. PRIOR YEAR CONTRIBUTIONS RELEASED FROM RESTRICTIONS 1,999,787. MCH PEDIATRIC CARDIOLOGY LLC 3100 SW 62ND AVENUE MIAMI FL 33155 651023909 CARDIAC SVC'S FL 4555576 -21617941 VCH MCH RESEARCH INSTITUTE INC 3100 SW 62ND AVENUE MIAMI FL 33155 592602318 RESEARCH FL 501(C)(3) 11B VCH 1 MCH WORKER'S COMPENSATION TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 597021572 WC CLAIMS FL 4947(A)(1) N/A VCH 1 PROFESSIONAL LIABILITY TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 592551434 LIAB. CLAIMS FL 4947(A)(1) N/A VCH 1 MIAMI CHILDREN'S HOSPITAL FND INC 3100 SW 62ND AVENUE MIAMI FL 33155 591720704 FUNDRAISING FL 501(C)(3) 7 VCH 1 MIAMI CHILDREN'S HEALTH SYSTEM INC 3100 SW 62ND AVENUE MIAMI FL 33155 453481327 HEALTHCARE FL 501(C)(3) 11 TYPE II N/A 0 PEDIATRIC SPECIALTY GROUP INC 3100 SW 62ND AVENUE MIAMI FL 33155 463756071 INACTIVE FL 501(C)(3) 4 MCHS 0 MIAMI CHILDREN'S HEALTH SYSTEM FOUNDATION INC 3100 SW 62ND AVENUE MIAMI FL 33155 461784918 FOUNDATION FL 501(C)(3) 7 MCHS 0 CANAVAN PARTNERS C/O COHEN PO BOX 812170 BOCA RATON FL 334812170 650974245 MED.INTEL.PRO FL N/A RELATED 130753 0 1 0.62500 MIAMI CHILDREN'S HOSPITAL AMBULATORY SURGERY CENTER LLC 3100 SW 62ND AVENUE MIAMI FL 331553009 463406805 AMBULATORY CNTR FL VCH N/A 739328 0 1 0.56020 MIAMI CHILDREN'S INSURANCE CO SPC LTD 720 WEST BAY ROAD PO BOX 69GT B GEORGETOWN GRAND CAYMAN CJ 980442086 INSURANCE CJ VCH C 1934221 70530305 1.00000 1 CHILDREN'S HEALTH VENTURES INC AND SUBSIDIARIES 3100 SW 62ND AVENUE MIAMI FL 33155 454541147 MERCHANT WHOLESALE FL N/A C 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 MIAMI CHILDREN'S INSURANCE CO SPC LTD R 3312000 CHANGE IN BALANCE MIAMI CHILDREN'S INSURANCE CO SPC LTD R 38126314 CHANGE IN BALANCE MCH RESEARCH INSTITUTE INC R 740761 CHANGE IN BALANCE CHVI INC AND SUBSIDIARIES L 60000 FMV CHVI INC AND SUBSIDIARIES R 286658 CHANGE IN BALANCE MIAMI CHILDREN'S HOSPITAL FOUNDATION INC C 12186187 FMV