2013-08-14T18:26:27-05:00 2012-09-30 910189318 MOSS ADAMS LLP 3121 WEST MARCH LANE SUITE 100 STOCKTON CA 952192303 990 2011-10-01 941294954 CHILDREN'S HOSPITAL CENTRAL CALIFORNIA CHIL 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 MICHELE WALDRON 5593533000 2013-08-13 1 TRACY S PAGLIA P00366884 2099556100 2011 2016-02-24 21:20:13Z MICHELE WALDRON 9300 VALLEY CHILDRENS PLACE MADERA CA 936368761 599315465 0 X WWW.CHILDRENSCENTRALCAL.ORG X 1949 CA PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN 15 11 3013 490 1110164 0 21770337 21751379 479173553 493001475 4857119 15550021 7470362 12152362 513271371 542455237 265040 385407 0 0 221933180 233968321 0 0 0 170720632 182439576 392918852 416793304 120352519 125661933 697990469 824282671 309774983 307355485 388215486 516927186 TO PROVIDE HIGH QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. 0 0 47873017 385407 158828055 SEE SCHEDULE O 274389642 0 334173420 SEE SCHEDULE O 322262659 1 1 0 1 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 1 0 0 1 260 0 1 3013 1 1 1 1 CJ 0 0 0 0 0 0 0 0 X 15 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MICHELE WALDRON CFO 5593533000 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 X GORDON ALEXANDER 34.00 X X 767496 0 16613 TODD SUNTRAPAK 34.00 X X 525558 0 89988 BRUCE ALBRIGHT 1.00 X 0 0 0 GREG COLEMAN 1.00 X X 0 0 0 DR LINDA FRALEY 1.00 X 0 0 0 RICHARD SHEHADEY 1.00 X 0 0 0 STEPHANIE HOULDING TERM 1211 1.00 X 0 0 0 DR DEVONNA KAJI TERM ENDED 1.00 X 75000 552723 34376 DAVID KRAUSE 1.00 X X 0 0 0 DR ROBERT KUBO 1.00 X X 0 0 0 MENDY LAVAL RESIGNED 1.00 X X 0 0 0 JEFF MAYER 1.00 X X 0 0 0 DAVE OLSON 1.00 X 0 0 0 PAT RICCHIUTI 1.00 X 0 0 0 DR CHARLES SMITH 1.00 X 0 0 0 BILL SMITTCAMP 1.00 X X 0 0 0 DR TIM HANSEN 1.00 X 0 0 0 RILEY WALTER 1.00 X 0 0 0 NANCY MASICH 1.00 X 0 0 0 MICHELE R WALDRON 38.00 X 510194 0 93614 DAVID CHRISTENSEN 40.00 X 492195 0 45299 BEVERLY HAYDEN-PUGH 40.00 X 343239 0 93378 JESSIE HUDGINS 40.00 X 328066 0 94111 MARTA BOYER 40.00 X 332104 0 30960 JANE WILLSON 40.00 X 315515 0 65458 DAVID SINGH 40.00 X 283946 0 17687 RICK WOLF 40.00 X 288528 0 29881 KIRK LARSON 40.00 X 238612 0 12189 RANDALL GUERRERO 40.00 X 226197 0 23074 STEPHANIE VANCE 40.00 X 243623 0 24030 JEFFREY LEFORS 40.00 X 238751 0 15887 KAMELA LOO 40.00 X 245761 0 33938 DANIEL DAVIS 40.00 X 230171 0 24446 WILLIAM F HAUG 34.00 X 2663377 0 28442 8348333 552723 773371 448 1 1 0 SPECIALTY MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 SUBSPEC PHYSICIAN SERVICES 11501912 PEDIATRIC ANETHESIA ASSOCIATION 6235 N FRESNO ST STE 103 FRESNO CA 93710 ANETHESIA/CRITICAL CARE 8135427 CROTHALL HEALTHCARE INC 1654 MARTHALER LANE WEST ST PAUL MN 55118 HOUSEKEEPING SERVICES 3288434 EMERGENCY PHYSICIANS MEDICAL 3300 DOUGLAS BOULEVARD 200 ROSEVILLE CA 95661 EMERGENCY PHYSICIAN SERVICES 1329861 MEDQUIST INC PO BOX 102467 ATLANTA GA 30368 TRANSCRIPTION SERVICES 1087427 69 2651665 18269618 830096 47969 21751379 PATIENT SERVICES 900099 492778657 492778657 OUTSIDE LAB SERVICES 900099 222818 222818 493001475 7102857 7102857 862738 862738 118466 81370 37096 37096 37096 64060255 13241 56475213 13857 7585042 -616 7584426 7584426 594225 289788 304437 304437 CAFETERIA REVENUE 900099 2597788 2597788 MANAGEMENT SERVICES 541610 1110164 1110164 8102877 8102877 11810829 542455237 493001475 1110164 26592219 157262 157262 228145 228145 5869692 31250 5838442 157336574 125512605 31823969 10228746 8023343 2205403 47295442 34469175 12826267 13237867 9954769 3283098 2994475 30589 2963886 1908175 1908175 188494 188494 1436431 1436431 29467375 28979383 487992 467493 467493 48246305 42021052 6225253 3223901 3223901 4396244 3143558 1252686 445639 195336 250303 244505 35987 208518 8746659 6653266 2093393 20097620 12373451 7724169 2172361 98133 2074228 HOSPITAL FEE PROGRAM 33158827 33158827 PURCHASED SERVICES 16515810 10862933 5652877 BAD DEBT 5245161 5245161 DUES 1150951 101528 1049423 2333150 519413 1813737 416793304 322262659 94530645 0 12928 13245 83116020 117087017 580092 898869 48997977 55256332 4865891 5725563 12358917 3903203 420526575 165699774 247244866 254826801 135169007 154238769 148422858 162903837 998628 1240746 16223285 68188289 697990469 824282671 82493887 60933380 159874416 155549710 67406680 90872395 309774983 307355485 X 383617976 511187675 4597510 5739511 388215486 516927186 697990469 824282671 X 125661933 3049767 X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 1 0 1 57177 1 13773 0 0 70950 0 PART IV, SUPPLEMENTAL INFORMATION: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA HAS HAD DIRECT CONTACT WITH AND HAS ENCOURAGED OTHERS TO HAVE DIRECT CONTACT WITH LOCAL, STATE AND FEDERAL LEGISLATORS REGARDING CHILDREN'S HEALTH CARE PUBLIC POLICY. THESE CONTACTS HAVE PROVIDED INFORMATION REGARDING THE PROVISION OF HEALTH CARE SERVICES TO CHILDREN, THE ANTICIPATED EFFECT ON CHILDREN'S HEALTH OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING CURRENT STATE AND FEDERAL FUNDING LEVELS FOR MEDI-CAL AND OTHER PUBLIC PROGRAMS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $13,773 ASSOCIATION DUES RELATED TO LOBBYING NACH 13,080 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 23,363 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIF. 20,734 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $70,950 3214538 3214538 258499957 63704285 194795672 2299393 2059302 240091 132415808 85258785 47157023 24096879 14677402 9419477 254826801 LIMITED PARTNERSHIPS 162903837 F 162903837 UNAMORTIZED BOND ISSUE COSTS 3560132 DISPROPORTIONATE SHARE FUNDS RECEIVABLE 11719752 INSURANCE RECEIVABLE 6034014 PROVIDER FEE RECEIVABLE 43627238 457 TRUST FUNDS 1702438 RESTRICTED CASH 1187060 OTHERS 357655 68188289 MALPRACTICE RESERVE 2376000 ACCRUED PENSION LIABILITY 73430336 457 LIABILITY 1702438 1732 LIABILITY 895525 OTHER 31111 CONSTRUCTION RETAINS ACCOUNT 1641985 WORKERS COMP 6453540 INS LIABILITY 4341460 90872395 1 1 1 X 1 X 1 0 1 1 102000 102000 0.00020 274389642 334173420 -59783778 0.00000 8577714 5116127 3461587 0.00840 283069356 339289547 -56220191 0.00860 588897 588897 0.00140 2579500 644650 1934850 0.00470 178272 178272 0.00040 3346669 644650 2702019 0.00650 286416025 339934197 -53518172 0.01510 5000 5000 0.00000 5000 5000 1 1778690 0 204682 409178 -204496 X 1 1 2 1 CHILDREN'S HOSPITAL CENTRAL CALIFORNIA

9300 VALLEY CHILDRENS PLACE MADERA CA 936368761

X 2 CHILDREN'S HOSPITAL CENTRAL CA HOME CARE

7555 N DEL MAR AVE FRESNO CA 93711

X CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 1 1 1 200.000000000000 1 350.000000000000 1 X X 1 1 X X X X X X X 1 0 1 X 0 1 CHILDREN'S HOSPITAL CENTRAL CA HOME CARE 2 1 1 200.000000000000 1 350.000000000000 1 X X 1 1 X X X X X X X 1 0 1 X 0 1 PART I, LINE 7: CHARITY CARE AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE DECISION SUPPORT SYSTEM WAS USED TO CALCULATE COST-TO-CHARGE FOR DETERMINING UNREIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THIS DECISION SUPPORT SYSTEM ADDRESSES ALL PATIENT SEGMENTS (I.E INPATIENT, OUTPATIENT, ETC.). IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING CHILDREN'S HOSPITAL CENTRAL CALIFORNIA, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. IN 2012, THE HOSPITAL RECEIVED APPROXIMATELY $80,397,000 IN NET REVENUE THROUGH THE STATE'S HOSPITAL FEE PROGRAM. BECAUSE THIS NET REVENUE RECOGNIZED IN 2012 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2012, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2012. WHILE THE PROGRAM'S PAYMENTS HAVE PLAYED AN IMPORTANT ROLE IN OFFSETTING SOME OF THE HOSPITAL'S LOSSES, THE PROGRAM'S LIMITED DURATION MEANS THAT IT WILL NOT SERVE AS A LONG-TERM SOLUTION TO THE HOSPITAL'S CHRONIC MEDI-CAL PAYMENT SHORTFALLS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 5245161. PART III, LINE 4: FOOTNOTE DESCRIBING BAD DEBT EXPENSE:THE HOSPITAL ANALYZES ITS COLLECTION HISTORY AND IDENTIFIES TRENDS TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS FOR PATIENTS WITHOUT THIRD PARTY COVERAGE. THE ALLOWANCE IS RECORDED IN THE PERIOD IN WHICH SERVICES ARE PROVIDED. FOR PATIENTS WITH THIRD-PARTY COVERAGE, THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY, FOR AMOUNTS THAT ARE THE PATIENT'S RESPONSIBILITY, INCLUDING DEDUCTIBLES AND COPAYMENTS. IN ADDITION, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS WOULD BE ESTABLISHED FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA TO EVALUATE THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS APPROXIMATELY 60 PERCENT OF SELF-PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2012 AND 2011. THE HOSPITAL HAS NOT CHANGED ITS UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2011 OR 2012 BUT MODIFIED ITS CHARITY CARE POLICY IN 2011 TO INCLUDE A BROADER RANGE OF INDIVIDUALS. THE HOSPITAL DOES NOT MAINTAIN AN ALLOWANCE FOR DOUBTFUL ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITEOFFS FROM THIRD-PARTY PAYORS.COSTING METHODOLOGY:ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND REVIEW OF LARGE BALANCE SELF-PAY ACCOUNTS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBT IF SUBSEQUENTLY COLLECTED. THE COST OF BAD DEBT WRITE-OFFS WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF. PART III, LINE 8: MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2012 MEDICARE COST REPORT. MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE SERVICES. ADDITIONALLY, THE MAJORITY OF THE HOSPITAL'S MEDICARE PATIENTS WOULD BE COVERED BY MEDI CAL IF THEY DID NOT FALL UNDER THE MEDICARE COVERAGE OPTION. PART III, LINE 9B: COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE; INSURANCE COLLECTION ATTEMPTS CONTINUE AS APPROPRIATE. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA PART V, SECTION B, LINE 11H: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS. CHILDREN'S HOSPITAL CENTRAL CA HOME CARE PART V, SECTION B, LINE 11H: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA PART V, SECTION B, LINE 13G: ADDITIONALLY THE POLICY IS SENT BY US POSTAL SERVICE TO COMMUNITY AGENCIES TO BE DISTRIBUTED. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA PART V, SECTION B, LINE 19D: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS. CHILDREN'S HOSPITAL CENTRAL CA HOME CARE PART V, SECTION B, LINE 19D: 200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES (EXCLUDING CO-PAYS, INDEMNITY BALANCES, AND SHARE OF COST) FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA PART V, SECTION B, LINE 21: IF A PATIENT DID NOT QUALIFY FOR FULL CHARITABLE DISCOUNT, LOW INCOME DISCOUNT, HIGH MEDICAL COST DISCOUNT OR 25% PROMPT PAY DISCOUNT THEN THEY COULD BE CHARGED GROSS CHARGES FOR THEIR SERVICES. CHILDREN'S HOSPITAL CENTRAL CA HOME CARE PART V, SECTION B, LINE 21: IF A PATIENT DID NOT QUALIFY FOR FULL CHARITABLE DISCOUNT, LOW INCOME DISCOUNT, HIGH MEDICAL COST DISCOUNT OR 25% PROMPT PAY DISCOUNT THEN THEY COULD BE CHARGED GROSS CHARGES FOR THEIR SERVICES. PART VI, LINE 2: NEEDS ASSESSMENT: CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS ESTABLISHED BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT. CONSISTENT WITH STATE LAW, CHILDREN'S HOSPITAL COMPLETES A FORMAL ASSESSMENT OF UNMET PEDIATRIC HEALTH CARE NEEDS IN THE COMMUNITY EVERY THREE YEARS. THE HOSPITAL'S MOST RECENT ASSESSMENT WAS COMPLETED IN AUGUST 2011 AND INCLUDED THE FOLLOWING ACTIVITIES: * REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT - UNDER THE AUSPICES OF THE CENTRAL VALLEY HEALTH POLICY INSTITUTE, CALIFORNIA STATE UNIVERSITY, FRESNO, CHILDREN'S HOSPITAL PARTNERED WITH OTHER HOSPITALS IN A FOUR COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. SOURCES OF DATA INCLUDED KEY STAKEHOLDER INTERVIEWS AS WELL PUBLISHED HEALTH STATUS INDICATOR DATA. * SUPPLEMENTAL STAKEHOLDER INTERVIEWS - IN ADDITION TO THE INTERVIEWS CONDUCTED AS PART OF THE NEEDS ASSESSMENT DESCRIBED ABOVE, CHILDREN'S HOSPITAL STAFF CONDUCTED ADDITIONAL INTERVIEWS TO EXPLORE MORE THOROUGHLY THE ISSUES AS THEY RELATE TO CHILDREN. INTERVIEWS WERE CONDUCTED WITH OVER A DOZEN KEY ORGANIZATIONS, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS, SCHOOL DISTRICTS, FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, AND A VARIETY OF COMMUNITY-BASED NONPROFIT AGENCIES SERVING LOW INCOME, NEEDY CHILDREN AND FAMILIES. PARTICULAR AREAS OF INTEREST INCLUDED CHRONIC DISEASE MANAGEMENT (ASTHMA, OBESITY, DIABETES), SERVICES FOR CHILDREN WITH, OR AT RISK FOR DEVELOPMENTAL DELAYS, ACCESS TO PRIMARY AND PREVENTATIVE SERVICES, CHILD ABUSE AND UNINTENTIONAL INJURY PREVENTION, MENTAL HEALTH, AND CAPACITY OF COMMUNITY-BASED PROVIDERS TO MANAGE KIDS WITH COMPLEX MEDICAL CONDITIONS. PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: EACH PATIENT THAT PRESENTS AS A SELF PAY PATIENT IS DIRECTED TO A FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR EDUCATES PATIENTS AND THEIR FAMILIES ABOUT GOVERNMENT AND CHARITY CARE PROGRAMS AND ASSISTS WITH RELATED APPLICATIONS. IF A PATIENT IS NOT COUNSELED BY A FINANCIAL COUNSELOR ON THE DATE OF SERVICE, FOLLOW UP ATTEMPTS ARE MADE BY THE COUNSELORS AND THE BUSINESS OFFICE TO CONTINUE TO INFORM AND EDUCATE PATIENTS OF AVAILABLE PROGRAMS. IN ADDITION, THE CHARITY CARE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE AND THERE IS SIGNAGE THROUGHOUT THE HOSPITAL INFORMING PATIENTS OF THE AVAILABILITY OF THE CHARITY CARE PROGRAM. PART VI, LINE 4: COMMUNITY INFORMATION: AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL'S PRIMARY SERVICE AREA EXTENDS FROM MODESTO IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE SIERRA NEVADA. THE SERVICE AREA INCLUDES 9 COUNTIES AND IS HOME TO OVER 1.2 MILLION CHILDREN AGES 0-17. IN 2012, CHILDREN'S HOSPITAL HAD 12,791 INPATIENT CASES, 77,994 EMERGENCY DEPARTMENT VISITS AND A COMBINED 181,853 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL BENEFITS COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 66% OF THE OUTPATIENT VISITS AT CHILDREN'S HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 4 YEARS OF AGE OR YOUNGER AND OVER 2/3 WERE AN ETHNICITY OTHER THAN CAUCASIAN. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH: CHILDREN'S HOSPITAL PARTNERS WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING THE FOLLOWING. CHILD ABUSE PREVENTION - PREVENTING AND PROTECTING CHILDREN FROM ABUSE AND NEGLECT FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH A NUMBER OF PRIVATE AND PUBLIC AGENCIES, THE PROGRAM PROVIDED EDUCATION, LEADERSHIP, AND DIRECT SERVICES FOR CHILDREN WHO WERE VICTIMS OF ABUSE AND TO PARENTS AND COMMUNITY-BASED ORGANIZATIONS TO HELP PREVENT ABUSE.CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN - CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. TO HELP ENSURE THESE CHILDREN RECEIVE MEDICALLY APPROPRIATE CARE AT SCHOOL, CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO REFERRING HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. TOPICS COVERED INCLUDED CARE FOR HIGH RISK NEWBORNS, HYPOTHERMIA, PEDIATRIC TRAUMA AND CHILD MALTREATMENT, PEDIATRIC LABORATORY SKILLS, SHAKEN BABY SYNDROME, TO NAME A FEW. IN 2012, CHILDREN'S HOSPITAL PROVIDED 20 SEPARATE CONTINUING MEDICAL EDUCATION PROGRAMS TO NEARLY 250 PRIMARY CARE PROVIDERS. PEDIATRIC SUBSPECIALTY PHYSICIANS FROM CHILDREN'S HOSPITAL SERVED AS THE FEATURED FACULTY, PROVIDING COMMUNITY BASED PHYSICIANS WITH GUIDANCE ON HOW TO MANAGE A WIDE ARRAY OF COMPLEX PEDIATRIC MEDICAL CONDITIONS IN A NUMBER OF TOPICAL AREAS INCLUDING OBESITY AND DIABETES, ONCOLOGY, GASTROENTEROLOGY AND GENETICS. PROGRAMS WERE PROVIDED AT LOCATIONS THROUGHOUT THE HOSPITAL'S SERVICE AREA, INCLUDING BAKERSFIELD, MADERA, MERCED, MODESTO AND SAN LUIS OBISPO. DEVELOPMENTAL DISABILITIES - CHILDREN'S HOSPITAL PROVIDED EDUCATION TO PROVIDERS AND FAMILIES IN A NUMBER OF WAYS, INCLUDING THROUGH THE HOSTING OF SEVERAL CONFERENCES AND WORKING WITH BIRTHING HOSPITALS IN FRESNO AND TULARE COUNTIES AS PART OF THE HOSPITAL'S NEONATAL STABILIZATION PROJECT. THE HOSPITAL CONTINUED TO PARTICIPATE IN COALITIONS FOCUSED ON IMPROVING CARE COORDINATION FOR INFANTS AND CHILDREN WITH, OR AT RISK FOR, DEVELOPMENTAL DELAYS, INCLUDING KERN COUNTY'S MEDICALLY VULNERABLE INFANT WORK GROUP INITIATIVE, AND FIRST 5 FRESNO'S MODEL OF CARE PARTNERSHIP OVERSIGHT COMMITTEE AND SYSTEMS OF CARE COMMITTEE. ALSO, THE HOSPITAL EXPANDED EDUCATION AND TECHNICAL ASSISTANCE OFFERED THROUGH ITS HIGH RISK INFANT FOLLOW UP PROGRAM TO OTHER PROVIDERS AND COMMUNITY BASED AGENCIES REGARDING SCREENING AND ASSESSMENT FOR DEVELOPMENTAL DELAYS IN HIGH RISK INFANTS. LAST, CHILDREN'S HOSPITAL MAINTAINED ITS STRONG PARTNERSHIP WITH THE MARCH OF DIMES IN SUPPORT OF HEALTHY MOMS AND HEALTHY BABIES.INJURY PREVENTION 2012 - RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN AGES 1-14, CHILDREN'S HOSPITAL OPERATES AN UNINTENTIONAL INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. SUPPORTED BY A CAST OF 90 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2012: DISTRACTED & RECKLESS TEEN DRIVING, PEDIATRIC TRAUMA, WATER SAFETY, WHEELED SPORTS SAFETY, CHILD PASSENGER SAFETY, THE CHOKING GAME, SPORTS INJURIES, LITHIUM (BUTTON) BATTERY INGESTION, CHILD MALTREATMENT, MUNCHAUSEN SYNDROME BY PROXY, AND ABUSIVE HEAD TRAUMA.CHILDREN'S HOSPITAL CHAIRED SAFE KICK CENTRAL VALLEY AND LED THE COALITION OF 16 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS FOCUSED ON DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. THE PROGRAM PROVIDED EDUCATION TO OVER 14,600 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,376 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS.IN 2012, CHILDREN'S HOSPITAL INJURY PREVENTION ALSO PROVIDED 31 TELEVISION INTERVIEWS AND MEDIA EVENTS TO ADDRESS CHILD SAFETY ISSUES. THE HOSPITAL NOW PROVIDES A MONTHLY CHILD SAFETY SEGMENT ON TWO LOCAL NEWS PROGRAMS BROADCAST THROUGHOUT THE CENTRAL VALLEY. OBESITY PREVENTION - CHILDREN'S HOSPITAL SERVES AS THE ADVOCACY COORDINATOR FOR THE KAISER HEAL ZONE PROJECT IN THE CITY OF MADERA. IN ITS ROLE AS BOTH ADVOCACY COORDINATOR AND CHAIR OF THE MADERA HEAL ZONE PARTNERSHIP COMMITTEE, CHILDREN'S HOSPITAL PROVIDED CONSIDERABLE SUPPORT OF INCREASED ACCESS TO HEALTHY FOODS AND PHYSICAL ACTIVITY.AS THE FOUNDER AND ONGOING ACTIVE MEMBER OF THE CHILDHOOD OBESITY PREVENTION TASK FORCE OF FRESNO AND MADERA COUNTIES, CHILDREN'S HOSPITAL PLAYED A LEAD ROLE IN SUPPORTING THE TASK FORCE'S ACTIVITIES IN 2012. EXAMPLES INCLUDE FACILITATING EDUCATION PROGRAMS FOR PRIMARY CARE PROVIDERS AND PREVENTING AND MANAGING OBESITY AS WELL AS PROMOTING A HIGHER LEVEL OF SUPPORT BY HEALTH PLANS FOR PRIMARY CARE BASED OBESITY PREVENTION OR MANGEMENT SERVICES.THE MISSION OF CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND IS AN INDEPENDENT NON PROFIT ORGANIZATION GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES WHICH IS THEREFORE ACCOUNTABLE TO OUR COMMUNITY AND ONLY OUR COMMUNITY. REPORTS FILED WITH STATES PART VI, LINE 7 CA 1 STAYWELL CONTENT SERVICES PO BOX 759 MORRISVILLE PA 190670759 134036258 12062 PROVIDE HEALTH INFORMATION VIA CHCC WEBSITE MARCH OF DIMES 4201W SHAW 105 FRESNO CA 93722 131846366 501(C)(3) 10650 MARCH FOR BABIES SPONSOR EASTER SEALS OF CENTRAL CA 9010 SOQUEL DR APTOS CA 95003 941497580 501(C)(3) 100000 DONATION 2 1 NURSING SCHOLARSHIP 9 21470 EDUCATION SCHOLARSHIP - RCP FOCUS 2 3238 CAFETERIA MEALS 12506 65657 FMV MEAL COUPONS FOR PATIENT FAMILIES AS NEEDED TAXI, BUS AND TRANSIT SERVICES 744 137780 BOOK SUBSIDIATION OF BUS AND TRANSIT SERVICES PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: NURSING SCHOLARSHIPS ARE DESIGNED TO HELP EMPLOYEES MEET FINANCIAL NEEDS THAT ARE NOT COVERED BY OTHER TUITION REIMBURSEMENT PROGRAMS. A SCHOLARSHIP COMMITTEE REVIEWS APPLICATIONS BI-ANNUALLY BASED ON CERTAIN CRITERIA. RECIPIENTS ARE CHOSEN BY THE COMMITTEE AND THE CHIEF NURSING OFFICER APPROVES THE SELECTIONS. ALL RECIPIENTS ARE EMPLOYEES OF THE HOSPITAL AND THE HOSPITAL IS MADE AWARE WHEN THE RECIPIENT COMPLETES THEIR EDUCATION. OTHER SERVICES PROVIDED ARE PURCHASED FROM VARIOUS VENDORS AND ARE SUPPLIED TO PATIENTS AND THEIR FAMILIES. THE RECORDS FOR THESE PURCHASED SERVICES ARE MAINTAINED BY THE HOSPITAL. X X X X 1 1 0 1 1 1 1 0 0 GORDON ALEXANDER 642016 0 24362 0 101118 0 15409 0 1204 0 784109 0 0 0 TODD SUNTRAPAK 464360 0 45508 0 15690 0 74233 0 15755 0 615546 0 0 0 DR DEVONNA KAJI TERM ENDED 75000 552723 0 0 0 0 0 20825 0 13551 75000 587099 0 0 MICHELE R WALDRON 446747 0 53619 0 9828 0 81797 0 11817 0 603808 0 0 0 DAVID CHRISTENSEN 407750 0 74873 0 9572 0 29544 0 15755 0 537494 0 0 0 BEVERLY HAYDEN-PUGH 314444 0 17984 0 10811 0 89439 0 3939 0 436617 0 0 0 JESSIE HUDGINS 284760 0 33047 0 10259 0 86233 0 7878 0 422177 0 0 0 MARTA BOYER 282562 0 38575 0 10967 0 27021 0 3939 0 363064 0 0 0 JANE WILLSON 279747 0 26289 0 9479 0 61519 0 3939 0 380973 0 0 0 DAVID SINGH 227452 0 33695 0 22799 0 17687 0 0 0 301633 0 0 0 RICK WOLF 267228 0 20883 0 417 0 18064 0 11817 0 318409 0 0 0 KIRK LARSON 229516 0 0 0 9096 0 8250 0 3939 0 250801 0 0 0 RANDALL GUERRERO 215301 0 10143 0 753 0 11257 0 11817 0 249271 0 0 0 STEPHANIE VANCE 203655 0 22363 0 17605 0 12213 0 11817 0 267653 0 0 0 JEFFREY LEFORS 227610 0 9823 0 1318 0 15887 0 0 0 254638 0 0 0 KAMELA LOO 237066 0 3591 0 5104 0 26060 0 7878 0 279699 0 0 0 DANIEL DAVIS 219426 0 10242 0 503 0 12629 0 11817 0 254617 0 0 0 WILLIAM F HAUG 176444 0 81000 0 2405933 0 28442 0 0 0 2691819 0 834810 0 PART I, LINES 4A-B PART I, LINES 4A-B: PART I, LINES 4A: SEVERANCE PAYMENTS TOTALLING $81,346 WERE MADE TO GORDON ALEXANDER, FORMER CEO DURING THE CALENDAR YEAR AND ARE INCLUDED IN PART II, COLUMN B(III). THE SEVERANCE AGREEMENT IS SUBJECT TO A CONFIDENTIALITY CLAUSE. TERMS AND CONDITIONS OF THE AGREEMENT WILL BE PROVIDED TO THE IRS UPON REQUEST. PART I, LINES 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AND A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. MARTA BOYER RECEIVED A DISTRIBUTION FROM THE SERP PLAN DURING THE YEAR ENDING 9/30/2012 IN THE AMOUNT OF $287,287. NO AMOUNTS WERE PAID OUT OF THE DEFERRED COMPENSATION PLAN DURING THE YEAR. RANDALL GUERRERO, JEFFREY LEFORS AND DANIEL DAVIS ARE ELIGIBLE TO CONTRIBUTE BUT NO CONTRIBUTION WAS MADE. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR THE YEAR ENDING 9/30/2012 ARE AS FOLLOWS: GORDON ALEXANDER - DEFERRED COMPENSATION PLAN $14,596; DEFINED CONTRIBUTION SERP PLAN $0 WILLIAM HAUG - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 MICHELE WALDRON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $53,767 TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $49,472 BEVERLY HAYDEN-PUGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $56,337 JESSIE HUDGINS - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $57,564 MARTA BOYER - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 DAVID CHRISTENSEN - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $13,698 RICK WOLF - DEFERRED COMPENSATION PLAN $0; CHANGE IN SERP ACTUARIAL VALUE $5,508 JANE WILLSON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $37,103 DAVID SINGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 STEPHANIE VANCE - DEFERRED COMPENSATION PLAN $16,500; NOT ELIGIBLE FOR SERP KIRK LARSEAN - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 IN FISCAL YR 2012, THE HOSPITAL ESTABLISHED A NON CONTRIBUTORY, NON QUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT, CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EXEC RETIREMENT PLAN (DC SERP). AMOUNTS CONTRIBUTED TO THE PLAN ARE NOT VESTED FOR 5 YRS. NO PAYMENTS FROM THE PLAN HAVE BEEN MADE. PART I, LINE 5 AN EXECUTIVE INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON BOTH ORGANIZATION-WIDE AND INDIVIDUAL GOALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING REVENUE, OPERATIONAL AND QUALITY RESULTS OF THE HOSPITAL AND FOUNDATION. THE INCENTIVE PLAN HAS BEEN APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE COMMITTEE REVIEWS THE FORECASTED PAYOUTS AT THE END OF EACH YEAR BASED ON THE FINANCIAL AND OPERATING RESULTS. PART I, LINE 6 SEE EXPLANATION FOR LINE 5, ABOVE COUNTY OF MADERA 946000518 556902DN1 2010-02-04 39512854 TO REFUND SERIES 2006 BONDS ISSUED ON 6/26/06. 0 0 0 39512854 4319911 1 0 1 1 0 0 0 0 0.00000 0.00000 0.00000 1 0 0 0 0 0 1 X WISHON RADIOLOGY MEDICAL GROUP ENTITY FOR WHICH DR. CHARLES SMITH, DIRECTOR, IS AN OFFICER 649209 DR. SMITH PROVIDES MEDICAL DIRECTOR SERVICES AND TELERADIOLOGIST COVERAGE THROUGH WISHON RADIOLOGY MEDICAL GROUP 0 PRODUCER'S DAIRY FOODS INC ENTITY FOR WHICH RICHARD SHEHADEY, DIRECTOR, IS AN OWNER 112227 PURCHASE OF FOOD PRODUCTS TO BE SOLD IN HOSPITAL CAFETERIA AND FOR PATIENT MEALS 0 X 1 8200 COST X IPADS 6 3219 COST X COUGH ASSIST MACHINE 1 1500 COST X FUN CENTERS 5 21250 COST X CLUBCAR IV 1 13600 COST 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 BRUCE ALBRIGHT, DIRECTOR AND JEFF MAYER, DIRECTOR, HAVE A BUSINESS RELATIONSHIP. IN ADDITION, GREG COLEMAN, DIRECTOR AND PAT RICCHIUTI, DIRECTOR, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. THE CFO PRESENTS HIGHLIGHTS OF KEY SECTIONS OF THE FORM 990 AT THE FINANCE COMMITTEE MEETING THAT IS HELD BEFORE THE FILING DATE AND ANSWERS QUESTIONS OR ADDRESSES ANY CONCERNS AT THIS MEETING. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS. FORM 990, PART VI, SECTION B, LINE 15 AS PROVIDED BY THE HOSPITAL BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE HOSPITAL AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE FORM 990, PART VI, SECTION C, LINE 19 A COPY OF CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF CHILDREN'S HOSPITAL CENTRAL CALIFORNIA IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE HOSPITAL PREPARES ANNUAL FINANCIAL STATEMENTS WHICH ARE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM PRIOR TO SUBMITTAL TO RELEVANT STATE AGENCIES. HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: FORM 990, PART VII, SECTION A, COLUMN B: MICHELE WALDRON'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 38 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 2 HRS GORDON ALEXANDER'S'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 34 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 6 HRS TODD SUNTRAPAK'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 34 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 6 HRS BRUCE ALLBRIGHT, DR. ROBERT KUBO, JEFF MAYER, DAVE OLSON, RICHARD SHEHADEY AND BILL SMITTCAMP DIVIDE THEIR TIME AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 1 HR CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 1 HR CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -19,826,241. TRADING GAIN INCLUDED IN INVESTMENT INCOME PER AFS 22,906,033. TRANSFER TO ENDOWMENT -30,026. ROUNDING 1. TOTAL TO FORM 990, PART XI, LINE 5: 3,049,767. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE FORM 990 PART III, LINE 4A: I. DESCRIPTION OF PROGRAM SERVICE ONE 60 YEARS AGO, OUR FOUNDING MOTHERS HAD A DREAM TO CARE FOR CHILDREN IN A HOSPITAL AS SPECIAL AS ITS PATIENTS. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA HAS FLOURISHED EVER SINCE, CARING FOR HUNDREDS OF THOUSANDS OF CHILDREN. OUR MISSION GUIDES US AS WE TRAVEL THE ROAD TO OUR FUTURE ALONGSIDE STAFF, PHYSICIANS, CHILDREN, FAMILIES, OUR COMMUNITY AND OUR PARTNERS THROUGHOUT THE REGION. MISSION THE MISSION OF CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. VISION OUR VISION CAPTURES THE PATH WE'VE TRAVELED AND SHOWCASES OUR COMMITMENT AND PASSION TO BE THE BEST. OUR CLEAR FOCUS IS TO CONTINUE TO PROVIDE THE BEST CARE AND THE BEST QUALITY PEDIATRIC SERVICES AVAILABLE ANYWHERE WITH A VISION TO BECOME THE NATION'S BEST CHILDREN'S HOSPITAL. CORE VALUES THE FOLLOWING CORE ORGANIZATIONAL VALUES GUIDE THE INVESTMENTS AND SUPPORT PROVIDED BY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM. EXCELLENCE - WE DEPEND ON EXCEPTIONAL PEOPLE TO PROVIDE EXCEPTIONAL QUALITY HEALTH CARE AND SERVICES THROUGHOUT CHILDREN'S HOSPITAL. WE SET HIGH STANDARDS AND WE SUPPORT EACH OTHER AS WE STRIVE TO ACHIEVE THEM. WE INVEST IN EACH OTHER AND WE VALUE THE INDIVIDUAL AND CULTURAL DIFFERENCES THAT MAKE US STRONG. WE ARE PROUD OF OUR SUPERIOR SERVICES AS MEASURED BY QUALITY OUTCOMES. COMPASSIONATE CARE - WE TREAT EVERY CHILD, EVERY FAMILY, EACH OTHER, OUR VISITORS AND OUR VENDORS WITH RESPECT, KINDNESS, HOPE, JOY AND GOOD HUMOR. WE DISPLAY OUR HELPFUL, HEALING, FAMILY-CENTERED SPIRIT AT EVERY OPPORTUNITY. WE RECOGNIZE THE IMPORTANCE OF PLAYFULNESS IN HUMAN INTERACTION AND IN THE HEALTH OF CHILDREN. WE LOOK FOR WAYS TO EASE SUFFERING AND PROVIDE COMFORT. INTEGRITY - WE ARE HONEST, ETHICAL AND RESPONSIBLE IN OUR WORK AND IN THE WAY WE DEAL WITH OTHERS. WE KEEP OUR PROMISES AND ADMIT OUR MISTAKES. WE KNOW OURSELVES AND WE AVOID HIDDEN AGENDAS. BY THE WAY WE LIVE OUR LIVES EVERYDAY, WE ARE WORTHY OF THE TRUST PEOPLE PLACE IN US. INNOVATION - WE EMBRACE CHANGE, CREATIVITY, CONTINUOUS LEARNING AND PERSONAL GROWTH. WE INCORPORATE NEW IDEAS, TECHNOLOGY AND METHODS TO IMPROVE THE HEALTH CARE AND SERVICES WE PROVIDE. WE ANTICIPATE FUTURE TRENDS AND WE CREATE STRATEGIC PLANS TO INSURE FUTURE GROWTH AND CONTINUED VITALITY. COLLABORATION - WE BUILD ENDURING INTERNAL AND EXTERNAL RELATIONSHIPS, JOINING WITH COLLEAGUES ACROSS ORGANIZATIONAL BOUNDARIES TO IMPROVE THE CARE AND SERVICES WE PROVIDE. WE ENCOURAGE AND REWARD BOTH INDIVIDUAL AND TEAM ACHIEVEMENTS. WE PUT THE COMMON GOOD AHEAD OF NARROW INTERESTS. STEWARDSHIP - WE ARE RESOURCEFUL, ADAPTABLE AND RESILIENT. WE HAVE A "CAN DO" ATTITUDE THAT GETS THE JOB DONE. WE ARE FISCALLY RESPONSIBLE AND EFFICIENT WITH OUR TIME. WE PROTECT OUR RESERVES AND MANAGE OUR OPERATING COSTS IN ORDER TO INVEST IN OUR FUTURE. WE ARE EACH PERSONALLY DEDICATED TO MAKING CHILDREN'S HOSPITAL BETTER BECAUSE WE WERE HERE. COMMITMENT TO THE COMMUNITY AS A NOT-FOR-PROFIT ORGANIZATION GOVERNED BY ITS OWN BOARD OF TRUSTEES, CHILDREN'S HOSPITAL IS SOLELY COMMITTED TO ADDRESSING THE MEDICAL NEEDS OF OUR REGION'S SICKEST CHILDREN. WITH 348 BEDS, CLOSE TO 600 PHYSICIANS AND APPROXIMATELY 2,800 TOTAL EMPLOYEES, CHILDREN'S HOSPITAL OFFERS ACCESSIBILITY TO OVER 40 FETAL, NEONATAL AND PEDIATRIC SUBSPECIALTIES, ALL COMMITTED TO PROVIDING THE HIGHEST LEVEL OF QUALITY CARE POSSIBLE. EXAMPLES INCLUDE THE HOSPITAL'S NEONATAL AND PEDIATRIC INTENSIVE CARE UNITS THAT MAINTAIN LOW MORTALITY RATES, WHEN COMPARED NATIONALLY, WHILE TREATING SOME OF THE SICKEST CHILDREN. WHILE PROVIDING EXCEPTIONAL CARE IS THE SINGLE GREATEST CONTRIBUTION THE HOSPITAL MAKES FOR OUR CHILDREN AND THEIR FAMILIES, THE HOSPITAL ALSO APPRECIATES THAT IT IS UNIQUELY POSITIONED TO SUPPORT THE NEEDS OF CHILDREN IN OTHER WAYS AS WELL. AS AN EXTENSION OF THE HOSPITAL'S MISSION AND VISION, THE GOAL OF CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS TO ADVANCE THE HEALTH AND WELLBEING OF UNDERSERVED, MEDICALLY NEEDY CHILDREN THROUGH COLLABORATION AND COMMON CONCERN. THE COMMUNITY BENEFITS PROGRAM IS OVERSEEN BY THE COMMUNITY BENEFITS ADVISORY COMMITTEE. II. SERVICE AREA DEMOGRAPHICS AND PATIENT VOLUME SERVICE AREA DEMOGRAPHICS AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL'S PRIMARY SERVICE AREA EXTENDS FROM MODESTO IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE SIERRA NEVADA. THE SERVICE AREA INCLUDES 9 COUNTIES AND IS HOME TO OVER 1.1 MILLION CHILDREN AGES 0-17. CHILDREN'S HOSPITAL'S PATIENT VOLUME IN 2012, CHILDREN'S HOSPITAL HAD 12,791 INPATIENT CASES, 77,994 EMERGENCY DEPARTMENT VISITS AND A COMBINED 181,853 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 66% OF TOTAL OUTPATIENT VISITS AT THE HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 4 YEARS OF AGE OR YOUNGER AND OVER 2/3 WERE AN ETHNICITY OTHER THAN CAUCASIAN. III. ASSESSING AND UNDERSTANDING COMMUNITY NEEDS CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS ESTABLISHED BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT. CONSISTENT WITH STATE AND FEDERAL LAW, CHILDREN'S HOSPITAL COMPLETES A FORMAL ASSESSMENT OF UNMET PEDIATRIC HEALTH CARE NEEDS IN THE COMMUNITY EVERY THREE YEARS. THE HOSPITAL'S MOST RECENT ASSESSMENT WAS COMPLETED IN AUGUST 2011 AND INCLUDED THE FOLLOWING ACTIVITIES. FORMAL NEEDS ASSESSMENT PROCESS * REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT - UNDER THE AUSPICES OF THE CENTRAL VALLEY HEALTH POLICY INSTITUTE, CALIFORNIA STATE UNIVERSITY, FRESNO, CHILDREN'S HOSPITAL PARTNERED WITH OTHER HOSPITALS IN A FOUR COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. SOURCES OF DATA INCLUDED KEY STAKEHOLDER INTERVIEWS AS WELL PUBLISHED HEALTH STATUS INDICATOR DATA. FOR A COPY OF THE NEEDS ASSESSMENT, VISIT THE FOLLOWING LINK. HTTP://WWW.FRESNOSTATE.EDU/CHHS/CVHPI/DOCUMENTS/2011-COMMUNITY-NEEDS. PDF *SUPPLEMENTAL STAKEHOLDER INTERVIEWS - IN ADDITION TO THE INTERVIEWS CONDUCTED AS PART OF THE NEEDS ASSESSMENT DESCRIBED ABOVE, CHILDREN'S HOSPITAL STAFF CONDUCTED ADDITIONAL INTERVIEWS TO EXPLORE MORE THOROUGHLY THE ISSUES AS THEY RELATE TO CHILDREN. INTERVIEWS WERE CONDUCTED WITH OVER A DOZEN KEY ORGANIZATIONS, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS, SCHOOL DISTRICTS, FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, AND A VARIETY OF COMMUNITY-BASED NONPROFIT AGENCIES SERVING LOW INCOME, NEEDY CHILDREN AND FAMILIES. PARTICULAR AREAS OF INTEREST INCLUDED CHRONIC DISEASE MANAGEMENT (ASTHMA, OBESITY, DIABETES), SERVICES FOR CHILDREN WITH, OR AT RISK FOR DEVELOPMENTAL DELAYS, ACCESS TO PRIMARY AND PREVENTATIVE SERVICES, CHILD ABUSE AND UNINTENTIONAL INJURY PREVENTION, MENTAL HEALTH, AND CAPACITY OF COMMUNITY-BASED PROVIDERS TO MANAGE KIDS WITH COMPLEX MEDICAL CONDITIONS. IV. COMMUNITY BENEFITS PROGRAM A COMMUNITY BENEFIT IS GENERALLY DEFINED AS A CLINICAL OR NON-CLINICAL PROGRAM OR SERVICE THAT - PROVIDES TREATMENT AND/OR PROMOTES HEALTH AND HEALING IN RESPONSE TO AN IDENTIFIED COMMUNITY HEALTH NEED OR SERVICE GAP IDENTIFIED THROUGH THE COMMUNITY NEEDS ASSESSMENT PROCESS, - IS INTENDED TO BENEFIT THE COMMUNITY AS OPPOSED TO THE HOSPITAL, AND - RESULTS IN A LOW OR NEGATIVE FINANCIAL MARGIN FOR THE HOSPITAL. ALSO INCLUDED IN THE DEFINITION IS THE PROVISION OF CHARITY CARE AND THE UNREIMBURSED COST OF PROVIDING HEALTH CARE SERVICES TO THOSE ENROLLED IN PUBLIC PROGRAMS, INCLUDING MEDI-CAL. FOR FY 2012, CHILDREN'S HOSPITAL DEDICATED IN EXCESS OF $2,776,284 IN COMMUNITY BENEFITS THAT CONTINUE THE HOSPITAL'S LONG TRADITION OF BEING AN ACTIVE AND INTEGRAL PART OF CENTRAL CALIFORNIA. DUE TO THE HOSPITAL'S RECEIPT OF HOSPITAL FEE PROGRAM REVENUE IN 2012, THE FIGURE ABOVE DOES NOT INCLUDE THE HOSPITAL'S COSTS ASSOCIATED WITH UNCOMPENSATED MEDI-CAL, WHICH WAS $21,418,838 IN 2012. A SUMMARY OF THE HOSPITAL'S COMMUNITY BENEFITS PROGRAM ACTIVITIES IN 2012: COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH EDUCATION CLASSES OFFERED BY THE HOSPITAL REFLECT THE HOSPITAL'S LONG-STANDING COMMITMENT TO SUPPORTING COMMUNITY WELLNESS AND DISEASE PREVENTION. CLASSES, WHICH ARE OFFERED AT THE HOSPITAL AT NO COST TO PARTICIPANTS, ARE TAUGHT BY CHILDREN'S HOSPITAL STAFF AND A COMMUNITY BASED VENDOR, BOTH OF WHICH HAVE SPENT YEARS STUDYING AND GAINING EXPERIENCE IN THEIR CHOSEN FIELDS. EXAMPLES OF CLASSES OFFERED IN 2012 INCLUDE THE FOLLOWING. ASTHMA BASICS THIS CLASS PROVIDED INFORMATION ABOUT CONTROLLING ASTHMA; PROPER USE OF MEDICATIONS; PEAK FLOW METERS; METER DOSE INHALERS AND SPACERS; RECOGNIZING EARLY WARNING SIGNS OF ASTHMA; ENVIRONMENTAL CONTROL AND WHAT TRIGGERS AN ASTHMA ATTACK. CPR FOR FAMILY AND FRIENDS OFFERED TO FAMILIES WHO WERE TAKING A CHILD HOME FROM CHILDREN'S HOSPITAL, THIS CLASS PRESENTED INFORMATION ON THE AMERICAN HEART ASSOCIATION'S (AHA) PEDIATRIC CHAIN OF SURVIVAL, SIGNS OF CHOKING, PREVENTION OF SUDDEN INFANT DEATH SYNDROME, AND PREVENTION OF THE MOST COMMON FATAL INJURIES IN INFANTS AND CHILDREN. THE COURSE ALSO PRESENTED INFORMATION ABOUT THE AHA ADULT CHAIN OF SURVIVAL AND SIGNS OF CARDIAC ARREST, HEART ATTACK, STROKE AND CHOKING IN ADULTS. HEALTH ENCYCLOPEDIA ($12,062) CHILDREN'S HOSPITAL ALSO PROVIDED ACCESS TO ON LINE EDUCATIONAL INFORMATION VIA THE HEALTH ENCYCLOPEDIA LINK ON ITS WEBSITE. HEALTH ENCYCLOPEDIA CONTAINS THOUSANDS OF PAGES OF INFORMATION ON PEDIATRIC DISEASES, CONDITIONS AND TREATMENTS, AS WELL AS SECTIONS ON HOW TO KEEP KIDS HEALTHY. THE ENCYCLOPEDIA IS AVAILABLE IN ENGLISH AND SPANISH. HEALTH CARE SUPPORT SERVICES HEALTH CARE SUPPORT SERVICES ARE PROVIDED BY THE HOSPITAL TO HELP ADDRESS THE HEALTH CARE NEEDS OF CHILDREN AND THEIR FAMILIES WHILE AT THE HOSPITAL, AT HOME, AND IN THE COMMUNITY. CAFETERIA MEALS ($65,656) MEAL COUPONS WERE PROVIDED TO BREAST-FEEDING MOMS WHOSE INFANTS WERE IN THE HOSPITAL. SOCIAL WORKERS ALSO PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. CANCER SURVIVORSHIP PROGRAM THE CHILDHOOD CANCER SURVIVORSHIP PROGRAM AT CHILDREN'S HOSPITAL PROVIDES SPECIALIZED, HIGH-QUALITY CARE TO HELP SURVIVORS OF CHILDHOOD CANCER LIVE HEALTHIER, HAPPIER LIVES. THE PROGRAM INCLUDES AN ANNUAL ASSESSMENT OF THE SURVIVOR'S HEALTH, ACADEMIC AND SOCIAL DEVELOPMENT, AND AN INDIVIDUALIZED ACTION PLAN TO ADDRESS LONG-TERM EFFECTS FROM CANCER TREATMENT. CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY-BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. A. SCHOOL NURSES - CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. B. HOSPITALS / COMMUNITY BASED ORGANIZATIONS - CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. TOPICS COVERED INCLUDED CARE FOR HIGH RISK NEWBORNS, HYPOTHERMIA, PEDIATRIC TRAUMA AND CHILD MALTREATMENT, PEDIATRIC LABORATORY SKILLS, SHAKEN BABY SYNDROME, TO NAME A FEW. CHILD ABUSE PREVENTION PREVENTING AND PROTECTING CHILDREN FROM MALTREATMENT, INCLUDING BUT NOT LIMITED TO, PHYSICAL ABUSE, SEXUAL ABUSE, COMMERCIAL SEXUAL EXPLOITATION, DRUG EXPOSURE AND NEGLECT, FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH COMMUNITY BASED ORGANIZATIONS, PARENTS, PRIVATE AND PUBLIC AGENCIES, THE CENTER PROVIDED EDUCATION, PREVENTION, LEADERSHIP, AND DIRECT SERVICES FOR THE COMMUNITY, CHILDREN AND THEIR FAMILIES TO HELP PREVENT FUTURE ABUSE. CULTURALLY COMPETENT HEALTH CARE WITH A SERVICE AREA THAT IS HOME TO OVER 100 DOCUMENTED LANGUAGES AND 37 DISTINCT CULTURES, CHILDREN'S HOSPITAL IS COMMITTED TO MEETING THE NEEDS OF A VERY DIVERSE PATIENT POPULATION. AS IT HAS DONE FOR YEARS, THE HOSPITAL IN 2012 PROVIDED LANGUAGE ASSISTANT 24 HOURS A DAY, SEVEN DAYS A WEEK. CHILDREN'S HOSPITAL ALSO WORKED WITH A VARIETY OF ETHNIC GROUPS TO ENSURE THAT THE HOSPITAL WAS PROVIDING CARE IN AS CULTURALLY SENSITIVE A MANNER AS POSSIBLE. DEVELOPMENTAL DISABILITIES CHILDREN'S HOSPITAL PROVIDED EDUCATION TO PROVIDERS AND FAMILIES IN A NUMBER OF WAYS, INCLUDING THROUGH THE HOSTING OF SEVERAL CONFERENCES AND WORKING WITH BIRTHING HOSPITALS IN FRESNO AND TULARE COUNTIES AS PART OF THE HOSPITAL'S NEONATAL STABILIZATION PROJECT. THE HOSPITAL ALSO HOSTED A CONFERENCE AS PART OF ITS PARTICIPATION IN THE CALIFORNIA PERINATAL QUALITY CARE COLLABORATIVE (CPQCC). THE GOAL OF CPQCC IS TO IMPROVE AND OPTIMIZE THE DELIVERY ROOM RESUSCITATION AND STABILIZATION PRACTICES FOR ALL INFANTS WHOM CHILDREN'S TRANSPORT OR RESUSCITATION TEAM WERE PRESENT FOR DELIVERY. THE HOSPITAL ALSO CONTINUED TO PARTICIPATE IN COALITIONS FOCUSED ON IMPROVING CARE COORDINATION FOR INFANTS AND CHILDREN WITH, OR AT RISK FOR, DEVELOPMENTAL DELAYS, INCLUDING KERN COUNTY'S MEDICALLY VULNERABLE INFANT WORK GROUP INITIATIVE, AND FIRST 5 FRESNO'S MODEL OF CARE PARTNERSHIP OVERSIGHT COMMITTEE AND SYSTEMS OF CARE COMMITTEE. ALSO, THE HOSPITAL CONTINUED TO PROVIDE EDUCATION AND TECHNICAL ASSISTANCE OFFERED THROUGH ITS HIGH RISK INFANT FOLLOW UP PROGRAM TO OTHER PROVIDERS AND COMMUNITY BASED AGENCIES REGARDING SCREENING AND ASSESSMENT FOR DEVELOPMENTAL DELAYS IN HIGH RISK INFANTS. LAST, CHILDREN'S HOSPITAL MAINTAINED ITS STRONG PARTNERSHIP WITH THE MARCH OF DIMES ($10,650) IN SUPPORT OF HEALTHY MOMS AND HEALTHY BABIES. ENROLLMENT INTO HEALTH INSURANCE CHILDREN'S HOSPITAL COMMITTED SIGNIFICANT RESOURCES TO HELP FAMILIES FIND HEALTH INSURANCE COVERAGE FOR THEMSELVES AND THEIR UNINSURED CHILDREN, INCLUDING FINANCIAL COUNSELORS AS WELL AS A CONTRACTED VENDOR WITH EXPERTISE IN ENROLLMENT SERVICES (APPROXIMATELY $286,900). WITH THESE RESOURCES, THE HOSPITAL IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM, OR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, THE HOSPITAL AND/OR THE CONTRACTED VENDOR ASSISTED THE FAMILY WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. CHILDREN'S HOSPITAL ALSO SUPPORTED OUTREACH AND ENROLLMENT SERVICES OFFERED THROUGH THE FRESNO HEALTHY COMMUNITIES ACTION PROGRAM ($1,000). FAMILY ASSISTANCE FUND ($48,764) WHEN SUPPORT FOR SERVICES WERE NOT AVAILABLE THROUGH A COMMUNITY PROGRAM OR ANOTHER FUNDING SOURCE, SOCIAL WORKERS WERE ABLE TO ACCESS THESE HOSPITAL FUNDS TO HELP PATIENTS AND FAMILIES OBTAIN ITEMS NEEDED UPON RETURN HOME OR ASSIST WITH TRANSPORTATION FOR FOLLOW UP CARE. INJURY PREVENTION RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN AGES 1-14, CHILDREN'S HOSPITAL OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. SUPPORTED BY A CAST OF OVER 90 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2012: DISTRACTED & RECKLESS TEEN DRIVING, PEDIATRIC TRAUMA, WATER SAFETY, WHEELED SPORTS SAFETY, CHILD PASSENGER SAFETY, THE CHOKING GAME, SPORTS INJURIES, LITHIUM (BUTTON) BATTERY INGESTION, AIR POWERED GUN INJURIES, TOY SAFETY, CHILD MALTREATMENT, MUNCHAUSEN SYNDROME BY PROXY, AND ABUSIVE HEAD TRAUMA. THE PROGRAM PROVIDED EDUCATION TO OVER 14,600 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY-BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,376 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS. THE PROGRAM ALSO PROVIDED 31 TELEVISION INTERVIEWS AND MEDIA EVENTS TO ADDRESS CHILD SAFETY ISSUES. THE HOSPITAL NOW PROVIDES A MONTHLY CHILD SAFETY SEGMENT ON TWO LOCAL NEWS PROGRAMS BROADCAST THROUGHOUT THE CENTRAL VALLEY. CHILDREN'S HOSPITAL ALSO CHAIRED SAFE KIDS CENTRAL VALLEY, LEADING THE COALITION OF 16 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS FOCUSED ON DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. LITERACY PROGRAM LITERACY, WHICH IS DEFINED AS THE ABILITY TO READ AND WRITE, IS ESSENTIAL TO FULLY DEVELOPING A SENSE OF WELL-BEING AND CITIZENSHIP. EXPERTS ESTIMATE THAT NEARLY 40 PERCENT OF U.S. 4TH GRADERS DO NOT ACHIEVE BASIC LEVELS OF READING PROFICIENCY. READING DIFFICULTIES AND ILLITERACY CONTRIBUTE TO INCREASED SCHOOL ABSENTEEISM, SCHOOL DROP-OUTS, JUVENILE DELINQUENCY, INCREASED CRIME, TEEN PREGNANCY, DRUG USE AND OTHER PROBLEMS THAT IMPACT OUR COMMUNITY. STUDIES SHOW THE EASIEST WAY TO INCREASE LITERACY AMONG PRE-SCHOOL AND SCHOOL AGE CHILDREN IS TO SIMPLY READ TO THEM. TO MAKE A MEANINGFUL CONTRIBUTION TO LITERACY IN OUR COMMUNITY, CHILDREN'S HOSPITAL'S LITERACY PROGRAM PROMOTES AND ENCOURAGES CHILDREN AND THEIR FAMILIES TO BECOME LIFELONG READERS. THE HOSPITAL'S "BOOK BUDDIES" INITIATIVE SPECIFICALLY FOCUSES ON DEVELOPING READING READINESS AND EARLY READING SKILLS FOR OUR YOUNG PATIENTS. HOSPITAL VOLUNTEERS BRING BOOKS TO THE CHILDREN, READ THEM STORIES AND ENGAGE THEM IN ACTIVITIES THAT COORDINATE WITH THE STORIES. SEPARATE FROM "BOOK BUDDIES", HOSPITAL VOLUNTEERS VISIT OUTPATIENT PRACTICE WAITING ROOMS TO READ TO CHILDREN, SHOWING PARENTS AND CHILDREN THE PLEASURES AND TECHNIQUES OF LOOKING AT BOOKS TOGETHER. ADDITIONALLY, BOOKS ARE AVAILABLE IN HOSPITAL CLINICS AND DEPARTMENTS, AND FAMILIES ARE ENCOURAGED TO TAKE THEM HOME TO USE WITH THEIR CHILDREN. IN 2012, CHILDREN'S HOSPITAL DISTRIBUTED OVER 14,000 BOOKS TO PATIENTS AND FAMILIES. OBESITY PREVENTION CHILDREN'S HOSPITAL SUPPORTED A NUMBER OF EFFORTS AIMED AT ADDRESSING THE ISSUE OF CHILDHOOD OBESITY IN OUR COMMUNITY. THE HOSPITAL CONTINUED TO SERVE AS THE ADVOCACY COORDINATOR FOR THE KAISER HEAL ZONE PROJECT IN THE CITY OF MADERA BY FACILITATING ADVOCACY IN SUPPORT OF INCREASED ACCESS TO HEALTHY FOODS AND PHYSICAL ACTIVITY. ADDITIONALLY, AS THE FOUNDER AND ONGOING ACTIVE MEMBER OF THE CHILDHOOD OBESITY PREVENTION TASK FORCE FOR FRESNO AND MADERA COUNTIES, CHILDREN'S HOSPITAL PLAYED A LEAD ROLE IN SUPPORTING THE TASK FORCE'S ACTIVITIES IN 2012. EXAMPLES INCLUDED FACILITATING EDUCATION PROGRAMS FOR PRIMARY CARE PROVIDERS ON PREVENTING AND MANAGING OBESITY, AS WELL AS PROMOTING A HIGHER LEVEL OF SUPPORT BY HEALTH PLANS FOR PRIMARY CARE BASED OBESITY PREVENTION OR MANAGEMENT SERVICES. POISON CONTROL ($50,122) THE CENTRAL CALIFORNIA POISON CONTROL CENTER IS LOCATED ON THE CHILDREN'S HOSPITAL CAMPUS AND RECEIVED A DONATION OF OFFICE SPACE. THE CENTRAL CALIFORNIA DIVISION OF THE CALIFORNIA POISON CONTROL CENTER ANSWERS CALLS FROM THROUGHOUT THE REGION AND PROVIDES EXPERT ADVICE AND INFORMATION REGARDING EXPOSURE TO POTENTIALLY HARMFUL SUBSTANCES. THE PHONES ARE STAFFED 24 HOURS A DAY, 7 DAYS A WEEK. IN ADDITION TO PROVIDING EMERGENCY TELEPHONE ADVICE REGARDING POISON EXPOSURES, THE POISON CONTROL CENTER OPERATES SEVERAL PROGRAMS CRITICAL TO A CULTURALLY DIVERSE, AGRICULTURALLY BASED COMMUNITY LIKE THE CENTRAL VALLEY. THE CENTER HAS BEEN EXPRESSLY RESPONSIVE TO THE GROWING AND LARGELY UNDERSERVED LATINO POPULATION BY DEVELOPING SPECIALIZED TEACHING TOOLS AND PROGRAM INTERVENTIONS IN SPANISH, AND PROVIDING CUSTOMIZED TRAININGS FOR COMMUNITY HEALTH WORKERS IN SPANISH. ALSO, THE CENTER CONTRACTS WITH THE STATE DEPARTMENT OF PESTICIDE REGULATION (DPR) TO ASSIST PHYSICIANS IN COMPLYING WITH MANDATORY REPORTING REQUIREMENTS FOR PESTICIDE EXPOSURES. THE POISON CONTROL CENTER ALSO PROVIDES THE STATE DPR WITH CASE DATA AND INFORMATION ON THE HEALTH ISSUES RELATED TO PESTICIDE EXPOSURE IN CALIFORNIA. REINTEGRATION CHILDREN'S HOSPITAL SUPPORTS A NUMBER OF PROGRAMS OR INITIATIVES DESIGNED TO HELP CHILDREN WHO SUFFER FROM PERMANENT OR LONG-TERM DISABILITIES REINTEGRATE AS EASILY AS POSSIBLE INTO REGULAR DAILY ACTIVITIES. CHILDREN'S HOSPITAL'S ADAPTIVE SPORTS PROGRAM PROVIDES RECREATIONAL AND ATHLETIC EXPERIENCES FOR CHILDREN WITH DISABILITIES. EXPERIENCES OFFERED IN 2012 INCLUDED WATER SKIING, SNOW SKIING, ROCK CLIMBING AND ICE HOCKEY. OPEN TO ALL AGES, THE PROGRAM IS THE ONLY ONE OF ITS KIND IN THE CENTRAL VALLEY. IT'S DESIGNED FOR INDIVIDUALS WITH PHYSICAL AND HEALTH IMPAIRMENTS AND CONDITIONS RANGING FROM CEREBRAL PALSY TO SPINAL CORD INJURIES. THROUGH HARD WORK AND DETERMINATION, PARTICIPANTS LEARN THAT IT'S POSSIBLE FOR THEM, TOO, TO TAKE PART IN ATHLETIC ACTIVITIES, EXCEED EXPECTATIONS AND ACHIEVE THEIR DREAMS. CHILDREN'S HOSPITAL ALSO WORKS TO ENSURE A SMOOTH TRANSITION FOR CHILDREN RETURNING TO SCHOOL BY COORDINATING A SERIES OF VISITS WITH SCHOOL STAFF AND STUDENTS. IN 2012, VISITS INCLUDED A TOUR OF THE CAMPUS TO REORIENT CHILDREN TO THE SCHOOL AND TO IDENTIFY AND ADDRESS ANY POTENTIAL ACCESS ISSUES. VISITS ALSO INCLUDED CONFERENCES WITH SCHOOL STAFF TO MAKE SURE THEY WERE AWARE OF THE CHILDREN'S DISABILITIES AND TO ENSURE STAFF COULD ACCOMMODATE THE CHILDREN'S HEALTH CARE NEEDS AS BEST AS POSSIBLE. ADDITIONALLY, THE HOSPITAL CONVENED 'CIRCLE OF FRIENDS' MEETINGS BETWEEN CHILDREN AND THEIR FRIENDS TO GIVE THEM A CHANCE TO SEE AND TALK ABOUT THE CHILDREN'S DISABILITIES. TRANSPORTATION ($137,779) CHILDREN'S HOSPITAL'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING TAXI VOUCHERS AND BUS TOKENS. IN ADDITION, CHILDREN'S HOSPITAL SUBSIDIZED BUS AND TRANSIT SERVICES FROM FRESNO AND THE KINGS COUNTY RURAL AREAS. PUBLIC TRANSPORTATION HAS BEEN A PROBLEM IN THE CENTRAL VALLEY FOR YEARS AND THUS CHILDREN'S HOSPITAL CONTINUES TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND ACCESS TO CARE. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO PART III, LINE 4B: COMMITMENT TO MEDI-CAL CHILDREN'S HOSPITAL'S COMMITMENT TO SERVING ITS COMMUNITY IS EVIDENCED BY THE LARGE NUMBER OF PATIENTS ITS SERVES THAT ARE COVERED BY MEDI-CAL. IN 2012, OF THE HOSPITAL'S 79,699 TOTAL INPATIENT DAYS, 59,503 (75%) WERE COVERED BY MEDI-CAL. THE HOSPITAL HAS HISTORICALLY BEEN ABLE TO NEGOTIATE INCREASES TO ITS MEDI-CAL INPATIENT REIMBURSEMENT. THESE INCREASES, HOWEVER, HAVE NOT OFFSET THE RISING COST OF CARE FOR THESE PATIENTS AND IN RECENT YEARS, ADDITIONAL RATES FREEZES AND CUTBACKS IN GOVERNMENT FUNDING CONTINUE TO PUT PRESSURE ON THE HOSPITAL'S ABILITY TO PROVIDE CARE. IN ADDITION, THE MEDI-CAL OUTPATIENT FEE SCHEDULE REIMBURSEMENT REMAINS SIGNIFICANTLY BELOW COST. THE COMBINED NET EFFECT OF TOTAL MEDI-CAL REIMBURSEMENT AND DISPROPORTIONATE SHARE FUNDING IN RELATION TO THE COST OF THESE SERVICES RESULTED IN A NET LOSS TO THE HOSPITAL IN 2012 OF $21,418,838. THIS FIGURE IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS, AND ALSO EXCLUDES THE REVENUE AND EXPENSES ASSOCIATED WITH THE HOSPITAL FEE PROGRAM, WHICH IS DESCRIBED IN MORE DETAIL BELOW. HOSPITAL FEE PROGRAM - IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING CHILDREN'S HOSPITAL CENTRAL CALIFORNIA, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. THE PROGRAM WAS FUNDED BY A QUALITY ASSURANCE FEE PAID BY HOSPITALS THAT THE STATE THEN USED TO COLLECT ADDITIONAL FEDERAL FUNDING. HOSPITAL FEE PROGRAMS LIKE CALIFORNIA'S ARE ALLOWABLE UNDER FEDERAL LAW, AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROVED CALIFORNIA'S PROGRAM. CALIFORNIA'S PROGRAM WAS IMPLEMENTED IN TWO PARTS, WITH PART ONE COVERING THE PERIOD APRIL 1, 2009 THROUGH DECEMBER 31, 2010, AND PART TWO COVERING THE PERIOD JANUARY 1, 2011 THROUGH JUNE 30, 2011. CALIFORNIA SUBSEQUENTLY ENACTED A THIRTY-MONTH QUALITY ASSURANCE PROGRAM FOR THE PERIOD OF JULY 1, 2011 THROUGH DECEMBER 31, 2013. AS OF SEPTEMBER 30, 2012, THE MANAGED CARE PORTION OF THE 30 MONTH PROGRAM HAD NOT BEEN APPPROVED. IN 2012, CHILDREN'S HOSPITAL RECOGNIZED PROGRAM REVENUE OF $80,897,470, NET OF THE HOSPITAL'S QUALITY ASSURANCE FEE AND HOSPITAL CONTRIBUTIONS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT). CHFT WAS ESTABLISHED UNDER THE PROGRAM FOR THE PURPOSE OF SUPPORTING CHARITABLE ACTIVITIES. THE NET REVENUE RECOGNIZED IN 2012 INCLUDES PART TWO OF THE PROGRAM AND 15 MONTHS OF THE FEE-FOR-SERVICE COMPONENT OF THE THIRTY-MONTH PROGRAM. AS THE HOSPITAL'S HOSPITAL FEE PROGRAM REVENUE RECOGNIZED IN 2012 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2012, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2012. FOR DECADES, CALIFORNIA HAS BEEN UNABLE TO REIMBURSE HOSPITALS LIKE CHILDREN'S FOR MEDI-CAL SERVICES AT LEVELS WHICH COVER COSTS. THE FUTURE LOOKS EVEN WORSE GIVEN MEDI-CAL FUNDING CUTS AT BOTH THE STATE AND FEDERAL LEVELS, ALONG WITH THE PRESSURE THAT ONGOING GOVERNMENT BUDGET DEFICITS WILL PLAY ON REDUCING MEDI-CAL FUNDING EVEN FURTHER. WHILE THE PROGRAM'S PAYMENTS HAVE PLAYED AN IMPORTANT ROLE IN OFFSETTING SOME OF THE HOSPITAL'S LOSSES, THE PROGRAM'S LIMITED DURATION MEANS THAT IT WILL NOT SERVE AS A LONG-TERM SOLUTION TO THE HOSPITAL'S CHRONIC MEDI-CAL PAYMENT SHORTFALLS. CHARITY CARE IN KEEPING WITH OUR MISSION, CHILDREN'S HOSPITAL CONTINUES TO ACCEPT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2012, CHILDREN'S HOSPITAL PROVIDED $102,000 IN CHARITY CARE. THE AMOUNT REPRESENTS COSTS ASSOCIATED WITH PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES IN RELATION TO THE COST OF THESE SERVICES. CHARITY CARE INCLUDES COUNTY INDIGENT AND FREE CARE, WHICH IS BASED ON THE PATIENT'S INABILITY TO PAY FOR SERVICES. IN ORDER TO ASSIST FAMILIES WITH ONGOING CARE NEEDS, CHILDREN'S HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES PATIENT FAMILIES TO APPLY FOR APPROPRIATE GOVERNMENT FUNDING IN CONJUNCTION WITH APPLYING FOR FINANCIAL ASSISTANCE (CHARITY CARE). AS A RESULT, MANY FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS AND DO NOT ULTIMATELY REQUIRE CHARITY CARE. THE HOSPITAL'S CHARITY CARE AMOUNT IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 942797447 PHILANTHROPY/FUNDRAISING FOR THE HOSPITAL CA 501(C)(3) 11 TYPE I N/A 0 SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA 9300 VALLEY CHILDRENS PLACE MADERA CA 93636 770450620 MEDICAL GROUP CA N/A C 41862362 5931391 1.00000 0 0 1 0 0 0 0 0 0 0 1 1 1 1 0 1 0 0 CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION C 2651665 CASH VALUE SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA K 1114664 CASH VALUE SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA L 14099527 CASH VALUE