Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private
foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
A For the 2014 calendar year, or tax year beginning 07-01-2014 , and ending 06-30-2015
BCheck if applicable:
CName of organization
ARKANSAS CHILDREN'S HOSPITAL
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1 CHILDRENS WAY
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LITTLE ROCK, AR72202
D Employer identification number

71-0236857
E Telephone number

G Gross receipts $ 563,968,720
F Name and address of principal officer:
MARCELLA DODERER
1 CHILDRENS WAY
LITTLE ROCK,AR72202
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.ARCHILDRENS.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1912
M State of legal domicile: AR
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: WE CHAMPION CHILDREN BY MAKING THEM BETTER TODAY AND HEALTHIER TOMORROW.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 30
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 25
5 Total number of individuals employed in calendar year 2014 (Part V, line 2a) ...... 5 4,892
6 Total number of volunteers (estimate if necessary) ............. 6 2,853
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 0
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 32,456,742 37,839,032
9 Program service revenue (Part VIII, line 2g) ......... 512,741,985 506,921,438
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 4,273,158 4,021,865
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 12,681,858 15,035,203
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 562,153,743 563,817,538
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 6,765,979 6,109,741
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 260,050,732 253,942,823
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 247,750,171 246,032,776
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 514,566,882 506,085,340
19 Revenue less expenses. Subtract line 18 from line 12....... 47,586,861 57,732,198
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 762,641,298 787,814,566
21 Total liabilities (Part X, line 26)............. 217,255,423 185,201,266
22 Net assets or fund balances. Subtract line 21 from line 20..... 545,385,875 602,613,300
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet
Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2014)
Form 990 (2014)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: WE CHAMPION CHILDREN BY MAKING THEM BETTER TODAY AND HEALTHIER TOMORROW.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 420,034,881 including grants of $ 6,109,741 ) (Revenue $ 515,405,166 )
ARKANSAS CHILDREN'S HOSPITAL (ACH) IS A NOT-FOR-PROFIT PEDIATRIC HOSPITAL THAT SERVES AS THE ONLY TERTIARY HEALTH CARE FACILITY FOR CHILDREN IN THE STATE OF ARKANSAS. ACH HAS THE ONLY BURN CENTER IN ARKANSAS AND PROVIDES TREATMENT TO ADULTS AS WELL AS CHILDREN. DURING THE YEAR ENDED JUNE 30, 2015, ACH EXPERIENCED THE FOLLOWING: 15,529 ADMISSIONS WITH AN AVERAGE STAY OF 5.28 DAYS; 81,889 PATIENT DAYS; 224.4 AVERAGE DAILY CENSUS; 342 OPERATING BEDS, INCLUDING 170 INTENSIVE CARE BEDS AND 159 MEDICAL/SURGICAL BEDS; 255,708 OUTPATIENT VISITS, EXCLUDING ER VISITS WHICH WERE 58,693; AND 15,089 SURGERIES INCLUDING 10 HEART TRANSPLANTS AND 8 KIDNEY TRANSPLANTS. CONTINUED ON SCHEDULE O:IN ADDITION TO PROVIDING CHARITY CARE, ACH WORKS WITH THE CENTRAL ARKANSAS COMMUNITY AND ORGANIZATIONS THROUGHOUT THE STATE TO PROVIDE THE FOLLOWING: FREE PHYSICALS, STAFF FOR HEALTH CAMPS, PROGRAMS ON HEALTH CARE TO ELEMENTARY STUDENTS, AND INFORMATION AND LEARNING EXPERIENCES FOR CHILDREN AND FAMILIES AT HEALTH FAIRS AND SEMINARS.ACH IS THE STATE'S ONLY PEDIATRIC LEVEL 1 TRAUMA CENTER, AN INDICATION THAT IT PROVIDES THE HIGHEST STANDARD OF CARE FOR INJURED CHILDREN.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet420,034,881
Form 990 (2014)
Form 990 (2014)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part III
Click to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions) ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
Yes
 
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
Yes
 
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?
......................
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I.... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If "Yes," complete Schedule L, Part II................ Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV
..................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I
...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
254
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
4,892
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
 
No
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
 
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds.
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?
.........................
8
 
 
9a
Did the sponsoring organization make any taxable distributions under section 4966?...
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note.
See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2014)
Form 990 (2014)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
30
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
25
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
Yes
 
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletGENA WINGFIELD

1 CHILDRENS WAY
LITTLE ROCK,AR72202 (501) 364-2555
Form 990 (2014)
Form 990 (2014)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) MARCELLA DODERER........................................................................
PRESIDENT/CEO
48.00
.......................2.00
X   X       586,706 0 97,823
(2) TOM BAXTER........................................................................
CHAIRMAN OF THE BOARD
1.50
.......................0.00
X   X       0 0 0
(3) JOHN BALE JR........................................................................
TRUSTEE/DIRECTOR
0.80
.......................0.00
X           0 0 0
(4) SHARON BALE........................................................................
TRUSTEE/DIRECTOR
0.10
.......................1.20
X           0 0 0
(5) RON CLARK........................................................................
TRUSTEE/DIRECTOR
0.50
.......................0.10
X           0 0 0
(6) JAYANT DESHPANDE MD........................................................................
SVP AND CMO
50.00
.......................0.00
X   X       505,608 0 0
(7) HASKELL DICKINSON........................................................................
TRUSTEE/DIRECTOR
0.20
.......................0.00
X           0 0 0
(8) HARRY C ERWIN III........................................................................
TRUSTEE/DIRECTOR
0.40
.......................0.30
X           0 0 0
(9) JEFF GARDNER........................................................................
TRUSTEE/DIRECTOR
0.10
.......................0.00
X           0 0 0
(10) SHARILYN GASAWAY........................................................................
TRUSTEE/DIRECTOR
0.70
.......................0.20
X           0 0 0
(11) MELISSA GRAHAM MD........................................................................
TRUSTEE/DIRECTOR
1.00
.......................0.00
X           0 0 0
(12) PAUL R HART........................................................................
TRUSTEE/DIRECTOR
0.20
.......................0.10
X           0 0 0
(13) JUDGE MARION HUMPHREY........................................................................
TRUSTEE/DIRECTOR
0.80
.......................0.00
X           0 0 0
(14) DORSEY JACKSON........................................................................
PAST CHAIRMAN
0.90
.......................0.10
X   X       0 0 0
(15) RICK JACKSON MD........................................................................
CHIEF OF STAFF
41.50
.......................0.00
X   X       707,621 0 0
(16) RICHARD JACOBS MD........................................................................
ACHRI PRESIDENT/UAMS DOP C
0.60
.......................52.00
X           0 243,800 0
(17) PHILLIP JETT........................................................................
TRUSTEE/DIRECTOR
1.00
.......................0.10
X           0 0 0
Form 990 (2014)
Form 990 (2014)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title
(B)
Average hours per week (list any hours for related organizations below dotted line)
(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee)
(D)
Reportable compensation from the organization (W- 2/1099-MISC)
(E)
Reportable compensation from related organizations (W- 2/1099-MISC)
(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) CHRIS KEMP........................................................................
TRUSTEE/DIRECTOR
0.10
.......................0.00
X           0 0 0
(19) HOLLY MARR........................................................................
TRUSTEE/DIRECTOR
1.00
.......................0.00
X           0 0 0
(20) MARK MCCASLIN........................................................................
TREASURER
1.20
.......................0.10
X   X       0 0 0
(21) PAT MCCLELLAND........................................................................
TRUSTEE/DIRECTOR
1.00
.......................0.00
X           0 0 0
(22) BARBARA G MOORE........................................................................
TRUSTEE/DIRECTOR
0.90
.......................0.30
X           0 0 0
(23) BEVERLY A MORROW........................................................................
TRUSTEE/DIRECTOR
1.10
.......................0.00
X           0 0 0
(24) JEFFREY NOLAN........................................................................
TRUSTEE/DIRECTOR
0.90
.......................0.10
X           0 0 0
(25) MARY SPEARS POLK........................................................................
TRUSTEE/DIRECTOR
0.10
.......................0.00
X           0 0 0
(26) DANIEL RAHN MD........................................................................
TRUSTEE/DIRECTOR
0.80
.......................0.10
X           0 0 0
(27) JAMES SKIP RUTHERFORD........................................................................
SECRETARY
0.50
.......................0.00
X   X       0 0 0
(28) MARK SAVIERS........................................................................
VICE CHAIRMAN
1.30
.......................0.30
X   X       0 0 0
(29) PATRICK SCHUECK........................................................................
TRUSTEE/DIRECTOR
1.00
.......................0.10
X           0 0 0
(30) CHARLES B WHITESIDE III........................................................................
TRUSTEE/DIRECTOR
0.70
.......................0.40
X           0 0 0
(31) GENA WINGFIELD........................................................................
SVP AND CFO
44.00
.......................1.00
    X       437,720 0 74,042
(32) CHARLES LARRY BECKIUS........................................................................
VP FACILITIES
50.00
.......................0.00
      X     208,837 0 21,912
(33) DAVID BERRY........................................................................
SVP AND COO
50.00
.......................0.00
      X     425,809 0 201,164
(34) LEE ANNE EDDY........................................................................
SVP/CHIEF NURSING OFFICER
50.00
.......................0.00
      X     319,955 0 19,214
(35) SCOTT GORDON........................................................................
EXECUTIVE VICE PRESIDENT (PARTIAL YEAR)
20.00
.......................20.00
      X     230,322 0 19,988
(36) MICHAEL HART........................................................................
VP IT APPLICATIONS
40.00
.......................0.00
      X     234,425 0 19,826
(37) CYNTHIA HOLLAND........................................................................
VP ANCILLARY SERVICES
50.00
.......................0.00
      X     212,885 0 22,150
(38) KATHERINE LEA........................................................................
VP ED/SURGICAL CARE
50.00
.......................0.00
      X     173,536 0 18,108
(39) DARRELL LEONHARDT........................................................................
SVP AND CIO
40.00
.......................0.00
      X     272,658 0 23,383
(40) MARY SALASSI-SCOTTER........................................................................
VP CRITICAL CARE SERVICES
47.00
.......................0.00
      X     172,590 0 19,180
(41) ROBERT STEELE........................................................................
SVP AND CSO
40.00
.......................0.00
      X     373,271 0 8,914
(42) ANDREE TROSCLAIR........................................................................
VP HUMAN RESOURCES
40.00
.......................0.00
      X     226,528 0 20,882
(43) STEPHEN M BEETSTRA........................................................................
DENTAL ASSISTANT DIRECTOR
40.00
.......................0.00
        X   229,410 0 23,136
(44) CARL CHIPMAN........................................................................
RN 1ST ASSISTANT- CVOR
40.00
.......................0.00
        X   216,434 0 9,675
(45) CHARLES E JOHNSON........................................................................
DIRECTOR - CARDIOTHORACIC SURG
40.00
.......................0.00
        X   216,777 0 14,943
(46) RHONDA MCKINNIS........................................................................
VP LEGAL AFFAIRS
50.00
.......................0.00
        X   219,369 0 18,973
(47) KIRT SIMMONS........................................................................
DIRECTOR - CRANIOFACIAL ORTHO
48.00
.......................0.00
        X   255,904 0 21,782
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 6,226,365 243,800 655,095
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet188
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
Yes
 
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address
(B)
Description of services
(C)
Compensation
UNIVERSITY OF ARKANSAS FOR MEDICAL SCIEN

4301 WEST MARKHAM
LITTLE ROCK,AR72205
MEDICAL SERVICES 66,276,885
NABHOLZ CONSTRUCTION CORP

PO BOX 2090
CONWAY,AR72033
GENERAL CONSTRUCTION CONTRACTOR 11,142,153
ARAMARK

24836 NETWORK PLACE
CHICAGO,IL60673
FOOD SERVICE 6,013,338
PRESIDIO NETWORKED SOLUTIONS

PO BOX 822169
PHILADELPHIA,PA19182
IT NETWORK SERVICES 4,329,144
MEDICAL INFORMATION TECHNOLOGY

PO BOX 74569
CHICAGO,IL60696
IT CONTRACTED SERVICES 1,741,756
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet94
Form 990 (2014)
Form 990 (2014)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 21,275,680
e Government grants (contributions)1e 16,563,352
f All other contributions, gifts, grants, and
similar amounts not included above
1f
 
g Noncash contributions included in lines
1a-1f:$
 
h Total. Add lines 1a-1f.......MediumBullet 37,839,032
 Program Service RevenueAmt Business Code
2a PAYMENTS FOR MED SVCS 900099 506,921,438 506,921,438    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 506,921,438
 OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 4,110,050     4,110,050
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet        
(i) Real (ii) Personal
6a Gross rents 1,334,964  
b Less: rental expenses 1,657  
c Rental income or (loss) 1,333,307  
d Net rental income or (loss).......MediumBullet 1,333,307     1,333,307
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   61,340
b Less: cost or other basis and sales expenses   149,525
c Gain or (loss)   -88,185
d Net gain or (loss)..........MediumBullet -88,185     -88,185
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a NUTRITIONAL SERVICES 900099 3,824,241     3,824,241
b CHILD ENRICHMENT 900099 1,393,927     1,393,927
c            
d All other revenue .... 8,483,728 8,483,728    
e Total. Add lines 11a–11d ...... MediumBullet 13,701,896
12 Total revenue. See Instructions......MediumBullet 563,817,538 515,405,166 0 10,573,340
Form 990 (2014)
Form 990 (2014)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII.
(A)
Total expenses
(B)
Program service expenses
(C)
Management and general expenses
(D)
Fundraising expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 5,737,666 5,737,666
2 Grants and other assistance to domestic individuals. See Part IV, line 22 .... 372,075 372,075
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............    
4 Benefits paid to or for members ....    
5 Compensation of current officers, directors, trustees, and key employees .... 5,759,938 2,302,352 3,457,586  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages .... 204,583,832 164,566,013 40,017,819  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 9,295,764 7,424,912 1,870,852  
9 Other employee benefits ....... 18,648,913 15,014,326 3,634,587  
10 Payroll taxes ........... 15,654,376 12,503,799 3,150,577  
11 Fees for services (non-employees):        
a Management ...... 2,194,390 1,246,469 947,921  
b Legal ......... 714,183   714,183  
c Accounting ........... 396,509   396,509  
d Lobbying ........... 138,391 138,391    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) .... 93,623,467 87,989,607 5,633,860  
12 Advertising and promotion .... 245,341 216,245 29,096  
13 Office expenses ....... 7,056,484 1,357,692 5,698,792  
14 Information technology ...... 10,467,736 5,665,907 4,801,829  
15 Royalties ..        
16 Occupancy ........... 4,970,298 4,103,540 866,758  
17 Travel ............ 1,652,797 1,339,099 313,698  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 584,910 454,400 130,510  
20 Interest ........... 6,834,392   6,834,392  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 25,486,630 21,793,230 3,693,400  
23 Insurance .............. 2,688,341 1,229,891 1,458,450  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 71,817,392 71,670,247 147,145  
b PROVISION FOR BAD DEBT 3,092,326 3,092,326    
c MINOR EQUIPMENT 2,510,963 1,790,599 720,364  
d DUES & SUBSCRIPTIONS 1,201,662 661,788 539,874  
e All other expenses 10,356,564 9,364,307 992,257  
25 Total functional expenses. Add lines 1 through 24e 506,085,340 420,034,881 86,050,459 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2014)
Form 990 (2014)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year
(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 12,339 1 13,431
2 Savings and temporary cash investments ......... 41,205,732 2 54,396,344
3 Pledges and grants receivable, net ...........   3  
4 Accounts receivable, net ............. 48,158,543 4 51,645,351
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
  5  
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
  6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 7,925,875 8 8,228,480
9 Prepaid expenses and deferred charges .......... 6,044,785 9 5,304,832
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 562,282,819
b Less: accumulated depreciation ..... 10b 277,168,042 274,130,150 10c 285,114,777
11 Investments—publicly traded securities .......... 251,092,720 11 262,774,498
12 Investments—other securities. See Part IV, line 11 ..... 410,404 12 439,198
13 Investments—program-related. See Part IV, line 11 ..... 800,468 13 368,888
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 132,860,282 15 119,528,767
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 762,641,298 16 787,814,566
Liabilities 17 Accounts payable and accrued expenses ......... 53,347,387 17 58,069,321
18 Grants payable .................   18  
19 Deferred revenue ................   19  
20 Tax-exempt bond liabilities ............. 163,714,022 20 126,998,208
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 194,014 25 133,737
26 Total liabilities. Add lines 17 through 25......... 217,255,423 26 185,201,266
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 524,564,887 27 576,237,364
28 Temporarily restricted net assets ........... 20,820,988 28 26,375,936
29 Permanently restricted net assets ...........   29  
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 545,385,875 33 602,613,300
34 Total liabilities and net assets/fund balances ........ 762,641,298 34 787,814,566
Form 990 (2014)
Form 990 (2014)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
563,817,538
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
506,085,340
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
57,732,198
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
545,385,875
5
Net unrealized gains (losses) on investments ...............
5
-458,408
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
-46,365
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
602,613,300
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? .................
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2014)
Form 990 (2014)
Page 13
Form 990, Special Condition Description:
Special Condition Description
Form 990 (2014)
Form 990 (2014)
Page 14
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
a
b
c
d
e
f
Enter the number of supported organizations .............................  
g
Provide the following information about the supported organization(s).
(i)Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total    

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..            
11 Total support Add lines 7 through 10.  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) 2014 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 4
Part IV
Supporting Organizations
(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)
Section A. All Supporting Organizations
Yes
No
1
Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.
1
 
 
2
Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.
3a
 
 
b
Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.
3b
 
 
c
Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.
3c
 
 
4a
Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.
4a
 
 
b
Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....
4b
 
 
c
Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.
4c
 
 
5a
Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).
5a
 
 
b
Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.
6
 
 
7
Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).
8
 
 
9a
Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.
9a
 
 
b
Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.
9c
 
 
10a
Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.
10a
 
 
b
Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).
10b
 
 
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described in (a) above?
11b
 
 
c
A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.
11c
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 5
Part IV
Supporting Organizations (continued)

Section B. Type I Supporting Organizations
Yes
No
1
Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.
1
 
 
2
Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?
1
 
 
2
Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).
2
 
 
3
By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer (a) and (b) below.
Yes
No
a
Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.
2a
 
 
b
Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.
2b
 
 
3
Parent of Supported Organizations. Answer (a) and (b) below.
a
Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.
3a
 
 
b
Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.
3b
 
 
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 6
Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1.   Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.
Section A - Adjusted Net Income (A) Prior Year (B) Current Year
(optional)
1 Net short-term capital gain 1    
2 Recoveries of prior-year distributions 2    
3 Other gross income (see instructions) 3    
4 Add lines 1 through 3 4    
5 Depreciation and depletion 5    
6 Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) 6    
7 Other expenses (see instructions) 7    
8 Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) 8    

Section B - Minimum Asset Amount (A) Prior Year (B) Current Year
(optional)
1 Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): 1
a Average monthly value of securities 1a    
b Average monthly cash balances 1b    
c Fair market value of other non-exempt-use assets 1c    
d Total (add lines 1a, 1b, and 1c) 1d    
e Discount claimed for blockage or other factors (explain in detail in Part VI):  
2 Acquisition indebtedness applicable to non-exempt use assets 2    
3 Subtract line 2 from line 1d 3    
4 Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). 4    
5 Net value of non-exempt-use assets (subtract line 4 from line 3) 5    
6 Multiply line 5 by .035 6    
7 Recoveries of prior-year distributions 7    
8 Minimum Asset Amount (add line 7 to line 6) 8    

Section C - Distributable Amount Current Year
1 Adjusted net income for prior year (from Section A, line 8, Column A) 1  
2 Enter 85% of line 1 2  
3 Minimum asset amount for prior year (from Section B, line 8, Column A) 3  
4 Enter greater of line 2 or line 3 4  
5 Income tax imposed in prior year 5  
6 Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) 6  
7   Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)
Schedule A (Form 990 or 990-EZ) 2014
Schedule A (Form 990 or 990-EZ) 2014
Page 7
Section D - Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes  
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in
excess of income from activity
 
3 Administrative expenses paid to accomplish exempt purposes of supported organizations  
4 Amounts paid to acquire exempt-use assets  
5 Qualified set-aside amounts (prior IRS approval required)  
6 Other distributions (describe in Part VI). See instructions  
7Total annual distributions. Add lines 1 through 6.  
8 Distributions to attentive supported organizations to which the organization is responsive (provide
details in Part VI). See instructions
 
9 Distributable amount for 2014 from Section C, line 6  
10 Line 8 amount divided by Line 9 amount  

Section E - Distribution Allocations (see instructions) (i)
Excess Distributions
(ii)
Underdistributions
Pre-2014
(iii)
Distributable
Amount for 2014
1 Distributable amount for 2014 from Section C, line
6
 
2 Underdistributions, if any, for years prior to 2014
(reasonable cause required--see instructions)
 
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2014 distributable amount  
i Carryover from 2009 not applied (see
instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.  
4Distributions for 2014 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2014 distributable amount  
c Remainder. Subtract lines 4a and 4b from 4.  
5 Remaining underdistributions for years prior to
2014, if any. Subtract lines 3g and 4a from line 2
(if amount greater than zero, see instructions)
 
6 Remaining underdistributions for 2014. Subtract
lines 3h and 4b from line 1 (if amount greater than
zero, see instructions)
 
7 Excess distributions carryover to 2015. Add lines
3j and 4c.
 
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......  
e From 2014.......  
Schedule A (Form 990 or 990-EZ) (2014)
Schedule A (Form 990 or 990-EZ) 2014
Page 8
Part VI
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Return Reference Explanation
Schedule A (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 2
Name of organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
RESTRICTED
 
 

   
 
 
  ,    

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.
(b)
Name, address, and ZIP + 4
(c)
Total contributions
(d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 3
Name of organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
(a) No.
from
Part I
(b)
Description of noncash property given
(c)
FMV (or estimate)
(see instructions)
(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)
Page 4
Name of organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part III
Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I
(b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2014

Schedule C (Form 990 or 990-EZ) 2014
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.)
(a) Filing
organization's
totals
(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in)
(a) 2011 (b) 2012 (c) 2013 (d) 2014 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2014


Schedule C (Form 990 or 990-EZ) 2014
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
118,391
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
218,430
j
Total. Add lines 1c through 1i ...............................
336,821
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
PART II-B, LINE 1: IN ORDER TO EFFECTIVELY ADVOCATE FOR AND ASSIST WITH THE IMPROVEMENT OF CHILDREN'S HEALTH, ARKANSAS CHILDREN'S HOSPITAL HAS AN OFFICE OF GOVERNMENT RELATIONS THAT WORKS WITH OTHER ORGANIZATIONS, ON A STATE AND NATIONAL LEVEL, TO FORMULATE POLICY AND TO ARTICULATE OUR PUBLIC POLICY AGENDA. IN ADDITION, A PERCENTAGE OF DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, ARKANSAS HOSPITAL ASSOCIATION, ASSOCIATION OF AMERICAN MEDICAL COLLEGES, CHILDREN'S HOSPITAL ASSOCIATION, LITTLE ROCK REGIONAL CHAMBER OF COMMERCE AND THE ARKANSAS STATE CHAMBER OF COMMERCE WAS FOR LOBBYING.
Schedule C (Form 990 or 990EZ) 2014

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate value of contributions to (during year)    
3 Aggregate value of grants from (during year)    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenue included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenue included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 260,807,759 212,925,418 176,416,750 166,396,164 145,568,315
b Contributions ........ 2,522,174 25,377,876 27,950,863 13,882,530 4,959,714
c Net investment earnings, gains, and losses 3,700,116 27,631,730 11,723,854 1,770,907 21,536,391
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........
3,865,616 5,127,265 3,166,049 5,632,851 5,668,256
f Administrative expenses ....          
g End of year balance ...... 263,164,433 260,807,759 212,925,418 176,416,750 166,396,164
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet73.630 %
b
Permanent endowment SchDMd Bullet14.130 %
c
Temporarily restricted endowment SchDMd Bullet12.240 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   14,211,833 14,211,833
b Buildings ................   317,113,733 158,191,727 158,922,006
c Leasehold improvements ............        
d Equipment ................   185,273,220 110,046,830 75,226,390
e Other .................   45,684,033 8,929,485 36,754,548
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 285,114,777
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)
(b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) FUNDS HELD BY TRUSTEE UNDER BOND AGREEMENTS 10,729,150
(2) ESTIMATED 3RD PARTY SETTLEMENT (MCD) 89,111,359
(3) UPL RECEIVABLE 9,528,847
(4) GME RECEIVABLE 1,279,693
(5) OTHER RECEIVABLES 5,575,694
(6) BOND ISSUE COSTS 3,225,514
(7) INTEREST RECEIVABLE - FUNDED DEPR 78,510


Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 119,528,767
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
OBLIGATIONS UNDER CAPITAL LEASES 133,737








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 133,737
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII
Schedule D (Form 990) 2014

Schedule D (Form 990) 2014
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART V, LINE 4: EARNINGS FROM ENDOWMENT FUNDS WILL BE USED TO SUPPORT VARIOUS HOSPITAL PROGRAMS. THE FILING ORGANIZATION DOES NOT HOLD ANY ENDOWMENTS; ALL ENDOWMENTS ARE HELD BY ARKANSAS CHILDREN'S HOSPITAL FOUNDATION, A RELATED ORGANIZATION.
PART X, LINE 2: THE HOSPITAL APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC TOPIC 740 (TOPIC 740), "ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES." TOPIC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS AND PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF JUNE 30, 2015 AND 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE H (Form 990)
Department of the TreasuryInternal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
%
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
%
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

 

No
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) ..
    9,379,045 0 9,379,045 1.860 %
b Medicaid (from Worksheet 3,
column a) ....
    285,558,834 295,850,200 -10,291,366 0 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) .
           
d Total Financial Assistance
and Means-Tested
Government Programs .
    294,937,879 295,850,200 -912,321 1.860 %
Other Benefits
    16,055,811 10,262,027 5,793,784 1.150 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) ..
    24,198,504 6,867,708 17,330,796 3.450 %
g Subsidized health services
(from Worksheet 6) ..
    39,450,954 17,425,344 22,025,610 4.380 %
h Research (from Worksheet 7)     8,926,190 0 8,926,190 1.770 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8)
    526,706 63,781 462,925 0.090 %
j Total. Other Benefits ..     89,158,165 34,618,860 54,539,305 10.840 %
k Total. Add lines 7d and 7j .     384,096,044 330,469,060 53,626,984 12.700 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue
(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     0      
2 Economic development     67,278   67,278 0.010 %
3 Community support     18,522   18,522 0 %
4 Environmental improvements            
5 Leadership development and training for community members     2,075   2,075 0 %
6 Coalition building     4,700   4,700 0 %
7 Community health improvement advocacy     27,423   27,423 0.010 %
8 Workforce development     3,900   3,900 0 %
9 Other     21,646   21,646 0 %
10 Total     145,544   145,544 0.020 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
1,958,735
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
3,636,113
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
4,287,264
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-651,151
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity
(c) Organization's
profit % or stock
ownership %
(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership %
(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 ARKANSAS CHILDREN'S HOSPITAL
1 CHILDRENS WAY
LITTLE ROCK,AR72202
WWW.ARCHILDRENS.ORG
AR4640
X X X X   X X      
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
ARKANSAS CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
Yes No
Community Health Needs Assessment
1 Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?....................... 1   No
2 Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C.......... 2   No
3 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12.................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
5 In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted ................. 5 Yes  
6a Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................ 6a   No
b Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public? .............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............
8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12
10 Is the hospital facility's most recently adopted implementation strategy posted on a website? ........ 10 Yes  
a If "Yes" (list url): WWW.ARCHILDRENS.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.
12a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 12a   No
b If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 12b    
c If "Yes" to line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

ARKANSAS CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Financial Assistance Policy (FAP)
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 Yes  
If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):
a
b
c
d
e
16 Included measures to publicize the policy within the community served by the hospital facility?....... 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
h
i
Billing and Collections
17 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?.................................. 17 Yes  
18 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:
a
b
c
d
e
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

ARKANSAS CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
19 Did the hospital facility or other authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?......... 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
20 Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?................ 21 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
22 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
23 During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ................................ 23   No
If "Yes," explain in Section C.
24 During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 3J: IN ADDITION TO THE ITEMS CHECKED IN BOXES A - I, OTHER INFORMATION WAS INCLUDED IN THE NEEDS ASSESSMENT. AS THE ONLY PEDIATRIC HOSPITAL IN THE STATE OF ARKANSAS, ACH CONSIDERS ITS COMMUNITY TO BE ALL CHILDREN IN THE STATE, ESTIMATED AT 710,000. THE NEEDS ASSESSMENT ALSO INCLUDES DETAILED INFORMATION ABOUT THE NEIGHBORHOOD IMMEDIATELY SURROUNDING THE HOSPITAL GIVEN THE ORGANIZATION'S ROLE IN SUPPORTING ITS NEIGHBORHOOD. LIMITED INFORMATION WAS ALSO INCLUDED REFERENCING THE HEALTH STATUS OF ADULTS SINCE PEDIATRIC HEALTH STATUS CAN BE CLOSELY LINKED TO THAT OF ADULTS IN THE HOUSEHOLD. LASTLY, THE NEEDS ASSESSMENT INCLUDED INTERVENTIONS SUGGESTED BY THE COMMUNITY THAT THE HOSPITAL COULD CONSIDER AS IT DEVELOPED ITS IMPLEMENTATION PLAN.
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL CONSIDERED BOTH SECONDARY AND PRIMARY DATA AS IT DETERMINED THE HEALTH NEEDS OF ARKANSAS' CHILDREN. SECONDARY DATA SETS REVIEWED INCLUDE THE U.S. CENSUS BUREAU, THE ANNIE E. CASEY KIDS' COUNT DATA CENTER, ARKANSAS STATE AGENCIES DATABASES, THE ARKANSAS STATISTICAL ABSTRACT, THE YOUTH RISK BEHAVIOR SURVEY, ARKANSAS CHILDREN'S HOSPITAL PEDIATRIC HEALTH INFORMATION SYSTEM, AND A VARIETY OF LOCAL ORGANIZATIONS' RESEARCH.PRIMARY DATA WAS ALSO COLLECTED TO DETERMINE PERCEIVED NEEDS OF THE COMMUNITY. FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS, AND A PHONE SURVEY SYNTHESIZED THE INPUT OF COMMUNITY MEMBERS, EDUCATORS, AND PROFESSIONALS WITH A WIDE VARIETY OF EXPERTISE IN THE HEALTH NEEDS OF CHILDREN. EIGHT FOCUS GROUPS WERE HELD IN THE CITIES OF BATESVILLE, FORREST CITY, GURDON, LAVACA, JONESBORO, SPRINGDALE, AND LITTLE ROCK, ARKANSAS. GENERALLY THESE GROUPS INCLUDED PARENTS, SCHOOL OFFICIALS, COMMUNITY LEADERS, AND ELECTED OFFICIALS. ANONYMITY WAS ASSURED AS A MEANS OF OBTAINING HONEST AND FRANK INPUT. THEREFORE, SPECIFIC NAMES WILL NOT BE PUBLISHED.KEY STAKEHOLDER INTERVIEWS WERE HELD WITH 23 INDIVIDUALS. THESE INCLUDE THE FOLLOWING: EXECUTIVE DIRECTOR OF ARKANSAS COMMUNITY HEALTH CENTERS, DIRECTOR OF THE ARKANSAS DEPARTMENT OF HEALTH, ASSOCIATE MEDICAL DIRECTOR OF ARKANSAS BLUE CROSS/BLUE SHIELD, THE COMMISSIONER OF ARKANSAS DEPARTMENT OF EDUCATION, PROFESSOR AT THE COLLEGE OF PUBLIC HEALTH, SENIOR VICE PRESIDENT OF ARKANSAS FOUNDATION FOR MEDICAL CARE, ASSOCIATE DIRECTOR OF ARKANSAS STATE UNIVERSITY CHILDHOOD SERVICES, CHIEF OPERATING OFFICER FOR WHITE RIVER HEALTH CENTER, EXECUTIVE DIRECTOR OF BOYS, GIRLS, ADULTS COMMUNITY DEVELOPMENT CENTER, PROFESSOR OF PEDIATRICS AND DIRECTOR OF THE INJURY PREVENTION CENTER AT ACH, DIRECTOR OF SOCIAL WORK AT ACH, DIRECTOR OF DISEASE PREVENTION AND HEALTH PROMOTION AT ARKANSAS CENTER FOR HEALTH IMPROVEMENT, VICE PRESIDENT OF NURSING SERVICES AT ST. BERNARD'S HOSPITAL, EXECUTIVE DIRECTOR OF THE ARKANSAS CHILDREN'S TRUST FUND, ASSOCIATE BRANCH CHIEF OF FAMILY HEALTH BRANCH OF THE ARKANSAS DEPARTMENT OF HEALTH, BUSINESS LEADER AND MEMBER OF RONALD MCDONALD CHILDREN'S CHARITY OF ARKOMA, VICE CHAIR OF ARKANSAS CHILDREN'S BEHAVIORAL HEALTH CARE COMMISSION, DIRECTOR OF DELTA AREA HEALTH EDUCATION CENTER AT UAMS, DIRECTOR OF THE DIVISION OF CHILDCARE AND EARLY CHILDHOOD EDUCATION WITH THE ARKANSAS DEPARTMENT OF HUMAN SERVICES, ASSOCIATE PROFESSOR OF PEDIATRICS AT UAMS, SECTION CHIEF OF THE TOBACCO PREVENTION AND CESSATION PROGRAMS WITH THE ARKANSAS DEPARTMENT OF HEALTH, DEAN OF THE CLINTON SCHOOL OF PUBLIC SERVICE, AND SEVERAL ACH "AMBASSADORS" WHO WERE CURRENT OR FORMER PATIENTS.IN ADDITION, A TELEPHONE SURVEY OF 1,000 RANDOMLY SELECTED FAMILIES (250 FROM EACH OF THE STATE'S FOUR CONGRESSIONAL DISTRICTS) WAS CONDUCTED. QUESTIONS FOCUSED ON VARIOUS TOPICS RELATED TO THE STATUS OF CHILDREN'S HEALTH AND ACCESS TO CARE MATTERS.
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA IS ALSO MADE AVAILABLE THROUGH A NEWS CONFERENCE AND THE NATURAL WONDERS PARTNERSHIP COUNCIL AND MORE THAN TWO DOZEN COMPANIES THAT COLLABORATE IN THAT GROUP. THE TECHNICAL NEEDS ASSESSMENT IS REPACKAGED INTO A FORMAT MORE SUITABLE FOR PUBLIC USE, WITH AN EFFORT TO MAKE THE ISSUES UNDERSTANDABLE TO A BROADER AUDIENCE. THIS PUBLIC-FACING REPORT, "NATURAL WONDERS: THE STATE OF CHILDREN'S HEALTH IN ARKANSAS" IS WIDELY DISTRIBUTED THROUGH THIS PARTNERSHIP AND MADE AVAILABLE FOR ANYONE THAT REQUESTS IT.
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11: IN THE EARLY PART OF FISCAL YEAR 2015, UNDER THE LEADERSHIP OF A NEW CHIEF STRATEGY OFFICER, THE HOSPITAL HIRED A NEW EXECUTIVE DIRECTOR (ED) OF CHILD ADVOCACY AND PUBLIC HEALTH TO OVERSEE THE HOSPITAL'S COMMUNITY BENEFIT WORK, AMONG OTHER DUTIES. ORGANIZATIONAL CHANGES WERE MADE TO BRING COMMUNITY-FACING DEPARTMENTS TOGETHER UNDER A SINGLE CHILD ADVOCACY AND PUBLIC HEALTH DIVISION TO ENSURE STRATEGIC AND PROACTIVE EFFORTS WERE MADE TO IMPROVE THE HEALTH OF CHILDREN IN ARKANSAS. ADDITIONALLY, FROM NOVEMBER THROUGH THE END OF FISCAL YEAR 2015, ACH WORKED WITH ITS NATURAL WONDERS PARTNERSHIP COUNCIL (NWPC) MEMBERS TO DEVELOP A COLLABORATIVE FIVE-YEAR STRATEGIC FRAMEWORK USING THE COLLECTIVE IMPACT MODEL. THIS FRAMEWORK PROVIDES STRATEGIC DIRECTION AND ENSURES BACKBONE SUPPORT FROM ACH FOR ORGANIZATIONS SEEKING TO IMPROVE THE HEALTH OF CHILDREN IN ARKANSAS. IN THIS FRAMEWORK, THE ACH CHNA IS USED AS THE "COMMON AGENDA" FOR MANY ORGANIZATIONS WORKING TOGETHER TO IMPROVE CHILD HEALTH IN ARKANSAS. THE NWPC SELECTED A "SHARED MEASUREMENT SYSTEM" OF DATA INDICATORS AND "MUTUALLY REINFORCING ACTIVITIES" FRAMED AS MEASURABLE GOALS TO MOVE FORWARD SHARED STRATEGIES. ACH PROVIDES "BACKBONE" FINANCIAL SUPPORT FOR THIS INITIATIVE AS WELL AS ADMINISTRATIVE GUIDANCE AND PARTNERSHIP-BUILDING FOR NWPC. PROGRAM EVALUATION CAPACITIES BEGAN TO BE DISCUSSED AND IMPLEMENTED. THE NEEDS THAT WERE IDENTIFIED IN THE MOST RECENT CHNA AND EMBRACED BY THE NWPC ARE LISTED BELOW WITH THE ACTION STEPS THAT ACH TOOK TO IMPROVE THE HEALTH OF CHILDREN IN THESE AREAS. IN SOME CASES, NWPC MEMBER ORGANIZATIONS LED THE STRATEGY FOR AN ISSUE AND IDENTIFIED NATURAL PLACES FOR ACH TO PARTNER ON CHILD HEALTH IMPROVEMENT. THE ISSUES AND ACTION STEPS LISTED BELOW ALIGN WITH THE IMPLEMENTATION PLAN OUTLINED IN THE MOST RECENT CHNA. ACCESS TO CARE: THE FRANKLIN ELEMENTARY SCHOOL-BASED HEALTH CENTER CONTINUED TO SERVE PATIENTS IN A LOW-INCOME, URBAN SCHOOL NEAR THE HOSPITAL BY SUPPORTING THE COST OF A NURSE PRACTITIONER WHO WORKS AT THE SCHOOL 20 HOURS PER WEEK. ACH PARTICIPATED ACTIVELY IN THE NWPC'S ACCESS TO CARE GROUP WHICH SEEKS TO REDUCE SYSTEMIC BARRIERS TO ACCESS TO QUALITY CARE FOR CHILDREN IN ARKANSAS AND TO EXPAND SCHOOL-BASED HEALTH OFFERINGS. ACH BEGAN EXPLORING NEW WAYS TO ENGAGE IN SCHOOL-BASED HEALTH INITIATIVES THROUGH COMMUNITY BENEFIT INVESTMENTS. ACH PROVIDED FINANCIAL COUNSELORS WHO HELP CONNECT PATIENTS AND FAMILIES TO HEALTH CARE COVERAGE, AN AFTER-HOURS RESOURCE LINE THAT HELPS FAMILIES AFTER-HOURS, AND INTERPRETERS TO HELP NON-ENGLISH-SPEAKING FAMILIES TO ACCESS CARE, BEYOND WHAT IS REQUIRED FOR ACCREDITATION. ACH SUPPORTED THE CONTINUATION OF THE MEDICAL-LEGAL PARTNERSHIP, A PROGRAM IMPLEMENTED IN COLLABORATION WITH LEGAL AID OF ARKANSAS TO HELP REDUCE HEALTH-HARMING LEGAL NEEDS. FOOD INSECURITY: LED BY THE ARKANSAS HUNGER RELIEF ALLIANCE, ARKANSAS HAS IMPROVED ITS NATIONAL RANKING FOR CHILD FOOD INSECURITY FROM LAST IN THE NATION. ACH WORKS THROUGH THE NWPC WITH THE HUNGER RELIEF ALLIANCE TO IDENTIFY AND IMPLEMENT INNOVATIVE WAYS TO ADDRESS CHILDHOOD FOOD INSECURITY FOR PATIENTS. DURING THIS TIME PERIOD, THE HOSPITAL CONTINUED TO ADDRESS FOOD INSECURITY ON THE ACH CAMPUS THROUGH A VARIETY OF INVESTMENTS THAT WERE STUDIED BY THE CONGRESSIONALLY-APPOINTED NATIONAL HUNGER COMMISSION IN MAY 2015. IN THIS TIMEFRAME, 29,993 UNITED STATES DEPARTMENT OF AGRICULTURE (USDA) MEALS WERE PROVIDED TO CHILDREN THANKS TO ACH'S EFFORTS TO ESTABLISH THE CHILDREN'S MEDICAL NUTRITION AND FEEDING PROGRAM. THE HOSPITAL'S PARTNERSHIP WITH THE NEARBY HELPING HAND FOOD PANTRY CONTINUES TO PROVIDE FOOD TO HUNGRY PATIENT FAMILIES, AND FAMILIES STAYING IN THE HOSPITAL RECEIVED $150,000 IN MEALS AND ASSISTANCE FROM THE HOSPITAL. FAMILIES CAN ALSO ENROLL IN THE SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) AND WOMEN, INFANTS AND CHILDREN (WIC) ON THE ACH CAMPUS THANKS TO STATE AGENCY PARTNERSHIPS. ACH BEGAN TAKING STEPS TOWARD IMPLEMENTATION OF A COMMUNITY GARDEN ON ITS CAMPUS THAT WILL ALLOW NEIGHBORHOOD RESIDENTS TO ACCESS FRESH FRUITS AND VEGETABLES AND LEARN TO GROW THEIR OWN FOOD. ACH BEGAN TO MAKE PLANS TO PARTNER WITH A LOCAL CHURCH AND HELPING HAND TO BRING A MOBILE FOOD PANTRY TO THE HOSPITAL'S NEIGHBORHOOD THAT WOULD VISIT THE ACH CAMPUS REGULARLY. SEXUAL HEALTH: ACH PROVIDED BACKBONE SUPPORT TO THE REPRODUCTIVE HEALTH NWPC SUB-GROUP, RE-ENERGIZING ITS WORK AND ESTABLISHING MEASURABLE GOALS. ACH ALSO PARTICIPATED IN A WORKGROUP TO IMPLEMENT A NEW LAW REQUIRING COLLEGES AND UNIVERSITIES TO HAVE AN ACTION PLAN TO REDUCE UNPLANNED TEENAGE PREGNANCIES AND TO SUPPORT YOUNG MOTHERS. CHILDHOOD OBESITY: LED BY THE ARKANSAS COALITION FOR OBESITY PREVENTION, ARKANSAS WORKED TO REDUCE CHILDHOOD OBESITY. ACH SUPPORTS STATEWIDE ACCESS TO AN ENHANCED VERSION OF GONOODLE, A PHYSICAL ACTIVITY PROGRAM THAT ALLOWS TEACHERS TO WORK 2-5 MINUTE "BRAIN BREAKS" INTO THE SCHOOL DAY. MORE THAN 700 SCHOOLS AND OVER 6,000 TEACHERS UTILIZED THE PROGRAM IN APRIL 2015, IMPROVING ACTIVE MINUTES FOR MORE THAN 158,000 STUDENTS. ACH'S COMMUNITY OUTREACH TEAM REACHED HUNDREDS OF SCHOOLS AND THOUSANDS OF STUDENTS THROUGH ITS F.A.N. (FITNESS AND NUTRITION) CLUB PROGRAM THAT EDUCATES STUDENTS AND ITS HEALTHY HABITS PROGRAM THAT TEACHES ABOUT HEALTH AND HYGIENE. ACH ALSO SUPPORTED THREE SIX-SESSION COOKING MATTERS PROGRAMS THAT TEACH LOW-INCOME RESIDENTS TO COOK HEALTHFUL, LOW-COST MEALS. INTENTIONAL AND UNINTENTIONAL INJURIES: THE ACH INJURY PREVENTION CENTER (IPC) CONTINUED TO WORK TO REDUCE CHILD INJURIES AND DEATHS THROUGH RESEARCH AND OUTREACH ON THE ISSUES OF MOTOR VEHICLE SAFETY, SAFE SLEEP/INFANT MORTALITY, INTENTIONAL INJURIES, AND ALL-TERRAIN VEHICLE SAFETY, UTILIZING A COMPREHENSIVE APPROACH THAT INCLUDES EDUCATION, AWARENESS, AND ADVOCACY. ACH ALSO IMPLEMENTS SEVERAL GRANTS THAT HELP TO REDUCE TRAUMA AND IMPROVE TRAUMA COORDINATION FOR ARKANSAS. THE IPC'S EFFORTS HAVE GENERATED MANY PROGRAM EVENTS, ACTIVITIES, BROCHURES, FACT SHEETS, AND OTHER USEFUL EDUCATIONAL MATERIALS FOR STATEWIDE DISTRIBUTION (INCLUDING RURAL AREAS). IN ADDITION, CONTINUING EDUCATION ACTIVITIES AND TRAINING CONTINUE TO BE AVAILABLE TO PHYSICIANS, MEDICAL STUDENTS, NURSES, MEDICAL APPLICATIONS OF SCIENCE STUDENTS, EMERGENCY MEDICAL SERVICES AND ARKANSAS DEPARTMENT OF HEALTH PROFESSIONALS. LIKEWISE, THE IPC IS LEADING THE EFFORTS OF THE INFANT DEATH REVIEW TEAM FOR THE STATE TO BETTER UNDERSTAND AND PREVENT INFANT MORTALITY.PARENTING SKILLS: THE FEDERALLY-FUNDED HOME VISITING NETWORK, A GRANT-FUNDED PARTNERSHIP BETWEEN THE ARKANSAS DEPARTMENT OF HEALTH AND ACH, HAS IMPROVED MATERNAL-CHILD HEALTH OUTCOMES IN FIVE OF SIX FEDERALLY-REQUIRED BENCHMARK AREAS. THE HOME INSTRUCTION FOR PARENTS OF PRESCHOOL YOUNGSTERS (HIPPY) AND PARENTS AS TEACHERS STATE OFFICES ARE HOUSED AT ACH AS WELL WITH STATE-FUNDED SUPPORT. ALL OF THESE DEPARTMENTS HAVE BEEN COMBINED UNDER ONE DIRECTOR WHO WORKS AT THE STATEWIDE AND NATIONAL LEVELS TO IMPROVE VISIBILITY AND REACH FOR HOME VISITING. THE EVALUATION TEAM AND TRAINING INSTITUTE FOR THE HOME VISITING NETWORK ARE NATIONALLY-RECOGNIZED FOR THEIR WORK. ACH ALSO PROVIDES HIPPY USA A DISCOUNTED LEASE FOR SPACE ON THE ACH CAMPUS FOR THE NATIONAL OFFICE. THROUGHOUT FY15, CONSTRUCTION WAS IN PROGRESS ON ACH'S NEW FAMILY RESOURCE CENTER, WHICH HELPS TO CONNECT FAMILIES TO RESOURCES THAT ALLOW THEM GO HOME FROM THE HOSPITAL TO RAISE HEALTHY AND HAPPY CHILDREN. THE FAMILY RESOURCE CENTER OPENED IN FY16.ORAL HEALTH: ACH CONTINUED TO SUPPORT 3 MOBILE DENTAL VANS THAT PROVIDE RESTORATIVE AND PREVENTIVE TREATMENT TO CHILDREN WITHOUT A DENTAL HOME IN THE SOUTHEAST, CENTRAL, AND NORTHWEST REGIONS OF ARKANSAS. THE HOSPITAL'S SEAL THE STATE SCHOOL-BASED SEALANT PROGRAM REACHES ABOUT 50 SCHOOLS AND 3,000 CHILDREN EACH YEAR. ACH STAFFS AND SUPPORTS THE ORAL HEALTH FOR CHILDREN SUBGROUP OF THE STATEWIDE ORAL HEALTH COALITION. MENTAL HEALTH AND SUBSTANCE USE: THE STATE HAS SEVERAL INITIATIVES ON BEHAVIORAL HEALTH, AND ACH BEGAN EXPLORING OPPORTUNITIES FOR BEHAVIORAL HEALTH PARTNERSHIPS AS PART OF ITS STRATEGIC PLANNING PROCESS. IMMUNIZATION: ACH PARTICIPATED IN THE CHILDHOOD IMMUNIZATION TASK FORCE SUBGROUP OF THE ARKANSAS IMMUNIZATION ACTION COALITION AND ALSO PROVIDED FLU VACCINES AND EDUCATION TO THE GENERAL PUBLIC. IN ADDITION TO PROGRAMMATIC WORK, ACH SUPPORTED HEALTH PROFESSIONS EDUCATION, RESEARCH, AND COMMUNITY EVENTS AND ORGANIZATIONS WHOSE MISSIONS AND ACTIVITIES ALIGN WITH THE WAYS ACH SEEKS TO IMPROVE CHILD HEALTH.
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 16I: THE FINANCIAL ASSISTANCE POLICY ITSELF IS NOT ATTACHED TO THE BILLING INVOICES, HOWEVER, THE FOLLOWING INFORMATION IS NOTED ON THE STATEMENTS: ARKANSAS CHILDREN'S HOSPITAL PROVIDES FINANCIAL ASSISTANCE TO OUR PATIENTS AND FAMILIES THAT QUALIFY; APPLICATION FORMS ARE AVAILABLE AT ALL REGISTRATION AREAS OR BY CONTACTING CUSTOMER SERVICE (PHONE NUMBER IS INCLUDED); IF PATIENTS ARE NOT ELIGIBLE FOR INSURANCE OR A GOVERNMENT ASSISTANCE PROGRAM, ARKANSAS CHILDREN'S HOSPITAL OFFERS A PROMPT PAY DISCOUNT AS WELL. IN ADDITION, FINANCIAL COUNSELORS ASSIST FAMILIES IN APPLYING FOR MEDICAID, SSI, AND CHILDREN'S MEDICAL SERVICES.
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 22D: AN AVERAGE OF THE CONTRACT RATES WAS USED.
SCHEDULE H, PART V, SECTION B, LINE 11 - CONTINUED THE CHNA IDENTIFIED SEVERAL AREAS FOR WHICH A COLLABORATIVE STRATEGY IS THE BEST APPROACH TO SOLVING COMPLEX SOCIAL ISSUES. THE HOSPITAL WORKS THROUGH THE NATURAL WONDERS PARTNERSHIP COUNCIL (NWPC) TO DETERMINE LEADERSHIP IN VARIOUS ISSUE AREAS AND TO PROVIDE A FORUM IN WHICH COLLABORATIONS ARE DEVELOPED. WHILE ACH PLAYS A LEADERSHIP ROLE IN SEVERAL AREAS INCLUDING INJURIES, PARENTING, AND ORAL HEALTH, FOR OTHER AREAS, THERE ARE MORE NATURAL LEADERS. ACH PROVIDES SPECIALTY CARE, RESEARCH, AND EDUCATION SERVICES IN MANY OF THE AREAS IDENTIFIED IN THE CHNA. AREAS IN WHICH ACH PLAYS A SUPPORTING/PARTNERSHIP ROLE, RATHER THAN A LEADERSHIP ROLE, INCLUDE: - HIGH SCHOOL GRADUATION RATE - MENTAL HEALTH - FOOD INSECURITY - SEXUAL HEALTH - SUBSTANCE ABUSE - ACCESS TO CARE - OBESITY - ASTHMA CARE - HOMELESSNESSSOME ISSUES ARE OVERLY COMPLEX. REGARDING POVERTY, THE HOSPITAL'S IMPLEMENTATION PLAN RECOGNIZES THAT POVERTY IS BEYOND THE SCOPE AND RESOURCES OF ACH TO MAKE A SIGNIFICANT IMPACT.
PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: WWW.ARCHILDRENS.ORG
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: WWW.ARCHILDRENS.ORG
ARKANSAS CHILDREN'S HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: WWW.ARCHILDRENS.ORG
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
Page
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?3
Name and address Type of Facility (describe)
1 WEST LITTLE ROCK PEDIATRIC CLINIC
BELLA ROSA CENTER 16101 CANTRELL RD
LITTLE ROCK,AR72223
OUTPATIENT HOSPITAL CLINIC
2 CENTERS FOR CHILDREN
519 LATHAM DRIVE
LOWELL,AR72745
OUTPATIENT HOSPITAL CLINIC
3 CENTERS FOR CHILDREN
520 CARSON STREET
JONESBORO,AR72401
OUTPATIENT HOSPITAL CLINIC
4
5
6
7
8
9
10
Schedule H (Form 990) 2014
Schedule H (Form 990) 2014
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Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: ACH USES FEDERAL POVERTY GUIDELINES TO DETERMINE FREE OR DISCOUNTED CARE.PART I, LINE 4:ACH DOES NOT HAVE A SPECIFIC FINANCIAL ASSISTANCE PROGRAM FOR THE "MEDICALLY INDIGENT" AS DEFINED BY AR CODE SECTION 6-64-503(A), BUT ITS FINANCIAL ASSISTANCE POLICY DOES PROVIDE FREE CARE FOR INDIVIDUALS WITH HOUSEHOLD INCOMES UP TO 200% OF POVERTY AND DISCOUNTED CARE FOR INDIVIDUALS WITH HOUSEHOLD INCOMES UP TO 400% OF POVERTY. ACH ALSO ASSISTS FAMILIES IN APPLYING FOR MEDICAID (INCLUDING THE TEFRA PROGRAM FOR DISABLED CHILDREN THAT ONLY CONSIDERS THE CHILD'S INCOME), SSI, CHILDREN'S MEDICAL SERVICES, AS WELL AS ACH'S OWN FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL ALSO ALLOWS INTEREST FREE PAYMENTS TO BE MADE UNTIL THE OUTSTANDING BALANCE IS PAID WITHOUT TIME CONSTRAINTS. ACH DOES NOT REPORT TO COLLECTION AGENCIES OR TAKE OTHER EXTRAORDINARY COLLECTION EFFORTS.
PART I, LINE 7: COSTING METHOD - ARKANSAS CHILDREN'S HOSPITAL (ACH) USES A COST ACCOUNTING (CA) SYSTEM AS THE BASIS FOR DETERMINING COST FOR ITS PATIENTS. ALL PATIENT ENCOUNTERS (INPATIENT, OUTPATIENT, ED, AMBULATORY SURGERY) ARE CAPTURED IN THE CA SYSTEM FOR ALL PATIENTS (MEDICAID, INSURANCE, UNINSURED) WITH NO DIFFERENTIATION FOR TYPE OF INSURANCE, IF ANY. A BRIEF DESCRIPTION OF THE CA SYSTEM IS BELOW.THE COST ACCOUNTING SYSTEM AT ACH IS A DETAILED PROCEDURE SYSTEM. ALL SERVICES PERFORMED BY PATIENT CARE STAFF HAVE BEEN EVALUATED AS TO THE RESOURCES UTILIZED TO PROVIDE THE SERVICES INCLUDING LABOR, DIRECT MATERIALS AND EQUIPMENT. IN ADDITION, OVERHEAD TYPE COSTS (BUILDING, UTILITIES, PAYROLL, ETC.) HAVE ALSO BEEN ALLOCATED TO THESE SERVICES. THE TWO COMPONENTS, DIRECT AND INDIRECT COSTS, ARE COMBINED AND REPRESENT THE TOTAL COST TO PROVIDE EACH SERVICE. THIS IS DONE ON A PROCEDURE LEVEL BASIS. AS A PATIENT IS ADMITTED AND INCURS SERVICES (X-RAYS, ROOM & BOARD, LAB, ETC.), THE APPLICABLE PROCEDURE COSTS ARE ASSIGNED TO EACH PARTICULAR PATIENT. UPON DISCHARGE, THE COSTS FROM THE INDIVIDUAL PROCEDURES THAT WERE PROVIDED TO EACH PATIENT ARE ADDED UP FOR A TOTAL COST OF PROVIDING CARE FOR EACH INDIVIDUAL PATIENT.THE COST ACCOUNTING SYSTEM IS UPDATED ANNUALLY TO REFLECT THE CURRENT YEAR'S EXPENSES.
PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES - ACH PROVIDES MANY PEDIATRIC AND SOME ADULT SPECIALIZED SERVICES TO THE COMMUNITY THAT ARE EITHER NOT AVAILABLE OR ARE BEYOND THE CAPACITY OF THE COMMUNITY TO PROVIDE. MANY OF THESE SERVICES ARE PROVIDED BY ACH AT A LOSS. THESE LOSSES WERE OBTAINED FROM THE COST ACCOUNTING SYSTEM.IN ADDITION, ACH PROVIDES PEDIATRIC RENAL SERVICES THAT ARE NOT PROVIDED IN THE COMMUNITY. THE COST OF THESE SERVICES PROVIDED TO PEDIATRIC PATIENTS IS MORE EXPENSIVE DUE TO THE SPECIALTY NATURE OF THE PATIENTS. THESE COSTS ARE GREATER THAN WHAT IS ALLOWED ON THE MEDICARE COST REPORT, AND THAT LOSS HAS BEEN REPORTED IN SUBSIDIZED HEALTH SERVICES.SIMILARLY, ACH INCURS LOSSES FROM PROVIDING PEDIATRIC LAB SERVICES TO ITS MEDICARE PATIENT POPULATION THAT ARE REIMBURSED LESS THAN COST. THOSE LOSSES ARE ALSO INCLUDED AS SUBSIDIZED HEALTH SERVICES.
PART I, LN 7 COL(F): BAD DEBT EXPENSE - BAD DEBT EXPENSE OF $3,092,326 IS INCLUDED IN THE TOTAL PRESENTED ON FORM 990, PART IX, LINE 24D. THIS AMOUNT HAS BEEN EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7, COLUMN F.
PART II, COMMUNITY BUILDING ACTIVITIES: ACH CONTRIBUTES TO THE COMMUNITY IT SERVES BOTH AT A NEIGHBORHOOD LEVEL AND AT A STATEWIDE LEVEL. LOCALLY, ACH IS A MAJOR EMPLOYER IN THE DOWNTOWN LITTLE ROCK AREA AND SERVES AS AN ACTIVE MEMBER OF THE BUSINESS COMMUNITY'S WORK TO RE-VITALIZE THE AREA FOR BOTH COMMERCE AND LIVING. ACH PARTICIPATES IN THE DOWNTOWN LITTLE ROCK PARTNERSHIP AND SUPPORTS EFFORTS TO IMPROVE CENTRAL ARKANSAS IN COLLABORATION WITH THE LITTLE ROCK CHAMBER OF COMMERCE, THE ARKANSAS ECONOMIC DEVELOPMENT FOUNDATION, THE LITTLE ROCK POLICE DEPARTMENT, AND THE CLINTON FOUNDATION, AMONG OTHERS. THESE ORGANIZATIONS ADDRESS WORKFORCE ISSUES, SAFETY, AND EDUCATIONAL ACHIEVEMENT IN THE NEIGHBORHOOD AND CITY IN WHICH ACH RESIDES.SINCE 2011, ACH HAS BEEN A PARTNER IN THE DEVELOPMENT OF THE CENTRAL LITTLE ROCK PROMISE NEIGHBORHOOD (CLRPN). CENTRAL LITTLE ROCK PROMISE NEIGHBORHOOD (CLRPN) IS A COLLABORATIVE EFFORT LED BY THE UNIVERSITY OF ARKANSAS AT LITTLE ROCK, ARKANSAS CHILDREN'S HOSPITAL, CENTRAL ARKANSAS LIBRARY SYSTEM, CITY OF LITTLE ROCK, LITTLE ROCK PREPARATORY SCHOOL, LITTLE ROCK SCHOOL DISTRICT, NEW FUTURES FOR YOUTH, AND UAMS. CLRPN'S MISSION IS TO CREATE AND SUSTAIN A COMMUNITY IN CENTRAL LITTLE ROCK WHOSE STAKEHOLDERS AGGRESSIVELY INTERVENE IN THE LIVES OF CHILDREN TO PREPARE AND MOTIVATE THEM FOR A PRODUCTIVE ADULTHOOD. THE VISION OF THE CLRPN IS THAT CHILDREN OF CENTRAL LITTLE ROCK WILL THRIVE PHYSICALLY, EDUCATIONALLY, SOCIALLY, AND EMOTIONALLY IN PREPARATION FOR PRODUCTIVE, ENJOYABLE LIVES VIA PROGRAMS WHICH PROMOTE ACADEMIC ACHIEVEMENT, FOSTER PHYSICAL, SOCIAL, AND EMOTIONAL DEVELOPMENT, ENCOURAGE PARENTAL ENGAGEMENT AND EFFECTIVE PARENTING, BUILD HEALTHY HABITS AND ENVIRONMENTS, AND NURTURE PRODUCTIVE CITIZENS. ACH HAS FOCUSED ITS EFFORTS ON THE DELIVERY OF HEALTH CARE TO CHILDREN IN THE CLRPN, ESTABLISHING HOME VISITING PROGRAMS IN THE AREA, PROVIDING COMMUNITY EDUCATION/OUTREACH AROUND CHILDREN'S HEALTH ISSUES, PROVIDING HEALTH LITERACY PROGRAMMING FOR THE CLRPN SCHOOLS, AND WORKING TO PREVENT AVOIDABLE CHILD INJURIES.FISCAL YEAR 2015 WAS THE FINAL YEAR FOR ACH'S CONTRIBUTION TO THE CLRPN.LOCALLY AND AROUND THE STATE, ACH PARTNERS WITH COMMUNITY ORGANIZATIONS TO IMPROVE THE CONDITIONS IN WHICH CHILDREN GROW UP. ACH IS A LEADING MEMBER OF MANY COALITIONS FOCUSING ON CHILD SAFETY MATTERS, INJURY PREVENTION, AND ENHANCED HEALTH SERVICES FOR CHILDREN. ACH HAS LONG SUPPORTED EDUCATION AND TRAINING PROGRAMS FOR YOUTH AND THEIR PARENTS, FOCUSING ON VIOLENCE PREVENTION, ALTERNATIVE DISPUTE RESOLUTION AMONG STUDENTS, AND DIVERSITY AND INCLUSION AMONG YOUTH. ACH SUPPORTS THE DEVELOPMENT OF INFORMATION AND EDUCATIONAL EFFORTS TO ILLUMINATE PROBLEMS IN CHILD HEALTH & SAFETY AND IDENTIFY BEST PRACTICES TO IMPROVE IDENTIFIED ISSUES. THROUGH ITS SUPPORT OF ORGANIZATIONS DEALING WITH SPECIFIC DISEASE STATES OR CHRONIC PHYSICAL AND BEHAVIORAL HEALTH CONDITIONS, ACH REMAINS AN ACTIVE PARTNER IN BUILDING COMMUNITIES TO BETTER SERVE THE OVERALL HEALTH NEEDS OF CHILDREN. ADDITIONALLY, THE HOSPITAL PARTNERS WITH VARIOUS AGENCIES' EFFORTS TO WORK WITH PARENTS TO ADDRESS THE SOCIAL DETERMINANTS OF ISSUES THAT IMPACT CHILDREN'S HEALTH, IMPROVE MENTAL HEALTH SERVICES FOR CHILDREN, AND SUPPORT VICTIMS OF DOMESTIC VIOLENCE AND CHILD ABUSE.ACH MAINTAINS ACTIVE PARTNERSHIPS WITH LOCAL UNIVERSITIES TO ENCOURAGE STUDENT INTEREST IN THE VARIOUS AREAS OF PROFESSIONAL DEVELOPMENT AND TO PROVIDE CLINICAL AND NON-CLINICAL TRAINING IMPORTANT TO ARKANSAS' HEALTH SYSTEM OPERATION. WHETHER ENCOURAGING YOUNG WOMEN AND MINORITIES TO CHOOSE PROFESSIONAL CAREERS IN HEALTHCARE AND SCIENCE OR WORKING WITH UNIVERSITY PROGRAMS TO PROVIDE CLINICAL EXPERIENCE FOR STUDENTS, ACH IS A KEY PLAYER IN COMMUNITY WORKFORCE DEVELOPMENT.ACH STAFF AND LEADERS CONTRIBUTE EXPERTISE AND LEADERSHIP IN MANY COMMUNITY SETTINGS IN PURSUIT OF THE HOSPITAL'S MISSION TO IMPROVE THE LIVES OF CHILDREN IN ARKANSAS. WHETHER SERVING ON VARIOUS BOARDS, COMMITTEES OR ADVISORY GROUPS OR SPENDING TIME WITH STUDENTS IN SUPPORT OF EDUCATION AND DEVELOPMENT, ACH IS AN ACTIVE CORPORATE PARTNER IN ITS COMMUNITY. ACH REGARDS THIS AS AN IMPORTANT COMPONENT OF ITS WORK IN THE LITTLE ROCK AND ARKANSAS COMMUNITY.
PART III, LINE 2: THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS DOES NOT INCLUDE THE EXPENSE FOR PATIENTS WHO ARE LIKELY TO QUALIFY FOR FINANCIAL ASSISTANCE. AT YEAR END, ALL ACCOUNTS WRITTEN OFF AS BAD DEBT ARE SENT TO TRANSUNION FOR CREDIT ANALYSIS. THOSE WITH CREDIT SCORES OF 620 AND BELOW ARE RECLASSIFIED AS CHARITY SINCE THESE WOULD LIKELY QUALIFY FOR FINANCIAL ASSISTANCE HAD THE FAMILIES FURNISHED SUFFICIENT INFORMATION. THIS AMOUNT IS ADDED TO THE OTHER CHARITY ADJUSTMENTS. FOR THOSE ACCOUNTS REMAINING CLASSIFIED AS BAD DEBT, THE COST TO CHARGE RATIO FOR EACH ACCOUNT IS CALCULATED AND APPLIED TO THE BAD DEBT WRITE OFF TO ADJUST THIS AMOUNT TO COST.
PART III, LINE 4: UNCOLLECTIBLE UNCOMPENSATED CARE GENERALLY REPRESENTS STANDARD CHARGES THAT ARE UNREALIZED DUE TO AN UNWILLINGNESS TO PAY BY THOSE RESPONSIBLE FOR PAYMENT, THEREFORE BAD DEBT. UNCOLLECTIBLE UNCOMPENSATED CARE IS REPORTED AS A DEDUCTION FROM GROSS PATIENT REVENUE.TEXT OF FOOTNOTE:ASC TOPIC 954 (TOPIC 954), "PRESENTATION AND DISCLOSURE OF PATIENT SERVICE REVENUE, PROVISION FOR BAD DEBTS, AND THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR CERTAIN HEALTH CARE ENTITIES", REQUIRES HEALTH CARE ENTITIES THAT RECOGNIZE SIGNIFICANT AMOUNTS OF PATIENT SERVICE REVENUE AT THE TIME THE SERVICES ARE RENDERED, EVEN THOUGH THEY DO NOT ASSESS THE PATIENT'S ABILITY TO PAY, TO PRESENT THE PROVISION FOR BAD DEBTS RELATED TO PATIENT SERVICE REVENUE AS A DEDUCTION FROM PATIENT SERVICE REVENUE (NET OF CONTRACTUAL ALLOWANCES AND DISCOUNTS) ON THE CONSOLIDATED STATEMENTS OF OPERATIONS.FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE BASED ON ESTABLISHED RATES, SUBJECT TO CERTAIN DISCOUNTS AS DETERMINED BY THE HOSPITAL. AN ESTIMATED PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED THAT RESULTS IN NET PATIENT SERVICE REVENUE BEING REPORTED AT THE NET AMOUNT EXPECTED TO BE RECEIVED. THE HOSPITAL HAS DETERMINED, BASED ON AN ASSESSMENT AT THE CONSOLIDATED ENTITY LEVEL, THAT PATIENT SERVICE REVENUE IS PRIMARILY RECORDED PRIOR TO ASSESSING THE PATIENT'S ABILITY TO PAY AND AS SUCH, THE ENTIRE PROVISION FOR UNCOLLECTIBLE ACCOUNTS RELATED TO PATIENT REVENUE IS RECORDED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS.
PART III, LINE 8: THE ACH MEDICARE POPULATION IS PRIMARILY RENAL PEDIATRIC PATIENTS AND ADULT BURN PATIENTS. ACH IS THE ONLY BURN CENTER IN THE STATE AND SERVES BOTH PEDIATRIC AND ADULT PATIENTS. THE COST OF PROVIDING CARE FOR THE ACUTE ADULT PATIENTS IS TYPICALLY GREATER THAN THE REIMBURSEMENT THAT MEDICARE ALLOWS ON THE MEDICARE COST REPORT. THEREFORE, THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE THE REIMBURSEMENT IS NOT NEGOTIATED AND SERVICES CANNOT BE PROVIDED ELSEWHERE.ACH INCLUDED $124,924 FROM PRIOR YEAR MEDICARE COST REPORT SETTLEMENTS THAT IS DUE TO ACH FROM THE MEDICARE PROGRAM.
PART III, LINE 9B: ARKANSAS CHILDREN'S HOSPITAL'S PATIENT ACCOUNTS DEPARTMENT USES ITS BEST EFFORTS TO ASSIST PATIENTS/GUARANTORS IN MEETING THEIR FINANCIAL RESPONSIBILITY FOR SERVICES PROVIDED AT ACH. THE ACH POLICY IS TO ACT WITH INTEGRITY IN ALL ENDEAVORS; TREATING ALL PATIENTS AND THEIR FAMILIES WITH DIGNITY, RESPECT, AND COMPASSION. THE STANDARD PROCESS INCLUDES OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE FAMILIES. NOTICES REGARDING THE FINANCIAL ASSISTANCE PROGRAM ARE POSTED IN ENGLISH AND SPANISH IN ALL REGISTRATION AREAS. FINANCIAL ASSISTANCE BROCHURES ARE AVAILABLE TO FAMILIES UPON REQUEST. THE GUARANTOR STATEMENTS AND THE ACH WEBSITE CONTAIN INFORMATION ABOUT THIS PROGRAM. THERE ARE FINANCIAL COUNSELORS AVAILABLE TO ALL REGISTRATION AREAS OF THE HOSPITAL TO ASSIST IN COMPLETING MEDICAID, CMS, SSI INTENTS, AND FINANCIAL ASSISTANCE APPLICATIONS. IT IS STANDARD PRACTICE AT ACH TO UTILIZE INTERNAL RESOURCES FOR COLLECTION THROUGH THE PATIENT ACCOUNTS DEPARTMENT. NO EXTRAORDINARY COLLECTION EFFORTS ARE TAKEN. ACH DOES NOT REPORT TO CREDIT BUREAUS OR CHARGE INTEREST OR FILE LIENS AGAINST A PATIENT'S OR FAMILY'S RESIDENCE TO SECURE PAYMENT ON PATIENT ACCOUNT BALANCES. UPON RECEIPT OF A PERSONAL BANKRUPTCY NOTICE, ANY OUTSTANDING SELF-PAY BALANCES FOR THE ASSOCIATED PATIENT ARE WRITTEN OFF ONCE ALL OTHER PAYMENTS HAVE BEEN RECEIVED. ALL SELF-PAY COLLECTION ACTIVITY IS STOPPED UPON NOTIFICATION OF THE BANKRUPTCY.UPFRONT DISCOUNTS ON SERVICES FOR THE UNINSURED ARE OFFERED. THE FAMILY CAN ALSO REQUEST A PROMPT PAY DISCOUNT. ADDITIONALLY, ACH ATTEMPTS TO ACCOMMODATE U.S. FAMILIES WHO DESIRE TO SET UP REASONABLE PAYMENT PLANS. INTEREST IS NOT CHARGED. THE HOSPITAL'S GUARANTOR STATEMENTS ARE DESIGNED TO KEEP THE GUARANTOR UPDATED AS TO WHETHER THE ACCOUNT IS STILL PENDING RESOLUTION BY INSURANCE OR DUE FROM THE GUARANTOR. SELF-PAY COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE.
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
PART VI, LINE 3: ARKANSAS CHILDREN'S HOSPITAL'S PATIENT ACCOUNTS DEPARTMENT USES ITS BEST EFFORTS TO ASSIST PATIENTS/GUARANTORS IN MEETING THEIR FINANCIAL RESPONSIBILITY FOR SERVICES PROVIDED AT ACH. THE ACH POLICY IS TO ACT WITH INTEGRITY IN ALL ENDEAVORS; TREATING ALL PATIENTS AND THEIR FAMILIES WITH DIGNITY, RESPECT, AND COMPASSION. THE STANDARD PROCESS INCLUDES OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE FAMILIES. NOTICES REGARDING THE FINANCIAL ASSISTANCE PROGRAM ARE POSTED IN ENGLISH AND SPANISH IN ALL OF OUR REGISTRATION AREAS. THE GUARANTOR STATEMENTS AND OUR WEBSITE CONTAIN INFORMATION ABOUT THIS PROGRAM. THERE ARE FINANCIAL COUNSELORS AVAILABLE TO ALL THE REGISTRATION AREAS OF THE HOSPITAL TO ASSIST IN COMPLETING MEDICAID, CMS, SSI INTENTS, AND FINANCIAL ASSISTANCE APPLICATIONS.
PART VI, LINE 4: AS THE ONLY PEDIATRIC MEDICAL CENTER IN ARKANSAS, ACH SERVES PATIENTS THROUGHOUT THE STATE AND, ON OCCASION, FROM OTHER STATES AND COUNTRIES. ACH DRAWS APPROXIMATELY 74% OF ITS OUTPATIENT POPULATION AND 59.5% OF ITS INPATIENT POPULATION FROM THE CENTRAL PART OF THE STATE (PULASKI COUNTY AND THE SURROUNDING COUNTIES OF LONOKE, FAULKNER, JEFFERSON, AND SALINE), AS WELL AS FROM WHITE COUNTY IN NORTH CENTRAL ARKANSAS, GARLAND COUNTY IN EAST CENTRAL ARKANSAS, AND BENTON, SEBASTIAN AND WASHINGTON COUNTIES IN THE NORTHWEST CORNER OF THE STATE. HOWEVER, ACH SERVES PATIENTS IN EVERY COUNTY ACROSS THE STATE AS WELL.BASED ON THE U.S. CENSUS BUREAU 2010 CENSUS DATA, POPULATION TOTALS WERE 2,915,918 FOR THE STATE OF ARKANSAS AND 382,748 FOR PULASKI COUNTY. ESTIMATED 2014 CENSUS DATA INDICATED POPULATION TOTALS TO BE 2,966,369 FOR ARKANSAS AND 392,702 FOR PULASKI COUNTY. ALSO ACCORDING TO ESTIMATED 2014 CENSUS DATA, APPROXIMATELY 24% OF THE ARKANSAS POPULATION WAS UNDER 18 YEARS OF AGE AND 6.5% WAS UNDER THE AGE OF 5. THE UNEMPLOYMENT RATE FOR THE STATE OF ARKANSAS FOR CALENDAR YEAR 2014 WAS 6.1%. THE PER CAPITA PERSONAL INCOME FOR THE STATE OF ARKANSAS FOR 2014 WAS $22,595. THEPERCENT OF ALL PEOPLE IN POVERTY IN AR WAS 19.2% AND THE PERCENT OF CHILDREN 18 OR YOUNGER IN POVERTY WAS 27.7%.ARKANSAS CHILDREN'S HOSPITAL (ACH) DEFINES ITS COMMUNITY AS ALL CHILDREN WHO RESIDE IN THE STATE. CHILDREN SERVED BY ACH COME FROM DIVERSE COMMUNITIES, RANGING FROM NORTHWEST ARKANSAS' BOOMING BUSINESS INDUSTRY TO THE PERSISTENT POVERTY OF THE MISSISSIPPI DELTA. RACIAL AND ETHNIC SUBCULTURES VARY ACROSS THE STATE INCLUDING A GROWING HISPANIC POPULATION IN THE NORTH AND WEST TO A LARGER AFRICAN AMERICAN POPULATION IN THE SOUTH AND EAST. IN GENERAL, ARKANSAS CHILDREN FARE WORSE THAN OTHERS IN THE U.S. IN TERMS OF HEALTH RISK FACTORS AND OUTCOMES, HIGHLIGHTING A NEED FORINVESTMENTS IN PUBLIC HEALTH INITIATIVES. DESPITE THE PRESENCE OF LARGE PRIVATE EMPLOYERS INCLUDING THE CORPORATE HOMES FOR WAL-MART, TYSON FOODS, AND JONES TRUCK LINES, AND A STRONG AGRICULTURAL ECONOMY, THE CONSEQUENCES OF POVERTY ARE FELT IN MOST COMMUNITIES IN THE STATE.THE ESTIMATED 705,728 ARKANSAS CHILDREN UNDER AGE 18 REPRESENT 23.8% OF THE STATE'S TOTAL POPULATION FOR 2014. DEMOGRAPHIC SHIFTS OCCUR RAPIDLY; THE HISPANIC CHILD POPULATION GREW DRAMATICALLY FROM 3.0% IN 2000 TO 9.3% IN 2010, AND THE NUMBER OF AFRICAN AMERICAN CHILDREN UNDER AGE 18 ALSO GREW FROM 15.7% TO 19.3% DURING THE SAME PERIOD. ESTIMATES FOR 2014 INDICATE THAT THE HISPANIC CHILD POPULATION IN WAS 11.2% AND THE AFRICAN AMERICAN CHILD POPULATION WAS 18.7%. THE RATE OF POVERTY IN ARKANSAS (2014 ESTIMATE) WAS APPROXIMATELY 19%, WITH APPROXIMATELY 27% OF CHILDREN UNDER AGE 18 AND 32% OF CHILDREN UNDER AGE 5 LIVING IN POVERTY. WITH A PRIMARILY RURAL POPULATION LIVING IN MANY SMALL AND MEDIUM-SIZED COMMUNITIES, ACCESS TO HEALTH CARE SERVICES PRESENTS A VERY REAL CHALLENGE. ARKANSAS SAW THE LARGEST DECLINE IN UNINSURED KIDS OF ALL STATES FROM 1990-2012, WITH 6% OF CHILDREN LACKING COVERAGE AS OF 2012 AND 5.8% AS OF 2014.
PART VI, LINE 5: ARKANSAS CHILDREN'S HOSPITAL IS THE ONLY PEDIATRIC MEDICAL CENTER IN ARKANSAS AND ONE OF THE LARGEST IN THE UNITED STATES SERVING CHILDREN FROM BIRTH TO AGE 21. THE CAMPUS SPANS OVER 30 CITY BLOCKS AND HOUSED 342 OPERATING BEDS IN FY15. THE STAFF IS COMPRISED OF APPROXIMATELY 509 PHYSICIANS, 95 RESIDENTS IN PEDIATRIC SPECIALTIES AND MORE THAN 4,400 EMPLOYEES. THE PRIVATE, NONPROFIT HEALTHCARE FACILITY BOASTS AN INTERNATIONALLY RENOWNED REPUTATION FOR MEDICAL BREAKTHROUGHS AND INTENSIVE TREATMENTS, UNIQUE SURGICAL PROCEDURES AND FORWARD-THINKING MEDICAL RESEARCH - ALL DEDICATED TO FULFILLING ITS MISSION.ACH SERVES AS THE PEDIATRIC TEACHING AFFILIATE OF UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS) AND IS HOME TO THE UAMS DEPARTMENT OF PEDIATRICS. ACH IS THE CLASSROOM WHERE MEDICAL STUDENTS STUDY THE PEDIATRIC COMPONENT OF ALL DISCIPLINES. UAMS FACULTY ON ACH CAMPUS ARE PRACTICING PHYSICIANS AS WELL AS TEACHERS TO UAMS STUDENTS IN MEDICINE, NURSING, PHARMACY AND ALLIED HEALTH.INPATIENT SERVICES INCLUDE: INFANT/TODDLER, CARDIOVASCULAR INTENSIVE CARE, NEONATAL INTENSIVE CARE, PEDIATRIC INTENSIVE CARE, INTERMEDIATE CARE, GENERAL MEDICINE, ORTHOPEDICS, HEMATOLOGY/ONCOLOGY, SURGERY/AMBULATORY SURGERY, NEUROSCIENCE, PROGRESSIVE/REHABILITATION, BURN CENTER, RENAL DIALYSIS, ADOLESCENT & YOUNG ADULT, EMERGENCY MEDICINE, AND EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO).ACH OFFERS MORE THAN 70 SPECIALTY AND SUBSPECIALTY CLINICS, LOCATED ON THE MAIN CAMPUS, WEST LITTLE ROCK, NORTHWEST ARKANSAS, AND OTHER AREAS OF THE STATE. THESE INCLUDE: ADOLESCENT & SPORTS MEDICINE, ASTHMA/ALLERGY, AUDIOLOGY/SPEECH PATHOLOGY, GENETICS, CARDIOLOGY, GASTROENTEROLOGY, HIGH RISK NEWBORN, OTOLARYNGOLOGY, CYSTIC FIBROSIS/PULMONARY, OPHTHALMOLOGY, SPINA BIFIDA, AND NUTRITION RESEARCH. ACH MAINTAINS A PRIMARY CARE CLINIC IN THE CITY OF LOWELL, LOCATED IN NORTHWEST ARKANSAS. THE LOWELL LOCATION INCLUDES 12 EXAMINATION ROOMS STAFFED BY FOUR PHYSICIANS, ANDADJACENT CLINIC SPACE FOR LANGUAGE DEVELOPMENT AND PHYSICAL, OCCUPATIONAL, AND SPEECH THERAPIES. THIS PRIMARY CARE CLINIC AND EXPANDED SERVICES IN NORTHWEST ARKANSAS WERE OFFERED IN AN EFFORT TO MEET THE NEEDS OF APPROXIMATELY 7,000 CHILDREN IN NORTHWEST ARKANSAS WITHOUT A PRIMARY CARE PHYSICIAN. ACH ALSO MAINTAINS A CLINIC IN JONESBORO, AR TO SERVE THE CHILDREN OF NORTHEAST ARKANSAS. THIS STATEWIDE PRESENCE HAS GROWN AS ACH CONTINUES TO EXPAND ITS REACH INTO COMMUNITIES IN NEED OF ITS SERVICES WITH INNOVATIVE NEW STRATEGIES.THE NATURAL WONDERS PARTNERSHIP COUNCIL (NWPC), NOW IN ITS NINTH YEAR, SERVES AS A CENTER OF MULTIPLE ACTIVITIES DESIGNED TO IMPROVE THE HEALTH STATUS OF CHILDREN IN OUR STATE. THE NWPC IS NATIONALLY RECOGNIZED AS AN OUTSTANDING EXAMPLE OF HOW A CHILDREN'S HOSPITAL CAN USE ITS RESOURCES AND REPUTATION AS A COMMUNITY LEADER TO BRING FOCUS AND COORDINATED ACTION TO A VARIETY OF ISSUES FACING CHILDREN AND THEIR FAMILIES. THE NWPC CONTINUES ITS EFFORTS IN ACCESS TO CARE, FOOD INSECURITY, SEXUAL HEALTH, CHILDHOOD OBESITY, INTENTIONAL AND UNINTENTIONAL INJURIES, PARENTING SKILLS, BEHAVIORAL HEALTH, ORAL HEALTH, AND IMMUNIZATIONS. THE NWPC CONTINUES TO SERVE AS THE PREFERRED FORUM FOR INFORMING, STRATEGIZING, AND SHARING INFORMATION ABOUT ISSUES IMPORTANT TO THE HEALTH AND DEVELOPMENT OF CHILDREN IN ARKANSAS.
PART VI, LINE 6: ACH IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. ACH AND THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS) ARE INVOLVED IN AN AFFILIATION AGREEMENT IN THE PURSUIT OF PROFESSIONAL EDUCATION, RESEARCH, AND CLINICAL CARE FOR CHILDREN. ALL PEDIATRIC SUB-SPECIALTY WORK IS CONDUCTED ON THE ACH CAMPUS WITH ACH PROVIDING SPACE, SUPPORTING STAFF AND SERVICES AND FUNDING FOR MAJOR EDUCATIONAL AND CLINICAL EXPERTISE.
Schedule H (Form 990) 2014
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990.
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number
71-0236857
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government
(b) EIN (c) IRC section
if applicable
(d) Amount of cash grant (e) Amount of non-cash
assistance
(f) Method of valuation
(book, FMV, appraisal,
other)
(g) Description of
non-cash assistance
(h) Purpose of grant
or assistance
(1) ARKANSAS ADVOCATES FOR CHILDREN & FAMILIES
1400 WEST MARKHAM SUITE 306
LITTLE ROCK,AR72201
71-0492205 501(C)(3) 5,350       GENERAL SUPPORT
(2) ARKANSAS CENTER FOR HEALTH IMPROVEMENT (UAMS)
1401 W CAPITOL AVE SUITE 300
LITTLE ROCK,AR72201
71-6046242 GOV'T ENTITY 200,000       HEALTH IMPROVEMENT PROGRAMS
(3) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION
1 CHILDRENS WAY
LITTLE ROCK,AR72202
71-0568795 501(C)(3) 46,073       ENDOWMENT AND GENERAL SUPPORT
(4) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE
13 CHILDRENS WAY
LITTLE ROCK,AR72202
71-0694931 501(C)(3) 3,487,629 1,769,690 FMV INDIRECT SUPPORT GENERAL SUPPORT
(5) HOME INSTRUCTION FOR PARENTS OF PRESCHOOL YOUNGSTERS (HIPPY)
1221 BISHOP
LITTLE ROCK,AR72202
13-3672592 501(C)(3)   38,804 FMV PROVIDE OFFICE SPACE & PHONE GENERAL SUPPORT
(6) ACCESS SCHOOLS
10618 BRECKENRIDGE DR
LITTLE ROCK,AR72211
62-1665314 501(C)(3) 5,000       GENERAL SUPPORT
(7) REACH OUT AND READ
PO BOX 21712
LITTLE ROCK,AR72221
33-1020070 501(C)(3) 5,790       GENERAL SUPPORT
(8) RONALD MCDONALD HOUSE CHARITIES
1009 WOLFE STREET
LITTLE ROCK,AR72202
71-0525252 501(C)(3) 16,700       GENERAL SUPPORT
(9) NEW FUTURES FOR YOUTH
323 CENTER STREET SUITE 1275
LITTLE ROCK,AR72201
71-0664490 GOV'T ENTITY 15,000       CENTRAL LR PROMISE NEIGHBORHOOD
(10) CAMP ALDERSGATE
2000 ALDERSGATE ROAD
LITTLE ROCK,AR72205
68-0560043 501(C)(3) 23,143       GENERAL SUPPORT AND CAMPS FOR CHILDREN WITH PHYSICAL CONDITIONS.
(11) NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS
PO BOX 79334
BALTIMORE,MD21279
51-0120256 501(C)(6) 7,462       GME ADVOCACY
(12) CHILDREN'S PROTECTION CENTER
1123 BISHOP
LITTLE ROCK,AR72202
26-1086937 501(C)(3)   23,323 FMV PROVIDE OFFICE SPACE GENERAL SUPPORT
(13) CLINTON FOUNDATION
1200 PRESIDENT CLINTON AVE
LITTLE ROCK,AR72201
31-1582024 501(C)(3) 10,000       GENERAL SUPPORT
(14) LITTLE ROCK TECHNOLOGY PARK AUTHORITY
ONE CHAMBER PLAZA
LITTLE ROCK,AR72201
45-5531676 GOV'T UNIT 50,000       GENERAL SUPPORT
(15) UNIVERSITY OF ARKANSAS AT LITTLE ROCK
2801 SOUTH UNIVERSITY
LITTLE ROCK,AR72204
71-0236904 GOV'T ENTITY         GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
14
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2014

Schedule I (Form 990) 2014
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients
(c)Amount of
cash grant
(d)Amount of
non-cash assistance
(e)Method of valuation (book,
FMV, appraisal, other)
(f)Description of non-cash assistance
(1) MEALS 2022 7,924 149,344 COST MEALS FOR FAMILIES/LACTATING MOTHERS
(2) INSURANCE PREMIUMS 60   106,919 COST PAYMENT OF PREMIUMS FOR PATIENT'S FAMILIES ALLOWED BY COBRA
(3) TRANSPORTATION COSTS (BUS TOKENS, CAB FARE, GAS CARDS) 1553 46,267   COST  
(4) FUNERAL EXPENSES 27 16,673   COST  
(5) RENT, MORTGAGE EXPENSE, UTILITIES, LODGING 31 5,483   COST  
(6) CAR SEATS FOR INFANTS AND CHILDREN 505   26,403 COST CAR SEATS FOR INFANTS AND CHILDREN
(7) GROCERY GIFT CARDS AND OTHER MISC. ASSISTANCE 97 13,062   COST  
Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: THE HOSPITAL CONSIDERS REQUESTS FROM NON-PROFIT OR GOVERNMENTAL ENTITIES FOR PROGRAMS OR ACTIVITIES THAT ALIGN WITH ITS PLAN TO ADDRESS NEEDS AS IDENTIFIED IN THE CHNA OR THAT OTHERWISE SUPPORT THE HOSPITAL'S MISSION. THE HOSPITAL ANTICIPATES THAT THESE NON-PROFIT OR GOVERNMENTAL ENTITIES WILL MONITOR THE USE OF FUNDS IN ACCORDANCE WITH NON-PROFIT OR GOVERNMENTAL REQUIREMENTS. THE HOSPITAL PROVIDES SOME ASSISTANCE TO INDIGENT FAMILIES. THE HOSPITAL'S SOCIAL WORK DEPARTMENT EVALUATES THE NEED ON A CASE BY CASE BASIS AND PROVIDES THE APPROPRIATE ASSISTANCE, WHICH IS TYPICALLY FOOD, CLOTHING, SHELTER, OR TRAVEL VOUCHERS. CASH OR CASH EQUIVALENT ASSISTANCE IS SOMETIMES PROVIDED. THE ASSISTANCE PROVIDED IS DOCUMENTED BY THE HOSPITAL'S SOCIAL WORK DEPARTMENT.
Schedule I (Form 990) 2014


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits
(E) Total of columns
(B)(i)-(D)
(F) Compensation in column(B) reported as deferred in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
1MARCELLA DODERERPRESIDENT/CEO (i)
(ii)
526,759
...............................
0
59,062
...............................
0
885
...............................
0
87,499
...............................
0
10,324
...............................
0
684,529
...............................
0
0
...............................
0
2JAYANT DESHPANDE MDSVP AND CMO (i)
(ii)
0
...............................
0
0
...............................
0
505,608
...............................
0
0
...............................
0
0
...............................
0
505,608
...............................
0
0
...............................
0
3RICK JACKSON MDCHIEF OF STAFF (i)
(ii)
0
...............................
0
0
...............................
0
707,621
...............................
0
0
...............................
0
0
...............................
0
707,621
...............................
0
0
...............................
0
4RICHARD JACOBS MDACHRI PRESIDENT/UAMS DOP C (i)
(ii)
0
...............................
0
0
...............................
0
0
...............................
243,800
0
...............................
0
0
...............................
0
0
...............................
243,800
0
...............................
0
5GENA WINGFIELDSVP AND CFO (i)
(ii)
392,231
...............................
0
44,509
...............................
0
980
...............................
0
63,718
...............................
0
10,324
...............................
0
511,762
...............................
0
0
...............................
0
6CHARLES LARRY BECKIUSVP FACILITIES (i)
(ii)
189,531
...............................
0
18,158
...............................
0
1,148
...............................
0
15,056
...............................
0
6,856
...............................
0
230,749
...............................
0
0
...............................
0
7DAVID BERRYSVP AND COO (i)
(ii)
380,339
...............................
0
44,509
...............................
0
961
...............................
0
190,840
...............................
0
10,324
...............................
0
626,973
...............................
0
0
...............................
0
8LEE ANNE EDDYSVP/CHIEF NURSING OFFICER (i)
(ii)
290,033
...............................
0
29,494
...............................
0
428
...............................
0
13,849
...............................
0
5,365
...............................
0
339,169
...............................
0
0
...............................
0
9SCOTT GORDONEXECUTIVE VICE PRESIDENT (PARTIAL YE (i)
(ii)
186,818
...............................
0
41,101
...............................
0
2,403
...............................
0
16,600
...............................
0
3,388
...............................
0
250,310
...............................
0
0
...............................
0
10MICHAEL HARTVP IT APPLICATIONS (i)
(ii)
200,404
...............................
0
33,749
...............................
0
272
...............................
0
10,056
...............................
0
9,770
...............................
0
254,251
...............................
0
0
...............................
0
11CYNTHIA HOLLANDVP ANCILLARY SERVICES (i)
(ii)
193,564
...............................
0
18,147
...............................
0
1,174
...............................
0
15,237
...............................
0
6,913
...............................
0
235,035
...............................
0
0
...............................
0
12KATHERINE LEAVP ED/SURGICAL CARE (i)
(ii)
158,187
...............................
0
15,146
...............................
0
203
...............................
0
12,392
...............................
0
5,716
...............................
0
191,644
...............................
0
0
...............................
0
13DARRELL LEONHARDTSVP AND CIO (i)
(ii)
240,811
...............................
0
28,719
...............................
0
3,128
...............................
0
13,413
...............................
0
9,970
...............................
0
296,041
...............................
0
0
...............................
0
14MARY SALASSI-SCOTTERVP CRITICAL CARE SERVICES (i)
(ii)
156,849
...............................
0
15,159
...............................
0
582
...............................
0
12,512
...............................
0
6,668
...............................
0
191,770
...............................
0
0
...............................
0
15ROBERT STEELESVP AND CSO (i)
(ii)
247,851
...............................
0
125,000
...............................
0
420
...............................
0
0
...............................
0
8,914
...............................
0
382,185
...............................
0
0
...............................
0
16ANDREE TROSCLAIRVP HUMAN RESOURCES (i)
(ii)
206,681
...............................
0
19,009
...............................
0
838
...............................
0
15,862
...............................
0
5,020
...............................
0
247,410
...............................
0
0
...............................
0
17STEPHEN M BEETSTRADENTAL ASSISTANT DIRECTOR (i)
(ii)
228,626
...............................
0
375
...............................
0
409
...............................
0
13,198
...............................
0
9,938
...............................
0
252,546
...............................
0
0
...............................
0
18CARL CHIPMANRN 1ST ASSISTANT- CVOR (i)
(ii)
209,560
...............................
0
4,433
...............................
0
2,441
...............................
0
9,672
...............................
0
3
...............................
0
226,109
...............................
0
0
...............................
0
19CHARLES E JOHNSONDIRECTOR - CARDIOTHORACIC SURG (i)
(ii)
211,799
...............................
0
4,593
...............................
0
385
...............................
0
13,266
...............................
0
1,677
...............................
0
231,720
...............................
0
0
...............................
0
20RHONDA MCKINNISVP LEGAL AFFAIRS (i)
(ii)
201,362
...............................
0
17,630
...............................
0
377
...............................
0
12,868
...............................
0
6,105
...............................
0
238,342
...............................
0
0
...............................
0
21KIRT SIMMONSDIRECTOR - CRANIOFACIAL ORTHO (i)
(ii)
254,315
...............................
0
375
...............................
0
1,214
...............................
0
16,600
...............................
0
5,182
...............................
0
277,686
...............................
0
0
...............................
0
Schedule J (Form 990) 2014

Schedule J (Form 990) 2014
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
PART I, LINE 1A CHARTER TRAVEL IS USED FOR STAFF TO TRAVEL TO THE NORTHWEST PART OF THE STATE, PRIMARILY TO THE ACH CLINIC LOCATED IN LOWELL, AR. UTILIZATION OF CHARTER TRAVEL, RATHER THAN HAVING STAFF DRIVE TO THE LOCATION, IS OCCASIONALLY DEEMED THE MOST EFFICIENT METHOD OF TRAVEL. STAFF WHO TRAVEL TO THIS LOCATION MAY INCLUDE EMPLOYEES LISTED AS OFFICERS AND KEY EMPLOYEES, AS WELL AS PHYSICIANS, NURSES, AND OTHER ADMINISTRATIVE OR PATIENT CARE STAFF.
PART I, LINE 4B ARKANSAS CHILDREN'S HOSPITAL HAS SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS TO PROVIDE EXECUTIVES WITH RETIREMENT AND DEATH BENEFITS. THE PLANS ARE INTENDED TO CONSTITUTE UNFUNDED PLANS FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES WITHIN THE MEANING OF TITLE I OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED. THE ORIGINAL SUPPLEMENTAL RETIREMENT PLAN (SERP) WAS FROZEN TO NEW PARTICIPANTS IN FY14; HOWEVER, TWO EXECUTIVES REMAINED IN THE PLAN. DURING THE 2014 TAX YEAR, THE FOLLOWING ACH REPORTABLE INDIVIDUALS WERE ELIGIBLE TO PARTICIPATE: DAVID BERRY SR. VP/COO GENA WINGFIELD SR. VP/CFO EFFECTIVE 6/30/2014, ACH INITIATED A NEW EXECUTIVE COMPENSATION PLAN, THE "DEFERRED COMPENSATION PLAN" (DCP). THE DCP IS A 457(F) NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN, PROVIDING ANNUAL CONTRIBUTIONS TO CERTAIN EXECUTIVES AT A PERCENTAGE OF THEIR BASE SALARY IN EFFECT ON JUNE 30 OF THE PLAN YEAR. PER THE PLAN DOCUMENT, EACH DCP CONTRIBUTION FOR A PLAN YEAR AND ITS ASSOCIATED EARNINGS VEST ON THE EARLIER OF: - THE FIRST DAY OF THE PLAN YEAR FOLLOWING THREE YEARS OF SERVICE WHICH BEGINS ON THE FIRST DAY OF THE PLAN YEAR FOR WHICH THE CONTRIBUTION IS CREDITED. - ATTAINMENT OF AGE 65 AND AT LEAST 3 YEARS OF SERVICE AS A DCP PARTICIPANT - DEATH OR PERMANENT DISABILITY - INVOLUNTARY TERMINATION (OTHER THAN FOR CAUSE) - PLAN TERMINATION FOR TAX YEAR 2014 (FISCAL YEAR 2015), THE FOLLOWING ACH REPORTABLE EMPLOYEES WERE ELIGIBLE TO PARTICIPATE IN THE DCP PLAN: - MARCELLA DODERER: PRES/CEO - DAVID BERRY: SVP/COO - LEE ANN EDDY: SVP/CNO - DARRELL LEONHARDT: SVP/SIO - GENA WINGFIELD: SVP/CFO - ROB STEELE: SVP/CSO
FORM 990, PART VII, SECTION A, LINE 5: DIRECTORS JAY DESHPANDE, M.D. AND RICK JACKSON, M.D. WERE COMPENSATED BY UAMS AS EMPLOYEES FOR SERVICES RENDERED TO ARKANSAS CHILDREN HOSPITAL (ACH) AND FOR WHICH ACH REMITTED PAYMENT LISTED AS "REPORTABLE COMPENSATION FROM THE ORGANIZATION" IN PART VII. DIRECTOR RICHARD JACOBS, M.D., COMPENSATED BY UAMS AS THE CHAIRMAN OF THE UAMS DEPARTMENT OF PEDIATRICS, IS A MEMBER OF VARIOUS ACH ADMINISTRATIVE COMMITTEES; HOWEVER, THE "REPORTABLE COMPENSATION FROM THE ORGANIZATION" LISTED IN PART VII IS FOR COMPENSATION FOR HIS ROLE AS PRESIDENT OF THE ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE, A RELATED ORGANIZATION. THE AMOUNTS NOTED AS COMPENSATION IN SCHEDULE J FOR THE PHYSICIANS NOTED ABOVE WERE THE DESIGNATED AMOUNTS PER THE RELATED CONTRACTS WITH UAMS.
Schedule J (Form 990) 2014

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990.

SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number
71-0236857
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer
(i) Pool
financing
Yes No Yes No Yes No
A PULASKI COUNTY ARKANSAS
 
71-6006487 745392HD5 05-28-2009 109,526,869 SEE SCHEDULE K, PART VI.   X   X   X
B PULASKI COUNTY ARKANSAS
 
71-6006487 745392GK0 12-08-2005 33,917,692 SEE SCHEDULE K, PART VI.   X   X   X
C PULASKI COUNTY ARKANSAS
 
71-6006487 745392HR4 11-17-2010 31,051,199 SEE SCHEDULE K, PART VI.   X   X   X
D ARKANSAS DEVELOPMENT FINANCE AUTHORITY
 
71-0503641   09-05-2013 19,800,000 SEE SCHEDULE K, PART VI.   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 13,110,000 33,370,000 14,935,000 5,063,624
2 Amount of bonds legally defeased . . . . . . . . . . .        
3 Total proceeds of issue . . . . . . . . . . . . . . 111,070,517 34,659,477 31,051,199 19,800,000
4 Gross proceeds in reserve funds . . . . . . . . . . . . 7,360,415      
5 Capitalized interest from proceeds . . . . . . . . . . . 439,815      
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 1,296,277 307,020 192,600  
8 Credit enhancement from proceeds . . . . . . . . . . . 1,876,252 603,623 206,911  
9 Working capital expenditures from proceeds . . . . . . . . .        
10 Capital expenditures from proceeds . . . . . . . . . . . 100,097,782 33,748,834   19,800,000
11 Other spent proceeds . . . . . . . . . . . . . . 30,651,688   30,651,688  
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2012 2006 2010 2015
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X   X  
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X    
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X     X    
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? X   X          
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . . X     X   X    
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?   X            
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0.060 % 0 %    
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet        
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0.060 % 0 %    
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X    
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X    
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .                
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . .
X   X   X      
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .   X   X X   X  
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . . X   X     X   X
If "Yes" to line 2c, provide in Part VI the date the rebate
computation was performed . . . . . .
3 Is the bond issue a variable rate issue? . . . .   X   X   X   X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of hedge . . . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was the hedge terminated? . . . . . .                
Schedule K (Form 990) 2014
Schedule K (Form 990) 2014
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . .  
 
 
 
 
 
 
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . . X     X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
DATE REBATE COMPUTATION PERFORMED ISSUER NAME: PULASKI COUNTY, ARKANSAS DATE THE REBATE COMPUTATION WAS PERFORMED: 07/18/2013 ISSUER NAME: PULASKI COUNTY, ARKANSAS DATE THE REBATE COMPUTATION WAS PERFORMED: 08/03/2010
SCHEDULE K SUPPLENTAL INFORMATION PART I, LINE A - DESCRIPTION OF PURPOSE. PROCEEDS USED TO ACCOMPLISH THE UTILITY PROJECT AND THE SOUTH WING PROJECT. THE UTILITY PROJECT INCLUDED MAJOR INFRASTRUCTURE IMPROVEMENTS, INCLUDING ADDED CAPACITY FOR THE SOUTH WING. THE SOUTH WING PROJECT WAS NEW CONSTRUCTION THAT ADDED APPROXIMATELY 243,114 SQUARE FEET INCLUDING A NEW EMERGENCY DEPARTMENT, ADDITIONAL OUTPATIENT CLINIC AREAS AND A NET ADDITION OF 54 INPATIENT BEDS. PART I, LINE B - DESCRIPTION OF PURPOSE. THE PROJECT GENERALLY INCLUDED THE CONSTRUCTION OF A FOUR STORY PARKING DECK, CONSTRUCTION OF A 116,525 SQUARE FOOT OFFICE BUILDING, THE ACQUISITION OF TWO MAGNETIC RESONANCE IMAGING SYSTEMS, AND THE ACQUISITION OF OPERATING ROOM EQUIPMENT. PART I, LINE C - DESCRIPTION OF PURPOSE. TO REFUND HOSPITAL REVENUE BONDS (ARKANSAS CHILDREN'S HOSPITAL PROJECT), SERIES 2002A AND SERIES 2002B REFUNDING, ISSUED 7/31/2002. PART I, LINE D - DESCRIPTION OF PURPOSE: PROCEEDS USED TO PURCHASE TWO SIKORSKY S-76D HELICOPTERS TO BE USED FOR MEDICAL TRANSPORT. PART II, LINE 1, BOND B - THE SERIES 2005 REVENUE BONDS WERE CALLED IN MARCH 2015. PART II, LINE 3, BOND A - TOTAL PROCEEDS DIFFER FROM ISSUE PRICE DUE TO CUMULATIVE INVESTMENT EARNINGS. PART II, LINE 3, BOND B - TOTAL PROCEEDS DIFFER FROM ISSUE PRICE DUE TO CUMULATIVE INVESTMENT EARNINGS. PART II, LINE 4 - THE AMOUNTS SHOWN HERE CONSIST SOLELY OF DEBT SERVICE RESERVE FUNDS. THE ORGANIZATION ALSO HAS THE FOLLOWING AMOUNTS IN BONA FIDE DEBT SERVICE FUNDS AS OF 6/30/2015: SERIES 2009: $2,570,101; SERIES 2010: $798,636. PART IV, LINE 6, BOND A - SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED.
Schedule K (Form 990) 2014

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
Total ......Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2014
Schedule L (Form 990 or 990-EZ) 2014
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) WINDSTREAM
 
PERFORMANCE OF SERVICES 998,749 SEE PART V. WINDSTREAM IS A TELECOMMUNICATIONS SERVICES COMPANY AND DIRECTOR JEFF GARDNER WAS CEO OF WINDSTREAM UNTIL DECEMBER 2014. TRANSACTIONS WITH INTERESTED PERSONS WERE PERFORMED IN ACCORDANCE WITH THE ACH BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY.   No
(2) JENNIFER J BECKIUS FAMILY MEMBER 30,998 SEE PART V. JENNIFER J. BECKIUS IS A FAMILY MEMBER OF KEY EMPLOYEE LARRY BECKIUS; HOWEVER, CONSISTENT WITH ARKANSAS CHILDREN'S HOSPITAL POLICY, SHE DOES NOT WORK WITHIN MR. BECKIUS'S LINE OF AUTHORITY.   No
(3) MISTY DAWN BERRY FAMILY MEMBER 44,159 SEE PART V. MISTY DAWN BERRY IS A FAMILY MEMBER OF KEY EMPLOYEE DAVID BERRY; HOWEVER, CONSISTENT WITH ARKANSAS CHILDREN'S HOSPITAL POLICY, SHE DOES NOT WORK WITHIN MR. BERRY'S LINE OF AUTHORITY.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2014

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2014
Open to Public
Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF THE CHAIRMAN OF THE BOARD OF DIRECTORS, WHO ALSO SERVES AS CHAIRMAN OF THE EXECUTIVE COMMITTEE, THE VICE CHAIRMAN, THE SECRETARY, THE TREASURER, THE IMMEDIATE PAST CHAIRMAN, THE CHAIRMAN OF THE SERVICES & QUALITY COMMITTEE, THE VICE-CHAIRMAN OF THE BOARD OF DIRECTORS OF ARKANSAS CHILDREN'S HOSPITAL FOUNDATION, INC., THE CHAIRMAN OF THE BOARD OF DIRECTORS OF ARKANSAS CHILDREN'S RESEARCH INSTITUTE, INC., AND THREE AT-LARGE MEMBERS OF THE BOARD OF DIRECTORS ELECTED BY THE BOARD AT ITS ANNUAL MEETING. THE THREE AT-LARGE MEMBERS ARE ELECTED TO A TWO-YEAR TERM. THE ACH CHIEF MEDICAL OFFICER, THE ACH CHIEF OF STAFF, THE UAMS CHAIRMAN OF THE DEPARTMENT OF PEDIATRICS, AND THE ACH PRESIDENT/CHIEF EXECUTIVE OFFICER ARE ALSO EX-OFFICIO MEMBERS OF THE EXECUTIVE COMMITTEE WITHOUT VOTE. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD AND WITH THE UNDERSTANDING THAT ALL MATTERS OF MAJOR IMPORTANCE WILL BE REFERRED TO THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE REVIEWS THE BUDGET PREPARED BY THE FINANCE COMMITTEE AND SUBMITS IT TO THE BOARD WITH THE EXECUTIVE COMMITTEE'S RECOMMENDATION AT THE LAST MEETING BEFORE THE END OF THE FISCAL YEAR. THE EXECUTIVE COMMITTEE RECEIVES A MONTHLY REPORT FROM THE FINANCE COMMITTEE CHAIRMAN RELATING TO THE MONTHLY FINANCIAL REPORTS. THE EXECUTIVE COMMITTEE HAS FINAL OVERSIGHT OF LONG RANGE PLANNING ACTIVITIES AND IS ALSO RESPONSIBLE FOR REVIEWING LEGAL ACTIVITIES INVOLVING THE HOSPITAL. MINUTES OF THE EXECUTIVE COMMITTEE MEETINGS ARE SUBMITTED TO THE BOARD, AND ITS ACTIONS ARE SUBJECT TO APPROVAL OR DISAPPROVAL AS SOON AS PRACTICAL AT A REGULAR BOARD MEETING. FORM 990, PART VI, SECTION A, LINE 2: ALTHOUGH NOT CONSIDERED COVERED RELATIONSHIPS AS NOTED IN PART VI, SECTION A, LINE 2, THE FOLLOWING DIRECTORS WERE ALL EMPLOYEES OF THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS) DURING THE TAX YEAR: JAYANT DESHPANDE, M.D., RICK JACKSON, M.D., RICHARD JACOBS, M.D., AND DANIEL RAHN, M.D.
FORM 990, PART VI, SECTION A, LINE 2 JOHN BALE IS AN ELECTED MEMBER OF THE ACH BOARD OF DIRECTORS. HIS WIFE, SHARON BALE, IS THE PRESIDENT OF THE ACH AUXILIARY BOARD AND IN THAT ROLE IS A DESIGNATED MEMBER OF THE ACH BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 3 THE HOSPITAL'S SVP/CHIEF QUALITY AND CHIEF MEDICAL OFFICER POSITION IS HELD BY DR. JAY DESHPANDE WHO HOLDS FACULTY APPOINTMENTS IN THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES, COLLEGE OF MEDICINE DEPARTMENTS OF PEDIATRICS AND ANESTHESIOLOGY. AS HE IS A UAMS EMPLOYEE, THE HOSPITAL REIMBURSES UAMS FOR HIS ROLE, WHICH IS TO HELP BROADEN AND STRENGTHEN THE HOSPITAL'S QUALITY EFFORTS AND OVERALL QUALITY PROGRAM FOR PATIENT CARE.
FORM 990, PART VI, SECTION A, LINE 4 THE GOVERNING DOCUMENTS WERE CHANGED DURING FY15 TO CLARIFY LANGUAGE, TO STREAMLINE THE ANNUAL BOARD OF DIRECTORS APPOINTMENTS/ELECTIONS, AND TO ADD AND CHANGE SOME DEFINITIONS: - ELIMINATED THE REFERENCE TO PSYCHIATRIC ADMISSIONS IN THE "PURPOSE" SECTION, DUE TO THE FACT THAT ACH NO LONGER HAS AN INPATIENT PSYCHIATRY UNIT. - CLARIFIED THE "ELECTED DIRECTORS" SECTION TO ELIMINATE THE NEED TO REAFFIRM ALL DIRECTORS ON AN ANNUAL BASIS. - MODIFIED THE "EXECUTIVE COMMITTEE" SECTION TO INCLUDE THE CHAIRMAN OF THE SERVICES & QUALITY COMMITTEE AND TO DEFINE THE TERMS OF THE THREE AT-LARGE MEMBERS OF THE EXECUTIVE COMMITTEE TO BE TWO YEARS. IN ADDITION, A MODIFICATION WAS MADE TO CHANGE THE TITLE OF "MEDICAL DIRECTOR" TO "ACH CHIEF MEDICAL OFFICER".
FORM 990, PART VI, SECTION B, LINE 11 HOSPITAL MANAGEMENT REVIEWS THE DRAFT FORM 990 AND RECONCILES IT TO THE HOSPITAL'S INTERNAL FINANCIALS AND CONSOLIDATED AUDIT REPORT. THE REVIEWED DRAFT OF THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE BY HOSPITAL MANAGEMENT. IF THE REVIEW BY THE COMMITTEE RESULTS IN REVISIONS TO THE FORM 990, THOSE REVISIONS ARE MADE. THE FORM 990 TO BE FILED IS THEN PROVIDED TO THE ENTIRE BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL HAS A BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY THAT IS REVIEWED WITH ALL NEW BOARD MEMBERS DURING THEIR BOARD ORIENTATION. IN ADDITION, PERIODICALLY EXTERNAL COUNSEL WILL REVIEW THE POLICY WITH THE FULL BOARD DURING A REGULAR BOARD MEETING. ANNUAL DISCLOSURE OF POTENTIAL CONFLICTS OR AFFIRMATIVE CONFIRMATION THAT NONE EXIST IS REQUIRED OF ALL BOARD MEMBERS. THE ANNUAL DISCLOSURES ARE REVIEWED AND APPROVED BY A MAJORITY OF THE DISINTERESTED DIRECTORS ON THE EXECUTIVE COMMITTEE. ALL CONFLICT DISCLOSURES ARE THEN COMPILED AND LISTED IN THE BOARD BOOK AT THE NEXT REGULARLY SCHEDULED MEETING. DETERMINATION OF WHETHER A LISTED CONFLICT IS MATERIAL IS DETERMINED BY THE CORPORATE COMPLIANCE OFFICER, WITH ADVICE FROM LEGAL COUNSEL IF STILL UNCERTAIN. DURING THE YEAR, WHILE BOARD MEMBERS MAY PARTICIPATE IN INITIAL DISCUSSION, BOARD MEMBERS WHO HAVE A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN DELIBERATIONS AND DECISIONS IN THE RELATED TRANSACTION AND ABSTAIN FROM VOTING, WHICH IS NOTED IN THE MINUTES.
FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR THE ORGANIZATION'S CEO, SENIOR VICE PRESIDENTS, VICE PRESIDENTS, AND KEY EMPLOYEES IS REVIEWED BY THE COMPENSATION COMMITTEE WHICH IS ESTABLISHED THROUGH THE BYLAWS OF ARKANSAS CHILDREN'S HOSPITAL TO DISCHARGE THE DUTY OF THE BOARD IN FULFILLING ITS OVERSIGHT RESPONSIBILITIES FOR DETERMINING THE ADEQUACY AND REASONABLENESS OF THE COMPENSATION PAID THE CEO AND OTHER EMPLOYEES THAT THE COMMITTEE BELIEVES ARE IN A POSITION TO EXERCISE A SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF THE HOSPITAL. THE COMMITTEE IS COMPOSED OF MEMBERS WHO PERSONALLY RECEIVE NO COMPENSATION, FEES, OR OTHER BENEFITS FROM THE HOSPITAL, RELATED ORGANIZATIONS OR FROM THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES. THE COMMITTEE MAY RELY UPON REASONED WRITTEN OPINIONS OF QUALIFIED LEGAL, ACCOUNTING, VALUATION AND EXECUTIVE COMPENSATION EXPERTS. THE COMMITTEE HAS THE SOLE AUTHORITY TO RETAIN AND TERMINATE ANY SPECIAL ADVISORS USED TO ASSIST IN THE EVALUATION OF COMPENSATION. THE COMMITTEE CONTEMPORANEOUSLY, WITH MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION OF DISQUALIFIED PERSONS, DOCUMENTS IN A WRITTEN REPORT TO THE EXECUTIVE COMMITTEE AND THE BOARD, THE BASIS FOR ITS DECISION.
FORM 990, PART VI, SECTION C, LINE 19 THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AS REQUIRED.
FORM 990, PART IX, LINE 11G PHYSICIAN'S REMUNERATION: PROGRAM SERVICE EXPENSES 71,159,650. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 71,159,650. TESTING: PROGRAM SERVICE EXPENSES 3,749,685. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,749,685. OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 8,807,512. MANAGEMENT AND GENERAL EXPENSES 3,719,117. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,526,629. REPAIRS & MAINTENANCE: PROGRAM SERVICE EXPENSES 4,272,760. MANAGEMENT AND GENERAL EXPENSES 1,914,743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,187,503.
FORM 990, PART XI, LINE 9: UNEXPENDED GRANT CARRYOVER ADJUSTMENTS -46,365.
FORM 990, PART XII, LINE 2C THERE WERE NO CHANGES TO THE OVERSIGHT PROCESS OR SELECTION PROCESS OF INDEPENDENT ACCOUNTANTS.
FORM 990, PART XII, LINE 3B THE CONSOLIDATED ORGANIZATION IS REQUIRED TO UNDERGO AN AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 AND DID UNDERGO THAT REQUIRED AUDIT.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2014

Additional Data


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SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet
Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2014
Open to Public Inspection
Name of the organization
ARKANSAS CHILDREN'S HOSPITAL
 
Employer identification number

71-0236857
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION
1 CHILDRENS WAY

LITTLE ROCK,AR72202
71-0568795
FUNDRAISING AR 501(C)(3) LINE 7 ARKANSAS CHILDREN'S HOSPITAL
 
Yes
 
(2) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE
13 CHILDRENS WAY

LITTLE ROCK,AR72202
71-0694931
RESEARCH AR 501(C)(3) LINE 11A, I ARKANSAS CHILDREN'S HOSPITAL
 
Yes
 
(3) ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY INC
1 CHILDRENS WAY

LITTLE ROCK,AR72202
91-1940376
BUILDING MANAGEMENT AR 501(C)(3) LINE 11A, I ARKANSAS CHILDREN'S HOSPITAL
 
Yes
 
(4) ARKANSAS CHILDREN'S HOSPITAL AUXILIARY
1 CHILDRENS WAY

LITTLE ROCK,AR72202
71-0606585
FUNDRAISING AR 501(C)(3) LINE 11A, I ARKANSAS CHILDREN'S HOSPITAL
 
 
No






For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



(b)
Primary activity




(c)
Legal
domicile
(state or foreign
country)


(d)
Direct controlling
entity



(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




(g)
Share of end-of-year
assets



(h)
Disproprtionate allocations?




(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?



(k)
Percentage
ownership


Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CHILDREN'S HEALTHCARE SYSTEM INC

1 CHILDRENS WAY
LITTLE ROCK,AR72202
58-6304957
MANAGEMENT SERVICES AR ARKANSAS CHILDREN'S HOSPITAL
 
C 177,648 445,714 50.000 % Yes  












Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1) CHILDREN'S HEALTHCARE SYSTEM INC

A 4,831 FMV
(2) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE

B 3,476,333 FMV
(3) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION

C 21,275,679 FMV
(4) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION

M 4,832,473 COST
(5) CHILDREN'S HEALTHCARE SYSTEM INC

M 189,413 FMV
(6) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION

N 2,364,705 COST
(7) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE

N 1,769,690 COST
(8) ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY INC

N 53,508 FMV
(9) ARKANSAS CHILDREN'S HOSPITAL AUXILIARY

N 303,377 FMV
(10) CHILDREN'S HEALTHCARE SYSTEM INC

O 203,746 COST
(11) ARKANSAS CHILDREN'S HOSPITAL AUXILIARY

O 264,483 COST
(12) ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY INC

O 105,296 COST
(13) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION

O 302,385 COST
(14) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE

O 180,988 COST
(15) CHILDREN'S HEALTHCARE SYSTEM INC

Q 58,765 FMV
(16) ARKANSAS CHILDREN'S HOSPITAL AUXILIARY

Q 63,928 FMV
(17) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE

Q 1,173,489 FMV
(18) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION

Q 459,321 FMV
(19) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE

R 4,103,687 FMV
(20) ARKANSAS CHILDREN'S HOSPITAL RESEARCH INSTITUTE

S 18,865,264 FMV
(21) ARKANSAS CHILDREN'S HOSPITAL FOUNDATION

S 3,412,619 FMV
(22) ARKANSAS CHILDREN'S HOSPITAL BUILDING RESEARCH FACILITY INC

S 132,441 FMV
(23) ARKANSAS CHILDREN'S HOSPITAL AUXILIARY

S 1,433,593 FMV
Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income




(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership


Yes No Yes No Yes No






























Schedule R (Form 990) 2014
Schedule R (Form 990) 2014
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2014
Additional Data


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