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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) MARCELLA DODERER...................................................................... PRESIDENT/CEO	0.26 ................. 56.66	X	X			0	1,160,823	148,595
(2) CHARLES M BOWER MD...................................................................... TRUSTEE/DIRECTOR-CHIEF OF STAFF	9.17 ................. 50.00	X				0	558,140	31,354
(3) RON CLARK...................................................................... TRUSTEE/DIRECTOR	0.03 ................. 0.27	X				0	0	0
(4) JON DYER...................................................................... VICE CHAIR	0.12 ................. 0.00	X				0	0	0
(5) HARRY C ERWIN...................................................................... BOARD CHAIR	0.29 ................. 0.65	X				0	0	0
(6) GARY GEORGE...................................................................... TRUSTEE/DIRECTOR	0.09 ................. 0.15	X				0	0	0
(7) STACY LEEDS...................................................................... TRUSTEE/DIRECTOR	0.14 ................. 0.00	X				0	0	0
(8) PAT MCCLELLAND...................................................................... TRUSTEE/DIRECTOR	0.32 ................. 0.45	X				0	0	0
(9) CHARLES REDFIELD...................................................................... TRUSTEE/DIRECTOR	0.09 ................. 0.00	X				0	0	0
(10) JOHN ROBERTS...................................................................... TRUSTEE/DIRECTOR	0.06 ................. 0.00	X				0	0	0
(11) MARK SAVIERS...................................................................... BOARD TREASURER	0.09 ................. 0.30	X				0	0	0
(12) KC TUCKER...................................................................... TRUSTEE/DIRECTOR	0.03 ................. 0.00	X				0	0	0
(13) BARBARA TYSON...................................................................... TRUSTEE/DIRECTOR	0.06 ................. 0.00	X				0	0	0
(14) MICHAEL HOWARD...................................................................... VP/CHIEF NURSING OFFICER	50.00 ................. 0.00			X		205,840	0	8,699
(15) DIANA MCDANIEL...................................................................... OPERATIONS VP	50.00 ................. 0.00			X		183,645	0	12,795
(16) PATRICIA MONTAGUE...................................................................... SVP/CHIEF ADMINISTRATOR	50.00 ................. 0.00			X		354,143	0	55,128
(17) EMILY HARRIS...................................................................... STAFF PHARMACIST	40.00 ................. 0.00				X	159,663	0	3,851

(A) Name and business address	(B) Description of services	(C) Compensation
NABHOLZ CONSTRUCTION CORP PO BOX 2090 CONWAY,AR72033	CONSTRUCTION CONTRACTING	10,247,772
PHILIPS MEDICAL SYSTEMS PO BOX 100355 ATLANTA,GA30384	INFORMATION TECHNOLOGY MAINTENANCE AGREE	2,259,076
CROTHALL HEALTHCARE 13028 COLLECTION CENTER DRIVE CHICAGO,IL60693	PATIENT TRANSPORT/EVS/LINEN SERVICES	1,484,518
COMPASS ONE PO BOX 102289 ATLANTA,GA30368	CAFETERIA SERVICES	1,351,429
TOSHIBA AMERICA MEDICAL SYSTEMS 2833 TRINITY SQUARE DRIVE 105 CARROLLTON,TX75006	INFORMATION TECHNOLOGY MAINTENANCE AGREE	1,074,824
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 21

- 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.
right arrow

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number

81-0817660

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

ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number

81-0817660

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 ARKANSAS CHILDREN'S NORTHWEST INC

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 ARKANSAS CHILDREN'S NORTHWEST INC		Employer identification number 81-0817660

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 ARKANSAS CHILDREN'S NORTHWEST INC			Employer identification number 81-0817660
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 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

ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number

81-0817660

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 ....
b	Contributions ...	3,721,746
c	Net investment earnings, gains, and losses	1,402,615
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	179,656
f	Administrative expenses ....
g	End of year balance ......	4,944,705

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

63.450 %

Temporarily restricted endowment SchDMd Bullet

36.550 %

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

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

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

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

Yes

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 .....	6,740,000		6,740,000
b	Buildings ....	120,017,423	7,446,351	112,571,072
c	Leasehold improvements
d	Equipment ....	23,464,823	5,341,801	18,123,022
e	Other .....	290,149	10,061	280,088
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				137,714,182

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) INTEREST RECEIVABLE				3,399
(2) MEDICAID RECEIVABLE				25,646,638
(3) DUE FROM AFFILIATES				1,538,891
(4) OTHER RECEIVABLES				91,354
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				27,280,282

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
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
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

PART V, LINE 4:

EARNINGS FROM ENDOWMENT FUNDS WILL BE USED TO SUPPORT VARIOUS HOSPITAL PROGRAMS. THE FILING ORGANIZATION DOES NOT HOLD ANY ENDOWMENTS; ALL ENDOWMENTS ARE HELD BY ARKANSAS CHILDREN'S FOUNDATION, A RELATED ORGANIZATION.

PART X, LINE 2:

NOTE: THE AUDIT IS COMPRISED OF THE CONSOLIDATED FINANCIAL STATEMENTS OF ARKANSAS CHILDREN'S, INC., ARKANSAS CHILDREN'S HOSPITAL, ARKANSAS CHILDREN'S FOUNDATION, ARKANSAS CHILDREN'S RESEARCH INSTITUTE, ARKANSAS CHILDREN'S NORTHWEST, ARKANSAS CHILDREN'S CARE NETWORK, ARKANSAS CHILDREN'S MEDICAL GROUP, AND SACOVA INSURANCE COMPANY (COLLECTIVELY, ARKANSAS CHILDREN'S). FOOTNOTE: ARKANSAS CHILDREN'S APPLIES FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ASC TOPIC 740 (TOPIC 740), ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. TOPIC 740 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS AND PROVIDES GUIDANCE ON WHEN TAX POSITIONS ARE RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS AND HOW THE VALUES OF THESE POSITIONS ARE DETERMINED. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY ARKANSAS CHILDREN'S AND HAS CONCLUDED THAT AS OF JUNE 30, 2019 AND 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 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

ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number

81-0817660

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 25000.0000000000 %

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

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? . . . . . .

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? . . . . . . . . .

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

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) . . .	2,434,007		2,434,007	3.770 %
b	Medicaid (from Worksheet 3, column a) . . . . .	51,686,754	44,302,765	7,383,989	11.440 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	54,120,761	44,302,765	9,817,996	15.210 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	488,713	14,979	473,734	0.730 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	7,215,133	2,972,691	4,242,442	6.570 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	23,200	2,550	20,650	0.030 %
j	Total. Other Benefits . .	7,727,046	2,990,220	4,736,826	7.330 %
k	Total. Add lines 7d and 7j .	61,847,807	47,292,985	14,554,822	22.540 %

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	300	300
3	Community support	250		250	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total	550	300	250	0 %

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. ......

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

39,408

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

44,782

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

-5,374

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?1Name, 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)
1	ARKANSAS CHILDREN'S NORTHWEST 2601 GENE GEORGE BLVD SPRINGDALE,AR72762 WWW.ARCHILDRENS.ORG AR5392	X	X	X	X

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)

	ARKANSAS CHILDREN'S NORTHWEST
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?........................

Yes

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): WWW.ARCHILDRENS.ORG/MEDIA/FILE/ACNW-CHNA-2019.PDF

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 18

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

Yes

If "Yes" (list url): WWW.ARCHILDRENS.ORG/MEDIA/FILE/ACNW_IS_2019.PDF

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)

	ARKANSAS CHILDREN'S NORTHWEST
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 250.000000000000% and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

ARCHILDRENS.ORG/MEDIA/FILE/FINANCIAL%20ASSISTANCE%20(SHARED%20HOSPITAL).PDF

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

WWW.ARCHILDRENS.ORG/MEDIA/FILE/FAP-ENGLISH-0032019.PDF

A plain language summary of the FAP was widely available on a website (list url):
WWW.ARCHILDRENS.ORG/MEDIA/FILE/AC_FINANCIALASSISTANCEFLYER.PDF

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

	ARKANSAS CHILDREN'S NORTHWEST
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)

	ARKANSAS CHILDREN'S NORTHWEST
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
ARKANSAS CHILDREN'S NORTHWEST	PART V, SECTION B, LINE 2: ARKANSAS CHILDREN'S NORTHWEST COMPLETED CONSTRUCTION DURING FISCAL YEAR 2018 AND OFFICIALLY OPENED ON FEBRUARY 27, 2018.
ARKANSAS CHILDREN'S NORTHWEST	PART V, SECTION B, LINE 3J: ARKANSAS CHILDREN'S NORTHWEST (ACNW) IS A PRIVATE, NONPROFIT HOSPITAL WITHIN ARKANSAS CHILDREN'S, INC., AND IS THE ONLY HEALTHCARE SYSTEM IN THE STATE SOLELY DEDICATED TO CARING FOR ARKANSAS'S 710,000 CHILDREN. THIS STATUS GIVES THE ORGANIZATION A UNIQUE ABILITY TO SHAPE THE LANDSCAPE OF PEDIATRIC CARE IN ARKANSAS AND TO TRANSFORM THE HEALTH OF CHILDREN THROUGHOUT THE REGION. ARKANSAS CHILDREN'S, INC. IS A PRIVATE, NON-PROFIT ORGANIZATION WHICH INCLUDES TWO PEDIATRIC HOSPITALS, A PEDIATRIC RESEARCH INSTITUTE AND USDA NUTRITION CENTER, A PHILANTHROPIC FOUNDATION, A NURSERY ALLIANCE, STATEWIDE CLINICS, AND MANY EDUCATION AND OUTREACH PROGRAMS. ARKANSAS CHILDREN'S NORTHWEST (ACNW), THE FIRST AND ONLY PEDIATRIC HOSPITAL IN THE NORTHWEST ARKANSAS REGION, OPENED IN SPRINGDALE IN EARLY 2018. ACNW OPERATES A 24-BED INPATIENT UNIT; A SURGICAL UNIT WITH FIVE OPERATING ROOMS; OUTPATIENT CLINICS OFFERING OVER 20 SUBSPECIALTIES; DIAGNOSTIC SERVICES; IMAGING CAPABILITIES; OCCUPATIONAL THERAPY SERVICES; AND NORTHWEST ARKANSAS' ONLY PEDIATRIC EMERGENCY DEPARTMENT, EQUIPPED WITH 30 EXAM ROOMS. AS A PEDIATRIC MEDICAL CENTER THAT TREATS CHILDREN FROM EVERY COUNTY IN NORTHWEST ARKANSAS, AND SOME FROM NEIGHBORING AREAS, ACNW DEFINES THE COMMUNITY IT SERVES AS ALL CHILDREN FROM BIRTH TO AGE 18 IN THE 11-COUNTY NORTHWEST REGION OF ARKANSAS (BENTON, CARROL, BOONE, WASHINGTON, MADISON, NEWTON, CRAWFORD, FRANKLIN, JOHNSON, SEBASTIAN AND LOGAN).
ARKANSAS CHILDREN'S NORTHWEST	PART V, SECTION B, LINE 5: IN 2019, ARKANSAS CHILDREN'S NORTHWEST TOOK A COMPREHENSIVE APPROACH TO UNDERSTAND CHILD HEALTH AND CONSIDERED BOTH PRIMARY AND SECONDARY DATA AT THE LOCAL, AND 11-COUNTY REGIONAL AREA IN NORTHWEST ARKANSAS, IN ORDER TO DETERMINE THE SPECIFIC HEALTH NEEDS OF CHILDREN IN THE AREA. SECONDARY DATA SETS REVIEWED INCLUDED THE U.S. CENSUS BUREAU, CENTERS FOR DISEASE CONTROL & PREVENTION, THE ANNIE E. CASEY KIDS COUNT DATA CENTER, ARKANSAS STATE AGENCY DATABASES, THE YOUTH RISK BEHAVIOR SURVEILLANCE SYSTEM (YRBSS), AND A VARIETY OF LOCAL ORGANIZATIONS' RESEARCH. ADDITIONAL DATA SOURCES INCLUDED FOCUS GROUPS, KEY INFORMATION INTERVIEWS, AND A TELEPHONE SURVEY OF NORTHWEST ARKANSAS PARENTS. COMMUNITY MEMBERS FROM ACROSS NORTHWEST ARKANSAS WERE INVITED TO SHARE THEIR EXPERIENCE AS PARENTS, GUARDIANS, EDUCATORS, SERVICE PROVIDERS FOR CHILDREN IN ARKANSAS, OR STAKEHOLDERS WITH KNOWLEDGE OF CHILD HEALTH THROUGH COMMUNITY DISCUSSIONS. EACH FOCUS GROUP INVOLVED RECORDED CONVERSATIONS IN GROUPS OF 5-15 PEOPLE FOR ABOUT 90 MINUTES. HOSPITAL STAFF CONDUCTED 6 TOTAL FOCUS GROUPS, WITH 76 TOTAL PARTICIPANTS, IN THREE LANGUAGES (ENGLISH, SPANISH, AND MARSHALLESE). FOCUS GROUPS WERE SPLIT AMONG CONSUMERS (THE LAY COMMUNITY OF LEGAL PARENTS OR GUARDIANS OF CHILDREN UNDER 18 YEARS OF AGE) AND PROVIDERS (HEALTHCARE PROVIDERS OR EDUCATORS WHO SERVE CHILDREN AND THEIR FAMILIES SUCH AS SCHOOL NURSES AND TEACHERS, SOCIAL SERVICE AGENCY EMPLOYEES, AND HEALTH EDUCATORS). TO ENSURE INCLUSION OF UNDER-SERVED, LOW-INCOME AND MINORITY POPULATIONS, STAFF REACHED OUT TO DIVERSE AREAS OF THE NORTHWEST ARKANSAS COUNTIES SERVED, SEEKING FEEDBACK FROM PROVIDERS AND GUARDIANS IN CULTURALLY AND LINGUISTICALLY UNDERREPRESENTED GROUPS. STAFF LED THREE FOCUS GROUPS IN SPANISH THROUGHOUT THE STATE AND ONE IN MARSHALLESE IN THE NORTHWEST, CONDUCTING PARTICIPANT OUTREACH THROUGH COMMUNITY REPRESENTATIVES AND ADVOCATES, NON-PROFIT COMMUNITY-BASED SERVICES, RELIGIOUS AND SECULAR ORGANIZATIONS, AND HEALTH AND EDUCATIONAL ORGANIZATIONS.COMMUNITY MEMBERS REPRESENTING NORTHWEST ARKANSAS WERE ASKED TO PARTICIPATE IN INTERVIEWS THAT WERE CONDUCTED IN PERSON OR VIA TELEPHONE BY HOSPITAL STAFF. INTERVIEWS WERE CONDUCTED WITH 17 PROVIDERS, BUSINESS AND INDUSTRY LEADERS, FAITH LEADERS, AND KEY DECISION MAKERS WHO WORK IN OR OVERSEE CHILD HEALTH PRIORITIES IN NORTHWEST ARKANSAS. QUESTIONS FOR KEY INFORMANT INTERVIEWS WERE STRUCTURED WITH BROAD TOPIC DOMAINS BASED ON THE SOCIAL DETERMINANTS OF HEALTH AS WELL AS OPEN-ENDED QUESTIONS DESIGNED TO OBTAIN SEMINAL INFORMATION.ARKANSAS CHILDREN'S CONTRACTED WITH THE UNIVERSITY OF ARKANSAS AT LITTLE ROCK (UALR) SURVEY RESEARCH CENTER (SRC) TO DESIGN AND CARRY OUT A TELEPHONE SURVEY OF PARENTS AND GUARDIANS LIVING IN NORTHWEST ARKANSAS WHO HAD CHILDREN CURRENTLY LIVING IN THEIR HOME. THE GOAL OF THE SURVEY WAS TO ASSESS ARKANSAS CAREGIVERS' VIEWS AND ATTITUDES TOWARD THEIR CHILDREN'S HEALTH AND COMMUNITY HEALTH NEEDS. A TOTAL OF 395 COMPLETED INTERVIEWS WERE CONDUCTED WITH NORTHWEST ARKANSAS ADULT RESIDENTS WHO ARE A PARENT, STEPPARENT, OR GUARDIAN OF A CHILD UNDER THE AGE OF 18 WHO LIVES IN THE HOUSEHOLD, EITHER FULL OR PART-TIME.
ARKANSAS CHILDREN'S NORTHWEST	PART V, SECTION B, LINE 6A: THE ARKANSAS CHILDREN'S NORTHWEST CHNA WAS CONDUCTED IN PARTNERSHIP WITH ARKANSAS CHILDREN'S HOSPITAL. BOTH HOSPITALS ARE PART OF THE ARKANSAS CHILDREN'S SYSTEM AND NORTHWEST ARKANSAS IS A SHARED COMMUNITY OF BOTH HOSPITALS.
ARKANSAS CHILDREN'S NORTHWEST	PART V, SECTION B, LINE 6B: ARKANSAS CHILDREN'S CONDUCTED THE NEEDS ASSESSMENTS FOR EACH OF THE TWO HOSPITALS IN PARTNERSHIP WITH OTHER ORGANIZATIONS OTHER THAN HOSPITAL FACILITIES. MEMBERS OF THE NATURAL WONDERS PARTNERSHIP COUNCIL, A COALITION OF STATEWIDE ORGANIZATIONS, IN ADDITION TO OTHER ORGANIZATIONAL AND COMMUNITY PARTNERS PARTICIPATED. THE FOLLOWING ORGANIZATIONS PROVIDED INPUT AND FEEDBACK ON THE ACH AND ACNW COMMUNITY HEALTH NEEDS ASSESSMENTS. MANY ALSO PROVIDED DATA AND INTERVIEWS TO THE ARKANSAS CHILDREN'S STAFF MEMBERS WHO WORKED ON BOTH OF THE NEEDS ASSESSMENTS. ARKANSAS CHILDREN'S HOSPITAL AND ARKANSAS CHILDREN'S NORTHWESTARKANSAS DEPARTMENT OF HEALTHARKANSAS DEPARTMENT OF EDUCATIONARKANSAS DEPARTMENT OF HUMAN SERVICESARKANSAS MINORITY HEALTH COMMISSIONTHE ARKANSAS COALITION FOR OBESITY PREVENTIONTHE ARKANSAS FOOD BANK AND THE NORTHWEST ARKANSAS FOOD BANKTHE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCESTHE UNIVERSITY OF ARKANSAS' COLLEGE OF PUBLIC HEALTHTHE CLINTON SCHOOL OF PUBLIC SERVICEADVOCACY ORGANIZATIONS INCLUDING ARKANSAS ADVOCATES FOR CHILDREN AND FAMILIES, THE HUNGER RELIEF ALLIANCE, THENORTHWEST ARKANSAS WORKERS JUSTICE CENTER, AND THE HISPANIC WOMEN'S ORGANIZATION OF ARKANSASHEALTH POLICY ORGANIZATIONS INCLUDING THE ARKANSAS CENTER FOR HEALTH IMPROVEMENT AND THE ARKANSAS SUPPORT NETWORKHEALTH CARE PROVIDERS INCLUDING PEDIATRICIANS, FAMILY PRACTICE PHYSICIANS, AND NURSESHEALTH RESEARCHERSTHE ARKANSAS ORAL HEALTH COALITIONTHE ARKANSAS IMMUNIZATION ACTION COALITIONTHE ARKANSAS FOUNDATION FOR MEDICAL CARE (AFMC)THE NETWORK OF ARKANSAS SCHOOL-BASED HEALTH CENTERS AND THE SCHOOL-BASED HEALTH ALLIANCE OF ARKANSASNONPROFIT ORGANIZATIONS PROVIDING DIRECT SERVICESMEMBERSHIP ORGANIZATIONS INCLUDING THE AMERICAN ACADEMY OF PEDIATRICS, THE ARKANSAS HOSPITAL ASSOCIATION, PHARMACY REPRESENTATIVES, AND DENTIST REPRESENTATIVESCOMMUNITY HEALTH CENTERS OF ARKANSASBEHAVIORAL HEALTH AGENCIESDENTAL INSURANCE COMPANIES AND PROVIDERSPRIVATE HEALTH INSURANCE COMPANIESFAITH COMMUNITY REPRESENTATIVESLOW-INCOME LEGAL SERVICESPRIVATE FOUNDATIONS AND THE ARKANSAS COMMUNITY FOUNDATIONTHE ARKANSAS CAMPAIGN FOR GRADE-LEVEL READINGPRIVATE INDUSTRIES RANGING FROM PHARMACEUTICAL COMPANIES TO CHAMBERS OF COMMERCEPARENTS
ARKANSAS CHILDREN'S NORTHWEST	PART V, SECTION B, LINE 7D: THE 2019 CHNA WAS DISTRIBUTED TO PARTNERS THROUGH THE NATURAL WONDERS PARTNERSHIP COUNCIL (NWPC) AND ITS MULTIPLE WORKGROUPS. IT IS ALSO AVAILABLE FOR PUBLIC VIEW WITHOUT CHARGE ON THE ARKANSAS CHILDREN'S WEBSITE.
ARKANSAS CHILDREN'S NORTHWEST	PART V, SECTION B, LINE 11: THE IMPLEMENTATION STRATEGY OUTLINES WHAT ACNW WILL DO DURING THE 2020-2022 TIME FRAME TO ADDRESS THE COMMUNITY HEALTH NEEDS FOUND IN THE CHNA. THE FIRST COMPONENT OF THE IMPLEMENTATION STRATEGY IS TO IMPLEMENT EVIDENCE-BASED NUTRITION EDUCATION CURRICULUM TO ADDRESS THE FOCUS AREAS OF FOOD INSECURITY AND CHILD OBESITY. ACNW WILL PROVIDE CLASSES TO PARENTS IN THE BROADER COMMUNITY USING EVIDENCE-BASED PROGRAMS SUCH AS COOKING MATTERS. ACNW WILL PARTNER WITH ARKANSAS CHILDREN'S HOSPITAL AND ARKANSAS HUNGER RELIEF ALLIANCE ON THIS WORK. CURRENT ACTIONS TO ADDRESS FOOD INSECURITY AND CHILD OBESITY INCLUDE: INPATIENT CAREGIVER MEAL PROGRAM, EMERGENCY FOOD BOXES AVAILABLE FOR FAMILIES, FOOD AVAILABLE IN FAMILY HOUSE FOR INPATIENT FAMILIES, STAFF PARTICIPATING IN FOOD DRIVES, AND ACNW SPONSORSHIP OF NWA FOOD BANK GALA (2019).THE SECOND COMPONENT OF THE IMPLEMENTATION STRATEGY IS TO IMPROVE ACCESS TO CARE BY PROMOTING CULTURAL AND LANGUAGE COMMUNICATION OPTIONS RELATED TO HEALTH CARE TO ADDRESS THE FOCUS AREA OF EQUITABLE ACCESS TO CARE. ACNW WILL ADD ADDITIONAL MULTILINGUAL FINANCIAL COUNSELORS. ACNW WILL DECREASE LANGUAGE BARRIERS BY INCREASING THE NUMBER OF HOSPITAL DOCUMENTS (I.E. IMMUNIZATION INFORMATION) THAT IS AVAILABLE IN LANGUAGES OTHER THAN ENGLISH (INCLUDING SPANISH AND MARSHALLESE). ACNW WILL WORK WITH THE ARKANSAS COALITION OF THE MARSHALLESE ON THESE EFFORTS. CURRENT ACTIONS TO ADDRESS EQUITABLE ACCESS TO CARE INCLUDE: INTERPRETER SERVICES STAFF (SPANISH AND MARSHALLESE), INTRODUCTION TO CULTURAL DIVERSITY IN HOSPITAL ORIENTATION, AND SPECIFIC DOCUMENTS WHICH ARE ALREADY BEING TRANSLATED.THE THIRD COMPONENT OF THE IMPLEMENTATION STRATEGY IS TO ADDRESS CHILD INJURY BY OFFERING SAFETY MATERIALS AND EDUCATIONAL CLASSES TO PARENTS AND CARETAKERS IN THE COMMUNITY TO ADDRESS THE FOCUS AREAS OF CHILD INJURY AND PARENTING SUPPORTS. ACNW WILL TRAIN STAFF ON EVIDENCE BASED BABYSITTING CLASSES SUCH AS THE "SAFE SITTER" CURRICULUM AND PROVIDE THOSE CLASSES TO THE COMMUNITY. ACNW WILL ENCOURAGE SAFE SLEEP PRACTICES BY PROVIDING "SAFETY BABY SHOWERS" FOR NEW PARENTS. ACNW WILL TRAIN STAFF TO BE CAR SEAT ADVOCATES OR TECHNICIANS, AND PROVIDE CAR SEATS AND INSTALLATION TO THE COMMUNITY. CURRENT ACTIONS TO ADDRESS CHILD INJURY AND TO SUPPORT PARENTS INCLUDE: CAR SEATS AVAILABLE TO FAMILIES WITH FINANCIAL NEED THROUGH THE SOCIAL WORK DEPARTMENT, MEDICATION LOCK BOXES AND GUN LOCKS AVAILABLE, SUICIDE PREVENTION TRAINING AND EDUCATION PROVIDED BY INJURY PREVENTION STAFF ON CAMPUS AT ACNW 2-3 TIMES ANNUALLY, HALO SLEEP SACKS UTILIZED ON INPATIENT UNIT (ALSO AVAILABLE THROUGH SOCIAL WORK BASED ON FINANCIAL NEED), SAFE SLEEP INITIATIVES PRACTICED ON INPATIENT UNIT ALONG WITH EDUCATION TO CAREGIVERS, AND STOP THE BLEED TRAINING PROVIDED THROUGH TRAUMA PROGRAM.THE FOURTH COMPONENT OF THE IMPLEMENTATION STRATEGY IS TO IMPROVE ACCESS TO IMMUNIZATIONS BY COORDINATING PROGRAMS WITH ACTIVITIES PARENTS AND FAMILIES ALREADY ATTEND TO ADDRESS THE FOCUS AREA OF IMMUNIZATIONS. ACNW WILL SUPPORT EFFORTS TO PROVIDE SCHOOL-BASED IMMUNIZATIONS, INCLUDING AN INQUIRY INTO PROVIDING IMMUNIZATIONS VIA ACH DENTAL VANS OR DAY-CARE CENTERS.THE FIFTH COMPONENT OF THE IMPLEMENTATION STRATEGY IS TO IMPROVE ACCESS TO REPRODUCTIVE HEALTH EDUCATION AND RESOURCES BY EXPANDING PARTNERSHIPS WITH OTHER HEALTHCARE GROUPS, TO ADDRESS THE FOCUS AREA OF REPRODUCTIVE HEALTH. ACNW WILL LEVERAGE CURRENT PARTNERSHIPS TO PROVIDE INCREASED REPRODUCTIVE HEALTH EDUCATION AND RESOURCES TO FAMILIES. CURRENT ACTIONS TO ADDRESS REPRODUCTIVE HEALTH INCLUDE: SOCIAL WORK PROVIDES EDUCATION AND RESOURCES RELATED TO PREGNANCY PREVENTION, OPTIONS FOR TEEN PARENTS FACED WITH DECISION, AND REFERRAL FOR PRENATAL CARE.THE SIXTH COMPONENT OF THE IMPLEMENTATION STRATEGY IS TO INCREASE ACCESS TO ORAL HEALTH CARE FOR KIDS IN NORTHWEST ARKANSAS BY PROVIDING ANCILLARY SUPPORT TO A NETWORK OF PARTNERS TO ADDRESS THE FOCUS AREA OF ORAL HEALTH. ACNW WILL WORK TO LEVERAGE CURRENT RESOURCES TO EXPAND THE REACH OF PARTNER GROUPS PROVIDING DENTAL OUTREACH. CURRENT ACTIONS TO ADDRESS ORAL HEALTH INCLUDE THE WORK OF THE ARKANSAS CHILDREN'S HOSPITAL DENTAL VAN IN WASHINGTON AND BENTON COUNTIES. THE SEVENTH COMPONENT OF THE IMPLEMENTATION STRATEGY IS TO ADDRESS SOCIAL ISSUES THAT IMPACT CHILD HEALTH BY COLLABORATING WITH A BROAD NETWORK OF CHILD HEALTH STAKEHOLDERS IN NORTHWEST ARKANSAS. ACNW WILL WORK TO BUILD A STRONG COALITION OF CHILD HEALTH ADVOCATES IN NORTHWEST ARKANSAS FROM A WIDE ARRAY OF GROUPS AND PARTNERS. CURRENT ACTIONS TO ADDRESS SOCIAL ISSUES INCLUDE SOCIAL WORK PROVIDING RESOURCES TO FAMILIES DAILY TO REMOVE BARRIERS WITH SOCIAL ISSUES AND INCREASE ACCESS TO HEALTHCARE. DUE TO THE CURRENT LIMITED RESOURCES AT ACNW, AND THE WORK ALREADY BEING DONE TO ADDRESS MENTAL HEALTH AND SUBSTANCE USE IN THE NORTHWEST REGION OF THE STATE, ACNW HAS CHOSEN NOT TO FOCUS ON MENTAL HEALTH AND SUBSTANCE USE FOR THE 2019 IMPLEMENTATION STRATEGY. ACNW, HOWEVER, REMAINS COMMITTED TO ACTING ON THESE ISSUES WHEN RESOURCES BECOME AVAILABLE.

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

Schedule H (Form 990) 2018

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 3C:	ACNW USES FEDERAL POVERTY GUIDELINES TO DETERMINE FREE OR DISCOUNTED CARE.PART I, LINE 4:ACNW DOES NOT HAVE A SPECIFIC FINANCIAL ASSISTANCE PROGRAM FOR THE "MEDICALLY INDIGENT" AS DEFINED BY AR CODE SECTION 6-64-503(A), BUT ITS FINANCIAL ASSISTANCE POLICY DOES PROVIDE FREE CARE FOR INDIVIDUALS WITH HOUSEHOLD INCOMES UP TO 250% OF POVERTY AND DISCOUNTED CARE FORINDIVIDUALS WITH HOUSEHOLD INCOMES UP TO 400% OF POVERTY. AS PART OF THE APPLICATION PROCESS, ACNW REQUESTS THAT PERSONS WITH NO INCOME AND ALSO INELIGIBLE FOR MEDICAID, MEDICARE, OR MARKETPLACE SUBSIDIES PROVIDE A WRITTEN SIGNED STATEMENT DESCRIBING HOW THEY ARE MEETING THEIR DAY TO DAY BASIC LIVING NEEDS. THE APPLICATION SPECIFIES SUCH REQUIREMENTS FOR APPLICANTS WITH "NO INCOME IN THE HOME". ACNW ALSO ASSISTS FAMILIES IN APPLYING FOR MEDICAID (INCLUDING THE TEFRA PROGRAM FOR DISABLED CHILDREN THAT ONLY CONSIDERS THE CHILD'S INCOME), SSI, CHILDREN'S MEDICAL SERVICES, AS WELL AS ACH'S OWN FINANCIAL ASSISTANCE PROGRAM. THE HOSPITAL ALSO ALLOWS INTEREST FREE PAYMENTS TO BE MADE UNTIL THE OUTSTANDING BALANCE IS PAID WITHOUT TIME CONSTRAINTS. ACNW DOES NOT REPORT TO COLLECTION AGENCIES OR TAKE OTHER EXTRAORDINARY COLLECTION EFFORTS.
PART I, LINE 7:	COSTING METHOD - ARKANSAS CHILDREN'S NORTHWEST (ACNW) USES A COST ACCOUNTING (CA) SYSTEM AS THE BASIS FOR DETERMINING COST FOR ITS PATIENTS. ALL PATIENT ENCOUNTERS (INPATIENT, OUTPATIENT, ED, AMBULATORY SURGERY) ARE CAPTURED IN THE COST ACCOUNTING SYSTEM FOR ALL PATIENTS (MEDICAID, INSURANCE, UNINSURED) WITH NO DIFFERENTIATION FOR TYPE OF INSURANCE, IF ANY. A BRIEF DESCRIPTION OF THE COST ACCOUNTING SYSTEM IS BELOW.THE COST ACCOUNTING SYSTEM AT ACNW IS A DETAILED PROCEDURE SYSTEM. ALL SERVICES PERFORMED BY PATIENT CARE STAFF HAVE BEEN EVALUATED AS TO THE RESOURCES UTILIZED TO PROVIDE THE SERVICES INCLUDING LABOR, DIRECT MATERIALS AND EQUIPMENT. IN ADDITION, OVERHEAD TYPE COSTS (BUILDING, UTILITIES, PAYROLL, ETC.) HAVE ALSO BEEN ALLOCATED TO THESE SERVICES. THE TWO COMPONENTS, DIRECT AND INDIRECT COSTS, ARE COMBINED AND REPRESENT THE TOTAL COST TO PROVIDE EACH SERVICE. THIS IS DONE ON A PROCEDURE LEVEL BASIS. AS A PATIENT IS ADMITTED AND INCURS SERVICES (X-RAYS, ROOM & BOARD, LAB, ETC.), THE APPLICABLE PROCEDURE COSTS ARE ASSIGNED TO EACH PARTICULAR PATIENT. UPON DISCHARGE, THE COSTS FROM THE INDIVIDUAL PROCEDURES THAT WERE PROVIDED TO EACH PATIENT ARE ADDED UP FOR A TOTAL COST OF PROVIDING CARE FOR EACH INDIVIDUAL PATIENT.THE COST ACCOUNTING SYSTEM IS UPDATED ANNUALLY TO REFLECT THE CURRENT YEAR'S EXPENSES.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES - ACNW PROVIDES MANY PEDIATRIC SPECIALIZED SERVICES TO THE COMMUNITY THAT ARE EITHER NOT AVAILABLE OR ARE BEYOND THE CAPACITY OF THE COMMUNITY TO PROVIDE. MANY OF THESE SERVICES ARE PROVIDED BY ACNW AT A LOSS. THESE LOSSES WERE OBTAINED FROM THE COST ACCOUNTING SYSTEM.
PART III, LINE 4:	UNCOLLECTIBLE UNCOMPENSATED CARE GENERALLY REPRESENTS STANDARD CHARGES THAT ARE UNREALIZED DUE TO AN UNWILLINGNESS TO PAY BY THOSE RESPONSIBLE FOR PAYMENT, THEREFORE BAD DEBT. UNCOLLECTIBLE UNCOMPENSATED CARE IS REPORTED AS A DEDUCTION FROM GROSS PATIENT REVENUE.TEXT OF FOOTNOTE IN CONSOLIDATED FINANCIAL STATEMENTS:IN MAY 2014, THE FASB ISSUED ASU 2014-09, AMENDED BY 2015-14, REVENUE FROM CONTRACTS WITH CUSTOMERS, WHICH SUPERSEDES VIRTUALLY ALL EXISTING REVENUE RECOGNITION GUIDANCE UNDER U.S. GAAP. THE ASU PROVIDES A FIVE-STEP MODEL FOR REVENUE RECOGNITION THAT ENTITIES WILL APPLY TO RECOGNIZE REVENUE IN A MANNER THAT REFLECTS THE TIMING OF THE TRANSFER OF SERVICES TO CUSTOMERS AND THE CONSIDERATION THAT AN ENTITY EXPECTS TO RECEIVE FOR THE GOODS AND SERVICES PROVIDED. ARKANSAS CHILDREN'S ADOPTED ASU 2014-09 ON JULY 1, 2018 USING THE RETROSPECTIVE METHOD OF TRANSITION. ARKANSAS CHILDREN'S PERFORMED AN ANALYSIS OF REVENUE STREAMS AND TRANSACTIONS UNDER ASU 2014-09. IN PARTICULAR, FOR NET PATIENT SERVICE REVENUE, ARKANSAS CHILDREN'S PERFORMED AN ANALYSIS INTO THE APPLICATION OF THE PORTFOLIO APPROACH AS A PRACTICAL EXPEDIENT TO GROUP PATIENT CONTRACTS WITH SIMILAR CHARACTERISTICS, SUCH THAT REVENUE FOR A GIVEN PORTFOLIO WOULD NOT BE MATERIALLY DIFFERENT THAN IF IT WERE EVALUATED ON A CONTRACT-BY-CONTRACT BASIS. UPON ADOPTION, THE MAJORITY OF WHAT WAS PREVIOUSLY CLASSIFIED AS PROVISION FOR UNCOLLECTIBLE ACCOUNTS AND PRESENTED AS A REDUCTION IN NET PATIENT SERVICE REVENUE ON THE CONSOLIDATED STATEMENTS OF OPERATIONS IS TREATED AS AN IMPLICIT PRICE CONCESSION THAT REDUCES THE TRANSACTION PRICE, WHICH IS REPORTED AS NET PATIENT SERVICE REVENUE. FOR THE YEAR ENDED JUNE 30, 2018, ARKANSAS CHILDREN'S RECORDED APPROXIMATELY $11.90 MILLION OF IMPLICIT PRICE CONCESSIONS AS A DIRECT REDUCTION OF PATIENT SERVICE REVENUE THAT WOULD HAVE BEEN RECORDED AS PROVISION FOR BAD DEBT PRIOR TO THE ADOPTION OF ASC 606. FOR THE YEAR ENDED JUNE 30, 2018, ARKANSAS CHILDREN'S RECORDED APPROXIMATELY $5.42 MILLION AS A DIRECT REDUCTION OF PATIENT ACCOUNTS RECEIVABLE THAT WOULD HAVE BEEN REFLECTED AS ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS PRIOR TO THE ADOPTION OF ASC 606. THE NEW STANDARD ALSO REQUIRES ENHANCED DISCLOSURES RELATED TO THE DISAGGREGATION OF REVENUE AND SIGNIFICANT JUDGMENTS MADE IN MEASUREMENT AND RECOGNITION.FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, ACNW RECOGNIZES REVENUE BASED ON ESTABLISHED RATES, SUBJECT TO CERTAIN DISCOUNTS AS DETERMINED BY ACNW. AN ESTIMATED PROVISION FOR UNCOLLECTIBLE ACCOUNTS IS RECORDED THAT RESULTS IN NET PATIENT SERVICE REVENUE BEING REPORTED AT THE NET AMOUNT EXPECTED TO BE RECEIVED. IT HAS BEEN DETERMINED, BASED ON AN ASSESSMENT AT THE CONSOLIDATED ENTITY LEVEL, THAT PATIENT SERVICE REVENUE IS PRIMARILY RECORDED PRIOR TO ASSESSING THE PATIENT'S ABILITY TO PAY AND AS SUCH, THE ENTIRE PROVISION FOR UNCOLLECTIBLE ACCOUNTS RELATED TO PATIENT REVENUE IS RECORDED AS A DEDUCTION FROM PATIENT SERVICE REVENUE IN THE ACCOMPANYING CONSOLIDATED STATEMENTS OF OPERATIONS.PATIENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE MODIFICATIONS TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES.FOR PATIENT RECEIVABLES ASSOCIATED WITH SELF PAY PATIENTS, INCLUDING PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES FOR WHICH THIRD PARTY COVERAGE PROVIDES FOR A PORTION OF THE SERVICES PROVIDED, ACNW RECORDS AN ESTIMATED PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE YEAR OF SERVICE.
PART III, LINE 8:	THE ACNW MEDICARE POPULATION IS PRIMARILY RENAL PEDIATRIC PATIENTS. THEREFORE, THE MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE THE REIMBURSEMENT IS NOT NEGOTIATED AND SERVICES CANNOT BE PROVIDED ELSEWHERE.
PART III, LINE 9B:	ARKANSAS CHILDREN'S USES ITS BEST EFFORTS TO ASSIST PATIENTS/GUARANTORS IN MEETING THEIR FINANCIAL RESPONSIBILITY FOR SERVICES PROVIDED AT ACNW. OUR POLICY IS TO ACT WITH INTEGRITY IN ALL ENDEAVORS; TREATING ALL PATIENTS AND THEIR FAMILIES WITH DIGNITY, RESPECT, AND COMPASSION. THE STANDARD PROCESS INCLUDES OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE FAMILIES. NOTICES REGARDING THE FINANCIAL ASSISTANCE PROGRAM ARE POSTED IN ENGLISH AND SPANISH IN ALL REGISTRATION AREAS. FINANCIAL ASSISTANCE BROCHURES ARE AVAILABLE TO FAMILIES UPON REQUEST. THE GUARANTOR STATEMENTS AND THE ARKANSAS CHILDREN'S WEBSITE CONTAIN INFORMATION ABOUT THIS PROGRAM. THERE ARE FINANCIAL COUNSELORS AVAILABLE TO ALL REGISTRATION AREAS OF THE HOSPITAL TO ASSIST IN COMPLETING MEDICAID, CMS, SSI INTENTS, AND FINANCIAL ASSISTANCE APPLICATIONS. ACNW BILLING AND COLLECTIONS IS A SERVICE PROVIDED BY ARKANSAS CHILDREN'S HOSPITAL (ACH), WHICH IS AN AFFILIATED COMPANY. ACH TAKES NO EXTRAORDINARY COLLECTION EFFORTS. ACH DOES NOT REPORT TO CREDIT BUREAUS OR CHARGE INTEREST OR FILE LIENS AGAINST A PATIENT'S OR FAMILY'S RESIDENCE TO SECURE PAYMENT ON PATIENT ACCOUNT BALANCES. UPON RECEIPT OF A PERSONAL BANKRUPTCY NOTICE, ANY OUTSTANDING SELF-PAY BALANCES FOR THE ASSOCIATED PATIENT ARE WRITTEN OFF ONCE ALL OTHER PAYMENTS HAVE BEEN RECEIVED. ALL SELF-PAY COLLECTION ACTIVITY IS STOPPED UPON NOTIFICATION OF THE BANKRUPTCY.UPFRONT DISCOUNTS ON SERVICES FOR THE UNINSURED ARE OFFERED. THE FAMILY CAN ALSO REQUEST A PROMPT PAY DISCOUNT. ADDITIONALLY, ACH ATTEMPTS TO ACCOMMODATE U.S. FAMILIES WHO DESIRE TO SET UP REASONABLE PAYMENT PLANS. INTEREST IS NOT CHARGED. THE HOSPITAL'S GUARANTOR STATEMENTS ARE DESIGNED TO KEEP THE GUARANTOR UPDATED AS TO WHETHER THE ACCOUNT IS STILL PENDING RESOLUTION BY INSURANCE OR DUE FROM THE GUARANTOR. SELF-PAY COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2:	DURING FISCAL YEAR 2019 AND EARLY FISCAL YEAR 2020, ACNW COMPLETED ITS INITIAL COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY THAT WILL GUIDE THE HOSPITAL'S COMMUNITY BENEFIT AND COMMUNITY PARTNERSHIPS TO IMPROVE HEALTH.
PART VI, LINE 3:	PLEASE SEE PART III, LINE 9B DESCRIPTION.
PART VI, LINE 4:	THE ARKANSAS CHILDREN'S NORTHWEST (ACNW) HOSPITAL, WHICH OPENED FEBRUARY 27, 2018, IS 233,613 SQ. FEET ON A 37-ACRE CAMPUS LOCATED IN SPRINGDALE ARKANSAS. ACNW IS THE REGION'S FIRST AND ONLY PEDIATRIC HOSPITAL AND WILL SERVE MORE THAN 200,000 CHILDREN LOCATED IN THE 11-COUNTY NORTHWEST ARKANSAS REGION. ACNW DREW APPROXIMATELY 82.1% OF ITS OUTPATIENTS AND 77.8% OF ITS INPATIENTS FROM WASHINGTON AND BENTON COUNTIES FOR THE FISCAL YEAR ENDING JUNE 30, 2019, WITH THE MAJORITY OF THE PATIENTS COMING FROM WASHINGTON COUNTY. ACCORDING TO U.S. CENSUS BUREAU 2010 CENSUS DATA, POPULATION TOTALS AT THAT TIME WERE 2,915,918 FOR THE STATE OF ARKANSAS AND 203,065 FOR WASHINGTON COUNTY. ESTIMATED 2018 CENSUS DATA INDICATED POPULATION TOTALS TO BE 3,013,825 FOR ARKANSAS WITH POPULATION TOTALS CLIMBING IN WASHINGTON COUNTY AS WELL. ALSO ACCORDING TO ESTIMATED 2018 CENSUS DATA, APPROXIMATELY 23.3% OF THE ARKANSAS POPULATION WAS UNDER 18 YEARS OF AGE AND 6.3% WAS UNDER THE AGE OF 5. THE UNEMPLOYMENT RATE FOR THE STATE OF ARKANSAS FOR CALENDAR YEAR 2018 WAS 3.7%. THE PER CAPITA PERSONAL INCOME FOR THE STATE OF ARKANSAS FOR 2018 WAS $25,635. THE PERCENT OF ALL PEOPLE IN POVERTY IN AR WAS 17.6% AND THE PERCENT OF CHILDREN 18 OR YOUNGER IN POVERTY WAS 24.7%, INDICATING A SLIGHT IMPROVEMENT FROM THE PRIOR YEAR.ESTIMATES FOR 2018 INDICATE THAT THE HISPANIC CHILD POPULATION IN ARKANSAS WAS 12.1% AND THE AFRICAN AMERICAN CHILD POPULATION WAS 18.0%. WITH A PRIMARILY RURAL POPULATION LIVING IN MANY SMALL AND MEDIUM-SIZED COMMUNITIES, ACCESS TO HEALTH CARE SERVICES PRESENTS A VERY REAL CHALLENGE. ARKANSAS HAS SEEN A LARGE DECLINE IN UNINSURED CHILDREN SINCE 1990, WITH 4.7% OF CHILDREN LACKING COVERAGE AS OF 2018. ARKANSAS' "ARKIDS FIRST" HEALTH INSURANCE PROGRAM HAS BEEN A MAJOR FACTOR IN PROVIDING HEALTH INSURANCE FOR CHILDREN WHO MAY HAVE OTHERWISE GONE WITHOUT. ARKIDS FIRST WAS DESIGNED BY THE STATE OF ARKANSAS TO PROVIDE INSURANCE FOR CHILDREN OF WORKING FAMILIES WHO EARNED TOO MUCH FOR PUBLIC ASSISTANCE BUT COULD NOT AFFORD TO PURCHASE HEALTH INSURANCE.
PART VI, LINE 5:	ARKANSAS CHILDREN'S VOLUNTEER ENGAGEMENT VOLUNTEER RESOURCES ARE INTEGRATED INTO MORE THAN 35 DEPARTMENTS ACROSS BOTH ARKANSAS CHILDREN'S HOSPITAL AND ARKANSAS CHILDREN'S NORTHWEST. THERE ARE SIX SEPARATE VOLUNTEER PROGRAMS AT ACNW INCLUDING OPPORTUNITIES FOR YOUTH DURING JUNIOR VOLUNTEER DAYS. THERE WERE OVER 500 VOLUNTEERS AT ACNW FOR FY19. THE ARKANSAS CHILDREN'S PATIENT AND FAMILY ADVISOR PROGRAM ENGAGES PARENTS AND CAREGIVERS IN A VARIETY OF WAYS TO CONTINUE ADVANCING OUR COMMITMENT TO PATIENT AND FAMILY-CENTERED CARE. THERE ARE 10 DIFFERENT FAMILY ADVISORY BOARD IN THE ARKANSAS CHILDREN'S SYSTEM. ONE OF THE FAMILY ADVISORY BOARDS IS FOR ACNW SPECIFICALLY, BUT INITIATIVES AND LEARNINGS ARE SHARED ACROSS ALL OF THE DIFFERENT BOARDS AND BETWEEN THE HOSPITALS. THESE GROUPS HAVE BROUGHT ABOUT MANY MEANINGFUL CHANGES TO THE HOSPITALS INCLUDING: VIDEO STREAMING, CO-DESIGNED PATIENT SAFETY INFORMATION, A MEAL ASSISTANCE PROGRAM, THE DEVELOPMENT OF PATIENT AND FAMILY HEALTH INFORMATION. PATIENT AND FAMILY ADVISORS ARE ENGAGED IN OTHER CAPACITIES, INCLUDING HOSPITAL COMMITTEES, A MENTOR PROGRAM, OUR E-COUNCIL, ETC. THE ADVISORS ARE A MAJOR ASSET IN THE COMMITMENT TO PATIENT SAFETY AND TO THE HOSPITAL MISSION.ARKANSAS CHILDREN'S CARE NETWORK (ACCN), WITHIN THE ARKANSAS CHILDREN'S SYSTEM, IS A COLLABORATOR WITH ACH. ACCN SEEKS TO FUNDAMENTALLY AND POSITIVELY TRANSFORM HEALTH IN THE CHILDREN OF ARKANSAS THROUGH A CLINICALLY INTEGRATED NETWORK (CIN) COMPRISED OF HEALTH CARE PROFESSIONALS WHO PROVIDE COORDINATED AND ACCOUNTABLE PEDIATRIC CARE. ACCN WILL ACHIEVE THIS BY IMPROVING QUALITY, ACCESS, AND PATIENT/FAMILY EXPERIENCE, WHILE IMPACTING THE AFFORDABILITY OF HEALTH CARE AND INCREASING PHYSICIAN ENGAGEMENT AND SATISFACTION.
PART VI, LINE 6:	ACNW IS PART OF AN AFFILIATED HEALTH CARE SYSTEM, FOR WHICH ARKANSAS CHILDRENS, INC., INCORPORATED IN DECEMBER 2015, SERVES AS THE PARENT CORPORATION. THE ARKANSAS CHILDREN'S HEALTH SYSTEM CONSISTS OF ARKANSAS CHILDREN'S, INC., ARKANSAS CHILDREN'S HOSPITAL (ACH), ARKANSAS CHILDREN'S NORTHWEST (ACNW), ARKANSAS CHILDREN'S FOUNDATION (ACF), ARKANSAS CHILDREN'S RESEARCH INSTITUTE (ACRI), ARKANSAS CHILDREN'S CARE NETWORK (ACCN), AND ARKANSAS CHILDREN'S MEDICAL GROUP (ACMG). ACH IS A NOT-FOR-PROFIT PEDIATRIC HOSPITAL LOCATED IN LITTLE ROCK, ARKANSAS AND SERVES AS THE ONLY QUATERNARY HEALTH CARE FACILITY FOR CHILDREN IN THE STATE OF ARKANSAS. ACNW IS A NOT-FOR-PROFIT PEDIATRIC HOSPITAL LOCATED IN SPRINGDALE, ARKANSAS, THAT OPENED IN FEBRUARY 2018. ACNW SERVES AS THE ONLY EXCLUSIVELY PEDIATRIC HEALTH CARE FACILITY FOR CHILDREN IN THE NORTHWEST REGION OF THE STATE. ACF IS A NOT-FOR-PROFIT ORGANIZATION THAT EXISTS AS THE FUNDRAISING BRANCH OF ARKANSAS CHILDREN'S. ACRI OPERATES TO SUPPORT, THROUGH CHARITABLE, SCIENTIFIC, AND EDUCATIONAL MEANS, THE MISSION OF ARKANSAS CHILDREN'S. ACCN IS A NOT-FOR-PROFIT PEDIATRIC STATEWIDE CLINICALLY INTEGRATED NETWORK. ACMG WAS FORMED TO PROVIDE PHYSICIAN SERVICES TO ACH AND ACNW.ALTHOUGH NOT CORPORATE AFFILIATES, ACNW AND THE UNIVERSITY OF ARKANSAS FOR MEDICAL SCIENCES (UAMS) ARE INVOLVED IN AN AGREEMENT IN THE PURSUIT OF PROFESSIONAL EDUCATION, RESEARCH, AND CLINICAL CARE FOR CHILDREN. ALL PEDIATRIC SUB-SPECIALTY WORK IS CONDUCTED ON THE ACNW CAMPUS WITH ACNW PROVIDING SPACE, SUPPORTING STAFF AND SERVICES AND FUNDING FOR MAJOR EDUCATIONAL AND CLINICAL EXPERTISE.

Schedule H (Form 990) 2018

Additional Data

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

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
ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number
81-0817660

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	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) SUNSHINE SCHOOL AND DEVELOPMENT CENTER 3400 WOODS LANE ROGERS,AR72756	71-0542730	501(C)(3)	5,700				GENERAL SUPPORT

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) MEALS	21		4,822	COST	MEALS FOR PATIENT FAMILIES/CAREGIVERS
(2) TRANSPORTATION COSTS (BUS TOKENS, CAB FARE, GAS CARDS)	108	2,529		COST
(3) FUNERAL EXPENSES	2	286		COST
(4) UTILITIES	1	200		COST
(5) GROCERY GIFT CARDS AND OTHER MISC. FAMILY ASSISTANCE	88	9,350		COST
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

PART I, LINE 2:

THE HOSPITAL CONSIDERS REQUESTS FROM NON-PROFIT OR GOVERNMENTAL ENTITIES FOR PROGRAMS OR ACTIVITIES THAT ALIGN WITH ITS PLAN TO ADDRESS NEEDS AS IDENTIFIED IN THE CHNA OR THAT OTHERWISE SUPPORT THE HOSPITAL'S MISSION. THE HOSPITAL ANTICIPATES THAT THESE NON-PROFIT OR GOVERNMENTAL ENTITIES WILL MONITOR THE USE OF FUNDS IN ACCORDANCE WITH NON-PROFIT OR GOVERNMENTAL REQUIREMENTS. THE HOSPITAL PROVIDES SOME ASSISTANCE TO INDIGENT FAMILIES. THE HOSPITAL'S SOCIAL WORK DEPARTMENT EVALUATES THE NEED ON A CASE BY CASE BASIS AND PROVIDES THE APPROPRIATE ASSISTANCE, WHICH IS TYPICALLY FOOD, CLOTHING, SHELTER, OR TRAVEL VOUCHERS. CASH OR CASH EQUIVALENT ASSISTANCE IS SOMETIMES PROVIDED. THE ASSISTANCE PROVIDED IS DOCUMENTED BY THE HOSPITAL'S SOCIAL WORK DEPARTMENT.

Schedule I (Form 990) 2018

Additional Data

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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

ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number

81-0817660

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 .........

Yes

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

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

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

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)
1MARCELLA DODERER PRESIDENT/CEO	(i) (ii)	0 ------------- 827,233	0 ------------- 228,000	0 ------------- 105,590	0 ------------- 137,101	0 ------------- 11,494	0 ------------- 1,309,418	0 ------------- 101,134
2CHARLES M BOWER MD TRUSTEE/DIRECTOR-CHIEF OF STAFF	(i) (ii)	0 ------------- 550,000	0 ------------- 8,140	0 ------------- 0	0 ------------- 0	0 ------------- 31,354	0 ------------- 589,494	0 ------------- 0
3MICHAEL HOWARD VP/CHIEF NURSING OFFICER	(i) (ii)	176,348 ------------- 0	29,251 ------------- 0	241 ------------- 0	0 ------------- 0	8,699 ------------- 0	214,539 ------------- 0	0 ------------- 0
4DIANA MCDANIEL OPERATIONS VP	(i) (ii)	158,358 ------------- 0	25,188 ------------- 0	99 ------------- 0	10,970 ------------- 0	1,825 ------------- 0	196,440 ------------- 0	0 ------------- 0
5PATRICIA MONTAGUE SVP/CHIEF ADMINISTRATOR	(i) (ii)	295,999 ------------- 0	56,228 ------------- 0	1,916 ------------- 0	48,820 ------------- 0	6,308 ------------- 0	409,271 ------------- 0	26,969 ------------- 0
6EMILY HARRIS STAFF PHARMACIST	(i) (ii)	156,099 ------------- 0	3,500 ------------- 0	64 ------------- 0	0 ------------- 0	3,851 ------------- 0	163,514 ------------- 0	0 ------------- 0
7JEFFREY WILLIAMS STAFF PHARMACIST	(i) (ii)	139,341 ------------- 0	2,500 ------------- 0	77 ------------- 0	0 ------------- 0	9,460 ------------- 0	151,378 ------------- 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
PART I, LINE 1A	CHARTER TRAVEL IS USED BY ARKANSAS CHILDREN'S AND AFFILIATED ENTITIES' BOARD MEMBERS AND STAFF (AND OCCASIONALLY ACCOMPANYING SPOUSES/COMPANIONS) WHEN IT IS DEEMED THE MOST EFFICIENT METHOD OF TRAVEL TO DISTANT AREAS WITHIN THE STATE OR TO SURROUNDING STATES FOR PURPOSES RELATED TO ARKANSAS CHILDREN'S BUSINESS. SEPARATE (NON-CHARTER) TRAVEL FOR COMPANIONS IS REIMBURSED BY THE EMPLOYEE IF SUCH TRAVEL IS ON AN INDIVIDUAL BASIS; THUS, SUCH TRAVEL IS NOT CONSIDERED TAXABLE COMPENSATION TO THE EMPLOYEE. ONE OFFICER/EMPLOYEE AND TWO BOARD MEMBERS USED CHARTER TRAVEL DURING THE CALENDAR YEAR. BECAUSE THE CHARTER TRAVEL WAS USED FOR ARKANSAS CHILDREN'S BUSINESS PURPOSES, IT WAS NOT CONSIDERED AS TAXABLE WAGES.
PART I, LINE 3	COMPENSATION FOR ANY ARKANSAS CHILDREN'S NORTHWEST EXECUTIVE OR SENIOR OFFICER (PRESIDENT; SENIOR VICE PRESIDENT) WHO IS NOT A CONTRACTED UAMS EMPLOYEE IS REVIEWED BY THE ARKANSAS CHILDREN'S HUMAN RESOURCES AND COMPENSATION COMMITTEE WHICH IS ESTABLISHED THROUGH THE BYLAWS OF ARKANSAS CHILDREN'S, INC. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE HAS THE FULL AUTHORITY AND SPECIFIC RESPONSIBILITY FOR REVIEWING AND APPROVING COMPENSATION POLICIES, BASE SALARY AND INCENTIVE COMPENSATION LEVELS, EXECUTIVE RETIREMENT AND OTHER EXECUTIVE BENEFIT PLANS FOR HEALTH SYSTEM SENIOR MANAGEMENT, INCLUDING OFFICERS OF THE CORPORATION AND AFFILIATES WHO ARE "DISQUALIFIED PERSONS" UNDER SECTION 4958 OF THE CODE. THE POLICIES AND PROGRAMS REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL BE DESIGNED TO ENSURE THAT THE CORPORATION AND ITS AFFILIATES REMAIN COMPETITIVE AND REASONABLE RELATIVE TO THE COMPENSATION AND BENEFITS PRACTICES OF SIMILARLY SITUATED HEALTH SYSTEMS LOCALLY AND NATIONALLY, AND TO PERMIT THE CORPORATION AND SUCH AFFILIATES TO ATTRACT AND RETAIN SUPERIOR SENIOR MANAGEMENT, IN FURTHERANCE OF THE CORPORATION'S AND AFFILIATES PURPOSES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL HAVE, TO THE FULLEST EXTENT OF THE LAW, THE AUTHORITY TO APPROVE THE COMPENSATION PACKAGES FOR SENIOR MANAGEMENT OF THE CORPORATION AND THE AFFILIATES. IN ITS PROCESS, THE COMMITTEE SHALL OBTAIN AND MUST RELY UPON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENTS OF DISQUALIFIED PERSONS. APPROPRIATE DATA INCLUDES, BUT IS NOT LIMITED TO, COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR FUNCTIONALLY COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA OF THE CORPORATION; CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE DISQUALIFIED PERSON. THE COMMITTEE MAY RELY UPON OPINIONS OF QUALIFIED LEGAL, ACCOUNTING, VALUATION AND EXECUTIVE COMPENSATION EXPERTS. CONTEMPORANEOUSLY WITH MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENT OF THE CEO AND DISQUALIFIED PERSONS, THE COMMITTEE SHALL DOCUMENT IN A WRITTEN REPORT THE BASIS FOR ITS DECISIONS AND FORWARD THE REPORT TO THE BOARD.
PART I, LINE 4B	THE ARKANSAS CHILDREN'S DEFERRED COMPENSATION PLAN (DCP), WAS INSTITUTED ON 6/30/2014. THE DCP IS A 457(F) NONQUALIFIED SUPPLEMENTAL RETIREMENT PLAN, PROVIDING ANNUAL CONTRIBUTIONS TO CERTAIN EXECUTIVES AT A PERCENTAGE OF THEIR BASE SALARY IN EFFECT ON JUNE 30 OF THE PLAN YEAR. THE SUPPLEMENTAL COMPENSATION SERVES TO ENCOURAGE CONTINUED EMPLOYMENT WITH ARKANSAS CHILDREN'S AND ITS AFFILIATES. THE PLAN PROVIDES THAT DEFERRED AMOUNTS ARE PAID AS SOON AS ADMINISTRATIVELY POSSIBLE AFTER BEING VESTED. IT IS INTENDED THAT SUCH PAYMENTS QUALIFY FOR THE "SHORT-TERM DEFERRAL" EXEMPTION FROM IRC SECTION 409A, AND FOR TAX DEFERRAL UNDER IRC SECTION 457(F). PER THE PLAN DOCUMENT, EACH DCP CONTRIBUTION FOR A PLAN YEAR AND ITS ASSOCIATED EARNINGS VEST AS FOLLOWS, ON THE EARLIER OF: - (SUBACCOUNT); THE FIRST DAY OF THE PLAN YEAR FOLLOWING THREE (3) CONTINUOUS PLAN YEARS OF EMPLOYMENT BY THE PARTICIPANT WITH ARKANSAS CHILDREN'S OR AFFILIATE, WHICH BEGINS ON THE FIRST DAY OF THE PLAN YEAR FOR WHICH THE CONTRIBUTION IS CREDITED. - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - ATTAINMENT OF AGE 65 AND AT LEAST 3 YEARS OF SERVICE AS A DCP PARTICIPANT - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - DEATH OR PERMANENT DISABILITY - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - INVOLUNTARY TERMINATION (OTHER THAN FOR CAUSE) - (PRIMARY ACCOUNT, INCLUDING SUBACCOUNTS) - PLAN TERMINATION FOR TAX YEAR 2018 (FISCAL YEAR 2019), THE FOLLOWING ACNW REPORTABLE EMPLOYEES WERE ELIGIBLE AND PARTICIPATING IN THE DEFERRED COMPENSATION PLAN: - MARCELLA DODERER: AC/ACH/ACNW PRESIDENT/CEO - PATRICIA MONTAGUE: ACNW SENIOR VICE PRESIDENT PER THE PLAN DOCUMENT, UPON BECOMING VESTED IN A PLAN YEAR SUBACCOUNT AND AS SOON AS ADMINISTRATIVELY PRACTICABLE AFTER SUCH VESTING DATE, BUT NO LATER THAN THE END OF THE CALENDAR YEAR IN WHICH SUCH VESTING DATE OCCURRED, INDIVIDUAL PARTICIPANTS WILL BE PAID A LUMP SUM PAYMENT EQUAL TO THE PLAN YEAR SUBACCOUNT BALANCE AS OF THE JUNE 30 IMMEDIATELY PRECEDING SUCH VESTING DATE. TWO ACNW REPORTABLE EMPLOYEES ELIGIBLE AND PARTICIPATING IN THE PLAN RECEIVED PAYMENTS IN FY19, DISTRIBUTED AS PER THE PLAN DOCUMENT. SUCH AMOUNT IS NOTED IN SCHEDULE J, PART II, COLUMN F AS PREVIOUSLY EARNED.
FORM 990, SCHEDULE J, PART I, LINES 5-7	THE INCENTIVE PLANS FOR ALL ENTITIES HAVE SPECIFIC RULES AND CALCULATIONS FOR BONUSES. NONE ARE CONTINGENT ON REVENUES OR NET EARNINGS OF THE ORGANIZATIONS (ANY), AND SINCE THEY ARE CALCULATED BASED ON A SPECIFIC FORMULA, THEY ARE NOT "NON-FIXED".
FORM 990, PART VII, SECTION A, LINE 5:	DIRECTOR AND CHIEF OF STAFF, CHARLES BOWER, M.D. WAS COMPENSATED BY UAMS AS AN EMPLOYEE FOR SERVICES RENDERED TO ARKANSAS CHILDREN'S HOSPITAL (ACH) AND ARKANSAS CHILDREN'S NORTHWEST (ACNW) FOR WHICH ACH REMITTED PAYMENT LISTED AS "REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS" IN PART VII. THE AMOUNT NOTED AS COMPENSATION IN SCHEDULE J FOR THE PHYSICIAN NOTED ABOVE WAS THE DESIGNATED AMOUNT PER THE RELATED CONTRACT WITH UAMS.

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
ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number
81-0817660

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 SPRINGDALE AR PUBLIC FACILITIES BOARD	83-0465683	82025WAW1	06-09-2016	84,999,875	SEE SCHEDULE K, PART VI.		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	4,240,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	85,258,623
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	742,725
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	84,515,898
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2018
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X
15 Were the bonds issued as part of an advance refunding issue? .....		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		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
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		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?
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 %
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 .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

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
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......	X
b Exception to rebate? ........		X
c No rebate due? .........		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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

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
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

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

Return Reference	Explanation
SCHEDULE K SUPPLENTAL INFORMATION	PART I, LINE A - DESCRIPTION OF PURPOSE. PROCEEDS USED TO (I) FINANCE THE ACQUISITION, CONSTRUCTION, AND EQUIPPING OF A PEDIATRIC HOSPITAL FACILITY TO BE LOCATED IN THE CITY OF SPRINGDALE, AR, AND (II) PAY CERTAIN EXPENSES IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2016 BONDS. PART II, LINE 3, BOND A - TOTAL PROCEEDS DIFFER FROM ISSUE PRICE DUE TO CUMULATIVE INVESTMENT EARNINGS.

Schedule K (Form 990) 2018

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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

ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number

81-0817660

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	THE FOLLOWING BOARD MEMBERS HAD A BUSINESS RELATIONSHIP DURING THE FISCAL YEAR: RON CLARK AND MARK SAVIERS.
FORM 990, PART VI, SECTION A, LINE 4	ARKANSAS CHILDREN'S NORTHWEST AMENDED AND RESTATED ITS BYLAWS AS OF NOVEMBER 2018. SIGNIFICANT CHANGES AFFECTING GOVERNANCE ARE AS FOLLOWS: * REGARDING THE ANNUAL MEETING, THE AMENDED BYLAWS CLARIFY THAT THE BOARD TREASURER WILL REPORT ON THE ACTIVITIES AND FINANCIAL CONDITION OF THE CORPORATION. * THE DIRECTORS' TERMS WERE AMENDED SUCH THAT EACH DIRECTOR SHALL HOLD OFFICE FOR A TERM OF THREE (3) YEARS THAT BEGINS JANUARY 1 FOLLOWING THE ANNUAL MEETING OF THE MEMBER AT WHICH HE OR SHE IS APPOINTED AND WHICH ENDS AT THE CLOSE OF THE THIRD CALENDAR YEAR FOLLOWING HIS OR HER APPOINTMENT, AND UNTIL HIS OR HER SUCCESSOR IS DULY APPOINTED AND QUALIFIED OR UNTIL HIS OR HER EARLIER RESIGNATION, REMOVAL OR DEATH. THE TERMS OF OFFICE OF APPOINTED DIRECTORS SHALL BE STAGGERED SUCH THAT, TO THE EXTENT POSSIBLE, THE TERMS OF ONE-THIRD (1/3) OF THE DIRECTORS SHALL EXPIRE EACH YEAR. THE MEMBER SHALL APPOINT DIRECTORS AT EACH ANNUAL MEETING TO REPLACE THOSE DIRECTORS WHOSE TERMS ARE EXPIRING AT THE END OF THE CALENDAR YEAR. * SPECIAL MEETINGS WERE FURTHER CLARIFIED TO STATE THAT THEY MAY BE CALLED BY THE CHAIR OF THE BOARD OF THE CORPORATION OR THE MEMBER, BY THE BOARD OR AT THE WRITTEN REQUEST OF AT LEAST TWENTY PERCENT (20%) OF THE DIRECTORS. * REGARDING THE OFFICERS OF THE BOARD, IT WAS CLARIFIED THAT THE CHAIR OF THE BOARD SHALL PRESIDE AT ALL MEETINGS OF THE BOARD OF DIRECTORS, AND SHALL PERFORM SUCH OTHER DUTIES AS ARE COMMONLY ASSOCIATED WITH SUCH OFFICE OR AS OTHERWISE DESIGNATED BY THE BOARD FROM TIME TO TIME. * IN REGARDS TO THE ORGANIZATION, APPOINTMENT AND HEARINGS OF MEDICAL STAFF, THE FOLLOWING AMENDMENTS WERE MADE: (A) ALL INDIVIDUALS WHO ARE NOT HOSPITAL EMPLOYEES WHO MAKE ENTRIES INTO THE HOSPITAL'S MEDICAL RECORDS SHALL BE CREDENTIALED THROUGH THE APPROPRIATE MEDICAL, DENTAL OR ADVANCE PRACTICE PROFESSIONAL STAFFS. THE BOARD OF DIRECTORS ORGANIZES PHYSICIANS AND DENTISTS INTO A MEDICAL STAFF. OTHER LICENSED INDEPENDENT PRACTITIONERS GRANTED PRIVILEGES BY THE BOARD OF DIRECTORS ARE ORGANIZED AS ADVANCE PRACTICE PROFESSIONAL STAFF. THE MEDICAL STAFF AND ADVANCE PRACTICE PROFESSIONAL STAFF ARE GOVERNED BY THESE BYLAWS AND THE MEDICAL STAFF BYLAWS AS APPROVED BY THE BOARD OF DIRECTORS. (B) THE BOARD OF DIRECTORS SHALL CONSIDER RECOMMENDATIONS OF THE MEC (MEDICAL EXECUTIVE COMMITTEE) AND QUALITY AND SAFETY COMMITTEE, AND APPOINT PHYSICIANS, DENTISTS OR OTHER LICENSED INDEPENDENT PRACTITIONERS TO THE ACTIVE OR COURTESY MEDICAL, DENTAL, OR ADVANCE PRACTICE PROFESSIONAL STAFFS. (C) ALL INITIAL APPOINTMENTS TO THE MEDICAL, DENTAL, AND ADVANCE PRACTICE PROFESSIONAL STAFFS SHALL BE FOR A PERIOD NOT TO EXCEED TWO (2) YEARS FROM THE DATE OF INITIAL GRANTING OF PRIVILEGES, RENEWABLE BY THE BOARD OF DIRECTORS PURSUANT TO FORMAL REAPPLICATION. * CLARIFICATIONS WERE MADE TO THE ROLE OF THE CHIEF OF MEDICAL STAFF AS FOLLOWS: (A) THE CHIEF OF THE MEDICAL STAFF SHALL SERVE AS LIAISON BETWEEN THE BOARD OF DIRECTORS, MEDICAL STAFF AND THE MEC, AND HIS/HER ACTIVITIES IN THIS CAPACITY SHALL BE DOCUMENTED AT LEAST QUARTERLY, INCLUDING THROUGH A REPORT TO THE BOARD WHICH SHALL BE PRESENTED AT LEAST QUARTERLY AND DOCUMENTED IN THE BOARD MINUTES. HIS/HER RESPONSIBILITIES SHALL BE AS FOLLOWS: (B) RECEIVE RECOMMENDATIONS FROM THE MEDICAL STAFF AND THE MEC, AND MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS ON ALL APPOINTMENTS TO THE MEDICAL STAFF AND ADVANCE PRACTICE PROFESSIONAL STAFF OF THE HOSPITAL AND ON ALL ASSIGNMENTS OF RESPONSIBILITIES WITHIN THE MEDICAL STAFF, INCLUDING DEFINITION OF THE SCOPE OF PRIVILEGES, REAPPOINTMENTS, AND REDUCTIONS, EXTENSIONS, SUSPENSIONS, AND TERMINATIONS OF PRIVILEGES. (C) RECOMMEND TO THE BOARD OF DIRECTORS THE SPECIFIC CLINICAL PRIVILEGES TO BE GRANTED TO EACH MEMBER OF THE MEDICAL STAFF AND ADVANCE PRACTICE PROFESSIONAL STAFF CONSISTENT WITH THE SCOPE OF CLINICAL PRIVILEGES ALLOWED IN THE INSTITUTION.
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF ACNW IS ARKANSAS CHILDREN'S, INC., AN ARKANSAS NONPROFIT PUBLIC BENEFIT CORPORATION (THE "SOLE MEMBER").
FORM 990, PART VI, SECTION A, LINE 7A	ARKANSAS CHILDREN'S, INC., ACNW'S SOLE MEMBER, HAS THE RESERVED POWER TO FIX THE SIZE OF THE BOARD OF DIRECTORS, AND THE GOVERNING BOARD OF ANY AFFILIATE CONTROLLED BY THE CORPORATION, AND APPOINT AND REMOVE, WITH OR WITHOUT CAUSE, THE DIRECTORS OF THE CORPORATION, AND MEMBERS OF THE GOVERNING BOARD OF ANY AFFILIATE CONTROLLED BY THE CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7B	ACNW'S ARTICLES OF INCORPORATION MAY BE AMENDED, AND THE BYLAWS MAY BE ALTERED, AMENDED, OR REPEALED AND NEW BYLAWS MAY BE ADOPTED: (I) UPON THE APPROVAL OF BOTH THE BOARD AND THE SOLE MEMBER, IF THE AMENDMENT DOES NOT RELATE TO THE NUMBER OF DIRECTORS, THE COMPOSITION OF THE BOARD, THE TERM OF OFFICE OF DIRECTORS, OR THE METHOD OR WAY IN WHICH DIRECTORS ARE ELECTED OR SELECTED; OR (II) BY THE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11B	THE DRAFT FORM 990, WHICH IS RECONCILED TO THE ARKANSAS CHILDREN'S NORTHWEST (ACNW) INTERNAL FINANCIAL STATEMENTS AND THE ARKANSAS CHILDREN'S, INC. CONSOLIDATED AUDIT REPORT, IS INITIALLY REVIEWED IN DETAIL WITH ACNW'S SENIOR VICE PRESIDENT. THE DRAFT IS ALSO REVIEWED IN DETAIL WITH BOTH THE SVP/CFO AND THE VP OF FINANCIAL OPERATIONS OF ARKANSAS CHILDREN'S, INC. IF THE REVIEW BY ACNW'S MANAGEMENT RESULTS IN REVISIONS TO THE DRAFT FORM 990, THOSE REVISIONS ARE MADE, AND THE FORM 990 TO BE FILED IS PROVIDED TO THE ACNW BOARD OF DIRECTORS PRIOR TO THE RETURN BEING FILED. IN ADDITION, THE FORM 990 IS PROVIDED TO BOTH THE CHAIRMAN OF THE BOARD AND THE TREASURER OF ARKANSAS CHILDREN'S, INC.
FORM 990, PART VI, SECTION B, LINE 12C	ARKANSAS CHILDREN'S, INC. (THE PARENT) HAS A BOARD OF DIRECTORS CONFLICT OF INTEREST POLICY THAT IS ISSUED TO AND REVIEWED WITH ALL NEW BOARD MEMBERS DURING THEIR BOARD ORIENTATION. IN ADDITION, THE INTERNAL GENERAL COUNSEL OR THE SYSTEM COMPLIANCE OFFICER WILL PERIODICALLY REVIEW THE POLICY WITH THE FULL BOARD DURING A REGULAR BOARD MEETING. A DIRECTOR SHALL DISCLOSE IN WRITING TO THE BOARD OF DIRECTORS ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST WHEN THE SITUATION DEVELOPS, INCLUDING THE FACTS THAT MAKE IT AN ACTUAL OR POTENTIAL CONFLICT. EACH DIRECTOR SHALL SIGN AN INITIAL CONFLICT OF INTEREST DISCLOSURE STATEMENT UPON ELECTION TO THE BOARD OF DIRECTORS. EACH DIRECTOR ALSO SHALL SIGN AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT. IF AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST DEVELOPS AFTER THE DIRECTOR'S INITIAL AND ANNUAL STATEMENTS ARE SIGNED, THE DIRECTOR SHALL IMMEDIATELY SIGN A NEW DISCLOSURE STATEMENT TO ADDRESS THE NEW SITUATION OR TRANSACTION. CONFLICT OF INTEREST DISCLOSURE STATEMENTS OR DECLARED CONFLICTS WILL BE REVIEWED BY THE DIRECTOR BOARD OFFICERS. REVIEW WILL RESULT IN ONE OF THE FOLLOWING ACTIONS BY MAJORITY VOTE: (1) DETERMINED NOT TO BE A CONFLICT; (2) CONFLICT IS ACCEPTED; OR (3) CONFLICT IS NOT ACCEPTED AND THE DIRECTOR WILL NEED TO ABSTAIN FROM PARTICIPATION IN CERTAIN VOTES. CONFLICT DISCLOSURES, FACTS AND ACTIONS WILL BE DOCUMENTED IN THE APPROPRIATE COMMITTEE OR BOARD MINUTES. A DIRECTOR WITH A CONFLICT OF INTEREST WILL NOT PARTICIPATE IN DELIBERATIONS OR VOTE BY THE BOARD OF DIRECTORS, OR COMMITTEE THEREOF, ON THE MATTER GIVING RISE TO THE CONFLICT. HE OR SHE MAY PRESENT RELEVANT INFORMATION ABOUT THE MATTER AND ALSO MAY RESPOND TO REQUESTS FOR FACTS NEEDED BY THE BOARD TO REACH AN INFORMED DECISION. AFTER ANY DISCUSSION, THE INTERESTED DIRECTOR SHALL EITHER ABSTAIN FROM VOTE OR RECUSE COMPLETELY AND BE ABSENT DURING FURTHER DELIBERATIONS AND ACTION ON THE MATTER, AS DETERMINED BY THE DIRECTOR BOARD OFFICERS OF THE ENTITY.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION FOR ANY ACNW EXECUTIVE OR SENIOR OFFICER (PRESIDENT; SENIOR VICE PRESIDENT) WHO IS NOT A CONTRACTED UAMS EMPLOYEE IS REVIEWED BY THE ARKANSAS CHILDREN'S HUMAN RESOURCES AND COMPENSATION COMMITTEE WHICH IS ESTABLISHED THROUGH THE BYLAWS OF ARKANSAS CHILDREN'S, INC. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE HAS THE FULL AUTHORITY AND SPECIFIC RESPONSIBILITY FOR REVIEWING AND APPROVING COMPENSATION POLICIES, BASE SALARY AND INCENTIVE COMPENSATION LEVELS, EXECUTIVE RETIREMENT AND OTHER EXECUTIVE BENEFIT PLANS FOR HEALTH SYSTEM SENIOR MANAGEMENT, INCLUDING OFFICERS OF THE CORPORATION AND AFFILIATES WHO ARE "DISQUALIFIED PERSONS" UNDER SECTION 4958 OF THE CODE. THE POLICIES AND PROGRAMS REVIEWED AND APPROVED BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL BE DESIGNED TO ENSURE THAT THE CORPORATION AND ITS AFFILIATES REMAIN COMPETITIVE AND REASONABLE RELATIVE TO THE COMPENSATION AND BENEFITS PRACTICES OF SIMILARLY SITUATED HEALTH SYSTEMS LOCALLY AND NATIONALLY, AND TO PERMIT THE CORPORATION AND SUCH AFFILIATES TO ATTRACT AND RETAIN SUPERIOR SENIOR MANAGEMENT, IN FURTHERANCE OF THE CORPORATION'S AND AFFILIATES PURPOSES. THE HUMAN RESOURCES AND COMPENSATION COMMITTEE SHALL HAVE, TO THE FULLEST EXTENT OF THE LAW, THE AUTHORITY TO APPROVE THE COMPENSATION PACKAGES FOR SENIOR MANAGEMENT OF THE CORPORATION AND THE AFFILIATES. IN ITS PROCESS, THE COMMITTEE SHALL OBTAIN AND MUST RELY UPON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENTS OF DISQUALIFIED PERSONS. APPROPRIATE DATA INCLUDES, BUT IS NOT LIMITED TO, COMPENSATION LEVELS PAID BY SIMILARLY SITUATED ORGANIZATIONS, BOTH TAXABLE AND TAX-EXEMPT, FOR FUNCTIONALLY COMPARABLE POSITIONS; THE AVAILABILITY OF SIMILAR SERVICES IN THE GEOGRAPHIC AREA OF THE CORPORATION, CURRENT COMPENSATION SURVEYS COMPILED BY INDEPENDENT FIRMS; AND ACTUAL WRITTEN OFFERS FROM SIMILAR INSTITUTIONS COMPETING FOR THE SERVICES OF THE DISQUALIFIED PERSON. THE COMMITTEE MAY RELY UPON OPINIONS OF QUALIFIED LEGAL, ACCOUNTING, VALUATION AND EXECUTIVE COMPENSATION EXPERTS. CONTEMPORANEOUSLY WITH MAKING ITS DETERMINATION OF REASONABLENESS WITH RESPECT TO THE COMPENSATION ARRANGEMENT OF THE CEO AND DISQUALIFIED PERSONS, THE COMMITTEE SHALL DOCUMENT IN A WRITTEN REPORT THE BASIS FOR ITS DECISIONS AND FORWARD THE REPORT TO THE BOARD.
FORM 990, PART VI, SECTION C, LINE 18	ARKANSAS CHILDREN'S NORTHWEST'S FORM 990 IS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	ARKANSAS CHILDREN'S NORTHWEST'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AS REQUIRED.
FORM 990, PART IX, LINE 11G	PHYSICIAN REMUNERATION: PROGRAM SERVICE EXPENSES 12,302,225. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,302,225. REFERRED TESTING: PROGRAM SERVICE EXPENSES 853,475. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 853,475. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 83,684. MANAGEMENT AND GENERAL EXPENSES 21,793. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 105,477. OTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 1,087,720. MANAGEMENT AND GENERAL EXPENSES 1,092,772. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,180,492.
FORM 990, PART XI, LINE 9:	TRANSFER OF TEMPORARY SUPPORT FROM ACH 15,000,000. ASSET TRANSFER FROM ACH 118,952.
FORM 990, PART XII, LINE 2C	IT IS PART OF THE RESERVED POWERS OF ARKANSAS CHILDREN'S, INC. TO RETAIN, OVERSEE AND TERMINATE INDEPENDENT EXTERNAL AUDITORS TO AUDIT THE FINANCIAL STATEMENTS OF ACH OR OF ANY AFFILIATE. ONE OF THE STANDING COMMITTEES OF ARKANSAS CHILDREN'S, THE FINANCIAL PLANNING AND OVERSIGHT COMMITTEE, SHALL UNDERTAKE THE FOLLOWING DUTIES IN THE AREAS OF FINANCE AND AUDITS: (I) CAUSING TO BE PREPARED, AND SUBMIT TO THE BOARD OF DIRECTORS AT ITS LAST MEETING BEFORE THE END OF THE FISCAL YEAR, THE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION, AS WELL AS THE CAPITAL AND OPERATING BUDGETS OF AFFILIATES; (II) EXAMINING THE MONTHLY FINANCIAL REPORTS OF THE HEALTH SYSTEM; (III) REVIEWING THE INTERNAL AUDITING FUNCTIONS OF THE HEALTH SYSTEM; (IV) ENGAGING AN EXTERNAL AUDIT FIRM, SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS; (V) REVIEWING WITH THE INDEPENDENT AUDITOR THE SCOPE AND PLANNING OF THE AUDIT PRIOR TO THE COMMENCEMENT OF THE AUDIT, AS WELL AS UPON COMPLETION OF THE AUDIT, REVIEWING AND DISCUSSING WITH THE INDEPENDENT AUDITOR ANY MATERIAL RISKS OR WEAKNESSES IN INTERNAL CONTROLS IDENTIFIED BY THE AUDITOR, ANY RESTRICTIONS ON THE SCOPE OF THE AUDITOR'S ACTIVITIES OR ACCESS TO REQUESTED INFORMATION, ANY SIGNIFICANT DISAGREEMENTS BETWEEN THE AUDITOR AND MANAGEMENT, AND THE ADEQUACY OF THE HEALTH SYSTEM'S ACCOUNTING AND FINANCIAL REPORTING PROCESSES; (VI) ANNUALLY CONSIDERING THE PERFORMANCE AND INDEPENDENCE OF THE INDEPENDENT AUDITOR; (VII) REVIEWING AND REPORTING TO THE BOARD ON THE ANNUAL AUDITED FINANCIAL STATEMENT OF THE HEALTH SYSTEM CERTIFIED BY THE CORPORATION'S CERTIFIED PUBLIC ACCOUNTANTS, TOGETHER WITH SUCH CERTIFIED PUBLIC ACCOUNTANTS' MANAGEMENT LETTER TO THE CORPORATION WHICH THE COMMITTEE SHALL REVIEW AND REPORT ON TO THE BOARD OF DIRECTORS; (VIII) SUGGESTING MEANS TO IMPROVE FISCAL ACCOUNTABILITY AND INTERNAL AUDIT PROCEDURES FOR THOSE AREAS IDENTIFIED AS REQUIRING IMPROVEMENT; (IX) PROVIDING OVERSIGHT FOR THE HEALTH SYSTEM'S CORPORATE COMPLIANCE PROGRAM, INCLUDING CORPORATE ETHICS AND COMPLIANCE WITH LEGAL AND REGULATORY REQUIREMENTS; AND (X) REPORTING ON THE FINANCIAL PLANNING AND OVERSIGHT COMMITTEE'S ACTIVITIES TO THE FULL BOARD.

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ARKANSAS CHILDREN'S NORTHWEST INC

Employer identification number

81-0817660

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(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)ARKANSAS CHILDREN'S INC 1 CHILDRENS WAY LITTLE ROCK,AR72202 81-0801296	HEALTH CARE PARENT CORP	AR	501(C)(3)	LINE 12B, II	N/A		No
(2)ARKANSAS CHILDREN'S HOSPITAL 1 CHILDRENS WAY LITTLE ROCK,AR72202 71-0236857	HOSPITAL	AR	501(C)(3)	LINE 3	ARKANSAS CHILDREN'S INC		No
(3)ARKANSAS CHILDREN'S FOUNDATION 1 CHILDRENS WAY LITTLE ROCK,AR72202 71-0568795	FUNDRAISING	AR	501(C)(3)	LINE 7	ARKANSAS CHILDREN'S INC		No
(4)ARKANSAS CHILDREN'S RESEARCH INSTITUTE 13 CHILDRENS WAY LITTLE ROCK,AR72202 71-0694931	RESEARCH	AR	501(C)(3)	LINE 7	ARKANSAS CHILDREN'S INC		No
(5)ARKANSAS CHILDREN'S HOSPITAL AUXILIARY 1 CHILDRENS WAY LITTLE ROCK,AR72202 71-0606585	FUNDRAISING & VOLUNTEERS	AR	501(C)(3)	LINE 12A, I	ARKANSAS CHILDREN'S INC VIA ARKANSAS CHILDREN'S HOSPITAL AND FOUNDATION		No
(6)ARKANSAS CHILDREN'S MEDICAL GROUP 1 CHILDRENS WAY LITTLE ROCK,AR72202 82-0771462	HOSPITAL/MEDICAL SERVICES	AR	501(C)(3)	LINE 3	ARKANSAS CHILDREN'S INC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(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

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CHILDREN'S HEALTHCARE SYSTEM INC 1 CHILDRENS WAY LITTLE ROCK,AR72202 58-6304957	MANAGEMENT SERVICES	AR	N/A	C				No
(2) ARKANSAS CHILDREN'S CARE NETWORK 1 CHILDRENS WAY LITTLE ROCK,AR72202 37-1854930	CLINICALLY INTEGRATED NETWORK	AR	N/A	C				No
(3) SACOVA INSURANCE COMPANY LTD 18 FORUM LANE 2ND FLOOR CAMANA BAY,GRAND CAYMANKY1-1102 CJ 98-1472934	CAPTIVE INSURANCE COMPANY	CJ	N/A	C				No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

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

Yes

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

Yes

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

Yes

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

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

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

Yes

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2018

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference

Explanation

FORM 990, SCHEDULE R, PART V, LINE 1D AND 1E

LINE 1D - LOANS OR LOAN GUARANTEES TO OR FOR RELATED ORGANIZATIONS: ALONG WITH AC, ACH, AND ACF, ACNW GUARANTEES THE ACH SERIES 2016 REFUNDING BONDS. PER THE OFFICIAL STATEMENT, "AS ADDITIONAL SECURITY FOR THE SERIES 2016 BONDS, THE PARENT, THE CORPORATION, ACNW AND THE FOUNDATION (COLLECTIVELY, THE "GUARANTORS") WILL EACH EXECUTE AND DELIVER SEPARATE GUARANTY AGREEMENTS DATED AS OF AUGUST 1, 2016 TO THE TRUSTEE PURSUANT TO WHICH THE GUARANTORS WILL SEVERALLY AND UNCONDITIONALLY GUARANTEE PAYMENT OF THE DEBT SERVICE ON THE SERIES 2016 BONDS. ACNW WILL FURTHER GUARANTEE THE PERFORMANCE OF THE OBLIGATIONS TO THE CORPORATION UNDER THE LEASE AGREEMENT. THE OBLIGATIONS OF ACNW UNDER ITS GUARANTY AGREEMENT ARE SECURED BY A PLEDGE OF AND SECURITY INTEREST IN THE GROSS RECEIPTS OF ACNW." LINE 1E - LOANS OR LOAN GUARANTEES BY RELATED ORGANIZATIONS: AC, ACH, AND ACF ALL GUARANTEE THE ACNW SERIES 2016 REVENUE BONDS. PER THE OFFICIAL STATEMENT, "AS ADDITIONAL SECURITY FOR THE SERIES 2016 BONDS, THE PARENT, THE CORPORATION, ACNW AND THE FOUNDATION (COLLECTIVELY, THE "GUARANTORS") WILL EACH EXECUTE AND DELIVER SEPARATE GUARANTY AGREEMENTS DATED AS OF JUNE 1, 2016 TO THE TRUSTEE PURSUANT TO WHICH THE GUARANTORS WILL SEVERALLY AND UNCONDITIONALLY GUARANTEE PAYMENT OF THE DEBT SERVICE ON THE SERIES 2016 BONDS. THE PARENT AND ACH WILL FURTHER GUARANTEE THE PERFORMANCE OF THE OBLIGATIONS OF THE CORPORATION UNDER THE LOAN AGREEMENT. THE OBLIGATIONS OF ACH UNDER ITS UNDER ITS GUARANTY AGREEMENT ARE SECURED BY A PLEDGE OF AND SECURITY INTEREST IN THE GROSS RECEIPTS OF ACH."

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: WE CHAMPION CHILDREN BY MAKING THEM BETTER TODAY AND HEALTHIER TOMORROW.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	11
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	407
6	Total number of volunteers (estimate if necessary) .............	6	586
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	13,661,235	16,865,152
9	Program service revenue (Part VIII, line 2g) .........	11,622,113	55,700,670
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	605,897	532,723
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	240,960	533,346
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	26,130,205	73,631,891
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	19,731	38,087
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)	11,811,027	23,468,153
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)....	30,609,096	41,043,883
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	42,439,854	64,550,123
19	Revenue less expenses. Subtract line 18 from line 12.......	-16,309,649	9,081,768
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	166,439,916	182,662,874
21	Total liabilities (Part X, line 26).............	91,056,045	83,078,283
22	Net assets or fund balances. Subtract line 21 from line 20.....	75,383,871	99,584,591

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 52,599,547 including grants of $ 38,087 ) (Revenue $ 55,719,765 )
	ARKANSAS CHILDREN'S NORTHWEST (ACNW) IS A FREESTANDING CHILDREN'S HOSPITAL IN SPRINGDALE, ARKANSAS THAT OPENED ON FEBRUARY 27, 2018 AND WAS ACCREDITED BY THE JOINT COMMISSION ON THE ACCREDITATION OF HEALTHCARE ORGANIZATIONS ON APRIL 10, 2018. THE HOSPITAL IS 233,613 SQUARE FEET THAT INCLUDES INPATIENT BEDS, EMERGENCY CARE, DIAGNOSTIC SERVICES AND CLINIC SPACE. THE CAMPUS INCLUDES NATURE TRAILS AND GARDENS FOR PATIENTS AND THEIR FAMILIES, AS WELL AS A HELIPAD AND REFUELING STATION FOR THE ARKANSAS CHILDREN'S HOSPITAL HELICOPTER TRANSPORT TEAM. DURING THE YEAR ENDED JUNE 30, 2019, ACNW EXPERIENCED THE FOLLOWING: 2,225 ADMISSIONS WITH AN AVERAGE STAY OF 2.12 DAYS; 4,560 PATIENT DAYS; 12.49 AVERAGE DAILY CENSUS; 24 OPERATING BEDS, ALL OF WHICH ARE MEDICAL/SURGICAL BEDS; 33,741 OUTPATIENT VISITS, EXCLUDING ER VISITS WHICH WERE 22,499; AND 2,541 SURGERIES. ACNW WILL ADVANCE PEDIATRIC HEALTHCARE IN THE NORTHWEST PORTION OF ARKANSAS AND PROVIDE CARE CLOSE TO HOME FOR MORE THAN 200,000 CHILDREN BY PROVIDING THE FOLLOWING SERVICES:24 INPATIENT BEDS TO CARE FOR CHILDREN REQUIRING OVERNIGHT STAYS24-HOUR PEDIATRIC EMERGENCY DEPARTMENTAN OUTPATIENT CLINIC WITH 30 EXAM ROOMS SUPPORTING MORE THAN 20 SUBSPECIALTY AREAS AND A PRIMARY CARE CLINICPEDIATRIC SURGERY UNIT WITH 5 OPERATING ROOMSA FULL RANGE OF ANCILLARY AND DIAGNOSTIC SERVICESIMAGING CAPABILITIES (MRI, CT, ULTRASOUND, AND ROUTINE X-RAY)DIAGNOSTIC SERVICES (INFUSION, PFT, EEG, ECHO, NEUROPHYSIOLOGY, AUDIOLOGY, AND REHABILITATION)HELIPAD AND REFUELING STATION SUPPORTING THE HELICOPTER TRANSPORT TEAM, ONE OF THE NATION'S LEADING PEDIATRIC INTENSIVE CARE TRANSPORT SERVICES WITH MORE THAN 2,000 TRANSPORTS ANNUALLY

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 expenses52,599,547

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) JAMA HUNTLEY........................................................................ PHARMACY MANAGER	50.00 .......................0.00	X	137,593	0	5,101
(19) LESLIE RYLEE........................................................................ PATIENT CARE SERVICES DIRECTOR	50.00 .......................0.00	X	111,058	0	14,592
(20) KEITH VEIT........................................................................ PATIENT CARE SVC DIRECTOR	50.00 .......................0.00	X	119,005	0	11,150
(21) JEFFREY WILLIAMS........................................................................ STAFF PHARMACIST	50.00 .......................0.00	X	141,918	0	9,460

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,412,865	1,718,963	300,725

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	16,865,152
e	Government grants (contributions)		1e

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.......		16,865,152

		Business Code
2a	PMTS FOR MEDICAL SERVI	622110	55,700,670	55,700,670
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		55,700,670

3 Investment income (including dividends, interest, and othersimilar amounts) ......			640,723			640,723
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses	108,000
c	Gain or (loss)	-108,000
d	Net gain or (loss).....			-108,000			-108,000
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	NUTRITIONAL SERVICES		900099	371,274			371,274
b	GIFT SHOP		900099	142,977			142,977
c
d	All other revenue ....			19,095	19,095
e	Total. Add lines 11a–11d ......			533,346
12	Total revenue. See Instructions......			73,631,891	55,719,765	0	1,046,974

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	20,900	20,900
2	Grants and other assistance to domestic individuals. See Part IV, line 22	17,187	17,187
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	1,480,000	1,253,967	226,033
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	18,118,644	15,566,359	2,552,285
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	3,869,509	3,326,670	542,839
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	3,706,290	1,362,778	2,343,512
b	Legal .........
c	Accounting ...........	7,000		7,000
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	15,441,669	14,327,104	1,114,565
12	Advertising and promotion ....	465,640		465,640
13	Office expenses .......	1,153,071	1,014,235	138,836
14	Information technology ......	1,330,091	323,199	1,006,892
15	Royalties ..
16	Occupancy ...........	782,888	744,098	38,790
17	Travel ............	200,282	164,784	35,498
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	35,931	27,543	8,388
20	Interest ...........	2,981,901		2,981,901
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	8,840,194	8,793,848	46,346
23	Insurance ...	303,539		303,539
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	4,933,943	4,870,574	63,369
b	OTHER ADMINISTRATIVE EX	564,176	534,102	30,074
c	MINOR & LEASED EQUIPMEN	267,546	238,568	28,978
d	DUES & SUBSCRIPTIONS	29,722	13,631	16,091
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	64,550,123	52,599,547	11,950,576	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			9,948,567	2	7,934,091
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			4,933,913	4	6,552,573
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			727,945	8	767,571
9	Prepaid expenses and deferred charges ......			633,091	9	680,242
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	150,512,395
b	Less: accumulated depreciation	10b	12,798,213	141,800,295	10c	137,714,182
11	Investments—publicly traded securities .			1,742,059	11	1,733,933
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			6,654,046	15	27,280,282
16	Total assets. Add lines 1 through 15 (must equal line 34)...			166,439,916	16	182,662,874

17	Accounts payable and accrued expenses .....	9,520,723	17	4,012,854
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	81,535,322	20	79,065,429
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	91,056,045	26	83,078,283

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	70,474,953	27	95,362,102
28	Temporarily restricted net assets ...........	4,908,918	28	4,222,489
29	Permanently restricted net assets		29
	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 ...........	75,383,871	33	99,584,591
34	Total liabilities and net assets/fund balances ........	166,439,916	34	182,662,874