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DAYTON CHILDRENS HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
DAYTON CHILDRENS HOSPITAL (EIN 31-0672132)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-10
IRS object ID
201241319349301089
Schema version
2010v3.7
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-05-10T13:23:29-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN310672132EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Children's Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone9376413338Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Childrens PlazaAddressLine1
CityDaytonCity
StateOHState
ZIP Code454041815ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDAVID MILLERName
TitleVP OF FINANCETitle
Date Signed2012-05-04DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDAVID KINSAULNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE CHILDRENS PLAZAAddressLine1
CityDAYTONCity
StateOHState
ZIP Code454041815ZIPCode
FieldValueIRS element (for citing)
Gross Receipts342746321GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.childrensdayton.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1967YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO IMPROVE THE HEALTH STATUS OF ALL CHILDREN THROUGH SERVICE, EDUCATION, RESEARCH AND ADVOCACY.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1888TotalNbrEmployees
Total Nbr Volunteers1096TotalNbrVolunteers
Total Gross UBI96296TotalGrossUBI
Net Unrelated Business Txbl Income95296NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year19295153ContributionsGrantsPriorYear
Contributions Grants Current Year10540270ContributionsGrantsCurrentYear
Program Service Revenue Prior Year181426163ProgramServiceRevenuePriorYear
Program Service Revenue CY194695740ProgramServiceRevenueCY
Investment Income Prior Year-5572645InvestmentIncomePriorYear
Investment Income Current Year8188402InvestmentIncomeCurrentYear
Other Revenue Prior Year2443284OtherRevenuePriorYear
Other Revenue Current Year2687349OtherRevenueCurrentYear
Total Revenue Prior Year197591955TotalRevenuePriorYear
Total Revenue Current Year216111761TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year102429GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY100525GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year96856215SalariesEtcPriorYear
Salaries Etc Current Year101995746SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1008282TotalFundrsngExpCurrentYear
Other Expense Prior Year75063253OtherExpensePriorYear
Other Expenses Current Year74336688OtherExpensesCurrentYear
Total Expenses Prior Year172021897TotalExpensesPriorYear
Total Expenses Current Year176432959TotalExpensesCurrentYear
Revenues Less Expenses Prior Year25570058RevenuesLessExpensesPriorYear
Revenues Less Expenses CY39678802RevenuesLessExpensesCY
Total Assets BOY340268641TotalAssetsBOY
Total Assets EOY410865595TotalAssetsEOY
Total Liabilities BOY49322357TotalLiabilitiesBOY
Total Liabilities EOY38047015TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY290946284NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY372818580NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO IMPROVE THE HEALTH STATUS OF ALL CHILDREN THROUGH SERVICE, EDUCATION, RESEARCH AND ADVOCACY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense164183070Expense
Grants100525Grants
Revenue194695740Revenue
DescriptionSEE SCHEDULE O.Description
Total Program Service Expense164183070TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficetrueForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109696NumberFormsTransmittedWith1096
Number W2 G Included1NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1888NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryBDNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDAVID T MILLERNamePerson
Telephone Number9376413338TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE CHILDRENS PLAZAAddressLine1
CityDAYTONCity
StateOHState
ZIP Code454041815ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
JEFFERY S ADAM MD
TRUSTEE1.0X2000000
JEFFREY CHRISTIAN MD
TRUSTEE1.0X048708452617
JEAN IRELAND
TRUSTEE1.0X000
ROBERT E JOHNSON
TRUSTEE1.0X000
ROBERT P MYERS DO
TRUSTEE1.0X1635200
TIMOTHY G PEPPER
TRUSTEE1.0X000
ARTHUR PICKOFF
TRUSTEE1.0X10727600
COLLEEN RYAN
TRUSTEE1.0X000
GREGORY SAMPLE
TRUSTEE1.0X000
BEVERLY SHILLITO
TRUSTEE1.0X000
EMILY CHAMBERS
TRUSTEE1.0X000
ELIZABETH H EY MD
TRUSTEE1.0X12687500
JARED M BARNETT
ASSISTANT TREASURER1.0X000X
CHARLES M FOLEY
CHAIRMAN1.0X91200X
LAURENCE KLABEN
TREASURER1.0X000X
NEIL A MCLACHLAN
FIRST VICE CHAIRMAN1.0X000X
VISHAL SOIN
SECOND VICE CHAIRMAN1.0X75500X
MARLA VICHICH
ASSISTANT SECRETARY1.0X000X
DEBBIE WATTS ROBINSON
SECRETARY1.0X000X
DAVID KINSAUL
PRESIDENT AND CEO40.0X5728190322770X
THOMAS MURPHY MD
VP MEDICAL AFFAIRS40.0X3153060231541X
DAVID T MILLER
VP FINANCE AND CFO40.0289783048509X
RENAE PHILLIPS
VP HOSPITAL OPERATIONS40.0224888040847X
GREGORY RAMEY
VP OUTPATIENT SERVICES40.0217898097916X
VICKI GIAMBRONE
VP MARKETING/EXTERNAL RELATION40.0215926035946X
LISA COFFEY
VP CORPORATION SUPPORT40.0171612038291X
MATTHEW GRAYBILL
VP ALTERNATIVE SITES40.0215998064697X
MARGARET HEMMEN
CRN ANESTHETIST40.0178861012714X
GREGORY HUFF
DIRECTOR OF PHARMACY40.0156256034159X
DUKE HADDAD JR
VP DEVELOPMENT40.0142330018111X
ELIZABETH FREDETTE
DIRECTOR OF INFORMATION SVCS40.0141034032732X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3114881TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs487084TotalReportableCompFrmRltdOrgs
Total Other Compensation1030850TotalOtherCompensation
Number Individuals GT100 K45NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CHILDREN'S CARE GROUP
1 CHILDRENS PLAZADAYTONOH45404PHYSICIAN SERVICES9028848
WRIGHT STATE PHYSICIANS
PO BOX 1144DAYTONOH45401PHYSICIAN SERVICES1658485
DAYTON CHILDREN'S CARDIOLOGY
1 CHILDRENS PLAZADAYTONOH45404PHYSICIAN SERVICES1649485
WRIGHT STATE UNIVERSITY
PO BOX 927DAYTONOH45401PHYSICIAN SERVICES1042757
ORTHOPAEDIC CENTER FOR SPINAL PED
1 CHILDRENS PLAZADAYTONOH45404PHYSICIAN SERVICES438435
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K
Federated Campaigns31956FederatedCampaigns
Fundraising Events49780FundraisingEvents
Government Grants823021GovernmentGrants
All Other Contributions9635513AllOtherContributions
Noncash Contributions391493NoncashContributions
Total Contributions10540270TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICES REVENUE900099121040854121040854
MEDICARE/MEDICAID9000997355859073558590
URGENT CARE CENTER621400121153121153
SURGERY CENTER621400-24857-24857
FieldValueIRS element (for citing)
Total Program Service Revenue194695740TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5697771TotalRevenueColumn
Exclusion$5,697,771ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real357648Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real737953Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-380305Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-380305TotalRevenueColumn
Exclusion-$380,305ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities127721560Securities
Other98737Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities125175032Securities
Other154634Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2546528Securities
Other-55897Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2490631TotalRevenueColumn
Exclusion$2,490,631ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events672704GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events49780CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses154272FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column518432TotalRevenueColumn
Exclusion$518,432ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory635848GrossSalesOfInventory
Cost Of Goods Sold412669CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column223179TotalRevenueColumn
Related Or Exempt Function Income223179RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CAFETERIA/KIDS CARE72221013085181308518
PARKING LOT624410307861307861
DAY CARE CENTER812930709664709664
FieldValueIRS element (for citing)
Total Other Revenue2326043TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column216111761TotalRevenueColumn
Related Or Exempt Function Income197148666RelatedOrExemptFunctionIncome
Unrelated Business Revenue96296UnrelatedBusinessRevenue
Exclusion$8,326,529ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total100525Total
Program Services100525ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2858537Total
Management And General2858537ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total75519954Total
Program Services71357563ProgramServices
Management And General3583448ManagementAndGeneral
Fundraising578943Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5993108Total
Program Services5662789ProgramServices
Management And General284375ManagementAndGeneral
Fundraising45944Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total11896429Total
Program Services11340354ProgramServices
Management And General464067ManagementAndGeneral
Fundraising92008Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total5727718Total
Program Services5412027ProgramServices
Management And General271782ManagementAndGeneral
Fundraising43909Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total235574Total
Management And General235574ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total240895Total
Management And General240895ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total170243Total
Program Services170243ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total14345910Total
Program Services14092869ProgramServices
Management And General253033ManagementAndGeneral
Fundraising8Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total695000Total
Program Services695000ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total28525487Total
Program Services27527348ProgramServices
Management And General848319ManagementAndGeneral
Fundraising149820Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3557092Total
Program Services3557092ProgramServices

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2617757Total
Program Services2511239ProgramServices
Management And General97292ManagementAndGeneral
Fundraising9226Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total631886Total
Program Services481100ProgramServices
Management And General127925ManagementAndGeneral
Fundraising22861Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total89224Total
Program Services89224ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14698898Total
Program Services14170708ProgramServices
Management And General475160ManagementAndGeneral
Fundraising53030Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total355523Total
Program Services355523ProgramServices

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PURCHASED SERVICES60351294582903143969312533
STATE HOSPITAL ASSESSMENT20765632076563
MISCELLANEOUS6150761507

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total176432959Total
Program Services164183070ProgramServices
Management And General11241607ManagementAndGeneral
Fundraising1008282Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY14610BOY
EOY14910EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12773925BOY
EOY29801992EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2165460BOY
EOY1738641EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY21512557BOY
EOY22926911EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY177608BOY
EOY98419EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1294743BOY
EOY1474060EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY606832BOY
EOY787044EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis182150194LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec79717366LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY105259704BOY
EOY102432828EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY189896424BOY
EOY238360447EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY2078733BOY
EOY2071712EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY4488045BOY
EOY11158631EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY340268641BOY
EOY410865595EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY26376084BOY
EOY28833376EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1415BOY
EOY1415EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY22944858BOY
EOY9212224EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY49322357BOY
EOY38047015EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY290084813BOY
EOY371563718EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY861471BOY
EOY1254862EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY290946284BOY
EOY372818580EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY340268641BOY
EOY410865595EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses39678802ReconcilationRevenueExpenses
Reconcilation Other Changes42193494ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MemberstrueMailingsMembers
Mailings Members$150MailingsMembersAmount
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$143,165GrantsOtherOrganizationsAmount
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$12,454DirectContactLegislatorsAmount
Rallies DemonstrationstrueRalliesDemonstrations
Rallies Demonstrations$27,868RalliesDemonstrationsAmount
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB183637TotalLobbyingExpendituresIIB

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierSCHEDULE C SUPPLEMENTAL INFORMATIONIdentifier
Return ReferenceSCHEDULE C, PART II-BReturnReference
ExplanationOHA - OHIO HOSPITAL ASSOCIATION DUES: 51,244 % ALLOC. TO LOBBYING: 5.00% LOBBYING EXPENSE: 2,562 OCHA - OHIO CHILDREN'S HOSPITAL ASSOCIATION DUES: 160,426 % ALLOC. TO LOBBYING: 85.00% LOBBYING EXPENSE: 136,362 NACH DUES: 22,429 % ALLOC, TO LOBBYING: 7.92% LOBBYING EXPENSE: 1,776 NACHRI - NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED ORGANIZATIONS DUES: 45,539 % ALLOC. TO LOBBYING: 0.00% LOBBYING EXPENSE: 0 NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS DUES: 21,772 % ALLOC. TO LOBBYING: 11.32% LOBBYING EXPENSE: 2,465 CONSULTING EXPENSES LOBBYING EXPENSE: 26,628 PRINTING & SUPPLIES LOBBYING EXPENSE: 450 MANAGEMENT TIME LOBBYING EXPENSE: 13,394 TOTAL LINE 1J: 183,637Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance97132791BeginningOfYearBalance
Contributions7689808Contributions
Investment Earnings Or Losses22325672InvestmentEarningsOrLosses
Grants Or Scholarships3402441GrantsOrScholarships
Other Expenditures4113OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance123741717EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance71668979BeginningOfYearBalance
Contributions19617386Contributions
Investment Earnings Or Losses8980654InvestmentEarningsOrLosses
Grants Or Scholarships2900616GrantsOrScholarships
Other Expenditures233612OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance97132791EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance87947632BeginningOfYearBalance
Contributions1194204Contributions
Investment Earnings Or Losses-14186547InvestmentEarningsOrLosses
Grants Or Scholarships3254832GrantsOrScholarships
Other Expenditures31478OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance71668979EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.00000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis3489979OtherCostOrOtherBasis
Book Value3489979BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis49130270OtherCostOrOtherBasis
Depreciation19207579Depreciation
Book Value29922691BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis125275596OtherCostOrOtherBasis
Depreciation59146431Depreciation
Book Value66129165BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4254349OtherCostOrOtherBasis
Depreciation1363356Depreciation
Book Value2890993BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings102432828TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
RESERVE FOR PROFESSIONAL LIABILITY$4,558,551
DEFERRED COMPENSATION PAYABLE$1,652,158
SERP PENSION ACCRUAL$3,001,515
FieldValueIRS element (for citing)
Total Of Amounts9212224TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePart V, Line 4ReturnReference
ExplanationThe endowments are held by the Children's Medical Center Foundation, a subsidiary of Children's Medical Center. The funds are used exclusively to support Children's Medical Center and its subsidiaries. The intended use of the funds is to support medical research, the child life program and the medical chairs of specific hospital departments. PART X, ASC 740-10(F/K/A FIN48) FOOTNOTE THE MEDICAL CENTER COMPLETED AN ANALYSIS OF ITS TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30. 2011 OR 2010.Explanation

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegion
Number Of Offices1NumberOfOffices
Number Of Employees2NumberOfEmployees
Type Of Activities ConductedProgram ServicesTypeOfActivitiesConducted
Specific Services ProvidedSELF-INSURANCESpecificServicesProvided
Total Expenditures499941TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices1SubtotalNumberOfOffices
Subtotal Number Of Employees2SubtotalNumberOfEmployees
Total Number Of Offices1TotalNumberOfOffices
Total Number Of Employees2TotalNumberOfEmployees
Subtotal Amount Spent499941SubtotalAmountSpent
Total Amount Spent499941TotalAmountSpent
Transfer To Foreign CorptrueTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorptrueOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Form990 Schedule F Part V Form990ScheduleFPartV

FieldValueIRS element (for citing)
IdentifierSCHEDULE F SUPPLEMENTAL INFORMATIONIdentifier
ExplanationTHE TOTAL EXPENDITURES WERE DETERMINED BASED ON THE ACCRUAL ACCOUNTING METHODOLOGY.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1CHA-CHA DINNERNameOfEvent1
Gross Receipts Event1400700GrossReceiptsEvent1
Charitable Contributions Event129100CharitableContributionsEvent1
Gross Revenue Event1371600GrossRevenueEvent1
Rent Facility Costs Event13827RentFacilityCostsEvent1
Food And Beverage Event127033FoodAndBeverageEvent1
Entertainment Event11300EntertainmentEvent1
Other Direct Expenses Event128365OtherDirectExpensesEvent1
Name Of Event2GOLF OUTINGNameOfEvent2
Gross Receipts Event2155628GrossReceiptsEvent2
Charitable Contributions Event29700CharitableContributionsEvent2
Gross Revenue Event2145928GrossRevenueEvent2
Food And Beverage Event213519FoodAndBeverageEvent2
Other Direct Expenses Event226945OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events166156GrossReceiptsOtherEvents
Charitable Contrib Other Events10980CharitableContribOtherEvents
Gross Revenue Other Events155176GrossRevenueOtherEvents
Rent Facility Costs Other Events5000RentFacilityCostsOtherEvents
Food And Beverage Other Events25649FoodAndBeverageOtherEvents
Entertainment Other Events1000EntertainmentOtherEvents
Other Direct Expenses Other Events21634OtherDirectExpensesOtherEvents
Gross Receipts Total722484GrossReceiptsTotal
Charitable Contributions Total49780CharitableContributionsTotal
Gross Revenue Total Events672704GrossRevenueTotalEvents
Rent Facility Costs Total Events8827RentFacilityCostsTotalEvents
Food And Beverage Total Events66201FoodAndBeverageTotalEvents
Entertainment Total Events2300EntertainmentTotalEvents
Other Direct Expenses Total Events76944OtherDirectExpensesTotalEvents
Direct Expense Summary Events154272DirectExpenseSummaryEvents
Net Income Summary518432NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense366886TotalCommunityBenefitExpense
Direct Offsetting Revenue85697DirectOffsettingRevenue
Net Community Benefit Expense281189NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense85578526TotalCommunityBenefitExpense
Direct Offsetting Revenue70401548DirectOffsettingRevenue
Net Community Benefit Expense15176978NetCommunityBenefitExpense
Percent Of Total Expense0.08600PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense85945412TotalCommunityBenefitExpense
Direct Offsetting Revenue70487245DirectOffsettingRevenue
Net Community Benefit Expense15458167NetCommunityBenefitExpense
Percent Of Total Expense0.08760PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense419980TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense419980NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense4410581TotalCommunityBenefitExpense
Direct Offsetting Revenue2970008DirectOffsettingRevenue
Net Community Benefit Expense1440573NetCommunityBenefitExpense
Percent Of Total Expense0.00820PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense14360466TotalCommunityBenefitExpense
Direct Offsetting Revenue5628217DirectOffsettingRevenue
Net Community Benefit Expense8732249NetCommunityBenefitExpense
Percent Of Total Expense0.04950PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense103730TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense103730NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense19294757TotalCommunityBenefitExpense
Direct Offsetting Revenue8598225DirectOffsettingRevenue
Net Community Benefit Expense10696532NetCommunityBenefitExpense
Percent Of Total Expense0.06070PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense105240169TotalCommunityBenefitExpense
Direct Offsetting Revenue79085470DirectOffsettingRevenue
Net Community Benefit Expense26154699NetCommunityBenefitExpense
Percent Of Total Expense0.14830PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense7518TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense7518NetCommunityBuildingExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense2418TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense2418NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense1301TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense1301NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense21456TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense21456NetCommunityBuildingExpense
Percent Of Total Expense0.00120PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense19770TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense19770NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense52463TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense52463NetCommunityBuildingExpense
Percent Of Total Expense0.00130PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,585,250BadDebtExpenseAmount
Amount Attributable To700182AmountAttributableTo
Amount Reimbursed By Medicare659618AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare659618CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHILDRENS MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1ONE CHILDRENS PLAZAAddressLine1
CityDAYTONCity
StateOHState
ZIP Code454041815ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Childrens HospitalXChildrensHospital
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CHILDRENS MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
SPRINGBORO URGENT CARE CENTER
3333 WEST TECH ROADMIAMISBURGOH45342URGENT CARE CENTER
SPRINGBORO OUTPATIENT CARE CENTER
3333 WEST TECH ROADMIAMISBURGOH45342OUTPATIENT CARE CENTER DIAGNOSTIC CENTER
BEAVERCREEK OUTPATIENT TESTING CENTER
3224 DAYTON-XENIA ROADBEAVERCREEKOH45431OUTPATIENT CARE CENTER DIAGNOSTIC CENTER
KETTERING OUTPATIENT TESTING CENTER
4475 FAR HILLS AVENUEKETTERINGOH45429OUTPATIENT CARE CENTER DIAGNOSTIC CENTER
VANDALIA OUTPATIENT TESTING CENTER
810 FALLS CREEK DRIVE SUITE AVANDALIAOH45377OUTPATIENT CARE CENTER DIAGNOSTIC CENTER
WARREN COUNTY SPECIALTY CARE CENTER
100 CAMPUS LOOP ROAD SUITE AFRANKLINOH45005OUTPATIENT CARE CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
IdentifierSchedule H Part VIIdentifier
Return ReferencePART I, LINE 7GReturnReference
ExplanationDAYTON CHILDREN'S DID INCLUDE $14,360,466 OF PHYSICIAN CLINIC COSTS IN THE SUBSIDIZED HEALTH SERVICES CATEGORY. PART I. LINE 7 THE FOLLOWING COSTING METHODOLOGIES WERE USED IN PREPARATION OF SCHEDULE H PART I, LINE 7: -CHARITY CARE AT COST WAS CALCULATED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT COST-TO-CHARGES. -UNREIMBURSED MEDICAID WAS CALCULATED USING THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT COST-TO-CHARGES. -COMMUNITY HEALTH IMPROVEMENT SERVICES WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION. -HEALTH PROFESSIONS EDUCATION COSTS WERE DETERMINED USING THE FACILITY'S MEDICARE COST REPORTED, SUPPLEMENTED BY THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. -SUBSIDIZED HEALTH SERVICES COSTS WERE DETERMINED USING THE FACILITY'S INTERNAL COST ACCOUNTING SYSTEM. THE COST OF THESE SERVICES INCLUDES DIRECT COSTS ATTRIBUTABLE TO HEALTH SERVICES OPERATIONS, TOGETHER WITH AN ALLOCATION OF FACILITY DIRECT AND INDIRECT OVERHEAD USING A COST FINDING METHODOLOGY PATTERNED AFTER THE MEDICARE COST REPORT. -CASH AND IN KIND CONTRIBUTIONS WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION. PART III, LINE 4: THE COSTING METHODOLOGY USED IN PREPARATION OF BAD DEBT ATIRIBUTABLE TO PATIENT ACCOUNTS IS THE COST TO CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT COST-TO-CHARGE. THE CHILDREN'S MEDICAL CENTER'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE. A PROVISION FOR BAD DEBT EXPENSE IS SHOWN ON THE PROFIT AND LOSS STATEMENT. THE CALCULATION OF BAD DEBT EXPENSE IS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES REQUIRING MANAGEMENT TO MAKE ESTIMATES AND ASSUMPTIONS BASED ON HISTORICAL DATA THAT AFFECT THE REPORTED AMOUNTS OF REVENUE AND EXPENSES DURING THE REPORTED PERIOD. LIKEWISE, AN ALLOWANCE FOR BAD DEBT IS SHOWN ON THE BALANCE SHEET UNDER THE SAME PRINCIPLE AFFECTING THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES DURING THE REPORTED PERIOD. PART III, LINE 8: THE COSTS REPORTED FOR SERVICES PROVIDED TO MEDICARE PATIENTS COME FROM SCHEDULE E OF THE FACILITY'S COST REPORT AS FILED. SINCE DAYTON CHILDREN'S IS REIMBURSED FOR MEDICARE SERVICES UNDER A TEFRA METHODOLOGY, THERE IS NORMALLY NO SHORTFALL, AS ALLOWED COSTS AND PAYMENTS DUE ARE EQUAL. PART III, LINE 9B: THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE UNDER THE "FINANCIAL MATTERS" TAB IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT AND OTHER FINANCIAL ASSISTANCE PROGRAMS UP FRONT BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS, AND THE WEBSITE. EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILTY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON SITE FINANCIAL COUNSELORS, WHO CONTACT PATIENTS WITHOUT COVERAGE TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE TO FACE INTERVIEWS. THESE FINANCIAL COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE PROGRAMS IF DESIRED. PART V: DAYTON CHILDREN'S HAS 7 HEALTH CARE FACILITIES OTHER THAN THOSE REQUIRED TO BE LICENSED, REGISTERED, OR SIMILARLY RECOGNIZED AS A HEALTH CARE FACILITY UNDER STATE LAW. WE HAVE 4 TESTING CENTERS, 2 OFFSITE CLINICS, AND 1 URGENT CARE CENTER(50% OWNED). #2. Needs Assessment Describe how the organization assesses the health care needs of the communities it serves. Improving the health status of children is a key component of The Children's Medical Center of Dayton's mission. To help develop meaningful strategies in this area, Dayton Children's evaluates the status of our region's pediatric health through a regional pediatric health assessment conducted every three years. The first assessment was conducted in 2002, the second in 2005, third in 2008. Our fourth and current assessment was completed in March 2011. We worked with Schwartz Consulting Partners and community health advocates including the Wright State School of Medicine, CareSource, ReadySetSoar and Public Health Dayton & Montgomery County to develop the questionnaire. The survey was administered online through telephone. Note: Previous waves of the assessment have been conducted exclusively using random telephone interviewing. However in recent years the proportion of families who rely exclusively on mobile phones has increased dramatically, leading to declines in telephone survey responses, especially among parents of young children. This has led health and epidemiological organizations such as the National Center for Health Statistics to recommend mixed online and telephone sampling methods. The combination of online and telephone sampling methods coupled with demographic weighting allowed this study to come within one or two percentage points of the most recent census figures for key demographic statistics for the Miami Valley area (based on 2009 U.S. Census results for 13 counties served by Dayton Children's ). The hospital uses the insight from the assessment to learn more about the health status of the region's children, to determine a course of action to meet their needs and improve children's quality of life and give children a voice regarding their health and safety. Our 2011 study reveals three areas requiring greater attention: 1. Managing colds and flu 2. Dealing with diet and nutrition/Childhood obesity, and 3. Preventing Injuries and improving safety. These areas suggest a focus for the region's pediatric health agenda for the coming years, particularly in areas where we are able to prevent the preventable. These findings are used to plan much of our community health and outreach programming. Because the survey is very robust and one of the few assessments that directly addresses children's health needs and parent perceptions in our community, Dayton Children's shares the data with community leaders and potential partners so that additional programming can be developed throughout our region. The assessment is intended to provide community health advocates with a guide to the health issues impacting the region's children and suggest some areas of focus for future programming and education beyond the walls of Dayton Children's. Dayton Children's also works with partners such as local health departments and child-serving organizations to gain additional information regarding these needs to create comprehensive action plans. Using data from the Regional Pediatric Health Assessment, our injury database, input from our pediatric experts, other local and national studies, Dayton Children's sets a robust agenda of injury prevention, health promotion and advocacy to address the health care needs facing our region's children. #4: Community information: Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves The Children's Medical Center of Dayton (Dayton Children's) is located in Old North Dayton, northeast of downtown Dayton and the urban core, in Montgomery County in southwestern Ohio. The hospital's roots can be traced back to 1919, when philanthropist and activist Anna Barney Gorman planned a North Dayton community center to offer health services, education and recreation. The Barney Community Center later developed into the Barney Convalescent Hospital, which cared for polio victims. In 1967 a full-service children's hospital, The Barney Children's Medical Center, opened, and in 1970 the name was changed to The Children's Medical Center of Dayton. Dayton Children's now serves 20 Ohio counties, including the primary (Clark, Greene, Miami and Montgomery counties), the northern (Allen, Auglaize and Shelby counties), and the southern (parts of Butler and Warren counties) service areas and our secondary service area including Preble, Darke, Mercer, Van Wert, Clinton, Madison, Hancock, Hardin, Logan, Fayette, Champaign and Wayne County, Indiana. Our service area spans 9,000 squExplanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedfalseRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII (6 entries)

Type Of GrantTypeOfGrantNumber Of RecipientsNumberOfRecipientsAmount Of Cash GrantAmountOfCashGrant
TRANSPORTATION59725937
MEALS/FOOD25113141
RENT/UTILITIES2113919
PHARMACY24136835
SPECIAL EQUIPMENT94639
OTHER566054

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JEFFREY CHRISTIAN MD
046419900022885030094022523053970100
ARTHUR PICKOFF
107276000000000107276000
ELIZABETH H EY MD
126875000000000126875000
DAVID KINSAUL
381340014095305052603036020191680895589000
THOMAS MURPHY MD
21631704652905246002139330176080546847000
DAVID T MILLER
1967870442270487690292920192170338292000
RENAE PHILLIPS
183432035329061270216640191830265735000
GREGORY RAMEY
1468170398990311820743980235180315814000
VICKI GIAMBRONE
1419020332110408130257090102370251872000
LISA COFFEY
136795027250075670186900196010209903000
MATTHEW GRAYBILL
1726550332660100770426180220790280695000
MARGARET HEMMEN
177289000157201241003040191575000
GREGORY HUFF
14104205470097440109500232090190415000
DUKE HADDAD JR
39739000102591010066080450160441000
ELIZABETH FREDETTE
124378056380110180101870225450173766000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferencePART I, LINE 1AReturnReference
ExplanationDAVID KINSAUL ($2,563), GREG RAMEY ($790), DAVID MILLER ($755), AND THOMAS MURPHY ($283) DID RECEIVE SPOUSE TRAVEL BENEFITS AND THEY WERE TAXED ON THIS BENEFIT. DAVID KINSAUL ($1,764) AND DAVID MILLER ($1,596) DID RECEIVE SOCIAL CLUB BENEFITS. THEY WERE NOT TAXED ON THESE BENEFITS AS THE MEMBERSHIP IS FOR BUSINESS. PART I, QUESTION 4A DUKE HADDAD JR. RECEIVED A SEVERANCE PAYMENT OF 76,502. PART I, QUESTION 4B PARTICIPANTS IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND THE INCREASE IN ACTUARIAL VALUE: DAVID KINSAUL $264,829 DAVID MILLER $ 9,395 THOMAS MURPHY $166,565 GREGORY RAMEY $ 22,681 VICKI GIAMBRONE $ 9,034 MATHEW GRAYBILL $ 11,622 RENAE PHILLIPS $ 1,645 LIAS COFFEY $ 6,417Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
CARRELL PICKOFF
SPOUSE OF TRUSTEE11976EMPLOYMENTfalse
SOUTHWEST OHIO ENT SPECIALISTS
BUSINESS OF TRUSTEE131346PHYSICIAN SERVICESfalse

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArt
Art Historical TreasuresArtHistoricalTreasures
Art Fractional InterestArtFractionalInterest
Books And PublicationsBooksAndPublications
Clothing And Household GoodsClothingAndHouseholdGoods
Cars And Other VehiclesCarsAndOtherVehicles
Boats And PlanesBoatsAndPlanes
Intellectual PropertyIntellectualProperty

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions6NumberOfContributions
Noncash Contribs Rptd F990391493NoncashContribsRptdF990
Method Of Determining RevenuesSELLING PRICEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Securities Closely Held StockSecuritiesCloselyHeldStock
Securities Prtnrshp Trust IntrstsSecuritiesPrtnrshpTrustIntrsts
Securities MiscellaneousSecuritiesMiscellaneous
Qualified Contrib Hist StructQualifiedContribHistStruct
Qualified Contrib OtherQualifiedContribOther
Real Estate ResidentialRealEstateResidential
Real Estate CommercialRealEstateCommercial
Real Estate OtherRealEstateOther
CollectiblesCollectibles
Food InventoryFoodInventory
Drugs And Medical SuppliesDrugsAndMedicalSupplies
TaxidermyTaxidermy
Historical ArtifactsHistoricalArtifacts
Scientific SpecimensScientificSpecimens
Archaeological ArtifactsArchaeologicalArtifacts
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedtrueThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
ExplanationALL STOCK DONATIONS ARE TRANSFERRED TO EITHER MORGAN STANLEY/SMITH BARNEY OR CHILDREN'S MEDICAL CENTER KEY BANK TRUST ACCOUNT TO SELL STOCK. MORGAN STANLEY/SMITH BARNEY SENDS CHECK FOR CASH RECEIVED TO CHILDREN'S. KEY BANK DIRECTLY DEPOSITS PROCEEDS INTO CHILDREN'S CHECKING ACCOUNT.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferenceFORM 990, PART III, LINE 4AReturnReference
ExplanationThe Children's Medical Center is a pediatric hospital located in downtown Dayton, Ohio. The Medical Center and its staff are committed to serving as an advocate for the children and their families in the Miami Valley through a variety of different programs. It offers inpatient, outpatient and ancilliary services to the children in the surrounding 20 counties. Services are provided to patients without regard to their ability to pay. For the fiscal year ending June 30, 2011, the hospital's mix of patients was 51.7% Medicaid, 41.9% Commercial, 5.5% Other Government Programs and .9% Self Pay. The hospital provides a Level III neonatal nursery for premature newborns as well as critical care and general pediatric inpatient beds. A 24 hour emergency department is available to all children in the area. Some of the specialities offered at the hospital are neurosurgery, hematology/oncology, pulmonary, gastroenterology, neurology, developmental disorders, psychology, endocrinology, genetics, cardiology, and general surgery. Without Children's Medical Center, many children in the area would have to travel a good distance to receive these services. The Medical Center also offers a Pediatric Residency Program that trains new pediatricians who will care for the next generation of children. Children's also sponsors many community events where children's health and safety are promoted. Some statistics for the fiscal year ending June 30, 2011 are as follows: # of beds: 155, Inpatient days: 29,622, Admissions: 6,744, Average length of stay: 4.43 days. Average daily census: 81 Occupancy rate: 52%, Surgeries performed: 12,013, X-Ray studies: 66,319, Lab Test: 838,090, Respiratory therapy procedures: 173,447, Pharmacy doses dispensed: 3,434,353 cardiology procedures: 35,836 Neurology procedures: 3,492, Urgent care visits: 15,158, Emergency department visits: 68,380, Outpatient clinics: 73,340. Form 990, Part VI, Lines 11a The CFO reviews key disclosures with appropriate committees of the Board of Trustees. Then prior to filing, the Form 990 is electronically loaded to a secure website for the entire Board of Trustees to review. An email is sent to all members notifying them that the form is available for their review and that it will be filed on or before 05/15/12. Form 990, Part VI, Line 12c - Monitoring conflict of interest At the beginning of each meeting, the chairman of the board asks each member to identify and disclose any potential conflicts of interest based on the agenda or any changes in their business practice that might be relevant. If there are any conflicts, the member(s) recuse themselves and do not participate in the discussion and do not vote on the item. This then is noted in the minutes of that meeting. Board members annually agree to abide by written conflict of interest and confidentiality policies. Board members also work to represent and balance the interests of Children's Medical Center's many constituents. The board annually evaluates its own performance. Form 990, Part VI, line 15a & 15b Compensation for the hospital's Chief Executive Officer (CEO) is set by an Executive Compensation Committee (the Committee) made up of three independent trustees who are also officers of the Board. This Committee also approves compensation levels, incentive plan payouts and executive benefits for each executive employed by the hospital. The Committee operates under a formal charter and keeps contemporaneous minutes of its proceedings. The Committee uses a total compensation philosophy to guide all decisions related to executive compensation at Dayton Children's Medical Center (DCMC), and as such determines and approves all aspects of the CEO's total compensation package, including benefits and expense allowances. These are detailed in a written employment agreement for the CEO. The Committee uses an outside consultant to conduct periodic reviews of the executive compensation levels of the organization versus those of similarly sized and situated organizations using published surveys. These survey results are used by the Committee in setting executive levels and the CEO's compensation in particular. The Committee follows a formal calendar of meetings and the chairman of the Committee reports to the Board of Trustees at least annually on the Committee's activities and on details of the CEO's compensation and benefits package. The Committee also reviews and approves disclosures related to executive compensation made as part of IRS Form 990. Part VI, line 19 - availability of financial statements, conflict of interest, organizing documents Children's Medical Center's conflict of interest policy is made available on our website. The financial statements and the organizing documents are made available as required by the extent of the law. Form 990, Part VII - Jeffery Adam MD is compensated by Children's Medical Center to perform the services of Medical Director for our Ears, Nose and Throat Clinic. - Jeffrey Christian MD works 40 hours per week for the subsidiary, Children's Care Group. -Robert Myers MD is compensated by Childrens Medical Center to perform services as the Chairman of the Professional Staff. - Arthur Pickoff MD is employed by Wright State University. Children's Medical Center contracts with Wright State University for Dr. Pickoff to provide services at Children's Medical Center as the Chairman of the Department of Pediatrics. -Elizabeth Ey MD is employed by Dayton Pediatric Imaging. Childrens Medical Center contracts with Dayton Pediatric Imaging for Dr. Ey to provide services at Childrens Medical Center as the Medical Director of Radiology. Schedule R, Part II, Column B Children's Homecare of Dayton - to provide pediatric healthcare in the home. Children's Medical Center Foundation - to accumulate funds to benefit for and to assist in its charitable missions. Form 990 Part XI Total Adjustment Unrealized gain on investment - 28,256,191 Transfer to Children's Medical Center Foundation - (6,491,983) Net assets released from restrictions used for purchase of property & equipment - 956,889 Net assets released from restrictions -temporarily restricted net assets - (3,068,254) Change in pension benefit obligation and plan assets - 22,540,651 ------------ Total 42,193,494 ------------Explanation

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CHILDREN'S HOMECARE OF DAYTON
ONE CHILDRENS PLAZADAYTONOH45404311356037SEE SCH OOH501(C)(3)9NA
CHILDREN'S MEDICAL CENTER FOUNDATION
ONE CHILDRENS PLAZADAYTONOH45404311045247SEE SCH OOH501(C)(3)11aNA

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsCode VCodeVAmountGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
AMCH COMPANY LLC
935 STATE RT 28MILFORDOH45150311610708URGENT CARE CTROHNAUNRELATED1231630false$0false0.50000
MIDDLETOWN SURGERY CENTER LLC
5950 INNOVATION DRIVEFRANKLINOH45005205160579SURGERY CENTEROHNAUNRELATED-24857784084false$0false0.10000

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
CHILDREN'S CARE GROUP
ONE CHILDRENS PLAZADAYTONOH45404311411364SPEC PHYS GROUPOHNAC-CORP1160791063889371.00000
CHILDREN'S ANESTHESIA GROUP
ONE CHILDRENS PLAZADAYTONOH45404260887231ANESTHESIA SVCSOHNAC-CORP374683621409531.00000
PEDIATRIC ASSURANCE COMPANY LTD
980478183SELF-INSURANCENAN/A1303977368461461.00000BUTTERFIELD BANK BLDG 6TH FLOORHAMILTONBERMUDABDHM12BD
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (11 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
CHILDRENS MEDICAL CENTER FOUNDATION
B6491984
CHILDRENS MEDICAL CENTER FOUNDATION
C3424899
CHILDRENS HOME CARE OF DAYTON
L421079
CHILDRENS MEDICAL CENTER FOUNDATION
K72905
CHILDRENS CARE GROUP
L8852728
CHILDRENS CARE GROUP
N118044
CHILDRENS CARE GROUP
P2524897
CHILDRENS HOME CARE OF DAYTON
P7434382
CHILDRENS CARE GROUP
Q1067600
CHILDRENS HOME CARE OF DAYTON
Q166614
CHILDRENS HOME CARE OF DAYTON
R500000