2024-05-14T09:00:49-05:00 2023-06-30 135565207 KPMG LLP 8350 BROAD STREET SUITE 900 MCLEAN VA 22102 990 2022-07-01 540506321 CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS CHIL 7576687000 601 CHILDRENS LANE NORFOLK VA 23507 KATHRYN ABSHIRE CFO/ASST TREAS/SECR 7576687000 2024-05-13 1 KATHRYN ABSHIRE 999009999 1 SHAWN HUTCHINSON P01048557 7032868000 2024-05-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JAMES D DAHLING 601 CHILDRENS LANE NORFOLK VA 23507 708193591 0 X WWW.CHKD.ORG X 1961 VA DEDICATED TO THE MISSION OF PROVIDING THE BEST POSSIBLE CARE AND SERVICES FOR ALL CHILDREN WHO COME TO US BECAUSE OF SICKNESS AND INJURY. 18 14 3988 371 463925 206714 88572506 56544790 545779845 575853785 -3631860 10603038 3906723 3262265 634627214 646263878 14604433 21325041 0 0 262614831 309144153 232113 239775 3334016 256248073 291313705 533699450 622022674 100927764 24241204 1082483548 1133029143 312473512 309996072 770010036 823033071 X SEE SCHEDULE O 0 0 551127125 21325041 579332824 SEE SCHEDULE O 551127125 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 1 0 0 1 1 1 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 1 143 0 1 3988 1 1 1 0 0 0 1 1 1 1 0 0 0 1 0 0 0 X 18 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 1 1 1 AL FL GA IL KY MD MA MN NJ NY NC OK SC UT VA WI X KATHRYN ABSHIRE 7576687000 601 CHILDRENS LANE NORFOLK VA 23507 AKHIL JAIN CHAIRMAN/DIRECTOR 2.00 2.00 X X 0 0 0 AMY SAMPSON AS OF 062123 PRESIDENT/DIRECTOR 1.00 42.00 X X 0 686334 289621 BRIAN SKINNER DIRECTOR 1.00 1.00 X 0 0 0 CARL ST REMY MD DIRECTOR 1.00 40.00 X 0 696945 40904 EDWARD WHITMORE TREASURER/DIRECTOR 2.00 2.00 X X 0 0 0 ELLY BRADSHAW SMITH DIRECTOR 1.00 1.00 X 0 0 0 JAMES D DAHLING UNTIL 62123 PRESIDENT/DIRECTOR 1.00 42.00 X X 0 1189913 40552 JOHN R LAWSON II DIRECTOR 1.00 1.00 X 0 0 0 JULIA CHILDRESS BECK DIRECTOR 1.00 1.00 X 0 0 0 KATHERINE KNAUS DIRECTOR 1.00 1.00 X 0 0 0 KATHRYN M VAN BUREN DIRECTOR 1.00 1.00 X 0 0 0 KEVIN MURPHY DIRECTOR 1.00 1.00 X 0 0 0 KIERAN POULOS DIRECTOR 1.00 1.00 X 0 0 0 KIM GEORGES SECRETARY/DIRECTOR 2.00 2.00 X X 0 0 0 MARTA SATIN-SMITH DIRECTOR 1.00 1.00 X 0 0 0 MARTHA COLEN DIRECTOR 1.00 1.00 X 0 0 0 MILES LEON DIRECTOR 1.00 1.00 X 0 0 0 NICOLE LEGUM DIRECTOR 1.00 1.00 X 0 0 0 OWEN GRIFFEN DIRECTOR 1.00 1.00 X 0 0 0 R JUSTIN FULTON VICE CHAIRMAN/DIRECTOR 2.00 2.00 X X 0 0 0 SCOTT NOTTINGHAM MD DIRECTOR 1.00 40.00 X 0 420028 40440 STACEY VELLINES DIRECTOR 1.00 1.00 X 0 0 0 SVINDER S TOOR MD DIRECTOR 1.00 1.00 X 0 0 0 DENNIS RYAN UNTIL 070822 CFO & ASSISTANT SECRETARY/TREASURER 1.00 42.00 X 0 348254 31377 KATHRYN ABSHIRE AS OF 070822 CFO & ASSISTANT SECRETARY/TREASURER 1.00 42.00 X 0 567656 192618 ALLISON SILVA VP - ANCILLARY SERVICES 40.00 0.00 X 464847 0 191024 DEBORAH BARNES VP - IS OPERATIONS 0.00 40.00 X 0 807442 260207 JALANA MCCASLAND VP - PHYSICIAN PRACTICE MANAGEME 40.00 0.00 X 455550 0 226903 JOHN HARDING CHIEF OPERATING OFFICER 0.00 40.00 X 0 909227 371789 KAREN MITCHELL VP- PATIENT CARE SERVICES 40.00 0.00 X 507110 0 28468 TAMIKA HARRIS VP - FACILITIES & SUPPORT SERV 40.00 0.00 X 283486 0 99698 JOHN HARRINGTON VP - QUALITY/SAFETY & CLINICAL INTEGRATION 20.00 20.00 X 416065 0 110543 JOHN WARBURTON VP - MENTAL HEALTH 40.00 0.00 X 353694 0 85159 PATRICIA HIGAZI DIRECTOR-OCUPATIONAL HEALTH 40.00 0.00 X 261013 0 19948 SAMUEL SCOTT PHYSICIAN 40.00 0.00 X 270627 0 16372 SUZANNE BRIXEY PHYSICIAN 40.00 0.00 X 368226 0 15805 3380618 5625799 2061428 365 0 1 0 CHILDREN'S SPECIALTY GROUP P O BOX 11049 NORFOLK VA 23517 MEDICAL 34040780 W M JORDAN 11010 JEFFERSON AVE NEWPORT NEWS VA 23601 CONSTRUCTION 22210491 EASTERN VIRGINIA MED SCHOOL P O BOX 1980 NORFOLK VA 235011980 MEDICAL 14355603 COMPASS ONE P O BOX 1022289 ATLANTA GA 30368 FOOD SERVICES 11056722 THE WHITING-TURNER CONTRACTING COMPANY 300 E JOPPA ROAD BALTIMORE MD 212863048 CONSTRUCTION 8924350 131 104269 19628154 12154397 24657970 6366868 56544790 PATIENT SERVICES 900099 546295811 546295811 OTHER RELATED SERVICES 900099 29094049 29094049 LAB SERVICES 621500 299565 299565 SPORTS RELATED SERVICE 900099 164360 164360 575853785 12155681 12155681 2216851 28724 2462349 0 -245498 28724 -216774 -216774 57789846 124875 59457085 10279 -1667239 114596 -1552643 -1552643 GRADUATE MEDICAL ED. 900099 3479039 3479039 3479039 646263878 578868899 463925 10386264 21325041 21325041 1749765 1383609 366156 265147125 241238584 22124336 1784205 6463982 4905499 1485719 72764 19522126 17945548 1367333 209245 16261155 14773433 1349608 138114 64300 64300 58196 58196 48000 48000 239775 239775 272270 272270 61764708 57604856 4054031 105821 296644 31695 250161 14788 4473985 3176664 1241158 56163 2975558 2209254 635768 130536 18859072 16461250 2381081 16741 313335 259130 48293 5912 1382827 1140779 239328 2720 5627512 5575812 51700 36237267 33200327 2983013 53927 2670201 925048 1744941 212 SUPPLIES 80412380 80308930 81708 21742 EQUIP RENTAL AND MAINT. 28078679 25401299 2574299 103081 PURCHASED SERVICES 23253733 18293578 4906710 53445 UNRELATED BUSINESS INC. 22518 0 22518 0 24502520 4966789 19210906 324825 622022674 551127125 67561533 3334016 64766381 57777910 24150559 24957982 92745444 116749503 13192307 13426907 8906221 12546317 855481614 383848712 474965762 471632902 318152363 323926289 45318925 46700214 40285586 65311119 1082483548 1133029143 56567101 51824086 1406048 217675 235172888 229954076 19327475 28000235 312473512 309996072 X 713694947 770097162 56315089 52935909 770010036 823033071 1082483548 1133029143 X 24241204 15483868 -597155 13895118 X 0 1 X 1 1 1 X 15669332 46947279 99087320 88572506 56544790 306821227 15669332 46947279 99087320 88572506 56544790 306821227 306821227 10139234 10070432 7246160 9745593 14401256 51602675 349255 397998 392485 495419 463925 2099082 360522984 1914246947 0.85100 0.84870 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 26170544 664247 1852435 700149 27987077 29093174 600675 -2262495 1260810 26170544 25741292 482624 3489607 620349 29093174 25731316 322831 754876 1067731 25741292 25265775 546670 1056618 1137747 25731316 1.00000 0 0 18417162 18417162 537492353 165532740 371959613 15978320 9790696 6187624 275504656 208213776 67290880 8089123 311500 7777623 471632902 CONTRIBUTION/REMAINDER TRUST 5588212 CASH SURRENDER VALUE LIFE INSURANCE 267288 INTERCOMPANY RECEIVABLES 2112531 INVESTMENT IN SHARED HOSPITAL 307111 RIGHT OF USE ASSETS 14318536 INSURANCE RECOVERABLE 3851254 DERIVATIVE INSTUMENTS ASSET 38866187 65311119 INSURANCE IBNR & IBNE 6080199 DERIVATIVE INSTRUMENTS 2909136 CAPITAL LEASE 2554766 ANNUITY PAYABLE 1046016 INTERCOMPANY LIABILITIES 24390 ACCRUED TAIL COVERAGE 33029 OPERATING LEASE OBLIGATIONS 15352699 28000235 X PART V, LINE 4: ENDOWMENT FUNDS ARE USED ACCORDING TO SPECIFIC WRITTEN REQUESTS OF THE DONOR ENDOWMENT AGREEMENT. IF NO DIRECT REQUESTS ARE MADE, FUNDS ARE USED IN ACCORDANCE WITH THE OVERALL MISSION OF THE ORGANIZATION. PART X, LINE 2: ASC 740 FOOTNOTE FROM CONSOLIDATED AUDIT REPORT CHS RECOGNIZES ANY BENEFITS FROM AN UNCERTAINTY IN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. IF APPLICABLE, THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION WOULD BE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE RESOLUTION. CHS DOES NOT BELIEVE ANY UNCERTAIN TAX PROVISIONS REQUIRE RECORDING IN ITS CONSOLIDATED FINANCIAL STATEMENTS. X X X X X X X 1 CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 CONSULTING 0 1628314 205155 1423159 HEALTH PHILANTHROPY 3996 N HAMPTON DRIVE POWELL OH 43065 CONSULTING 0 0 34620 -34620 1628314 239775 1388539 AL AR CA CO CT DC FL GA HI IL KS KY LA ME MD MA MI MN MO NV NJ NY NC OH OK PA RI SC TN UT VA WA WV WI 1 1 X 1 X 175.000000000000 1 X 1 1 1 0 1 1 3497722 3497722 0.00580 290457757 229419785 61037972 0.10080 293955479 229419785 64535694 0.10660 98517674 16135152 82382522 0.13600 15434704 7797645 7637059 0.01260 103392084 71443272 31948812 0.05280 658152 25351 632801 0.00100 218002614 95401420 122601194 0.20240 511958093 324821205 187136888 0.30900 0 16380049 8778801 2754039 6886819 -4132780 X 1 1 3 1 CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS 601 CHILDRENS LANE NORFOLK VA 23507 H1843 X X X X X X MEDICAID DSH HOSPITAL A 2 CHKD HEALTH AND SURGERY CENTER 2021 CONCERT DRIVE VIRGINIA BEACH VA 23456 OH713 X OUTPATIENT SURGICAL HOSPITAL A 3 CHKD HEALTH AND SURGERY CENTER 11783 ROCK LANDING DRIVE NEWPORT NEWS VA 23608 OH694 X OUTPATIENT SURGICAL HOSPITAL A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 21 1 1 0 1 X WWW.CHKD.ORG X 1 22 1 WWW.CHKD.ORG 0 1 X 175.000000000000 400.000000000000 X X X X X X 1 1 X X X 1 X WWW.CHKD.ORG X WWW.CHKD.ORG X WWW.CHKD.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, - FACILITY 2: CHKD HEALTH AND SURGERY CENTER, - FACILITY 3: CHKD HEALTH AND SURGERY CENTER FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5: CHKD'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PROCESS INCLUDED COLLECTING DATA FROM SEVERAL DIFFERENT SOURCES: A COMMUNITY HEALTH SURVEY (IN COLLABORATION WITH OTHER AREA HOSPITAL SYSTEMS), FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS AND HEALTH INDICATOR ANALYSIS.TWO VERSIONS OF THE SURVEY WITH SIMILAR QUESTIONS WERE CIRCULATED ACROSS CHKD'S SERVICE AREA. THE FIRST VERSION WAS A STAKEHOLDER SURVEY IN WHICH MANY PARTICIPANTS PROVIDED (OR HAD KNOWLEDGE OF) HEALTH, PREVENTIVE AND SUPPORT SERVICES, AS WELL AS THE NEEDS OF LOW INCOME AND MINORITY RESIDENTS. THE SECOND VERSION WAS A COMMUNITY SURVEY THAT WAS CIRCULATED MORE BROADLY TO COMMUNITY MEMBERS. THERE WERE A TOTAL OF 11,744 COMMUNITY MEMBERS WHO COMPLETED THE SURVEY QUESTIONS. THERE WERE 1,099 RESPONSES TO THE STAKEHOLDER SURVEY.GIVEN THE PREVIOUSLY IDENTIFIED PRIORITY OF MENTAL AND BEHAVIORAL HEALTH AND AN INTEREST IN HEARING FROM STAKEHOLDERS FROM ACROSS THE REGION WHO WERE FAMILIAR WITH THESE ISSUES, KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUPS WERE CONDUCTED. A TOTAL OF 51 PEOPLE PARTICIPATED IN KEY STAKEHOLDER INTERVIEWS AND FOCUS GROUPS. THERE WERE 4 FOCUS GROUPS CONDUCTED BY VOICES (VIRGINIA ORGANIZATION FOR INCLUSIVE CONCEPTS AND EQUITABLE SOLUTIONS), A THINK TANK THAT FOCUSES ON PROVIDING BEST PRACTICE AND GUIDANCE ON FAIR AND EQUAL TREATMENT, SYSTEMIC AND INSTITUTIONAL RACISM, SOCIO-ECONOMIC ISSUES, AND SOCIAL DETERMINANTS OF HEALTH THAT CREATE IMPEDIMENTS FOR MARGINALIZED AND UNDERSERVED PEOPLE. TWENTY-FOUR PARTICIPANTS FROM ACROSS THE REGION TOOK PART IN THE GROUP DISCUSSIONS ON THE FOLLOWING TOPICS: (1) A HEALTHY WORKPLACE, (2) ACCESS TO HEALTHCARE, (3) ACCESS TO FOOD, (4) EMERGENCIES AND FINANCES.THE 27 KEY STAKEHOLDER INTERVIEWS TARGETED LOCAL PUBLIC HEALTH AND SOCIAL SERVICE DEPARTMENT REPRESENTATIVES, INDIVIDUALS OR ORGANIZATIONS SERVING MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY, SCHOOL NURSES FROM LOCAL SCHOOL SYSTEMS PARTICULARLY IN RURAL AND PREDOMINANTLY LOW INCOME AREAS, AND HEALTHCARE AND MENTAL/BEHAVIORAL HEALTHCARE PROVIDERS WHO OFFER SERVICES FOR CHILDREN AND FAMILIES. ORGANIZATIONAL PARTICIPANTS INCLUDED HOSPITALS, COMMUNITY HEALTH CENTERS, SCHOOL SYSTEMS, SOCIAL SERVICES, NON-PROFIT AND OTHER COMMUNITY-BASED ORGANIZATIONS.NATIONAL, STATE AND PRIVATE DATA SOURCES WERE USED IN THE HEALTH INDICATOR ANALYSIS. KEY HEALTH ISSUES WERE IDENTIFIED WHEN MULTIPLE LOCALITIES HAD WORSE RATES OR PERCENTAGES IN COMPARISON TO STATE AVERAGES. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A: A JOINT COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED FOR CHKD'S THREE LICENSED FACILITIES LISTED IN PART V, SECTION A. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 11: AFTER COMPILING ALL OF THE RESULTS FROM THE STAKEHOLDER AND COMMUNITY SURVEYS, FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS AND HEALTH INDICATOR ANALYSIS, COMMON THEMES AND SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED ACROSS DATA SOURCES. THESE THEMES EITHER AROSE AS PRIORITIES IN AT LEAST TWO OF THE DATA SOURCES OR IF DATA FROM ONE OF THE SOURCES REVEALED OVERWHELMING NEED. THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED: MENTAL/BEHAVIORAL HEALTH, HEALTHY EATING AND ACCESS TO HEALTHY FOODS, ALCOHOL/SUBSTANCE ABUSE, SAFE AND AFFORDABLE HOUSING, PEDIATRIC ASTHMA, INFANT HEALTH, SEXUALLY TRANSMITTED INFECTIONS, AND CHILD ABUSE.CHKD LEADERS REVIEWED RESULTS FROM ALL THREE DATA SOURCES TO BETTER UNDERSTAND THE SIGNIFICANT HEALTH NEEDS AND PRIORITIES TO DETERMINE THE BEST FOCUS FOR ITS IMPLEMENTATION PLAN. INDIVIDUALS AND GROUPS INVOLVED IN THIS PROCESS INCLUDED THE FOLLOWING: THE HOSPITAL'S SENIOR LEADERSHIP TEAM, WHICH INCLUDES ITS CEO, PRESIDENT AND VICE PRESIDENTS; CHKD PHYSICIAN LEADERS; AND CHKD'S PARENT AND FAMILY ADVISORY COUNCIL.GIVEN THE SCOPE AND DEPTH OF THE NEED FOR MENTAL HEALTH CARE AND THE SIGNIFICANT RESOURCES CHKD HAS DEVOTED TO EXPANDING ITS MENTAL HEALTH SERVICES, CHKD IS PRIORITIZING THIS ISSUE IN ITS IMPLEMENTATION PLAN STRATEGY FROM 2022 TO 2024. SINCE THE 2019 CHNA, CHKD HAS MADE SIGNIFICANT PROGRESS TOWARD DEVELOPING A COORDINATED, REGIONAL CONTINUUM OF INPATIENT, OUTPATIENT AND DAY TREATMENT PROGRAMS FOR CHILDREN WITH MENTAL HEALTH CHALLENGES. ADDRESSING PEDIATRIC MENTAL/BEHAVIORAL HEALTH WOULD HAVE A POSITIVE EFFECT ON PEDIATRIC HEALTH AND WELL-BEING OVERALL, AFFECTING MULTIPLE OTHER IDENTIFIED HEALTH NEEDS, SUCH AS VIOLENCE AND ALCOHOL/SUBSTANCE ABUSE. CHKD WILL CONTINUE ITS COMMITMENT TO PREVIOUSLY IMPLEMENTED PROGRAMS INCLUDING ITS EXISTING CHILD ADVOCACY CENTER THAT ADDRESSES CHILD ABUSE.MENTAL/BEHAVIORAL HEALTH: CHKD OPENED CHKD'S CHILDREN PAVILION, A 60-BED PEDIATRIC MENTAL HEALTH HOSPITAL AND OUTPATIENT CENTER IN LATE 2022. THE NEW FACILITY WILL INCLUDE THOUGHTFUL PATIENT AND FAMILY-CENTERED DESIGN, EVIDENCE-BASED TREATMENTS, ACADEMIC TRAINING PROGRAMS, AND CLINICAL RESEARCH TO GUIDE INNOVATION. CHKD'S MENTAL HEALTH IMPLEMENTATION STRATEGY INCLUDES ESTABLISHING A PARTIAL HOSPITALIZATION PROGRAM THAT OFFERS FULL-DAY MENTAL HEALTH TREATMENT, OFFERING AND EXPANDING INTENSIVE OUTPATIENT PROGRAMMING, WORKING WITH OUR COMMUNITY TO ESTABLISH PARTNERSHIPS AND SUPPORT CHILDREN AND ADOLESCENTS IN THEIR TYPICAL ENVIRONMENTS, AND CONTINUING TO OFFER TELEHEALTH FOR OUTPATIENT CARE. CHKD HAS ESTABLISHED 2 OUTPATIENT MENTAL HEALTH FACILITIES FOCUSING ON MENTAL HEALTH THERAPY, PSYCHOLOGICAL ASSESSMENT, AND PSYCHIATRY SERVICES: NEWPORT NEWS HEALTH CENTER AT TECH CENTER AND VIRGINIA BEACH HEALTH CENTER AT LANDSTOWN. IN AN ANSWER TO THE PEDIATRIC MENTAL HEALTH CARE FRAGMENTATION DUE TO THE LACK OF COMMUNICATION BETWEEN A CHILD'S VARIOUS MEDICAL AND MENTAL HEALTH PROVIDERS, CHKD'S GOAL IS TO DEVELOP A COORDINATED CONTINUUM OF CARE ACROSS ITS FACILITIES. WITH ITS BROAD NETWORK OF MORE THAT 300 PEDIATRICIANS, SPECIALISTS, AND SURGEONS IN MORE THAN 40 LOCATIONS THROUGHOUT THE REGION, CHKD HEALTH SYSTEM IS IN A UNIQUE POSITION TO ADDRESS AND IMPROVE CARE FRAGMENTATION. CHKD IS THE REGION'S PARTNER FOR THE VIRGINIA MENTAL HEALTH ACCESS PROGRAM (VMAP), A STATEWIDE INITIATIVE THAT OFFERS PEDIATRICIANS REAL-TIME PHONE CONSULTATIONS WITH BOARD-CERTIFIED CHILD AND ADOLESCENT PSYCHIATRISTS. VMAP ALSO SERVES AS A RESOURCE FOR PEDIATRICIANS WHO ARE LOOKING FOR MENTAL HEALTH CARE AND BEHAVIORAL CONSULTATION FOR A CHILD IN THEIR CARE.CHKD PLANS TO CONTINUE TO COMMIT PROGRAMMING AND RESOURCES TO ITS ONGOING INITIATIVES TO ADDRESS OBESITY, CHILD ABUSE AND INFANT HEALTH. OTHER SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH THE CHNA ARE NOT BEING SPECIFICALLY ADDRESSED IN THE CURRENT IMPLEMENTATION ARE ALCOHOL/SUBSTANCE ABUSE, SAFE AND AFFORDABLE HOUSING, PEDIATRIC ASTHMA, AND SEXUALLY TRANSMITTED INFECTIONS, THESE ARE ALL CONDITIONS THAT CHKD EITHER CURRENTLY PROVIDES CARE FOR AND/OR COLLABORATES WITH OTHER COMMUNITY AGENCIES TO ADDRESS. CHKD REGULARLY AND ROUTINELY OFFERS ITS EXPERTISE AND ASSISTANCE AS WELL AS COMMUNITY RESOURCES TO ADDRESS A BROAD RANGE OF ISSUES RELATING TO THE HEALTH AND WELFARE OF CHILDREN. FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13H: PRESUMPTIVE ELIGIBILITY MAY BE DETERMINED ON THE BASIS OF INDIVIDUAL LIFE CIRCUMSTANCES THAT MAY INCLUDE:1. STATE-FUNDED PRESCRIPTION PROGRAMS;2. HOMELESS OR RECEIVED CARE FROM A HOMELESS CLINIC;3. PARTICIPATION IN WOMEN, INFANTS AND CHILDREN PROGRAMS (WIC);4. FOOD STAMP ELIGIBILITY;5. SUBSIDIZED SCHOOL LUNCH PROGRAM ELIGIBILITY;6. ELIGIBILITY FOR OTHER STATE OR LOCAL ASSISTANCE PROGRAMS THAT AREUNFUNDED (E.G., MEDICAID SPEND-DOWN);7. LOW INCOME/SUBSIDIZED HOUSING IS PROVIDED AS A VALID ADDRESS; AND8. PATIENT IS DECEASED WITH NO KNOWN ESTATE. 14 1 - CHKD HEALTH CENTER AT OAKBROOKE 500 DISCOVERY DRIVE CHESAPEAKE VA 23320 OUTPATIENT SERVICES 2 - CHKD HLTH CTR & URGENT CARE AT LOEHMAN'S 3960 VIRGINIA BEACH BLVD VIRGINIA BEACH VA 23452 URGENT CARE & OUTPATIENT SERVICES 3 - CHKD HLTH CTR & URGENT CARE AT TECH CNTR 680 OYSTER POINT ROAD NEWPORT NEWS VA 23602 URGENT CARE & OUTPATIENT SERVICES 4 - CHKD URGENT CARE AT VOLVO 817 VOLVO PARKWAY CHESAPEAKE VA 23320 URGENT CARE & OUTPATIENT SERVICES 5 - CHKD HLTH CTR & URGENT CARE AT LANDSTOWN 1924 LANDSTOWN WAY VIRGINIA BEACH VA 23456 URGENT CARE & OUTPATIENT SERVICES 6 - CHKD HEALTH CENTER AT HARBOUR VIEW 5832 HARBOUR VIEW BLVD SUFFOLK VA 23435 OUTPATIENT SERVICES 7 - CHKD HEALTH CENTER AT HARBOUR VIEW 5834 HARBOUR VIEW BLVD SUFFOLK VA 23455 OUTPATIENT SERVICES 8 - SATELLITE AT MEDICAL TOWER 400 GRESHAM DRIVE NORFOLK VA 23507 OUTPATIENT SERVICES 9 - CHKD HEALTH CENTER AT LIGHTFOOT 6425 RICHMOND ROAD WILLIAMSBURG VA 23188 OUTPATIENT SERVICES 10 - HEALTH CENTER AT MEDICAL CENTER CAMPUS 850 SOUTHAMPTON AVENUE NORFOLK VA 23510 OUTPATIENT SERVICES 11 - SPORTS MEDICINE IN GHENT 702 WEST 21ST STREET NORFOLK VA 23517 OUTPATIENT SERVICES 12 - CHKD CAP 935 REDGATE AVENUE NORFOLK VA 23507 OUTPATIENT SERVICES 13 - FORT NORFOLK PLAZA MEDICAL BUILDING 301 RIVERVIEW AVENUE NORFOLK VA 23510 OUTPATIENT SERVICES 14 - CHKD HEALTH CENTER AT KEMPSVILLE 171 KEMPSVILLE ROAD NORFOLK VA 23510 OUTPATIENT SERVICES PART I, LINE 7(E): THE AMOUNT REPORTED ON PART I, LINE 7(E) INCLUDES $74,502,103 OF COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS.PART I, LINE 7(F):THE AMOUNT OF BAD DEBT INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A) THAT WAS SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENT OF TOTAL EXPENSE IN PART I, LINE 7, COLUMN (F) IS $16,380,049. PART I, LINE 7: A HYBRID APPROACH WAS USED FOR DETERMINING COSTS RELATED TO COMMUNITY BENEFIT. ACTUAL COSTS FROM ALL PATIENT SEGMENTS ARE IDENTIFIED BY DEPARTMENT IN THE GENERAL LEDGER AND THEN WERE GROUPED INTO LIKE COMMUNITY BENEFIT PROGRAMS. INDIRECT COSTS WERE ADJUSTED FOR COSTS ATTRIBUTABLE TO UNREIMBURSED MEDICAID COSTS REPORTED ELSEWHERE, MARKETING AND GRANT WRITING EXPENSES. THE MEDICAID COSTS ADJUSTMENT WAS CALCULATED USING A COST TO CHARGE RATIO OF APPLICABLE EXPENSES DIVIDED BY TOTAL APPLICABLE CHARGES APPLIED TO MEDICAID REVENUE. THE REMAINING INDIRECT COSTS WERE ALLOCATED PROPORTIONATELY TO THE DIRECT COSTS REPORTED BY DEPARTMENT. IN ADDITION, EXPENSES WERE CALCULATED AT COST AND THEN COSTS RELATED TO CHARITY CARE, BAD DEBT AND MEDICAID WERE REMOVED BEFORE ARRIVING AT THE AMOUNTS FOR COMMUNITY BENEFIT AT COST. PART III, LINE 2: BAD DEBT REPORTED IN PART III LINE 2 IS BASED ON THE AMOUNT REPORTED AS BAD DEBT IN THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES. THE AMOUNT DOES NOT INCLUDE DISCOUNTS OR OTHER ADMINISTRATIVE WRITE OFFS. IF A PATIENT ACCOUNT HAS BEEN WRITTEN OFF TO BAD DEBT AND IS SUBSEQUENTLY COLLECTED, BAD DEBT EXPENSE IS REDUCED IN THAT PERIOD BY THE PAYMENT.PART III, LINE 3:THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS CALCULATED BASED OFF THE PERCENTAGE OF CHARITY CARE EXPENSES AS A PERCENTAGE OF SELF-PAY REVENUE. CHKD DOES NOT MAINTAIN RECORDS THAT TRACK PATIENTS WHO COULD HAVE QUALIFIED FOR CHARITY CARE. THIS AMOUNT IS AN ESTIMATE OF PATIENTS WHO LIKELY WOULD HAVE QUALIFIED FOR FINANCIAL ASSISTANCE UNDER THE CHARITY CARE POLICY IF SUFFICIENT INFORMATION HAD BEEN AVAILABLE TO DETERMINE THEIR ELIGIBILITY. THIS AMOUNT IS NOT INCLUDED AS COMMUNITY BENEFIT. PART III, LINE 4: CHKD PRESENTS BAD DEBT PROVISION ON THE FINANCIAL STATEMENTS AS A DEDUCTION FROM NET PATIENT SERVICE REVENUE PER ACCOUNTING STANDARDS UPDATE (ASU) 2011-07. THE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES IS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN THE HOSPITAL'S EXISTING RECEIVABLES. THE HOSPITAL DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE, NET OF PAYMENTS AND DISCOUNTS, AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR THE RECOVERY IS CONSIDERED REMOTE. FOR ADDITIONAL DETAILS SEE FOOTNOTE 17 ON PAGE 32 OF AUDITED FINANCIAL STATEMENTS.PART III, LINE 8:AS A CHILDREN'S HOSPITAL, THE HOSPITAL HAS A SMALL POPULATION OF MEDICARE PATIENTS AND IS PAID LESS THAN COST DUE TO THE REIMBURSEMENT METHODOLOGY USED BY MEDICARE. THE SHORTFALL WAS CALCULATED USING THE HOSPITAL'S OVERALL COST TO CHARGE RATIO APPLIED TO MEDICARE GROSS CHARGES. THIS SHORTFALL IS NOT SEPARATELY INCLUDED AS A COMMUNITY BENEFIT AS 100% OF IT HAS ALREADY BEEN CAPTURED IN THE APPROPRIATE CATEGORY ON PART I, LINE 7. PART III, LINE 9B: ACCOUNTS WITH AN UNPAID BALANCE OR WITHOUT AN ESTABLISHED PAYMENT PLAN ARE REFERRED TO A COLLECTION AGENCY OR ATTORNEY FOR CONTINUED COLLECTION EFFORTS. CHKD MAKES REASONABLE EFFORTS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE/CHARITY CARE BEFORE REFERRING TO A COLLECTION AGENCY OR AN ATTORNEY. REASONABLE EFFORT INCLUDES AND IS NOT LIMITED TO NOTIFICATION ABOUT THE FINANCIAL ASSISTANCE - CHARITY CARE/COLLECTION POLICY POSTED IN ADMISSIONS, EMERGENCY DEPARTMENT OR OTHER DESIGNATED AREAS. THE INFORMATION REGARDING THE POLICY IS INCLUDED IN THE ADMISSION PACKAGE AND ON THE PATIENT BILL. THE HEALTH BENEFITS ANALYST AND CUSTOMER SERVICE REPRESENTATIVE WHO MAY SPEAK WITH THE GUARANTOR BY PHONE PROVIDE THEM WITH FINANCIAL ASSISTANCE INCLUDING CHARITY CARE INFORMATION. THE FINANCIAL ASSISTANCE-CHARITY CARE/COLLECTION POLICY IS AVAILABLE UPON REQUEST AND VIA WWW.CHKD.ORG. CHKD ENSURES ALL COLLECTION PROTOCOLS ARE MET PRIOR TO REFERRAL TO COLLECTIONS AGENCY OR ATTORNEY. APPROVED CHARITY CARE AMOUNT WILL NOT BE SUBJECT TO COLLECTION ACTIVITIES. THE REMAINING BALANCE WILL BE SUBJECT TO CHKD'S STANDARD COLLECTION PROTOCOLS.PART VI, LINE 2:NEEDS ASSESSMENT:AS THE ONLY HEALTHCARE PROVIDER IN VIRGINIA DEVOTED EXCLUSIVELY TO THE NEEDS OF CHILDREN, CHKD ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF PEDIATRIC CARE AND THE PROMOTION OF CHILDREN'S HEALTH AND IS TRUSTED THROUGHOUT ITS COMMUNITY TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. CHKD USES A VARIETY OF METHODS TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON PROFIT AND PUBLIC HEALTH AGENCIES AND ORGANIZATIONS AND THROUGH REGIONAL, STATE AND NATIONAL DATA. FROM NOVEMBER 2021 TO APRIL 2022, CHKD CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH SUPPORT FROM TOXCEL, LLC, A GAINESVILLE, VIRGINIA-BASED SCIENCE, ENGINEERING AND HEALTH RESEARCH AND CONSULTING FIRM. THIS JOINT CHNA COVERS ALL THREE LICENSED FACILITIES ASSOCIATED WITHIN THE CHKD HEALTH SYSTEM: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) LOCATED IN NORFOLK AND CHKD'S TWO HEALTH AND SURGERY CENTERS, ONE AT OYSTER POINT IN NEWPORT NEWS AND ONE AT PRINCESS ANNE IN VIRGINIA BEACH. CHKD'S CHNA PROVIDES AN OVERVIEW OF THE PRIMARY AND SECONDARY DATA USED TO IDENTIFY KEY HEALTH ISSUES WITHIN THE CHKD COMMUNITY. IT COMBINES AND COMPARES RESULTS FROM THREE SOURCES: A COMMUNITY HEALTH SURVEY, FOCUS GROUPS, AND KEY STAKEHOLDER INTERVIEWS. CHKD'S CURRENT COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT WWW.CHKD.ORG/COMMUNITYBENEFIT.PART VI, LINE 3:PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:CHKD'S CHARITY CARE ELIGIBILITY CRITERIA AND PROCEDURES FOR APPLYING ARE PROVIDED TO ALL PATIENTS. CHARITY CARE INFORMATION IS INCLUDED IN EVERY INPATIENT ADMISSION PACKET AND DISTRIBUTED TO THE OUTPATIENT DURING THE OUTPATIENT REGISTRATION PROCESS. AN APPLICATION FOR CHARITY CARE, ALONG WITH A LETTER EXPLAINING THE PROCESS, IS SENT TO ANY PATIENT OR GUARANTOR WHO REQUESTS INFORMATION ON ANY PROGRAMS OR PROVISIONS THE HOSPITAL MAY HAVE TO HELP ASSIST PATIENTS OR GUARANTORS IN PAYING THEIR HOSPITAL BILL. THE CHARITY CARE POLICY AND APPLICATION ARE PROMINENTLY DISPLAYED ON THE MAIN "BILLING" PAGE OF THE HOSPITAL WEBSITE, JUST ONE CLICK FROM THE HOME PAGE, AT WWW.CHKD.ORG/BILLING/FINANCIAL-ASSISTANCE. PRINTED COPIES ARE ALSO AVAILABLE AT EACH REGISTRATION WORKSTATION. ALL BILLING STATEMENTS MAILED TO GUARANTORS INCLUDE A NOTICE OF THE AVAILABILITY OF CHARITY AND HOW TO OBTAIN THE INFORMATION/APPLICATION. ASSISTANCE WITH THE APPLICATION PROCESS IS AVAILABLE THROUGH THE HEALTH BENEFITS ANALYST (HBA). THE HBA SENDS OUT APPLICATIONS VIA MAIL AND REFERS FAMILIES TO THE HOSPITAL'S WEBSITE. THE UNIT SOCIAL WORKER IS AVAILABLE TO PROVIDE INFORMATION OR REFERRAL TO THE HBA DURING AN INPATIENT STAY.PART VI, LINE 4:COMMUNITY INFORMATION:CHKD IS THE REGIONAL PEDIATRIC REFERRAL CENTER FOR SOUTHEASTERN VIRGINIA, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA. CHKD SERVES THE FOLLOWING REGIONS IN VIRGINIA: ACCOMACK COUNTY, CHESAPEAKE CITY, FRANKLIN CITY, GLOUCESTER COUNTY, HAMPTON CITY, ISLE OF WIGHT COUNTY, JAMES CITY COUNTY, MATHEWS COUNTY, NEWPORT NEWS CITY, NORFOLK CITY, NORTHAMPTON COUNTY, POQUOSON CITY, PORTSMOUTH CITY, PRINCE GEORGE COUNTY, SOUTHAMPTON COUNTY, SUFFOLK CITY, SURRY COUNTY, SUSSEX COUNTY, VIRGINIA BEACH CITY, WILLIAMSBURG CITY AND YORK COUNTY. WITHIN NORTH CAROLINA, CHKD SERVES THE FOLLOWING REGIONS: BERTIE COUNTY, CAMDEN COUNTY, CHOWAN COUNTY, CURRITUCK COUNTY, DARE COUNTY, GATES COUNTY, HERTFORD COUNTY, PASQUOTANK COUNTY AND PERQUIMANS COUNTY. AS REFLECTED IN OUR 2022 CHNA, THIS SERVICE REGION INCLUDED 458,649 PERSONS AGE 0-19. CHKD'S SERVICE AREA COMPRISES A DIVERSE MIX OF URBAN, SUBURBAN AND RURAL COMMUNITIES, AS WELL AS 10 MILITARY INSTALLATIONS. CHKD IS WELL VERSED IN THE SPECIAL NEEDS OF MILITARY FAMILIES AND HAS ONE OF THE HIGHEST TRICARE PAYER PERCENTAGES AMONG THE CHILDREN'S HOSPITALS IN THE NATION.PART VI, LINE 5:PROMOTION OF COMMUNITY HEALTHCHKD PLAYS A UNIQUE ROLE IN ITS COMMUNITY BY PROVIDING PEDIATRICHEALTHCARE SERVICES AVAILABLE NOWHERE ELSE IN THE REGION AND, AT THE SAME TIME, SERVING AS THE SAFETY NET PROVIDER TO THE REGION'S INDIGENT CHILDREN. IN FY 2023, CHKD HAD 5,372 ADMISSIONS RESULTING IN 51,716 PATIENT DAYS. 55.5 PERCENT OF THESE DAYS, WERE COVERED BY MEDICAID, WHICH IS THE HIGHEST PERCENTAGE BY FAR OF ANY ACUTE-CARE HOSPITAL IN VIRGINIA. CHKD LEADS THE REGION IN EFFORTS TO ADDRESS PUBLIC HEALTH CONCERNS LIKE CHILD ABUSE AND CHILDHOOD OBESITY. IT IS THE SOLE PROVIDER OF PEDIATRIC SUBSPECIALTY CARE FOR CHILDREN WITH CHRONIC ILLNESSES LIKE CANCER AND DIABETES AND EMPLOYS THE REGION'S ONLY PEDIATRIC SURGEONS. THE HOSPITAL'S VIBRANT COMMUNITY OUTREACH PROGRAM COORDINATES PARENT, PROFESSIONAL AND STUDENT PROGRAMS THAT BRING IMPORTANT HEALTH, SAFETY AND WELLNESS INFORMATION TO THOUSANDS OF PARTICIPANTS. CHKD ALSO TAKES AN ACTIVE ROLE IN THE EDUCATION OF PEDIATRICIANS.COMPREHENSIVE INFORMATION ON CHKD'S EFFORTS TO IMPROVE THE HEALTH OF CHILDREN IS AVAILABLE AT WWW.CHKD.ORG/COMMUNITYBENEFIT PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM:CHKD IS PART OF CHILDREN'S HEALTH SYSTEM, A 501(C)(3) ORGANIZATION GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF COMMUNITY MEMBERS. A MAJORITY OF THE ORGANIZATION'S GOVERNING BODY ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CHKD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. SURPLUS FUNDS ARE USED TO MEET THE NEEDS OF THE ORGANIZATION AS DETERMINED BY CHKD SENIOR MANAGEMENT AND THE CHS BOARD OF DIRECTORS. HISTORICALLY, SURPLUS FUNDS HAVE BEEN USED FOR A VARIETY OF PURPOSES INCLUDING PATIENT CARE PROGRAMS, CAPITAL IMPROVEMENT NEEDS, RESERVES, ETC.ROLES OF ORGANIZATION AND ITS AFFILIATES IN PROMOTING THE HEALTH OF THE COMMUNITIES SERVED: THE CHILDREN'S HEALTH SYSTEM IS COMPRISED OF SEVERAL ORGANIZATIONS. CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS IS A FREESTANDING CHILDREN'S HOSPITAL THAT PROVIDES A BROAD SPECTRUM OF INPATIENT AND OUTPATIENT CARE SERVICES ACROSS MANY PEDIATRIC SPECIALTIES, INCLUDING EVERYTHING FROM PRIMARY CARE AND WELLNESS INITIATIVES TO NEONATAL AND PEDIATRIC INTENSIVE CARE. OTHER ENTITIES UNDER THE CHILDREN'S HEALTH SYSTEM UMBRELLA INCLUDE:* CHILDREN'S HEALTH FOUNDATION, WHICH MANAGES INVESTMENTS AND FUNDS EDUCATION, RESEARCH AND OTHER PROGRAMS FOR CHILDREN'S HEALTH SYSTEM* CHILDREN'S MEDICAL GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC PHYSICIAN PRACTICES* CMG OF NORTH CAROLINA, INC., A NORTH CAROLINA STOCK CORPORATION, WHICH OWNS AND OPERATES A PEDIATRIC PHYSICIAN PRACTICE IN NORTHEASTERN NORTH CAROLINA* CHILDREN'S SURGICAL SPECIALTY GROUP, INC., A VIRGINIA STOCK CORPORATION, WHICH OWNS AND OPERATES PEDIATRIC SURGICAL SUBSPECIALTY PRACTICES, INCLUDING PEDIATRIC GENERAL SURGERY, PEDIATRIC UROLOGY, PEDIATRIC CARDIAC SURGERY, PEDIATRIC ORTHOPEDIC SURGERY, PEDIATRIC NEUROSURGERY AND PEDIATRIC PLASTIC SURGERY.* CHILDREN'S HEALTH INSURANCE, LLC, A CAPTIVE INSURANCE COMPANY INCORPORATED IN SOUTH CAROLINA IS A DISREGARDED ENTITY OF CHKD.* CHKD THRIFT STORES, LLC, A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.* CHILDREN'S REAL ESTATE, LLC, IS A DISREGARDED ENTITY ORGANIZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.* CHILDREN'S RESEARCH HOLDING, LLC, A DISREGARDED ENTITY ORGANINZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.* CHILDREN'S QUALITY CARE, LLC, A DISREGARDED ENTITY ORGANINZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.* CHILDREN'S PHARMACY SERVICES, LLC, A DISREGARDED ENTITY ORGANINZED TO SUPPORT THE CHARITABLE MISSION AND PURPOSE OF CHILDREN'S HEALTH SYSTEM.PART VI, LINE 7:FACILITY REPORTING GROUP(S):FACILITY REPORTING GROUP A INCLUDES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, CHKD HEALTH AND SURGERY CENTER IN NEWPORT NEWS AND CHKD HEALTH AND SURGERY CENTER IN VIRGINIA BEACH. STATE FILING OF COMMUNITY BENEFIT REPORT:VA 1 CHILDREN'S HEALTH FOUNDATION INC 601 CHILDRENS LANE NORFOLK VA 23507 541278865 501(C)(3) 8878095 0 CASH GENERAL SUPPORT CHILDREN'S HEALTH SYSTEM INC 601 CHILDRENS LANE NORFOLK VA 23507 541278830 501(C)(3) 12300000 0 CASH GENERAL SUPPORT OLD DOMINION UNIVERSITY RESEARCH FOUNDATION PO BOX 6369 NORFOLK VA 23508 546068198 501(C)(3) 12844 0 CASH CHEST WALL STUDY FRIENDS OF THE ELIZABETH RIVER TRAIL FOUNDATION PO BOX 3042 NORFOLK VA 23514 814431199 501(C)(3) 120000 0 CASH GENERAL SUPPORT 4 PART I, LINE 2: PROCESS FOR AWARDS AWARDS ARE MADE TO INVESTIGATORS/PHYSICIANS BY CHKD (CHILDREN'S HOSPITAL THE KING'S DAUGHTERS) FOR SPECIFIC PROJECT OR RESEARCH ENDEAVORS. FUNDING REQUESTS ARE COMPLETED AND SUBMITTED WHERE THEY ARE REVIEWED BY THE FINANCE DEPARTMENT, THE CEO AND THE APPLICABLE BOARD. AFTER AN AWARD IS MADE, THE AWARDEE MUST FILE QUARTERLY FINANCIAL SUMMARIES AND A FINAL REPORT TO BE SUBMITTED TO THE CEO AT THE END OF THE FUNDING PERIOD. ADDITIONALLY, CHKD GIVES CONTRIBUTIONS TO ITS PARENT ORGANIZATION, CHILDREN'S HEALTH SYSTEM, AND TO CHILDREN'S HEALTH FOUNDATION. X 1 1 X X X X 0 1 0 0 0 0 0 1 0 JOHN HARDING CHIEF OPERATING OFFICER 0 488108 0 0 0 421119 0 338305 0 33484 0 1281016 0 262810 JAMES D DAHLING UNTIL 62123 PRESIDENT/DIRECTOR 0 1078156 0 0 0 111757 0 12200 0 28352 0 1230465 0 0 DEBORAH BARNES VP - IS OPERATIONS 0 431022 0 0 0 376420 0 230378 0 29829 0 1067649 0 343695 AMY SAMPSON AS OF 062123 PRESIDENT/DIRECTOR 0 405847 0 19125 0 261362 0 270031 0 19590 0 975955 0 247211 KATHRYN ABSHIRE AS OF 070822 CFO & ASSISTANT SECRETARY/TREASURER 0 477698 0 0 0 89958 0 156267 0 36351 0 760274 0 76184 CARL ST REMY MD DIRECTOR 0 696531 0 0 0 414 0 12200 0 28704 0 737849 0 0 JALANA MCCASLAND VP - PHYSICIAN PRACTICE MANAGEME 354424 0 17955 0 83171 0 187939 0 38964 0 682453 0 69031 0 ALLISON SILVA VP - ANCILLARY SERVICES 289337 0 0 0 175510 0 175145 0 15879 0 655871 0 158295 0 KAREN MITCHELL VP- PATIENT CARE SERVICES 371957 0 18584 0 116569 0 12200 0 16268 0 535578 0 18750 0 JOHN HARRINGTON VP - QUALITY/SAFETY & CLINICAL INTEG 391257 0 0 0 24808 0 79292 0 31251 0 526608 0 0 0 SCOTT NOTTINGHAM MD DIRECTOR 0 419778 0 0 0 250 0 12200 0 28240 0 460468 0 0 JOHN WARBURTON VP - MENTAL HEALTH 328297 0 16697 0 8700 0 58952 0 26207 0 438853 0 0 0 SUZANNE BRIXEY PHYSICIAN 358004 0 0 0 10222 0 12200 0 3605 0 384031 0 0 0 TAMIKA HARRIS VP - FACILITIES & SUPPORT SERV 252549 0 0 0 30937 0 64041 0 35657 0 383184 0 17761 0 DENNIS RYAN UNTIL 070822 CFO & ASSISTANT SECRETARY/TREASURER 0 296651 0 0 0 51603 0 12179 0 19198 0 379631 0 35452 SAMUEL SCOTT PHYSICIAN 270465 0 0 0 162 0 3531 0 12841 0 286999 0 0 0 PATRICIA HIGAZI DIRECTOR-OCUPATIONAL HEALTH 142732 0 5419 0 112862 0 6154 0 13794 0 280961 0 0 0 PART I, LINE 1A IN CONNECTION WITH A RETIREMENT PROGRAM, TAX GROSS-UP PAYMENTS ARE PROVIDED TO CERTAIN EMPLOYEES WHOSE EMPLOYER FUNDED CONTRIBUTIONS ARE IMMEDIATELY BENEFITS OF PARTICIPANTS WHOSE CONTRIBUTIONS ARE NOT IMMEDIATELY TAXABLE. PART I, LINE 4B CHILDREN'S HEALTH SYSTEM SPONSORS TWO SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS ("THE PLANS"). THE PLANS ARE DESIGNED TO RETAIN EXECUTIVES IN POSITIONS ESSENTIAL TO THE SUCCESS OF CHILDREN'S HEALTH SYSTEM. DURING THE YEAR, THE FOLLOWING INDIVIDUALS WERE PARTICIPANTS IN ONE OF THE SPONSORED SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS AND RECEIVED THE FOLLOWING ANNUAL ACTUARIAL INCREASE OR DEFERRED CONTRIBUTION (INCLUDED IN SCHEDULE J, PART II, COLUMN (C)) AND/OR PAYMENT (INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III)). AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III) MAY DIFFER FROM AMOUNTS PAID DUE TO TIMING DIFFERENCES IN VESTING AND PAYMENTS. NAME: KAREN MITCHELL ACT. INCREASE $0 AMT. PAID $44,330 NAME: ALLISON SILVA ACT. INCREASE $142,938 AMT. PAID $62,515 NAME: JOHN HARDING ACT. INCREASE: $315,725 AMT. PAID: $162,661 NAME: DEBORAH BARNES ACT. INCREASE: $200,974 AMT. PAID: $147,204 NAME: KATHY ABSHIRE ACT. INCREASE $121,446 AMT. PAID: $32,987 NAME: TAMIKA HARRIS ACT. INCREASE $33,103 AMT. PAID: $0 NAME: DENNIS RYAN ACT. INCREASE: $ 0 AMT. PAID: $0 NAME: JOHN WARBURTON ACT. INCREASE: $46,752 AMT. PAID: $0 NAME: JALANA MCCASLAND ACT INCREASE: $149,844 AMT PAID: $20,419 NAME: PAUL MORLOCK ACT. INCREASE: $0 AMT PAID: $620,667 NAME: AMY SAMPSON ACT. INCREASE: $230,924 AMT PAID: $101,131 PART I, LINE 7 OFFICERS AND VICE PRESIDENTS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET UP BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. DEPARTMENT DIRECTORS MAY RECEIVE ADDITIONAL COMPENSATION BASED ON CRITERIA SET BY MANAGEMENT AND APPROVED BY THE BOARD OF DIRECTORS. A VA SMALL BUSINESS FIN AUTH (2015) 541300845 2015-12-01 100000000 FINANCING OF HEALTH CARE FACILITIES 0 0 0 B VA SMALL BUSINESS FIN AUTH (2020) 541300845 2020-06-10 100000000 FINANCING OF HOSPITAL FACILITIES 0 0 0 C VA SMALL BUSINESS FIN AUTH (2021) 541300845 2021-11-09 91958991 REFINANCE 2012 SERIES BONDS (ISSUED 9/19/12) & FIN. OF HOSP. FACILITIES 0 0 0 A 2986013 48650000 48650000 2018 0 0 1 1 B 1705000 100000000 100000000 2022 0 0 1 1 C 5800000 91958991 91958991 2022 1 0 1 1 A 0 1 1 1 1 1 0.00330 0.00330 0 0 1 B 0 1 1 1 1 1 0.00000 0.00000 0 0 1 C 0 1 1 1 1 1 0.00590 0.00590 0 0 1 A 0 0 0 1 1 0 0 0 1 B 0 1 0 0 1 0 0 0 1 C 0 1 0 0 1 0 0 0 1 A 1 B 1 C 1 DATE REBATE COMPUTATION PERFORMED ISSUER NAME: VA SMALL BUSINESS FIN. AUTH. (2015) DATE THE REBATE COMPUTATION WAS PERFORMED: 05/12/2021 PART II, LINE 10 COLUMN A: CAPITAL EXPENDITURES FROM REQUISITIONED PROCEEDS CURRENTLY TOTAL $99,950,000, OF WHICH $51,300,000 WAS ALLOCATED TO CHILDREN'S HEALTH SYSTEM AND $48,650,000 WAS ALLOCATED TO CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. PART III, LINE 4 COLUMN A: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.33% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR. COLUMN C: WE HAVE CONCLUDED THAT OUT OF THE ACTIVITIES CONDUCTED IN THIS BOND FINANCED SPACE, WE HAVE NOTED THAT 0.59% OF THE SPACE WAS PRIVATE BUSINESS USE. THE REMAINING SPACE DID NOT RESULT IN PRIVATE BUSINESS USE DUE TO EQUITY PROVIDED OR A REGULATORY SAFE HARBOR. WM JORDAN CO INC SEE PART V 4398942 CONSTRUCTION SERVICES 0 INTERESTED PERSON AND THE ORGANIZATION ENTITY MORE THAN 35% OWNED BY JOHN LAWSON II, CURRENT BOARD MEMBER. X 5 11750 CASH ON SALE X 43 6334308 AVG FMV ON DATE REC X OTHER 14 20810 AVG FMV ON DATE REC 0 1 1 PART I, LINE 32B: CHKD PAYS ABC VIRGINIA AUTO AUCTION, LLC A FEE TO AUCTION CARS FOR THE BENEFIT OF THE ORGANIZATION. SCHEDULE M, PART I: COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTIONS, NOT THE NUMBER OF ITEMS RECEIVED. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: FOR SIX DECADES, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS (CHKD) HAS BEEN THE ONLY FACILITY OF ITS KIND IN VIRGINIA, SERVING THE MEDICAL AND SURGICAL NEEDS OF CHILDREN THROUGHOUT THE STATE. ITS PRIMARY SERVICE AREA ENCOMPASSES GREATER HAMPTON ROADS, THE EASTERN SHORE OF VIRGINIA AND NORTHEASTERN NORTH CAROLINA, A REGION THAT IS HOME TO APPROXIMATELY 500,000 CHILDREN UNDER THE AGE OF 21. CHKD WAS ESTABLISHED AS AN 88-BED, NOT-FOR-PROFIT HOSPITAL IN 1961 BY THE KING'S DAUGHTERS, A WOMEN'S SERVICE ORGANIZATION DEDICATED TO THE HEALTH AND WELL BEING OF THE COMMUNITY'S INDIGENT CHILDREN. THE HOSPITAL HAS ALWAYS UPHELD THE CHARITABLE MISSION OF ITS FOUNDERS, AND IN FY2023, OVER 55.5 PERCENT OF ITS INPATIENT DAYS WERE COVERED BY MEDICAID. OVER THE PAST 60 YEARS, CHKD'S HOSPITAL HAS GROWN INTO AN EXTENSIVE PEDIATRIC HEALTH CARE SYSTEM THAT INCLUDES A 206-BED TEACHING HOSPITAL, AND A NEW MENTAL HEALTH TOWER, CHILDREN'S PAVILION, THAT WILL ACCOMMODATE 60 INPATIENT PSYCHIATRIC BEDS. THE SYSTEM PROVIDES COMPREHENSIVE MEDICAL CARE TO CHILDREN AT THE MAIN HOSPITAL, CHILDREN'S PAVILION, AND MULTI-SERVICE HEALTH CENTERS IN VIRGINIA BEACH, NEWPORT NEWS, CHESAPEAKE, HAMPTON, SUFFOLK, NORFOLK AND WILLIAMSBURG. ITS SERVICES INCLUDE EVERYTHING FROM WELLNESS AND PREVENTION INITIATIVE TO PRIMARY CARE, SURGERY AND REHABILITATION. MANY OF ITS UNIQUE SERVICES AND PROGRAMS ADDRESS PRESSING PUBLIC HEALTH NEEDS THAT WOULD OTHERWISE GO UNMET. CHKD COMPLETED CONSTRUCTION OF A MENTAL HEALTH FACILITY IN 2022 IN RESPONSE TO THE GROWING NEED FOR PEDIATRIC PSYCHIATRIC CARE - IN APRIL OF 2022 CHILDREN'S PAVILION OPENED TO OUTPATIENT MENTAL HEALTH SERVICES, PRIMARY PEDIATRIC CARE, SPORTS MEDICINE, AND LABORATORY AND RADIOLOGY SERVICES. IN OCTOBER OF 2022 THE FIRST INPATIENT MENTAL HEALTH BEDS OPENED. THE 14-STORY MENTAL HEALTH CENTER ALSO HAS INDOOR AND OUTDOOR EXERCISE AREAS, AND ROOMS FOR OUTPATIENT SERVICES. AS THE PREMIER PROVIDER OF HEALTHCARE SERVICES TO THE REGION'S CHILDREN, CHKD HAS SECURED A PLACE IN THE HEART OF THE COMMUNITY. THE HOSPITAL IS AN EAGER COLLABORATOR WITH OTHER COMMUNITY ORGANIZATIONS AND INSTITUTIONS THAT SHARE ITS CONCERN FOR THE WELL-BEING OF YOUNG PEOPLE AND OFFERS A VARIETY OF EDUCATION, RESEARCH AND HEALTH INITIATIVES TO IMPROVE THE HEALTH AND WELL BEING OF CHILDREN IN THIS COMMUNITY AND BEYOND. THE HEALTH SYSTEM'S PRIMARY SERVICES CENTER ON INPATIENT AND OUTPATIENT CARE, MENTAL HEALTH SERVICES, COMMUNITY OUTREACH PROGRAMS AND MEDICAL EDUCATION/RESEARCH. SECTION ONE: INPATIENT CARE CHILDREN WITH A VAST RANGE OF MEDICAL PROBLEMS INCLUDING LIFE-THREATENING ILLNESSES AND INJURIES TURN TO CHKD FOR INPATIENT CARE. IN FY23, CHKD HAD 4,912 ADMISSIONS RESULTING IN 47,779 PATIENT DAYS. APPROXIMATELY 55.5 PERCENT OF THESE DAYS WERE COVERED BY MEDICAID. CHKD HAS 206 INPATIENT BEDS AND ALMOST HALF OF THOSE ARE FOR PEDIATRIC INTENSIVE CARE. THE HOSPITAL IS HOME TO THE REGION'S HIGHEST LEVEL NEONATAL INTENSIVE CARE UNIT, WHERE EACH YEAR CRITICALLY ILL NEWBORNS, SOME AS YOUNG AS 22 WEEKS GESTATION, BENEFIT FROM A UNIQUE COMBINATION OF ADVANCED MEDICAL TECHNOLOGY, DEVELOPMENTAL CARE, FAMILY SUPPORT, AND PALLIATIVE CARE. IN SEPTEMBER 2020, A RENOVATION OF THE NICU WAS COMPLETED CREATING 50 PRIVATE ROOMS AND 10 SEMI-PRIVATE ROOMS TO CREATE A MORE INDIVIDUALIZED AND FAMILY CENTERED APPROACH, GIVING FAMILIES MORE PRIVACY TO BOND WITH THEIR BABIES. THERE WERE APPROXIMATELY 515 ADMISSIONS TO THE NICU IN FY23. THE REGION'S LARGEST AND MOST EXPERIENCED PEDIATRIC INTENSIVE CARE UNIT IS AT CHKD. IN THIS UNIT, A FULL-TIME STAFF OF BOARD-CERTIFIED PEDIATRIC INTENSIVE CARE PHYSICIANS, CRITICAL CARE NURSES AND RESPIRATORY THERAPISTS PROVIDE EXTREMELY SOPHISTICATED, TECHNOLOGICALLY-ADVANCED CARE TO CHILDREN WITH LIFE-THREATENING INJURIES AND ILLNESSES. MEDICAL CARE IS SUPPLEMENTED WITH SUPPORT FROM CHILD LIFE SPECIALISTS, SOCIAL WORKERS AND CHAPLAINS WHO HAVE EXTENSIVE EXPERIENCE HELPING FAMILIES THROUGH THE TRAUMA AND STRESS OF A SEVERE ILLNESS OR INJURY IN A CHILD. THERE WERE 1,413 ADMISSIONS TO THE PICU IN FY23. MANY PATIENTS ARE BROUGHT FROM OTHER AREA HOSPITALS TO CHKD BY THE HOSPITAL'S NEONATAL/PEDIATRIC TRANSPORT PROGRAM, WHICH OPERATES OUT OF FOUR FULLY-EQUIPPED MOBILE INTENSIVE CARE UNITS. TWO EMT CERTIFIED CRITICAL CARE TRANSPORT TEAMS ARE AVAILABLE 24 HOURS A DAY, SEVEN DAYS A WEEK TO ALL AREA MEDICAL FACILITIES THAT NEED TO SEND SICK OR INJURED CHILDREN TO CHKD. CHKD TRANSPORT TEAMS ARE EQUIPPED AND TRAINED TO TRANSPORT ALL TRAUMA PATIENTS UNDER THE AGE OF 15 TO CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS FOR SPECIALIZED PEDIATRIC TRAUMA CARE. EACH CRITICAL CARE TRANSPORT CALL IS ANSWERED BY A CERTIFIED EMT-B NEONATAL/PEDIATRIC CRITICAL CARE NURSE, A CERTIFIED EMT-B REGISTERED RESPIRATORY THERAPIST AND A CERTIFIED EMT PARAMEDIC TRAINED IN NEONATAL/PEDIATRIC CARE. IN FY23, THE TEAM TRANSPORTED 1,640 PATIENTS. OF THOSE, 380 WERE NEWBORNS IN NEED OF NEONATAL INTENSIVE CARE. CHKD'S TRANSPORT SERVICE IS ALSO UNDER CONTRACT TO THE NAVAL MEDICAL CENTER, PORTSMOUTH, TO PROVIDE ALL CRITICAL CARE NEONATAL AND PEDIATRIC MILITARY TRANSPORTS IN THE REGION. BESIDES GROUND TRANSPORTS IN OUR MOBILE ICUS OR ACUTE CARE TRANSPORT, THE TEAM CAN RESPOND VIA FIXED WING AIRCRAFT OR HELICOPTER TRANSPORT WHEN MEDICALLY NECESSARY. CHKD TRANSFER CENTER IS STAFFED WITH PARAMEDICS WHO OPERATE TO ENSURE APPROPRIATE DISPATCH SERVICES TO THE TRANSPORT TEAM AS WELL AS TO DELIVER ASSISTANCE AND SUPPORT FOR REFERRAL FACILITIES AND STAFF THROUGHOUT THE COMMUNITY. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CHKD OPERATES THE REGION'S ONLY PEDIATRIC SURGERY PROGRAM, OFFERING YOUNG PEOPLE STATE-OF-THE-ART TREATMENT IN A SUPPORTIVE, NON-THREATENING ENVIRONMENT CREATED EXCLUSIVELY TO MEET THEIR NEEDS. IN FY23, SURGEONS PERFORMED 13,358 CASES AT CHKD FACILITIES FOR A VAST RANGE OF PROBLEMS, FROM THE SIMPLEST OUTPATIENT PROCEDURES TO COMPLEX CRANIOFACIAL, ORTHOPEDIC AND CHEST WALL SURGERIES. CHKD'S CARDIAC SURGERY PROGRAM IS PART OF A REGIONAL COLLABORATIVE BETWEEN CHKD AND THE UNIVERSITY OF VIRGINIA. CHKD AND UVA COMBINE THE EFFORTS OF PEDIATRIC CARDIOLOGISTS, CARDIAC SURGEONS, CARDIAC ANESTHESIOLOGISTS, INTENSIVE CARE PHYSICIANS AND CARDIAC SUPPORT PROFESSIONALS FROM BOTH INSTITUTIONS WITH THE GOAL OF IMPROVING OUTCOMES FOR CHILDREN WITH COMPLEX CONGENTIAL HEART DEFECTS. (SEE OUTPATIENT SERVICES AND PROGRAMS FOR MORE INFORMATION OF CHKD'S SURGERY PROGRAM.) CHKD EMPLOYS DOZENS OF PROFESSIONALS WHO PROVIDE EMOTIONAL, RECREATIONAL, SPIRITUAL AND PRACTICAL SUPPORT TO CHILDREN AND FAMILIES DURING HOSPITALIZATIONS. THE WORK OF THESE PROFESSIONALS COMPLEMENTS OUR EXPERT MEDICAL CARE TO CREATE A UNIQUE TREATMENT AND HEALING ENVIRONMENT FOR CHILDREN AND THEIR FAMILIES. OUR CHAPLAINCY SERVICES PROVIDE EMOTIONAL SUPPORT, SPIRITUAL CARE, ETHICAL REFLECTION, BEREAVEMENT CARE/RESOURCES/FOLLOW-UP (INCLUDING PARENT AND CHILD SUPPORT GROUP), SPIRITUAL ASSESSMENT AND GUIDANCE TO PATIENTS, FAMILIES AND STAFF WITH IN-HOSPITAL PRESENCE SEVEN DAYS A WEEK AND 24 HOURS A DAY. ADDITIONALLY, A CHAPLAIN IS ASSIGNED TO CHILDREN'S PAVILION TO PROVIDE FOR PATIENTS ON OUR INPATIENT MENTAL HEALTHCARE FLOORS. CHAPLAINS ASSIST WITH ADVANCE DIRECTIVES, ADVANCE CARE PLANS AND SERVE ON THE TRAUMA TEAM AS PRIMARY PROVIDERS OF FAMILY SUPPORT. THE HOSPITAL EMPLOYS A CHAPLAINCY MANAGER, SIX FULL-TIME CHAPLAINS, ONE FULL-TIME FAMILY/STAFF SUPPORT COORDINATOR, AND TWO PER-DIEM CHAPLAINS WHO REFLECT THE DIVERSITY OF THE COMMUNITY. ALL CHAPLAINS ARE PROFESSIONALLLY TRAINED TO MEET THE VARIED SPIRITUAL NEEDS OF FAMILIES AND STAFF WITH RESPECT AND COMPASSION. CHAPLAINCY SERVICES HAS NUMEROUS CONNECTIONS WITH COMMUNITY CLERGY TO ENSURE MOST RELIGIOUS NEEDS CAN BE MET. THE CHAPLAINS PROVIDE AN ANNUAL MEMORIAL SERVICE TO REMEMBER AND CELEBRATE THE LIVES OF THE CHILDREN WHO HAVE PASSED ON DURING THE PREVIOUS YEAR. THE CHAPLAINS ALSO FACILITATE EDUCATIONAL AND WELLNESS PROGRAMS FOR HOSPITAL STAFF AND PHYSICIANS, AS WELL AS PLANNING AND PARTICIPATING IN OUTREACH TO THE COMMUNITY. THE HOSPITAL EMPLOYS 17 CHILD LIFE STAFF MEMBERS, INCLUDING AN ART THERAPIST AND A MUSIC THERAPIST, WHO HELP CHILDREN ADJUST AND COPE DURING HOSPITALIZATION. THEIR GOAL IS TO MAKE THE CHILD'S HOSPITAL EXPERIENCE AS NORMAL AS POSSIBLE BY DEVELOPING SUPPORTIVE RELATIONSHIPS WITH PATIENTS AND FAMILIES, PROVIDING AGE-APPROPRIATE PREPARATION FOR MEDICAL PROCEDURES AND SURGERIES, COPING STRATEGIES AND PLAY OPPORTUNITIES FOR CHILDREN TO RELIEVE STRESS. WITH THE OPENING OF CHILDREN'S PAVILION IN 2022, SEVEN NEW CHILD LIFE POSITIONS WERE ADDED FOR THAT FACILITY, INCLUDING CERTIFIED THERAPEUTIC RECREATION SPECIALISTS, CERTIFIED CHILD LIFE SPECIALISTS, AND AN ART AND MUSIC THERAPIST. THERE ARE FOUR POPULAR ACTIVITY AREAS, INCLUDING A TEEN ROOM, IN THE MAIN HOSPITAL, PROVIDING HOSPITALIZED CHILDREN OPPORTUNITIES FOR SOCIALIZATION AND CREATIVE PLAY. CHILD LIFE ASSISTANTS WORK WITH CHKD'S VOLUNTEER SERVICES DIVISION TO MANAGE THE HOSPITAL'S POPULAR PET THERAPY PROGRAM -- THE BUDDY BRIGADE -- WHICH BRINGS VISITS OF DOG/HANDLER TEAMS TO THE HOSPITAL SEVERAL TIMES EACH WEEK. CHKD ALSO HAS A FACILITY DOG THAT WORKS ALONGSIDE A CHILD LIFE STAFF MEMBER. CHILD LIFE STAFF MEMBERS COLLABORATE WITH OTHER HOSPITAL STAFF TO PROVIDE SUPPORT FOR PARENTS AND SIBLINGS, OFFERING AN ANNUAL TEDDY BEAR CLINIC, WEEKLY CLOSED-CIRCUIT TV BINGO, INPATIENT DEVELOPMENTAL SCREENINGS, AND A KIDS-AS-PARTNERS ADVISORY COUNCIL. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CHKD'S MEDICAL SOCIAL WORK TEAM PROVIDES MANY SERVICES, INCLUDING: * CONDUCT BIOPSYCHOSOCIAL AND BEHAVIORAL ASSESSMENTS. * PROVIDE SUPPORT DURING HOSPITALIZATION TO CHKD PATIENTS AND FAMILIES DEALING WITH TRAUMA, CHRONIC ILLNESS AND LOSS. * REFER TO CHKD'S ELIGIBILITY WORKERS TO COMPLETE APPLICATIONS FOR INSURANCE COVERAGE FOR MEDICAL CARE, PRESCRIPTIONS, AND MEDICAL SUPPLIES. * COORDINATE REFERRALS AND ONGOING COMMUNICATIONS TO OTHER COMMUNITY RESOURCES FOR ASSISTANCE WITH NEEDS SUCH AS HOUSING, MENTAL HEALTH COUNSELING, EDUCATIONAL ADVOCACY, LEGAL ASSISTANCE AND MUCH MORE. * AID IN COMMUNICATION WITH FAMILIES WITH THE MEDICAL TREATMENT TEAMS BY COORDINATING PATIENT CARE CONFERENCES AND TEAM MEETINGS. * EVALUATE AND REPORT SUSPICION FOR CHILD ABUSE/NEGLECT. IN JULY 2021, A GRANT WAS AWARDED TO THE MEDICAL SOCIAL WORK TEAM UNDER THE HOSPITAL VIOLENCE INTERVENTION PROGRAM INITIATIVE. THIS PROGRAM IS NOW IDENTIFIED AS "SAFER FUTURES AND IS MANAGED BY AN IDENTIFIED LICENSED ELIGIBLE COORDINATOR AND ONE FULL TIME MEDICAL SOCIAL WORKER. ADDITIONALLY, MEDICAL SOCIAL WORKERS ALSO FACILITATE A VARIETY OF SUPPORT GROUPS THAT HELP PATIENTS AND FAMILIES IN CONNECTING WITH OTHERS WHO SHARE SIMILAR CHALLENGES. SOME EXAMPLES INCLUDE SIBSHOPS, HEALTHY MOMMY HEALTHY BABY, DINE AND DISCOVER FOR NICU FAMILIES. THE MEDICAL SOCIAL WORK TEAM MANAGES THE HALO FUND, BUTTERFLY BLESSINGS FUND, AND SAM'S WARRIORS FUNDS, MONETARY FUNDS DESIGNATED TO ASSIST PATIENTS/FAMILIES ENCOUNTERING BARRIERS SUCH AS TRANSPORTATION NEEDS, MEALS, MEDICATION/PRESCRIPTION ASSISTANCE AND OTHER DISCHARGE-RELATED COSTS. THESE DONATED FUNDS MAY ALSO BE USED IN EMERGENCY SITUATIONS TO ASSIST WITH SPECIAL HEALTHCARE CHALLENGES, LOST MONEY DUE TO PARENT'S INABILITY TO WORK DURING CHILDREN'S INPATIENT STAY, AND PARTIAL OR ONE-TIME PAYMENTS FOR UTILITIES OR RENT FEES POST DISCHARGE. THE MEDICAL SOCIAL WORK TEAM IS PART OF CHKD'S MENTAL HEALTH PROGRAM, WHICH IS COVERED IN MORE DETAIL IN THE NEXT SECTION. THE CHKD'S CULTURAL/LANGUAGE SERVICES DEPARTMENT MEETS THE NEEDS OF PATIENTS AND FAMILIES WITH LIMITED ENGLISH PROFICIENCY BY COORDINATING ACCESS TO LANGUAGE INTERPRETATION VIA FACE-TO-FACE, OVER THE PHONE AND VIDEO REMOTE INTERPRETATION THROUGHOUT THE HEALTH SYSTEM. THE PROGRAM'S GOAL IS TO IMPROVE CUSTOMER SERVICE, CONSISTENCY OF CARE AND PATIENT SAFETY. WE RECOGNIZE THAT IT IS CRITICAL TO HAVE ACCESS TO INTERPRETERS AND CAREGIVERS WHO CAN PROVIDE CULTURALLY SENSITIVE AND ACCURATE INFORMATION SO THEY CAN UNDERSTAND AND PARTICIPATE IN THE CHILDREN'S TREATMENT AND DISCHARGE PROCESS AND HELP PREVENT POTENTIAL MEDICAL ERRORS. IT ALSO CONTRIBUTES TO OVERALL SATISFACTION, WHICH IS VITALLY IMPORTANT. WE MEET THIS GOAL THROUGH THE ACTIVITIES DESCRIBED BELOW: CHKD PROVIDED INTERPRETATION SERVICES IN 39 DIFFERENT LANGUAGES FOR OUR LIMITED ENGLISH POPULATION THROUGH 17,207 OUTPATIENT VISITS DURING FY23. TO MEET THE NEEDS OF THESE FAMILIES HOSPITAL STAFF USED OVER THE PHONE INTERPRETATION, VIDEO REMOTE INTERPRETATION AND THREE FULL TIME SPANISH MEDICAL INTERPRETERS IN THE LANGUAGE SERVICES DEPARTMENT COVERING THE MAIN HOSPITAL AND THE GENERAL ACEDEMIC PEDIATRICS CLINIC. ADDITIONALLY, THE HEALTH SYSTEM HAD 29 DUAL ROLE BILINGUAL STAFF MEMBERS WHO WERE AVAILABLE TO PROVIDE MEDICAL INTERPRETATION IN THEIR ASSIGNED AREAS. FOR WRITTEN DOCUMENT TRANSLATION, THE HEALTH SYSTEM RELIED ON ONE REMOTE PRN DOCUMENT TRANSLATOR IN ADDITION TO TWO OF THE LANGUAGE SERVICES FULL-TIME SPANISH MEDICAL INTERPRETERS. DURING FY23, THE LANGUAGE SERVICES DEPARTMENT ASSISTED WITH IN-PERSON AND OVER THE PHONE INTERPRETATION FOR 10,773 PATIENT ENCOUNTERS AT THE MAIN HOSPITAL AND AT THE GAP CLINIC, TRANSLATED 376 DOCUMENTS FROM ENGLISH TO SPANISH AND CONDUCTED 23 LANGUAGE PROFICIENCY ASSESSMENTS (13 FOR BASIC SPANISH AND 10 FOR MEDICAL SPANISH). LANGUAGE PROFICIENCY ASSESSMENTS ARE CONDUCTED BY THE LANGUAGE SERVICES DEPARTMENT TO ENSURE BILINGUAL STAFF THROUGHOUT THE CHKD HEALTH SYSTEM HAVE THE SKILLS NECESSARY TO COMMUNICATE EFFECTIVELY WITH PATIENTS AND FAMILIES IN SPANISH, OR BEFORE THEY ARE ALLOWED TO PROVIDE MEDICAL INTERPRETATION IN SPANISH. AS THE REGIONAL PROVIDER OF PEDIATRIC CARE, CHKD IS AN INTEGRAL PART OF THE COMMUNITY'S NATURAL OR MAN-MADE DISASTER PLANNING EFFORTS. CHKDHS RECOGNIZES THE IMPORTANCE OF A NATIONAL INCIDENT MANAGEMENT SYSTEM(NIMS) COMMUNITY-INTEGRATED, ALL-HAZARD EMERGENCY OPERATIONS PLAN. THIS PLAN IS PREPARED, EXERCISED AND SHARED INTERNALLY AND EXTERNALLY WITH COMMUNITY, STATE AND FEDERAL EMERGENCY RESPONSE AGENTS. SECTION TWO: OUTPATIENT SERVICES AND PROGRAMS CHKD HEALTH SYSTEM ALSO OFFERS THE COMMUNITY MANY IMPORTANT PEDIATRIC SERVICES ON AN OUTPATIENT BASIS. IN FY23, CHILDREN MADE APPROXIMATELY 644,136 (THIS IS CMG, CSSG VISITS, AND OUTPATIENT CLINIC VISITS) OUTPATIENT VISITS TO CHKD PEDIATRICIANS, SURGEONS AND SUBSPECIALTY SPECIALTY CLINICS. THEY MADE 384,403 VISITS TO THE PRIMARY CARE PEDIATRICIANS OF CHKD'S MEDICAL GROUP, WHICH OFFERS CARE IN 20 PRACTICES AND 32 OFFICES THROUGHOUT OUR SERVICE AREA. CHKD'S SURGICAL SPECIALTY GROUP MAKES THE SERVICES OF THE REGION'S ONLY PEDIATRIC GENERAL, UROLOGICAL, CARDIAC, NEUROSURGICAL, PLASTIC AND ORTHOPEDIC SURGEONS AVAILABLE TO THOUSANDS OF CHILDREN WHO MIGHT OTHERWISE HAVE TO TRAVEL OUTSIDE OF THE AREA FOR SURGERY. CHILDREN MADE 46,833 VISITS TO THE SURGICAL GROUP PRACTICES IN FY23. THE SURGEONS PERFORMED 5,634 SURGICAL CASES. THE HOSPITAL ALSO PROVIDES CARE TO CHILDREN FACING HEALTH CONDITIONS SUCH AS CANCER, GENETIC DISORDERS, OBESITY, HEART PROBLEMS, DEVELOPMENTAL DISABILITIES, ASTHMA/ALLERGIES AND DIABETES THROUGH MORE THAN 50 OUTPATIENT SPECIALTY CLINICS OFFERING SPECIALIZED PEDIATRIC CARE. IN FY23, CHILDREN MADE 213,260 VISITS TO OUR OUTPATIENT CLINICS. CHILDREN'S HOSPITAL WAS FOUNDED ON THE PREMISE THAT ALL CHILDREN DESERVE EQUAL ACCESS TO QUALITY PEDIATRIC CARE. AS OUR POPULATION GREW AND SETTLED INTO THE FAR CORNERS OF OUR BRIDGE-AND TUNNEL-LACED REGION, TRAVEL TO CHKD'S MAIN FACILITY IN NORFOLK BECAME MORE OF A HARDSHIP FOR FAMILIES. TO EASE THAT BURDEN AND IMPROVE CHILDREN'S ACCESS TO CARE IN EVERY CORNER OF OUR SERVICE AREA, CHKD HAS ESTABLISHED MULTI-SERVICE HEALTH CENTERS IN STRATEGIC LOCATIONS. THESE INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING: * THE CHKD HEALTH AND SURGERY CENTER AT OYSTER POINT OFFERS FAMILIES WHO LIVE NORTH OF THE HAMPTON ROADS BRIDGE TUNNEL A WEALTH OF IMPORTANT SERVICES IN A CONVENIENT LOCATION. THE CENTER IS HOME TO THE REGION'S FIRST PEDIATRIC SURGERY CENTER. OTHER SERVICES OFFERED AT THE SITE INCLUDE PRIMARY, SURGICAL AND SUB-SPECIALTY PEDIATRICS; LAB AND RADIOLOGY (INCLUDING ULTRASOUND AND MRI), AUDIOLOGY TESTING AND OCCUPATIONAL, SPEECH AND PHYSICAL THERAPY. AQUATIC THERAPY AND CHILD ABUSE PROGRAM SERVICES ARE ALSO AVAILABLE. * THE CHKD HEALTH CENTER AND URGENT CARE AT TECH CENTER IS HOME TO THE PENINSULA'S ONLY PEDIATRIC URGENT CARE AS WELL AS THE CENTER FOR PEDIATRIC SLEEP MEDICINE, X-RAY, LAB, PHYSICAL MEDICINE AND REHABILITATION, RHEUMATOLOGY, AND SPORTS MEDICINE PRIMARY CARE, PHYSICAL THERAPY, AND PERFORMANCE TRAINING. * THE CHKD HEALTH CENTER AT OAKBROOKE SERVES FAMILIES IN CHESAPEAKE AND NORTHEASTERN NORTH CAROLINA. IT IS HOME TO A PRIMARY CARE PEDIATRIC PRACTICE; PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY; X-RAY AND LAB SERVICES, A SPORTS MEDICINE GYM, SLEEP STUDIES UNIT AND THERAPY POOL, AS WELL AS CLINIC SPACE FOR A VARIETY OF PEDIATRIC SPECIALISTS AND SURGEONS PROVIDING EVALUATION, TREATMENT AND FOLLOW-UP. * THE CHKD HEALTH AND SURGERY CENTER AT CONCERT DRIVE SERVES THE GROWING MEDICAL NEEDS OF FAMILIES IN VIRGINIA BEACH. THE CENTER IS HOME TO VIRGINIA BEACH'S FIRST SURGERY CENTER EXCLUSIVELY FOR CHILDREN. BEACH FAMILIES CAN ALSO FIND PRIMARY CARE PEDIATRICIANS AND IN-HOUSE LAB AND RADIOLOGY SERVICES - INCLUDING MRI - AT THE CENTER. OTHER SERVICES INCLUDE SPECIALTY CARE PEDIATRICS FOR HELP WITH CHRONIC PROBLEMS SUCH AS DIABETES. THIS YEAR, A THIRD OPERATING ROOM WAS ADDED TO THIS LOCATION TO SUPPORT THE PEDIATRIC DENTAL NEEDS OF THE COMMUNITY. IT WAS BUILT AND DESIGNED ACCORDING TO THE INPUT FROM COMMUNITY DENTISTS. * THE CHKD HEALTH CENTER AT LANDSTOWN IS LOCATED JUST DOWN THE ROAD FROM CONCERT DRIVE AND OFFERS DEDICATED VIRGINIA BEACH SPACE FOR SERVICES SUCH AS SPORTS MEDICINE, DERMATOLOGY AND GYNECOLOGY. * THE CHKD HEALTH CENTER AND URGENT CARE AT LOEHMANN'S SERVES THE NORTHERN AND MIDDLE VIRGINIA BEACH REGION AND IS HOME TO CHKD URGENT CARE, SPORTS MEDICINE (PRIMARY CARE) AND THERAPY, SPORTS PERFORMANCE TRAINING AND PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY. * THE CHKD HEALTH CENTER AT HARBOUR VIEW NORTH OFFERS SPECIALIZED PEDIATRIC CARE TO FAMILIES IN SUFFOLK. THE SITE OFFERS APPOINTMENTS IN PEDIATRIC DERMATOLOGY, ALLERGY, GASTROENTEROLOGY, CARDIOLOGY AND NEPHROLOGY, AS WELL AS DEVELOPMENTAL PEDIATRICS. * THE CHKD HEALTH CENTER AT LIGHTFOOT OFFERS FAMILIES IN THE NORTHERN CORNER OF OUR SERVICE AREA APPOINTMENTS IN PEDIATRIC CARDIOLOGY, NEPHROLOGY, GYNECOLOGY, PHYSICAL MEDICINE AND REHABILITATION, REHABILITATIVE THERAPIES, SPORTS MEDICINE AND UROLOGY. CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS OPERATES THE REGION'S ONLY PEDIATRIC URGENT CARE. PARENTS OF CHILDREN WITH URGENT, BUT NOT EMERGENT MEDICAL NEEDS, NOW HAVE ACCESS TO QUALITY MEDICAL CARE JUST FOR KIDS AFTER-HOURS, ON WEEKENDS AND HOLIDAYS. IN FY23, CHILDREN MADE 106,171 VISITS TO CHKD URGENT CARE CENTERS IN CHESAPEAKE, VIRGINIA BEACH AND NEWPORT NEWS. CHKD'S CHILD ADVOCACY CENTER (CAC) COORDINATES THE REGION'S EFFORTS TO ACCURATELY IDENTIFY, TREAT AND SUPPORT CHILDREN WHO HAVE BEEN SUSPECTED OF ABUSE OR NEGLECT. IN ADDITION TO THE MAIN PROGRAM IN NORFOLK, SERVICES ARE ALSO AVAILABLE AT CHKD'S OUTPATIENT CENTERS IN VIRGINIA BEACH AND NEWPORT NEWS. THE CAC PROVIDES COMPREHENSIVE ASSESSMENT, EVALUATION AND TREATMENT SERVICES, INCLUDING CASE MANAGEMENT AND ADVOCACY, AN ARRAY OF EVIDENCE-BASED MENTAL HEALTH SERVICES, FORENSIC INTERVIEWING, FORENSIC MEDICAL EXAMINATIONS AND CONSULTATIONS, WHICH INCLUDE 24/7 COVERAGE OF ACUTE SEXUAL ASSAULTS OF CHILDREN. THE CAC ALSO HELPS COORDINATE THE EFFORTS OF INVESTIGATIVE AGENCIES INVOLVED IN THE INVESTIGATION AND PROSECUTION OF CHILD MALTREATMENT AND FACILITATES THE COLLABORATION OF 12 MULTIDISCIPLINARY TEAMS (MDTS). THESE TEAMS DISCUSS ALL CHILDREN REFERRED TO THE PROGRAM TO HELP ENSURE THE BEST OUTCOMES CAN BE REALIZED. WITH STRONG COMMUNITY SUPPORT, CHKD'S CHILD ADVOCACY CENTER HELPED 2,638 CHILDREN AND THEIR FAMILIES IN FY23 A 15% INCREASE OVER FY22. FOR ALMOST 25 YEARS, INVESTIGATIVE AGENCIES ACROSS SOUTHEASTERN VIRGINIA HAVE TRUSTED THIS SPECIALIZED PROGRAM FOR ASSESSMENT AND TREATMENT SERVICES AFTER A CHILD IS SUSPECTED OF HAVING EXPERIENCED ALL FORMS OF CHILD MALTREATMENT. A SPECIALTY PROGRAM WITHIN THE CAC HELPS ACCURATELY IDENTIFY AND PROVIDE ASSISTANCE AND TREATMENT TO COMMERCIALLY SEXUALLY EXPLOITED CHILDREN (CSEC). SINCE LAUNCHING OUR PROGRAM AND CSEC MDT WE HAVE SEEN A SHARP INCREASE IN THE NEED FOR SERVICES FOR CHILDREN WHO NEED SUPPORT. OUR TEAM OFTEN COORDINATES WITH FEDERAL AND LOCAL INVESTIGATORS AS WELL AS JUVENILE COURT SERVICES AND MEDICAL AND MENTAL HEALTH PROVIDERS TO BEST SERVE THE UNIQUE NEEDS OF EACH CHILD. THE CAC IS ALSO THE BACKBONE AGENCY FOR THE HAMPTON ROADS TRAUMA INFORMED COMMUNITY NETWORK (HRTICN). THE NETWORK EXISTS TO PROMOTE AN UNDERSTANDING OF HOW TRAUMA AFFECTS INDIVIDUALS AND COMMUNITIES, AND TO ADVOCATE PRACTICES THAT HELP ALL PEOPLE REACH THEIR FULL POTENTIAL. THE HRTICN WORKED WITH THE VIRGINIA CHAPTER OF AMERICAN ACADEMY OF PEDIATRICS THIS YEAR TO TRAIN PEDIATRICIANS ON APPROACHES TO SCREENING, REFERRAL, AND FOLLOW-UP FOR MATERNAL DEPRESSION, SOCIAL DETERMINANTS OF HEALTH AND SOCIAL-EMOTIONAL DEVELOPMENT DURING WELL VISITS. ALMOST 15% OF THE CHILDREN SERVED AT OUR CAC HAVE A MILITARY AFFILIATION; A CASE MANAGER, WHO IS A DECORATED VETERAN IN HIS OWN RIGHT, IS SPECIFICALLY DEDICATED TO SERVING THESE FAMILIES. HE UNDERSTANDS THE NUANCED NEEDS OF FAMILIES WHO HAVE MILITARY AFFILIATION- THE PROGRAM MAINTAINS THREE MILITARY MULTIDISCIPLINARY TEAMS THAT COVER ALL BRANCHES OF THE MILITARY, AND WE STRIVE TO CONTINUALLY IMPROVE OUR RESPONSE TO MILITARY FAMILIES, LINK THEM TO OTHER MILITARY RESOURCES AVAILABLE TO THEM, AND PROVIDE EDUCATIONAL OPPORTUNITIES TO OUR MDT PARTNERS WE WORK WITH. THE EPIDEMIC OF CHILDHOOD OBESITY CONTINUES TO BE A CONCERN AND FOCUS AREA FOR CHKD, IN ORDER TO ADDRESS THIS CRITICAL ISSUE, IN 2001, CHKD ESTABLISHED A COMPREHENSIVE PROGRAM CALLED HEALTHY YOU FOR LIFE THAT IS OFFERED TO CHILDREN AGES 3 THROUGH 21. HEALTHY YOU FOR LIFE OFFERS A MULTIDISCIPLINARY TEAM APPROACH THAT PROVIDES CLINICAL AND PSYCHOLOGICAL EVALUATION AND TREATMENT PLANNING FOR INDIVIDUALS EITHER IN PERSON OR BY TELEMEDICINE VISITS. THE PROGRAM'S STAFF INCLUDES PHYSICIANS, NURSE PRACTITIONERS, REGISTERED DIETITIANS, LICENSED CLINICAL SOCIAL WORKERS, A MEDICAL ASSISTANT, AND EXERCISE PHYSIOLOGIST. THE HEALTHY YOU FOR LIFE PROGRAM ALSO OFFERS INDIVIDUAL COUNSELING SESSIONS. IN FY23 THE TEAM CONDUCTED NEARLY 1,200 VISITS COVERING 95 ZIP CODES. MOVING INTO THE NEW FISCAL YEAR, THE TEAM IS CONTINUING TO USE TELEMEDICINE AS A WAY TO ENSURE ACCESS TO A BEHAVIORAL HEALTH COUNSELOR TO ADDRESS PSYCHO-SOCIAL STRESSORS MANY PATIENTS EXPERIENCE. MIDDLE SCHOOL AND HIGH SCHOOL GROUP THERAPY SESSIONS CONTINUE VIA TELEHEALTH TO HELP PRE-TEEN AND TEENAGERS FEEL CONNECTED AND SUPPORTED. PERSONAL TRAINING IS ALSO OFFERED FOR INTERESTED PATIENTS. PURSUANT TO RECOMMENDATIONS FROM THE AMERICAN ACADEMY OF PEDIATRICS, THE USE OF PHARMACOTHERAPY HAS BEEN CONSIDERED AS AN ADDITIONAL TREATMENT IN CONJUCTION WITH DIET, EXERCISE AND LIFESTYLE. HEALTHY YOU CONTINUES TO PARTNER WITH VARIOUS COMMUNITY ORGANZIATIONS TO EDUCATE AND ENCOURAGE HEALTHY LIFESTYLES FOR CHRONICALLY OBESE CHILDREN AND THEIR FAMILIES IN HAMPTON ROADS. CHKD'S DIABETES EDUCATION PROGRAM HELPS APPROXIMATELY 1,600 LOCAL CHILDREN WHO LIVE WITH THE CHRONIC DISEASE. THREE CERTIFIED DIABETES EDUCATORS, A SOCIAL WORKER, A REGISTERED DIETITIAN AND OFFICE COORDINATOR HELP PATIENTS AND FAMILIES AT THE ONSET OF THE DISEASE AND UNTIL ADULTHOOD. THE DIABETES CENTER PROVIDES INPATIENT AND OUTPATIENT CLINICAL MANAGEMENT, DIABETES EDUCATION, SUPPORT GROUPS, AND PROFESSIONAL AND COMMUNITY EDUCATION PROGRAMS. A TRANSITION PROGRAM HELPS THE OLDER TEENS AND YOUNG ADULTS BEGIN TRANSFERRING CARE TO ADULT PROVIDERS IN THE COMMUNITY. CHILDREN MADE 750 VISITS TO THE DIABETES CENTER IN FY23. THE CHILDREN'S CANCER AND BLOOD DISORDERS CENTER PROVIDES CARE TO YOUNG PEOPLE WITH CANCER, SICKLE CELL DISEASE, BLEEDING AND OTHER BLOOD DISORDERS THROUGH TREATMENT PROGRAMS THAT ENCOMPASS CHILDREN'S PHYSICAL, EMOTIONAL AND EDUCATIONAL NEEDS AND INCORPORATES THE WHOLE FAMILY. PATIENTS MADE 8,268 VISITS TO THE CENTER IN FY23. CHKD IS THE ONLY EMERGENCY DEPARTMENT AND LEVEL 1 TRAUMA CENTER EXCLUSIVELY SERVING CHILDREN AND THEIR FAMILIES IN THE SOUTHEAST REGION OF VIRGINIA. IN FY23, CHILDREN MADE 62,947 VISITS TO OUR EMERGENCY CENTER. CHKD PROVIDES CARE FOR PATIENTS AND THEIR FAMILIES FROM BIRTH TO YOUNG ADULTHOOD WITH VARIED LEVELS OF ACUITY FROM TRAUMA AND RESUSCITATIONS TO URGENT CARE TYPE PATIENTS. OUR COLLABORATIVE TEAM INCLUDES PEDIATRIC BOARD-CERTIFIED EMERGENCY PHYSICIANS, NURSE PRACTITIONERS, NURSES, ED TECHS, NURSING CARE PARTNERS, BEHAVIORAL HEALTH TECHS, PHARMACISTS, SOCIAL WORKERS, CHILD LIFE SPECIALISTS, CHAPLAINS, RESPIRATORY THERAPISTS AND MORE. CHKD OFFERS THE ONLY PEDIATRIC RENAL DIALYSIS SERVICE IN THE AREA. DIALYSIS IS A TIME-CONSUMING PROCESS AND CHILDREN APPRECIATE THE CHANCE TO HAVE THE SERVICE IN A SETTING WHERE THEY CAN MEET WITH FRIENDS THEIR OWN AGES AS WELL AS HOSPITAL SUPPORT STAFF AND SCHOOL TEACHERS. DURING FY23 CHILDREN MADE 3,002 CHRONIC AND ACUTE DIALYSIS VISITS, AND 5,545 VISITS TO THE RENAL CLINIC AND RECEIVED 515 RENAL INFUSIONS. CHKD IS A STAND-ALONE PEDIATRIC TRANSPLANT HOSPITAL. SINCE 2005, CHKD HAS PERFORMED 98 KIDNEY TRANSPLANTS FROM LIVING DONORS AS WELL AS DECEASED DONORS. LIVING DONATION OPTIONS INCLUDE A PARTNERSHIP WITH SENTARA NORFOLK GENERAL HOSPITAL AND THE NATIONAL KIDNEY REGISTRY (NATIONWIDE LIVING DONOR PAIRED-EXCHANGE PROGRAM). ONE MARK OF CHKD'S DISTINCTIVE PEDIATRIC CARE HAS ALWAYS BEEN CHILD-CENTERED DIAGNOSTIC SERVICES, SUCH AS RADIOLOGY AND LABORATORY. OVER THE PAST SEVERAL YEARS, CHKD HAS WORKED HARD TO MAKE THESE UNIQUE SERVICES MORE ACCESSIBLE TO FAMILIES THROUGHOUT OUR SERVICE REGION. IN ADDITION TO THE LAB AT THE MAIN HOSPITAL, CHKD NOW HAS LAB SERVICES AT ITS OYSTER POINT, HARBOUR VIEW, CONCERT DRIVE, OAKBROOKE, LOEHMANN'S AND TECH CENTER LOCATIONS AS WELL AS THE VOLVO URGENT CARE CENTER. THE LABORATORY ALSO OPERATES A COURIER SERVICE THAT FACILITATES QUICK TURNAROUND OF SPECIMENS. OF THE 956,543 LAB TESTS PERFORMED IN FY23, APPROXIMATELY 68 PERCENT WERE FOR OUTPATIENTS. CHKD RADIOLOGY SERVICES ARE ALSO AVAILABLE TO FAMILIES AT OUR CHKD FACILITIES IN NEWPORT NEWS, CHESAPEAKE, SUFFOLK, HAMPTON, NORFOLK AND VIRGINIA BEACH. THE RADIOLOGY DEPARTMENT IS A FULLY INTEGRATED DIGITAL IMAGING CENTER THAT ALLOWS DIAGNOSTIC IMAGES AND REPORTS TO BE TRANSMITTED AND VIEWED ELECTRONICALLY. IN FY23, 115,964 DIAGNOSTIC EXAMS WERE PERFORMED, INCLUDING X-RAYS, FLUOROSCOPIC TESTS, URODYNAMICS AND BONE DENSITY TESTS, CT AND MRI SCANS, ULTRASOUND, PVL AND NUCLEAR MEDICINE STUDIES. APPROXIMATELY 80 PERCENT WERE OUTPATIENT BASED. CHKD'S REHABILITATIVE THERAPY SERVICES ARE OFFERED IN LOCATIONS THROUGHOUT THE COMMUNITY, INCLUDING NORFOLK, CHESAPEAKE, VIRGINIA BEACH, SUFFOLK, WILLIAMSBURG, AND NEWPORT NEWS. IN ADDITION TO ITS HIGHLY SPECIALIZED PEDIATRIC PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, THE DEPARTMENT ALSO OFFERS: * AQUATIC THERAPY - PHYSICAL AND OCCUPATIONAL THERAPISTS WORK WITH CHILDREN IN THE WATER TO HELP RELAX TIGHT MUSCULATURE, INCREASE RANGE OF MOTION AND IMPROVE STRENGTH, BALANCE AND ENDURANCE. THERE WERE 412 COMPLETED VISITS IN FY23. * ASSISTIVE TECHNOLOGY/AUGMENTATIVE PROGRAM - SERVICES PROVIDED FOR CHILDREN WHO ARE UNABLE TO COMMUNICATE VERBALLY OR THROUGH GESTURES DUE TO VARIOUS MEDICAL CONDITIONS, THEREBY ALLOWING THEM AN ALTERNATIVE WAY TO INCREASE THEIR PARTICIPATION AND INCLUSION IN DAILY ACTIVITIES. IN FY23, WE DID 258 AUGMENTATIVE COMMUNICATION EVALUATIONS. * CAR SEAT PROGRAM - SPECIALLY TRAINED THERAPISTS OFFER CAR SEAT SAFETY RESTRAINT EVALUATIONS FOR PATIENTS WITH SPECIAL NEEDS. IN FY23, WE DID 143 CAR SEAT EVALUATIONS, DISTRIBUTED 73 CAR SEATS DURING THOSE EVALUATIONS, DISTRIBUTED AN ADDITIONAL 141 STANDARD CAR SEATS, AND PARTICIPATED IN ONE COMMUNITY-BASED CAR SEAT SAFETY CHECKS THROUGH THIS PROGRAM. * WHEELCHAIR CLINIC - CERTIFIED THERAPISTS COMPLETE A COMPREHENSIVE EVALUATION TO DETERMINE AND PRESCRIBE THE APPROPRIATE WHEELCHAIR AND SEATING SYSTEM. CHILDREN MADE ALMOST 610 VISITS TO THIS CLINIC IN FY23. FOR EVALUATION AND TECHNICAL ADJUSTMENTS. SECTION THREE: CHKD'S COMMUNITY HEALTH NEEDS ASSESSMENTS PERFORMED IN 2013, 2016, AND 2019 SHOWED THAT THE REGION'S NUMBER ONE NEED IN THE CHILDREN'S HEALTH ARENA WAS IMPROVED ACCESS TO PEDIATRIC MENTAL HEALTH SERVICES. IN RESPONSE, CHKD FORMALLY EXPANDED ITS MISSION TO INCORPORATE CHILDREN'S MENTAL HEALTH SERVICES AND BEGAN BUILDING A PROGRAM TO ANSWER OUR CHILDREN'S MOST PRESSING MENTAL HEALTH NEEDS. IN SEPTEMBER OF 2019, WE BROKE GROUND FOR A 14-STORY MEDICAL BUILDING WHICH WILL PROVIDE 60 INPATIENT BEDS FOR ACUTE MENTAL HEALTH CARE, EXPANDED OUTPATIENT SERVICES, INCLUDING PARTIAL HOSPITALIZATION PROGRAMS AND INTENSIVE OUTPATIENT SERVICES. THE NEW MENTAL HEALTH HOSPITAL OPENED OUTPATIENT ON SCHEDULE IN APRIL OF 2022 AND OUR FIRST INPATIENT BEDS OPENED IN OCTOBER 2022. IN THE HOSPITAL'S FIRST YEAR OF OPERATION THERE WERE 460 ADMISSIONS. CHILDREN'S PAVILLION IS THE HUB OF CHKD'S GROWING MENTAL HEATH PROGRAM, WHICH HAS THE GOAL OF OFFERING A COMPREHENSIVE, INTEGRATED CONTINUUM OF MENTAL HEALTH SERVICES THAT PROVIDES THE SPECIFIC CARE EACH CHILD NEEDS IN THE LEAST-RESTRICTIVE ENVIRONMENT POSSIBLE. ELEMENTS OF THIS PLAN INCLUDE THE FOLLOWING: - 60-BED PSYCHIATRIC HOSPITAL AND OUTPATIENT CENTER - 7-BED MED-PSYCH UNIT IN MAIN HOSPITAL - 6-BED SECURED WING FOR MENTAL HEALTH IN EMERGENCY DEPARTMENT - PARTIAL HOSPITALIZATION PROGRAM - INTENSIVE OUTPATIENT PROGRAM - OUTPATIENT MENTAL HEALTH THERAPY - COMMUNITY OUTREACH/EDUCATION - RESEARCH - CHILD AND ADOLESCENT PSYCHIATRY FELLOWSHIP THE HEALTH SYSTEM MADE PROGRESS IN EVERY AREA ABOVE LAST YEAR. - MENTAL HEALTH VISITS TOTALED 36,420. - MORE THAN 100 MENTAL HEALTH PROVIDERS WERE HIRED, INCLUDING 18 CHILD AND ADOLESCENT PSYCHIATRISTS, PLUS MORE THAN 300 SUPPORT STAFF MEMBERS. - IN FY23, 486 PATIENTS ADMITTED TO THE MAIN HOSPITAL FOR MEDICAL CARE ALSO RECEIVED MENTAL HEALTH SERVICES. MOST OF THESE PATIENTS WERE CARED FOR ON 7D, A UNIT WE CREATED SPECIFICALLY FOR THIS NEED. - DURING THE SAME TIME PERIOD, 2,587 EMERGENCY DEPARTMENT PATIENTS RECEIVED MENTAL HEALTH EVALUATIONS. - WE INAUGURATED A PARTIAL HOSPITALIZATION PROGRAM FOR CHILDREN NEEDING ADDITIONAL CONSISTENT AND STRUCTURED CARE EITHER AFTER AN INPATIENT STAY OR TO AVOID AN INPATIENT STAY. PATIENTS ATTEND MONDAY THRU FRIDAY FROM 8:30 TO 3:15, SO THEY CAN REMAIN AT HOME AT NIGHT. - WE STARTED AN INTENSIVE OUTPATIENT PROGRAM FOR TEENS WHO NEED A LITTLE MORE THAN WEEKLY OUTPATIENT SESSIONS TO ADDRESS THEIR CHALLENGES, BUT LESS THAN PARTIAL HOSPITALIZATION OR INPATIENT CARE. THIS PROGRAM MEETS THREE TIMES A WEEK AFTER SCHOOL. - WE ARE COMMITTED TO RESEARCH AND EDUCATION. THIS JULY WE WERE PROUD TO WELCOME THE FIRST TWO PHYSICIANS IN OUR FELLOWSHIP TRAINING PROGRAM FOR CHILD AND ADOLESCENT PSYCHIATRY. WE ARE THE HOME SITE FOR AN INNOVATIVE STATE PROGRAM THAT FACILITATES CONSULTATIONS BETWEEN PSYCHIATRIC PROVIDERS AND CHILDREN'S PRIMARY CARE PROVIDERS. IN THE FALL OF 2023, MEMBERS OF THE CHKD MENTAL HEALTH TEAM LED SEVEN CONTINUING EDUCATION SEMINARS AND SHARED THE RESULTS OF FOUR RESEARCH STUDIES AT THE NATIONAL CONFERENCE FOR THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY. COMMUNITY OUTREACH CHKD REACHED 44,806 FAMILIES IN THEIR HOMES, DOCTORS' OFFICES, SCHOOLS, NEIGHBORHOODS AND COMMUNITY CENTERS WITH A WIDE VARIETY OF PROGRAMS, SOCIAL MEDIA AND PUBLICATIONS THAT PROMOTE MENTAL WELLNESS, PREVENT INJURIES, AND STRENGTHEN FAMILIES. USING CREATIVE AND INNOVATIVE WAYS WITH OUR STRONG COMMUNITY PARTNERS, OUR COMMUNITY OUTREACH AND ENGAGEMENT (CORE) PROGRAM CONDUCTED 260 OUTREACH EVENTS REACHING 26,940 FAMILIES. UTILIZING WEB-BASED EDUCATION (BLOGS, PODCASTS, AND WEBINARS ON DEMAND) AND I&R CONTACTS, CORE EXTENDED THEIR REACH TO AN ADDITIONAL 17,866 FAMILIES. EFFORTS FOCUSED ON MENTAL HEALTH, TRAUMA, AND SOCIAL EMOTIONAL LEARNING FOR BOTH PARENTS AND PROFESSIONALS. OUR STRONG COMMUNITY PARTNERS ASSISTED WITH PROGRAM MARKETING AND COLLABORATION TO PROVIDE A VARIETY OF TIMELY PRESENTATIONS TO EQUIP PARENTS, PROFESSIONALS AND CHILDREN IN OUR COMMUNITY. CHKD IS A SITE OF THE NATIONAL "REACH OUT AND READ" LITERACY PROGRAM, WHICH ENCOURAGES READING BY DISTRIBUTING FREE BOOKS TO CHILDREN AT THEIR WELL CHILD VISITS BY THEIR PEDIATRICIANS. THROUGH THE DONOR-FUNDED PROGRAM, CHKD PRIMARY CARE PEDIATRICIANS GAVE APPROXIMATELY 73,503 BOOKS TO CHILDREN IN FY23. CHKD ALSO HAS A "REACH OUT AND READ" PROGRAM IN OUR NICU, WHERE 1,411 BOOKS WERE DISTRIBUTED IN FY23. IN FY23, CHKD'S WEBSITE, WWW.CHKD.ORG, CONTINUES TO BE A POPULAR AND EFFECTIVE METHOD OF COMMUNICATION. IN FY23, CHKD.ORG HAD MORE THAN 3 MILLION VISITS. NEARLY 2 MILLION NEW AND RETURNING VISITORS VIEWED 4,812,296 PAGES ON OUR SITE. THE CONTENT MANAGEMENT SYSTEM THAT IS IN PLACE ALLOWS MULTIPLE USERS TO CREATE AND UPDATE CONTENT AS NEEDED. CHKD.ORG IS A RESPONSIVE DESIGN SITE AND AUTOMATICALLY FORMATS ITSELF TO ANY DEVICE (PC, TABLET OR SMARTPHONE)- NO APP NEEDED. CLICKABLE PHONE NUMBERS AND INTERACTIVE MAPS MAKE IT EASY FOR OUR PATIENTS TO CALL OR FIND ANY PRACTICE, AND FAMILIES HAVE EASY ACCESS TO TEST RESULTS, SHOT RECORDS, AND CAN EVEN REQUEST PRESCRIPTION REFILLS AND MAKE APPOINTMENTS ONLINE STRAIGHT FROM THE HOMEPAGE BY ACCESSING THE MYCHKD PATIENT PORTAL. ENHANCED PHYSICIAN PROFILES, INCLUDING CLICKABLE PHONE NUMBERS, INTERACTIVE MAPS, BIOGRAPHICAL INFORMATION AND A LINK TO THE PHYSICIAN'S PRACTICE MAKE IT EASIER THAN EVER TO CHOOSE THE DOCTOR THAT'S RIGHT FOR YOU. CHKD CONTINUES TO UTILIZE SOCIAL MEDIA OUTLETS SUCH AS FACEBOOK, LINKEDIN, AND INSTAGRAM TO INCREASE DIRECT INTERACTION WITH OUR PATIENTS AND THEIR FAMILIES. THE WEBSITE CONTINUES TO BE A RESOURCE FOR OUR SERVICES AND HEALTH INFORMATION. CHKD IS ONE OF SIX LOCATIONS IN THE STATE FOR THE CARE CONNECTION FOR CHILDREN (CCC), THE STATE-FUNDED TITLE V PROGRAM THAT PROVIDES COMPREHENSIVE CARE COORDINATION, INFORMATION AND REFERRAL FOR CHILDREN AND YOUTH WITH SPECIAL HEALTH CARE NEEDS. THERE ARE APPROXIMATELY 12,000 CHILDREN WITH SPECIAL HEALTH CARE NEEDS IN THE REGION'S PUBLIC HEALTH DISTRICTS. IN FY23, CCC ASSISTED WITH MORE THAN 600 INFORMATION AND REFERRAL CALLS AND PROVIDED COMPREHENSIVE CASE MANAGEMENT SERVICES TO MORE THAN 600 FAMILIES. FINANCIAL ASSISTANCE WAS PROVIDED FOR 36 CHILDREN AND YOUTH WHO WERE UNINSURED OR UNDERINSURED AND 67 FAMILIES WERE ASSISTED IN APPLYING FOR STATE HEALTH PROGRAMS, TO INCLUDE VIRGINIA'S WAIVER SERVICES. THE PROGRAM PROVIDED ONGOING BILINGUAL CARE COORDINATION SERVICES TO 100 CLIENTS/FAMILIES AND ASSISTED THEM WITH ACCESS TO COMMUNITY RESOURCES AND FINANCIAL ASSISTANCE. WE MAINTAINED AN UPDATED LOCAL AND REGIONAL COMMUNITY DATABASE WITH CATALOGED RESOURCES FOR ALL 21 CITIES AND COUNTIES IN OUR REGION. THIS RESOURCE DIRECTORY WAS MADE AVAILABLE TO THE HEALTH SYSTEM AS WELL AS LOCAL AGENCIES AND THE COMMUNITY. THE PARENT EDUCATORS FROM THE FAMILIES AS EDUCATORS PROGRAM (SHARING OF CHALLENGES AND POSITIVE EXPERIENCES IN RAISING CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS) PROVIDED COMMUNITY BASED EXPERIENCES TO PARTICIPATING RESIDENTS. 2022-2023 HIGHLIGHTS *DEVELOPED, IMPLEMENTED AND CONTINUED TO MODERATE A LISTSERV FOR THE COMMUNITY ON DISABILITY TOPICS WITH MORE THAN 500 PEOPLE REGISTERED. MEMBERS ARE PATIENTS, PARENTS, CAREGIVERS, AND PROVIDERS. *ONGOING COLLABORATION WITH CHKD, FORTIFY CLINICALLY INTEGRATED NETWORK AND CMG TO INTEGRATE CARE COORDINATION ACTIVITIES WITHIN THE ELECTRONIC RECORD TO IMPROVE COMMUNICATION WITH PATIENT CENTERED MEDICAL HOME. *CCC IS ACTIVELY ENGAGED IN HOME VISITING COLLABORATION, AUTISM COLLABORATIVE, INFANT TODDLER CONNECTION, PEATC, FAPT TEAMS, SEAC STATE REPRESENTATIVE FOR MEDICAID ADVISORY GROUP. *OFFERED A VIRTUAL SPANISH SPEAKING SUPPORT GROUP. OTHER TRANINGS PLANNED, COORDINATED, AND REPORTED ON QUARTERLY, BASED ON NEEDS IDENTIFIED THROUGH NETWORKS WE ARE INVOLVED IN WITH THE COMMUNITY AND OUR FAMILIES AS EDUCATORS GROUP. * REVISED OUR INTAKE PROCESS TO IMPROVE ENROLLMENT PROCESSES FOR FAMILIES AND IMPROVE COMMUNICATION WITH REFERRAL SOURCES. ROBUST RESEARCH AND UPDATING RESOURCES IN OUR COMMUNITY ASSET MAPPING TOOL. COLLABORATE ACROSS THE CCC NETWORK TO IDENTIFY RESOURCES. * ACTIVELY ENGAGED WITH INTERCENTER WORK GROUP MEETINGS, TRAININGS, EMAIL COLLABORATIONS AND TELECONFERENCE SESSIONS. THIS GROUP IS RESOURCEFUL, AND MEMBERS SUPPORT ONE ANOTHER TO IDENTIFY RESOURCES WHEN WE FACE CHALLENGES. THIS TALENTED AND EXPERIENCED GROUP WORKS TOGETHER FOR ADVOCACY AND TO CLOSE GAPS IN SERVICE. * CONTINUE TO OFFER EDUCATIONAL CONSULTANT SERVICES PER VDOE REGULATIONS. PROVIDE INFORMATION AND REFERRAL SERVICES FOR HEALTH SYSTEM RELATED TO EDUCATIONAL CONCERNS (IEP/IFSP). SECTION FOUR: MEDICAL EDUCATION AND RESEARCH CHKD INVESTS IN THE PRESENT AND FUTURE HEALTH OF OUR CHILDREN THROUGH A VARIETY OF RESEARCH PROGRAMS AND EDUCATIONAL ACTIVITIES. CHILDREN'S HOSPITAL IS HOME TO EASTERN VIRGINIA MEDICAL SCHOOL'S PEDIATRIC RESIDENCY PROGRAM, WHERE NEW PHYSICIANS BECOME SPECIALISTS IN THE FIELD OF PEDIATRICS. MANY OF OUR RESIDENTS ELECT TO STAY AND PRACTICE PEDIATRICS IN THIS COMMUNITY OR IN THE STATE OF VIRGINIA. CHKD ALSO SERVES AS THE EXCLUSIVE PEDIATRIC TEACHING SITE FOR PHYSICIAN ASSISTANTS AND RESIDENTS IN FAMILY MEDICINE, EMERGENCY MEDICINE, OBSTETRICS-GYNECOLOGY, ENT, PLASTIC SURGERY, AND GENERAL SURGERY. CHKD PARTICIPATES IN THE EDUCATION OF ALL EVMS MEDICAL STUDENTS AND IS THE EXCLUSIVE SITE FOR SOME 150 THIRD-YEAR MEDICAL SCHOOL STUDENTS FOR THEIR SIX-WEEK PEDIATRIC CLERKSHIP ROTATION. CHKD PROVIDES A SETTING FOR MANY CLINICAL RESEARCH TRIALS. HIGHLIGHTS OF THE BASIC SCIENCE RESEARCH INCLUDE NEW GENE THERAPY FOR NEUROMUSCULAR DISORDERS, BREAKTHROUGHS IN TREATMENT OF CYSTIC FIBROSIS, INNOVATIVE THERAPIES IN SPORTS MEDICINE, ADVANCE GROWTH HORMONE TREATMENTS, AND INTERVENTIONS FOR DISORDERED SLEEP. IN ADDITION, RESEARCH INCLUDES NEW MEDICATIONS AND OTHER THERAPIES, CLINICAL OUTCOME ANALYSES AND EPIDEMIOLOGICAL STUDIES SANCTIONED BY THE EASTERN VIRGINIA MEDICAL SCHOOL INSTITUTIONAL REVIEW BOARD. THERE WERE 203 IRB-APPROVED ACTIVE FUNDED STUDIES IN FY23. TOPICS OF STUDY INCLUDED HEMATOLOGY/ONCOLOGY, ALLERGY/ASTHMA, INFECTIOUS DISEASE, NEUROLOGY, PEDIATRIC SURGERY, CARDIOLOGY, OTOLARYNGOLOGY, PULMONOLOGY, GASTROENTEROLOGY, CHILD ABUSE, ENDOCRINOLOGY, DERMATOLOGY, NEONATOLOGY AND MENTAL HEALTH. MANY OF THESE STUDIES ARE PHASE THREE CLINICAL TRIALS THAT BRING CUTTING-EDGE TREATMENTS TO CHKD PATIENTS YEARS BEFORE THEY ARE AVAILABLE TO THE PUBLIC. THIS FISCAL YEAR THERE WERE ALSO NEW PHASE ONE TRIALS OPENED, WHICH ALLOWED OUR PATIENTS THE EARLIEST POSSIBLE ACCESS TO NOVEL THERAPIES. THERE IS AN INCREASED FOCUS ON REGISTRY STUDIES ACROSS ALL DISCIPLINES. DATA COLLECTED IN THESE REGISTRIES IS INTENDED TO STANDARDIZE OPTIMAL LEVELS OF CARE AND LEAD TO IMPROVED PATIENT OUTCOMES. THERE HAVE ALSO BEEN OPPORTUNITIES TO STUDY THE EFFECTS OF VARIOUS TELEHEALTH TELEMEDICINE INTERVENTIONS, NOT ONLY TO ADAPT TO THE COVID-19 PANDEMIC, BUT TO BE ABLE TO REACH SUBJECTS WHO CANNOT TRAVEL TO THE SITE, SUCH AS SUBJECTS WHO ARE HOMEBOUND OR IN HOSPICE CARE. THE NUSS PROCEDURE FOR THE CORRECTION OF PECTUS EXCAVATUM, DEVELOPED AT CHKD MORE THAN 30 YEARS AGO, CONTINUES TO DRAW NATIONAL ATTENTION FROM BOTH PATIENTS AND SURGEONS. THE CHILDREN'S SURGICAL SPECIALTY GROUP SURGEONS CONTINUE TO PUBLISH MANUSCRIPTS AND PRESENT THEIR WORK AT NATIONAL MEETINGS TO REINFORCE AND MAINTAIN OUR REPUTATION OF EXCELLENCE ON AN INTERNATIONAL SCALE. THE NUSS CENTER CONTINUES TO OFFER NON-SURGICAL TREATMENT THERAPIES AS WELL. THE ARGENTINA COMPRESSION BRACE INITIATED IN 2009 HAS HELPED MORE THAN 575 PATIENTS WITH OVER 92% OF THOSE PATIENTS EXPERIENCING A CORRECTION TO THEIR DEFORMITY. THAT TYPE OF TREATMENT WAS EXPANDED IN 2020 BY USING A BRACE KNOWN AS THE EMBRACE, WHICH CHKD HAS USED WITH 32 PATIENTS. IN ADDITION, THE VACUUM BELL TREATMENT FIRST OFFERED IN 2012 HAS HELPED OVER 381 PATIENTS. IN JUNE 2016, CHKD OPENED THE NEW NUSS CENTER, OFFERING A SPACE DEDICATED TO THE EVALUATION AND TREATMENT OF CHEST WALL CONDITIONS. THE HOSPITAL CONTINUES ITS ENDEAVORS ON MULTIPLE RESEARCH STUDIES IN AN EFFORT TO FURTHER UNDERSTAND CHEST WALL DEFORMITIES. TO DATE, MORE THAN 2,601 SURGICAL PATIENTS HAVE UNDERGONE THE NUSS PROCEDURE AT CHKD AND OVER 5,949 PATIENTS HAVE BEEN EVALUATED FOR CHEST WALL CONDITIONS. CHKD IS A MEMBER OF CHILDREN'S ONCOLOGY GROUP (COG), AN INTERNATIONAL RESEARCH GROUP THAT CONDUCTS CLINICAL TRIALS FOR CHILDREN WITH CANCER. AS A MEMBER, CHKD HAS ACCESS TO THE LATEST PROTOCOLS FOR TREATMENT OF CHILDHOOD CANCER, PROVIDING THE COMMUNITY AND REGION WITH THE BEST PRACTICES AND TREATMENT RESULTS FROM MORE THAN 200 COG-MEMBER HOSPITALS IN NORTH AMERICA, AUSTRALIA, NEW ZEALAND, EUROPE, AND SAUDI ARABIA. OUR PRIMARY GOAL IS TO INCREASE PARTICIPATION IN CLINICAL TRIALS WHICH WE FEEL WILL ADVANCE THE FIELD OF PEDIATRIC ONCOLOGY. IN FY23, CHKD HAD APPROXIMATELY 95 COG STUDIES INCLUDING LTF STUDIES OPEN TO ENROLLMENT OR UNDERGOING DATA ANALYSIS. IN ALL, OVER 200 CHKD PATIENTS PARTICIPATED IN EITHER OPEN OR FOLLOW-UP COG STUDIES IN FY23. THE HEMATOLOGY ONCOLOGY DIVISION HAD 17 RESEARCH STUDIES OPEN THAT WERE NOT COG STUDIES. IN FY23, CHKD HOSTED 6 CONTINUING MEDICAL EDUCATION EVENTS IN VARIOUS LOCATIONS THROUGHOUT THE REGION. HELPING CHILD HEALTH EXPERTS IN OUR REGION KEEP UP WITH THEIR SKILLS AND THEIR ACCREDITATION. THERE WERE TEN REGULARLY SCHEDULED SERIES FOR A TOTAL OF 212 ACTIVITIES. FORM 990, PART VI, SECTION A, LINE 6 LINE 6: CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK CORPORATION WITH A SOLE MEMBER. THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS CHILDREN'S HEALTH SYSTEM, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS MANAGED BY ITS SOLE MEMBER, CHILDREN'S HEALTH SYSTEM, INC. FORM 990, PART VI, SECTION A, LINE 7A LINE 7A: CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, IS A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION. PURSUANT TO SECTION 13.1-852.1 OF THE CODE OF VIRGINIA, CHILDREN'S HEALTH SYSTEM, INC., THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, MANAGES CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS. ACCORDINGLY, THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED. AS A VIRGINIA NON-STOCK CORPORATION, CHILDREN'S HEALTH SYSTEM, INC., HAS MEMBERS THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. THE MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC., THAT ELECT THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC. ARE THE CLASS A MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC. (I.E., THE THEN CURRENT MEMBERS IN GOOD STANDING OF THE NORFOLK CITY UNION OF THE KING'S DAUGHTERS, INC., A VIRGINIA NON-STOCK NOT-FOR-PROFIT CORPORATION) AND THE CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM INC. (I.E., THE THEN CURRENT DIRECTORS ON THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC.). FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 11B THE FOLLOWING DECISIONS OF THE BOARD OF DIRECTORS OF CHILDREN'S HEALTH SYSTEM, INC., WHICH IS THE GOVERNING BODY FOR CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS, INCORPORATED, ARE SUBJECT TO APPROVAL BY THE CLASS A AND CLASS B MEMBERS OF CHILDREN'S HEALTH SYSTEM, INC.: 1) ANY AMENDMENTS TO THE ARTICLES OF INCORPORATION OF THE CORPORATION; AND 2) ANY PROPOSED MERGER OR CONSOLIDATION OF THE CORPORATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE PROPERTY AND ASSETS OF THE CORPORATION. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT POLICY CONSIDERATIONS: CHKD CONFLICT OF INTEREST POLICY INCLUDES OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES, KEY EMPLOYEES, ALL OTHER EMPLOYEES, PROFESSIONAL STAFF AND SUBSTANTIAL DONORS. ANNUALLY, A QUESTIONNAIRE IS DISTRIBUTED AND COLLECTED FROM OFFICERS, MEMBERS OF THE BOARD OF DIRECTORS AND BOARD COMMITTEES AND KEY EMPLOYEES. THE QUESTIONNAIRES ARE REVIEWED BY THE LEGAL DEPARTMENT. FOR KNOWN CONFLICTS, THE PERSON INVOLVED RECUSES HIMSELF OR HERSELF FROM DELIBERATIONS REGARDING THE TRANSACTION. VIOLATIONS OF THE CONFLICT OF INTEREST POLICY ARE REPORTED TO THE CHKD BOARD CHAIR OR THE CHKD COMPLIANCE OFFICER, AS APPLICABLE, AND MAY REQUIRE CORRECTIVE ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT. FORM 990, PART VI, SECTION B, LINE 15B LINE 15A: COMPENSATION PROCESS CONSIDERATIONS: CHILDREN'S HEALTH SYSTEM ESTABLISHES THE COMPENSATION OF THE CEO AMY SAMPSON. LINE 15B: CHILDREN'S HEALTH SYSTEM AND CHILDREN'S HOSPITAL OF THE KING'S DAUGHTERS USE THE FOLLOWING PROCESS TO ESTABLISH COMPENSATION FOR OFFICERS AND KEY EMPLOYEES: AN INDEPENDENT COMPENSATION CONSULTANT APPROVED AND RETAINED BY THE COMPENSATION COMMITTEE OF THE BOARD ANNUALLY, USUALLY IN APRIL, PROVIDES EDUCATION AND PRESENTS TO THE FULL BOARD COMPARATIVE SALARIES AND SALARY RANGES FROM A DATABASE COMPRISED OF CHILDREN'S HOSPITALS AND OTHER APPLICABLE HOSPITALS FOR OFFICERS & EXECUTIVES FOR THE BOARD TO REVIEW. THE COMPENSATION COMMITTEE WITH THE AID OF THE CONSULTANT REVIEWS AND MAKES DECISIONS AS TO EXECUTIVE SALARIES OF CHKD AND ITS SUBSIDIARIES. THOSE SALARY CHANGES AND APPROVALS ARE CONTEMPORANEOUSLY DOCUMENTED BY MINUTES MAINTAINED BY THE COMPENSATION COMMITTEE AND SIGNED BY THE CHAIRMAN OF THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS (PART OF THE CONSOLIDATED FINANCIAL STATEMENTS OF CHILDREN'S HEALTH SYSTEM, INC.) ALONG WITH GOVERNING DOCUMENTS OF THE ORGANIZATION INCLUDING THE CONFLICT OF INTEREST POLICY, ARE AVAILABLE TO THE PUBLIC THROUGH DIRECT INQUIRY AND REQUEST. FORM 990, PART XI, LINE 9: GAIN/LOSS ON DERIVATIVE INVESTMENTS 12,009,698. CHANGE IN DONOR RESTRICTED CONTRIBUTIONS 1,885,420. 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