TY 2018 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) BARTH WHITMAN...................................................................... board member/chair	1.0 ................. 4.0	X	X
(2) DAVID HOOVER...................................................................... board member/Chair-Elect	1.0 ................. 0.0	X	X
(3) DAVID HONEYFIELD...................................................................... board member/Treasurer	1.0 ................. 4.0	X	X
(4) William N Lindsay III...................................................................... board member/Chair (outgoing)	1.0 ................. 4.0	X	X
(5) LAURA BARTON...................................................................... Board member	1.0 ................. 0.0	X
(6) MEGAN FEARNOW...................................................................... Board member	1.0 ................. 0.0	X
(7) MIKE GOULD...................................................................... Board member	1.0 ................. 0.0	X
(8) RANDY HERTEL...................................................................... Board member	1.0 ................. 0.0	X
(9) SOLEDAD HURST...................................................................... Board member	1.0 ................. 0.0	X
(10) WAYNE HUTCHENS...................................................................... Board member	1.0 ................. 0.0	X
(11) JOHN IKARD...................................................................... Board member	1.0 ................. 0.0	X
(12) Judith KOFF...................................................................... Board member	1.0 ................. 0.0	X
(13) ANNITA MENOGAN...................................................................... BOARD MEMBER/Secretary	1.0 ................. 4.0	X	X
(14) MARTHA MIDDLEMIST MD...................................................................... Board member	1.0 ................. 0.0	X
(15) SHEN NAGEL MD...................................................................... Board member	1.0 ................. 0.0	X
(16) VICTORIA QUINTANA...................................................................... Board member	1.0 ................. 0.0	X
(17) KEVIN REIDY...................................................................... BOARD MEMBER	1.0 ................. 4.0	X

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) KRISTIN RICHARDSON........................................................................ Board member	1.0 .......................0.0	X				0	0
(19) BRUCE WAGNER........................................................................ Board member	1.0 .......................0.0	X				0	0
(20) JACK WOLD........................................................................ Board member	1.0 .......................0.0	X				0	0
(21) LAURA WRIGHT........................................................................ BOARD MEMBER	1.0 .......................4.0	X				0	0
(22) DON ELLIMAN........................................................................ BOARD MEMBER	1.0 .......................4.0	X				0	0
(23) JENA HAUSMANN........................................................................ President and CEO	40.0 .......................4.0	X	X			1,580,314	273,278
(24) DEBRA FAULK MD........................................................................ BOARD MEMBER	1.0 .......................0.0	X				0	0
(25) ARLEN HELLER........................................................................ board member	1.0 .......................0.0	X				0	0
(26) JOHN REILLY MD........................................................................ board member	1.0 .......................0.0	X				0	0
(27) JANE SCHUMAKER........................................................................ board member	1.0 .......................0.0	X				0	0
(28) Russell Dispense........................................................................ board member (part year)	1.0 .......................0.0	X				0	0
(29) Karen Leamer MD........................................................................ board member (part year)	1.0 .......................0.0	X				0	0
(30) Davnid Shapiro........................................................................ board member (part year)	1.0 .......................0.0	X				0	0
(31) MICHELLE LUCERO........................................................................ Chief Legal Officer	40.0 .......................0.0		X			630,204	124,228
(32) DAVID BIGGERSTAFF........................................................................ EVP and COO	40.0 .......................0.0		X			783,612	187,247
(33) JEFFREY HARRINGTON........................................................................ SVP and CFO	40.0 .......................4.0		X			836,853	172,038
(34) SUZANNE JAEGER........................................................................ SVP Experience and Access	40.0 .......................0.0			X		471,603	79,883
(35) RAPHE SCHWARTZ........................................................................ SVP AND CHIEF STRATEGY OFFICER	40.0 .......................0.0			X		420,021	111,621
(36) PATRICIA GIVENS........................................................................ SVP Patient Care SVCS & CNO	40.0 .......................0.0			X		474,525	40,518
(37) JERROD MILTON........................................................................ VP Operations	40.0 .......................0.0				X	380,556	94,740
(38) GREGORY RAYMOND........................................................................ Colorado Springs COO	40.0 .......................0.0				X	334,749	94,056
(39) CATHERINE DAL SANTO........................................................................ VP Finance	40.0 .......................0.0				X	413,461	67,869
(40) CHARLOTTE ISOLINE........................................................................ VP Marketing	40.0 .......................0.0				X	332,185	18,390
(41) DANA MOORE........................................................................ SVP and CIO	40.0 .......................0.0				X	529,044	156,777

(A) Name and business address	(B) Description of services	(C) Compensation
University of Colorado Medicine, 13199 East Montview Blvd Aurora,CO80045	Physician Services	83,153,753
University of Colorado Denver, 13123 East 16th ave BOD B-219 Aurora,CO80045	Education Services	25,420,596
University Hospital, 12605 E 16th Ave Aurora,CO80045	Phys/Medical Service	14,222,199
Sapient Razorfish, PO Box 4886 Boston,MA02212	Marketing Services	5,713,582
Publicis Health Media, 222 W Merchandise Mart Plaza 555 Chicago,IL60654	Marketing Services	3,585,951
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 128

- 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 the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL COLORADO

Employer identification number

84-0166760

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) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

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) 2018

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) 2018

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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, 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 2018. 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 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

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) 2018

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

2018

Name of the organization

CHILDREN'S HOSPITAL COLORADO

Employer identification number

84-0166760

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization CHILDREN'S HOSPITAL COLORADO

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

Name of organization CHILDREN'S HOSPITAL COLORADO		Employer identification number 84-0166760

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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization CHILDREN'S HOSPITAL COLORADO			Employer identification number 84-0166760
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) (2018)

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

2018

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

CHILDREN'S HOSPITAL COLORADO

Employer identification number

84-0166760

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) 2018

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.)		(a) Filing organization's totals	(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................	62,898
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................	452,561
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................	515,459
d	Other exempt purpose expenditures ........................................................................	941,491,265
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................	942,006,724
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000
	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) .................................................	250,000
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) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	486,949	678,362	508,678	515,459	2,189,448

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures	82,676	43,943	52,093	62,898	241,610

Schedule C (Form 990 or 990-EZ) 2018

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

(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)? ........

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

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

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

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

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

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

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

Schedule C (Form 990 or 990EZ) 2018

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 the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL COLORADO

Employer identification number

84-0166760

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 SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included 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 SFAS 116 (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) 2018

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 ....	44,803,998	39,760,313	37,970,011	38,851,637	37,734,642
b	Contributions ...
c	Net investment earnings, gains, and losses	-2,040,626	5,959,341	2,303,237	-42,145	2,029,994
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	1,390,736	826,784	430,693	654,207	830,947
f	Administrative expenses ....	93,340	88,872	82,242	185,274	82,052
g	End of year balance ......	41,279,296	44,803,998	39,760,313	37,970,011	38,851,637

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

100.000 %

Temporarily restricted 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)

Yes

(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 .....	57,440,327		57,440,327
b	Buildings ....	880,668,191	254,817,007	625,851,184
c	Leasehold improvements	18,586,369	11,280,238	7,306,131
d	Equipment ....	523,980,972	337,150,303	186,830,669
e	Other .....	156,310,588	8,576,154	147,734,434
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				1,025,162,745

Schedule D (Form 990) 2018

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
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) TAMMEN TRUST				41,279,296
(2) MISC. RECEIVABLES				25,430,392
(3) SELF INSURANCE TRUST LT REC.				7,425,000
(4) INTERCOMPANY OTHER AFFILIATES				7,323,118
(5) 457 ASSETS				6,226,653
(6) OTHER NON CURRENT ASSETS				4,391,508
(7) ENTERO TRACK NOTE RECEIVABLE				1,556,383
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				93,632,350

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	0
VALUE OF FINANCIAL SWAP	22,235,899
SELF INSURANCE TRUST PAYABLE	21,235,816
CURRENT PORTION LT DEBT	8,530,350
457 LIABILITIES	6,264,002
LEASE TENANT IMPROVEMENT	2,068,888
DEFERRED RENT	1,525,639
DEFERRED COMP ESCROW	438,692
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	62,299,286
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) 2018

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, PART V, LINE 4	THE HOSPITAL IS THE INCOME BENEFICIARY OF THE H.H. TAMMEN TRUST, A PERPETUAL TRUST UNDER WHICH THE HOSPITAL HAS THE IRREVOCABLE RIGHT TO RECEIVE THE INCOME EARNED ON THE TRUST ASSETS IN PERPETUITY. FUNDS ARE USED TO SUPPORT HOSPITAL ACTIVITIES.
SCHEDULE D, PART X, LINE 2	MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2018

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

2018

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL COLORADO

Employer identification number

84-0166760

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

Yes

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

Yes

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) . . .	3,462,481	1,158,180	2,304,301	0.210 %
b	Medicaid (from Worksheet 3, column a) . . . . .	438,243,168	317,930,175	120,312,993	10.790 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	441,705,649	319,088,355	122,617,294	11.000 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	18,229,081	3,767,894	14,461,187	1.300 %
f	Health professions education (from Worksheet 5) . . .	28,611,192	9,392,754	19,218,438	1.720 %
g	Subsidized health services (from Worksheet 6) . . . .	48,091,191	40,224,719	7,866,472	0.710 %
h	Research (from Worksheet 7) .	28,932,753	11,483,008	17,449,745	1.560 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	539,846		539,846	0.050 %
j	Total. Other Benefits . .	124,404,063	64,868,375	59,535,688	5.340 %
k	Total. Add lines 7d and 7j .	566,109,712	383,956,730	182,152,982	16.340 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

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.

		(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	41,014		41,014	0 %
4	Environmental improvements	42,079	19,849	22,230
5	Leadership development and training for community members	59,487		59,487	0 %
6	Coalition building
7	Community health improvement advocacy	17,575		17,575	0 %
8	Workforce development	1,260,326	116,000	1,144,326	0.100 %
9	Other
10	Total	1,420,481	135,849	1,284,632	0.100 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare 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. ......

4,254,898

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. ......

450,000

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).....

1,623,361

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

2,833,126

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

-1,209,765

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) 2018

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?3Name, 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)							Other (describe)	Facility reporting group
1	CHILDREN'S HOSPITAL CO - ANSCHUTZ 13123 EAST 16TH AVENUE AURORA,CO80045 WWW.CHILDRENSCOLORADO.ORG 010417	X	X	X	X	X		A
2	CHILDREN'S HOSPITAL COLORADO - SOUTH 1811 PLAZA DRIVE HIGHLANDS RANCH,CO80129 WWW.CHILDRENSCOLORADO.ORG 01F105	X	X	X	X	X		A
3	CHCO - At Parker Adventist Hospital 9395 Crown Crest Blvd Parker,CO80138 WWW.CHILDRENSCOLORADO.ORG 132405	X	X			X	Hospital Unit or Hospital-Within a Hospital	A

Schedule H (Form 990) 2018

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)

	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 18

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

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.CHILDRENSCOLORADO.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 19

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

Yes

If "Yes" (list url): WWW.CHILDRENSCOLORADO.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) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	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.% and FPG family income limit for eligibility for discounted care of 400.%

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.childrenscolorado.org

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

www.childrenscolorado.org

A plain language summary of the FAP was widely available on a website (list url):
www.childrenscolorado.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) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	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

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

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) 2018

Page 7

Part VFacility Information (continued)

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

	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) 2018

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, 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
SCHEDULE H, PART V, SECTION B	A SINGLE SCHEDULE H, PART V, SECTION B WAS COMPLETED FOR FACILITY REPORTING GROUP A. THE FOLLOWING HOSPITAL FACILITIES ARE INCLUDED IN FACILITY REPORTING GROUP A: (1) CHILDREN'S HOSPITAL COLORADO (2) CHILDREN'S HOSPITAL COLORADO - SOUTH (3) CHILDREN'S HOSPITAL COLORADO - AT PARKER ADVENTIST HOSPITAL Schedule H, Part V, Section B, Line 3e THE TOP FIVE IDENTIFIED CHNA NEEDS ARE NOT PRIORITIZED AND ALL RECEIVED EQUAL WEIGHT IN THE IMPLEMENTATION PLAN AND ON-GOING PROGRAMING. Schedule H, Part V, Section B, Line 5 THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 5 APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: PRIOR TO LAUNCHING OUR 2018 ASSESSMENT, CHILDREN'S COLORADO SOLICITED INTERNAL AND EXTERNAL FEEDBACK ON OUR PREVIOUS ASSESSMENT, WHICH WAS CONDUCTED IN 2015. WE WERE INTERESTED IN LEARNING ABOUT AND IMPROVING BOTH THE PROCESS THAT WAS USED PREVIOUSLY AND THE CONCLUSIONS THAT WERE DRAWN IN THAT ASSESSMENT. A TOTAL OF SEVEN EXTERNAL EVALUATORS PROVIDED DETAILED WRITTEN FEEDBACK ON THE 2015 ASSESSMENT. THEY INCLUDED REPRESENTATIVES FROM PUBLIC HEALTH, NONPROFIT ORGANIZATIONS, HEALTH ADVOCACY ORGANIZATIONS AND HEALTH CARE PROVIDERS. REVIEWERS WERE ASKED TO IDENTIFY KEY STRENGTHS AND WEAKNESSES OF THE PREVIOUS ASSESSMENTS. FOR THE PURPOSES OF THE ASSESSMENT, WE USED FOUR QUALITATIVE DATA COLLECTION METHODS: KEY STAKEHOLDER INTERVIEWS WITH COMMUNITY AND HEALTH LEADERS. A TOTAL OF 44 INTERVIEWS WERE COMPLETED WITH INDIVIDUALS WHO REPRESENTED PUBLIC HEALTH, GOVERNMENT, PUBLIC SAFETY, DIRECT SERVICE, PUBLIC EDUCATION AND ADVOCACY ORGANIZATIONS. INTERVIEWEES ALSO REPRESENTED A RANGE OF GEOGRAPHIC AREAS AND ALL FOUR COUNTIES IN OUR COMMUNITY WERE WELL REPRESENTED. 7 OF THE INTERVIEWS WERE WITH STAFF MEMBERS OF THE TRI-COUNTY HEALTH DEPARTMENT, WHICH IS ONE OF THE LARGEST PUBLIC HEALTH DEPARTMENTS IN THE STATE AND COVERS ADAMS, ARAPAHOE AND DOUGLAS COUNTIES. THE LIST OF ORGANIZATIONS INTERVIEWED IS IDENTIFIED IN THE CHNA AND THE NAMES OF THE INTERVIEWEES ARE ON FILE. FOCUS GROUPS IN EACH OF THE FOUR COUNTIES IN OUR COMMUNITY. WE FOCUSED ON RECRUITING LOW-INCOME AND VULNERABLE POPULATIONS TO THE FOCUS GROUPS THAT WE CONDUCTED. WE CONDUCTED 6 FOCUS GROUPS AND HAD A TOTAL OF 48 PARTICIPANTS. WE CONDUCTED 2 GROUPS IN DENVER COUNTY, 1 IN DOUGLAS COUNTY, AND 3 IN LOCATIONS WHERE BOTH ADAMS AND ARAPAHOE COUNTY RESIDENTS COULD PARTICIPATE. PARENT SURVEY IN BOTH ENGLISH AND SPANISH. OUR SURVEY TARGETED PARENTS AND CAREGIVERS OF CHILDREN AGES 0-17 WHO LIVE IN THEIR HOME. PARTICIPANTS WERE RECRUITED VIA CHILDREN'S HOSPITAL EMAIL LISTS AND SOCIAL MEDIA AND THROUGH EMAIL CAMPAIGNS WITH OUR PARTNERS. ADDITIONALLY, WE WORKED CLOSELY WITH THE COMMUNITY CAMPUS PARTNERSHIP (CCP), A NONPROFIT ORGANIZATION THAT FOSTERS COLLABORATIONS BETWEEN THE ANSCHUTZ MEDICAL CAMPUS AND THE SURROUNDING AURORA COMMUNITY NEIGHBORHOODS TO IMPROVE THE HEALTH AND ECONOMIC WELL-BEING OF THE AURORA COMMUNITY. MEMBERS OF THE CCP'S RESIDENT LEADERSHIP COUNCIL, WHO ALL RESIDE NEAR THE MAIN CAMPUS, WEre RECRUITED TO CONDUCT THE SURVEYS IN ADDITIONAL LANGUAGES AND TRANSLATE THE RESPONSES. THEY GREATLY EXPANDED OUR ACCESS TO NON-ENGLISH SPEAKERS WHO RESIDE IN THE THREE ZIP CODES CLOSE TO THE HOSPITAL. IN 2018, ADDITIONAL DEMOGRAPHIC QUESTIONS WERE ADDED TO THE PARENT SURVEY. THIS ALLOWED US TO ANALYZE THE RESULTS IN A MORE IN-DEPTH MANNER. FIRST, AN ANALYSIS OF THE TOP-RATED ISSUES/CONCERNS WAS PERFORMED WITH DIFFERENCES NOTED BETWEEN THE ENGLISH LANGUAGE AND SPANISH LANGUAGE SURVEY RESPONSES. NEXT, WE SORTED RESULTS BY COUNTY AS WELL AS BY INCOME LEVELS TO DETERMINE SIGNIFICANT VARIATIONS IN THE ISSUES IDENTIFIED AS TOP CONCERNS. THIS APPROACH PERMITTED THE TEAM TO GAIN INSIGHT INTO A LARGE CROSS SECTION OF THE POPULATION. IN ALL, 582 RESIDENTS OF OUR FOUR-COUNTY COMMUNITY RESPONDED TO THE SURVEY; 409 IN ENGLISH AND 173 IN SPANISH. THE FOUR COUNTIES WERE FAIRLY EQUALLY REPRESENTED IN THE TOTAL RESPONSES. ONLINE PROVIDER SURVEY. THE PROVIDER SURVEY WAS A NEW ADDITION TO OUR DATA COLLECTION EFFORTS THIS YEAR AND ALLOWED US TO HEAR DIRECTLY FROM HEALTH CARE WORKERS ABOUT THE COMMUNITY NEEDS THEY ARE SEEING IN THEIR PRACTICES. WE HAD 108 PROVIDER RESPONSES FROM PHYSICIANS, SCHOOL NURSES AND OTHER HEALTH CARE PROVIDERS. UNDERSERVED POPULATION INPUT. AS PART OF THIS ASSESSMENT, WE PRIORITIZED GETTING INPUT FROM UNDERSERVED POPULATIONS INCLUDING LOW-INCOME AND MINORITY GROUPS AND GROUPS WHOSE PRIMARY LANGUAGE IS NOT ENGLISH. STAKEHOLDER INTERVIEWS WERE CONDUCTED WITH LEADERS OF ORGANIZATIONS THAT SERVE AND/OR ADVOCATE FOR UNDERSERVED GROUPS. SPECIFIC ORGANIZATIONS IDENTIFIED IN THE CHNA. THE TEAM WORKED WITH COMMUNITY PARTNERS TO ENSURE THAT THE PARENT SURVEY REACHED A SOCIO-ECONOMICALLY AND ETHNICALLY DIVERSE POPULATION. 60% OF OUR RESPONDENTS HAVE A HOUSEHOLD INCOME THAT IS LESS THAN THE STATE'S AVERAGE HOUSEHOLD INCOME OF $75,000 AND 21% HAVE HOUSEHOLD INCOMES OF LESS THAN $25,000. 65% OF OUR RESPONDENTS ARE ETHNIC MINORITIES. ADDITIONAL DETAILS AVAILABLE IN THE CHNA.
SCHEDULE H, PART V, SECTION B, LINE 6A	THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 6A APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: DUE TO THE PROXIMITY OF GEOGRAPHIC LOCATIONS in 2018 CHILDREN'S HOSPITAL COLORADO CONDUCTED A JOINT CHNA FOR ITS LICENSED HOSPITAL FACILITIES, WHICH INCLUDED MAIN CAMPUS, SOUTH CAMPUS AND PARKER ADVENTIST (HOSPITAL UNIT LICENSE). THE IRS ALLOWS HOSPITAL FACILITIES TO PRODUCE A JOINT CHNA REPORT IF THE FACILITIES USE THE SAME DEFINITIONS OF COMMUNITY AND CONDUCT A JOINT CHNA PROCESS. WE HAVE FOLLOWED THOSE REQUIREMENTS FOR THE 2018 CHNA. WHILE OUR NETWORK SERVES CHILDREN IN A SEVEN-STATE REGION, FOR THE PURPOSES OF THE 2018 CHNA WE DEFINED COMMUNITY AS ALL CHILDREN LIVING IN THE FOUR-COUNTY AREA FROM WHICH MOST OF OUR PATIENT POPULATION IS DRAWN AND IN WHICH WE HAVE FACILITIES. THIS INCLUDES DENVER, DOUGLAS, ADAMS AND ARAPAHOE COUNTIES. LOCATED WITHIN A 50 MILE RADIUS OF EACH OTHER. IN 2018, WE HAD MORE THAN 15,000 INPATIENT ADMISSIONS, approximately 600,000 OUTPATIENT VISITS, AND MORE THAN 160,000 EMERGENCY DEPARTMENT AND URGENT CARE VISITS. 60% OF ALL VISITS FOR ALL LOCATIONS WERE FROM PATIENTS WHO RESIDE IN DENVER, DOUGLAS, ADAMS AND ARAPAHOE COUNTIES.
SCHEDULE H, PART V, SECTION B, LINE 7D	THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 7D APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: IN ADDITION TO POSTING THE CHNA ON THE HOSPITALS EXTERNAL-FACING WEBSITE AND MAKING THE REPORT AVAILABLE UPON REQUEST, OVER 500 PHYSICAL COPIES HAVE BEEN DISTRIBUTED TO THE COMMUNITY SINCE DECEMBER 2018. AS PART OF THE CHNA COMMUNICATION PLAN CHILDRENS CHILD HEALTH ADVOCACY INSTITUTE (CHAI) STAFF PRESENTED THE CHNA FINDINGS TO SEVERAL STAKEHOLDER GROUPS. CHAI STAFF ALSO ROUTINELY SHARE CHNA FINDINGS IN MEETINGS WITH COMMUNITY PARTNERS, WITH THE GOAL OF IDENTIFYING OPPORTUNITIES TO ENGAGE IN COLLABORATIVE EFFORTS TO ADDRESS THE AREAS OF NEED. WITH THE GOAL OF MAKING THE CHNA MORE ACCESSIBLE TO THE LARGER COMMUNITY, UPON THE COMPLETION OF THE IMPLEMENTATION STRATEGY, ADDITIONAL MATERIALS WILL BE MADE AVAILABLE IN VARIOUS FORMATS TO SUMMARIZE BOTH THE CHNA AND ACCOMPANYING PLAN. 2018 CHNA: https://www.childrenscolorado.org/community/community-health/community-hea lth-needs-assessment/
SCHEDULE H, PART V, SECTION B, LINE 11	THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL HOSPITAL FACILITIES INCLUDED IN FACILITY REPORTING GROUP A: THE COMMUNITY HEALTH ACTION PLAN (CHAP) OF 2016-2019 SERVED AS A FOUNDATION AND ROAD MAP FOR CHILDRENS COLORADOS POPULATION HEALTH WORK. SINCE THE START OF CHAP IN 2016, THE HOSPITALS COMMUNITY HEALTH TEAM AND ITS PARTNERS ENGAGED IN A VARIETY OF INITIATIVES TO PROMOTE HEALTH AND PREVENT ILLNESS IN THE SURROUNDING COMMUNITY. CHILDRENS COLORADO FOCUSED ON THE SIX HEALTH PRIORITY AREAS THAT WERE IDENTIFIED IN THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND LED OR COLLABORATED WITH PARTNERS ON INITIATIVES WITHIN THE HOSPITAL, IN THE COMMUNITY AND ACROSS THE STATE. THESE INITIATIVES INCLUDED EDUCATION AND PUBLIC AWARENESS, TRAININGS, SCREENINGS AND IMPROVING ACCESS TO CARE, POLICY AND ADVOCACY EFFORTS AND EXPANSION OF THE WORKFORCE IN COMMUNITY HEALTH. THE ANNUAL EVALUATION SUMMARIZES THE IMPACT OF THE WORK OUTLINED IN THE 2016 CHAP, AS WELL AS ONGOING AND FUTURE INITIATIVES TO ADDRESS SOCIAL DETERMINANTS OF HEALTH AND IMPROVE THE HEALTH AND LIVES OF CHILDREN AND FAMILIES IN THE COMMUNITY. THE ANNUAL EVALUATION CAN BE FOUND AT: HTTPS://WWW.CHILDRENSCOLORADO.ORG/GLOBALASSETS/COMMUNITY/2016-2018-ACTION- PLAN-EVALUATION-REPORT.PDF CHILDRENS COLORADO WILL CONTINUE TO FOCUS ITS EFFORTS IN THE COMMUNITY TO PROMOTE HEALTH AND REDUCE ILLNESS IN OUR COMMUNITY AND FOCUSING ON NEW AND EXISTING COMMUNITY PARTNERSHIPS TO DEVELOP A SUSTAINABLE MODEL TO ADDRESS POPULATION HEALTH. IN 2018, AS PART OF OUR COMMITMENT TO BE AN ACTIVE PARTNER IN THE COMMUNITY THAT GOES WELL BEYOND THE PROVISION OF PATIENT CARE, WE CONDUCTED A COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT. THE GOAL OF THE ASSESSMENT WAS TO BETTER UNDERSTAND THE CONCERNS AND PRIORITIES OF THE FAMILIES WE SERVE, THE COMMUNITY ORGANIZATIONS WE PARTNER WITH, AND THE PROVIDERS WHO WORK WITH OUR PATIENTS. THE 2018 COMMUNITY NEEDS HEALTH ASSESSMENT, WHICH SUMMARIZES THESE FINDINGS, CAN BE FOUND AT CHILDRENSCOLORADO.ORG/GLOBALASSETS/COMMUNITY/CHILDRENS-HOSPITAL-COLORADO-2 018-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF. THE CHNA WAS APPROVED BY THE CHCO BOARD OF DIRECTORS IN DECEMBER 2018. THROUGH OUR 2018 NEEDS ASSESSMENT, WE IDENTIFIED FIVE PRIORITY AREAS THAT WILL BE THE FOCUS OF OUR COMMUNITY HEALTH IMPROVEMENT WORK FOR THE NEXT THREE YEARS (2019-2022): MENTAL HEALTH/BEHAVIORAL HEALTH, INJURY PREVENTION, PREMATURITY, OBESITY/NUTRITION/PHYSICAL ACTIVITY, AND ASTHMA/RESPIRATORY CARE. CHCO IS ACTIVELY WORKING ON THE DEVELOPMENT OF OUR THREE-YEAR IMPLEMENTATION PLAN TO ADDRESS THE FIVE COMMUNITY HEALTH PRIORITY AREAS. THE PLAN IS SCHEDULED TO BE COMPLETED AND APPROVED BY THE BOARD IN MAY 2019. TO DEVELOP THE IMPLEMENTATION PLAN, CHILDRENS HOSPITAL COLORADO IS UTILIZING THE INFORMATION GATHERED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT AS THE MAJOR SOURCE OF INFORMATION AND INCORPORATED ADDITIONAL INSIGHTS FROM PLANNING DISCUSSIONS WITH COMMUNITY PARTNERS. WE PLAN TO CONVENE A SERIES OF STRATEGY SESSIONS WITH PROVIDERS, COMMUNITY HEALTH STRATEGISTS AND ADMINISTRATORS. EACH OF THESE SESSIONS WILL FOCUS ON ONE OF THE FIVE PRIORITY AREAS THAT HAD BEEN SELECTED THROUGH THE NEEDS ASSESSMENT. WITH THE HELP OF AN OUTSIDE FACILITATOR, TEAMS WILL VISION STATEMENTS, GOALS AND OBJECTIVES FOR EACH PRIORITY. THE OBJECTIVES SELECTED WILL ALL BE QUANTIFIABLE AND TIME-LIMITED, WHICH WILL ALLOW FOR EFFECTIVE EVALUATION OF OUR EFFORTS IN THE FUTURE.

Schedule H (Form 990) 2018

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?12
Name and address		Type of Facility (describe)
1	CHILDREN'S HOSPITAL COLORADO-NORTH 469 WEST STATE HIGHWAY 7 BROOMFIELD,CO80023	UC,SPECIALTY CARE,observation, REHAB & SPORT THERAPY licensed cmty clinic 18F110
2	CHILDREN'S HOSPITAL CO OP SPECIALTY CARE 4125 BRIARGATE PKWY COLORADO SPRINGS,CO80920	SPECIALTY CARE, Oncology CLINICS, URGENT CARE
3	CHILDREN'S HOSPITAL COLORADO-UPTOWN 1830 FRANKLIN ST DENVER,CO80218	EMERGENCY CARE, UC, OP SPCLTY, DIAGNOSTIC, observation, licensed cmty clinic 18M127
4	CHILDREN'S HOSPITAL CO THERAPY CARE 8401 ARISTA PLACE BROOMFIELD,CO80021	OT/PT, SPEECH & AUDIOLOGY SERVICES
5	KIDSTREET 3615 MARTIN LUTHER KING BLVD DENVER,CO80205	REHABILITATION & THERAPY SERVICES
6	CHILDREN'S HOSPITAL CO THERAPY CARE PRINTERS PARK MEDICAL PLAZA COLORADO SPRINGS,CO80910	OT/PT, SPEECH & AUDIOLOGY SERVICES
7	CHILDREN'S HOSPITAL CO Therapy Care 19284 COTTONWOOD DRIVE PARKER,CO80138	OT/PT, SPEECH & AUDIOLOGY SERVICES
8	CHILDREN'S HOSPITAL CO Therapy Care 9139 S RIDGELINE BLVD 100 HIGHLANDS RANCH,CO80129	REHABILITATION & THERAPY SERVICES
9	CHILDREN'S HOSPITAL CO UC & OP CARE 3455 LUTHERAN PKWY WHEATRIDGE,CO80033	URGENT CARE, SPECIALIST CARE, SPORTS MEDICINE
10	CHILDREN'S HOSPITAL CO THERAPY CARE 704 FORTINO BLVD STE A PUEBLO,CO81008	SPEECH THERAPY, LEARNING DISABILITIES
11	CHILDREN'S HOSPITAL CO SPECIALTY CARE 9399 CROWN CREST BLVD PARKER,CO80138	SPECIALTY CARE, SPORTS MEDICINE
12	CHILDREN'S HOSPITAL CO ORTHOPEDIC CARE 9094 E MINERAL AVE SUITE 110 CENTENNIAL,CO80112	ORTHOPEDIC ARE, RADIOLOGY SERVICES, SPORTS MEDICINE

Schedule H (Form 990) 2018

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
SCHEDULE H, PART I, LINE 6A	CHILDRENS COLORADO PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT. THE 2018 REPORT WILL BE PUBLISHED AFTER THE FINALIZATION OF THE 2018 SCHEDULE H 990 REPORTING. THE 2017 REPORT CAN BE FOUND AT HTTPS://WWW.CHILDRENSCOLORADO.ORG/COMMUNITY/COMMUNITY-HEALTH/. PRIOR TO THE COMPLETION OF THE REPORT A DISTRIBUTION LIST OF COMMUNITY MEMBERS, PARTNERS AND STATE AND LOCAL OFFICIALS IS DEVELOPED, AND THE REPORT IS DISTRIBUTED UPON COMPLETION. COINCIDING WITH THE PHYSICAL DISTRIBUTION THE REPORT IS THEN PUBLISHED ON THE CHCO WEBSITE. SCHEDULE H, PART I, LINE 7 IN 2018, CHILDRENS HOSPITAL COLORADO PROVIDED $182,152,982 OR 16.34% OF TOTAL OPERATING EXPENSES, IN BENEFIT TO THE COMMUNITY. MEDICAID AT CHILDRENS HOSPITAL COLORADO ACCOUNTED FOR $120,312,993 OF NET COMMUNITY BENEFIT EXPENSE OR 10.79% OF TOTAL OPERATING EXPENSES WITH $2,304,301 IN FINANCIAL ASSISTANCE OR 0.21% OF TOTAL EXPENSE. OTHER BENEFITS ACCOUNTED FOR $59,535,688 IN NET COMMUNITY BENEFIT EXPENSE OR 5.34% OF TOTAL EXPENSE. OF THAT $14,461,187 IN COMMUNITY HEALTH IMPROVEMENT, $19,218,438 IN HEALTH PROFESSION EDUCATION, $7,866,472 IN SUBSIDIZED HEALTH SERVICES, $17,449,745 IN RESEARCH AND $539,846 IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT. INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THOSE WHICH CHILDRENS HOSPITAL COLORADO PROVIDES TO ITS PATIENT POPULATION AT A LOSS. IN 2018, PROGRAMS ASSOCIATED WITH THESE LOSSES ARE REHABILITATION, DERMATOLOGY AND MENTAL HEALTH. THE NUMBER REFLECTED IN SUBSIDIZED HEALTH SERVICES EXCLUDES BAD DEBT, MEDICAID AND OTHER MEANS TESTED PROGRAMS SHORTFALLS AND FINANCIAL ASSISTANCE. CHILDRENS HOSPITAL COLORADO IS COMMITTED TO SERVING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.
SCHEDULE H, PART II	IN 2018, CHILDRENS HOSPITAL COLORADO PROVIDED $1,284,632 IN COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE DESIGNED TO PROMOTE THE HEALTH OF THE BROADER COMMUNITY. WE CONTINUE TO BUILD ON OUR LONG AND STRONG RECORD OF COLLABORATION WITH COMMUNITY GROUPS, BUSINESSES, ACADEMIC INSTITUTIONS AND GOVERNMENTAL AND NON-GOVERNMENTAL ORGANIZATIONS, WITH THE GOAL OF IMPROVING HEALTH OUTCOMES AND REDUCING HEALTH DISPARITIES FOR CHILDREN AND THEIR FAMILIES. ADDITIONALLY, SIGNIFICANT RESOURCES WERE ALLOCATED IN 2018 TO SUPPORT EFFORTS TO ENGAGE COMMUNITY MEMBERS IN ADVOCATING FOR ACCESS TO HEALTH CARE AS WELL AS PROVIDING EDUCATIONAL SESSIONS FOR BOTH POLICYMAKERS AND ADVOCATES ON CHILD HEALTH ISSUES OF IMPORTANCE. IMPROVING THE HEALTH OF THE COMMUNITY THROUGH ENVIRONMENTAL EFFORTS WAS ALSO A PRIORITY, INCLUDING LONG-STANDING RECYCLING AND RETRO COMMISSIONING EFFORTS. FINALLY, THE HOSPITAL CONTRIBUTED SUBSTANTIAL RESOURCES TO PROGRAMS, SUCH AS OUR HIRE LOCAL PROGRAM, THAT PROVIDE A PIPELINE FOR AT-RISK HIGH SCHOOL STUDENTS, AND UNDERSERVED COMMUNITY MEMBERS TO PURSUE HEALTHCARE SPECIFIC CAREERS. SELECTED COMMUNITY BUILDING ACTIVITIES ARE HIGHLIGHTED BELOW. ADVOCACY FOR COMMUNITY HEALTH IMPROVEMENTS AND SAFETY. DURING THE 2018 COLORADO LEGISLATIVE SESSION, THE CHILDRENS HOSPITAL COLORADO GOVERNMENT AFFAIRS TEAM WORKED WITH INTERNAL AND EXTERNAL PARTNERS TO KEEP KIDS OUT OF THE HOSPITAL BY SUPPORTING LAWS THAT WOULD IMPROVE KIDS' HEALTH-AND DEFENDING AGAINST THOSE THAT WOULD NOT. WE BUILT PARTNERSHIPS WITH OUR ALLIES AND ADVOCATES ACROSS THE STATE, ENGAGED OUR HEALTHCARE PROFESSIONALS AND OTHER TEAM MEMBERS AND GAVE A VOICE TO OUR PATIENTS AND FAMILIES. TOGETHER, WE ADVANCED A NUMBER OF POLICY AND ADVOCACY GOALS THAT HAVE THE POTENTIAL TO LIFT THE TRAJECTORY OF A CHILDS LIFE. FOR EXAMPLE: MODERNIZING NEWBORN SCREENING: COLORADOS NEWBORN SCREENING PROGRAM AIMS TO ENSURE EVERY COLORADO BABY RECEIVES A GENETIC, METABOLIC AND HEARING SCREENING UPON BIRTH. THESE SCREENINGS HELP IDENTIFY POTENTIALLY LIFE-THREATENING CONDITIONS, AS WELL AS HEARING LOSS. IF THESE CONDITIONS ARENT IDENTIFIED VERY EARLY IN LIFE, THEY CAN LEAD TO SEVERE HEALTH CONSEQUENCES AND DEVELOPMENTAL DELAYS OR EVEN DEATH. HOWEVER, THAT LAW DATES BACK TO THE 1990S AND DID NOT INCLUDE SCREENING FOR MANY CONDITIONS THAT ARE STANDARD IN OTHER STATES. COLORADO'S SCREENING PROGRAM AIMS TO ENSURE EVERY ONE OF THE 67,000 BABIES BORN EACH YEAR IN THE STATE RECEIVES A SCREENING FOR POTENTIALLY LIFE-THREATENING MEDICAL CONDITIONS AND HEARING PROBLEMS. HOUSE BILL 18-1006 MAKES THE NEWBORN SCREENING PROGRAM MORE COMPREHENSIVE, ENSURES TIMELINESS OF SCREENING RESULTS AND OFFERS AN ENHANCED PROGRAM FOR THE 2,000 BABIES EACH YEAR WHO FAIL THEIR HEARING SCREENING. THE SCREENING ENSURES THAT BABIES AND FAMILIES ARE SWIFTLY CONNECTED TO CARE IF THERE IS A RISK FOR A MEDICAL CONDITION OR HEARING LOSS THAT NEEDS FURTHER EVALUATION. CLINICIANS AT CHILDRENS HOSPITAL COLORADO, INCLUDING PULMONOLOGISTS, APPROACHED OUR GOVERNMENT AFFAIRS TEAM WITH CONCERNS ABOUT THESE GAPS. WITH HELP FROM COMMUNITY PARTNERS, WE ADVOCATED TO MODERNIZE COLORADOS NEWBORN SCREENING PROGRAM BY EXPANDING TESTING TO COVER NEW DISEASES, IMPROVING THE FOLLOW-UP PROCESS FOR BABIES NEEDING ADDITIONAL TESTING, AND ENSURING ADEQUATE PROGRAM RESOURCES. PULMONARY FACULTY MEMBERS PROVIDED GUIDANCE ON BILL DEVELOPMENT AND TESTIMONY AT THE COLORADO LEGISLATURE. THIS BILL WAS SIGNED INTO LAW ON JUNE 8, 2018. FOOD INSECURITY: DURING THE 2018 STATE LEGISLATIVE SESSION, WE JOINED A COALITION OF ANTI-HUNGER ORGANIZATIONS TO SUPPORT SENATE BILL 13, WHICH EXPANDS THE STATE COVERAGE FOR FREE LUNCHES THROUGH THE NATIONAL SCHOoL LUNCH PROGRAM FOR MIDDLE SCHOOL STUDENTS. SB13 PASSED BOTH HOUSES OF THE LEGISLATURE AND WAS SIGNED INTO LAW. WE ALSO COLLABORATED WITH PARTNERS INVOLVED IN THE COLORADO BLUEPRINT TO END HUNGER INITIATIVE TO PASS A COLORADO STATE BOARD OF HUMAN SERVICES RULE CHANGE. ONE OF OUR PEDIATRICIANS TESTIFIED BEFORE THE STATE HUMAN SERVICES BOARD IN SUPPORT OF THE CHANGE TO INCREASE THE SNAP INCOME ELIGIBILITY THRESHOLD FOR ALL COLORADOANS TO 200% OF THE FEDERAL POLICY LEVEL. THIS CHANGE PROTECTS CHILDREN AND LOW-INCOME FAMILIES FROM LOSING SNAP BENEFITS BY BEING SLIGHTLY OVER THE PREVIOUS ELIGIBILITY THRESHOLD, WITH EXPANDED ACCESS TO THESE CRITICAL BENEFITS FOR OUR FAMILIES. ADDITONALLY, THROUGH OUR GRASSROOTS ADVOCACY NETWORK, CHILD HEALTH CHAMPIONS, WE HARNESS THE POWER OF OUR MEMBERS ACROSS COLORADO TO PUSH FOR BETTER CHILD HEALTH THROUGH PUBLIC POLICY. THIS LEGISLATIVE SESSION, WE ADDED 707 NEW MEMBERS TO THE NETWORK, INCREASING OUR TOTAL NUMBER OF ADVOCATES TO OVER 7,000. MORE THAN 1,200 OF THESE ADVOCATES WROTE EMAILS TO THEIR LAWMAKERS ON POLICY ISSUES THAT IMPACT KIDS AND FAMILIES. WE ALSO CO-HOSTED THE SEVENTH ANNUAL SPEAK UP FOR KIDS DAY AT THE CAPITOL, TRAINING 190 NEW ADVOCATES FROM ACROSS THE STATE AT AN INTENSIVE, INSPIRING AND HANDS-ON EVENT THAT CONNECTS THEM WITH THEIR LOCAL LEGISLATORS TO HAVE CONVERSATIONS ABOUT PENDING KIDS HEALTH LEGISLATION. PARTNERSHIPS ARE AN ESSENTIAL COMPONENT TO CHILDRENS COMMUNITY HEALTH WORK. THE HOSPITAL HAS PARTNERED WITH AN ARRAY OF LOCAL, STATE AND NATIONAL ORGANIZATIONS TO COORDINATE, COLLABORATE AND SHARE KEY FINDINGS AND LESSONS LEARNED IN IMPROVING HEALTH AND QUALITY OF LIFE FOR CHILDREN IN COLORADO. BELOW ARE A FEW EXAMPLES OF CHILDRENS COLLABORATIONS ADDRESSING COMMUNITY BUILDING AND HEALTH IMPROVEMENT. COALITION BUILDING. IN 2016, CHILDRENS HOSPITAL COLORADO JOINED FORCES WITH EIGHT OTHER STATEWIDE HEALTH AND EDUCATION ORGANIZATIONS TO FORM THE COLORADO ALLIANCE FOR SCHOOL HEALTH (THE "ALLIANCE"). THE ALLIANCE AIMS TO TRANSFORM HOW HEALTH CARE AND EDUCATION PARTNERS COLLABORATE TO CREATE SUSTAINABLE SYSTEMS THAT RESULT IN HEALTH EQUITY AMONG ALL COLORADO STUDENTS. OVER THE PAST YEAR, THE ALLIANCE IDENTIFIED ADVOCACY PRIORITIES THAT INCLUDE FUNDING FOR SCHOOL HEALTH SERVICES, ACCESS TO INTEGRATED CARE FOR STUDENTS AND FAMILIES, AND EFFORTS TO DEVELOP A COMMON, COMPREHENSIVE, APPROACH TO SHARING DATA ACROSS SYSTEMS TO INFORM PLANNING, DOCUMENT PROGRESS, AND ULTIMATELY IMPROVE THE HEALTH, DEVELOPMENT, LEARNING, AND SUCCESS OF CHILDREN AND THEIR SCHOOL COMMUNITIES. IN 2018, THE ALLIANCE ESTABLISHED THEIR ADVOCACY AGENDA, PUBLISHING A CALL TO ACTION IN EARLY 2019; ITS INTENT IS TO DEFINE SCHOOL HEALTH SERVICES, ELEVATE THE IMPORTANCE OF THESE SERVICES, OUTLINE OPPORTUNITIES FOR HEALTH AND EDUCATION TO WORK TOGETHER TO MEET THE HEALTHCARE NEEDS OF EVERY STUDENT AND IDENTIFY ACTIONS WE CAN TAKE RIGHT NOW TO IMPROVE THE HEALTH OF ALL COLORADO STUDENTS. PHYSICAL IMPROVEMENTS AND HOUSING. AT CHILDRENS COLORADO, WE SERVE A DIVERSE PATIENT POPULATION WHOSE EXPERIENCES WITH SOCIAL DETERMINANTS OF HEALTH VARY GREATLY. TO BETTER UNDERSTAND THESE EXPERIENCES, WE HAVE BEGUN SYSTEMATICALLY SCREENING PATIENTS FOR BARRIERS TO WELLNESS AND UTILIZING PATIENT NAVIGATORS TO HELP FAMILIES ADDRESS THESE BARRIERS. OUR PSYCHOSOCIAL SCREENING PROGRAM WAS PILOTED IN OUR CHILD HEALTH CLINIC, A PRIMARY CARE CLINIC FOR CHILDREN FROM BIRTH TO ADOLESCENCE, AND HAS BEEN EXPANDED TO ADDITIONAL CLINICAL AREAS, INCLUDING SPECIFIC INPATIENT UNITS AND OUR PRIMARY CARE CLINIC FOR CHILDREN WITH COMPLEX HEALTHCARE NEEDS. IN 2018, 14,878 SCREENINGS OCCURRED WITH 8,548 UNIQUE PATIENTS. HOUSING WAS THE SIXTH MOST FREQUENTLY REPORTED CONCERN, WITH 10.5% OF PATIENTS SCREENED BEING REFERRED TO A NAVIGATOR FOR ASSISTANCE WITH HOUSING. AS A NON-PROFIT HOSPITAL, WE COMPLETE A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS TO ENSURE THAT OUR PATIENTS, FAMILIES, AND COMMUNITY PARTNERS ARE ABLE TO GUIDE OUR POPULATION HEALTH EFFORTS. OUR MOST RECENT NEEDS ASSESSMENT WAS COMPLETED IN DECEMBER 2018 AND INCLUDED INPUT FROM MORE THAN 40 PARTNER ORGANIZATIONS AND NEARLY 600 COMMUNITY MEMBERS. IN THIS PROCESS, STAKEHOLDERS WERE ASKED TO PRIORITIZE THE MOST "CRITICAL HEALTH NEEDS"OTHER CRITICAL NEEDS" IN THEIR COMMUNITY. HOUSING, IDENTIFIED AS AN "OTHER CRITICAL NEED" BECAUSE IT IS NOT CONDITION-SPECIFIC, WAS RATED AS THE SIXTH MOST IMPORTANT NEED IN THE COMMUNITIES CHILDREN'S COLORADO SERVES. WE HAVE ALSO BEEN APPROACHED BY SEVERAL ADVOCACY PARTNERS ON HOUSING-RELATED MEASURES AT THE STATE AND FEDERAL LEVELS, INCLUDING EFFORTS TO IMPROVE TENANT RIGHTS, ESTABLISH A STATEWIDE EVICTION PREVENTION FUND, AND ASSESS THE HEALTH IMPACT OF MILITARY HOUSING. AS A RESULT OF FEEDBACK FROM COMMUNITY PARTNERS AND RESIDENTS, CHILDRENS COLORADO IS ALSO WORKING WITH THE UNIVERSITY OF COLORADO DENVER TO CONDUCT AN ENVIRONMENTAL NEEDS ASSESSMENT OF LIVING CONDITIONS IN THE COMMUNITY IMMEDIATELY SURROUNDING OUR AURORA HOSPITAL. THIS PROJECT, FUNDED BY PHILANTHROPIC DONATIONS TO CHILDRENS COLORADO, WILL PROVIDE HYPERLOCAL DATA ON HOUSING CONDITIONS AND THE RELATED HEALTH IMPACTS ON CHILDREN AND FAMILIES; OUR INTENTION IS TO PROVIDE THE RESULTS TO COMMUNITY MEMBERS TO USE IN THEIR OWN ADVOCACY AND PROGRAMMATIC EFFORTS. THE DEVELOPMENT O
SCHEDULE H, PART III, LINE 2	The Organization adopted ASC 606 on January 1, 2018, using the modified retrospective method to all patient contracts at the date of initial application. The adoption of ASC 606 resulted in changes to the presentation for net patient services revenue related to uninsured or underinsured patients. Prior to the adoption of ASC 606, a significant portion of the Hospitals provision for bad debts related to self-pay patients, as well as co-pay and deductibles owed by patients with insurance. Under ASC 606, the estimated uncollectable amounts due from these patients are generally considered implicit price concessions that are a direct reduction to net patient service revenue, rather than as a provision for bad debts. Other than these changes in presentation, the adoption of ASC 606 did not have a material impact on the overall financial statements of the Organization. Expanded disclosures required by ASC 606 are included within Note 4, Net Patient Services Revenue. SCHEDULE H, PART III, LINE 3 CHILDREN'S HOSPITAL INACTIVATES AR BALANCES BETWEEN 150-175 DAYS AFTER THE FIRST BILLING CYCLE. ACCOUNTS ARE REFERRED TO COLLECTION AGENCIES FOR RECOVERY. THE HOSPITAL DOES NOT REPORT ANY BAD DEBT AMOUNT IN COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 4	The Organization adopted ASC 606 on January 1, 2018, using the modified retrospective method to all patient contracts at the date of initial application. The adoption of ASC 606 resulted in changes to the presentation for net patient services revenue related to uninsured or underinsured patients. Prior to the adoption of ASC 606, a significant portion of the Hospital's provision for bad debts related to self-pay patients, as well as co-pay and deductibles owed by patients with insurance. Under ASC 606, the estimated uncollectable amounts due from these patients are generally considered implicit price concessions that are a direct reduction to net patient service revenue, rather than as a provision for bad debts. Other than these changes in presentation, the adoption of ASC 606 did not have a material impact on the overall financial statements of the Organization. Expanded disclosures required by ASC 606 are included within Note 4, Net Patient Services Revenue.
SCHEDULE H, PART III, LINE 8	THE SHORTFALL REPORTED IN LINE 7 REPRESENTS MEDICARE SHORTFALLS FOR HIGH NEED PEDIATRIC PATIENTS SERVED BY CHILDREN'S HOSPITAL COLORADO. IF CHILDREN'S HOSPITAL COLORADO DID NOT SUBSIDIZE THE HIGHLY SPECIALIZED CARE, ACCESS FOR THIS POPULATION WOULD BE LIMITED, THUS WE VIEW THIS CARE AS COMMUNITY BENEFIT. THE HOSPITAL UTILIZED COST TO CHARGE RATIO METHODOLOGY TO ARRIVE AT THIS NUMBER. THE AMOUNT INCLUDES ALL COSTS LESS ALL PAYMENTS RECEIVED.
SCHEDULE H, PART III, LINE 9B	YES, THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. PRIOR TO DEBT REFERRALS, ACCOUNTS ARE REVIEWED FOR ALL THIRD-PARTY PAYER ELIGBILITY PRIOR TO QUALIFYING FOR ANY CHARITY CARE OR FINANCIAL ASSISTANCE. ONCE THE PATIENT'S RESPONSIBILITY IS VALIDATED, THE HOSPITAL PROVIDES SLIDING SCALE DISCOUNTS BASED ON INCOME AND/OR EXPENSES. PARENTS WHOSE CHILDREN DO NOT QUALIFY FOR MEDICAID CAN ALSO APPLY FOR THIS DISCOUNT PLAN. THE HOSPITAL HAS A DEDICATED FINANCIAL COUNSELING/SERVICES DEPARTMENT WHO WORK CLOSELY WITH PARENTS TO ESTABLISH PAYMENT PLANS.
SCHEDULE H, PART VI, LINE 2	IN ADDITION TO THE CHNA, CHILDRENS HOSPITAL COLORADO REGULARLY ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY WE SERVE. ACROSS THE HOSPITAL, NUMEROUS INTERNAL AND EXTERNAL DATA SOURCES ARE REGULARLY MONITORED AND UTILIZED TO IDENTIFY TRENDS AND OPPORTUNITIES TO IMPACT CHILD HEALTH. ADDITIONALLY, HOSPITAL STAFF DEDICATES SIGNIFICANT TIME TO SERVING ON COMMUNITY BOARDS AND OTHER COMMUNITY GROUPS THAT ASSESS HEALTH NEEDS OF THE COMMUNITY AND PROACTIVELY PARTICIPATES IN THE HEALTH IMPROVEMENT EFFORTS LED BY THESE PARTNERS. IN 2018, CHCO FORMALIZED A POPULATION HEALTH STRATEGY. DELIVERING CARE TO KIDS ISN'T A ONE-SIZE-FITS-ALL MODEL. CONSIDERING THEIR DIFFERENT BARRIERS TO WELLNESS IS NECESSARY TO CHANGE THE WAY WE DELIVER HEALTHCARE, AND EMPOWERING COMMUNITIES TO FOCUS ON PREVENTION IS KEY. WE CALL THIS APPROACH POPULATION HEALTH. OUR ADVOCACY TEAM IS WORKING WITHIN OUR COMMUNITIES, EMPOWERING THEM TO FOCUS ON PREVENTION AND IMPLEMENTING PROGRAMMING THAT KEEPS KIDS OUT OF OUR DOORS. WE ARE CHARTING NEW TERRITORY TO FURTHER OUR REACH AND IMPACT AND SUPPORT THE WHOLE PICTURE OF A CHILD'S HEALTH AND WELLBEING. EXAMPLES OF RESPONDING TO THE NEEDS OF THE COMMUNITY: RESPIRATORY HEALTH. BASED ON FEEDBACK CHILDRENS COLORADO RECEIVED FROM COMMUNITY PARTNERS IN 2017, WE BEGAN A HEALTH IMPACT ASSESSMENT OF THE HOUSING IMMEDIATELY SURROUNDING OUR MAIN CAMPUS IN AURORA. THIS PROJECT, FUNDED BY CHILDRENS COLORADO PREVENTION AND WELLNESS FUND, IS COMPARING CHILD AND CAREGIVER EXPOSURES TO INDOOR ENVIRONMENTAL HAZARDS AND ASSOCIATED HEALTH OUTCOMES BY HOUSING TYPE (E.G., MOTEL, MULTIUNIT HOUSING, AND SINGLE-FAMILY HOMES). IN 2018, WE CONVENED A COMMUNITY ADVISORY BOARD TO HELP SHAPE RECRUITMENT AND DATA COLLECTION, RECEIVED INSTITUTIONAL REVIEW BOARD APPROVAL, RECRUITED AND TRAINED TEAM MEMBERS, AND BEGAN DATA COLLECTION. FUTURE EFFORTS WILL FOCUS ON COMPLETING DATA COLLECTION AND ANALYSIS, DISSEMINATING FINDINGS, AND PLANNING APPROPRIATE INTERVENTIONS. SCHOOL HEALTH: AIMING TO INCREASE ACCESS OF TYPE 1 DIABETES-SPECIFIC PROFESSIONAL DEVELOPMENT OPPORTUNITIES FOR COLORADO SCHOOL NURSES, WHILE ALSO BUILDING PROFESSIONAL NETWORKS, THE SCHOOL HEALTH PROGRAM AT CHILDREN'S HOSPITAL COLORADO (CHCO) PARTNERED WITH EXTENSION FOR COMMUNITY HEALTH OUTCOMES (ECHO) COLORADO TO ENVISION, DESIGN, AND EVALUATE A "SCHOOL NURSES MANAGING DIABETES CARE" ECHO LEARNING SERIES. FIELD EXPERTS FROM THE CHCO SCHOOL HEALTH PROGRAM, BARBARA DAVIS CENTER FOR CHILDHOOD DIABETES, AND ECHO COLORADO CAME TOGETHER TO DEVELOP A MULTI-COHORT, FOUR-WEEK EDUCATIONAL ECHO SERIES, WHICH LAUNCHED IN FEBRUARY AND APRIL 2018, AND INCLUDED THE FOLLOWING CURRICULUM: 1) PATHOPHYSIOLOGY OF DIABETES; 2) INSULIN TECHNOLOGY; 3) INSULIN MANAGEMENT; AND, 4) DEVELOPMENTALLY-APPROPRIATE CARE FOR SCHOOL-AGED CHILDREN. TWENTY-NINE PARTICIPANTS ATTENDED THE FIRST DIABETES CARE ECHO LEARNING SERIES. DIFFERENT FROM WEBINAR FORMAT, ECHO SERIES ARE PROVIDED VIA A VIDEOCONFERENCING PLATFORM, WHICH CREATES AN INTERACTIVE, ENGAGING FORUM FOR THE CONSISTENT DISSEMINATION OF SCHOOL NURSING BEST PRACTICE AND EVIDENCE-BASED STANDARDS OF CARE. THIS ECHO SERIES ALLOWED SCHOOL NURSES TO OBTAIN EDUCATION FROM CONTENT MATTER EXPERTS, SHARE PEER-TO-PEER KNOWLEDGE AND EXPERTISE, COLLABORATE WITH COLLEAGUES, AND BUILD A SENSE OF COMMUNITY REGARDING THE MANAGEMENT OF DIABETES IN SCHOOLS. SCHOOL NURSES WERE RECRUITED THROUGHOUT COLORADO, INCLUDING URBAN AND RURAL SETTINGS, AND A TOTAL OF FORTY-EIGHT SCHOOL NURSES ATTENDED COHORTS 1 AND 2 OF THE SERIES. EVALUATION FINDINGS SHOWED THAT THE SERIES IS A PROMISING APPROACH TO INCREASE THE SELF-EFFICACY OF SCHOOL NURSES FOR MANAGING DIABETES CARE, REDUCE PROFESSIONAL ISOLATION, AND IMPROVE CARE OF STUDENTS. AS A RESULT OF THE IMPACTS OF THIS SERIES, THE FOLLOWING TOOK PLACE: 1) A "SCHOOL NURSES MANAGING NEUROLOGICAL CONDITIONS" ECHO LEARNING SERIES WAS DEVELOPED, IMPLEMENTED AND EVALUATED IN OCTOBER, 2018, WITH TWENTY-TWO SCHOOL NURSES IN ATTENDANCE; 2) A MONTHLY ECHO COMMUNITY OF PRACTICE SERIES FOR COLORADO SCHOOL NURSE LEADERS WAS DEVELOPED AND LAUNCHED IN OCTOBER, 2018; 3) TWO MORE COHORTS OF THE "SCHOOL NURSE MANAGING DIABETES CARE" HAVE BEEN SCHEDULED FOR 2019, AND 4) ONE MORE COHORT OF THE "SCHOOL NURSES MANAGING NEUROLOGICAL CONDITIONS" HAS BEEN SCHEDULED FOR 2019. AS SCHOOL NURSES CONTINUE TO SERVE AS POPULATION HEALTH LEADERS, PROVIDING HIGHLY COMPLEX COORDINATED CARE TO INCREASING NUMBERS OF CHILDREN IN EDUCATIONAL SETTINGS, THE NEED FOR ONGOING CONTINUING EDUCATION OFFERINGS IN COLLABORATIVE PEER-TO-PEER LEARNING ENVIRONMENTS IS CRITICAL TO ENSURING THEIR ABILITIES TO SUPPORT THE HEALTH OF CHILDREN IN SCHOOLS. THE ECHO MODEL PROVIDES A PROMISING WAY TO SUPPORT SCHOOL NURSES ACROSS ALL GEOGRAPHIES IN GAINING THE NECESSARY INFORMATION, SKILLS, AND SUPPORT TO EFFECTIVELY CARE FOR STUDENTS AND STAY INFORMED ABOUT UP-TO-DATE CLINICAL INFORMATION, SO STUDENTS HAVE THE OPPORTUNITY TO SUCCEED IN SCHOOL. ADDRESSING SOCIAL DETERMINANTS OF HEALTH. IN 2016, CHILDRENS COLORADO EXPANDED ITS WORKFORCE TO INCLUDE, FOR THE FIRST TIME, COMMUNITY HEALTH NAVIGATORS CHN TO ADDRESS SOCIAL DETERMINANTS OF HEALTH. THE CHN WORKFORCE DIFFERS FROM THE CLINICALLY BASED FAMILY NAVIGATORS IN THAT THEY WORK WITH FAMILIES IN PRIMARY CARE CLINICS, COMMUNITY BASED-SETTINGS AND CONDUCT HOME VISITS TO ENSURE THE MAXIMUM SUPPORT TO OUR FAMILIES. CHNS PROVIDE ASSISTANCE TO PATIENTS AND FAMILIES WITH BARRIERS TO CARE AND RESOURCE NEEDS. THE RELATIONSHIP BETWEEN SOCIAL DETERMINANTS OF HEALTH AND HEALTH OUTCOMES IS WELL DOCUMENTED. ADDRESSING SOCIAL DETERMINANTS OF HEALTH IS IMPORTANT FOR IMPROVING HEALTH OUTCOMES AND REDUCING HEALTH DISPARITIES. SINCE 2016, THE TEAM HAS EXPANDED FROM 6 NAVIGATORS IN THREE UNIQUE SETTINGS TO 13 NAVIGATORS IN 9 SETTINGS. THE POPULATION SERVED IS PRIMARILY MEDICAID OR UNINSURED FAMILIES WITH A SIGNIFICANT NUMBER OF NON-ENGLISH-SPEAKING FAMILIES. IN 2018, THE TEAM PROVIDED SUPPORT TO 5,135 PATIENTS/FAMILIES. TOP NEEDS INCLUDE: FINANCIAL ASSISTANCE, PUBLIC BENEFIT ASSISTANCE, FOOD INSECURITY, HOUSING AND ASSISTANCE FINDING A PRIMARY CARE PROVIDER FOR THE CAREGIVER. THIS INITIATIVE ALSO PROVED AN OPPORTUNITY TO EXPAND OUR PARTNERSHIP WITH PUBLIC HEALTH. IN 2016, TWO NAVIGATORS WERE PLACED IN A TRI-COUNTY HEALTH DEPARTMENT WIC OFFICE. THIS FEDERAL PROGRAM PROVIDES SUPPLEMENTAL NUTRITIONAL SUPPORT FOR WOMEN, INFANTS AND CHILDREN (WIC) FOR LOW-INCOME PREGNANT, BREASTFEEDING, AND NON-BREASTFEEDING POSTPARTUM WOMEN AND TO INFANTS AND CHILDREN UP TO THE AGE OF FIVE WHO ARE AT NUTRITIONAL RISK. IN 2018, THE NAVIGATORS PROVIDED RESOURCE SUPPORT TO 590 FAMILIES AND EXPANDED TO A SECOND WIC OFFICE. ADDITIONALLY, THROUGH COMMUNITY ENGAGEMENT EFFORTS THE NAVIGATION TEAM DISCOVERED THAT MANY OF THE NON-ENGLISH SPEAKING AND REFUGEE FAMILIES DID NOT UNDERSTAND HOW TO UTILIZE THEIR FAMILIES WIC BENEFITS. THIS STARTED A NEW COMPONENT OF THE PROGRAM WHERE NAVIGATORS WILL TAKE FAMILIES TO THE GROCERY STORE 1-2 TIMES TO ASSIST THEM WITH WHAT FOODS IN WHAT QUANTITIES THEY WERE ELIGIBLE TO PURCHASE THROUGH THE WIC BENEFITS.
SCHEDULE H, PART VI, LINE 3	CHILDREN'S HOSPITAL COLORADO HAS A PROCESS FOR INFORMING AND EDUCATING FAMILIES ABOUT HOW THEY MAY BE BILLED FOR PATIENT CARE AND THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL COLORADO'S FULL TIME PATIENT FINANCIAL COUNSELORS ARE DEDICATED TO WORKING WITH FAMILIES TO PROVIDE GUIDANCE REGARDING AVAILABLE FINANCIAL ASSISTANCE WHICH ENSURES THAT ITS PATIENT POPULATION RECEIVES THE CRITICAL CARE IT NEEDS. ADDITIONALLY, CHILDREN'S HOSPITAL COLORADO PROVIDES PATIENT ASSISTANCE TO HELP IDENTIFY COMMUNITY-BASED RESOURCES, FACILITATE SERVICES AND PROVIDE APPROPRIATE REFERRAL ASSISTANCE TO HELP WITH CONTINUITY OF CARE. INPATIENT PROCESS: THIS PROCESS APPLIES TO PATIENTS WHO ARE BEING ADMITTED FOR OBSERVATION, SURGERY OR OTHER INPATIENT SERVICES. IF THE PATIENT IS PRE-SCHEDULED, CHILDREN'S HOSPITAL COLORADO PATIENT ACCESS WORKS TO CONTACT THE FAMILY PRIOR TO ADMISSION TO ARRANGE FOR A FINANCIAL SCREENING APPOINTMENT. REGARDLESS OF WHETHER AN APPOINTMENT IS SET PRIOR TO ADMISSION, THE PATIENT FINANCIAL COUNSELING TEAM WORKS WITH THE FAMILY TO DETERMINE THEIR SELF-PAY STATUS (EITHER NON-COMMERCIAL OR GOVERNMENT INSURANCE) AND SUBSEQUENTLY WORKS WITH THEM TO SCREEN FOR FINANCIAL ASSISTANCE OPTIONS. OUTPATIENT PROCESS: WHEN A PATIENT SCHEDULES A NON-EMERGENT OR URGENT OUTPATIENT CLINIC VISIT, THEY WILL IDENTIFY THEMSELVES AS SELF-PAY IF THEY DO NOT HAVE EITHER COMMERCIAL OR GOVERNMENT INSURANCE. AT THIS POINT, THEY ARE GIVEN TWO OPTIONS: (1) PAY A $200 DEPOSIT AT THE TIME OF APPOINTMENT AND BE BILLED ANY REMAINING BALANCE OR (2) SCHEDULE TIME WITH PATIENT FINANCIAL COUNSELING FOR ASSISTANCE. IF THE PATIENT WAS SEEN IN THE EMERGENCY DEPARTMENT OR URGENT CARE WITHOUT THE PRE-SCREEN, THEY STILL CAN APPLY FOR FINANCIAL ASSISTANCE WITH THE PATIENT FINANCIAL COUNSELING OFFICE. ALL SELF-PAY FAMILIES ARE AUTOMATICALLY GIVEN A 35 PERCENT DISCOUNT. CHILDREN'S HOSPITAL COLORADO HAS A FORMAL POLICY REGARDING ELIGIBILITY CRITERIA FOR CHARITY CARE. THE DECISION TO PROVIDE CHARITY CARE WILL BE, IN ALL CASES, BASED ON A REVIEW OF THE INCOME, ASSETS AND LIABILITIES OF THE FAMILY AT THE TIME OF ADMISSION TO THE HOSPITAL OR CLINIC. THE LEVELS OF CHARITY CARE AND FINANCIAL ASSISTANCE PROVIDED BY CHILDREN'S HOSPITAL COLORADO WILL BE DETERMINED BASED ON FEDERAL POVERTY GUIDELINES WHICH MAY BE ADJUSTED UP TO 200 PERCENT AND REVISED FROM TIME TO TIME. FAMILIES WITH ADJUSTED GROSS INCOME BETWEEN 200 PERCENT AND 400 PERCENT OF FEDERAL POVERTY GUIDELINES MAY ALSO BE CONSIDERED FOR CHARITY CARE WITH A CAP FOR OUT-OF-POCKET RESPONSIBILITY. DETERMINATION OF ELIGIBILITY WILL BE EFFECTIVE FOR SIX MONTHS AND APPLY TO ALL PATIENTS REGARDLESS OF IMMIGRATION STATUS. CHILDREN'S COLORADO WORKS TO PROVIDE NECESSARY HOSPITAL-RELATED SERVICES CONSISTENT WITH ITS MISSION, ITS STATUS AS A NONPROFIT HOSPITAL AND ITS STEWARDSHIP RESPONSIBILITY TO ITS DONORS. CHILDRENS HOSPITAL COLORADOS FINANCIAL ASSISTANCE PUBLIC POLICY AND PLAIN LANGUAGE SUMMARY ARE LISTED ON THE ORGANIZATIONS HOMEPAGE WWW.CHILDRENSCOLORADO.ORG.
SCHEDULE H, PART VI, LINE 4	CHILDRENS COLORADO PROVIDES COMPREHENSIVE MEDICAL CARE FOR KIDS FROM BIRTH THROUGH ADOLESCENCE. CHILDRENS COLORADO SERVES A SEVEN-STATE REGION; HOWEVER, MOST OF OUR PATIENTS COME FROM COLORADO AND SPECIFICALLY THE DENVER METRO AREA. ADDITIONALLY, CHILDRENS HOSPITAL COLORADO IS THE ONLY LEVEL 1 PEDIATRIC TRAUMA CENTER IN OUR SEVEN-STATE REGION. DEMOGRAPHICALLY, CHILDREN SERVED COME FROM DIVERSE CULTURAL AND ETHNIC BACKGROUNDS. NORTHWEST AURORA, SURROUNDING THE MAIN CAMPUS IS ONE OF THE MOST DIVERSE AREAS IN THE STATE. MORE THAN HALF OF AURORAS 350,000 RESIDENTS BELONG TO A MINORITY POPULATION, AND OVER 100 LANGUAGES ARE SPOKEN IN AURORA PUBLIC SCHOOLS. ALONG WITH ITS DIVERSITY, AURORA FACES CHALLENGES WITH HEALTH DISPARITIES, LOWER INCOME AND EMPLOYMENT LEVELS AND OTHER SOCIAL DETERMINANTS OF HEALTH AND ECONOMIC WELL-BEING AS COMPARED TO OTHER PARTS OF AURORA, THE METRO DENVER AREA AND THE STATE OF COLORADO. IN RESPONSE TO OUR DIVERSE POPULATION, CHILDRENS COLORADO TRANSLATES MEDICAL CARE AND EDUCATION INSTRUCTIONS INTO 65 + LANGUAGES, INCLUDING SIGN LANGUAGE, TO DELIVER CULTURALLY SENSITIVE, HIGH-QUALITY PEDIATRIC HEALTH CARE. MOST PATIENTS SPEAK ENGLISH, FOLLOWED BY A SIGNIFICANT NUMBER OF FAMILIES WHO SPEAK SPANISH, ARABIC, BURMESE, VIETNAMESE, SOMALIAN, RUSSIAN AND KOREAN. THE PAYER MIX OF THE POPULATION SERVED IS 44.9% MEDICIAID, 48.8% MANAGED CARE/COMMERCIAL, 4.4% OTHER GOVERNMENT AND 1.9% SELF-PAY AND INDIGENT.
SCHEDULE H, PART VI, LINE 5	IN 2018, CHILDRENS HOSPITAL COLORADO PROVIDED $14,461,187 IN COMMUNITY HEALTH IMPROVEMENT AND COMMUNITY BENEFIT OPERATIONS. CHCO IS COMMITTED TO IMPROVING THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY. CHILDRENS HOSPITAL COLORADO WORKS TO DELIVER ON THIS MISSION NOT ONLY IN THE DENVER METRO AREA AND IN THE STATE OF COLORADO, BUT ALSO THROUGHOUT THE ROCKY MOUNTAIN REGION. THERE ARE EXTENSIVE EFFORTS LED BY CHILDRENS HOSPITAL COLORADO THAT POSITIVELY IMPACT THE HEALTH AND SAFETY OF CHILDREN IN THE COMMUNITY. THROUGHOUT 2018, THE HOSPITALS CHILD HEALTH ADVOCACY INSTITUTE AND ITS PARTNERS ENGAGED IN EXTENSIVE EFFORTS TO PROMOTE HEALTH AND PREVENT ILLNESS, IN ACCORDANCE WITH THE CHILDRENS HOSPITAL COLORADO (CHILDRENS COLORADO) 2016-2018 COMMUNITY HEALTH ACTION PLAN (CHAP). IN THE CHAP, CHILDRENS COLORADO FOCUSED ON SIX HEALTH PRIORITY AREAS THAT WERE IDENTIFIED IN THE 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND LED OR COLLABORATED WITH PARTNERS ON INITIATIVES WITHIN THE HOSPITAL, IN THE COMMUNITY AND ACROSS THE STATE. THESE INITIATIVES INCLUDED EDUCATION AND PUBLIC AWARENESS, TRAININGS, SCREENINGS, DIRECT SERVICES, ACCESS TO CARE, AS WELL AS POLICY AND ADVOCACY EFFORTS. ADDITIONALLY, CHILDRENS COLORADO PRIORITIZED ADDRESSING SOCIAL DETERMINANTS OF HEALTH THAT IMPACT HEALTH OUTCOMES THROUGH DEVELOPMENT OF COMMUNITY PARTNERSHIPS TO ENHANCE REFERRALS AND CONNECTIONS FOR FAMILIES, ALONG WITH CONTINUED EXPANSION OF THE WORKFORCE IN COMMUNITY HEALTH. AS PART OF OUR EFFORTS IN ADDRESSING CHNA PRIORITY AREAS, THE TEAM EPIDEMIOLOGIST CONDUCTS A COMPREHENSIVE ANNUAL EVALUATION OF THE ACTIVITIES IDENTIFIED IN THE 2016-2018 COMMUNITY HEALTH ACTION PLAN. THE EVALUATION PLAN IS AVAILABLE ON-LINE: HTTPS://WWW.CHILDRENSCOLORADO.ORG/COMMUNITY/COMMUNITY-HEALTH/COMMUNITY-HEA LTH-NEEDS-ASSESSMENT/ HIGHLIGHTS OF THIS WORK IN 2018 INCLUDE: MENTAL HEALTH: MENTAL HEALTH IS A TOP CONCERN FOR YOUTH AND FAMILIES, AS IDENTIFIED IN THE CHILDRENS COLORADO COMMUNITY HEALTH NEEDS ASSESSMENT, AS WELL AS ASSESSMENTS CONDUCTED BY NUMEROUS OTHER HOSPITALS, LOCAL PUBLIC HEALTH DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS. IN LOOKING FOR WAYS TO ADDRESS MENTAL HEALTH EDUCATION AND DE-STIGMATIZATION, THE CHILDRENS COLORADO PEDIATRIC MENTAL HEALTH INSTITUTE, REVIEWED EXISTING PROGRAMS TARGETING STIGMA REDUCTION AMONG YOUTH AND TURNED TO THE WORK OF OUR MENTAL HEALTH YOUTH ACTION BOARD (YAB). THE YAB WAS CREATED IN 2013 TO GENERATE SOCIAL ACTION AROUND MENTAL HEALTH. EACH YEAR A GROUP OF 15 TEENS FROM ACROSS THE DENVER METRO AREA CREATE AN ARTS-BASED PROJECT TO SHARE WITH THE COMMUNITY TO HELP INCREASE CONVERSATIONS REGARDING THE SPECTRUM OF MENTAL AND EMOTIONAL EXPERIENCES. TWO OF THE YABS GOALS DIRECTLY ADDRESS CHILDRENS COLORADO DESIRE TO SERVE THE COMMUNITY IN THESE WAYS: 1. RAISE AWARENESS OF CHILD AND ADOLESCENT MENTAL HEALTH ISSUES IN THE COMMUNITIES WE SERVE BY CREATING A PROJECT EACH YEAR THAT WILL SUPPORT SOCIAL CHANGE, 2. DEVELOP THE LEADERSHIP AND ADVOCACY SKILLS OF OUR YOUTH. IN 2018, THE TEAM TRANSFORMED THE YAB PROJECTS INTO A TOOLKIT THAT CAN BE USED WITH GROUPS OF YOUTH IN THE COMMUNITY BY TEACHERS, YOUTH PROGRAM LEADERS AND OTHER YOUTH SERVING PROFESSIONALS. THE TOOLKIT WAS COMPLETED IN APRIL 2018, WITH OVER 1000 COPIES DISTRIBUTED TO SCHOOLS AND COMMUNITY-BASED ORGANIZATIONS. PHYSICAL ACTIVITY, NUTRITION AND OBESITY: IN 2018, 72 CHILDREN WERE ENROLLED IN CAMP CHAMPIONS, A CAMP PROGRAM FOR LOW-INCOME, UNDERSERVED YOUTH WHO ARE OVERWEIGHT OR OBESE. CAMP CHAMPIONS AIMS TO IMPROVE HEALTHY LIFESTYLES THROUGH EDUCATION AND ACTIVITIES, DURING WHICH CAMPERS INCREASED THEIR DAILY VIGOROUS PHYSICAL ACTIVITY BY AN AVERAGE OF 27 MINUTES AND INCREASED THEIR DAILY STEP COUNT EXCEEDING RECOMMENDATIONS BY AN AVERAGE OF 3,000 STEPS. ORAL HEALTH: IN PARTNERSHIP WITH AURORA PUBLIC SCHOOLS (APS), CHILDRENS COLORADO WORKED TO ADVANCE THE ORAL HEALTH OF CHILDREN IN THE COMMUNITY THROUGH EDUCATION, SCREENING, AND PREVENTIVE SERVICES. IN 2018, 501 CHILDREN UNDER THE AGE OF 5 ENROLLED IN APS EARLY CHILDHOOD EDUCATION SITES PARTICIPATED IN A LEARNING ACTIVITY ABOUT ORAL HEALTH, AND 216 CHILDREN WERE SCREENED FOR ORAL HEALTH NEEDS AND RECEIVED FLUORIDE VARNISH. ADDITIONALLY, PARENTS OF YOUNG CHILDREN, INCLUDING 24 TEEN PARENTS, WERE ALSO ENGAGED IN EDUCATIONAL SESSIONS AND PROVIDED RESOURCES RELATED TO ORAL HEALTH FOR BOTH THEM AND THEIR CHILD. PREMATURITY AND EARLY CHILDHOOD: IN 2016, CHILDRENS COLORADO LAUNCHED A UNIVERSAL PSYCHOSOCIAL SCREENING PROGRAM IN THE CHILD HEALTH CLINIC TO IDENTIFY FAMILIES WITH PSYCHOSOCIAL NEEDS AND PROVIDE THEM WITH APPROPRIATE LEVELS OF INTERVENTION. IN 2017, NEARLY 8,000 PSYCHOSOCIAL SCREENINGS WERE COMPLETED IN THE CHILD HEALTH CLINIC AND 68% OF FAMILIES WITH PATIENTS UNDER AGE 2 WERE SCREENED. IN 2018 THAT NUMBER CLIMBED TO ALMOST 14,000 SCREENINGS; 63% WERE AGE 2 OR YOUNGER. THROUGH THIS WORK, CHILDRENS COLORADO HAS LEARNED ABOUT THE EVOLVING PSYCHOSOCIAL AND SOCIAL DETERMINANTS OF HEALTH THAT OUR FAMILIES FACE. PEDIATRIC ASTHMA: AS A RESULT OF THE PREVIOUSLY CONDUCTED NEEDS ASSESSMENT FOCUSED ON HIGH RISK ASTHMA PATIENTS SEEN AT CHILDRENS HOSPITAL COLORADO, THE BREATHING INSTITUTE CREATED A HOME VISIT PROGRAM FOR PATIENTS WITH DIFFICULT-TO-CONTROL ASTHMA IN 2016. THE FIRST TWO YEARS WERE FOCUSED ON PROGRAM DEVELOPMENT, HIRING AND TRAINING STAFF, AND CONDUCTING QUARTERLY PDSA QUALITY IMPROVEMENT CYCLES. IN 2018, WE CONCLUDED OUR PILOT PHASE AND INCORPORATED HOME VISITS INTO OUR CLINICAL OPERATIONS AS STANDARD OF CARE FOR HIGH RISK ASTHMA PATIENTS. WE CONDUCTED 116 HOME VISITS WITH 44 PATIENTS. THESE VISITS WERE CONDUCTED BY A NURSE AND COMMUNITY HEALTH NAVIGATORS AND FOCUSED ON ASTHMA EDUCATION, BARRIER IDENTIFICATION AND PATIENT NAVIGATION, HOME ENVIRONMENTAL ASSESSMENT AND TRIGGER REMEDIATION. SUPPORT PROVIDED TO EACH FAMILY VARIES BASED ON BARRIERS IDENTIFIED BUT COMMONLY INCLUDES MEDICATION DEVICE TECHNIQUE TEACHING, HELP WITH APPLICATIONS FOR BENEFITS (E.G., MEDICAID AND WIC PAPERWORK), AND REMEDIATION SUPPLIES SUCH AS HEPA-FILTER VACUUMS, SAFE CLEANING SUPPLIES, AND PEST EXTERMINATION SERVICES. DURING THE PILOT PHASE THAT ENDED IN 2018, WE SAW A 41% REDUCTION IN READMISSIONS/EMERGENCY DEPARTMENT REVISITS FOR ASTHMA IN THE SIX MONTHS FOLLOWING PARTICIPATION IN THE HOME VISIT PROGRAM. INJURY PREVENTION: IN 2018 OUR CONTINUED COLLABORATION WITH COMMUNITY-BASED ORGANIZATIONS, AND PARTNERSHIPS WITH LOCAL AND STATE GOVERNMENT LED TO OVER 700 CHILD RESTRAINT INSPECTIONS AND NEARLY 500 CAR SEAT DISTRIBUTIONS TO LOW-INCOME FAMILIES QUALIFYING FOR FEDERAL ENTITLEMENT PROGRAMS AND RESIDING IN TARGETED NEIGHBORHOODS. THE CPS PROGRAM CONTINUED ITS PARTNERSHIP WITH THE WOMEN, INFANTS, AND CHILDREN (W.I.C.) PROGRAM AT TRI-COUNTY HEALTH DEPARTMENT, WHERE W.I.C CLIENTS IDENTIFIED IN NEED OF SAFE TRANSPORTATION FOR THEIR INFANTS, TODDLERS, AND YOUNG CHILDREN ARE ELIGIBLE TO RECEIVE A SUBSIDIZED-COST CAR SEAT. THIS PARTNERSHIP WITH LOCAL W.I.C. OFFICES REPRESENTS A UNIQUE EXAMPLE IN COLORADO WHERE A PRIVATE, NON-PROFIT HOSPITAL DEDICATES STAFF RESOURCES TO SERVE THE SAFE TRANSPORTATION NEEDS OF FAMILIES ENROLLED IN FEDERALLY-FUNDED SAFETY NET PROGRAM. THROUGH OUR "CRIBS FOR KIDS" INFANT SAFE SLEEP AWARENESS AND EDUCATION PROGRAM, COMMUNITY HEALTH NAVIGATORS PROVIDED EDUCATION AND ANTICIPATORY GUIDANCE TO MOTHERS RECEIVING PRIMARY CARE SERVICES AT CHILDRENS COMMUNITY HEALTH CLINICS. IN ADDITION TO HIGHLIGHTING THIS PRIORITY ISSUE WITH PARENTS, THE NAVIGATORS PROVIDED PORTABLE CRIBS TO 34 MOTHERS WHOSE INFANTS WERE IDENTIFIED AS BEING AT HIGH RISK FOR SUDDEN UNEXPLAINED INFANT DEATH (SUID). IN ADDITION TO CHILDRENS COLORADOS HEALTH PRIORITY AREAS, THERE WERE KEY MILESTONES ACHIEVED IN OUR PARTNERSHIPS, COMMUNITY HEALTH AND POLICY AND ADVOCACY EFFORTS. BELOW ARE SOME HIGHLIGHTS OF THOSE EFFORTS. PARTNERSHIP DEVELOPMENT: IN 2018, CHILDRENS COLORADO MADE A CONCERTED EFFORT TO ENHANCE PARTNERSHIPS WITH OTHER SYSTEMS AND SECTORS SERVING CHILDREN AND FAMILIES IN THE COMMUNITY TO IMPROVE COORDINATION OF EFFORTS RELATED TO OUR SHARED POPULATION, AS WELL AS IDENTIFY OPPORTUNITIES TO ENHANCE OUR COLLECTIVE IMPACT ON THE HEALTH AND WELLBEING OF CHILDREN LIVING IN OUR COMMUNITY. SHARED GOALS, INTEGRATED STAFFING MODELS, COLLABORATIVE FUNDING PROPOSALS, AND DATA/INFORMATION SHARING ARE SOME OF THE KEY COMPONENTS OF THIS WORK. CHILDRENS COLORADO INTENDS TO PILOT THESE INNOVATIVE COLLABORATIONS WITH PARTNERS IN THE COMMUNITY IMMEDIATELY SURROUNDING THE HOSPITALS MAIN CAMPUS. KEY PARTNERS INCLUDE THE LOCAL PUBLIC HEALTH DEPARTMENT, THE LOCAL PUBLIC-SCHOOL DISTRICT, CITY PARKS AND RECREATION DIVISION, AND PRIMARY CARE CLINICS SERVING MEDICAID FAMILIES. MANY OTHER COMMUNITY BASED ORGANIZATIONS WILL BE CRITICAL STAKEHOLDERS IN THIS WORK GOING FORWARD AS WELL. MEDICAL FACULTY PROFILE: CHILDRENS HOSPITAL COLORADO HAS AN OPEN MEDICAL STAFF, MEANING COMMUNITY PRACTITIONERS CAN HOLD PRIVILEG
SCHEDULE H, PART VI, LINE 7	THERE ARE NO FILING REQUIREMENTS IN THE STATE OF COLORADO. CHCO DOES PROVIDE THE ANNUAL COMMUNITY BENEFIT REPORT TO THE COLORADO HOSPITAL ASSOCIATION AND SELECTIVE GOVERNMENTAL ENTITIES.

Schedule H (Form 990) 2018

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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

2018

Open to Public
Inspection

Name of the organization
CHILDREN'S HOSPITAL COLORADO

Employer identification number
84-0166760

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	(e) Amount of non-cash assistance	(h) Purpose of grant or assistance
(1) Denver Botanic Gardens 1007 York St Denver,CO80206	84-0440359	501(c)(3)	7,500	0	GENERAL PROGRAM
(2) St Anthony Foundation 116000 W 2nd Pl Lakewood,CO80228	84-0902211	501(c)(3)	8,500	0	GENERAL PROGRAM
(3) Rocky Mountain Butterfly Consortium 6252 W 104th Ave Westminister,CO80020	84-1155029	501(c)(3)	9,600	0	GENERAL PROGRAM
(4) American Academy of Pediatrics 141 NW Pt Elk Groove Village,IL60007	36-2275597	501(c)(3)	10,000	0	GENERAL PROGRAM
(5) Colorado Children's Campaign 1580 Lincoln St 420 Denver,CO80203	74-2374672	501(c)(3)	10,000	0	GENERAL PROGRAM SPONSORSHIP
(6) Ronald McDonald House Charities 110 North Carpenter St Chicago,IL60607	84-1013843	501(c)(3)	10,000	0	GENERAL PROGRAM
(7) Colorado College 14 Cace La poudre CO Springs,CO80903	84-0402510	501(c)(3)	10,500	0	GENERAL PROGRAM
(8) Columbine lakewood Colorado Soccer 8101 S Shaffer Parkway Littleton,CO80127	84-1411827	501(c)(3)	15,000	0	GENERAL PROGRAM
(9) Young Americans Center for Financial 3550 E First Ave Denver,CO80206	84-1564936	501(c)(3)	15,000	0	GENERAL PROGRAM
(10) Denver Museum of Nature & Science 2001 Colorado Bvld Denver,CO80205	84-0518447	501(c)(3)	17,500	0	GENERAL PROGRAM
(11) Douglas County Soccer Assoc 8200 S Akron St 122 Centennial,CO80112	74-2392779	501(c)(3)	30,000	0	GENERAL PROGRAM
(12) Colorado High School Activities 14855 E 2nd Ave Aurora,CO80011	84-0427063	501(c)(3)	37,500	0	GENERAL PROGRAM
(13) Childrens Museum of Denver 2121 Childrens Museum Dr Denver,CO80211	84-0658142	501(c)(3)	40,000		GENERAL PROGRAM Support
(14) Gold Grown Foundation 1743 Wazee St 300 Denver,CO80202	74-2422126	501(c)(3)	45,000	0	GENERAL PROGRAM
(15) Ronald Mc Donald House Colorado 1300 E 21st Ave Denver,CO80205	36-2934689	501(c)(3)	150,000	0	GENERAL PROGRAM
(16) Young Men's Christian Association 316 N Tejon St Colorado Springs,CO80903	84-0404266	501(c)(3)	175,000	0	GENERAL PROGRAM
(17) American Cancer Society 10065 Ek Harvard Ave 400 Denver,CO80231	13-1788491	501(c)(3)	10,000	0	GENERAL PROGRAM
(18) Global Down Syndrome Foundation 3300 E 1st Aven Suite 390 Denver,CO80206	26-4431001	501(c)(3)	11,500	0	GENERAL PROGRAM

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) 2018

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)
(2)
(3)
(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
SCHEDULE I, PART I, LINE 2	CHILDREN'S HOSPITAL COLORADO RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT EXEMPT ORGANIZATIONS TO MONITOR THE USE OF FUNDS AS INTENDED.

Schedule I (Form 990) 2018

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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

2018

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL COLORADO

Employer identification number

84-0166760

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 in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

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

Yes

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

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

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

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

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

Yes

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) 2018

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)
1JENA HAUSMANN President and CEO	(i) (ii)	920,513 ------------- 0	520,940 ------------- 0	138,861 ------------- 0	249,877 ------------- 0	23,401 ------------- 0	1,853,592 ------------- 0	136,521 ------------- 0
2JERROD MILTON VP Operations	(i) (ii)	264,679 ------------- 0	62,796 ------------- 0	53,081 ------------- 0	76,768 ------------- 0	17,972 ------------- 0	475,296 ------------- 0	50,213 ------------- 0
3GREGORY RAYMOND Colorado Springs COO	(i) (ii)	255,756 ------------- 0	59,075 ------------- 0	19,918 ------------- 0	73,173 ------------- 0	20,883 ------------- 0	428,805 ------------- 0	18,083 ------------- 0
4MICHELLE LUCERO Chief Legal Officer	(i) (ii)	421,686 ------------- 0	137,775 ------------- 0	70,743 ------------- 0	109,178 ------------- 0	15,050 ------------- 0	754,432 ------------- 0	63,772 ------------- 0
5DAVID BIGGERSTAFF EVP and COO	(i) (ii)	553,680 ------------- 0	225,979 ------------- 0	3,953 ------------- 0	163,846 ------------- 0	23,401 ------------- 0	970,859 ------------- 0	0 ------------- 0
6SUZANNE JAEGER SVP Experience and Access	(i) (ii)	301,249 ------------- 0	101,524 ------------- 0	68,830 ------------- 0	59,000 ------------- 0	20,883 ------------- 0	551,486 ------------- 0	0 ------------- 0
7JEFFREY HARRINGTON SVP and CFO	(i) (ii)	533,839 ------------- 0	210,516 ------------- 0	92,498 ------------- 0	151,154 ------------- 0	20,884 ------------- 0	1,008,891 ------------- 0	87,169 ------------- 0
8RAPHE SCHWARTZ SVP AND CHIEF STRATEGY OFFICER	(i) (ii)	357,334 ------------- 0	60,000 ------------- 0	2,687 ------------- 0	94,217 ------------- 0	17,404 ------------- 0	531,642 ------------- 0	0 ------------- 0
9PATRICIA GIVENS SVP Patient Care SVCS & CNO	(i) (ii)	315,438 ------------- 0	98,799 ------------- 0	60,288 ------------- 0	40,500 ------------- 0	18 ------------- 0	515,043 ------------- 0	0 ------------- 0
10CATHERINE DAL SANTO VP Finance	(i) (ii)	281,970 ------------- 0	82,688 ------------- 0	48,803 ------------- 0	59,500 ------------- 0	8,369 ------------- 0	481,330 ------------- 0	0 ------------- 0
11CHARLOTTE ISOLINE VP Marketing	(i) (ii)	226,787 ------------- 0	65,333 ------------- 0	40,065 ------------- 0	0 ------------- 0	18,390 ------------- 0	350,575 ------------- 0	0 ------------- 0
12DANA MOORE SVP and CIO	(i) (ii)	427,047 ------------- 0	94,533 ------------- 0	7,464 ------------- 0	133,376 ------------- 0	23,401 ------------- 0	685,821 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

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

SCHEDULE J, PART I, LINE 4b

THE FOLLOWING INDIVIDUALS RECEIVED PAYOUTS FROM A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: SUZANNE JAEGER $ 63,306 JERROD MILTON $ 50,213 GREGORY RAYMOND $ 18,083 JEFFREY HARRINGTON $ 87,169 JENA HAUSMANN $136,521 PATRICIA GIVENS $ 52,145 MICHELLE LUCERO $ 63,772 CATHERINE DAL SANTO $ 41,431 CHARLOTTE ISOLINE $ 33,930

Schedule J, Part I, Line 7

CERTAIN INDIVIDUALS ARE ELIGIBLE TO PARTICIPATE IN THE INCENTIVE PLAN FOR CHILDREN'S COLORADO, THE COMPONENTS OF WHICH INCLUDE ACHIEVEMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE GOALS. BECAUSE THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS RESERVES THE RIGHT TO CHANGE, AMEND OR TERMINATE THIS PLAN AT ANY TIME, FOR ANY REASON, AT ITS SOLE DISCRETION AND BECAUSE OF CERTAIN OTHER CONDITIONS OF THE PLAN, LINE 7 REGARDING "NON-FIXED PAYMENTS" IS ANSWERED YES. NOTE THAT PRIOR TO THE PAYMENT OF ANY AMOUNTS TO AN INDIVIDUAL WHO IS CONSIDERED A DISQUALIFIED PERSON, THE COMPENSATION COMMITTEE SHALL CERTIFY IN WRITING THE EXTENT TO WHICH THE PERFORMANCE FACTORS ESTABLISHED BY THE COMPENSATION COMMITTEE HAVE BEEN SATISFIED AND SHALL APPROVE THE PAYMENT OF SUCH BONUSES TO SUCH INDIVIDUALS. SEE PART VI, LINES 15A AND 15B FOR ADDITIONAL INFORMATION ON EXECUTIVE COMPENSATION.

Schedule J (Form 990) 2018

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
CHILDREN'S HOSPITAL COLORADO

Employer identification number
84-0166760

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CITY OF AURORA CO	84-6000564	05155XBT5	06-06-2008	258,814,487	SERIES 2008 - SEE PART VI		X		X		X
B	CITY OF AURORA CO	84-6000564	05155XBX6	05-25-2010	59,999,130	SERIES 2010A - SEE PART VI		X		X		X
C	COLORADO HEALTH FACILITIES AUTHORITY	84-0752932	1964BAL52	08-04-2013	309,252,566	SERIES 2013 - SEE PART VI		X		X		X
D	COLORADO HEALTH FACILITIES AUTHORITY	84-0752932	19648A7J8	05-24-2016	200,724,807	SERIES 2016A & 2016C - SEE PART VI		X		X		X
	COLORADO HEALTH FACILITIES AUTHORITY	84-0752932	19648A8D0	05-24-2016	70,300,000	SERIES 2016B - SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	140,430,000		0		1,040,000		1,484,500
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	258,814,487		59,999,130		309,252,566		200,724,807
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	2,381,234		709,432		1,844,600		1,519,986
8 Credit enhancement from proceeds .............	183,253		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		59,289,698		197,052,966		59,414,950
11 Other spent proceeds .............	256,250,000		0		110,355,000		119,204,821
12 Other unspent proceeds .............	0		0		0		20,585,050
13 Year of substantial completion .............	2008		2012		2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X	X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............	X			X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X			X	X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X	X			X
b Name of provider ..........	0		0		JP MORGAN		0
c Term of hedge .........	270 %				2490 %
d Was the hedge superintegrated? ......	X				X
e Was the hedge terminated? ........		X				X

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

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

Return Reference

Explanation

SCHEDULE K, PART I, COLUMN (F)

BOND A - HOSPITAL REVENUE BONDS SERIES 2008 THE PURPOSE OF THIS BOND ISSUE was TO REFUND BONDS THAT WERE PREVIOUSLY ISSUED ON 1/22/04 AND 4/7/08. THE REMAINING WEIGHTED AVERAGE MATURITY OF THE BONDS CURRENTLY REFUNDED is 11.8929 YEARS. BOND B - HOSPITAL REVENUE BONDS SERIES 2010A THE PURPOSE OF THIS BOND ISSUE was TO PAY FOR THE CONSTRUCTION OF A NEW TEN-STORY ADDITION TO THE EXISTING FACILITY, EQUIPMENT FOR THAT ADDITION, AND EXPANSION OF AN EXISTING PARKING GARAGE. BOND C - HOSPITAL REVENUE BONDS SERIES 2013 THE PURPOSE OF THIS BOND ISSUE was TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2008B AND 2008C BONDS. BOND D - HOSPITAL REVeNUE BONDS SERIES 2016A & 2016C THE PURPOSE OF THIS BOND ISSUE was TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2004C AND 2004D BONDS. BOND A (2) HOSPITAL REVENUE BONDS SERIES 2016B THE PURPOSE OF THIS BOND ISSUE was TO FINANCE LONG-TERM PROJECTS. SCHEDULE K, PART IV, LINE 2C BOND A - HOSPITAL REVENUE BONDS SERIES 2008 JULY 31, 2018 BOND B - HOSPITAL REVENUE BONDS SERIES 2010A - OCTOBER 12, 2016 BOND C - HOSPITAL REVENUE BONDS SERIES 2013 MAY 23, 2018

Schedule K (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
CHILDREN'S HOSPITAL COLORADO

Employer identification number
84-0166760

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CITY OF AURORA CO	84-6000564	05155XBT5	06-06-2008	258,814,487	SERIES 2008 - SEE PART VI		X		X		X
B	CITY OF AURORA CO	84-6000564	05155XBX6	05-25-2010	59,999,130	SERIES 2010A - SEE PART VI		X		X		X
C	COLORADO HEALTH FACILITIES AUTHORITY	84-0752932	1964BAL52	08-04-2013	309,252,566	SERIES 2013 - SEE PART VI		X		X		X
D	COLORADO HEALTH FACILITIES AUTHORITY	84-0752932	19648A7J8	05-24-2016	200,724,807	SERIES 2016A & 2016C - SEE PART VI		X		X		X
	COLORADO HEALTH FACILITIES AUTHORITY	84-0752932	19648A8D0	05-24-2016	70,300,000	SERIES 2016B - SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	140,430,000		0		1,040,000		1,484,500
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	258,814,487		59,999,130		309,252,566		200,724,807
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		0		0
7 Issuance costs from proceeds ...............	2,381,234		709,432		1,844,600		1,519,986
8 Credit enhancement from proceeds .............	183,253		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	0		59,289,698		197,052,966		59,414,950
11 Other spent proceeds .............	256,250,000		0		110,355,000		119,204,821
12 Other unspent proceeds .............	0		0		0		20,585,050
13 Year of substantial completion .............	2008		2012		2013
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....	X			X	X			X
15 Were the bonds issued as part of an advance refunding issue? .....		X		X		X	X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2018

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............	X			X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X		X		X		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X		X			X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X			X	X			X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X	X			X
b Name of provider ..........	0		0		JP MORGAN		0
c Term of hedge .........	270 %				2490 %
d Was the hedge superintegrated? ......	X				X
e Was the hedge terminated? ........		X				X

Schedule K (Form 990) 2018

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........	0		0		0		0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

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

Return Reference

Explanation

SCHEDULE K, PART I, COLUMN (F)

Schedule K (Form 990) 2018

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

2018

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL COLORADO

Employer identification number

84-0166760

Return Reference	Explanation
FORM 990, PART I, LINE 6	FROM TEENAGERS TO GREAT GRANDPARENTS, FROM HOMEMAKERS TO PROFESSIONAL ATHLETES, CHILDREN'S HOSPITAL COLORADO VOLUNTEERS ENCOMPASS ALL WALKS OF LIFE AND ALL INCOME LEVELS, EACH VOLUNTEER WITH SOMETHING UNIQUE TO OFFER. OUR DIVERSE GROUP OF VOLUNTEERS HAS ONE THING IN COMMON, HOWEVER, THE DESIRE TO HELP SICK CHILDREN AND THEIR FAMILIES. CHILDREN'S HOSPITAL COLORADO IS FORTUNATE TO HAVE HUNDREDS OF DEDICATED VOLUNTEERS WHO WORK REGULARLY, FROM SEVERAL HOURS A YEAR TO SEVERAL HOURS A WEEK, TO PROVIDE BETTER CARE FOR THE CHILDREN OF CHILDREN'S HOSPITAL COLORADO. THE ASSOCIATION OF VOLUNTEERS THE VOLUNTEERS AT CHILDREN'S HOSPITAL COLORADO ARE ALL PART OF A GROUP CALLED CHILDREN'S HOSPITAL COLORADO ASSOCIATION OF VOLUNTEERS (AOV). THE AOV COORDINATES PLACEMENTS FOR VOLUNTEERS AND ENSURES THAT COMPLETE ORIENTATION AND TRAINING IS PROVIDED TO ALL VOLUNTEERS. OUR VOLUNTEER'S SKILLS AND INTERESTS ARE ALL SO APPRECIATED AND WE TRY TO PLACE EVERYONE IN A ROLE THAT SUITS THEM AND OUR NEEDS. THE EXAMPLES BELOW ARE JUST SOME OF THE WAYS THAT OUR VOLUNTEERS CONTRIBUTE: - VOLUNTEERS ARE ACTIVE AT THE HOSPITAL ON THE ANSCHUTZ MEDICAL CAMPUS, THE SOUTH CAMPUS, HIGHLANDS RANCH THERAPY CARE CENTER, BRIARGATE, AND THE NORTH CAMPUS. - VOLUNTEERS SPEND TIME WITH OUR PATIENTS BY HOLDING, COMFORTING, PLAYING WITH THEM AND MAKING THEM LAUGH. - VOLUNTEERS BRING SPECIALLY-SCREENED DOGS TO PROVIDE ANIMAL-ASSISTED THERAPY FOR THE PRESCRIPTION PET PROGRAM. - SPECIALLY TRAINED VOLUNTEERS SERVE AS AMBASSADORS WITH THE WELCOME PROGRAM. VOLUNTEERS GREET NEWLY ADMITTED PATIENT FAMILIES UPON THEIR ARRIVAL AND INTRODUCE THEM TO THE HOSPITAL'S MANY AMENITIES. THE GOAL IS TO PROVIDE A WARM AND WELCOMING ENVIRONMENT AND TO ANSWER ANY NON-MEDICAL QUESTIONS. - THE WINE EVENT IS THE ASSOCIATION OF VOLUNTEERS' SIGNATURE EVENT. THE SPECIAL EVENING FEATURES A SILENT AND LIVE AUCTION OF FINE WINES AND EXPERIENCES WITH ALL PROCEEDS BENEFITING THE MATERNAL FETAL MEDICINE PROGRAM. - MANY GROUPS OF VOLUNTEERS DO NOT SPEND TIME DIRECTLY WITH OUR PATIENTS, BUT PERFORM MORE ADMINISTRATIVE DUTIES, WHICH CAN BE JUST AS IMPORTANT TO THE DAY-TO-DAY OPERATIONS OF CHILDREN'S HOSPITAL COLORADO. - TEENAGERS BETWEEN 13 AND 18 YEARS OF AGE PARTICIPATE IN THE JUNIOR VOLUNTEER PROGRAM. THEY SUPPORT THE HOSPITAL BY WORKING IN SEVERAL DEPARTMENTS AS WELL AS SUPPORTING FUNDRAISING ACTIVITIES. - VOLUNTEERS ALSO ASSIST IN FUNDRAISING BY STAFFING CHILDREN'S HOSPITAL COLORADO GIFT SHOP AND LA CACHE. - CHAPTER VOLUNTEERS IN THE COMMUNITY ARE VERY ACTIVE IN FUNDRAISING EVENTS THROUGHOUT THE YEAR THAT HELP TO FUND SPECIAL EQUIPMENT, FACILITIES AND PROGRAMS FOR THE PATIENTS OF CHILDREN'S HOSPITAL COLORADO.
FORM 990, PART III, LINE 4A	RESPIRATORY CARE At Childrens Hospital Colorado, Respiratory Care is part of the Breathing Institute service line. This department cares for a diverse patient population from around the United States, ranging in age from birth to early adulthood. We provide care at three inpatient facilities, four emergency departments, seven outpatient clinic locations, and three outreach clinics in addition to our growing telemedicine outreach. In 2018, we cared for 48% of patients from birth to age 18 hospitalized for respiratory disease in Colorado and 79% of those hospitalized with the most severe respiratory disease. The Respiratory Care team includes 27 Pediatric Pulmonologists (9.23 clinical FTEs), 7 Pediatric Sleep Medicine Physicians (3.45 clinical FTEs), 2 Allergists (0.19 clinical FTEs), 16 Advanced Practice Providers (12.5 clinical FTEs), and 21.73 outpatient RN FTEs. The multidisciplinary care team also includes respiratory therapists, social workers, registered dieticians, physical and speech therapists, psychologists, and health navigators. In 2018, the Breathing Institute had 18,658 outpatient visits (9% increase from 2017), 3,621 inpatient discharges (2% increase from 2017) performed 357 bronchoscopies (19% increase from 2017), 22 laryngoscopies (8% decrease from 2017), and 4,131 sleep studies (2.8% increase from 2017). In 2018, the Respiratory Care team dedicated focused resources to quality improvement, advocacy, and healthcare provider education. Four of those projects have yielded strong results and are described below as our 2018 accomplishments. Quality Initiative: Home Visits for Pediatric Asthma Patients As a result of a previously conducted needs assessment focused on high risk asthma patients seen at Childrens Hospital Colorado, the Breathing Institute created a home visit program for patients with difficult-to-control asthma in 2016. The first two years were focused on program development, hiring and training staff, and conducting quarterly PDSA quality improvement cycles. In 2018, we concluded our pilot phase and incorporated home visits into our clinical operations as standard of care for high risk asthma patients. We conducted 116 home visits with 44 patients. These visits were conducted by a nurse and community health navigators and focused on asthma education, barrier identification and patient navigation, home environmental assessment and trigger remediation. Support provided to each family varies based on barriers identified but commonly includes medication device technique teaching, help with applications for benefits (e.g., Medicaid and WIC paperwork), and remediation supplies such as HEPA-filter vacuums, safe cleaning supplies, and pest extermination services. During the pilot phase that ended in 2018, we saw a 41% reduction in readmissions/emergency department revisits for asthma in the six months following participation in the home visit program. Healthcare Advocacy: Updating Colorados Newborn Screening Law Colorados newborn screening program aims to ensure every Colorado baby receives a genetic, metabolic and hearing screening upon birth. These screenings help identify potentially life-threatening conditions, as well as hearing loss. If these conditions arent identified very early in life, they can lead to severe health consequences and developmental delays or even death. However, that law dates back to the 1990s and did not include screening for many conditions that are standard in other states. Clinicians at Childrens Hospital Colorado, including pulmonologists, approached our Government Affairs team with concerns about these gaps. With help from community partners, we advocated to modernize Colorados newborn screening program by expanding testing to cover new diseases, improving the follow-up process for babies needing additional testing, and ensuring adequate program resources. Pulmonary faculty members provided guidance on bill development and testimony at the Colorado legislature. This bill was signed into law on June 8, 2018. Quality Initiative: Improving Care for Patients with Obstructive Sleep Apnea by Leveraging Electronic Medical Records Since the original description of positive airway pressure (PAP) therapy for treatment of Obstructive Sleep Apnea (OSA) in 1980, the science and evidence of its effectiveness has expanded. Clinical applications of PAP therapy, along with the evolution of improved medical devices using this technology, has outpaced the medical communitys ability to supply and monitor patients who would benefit from PAP therapy. In 2015, the American Academy of Sleep Medicine (AASM) published "Quality Measures for the Care of Pediatric Patients with Obstructive Sleep Apnea" but did not provide specific means to accomplish the outcomes and processes. Improving access to PAP therapy became a quality care, high priority issue at our institution. The increased numbers of patients needing to be assessed and treated overwhelmed our work flow. To effectively capture the ever-growing PAP patient population, a customized report was created to extract data within EMR system to track all new PAP patients from completion of their PAP titration sleep study to subsequent clinic visit. A process map was created to identify communication gaps and 100% of new PAP patients received a call to schedule a follow up visit. Through three quality improvement cycles, the team increased sleep study follow-up clinic visits from 61% at baseline to 88%. Quality Initiative: Simulation Training for Families of Children with Long-term Mechanical Ventilation Preparing families of children requiring long-term mechanical ventilation (LTMV) to manage medical emergencies at home is challenging. Opportunities for family caregivers to rehearse crisis management in a controlled setting before discharge are limited. We created a multimodal discharge preparedness curriculum, incorporating high-fidelity simulation training, to prepare family caregivers of children with complex medical conditions requiring LTMV. We also sought to determine which curricular elements were most helpful and whether this curriculum impacted the rate of readmissions within 7 days of hospital discharge. The curriculum included instructional videos, printed handouts, cardiopulmonary resuscitation training, and two mandatory high fidelity simulation scenarios depicting tracheostomy- and ventilator-related emergencies. Teams of one to three family caregivers per patient managed each scenario. A video-based debriefing focused on identifying and closing performance gaps. Participants rated their perceptions regarding each curricular element and its relative impact on their preparedness for discharge. Eighty-seven family caregivers completed the curriculum. Simulation-enhanced curriculum was well-received by participants. Participants reported that post-simulation debriefing was the most beneficial component. We observed a trend toward reduced readmissions within 7 days of discharge since implementation of our revised curriculum: from 15% 7-day readmission rate (n=20) to 7.9% 7-day readmission rate (n=38). Simulation training can be incorporated into discharge training for families of children requiring LTMV. Rehearsal of emergency management in a simulated clinical setting increases caregiver confidence and preparation to assume care for their ventilator-dependent child at home. Neuroscience Institute Childrens Hospital Colorados (CHCO) Neuroscience Institute (NSI) has one of the best pediatric developmental pediatrics, neurology, and neurosurgery programs in the country. We have consistently ranked among the Top 15 programs by US News & World Report. The NSI provides evaluation and treatment of neurological disorders, parent and patient education, and inpatient and outpatient treatments, therapies and procedures. Our neurology team is specially trained to diagnose and treat disorders of the brain and nervous system, caring for kids with conditions like stroke, neuromuscular disorders, movement disorders, neurometabolic disorders, epilepsy, and migraines. Our neurosurgery team provides surgical treatment for all types of disorders affecting the brain, spinal cord and skull including epilepsy, hydrocephalus, traumatic injury, brain tumors, spina bifida, and facial and skull deformities. Our Developmental Pediatrics team sees children with a variety of developmental and neurobehavioral differences such as autism spectrum disorders, X&Y chromosome variations, fragile X and developmental delays.
FORM 990, PART III, LINE 4A CONTINUED	The NSI clinical care team is comprised of Neonatologists, Neonatal Nurse Practitioners, specially trained nurses, respiratory therapists, pharmacists, physical, speech and occupational therapists, lactation specialists, neonatal nutrition, social work, chaplains and case managers. Specialty consultants include neurology, pulmonology, genetics, gastroenterology, nutrition, metabolic, endocrinology, hematology, cardiology and cardiovascular surgery, general pediatric surgery, renal, ophthalmology, orthopedics and ear, nose and throat specialists. NSI includes 50 physicians, 24 advanced practice providers, 27 psychologists across 8 Childrens sites as well as 7 outreach sites across Colorado and a growing telemedicine practice. Our Childrens sites include Anschutz, COS/Briargate, North/Broomfield, Parker, Uptown, Wheatridge, South, Highlands Ranch Therapy. The NSI treated 37,622 patient visits in 2018, serving the Colorado community and our 7-state region. Our Anschutz facility location alone saw 22,260 visits, and we see patients at eight of CHCOs network sites. NSI tripled the number of telemedicine visits in 2018, to 182, and saw almost 500 patient visits in eight outreach clinics across Colorado. Due to the high demand for NSIs services, we have focused on expanding our outreach and telemedicine efforts to better serve patients across Colorado and the 7-state region. Increasing access to care for NSIs specialized services is our high priority to enable our families live healthier lives. NSI Inpatient had 6,822 patient days recorded in 2018. There was a total of 1,236 inpatient discharges in 2018. National/Regional Presence: NSI has an outreach program reaching from Montana to New Mexico with extensive presence in Colorado. We host over 100 Neurology outreach clinics annually across Colorado, in Alamosa, Durango, Ft. Morgan, Grand Junction, Montrose, Pueblo and Sterling. Our Neurologists provide EEG reading services for 8 hospitals/medical centers in Colorado, Nebraska and Montana. Our Developmental Pediatrics team travels throughout the state to train PCPs on best practices in diagnosing and managing patients with autism. In 2018 we expanded our telemedicine efforts significantly, seeing an increase of over 200% in the number of visits. We were successful in arranging physician licensing, credentialing, and contracts in Montana. We are also working to expand our regional partnerships in 2019 we expect to host an outreach and telemedicine clinics in Casper, WY. NSI is acknowledged by the National Association of Epilepsy Centers as a Level 4 Epilepsy Center. We are recognized by the International Foundation for CDKL5 Research as Center of Excellence for Rett patients, drawing patients nationally to be treated by Dr. Tim Benke, an international expert in this area. Our Neurology Complex Drugs Program draw patients from around the region to be treated for complex neurodegenerative diseases, and the program has been recognized as model for care for these treatments. Our faculty offer local and regional CMEs and organize an annual Rett Symposium and regular Seizure Safety Schools for parents and families. Quality Improvement: The NSI is committed to developing quality improvement as a core clinical strategy by continually advancing the effectiveness, efficiency, safety, experience and coordination of the care it provides to its patients. Our Quality Improvement committee meets monthly to review quality and safety metrics and initiatives and has representatives from all three sections. NSI has numerous active Quality & Process Improvement initiatives underway in 2018 (and continuing into 2019), including the following: - A QSRS review that resulted in establishment of medication safety task force impacting prescription practices and improving parental compliance with Rx orders. - Restructured monthly M&M conferences for faculty and trainees to make them more outcome oriented and to facilitate follow-up on progress toward agreed upon goals. - Established clinical pathways for headache, pediatric arterial ischemic stroke, infantile spasms, neonatal seizures after acquired brain injury, traumatic brain injury, neuromuscular disorders, and status epilepticus. - Established dedicated appointments within the infusion center for status migrainosis patients. - Implemented and trained inpatient nurses specifically to neuroscience patient care improving patient outcomes such as unplanned RRT/Codes related to seizures. - Established dedicated inpatient Neurology service and separate Neurocritical Care (for PICU, CICU, NICU) and Neurohospitalist (ED and regular inpatient units) consultative services. - Care team optimization completed to fully integrate medical assistants into clinic practice. - Piloted RN bookend model in our Developmental Pediatrics clinic to increase access - Redesigned our autism intake model to better serve patients As a result of ongoing Quality & Process Improvement initiatives, NSI has seen the following outcomes: - Decreased utilization of free text only sigs used when writing prescriptions by 25% - 50% decrease in EEG lead pressure injuries - 30% improvement in rate of medication reconciliation during telephone encounters - Greater than 90% rate of responding to over 54K annual patient telephone and MyChart encounters within 2 days. - Decreased headache patient visits through the ED, decreased cost to hospital and increased patient access and satisfaction. - Improved referring physician satisfaction with timeliness and quality of input from inpatient Neurology consultations CENTER FOR CANCER AND BLOOD DISORDERS Childrens Hospital Colorados (CHCO) Center for Cancer and Blood Disorders (CCBD) has one of the best pediatric hematology, oncology and bone marrow transplant programs in the country. The CHC CCBD has been ranked in the Top 10 programs by US News & World Report each year. The CCBD treated 34,848 patient visits in 2018, in an effort to serve the Colorado community, as well as our 7-state region. Our Anschutz facility location alone saw 22,914 visits, with our infusion center volume making up 8,632 (38%) of those visits. Our Network of Care sites in Highlands Ranch, Colorado Springs, and our Hemophilia Thrombosis Center on the Anschutz campus serviced 11,934 patient visits in 2018, 3,507 of which were infusions (29%). Because of the depth and breadth of CCBD outpatient services, a large number of our clinic and infusion visits mean that many children can be cared for on an outpatient basis instead of being admitted to the hospital. Limiting hospitalization when possible is our high priority to enable our families live healthier lives. CCBD Inpatient had 11,592 patient days recorded in 2018. The inpatient unit had a total of 8,228 inpatient Hematology and Oncology patient days and 3,158 BMT patient days recorded. There was a total of 1,722 admissions to the inpatient unit in 2016. National/Regional Presence: CCBD has an outreach program reaching from Montana to New Mexico with extensive presence in Colorado. Our outreach clinics in Grand Junction bring Hematology sub-specialty expertise to the Western slope. Our Hemophilia & Thrombosis Center (HTC) provides comprehensive care clinics throughout the region. We host bi-weekly Bone Marrow Transplant teleconferences with cancer programs in New Mexico. Our CCBD nursing program travels throughout the region to train other hospital nurse staff on best practices in chemotherapy administration. CCBD also hosts regional private practice physicians through our Visiting Provider program, inviting them to our Anschutz location to share best care practices with our community partners first hand, and giving them educational materials and strategies to bring home. In 2018 we expanded our telemedicine efforts. We were successful in arranging physician licensing, credentialing, and contracts in Montana and New Mexico. Our HTC faculty successfully treated rural out of state patients via telemedicine in 2018, and they have set the stage for expanding this platform for 2019 and beyond. We are also working to expand our regional partnerships in 2019 we fully expect to host an outreach clinic in Cheyenne, WY. CCBD is acknowledged by Optum as a Center of Excellence for both our Cancer Care as well as our Bone Marrow Transplant program. We are the only pediatric Foundation for the Accreditation of Cellular Therapy (FACT) program in a 16-state region, which brings us the capacity to deliver the most sophisticated stem cell transplant and chimeric antigen receptor T (CAR-T) cell immunotherapy. Our Neuro-Oncology and Experimental Therapeutics programs draw patients nationally and internationally for treatment and clinical trials available in only a few centers in the world.
FORM 990, PART III, LINE 4A CONTINUED	CCBD Fellowship Program: Each year we select 4 new fellows to join our highly selective 3-year Accreditation Council of Graduate Medical Education-sanctioned Fellowship Program. Our fellows train in all aspects of sub-specialty care of children, adolescents and young adults with blood and cancer disorders in preparation for a career in academic medicine. We emphasize excellence in clinical care and research, developing fellows in the physician-scientist model with numerous mentors among the faculty such that our graduates acquire the skills and strategies needed for a career as life-long learners, educators, and influential leaders. We have successfully prepared subspecialty pediatricians that provide comprehensive, patient- and family-centered care with particular focus on excellent communication skills, as well as safety and quality improvement. Almost 90% of our graduates go on to prestigious academic positions with leadership positions across the country. Access: CCBD is privileged to have a dedicated Wellness program. This interdisciplinary team is comprised of specialists in Social Work, Psychology, Child Life, Family Navigation, Creative Arts Therapy, Chaplaincy, and Learning Specialists. The Wellness program benefits families and patients by integrating and coordinating clinical services to meet every familys needs at the individual level and increases possibilities for prevention/intervention and on-going care and connection. The CCBD is a home for multiple sub-programs within Oncology, Hematology and BMT. Our Vascular Anomalies Center is a less commonly known program that is a national and regional leader. This interdisciplinary team evaluates and treats vascular anomalies in children. The team includes specialists from Otolaryngology (ear, nose and throat), Plastic Surgery, Dermatology, Hematology, Pediatric General Surgery and Interventional Radiology. This program exemplifies our priority to put the patient first. Our specialists coordinate their care in one patient appointment to minimize the number of visits needed to evaluate and treat the patients condition. Quality Improvement: The CCBD is committed to developing quality improvement as a core clinical strategy by continually advancing the effectiveness, efficiency, safety, experience and coordination of the care it provides to its patients. The Clinical Effectiveness Collaborative (CEC) supports data driven improvement work on clinical effectiveness, operational excellence and value throughout the CCBD, CHC, and the University of Colorado Anschutz Medical Campus with multidisciplinary standing membership drawn from individuals within the CCBD who can provide meaningful review and guidance to projects shared and supported by the CEC. The CEC is broadly representative, multidisciplinary and guides the range of activities and initiatives through which the CCBD is pursuing its clinical, operational, value-driven, and financial improvement goals. One primary function of the CEC is to review and provide feedback related to clinical and operational improvement projects, including measures, PI methods, and project alignment across the CCBD and CHC. The Collaboratives members help guide clinical and operational improvement initiatives, spread successful interventions, identify and recommend strategies to overcome barriers/challenges, and serve as enthusiastic advocates for, participants and leaders of continuous learning and improvement in their respective areas and across the CCBD. The CCBD has several active Quality & Process Improvement initiatives underway in 2018 (and continuing into 2019) to include: - The CCBD outpatient infusion center on the Anschutz Medical Campus significantly surpassed the Childrens Hospital Colorado patient satisfaction goal for 2018. - Standardizing an approach to screening for transfusion-associated iron overload increasing the number of patients identified and treated for this complication and preventing long-term toxicities. - Decreasing length of stay of high-dose methotrexate admissions resulting in more time outside the hospital for children with leukemia and osteosarcoma. - Preventing blood stream infections in patients with a central line/catheter (tube). - Improving time to administration of pain medications with Sickle Cell patients in acute pain. - Decreasing the rate of clostridium difficile infections resulting in decreased mortality, decreased length of inpatient hospital stay and decreased cost for both community and hospital onset. - Effective clinical management: Quality & Strategy Team at the HTC developed a transitions of care program for patients and is beginning to address transition of care for care givers. Their processes are now being used in HTCs throughout Region VIII of the federal HTC network. - Successful Foundation for the Accreditation of Cellular Therapy (FACT) re-accreditation. FACT accreditation is a threshold for excellence in cellular therapy within the bone marrow or cord blood transplant (BMT) patient population. - Reorganizing the program to a "Door to Door model" providing patients and families a single point of contact to facilitate providing high quality patient care. - Evaluating and changing the Bone Marrow Harvest process to reduce the positive sterility rate of products collected by CHCO providers.
FORM 990, PART VI, LINE 1A	CHILDREN'S HOSPITAL COLORADO'S EXECUTIVE COMMITTEE CONSISTS OF THE BOARD CHAIR, CHAIR ELECT, CHIEF EXECUTIVE OFFICER, SECRETARY, BOARD TREASURER, CORPORATE TREASURER, IMMEDIATE PAST CHAIR, THE CHAIR OF THE CHILDREN'S HOSPITAL COLORADO FOUNDATION, THE CHANCELLOR (OR DESIGNEE) AND UP TO TWO (2) ADDITIONAL SEATS TO BE FILLED BY THE BOARD CHAIR. THE EXECUTIVE COMMITTEE HAS ALL THE POWERS OF THE BOARD OF DIRECTORS, EXCEPT AS LIMITED BY LAW, DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD.
FORM 990, PART VI, LINE 6	CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL COLORADO.
FORM 990, PART VI, LINE 7A	THE WRITTEN CONSENT OF CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS REQUIRED TO APPROVE THE BOARD OF DIRECTORS OF CHILDREN'S HOSPITAL COLORADO.
FORM 990, PART VI, LINE 7B	CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM AS THE SOLE MEMBER HAS CERTAIN APPROVAL POWERS AS DESCRIBED IN THE AMENDED AND RESTATED BYLAWS DATED SEPTEMBER 22, 2011 AND AMENDED MOST RECENTLY IN FEBRUARY 2017.
FORM 990, PART VI, Line 11B	CHILDREN'S HOSPITAL COLORADO'S FINANCE DEPARTMENT WORKS CLOSELY WITH HUMAN RESOURCES, CORPORATE COMPLIANCE, LEGAL AND PUBLIC RELATIONS TO GATHER ALL THE DATA REQUIRED TO COMPLETE THE FORM 990. THE VP OF FINANCE AND THE DIRECTOR OF ACCTG. & REPORTING CONDUCT A REVIEW WITH THE CFO PRIOR TO THE DRAFT BEING DISTRIBUTED TO THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE MADE, THE FORM IS SIGNED BY THE CFO, REVIEWED BY THE AUDIT COMMITTEE, AND A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS VIA A SECURED WEBSITE.
FORM 990, PART VI, LINE 12C	BOARD MEMBERS ARE REQUIRED TO DISCLOSE, ON AN ANNUAL BASIS, POTENTIAL CONFLICTS OF INTEREST PURSUANT TO THE WRITTEN POLICIES OF CHILDREN'S HOSPITAL COLORADO (CHCO) AND CHILDREN'S HOSPITAL COLORADO FOUNDATION (CHCF). ALL EMPLOYEES AND BOARD MEMBERS MUST PROMPTLY PROVIDE A WRITTEN DESCRIPTION OF MATERIAL FACTS OF AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO CORPORATE COMPLIANCE AND/OR GENERAL COUNSEL ON THE APPROPRIATE DISCLOSURE FORM. SUCH DISCLOSURE WILL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF THE CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. POLICIES AND PROCEDURES FOR DISCLOSING CONFLICTS OF INTEREST ARE TO BE FOLLOWED ACCORDING TO THE INDIVIDUAL'S FUNCTION, IN COMPLIANCE WITH STATE AND FEDERAL REGULATIONS. COMPLETED DISCLOSURE FORMS ARE SUBJECT TO AUDIT REVIEW BY LEGAL, THE CORPORATE COMPLIANCE PROGRAM, AND THE COMPLIANCE AND BUSINESS ETHICS COMMITTEE OF THE BOARD OF DIRECTORS. FAILURE TO COMPLY WITH CONFLICT OF INTEREST POLICIES MAY LEAD TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR WORKING RELATIONSHIP WITH THE CHILDREN'S HOSPITAL COLORADO. ONCE THE COMPLIANCE AND BUSINESS ETHICS (CABE) COMMITTEE HAS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WITH RESPECT TO AN AGREEMENT/CONTRACT THEN: 1. THE (CABE) COMMITTEE WILL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER CHILDREN'S HOSPITAL COULD OBTAIN A MORE ADVANTAGEOUS AGREEMENT/CONTRACT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES AND, IF APPROPRIATE, WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT. 2. IN CONSIDERING WHETHER TO ENTER THE PROPOSED AGREEMENT/CONTRACT, THE CABE COMMITTEE MAY APPROVE SUCH CONTRACT, TRANSACTION OR ARRANGEMENT ONLY IF THE DISINTERESTED PERSON OR COMMITTEE DETERMINE BY A MAJORITY VOTE THAT: - THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT IS IN CHILDREN'S COLORADOS BEST INTERESTS AND FOR COLORADO CHILDREN'S OWN BENEFIT; AND - THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO CHILDREN'S HOSPITAL COLORADO (CHCO), CONSIDERING, AMONG OTHER RELEVANT FACTORS, WHETHER CHCO COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES.
FORM 990, PART VI, LINES 15A AND 15B	CHILDREN'S HOSPITAL COLORADO HAS AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS THAT REVIEWS AND APPROVES ANY PROPOSED INCREASES RELATED TO ANY OFFICERS AND KEY EMPLOYEES OF THE COMPANY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE ALONG WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EACH YEAR. ONCE A CHANGE IN COMPENSATION IS APPROVED, FORMAL DOCUMENTS ARE COMPLETED AND MINUTES OF THE MEETING ARE PREPARED, REVIEWED AND APPROVED. REVIEW PROCESS INCLUDES: - REVIEW MARKET RATIO - SHOULD FALL BETWEEN 80% TO 120% OF MARKET - REVIEW 25TH, 50TH, AND 75TH PERCENTILE - BASE SALARY - INDIVIDUAL QUALIFICATIONS AND PERFORMANCE DETERMINES MARKET POSITION. BASE SALARY FOR EACH INDIVIDUAL IS TARGETED AT THE MEDIAN (50TH PERCENTILE) OF THE PEER GROUP. - VARIABLE PAY - LEADERSHIP INCENTIVE IS IN PLACE WHICH REWARDS FOR ORGANIZATIONAL PERFORMANCE WITH A COMPONENT ALSO BASED ON INDIVIDUAL PERFORMANCE. THE INCLUSION OF VARIABLE PAY WILL PLACE TOTAL CASH COMPENSATION (E.G., BASE SALARY AND VARIABLE PAY) BETWEEN THE 50TH AND 75TH PERCENTILE FOR EACH INDIVIDUAL. - AWARDS ARE BASED ON ACHIEVEMENT OF PRE-ESTABLISHED CHILDREN'S COLORADO GOALS WHICH SUPPORT THE STRATEGIC PLAN - BENEFITS - TARGETED AT THE "MIDDLE OF MARKET" DECISION FACTORS IN EXECUTIVE COMPENSATION DECISIONS: - MARKET DATA FROM INDEPENDENT COMPENSATION SURVEYS THAT REFLECT FUNCTIONALLY COMPARABLE POSITIONS IN ORGANIZATIONS OF SIMILAR SIZE AND SCOPE - DIFFICULTIES IN RECRUITING AND RETAINING EXECUTIVES - SKILLS, EXPERIENCE AND PERFORMANCE HISTORY OF INDIVIDUAL EXECUTIVES - CRITICAL BUSINESS OR STRATEGIC ISSUES THAT THE ORGANIZATION MAY FACE - UTILIZED APPROVED PEER GROUP FROM JANUARY 2018 MEETING - ON POSITIONS WITH INSUFFICIENT DATA (LESS THAN 10 MATCHES) - USED EXPANDED PEER GROUP OF ALL ACUTE CARE ORGANIZATIONS - BENCHMARKED BASE PAY, TOTAL CASH COMPENSATION, AND BENEFITS 2018 CUSTOM PEER GROUP - ATLANTA - BOSTON - CHICAGO - CINCINNATI - COLUMBUS - DALLAS - FORT WORTH - HOUSTON - KANSAS CITY - LOS ANGELES - MILWAUKEE - MINNEAPOLIS - ORANGE - PALO ALTO - PHILADELPHIA - SAN DIEGO - SEATTLE - WASHINGTON, DC THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2018.
FORM 990, PART VI, LINE 19	THESE DOCUMENTS ARE MADE AVAILABLE UPON REASONABLE REQUEST. Form 990, Part IX, Line 11g PHYSICIAN SERVICES $ 112,343,732 PURCHASED SERVICES $ 26,647,847 CONSULTING FEES $ 4,920,199 OTHER $ 21,371,387 ------------- TOTAL $ 165,283,165 =============
FORM 990, PART XI, LINE 9	EQUITY TRANSFER FROM CHCHS $ 6,996,209 EQUITY TRANSFER FROM FOUNDATION $ 29,700,130 CHANGE IN PERPETUAL TRUST ($ 3,524,702) OTHER CHANGES IN NET ASSETS $ 573,476 ------------- TOTAL $ 33,745,113 =============

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	28
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	27
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	8,195
6	Total number of volunteers (estimate if necessary) .............	6	3,127
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	4,816,248
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	806,515

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	45,374,318	15,421,891
9	Program service revenue (Part VIII, line 2g) .........	1,027,947,219	1,197,640,060
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,540,339	10,559,773
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	979,525	5,885,303
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,081,841,401	1,229,507,027
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	847,231	632,600
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)	533,464,125	576,951,334
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)....	477,235,081	537,936,873
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,011,546,437	1,115,520,807
19	Revenue less expenses. Subtract line 18 from line 12.......	70,294,964	113,986,220
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,618,767,354	1,763,582,517
21	Total liabilities (Part X, line 26).............	901,516,967	898,216,953
22	Net assets or fund balances. Subtract line 21 from line 20.....	717,250,387	865,365,564

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	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 942,006,724 including grants of $ 632,600 ) (Revenue $ 1,197,640,060 )
	Routine inpatient services; ancillary inpatient services such as lab, radiology, operating room, recovery room, central supplies, etc.; Outpatient services such as emergency room, multi-specialty ambulatory services including ortho clinic, oncology clinic, etc. See schedule O for additional information.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses942,006,724

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	7,187,127	0	1,420,645

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	8,218,789
e	Government grants (contributions)		1e	7,203,102

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

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		15,421,891

		Business Code
2a	NET PATIENT SERVICES REVENUE	622110	1,102,847,371	1,102,847,371	0	0
b	Research Funding	541900	13,276,307	13,276,307	0	0
c	Cafeteria	722210	4,473,291	4,473,291	0	0
d	Lab Billing	561000	4,309,478	752,113	3,557,365	0
e	Parking Lot Revenue	461790	1,850,676	1,850,676	0	0
f	All other program service revenue.		70,882,937	69,624,054	1,258,883	0
g	Total. Add lines 2a–2f ....		1,197,640,060

3 Investment income (including dividends, interest, and othersimilar amounts) ......			7,464,817			7,464,817
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		634,721
b	Less: rental expenses
c	Rental income or (loss)	0	634,721
d	Net rental income or (loss)......			634,721			634,721
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	3,103,873	-8,917
b	Less: cost or other basis and sales expenses
c	Gain or (loss)	3,103,873	-8,917
d	Net gain or (loss).....			3,094,956			3,094,956
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		0
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
	a		0
b	Less: cost of goods sold ..b		0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	GAIN/LOSS INTEREST RATE SWAPS			5,250,582	0	0	5,250,582
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			5,250,582
12	Total revenue. See Instructions......			1,229,507,027	1,192,823,812	4,816,248	16,445,076

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	632,600	632,600
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	7,187,130	6,044,117	1,143,013
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0	0	0	0
7	Other salaries and wages	456,686,530	384,056,887	72,629,643
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	19,874,857	16,714,037	3,160,820
9	Other employee benefits .......	60,647,531	51,002,384	9,645,147
10	Payroll taxes ...........	32,555,286	27,377,820	5,177,466
11	Fees for services (non-employees):
a	Management ......	124,298	104,530	19,768
b	Legal .........	1,187,418	0	1,187,418	0
c	Accounting ...........	0	0	0	0
d	Lobbying ...........	515,459	515,459	0	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	230,795	0	230,795	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	165,283,165	138,969,271	26,313,894	0
12	Advertising and promotion ....	12,351,471	10,387,141	1,964,330
13	Office expenses .......	7,175,260	6,034,135	1,141,125
14	Information technology ......	19,806,587	16,656,625	3,149,962
15	Royalties ..	0	0	0	0
16	Occupancy ...........	13,915,745	11,702,639	2,213,106
17	Travel ............	4,135,627	3,477,913	657,714
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	1,873,736	1,575,744	297,992
20	Interest ...........	18,607,589	15,648,311	2,959,278
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	59,335,640	49,899,131	9,436,509
23	Insurance ...	5,120,715	4,306,336	814,379
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	UBTI TAXES	630,000	0	630,000	0
b	MEDICAL/PHARM SUPPLIES	142,899,921	120,173,675	22,726,246	0
c	HOSPITAL PROVIDER FEE	31,011,708	31,011,708	0	0
d	EQUIPMENT RENTAL & MAINT	15,419,400	12,967,159	2,452,241	0
e	All other expenses	38,312,339	32,749,102	5,563,237
25	Total functional expenses. Add lines 1 through 24e	1,115,520,807	942,006,724	173,514,083	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).	0

1	Cash–non-interest-bearing ........			70,877,984	1	135,643,183
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			4,249,467	3	5,259,965
4	Accounts receivable, net .............			155,810,359	4	168,702,568
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
				0	6	0
7	Notes and loans receivable, net ....			0	7	0
8	Inventories for sale or use ........			12,356,151	8	13,977,157
9	Prepaid expenses and deferred charges ......			10,903,560	9	15,550,559
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,636,986,447
b	Less: accumulated depreciation	10b	611,823,702	916,873,710	10c	1,025,162,745
11	Investments—publicly traded securities .			357,246,459	11	298,941,401
12	Investments—other securities. See Part IV, line 11 .....			1,125,000	12	6,712,589
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			89,324,664	15	93,632,350
16	Total assets. Add lines 1 through 15 (must equal line 34)...			1,618,767,354	16	1,763,582,517

17	Accounts payable and accrued expenses .....	152,933,160	17	163,137,238
18	Grants payable ...	4,388,407	18	5,828,943
19	Deferred revenue .........	0	19	144,304
20	Tax-exempt bond liabilities .........	671,892,140	20	653,519,174
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	13,255,501	24	13,288,008
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	59,047,759	25	62,299,286
26	Total liabilities. Add lines 17 through 25..	901,516,967	26	898,216,953

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	619,173,271	27	759,030,824
28	Temporarily restricted net assets ...........	53,273,118	28	65,055,444
29	Permanently restricted net assets	44,803,998	29	41,279,296
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	717,250,387	33	865,365,564
34	Total liabilities and net assets/fund balances ........	1,618,767,354	34	1,763,582,517

(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) Children's North Surgery Cntr 469 state highway 7 suite 2 broomfield,CO80023 26-2394578	O/P surgery	CO	0	0	CH-Colorado

(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)CHILDREN'S HOSPITAL COLORADO HLTH SYSTEM 13123 EAST 16TH AVE AURORA,CO80045 45-4182666	HEALTHCARE	CO	501(c)(3)	12c, iii-fi	NA		No
(2)CHILD HEALTH MANAGEMENT SERVICES INC 13123 EAST 16TH AVE AURORA,CO80045 74-2266667	IT SERVICES	CO	501(c)(3)	3	CH-COLORADo	Yes
(3)THE CHILDREN'S HOSPITAL FOUNDATION 13123 EAST 16TH AVE AURORA,CO80045 84-0813462	FOUNDATION	CO	501(c)(3)	7	CHCHS	Yes
(4)CHILDREN'S HEALTH CORPORATION 13123 EAST 16TH AVE AURORA,CO80045 74-2235572	SUPPORTING	CO	501(c)(3)	12A-I	CH-COLORADo	Yes

(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?
(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) Children's north surgery cntr 469 state highway 7 suite 2 broomfield,CO80023 26-2394578	Outpatient Surg	CO	CH-COLORADO	Related	293,645	1,624,332		No			No

(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