2011-11-10T18:04:10-06:00 2010-12-31 DELOITTE TAX LLP 201 E KENNEDY BLVD STE 1200 TAMPA FL 33602 990 2010-01-01 590638499 VARIETY CHILDREN'S HOSPITAL DBA MIAMI CHILDREN'S HOSPITAL VARI 3056666511 3100 SW 62ND AVENUE MIAMI FL 331553009 PEDRO ALFARO 3056666511 2011-11-10 0 8132738355 2010 2016-02-24 21:20:13Z PEDRO ALFARO 3100 SW 62ND AVENUE MIAMI FL 331553009 445453965 0 X WWW.MCH.COM X 1950 FL THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. 19 15 3354 2316 -624514 -624514 3400385 2396956 398282673 417422557 4270134 10066481 14389328 15055580 420342520 444941574 0 0 0 0 214425530 234314266 0 0 0 176773064 174189789 391198594 408504055 29143926 36437519 615519508 728858751 282411377 358328167 333108131 370530584 X THE HOSPITAL PROVIDES SPECIALIZED PEDIATRIC HEALTH CARE TO CHILDREN REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. 0 0 326803244 417422557 SEE SCHEDULE O: PROGRAM SERVICE ACCOMPLISHMENTS. 326803244 1 1 0 1 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 1 1 1 1 0 0 1 676 0 1 3354 1 1 1 1 CJ 0 0 0 0 0 0 0 0 0 0 0 X 19 15 1 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 X PETER BERMONT 1.30 X 0 0 0 THOMAS M CORNISH 1.30 X 0 0 0 JARET DAVIS ESQUIRE 1.30 X 0 0 0 MARIA FRANCO MD 1.30 X 0 0 0 LUIS GONZALEZ-MENDOZA MD 39.30 X 122083 0 3883 DEISE GRANADO-VILLAR MD 39.30 X 308015 0 93238 GARY GREGORY 1.30 X 0 0 0 ROBERT K JORDAN 1.30 X 0 0 0 ANDREW LABBIE MD 1.30 X 0 0 0 JUAN C MAS 1.30 X 0 0 0 JAY MASSIRMAN 1.30 X 0 0 0 STEVEN MCKEAN 1.30 X 0 0 0 MARIO MURGADO 1.30 X 0 0 0 PHILIP NEWCOMM MD 1.30 X 0 0 0 CARMEN PEREZ 1.30 X 0 0 0 GENE PRESCOTT 1.30 X 0 0 0 ALEX SOTO 1.30 X 0 0 0 KEITH WARD 1.30 X 0 0 0 DONNA HUCK 1.30 X X 0 0 0 NARENDRA KINI MD 39.30 X X 1026029 0 170246 PEDRO ALFARO 39.30 X 365242 0 130383 WILLIAM M DECAMPLI MD 40.00 X 1441631 0 30686 REDMOND P BURKE MD 40.00 X 1395909 0 27333 ROBERT L HANNAN MD 40.00 X 1126576 0 26910 HARRY SHUFFLEBARGER MD 40.00 X 851708 0 27176 EVAN M ZAHAN MD 40.00 X 849178 0 27333 KEVIN HAMMERAN 0.00 X 345108 0 0 THOMAS ROZEK 0.00 X 504552 0 0 8336031 0 537188 292 1 1 0 ARELLANO CONSTRUCTION 7051 SW 12TH STREET MIAMI FL 33144 CONSTRUCTION COMPANY 7420593 CHILDREN'S ANESTHESIA ASSOC PA 3100 SW 62ND AVENUE MIAMI FL 33155 ANESTESIA SERVICES 2973764 MAYO COLLABORATIVE SERVICES INC PO BOX 9146 MINNEAPOLIS MN 554809146 OUTSIDE LAB TEST 1821754 ERA HELICOPTER LLC 1 EARHART DRIVE SUITE 11 COATSVILLE PA 19320 TRANSPORTATION SUPPORT 1552556 METROPOLITAN LIFE INSURANCE COMPANY PO BOX 440668 KENNESAW GA 30160 LIFE INSURANCE 1341911 113 2361709 35247 2396956 PATIENT SERVICE REVENU 621300 243576633 243576633 MEDICARE/MEDICAD PAYME 621300 158976873 158976873 GRANT REVENUE 900099 13466936 13466936 SEMINAR/WORKSHOPS 621300 1141304 1141304 ORDINARY INCOME PARTNE 621300 260811 260811 417422557 10340168 -383 10340551 1343142 1343142 1343142 1343142 15660 223044 512391 15660 -289347 -273687 -273687 MANAGEMENT FEES 621990 6247175 6247175 PHARMACY 446110 2465718 -624131 3089849 CAFETERIA VENDING 722210 2392831 2392831 2606714 2606714 13712438 444941574 417422557 -624514 25746575 0 0 0 0 8336031 8336031 0 185176135 154809733 30366402 8088498 6470798 1617700 32525297 26020238 6505059 188305 150644 37661 0 2032714 1626171 406543 1027549 822039 205510 0 0 0 35229772 28183818 7045954 1841721 1473377 368344 51018255 40814604 10203651 0 0 20461637 16369310 4092327 1355495 1084396 271099 0 0 10802113 8641690 2160423 0 20025050 16020040 4005010 10039729 8031783 2007946 BAD DEBTS 9654375 7723500 1930875 MEDICAL ASSISTANCE TAX 4538700 3630960 907740 SUPPLIES 3010055 2408044 602011 DUES & SUBSCRIPTIONS 1549337 1239470 309867 MISCELLANEOUS EXPENSES 1289444 1031555 257889 313843 251074 62769 408504055 326803244 81700811 0 555146 0 40047110 34921888 41790309 49849829 3906475 4169730 5749328 5729140 417883302 206925867 201696414 210957435 229872076 325064045 91902650 98166684 615519508 728858751 61254884 59529853 184275000 246585824 297026 36584467 52212490 282411377 358328167 X 245395525 278387150 59693070 63562282 28019536 28581152 333108131 370530584 615519508 728858751 X 36437519 984934 X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 260261 0 1 111540 371801 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: OTHER ACTIVITIES RELATE TO RESEARCH, MONITORING LEGISLATION AND ATTENDING MEETINGS. 0 2932156 2932156 0 240760816 103744916 137015900 0 4686600 949309 3737291 0 137743014 85873385 51869629 0 31760716 16358257 15402459 210957435 BOND ISSUE COSTS 1581531 BENEFICIAL INTEREST IN MIAMI CHILDREN'S HOSPITAL FNDTN 82103400 DUE FROM AFFILIATED ORGANIZATION 8510120 EXEC LIFE 1094610 SELF INSURANCE TRUST 4877023 98166684 OTHER LIABILITIES 16664487 SWAP LIABILITIES 30576355 THIRD PARTY SETTLEMENT PAYABLE 4971648 52212490 444941574 408504055 36437519 -2370328 -5185472 -7555800 28881719 446055754 -2370328 -964743 -3335071 449390825 -4449251 -4449251 444941574 417174035 0 417174035 -8669980 -8669980 408504055 PART XII, LINE 2D - OTHER ADJUSTMENTS: RESTRICTED CONTRIBUTIONS -964,743. PART XII, LINE 4B - OTHER ADJUSTMENTS: AMOUNTS REPORTED SEPARATELY -4,159,904. LOSSES NETTED AGAINST REVENUES -289,347. PART XIII, LINE 4B - OTHER ADJUSTMENTS: LOSSES NETTED AGAINST REVENUES -289,347. AMOUNTS REPORTED SEPARATELY -8,660,997. EXPENSES FROM FLOW-THROUGH ENTITY NOT INCLUDED IN FINANCIAL STATEMENTS 280,364. CENTRAL AMERICA/CARIBBEAN 1 1 PROGRAM SERVICES INSURANCE PREMIUM 5349349 1 0 1 5349349 0 5349349 0 0 1 0 0 0 1 1 X 1 X 1 X 401.000000000000 1 1 0 1 1 2029226 2029226 0.00510 231242728 183471878 47770850 0.11980 5466610 3952061 1514549 0.00380 238738564 187423939 51314625 0.12870 961506 961506 0.00240 13386959 13386959 0.03360 414020 414020 0.00100 14762485 14762485 0.03700 253501049 187423939 66077110 0.16570 30000 30000 0.00010 30000 30000 0.00010 1 2708920 538995 776018 -237023 X 1 0 1 1 MCH - MAIN CAMPUS

3100 SW 62ND AVENUE MIAMI FL 33155

X X X X X X NA 1 PART I, L7 COL(F): THE BAD DEBT EXPESNE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $9,654,375. 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 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 UNCOLLECTIBLE ACCOUNTS FOR THE YEAR ENDED DECEMBER 31, 2010:BALANCE - BEGINNING OF THE YEAR 10,867,237PROVISIONS DURING THE YEAR, NET OF RECOVERIES 9,654,375LESS ACCOUNTS WRITTEN OFF (9,611,734) -----------BALANCE - END OF THE YEAR 10,909,878COSTING METHODOLOGY OR SOURCE USED TO DETERMINE THE AMOUNT REPORTED:MANAGEMENT RELIES ON HISTORICAL EXPERIENCE AND ON OTHER ASSUMPTIONS BELIEVED TO BE REASONABLE UNDER THE CIRCUMSTANCES IN ESTIMATING PROVISION FOR UNCOLLECTIBLE ACCOUNTS. IF A PATIENT IS CONSIDERD CHARITABLE UNDER THE HOSPITAL'S CHARITY POLICY, THEN NO BAD DEBT EXPENSE IS INCURRED. THE GROSS PATIENT CHARGES PER ANNUAL PATIENT LOG ARE MULTIPLIED BY THE OVERALL COST TO CHARGE RATIO TO DETERMINE COST OF PROGRAM. PART III, LINE 8 BASED ON COST REPORT - ALLOWABLE COSTS. FINANCIAL ASSISTANCE PROGRAM POLICY: PART III, LINE 9B 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.ACOORDING 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. HOSPITAL FACILITIES PART V, SECTION A 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 CENTEROFFICE OF DR. JOSE VARGASPRIMARY CARE CLINICNICKLAUS CARE CENTER (MOB SPECIALIST PHYSICIAN OFFICE)SPECIALIST PHYSICIAN OFFICE 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. 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. 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. COMMUNITY BUILDING ACTIVITIES: MANY COMMUNITY BUILDING ACTIVES ARE CO-SPONSORED BY OTHER INDEPENDENT NON-PROFIT ORGANIZATIONS, SUCH AS NATIONAL CENTER FOR MISSING AND EXPLOITED CHILDREN, BIG BROTHERS BIG SISTERS OF DADE COUNTY, PARENT TO PARENT AND AMERICAN CANCER SOCIETY, WHO PROVIDE EXPERT SPEAKERS AT NO CHARGE TO MIAMI CHILDREN'S HOSPITAL. OTHER INFORMATION: 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 ARE 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 DEISE GRANADO-VILLAR MD 282331 0 25684 0 0 0 49124 0 44114 0 401253 0 0 0 NARENDRA KINI MD 581729 0 444300 0 0 0 133626 0 36620 0 1196275 0 0 0 PEDRO ALFARO 317776 0 37481 0 9985 0 51883 0 78500 0 495625 0 9985 0 WILLIAM M DECAMPLI MD 1254131 0 187500 0 0 0 0 0 30686 0 1472317 0 0 0 REDMOND P BURKE MD 1316668 0 79241 0 0 0 0 0 27333 0 1423242 0 0 0 ROBERT L HANNAN MD 1080817 0 45759 0 0 0 0 0 26910 0 1153486 0 0 0 HARRY SHUFFLEBARGER MD 515461 0 336247 0 0 0 27176 0 0 0 878884 0 0 0 EVAN M ZAHAN MD 825648 0 23530 0 0 0 0 0 27333 0 876511 0 0 0 KEVIN HAMMERAN 0 0 0 0 345108 0 0 0 0 0 345108 0 345108 0 THOMAS ROZEK 0 0 0 0 504552 0 0 0 0 0 504552 0 504552 0 PART I, LINES 4A-B PART I, LINES 4A-B: PART I, LN 4(A) KEVIN HAMMERAN RECEIVED A DEFERRED COMPENSATION PAYOUT OF $345,108. SUPPLEMENTAL INFORMATION PART III PART I LINE 4(B) THE EXECUTIVES PARTICIPATE IN A SUPPLEMENTAL 457(F) DEFINED CONTRIBUTION RETIREMENT ACCOUNT. THE VALUES ARE REPORTED IN SCEDULE J, PART 11, COLUMN C MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NCE0 2010-12-22 107784753 SEE PART V 0 0 0 MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NBT8 2008-04-17 55000000 SEE PART V 0 0 0 MIAMI-DADE COUNTY HEATH FACILITIES AUTHORITY 521293036 59334NBS0 2006-12-21 209475000 SEE PART V 0 0 0 107784753 1227083 1368446 63423933 1 0 0 1 55000000 2009 1 0 1 1 41925000 70000000 216976676 112691982 2042037 5553000 2793651 2566765 0 1 0 1 0 1 1 1 1 0.00800 0.00000 0.00800 1 0 1 1 1 1 0.03600 0.00000 0.03600 1 0 1 1 1 1 0.03000 0.00000 0.03000 1 0 1 0 1 BAYERISCHE LANDESBAN 2.000000000000 1 0 1 0 1 0 1 WELLS FARGO BANK 2.200000000000 1 0 0 0 1 1 CITIBANK 35.700000000000 0 0 1 WELLS FARGO BANK 2.200000000000 1 1 0 PART I, LINE A(F) DESCRIPTION OF PURPOSE REFUND 2006-B3 DATED 12/21/2006 AND NEW MONEY PROJECT PART I, LINE B(F) DESCRIPTION OF PURPOSE CONVERTED AUCTION RATE SECURITIES (ARS) TO PUT BONDS AFTER THE ARS MARKET COLLAPSED IN 2008; REISSUE OF 12/21/2006 BOND ISSUE PART I, LINE C(F) DESCRIPTION OF PURPOSE PROVIDED BOND PROCEEDS FOR NEW PROJECT AND REFUNDED 6/7/2001 ISSUE PART II, LINE 1(C) $41,925,000 OF THE 2006B-3 SERIES WAS REFUNDED BY THE 12/22/2010 ISSUE. PART II, LINE 2(C) $70,000,000 OF BOND AND INVESTMENT PROCEEDS WERE USED TO REDEEM SERIES 2006B BONDS UPON DECISION TO POSTPONE BED TOWER PROJECT. PART II, LINE 3(C) THE DIFFERENCE BETWEEN THE TOTAL PROCEEDS OF THE ISSUE AND THE ISSUE PRICE IS THE TOTAL INVESTMENT EARNINGS. PART II, LINE 6(A) $41,925,000 OF BOND PROCEEDS WERE USED TO CURRENTLY REFUND ISSUE DATED 12/21/2006; THEREFORE, NO MONEYS REMAIN IN ESCROW AS OF THE END OF FISCAL YEAR 2010. PART II, LINE 6(B) $55,000,000 OF ORIGINAL PROCEEDS WERE USED TO REISSUE (REFUND) THE 2006A BONDS; THEREFORE, NO MONEYS REMAIN IN A REFUNDING ESCROW. PART II, LINE 7(A) THE ISSUE PRICE ON FORM 8038 WAS AMENDED FROM $2,155,695 TO $1,227,083, THE DIFFERENCE WILL BE APPLIED TO CAPITAL EXPENDITURES. PART II, LINE 12(A) THE ENTIRE AMOUNT OF UNSPENT PROCEEDS IS ANTICIPATED TO FULLY APPLIED TO CAPITAL EXPENDITURES. RODOBALDO PEREZ HASSOR SEE PART V 54113 PART V 0 CHILDREN'S UROLOGY ASSOCIATES SEE PART V 388188 PART V 0 0 PART IV, COLUMN B AND PART IV, COLUMN D BUSINESS RELATIONSHIPS WITH THE ORGANIZATION RODOBALDO PEREZ HASSOR IS A FAMILY MEMBER OF DEISE GRANADO-VILLAR, A MEMBER OF THE MCH BOARD OF DIRECTORS. DESCRIPTION OF TRANSACTION: COMPENSATIONANDREW LABBIE, MD HAS A PARTNERSHIP INTEREST IN CHILDREN'S UROLOGY ASSOCIATES AND IS ALSO A MEMBER OF THE MCH BOARD OF DIRECTORS. DESCRIPTION OF TRANSACTION: TEACHING AND ADMININSTRATIVE SERVICES PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A VARIETY CHILDREN'S HOSPITAL, ESTABLISHED IN 1950, OWNS AND OPERATES AND 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 2010, 1,787 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. 2010 STATISTICAL DATA INCLUDES TOTAL INPATIENT DAYS: 64,713 TOTAL INPATIENT ADMISSIONS: 12,394 INPATIENT AVERAGE DAILY CENSUS: 177 TOTAL ED VISITS (MAIN CAMPUS): 85,439 MCH GENERAL CLINIC VISITS: 12,048 AMBULATORY VISITS: 9,925 PRIVATE OUTPATIENT VISITS (MAIN CAMPUS): 112,623 PRIVATE OUTPATIENT VISITS (AMBULATORY CENTERS): 95,636 TOTAL SURGICAL CASES: 12,668 AVERAGE LENGTH OF STAY: 5.2 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 2011 LISTING OF "AMERICA'S BEST CHILDREN'S HOSPITALS." (RANKINGS ARE BASED ON 2010 DATA). THE HOSPITAL IS THE ONLY ONE 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 ORTHOPEDICS, UROLOGY. IN ADDITION, THE HOSPITAL SYSTEM INCLUDES A NETWORK OF AMBULATORY CENTERS THAT EXTEND CARE THROUGHOUT THE SOUTH FLORIDA REGION. DURING 2010, THESE CENTERS OFFERED OUTPATIENT SERVICES AS FOLLOWS: MCH DAN MARINO OUTPATIENT CENTER: OFFERS COMPREHENSIVE SERVICES FOR CHILDREN WITH NEURODEVELOPMENTAL DISORDERS. SERVICES ON SITE INCLUDE IMAGING, REHABILITATION AND AN AFTER-HOURS URGENT CARE CENTER. ALSO ON SITE IS A SWIMMING POOL FOR AQUATIC THERAPY. MCH DORAL OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES AND AN AFTER-HOURS URGENT CARE CENTER. MCH PALMETTO BAY OUTPATIENT CENTER: OFFERS REHABILITATION SERVICES, IMAGING SERVICES AND AN AFTER-HOURS URGENT CARE CENTER. 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, SUBSPECIALTY OFFICE VISITS AND AN AFTER-HOURS URGENT CARE CENTER. MCH NICKLAUS CARE CENTER: OFFERS PEDIATRIC SUBSPECIALTY CONSULTATIONS IN PALM BEACH COUNTY. MCH REHABILITATION SERVICES - MIAMI LAKES: OFFERS COMPREHENSIVE REHABILITATION SERVICES. QUALITY/SAFETY AND ERROR PREVENTION INITIATIVES FROM 2010 THE HOSPITAL IS COMMITTED TO ADVANCING QUALITY AND SAFETY. INITIATIVES FOR 2010 ARE DETAILED BELOW: LEAN INITIATIVES: LEAN IS AN INTERNATIONALLY RECOGNIZED BUSINESS IMPROVEMENT MODEL. IN 2010, THE HOSPITAL CONTINUED TO UTILIZE LEAN METHODS TO IMPROVE PROCESSES THAT ENHANCE SAFETY, EFFICIENCY AND PREVENT ERRORS AT THE HOSPITAL. 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. 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. PHYSICIANS AND OTHER CAREGIVERS WILL BE ABLE TO ACCESS 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. 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. MORE THAN 400 HOSPITALS AROUND THE GLOBE NOW USE THIS MCH TOOL TO PREVENT PATIENT FALLS. HYGREEN: IMPLEMENTATION OF XHALE INNOVATIONS' HYGREEN(R) HAND HYGIENE SYSTEM IS ANOTHER WAY MIAMI CHILDREN'S HOSPITAL LED THE WAY IN PATIENT SAFETY IN 2010. 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. HYGREEN HAS ALREADY BEEN INTEGRATED INTO THE MCH ONCOLOGY UNIT'S INFECTION CONTROL PROGRAM WITH THE POTENTIAL TO EXPAND INTO OTHER AREAS OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 2 PETER BERMONT HAS A BUSINESS RELATIONSHIP WITH DONNA HUCK, AND GARY GREGORY, MEMBERS OF THE MCH BOARD OF DIRECTORS. JARET DAVIS, ESQ. HAS A BUSINESS RELATIONSHIP WITH THOMAS CORNISH, MARIO MURGADO, AND GENE PRESCOTT, MEMBERS OF THE MCH BOARD OF DIRECTORS. 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 AND INVESTMENT 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 AND INVESTMENT 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 IF 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 FORM 990, PART VI, SECTION C, LINE 19: DOCUMENTS THAT ARE REQUIRED TO BE OPEN FOR PUBLIC INSPECTION ARE MADE AVAILABLE UPON REQUEST. AVERAGE HOURS PER WEEK PART VII, LINE 1A, COLUMN B THE OFFICERS LISTED ON PART VII, SECTION A, LINE 1(A), COLUMN B DEVOTED THEIR TIME TO THE ORGANIZATION AND RELATED ORGANIZATIONS AS FOLLOWS: WORKER'S PROFESSIONAL VARIETY COMPENSATION LIABILITY RESEARCH CHILDREN'S TRUST TRUST INSTITUTE HOSPITAL PETER BERMONT 0.1 0.1 0.5 1.3 THOMAS M. CORNISH 0.1 0.1 0.5 1.3 JARET DAVIS, ESQUIRE 0.1 0.1 0.5 1.3 MARIA FRANCO, MD 0.1 0.1 0.5 1.3 LUIS GONZALEZ-MENDOZA, MD 0.1 0.1 0.5 39.3 DEISE GRANADO-VILLAR, MD 0.1 0.1 0.5 39.3 GARY GREGORY 0.1 0.1 0.5 1.3 ROBERT K. JORDAN 0.1 0.1 0.5 1.3 ANDREW LABBIE, MD 0.1 0.1 0.5 1.3 JUAN C. MAS 0.1 0.1 0.5 1.3 JAY MASSIRMAN 0.1 0.1 0.5 1.3 STEVEN MCKEAN 0.1 0.1 0.5 1.3 MARIO MURGADO 0.1 0.1 0.5 1.3 PHILIP NEWCOMM, MD 0.1 0.1 0.5 1.3 CARMEN PEREZ 0.1 0.1 0.5 1.3 GENE PRESCOTT 0.1 0.1 0.5 1.3 ALEX SOTO 0.1 0.1 0.5 1.3 KEITH WARD 0.1 0.1 0.5 1.3 PEDRO ALFARO 0.1 0.1 0.5 39.3 DONNA HUCK 0.1 0.1 0.5 1.3 NARENDRA KINI, MD 0.1 0.1 0.5 39.3 CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -2,309,250. CHANGE IN CHARITABLE REMAINDER TRUSTS 279,861. CHANGE IN BENEFICIAL INTEREST IN MCHF - TEMPORARY 3,755,534. CHANGE IN UNREALIZED GAIN ON INVESTMENT 561,616. PARTNERSHIP LOSS NOT RECORDED FOR BOOK PURPOSES 231,681. PARTNERSHIP EXPENSES NOT RECORDED FOR BOOK PURPOSES 280,364. AMOUNTS REPORTED SEPARATELY -1,814,872. TOTAL TO FORM 990, PART XI, LINE 5: 984,934. MCH PEDIATRIC CARDIOLOGY LLC 3100 SW 62ND AVENUE MIAMI FL 33155 651023909 CARDIAC SVC'S FL 10609975 -15343823 N/A MCH RESEARCH INSTITUTE INC 3100 SW 62ND AVENUE MIAMI FL 33155 592602318 RESEARCH FL 501(C)(3) 11B N/A 1 MCH WORKER'S COMPENSATION TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 597021572 WC CLAIMS FL 4947(A)(1) N/A N/A 1 PROFESSIONAL LIABILITY TRUST 3100 SW 62ND AVENUE MIAMI FL 33155 592551434 LIAB. CLAIMS FL 4947(A)(1) N/A N/A 1 MIAMI CHILDREN'S HOSPITAL FND INC 3100 SW 62ND AVENUE MIAMI FL 33155 861065772 FUNDRAISING FL 501(C)(3) 7 N/A 1 CANAVAN PARTNERS C/O COHEN PO BOX 812170 BOCA RATON FL 334812170 650974245 MED.INTEL.PRO FL N/A RELATED 226877 0 1 0.62500 CHILDREN'S HEALTH SERVICES INC 3100 SW 62ND AVENUE MIAMI FL 33155 650438667 PHYSICIAN SUP FL N/A C 1.00000 MIAMI CHILDREN'S INSURANCE CO SPC LTD 720 WEST BAY ROAD PO BOX 69GT B GEORGETOWN GRAND CAYMAN CJ 980442086 INSURANCE CJ N/A C 1812333 58721469 1.00000 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 MIAMI CHILDREN'S HOSPITAL FOUNDATION INC C 3858460 FMV MIAMI CHILDREN'S INSURANCE CO SPC LTD Q 3216612 CHANGE IN BALANCE MIAMI CHILDREN'S INSURANCE CO SPC LTD R 1250000 FMV MIAMI CHILDREN'S HOSPITAL FOUNDATION INC P 175820 FMV