TY 2017 Form 990

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) TODD SUNTRAPAK...................................................................... CEO	17.50 ................. 32.50	X	X	1,448,458	231,125
(2) DR LINDA FRALEY...................................................................... BOARD MEMBER (TERMED 12/31/2017)	1.00 ................. 1.00	X		0	0
(3) DAVE NALCHAJIAN...................................................................... BOARD SECRETARY/TREASURER/VICE CHAIR	1.00 ................. 1.00	X	X	0	0
(4) RILEY WALTER...................................................................... BOARD MEMBER	1.00 ................. 1.00	X		0	0
(5) MICHAEL HANSON...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(6) BILL SMITTCAMP...................................................................... BOARD CHAIR	1.00 ................. 1.00	X	X	0	0
(7) KIM RUIZ BECK...................................................................... BOARD MEMBER	1.00 ................. 1.00	X		0	0
(8) JEANNINE CAMPOS GRECH...................................................................... BOARD TREASURER/ CHAIR	1.00 ................. 1.00	X	X	0	0
(9) FRED LANINGHAM MD...................................................................... CHIEF OF STAFF (TERMED 2/2018)	1.00 .................	X		75,000	0
(10) ADAM HOLMES...................................................................... CHIEF OF STAFF	1.00 .................	X		0	0
(11) JOSE ELGORRIAGA...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(12) MENDY LAVAL...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(13) ROB YRACEBURU...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(14) ALLISON KARAHADIAN...................................................................... BOARD MEMBER (TERMED 1/2018)	1.00 .................	X		0	0
(15) VICKI BURKHALTER...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(16) SISSY DALENA WOOD...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(17) DEBRA FLORES...................................................................... PRESIDENT & COO	40.00 .................	X	X	149,415	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) MICHELE R WALDRON........................................................................ SENIOR VP, CFO	18.50 .......................31.50	X			760,513	131,999
(19) DAVID CHRISTENSEN........................................................................ SENIOR VP, CPE	27.00 .......................18.00		X		871,294	129,257
(20) BEVERLY HAYDEN-PUGH........................................................................ SENIOR VP, CLINICAL INTEGRATION/CNO	18.00 .......................27.00		X		719,995	119,050
(21) JESSIE HUDGINS........................................................................ VP, FACILITIES	40.00 .......................		X		448,671	121,104
(22) NATALE PONTICELLO JR........................................................................ SENIOR VP, CHIEF PEOPLE OFFICER	29.00 .......................11.00		X		468,794	67,565
(23) JANE WILLSON........................................................................ SENIOR VP, CHIEF STRATEGY OFFICER	8.00 .......................32.00		X		553,768	102,626
(24) DAVID SINGH........................................................................ VP, CHIEF OPERATING OFFICER VCMG	20.00 .......................20.00		X		463,533	68,414
(25) MICHAEL GOLDRING........................................................................ PRESIDENT, VCMG	12.00 .......................28.00		X		627,717	94,711
(26) STEPHANIE VANCE........................................................................ FINANCE, VP	40.00 .......................		X		374,680	85,242
(27) JOEL BROWNELL MD........................................................................ VP, CHIEF MEDICAL INFORMATION OFFICE	40.00 .......................		X		438,755	83,167
(28) KAREN DAHL........................................................................ VP, QUALITY & PATIENT SAFEY	40.00 .......................		X		492,690	78,881
(29) KEVIN SHIMAMOTO........................................................................ VP AND CIO	40.00 .......................		X		455,495	75,519
(30) DANIEL DAVIS........................................................................ VP, PATIENT CARE	40.00 .......................		X		351,517	82,626
(31) DANIELLE BARRY........................................................................ VP, REVENUE CYCLE MGMT	40.00 .......................		X		294,556	65,037
(32) WILLIAM CHALTRAW........................................................................ SENIOR VP/CHIEF LEGAL OFFICER	40.00 .......................		X		465,757	77,675
(33) BRIAN SMULLIN........................................................................ VP MANAGED CARE	40.00 .......................		X		268,617	44,974
(34) DAVID HODGE JR........................................................................ VP ANCILLARY SERVICES	40.00 .......................		X		323,438	50,267
(35) LYNNE ASHBECK........................................................................ SVP, COMMUNITY ENGAGEMENT & POPULATION WELLNESS	40.00 .......................		X		231,690	0
(36) YVONNE WOOD........................................................................ MANAGER PATIENT THROUGHPUT	40.00 .......................			X	237,470	48,367
(37) PAUL LEBBY........................................................................ NEURODEVELOPMENT PROGRAM DIRECTOR	40.00 .......................			X	231,370	33,183
(38) AMY BOLING........................................................................ RN IV CRITICAL CARE	40.00 .......................			X	240,494	45,770
(39) JOLIE LIMON........................................................................ EXECUTIVE DIRECTOR MEDICAL EDUCATION	40.00 .......................			X	304,167	17,677
(40) TRACY BLAIR........................................................................ EXEC DIR/DEP GENERAL COUNSEL	40.00 .......................			X	264,263	21,190

(A) Name and business address	(B) Description of services	(C) Compensation
VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA,CA93636	SUBSPEC PHYSICIAN SERVICES	57,925,000
PEDIATRIC ANETHESIA ASSOCIATES 6235 N FRESNO ST STE 103 FRESNO,CA93710	ANETHESIA/CRITICAL CARE	12,323,668
SODEXO INC & ASSOCIATES PO BOX 360170 PITTSBURGH,PA152516170	HOUSEKEEPING SERVICES	5,375,436
TECH KNOWLEDGE ASSOC 1 CENTERPOINT DR ST 200 LA PALMA,CA906232529	BIOMED EQIPMENT MAINTENANCE	3,825,381
ZUMWALT CONSTRUCTION INC 5520 E LAMONA AVE FRESNO,CA93727	CONSTRUCTION SERVICES	3,754,161
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 98

- TIN:

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.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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

Gross receipts from related activities, etc. (see instructions) ..................

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

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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.)..

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

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

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.

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).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

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.

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.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

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.

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.

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).

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?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) 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.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

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.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) 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.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

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

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

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

A family member of a person described in (a) above?

11b

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

Section B. Type I Supporting Organizations

Yes

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.

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.

Section C. Type II Supporting Organizations

Yes

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).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

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).

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.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

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.

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.

Parent of Supported Organizations. Answer (a) and (b) below.

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.

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.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). 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

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) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2019 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-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

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) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization VALLEY CHILDREN'S HOSPITAL

Part I Contributors	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
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization VALLEY CHILDREN'S HOSPITAL		Employer identification number 94-1294954

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization VALLEY CHILDREN'S HOSPITAL			Employer identification number 94-1294954
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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on 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

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Yes

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

7,910

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

1,526,465

Total. Add lines 1c through 1i ....................................................................................................

1,534,375

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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	VALLEY CHILDREN'S HOSPITAL HAS HAD DIRECT CONTACT WITH AND HAS ENCOURAGED OTHERS TO HAVE DIRECT CONTACT WITH LOCAL, STATE AND FEDERAL LEGISLATORS REGARDING CHILDREN'S HEALTH CARE PUBLIC POLICY. THESE CONTACTS HAVE PROVIDED INFORMATION REGARDING THE PROVISION OF HEALTH CARE SERVICES TO CHILDREN, THE ANTICIPATED EFFECT ON CHILDREN'S HEALTH OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING CURRENT STATE AND FEDERAL FUNDING LEVELS FOR MEDI-CAL AND OTHER PUBLIC PROGRAMS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. VALLEY CHILDREN'S HOSPITAL HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $7,910 ASSOCIATION DUES RELATED TO LOBBYING NACH 36,622 NACH CONTRIBUTION 2,900 ASSOCIATION FOR HEALTHCARE RESOURCE PROFESSIONALS 74 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 477 CALIFORNIA CHAMBER OF COMMERCE 115 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 1,437,725 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 20,661 CHILDREN'S SPECIALTY CARE COALITION 4,810 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIF. 22,961 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $1,534,375

Return Reference

Explanation

PART II-B, LINE 1

VALLEY CHILDREN'S HOSPITAL HAS HAD DIRECT CONTACT WITH AND HAS ENCOURAGED OTHERS TO HAVE DIRECT CONTACT WITH LOCAL, STATE AND FEDERAL LEGISLATORS REGARDING CHILDREN'S HEALTH CARE PUBLIC POLICY. THESE CONTACTS HAVE PROVIDED INFORMATION REGARDING THE PROVISION OF HEALTH CARE SERVICES TO CHILDREN, THE ANTICIPATED EFFECT ON CHILDREN'S HEALTH OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING CURRENT STATE AND FEDERAL FUNDING LEVELS FOR MEDI-CAL AND OTHER PUBLIC PROGRAMS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. VALLEY CHILDREN'S HOSPITAL HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $7,910 ASSOCIATION DUES RELATED TO LOBBYING NACH 36,622 NACH CONTRIBUTION 2,900 ASSOCIATION FOR HEALTHCARE RESOURCE PROFESSIONALS 74 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 477 CALIFORNIA CHAMBER OF COMMERCE 115 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 1,437,725 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 20,661 CHILDREN'S SPECIALTY CARE COALITION 4,810 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIF. 22,961 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $1,534,375

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on 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 ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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 on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

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" on 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 .....	14,953,094		14,953,094
b	Buildings ....	305,310,536	111,260,933	194,049,603
c	Leasehold improvements	3,881,003	3,028,547	852,456
d	Equipment ....	199,982,975	142,487,704	57,495,271
e	Other .....	25,965,668	22,638,074	3,327,594
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				270,678,018

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on 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........
(3) Other (A) LIMITED PARTNERSHIPS	229,737,617	F
(B) HEDGE FUNDS	66,574,098	F
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	296,311,715

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)DISPROPORTIONATE SHARE FUNDS RECEIVABLE				8,267,286
(2)INSURANCE RECEIVABLE				8,045,954
(3)PROVIDER FEE RECEIVABLE				35,005,031
(4)457 TRUST FUNDS				3,095,143
(5)OTHER				11,314,804
(6)ADVANCE MED FOUNDATION				20,194,280
(7)PREPAID LEASE ASSET				2,440,603
(8)PROPOSITION 3 AND PROPOSITION 61 RECEIVABLE				23,859,167
(9)SPLIT DOLLAR POLICIES				24,517,006
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				136,739,274

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	313,604,713
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on 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' on 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

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization
VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS	41,334,949
	EUROPE (INCLUDING ICELAND & GREENLAND)	0	0	INVESTMENTS	10,160,147















3a	Sub-total ....	0	0		51,495,096
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		51,495,096

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019

Schedule F (Form 990) 2019

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2019

Schedule F (Form 990) 2019Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2019

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2019

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.

ReturnReference	Explanation

Schedule F (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other %

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

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.

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"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	241,142		241,142	0.040 %
b	Medicaid (from Worksheet 3, column a) . . . . .	445,163,394	409,380,017	35,783,377	5.700 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	60,145	13,921	46,224	0.010 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	445,464,681	409,393,938	36,070,743	5.750 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,463,146		1,463,146	0.230 %
f	Health professions education (from Worksheet 5) . . .	9,039,178	929,724	8,109,454	1.290 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	957,572	318,001	639,571	0.100 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	34,334,162		34,334,162	5.470 %
j	Total. Other Benefits . .	45,794,058	1,247,725	44,546,333	7.090 %
k	Total. Add lines 7d and 7j .	491,258,739	410,641,663	80,617,076	12.840 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

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
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,383,191

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

208,345

Enter Medicare allowable costs of care relating to payments on line 5.....

385,307

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-176,962

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

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) 2019

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?2Name, 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)				Facility reporting group
1	VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA,CA936368761 WWW.VALLEYCHILDRENS.ORG 040000160	X	X	A
2	VALLEY CHILDREN'S HOME CARE 7555 N DEL MAR AVE FRESNO,CA93711 WWW.VALLEYCHILDRENS.ORG 040000160	X		A

Schedule H (Form 990) 2019

Page 4

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)

	FACILITY REPORTING GROUP - A
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):

Yes

Community Health Needs Assessment

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?........................

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...............

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......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 16

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 .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

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. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.VALLEYCHILDRENS.ORG

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

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. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 16

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): WWW.VALLEYCHILDRENS.ORG

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

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

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on 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) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000%
and FPG family income limit for eligibility for discounted care of 350.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

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):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

WWW.VALLEYCHILDRENS.ORG

The FAP application form was widely available on a website (list url):

WWW.VALLEYCHILDRENS.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.VALLEYCHILDRENS.ORG

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized 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?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	FACILITY REPORTING GROUP - A
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: VALLEY CHILDREN'S HOSPITAL, - FACILITY 2: VALLEY CHILDREN'S HOME CARE
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 5:	IN ORDER TO CONDUCT THE REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FOR FRESNO, KINGS, MADERA AND TULARE COUNTIES, HOSPITAL LEADERS FROM EACH COUNTY, INCLUDING VALLEY CHILDREN'S HOSPITAL, ENGAGED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA TO FORM THE HOSPITAL COUNCIL COMMUNITY BENEFIT WORKGROUP. THIS WORKGROUP REPRESENTS 15 HOSPITALS THROUGHOUT THE FOUR COUNTIES. UNDER THEIR DIRECTION, CONSULTANTS REVIEWED THE SECONDARY DATA IN THE REGION IN ORDER TO BEGIN LOOKING FOR EVIDENCE OF HEALTH NEEDS, TO DESIGN A COMMUNITY ENGAGEMENT PROCESS TO SOLICIT FEEDBACK ON THESE NEEDS, AND TO CREATE A PROCESS TO PRIORITIZE THESE NEEDS BASED ON COMMUNITY INPUT. CONSULTANTS FROM LEAP SOLUTIONS REVIEWED THREE SOURCES TO DETERMINE WHAT THE MOST COMMON HEALTH NEEDS ARE FOR CONSIDERATION IN A CHNA. INCLUDED IN THE REVIEW WERE METRICS OR INDICATORS IDENTIFIED BY THE CENTER FOR DISEASE CONTROL (CDC) AND METRICS USED BY HEALTHY PEOPLE 2020 INITIATIVE, A COLLABORATION OF THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES AND OTHER FEDERAL AGENCIES AND RESEARCH INSTITUTIONS. CONSULTANTS ALSO REVIEWED THE LIST OF THE MOST COMMONLY IDENTIFIED HEALTH NEEDS ACROSS KAISER PERMANENTE'S CHNA DATA PLATFORM (WWW.CHNA.ORG). AFTER REVIEWING ALL THE LISTS, THE CONSULTANTS FOUND THAT THE 15 POTENTIAL HEALTH NEEDS IDENTIFIED BY THE CHNA DATA PLATFORM ALIGN WELL WITH THOSE DEFINED BY THE CDC AND THOSE USED BY THE HEALTHY PEOPLE 2020 INITIATIVE. THEY WERE ADOPTED FOR USE IN THIS CHNA TO GUIDE THE PRIMARY AND SECONDARY DATA COLLECTION. THESE HEALTH NEEDS ARE: - ACCESS TO CARE - BREATHING PROBLEMS (ASTHMA) - CANCERS - CLIMATE AND HEALTH - CARDIOVASCULAR DISEASE/STROKE (HEART DISEASE) - DIABETES - ECONOMIC SECURITY - HIV/AIDS/STDS - MATERNAL, INFANT AND CHILD HEALTH - MENTAL HEALTH - OBESITY - ORAL HEALTH - OVERALL HEALTH - SUBSTANCE ABUSE - VIOLENCE/INJURY PREVENTIONTHE NEXT STEP IN THE CHNA PROCESS REQUIRED ENGAGING THE COMMUNITY TO SOLICIT THEIR PERCEPTIONS OF THE MOST PRESSING HEALTH NEEDS IN THE COMMUNITY. THIS EFFORT INCLUDED CHNA SURVEYS, FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS WITH PUBLIC HEALTH DIRECTORS, HOSPITAL CEOS AND NONPROFIT ORGANIZATION LEADERS SERVING UNIQUE SEGMENTS OF THE COMMUNITY (I.E. THE DISABLED, POOR, OR UNIQUE ETHNIC GROUPS). THESE THREE METHODOLOGIES WERE USED IN ORDER TO REACH COMMUNITY MEMBERS WHO MIGHT BE MORE COMFORTABLE SHARING THEIR PERSPECTIVES ON AN INDIVIDUAL SURVEY VERSUS ATTENDING A FOCUS GROUP. IN ORDER TO LEVERAGE THE OPPORTUNITY TO USE A CONSISTENT SET OF QUESTIONS ACROSS ALL FOUR COUNTIES, THE WORKGROUP SELECTED A CHNA SURVEY DESIGNED BY THE HEALTHY MADERA COALITION WITH THE COUNTY PUBLIC HEALTH DEPARTMENT STAFF. THIRTY-SIX QUESTIONS CENTERED ON KEY HEALTH CONCERNS AND FACTORS THAT INFLUENCE THE HEALTH OF THE COMMUNITY AND INCLUDED DEMOGRAPHIC. THE CHNA SURVEY FOCUSED ON: - COMMUNITY HEALTH NEEDS, - ENVIRONMENTAL FACTORS THAT INFLUENCE THE HEALTH OF THE COMMUNITY, - BEHAVIORS THAT IMPACT HEALTH - BARRIERS TO GETTING HEALTH CARE IN THEIR COUNTY - INDICATORS OF A HEALTHY COMMUNITY, AND - FACTORS IN THEIR COMMUNITIES NEEDING MOST IMPROVEMENT. THE SURVEY WAS PROVIDED THROUGH SURVEY MONKEY, AN ONLINE WEB PLATFORM, IN BOTH SPANISH AND ENGLISH AND CORRESPONDING WEBSITE LINKS WERE EMAILED TO HOSPITAL AND FACILITY STAFF AS WELL AS COMMUNITY MEMBERS. THE SURVEY LINK WAS CONFIGURED TO ALLOW FOR CONFIDENTIALITY OF RESPONSES AND THE SURVEY WAS AVAILABLE FROM JULY 1, 2015 TO DECEMBER 2, 2015. TWO COMMUNITY ORGANIZATIONS WERE CONTRACTED TO ASSIST WITH THE COMMUNITY OUTREACH EFFORTS. THESE WERE: FRESNO METRO MINISTRYA NONPROFIT ESTABLISHED IN 1970 WITH A MISSION TO ADVOCATE FOR THE HEALTH AND WELL-BEING OF THE COMMUNITY AND CENTRO LA FAMILIA ADVOCACY SERVICESA NONPROFIT WORKING TO EMPOWER LOW INCOME PEOPLE TO ACCESS LIFE SUSTAINING RESOURCES THROUGH EDUCATION, TRAINING AND SOCIAL SERVICES. IN ADDITION, THE MADERA COUNTY DEPARTMENT OF PUBLIC HEALTH AND CAMARENA HEALTH, A FEDERALLY QUALIFIED HEALTH CENTER, ASSISTED WITH THE OUTREACH EFFORTS IN THEIR OWN COUNTY AND PROVIDED THE COMMUNITY SURVEY USED FOR THIS CHNA. FOCUS GROUPSA TOTAL OF 15 FOCUS GROUPS WERE CONDUCTED RANGING IN SIZE FROM 4 TO 24 PARTICIPANTS. THE FOCUS GROUPS WERE ATTENDED BY HOSPITAL AND FACILITY STAFF, COMMUNITY LEADERS FROM NONPROFIT AND FAITH-BASED ORGANIZATION AND ELECTED OFFICIALS AND RESIDENTS. THESE SESSIONS WERE CONDUCTED PRIMARILY IN ENGLISH. OTHER FOCUS GROUPS WERE COMPRISED OF PRIMARILY RESIDENTS, INCLUDING MOTHERS AND YOUTH, AND WERE CONDUCTED IN ENGLISH AND SPANISH. CHILDCARE WAS PROVIDED AT TWO OF THE FOCUS GROUPS. ALL OF THE FOCUS GROUPS FOLLOWED THE SAME FORMAT AND AGENDA: - AN INTRODUCTION AND OVERVIEW OF THE CHNA PROCESS AND PURPOSE- A REVIEW OF EIGHT KEY HEALTH INDICATORS TO UNDERSTAND HOW THE COUNTIES RANKED IN COMPARISON WITH CALIFORNIA AND THE UNITED STATES- A REVIEW OF HOW OTHER RESIDENTS AND HEALTH CARE WORKERS RESPONDED TO THE CHNA SURVEY AND WHETHER THOSE ATTENDING AGREE OR DISAGREE WITH MOST COMMON RESPONSES TO THE ABOVE-MENTIONED FIVE KEY QUESTIONS (Q11, Q12, Q13, Q14 AND Q16- A LARGE GROUP DISCUSSION WAS FACILITATED ON THREE ADDITIONAL QUESTIONS THAT WERE USED TO SEEK THE GROUP'S CONSENSUS ON: WHAT ARE SOME KEY SERVICES YOU BELIEVE WOULD HELP ADDRESS THESE CHALLENGES FROM THE FOLLOWING OPTIONS: 1. MORE COMMUNITY CLINICS/AMBULATORY CENTERS 2. MORE REGIONAL INITIATIVES ON COMMUNITY HEALTH 3. ENGAGING NONPROFITS IN COORDINATED CARE 4. USING COMMUNITY ADVISORY COUNCILS 5. MORE PATIENT SUPPORT GROUPS 6. MORE HEALTH EDUCATION FAIRS/ EVENTS 7. MORE UPSTREAM HEALTH INTERVENTIONS 8. OTHER: WHAT ONE EFFORT WOULD MAKE THE GREATEST IMPACT ON HEALTH OUTCOMES IN YOUR COMMUNITY FROM THE FOLLOWING OPTIONS: 1. MORE DISEASE PREVENTION EFFORTS 2. MORE COORDINATED CARE PROGRAMS/SERVICES 3. MORE UPSTREAM HEALTH INITIATIVES 4. BETTER COMMUNITY INFRASTRUCTURE TO SUPPORT HEALTHY LIVING 5. IMPROVED HEALTH EDUCATION 6. IMPROVED ENVIRONMENTAL CONDITIONS 7. IMPROVED ECONOMIC CONDITIONS 8. OTHER ARE YOU AWARE OF ANY NEW PROGRAMS OR SERVICES THAT WERE CREATED IN THE LAST THREE YEARS THAT HAVE THE POTENTIAL TO ADDRESS YOUR COMMUNITY'S HEALTH NEEDS?IN ORDER TO KEEP EACH OF THE FOCUS GROUPS TO A 60-MINUTE FORMAT, IT WAS NECESSARY TO CHOOSE AMONG A SIGNIFICANT AMOUNT OF SECONDARY DATA TO SHARE WITH PARTICIPANTS. THE CONSULTANTS SELECTED HEALTH INDICATORS DIRECTLY LINKED TO THE RESULTS OF THE 2013 HOSPITAL COUNCIL REGIONAL CHNA REPORT PRODUCED FOR THE SAME FOUR COUNTIES. THIS ALLOWED THE FOCUS GROUP PARTICIPANTS TO CONTINUE DISCUSSING ASTHMA, OBESITY, ACCESS TO CARE, MENTAL HEALTH AND SOCIOECONOMIC FACTORS THAT WERE CONCERNS RAISED IN 2013 CHNA.KEY STAKEHOLDER INTERVIEWSTHE WORKGROUP IDENTIFIED APPROXIMATELY 95 KEY STAKEHOLDERS IN THE REGION WHO WOULD BE IMPORTANT TO INTERVIEW. CONSULTANTS CONTACTED EACH STAKEHOLDER OFFERING TO CONDUCT PHONE OR IN-PERSON INTERVIEWS. PARTICIPANTS IN THIS EFFORT INCLUDED: COUNTY PUBLIC HEALTH DIRECTORS, HOSPITAL EXECUTIVES AND NONPROFIT LEADERS WHO SERVE THE COMMUNITY WITH SOCIAL, HEALTH, OR EDUCATIONAL SUPPORT SERVICES. THESE KEY STAKEHOLDERS WERE SELECTED AS THEY COULD PROVIDE A UNIQUE PERSPECTIVE ON THE HEALTH OF THE COMMUNITY, HEALTH CARE DELIVERY SYSTEMS AND OVERALL CONDITIONS THAT INFLUENCE HEALTH BEHAVIORS. IN ADDITION, THE CHNA COMMUNITY OUTREACH ALSO INVOLVED THE TULE RIVER NATION ELDERS AND TRIBAL COUNCIL MEMBERS IN TULARE COUNTY. EACH STAKEHOLDER WAS GIVEN THE OPPORTUNITY TO REVIEW THE KEY HEALTH INDICATORS FOR THEIR COUNTY AND THEN WAS ASKED TO RANK RESPONSES TO THE FIVE KEY QUESTIONS REVIEWED BY THE FOCUS GROUPS.IDENTIFYING HEALTH NEEDSIN ORDER TO IDENTIFY THE HEALTH NEEDS IN THIS CHNA REPORT, THE WORKGROUP AND HEALTH OFFICERS FROM EACH COUNTY'S DEPARTMENT OF PUBLIC HEALTH MET NOVEMBER 12, 2015 TO REVIEW THE SURVEY DATA AND A SUMMARY OF SECONDARY DATA ON THE HEALTH NEEDS FOR ALL FOUR COUNTIES.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	- ADVENTIST HEALTH CENTRAL - HANFORD- ADVENTIST HEALTH CENTRAL - REEDLEY- ADVENTIST HEALTH CENTRAL - SELMA- COMMUNITY REGIONAL MEDICAL CENTER FRESNO- CLOVIS COMMUNITY MEDICAL CENTER- COALINGA REGIONAL MEDICAL CENTER- KAISER PERMANENTE FRESNO REGION - KAWEAH DELTA HEALTH CARE DISTRICT - MADERA COMMUNITY HOSPITAL - SAINT AGNES MEDICAL CENTER - SAN JOAQUIN VALLEY REHABILITATION HOSPITAL- SIERRA VIEW DISTRICT HOSPITAL- TULARE REGIONAL MEDICAL CENTER
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:	- HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA- MADERA COUNTY PUBLIC HEALTH DEPARTMENT- CENTRO LA FAMILIA- FRESNO METRO MINISTRY
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 13B:	200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES. FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.351% AND GREATER THAN FPG - PROMPT PAY DISCOUNT 25% DISCOUNT FROM CHARGES FOR PATIENTS WHO PAY THEIR BALANCE IN FULL WITHIN 30 DAYS.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16J:	ADDITIONALLY THE POLICY IS SENT BY US POSTAL SERVICE TO COMMUNITY AGENCIES TO BE DISTRIBUTED.IN CONNECTION WITH A REVIEW IN JULY 2018 OF COMPLIANCE BY VALLEY CHILDREN'S HOSPITAL (THE ORGANIZATION") WITH THE FINAL REGULATIONS UNDER 501(R) OF THE CODE (THE "JULY 2018 REVIEW"), TWO COMPLIANCE ITEMS WERE IDENTIFIED AND CORRECTED AS PROMPTLY AFTER DISCOVERY AS WAS REASONABLE: A. ADOPTION OF THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY ("FAP") AND EMERGENCY MEDICAL CARE POLICY (TOGETHER WITH THE FAP, THE "POLICIES, AND EACH A "POLICY") PURSUANT TO TREAS. REG. 1.501(R)-4(D)(1). 1. ISSUE: THE BOARD OF TRUSTEES (THE "BOARD"), AN AUTHORIZED BODY OF THE HOSPITAL FACILITY (AS DEFINED IN TREAS. REG. 1.501(R)-1(B)(4)), ADOPTED THE FAP ON AUGUST 14, 1991. THE BOARD ADOPTED THE EMERGENCY MEDICAL CARE POLICY IN MAY 1999. EACH POLICY WAS PERIODICALLY UPDATED, INCLUDING IN RESPONSE TO THE REGULATIONS UNDER 501(R) OF THE CODE. EACH AMENDED POLICY WAS APPROVED BY THE CHIEF EXECUTIVE OFFICER ("CEO") OF THE ORGANIZATION, BASED ON THE ORGANIZATION'S UNDERSTANDING THAT THE BOARD HAD DELEGATED TO THE CEO THE AUTHORITY TO APPROVE UPDATED VERSIONS OF EACH POLICY. THE CEO IS PERMITTED UNDER STATE LAW TO ACT ON BEHALF OF THE BOARD. DURING THE JULY 2018 REVIEW, THE ORGANIZATION WAS NOT ABLE TO LOCATE A RECORD OF DELEGATION OF AUTHORITY BY THE BOARD TO THE CEO TO ADOPT REVISED VERSIONS OF THE POLICIES. NO PERSONS WERE AFFECTED BY SUCH ERROR, WHICH WAS DUE TO ADMINISTRATIVE OVERSIGHT. 2. CORRECTION: ON NOVEMBER 18, 2018, THE BOARD (I) ADOPTED THE CURRENT, REVISED VERSION OF EACH POLICY, AND (II) DELEGATED AUTHORITY TO THE CEO TO ADOPT FUTURE REVISIONS TO EITHER POLICY. 3. PRACTICES/PROCEDURES: AS DESCRIBED ABOVE, THE ORGANIZATION UPDATED ITS PRACTICES AND PROCEDURES BY DOCUMENTING THE DELEGATION OF AUTHORITY BY THE BOARD TO THE CEO TO ADOPT REVISED VERSIONS OF THE POLICIES.B. STATEMENTS REQUIRED TO BE INCLUDED IN THE FAP PURSUANT TO TREAS. REG. 1.501(R)-4(B). 1. ISSUE: DURING THE JULY 2018 REVIEW, THE ORGANIZATION IDENTIFIED CERTAIN ASPECTS OF ITS FAP WHICH COULD BE UPDATED IN ORDER TO MORE CLEARLY COMPLY WITH THE REGULATIONS UNDER 501(R) OF THE CODE. IN PARTICULAR, THE FAP: A) IMPLIED BUT DID NOT EXPRESSLY STATE IN THE "LOW INCOME DISCOUNT" SECTION OF THE FAP THAT A FAP-ELIGIBLE INDIVIDUAL MAY NOT BE CHARGED MORE THAN AMOUNTS GENERALLY BILLED FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE (SEE TREAS. REG. 1.501(R)-1(B)(24)(VII)); B) INDICATED THAT CERTAIN PROVIDERS DELIVERING EMERGENCY OR OTHER MEDICALLY NECESSARY CARE IN THE HOSPITAL FACILITY WERE NOT REQUIRED TO FOLLOW THE FAP BUT DID NOT INCLUDE AN ITEMIZED LIST OF SUCH PROVIDERS AS INDICATED IN IRS NOTICE 2015-46 (SEE TREAS. REG. 1.501(R)-4(B)(1)(III)(F)); AND C) DISCLOSED THE OFFICE, DEPARTMENT, COMMITTEE OR OTHER BODY WHICH WAS GENERALLY IN CHARGE OF MANAGING THE DECISIONS RELATING TO THE FAP BUT DID NOT EXPRESSLY STATE THAT SUCH OFFICE, DEPARTMENT, COMMITTEE OR OTHER BODY HAD FINAL AUTHORITY OR RESPONSIBILITY FOR DETERMINING THAT THE ORGANIZATION HAS MADE REASONABLE EFFORTS TO DETERMINE WHETHER AN INDIVIDUAL IS FAP-ELIGIBLE AND MAY THEREFORE ENGAGE IN AN EXTRAORDINARY COLLECTION ACTION AGAINST THE INDIVIDUAL (SEE TREAS. REG. 1.501(R)-4(B)(4)(I)(C)). THE ORGANIZATION IS NOT AWARE OF ANY PERSONS AFFECTED BY THESE POINTS REQUIRING ADDITIONAL CLARIFICATION. 2. CORRECTION: PROMPTLY UPON LEARNING OF THE OMISSIONS DESCRIBED ABOVE, THE ORGANIZATION REVISED ITS FAP TO PROVIDE FURTHER CLARIFICATION WITH RESPECT TO EACH OF THESE POINTS. AS DESCRIBED ABOVE, THE BOARD APPROVED THE REVISED FAP ON NOVEMBER 18, 2018. 3. PRACTICES/PROCEDURES: AS THE JULY 2018 REVIEW FACILITATED THE PROMPT IDENTIFICATION AND CORRECTION OF THE OMISSIONS DESCRIBED ABOVE, NO FURTHER CHANGES WERE NECESSARY TO THE ORGANIZATION'S PRACTICES OR PROCEDURES. TO ENSURE CONTINUED COMPLIANCE, THE ORGANIZATION WILL PERIODICALLY REVIEW THE FAP TO ENSURE THAT IT IS COMPLIANT WITH 501(R) OF THE CODE AND THE REGULATIONS THEREUNDER.C. WIDELY PUBLICIZING THE FAP PURSUANT TO TREAS. REG. 1.501(R)-4(B)(II). 1. ISSUE: DURING THE JULY 2018 REVIEW, THE ORGANIZATION BECAME AWARE THAT THE PLAIN LANGUAGE SUMMARY OF THE FAP APPLICABLE TO EACH HOSPITAL FACILITY INCLUDED THE GENERAL WEBSITE ADDRESS FOR THE HOSPITAL RATHER THAN THE DIRECT WEBSITE ADDRESS WHERE AN INDIVIDUAL CAN OBTAIN COPIES OF THE FAP AND FAP APPLICATION FORM (SEE TREASURY REGULATION 1.501(R)-1(B)(24)(III)). 2. CORRECTION: PROMPTLY UPON LEARNING OF THE ISSUE DESCRIBED ABOVE, THE ORGANIZATION REVISED ITS PLAIN LANGUAGE SUMMARY OF THE FAP TO INCLUDE THE DIRECT WEBSITE ADDRESS WHERE AN INDIVIDUAL CAN OBTAIN COPIES OF THE FAP AND FAP APPLICATION FORM. 3. PRACTICES/PROCEDURES: AS THE JULY 2018 REVIEW FACILITATED THE PROMPT IDENTIFICATION AND CORRECTION OF THE ISSUE DESCRIBED ABOVE, NO FURTHER CHANGES WERE NECESSARY TO THE ORGANIZATION'S PRACTICES OR PROCEDURES. TO ENSURE CONTINUED COMPLIANCE, THE ORGANIZATION WILL PERIODICALLY REVIEW THE PLAIN LANGUAGE SUMMARY OF THE FAP TO ENSURE THAT IT IS COMPLIANT WITH 501(R) OF THE CODE AND THE REGULATIONS THEREUNDER.

Schedule H (Form 990) 2019

Page 9

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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

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 7:	CHARITY CARE AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE DECISION SUPPORT SYSTEM WAS USED TO CALCULATE COST-TO-CHARGE FOR DETERMINING UNREIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THIS DECISION SUPPORT SYSTEM ADDRESSES ALL PATIENT SEGMENTS (I.E INPATIENT, OUTPATIENT, ETC.).
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 7,072,241.
PART III, LINE 4:	FOOTNOTE DESCRIBING BAD DEBT EXPENSE: SEE PAGE 14, NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS.COSTING METHODOLOGY:ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND REVIEW OF LARGE BALANCE SELF-PAY ACCOUNTS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBT IF SUBSEQUENTLY COLLECTED. THE COST OF BAD DEBT WRITE-OFFS WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF.
PART III, LINE 8:	MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2018 MEDICARE COST REPORT. MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE SERVICES. ADDITIONALLY, THE MAJORITY OF THE HOSPITAL'S MEDICARE PATIENTS WOULD BE COVERED BY MEDI CAL IF THEY DID NOT FALL UNDER THE MEDICARE COVERAGE OPTION.
PART III, LINE 9B:	COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE; INSURANCE COLLECTION ATTEMPTS CONTINUE AS APPROPRIATE.
PART VI, LINE 2:	COMMUNITY HEALTH NEEDS ASSESSMENT: VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CONSISTENT WITH STATE AND FEDERAL LAW, VALLEY CHILDREN'S HOSPITAL COMPLETES A FORMAL CHNA AT LEAST ONCE EVERY THREE YEARS. VALLEY CHILDREN'S HOSPITAL'S 2018 COMMUNITY BENEFITS PROGRAM IS BUILT UPON THE OUTCOMES OF A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDED THE FOLLOWING ACTIVITIES:JOINT NEEDS ASSESSMENT -VALLEY CHILDREN'S HOSPITAL PARTNERED WITH HOSPITALS IN A FOUR-COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. COUNTIES COVERED INCLUDED MADERA, KINGS, FRESNO, AND TULARE. THROUGH THEIR REGIONAL HOSPITAL ASSOCIATION, THE HOSPITALS CONTRACTED JOINTLY WITH LEAP SOLUTIONS TO FACILITATE THE CHNA, WHICH WAS CONDUCTED BETWEEN OCTOBER 2015 AND FEBRUARY 2016 AND PUBLISHED IN MARCH 2016. LEAP SOLUTIONS, LLC FOLLOWED SEVERAL STEPS TO ENSURE THAT THE HOSPITALS WOULD HAVE ADEQUATE INFORMATION FROM WHICH TO IDENTIFY POSSIBLE ACTIONS. FIRST, IT WAS IMPORTANT TO REVIEW THE WORK THAT HAD BEEN DONE IN THE PAST AND IDENTIFY OPPORTUNITIES FOR IMPROVEMENT. SECOND, IT WAS ESSENTIAL TO AGREE UPON THE DATA TO BE USED FOR THE REPORT IN ORDER TO APPLY A CONSISTENT SET OF KEY SOCIAL DETERMINANTS OF HEALTH IN EACH OF THE FOUR COUNTIES. SUPPLEMENTAL ASSESSMENT ACTIVITY - IN ADDITION TO THE LEAP SOLUTIONS' FACILITATED ASSESSMENT, VALLEY CHILDREN'S HOSPITAL STAFF ACCESSED OTHER RESOURCES TO FURTHER ASSESS CHILDREN'S HEALTH CARE NEEDS THROUGHOUT THE HOSPITAL'S ENTIRE SERVICE AREA. RESOURCES INCLUDED DATA SOURCES AS WELL AS CONVERSATIONS WITH LOCAL HEALTH CARE PROVIDERS AND ADVOCATES. DATA SOURCES INCLUDED KIDSDATA.ORG, THE CALIFORNIA HEALTH INTERVIEW SURVEY DATA, THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH'S PEDIATRIC NUTRITION SURVEILLANCE DATA, AND THE CALIFORNIA CHILD WELFARE INDICATORS PROJECT AT THE UNIVERSITY OF CALIFORNIA AT BERKELEY. LOCAL PROVIDERS AND ADVOCATES CONSULTED INCLUDED FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, THE CENTRAL CALIFORNIA CHILDREN'S INSTITUTE AND THE CENTRAL VALLEY HEALTH POLICY INSTITUTE.VALLEY CHILDREN'S HOSPITAL STAFF ALSO REMAINED ACTIVELY ENGAGED IN A NUMBER OF COMMUNITY-BASED ORGANIZATIONS AND INITIATIVES IN 2018. THIS CONTINUOUS ENGAGEMENT KEPT THE HOSPITAL CLOSE TO THE ISSUES MOST IMPACTING THE HEALTH AND WELLBEING OF CHILDREN IN ITS SERVICE AREA AND ALLOWED THE HOSPITAL TO MAKE ADJUSTMENTS TO ITS COMMUNITY BENEFITS PROGRAM ACTIVITIES AS APPROPRIATE.
PART VI, LINE 4:	COMMUNITY INFORMATION: AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, VALLEY CHILDREN'S HOSPITAL'S PRIMARY SERVICE AREA EXTENDS FROM SACRAMENTO IN THE NORTH TO KERN COUNTY IN THE SOUTH, AND PICKS UP MUCH OF THE CENTRAL COAST AND EASTERN SIERRA AS WELL. THE SERVICE AREA INCLUDES 11 COUNTIES AND IS HOME TO OVER 1.4 MILLION CHILDREN AGES 0-20. IN 2018, VALLEY CHILDREN'S HOSPITAL HAD 12,040 INPATIENT CASES, 114,452 EMERGENCY DEPARTMENT VISITS AND A COMBINED 297,563 OUTPATIENT CENTER, REGIONAL SPECIALTY CARE CENTER AND DAY SURGERY VISITS. MEDI-CAL BENEFITS COVERED 76% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 76% OF THE OUTPATIENT VISITS AT VALLEY CHILDREN'S HOSPITAL. ALMOST TWO-THIRDS OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 4 YEARS OF AGE OR YOUNGER AND OVER 75% WERE AN ETHNICITY OTHER THAN CAUCASIAN.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTH: VALLEY CHILDREN'S HOSPITAL PARTNERS WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING THE FOLLOWING. CHILD ABUSE PREVENTION - PREVENTING AND PROTECTING CHILDREN FROM ABUSE AND NEGLECT FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH A NUMBER OF PRIVATE AND PUBLIC AGENCIES, THE PROGRAM PROVIDED EDUCATION, LEADERSHIP, AND DIRECT SERVICES FOR CHILDREN WHO WERE VICTIMS OF ABUSE AND TO PARENTS AND COMMUNITY-BASED ORGANIZATIONS TO HELP PREVENT ABUSE.CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN - VALLEY CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. TO HELP ENSURE THESE CHILDREN RECEIVE MEDICALLY APPROPRIATE CARE AT SCHOOL, VALLEY CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, VALLEY CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. VALLEY CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO REFERRING HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. IN FY2018, VALLEY CHILDREN'S PROVIDED CONTINUING MEDICAL EDUCATION TO MORE THAN 500 COMMUNITY-BASE PRIMARY CARE PHYSICIANS. PEDIATRIC SUBSPECIALTY PHYSICIANS FROM VALLEY CHILDREN'S SERVED AS FEATURED FACULTY, PROVIDING COMMUNITY-BASED PHYSICIANS WITH GUIDANCE ON A VARIETY OF PEDIATRIC MEDICAL CONDITIONS INCLUDING CHRONIC DIARRHEA, CONCUSSION MANAGEMENT, CONSTIPATION IN CHILDREN, DIABETIC KETOACIDOSIS MANAGEMENT, GROWTH AND PUBERTY DISORDERS, EVALUATION AND DIAGNOSIS OF MALABSORPTION AND MALDIGESTION DISORDERS, IMAGING OF SPORTS INJURIES, INHERITED AND ACQUIRED BONE MARROW FAILURE, NEONATAL ABSTINENCE SYNDROME AND VALLEY FEVER. PROGRAMS WERE PROVIDED AT LOCATIONS THROUGHOUT THE VALLEY CHILDREN'S SERVICE AREA, INCLUDING BAKERSFIELD, HANFORD, MADERA, MERCED, MODESTO, POTERVILLE, REEDLEY AND VISALIA.VALLEY CHILDREN'S PARTICIPATED IN A NUMBER OF INITIATIVES SUPPORTING THE HEALTHY DEVELOPMENT OF CHILDREN BOTH DURING PREGNANCY AND DURING THE FIRST THREE YEARS OF LIFE. EXAMPLES INCLUDE THE FOLLOWING.FRESNO COUNTY PRE-TERM BIRTH INITIATIVE: FRESNO COUNTY HAS ONE OF CALIFORNIA'S HIGHEST RATES OF PREMATURE BIRTH WITH 1 OUT OF EVERY 9 BABIES BORN TOO EARLY. PREMATURE BIRTH CAN CAUSE SERIOUS PHYSICAL AND MENTAL DISABILITIES, OR EVEN DEATH, BEFORE THE BABY'S FIRST BIRTHDAY. OVER A 10-YEAR PERIOD, THE FRESNO COUNTY PRE-TERM BIRTH INITIATIVE IS WORKING TO IMPROVE THE HEALTH OF FRESNO MOTHERS AND REDUCE THE RATE OF PREMATURE BABIES. USING AN APPROACH CALLED COLLECTIVE IMPACT, PARTNERS ACROSS MANY SECTORS HAVE COME TOGETHER TO CREATE CHANGE IN FRESNO COUNTY. VALLEY CHILDREN'S HAS BEEN AN ACTIVE PARTICIPANT IN THIS INITIATIVE, WITH VALLEY CHILDREN'S SENIOR VICE PRESIDENT FOR COMMUNITY ENGAGEMENT AND POPULATION WELLNESS SERVING AS CHAIR OF THE INITIATIVE'S STEERING COMMITTEE. CRADLE TO CAREER: BOTH FRESNO AND STANISLAUS COUNTIES HAVE BEGUN FORMAL CRADLE TO CAREER INITIATIVES FOR THE PURPOSE OF CONVENING PUBLIC AND PRIVATE SECTOR STAKEHOLDERS TO WORK TOGETHER TO IMPROVE OUTCOMES FOR CHILDREN IN THEIR COMMUNITIES, FROM PRE-CONCEPTION TO COLLEGE AND/OR VOCATIONAL TRAINING. VALLEY CHILDREN'S PARTICIPATES IN BOTH INITIATIVES AND HAS BEEN A STRONG VOICE FOR THE INCLUSION OF OUTCOMES AND INDICATORS FOCUSED ON CHILD HEALTH AND WELLNESS. HELP ME GROW FRESNO COUNTY: HELP ME GROW IS A COORDINATED SYSTEM OF EARLY IDENTIFICATION AND REFERRAL FOR CHILDREN AGES 0-5 WHO ARE AT RISK FOR DEVELOPMENTAL DELAYS. IN FY2018, VALLEY CHILDREN'S SUPPORTED THE IMPLEMENTATION OF HELP ME GROW IN ITS PEDIATRIC PRIMARY CARE PRACTICES IN FRESNO COUNTY BY PROMOTING THE USE OF A SPECIFIC DEVELOPMENTAL ASSESSMENT AND SCREENING TOOL THAT IS PART OF THE HELP ME GROW MODEL. MARCH OF DIMES: VALLEY CHILDREN'S PARTNERED CLOSELY WITH THE MARCH OF DIMES TO ADVOCATE ON BEHALF OF POLICIES AT THE STATE AND FEDERAL LEVEL THAT PROMOTE HEALTHY PREGNANCIES AND HEALTHY BABIES. ADDITIONALLY, VALLEY CHILDREN'S DIRECTOR OF COMMUNITY AND GOVERNMENT RELATIONS CHAIRED THE MARCH OF DIMES OF CALIFORNIA'S ADVOCACY AND GOVERNMENT AFFAIRS COMMITTEE IN FY2018. MENTAL HEALTH ISSUES AND CHALLENGES ASSOCIATED WITH CHILD AND ADOLESCENT MENTAL HEALTH CONTINUED TO BE A MAJOR CONCERN IN FY2018. TO HELP IDENTIFY POTENTIAL REGIONAL SOLUTIONS, VALLEY CHILDREN'S SUPPORTED OR PARTICIPATED IN A NUMBER OF ACTIVITIES. VALLEY CHILDREN'S STAFF PROVIDED TEEN SUICIDE PREVENTION EDUCATION TO STUDENTS AND STAFF AT AREA HIGH SCHOOLS. IN ADDITION, VALLEY CHILDREN'S STAFF EITHER LED OR PARTICIPATED IN A NUMBER OF COMMUNITY-BASED COLLABORATIVES FOCUSED ON PREVENTING CHILD MENTAL ILLNESS AND/OR EARLY IDENTIFICATION AND TREATMENT OF CHILD MENTAL ILLNESS. VALLEY CHILDREN'S STAFF CHAIRED AN INITIATIVE CALLED COMMUNITY CONVERSATIONS, A SO-MEMBER COLLABORATIVE ADDRESSING ISSUES OF MENTAL HEALTH, HOMELESSNESS AND THE IMPACT ON FAMILIES. A NUMBER OF VALLEY CHILDREN'S STAFF ALSO SERVED AS MEMBERS OF THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE. INJURY PREVENTION - VALLEY CHILDREN'S OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. IN FY2018, THE PROGRAM RECORDED 15,519 CONTACTS WITH CHILDREN, PARENTS, HEALTHCARE PROFESSIONAL AND OTHERS AT 184 DIFFERENT COMMUNITY, MEDIA AND PROFESSIONAL EVENTS CONCERNING THE FOLLOWING TOPICS: CHILD PASSENGER SAFETY, ABUSIVE HEAD TRAUMA, PEDESTRIAN SAFETY, SAFE SLEEP, TRAUMATIC BRAIN INJURY (HELMET SAFETY), HALLOWEEN SAFETY, POISON PREVENTION, RESPONDING TO A BLEEDING EMERGENCY, DRIVER SAFETY AND AWARENESS (INCLUDING DRUNK/DISTRACTED DRIVING), BABY BASICS, MEDICATION SAFETY, CHOKING PREVENTION, HOME SAFETY, CONCUSSION PREVENTION AND MANAGEMENT, BICYCLE SAFETY, PEDIATRIC TRAUMA, WATER SAFETY AND SUICIDE PREVENTION. THE MISSION OF VALLEY CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND IS AN INDEPENDENT NON PROFIT ORGANIZATION GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES WHICH IS THEREFORE ACCOUNTABLE TO OUR COMMUNITY AND ONLY OUR COMMUNITY.
PART VI, LINE 6:	N/A
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule H (Form 990) 2019

Additional Data

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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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
VALLEY CHILDREN'S HOSPITAL

Employer identification number
94-1294954

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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" on 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	(h) Purpose of grant or assistance
(1) HINDS HOSPICE 2490 W SHAW 101 FRESNO,CA93711	77-0071360	501(C)(3)	7,500	DONATION/SPONSORSHIP
(2) RONALD MCDONALD HOUSE 9161 RANDALL WAY MADERA,CA93736	94-2864490	501(C)(3)	7,500	SPONSORSHIP
(3) BEST BUDDIES INTERNATIONAL INC 100 SE SECOND ST2200 MIAMI,FL33131	52-1614576	501(C)(3)	10,000	DONATION
(4) MARJAREE MASON CENTER INC 1600 M STREET FRESNO,CA93721	94-1156639	501(C)(3)	12,500	SPONSORSHIP
(5) SAN JOAQUIN VALLEY RIVER PARKWAY 11605 OLD FRIANT ROAD FRESNO,CA93730	77-0196692	501(C)(3)	15,000	DONATION
(6) MARCH OF DIMES PO BOX 673667 MARIETTA,GA30006	13-1846366	501(C)(3)	20,000	SPONSORSHIP
(7) CENTRAL VALLEY COMM FOUNDATION 5260 N PALM AVE 122 FRESNO,CA93704	77-0478025	501(C)(3)	22,500	DONATION
(8) AMERICAN HEART ASSOCIATION PO BOX 4002030 DE MOINES,IA50340	13-5613797	501(C)(3)	40,000	SPONSORSHIP
(9) FOUNDATION OF CLOVIS SCHOOLS 1000 S GARFIELD AVE ALHAMBRA,CA91801	95-4457939	501(C)(3)	50,000	DONATION
(10) VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA,CA936368782	46-4150987	501(C)(3)	33,960,095	DONATION
(11) VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA,CA936368782	46-4150987	501(C)(3)	4,244,687	DONATION

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1) NURSING SCHOLARSHIP	8	26,270
(2) EDUCATION SCHOLARSHIP - RESPIRATORY FOCUS	1	797
(3) CAFETERIA MEALS	12033	0	74,003	FMV	MEAL COUPONS FOR PATIENT FAMILIES
(4) TAXI, BUS AND TRANSIT SERVICES	574	0	119,985	BOOK	SUBSIDIZATION OF BUS AND TRANSIT SERVICES
(4)
(5)
(6)
(7)

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:

NURSING SCHOLARSHIPS ARE DESIGNED TO HELP EMPLOYEES MEET FINANCIAL NEEDS THAT ARE NOT COVERED BY OTHER TUITION REIMBURSEMENT PROGRAMS. A SCHOLARSHIP COMMITTEE REVIEWS APPLICATIONS BI-ANNUALLY BASED ON CERTAIN CRITERIA. RECIPIENTS ARE CHOSEN BY THE COMMITTEE AND THE CHIEF NURSING OFFICER APPROVES THE SELECTIONS. ALL RECIPIENTS ARE EMPLOYEES OF THE HOSPITAL AND THE HOSPITAL IS MADE AWARE WHEN THE RECEIPIENT COMPLETES THEIR EDUCATION. OTHER SERVICES ARE PURCHASED FROM VARIOUS VENDORS AND ARE SUPPLIED TO PATIENTS AND THEIR FAMILIES. THE RECORDS FOR THESE PURCHASED SERVICES ARE MAINTAINED BY THE HOSPITAL.

Schedule I (Form 990) 2019

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .........

Yes

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 on Line 1a? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Yes

Any related organization? .......................

Yes

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Yes

Any related organization? ......................

Yes

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

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 on 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 on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1TODD SUNTRAPAK CEO	(i) (ii)	915,510 ------------- 0	289,090 ------------- 0	243,858 ------------- 0	206,725 ------------- 0	24,400 ------------- 0	1,679,583 ------------- 0	183,737 ------------- 0
2MICHELE R WALDRON SENIOR VP, CFO	(i) (ii)	514,873 ------------- 0	121,343 ------------- 0	124,297 ------------- 0	117,359 ------------- 0	14,640 ------------- 0	892,512 ------------- 0	100,758 ------------- 0
3DAVID CHRISTENSEN SENIOR VP, CPE	(i) (ii)	583,059 ------------- 0	138,582 ------------- 0	149,653 ------------- 0	104,857 ------------- 0	24,400 ------------- 0	1,000,551 ------------- 0	126,747 ------------- 0
4BEVERLY HAYDEN-PUGH SENIOR VP, CLINICAL INTEGRATION/CNO	(i) (ii)	419,731 ------------- 0	100,075 ------------- 0	200,189 ------------- 0	109,290 ------------- 0	9,760 ------------- 0	839,045 ------------- 0	177,581 ------------- 0
5JESSIE HUDGINS VP, FACILITIES	(i) (ii)	258,363 ------------- 0	72,951 ------------- 0	117,357 ------------- 0	106,464 ------------- 0	14,640 ------------- 0	569,775 ------------- 0	61,263 ------------- 0
6NATALE PONTICELLO JR SENIOR VP, CHIEF PEOPLE OFFICER	(i) (ii)	299,821 ------------- 0	77,679 ------------- 0	91,294 ------------- 0	67,565 ------------- 0	0 ------------- 0	536,359 ------------- 0	45,341 ------------- 0
7JANE WILLSON SENIOR VP, CHIEF STRATEGY OFFICER	(i) (ii)	347,803 ------------- 0	82,024 ------------- 0	123,941 ------------- 0	97,746 ------------- 0	4,880 ------------- 0	656,394 ------------- 0	82,580 ------------- 0
8DAVID SINGH VP, CHIEF OPERATING OFFICER VCMG	(i) (ii)	308,531 ------------- 0	74,393 ------------- 0	80,609 ------------- 0	68,414 ------------- 0	0 ------------- 0	531,947 ------------- 0	60,246 ------------- 0
9MICHAEL GOLDRING PRESIDENT, VCMG	(i) (ii)	436,800 ------------- 0	106,114 ------------- 0	84,803 ------------- 0	84,951 ------------- 0	9,760 ------------- 0	722,428 ------------- 0	56,800 ------------- 0
10STEPHANIE VANCE FINANCE, VP	(i) (ii)	256,019 ------------- 0	63,012 ------------- 0	55,649 ------------- 0	65,722 ------------- 0	19,520 ------------- 0	459,922 ------------- 0	36,694 ------------- 0
11JOEL BROWNELL MD VP, CHIEF MEDICAL INFORMATION OFFICE	(i) (ii)	328,621 ------------- 0	79,768 ------------- 0	30,366 ------------- 0	68,527 ------------- 0	14,640 ------------- 0	521,922 ------------- 0	29,568 ------------- 0
12KAREN DAHL VP, QUALITY & PATIENT SAFEY	(i) (ii)	369,838 ------------- 0	88,179 ------------- 0	34,673 ------------- 0	74,001 ------------- 0	4,880 ------------- 0	571,571 ------------- 0	15,640 ------------- 0
13KEVIN SHIMAMOTO VP AND CIO	(i) (ii)	341,488 ------------- 0	82,604 ------------- 0	31,403 ------------- 0	70,639 ------------- 0	4,880 ------------- 0	531,014 ------------- 0	9,662 ------------- 0
14DANIEL DAVIS VP, PATIENT CARE	(i) (ii)	281,155 ------------- 0	63,901 ------------- 0	6,461 ------------- 0	72,866 ------------- 0	9,760 ------------- 0	434,143 ------------- 0	0 ------------- 0
15DANIELLE BARRY VP, REVENUE CYCLE MGMT	(i) (ii)	241,334 ------------- 0	52,884 ------------- 0	338 ------------- 0	45,517 ------------- 0	19,520 ------------- 0	359,593 ------------- 0	0 ------------- 0
16WILLIAM CHALTRAW SENIOR VP/CHIEF LEGAL OFFICER	(i) (ii)	369,829 ------------- 0	77,035 ------------- 0	18,893 ------------- 0	58,155 ------------- 0	19,520 ------------- 0	543,432 ------------- 0	0 ------------- 0
17BRIAN SMULLIN VP MANAGED CARE	(i) (ii)	247,826 ------------- 0	20,210 ------------- 0	581 ------------- 0	25,454 ------------- 0	19,520 ------------- 0	313,591 ------------- 0	0 ------------- 0
18DAVID HODGE JR VP ANCILLARY SERVICES	(i) (ii)	268,243 ------------- 0	39,024 ------------- 0	16,171 ------------- 0	30,747 ------------- 0	19,520 ------------- 0	373,705 ------------- 0	0 ------------- 0
19LYNNE ASHBECK SVP, COMMUNITY ENGAGEMENT & POPULATI	(i) (ii)	224,512 ------------- 0	0 ------------- 0	7,178 ------------- 0	0 ------------- 0	0 ------------- 0	231,690 ------------- 0	0 ------------- 0
20YVONNE WOOD MANAGER PATIENT THROUGHPUT	(i) (ii)	236,469 ------------- 0	758 ------------- 0	243 ------------- 0	28,847 ------------- 0	19,520 ------------- 0	285,837 ------------- 0	0 ------------- 0
21PAUL LEBBY NEURODEVELOPMENT PROGRAM DIRECTOR	(i) (ii)	230,988 ------------- 0	0 ------------- 0	382 ------------- 0	23,423 ------------- 0	9,760 ------------- 0	264,553 ------------- 0	0 ------------- 0
22AMY BOLING RN IV CRITICAL CARE	(i) (ii)	235,022 ------------- 0	1,123 ------------- 0	4,349 ------------- 0	21,370 ------------- 0	24,400 ------------- 0	286,264 ------------- 0	0 ------------- 0
23JOLIE LIMON EXECUTIVE DIRECTOR MEDICAL EDUCATION	(i) (ii)	303,437 ------------- 0	0 ------------- 0	730 ------------- 0	12,797 ------------- 0	4,880 ------------- 0	321,844 ------------- 0	0 ------------- 0
24TRACY BLAIR EXEC DIR/DEP GENERAL COUNSEL	(i) (ii)	224,178 ------------- 0	39,258 ------------- 0	827 ------------- 0	16,310 ------------- 0	4,880 ------------- 0	285,453 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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	TODD SUNTRAPAK CHARTERED AN AIRPLANE TO ATTEND THREE MEETINGS DURING THE YEAR INCLUDING A CURRICULUM AND INSTRUCTION STEERING COMMITTEE (CISC) MEETING, A MEETING AT CHILDREN'S HOSPITAL LOS ANGELES AND TO ATTEND THE HOSPITAL COUNCIL SEARCH COMMITTEE INTERVIEWS. IN ADDITION TODD SUNTRAPAK, MICHELE WALDRON AND BEVERLY HAYDEN-PUGH CHARTERED AN AIRPLANE TO ATTEND THE PARTNERS IN CARE TRIBUTE RECEPTION IN LOS ANGELES. NO PART OF THE EXPENSE WAS TREATED AS TAXABLE COMPENSATION TO ANY OF THE EMPLOYEES.
PART I, LINE 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE 1) A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), 2) A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES AND 3) A NONCONTRIBUTORY, NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (DCSERP) AND 4) A SPLIT DOLLAR LIFE INSURANCE PROGRAM AVAILABLE TO CERTAIN KEY EXECUTIVES (SEE SCHEDULE L PART V FOR A BROADER DESCRIPTION). TODD SUNTRAPAK, JOEL BROWNELL, DAVID HODGE JR, DANIELLE BARRY, LYNNE ASHBECK, BRIAN SMULLIN AND DANNY DAVIS ARE ELIGIBLE TO CONTRIBUTE TO THE DEFERRED COMPENSATION PLAN, BUT NO CONTRIBUTIONS WERE MADE. $1,025,896 WAS PAID OUT OF THE DCSERP PLAN DURING THE YEAR. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN, EMPLOYER CONTRIBUTIONS TO THE DCSERP, AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR CALENDAR YEAR 2017 ARE AS FOLLOWS: MICHELE WALDRON - DEFERRED COMPENSATION PLAN $18,000; DCSERP $76,341; NOT ELIGIBLE FOR SERP TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $0; DCSERP $170,555; NOT ELIGIBLE FOR SERP BEVERLY HAYDEN-PUGH - DEFERRED COMPENSATION PLAN $18,000; DCSERP $61,042; CHANGE IN SERP ACTUARIAL VALUE $0 JESSIE HUDGINS - DEFERRED COMPENSATION PLAN $36,000; DCSERP $61,042; CHANGE IN SERP ACTUARIAL VALUE $20,014 DAVID CHRISTENSEN - DEFERRED COMPENSATION PLAN $18,000; DCSERP $84,537; NOT ELIGIBLE FOR SERP JANE WILLSON - DEFERRED COMPENSATION PLAN $18,000; DCSERP $51,561; CHANGE IN SERP ACTUARIAL VALUE $10,270 DAVID SINGH - DEFERRED COMPENSATION PLAN $18,000; DCSERP $46,775; CHANGE IN SERP ACTUARIAL VALUE $0 STEPHANIE VANCE - DEFERRED COMPENSATION PLAN $18,000; DCSERP $39,566; NOT ELIGIBLE FOR SERP NATALIE PONTICELLO - DEFERRED COMPENSATION PLAN $36,000; DCSERP $47,245; NOT ELIGIBLE FOR SERP MICHAEL GOLDRING - DEFERRED COMPENSATION PLAN $18,000; DCSERP $64,631; NOT ELIGIBLE FOR SERP JOEL BROWNELL - DEFERRED COMPENSATION PLAN $0; DCSERP $48,207; NOT ELIGIBLE FOR SERP KAREN DAHL - DEFERRED COMPENSATION PLAN $18,000; DCSERP $53,856; NOT ELIGIBLE FOR SERP KEVIN SHIMAMOTO - DEFERRED COMPENSATION PLAN $18,000; DCSERP $50,424; NOT ELIGIBLE FOR SERP DAVID HODGE AND LYNNE ASHBECK - NOT ELIGIBLE FOR DCSERP OR SERP DANIEL DAVIS - DEFERRED COMPENSATION PLAN $0; DCSERP $40,246; NOT ELIGIBLE FOR SERP DANIELLE BARRY - DEFERRED COMPENSATION PLAN $0; DCSERP $32,474; NOT ELIGIBLE FOR SERP BRIAN SMULLIN - DEFERRED COMPENSATION PLAN $0; DCSERP $20,924; NOT ELIGIBLE FOR SERP WILLIAM CHALTRAW - DEFERRED COMPENSATION PLAN $18,000; DCSERP $52,103; NOT ELIGIBLE FOR SERP
PART I, LINE 5	AN EXECUTIVE INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON BOTH NETWORK WIDE AND INDIVIDUAL GOALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING REVENUE, OPERATIONAL AND QUALITY RESULTS OF THE HOSPITAL AND ITS RELATED ENTITIES. THE INCENTIVE PLAN HAS BEEN APPROVED BY THE COMPENSATION COMMITTEE OF THE VALLEY CHILDREN'S HEALTHCARE BOARD OF TRUSTEES. THE COMMITTEE REVIEWS THE FORECASTED PAYOUTS AT THE END OF EACH YEAR BASED ON THE FINANCIAL AND OPERATING RESULTS.
PART I, LINE 6	SEE EXPLANATION FOR LINE 5, ABOVE

Schedule J (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No
(1) TODD SUNTRAPAK	CURRENT OFFICER	SEE BELOW		X	10,434,500	10,623,095		No	Yes		Yes
(2) MICHELE WALDRON	CURRENT OFFICER	SEE BELOW		X	8,325,373	8,325,373		No	Yes		Yes
(3) DAVID CHRISTENSEN	CURRENT KEY EMPLOYEE	SEE BELOW		X	5,013,793	5,013,793		No	Yes		Yes
(4) WILLIAM CHALTRAW	CURRENT KEY EMPLOYEE	SEE BELOW		X	2,014,651	2,014,651		No	Yes		Yes


Total ............... $						25,976,912

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) 2019

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	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference

Explanation

PART II, COLUMN C:

THE ORGANIZATION PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS THROUGH AN ALTERNATIVE FUNDING ARRANGEMENT THE IRS CALLS "COLLATERAL ASSIGNMENT SPLIT DOLLAR" (CASD). ALTHOUGH THE IRS REQUIRES REPORTING IN THE LOAN SECTION OF THE SCHEDULE L, CASD IS NOT AN ACTUAL LOAN NO FUNDS ARE TRANSFERRED TO THE EXECUTIVES. RATHER, THE "LOAN" TREATMENT APPLIES BECAUSE AFTER THE EXECUTIVES HAVE RECEIVED RETIREMENT BENEFITS, THE ORGANIZATION RECOVERS ALL OF ITS OUTLAYS PLUS INTEREST.

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Return Reference	Explanation
FORM 990 PART III, LINE 4A:	STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE I. DESCRIPTION OF PROGRAM SERVICE ONE OVER 60 YEARS AGO, OUR FOUNDING MOTHERS HAD A DREAM TO CARE FOR CHILDREN IN A HOSPITAL AS SPECIAL AS ITS PATIENTS. VALLEY CHILDREN'S HOSPITAL HAS FLOURISHED EVER SINCE, CARING FOR HUNDREDS OF THOUSANDS OF CHILDREN. OUR MISSION GUIDES US AS WE TRAVEL THE ROAD TO OUR FUTURE ALONGSIDE STAFF, PHYSICIANS, CHILDREN, FAMILIES, OUR COMMUNITY AND OUR PARTNERS THROUGHOUT THE REGION. MISSION THE MISSION OF VALLEY CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. VISION OUR VISION CAPTURES THE PATH WE'VE TRAVELED AND SHOWCASES OUR COMMITMENT AND PASSION TO BE THE BEST. OUR CLEAR FOCUS IS TO CONTINUE TO PROVIDE THE BEST CARE AND THE BEST QUALITY PEDIATRIC SERVICES AVAILABLE ANYWHERE WITH A VISION TO BECOME THE NATION'S BEST CHILDREN'S HOSPITAL. CORE VALUES THE FOLLOWING CORE ORGANIZATIONAL VALUES GUIDE THE INVESTMENTS AND SUPPORT PROVIDED BY VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM. EXCELLENCE - WE DEPEND ON EXCEPTIONAL PEOPLE TO PROVIDE EXCEPTIONAL QUALITY HEALTH CARE AND SERVICES THROUGHOUT VALLEY CHILDREN'S HOSPITAL. WE SET HIGH STANDARDS AND WE SUPPORT EACH OTHER AS WE STRIVE TO ACHIEVE THEM. WE INVEST IN EACH OTHER AND WE VALUE THE INDIVIDUAL AND CULTURAL DIFFERENCES THAT MAKE US STRONG. WE ARE PROUD OF OUR SUPERIOR SERVICES AS MEASURED BY QUALITY OUTCOMES. COMPASSIONATE CARE - WE TREAT EVERY CHILD, EVERY FAMILY, EACH OTHER, OUR VISITORS AND OUR VENDORS WITH RESPECT, KINDNESS, HOPE, JOY AND GOOD HUMOR. WE DISPLAY OUR HELPFUL, HEALING, FAMILY-CENTERED SPIRIT AT EVERY OPPORTUNITY. WE RECOGNIZE THE IMPORTANCE OF PLAYFULNESS IN HUMAN INTERACTION AND IN THE HEALTH OF CHILDREN. WE LOOK FOR WAYS TO EASE SUFFERING AND PROVIDE COMFORT. INTEGRITY - WE ARE HONEST, ETHICAL AND RESPONSIBLE IN OUR WORK AND IN THE WAY WE DEAL WITH OTHERS. WE KEEP OUR PROMISES AND ADMIT OUR MISTAKES. WE KNOW OURSELVES AND WE AVOID HIDDEN AGENDAS. BY THE WAY WE LIVE OUR LIVES EVERYDAY, WE ARE WORTHY OF THE TRUST PEOPLE PLACE IN US. INNOVATION - WE EMBRACE CHANGE, CREATIVITY, CONTINUOUS LEARNING AND PERSONAL GROWTH. WE INCORPORATE NEW IDEAS, TECHNOLOGY AND METHODS TO IMPROVE THE HEALTH CARE AND SERVICES WE PROVIDE. WE ANTICIPATE FUTURE TRENDS AND WE CREATE STRATEGIC PLANS TO INSURE FUTURE GROWTH AND CONTINUED VITALITY. COLLABORATION - WE BUILD ENDURING INTERNAL AND EXTERNAL RELATIONSHIPS, JOINING WITH COLLEAGUES ACROSS ORGANIZATIONAL BOUNDARIES TO IMPROVE THE CARE AND SERVICES WE PROVIDE. WE ENCOURAGE AND REWARD BOTH INDIVIDUAL AND TEAM ACHIEVEMENTS. WE PUT THE COMMON GOOD AHEAD OF NARROW INTERESTS. STEWARDSHIP - WE ARE RESOURCEFUL, ADAPTABLE AND RESILIENT. WE HAVE A "CAN DO" ATTITUDE THAT GETS THE JOB DONE. WE ARE FISCALLY RESPONSIBLE AND EFFICIENT WITH OUR TIME. WE PROTECT OUR RESERVES AND MANAGE OUR OPERATING COSTS IN ORDER TO INVEST IN THE NEXT GENERATION OF KIDS. WE ARE EACH PERSONALLY DEDICATED TO MAKING VALLEY CHILDREN'S HOSPITAL BETTER BECAUSE WE WERE HERE. COMMITMENT TO THE COMMUNITY AS A NOT-FOR-PROFIT ORGANIZATION GOVERNED BY ITS OWN BOARD OF TRUSTEES, VALLEY CHILDREN'S HOSPITAL IS SOLELY COMMITTED TO ADDRESSING THE MEDICAL NEEDS OF OUR REGION'S SICKEST CHILDREN. WITH 358 BEDS AT SEPTEMBER 30, 2018, A MEDICAL STAFF OF OVER 650 PHYSICIANS AND APPROXIMATELY 3,400 TOTAL EMPLOYEES, VALLEY CHILDREN'S HOSPITAL OFFERS ACCESSIBILITY TO OVER 40 FETAL, NEONATAL AND PEDIATRIC SUBSPECIALTIES, ALL COMMITTED TO PROVIDING THE HIGHEST LEVEL OF QUALITY CARE POSSIBLE. EXAMPLES INCLUDE THE HOSPITAL'S NEONATAL AND PEDIATRIC INTENSIVE CARE UNITS THAT MAINTAIN LOW MORTALITY RATES, WHEN COMPARED NATIONALLY, WHILE TREATING SOME OF THE SICKEST CHILDREN. WHILE PROVIDING EXCEPTIONAL CARE IS THE SINGLE GREATEST CONTRIBUTION THE HOSPITAL MAKES FOR OUR CHILDREN AND THEIR FAMILIES, THE HOSPITAL ALSO APPRECIATES THAT IT IS UNIQUELY POSITIONED TO SUPPORT THE NEEDS OF CHILDREN IN OTHER WAYS AS WELL. AS AN EXTENSION OF THE HOSPITAL'S MISSION AND VISION, THE GOAL OF VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS TO ADVANCE THE HEALTH AND WELLBEING OF UNDERSERVED, MEDICALLY NEEDY CHILDREN THROUGH COLLABORATION AND COMMON CONCERN. II. SERVICE AREA DEMOGRAPHICS AND PATIENT VOLUME SERVICE AREA DEMOGRAPHICS AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, VALLEY CHILDREN'S HOSPITAL'S SERVICE AREA EXTENDS FROM SACRAMENTO COUNTY IN THE NORTH TO KERN COUNTY IN THE SOUTH, AND PICKS UP MUCH OF THE CENTRAL COAST AND EASTERN AS WELL. VALLEY CHILDREN'S HOSPITAL'S PATIENT VOLUME IN 2018, VALLEY CHILDREN'S HOSPITAL HAD 12,040 INPATIENT CASES, 114,452 EMERGENCY DEPARTMENT VISITS AND A COMBINED 297,563 OUTPATIENT CENTER, REGIONAL SPECIALTY CARE CENTER AND DAY SURGERY VISITS. MEDI-CAL COVERED 76% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 76% OF TOTAL OUTPATIENT VISITS AT THE HOSPITAL.
FORM 990, PART III, LINE 4A	III. COMMUNITY BENEFITS PROGRAM ACCORDING TO THE CATHOLIC HEALTH ASSOCIATION, COMMUNITY BENEFITS ARE GENERALLY DEFINED AS THOSE ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING IN RESPONSE TO IDENTIFIED COMMUNITY NEEDS, AND MEET AT LEAST ONE OF THE FOLLOWING OBJECTIVES: - IMPROVE ACCESS TO HEALTH CARE SERVICES - ENHANCE HEALTH OF THE COMMUNITY - ADVANCE MEDICAL OR HEALTH CARE KNOWLEDGE - RELIEVE OR REDUCE THE BURDEN OF GOVERNMENT OR PRIVATE, COMMUNITY-BASED EFFORTS ALSO INCLUDED IN THE DEFINITION IS THE PROVISION OF CHARITY CARE AND THE UNREIMBURSED COST OF PROVIDING HEALTH CARE SERVICES TO THOSE ENROLLED IN PUBLIC PROGRAMS, INCLUDING MEDI-CAL. IN FY 2018, VALLEY CHILDREN'S HOSPITAL PROVIDED COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS WITHIN ITS SERVICE AREA. A SUMMARY OF THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS IN 2018: COMMUNITY HEALTH EDUCATION CLINICAL PARTNERSHIPS VALLEY CHILDREN'S CLINICAL PARTNERSHIP PROGRAM BRINGS TOGETHER INSTITUTIONS FOCUSED ON ENHANCING NEONATAL AND PEDIATRIC CARE, REGARDLESS IF THE ILL OR INJURED CHILD BECOMES A VALLEY CHILDREN'S PATIENT. THIS EFFORT HELPS PREVENT CHILDREN FROM BEING TRANSFERRED OR REFERRED UNNECESSARILY TO VALLEY CHILDREN'S, AS WELL AS POTENTIALLY IDENTIFIES EARLIER WHEN A CHILD NEEDS ADVANCED PEDIATRIC CARE. WITH IMPROVED COMMUNICATION AND TOOLS, WE DECREASE STRESS FOR PATIENTS AND FAMILIES AND INCREASE PROVIDER CONFIDENCE IN PROVIDING PEDIATRIC CARE, WHILE ENHANCING PERFORMANCE AT BOTH INSTITUTIONS. THE GOALS OF OUR CLINICAL PARTNERSHIPS INCLUDE PROVIDING: -IMPROVED QUALITY AND CONFIDENCE IN PROVIDING PEDIATRIC CARE -MORE CARE DELIVERED CLOSER TO HOME -ENHANCED, COORDINATED CARE IN 2018, VALLEY CHILDREN'S SUPPORTED 13 CLINICAL PARTNERS. INJURY PREVENTION VALLEY CHILDREN'S OPERATES AN INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. IN FY2018, THE PROGRAM RECORDED 15,519 CONTACTS WITH CHILDREN, PARENTS, HEALTHCARE PRFESSIONALS AND OTHERS AT 184 DIFFERENT COMMUNITY, MEDIA, AND PROFESSONALS EVENTS, COVERING THE FOLLOWING TOPICS: CHILD PASSANGER SAFETY, SAFE SLEEP, TRAUMATIC BRAIN INJURY (HELMET SAFETY), HALLOWEEN SAFETY, POISON PREVENTION, RESPONDING TO A BLEEDING EMERGENCY, DRIVER SAFETY AWARENESS (INCLUDING DRUNK/ DISTRACTED DRIVING), BABY BASICS, MEDICATION SAFETY, CHOKING PREVENTION, HOME SAFETY, CONCUSSION PREVENTION AND MANAGEMENT, BICYCLE SAFETY, PEDIATRIC TRAUMA, WATER SAFETY AND SUICIDE PREVENTION. REGARDING BICYCLE SAFETY, VALLEY CHILDREN'S DISTRIBUTED 525 BICYCLE HELMETS TO CHILDREN AND FAMILIES WHOSE EXISTING HELMETS DID NOT MEET MINIMUM SAFETY STANDARDS OR WHO DID NOT HAVE HELMETS AT ALL. REGARDING CAR SEAT SAFETY, VALLEY CHILDREN'S CONDUCTED SAFETY CHECKS ON 561 CAR SEATS AND DISTRIBUTED 349 CAR SEATS TO FAMILIES WHOSE EXISTING CAR SEATS DID NOT MEET MINIMUM SAFETY STANDARDS OR WHO SIMPLY DID NOT HAVE A CAR SEAT AND NEEDED ONE. HEALTHCARE LITERACY VALLEY CHILDREN'S PROVIDED ACCESS TO ON-LINE EDUCATIONAL INFORMATION VIA THE HEALTH ENCYCLOPEDIA LINK ON ITS WEBSITE. HEALTH ENCYCLOPEDIA CONTAINS THOUSANDS OF PAGES OF INFORMATION ON PEDIATRIC DISEASES, CONDITIONS AND TREATMENTS, AS WELL AS SECTIONS ON HOW TO KEEP KIDS HEALTHY. THE ENCYCLOPEDIA IS AVAILABLE IN ENGLISH AND SPANISH. MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN VALLEY CHILDREN'S RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY-BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. THE HOSPITAL PROVIDED OUTREACH EDUCATION TO HOSPITAL STAFF AND COMMUNITY-BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN, INCLUDING CHILDREN WITH TRACHEOSTOMIES AND VENTILATORS. ADAPTIVE SPORTS PROGRAM VALLEY CHILDREN'S ADAPTIVE SPORTS PROGRAM PROVIDES FREE RECREATIONAL AND ATHLETIC EXPERIENCES FOR CHILDREN, ADOLESCENTS AND YOUNG ADULTS WITH DISABILITIES, REGARDLESS OF WHETHER THEY HAVE BEEN OR CURRENTLY ARE PATIENTS AT VALLEY CHILDREN'S. THE ONLY ONE OF ITS KIND IN CENTRAL CALIFORNIA, THE PROGRAM IS DESIGNED FOR INDIVIDUALS WITH PHYSICAL IMPAIRMENTS AND CONDITIONS RANGING FROM CEREBRAL PALSY TO SPINAL CORD INJURIES. DISABLED YOUTH UP TO AGE 21 ARE ESPECIALLY ENCOURAGED TO ATTEND. HEALTH CARE SUPPORT SERVICES VALLEY CHILDREN'S PROVIDED HEALTH CARE SUPPORT SERVICES TO HELP ADDRESS THE HEALTH CARE NEEDS OF CHILDREN AND THEIR FAMILIES, AT HOME, AT SCHOOL, AND IN THE COMMUNITY. CHILD ABUSE PREVENTION THE GUILDS OF VALLEY CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER'S MISSION IS TO PROVIDE COMPREHENSIVE SERVICES TO CHILDREN, DEPENDENT ADULTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY, CHILD-FRIENDLY PROGRAM, AND TO MEET THE PHYSICAL AND EMOTIONAL NEEDS OF VICTIMS OF CHILD ABUSE. THE CENTER'S VISION IS TO BE THE PREMIER PROVIDER IN CENTRAL CALIFORNIA FOR DIAGNOSTIC PHYSICAL ABUSE ASSESSMENTS, FOSTER CARE MEDICAL CLEARANCE EXAMINATIONS AND PEDIATRIC SEXUAL ASSAULT EVALUATIONS, INCLUDING CHILDREN WHO HAVE BEEN VICTIMS OF COMMERCIAL SEXUAL EXPLOITATION. ADDITIONALLY, THE CENTER'S PROVIDERS, KNOWN AS THE CHILD ADVOCACY TEAM, REGULARLY TESTIFY IN BOTH DEPENDENCY AND CRIMINAL COURTS THROUGHOUT THE VALLEY. THE CENTER IS RECOGNIZED IN CENTRAL CALIFORNIA AND AROUND THE STATE AS A LEADER IN ADVOCACY,INJURY PREVENTION, CLINICAL RESEARCH AND ACADEMIC TRAINING. IN FY2018, THE CENTER BECAME A MEMBER OF THE CHILD ADVOCACY CENTERS OF CALIFORNIA, CENTRAL CHAPTER. MEMBERSHIP PROVIDES A NUMBER OF BENEFITS AND OPPORTUNITIES TO EXPAND EFFORTS IN CHILD ABUSE PREVENTION AND TREATMENT. ACCORDING TO THE REPORT "CHILD MALTREATMENT 2017," AN ESTIMATED 4.1 MILLION REFERRALS INVOLVING THE SUSPECTED MALTREATMENT OF ABOUT 7.5 MILLION CHILDREN WERE MADE TO CHILD PROTECTIVE SERVICES (CPS) AGENCIES IN THE UNITED STATES IN 2017. THIS IS AN INCREASE OF APPROXIMATELY 91,000 REFERRALS FROM 2016. IN CALIFORNIA, AN ESTIMATED 400,190 SUSPECTED CHILD MALTREATMENT REPORTS WERE COMPLETED, OF WHICH ABOUT 86,700 REPORTS CAME FROM VALLEY CHILDREN'S SERVICE AREA. THE CENTER INCLUDES THE CHILD ADVOCACY CLINIC, WHICH OPERATES FIVE DAYS A WEEK AND SEES APPROXIMATELY 1,000 CHILDREN EACH YEAR. CENTER PROVIDERS ALSO ARE AVAILABLE SEVEN DAYS A WEEK, 24 HOURS A DAY FOR EMERGENCY COVERAGE. THE CENTER INCLUDES AN INPATIENT COMPONENT THAT EVALUATES ABOUT 100 CHILDREN YEARLY IN THE PEDIATRIC EMERGENCY DEPARTMENT, ACUTE-CARE FLOORS AND PEDIATRIC INTENSIVE CARE UNIT. THESE CHILDREN ARE EVALUATED FOR SUSPECTED PHYSICAL ABUSE, SEXUAL ABUSE AND NEGLECT. THE STAFF INCLUDES CHILD ABUSE PEDIATRICIANS, NURSE PRACTITIONERS SPECIALIZED IN CHILD MALTREATMENT, FORENSIC NURSES, SOCIAL WORKERS, FORENSIC INTERVIEWERS, A CENTER COORDINATOR, A LICENSED MENTAL HEALTH PROVIDER AND SUPPORT STAFF. IN ADDITION TO THE CLINICAL SERVICES OFFERED BY THE CENTER, A MULTI-DISCIPLINARY INTERVIEWING CENTER IS ALSO AVAILABLE FOR VICTIMS OR WITNESSES OF CRIMES. FORENSIC INTERVIEWING SERVICES ARE REQUESTED BY LAW ENFORCEMENT AND/OR CPS. THE PURPOSE OF THE FORENSIC INTERVIEWING PROGRAM COMPONENT IS TO REDUCE THE NUMBER OF INTERVIEWS AND DECREASE THE NUMBER OF INDIVIDUALS WHO WILL TALK TO THE VICTIM. THE CENTER STRIVES TO PROVIDE A WELCOMING, CHILD-FRIENDLY ENVIRONMENT WHERE CHILDREN/DEPENDENT ADULTS CAN FEEL SAFE AND BE INTERVIEWED BY A TRAINED PROFESSIONAL. THERE IS ONGOING COLLABORATION WITH EXTERNAL COMMUNITY PARTNERS AND OTHER HOSPITAL SERVICES INCLUDING SUBSPECIALTY CLINICS, PATIENT AND FAMILY SERVICES, INTERPRETER SERVICES, RADIOLOGY, DIAGNOSTIC CLINICAL LABORATORIES, CHILD LIFE SERVICES AND PASTORAL CARE. THE CENTER WORKS CLOSELY WITH LAW ENFORCEMENT, CPS AND DISTRICT ATTORNEYS' OFFICES IN THEIR INVESTIGATIVE EFFORTS OF CHILD MALTREATMENT. COLLABORATIVE EFFORTS INCLUDE CASE CONSULTATION AND MONTHLY SUSPECT CHILD ABUSE AND NEGLECT (SCAN) MEETINGS FACILITATED BY OUR CHILD ADVOCACY CLINIC IN AN EFFORT TO TRACK, MONITOR AND ADVOCATE FOR THE HEALTH AND SAFETY OF AT-RISK CHILDREN THROUGHOUT THE VALLEY.
FORM 990, PART III, LINE 4A	FOR PREVENTION EDUCATION, THE CENTER COLLABORATES WITH INTERNAL AND EXTERNAL PARTNERS TO PROVIDE EDUCATION TO PARENTS, CAREGIVERS, HEALTHCARE PERSONNEL, TEACHERS AND MANDATED REPORTERS OF SUSPECTED CHILD MALTREATMENT. THESE PARTNERS INCLUDE VALLEY CHILDREN'S TRAUMA DEPARTMENT'S INJURY PREVENTION TEAM, SAFE KIDS, CHILD ABUSE PREVENTION COUNCILS OF CALIFORNIA, COMPREHENSIVE YOUTH SERVICES, CPS, EXCEPTIONAL PARENTS UNLIMITED, SEXUAL ASSAULT RESPONSE TEAMS (SART) AND COUNCIL PUBLIC HEALTH DEPARTMENTS. ENROLLMENT IN HEALTH INSURANCE VALLEY CHILDREN'S IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM, OR THE VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S STAFF ASSISTED THE FAMILY WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. FOOD FOR FAMILIES VALLEY CHILDREN'S DIETARY DEPARTMENT PROVIDED MEAL COUPONS TO BREAST-FEEDING MOMS WHOSE INFANTS WERE AT VALLEY CHILDREN'S. ADDITIONALLY, THROUGH A PROGRAM CALLED MEALS OF THE HEART, WHICH IS SPONSORED BY RONALD MCDONALD CHARITIES OF CENTRAL CALIFORNIA, VALLEY CHILDREN'S SOCIAL WORK TEAM PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. THE SOCIAL WORK TEAM ALSO WORKS CLOSELY WITH THE CALIFORNIA CHILDREN'S SERVICES PROGRAM TO PROVIDE FOOD FOR ELIGIBLE FAMILIES. VALLEY CHILDREN'S ALSO RECEIVED SUPPORT FROM A NUMBER OF OTHER ORGANIZATIONS, INCLUDING THE MENDIBURU MAGIC FOUNDATION BASED IN BAKERSFIELD, THE ROMAN CATHOLIC DIOCESE OF FRESNO, AND THE SWEET NECTAR SOCIETY THAT EITHER DONATED FOOD TO VALLEY CHILDREN'S TO DISTRIBUTE TO NEEDY FAMILIES OR DONATED CASH TO GIVE TO FAMILIES TO PURCHASE FOOD. LITERACY PROGRAM VALLEY CHILDREN'S HEALTHCARE IS UNIQUELY POSITIONED TO MAKE A DIFFERENCE IN THE LITERACY OF CHILDREN THROUGHOUT OUR SERVICE AREA. IT IS THE AIM OF OUR LITERACY PROGRAM TO PUT A NEW, AGE- APPROPRIATE BOOK INTO THE HANDS OF EVERY CHILD WHO COMES INTO OUR HOSPITAL. IN FY2018, WE PROVIDED 1,500-2,000 NEW BOOKS A MONTH TO OUR INPATIENTS AND OUTPATIENTS. FOR MANY FAMILIES IN THE CENTRAL VALLEY, BOOKS ARE A LUXURY. THE AREA IS AMONG THE POOREST IN THE NATION WITH 41 PERCENT OF THE AREA'S CHILDREN AGES 0-5 LIVING IN HOUSEHOLDS WHERE THE INCOME IS BELOW THE FEDERAL POVERTY LEVEL. NOT COINCIDENTALLY, THE VALLEY IS ALSO ONE OF THE LEAST LITERATE PARTS OF THE COUNTRY. STUDIES HAVE SHOWN THAT CHILDREN FROM POOR SOCIO-ECONOMIC ENVIRONMENTS CAN START KINDERGARTEN HAVING HEARD 30 MILLION FEWER WORDS THAN THEIR MORE AFFLUENT PEERS. READING TO CHILDREN CAN SHIFT THIS KIND OF TREND. HOWEVER, ASKING FINANCIALLY STRAPPED FAMILIES TO PUT BOOKS FOR THEIR CHILDREN AHEAD OF OTHER VITAL PRIORITIES IS UNREALISTIC. THAT IS WHY OUR PROGRAM WANTS TO HELP THEM TAKE THE LUXURY OUT OF LITERACY. PUTTING BOOKS INTO THE HANDS OF FAMILIES THAT CANNOT AFFORD THEM CAN GO A LONG WAY IN INCREASING LITERACY RATES AND PERFORMANCE IN SCHOOL, HIGHLIGHTING THE IMPORTANCE OF MAKING BOOKS A PART OF NORMAL LIFE FOR EVERY CHILD WHO VISITS VALLEY CHILDREN'S. TRANSPORTATION GIVEN THE CENTRAL VALLEY'S LARGELY RURAL LANDSCAPE AND HIGH CONCENTRATION OF POVERTY, TRANSPORTATION HAS LONG BEEN A CHALLENGE FOR MANY FAMILIES. VALLEY CHILDREN'S CONTINUES TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND ACCESS TO CARE. VALLEY CHILDREN'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING GAS CARDS, TAXI VOUCHERS, AMTRAK TICKETS AND BUS TOKENS. VALLEY CHILDREN'S ALSO SUBSIDIZED BUS AND OTHER PUBLIC TRANSIT SERVICES FROM THE CITY OF FRESNO AND KINGS COUNTY. *SOCIAL AND ENVIRONMENTAL IMPROVEMENT ACTIVITIES VALLEY CHILDREN'S SUPPORTED A NUMBER OF PROGRAMS AND ACTIVITIES TO IMPROVE THE CAPACITY OF COMMUNITIES TO PROMOTE HEALTH AND WELLNESS AMONG CHILDREN. CHILDHOOD OBESITY PREVENTION IN FY2018, VALLEY CHILDREN'S FORMALLY DEVELOPED A REGIONAL APPROACH TO REDUCING THE CHILDHOOD OBESITY EPIDEMIC IN THE CENTRAL VALLEY. THE "COMMUNITIES FOR HEALTHY KIDS" INITIATIVE IS A MULTI-SECTOR PARTNERSHIP BETWEEN HEALTHCARE PROVIDERS, HEALTH PLANS, SCHOOLS, COMMUNITY-BASED ORGANIZATIONS, PUBLIC HEALTH DEPARTMENTS AND THE AGRICULTURE INDUSTRY TO INCREASE ACCESS TO AND CONSUMPTION OF HEALTHY FOODS AND BEVERAGES AND TO INCREASE OPPORTUNITIES FOR AND PARTICIPATION IN PHYSICAL ACTIVITY. THE PURPOSE OF THIS EFFORT IS TO ALIGN AND SUPPORT EXISTING PARTNERSHIPS ACROSS FRESNO, MADERA AND KINGS COUNTIES IN AN EFFORT TO REDUCE. CHILDHOOD OBESITY IN THE CENTRAL VALLEY THROUGH EDUCATION, ADVOCACY AND THE COORDINATED IMPLEMENTATION OF IDENTIFIED STRATEGIES. FURTHERMORE, VALLEY CHILDREN'S HAS IDENTIFIED FOOD INSECURITY AS A CRITICAL SOCIAL DETERMINANT OF HEALTH THAT IMPACTS THE HEALTH AND WELLBEING OF OUR PATIENTS AND FAMILIES. CHILDREN WHO ARE FOOD INSECURE LACK ACCESS TO AFFORDABLE AND HEALTHY FOODS WHICH LEADS TO ADVERSE HEALTH OUTCOMES, INCLUDING INCREASED OBESITY RATES. ADDRESSING FOOD INSECURITY WITHIN THE HEALTHCARE SETTING PROVIDES VALLEY CHILDREN'S THE ABILITY TO FURTHER FOSTER THE HEALTH OF OUR PATIENTS AND COMMUNITIES. TO SUPPORT THIS EFFORT, VALLEY CHILDREN'S LAUNCHED A PILOT PROJECT AT ONE OF ITS COMMUNITY-BASED PRIMARY CARE PEDIATRIC PRACTICES. PROVIDERS AT THE PRACTICE SCREEN THEIR PATIENTS FOR FOOD INSECURITY. IF FOUND TO BE AT-RISK, PATIENTS ARE CONNECTED TO NUTRITION PROGRAMS AND EMERGENCY FOOD RESOURCES. ADDITIONAL SUPPORT IN FY 2018 INCLUDED THE FOLLOWING ACTIVITIES: -VALLEY CHILDREN'S CONVENED A CONTINUING MEDICAL EDUCATION EVENT ON CHILDHOOD OBESITY PREVENTION FOR COMMUNITY PROVIDERS IN FRESNO, MADERA, MERCED, KINGS AND TULARE COUNTIES TO RAISE AWARENESS ABOUT WAYS TO ADDRESS CHILDHOOD OBESITY WITHIN THE CLINICAL SETTING. - VALLEY CHILDREN'S SERVED ON THE STEERING COMMITTEE FOR THE FRESNO COUNTY HEALTH IMPROVEMENT PARTNERSHIP, CO-CHAIRED THE FRESNO COUNTY DIABETES COLLABORATIVE AND PARTICIPATED IN THE LIVE WELL MADERA COUNTY DIABETES AND OBESITY WORKGROUP, THE KINGS COUNTY DIABESITY COALITION AND THE TULARE COUNTY DIABETES AND OBESITY WORKGROUP. EARLY CHILD DEVELOPMENT AND CARE COORDINATION VALLEY CHILDREN'S PARTICIPATED IN A NUMBER OF INITIATIVES SUPPORTING THE HEALTHY DEVELOPMENT OF CHILDREN BOTH DURING PREGNANCY AND INTO THE FIRST 3-5 YEARS OF LIFE. EXAMPLES INCLUDE THE FOLLOWING: FRESNO COUNTY PRE-TERM BIRTH INITIATIVE: FRESNO COUNTY HAS ONE OF CALIFORNIA'S HIGHEST RATES OF PREMATURE BIRTH WITH 1 OUT OF EVERY 9 BABIES BORN TOO EARLY. PREMATURE BIRTH CAN CAUSE SERIOUS PHYSICAL AND MENTAL DISABILITIES, OR EVEN DEATH, BEFORE THE BABY'S FIRST BIRTHDAY. OVER A 10-YEAR PERIOD, THE FRESNO COUNTY PRE-TERM BIRTH INITIATIVE IS WORKING TO IMPROVE THE HEALTH OF FRESNO MOTHERS AND REDUCE THE RATE OF PREMATURE BABIES. USING AN APPROACH CALLED COLLECTIVE IMPACT, PARTNERS ACROSS MANY SECTORS HAVE COME TOGETHER TO CREATE CHANGE IN FRESNO COUNTY. VALLEY CHILDREN'S HAS BEEN AN ACTIVE PARTICIPANT IN THIS INITIATIVE, WITH VALLEY CHILDREN'S SENIOR VICE PRESIDENT FOR COMMUNITY ENGAGEMENT AND POPULATION WELLNESS SERVING AS CHAIR OF THE INITIATIVE'S STEERING COMMITTEE. CRADLE TO CAREER: BOTH FRESNO AND STANISLAUS COUNTIES HAVE BEGUN FORMAL CRADLE TO CAREER INITIATIVES FOR THE PURPOSE OF COVENING PUBLIC AND PRIVATE SECTOR STOCKHOLDERS TO WORK TOGETHER TO IMPROVE OUTCOMES FOR CHILDREN'S IN THEIR COMMUNITIES, FROM PRE-CONCEPTION TO COLLEGE AND/OR VOCATIONAL TRAINING. VALLEY CHILDREN'S PARTICIPATES IN BOTH INITIATIVES AND HAS BEEN A STRONG VOICE FOR THE INCLUSION OF OUTCOMES AND INDICATORS FOCUSED ON CHILD HEALTH AND WELLNESS. HELP ME GROW FRESNO COUNTY: HELP ME GROW IS A COORDINATED SYSTEM OF EARLY IDENTIFICATION AND REFERRAL FOR CHILDREN AGES 0-5 WHO ARE AT RISK FOR DEVELOPMENTAL DELAYS. IN FY2018, VALLEY CHILDREN'S SUPPORTED THE IMPLEMENTATION OF HELP ME GROW IN ITS PEDIATRIC PRIMARY CARE PRACTICES IN FRESNO COUNTY BY PROMOTING THE USE OF A SPECIFIC DEVELOPMENTAL ASSESSMENT AND SCREENING TOOL THAT IS PART OF THE HELP ME GROW MODEL. MARCH OF DIMES: VALLEY CHILDREN'S PARTNERED CLOSELY WITH THE MARCH OF DIMES TO ADVOCATE ON BEHALF OF POLICIES AT THE STATE AND FEDERAL LEVEL THAT PROMOTE HEALTHY PREGNANCIES AND HEALTHY BABIES. ADDITIONALLY, VALLEY CHILDREN'S DIRECTOR OF COMMUNITY AND GOVERNMENT RELATIONS CHAIRED THE MARCH OF DIMES OF CALIFORNIA'S ADVOCACY AND GOVERNMENT AFFAIRS COMMITTEE IN FY2018. MENTAL HEALTH ISSUES AND CHALLENGES ASSOCIATED WITH CHILD AND ADOLESCENT MENTAL HEALTH CONTINUED TO BE A MAJOR CONCERN IN 2017. TO HELP IDENTIFY POTENTIAL REGIONAL SOLUTIONS, VALLEY CHILDREN'S SUPPORTED OR PARTICIPATED IN A NUMBER OF ACTIVITIES. VALLEY CHILDREN'S STAFF PROVIDED TEEN SUICIDE PREVENTION EDUCATION TO STUDENTS AND STAFF AT AREA HIGH SCHOOLS.
FORM 990, PART III, LINE 4A	IN ADDITION, VALLEY CHILDREN'S STAFF EITHER LED OR PARTICIPATED IN A NUMBER OF COMMUNITY-BASED COLLABORATIVES FOCUSED ON PREVENTING CHILD MENTAL ILLNESS AND / OR EARLY IDENTIFICATION AND TREATMENT OF CHILD MENTAL ILLNESS. VALLEY CHILDREN'S STAFF CHAIRED AN INITIATIVE CALLED COMMUNITY CONVERSATIONS, WHICH IS A 50 MEMBER COLLABORATIVE ADDRESSING ISSUES OF MENTAL HEALTH, HOMELESSNESS AND THE IMPACT ON FAMILIES. A NUMBER OF VALLEY CHILDREN'S STAFF ALSO SERVED AS MEMBERS OF THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE.
FORM 990 PART III, LINE 4B:	STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO COMMITMENT TO MEDI-CAL - VALLEY CHILDREN'S HOSPITAL'S COMMITMENT TO SERVING ITS COMMUNITY IS EVIDENCED BY THE LARGE NUMBER OF PATIENTS SERVES THAT ARE COVERED BY MEDI-CAL. IN 2018, 76% OF HOSPITAL INPATIENT DAYS WERE COVERED BY MEDI-CAL. THE COMBINED NET EFFECT OF TOTAL MEDI-CAL REIMBURSEMENT AND DISPROPORTIONATE SHARE FUNDING IN RELATION TO THE COST OF THESE SERVICES RESULTED IN A NET LOSS TO THE HOSPITAL IN 2018 OF $123,786,726. THIS FIGURE IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS, AND ALSO EXCLUDES THE REVENUE AND EXPENSES ASSOCIATED WITH THE HOSPITAL FEE PROGRAM, WHICH IS DESCRIBED IN MORE DETAIL BELOW. HOSPITAL FEE PROGRAM - IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING VALLEY CHILDREN'S HOSPITAL, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. THE PROGRAM WAS FUNDED BY A QUALITY ASSURANCE FEE PAID BY HOSPITALS THAT THE STATE THEN USES TO COLLECT ADDITIONAL FEDERAL FUNDING. HOSPITAL FEE PROGRAMS LIKE CALIFORNIA'S ARE ALLOWABLE UNDER FEDERAL LAW, AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROVED CALIFORNIA'S PROGRAM. IN 2018, VALLEY CHILDREN'S HOSPITAL RECOGNIZED PROGRAM REVENUE OF $88,003,350, NET OF THE HOSPITAL'S QUALITY ASSURANCE FEE AND HOSPITAL CONTRIBUTIONS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT). CHFT WAS ESTABLISHED UNDER THE PROGRAM FOR THE PURPOSE OF SUPPORTING CHARITABLE ACTIVITIES. CHARITY CARE - IN KEEPING WITH OUR MISSION, VALLEY CHILDREN'S HOSPITAL CONTINUES TO ACCEPT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2018, CHILDREN'S HOSPITAL PROVIDED $241,142 IN CHARITY CARE. THE AMOUNT REPRESENTS COSTS ASSOCIATED WITH PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES IN RELATION TO THE COST OF THESE SERVICES. CHARITY CARE INCLUDES COUNTY INDIGENT AND FREE CARE, WHICH IS BASED ON THE PATIENT'S INABILITY TO PAY FOR SERVICES. IN ORDER TO ASSIST FAMILIES WITH ONGOING CARE NEEDS, VALLEY CHILDREN'S HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES PATIENT FAMILIES TO APPLY FOR APPROPRIATE GOVERNMENT FUNDING IN CONJUNCTION WITH APPLYING FOR FINANCIAL ASSISTANCE (CHARITY CARE). AS A RESULT, MANY FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS AND DO NOT ULTIMATELY REQUIRE CHARITY CARE. THE HOSPITAL'S CHARITY CARE AMOUNT IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS.
FORM 990, PART VI, SECTION A, LINE 6	THE AMENDED AND RESTATED BYLAWS OF VALLEY CHILDREN'S HOSPITAL, EFFECTIVE 10/17/13, ESTABLISHED VALLEY CHILDREN'S HEALTHCARE AS THE SOLE MEMBER OF THE CORPORATION. CERTAIN MEMBER RIGHTS, INCLUDING THE RIGHT TO APPROVE, FIX THE NUMBER, ELECT, AND REMOVE ELECTED TRUSTEES, ARE INCLUDED IN THESE BYLAWS.
FORM 990, PART VI, SECTION A, LINE 7A	SEE ANSWER FOR LINE 6 ABOVE
FORM 990, PART VI, SECTION A, LINE 7B	SEE ANSWER FOR LINE 6 ABOVE
FORM 990, PART VI, SECTION B, LINE 11B	A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS.
FORM 990, PART VI, SECTION B, LINE 15	AS PROVIDED BY THE VALLEY CHILDREN'S HEALTHCARE BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE NETWORK AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE
FORM 990, PART VI, SECTION C, LINE 19	A COPY OF VALLEY CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF VALLEY CHILDREN'S HOSPITAL IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE ANNUAL FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 62,412,321. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 62,412,321. PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 4,607,240. MANAGEMENT AND GENERAL EXPENSES 320,629. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,927,869. CONSULTING & MANAGEMENT FEES - ON PARENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 38,713. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,713.
FORM 990, PART XI, LINE 9:	PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 13,459,412.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

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
(1) HERNDON TEMPERANCE LLC 5286 E HOME AVE FRESNO,CA93727 81-2808671	REAL PROPERTY	CA	53,137	6,643,197	VALLEY CHILDREN'S HOSPITAL

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?
(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	Yes	No
(1)VALLEY CHILDREN'S HEALTHCARE FOUNDATION 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 94-2797447	PHILANTHROPY/FUNDRAISING FOR VALLEY CHILDREN'S HEALTHCARE & RELATED ENTITIES	CA	501(C)(3)	LINE 7	VALLEY CHILDREN'S HEALTHCARE		No
(2)VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 46-4150987	HEALTH CARE	CA	501(C)(3)	LINE 10	VALLEY CHILDREN'S HEALTHCARE	Yes
(3)VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 46-4158433	HEALTH CARE	CA	501(C)(3)	LINE 12C, III-FI	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) VALLEY PHYSICIANS ALLIANCE LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 81-3817791	INVESTING	CA	N/A
(2) FOWLER BUSINESS & PROFESSIONAL PARK LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 47-1813772	REAL ESTATE INVESTMENT	CA	N/A	RELATED	-47,934	13,598,800		No			No	50.000 %
(3) COMPASS HEALTH ADMINISTRATORS LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 82-2891309	BENEFIT ADMIN	CA	N/A

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?
(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		Yes	No
(1) VALLEY CHILDREN'S HOLDINGS I LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 37-1872422	HEALTHCARE	CA	N/A	C					No
(2) VPA HOLDINGS LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 81-4192995	INVESTING	CA	N/A	C			50.000 %	Yes
(3) FOWLER BUSINESS & PROFESSIONAL PARK PROPERTY OWNERS ASSOCIATION 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 30-1030354	PROPERTY OWNERS ASSOCIATION	CA	FOWLER BUSINESS & PROFESSIONAL PARK LLC	C			50.000 %		No

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

Yes

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

Yes

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

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

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	3,570
6	Total number of volunteers (estimate if necessary) .............	6	424
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 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	24,828,237	34,039,952
9	Program service revenue (Part VIII, line 2g) .........	532,224,270	614,207,247
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	48,604,582	24,789,411
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	19,645,264	20,176,687
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	625,302,353	693,213,297
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	13,187,157	38,678,604
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)	291,045,351	302,339,673
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	254,453,232	293,519,984
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	558,685,740	634,538,261
19	Revenue less expenses. Subtract line 18 from line 12.......	66,616,613	58,675,036
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,214,830,788	1,540,317,940
21	Total liabilities (Part X, line 26).............	228,566,436	473,320,364
22	Net assets or fund balances. Subtract line 21 from line 20.....	986,264,352	1,066,997,576

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 87,389,889 including grants of $ 38,678,604 ) (Revenue $ 334,519,190 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ 411,596,659 including grants of $ 0 ) (Revenue $ 279,688,057 )
	SEE SCHEDULE O

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses498,986,548

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	11,562,117	0	1,875,426

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	7,902,144
e	Government grants (contributions)		1e	25,688,948

f	All other contributions, gifts, grants, and similar amounts not included above		1f	448,860

g	Noncash contributions included in lines 1a - 1f:$		1g	11,373

h Total. Add lines 1a-1f.......		34,039,952

		Business Code
2a	PATIENT SERVICES	900099	610,224,759	610,224,759
b	MANAGEMENT SERVICES	541610	3,835,988	3,835,988
c	LAB SERVICES	900099	146,500	146,500
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		614,207,247

3 Investment income (including dividends, interest, and othersimilar amounts) ......			17,756,832			17,756,832
4 Income from investment of tax-exempt bond proceeds			1,276,392			1,276,392
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		396,876	6a
b	Less: rental expenses		323,309	6b
c	Rental income or (loss)		73,567	6c
d	Net rental income or (loss).......			73,567			73,567
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	1,382	715,911,220	7a
b	Less: cost or other basis and sales expenses	31,624	710,124,791	7b
c	Gain or (loss)	-30,242	5,786,429	7c
d	Net gain or (loss).........			5,756,187			5,756,187
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	612,978
b	Less: cost of goods sold ..		10b	278,898
c	Net income or (loss) from sales of inventory..			334,080			334,080
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		900099	3,091,619			3,091,619
b
c
d	All other revenue ....			16,677,421			16,677,421
e	Total. Add lines 11a–11d ......			19,769,040
12	Total revenue. See instructions.....			693,213,297	614,207,247	0	44,966,098

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	38,457,549	38,457,549
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	221,055	221,055
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 ...........	17,942,536		17,942,536
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........	195,376,428	158,787,431	36,588,997
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	11,593,644	10,378,037	1,215,607
9	Other employee benefits .......	60,523,459	44,289,452	16,234,007
10	Payroll taxes ...........	16,903,606	12,684,052	4,219,554
11	Fees for services (non-employees):
a	Management ......	3,088,608	100,912	2,987,696
b	Legal .........	2,249,303		2,249,303
c	Accounting ...........	179,376		179,376
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	3,271,802		3,271,802
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	67,378,903	67,019,561	359,342
12	Advertising and promotion ....	3,770,689	93,375	3,677,314
13	Office expenses .......	82,409,571	74,446,181	7,963,390
14	Information technology ......	6,058,678		6,058,678
15	Royalties ..
16	Occupancy ...........	5,768,036	4,083,912	1,684,124
17	Travel ............	836,037	302,940	533,097
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	260,798	74,855	185,943
20	Interest ...........	6,865,072	5,333,015	1,532,057
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	25,562,148	15,077,838	10,484,310
23	Insurance ...	3,264,480	359	3,264,121
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	HOSPITAL FEE PROGRAM	41,708,611	41,708,611
b	PURCHASED SERVICES	24,617,210	18,329,810	6,287,400
c	BAD DEBT	7,072,241	7,072,241
d	DUES	2,075,543	228,373	1,847,170
e	All other expenses	7,082,878	296,989	6,785,889
25	Total functional expenses. Add lines 1 through 24e	634,538,261	498,986,548	135,551,713	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			13,685	1	14,394
2	Savings and temporary cash investments .........			216,742,357	2	389,975,007
3	Pledges and grants receivable, net ......			401,514	3	560,199
4	Accounts receivable, net .............			79,144,610	4	75,373,277
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			8,662,016	8	9,763,049
9	Prepaid expenses and deferred charges ......			14,653,449	9	19,488,786
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	550,093,276
b	Less: accumulated depreciation	10b	279,415,258	260,158,665	10c	270,678,018
11	Investments—publicly traded securities .			332,510,847	11	321,908,138
12	Investments—other securities. See Part IV, line 11 .....			235,911,898	12	296,311,715
13	Investments—program-related. See Part IV, line 11 ..			9,492,668	13	19,506,083
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			57,139,079	15	136,739,274
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,214,830,788	16	1,540,317,940

17	Accounts payable and accrued expenses .....	60,099,865	17	53,631,715
18	Grants payable ...		18
19	Deferred revenue .........		19	106,083,936
20	Tax-exempt bond liabilities .........	115,615,136	20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			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	52,851,435	25	313,604,713
26	Total liabilities. Add lines 17 through 25..	228,566,436	26	473,320,364

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	986,264,352	32	1,066,997,576
33	Total liabilities and net assets/fund balances ........	1,214,830,788	33	1,540,317,940

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No