2024-05-14T06:08:11-05:00 2023-06-30 366055558 GRANT THORNTON LLP 1000 WILSON BLVD SUITE 1500 ARLINGTON VA 22209 990 2022-07-01 530196580 CHILDREN'S HOSPITAL CHIL 3015723502 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 ALDWIN LINDSAY CFO 3015723502 2024-05-13 1 ALDWIN LINDSAY 0 MARY TORRETTA P00847851 7038477500 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CHILDREN'S NATIONAL HOSPITAL MICHELLE RILEY-BROWN MHA 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 1629055873 0 X WWW.CHILDRENSNATIONAL.ORG X 1870 DC SEE SCHEDULE O. 11 10 9441 1114 1604416 0 66496859 53753566 1373049864 1502472344 7791262 7449655 -1631298 -1443634 1445706687 1562231931 0 0 0 0 834429360 874349566 0 0 0 581978911 643588868 1416408271 1517938434 29298416 44293497 2196591270 2228485013 1380604530 1366024806 815986740 862460207 X SEE SCHEDULE O. 0 0 1144806009 1490316318 CHILDREN'S HOSPITAL DBA CHILDREN'S NATIONAL HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER DBA CHILDREN'S NATIONAL IS THE PARENT COMPANY OF THE HOSPITAL. CHILDREN'S NATIONAL AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE H, PART VI FOR COMPLETE FY23 COMMUNITY BENEFIT REPORT. 1144806009 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 1 1 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 1 1 0 0 1 779 0 1 9441 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X CORPORATE OFFICERS 3015723502 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 KURT D NEWMAN MD PRESIDENT / CEO (CNMC) TO 06/23 43.00 12.00 X X 2973754 0 52949 AMY FREEMAN BOARD CHAIRMAN 2.00 1.00 X X 0 0 0 PAUL KALB MD BOARD VICE CHAIRMAN 1.00 0.00 X X 0 0 0 MARY GEN LEDECKY BOARD MEMBER 1.00 0.00 X 0 0 0 ARTENCIA HAWKINS-BELL BOARD MEMBER 1.00 0.00 X 0 0 0 HORACIO ROZANSKI BOARD MEMBER 2.00 4.00 X 0 0 0 AMANDA LELAND BOARD MEMBER 1.00 0.00 X 0 0 0 JERRY STOUCK BOARD MEMBER 1.00 0.00 X 0 0 0 IVY WAFFORD DUKE BOARD MEMBER 1.00 0.00 X 0 0 0 ELLIE HAMBURGER MD BOARD MEMBER FROM 7/22 1.00 0.00 X 0 0 0 MARSHA REGENSTEIN BOARD MEMBER FROM 7/22 1.00 2.00 X 0 0 0 ALDWIN LINDSAY EVP/CFO 37.00 18.00 X 1068278 0 124440 MARY ANNE HILLIARD EVP/CHIEF LEGAL OFFICER 38.00 17.00 X 944536 0 109508 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 45.00 10.00 X 1728225 0 203233 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 52.00 3.00 X 1337573 0 163270 DAVID WESSEL MD CHIEF MEDICAL OFFICER 54.00 1.00 X 1271732 0 83599 DEANN MARSHALL PRESIDENT OF FOUNDATION 1.00 54.00 X 1008716 0 52819 ROGER PACKER MD SVP CENTER OF EXCELLENCE TO 3/23 53.00 2.00 X 1002589 0 46798 CHARLES WEINSTEIN CHIEF REAL ESTATE OFFICER 54.00 1.00 X 907254 0 44366 MICHELLE M MCGUIRE CHIEF STRATEGY OFFICER 54.00 1.00 X 818934 0 129748 NATHANIEL BEERS MD PRESIDENT OF HSC 1.00 54.00 X 821699 0 120412 CATHERINE CODISPOTI MD CHIEF PEOPLE OFFICER 54.00 1.00 X 821117 0 46293 MATTHEW MACVEY CHIEF INFO OFFICER 54.00 1.00 X 712158 0 129890 VITTORIO GALLO PHD CHIEF RESEARCH OFFICER 15.00 40.00 X 785775 0 25913 LINDA TALLEY CHIEF NURSING OFFICER 54.00 1.00 X 702536 0 101273 ELIZABETH WELLS SVP CENTER OF EXCELLENCE FROM 3/23 54.00 1.00 X 557270 0 50375 YVES D'UDEKEM D'ACOZ MD CHIEF OF CARDIO SURGERY 55.00 0.00 X 2146984 0 45675 ROBERT KEATING MD CHIEF OF NEUROSURGERY 55.00 0.00 X 1337672 0 130280 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 55.00 0.00 X 1144904 0 44128 RICARDO MUNOZ MD CHIEF OF CARDIAC CRITICAL CARE 55.00 0.00 X 1120177 0 88259 RAHUL SHAH MD SVP, HOSPITAL-BASED SPECIALTIES 54.00 1.00 X 1048832 0 109728 MARK L BATSHAW MD FMR EVP & CHIEF ACADEMIC OFFICER 53.00 2.00 X 761072 0 162760 DARRYL VARNADO PHD FMR CHIEF PEOPLE OFFICER 54.00 1.00 X 226437 0 23876 DENICE CORA-BRAMBLE MD FMR CHIEF MEDICAL OFFICER 54.00 1.00 X 305556 0 56381 25553780 0 2145973 2706 1 1 0 CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY MO 64117 INFORMATION TECHNOLOGY 49451266 PRESIDIO NETWORKED SOLUTIONS LLC PO BOX 822169 PHILADELPHIA PA 19182 INFORMATION TECHNOLOGY 3529340 TAG B VALET PARKING LLC 15 LEWIS STREET HARTFORD CT 06103 PARKING 2605926 BRSI LP 1111 NORTH LOOP WEST SUITE 1000 HOUSTON TX 77008 HEALTH CARE SERVICES 2354423 MORRISON MANAGEMENT SPECIALISTS INC 5801 PEACHTREE DUNWOODY RD ATLANTA GA 30342 PURCHASED FOOD SERVICES 2289858 174 32206442 12012446 9534678 495933 53753566 PATIENT REVENUE 621400 1389308992 1389308992 ALL OTHER PROGRAM SERV 900099 113163352 113163352 1502472344 7916337 7916337 411950 411950 3743350 0 3743350 3743350 3743350 63949995 2407265 64655287 2168655 -705292 238610 -466682 -466682 PARKING 812390 4952676 4952676 LAB FEES 621500 1604416 1604416 PARTNERSHIP LOSS 621110 -12156026 -12156026 -5598934 1562231931 1490316318 1604416 16557631 14818486 635689 14182797 849244 113365 735879 715694258 525943308 189750950 27035944 19468583 7567361 68783257 49530823 19252434 47168377 33965948 13202429 3641548 2622279 1019269 2032395 2032395 535954 535954 431686 310857 120829 118209689 85470143 32739546 6375755 4591181 1784574 14727548 10605641 4121907 84073526 60541346 23532180 31151186 22431969 8719217 2813149 2025749 787400 1114226 802354 311872 28687803 20658087 8029716 100970142 72708599 28261543 23278790 16763057 6515733 MEDICAL SUPPLIES 163141903 163141903 BAD DEBT EXPENSE 26932186 26932186 REPAIRS & MAINTENANCE 25064497 18048944 7015553 DUES & MEMBERSHIPS 3511703 2528777 982926 6895182 4965221 1929961 1517938434 1144806009 373132425 0 101393747 69359836 1727000 3728298 339101037 337220959 50000 13488520 15045348 79811336 74611724 1805285510 1028908457 799055245 776377053 217649301 270094021 12050193 11637332 632314891 670360442 2196591270 2228485013 242323782 231904646 5036712 6394536 360432528 350214726 352480046 352030242 420331462 425480656 1380604530 1366024806 X 815986740 862460207 815986740 862460207 2196591270 2228485013 X 44293497 19052355 -16872385 X 0 1 X 1 1 1 X 24932071 85105614 58540048 66496859 53753566 288828158 24932071 85105614 58540048 66496859 53753566 288828158 288828158 5535245 7995875 11995360 13818827 12071637 51416944 4441568 4528932 3800400 4254430 4952676 21978006 362223108 6447015267 0.79740 0.80610 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: PARKING - 2018 AMOUNT: $ 4,441,568. 2019 AMOUNT: $ 4,528,932. 2020 AMOUNT: $ 3,800,400. 2021 AMOUNT: $ 4,254,430. 2022 AMOUNT: $ 4,952,676. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 0 0 0 1 481907 0 1 54057 535964 0 SCHEDULE C, PART II-B, LINE 1A: VOLUNTEERS COORDINATED THE PARTICIPATION OF THE PATIENT FAMILIES IN THE CHILDREN'S HOSPITAL ASSOCIATION FAMILY ADVOCACY DAY FOCUSED PRIMARILY ON PROTECTING HEALTH CARE SERVICES FOR CHILDREN. SCHEDULE C, PART II-B, LINE 1B: PAID STAFF OR MANAGEMENT FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS AND ADVANCE PUBLIC POLICY THAT SUPPORT THE HEALTH AND WELL-BEING OF CHILDREN. SCHEDULE C, PART II-B, LINE 1G: DIRECT CONTACT THE LOBBYING ACTIVITIES ENGAGED IN BY CHILDREN'S HOSPITAL FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR CHILDREN IN PUBLIC HEALTH PROGRAMS AND ADVANCE PUBLIC POLICY THAT SUPPORTS THE HEALTH AND WELL-BEING OF CHILDREN. THOSE LOBBYING ACTIVITIES INCLUDE CONTINUAL MONITORING OF LEGISLATION VIA DISCUSSIONS WITH LEGISLATIVE STAFF, HOSTING EDUCATIONAL BRIEFING SESSIONS FOR MEMBERS OF CONGRESS, EXECUTIVE BRANCH, STATE AND LOCAL OFFICIALS/STAFF REGARDING CHILD HEALTH ISSUES, AND COORDINATING THE SUBMISSION OF CORRESPONDENCE AND WRITTEN COMMENTS ON PROPOSED LEGISLATION AND REGULATIONS, AS WELL AS THE PRESENTATION OF TESTIMONY BEFORE LEGISLATIVE COMMITTEES. CHILDREN'S HOSPITAL ALSO DEVELOPS POLICY POSITIONS IN RESPONSE TO PROBLEMS AND OPPORTUNITIES IN THE PUBLIC SECTOR. SCHEDULE C, PART II-B, LINE 1I: OTHER ACTIVITIES THE HOSPITAL IS A MEMBER OF THE CHILDREN'S HOSPITAL ASSOCIATION (CHA), AMERICAN HOSPITAL ASSOCIATION (AHA), DISTRICT OF COLUMBIA HOSPITAL ASSOCIATION (DCHA), MARYLAND HOSPITAL ASSOCIATION (MHA) AND VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION (VHHA). ALL OF THE INDUSTRY ASSOCIATIONS THAT THE HOSPITAL IS A MEMBER OF HAVE CHILD ADVOCACY AND LEGISLATIVE ADVOCACY PROGRAMS. 22186326 22186326 349402374 97359248 252043126 937565509 682850552 254714957 375993843 244215764 131778079 120137458 4482893 115654565 776377053 DUE FROM AFFILIATES 544762337 OPERATING ROU ASSETS 121267295 DEFERRED COMPENSATION PLAN 4330810 670360442 FINANCE LEASE OBLIGATIONS 157147609 RESERVE FOR CLAIMS 129292630 OPERATING LEASE OBLIGATIONS 71618257 OTHER LIABILITIES 61816503 DUE TO AFFILIATES 4085010 SETTLEMENTS TO THIRD PARTY PAY 1520647 425480656 X PART X, LINE 2: LIABILITY FOR UNCERTAIN TAX POSITIONS (ASC 740) FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL), OF WHICH CHILDREN'S NATIONAL HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: CHILDREN'S NATIONAL EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THERE WAS NO IMPACT ON CHILDREN'S NATIONAL'S FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2023 AND 2022 AS CHILDREN'S NATIONAL HAS NO UNCERTAIN TAX POSITIONS. MIDDLE EAST AND NORTH AFRICA 0 1 PROGRAM SERVICES PATIENT REFERALS 987409 CENTRAL AMERICA AND THE CARIBBEAN 0 0 PROGRAM SERVICES INSRUANCE PREMIUMS 17474683 0 1 0 0 0 1 18462092 0 18462092 0 0 0 0 0 0 PART III ACCOUNTING METHOD: PART I, LINE 3, COLUMN F: ACCOUNTING METHOD USED THE EXPENDITURES, PER REGION, ARE PRESENTED ON THE ACCRUAL BASIS OF ACCOUNTING. 1 1 1 X 400.000000000000 1 X 1 1 0 1 1 7613697 7613697 0.00510 763509119 618053207 145455912 0.09760 771122816 618053207 153069609 0.10270 101024 6209635 2364604 3845031 0.00260 1448 57466282 7709695 49756587 0.03340 11862661 8465619 3397042 0.00230 3041 1206928 1206928 0.00080 105513 76745506 18539918 58205588 0.03910 105513 847868322 636593125 211275197 0.14180 66084 66084 0.00000 3 77667 77667 0.00010 4973 4973 0.00000 548 838433 40531 797902 0.00050 551 987157 40531 946626 0.00060 1 26932186 310000 2138139 2348671 -210532 X 1 1 1 1 CHILDREN'S HOSPITAL 111 MICHIGAN AVE NW WASHINGTON DC 20010 WWW.CHILDRENSNATIONAL.ORG HFD01-0208 X X X X X X X X CHILDREN'S HOSPITAL 1 0 0 1 X X X X X X X X X X 22 1 1 0 1 X WWW.CHILDRENSNATIONAL.ORG X X 1 22 1 WWW.CHILDRENSNATIONAL.ORG 0 1 X 400.000000000000 400.000000000000 X X X X 1 1 X X X X 1 X WWW.CHILDRENSNATIONAL.ORG X WWW.CHILDRENSNATIONAL.ORG X WWW.CHILDRENSNATIONAL.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B, LINE 3J: CHILDREN'S NATIONAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN PARTNERSHIP WITH THE HSC HEALTH CARE SYSTEM IN 2022. PRIOR ASSESSMENTS (2013, 2016 AND 2019) WERE CONDUCTED IN COLLABORATION WITH THE DC HEALTH MATTERS COLLABORATIVE, A COALITION OF WASHINGTON, D.C., HOSPITALS AND COMMUNITY HEALTH CENTERS THAT ENVISION AN EQUITABLE AND SUSTAINABLE STATE OF HEALTH FOR ALL DISTRICT OF COLUMBIA RESIDENTS. THIS 2022 CHNA IS DIFFERENT FROM OUR PRIOR ASSESSMENTS AS IT FOCUSES SPECIFICALLY ON CHILDREN, IS AN ASSESSMENT OF CHILDREN'S NATIONAL AND HSC'S PRIMARY SERVICE AREA (PSA) WHICH INCLUDES WASHINGTON, D.C., AND PARTS OF MARYLAND, AND APPLIES A STRONGER PEDIATRIC HEALTH EQUITY LENS BY UTILIZING THE CHILD OPPORTUNITY INDEX (COI). THE COI DEFINES OPPORTUNITY AS THE NEIGHBORHOOD RESOURCES THAT MATTER FOR A CHILD'S HEALTHY DEVELOPMENT. THE 29 INDICATORS FOCUS ON NEIGHBORHOOD FEATURES SUCH AS ACCESS TO HEALTHY FOOD, HIGH-QUALITY EDUCATION, PARKS AND PLAYGROUNDS. EACH NEIGHBORHOOD IS ASSIGNED A SCORE RANGING FROM 1 TO 100 TO INDICATE THE OPPORTUNITY IN THAT SPECIFIC NEIGHBORHOOD FOR CHILDREN TO REACH THEIR POTENTIAL. THE HIGHER THE SCORE, THE BETTER THE OPPORTUNITY A CHILD HAS TO DEVELOP IN A HEALTHY MANNER. THE COI HIGHLIGHTS THE INTERPLAY BETWEEN PLACE-AND RACE-BASED INEQUITIES AS LOW OPPORTUNITY NEIGHBORHOODS ARE OFTEN DISPROPORTIONATELY HOME TO CHILDREN OF COLOR.OUR CHNA FINDINGS REVEALED THAT CHILD OPPORTUNITY VARIES CONSIDERABLY WITHIN OUR SERVICE AREA. CHILD OPPORTUNITY IS LOWEST AND CRITICALLY LACKING IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS CERTAIN PRINCE GEORGE'S COUNTY NEIGHBORHOODS IN MARYLAND. IN ADDITION TO THE QUANTITATIVE DATA, WE IMPLEMENTED MANY COMMUNITY ENGAGEMENT EFFORTS TO GATHER QUALITATIVE DATA. WE INVITED RESIDENTS FROM OUR COMMUNITY, SPECIFICALLY THE NEIGHBORHOODS WE IDENTIFIED WITH THE LOWEST OPPORTUNITY SCORES, TO SHARE THEIR EXPERIENCES ON OPPORTUNITY IN THEIR COMMUNITIES. WE ENGAGED WITH YOUTH, PARENTS AND OLDER ADULTS IN OUR COMMUNITIES THROUGH VIRTUAL CONVERSATIONS, INPUT FORMS AND INTERVIEWS TO FURTHER INFORM OUR FINDINGS AND RECOMMENDATIONS SPECIFICALLY RELATED TO EDUCATION, HEALTH, AND ECONOMIC CONDITIONS. TO ELEVATE THE VOICE OF OUR YOUTH IN THIS ASSESSMENT, WE CREATED AN EIGHT-WEEK PHOTOVOICE PROGRAM TAILORED TO ADOLESCENTS. THE STUDENTS WERE ASKED TO USE THEIR CELL PHONES TO CAPTURE IMAGES THAT SHOWED THE ASSETS AND CHALLENGES THAT IMPACT HEALTH IN THEIR COMMUNITIES. THEY WORKED WITH THE FACILITATORS TO LEARN HOW TO USE THEIR VOICES TO PROMOTE POSITIVE CHANGE IN THEIR NEIGHBORHOODS. THE FOUR INDICATORS THAT SCORED AS THE HIGHEST PRIORITY INDICATORS ARE (1) EARLY CHILDHOOD EDUCATION, (2) HEALTH INSURANCE COVERAGE, (3) HEALTHY FOOD AND (4) EMPLOYMENT RATE. PART V, SECTION B, LINE 5: IN CONDUCTING THE MOST RECENT CHNA, CHILDREN'S NATIONAL CONSIDERED INPUT FROM COMMUNITY RESIDENTS, STAKEHOLDERS INCLUDING LEADERS IN HEALTHCARE AND COMMUNITY-BASED ORGANIZATIONS AND BUSINESS AND GOVERNMENT OFFICIALS INCLUDING THE DC HOSPITAL ASSOCIATION, PRINCE GEORGE'S COUNTY CHAMBER OF COMMERCE, DC PRIMARY CARE ASSOCIATION, CHILDREN'S LAW CENTER AND THE DC HEALTH MATTERS COLLABORATIVE. THROUGH OUR QUALITATIVE WORK WE HEARD FROM OVER 300 STAKEHOLDERS. WE CONDUCTED ELEVEN 60-MINUTE, VIRTUAL COMMUNITY CONVERSATIONS WITH 67 PARENTS AND CAREGIVERS LIVING IN THE PREVIOUSLY IDENTIFIED NEIGHBORHOODS WITH THE LOWEST OPPORTUNITY FOR CHILDREN IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS PRINCE GEORGE'S COUNTY, MD. THREE OF THE 11 COMMUNITY CONVERSATIONS WERE HELD IN SPANISH. THESE CONVERSATIONS PROVIDED PERSPECTIVES FROM NEIGHBORHOOD RESIDENTS ON HOW THEY VIEW THE IMPACT OF NEIGHBORHOOD CONDITIONS - SPECIFICALLY RELATED TO EDUCATION, HEALTH, AND ECONOMIC CONDITIONS - ON A CHILD'S OPPORTUNITY TO LIVE A HEALTHY AND PRODUCTIVE LIFE. WE CONDUCTED 33 KEY INFORMANT INTERVIEWS WITH A WIDE RANGE OF PEOPLE - INCLUDING COMMUNITY LEADERS, GOVERNMENT LEADERS, AND RESIDENTS - WHO HAD FIRSTHAND KNOWLEDGE ABOUT THE COMMUNITY. WE ALSO ISSUED A COMMUNITY INPUT FORM AS A WAY FOR RESIDENTS WHO MAY NOT HAVE BEEN ABLE TO PARTICIPATE IN PREVIOUS CONVERSATIONS AND INTERVIEWS TO PROVIDE THEIR INPUT. WE RECEIVED FEEDBACK FROM 88 NEIGHBORHOOD RESIDENTS ON WHICH INDICATORS SHOULD BE A PRIORITY, WHAT FACTORS IMPACT OPPORTUNITIES IN THEIR NEIGHBORHOOD, AND HOW HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS CAN WORK TOGETHER TO MAKE IMPROVEMENTS IN THESE AREAS. IN ADDITION TO THE COMMUNITY INPUT FORM, WE RECEIVED FEEDBACK FROM 156 HOSPITAL STAFF VIA A HOSPITAL INPUT FORM TO GAIN THEIR PERSPECTIVE ON WHICH OF THE 29 COI INDICATORS WE SHOULD SELECT AS "PRIORITY INDICATORS" FOR THE 2022 CHNA. ONCE THE PRIORITIES WERE SELECTED, WE HOSTED FOUR ADDITIONAL COMMUNITY CONVERSATIONS WITH 26 PARENTS AND CAREGIVERS LIVING IN PRIORITY NEIGHBORHOODS TO IDENTIFY SPECIFIC STRATEGIES TO IMPROVE ACCESS TO EARLY CHILDHOOD EDUCATION, HEALTHY FOOD, HEALTH INSURANCE AND HEALTH SERVICES AND EMPLOYMENT. PART V, SECTION B, LINE 6A: THE CHNA WAS CONDUCTED WITH THE HSC HEALTH CARE SYSTEM (HSC). BASED IN WASHINGTON, D.C., CHILDREN'S NATIONAL AND HSC ARE COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE FOR CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH COMPLEX MEDICAL CONDITIONS. OUR GOAL IS TO PROVIDE COMPREHENSIVE, FAMILY-CENTERED CARE THAT MEETS OUR PATIENTS' PHYSICAL, EMOTIONAL, AND PSYCHOLOGICAL NEEDS. WE STRIVE TO CREATE AN ENVIRONMENT WHERE EVERY FAMILY FEELS INCLUDED, RESPECTED, AND SUPPORTED. OUR TEAM OF PHYSICIANS, NURSES, AND OTHER HEALTHCARE PROVIDERS WORK TOGETHER TO ENSURE THE BEST OUTCOMES FOR OUR PATIENTS. PART V, SECTION B, LINE 7D: THE CHNA IS LOCATED ON THE HOSPITAL WEBSITE. CHILDREN'S NATIONAL ALSO SHARED FINDINGS AND ANNOUNCEMENTS ABOUT THE CHNA WITH CHILDREN'S NATIONAL LEADERSHIP AND BOARD MEMBERS. WE ALSO SHARED OUR CHNA AND IMPLEMENTATION STRATEGY (COMMUNITY HEALTH IMPROVEMENT PLAN) DURING COMMUNITY EVENTS SUCH AS OUR CELEBRATING OUR PARTNERS EVENT HELD IN JUNE 2023. DURING THIS EVENT, WE GATHERED WITH OUR COMMUNITY PARTNERS AND PROVIDED AN OVERVIEW OF OUR CHNA AND CHIP AND HELD A DISCUSSION ON THE IMPORTANCE OF PARTNERSHIPS TO ADVANCE COMMUNITY HEALTH IMPROVEMENT EFFORTS.PART V, SECTION B, LINE 8:CHILDREN'S HOSPITAL ADOPTED AN IMPLEMENTATION STRATEGY IN NOVEMBER 2022, REFERRED TO AS THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE CHIP IS AVAILABLE AT: HTTPS://CHILDRENSNATIONAL.ORG/ADVOCACY-AND-OUTREACH/CHILD-HEALTH-ADVOCACY-INSTITUTE/COMMUNITY-AFFAIRS/IMPROVING-COMMUNITY-HEALTH. PART V, SECTION B, LINE 11: FROM THE INSIGHT GAINED FROM THE COI AND OUR UNDERSTANDING OF OUR COMMUNITY PERSPECTIVES, WE PARED DOWN THE 29 COI INDICATORS TO FOUR INDICATORS THAT WILL BE OUR HOSPITAL'S FOCUS FOR THE NEXT THREE YEARS. TO GET TO THESE FOUR INDICATORS, WE USED A PROCESS MODELED OFF A WIDELY USED PRIORITIZATION METHOD, CALLED THE HANLON METHOD. THE PRIORITIZATION EXERCISE SCORED EACH INDICATOR BASED ON THE IMPORTANCE TO OUR COMMUNITY, IMPORTANCE TO OUR HOSPITALS, HOSPITAL'S CAPACITY TO ADDRESS THE INDICATOR, ALIGNMENT WITH THE HOSPITAL'S MISSION, AND HOSPITAL'S EXISTING WORK IN THE AREA. THE FOUR INDICATORS THAT SCORED AS THE HIGHEST PRIORITY INDICATORS ARE EARLY CHILDHOOD EDUCATION, HEALTH INSURANCE COVERAGE, HEALTHY FOOD AND EMPLOYMENT RATE.THE CHNA IDENTIFIED MANY NEEDS IN OUR COMMUNITY, HOWEVER, DUE TO PRACTICAL AND RESOURCE CONSTRAINTS, THE ORGANIZATION FOCUSED ITS RESOURCES ON THE TOP NEEDS IN WHICH THE ORGANIZATION CAN BE IMPACTFUL.WITH A FOCUS ON THE HIGHEST PRIORITY INDICATORS, WE DEVELOPED AN IMPLEMENTATION STRATEGY THAT WE CALL A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IN WHICH WE OUTLINE ACTIONS AND IDENTIFY RESOURCES TO RESPOND TO THE ASSESSMENT FINDINGS OVER THE NEXT THREE YEARS. TO CREATE THE CHIP, WE ENGAGED WITH OUR HOSPITAL EMPLOYEES, LOCAL COMMUNITIES AND AREA ORGANIZATIONS TO SHARE THESE FINDINGS AND IDENTIFY POLICY AND SYSTEMS CHANGES THAT WILL IMPROVE OPPORTUNITY LEVELS FOR CHILDREN LIVING IN LOW OPPORTUNITY NEIGHBORHOODS. IN THE 2022 CHIP, ADOPTED BY OUR HOSPITAL BOARD IN NOVEMBER 2022, WE OUTLINE NINE STRATEGIES THAT USE A VARIETY OF TACTICS TO IMPROVE OPPORTUNITY FOR CHILDREN LIVING IN WARDS 7 AND 8 IN WASHINGTON, D.C. AND PRINCE GEORGE'S COUNTY, MARYLAND INCLUDING ADVOCACY EFFORTS AND PROGRAMS AND PRACTICE.1. EARLY CHILDHOOD EDUCATION GOAL: BUILD A STRONGER EARLY CHILDHOOD EDUCATION COMMUNITYADVOCACY: ADVOCATE FOR HIGH QUALITY, AFFORDABLE ECE CENTERS WITH WELL COMPENSATED STAFFPROGRAMS AND PRACTICE: STRENGTHEN CONNECTIONS BETWEEN ECE AND HOSPITALS ABOUT THE REFERRAL PROCESS (E.G., WHAT'S AVAILABLE, HOW TO ENROLL, REQUIREMENTS FOR VOUCHERS, HELPING FAMILIES WHO HAVE CHILDREN WITH DISABILITIES, MATERIALS IN MULTIPLE LANGUAGES, ETC.)2. HEALTHY FOODGOAL: INCREASE ACCESS TO HEALTHY FOOD OPTIONSADVOCACY: ADVOCATE FOR FUNDING AND IMPROVED ACCESS TO HEALTHY FOOD OPTIONS IN THE COMMUNITYPROGRAMS AND PRACTICE: INCREASE ACCESS TO HEALTHY FOOD OPTIONS WITHIN THE HOSPITAL AND COMMUNITY THROUGH THE HOSPITAL CAFETERIA, FOOD PHARMACIES, FARMERS MARKETS AND OTHER INITIATIVESEXPAND FOOD INSECURITY SCREENINGS TO DETERMINE ELIGIBILITY FOR ENROLLMENT IN FOOD ACCESS PROGRAMS 3. HEALTH INSURANCE COVERAGEGOAL: IMPROVE ACCESS TO HEALTH CARE AND HEALTH INSURANCE COVERAGEADVOCACY: ADVOCATE FOR HIGH QUALITY AND EASILY ACCESSIBLE MENTAL HEALTH SERVICE CONTINUUM INCLUSIVE OF SUSTAINABLE PROMOTION, PREVENTION, EARLY INTERVENTION, TREATMENT, CRISIS AND RECOVERY SERVICES COVERED BY INSURANCEPROGRAMS AND PRACTICE: IMPROVE CARE COORDINATION WITHIN THE HOSPITAL AND WITH INSURANCE PROVIDERS AND COMMUNITY ORGANIZATIONS.4. EMPLOYMENT RATEGOAL: STRENGTHEN EMPLOYMENT OPPORTUNITIESPROGRAMS AND PRACTICE: SUSTAIN AND EXPAND HOSPITAL RESEARCH YOUTH ENGAGEMENT PROGRAMS AND JOB OPPORTUNITIES (INTERNSHIPS, TRAININGS, AND RESEARCH OPPORTUNITIES)CREATE JOB OPPORTUNITIES FOR PEOPLE WITH DISABILITIES, INCLUDING PARTNERING WITH ORGANIZATIONS TO PROVIDE SKILL-BASED TRAINING. WE WILL PARTNER WITH LOCAL AND REGIONAL ORGANIZATIONS, LIKE HEALTH DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT THE STRATEGIES OF THE CHIP. WE ALSO HAVE AN INTERNAL CHIP STRUCTURE TO ENSURE THE SUCCESS OF OUR INVESTMENTS IN CHANGING POLICY, IMPROVING PROGRAMS AND ALLOCATING RESOURCES MORE EQUITABLY. AS PART OF THIS STRUCTURE, WE FORMED THE CHIP STEERING COMMITTEE (LAUNCHED IN FEBRUARY 2023) COMPRISED OF REPRESENTATIVES FROM ACROSS CHILDREN'S NATIONAL AND HSC THAT PROVIDES STRATEGIC DIRECTION FOR THE CHIP AND CHAMPIONS ITS WORK. WE ALSO HAVE WORKGROUPS (LAUNCHED IN MARCH 2023) FOR EACH PRIORITY AREA, COMPRISED OF REPRESENTATIVES FROM ACROSS CHILDREN'S NATIONAL AND HSC THAT PROVIDES SUBJECT MATTER EXPERTISE FOR THE CHIP AND LEAD THE ACTIVITIES ACROSS THE FOUR PRIORITY AREAS. WORKGROUPS ARE LED BY TWO CO-LEADS THAT DRIVE THE AGENDA, MONITOR PROGRESS, AND REPORT TO THE STEERING COMMITTEE. 22 1 - CHILDREN'S NAT'L AMBU SURGERY CTR 9850 KEY WEST AVENUE ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER 2 - CHILDREN'S OUTPATIENT CTR FREDERICK 5285 WESTVIEW DRIVE SUITE 103 FREDERICK MD 21703 REGIONAL OUTPATIENT CENTER 3 - MOBILE VAN - DENTAL N/A NA DC 20010 MOBILE HEALTH CARE 4 - CHILDREN'S HEALTH CENTER AT THEARC 1801 MISSISSIPPI AVE SE WASHINGTON DC 20020 HEALTH CENTERS 5 - CHILDREN'S OUTPATIENT CTR MONTGOMERY 15245 SHADY GROVE ROAD SUITE 350 ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER 6 - CHILDREN'S OUTPATIENT FREDRICKSBURG 1300 HOSPITAL DRIVE SUITE 201 FREDRICKSBURG VA 22401 REGIONAL OUTPATIENT CENTER 7 - CHILDREN'S NATIONAL IMAGING CENTER 9850 KEY WEST AVENUE SUITE 110 ROCKVILLE MD 20850 REGOINAL OUTPATIENT CENTER 8 - CHILDREN'S NATIONAL PULMONARY MED - R 9711 MEDICAL CENTER DRIVE SUITE 212 ROCKVILLE MD 20850 HEALTH CENTERS 9 - CHILDREN'S OUTPATIENT CTR HOWARD CITY 7625 MAPLE LAWN BLVD SUITE 230 FULTON MD 20759 REGOINAL OUTPATIENT CENTER 10 - FIGHT FOR CHILDREN SPORTS MED CTR 1 INVENTA PLACE SUITE 150 SILVER SPRING MD 20910 HEALTH CENTERS 11 - CHILDREN'S HEALTH CTR AT SHAW METRO 641 S STREET NW WASHINGTON DC 20001 HEALTH CENTERS 12 - CHILDREN'S HEALTH CTR AT WALTER REED 7125 13TH PLACE NW WASHINGTON DC 20012 HEALTH CENTERS 13 - CHILDREN'S OUTPATIENT CTR OF MONTGOMERY SHADY GROVE MEDICAL PARK ROCKVILLE MD 20850 REGIONAL OUTPATIENT CENTER 14 - CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 3023 HAMACKER COURT SUITE 300 FAIRFAX VA 22031 REGIONAL OUTPATIENT CENTER 15 - CHILDREN'S HEALTH CTR AT TAKOMA THEATRE 6833 4TH STREET NW WASHINGTON DC 20012 HEALTH CENTERS 16 - CHILDREN'S HEALTH CTR AT COLUMBIA HEI 3336 14TH STREET NW WASHINGTON DC 20010 HEALTH CENTERS 17 - CHILDREN'S HEALTH CENTER AT ANACOSTIA 2101 MARTIN LUTHER KING JR AVENUE SE WASHINGTON DC 20020 HEALTH CENTERS 18 - CHILDREN'S OUTPATIENT CTR PRINCE GEOR 2900 CAMPUS WAY NORTH LANHAM MD 20706 REGIONAL OUTPATIENT CENTER 19 - MOBILE VAN - HEALTH CARE N/A NA DC 20010 MOBILE HEALTH CARE 20 - CHILDREN'S OUTPATIENT CTR OF ANNAPOLIS 1730 WEST STREET SUITE 100 ANNAPOLIS MD 21401 REGIONAL OUTPATIENT CENTER 21 - CHILDREN'S NATIONAL EMERG DEPT UNIT 1310 SOUTHERN AVENUE SE1ST FLOOR WASHINGTON DC 20032 ED FACILITY 22 - CHILDREN'S OUTPATIENT CTR OF FRIENDSHIP 5028 WISCONSIN AVE SUITES 250 310 WASHINGTON DC 20016 REGIONAL OUTPATIENT CENTER PART I, LINE 3C: ELIGIBILITY FOR CHARITY CARE PROGRAMCHILDREN'S NATIONAL USED THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR ITS CHARITY CARE PROGRAM. ELIGIBILITY WAS INCOME BASED AND NOT ASSET BASED. PART I, LINE 6A: CHILDREN'S NATIONAL MEDICAL CENTER ANNUAL REPORTCHILDREN'S NATIONAL HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS POSTED ON THE HOSPITAL WEBSITE AND HARD COPIES ARE MADE AVAILABLE AND DISTRIBUTED TO THE HOSPITAL'S KEY INTERNAL AND EXTERNAL STAKEHOLDERS. AS PART OF OUR COMMITMENT TO THE COMMUNITY, BELOW ARE SOME OF THE PROGRAMS AND ACTIVITIES THAT WERE CONDUCTED IN FY 2023.SCHOOL-FRIENDLY HEALTH SYSTEMEDUCATION IS A CRITICAL SOCIAL DETERMINANT OF HEALTH FOR CHILDREN AND IMPACTS LONG-TERM HEALTH AND ECONOMIC OUTCOMES. HEALTH SYSTEMS HAVE DEMONSTRATED THE ABILITY TO HELP CHILDREN ACHIEVE FULFILLING LEARNING EXPERIENCES THAT CONTRIBUTE TO BETTER ACADEMIC OUTCOMES AND SUCCESS (E.G., DECREASED HEALTH RELATED ABSENCES, MORE ACCESSIBLE SERVICES AND IMPROVED CARE COORDINATION IN SCHOOL). CHILDREN'S NATIONAL IS LEADING AN INITIATIVE TO DEVELOP SCHOOL-FRIENDLY HEALTH CARE SYSTEM PRINCIPLES TO HELP HOSPITALS AND HEALTH SYSTEMS DELIVER BETTER CARE AND PATIENT EXPERIENCE THAT ENHANCE CHILDREN'S PROSPECTS FOR IMPROVED HEALTH AND ACADEMIC SUCCESS. A SCHOOL-FRIENDLY HEALTH SYSTEM IS A HEALTH SYSTEM WORKING TO ENSURE ALL CHILDREN ACHIEVE OPTIMAL HEALTH AND REACH THEIR FULL ACADEMIC POTENTIAL. THE CHILD HEALTH ADVOCACY INSTITUTE'S SCHOOL HEALTH TEAM LEADS THIS EFFORT THROUGH COLLABORATION AND PARTNERSHIPS WITH LOCAL SCHOOL DISTRICTS, GROUPS THAT SUPPORT SCHOOLS SUCH AS GOVERNMENT, COMMUNITY-BASED, AND ADVOCACY ORGANIZATIONS, ALONG WITH MULTIDISCIPLINARY PROFESSIONALS.THE SCHOOL HEALTH TEAM AIMS TO SUPPORT STUDENT AND SCHOOL WELLNESS THROUGH COORDINATION AND PARTNERSHIPS BETWEEN THE HEALTH AND EDUCATION SECTORS. COORDINATION AND PARTNERSHIPS ARE AT THE SYSTEM OR ORGANIZATIONAL LEVEL BETWEEN THE HOSPITAL, LOCAL SCHOOL DISTRICTS AND RELEVANT GROUPS THAT SUPPORT SCHOOLS (GOVERNMENT, COMMUNITY-BASED ORGANIZATIONS, AND ADVOCACY ORGANIZATIONS). WE ACCOMPLISH THIS THROUGH:- COMMUNICATION: WE STRIVE FOR COMMUNICATION AND DATA-SHARING BETWEEN SCHOOLS AND THE HEALTH SYSTEM TO IMPROVE INDIVIDUAL AND POPULATION HEALTH IN SCHOOLS.- COORDINATION: WE ALIGN OUR SCHOOL-BASED WORK WITH COMMUNITY NEEDS AND EDUCATIONAL SYSTEM GOALS TO IMPROVE POPULATION HEALTH IN SCHOOLS THROUGH POLICY, ADVOCACY AND EVIDENCE-BASED FRAMEWORKS.- EDUCATION: WE EDUCATE OUR HEALTHCARE SYSTEM ON ACADEMIC ISSUES, AND WE EDUCATE THE SCHOOL SYSTEM ON CHILD HEALTH ISSUES.- DATA-DRIVEN: WE USE PROGRAM EVALUATION AND COMMUNITY-WIDE DATA TO GUIDE ALL ASPECTS OF OUR WORK AND TO IDENTIFY GAPS AND NEEDS.IN FY 2023, THE SCHOOL HEALTH TEAM ACCOMPLISHED THE FOLLOWING:- FACILITATED THE SCHOOL HEALTH COLLABORATIVE AND SCHOOL HEALTH ADVISORY COMMITTEE WORKGROUPS REACHING OVER 100 STAFF FROM ACROSS THE HOSPITAL AND DISSEMINATED MONTHLY SCHOOL HEALTH CONNECTIONS NEWSLETTERS FOR CHILDREN'S NATIONAL STAFF AND EDUCATION PARTNERS REACHING MORE THAN 200 INDIVIDUALS TO SHARE INFORMATION ON REGIONAL SCHOOL HEALTH EFFORTS AND INCREASE COORDINATION OF HOSPITAL-WIDE SCHOOL-BASED EFFORTS.- LAUNCHED A NATIONAL SCHOOL-FRIENDLY HEALTH SYSTEMS LEARNING COLLABORATIVE THAT ENGAGED MORE THAN 40 LEADERS FROM EIGHT HEALTH CARE ORGANIZATIONS AND PARTNERS TO UPDATE THE FRAMEWORK AND PRODUCE CASE EXAMPLES TO HELP DELIVER BETTER CARE AND PATIENT EXPERIENCE.- LED THE COLLABORATIVE FOR ATTENDANCE RESOURCES IN EDUCATION AND HEALTH (CARE-H) PROGRAM IN DISTRICT OF COLUMBIA PUBLIC SCHOOLS (DCPS) TO IMPROVE SCHOOL ATTENDANCE. THROUGH THIS EFFORT, CHILDREN'S NATIONAL LEADS A DATA-SHARING PARTNERSHIP WITH DC PUBLIC SCHOOLS SO THAT PILOT PRACTICES CAN RECEIVE STUDENT ATTENDANCE DATA FOR THEIR PATIENTS WHEN PARENTS CONSENT TO SHARING ATTENDANCE DATA. PRACTICES PROVIDE OUTREACH AND SUPPORT TO FAMILIES WHO ARE STRUGGLING WITH SCHOOL ATTENDANCE. THE PROGRAM HAS REACHED 14 PILOT SCHOOLS AND THREE PEDIATRIC PRACTICES, WHICH PROVIDED OVER 4000 MINUTES OF OUTREACH SUPPORT TO FAMILIES AND 98 REFERRALS TO MEDICAL AND SOCIAL RESOURCES TO SUPPORT SCHOOL ATTENDANCE. THE CARE-H PROGRAM ALSO CONVENED A NATIONAL ATTENDANCE DATA SHARING LEARNING COLLABORATIVE WITH MORE THAN 50 MEMBERS FROM 17 ORGANIZATIONS WITH 12 MEETINGS HELD SINCE 2021.- CONVENED MONTHLY STAKEHOLDER MEETINGS WITH DCPS AND SCHOOL HEALTH PARTNERS TO DISCUSS STRATEGIES TO INCREASE IMMUNIZATION RATES AND ADDRESS CRITICAL HEALTH AND EDUCATION CHALLENGES.- CONVENED A SCHOOL HEALTH POLICY COMMITTEE TO MONITOR THE POLICY LANDSCAPE LOCALLY AND AT THE FEDERAL LEVEL AND USE ADVOCACY AS A LEVER TO IMPROVE STUDENT HEALTH AND ACADEMIC OUTCOMES IN THE REGION AND NATIONALLY.RESOURCES AND SUPPORTS FOR PATIENTS WITH SICKLE CELL DISEASESICKLE CELL DISEASE AFFECTS APPROXIMATELY ONE IN EVERY 365 AFRICAN AMERICAN CHILDREN AND ONE IN EVERY 16,300 HISPANIC AMERICAN CHILDREN, MAKING IT THE MOST COMMONLY DIAGNOSED DISEASE IN NEWBORN SCREENINGS. CHILDREN'S NATIONAL TREATS NEARLY 1,400 CHILDREN A YEAR, MAKING US AMONG THE LARGEST SICKLE CELL PROGRAMS IN THE COUNTRY.ANNUALLY, HEMATOLOGY STAFF HOSTS A SICKLE CELL FAMILY EDUCATION SYMPOSIUM. THROUGH THE SYMPOSIUM, THE TEAM RAISES AWARENESS ABOUT SICKLE CELL DISEASE WITHIN THE BROADER COMMUNITY; PROVIDES FAMILIES WITH INFORMATION ABOUT SYMPTOMS, TREATMENTS, AND MANAGEMENT STRATEGIES; OFFERS SUPPORT AND FACILITATES CONNECTIONS BETWEEN FAMILIES; AND ENCOURAGES FAMILIES TO BE ADVOCATES. IN FY 2023, THE SYMPOSIUM HAD 50 PARTICIPANTS.CHILDREN'S NATIONAL ALSO PARTNERS WITH NEXT STEP TO CONDUCT STRIVE DC, A MENTORING AND ADVOCACY PROGRAM FOR TEENS THAT ARE LIVING WITH SICKLE CELL DISEASE. THROUGH THIS PROGRAM, TEENS BETWEEN THE AGES OF 13 TO 18 YEARS OF AGE RECEIVE HOMEWORK ASSISTANCE FROM LOCAL COLLEGE STUDENTS, GO ON FIELD TRIPS, AND LEARN FROM EACH OTHER. THE SICKLE CELL TEAM ALSO LEADS A SUPPORT GROUP FOR PARENTS. IN FY 2023, TWENTY PARENTS PARTICIPATED IN THE SUPPORT GROUP, SHARING STORIES AND ADVICE WITH EACH OTHER.COMMUNITY AWARENESS AND EDUCATIONFALLS CONTINUE TO BE THE NUMBER ONE MECHANISM OF INJURY SEEN AT CHILDREN'S NATIONAL IN FY 2023. THE DEPARTMENT OF TRAUMA AND BURN SURGERY AT CHILDREN'S NATIONAL IS EDUCATING THE COMMUNITY THROUGH THE IMPLEMENTATION OF A SOCIAL MEDIA CAMPAIGN FOCUSED ON THE PREVENTION OF FALL INJURIES. THROUGH THIS 3-YEAR INITIATIVE, THE TEAM HAS CREATED VIDEOS PROVIDING TIPS ON HOW TO DECREASE THE RISK OF FALL-RELATED INJURIES. IN FY 2023, THERE WERE OVER 130,000 TOTAL VIEWS OF VIDEOS WITH 103,000 OF THOSE VIEWING THE ENTIRE AD. OVER 36,000 PARENTS VIEWED THE VIDEOS.CHILDREN'S NATIONAL STAFF PARTNERS WITH LOCAL MEDIA OUTLETS TO BRING AWARENESS TO IMPORTANT HEALTH-RELATED TOPICS. OVER THE SUMMER, OUR LOCAL COMMUNITY EXPERIENCED BAD AIR QUALITY DUE TO THE CANADIAN WILDFIRES. THERE WERE MANY QUESTIONS FROM OUR COMMUNITY AND STAFF FROM OUR DIVISION OF EMERGENCY MEDICINE PROVIDED INFORMATION THROUGH MEDIA INTERVIEWS. COMMUNITY MEMBERS WERE INFORMED ON WAYS TO STAY SAFE AND WHEN THOSE WITH ASTHMA SHOULD RECEIVE CARE FROM THEIR PRIMARY CARE PROVIDER OR EMERGENCY DEPARTMENT.THE CHILDREN'S NATIONAL CHILD AND ADOLESCENT PROTECTION CENTER IS THE ONLY MEDICAL CENTER IN THE DISTRICT OF COLUMBIA WITH A TEAM OF HEALTH PROFESSIONALS DEDICATED TO THE VICTIMS AND SURVIVORS OF CHILD ABUSE AND THEIR FAMILIES. OUR PHYSICIANS AND STAFF CONDUCT LECTURES AND LEARNING SESSIONS TO EDUCATE THE LOCAL COMMUNITY ON THE EFFECTS OF CHILD ABUSE, INCLUDING IDENTIFICATION, TREATMENT AND PREVENTION. THE CENTER HOSTED THE DC REGIONAL ACADEMY ON FAMILY VIOLENCE: GENERATIONAL TRAUMA-BREAKING THE CYCLE IN MAY 2023. A HYBRID EVENT (IN-PERSON AND ZOOM) INCLUDED SESSIONS ON INFANT MENTAL HEALTH, THE STORIES OF MALE SURVIVORS OF SEXUAL TRAUMA, AND REDUCING HARM AND EXAMINING BIAS IN MANDATED REPORTING. OVER 100 PEOPLE PARTICIPATED IN THE SYMPOSIUM.ADVOCACY EDUCATION (HEALTH PROFESSIONS EDUCATION)AS PART OF CHILDREN'S NATIONAL HOSPITAL'S CARE MISSION TO EXCEL IN CARE, ADVOCACY, RESEARCH AND EDUCATION, THE CHILD HEALTH ADVOCACY INSTITUTE (CHAI) STRIVES TO TEACH STUDENTS, RESIDENTS, FELLOWS, FACULTY, AND OTHER STAFF THE MOST EFFECTIVE METHODS TO BECOME CHILD HEALTH ADVOCATES. THE CHAI PROVIDES EDUCATION AND EXPOSURE TO ADVOCACY OPPORTUNITIES AT THE INDIVIDUAL, COMMUNITY AND LEGISLATIVE LEVELS. 66 RESIDENTS AND OTHER STAFF PARTICIPATED IN THE FOLLOWING ACTIVITIES IN FY2023: MOVING COMMUNITY CONVERSATIONS (COMMUNITY BUS TRIP) - FIRST-YEAR PEDIATRIC RESIDENTS ARE PROVIDED A DEEPER UNDERSTANDING OF HOW SOCIAL DETERMINANTS OF HEALTH CONTRIBUTE TO HEALTH DISPARITIES. RESIDENTS TAKE A SCRIPTED ROUTE THROUGH WARDS 7 AND 8 AND COLUMBIA HEIGHTS (WARD 1) TO LEARN ABOUT COMMUNITY CHARACTERISTICS, BARRIERS THAT THEIR PATIENTS AND FAMILIES MAY EXPERIENCE AS WELL AS SOME COMMUNITY ASSETS THAT CAN HELP BUILD RESILIENCE AND PROMOTE GOOD HEALTH OUTCOMES. THE BUS TRIP ALSO EDUCATES PEDIATRIC RESIDENTS ON THE FINDINGS IN THE CHNA, THE STRATEGIES IN THE CHIP, AND THE RESOURCES IN THE COMMUNITY TO ADDRESS THE CHIP PRIORITY AREAS.INTERN ADVOCACY DAY - EMBEDDED IN THE CURRICULUM FOR FIRST-YEAR PEDIATRIC RESIDENTS AND OFFERED TO SENIOR RESIDENTS, FELLOWS, FACULTY, AND ALL STAFF, THIS YEAR-ROUND PROGRAM PROMOTES COMMUNITY-BASED LEARNING IN ADVOCACY AND FOOD INSECURITY. PARTICIPANTS SPEND A DAY VOLUNTEERING AT THE CAPITAL AREA FOOD BANK'S COMMUNITY GARDEN OR DISTRIBUTION CENTER, UNDERGO A FOOD INSECURITY SIMULATION ACTIVITY WHILE LEARNING HOW TO BEST CONNECT FAMILIES TO LOCAL RESOURCES, AND REFLECT ON THEIR PROFESSIONAL ROLE IN ADVOCACY. PARTICIPANTS DEMONSTRATE IMPROVED KNOWLEDGE OF ADVOCACY AND IMPROVED ADVOCACY-RELATED SELF-EFFICACY. THIS PROGRAM IS PARTICULARLY VALUABLE AS ACCESS TO HEALTHY FOOD IS ONE OF OUR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PRIORITY AREAS. PART I, LINE 7A: CHARITY AT COSTHOSPITAL AND PHYSICIAN CHARITY AMOUNTS REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS. PART I, LINE 7B:MEDICAIDHOSPITAL AND PHYSICIAN GROSS PATIENT REVENUE AND PAYMENT FROM FINANCIAL DECISION SUPPORT SYSTEMS WERE ADJUSTED TO COST USING THE COST TO CHARGES RATIO PER THE IRS INSTRUCTIONS. MEDICAID GRADUATE MEDICAL EDUCATION (GME) ADD-ON PAYMENTS WERE EXCLUDED AS THEY ARE REPORTED ON THE HEALTH EDUCATION LINE. CHILDREN'S NATIONAL GME INDIRECT MEDICAL EDUCATION (IME) PAYMENTS WERE INCLUDED AS PER 990 INSTRUCTIONS.PART I, LINE 7F:HEALTH EDUCATIONTHE HEALTH EDUCATION COST INCLUDES THE TOTAL COST OF INTERNS AND RESIDENTS FROM THE FY23 SUBMITTED MEDICARE COST REPORT. EDUCATION PAYMENTS AND RESIDENT FUNDING AMOUNTS OFFSET THE REPORTED EXPENSE. DC MEDICAID GME PAYMENTS WERE CALCULATED AND DEDUCTED FROM TOTAL MEDICAID PAYMENTS TO BE REPORTED ON THE LINE FOR HEALTH EDUCATION (PART I, LINE 7B).PART I, LINE 7G:SUBSIDIZED HEALTH SERVICESTHE HOSPITAL AND PHYSICIAN COMBINED SERVICE LINES FOR PROGRAMS IN UNDERSERVED AREAS WITH LOSSES WERE REPORTED AS SUBSIDIZED HEALTH SERVICES. TOTAL CHARGES WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO BASED ON THE IRS INSTRUCTIONS. THE CLAIMS PAYMENTS WERE NETTED AGAINST THE COST.COSTS ATTRIBUTABLE TO A PHYSICAL CLINIC:SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. THE SERVICES ARE PROVIDED DESPITE THE FINANCIAL LOSS TO MEET THE IDENTIFIED AND UNMET NEEDS OF THE COMMUNITY. IF THE SERVICES WERE NOT PROVIDED, THEY WOULD NOT BE AVAILABLE TO THE AREA OR WOULD RESULT IN THE GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION PROVIDING THE SERVICES. THE SUBSIDIZED HEALTH SERVICES AMOUNT IN PART I, LINE 7G INCLUDES $3,397,042 WHICH IS ATTRIBUTED TO THE PRIMARY CLINICAL SERVICES PROVIDED VIA CHILDREN'S NATIONAL HOSPITAL. CHILDREN'S HEALTH CENTERS PROVIDE PROGRAMS AND INITIATIVES INCLUDING COMPREHENSIVE AND HIGH-QUALITY PREVENTIVE SERVICES, IMPROVEMENT OF IMMUNIZATION RATES, AND COORDINATION OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THE AMOUNT INCLUDES SALARY, FRINGE, DIRECT, AND INDIRECT COSTS EXPENDED TO PROVIDE THE CLINICAL SERVICES. OUR CHILDREN'S HEALTH CENTERS ARE ESTABLISHING BEST PRACTICES IN COMMUNITY HEALTH.PART I, LINES 7E - F:OTHER BENEFITSIN CALCULATING THE AMOUNTS REPORTED IN THE TABLE IN PART I RELATING TO OTHER BENEFITS (E - I), WE USE AN ACCOUNTABILITY AND ELIGIBILITY SYSTEM BASED ON THE COMMUNITY BENEFIT DEFINITION AND GUIDELINES FOR DETERMINING WHERE PROGRAMS FIT INTO EACH COMMUNITY BENEFIT CATEGORY. TIME SPENT ON PROGRAMS/ACTIVITIES AND PROGRAM FUNDING IS PROVIDED BY PROGRAM STAFF. AVERAGE SALARY RATES ARE USED TO CALCULATE SALARY EXPENSES AND A FRINGE RATE IS ATTACHED AS NECESSARY. THE COMMUNITY BENEFIT STAFF ANALYZES THE FINANCIALS SUBMITTED TO ENSURE CONSISTENCY IN REPORTING AND CONFIRM WITH PROGRAM STAFF THE ACCURACY OF THE FINANCIALS. THE COMMUNITY BENEFIT STAFF ALSO WORKS WITH THE ACCOUNTING & FINANCE DEPARTMENT TO VERIFY THE ACCURACY OF SUBMITTED FINANCIALS.PART I, LINE 7, COLUMN (F):BAD DEBT EXPENSESCHILDREN'S NATIONAL MEDICAL CENTER DOES NOT INCLUDE ITS BAD DEBT EXPENSE ($26,932,186) REPORTED ON FORM 990, PART IX, LINE 25 FOR PURPOSES OF ITS COMMUNITY BENEFIT CALCULATION HERE. SCHEDULE H, PART II: COMMUNITY BUILDING ACTIVITIES PART II INCLUDES THE COST INCURRED FOR ACTIVITIES AND PROGRAMS TO PROTECT OR IMPROVE THE COMMUNITY'S HEALTH OR SAFETY. PROGRAMS ACCOUNTED FOR AS COMMUNITY BUILDING ACTIVITIES FALL INTO THE SUBCATEGORIES OF ECONOMIC DEVELOPMENT, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: IN FY 2023, HOSPITAL STAFF SERVED AS A VOICE FOR CHILDREN AT THE LOCAL, STATE AND FEDERAL LEVELS BY BRINGING ATTENTION TO AND RALLYING SUPPORT FOR PUBLIC POLICIES THAT PROTECT THE INTEREST OF CHILDREN'S HEALTH, AIM TO ELIMINATE HEALTH DISPARITIES, AND SUPPORT MEDICAL AND RESEARCH INNOVATION. STAFF HELPED DRAFT AND SUPPORTED LEGISLATION THAT WILL AUTHORIZE ACCESS TO EMERGENCY MEDICATIONS IN SCHOOLS AND PROVIDE ADDITIONAL FUNDING FOR SCHOOL NURSES IN DISTRICT OF COLUMBIA PUBLIC SCHOOLS.ECONOMIC DEVELOPMENT: CHILDREN'S NATIONAL LEADERSHIP PARTICIPATES IN BOARDS AND COUNCILS THAT FOCUS ON THE ECONOMIC DEVELOPMENT OF OUR LOCAL COMMUNITY. STAFF PARTICIPATED IN DISCUSSIONS TO STRENGTHEN TIES AMONG THE BUSINESS COMMUNITY AND EMPLOYMENT OPPORTUNITIES IN WASHINGTON, DC AND TOPICS RELATED TO THE HEALTH OF OUR LOCAL COMMUNITY. THE FOCUS ON HELPING TO EXPAND EMPLOYMENT IN PATHWAY TO THE MIDDLE CLASS OPPORTUNITIES ARE ESSENTIAL TO ADDRESSING POVERTY - A KEY DRIVER OF HEALTH INEQUITIES.COMMUNITY SUPPORT: CHILDREN'S NATIONAL STAFF WORKS WITH LOCAL GOVERNMENT AND HEALTHCARE PARTNERS FOCUSED ON EMERGENCY PREPAREDNESS AND RESPONSE AND BRINGS THE PEDIATRIC HOSPITAL PERSPECTIVE. MEETINGS INCLUDE PLANNING FOR LARGE-SCALE EVENTS, EVACUATION PLANS, EMERGENCY PREPAREDNESS AND DECONTAMINATION EXERCISES, AND FAMILY REUNIFICATION.WORKFORCE DEVELOPMENT: CHILDREN'S NATIONAL IS DEDICATED TO ENGAGING IN AND PROVIDING OPPORTUNITIES FOR LEARNING AND DEVELOPMENT FOR SCHOOL-AGED CHILDREN AND ADULTS. WE WORK WITH MANY LOCAL SCHOOLS, COLLEGES AND UNIVERSITIES TO PROVIDE LEARNING OPPORTUNITIES FOR STUDENTS INTERESTED IN HEALTH PROFESSIONS. CHILDREN'S NATIONAL OFFERED IN-PERSON AND VIRTUAL RESUME BUILDING AND EDITING WORKSHOPS FOR UNIVERSITY STUDENTS AND COMMUNITY MEMBERS. IN ADDITION, CHILDREN'S NATIONAL OFFERS INTERNSHIP PROGRAMS FOR LOCAL HIGH SCHOOL STUDENTS INTERESTED IN HEALTH-RELATED CAREERS. DURING THE INTERNSHIP PROGRAM LED BY THE COMMUNITY AFFAIRS DEPARTMENT, STUDENTS PARTICIPATED IN RESEARCH, ACADEMIC ACTIVITIES, PROFESSIONAL DEVELOPMENT AND SKILL-BUILDING. AT THE END OF THE INTERNSHIP, STUDENTS PRODUCED AN ADVOCACY PLAN AND DELIVERED ORAL PRESENTATIONS SUMMARIZING THEIR EXPERIENCE. THROUGH A PRE- AND POST-EVALUATION, INTERNS SHOWED AN INCREASE IN KNOWLEDGE IN AREAS SUCH AS UNDERSTANDING OF THE HEALTH INEQUITIES IN THEIR COMMUNITIES AND HOW YOUTH CIVIC ENGAGEMENT CAN HELP TO IMPROVE COMMUNITY HEALTH. CHILDREN'S NATIONAL ALSO SUPPORTS THE LEADING THE ADVANCEMENT OF UNDERGRADUATE NURSES AT CHILDREN'S NATIONAL (LAUNCH) AND CONWAY NURSING PATHWAY PROGRAMS WHICH ALLOW UNIVERSITY STUDENTS INTERESTED IN NURSING TO SHADOW PEDIATRIC NURSES DURING A SUMMER INTERNSHIP. THESE STUDENTS WORK CLOSELY WITH A PRECEPTOR AND SUPERVISOR LEARNING THE SKILLS AND TECHNIQUES OF A PEDIATRIC NURSE. PART III, LINES 2, 3 AND 4: BAD DEBT EXPENSETHE HOSPITAL AND PHYSICIAN BAD DEBT WRITE-OFF REPORTED IN THE AUDITED FINANCIAL STATEMENTS IS REFLECTED ON SCHEDULE H, PART III, LN 2. DISCOUNTS AND PAYMENTS REDUCE THE PATIENT'S ACCOUNT BALANCE PRIOR TO SENDING THE PATIENT A STATEMENT FOR ANY REMAINING BALANCES DUE TO CHILDREN'S HOSPITAL. FINANCIAL ASSISTANCE ELIGIBLE PATIENTS RECEIVE A 100% DISCOUNT ON THE BALANCE DUE. PAYMENT PLANS ARE ALSO AVAILABLE FOR PATIENT BALANCES DUE. ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER COLLECTION EFFORTS (BILLING STATEMENTS AND PHONE CALLS) ARE UNSUCCESSFUL.BAD DEBT IS NOT INCLUDED IN CHILDREN'S NATIONAL'S COMMUNITY BENEFIT. A DEMOGRAPHIC ANALYSIS BASED ON ZIP CODES WAS COMPLETED TO ESTIMATE THE AMOUNT OF BAD DEBT THAT COULD HAVE BEEN ATTRIBUTED TO PATIENTS WITH A LIKELIHOOD OF QUALIFYING FOR FINANCIAL ASSISTANCE HAD SUFFICIENT INFORMATION BEEN OBTAINED TO DETERMINE THEIR ELIGIBILITY. BASED ON THE ANALYSIS, APPROXIMATELY $310K OF BAD DEBT COULD HAVE BEEN ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. CHILDREN'S HOSPITAL REPORTS ITS APPLICABLE BAD DEBT ($26.9M) AMOUNT WITHIN THE AUDITED FINANCIAL STATEMENTS. THERE IS NO SPECIFIC FOOTNOTE FOR BAD DEBT IN THE STATEMENTS. PART III, LINE 8: COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT ON LINE 6MEDICARE SHORTFALLS ARE NOT INCLUDED AS A COMMUNITY BENEFIT AS ANY SHORTFALL DETERMINATION FROM THE MEDICARE COST REPORT IS EVENTUALLY PAID AS A SETTLEMENT.PART III, LINE 9B:COLLECTION PRACTICESCHILDREN'S HOSPITAL HAS A WRITTEN COLLECTION POLICY. POLICY IS APPLIED UNIFORMLY TO ALL PATIENTS. CHILDREN'S HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS WHILE MAINTAINING RESPONSIBLE AND EFFECTIVE FINANCIAL PROGRAMS WHICH ENSURE THAT THIS COMMITMENT CAN CONTINUE. CHILDREN'S HOSPITAL SUPPORTS FAMILIES IN CARRYING OUT THEIR RESPONSIBILITY FOR OBTAINING MEDICAL CARE FOR THEIR CHILDREN. CHILDREN'S HOSPITAL THEREFORE WILL ASSIST FAMILIES IN VERIFYING THEIR ABILITY TO MEET THEIR FINANCIAL OBLIGATION TO THE HOSPITAL OR IN SECURING THE RESOURCES NECESSARY TO DO SO. THE PURPOSE OF THIS POLICY IS TO ESTABLISH GUIDELINES FOR EFFECTIVE AND RESPONSIBLE FISCAL PROGRAMMING, WHICH ASSURES THE FINANCIAL VIABILITY OF THE INSTITUTION AND MAINTAINS THE DIGNITY OF THE FAMILY.COLLECTION EFFORTS ARE THEREFORE THE SAME FOR ALL PATIENTS. ONCE THE APPROVED CHARITY ADJUSTMENT HAS BEEN DETERMINED, THE ACCOUNT BALANCE IS WRITTEN OFF TO CHARITY AND COLLECTION EFFORTS CEASE. FOR PATIENT BALANCES THAT ARE NOT FINANCIAL ASSISTANCE ELIGIBLE, CHILDREN'S OFFERS PAYMENT PLANS. BILLING STATEMENTS WILL BE SENT TO GUARANTORS FOR OUTSTANDING BALANCES. ATTEMPTS TO CONTACT THE GUARANTORS VIA PHONE WILL ALSO OCCUR. ACCOUNTS WITH BALANCES AND NO RESPONSE FROM GUARANTORS AFTER REPEATED STATEMENTS AND PHONE CALLS WILL BE WRITTEN OFF TO BAD DEBT. AN EXTERNAL AGENCY WILL THEN ATTEMPT TO REACH THE PATIENT FOR PAYMENT. IF THE PATIENT SUBSEQUENTLY PAYS, THE BAD DEBT ADJUSTMENT WILL BE REVERSED, AND PAYMENT POSTED TO THE PATIENT'S ACCOUNT. IF THE EXTERNAL AGENCY'S EFFORTS, PROVE TO BE INEFFECTIVE, THE ACCOUNT WILL BE CLOSED WITH THE AGENCY AND THEIR EFFORTS WILL CEASE. CHILDREN'S HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES, E.G. CREDIT REPORTING, WAGE GARNISHMENTS, LIENS, ETC. PART VI, LINE 2: COMMUNITY HEALTH CARE NEEDS ASSESSMENTIN ADDITION TO THE JOINT PEDIATRIC COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE HSC HEALTH CARE SYSTEM, CHILDREN'S NATIONAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH OTHER EFFORTS.THE CHILDREN'S NATIONAL ASTHMA PROGRAM, IMPACT DC, ANALYZES ON AN ANNUAL BASIS EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS FOR ASTHMA TO ALL NON-MILITARY HOSPITAL EMERGENCY DEPARTMENTS IN DC. THIS ALLOWS THE HOSPITAL TO TRACK TRENDS OVER TIME AND ACROSS ZIP CODES IN DC. THE HOSPITAL ALSO CONDUCTS STUDIES TO IDENTIFY BARRIERS TO CARE, INTERVENTION PREFERENCES, AND PARENT CONCERNS ABOUT ASTHMA. IN 2018-2019, THE HOSPITAL USED FUNDING FROM NIH TO SPECIFICALLY CONDUCT A COMMUNITY NEEDS ASSESSMENT FOCUSED ON ASTHMA. IMPACT DC PRODUCED REPORTS USING BOTH QUANTITATIVE AND QUALITATIVE METHODS. THE HOSPITAL SUBSEQUENTLY SUBMITTED ANOTHER NIH GRANT TO REFINE AND STUDY AN ASTHMA INTERVENTION THAT IS HIGHLY RESPONSIVE TO THE FINDINGS. MOST RECENTLY, THE ASTHMA PROGRAM LED FOCUS GROUPS WITH FAMILIES TO LEARN HOW HOUSING CONDITIONS IMPACT ASTHMA CARE AND IS WORKING TOGETHER WITH COMMUNITY-BASED ORGANIZATIONS TO ADDRESS SOME OF THE BARRIERS IDENTIFIED THROUGH THE ASSESSMENT. AS PART OF THIS WORK, THE TEAM GATHERED DATA AND MAPPED PROPERTIES MOST FREQUENTLY REPORTED WITH UNHEALTHY HOUSING CONDITIONS AND ASTHMA EXACERBATIONS. USING THE DATA, INTERACTIVE MAPS WERE DEVELOPED. THE MAPS HELP IDENTIFY LARGE-SCALE PROBLEMATIC REGIONS WHERE THERE IS AN INTERSECTION BETWEEN HEALTH AND HOUSING CONDITIONS THAT REQUIRES LARGER-SCALE INTERVENTIONS.SIMILARLY, THE HOSPITAL PUBLISHED THREE REPORTS IN FY 2021 ON BEHAVIORAL HEALTH SERVICES IN WASHINGTON, D.C. ONE REPORT DESCRIBED THE CURRENT LANDSCAPE OF BEHAVIORAL HEALTH SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDER INSURED BY MEDICAID IN WASHINGTON, D.C. AND ANOTHER REPORT ON HOW TO TRANSFORM BEHAVIORAL HEALTH IN THE DISTRICT OF COLUMBIA WITH PERSPECTIVES AND RECOMMENDATIONS FROM CHILDREN'S NATIONAL HOSPITAL AND THE EARLY CHILDHOOD INNOVATION NETWORK. THE THIRD REPORT ILLUSTRATED HOW COVID-19 HAD AN IMPACT ON CHILD BEHAVIORAL HEALTH OUTCOMES AND THE BEHAVIORAL HEALTH CARE SYSTEM. ALL THREE REPORTS ARE AVAILABLE ON THE HOSPITAL WEBSITE: HTTPS://CHILDRENSNATIONAL.ORG/ADVOCACY-AND-OUTREACH/CHILD-HEALTH-ADVOCACY-INSTITUTE/COMMUNITY-MENTAL-HEALTH/PUBLICATIONS.FINALLY, TO SUPPORT CONTINUOUS ASSESSMENT OF THE NEEDS OF OUR COMMUNITY, THE HOSPITAL ESTABLISHED THE CHILD HEALTH DATA LAB OVER TEN YEARS AGO WHERE DATA SCIENTIST USE EVIDENCE-BASED APPROACHES TO IDENTIFY AND TRACK TRENDS IN POPULATION HEALTH USING BIG DATA ANALYSIS, DEVELOPING INTERACTIVE MAPS, AND COLLECTING COMMUNITY INPUT. THE CHILD HEALTH DATA LAB OVERSEES THE DC HEALTH MATTERS WEB PORTAL THAT PROVIDES A ONE-STOP RESOURCE FOR ONLINE ACCESS TO COMMUNITY HEALTH INDICATORS THAT IMPACT THE HEALTH OF DC COMMUNITIES. PART VI, LINE 3: ELIGIBILITY EDUCATION CHILDREN'S HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY (FAP) THAT PROVIDES ELIGIBLE PATIENTS WITH DISCOUNTED EMERGENCY OR OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES PROVIDED BY CHILDREN'S HOSPITAL. CHILDREN'S WILL PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL PROHIBITS ANY ACTIONS THAT WOULD DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE. FINANCIAL ASSISTANCE INFORMATION, INCLUDING THE POLICY AND PLAIN LANGUAGE GUIDES, AND APPLICATION FORM, IS AVAILABLE ON CHILDREN'S PUBLIC WEBSITE. FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND VIA PHONE. THE COUNSELORS CONTACT INFORMATION IS PUBLICIZED ON THE WEBSITE. CUSTOMER SERVICE CONTACT INFORMATION IS ALSO PROVIDED ON THE WEBSITE AS WELL AS BILLING STATEMENTS. SIGNAGE ALERTING PATIENTS TO THE AVAILABILITY OF FINANCIAL AID IS POSTED AT REGISTRATION AREAS AND APPLICATIONS ARE READILY AVAILABLE. CHILDREN'S ALSO WORKS WITH EXTERNAL VENDORS WHO ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE APPLICATION AS WELL AS APPLYING FOR STATE MEDICAID AND OTHER FEDERAL AND LOCAL PROGRAMS.THE FOLLOWING PROCESSES TAKE PLACE FOR FAMILIES WHO DO NOT HAVE INSURANCE OR WHO CANNOT PAY:1. THROUGH OUR CONTRACTED COMPANIES (MEDLAW AND DECO) WHO RESIDE IN OUR FINANCIAL INFORMATION CENTER (FIC), AN APPLICATION IS MADE FOR MEDICAL ASSISTANCE AND OUR FINANCIAL ASSISTANCE PROGRAM (FAP). ELIGIBILITY IS CONSIDERED FOR ALL APPROPRIATE PUBLIC PROGRAMS. IN AN EFFORT TO HAVE THIS PROCESS TAKE PLACE PRIOR TO THE MEDICAL VISIT, FAP APPLICATIONS ARE MAILED TO SELF-PAY PATIENTS WHEN THEY MAKE AN APPOINTMENT.2. WHILE THE APPLICATION IS IN PROCESS, THE PATIENT IS REGISTERED AS MEDICAID PENDING AND THE MEDICAL VISIT TAKES PLACE (CITIZENS ONLY). NON-CITIZENS ARE REGISTERED AS SELF-PAY.3. IF THE PATIENT IS DETERMINED TO BE MEDICAID ELIGIBLE, THE PATIENT REGISTRATION IS CONVERTED TO THE MEDICAID PLAN.4. IF NOT ELIGIBLE, THE PATIENT'S CHARITY CARE APPLICATION IS FURTHER EVALUATED FOR CHARITY CARE BY CHILDREN'S CUSTOMER SERVICE STAFF IN THE FIC.5. IF FAP IS APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. THE ACCOUNTS ARE MANAGED BY CUSTOMER SERVICE STAFF. ONLY EXPECTED BALANCES REMAIN ON THE ACCOUNT AND FAMILIES RECEIVE STATEMENTS SHOWING THEIR RESPONSIBILITY.6. IF FAP IS NOT APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. FAMILIES CAN SET UP PAYMENT PLANS TO RESOLVE THEIR ACCOUNT BALANCES.7. MEDICALLY INDIGENT STATUS CAN APPLY FOR INSURED FAMILIES. THIS STATUS CAN BE EVALUATED AT ANY TIME IF A FAMILY'S REMAINING BALANCE (EXCLUDING ANY DEDUCTIBLES) AFTER THIRD PARTY PAYER PAYMENT IS GREATER THAN 30% OF ANNUAL INCOME LESS HOUSING EXPENSES.- WHENEVER APPLICABLE, IT IS ENCOURAGED THAT FAMILIES REVIEW THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE THE APPOINTMENT DATE. APPOINTMENTS ARE TYPICALLY MADE WITH THE FIC OFFICE WHEN FAMILIES MAKE THEIR MEDICAL APPOINTMENTS. THEY CAN GO DIRECTLY TO THE FIC OFFICE AT CHILDREN'S HOSPITAL AT ANY OTHER TIME.- FAMILIES ARE ENCOURAGED TO COOPERATE WITH OUR STAFF BY SUPPLYING ALL NECESSARY INFORMATION FOR THE MEDICAID AND FAP APPLICATIONS. PART VI, LINE 4: DESCRIPTION OF COMMUNITY SERVEDAS THE ONLY EXCLUSIVE PROVIDER OF PEDIATRIC CARE IN THE NATION'S CAPITAL, CHILDREN'S NATIONAL SERVES A DIVERSE AND BROAD COMMUNITY, SPANNING FROM THE DISTRICT OF COLUMBIA TO MARYLAND AND VIRGINIA AND BEYOND. THE U.S. CENSUS ESTIMATES THE 2023 POPULATION OF THE DISTRICT OF COLUMBIA TO BE 678,972 RESIDENTS. THE POPULATION GREW BY 8,023 PEOPLE FROM JULY 1, 2022 TO JULY 1, 2023, WHICH IS ATTRIBUTED TO THE DISTRICT HAVING 2,607 MORE BIRTHS THAN DEATHS IN THE YEAR. MARYLAND AND VIRGINIA ARE HOME TO 6 MILLION AND 8 MILLION RESIDENTS, RESPECTIVELY. THE SOCIAL DEMOGRAPHICS FOR THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA, ACCORDING TO THE U.S. CENSUS, ARE AS FOLLOWS: DISTRICT OF COLUMBIA: ABOUT 45.0% BLACK; 46.2% WHITE; 11.7% LATINO; 4.7% ASIAN AND 0.7% AMERICAN INDIAN/ALASKA NATIVE; MARYLAND: APPROXIMATELY 57.3% WHITE; 31.7% BLACK; 11.5% HISPANIC; 7.1% ASIAN AND VIRGINIA 68.5% WHITE, 20.0% BLACK, 10.5% HISPANIC, 7.3% ASIAN, AND 0.6% AMERICAN INDIAN/ALASKA NATIVE. IN THE DISTRICT OF COLUMBIA, CHILDREN 18 YEARS OLD AND YOUNGER MAKE UP 18.5 PERCENT OF THE POPULATION WITH THE HIGHEST PERCENTAGE RESIDING IN WARDS 7 AND 8, 3.14% AND 3.30% RESPECTIVELY. IN BOTH MARYLAND AND VIRGINIA ABOUT 21 PERCENT OF THE POPULATION IS CHILDREN 18 YEARS OLD AND YOUNGER. CHILDREN AGED FIVE AND YOUNGER MAKE UP APPROXIMATELY 5.7% PERCENT OF THE POPULATION IN THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA.SOCIOECONOMIC STATUS IS THE SOCIAL STANDING OF AN INDIVIDUAL OR GROUP. IT IS OFTEN MEASURED AS A COMBINATION OF EDUCATION, INCOME, AND OCCUPATION. LOW SOCIOECONOMIC STATUS IS STRONGLY CORRELATED WITH INEQUITIES IN ACCESS TO RESOURCES, AS WELL AS ISSUES RELATED TO PRIVILEGE, POWER, AND CONTROL. PEOPLE WITH LOWER SOCIOECONOMIC STATUS TYPICALLY EXPERIENCE POORER HEALTH AND DIE YOUNGER THAN THOSE WITH MORE ECONOMIC ADVANTAGE. CITYWIDE AVERAGES OFTEN PAINT DC AS A SOCIALLY AND ECONOMICALLY RICH CITY; HOWEVER, A MORE DETAILED LOOK REVEALS A STORY OF PROFOUND INEQUITIES. SOCIOECONOMIC CHARACTERISTICS OF DC RESIDENTS VARY IMMENSELY ACROSS THE CITY. HEALTH INEQUITIES FOLLOW THE SAME PATTERN. FOR EXAMPLE, THERE ARE DIRECT CORRELATIONS BETWEEN THE CONCENTRATION OF POVERTY IN SEGMENTS OF THE CITY, PARTICULARLY IN WARDS 7 AND 8, AND PATTERNS OF POOR HEALTH OUTCOMES CONCENTRATED IN THE SAME AREAS. 36% OF CHILDREN IN WARD 8, THE WARD WITH THE LOWEST HOUSEHOLD INCOME IN THE DISTRICT OF COLUMBIA, LIVE IN POVERTY, AS COMPARED TO 1% OF CHILDREN IN WARD 3, THE WEALTHIEST WARD. ADDITIONALLY, DC HAS A 15+ YEAR DIFFERENCE IN LIFE EXPECTANCY BY WARD: 86 YEARS IN WARD 3 COMPARED TO 71 YEARS IN WARD 8. RACIAL DIFFERENCES IN LIFE EXPECTANCY ARE ALSO STRIKING. WHEN COMPARED TO OTHER RACIAL GROUPS, THE LIFE EXPECTANCY FOR BLACK RESIDENTS IS THE LOWEST. WHITE MALES IN THE DISTRICT ARE EXPECTED TO LIVE ALMOST 15 YEARS LONGER THAN BLACK MALES (83.2 AND 68.8 YEARS, RESPECTIVELY). WHITE FEMALES IN THE DISTRICT ARE EXPECTED TO LIVE APPROXIMATELY 9 YEARS LONGER THAN BLACK FEMALES (85.2 AND 76.2 YEARS, RESPECTIVELY).CHILDREN'S NATIONAL IS IN AN URBAN COMMUNITY WHERE THERE ARE SEVERAL LARGE ACADEMIC AND COMMUNITY HOSPITALS. HOWEVER, WE SERVE MOST OF THE CHILDREN IN DC. WE CARED FOR MORE THAN 253,167 UNIQUE PATIENTS THROUGH OUR HEALTH CENTERS IN 2023, AS THE LARGEST NON-GOVERNMENT PROVIDER OF PRIMARY CARE IN THE DISTRICT OF COLUMBIA. MARYLAND RESIDENTS ACCOUNTED FOR 50% CHILDREN'S NATIONAL PATIENTS, AND CHILDREN'S NATIONAL IS THE LARGEST PROVIDER OF PEDIATRIC CARE FOR RESIDENTS OF NORTHERN VIRGINIA AS WELL. THE NEEDS OF THE POPULATION SERVED IN MARYLAND AND NORTHERN VIRGINIA ARE SIMILAR TO THE DISTRICT OF COLUMBIA.AS PREVIOUSLY MENTIONED, THE CHILDHOOD OPPORTUNITY INDEX (COI) DEFINES OPPORTUNITY AS THE NEIGHBORHOOD RESOURCES THAT MATTER FOR A CHILD'S HEALTHY DEVELOPMENT. THE 29 INDICATORS FOCUS ON NEIGHBORHOOD FEATURES SUCH AS ACCESS TO HEALTHY FOOD, HIGH-QUALITY EDUCATION, PARKS AND PLAYGROUNDS. IN THE 2022 CHNA, OUR FINDINGS REVEAL THAT CHILD OPPORTUNITY VARIES CONSIDERABLY WITHIN OUR SERVICE AREA. CHILD OPPORTUNITY IS LOWEST AND CRITICALLY LACKING IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS CERTAIN PRINCE GEORGE'S COUNTY NEIGHBORHOODS IN MARYLAND.WE ALSO OFFER FAMILIES A LINK TO QUALITY PEDIATRIC CARE THROUGH OUR MOBILE MEDICAL PROGRAM AND AT COMMUNITY HEALTH CENTERS. OUR TEAM AVERAGES MORE THAN 552,000 OUTPATIENT VISITS EACH YEAR AT HEALTH CLINICS IN THE DISTRICT OF COLUMBIA, AFFILIATED CENTERS IN MARYLAND AND VIRGINIA, AND AT THE SHEIKH ZAYED CAMPUS IN WASHINGTON, DC. ON AVERAGE, THAT EQUALS OVER 1,000 PATIENT VISITS IN ONE DAY TO ONE OF CHILDREN'S NATIONAL'S 30 LOCATIONS IN THE DISTRICT OF COLUMBIA AND THROUGHOUT THE METROPOLITAN AREA. IN FISCAL YEAR 2023, WE PERFORMED 19,601 SURGICAL PROCEDURES, 135,498 DIAGNOSTIC IMAGING PROCEDURES, AND MORE THAN 1.3 MILLION LABORATORY TESTS. PART VI, LINE 5: PROMOTING THE HEALTH OF THE COMMUNITYCHILDREN'S NATIONAL WAS FOUNDED 150 YEARS AGO AS A MODEST 12-BED FACILITY DEDICATED TO SERVING THE CHILDREN OF THE NATION'S CAPITAL. WHILE THE HEALTH CARE LANDSCAPE LOOKS VERY DIFFERENT TODAY THAN IT DID IN THE 19TH CENTURY, OUR CORE MISSION REMAINS THE SAME. THE MISSION OF CHILDREN'S NATIONAL IS TO EXCEL IN CARE, ADVOCACY, RESEARCH, AND EDUCATION. WE ACCOMPLISH THIS THROUGH PROVIDING A QUALITY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND FAMILIES, IMPROVING HEALTH OUTCOMES FOR CHILDREN, AND LEADING THE CREATION OF INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES. RECOGNIZING THAT A CHILD'S HEALTH IS THE RESULT OF COUNTLESS FACTORS, CHILDREN'S NATIONAL ALSO ADVOCATES FOR POLICIES THAT PROMOTE HEALTH AND WELL-BEING FOR CHILDREN, MANY OF WHICH EXIST OUTSIDE THE CLINICAL SETTING. WHILE THE HOSPITAL HAS SUPPORTED ADVOCACY AND COMMUNITY HEALTH EFFORTS FOR DECADES, IN 2007, THE CHILDREN'S HEALTH BOARD PROVIDED FUNDING TO FORMALLY ESTABLISH THE CHILD HEALTH ADVOCACY INSTITUTE (CHAI). CHILDREN'S NATIONAL BECAME THE FIRST PEDIATRIC HOSPITAL IN THE NATION TO FORM AN IN-HOUSE ADVOCACY INSTITUTE. CHAI FOUNDERS BELIEVED THAT TO CREATE AN ENVIRONMENT WHERE CHILDREN COULD GROW UP TO FULFILL THEIR POTENTIAL, THERE SHOULD BE A COHORT OF ADVOCATES AND COMMUNITY HEALTH EXPERTS TO ENSURE SYSTEMS AND POLICY DID NOT IGNORE THE NEEDS OF THE REGION'S SMALLEST RESIDENTS. THAT MISSION IS EVEN MORE IMPORTANT TODAY.COMPRISED OF CLINICIANS, PUBLIC HEALTH EXPERTS, DATA ANALYSTS, AND GOVERNMENT AFFAIRS PROFESSIONALS, THE CHAI IS DEDICATED TO ADVANCING COMMUNITY HEALTH AND WELL-BEING, WITH A FOCUS ON CHILDREN AND FAMILIES IN UNDER-RESOURCED COMMUNITIES.CHAI'S PORTFOLIO INCLUDES A WIDE RANGE OF INITIATIVES THAT PROMOTE COMMUNITY HEALTH. FROM LEADING THE CHILDREN'S NATIONAL COMMUNITY BENEFIT PROGRAM TO EDUCATING AND MOBILIZING STAFF TO ENGAGE IN COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY - THE CHAI IS DEVOTED TO ADVANCING POLICY AND SYSTEMS CHANGES WITH THE GOAL OF ACHIEVING HEALTH EQUITY FOR ALL CHILDREN. IT IS THROUGH THIS LENS THAT CHILDREN'S NATIONAL ADDS A UNIQUE APPROACH TO ADDRESSING COMMUNITY HEALTH PRIORITIES AND PROMOTING HEALTH EQUITY. THIS WORK CANNOT BE DONE ALONE; THUS, THE CHAI SERVES AS A CONDUIT THROUGH WHICH THE COMBINED EXPERTISE OF MORE THAN 7,300 CHILDREN'S NATIONAL EMPLOYEES AND COUNTLESS COMMUNITY STAKEHOLDERS INTERACT WITH, REACT TO, AND SPEAK ON BEHALF OF CHILDREN AND FAMILIES. IN ADDITION, CHILDREN'S NATIONAL IS ENSURING THAT WE ARE ON THE PATH TOWARD BECOMING A MORE DIVERSE, EQUITABLE AND INCLUSIVE ORGANIZATION TO IMPROVE HEALTH AND RACIAL EQUITY. OUR HOSPITAL HAS BEEN ON A JOURNEY TOWARD GREATER DIVERSITY, EQUITY AND INCLUSION SINCE THE EARLY 2000S. LEADING UP TO THE YEAR 2020, WE FOCUSED ON RECRUITMENT, ACADEMIC ADVANCEMENT AND LEADERSHIP DEVELOPMENT OF FACULTY MEMBERS AND TRAINEES UNDERREPRESENTED IN MEDICINE. THIS WORK HAS CONTRIBUTED TO IMPORTANT MILESTONES, INCLUDING WELCOMING A 2021 RESIDENCY CLASS THAT IS OUR MOST DIVERSE CLASS EVER AND MORE THAN THREE TIMES THE NATIONAL AVERAGE FOR DIVERSITY, BETTER REFLECTING OUR PATIENTS AND FAMILIES IN OUR COMMUNITY. OUR HISTORY OF LEADING THESE EFFORTS MEANT WE WERE POISED TO EXPAND OUR SCOPE OF WORK ON DIVERSITY, EQUITY AND INCLUSION. IN FISCAL YEAR 2021, WE BEGAN DESIGNING EFFECTIVE, DATA-DRIVEN AND RESPONSIVE HOSPITAL AND COMMUNITY PROGRAMS THAT LED TO A MORE DIVERSE, EQUITABLE AND INCLUSIVE WORKPLACE AND MORE IMPORTANTLY, WILL ENSURE THE CONTINUED DELIVERY OF HIGH-QUALITY HEALTH CARE SERVICES AND EDUCATION TO ALL PATIENTS AND FAMILIES. THIS IS NOT AN EASY PATH - DEVELOPING INITIATIVES AND PROGRAMS TO REACH THE GOAL OF EQUITY AND INCLUSION FOR ALL REQUIRES US TO OVERCOME CENTURIES OF PERVASIVE RACISM, SEXISM AND CULTURAL AND RELIGIOUS BIAS THAT HAVE CREATED FUNCTIONAL, ECONOMIC AND STRUCTURAL BARRIERS IN SOCIETY. BUT THE DEDICATION AND PASSION THAT OUR TEAMS CONTINUE TO SHOW IN THE FACE OF THESE CHALLENGES GIVE US CONFIDENCE THAT WE HAVE THE VISION, RESOLVE, KNOWLEDGE AND SKILLS TO ADVANCE THIS IMPORTANT BODY OF WORK ON BEHALF OF OUR PATIENTS, FAMILIES AND COMMUNITY. IN FY 2023, WE ESTABLISHED THE COMMUNITY HEALTH ADVISORY COUNCIL. THE COUNCIL IS COMPRISED OF PARENTS/CAREGIVERS THAT RESIDE IN WARDS 7 AND 8 IN WASHINGTON, D.C. AND PRINCE GEORGE'S COUNTY, MARYLAND. THE COUNCIL'S MEMBERS HAVE PROVIDED VALUABLE INPUT REGARDING THEIR EXPERIENCES WITH THE QUALITY AND SAFETY OF CARE, INCLUDING HOW COMMUNITY CHALLENGES, FAMILY BARRIERS AND CULTURAL TRADITIONS IMPACT THE CARE RECEIVED. THEY HAVE ADVISED ON CHIP PRIORITIES AND PROVIDED STRATEGIC DIRECTION FOR COMMUNITY HEALTH PLANNING. ALSO, WE CREATED AN EXPANDED COMMUNITY-BASED SERVICE-LEARNING CURRICULUM THAT ESTABLISHED A NATIONAL MODEL FOR SERVICE-LEARNING IN GRADUATE MEDICAL EDUCATION. THROUGH A PARTNERSHIP WITH A LOCAL, NONCLINICAL, COMMUNITY-BASED ORGANIZATION (CBO) THAT SERVES UNDER-RESOURCED CHILDREN AND FAMILIES LIVING WITH MENTAL HEALTH ISSUES, SECOND-YEAR RESIDENTS SERVE AS MEDICAL EXPERTS FOR FAMILY SUPPORT GROUPS, ADVOCATE FOR SUPPORT SERVICES DURING HEARINGS FOR JUSTICE-INVOLVED YOUTH AND PARTICIPATE IN SCHOOL ADVOCACY WORK. THESE ACTIVITIES GIVE STAFF THE OPPORTUNITY TO HELP IMPROVE ACCESS TO HEALTH CARE, LEARN FROM OUR COMMUNITY AND BUILD TRUST WITH COMMUNITY MEMBERS. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM ROLESCHILDREN'S HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING TAX-EXEMPT ENTITIES:- CHILDREN'S NATIONAL MEDICAL CENTER - 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBLE FOR HEALTH CARE SYSTEM- CHILDREN'S HOSPITAL FOUNDATION - 501(C)(3), FUNDRAISING- CHILDREN'S RESEARCH INSTITUTE - 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS- SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN- BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN- CHILDREN'S SCHOOL SERVICES - 501(C)(3), OPERATION OF A SCHOOL NURSE PROGRAM- HSC FOUNDATION - 501(C)(3), SUPPORT FOR THE HSC ENTITIES - HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS - 501(C)(3), HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES FOR YOUNG INDIVIDUALS WITH SPECIAL NEEDS- THE HOSPITAL FOR SICK CHILDREN DBA THE HSC PEDIATRIC CENTER - 501(C)(3), ACUTE CARE HOSPITAL FACILITY THAT PROVIDES REHABILITATION AND TRANSITIONAL CARE FOR CHILDREN AND ADOLESCENTS WITH DISABILITIESAND CHRONIC ILLNESSES- HSC HOME CARE, LLC - 501(C)(3), HOME AND COMMUNITY PROVIDES ACCESS TO QUALITY REHABILITATIVE AND SPECIALTY SERVICES FOR INFANTS, CHILDREN AND ADOLESCENTS WITH SPECIAL NEEDSEACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS. PART VI, LINE 7, REPORTS FILED WITH STATES DC X X 1 1 X X X X 1 1 0 0 0 0 0 1 1 1 KURT D NEWMAN MD PRESIDENT / CEO (CNMC) TO 06/23 1615608 0 1076563 0 281583 0 15250 0 37699 0 3026703 0 0 0 YVES D'UDEKEM D'ACOZ MD CHIEF OF CARDIO SURGERY 1702141 0 318623 0 126220 0 15250 0 30425 0 2192659 0 0 0 ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE 945874 0 519210 0 263141 0 162196 0 41037 0 1931458 0 232321 0 KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER 760222 0 400152 0 177199 0 128500 0 34770 0 1500843 0 150880 0 ROBERT KEATING MD CHIEF OF NEUROSURGERY 890779 0 172848 0 274045 0 105628 0 24652 0 1467952 0 268002 0 DAVID WESSEL MD CHIEF MEDICAL OFFICER 722447 0 399831 0 149454 0 15250 0 68349 0 1355331 0 0 0 RICARDO MUNOZ MD CHIEF OF CARDIAC CRITICAL CARE 738881 0 137229 0 244067 0 68282 0 19977 0 1208436 0 179211 0 ALDWIN LINDSAY EVP/CFO 671077 0 340588 0 56613 0 111643 0 12797 0 1192718 0 30753 0 TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY 841932 0 298616 0 4356 0 15250 0 28878 0 1189032 0 0 0 RAHUL SHAH MD SVP, HOSPITAL-BASED SPECIALTIES 564976 0 276649 0 207207 0 99253 0 10475 0 1158560 0 184589 0 DEANN MARSHALL PRESIDENT OF FOUNDATION 572442 0 311118 0 125156 0 15250 0 37569 0 1061535 0 0 0 MARY ANNE HILLIARD EVP/CHIEF LEGAL OFFICER 521914 0 269596 0 153026 0 80233 0 29275 0 1054044 0 100169 0 ROGER PACKER MD SVP CENTER OF EXCELLENCE TO 3/23 549112 0 315230 0 138247 0 15250 0 31548 0 1049387 0 0 0 CHARLES WEINSTEIN CHIEF REAL ESTATE OFFICER 496567 0 272105 0 138582 0 15250 0 29116 0 951620 0 0 0 MICHELLE M MCGUIRE CHIEF STRATEGY OFFICER 503410 0 262656 0 52868 0 91752 0 37996 0 948682 0 28749 0 NATHANIEL BEERS MD PRESIDENT OF HSC 469321 0 232918 0 119460 0 86395 0 34017 0 942111 0 96313 0 MARK L BATSHAW MD FMR EVP & CHIEF ACADEMIC OFFICER 508148 0 134413 0 118511 0 140250 0 22510 0 923832 0 0 0 CATHERINE CODISPOTI MD CHIEF PEOPLE OFFICER 454624 0 295973 0 70520 0 15250 0 31043 0 867410 0 0 0 MATTHEW MACVEY CHIEF INFO OFFICER 484976 0 189907 0 37275 0 90250 0 39640 0 842048 0 35781 0 VITTORIO GALLO PHD CHIEF RESEARCH OFFICER 473627 0 214200 0 97948 0 13923 0 11990 0 811688 0 0 0 LINDA TALLEY CHIEF NURSING OFFICER 419046 0 228404 0 55086 0 77208 0 24065 0 803809 0 29249 0 ELIZABETH WELLS SVP CENTER OF EXCELLENCE FROM 3/23 423209 0 132841 0 1220 0 15250 0 35125 0 607645 0 0 0 DENICE CORA-BRAMBLE MD FMR CHIEF MEDICAL OFFICER 200219 0 47447 0 57890 0 11502 0 44879 0 361937 0 0 0 DARRYL VARNADO PHD FMR CHIEF PEOPLE OFFICER 0 0 0 0 226437 0 0 0 23876 0 250313 0 0 0 SCHEDULE J, PART I, LINE 1A: FIRST CLASS OR CHARTER TRAVEL THE CEO PER HIS EMPLOYMENT CONTRACT IS ENTITLED TO USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS. HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL. SCHEDULE J, PART I, LINE 1A: PERSONAL SERVICES CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. SCHEDULE J, PART I, LINE 4A: SEVERANCE THE FOLLOWING FORMER KEY EMPLOYEE RECEIVED A SEVERANCE PAYMENT. THE SEVERANCE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF OTHER REPORTABLE COMPENSATION: DARYL VARNADO $226,437 SCHEDULE J, PART I, LINE 4B: SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II COLUMN (C ) AS PART OF DEFERRED COMPENSATION OR SCHEDULE J, PART II, COLUMN (B)(III) WHEN AMOUNTS ARE DEFERRED AND DISTRIBUTED IN THE SAME CALENDAR YEAR: KURT NEWMAN, MD $243,750 ANTHONY SANDLER, MD $146,946 MARK BATSHAW, MD $204,067 DAVID WESSEL, MD $113,160 KATHLEEN CHAVANU GORMAN $113,250 ROGER PACKER, MD $76,316 VITTORIO GALLO, PHD $64,260 DENISE CORA-BRAMBLE, MD $35,197 ALDWIN LINDSAY $96,393 MICHELLE MCGUIRE $76,502 LINDA TALLEY $64,643 MARY ANNE HILLIARD $64,983 ROBERT KEATING $90,378 NATHANIEL BEERS, MD $71,145 MATTHEW MACVEY $75,000 CHARLES WEINSTEIN $78,795 RICARDO MUNOZ, MD $53,293 RAHUL SHAH, MD $84,003 ADDITIONALLY, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE PLAN THAT WERE DEFERRED ON A PREVIOUSLY FILED FORM 990 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AS TAXABLE WAGES IN THE CURRENT YEAR. ANTHONY SANDLER, MD $232,321 KATHLEEN CHAVANU GORMAN $150,880 ROBERT KEATING, MD $268,002 RICARDO MUNOZ, MD $179,211 ALDWIN LINDSAY $30,753 RAHUL SHAH, MD $184,589 MARY ANNE HILLIARD $100,169 MICHELLE M. MCGUIRE $28,749 NATHANIEL BEERS, MD $96,313 MATTHEW MACVEY $35,781 LINDA TALLEY $29,249 SCHEDULE J, PART I, LINE 7: NON-FIXED PAYMENTS THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT. SCHEDULE J, PART I, LINE 8: INITIAL CONTRACT EXCEPTION CERTAIN INDIVIDUALS HIRED DURING THE YEAR HAVE EMPLOYMENT CONTRACTS WHICH MEET THE INITIAL CONTRACT EXCEPTIONS DESCRIBED IN THE TREASURY REGULATIONS. SCHEDULE J, PART II, COLUMN (F): COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990 THE AMOUNTS REPORTED IN COLUMN F REPRESENT THE ACCUMULATION OVER MANY YEARS OF DEFERRED COMPENSATION BENEFITS WHICH ARE NOW TAXABLE TO THE RECIPIENT. THE ORGANIZATION HAS ALSO REPORTED THESE SAME AMOUNTS AS ACCRUED DEFERRED COMPENSATION IN PRIOR YEARS' COLUMN C. A DISTRICT OF COLUMBIA 536001131 254764KB8 2015-09-17 413728662 SEE PART VI 0 0 0 A 39885000 413728662 410562146 3166515 2012 0 1 1 1 A 0 1 1 1 1 1 0.00100 0.00000 0.00100 0 0 1 A 0 0 0 1 0 0 0 0 1 A 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: DISTRICT OF COLUMBIA DATE THE REBATE COMPUTATION WAS PERFORMED: 09/17/2020 SCHEDULE K, PART I, LINE A, COLUMN (F): ADV REFUND BOND ISSUES 10/26/2005 AND 4/10/2008 CATHERINE CODISPOTI KEY EMPLOYEE HOUSING X 200000 50000 0 1 1 50000 X MEDICAL EQUIPMENT 1 495933 FMV 0 1 0 SCHEDULE M, PART I, COLUMN (B): THE AMOUNT IN COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED. FORM 990, PART I, LINE 1 AND PART III, LINE 1: ORGANIZATION'S MISSION TO IMPROVE HEALTH OUTCOMES FOR CHILDREN; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH. AS THE NATION'S CHILDREN'S HOSPITAL, THE MISSION OF CHILDREN'S NATIONAL IS TO EXCEL IN CARE, ADVOCACY, RESEARCH AND EDUCATION. WE ACCOMPLISH THIS THROUGH: - PROVIDING A QUALITY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND FAMILIES. - IMPROVING HEALTH OUTCOMES FOR CHILDREN REGIONALLY, NATIONALLY, AND INTERNATIONALLY. - LEADING THE CREATION OF INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS OR STOCKHOLDERS CHILDREN'S NATIONAL IS THE SOLE MEMBER OF CHILDREN'S NATIONAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS OR STOCKHOLDERS THE SOLE MEMBER OF CHILDREN'S NATIONAL HOSPITAL HAS THE RIGHT TO ELECT DIRECTORS OF CHILDREN'S NATIONAL HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B MEMBERS OR STOCKHOLDERS THE ARTICLES AND BY-LAWS OF CHILDREN'S NATIONAL HOSPITAL DESCRIBE CERTAIN RIGHTS RESERVED TO THE SOLE MEMBER. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS ONCE THE FORM 990 AND ALL SCHEDULES HAVE BEEN PREPARED BY THE ORGANIZATION'S PROFESSIONAL TAX SERVICES PROVIDER, THE RELEVANT COMMITTEES OF THE ORGANIZATION, ENTITY OPERATIONAL LEADERSHIP, AND FINANCE MANAGEMENT REVIEW APPLICABLE PORTIONS OF THE FORM 990. THE COMPLETED FORM 990 IS ALSO MADE AVAILABLE TO THE BOARD OF CHILDREN'S NATIONAL PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT CHILDREN'S NATIONAL HOSPITAL ASKS THAT EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE COMPLETE A CONFLICT OF INTEREST FORM AT LEAST EVERY YEAR. IN ADDITION, EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS INSTRUCTED TO AMEND THE CONFLICT OF INTEREST FORM IMMEDIATELY UPON A CHANGE IN STATUS OF ANY OF THE QUESTIONS ON THE FORM. THESE FORMS ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND CONFLICTS OF INTERESTS ARE NOTED. THE CHILDREN'S NATIONAL HOSPITAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY. IF ANYONE IS FOUND TO BE CONFLICTED OR A SIGNIFICANT PERCEIVED CONFLICT EXISTS, THAT BOARD MEMBER WOULD RECUSE HIMSELF OR HERSELF FROM ALL DISCUSSIONS RELATED TO THE TRANSACTION. FORM 990, PART VI, LINES 13 & 14: GOVERNING POLICIES CHILDREN'S NATIONAL HOSPITAL IS GOVERNED BY THE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL. THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY. FORM 990, PART VI, SECTION B, LINE 15 PROCESS FOR DETERMINING COMPENSATION THE PEOPLE, CULTURE AND COMPENSATION COMMITTEE OF THE CHILDREN'S NATIONAL BOARD OF DIRECTORS IS COMPRISED WHOLLY OF DISINTERESTED, INDEPENDENT BOARD MEMBERS. THE COMMITTEE HAS RETAINED INDEPENDENT OUTSIDE CONSULTANTS EXPERT ON COMPENSATION MATTERS. THE COMMITTEE DETERMINES ADJUSTMENTS IN COMPENSATION, INCLUDING BASE PAY, INCENTIVES, AND OTHER FORMS OF COMPENSATION FOR EACH PERSON DEEMED BY THE COMPENSATION COMMITTEE TO BE A "DISQUALIFIED PERSON" AS THAT TERM IS USED IN THE INTERMEDIATE SANCTIONS REGULATIONS OF THE IRS. THE COMMITTEE IS INFORMED IN ITS DECISION-MAKING BY COMPENSATION STUDIES AND COMPARISONS DONE BY THE INDEPENDENT CONSULTANT AND RELIES UPON "REASONABLENESS" OPINIONS FOR SUCH CONSULTANTS, PRIOR TO OR CONTEMPORANEOUS WITH MAKING COMPENSATION DECISIONS. THE COMMITTEE MEETS 4-6 TIMES PER YEAR TO CONSIDER SUCH MATTERS AND DOCUMENTS THESE MEETINGS IN MINUTES. FORM 990, PART VI, SECTION C, LINE 19 HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC CHILDREN'S NATIONAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 ARE PROVIDED ON REQUEST. FORM 990, PART XI, LINE 9: UNRESTRICTED EQUITY TRANSFER -16,872,385. CHILDREN'S NATIONAL AT WALTER REED LLC 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 383987350 HEALTH CARE DC 993822 100652527 CH CHILDREN'S HOSPITAL FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521640402 FUNDRAISING DC 501(C)(3) LINE 7 CNMC 0 CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521640403 HEALTH CARE DC 501(C)(3) LINE 12C, III-FI N/A 0 CHILDREN'S RESEARCH INSTITUTE 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521654453 RESEARCH DC 501(C)(3) LINE 7 CNMC 0 SAFE KIDS WORLDWIDE 1255 23RD STREET NW WASHINGTON DC 20037 521627574 INJURY PREVENTION DC 501(C)(3) LINE 7 CNMC 0 BRAINY CAMPS ASSOCIATION 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 271547370 CHILD CAMPS DC 501(C)(3) LINE 12A, I CH 1 CHILDREN'S SCHOOL SERVICES 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 814291601 NURSING SERVICES DC 501(C)(3) LINE 12A, I CNMC 0 THE HSC FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521346603 HEALTH CARE DC 501(C)(3) LINE 12C, III-FI CNMC 0 THE HOSPITAL FOR SICK CHILDREN 111 MICHIGAN AVE NW WASHINGTON DC 20010 530204670 HOSPITAL DC 501(C)(3) LINE 3 HSC FNDN 0 HEALTH SVCS FOR CHILDREN W SPEC NEEDS 111 MICHIGAN AVE NW WASHINGTON DC 20010 521862406 HEALTH CARE DC 501(C)(3) LINE 10 HSC FNDN 0 CHILDREN'S PEDIATRICIANS AND ASSOCIATES LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 522072589 HEALTH CARE DC N/A RELATED -962502 8762420 0 0 0.50000 5253 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 832873855 PROPERTY MANAGEMENT DC N/A 0 0 5253 HTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 833044006 PROPERTY MANAGEMENT DC N/A 0 0 54 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 833358685 PROPERTY MANAGEMENT DC N/A 0 0 54 HTC LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 833385522 PROPERTY MANAGEMENT DC N/A 0 0 CHILDREN'S NATIONAL HEALTH NETWORK 111 MICHIGAN AVENUE NW WASHINGTON DC 20010 521996521 HEALTH CARE DC N/A C 0 BEARACUDA RE PO BOX 69 GRANDCAYMAN CJ KY1-1102 REINSURANCE CJ N/A C 0 PEDIATRIC HEALTH NETWORK INC 12211 PLUM ORCHARD DR STE 102 SILVER SPRING MD 20904 833415276 HEALTH CARE DC N/A C 0 BUILDING 5253 MANAGING MEMBER LLC 111 MICHIGAN AVE NW WASHINGTON DC 20010 832801690 PROPERTY MGMT DC N/A C 0 BUILDING 54 MANAGING MEMBER LLC 111 MICHIGAN AVE WASHINGTON DC 20010 833272918 PROPERTY MGMT DC N/A C 0 0 0 1 1 1 0 0 0 0 0 0 1 1 1 1 1 1 1 1 BRAINY CAMPS ASSOCIATION Q 396483 COST BRAINY CAMPS ASSOCIATION S 234493 COST