TY 2021 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/1099-NEC)
(1) TODD SUNTRAPAK...................................................................... CEO	20.00 ................. 30.00	X	X	5,107,768	65,662
(2) FAISAL RAZZAQUI MD...................................................................... CHIEF OF STAFF	1.00 .................	X		0	0
(3) JEANNINE CAMPOS GRECH...................................................................... BOARD CHAIR	1.00 ................. 1.00	X	X	0	0
(4) JOSE ELGORRIAGA...................................................................... BOARD VICE CHAIR	1.00 ................. 1.00	X	X	0	0
(5) DAN ADAMS...................................................................... BOARD SECRETARY/TREASURER	1.00 ................. 1.00	X	X	0	0
(6) MIMI CHAO MD...................................................................... CHIEF OF STAFF (THRU 12/21)	1.00 ................. 1.00	X		75,000	0
(7) RILEY WALTER...................................................................... BOARD MEMBER	1.00 ................. 1.00	X		0	0
(8) BILL SMITTCAMP...................................................................... BOARD MEMBER	1.00 ................. 1.00	X		0	0
(9) KIM RUIZ BECK...................................................................... BOARD MEMBER	1.00 ................. 1.00	X		0	0
(10) DANIELLE PARNAGIAN...................................................................... BOARD MEMBER	1.00 ................. 1.00	X		0	0
(11) DAN KOONTZ...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(12) MENDY LAVAL...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(13) CONNIE MCCLASKEY...................................................................... BOARD MEMBER (THRU 12/21)	1.00 .................	X		0	0
(14) SISSY DALENA WOOD...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(15) NICO GENTILE...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(16) LUZ GONZALEZ MD...................................................................... BOARD MEMBER	1.00 .................	X		0	0
(17) LISA SMITTCAMP...................................................................... BOARD MEMBER	1.00 .................	X		0	0

(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/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) VALERIE VUICICH........................................................................ GUILD MEMBER	1.00 .......................	X					0	0
(19) MICHELE R WALDRON........................................................................ SVP, CFO	18.50 .......................31.50		X				2,841,006	49,907
(20) BEVERLY HAYDEN-PUGH........................................................................ SVP, CLINICAL INT, PATIENT	18.00 .......................27.00			X			1,676,308	132,625
(21) NATALE PONTICELLO JR........................................................................ SVP, CHIEF PEOPLE OFFICER	29.00 .......................11.00			X			1,345,610	95,642
(22) DAVID CHRISTENSEN........................................................................ SVP, CPE & PRES VCMG	27.00 .......................18.00			X			1,289,465	56,894
(23) JANE WILLSON........................................................................ SVP, CHIEF STRATEGY OFFICER	8.00 .......................32.00			X			985,558	105,871
(24) MICHAEL GOLDRING........................................................................ SVP STRATEGIC PARTNERSHIPS	40.00 .......................			X			900,166	37,969
(25) WILLIAM CHALTRAW........................................................................ SVP AND CHIEF LEGAL OFFICER	40.00 .......................			X			792,183	52,271
(26) KEVIN SHIMAMOTO........................................................................ VP AND ADVISOR TO CIO	40.00 .......................			X			764,883	100,751
(27) KAREN DAHL........................................................................ VP, MED AFFAIRS & PHYS DEV	40.00 .......................			X			764,770	97,979
(28) LYNN ASHBECK........................................................................ SVP, CHIEF COMMUNITY IMPACT	40.00 .......................			X			752,550	89,897
(29) DAVID HODGE JR........................................................................ VP HOSPITAL OPERATIONS	40.00 .......................			X			748,405	123,568
(30) JOEL BROWNELL MD........................................................................ VP, CHIEF MEDICAL INFO OFF	40.00 .......................			X			641,044	102,701
(31) JOLIE LIMON........................................................................ VP ACAD AFFAIRS, DIO & CHI	40.00 .......................			X			598,935	95,237
(32) STEPHANIE VANCE........................................................................ VP, FINANCE	40.00 .......................			X			590,899	107,077
(33) DANIELLE BARRY........................................................................ SVP, CHIEF OP INTEG	40.00 .......................			X			590,130	89,826
(34) DAVID SINGH........................................................................ VP, COO OF VCMG	40.00 .......................			X			581,415	97,780
(35) JESSIE HUDGINS........................................................................ VP, FACILITIES & SUPPORT SERVICES	40.00 .......................			X			572,827	86,742
(36) BRIAN SMULLIN........................................................................ VP, MANAGED CARE (THRU 09/22)	40.00 .......................			X			538,643	92,333
(37) VICKY TILTON........................................................................ VP PATIENT CARE SERVICES & ASST CNO	40.00 .......................			X			445,149	40,629
(38) RAED KHOURY........................................................................ VP, QUAL, PATIENT SAFETY	40.00 .......................			X			327,057	45,317
(39) RATAN MILEVOJ........................................................................ VP MKTG, COMM, INNOVATION	40.00 .......................			X			291,743	44,455
(40) AMANDA PATTERSON........................................................................ EXEC DIREC & DEPUTY GEN CO	40.00 .......................				X		333,856	40,736
(41) YVONNE WOOD........................................................................ MANAGER PATIENT THROUGHPUT	40.00 .......................				X		314,933	58,947
(42) ADAM VAN DUSON........................................................................ EXEC DIR, FOUNDATION	40.00 .......................				X		298,465	11,552
(43) JOSEPH EGAN........................................................................ VP & CIO	40.00 .......................				X		267,572	58,591
(44) JULIE MACIAS........................................................................ DIRECTOR, ACCOUNTING & REPORTING	40.00 .......................				X		262,411	50,903
(45) DAVID NALCHAJIAN........................................................................ FORMER BOARD MEMBER	0.00 .......................					X	300,000	0

(A) Name and business address	(B) Description of services	(C) Compensation
VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA,CA93636	SUBSPEC PHYSICIAN SERVICES	34,100,000
PEDIATRIC ANETHESIA ASSOCIATES 6235 N FRESNO ST STE 103 FRESNO,CA93710	ANETHESIA/CRITICAL CARE	13,693,555
QUIRING GENERAL LLC 5118 E CLINTON WAY FRESNO,CA93727	CONSTRUCTION SERVICES	8,240,116
SODEXO INC & ASSOCIATES PO BOX 360170 PITTSBURGH,PA152516170	HOUSEKEEPING SERVICES	5,288,516
TECH KNOWLEDGE & ASSOCIATES 1 CENTERPOINTE DR ST 200 LA PALMA,CA906232539	BIOMEDICAL MAINTENANCE	4,529,015
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 40

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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 33 1/3% 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 33 1/3% 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 on 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) 2021

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 5 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 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. 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—2021. 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—2020. 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) 2021

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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 5 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 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2021

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2021

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 0.015 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 0.035	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) 2021

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, 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 2021. 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 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

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) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

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

2021

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

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

Special Rules

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

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

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

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization VALLEY CHILDREN'S HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
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) (2021)

Schedule B (Form 990) (2021)

Page 3

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

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization VALLEY CHILDREN'S HOSPITAL			Employer identification number 94-1294954
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2021

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

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

Yes

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

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

Yes

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

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

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

Yes

16,163

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

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

Yes

383,139

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

399,302

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1	VALLEY CHILDREN'S HOSPITAL HAS HAD DIRECT CONTACT WITH AND HAS ENCOURAGED OTHERS TO HAVE DIRECT CONTACT WITH LOCAL, STATE AND FEDERAL LEGISLATORS REGARDING CHILDREN'S HEALTH CARE PUBLIC POLICY. THESE CONTACTS HAVE PROVIDED INFORMATION REGARDING THE PROVISION OF HEALTH CARE SERVICES TO CHILDREN, THE ANTICIPATED EFFECT ON CHILDREN'S HEALTH OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING CURRENT STATE AND FEDERAL FUNDING LEVELS FOR MEDI-CAL AND OTHER PUBLIC PROGRAMS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. VALLEY CHILDREN'S HOSPITAL HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $16,163 BROWNSTEIN HYATT FARBER SCHRECK $153,750 ASSOCIATION DUES RELATED TO LOBBYING NACH 30,188 NACH CONTRIBUTION 3,100 AMERICAN SOCIETY HEALTHCARE ENGINEERING 119 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 336 CALIFORNIA CHAMBER OF COMMERCE 130 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 48,153 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 4,688 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 25,627 CHILDREN'S SPECIALTY CARE COALITION 3,350 FRESNO CHAMBER OF COMMERCE 1,600 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA 111,981 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $399,302

Return Reference

Explanation

PART II-B, LINE 1

VALLEY CHILDREN'S HOSPITAL HAS HAD DIRECT CONTACT WITH AND HAS ENCOURAGED OTHERS TO HAVE DIRECT CONTACT WITH LOCAL, STATE AND FEDERAL LEGISLATORS REGARDING CHILDREN'S HEALTH CARE PUBLIC POLICY. THESE CONTACTS HAVE PROVIDED INFORMATION REGARDING THE PROVISION OF HEALTH CARE SERVICES TO CHILDREN, THE ANTICIPATED EFFECT ON CHILDREN'S HEALTH OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING CURRENT STATE AND FEDERAL FUNDING LEVELS FOR MEDI-CAL AND OTHER PUBLIC PROGRAMS. EXPENSES ASSOCIATED WITH THIS ACTIVITY ARE LESS THAN 1% OF TOTAL HOSPITAL EXPENDITURES. VALLEY CHILDREN'S HOSPITAL HAS MADE NO CONTRIBUTIONS TO ANY POLITICAL CANDIDATE OR ELECTED OFFICIAL. SALARIES RELATED TO LOBBYING $16,163 BROWNSTEIN HYATT FARBER SCHRECK $153,750 ASSOCIATION DUES RELATED TO LOBBYING NACH 30,188 NACH CONTRIBUTION 3,100 AMERICAN SOCIETY HEALTHCARE ENGINEERING 119 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 336 CALIFORNIA CHAMBER OF COMMERCE 130 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 48,153 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 4,688 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 25,627 CHILDREN'S SPECIALTY CARE COALITION 3,350 FRESNO CHAMBER OF COMMERCE 1,600 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA 111,981 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $399,302

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

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

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

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

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

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	60,066,352		60,066,352
b	Buildings ....	381,234,624	153,656,458	227,578,166
c	Leasehold improvements	3,554,556	3,538,829	15,727
d	Equipment ....	316,185,598	216,917,700	99,267,898
e	Other .....	40,398,957	26,723,722	13,675,235
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				400,603,378

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3) Other (A) LIMITED PARTNERSHIPS	75,381,780	F
(B) HEDGE FUNDS	92,755,154	F
(C) PRIVATE CAPITAL FUNDS	38,130,013	F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	206,266,947

Part VIII

Investments - Program 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)DISPROPORTIONATE SHARE FUNDS RECEIVABLE				9,251,166
(2)INSURANCE RECEIVABLE				10,387,726
(3)PROVIDER FEE RECEIVABLE				95,360,420
(4)457 TRUST FUNDS				4,280,743
(5)OTHER				5,290,350
(6)ADVANCE MED FOUNDATION				-14,364,860
(7)PREPAID LEASE ASSET				1,694,824
(8)PROP 3 & 4 RECEIVABLE				11,777,248
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				123,677,617

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	282,595,738
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) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Attach to Form 990. Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

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

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

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

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

Yes

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

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

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS	102,139,351
	EUROPE (INCLUDING ICELAND & GREENLAND)	0	0	INVESTMENTS	22,397,480















3a	Sub-total ....	0	0		124,536,831
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		124,536,831

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021

Schedule F (Form 990) 2021

Page 2

Part II

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

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

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

Schedule F (Form 990) 2021

Schedule F (Form 990) 2021Page 3

Part III

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

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2021

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2021

Page 5

Part V

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

ReturnReference	Explanation
PART I, LINE 3:	THE AMOUNT IN COLUMN F IS BASED ON FAIR MARKET VALUE.
PART III ACCOUNTING METHOD:

Schedule F (Form 990) 2021

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

2021

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

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

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

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

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	181,952		181,952	0.020 %
b	Medicaid (from Worksheet 3, column a) . . . . .	522,481,211	787,206,514	0	0 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	399,138	173,733	225,405	0.030 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	523,062,301	787,380,247	407,357	0.050 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,911,208		1,911,208	0.250 %
f	Health professions education (from Worksheet 5) . . .	10,330,948	1,264,984	9,065,964	1.190 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	1,154,486	631,221	523,265	0.070 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	3,534,695		3,534,695	0.460 %
j	Total. Other Benefits . .	16,931,337	1,896,205	15,035,132	1.970 %
k	Total. Add lines 7d and 7j .	539,993,638	789,276,452	15,442,489	2.020 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

3,682,434

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).....

493,419

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

576,800

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

-83,381

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) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?2Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)				Facility reporting group
1	VALLEY CHILDREN'S HOSPITAL 9300 VALLEY CHILDRENS PLACE MADERA,CA936368761 WWW.VALLEYCHILDRENS.ORG 040000160	X	X	A
2	VALLEY CHILDREN'S HOME CARE 5085 E MCKINLEY AVE FRESNO,CA93727 WWW.VALLEYCHILDRENS.ORG 040000160	X		A

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

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

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): WWW.VALLEYCHILDRENS.ORG/ABOUT-US

Other website (list url):

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

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

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

Yes

If "Yes" (list url): SEE PART V, PAGE 8

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) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

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

Yes

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

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

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE PART V, PAGE 8

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

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

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) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

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

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

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

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

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 5:	FACILITY REPORTING GROUP AVALLEY CHILDREN'S 2019 CHNA WAS BASED ON A JOINT NEEDS ASSESSMENT FOR FRESNO, KINGS, MADERA AND TULARE COUNTIES, AND THEN SEPARATE NEEDS ASSESSMENTS FOR KERN, MERCED AND STANISLAUS COUNTIES. VALLEY CHILDREN'S PARTNERED WITH 15 HOSPITALS TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. THE CHNA WAS FACILITATED BY THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA'S COMMUNITY BENEFITS WORKGROUP, AND INCLUDED A THOROUGH REVIEW OF SECONDARY DATA AS WELL AS SIGNIFICANT COMMUNITY ENGAGEMENT THROUGH SURVEYS, FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS. TO ASSESS THE NEEDS OF CHILDREN IN KERN, MERCED, AND STANISLAUS COUNTIES, VALLEY CHILDREN'S CONSULTED SECONDARY DATA SOURCES AND WORKED WITH COMMUNITY PARTNERS TO CONVENE ONE-ON-ONE INTERVIEWS AND FOCUS GROUPS WITH ORGANIZATIONS REPRESENTING LOW INCOME, UNDERSERVED COMMUNITIES. THE FRESNO, KINGS, MADERA, AND TULARE COUNTIES CHNA WAS FACILITATED BY THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA'S COMMUNITY BENEFITS WORKGROUP. THE WORKGROUP COLLABORATED WITH HC2 STRATEGIES, INC. TO CONDUCT KEY INFORMANT INTERVIEWS, FOCUS GROUPS, AND ESTABLISH PRIORITY HEALTH NEEDS FOR THE 2019-2021 COMMUNITY HEALTH NEEDS CYCLE. ADDITIONALLY, THE COMMITTEE WORKED WITH WILDFIRE GRAPHICS & ANALYTICS, LLC TO GATHER HEALTH INDICATOR DATA, ANALYZE QUANTITATIVE AND QUALITATIVE DATA, AND PACKAGE THE FINAL REPORT. AD LUCEM CONSULTING ESTABLISHED THE METHODOLOGY FOR RANKING HEALTH NEED DATA FROM KEY INFORMANT AND FOCUS GROUP INTERVIEWS. AD LUCEM ALSO PROVIDED THE OVERALL RANKINGS FOR THE FOUR-COUNTY REGION. BIEL CONSULTING, INC. CONDUCTED THE CHNA IN KERN COUNTY. BIEL CONSULTING, INC. HAS EXTENSIVE EXPERIENCE CONDUCTING HOSPITAL HEALTH ASSESSMENTS AND WORKING WITH HOSPITALS ON DEVELOPING, IMPLEMENTING, AND EVALUATING COMMUNITY BENEFIT PROGRAMS. DR. MELISSA BIEL CONDUCTED THE KERN COUNTY CHNA.THE MERCED COUNTY CHNA WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS, INC. (PRC). PRC IS A NATIONALLY RECOGNIZED HEALTHCARE CONSULTING FIRM WITH EXTENSIVE EXPERIENCE CONDUCTING CHNAS IN HUNDREDS OF COMMUNITIES ACROSS THE UNITED STATES SINCE 1994. THE STANISLAUS COUNTY MAPP EFFORT COLLABORATED WITH COMMUNITY HEALTH INSIGHTS (CHI). CHI CONDUCTED THE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS. THE CHNA PROCESS INCLUDED COLLECTION AND ANALYSIS OF UP-TO-DATE DATA FOR VALLEY CHILDREN'S SERVICE AREA FROM A NUMBER OF SECONDARY SOURCES. IN ADDITION, PRIMARY DATA WERE COLLECTED DIRECTLY FROM STAKEHOLDERS IN THE COMMUNITY. A VARIETY OF PRIMARY DATA COLLECTION METHODS WERE USED TO OBTAIN COMMUNITY INPUT INCLUDING, FOCUS GROUPS, INTERVIEWS AND SURVEYS. THE COLLECTED DATA WERE USED TO IDENTIFY SIGNIFICANT COMMUNITY NEEDS. FRESNO, KINGS, MADERA, AND TULARE COUNTIESSOURCES OF DATA FOR THIS ASSESSMENT INCLUDED BOTH PRIMARY AND SECONDARY DATA. SECONDARY DATA SOURCES INCLUDED PUBLICLY REPORTED STATE AND NATIONALLY-RECOGNIZED DATA SOURCES SUCH AS COMMUNITY COMMONS, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, AND COUNTY HEALTH RANKINGS & ROADMAPS. PRIMARY DATA WERE COLLECTED THROUGH 48 KEY INFORMANT INTERVIEWS, 24 FOCUS GROUPS THAT REACHED 284 PERSONS, AND AN ONLINE SURVEY THAT REACHED 1,178 PERSONS. KEY INFORMANTS AND FOCUS GROUPS WERE PURPOSEFULLY CHOSEN TO REPRESENT MEDICALLY UNDER-SERVED, LOW-INCOME OR MINORITY POPULATIONS IN OUR COMMUNITY. THE ONLINE SURVEY WAS DISTRIBUTED TO PARTNER ORGANIZATIONS THAT WERE NOT REPRESENTED BY KEY INFORMANTS AND ADVERTISED TO THE GENERAL PUBLIC VIA A PUBLIC SERVICE ANNOUNCEMENT HOSTED ON UNIVISION'S ARRIBA VALLE CENTRAL SHOW.KERN COUNTY SECONDARY DATA WERE COLLECTED FROM A VARIETY OF LOCAL, COUNTY AND STATE SOURCES TO PRESENT A COMMUNITY PROFILE, SOCIAL DETERMINANTS OF HEALTH, HEALTH CARE ACCESS, BIRTH INDICATORS, LEADING CAUSES OF DEATH, ACUTE AND CHRONIC DISEASE, HEALTH BEHAVIORS, MENTAL HEALTH, SUBSTANCE USE AND MISUSE, AND PREVENTIVE PRACTICES. WHEN AVAILABLE, DATA SETS ARE PRESENTED IN THE CONTEXT OF KERN COUNTY AND CALIFORNIA TO HELP FRAME THE SCOPE OF AN ISSUE, AS IT RELATES TO THE BROADER COMMUNITY. SOURCES OF DATA INCLUDE: THE U.S. CENSUS AMERICAN COMMUNITY SURVEY, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, CALIFORNIA HEALTH INTERVIEW SURVEY, KERN COUNTY PUBLIC HEALTH DEPARTMENT, HEALTHY KERN COUNTY, COUNTY HEALTH RANKINGS, CALIFORNIA DEPARTMENT OF EDUCATION, CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT AND CALIFORNIA DEPARTMENT OF JUSTICE, AMONG OTHERS. INFORMATION WAS ALSO OBTAINED THROUGH COMMUNITY SURVEYS AND INTERVIEWS WITH INDIVIDUALS WHO ARE LEADERS AND/OR REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS, LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY. INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE COMMUNITY SERVED BY THE HOSPITAL. FORTY-ONE (41) INTERVIEWS WERE COMPLETED FROM OCTOBER 2018 THROUGH MARCH 2019. THE KERN COUNTY COMMUNITY BENEFIT COLLABORATIVE REPRESENTATIVES DEVELOPED A PLAN FOR DISTRIBUTION OF A SURVEY TO ENGAGE COMMUNITY RESIDENTS. THE SURVEY WAS AVAILABLE IN AN ELECTRONIC FORMAT THROUGH A SURVEY MONKEY LINK, AND IN A PAPER COPY FORMAT. THE ELECTRONIC AND PAPER SURVEYS WERE AVAILABLE IN ENGLISH AND SPANISH. THE SURVEYS WERE AVAILABLE FROM NOVEMBER 2018 TO JANUARY 2019 AND DURING THIS TIME, 1,114 USABLE SURVEYS WERE COLLECTED.MERCED COUNTY THIS ASSESSMENT INCORPORATED DATA FROM QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDED PRIMARY RESEARCH FROM THE PRC COMMUNITY HEALTH SURVEY AND SECONDARY RESEARCH. THESE QUANTITATIVE COMPONENTS ALLOWED FOR TRENDING AND COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDED PRIMARY RESEARCH GATHERED THROUGH AN ONLINE KEY INFORMANT SURVEY. THE SURVEY INSTRUMENT USED FOR THIS STUDY WAS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC) BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), AS WELL AS OTHER PUBLIC HEALTH SURVEYS AND CUSTOMIZED QUESTIONS ADDRESSING GAPS IN INDICATOR DATA RELATIVE TO HEALTH PROMOTION AND DISEASE PREVENTION OBJECTIVES AND OTHER RECOGNIZED HEALTH ISSUES.FOR THE PRC COMMUNITY HEALTH SURVEY, A TELEPHONE INTERVIEW METHODOLOGY ONE THAT INCORPORATES BOTH LANDLINE AND CELL PHONE INTERVIEWS WAS EMPLOYED. THE SAMPLE DESIGN USED FOR THIS EFFORT CONSISTED OF A RANDOM SAMPLE OF 300 INDIVIDUALS, AGE 18 AND OLDER, IN MERCED COUNTY. ONCE THE INTERVIEWS WERE COMPLETED, THESE WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION SO AS TO APPROPRIATELY REPRESENT MERCED COUNTY AS A WHOLE. AN ONLINE KEY INFORMANT SURVEY WAS ALSO COMPLETED. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY THE HOSPITAL PARTNERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF UNDERSERVED, LOW INCOME, AND MINORITY POPULATIONS, AS WELL AS OF THE COMMUNITY OVERALL. KEY INFORMANTS WERE CONTACTED BY EMAIL, INTRODUCING THE PURPOSE OF THE SURVEY AND PROVIDING A LINK TO TAKE THE SURVEY ONLINE. IN ALL, 49 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.STANISLAUS COUNTY QUANTITATIVE DATA COLLECTION FOR THE CHNA WAS CONDUCTED USING SECONDARY SOURCES. IN ORDER TO IDENTIFY INDICATORS TO BE INCLUDED IN THE ANALYSIS, A LIST OF POTENTIAL INDICATORS WAS COMPILED FROM THE 2013 STANISLAUS COUNTY COMMUNITY HEALTH ASSESSMENT, HEALTHY PEOPLE 2020, LET'S GET HEALTHY CALIFORNIA, THE STANISLAUS COUNTY ADMINISTRATIVE OFFICE, COUNTY HEALTH RANKINGS, KAISER PERMANENTE'S MODESTO MEDICAL CENTER'S CHNA, SUTTER HEALTH MODESTO'S CHNA, STANISLAUS COUNTY'S FOCUS ON PREVENTION AND THE NATIONAL ASSOCIATION OF COUNTY AND CITY HEALTH OFFICIALS' (NACCHO) RECOMMENDED AND EXTENDED INDICATOR AND TOPIC LISTS. THOSE INDICATORS WERE GROUPED INTO THE NACCHO RECOMMENDED CATEGORIES AND THEMATIC SUBCATEGORIES. QUALITATIVE DATA WERE GATHERED FROM PRIMARY SOURCES. NINE FOCUS GROUPS WERE CONDUCTED FROM JANUARY TO FEBRUARY,2019 IN STANISLAUS COUNTY. ELEVEN KEY INFORMANT INTERVIEWS WERE CONDUCTED FROM DECEMBER 2018 TO FEBRUARY 2019. FOCUS GROUP AND KEY INFORMANT RESPONSES TO QUESTIONS ABOUT KEY HEALTH NEEDS WERE MATCHED TO THE COMMUNITY HEALTH ASSESSMENT TOPIC CATEGORIES AND SUBCATEGORIES. THE IDENTIFICATION OF SIGNIFICANT COMMUNITY NEEDS BEGAN WITH A REVIEW OF THE DATA THAT DESCRIBED THE HOSPITAL SERVICE AREA. HEALTH NEEDS THAT DID NOT MEET STATE OR NATIONAL BENCHMARKS WERE IDENTIFIED. THE PRIMARY DATA COLLECTION PROCESS THEN OBTAINED COMMUNITY INPUT TO SUPPORT THE SECONDARY DATA FINDINGS, IDENTIFY ADDITIONAL COMMUNITY ISSUES, SOLICIT INFORMATION ON DISPARITIES AMONG SUBPOPULATIONS, ASCERTAIN COMMUNITY ASSETS TO ADDRESS NEEDS, AND DISCOVER GAPS IN RESOURCES. COMMUNITY INPUT WAS USED TO PRIORITIZE THESE NEEDS.
PART V, SECTION B, LINE 5 (CONTINUED):	THE 2019 CHNA REPORT PROCESS IDENTIFIED THE FOLLOWING 13 HEALTH NEEDS IN FRESNO, KINGS, MADERA AND TULARE COUNTIES. - ACCESS TO CARE - ASTHMA - CANCER - CLIMATE AND HEALTH - CARDIOVASCULAR DISEASE - ECONOMIC SECURITY - HIV/AIDS/STIS - MATERNAL AND INFANT HEALTH - MENTAL HEALTH - OBESITY/HEAL/DIABETES - ORAL HEALTH - SUBSTANCE USE/TOBACCO USE - VIOLENCE AND INJURY PREVENTION COMMUNITY MEDICAL CENTERS, SAINT AGNES MEDICAL CENTER, AND VALLEY CHILDREN'S HOSPITAL, INVITED LEADERS REPRESENTING COUNTY PUBLIC HEALTH AND COMMUNITY-BASED ORGANIZATIONS FROM FRESNO, KINGS, MADERA AND TULARE COUNTIES TO PARTICIPATE IN A HEALTH NEEDS RANKING PROCESS. PUBLIC HEALTH AND COMMUNITY LEADERS WERE TASKED WITH RANKING THE NEEDS THAT WERE MOST PRESSING IN THEIR RESPECTIVE COUNTIES, BASED ON HEALTH ISSUES PREVIOUSLY IDENTIFIED IN THE 2019 PRIMARY DATA COLLECTION PHASE. PARTICIPANTS IN THE COLLABORATIVE HEALTH RANKING SESSION WERE TASKED WITH RANKING THE IDENTIFIED HEALTH NEEDS BASED ON THE FOLLOWING CRITERIA: - SEVERITY, MAGNITUDE, URGENCY - FEASIBILITY AND EFFECTIVENESS OF POSSIBLE INTERVENTIONS - POTENTIAL IMPACT ON GREATEST NUMBER OF PEOPLE - POTENTIAL HEALTH NEED SCORE (BASED ON COMMUNITY STAKEHOLDER AND RESIDENT FEEDBACK) - OUTCOMES ARE MEASURABLE AND ACHIEVABLE IN A 3-YEAR SPAN - EXISTING RESOURCES/PROGRAMS KERN COUNTY SIGNIFICANT HEALTH NEEDS WERE IDENTIFIED FROM SECONDARY DATA USING THE SIZE OF THE PROBLEM (RELATIVE PORTION OF POPULATION AFFLICTED BY THE PROBLEM) AND THE SERIOUSNESS OF THE PROBLEM (IMPACT AT INDIVIDUAL, FAMILY, AND COMMUNITY LEVELS). TO DETERMINE SIZE OR SERIOUSNESS OF THE PROBLEM, THE HEALTH NEED INDICATORS THAT WERE IDENTIFIED IN THE SECONDARY DATA WERE MEASURED AGAINST BENCHMARK DATA; SPECIFICALLY, COUNTY RATES, STATE RATES AND/OR HEALTHY PEOPLE 2020 OBJECTIVES. INDICATORS RELATED TO THE HEALTH NEEDS THAT PERFORMED POORLY AGAINST ONE OR MORE OF THESE BENCHMARKS MET THIS CRITERION TO BE CONSIDERED A HEALTH NEED. THE FOLLOWING SIGNIFICANT HEALTH NEEDS WERE DETERMINED: - ACCESS TO HEALTH CARE - ALZHEIMER'S DISEASE - BIRTH INDICATORS - CHRONIC DISEASES (ASTHMA, CANCER, DIABETES, HEART DISEASE, KIDNEY DISEASE, LIVER DISEASE, LUNG DISEASE, STROKE, VALLEY FEVER) - DENTAL CARE/ORAL HEALTH - ECONOMIC INSECURITY - ENVIRONMENTAL POLLUTION - FOOD INSECURITY - HOUSING AND HOMELESSNESS - MENTAL HEALTH - OVERWEIGHT AND OBESITY - PREVENTIVE PRACTICES - SEXUALLY TRANSMITTED INFECTIONS - SUBSTANCE USE AND MISUSE - UNINTENTIONAL INJURIES - VIOLENCE AND INJURY THE LIST OF SIGNIFICANT HEALTH NEEDS INFORMED PRIMARY DATA COLLECTION. THE PRIMARY DATA COLLECTION PROCESS WAS DESIGNED TO VALIDATE SECONDARY DATA FINDINGS, IDENTIFY ADDITIONAL COMMUNITY ISSUES, SOLICIT INFORMATION ON DISPARITIES AMONG SUBPOPULATIONS, ASCERTAIN COMMUNITY ASSETS TO ADDRESS NEEDS, AND DISCOVER GAPS IN RESOURCES. COMMUNITY STAKEHOLDER INTERVIEWS WERE USED TO GATHER INPUT AND PRIORITIZE THE SIGNIFICANT HEALTH NEEDS. THE FOLLOWING CRITERIA WERE USED TO PRIORITIZE THE HEALTH NEEDS: - THE PERCEIVED SEVERITY OF A HEALTH ISSUE OR HEALTH FACTOR AS IT AFFECTS THE HEALTH AND LIVES OF THOSE IN THE COMMUNITY; - THE LEVEL OF IMPORTANCE THE HOSPITAL SHOULD PLACE ON ADDRESSING THE ISSUE. THE STAKEHOLDERS WERE ALSO ASKED TO RANK ORDER (POSSIBLE SCORE OF 4) THE HEALTH NEEDS ACCORDING TO HIGHEST LEVEL OF IMPORTANCE IN THE COMMUNITY. THE TOTAL SCORE FOR EACH SIGNIFICANT HEALTH NEED WAS DIVIDED BY THE TOTAL NUMBER OF RESPONSES FOR WHICH DATA WERE PROVIDED, RESULTING IN AN OVERALL AVERAGE FOR EACH HEALTH NEED. MERCED COUNTY SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY WERE IDENTIFIED FROM THE INFORMATION GATHERED THROUGH THE CHNA AND THE GUIDELINES SET FORTH IN HEALTHY PEOPLE 2020 (WWW.HEALTHYPEOPLE.GOV). SIGNIFICANT HEALTH NEEDS WERE DETERMINED AFTER CONSIDERATION OF VARIOUS CRITERIA, INCLUDING: STANDING IN COMPARISON WITH BENCHMARK DATA (PARTICULARLY NATIONAL DATA); IDENTIFIED TRENDS; THE PREPONDERANCE OF SIGNIFICANT FINDINGS WITHIN TOPIC AREAS; THE MAGNITUDE OF THE ISSUE IN TERMS OF THE NUMBER OF PERSONS AFFECTED; AND THE POTENTIAL HEALTH IMPACT OF A GIVEN ISSUE. THESE NEEDS ALSO TAKE INTO ACCOUNT THOSE ISSUES OF GREATEST CONCERN TO THE COMMUNITY STAKEHOLDERS (KEY INFORMANTS) GIVING INPUT TO THIS PROCESS. FOLLOWING IS THE LIST OF SIGNIFICANT HEALTH NEEDS IDENTIFIED IN MERCED COUNTY. - ACCESS TO HEALTH CARE - CANCER - DEMENTIA, INCLUDING ALZHEIMER'S DISEASE - DIABETES - HEART DISEASE AND STROKE - INFANT HEALTH AND FAMILY PLANNING - INJURY AND VIOLENCE - KIDNEY DISEASE - MENTAL HEALTH - NUTRITION, PHYSICAL ACTIVITY AND WEIGHT - POTENTIALLY DISABLING CONDITIONS - RESPIRATORY DISEASES - SUBSTANCE USE - TOBACCO USE STANISLAUS COUNTY AFTER GATHERING QUANTITATIVE AND QUALITATIVE DATA, TOPIC CATEGORIES AND SUBCATEGORIES WERE CONSIDERED AS KEY HEALTH NEEDS IF THEY MET THE FOLLOWING CRITERIA: - INDICATORS REVIEWED IN SECONDARY DATA DEMONSTRATED THAT THE COUNTY ESTIMATE WAS POORER BY MORE THAN ONE PERCENTAGE POINT WHEN COMPARED TO THE BENCHMARK ESTIMATE (IN MOST CASES, CALIFORNIA STATE AVERAGE). - THE HEALTH ISSUE WAS IDENTIFIED AS A KEY THEME IN AT LEAST THREE INTERVIEWS. - THE HEALTH ISSUE WAS IDENTIFIED AS A KEY THEME IN AT LEAST THREE FOCUS GROUPS. THIS METHOD REVEALED THE FOLLOWING KEY HEALTH NEEDS: - ACCESS TO CARE - ASTHMA/AIR QUALITY - CHRONIC DISEASE - COMMUNICABLE DISEASE - ECONOMIC INSECURITY - EDUCATION - HOUSING AND HOMELESSNESS - MENTAL HEALTH - SAFETY - SUBSTANCE USE - TRANSPORTATION ON MAY 30, 2019, COMMUNITY MEMBERS AND STAKEHOLDERS WERE CONVENED FOR A COMMUNITY CONVERSATION TO PRIORITIZE THESE HEALTH NEEDS. DURING THE COMMUNITY CONVERSATION BREAKOUT GROUPS, PARTICIPANTS DISCUSSED ISSUES AND CONCERNS THAT IMPACTED THE HEALTH OF STANISLAUS COUNTY. THEY WERE ALSO ASKED TO IDENTIFY COMMUNITY ASSETS AND RESOURCES.
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: VALLEY CHILDREN'S HOSPITAL, - FACILITY 2: VALLEY CHILDREN'S HOME CARE
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	- ADVENTIST HEALTH HANFORD, REEDLEY, SELMA, TULARE, BAKERSFIELD AND TEHACHAPI VALLEY- CLOVIS COMMUNITY MEDICAL CENTER - COALINGA REGIONAL MEDICAL CENTER (CLOSED) - COMMUNITY REGIONAL MEDICAL CENTER (INCLUDES COMMUNITY BEHAVIORAL HEALTH CENTER) - DELANO REGIONAL MEDICAL CENTER (KERN COUNTY)- DIGNITY HEALTH (KERN COUNTY)- KAISER PERMANENTE, FRESNO SERVICE AREA, KERN COUNTY - KAWEAH DELTA HEALTH CARE DISTRICT - KERN MEDICAL- MADERA COMMUNITY HOSPITAL - MERCY MEDICAL MERCED- MEMORIAL HOSPITAL LOS BANOS- SAN JOAQUIN VALLEY REHABILITATION HOSPITAL - SIERRA VIEW MEDICAL CENTER - SAINT AGNES MEDICAL CENTER - VALLEY CHILDREN'S HOSPITAL
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:	- HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA- COMMUNITY COMMONS- CALIFORNIA DEPARTMENT OF PUBLIC HEALTH- COUNTY HEALTH RANKINGS & ROADMAPS- KERN COUNTY COMMUNITY BENEFIT COLLABORATIVE- STANISLAUS COUNTY HEALTH SERVICES AGENCY PUBLIC HEALTH DEPARTMENT
PART V, LINE 10A, IMPLEMENTATION STRATEGY WEBSITE:	HTTPS://WWW.VALLEYCHILDRENS.ORG/GUILDS-CENTER-FOR-COMMUNITY-HEALTH/COMMUNITY-BENEFIT
PART V, SECTION B, LINE 11	ACCESS TO CARE ENROLLMENT IN HEALTH INSURANCE VALLEY CHILDREN'S PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM OR VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S STAFF ASSISTED FAMILIES WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. CLINICAL PARTNERSHIPS VALLEY CHILDREN'S CLINICAL PARTNERSHIP PROGRAM BRINGS TOGETHER INSTITUTIONS FOCUSED ON ENHANCING NEONATAL AND PEDIATRIC CARE, REGARDLESS OF WHETHER THE ILL OR INJURED CHILD BECOMES A VALLEY CHILDREN'S PATIENT. THIS EFFORT HELPS PREVENT CHILDREN FROM BEING TRANSFERRED OR REFERRED UNNECESSARILY TO VALLEY CHILDREN'S AND HELPS IDENTIFY WHEN A CHILD NEEDS ADVANCED PEDIATRIC CARE. THE GOALS OF THE CLINICAL PARTNERSHIP PROGRAM INCLUDE PROVIDING: ENHANCED, COORDINATED CARE, MORE CARE DELIVERED CLOSER TO HOME, AND IMPROVED QUALITY AND CONFIDENCE IN PROVIDING PEDIATRIC CARE. IN 2017, VALLEY CHILDREN'S SUPPORTED 10 CLINICAL PARTNERSHIPS. IN 2018, VALLEY CHILDREN'S SUPPORTED 13 INPATIENT CLINICAL PARTNERS AND TWO OUTPATIENT CLINICAL PARTNERS. MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN VALLEY CHILDREN'S RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY-BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. VALLEY CHILDREN'S PROVIDED SIGNIFICANT OUTREACH AND EDUCATION FOR COMMUNITY-BASED ORGANIZATIONS AND PROVIDERS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN, INCLUDING CHILDREN WITH TRACHEOSTOMIES AND VENTILATORS. TRANSPORTATION GIVEN THE CENTRAL VALLEY'S LARGELY RURAL LANDSCAPE AND HIGH CONCENTRATION OF POVERTY, TRANSPORTATION HAS LONG BEEN A CHALLENGE FOR MANY FAMILIES. VALLEY CHILDREN'S CONTINUED TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND INCREASE ACCESS TO CARE BY PROVIDING GAS CARDS, TAXI VOUCHERS, AMTRAK TICKETS AND BUS TOKENS. VALLEY CHILDREN'S ALSO SUBSIDIZED BUS AND OTHER PUBLIC TRANSIT SERVICES FROM THE CITY OF FRESNO AND KINGS COUNTY. CHRONIC DISEASE PREVENTION HEALTH CARE LITERACY VALLEY CHILDREN'S PROVIDED ACCESS TO ONLINE EDUCATIONAL INFORMATION VIA THE HEALTH ENCYCLOPEDIA LINK ON ITS WEBSITE. THE HEALTH ENCYCLOPEDIA CONTAINS THOUSANDS OF PAGES OF INFORMATION ON PEDIATRIC DISEASES, CONDITIONS AND TREATMENTS, AS WELL AS SECTIONS ON HOW TO KEEP KIDS HEALTHY. THE ENCYCLOPEDIA IS AVAILABLE IN ENGLISH AND SPANISH. COMMUNITIES FOR HEALTHY KIDS THE COMMUNITIES FOR HEALTHY KIDS INITIATIVE IS A MULTI-SECTOR PARTNERSHIP BETWEEN HEALTH CARE PROVIDERS, HEALTH PLANS, SCHOOLS, COMMUNITY-BASED ORGANIZATIONS, PUBLIC HEALTH DEPARTMENTS AND THE AGRICULTURE INDUSTRY TO INCREASE ACCESS TO AND CONSUMPTION OF HEALTHY FOODS AND BEVERAGES AND TO INCREASE OPPORTUNITIES FOR AND PARTICIPATION IN PHYSICAL ACTIVITY. THE PURPOSE OF THIS EFFORT IS TO ALIGN AND SUPPORT EXISTING PARTNERSHIPS ACROSS FRESNO, MADERA AND KINGS COUNTIES IN AN EFFORT TO REDUCE CHILDHOOD OBESITY IN THE CENTRAL VALLEY THROUGH EDUCATION, ADVOCACY AND THE COORDINATED IMPLEMENTATION OF IDENTIFIED STRATEGIES. FURTHERMORE, VALLEY CHILDREN'S HAS IDENTIFIED FOOD INSECURITY AS A CRITICAL SOCIAL DETERMINANT OF HEALTH THAT IMPACTS THE HEALTH AND WELLBEING OF OUR PATIENTS AND FAMILIES. CHILDREN WHO ARE FOOD INSECURE LACK ACCESS TO AFFORDABLE AND HEALTHY FOODS, WHICH LEADS TO ADVERSE HEALTH OUTCOMES, INCLUDING INCREASED OBESITY RATES. TO SUPPORT THIS EFFORT, VALLEY CHILDREN'S LAUNCHED A PILOT PROJECT AT ONE OF ITS COMMUNITY-BASED PRIMARY CARE PEDIATRIC PRACTICES. PROVIDERS AT THE PRACTICE SCREEN THEIR PATIENTS FOR FOOD INSECURITY. IF ASSESSED TO BE "AT-RISK," PATIENTS ARE CONNECTED TO NUTRITION PROGRAMS AND EMERGENCY FOOD RESOURCES. ADDITIONAL SUPPORT INCLUDED THE FOLLOWING ACTIVITIES: - VALLEY CHILDREN'S CONVENED A CONTINUING MEDICAL EDUCATION EVENT ON CHILDHOOD OBESITY PREVENTION FOR COMMUNITY PROVIDERS IN FRESNO, MADERA, MERCED, KINGS AND TULARE COUNTIES TO RAISE AWARENESS ABOUT WAYS TO ADDRESS CHILDHOOD OBESITY WITHIN THE CLINICAL SETTING. - VALLEY CHILDREN'S SERVED ON THE STEERING COMMITTEE FOR THE FRESNO COUNTY HEALTH IMPROVEMENT PARTNERSHIP, CO-CHAIRED THE FRESNO COUNTY DIABETES COLLABORATIVE AND PARTICIPATED IN THE LIVE WELL MADERA COUNTY DIABETES AND OBESITY WORKGROUP, THE KINGS COUNTY DIABESITY COALITION AND THE TULARE COUNTY DIABETES AND OBESITY WORKGROUP. INFANT HEALTH VALLEY CHILDREN'S PARTICIPATED IN INITIATIVES THAT SUPPORTED THE HEALTHY DEVELOPMENT OF CHILDREN, DURING PREGNANCY AND INTO THE FIRST 3-5 YEARS OF LIFE. EXAMPLES INCLUDED THE FOLLOWING: - FRESNO COUNTY PRE-TERM BIRTH INITIATIVE FRESNO COUNTY HAS ONE OF CALIFORNIA'S HIGHEST RATES OF PREMATURE BIRTH WITH 1 OUT OF EVERY 9 BABIES BORN TOO EARLY. PREMATURE BIRTH CAN CAUSE SERIOUS PHYSICAL AND MENTAL DISABILITIES, OR EVEN DEATH, BEFORE THE BABY'S FIRST BIRTHDAY. OVER A 10-YEAR PERIOD, THE FRESNO COUNTY PRE-TERM BIRTH INITIATIVE HAS WORKED TO IMPROVE THE HEALTH OF FRESNO MOTHERS AND REDUCE THE RATE OF PREMATURE BABIES. USING AN APPROACH CALLED COLLECTIVE IMPACT, PARTNERS ACROSS MANY SECTORS HAVE COME TOGETHER TO CREATE CHANGE IN FRESNO COUNTY. VALLEY CHILDREN'S HAS BEEN AN ACTIVE PARTICIPANT IN THIS INITIATIVE, WITH VALLEY CHILDREN'S SENIOR VICE PRESIDENT FOR COMMUNITY ENGAGEMENT AND POPULATION WELLNESS SERVING AS CHAIR OF THE INITIATIVE'S STEERING COMMITTEE. - CRADLE TO CAREER FRESNO AND STANISLAUS COUNTIES HAVE BEGUN FORMAL CRADLE TO CAREER INITIATIVES FOR THE PURPOSE OF CONVENING PUBLIC AND PRIVATE SECTOR STAKEHOLDERS TO WORK TOGETHER TO IMPROVE OUTCOMES FOR CHILDREN IN THEIR COMMUNITIES, FROM PRE-CONCEPTION TO COLLEGE AND/OR VOCATIONAL TRAINING. VALLEY CHILDREN'S PARTICIPATES IN BOTH INITIATIVES AND HAS BEEN A STRONG VOICE FOR THE INCLUSION OF OUTCOMES AND INDICATORS FOCUSED ON CHILD HEALTH AND WELLNESS. - HELP ME GROW FRESNO COUNTY HELP ME GROW IS A COORDINATED SYSTEM OF EARLY IDENTIFICATION AND REFERRAL FOR CHILDREN, AGES 0-5, WHO ARE AT RISK FOR DEVELOPMENTAL DELAYS. IN FY2018, VALLEY CHILDREN'S SUPPORTED THE IMPLEMENTATION OF HELP ME GROW IN ITS PEDIATRIC PRIMARY CARE PRACTICES IN FRESNO COUNTY BY PROMOTING THE USE OF A SPECIFIC DEVELOPMENTAL ASSESSMENT AND SCREENING TOOL THAT IS PART OF THE HELP ME GROW MODEL. - MARCH OF DIMES VALLEY CHILDREN'S PARTNERED WITH THE MARCH OF DIMES TO ADVOCATE FOR POLICIES AT THE STATE AND FEDERAL LEVEL THAT PROMOTE HEALTHY PREGNANCIES AND HEALTHY BABIES. ADDITIONALLY, VALLEY CHILDREN'S DIRECTOR OF COMMUNITY AND GOVERNMENT RELATIONS CHAIRED THE MARCH OF DIMES OF CALIFORNIA'S ADVOCACY AND GOVERNMENT AFFAIRS COMMITTEE IN FY2017 AND FY2018. MENTAL HEALTH ISSUES AND CHALLENGES ASSOCIATED WITH CHILD AND ADOLESCENT MENTAL HEALTH CONTINUED TO BE A MAJOR CONCERN. TO HELP IDENTIFY POTENTIAL REGIONAL SOLUTIONS, VALLEY CHILDREN'S SUPPORTED OR PARTICIPATED IN A NUMBER OF ACTIVITIES. VALLEY CHILDREN'S STAFF PROVIDED TEEN SUICIDE PREVENTION EDUCATION TO STUDENTS AND STAFF AT AREA HIGH SCHOOLS. IN FEBRUARY 2017, VALLEY CHILDREN'S HOSTED A SEMINAR TITLED "A DISCUSSION ON TEEN DEPRESSION AND SUICIDE PREVENTION" THAT DREW OVER 200 ATTENDEES FROM ACROSS THE CENTRAL VALLEY. VALLEY CHILDREN'S STAFF EITHER LED OR PARTICIPATED IN A NUMBER OF COMMUNITY-BASED COLLABORATIVES FOCUSED ON PREVENTING CHILD MENTAL ILLNESS AND/OR EARLY IDENTIFICATION AND TREATMENT OF CHILD MENTAL ILLNESS. VALLEY CHILDREN'S STAFF CHAIRED COMMUNITY CONVERSATIONS, A 50-MEMBER COLLABORATIVE ADDRESSING ISSUES OF MENTAL HEALTH, HOMELESSNESS AND THE IMPACT ON FAMILIES. A NUMBER OF VALLEY CHILDREN'S STAFF ALSO SERVED AS MEMBERS OF THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE. VIOLENCE AND INJURY PREVENTION UNINTENTIONAL INJURY IS THE LEADING CAUSE OF DEATH FOR CHILDREN IN THE U.S. AS A LEADER IN PROVIDING SPECIALIZED PEDIATRIC HEALTHCARE, VALLEY CHILDREN'S RECOGNIZES THE IMPORTANCE OF INJURY PREVENTION AND WORKS COLLABORATIVELY WITH COMMUNITY AGENCIES TO PREVENT THOSE TRAGEDIES. EACH YEAR, VALLEY CHILDREN'S INJURY PREVENTION PROGRAM PROVIDES INJURY PREVENTION EDUCATION AND OUTREACH TO CHILDREN AND FAMILIES THROUGH A VARIETY OF FORUMS THROUGHOUT CENTRAL CALIFORNIA. THE PROGRAM IS DESIGNED TO HELP KEEP OUR KIDS SAFE.
PART V, SECTION B, LINE 11 (CONTINUED)	CHILD ABUSE PREVENTION THE GUILDS OF VALLEY CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER'S MISSION IS TO PROVIDE COMPREHENSIVE SERVICES TO CHILDREN, DEPENDENT ADULTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY, CHILD-FRIENDLY PROGRAM, AND TO MEET THE PHYSICAL AND EMOTIONAL NEEDS OF VICTIMS OF CHILD ABUSE. THE CENTER'S VISION IS TO BE THE PREMIER PROVIDER IN CENTRAL CALIFORNIA FOR DIAGNOSTIC PHYSICAL ABUSE ASSESSMENTS, FOSTER CARE MEDICAL CLEARANCE EXAMINATIONS AND PEDIATRIC SEXUAL ASSAULT EVALUATIONS, INCLUDING CHILDREN WHO HAVE BEEN VICTIMS OF COMMERCIAL SEXUAL EXPLOITATION. ADDITIONALLY, THE CENTER'S PROVIDERS, KNOWN AS THE CHILD ADVOCACY TEAM, REGULARLY TESTIFY IN BOTH DEPENDENCY AND CRIMINAL COURTS THROUGHOUT THE VALLEY. THE CENTER IS RECOGNIZED IN CENTRAL CALIFORNIA AND AROUND THE STATE AS A LEADER IN ADVOCACY, INJURY PREVENTION, CLINICAL RESEARCH AND ACADEMIC TRAINING. THE CENTER INCLUDES THE CHILD ADVOCACY CLINIC, WHICH OPERATES FIVE DAYS A WEEK AND SEES APPROXIMATELY 1,000 CHILDREN EACH YEAR. CENTER PROVIDERS ALSO ARE AVAILABLE SEVEN DAYS A WEEK, 24 HOURS A DAY FOR EMERGENCY COVERAGE. THE CENTER INCLUDES AN INPATIENT COMPONENT THAT EVALUATES ABOUT 100 CHILDREN YEARLY IN THE PEDIATRIC EMERGENCY DEPARTMENT, ACUTE-CARE FLOORS AND PEDIATRIC INTENSIVE CARE UNIT. THESE CHILDREN ARE EVALUATED FOR SUSPECTED PHYSICAL ABUSE, SEXUAL ABUSE AND NEGLECT. THE STAFF INCLUDES CHILD ABUSE PEDIATRICIANS, NURSE PRACTITIONERS SPECIALIZED IN CHILD MALTREATMENT, FORENSIC NURSES, SOCIAL WORKERS, FORENSIC INTERVIEWERS, A CENTER COORDINATOR, A LICENSED MENTAL HEALTH PROVIDER AND SUPPORT STAFF. IN ADDITION TO THE CLINICAL SERVICES OFFERED BY THE CENTER, A MULTI-DISCIPLINARY INTERVIEWING CENTER IS ALSO AVAILABLE FOR VICTIMS OR WITNESSES OF CRIMES. FORENSIC INTERVIEWING SERVICES ARE REQUESTED BY LAW ENFORCEMENT AND/OR CPS. THE PURPOSE OF THE FORENSIC INTERVIEWING PROGRAM COMPONENT IS TO REDUCE THE NUMBER OF INTERVIEWS AND DECREASE THE NUMBER OF INDIVIDUALS WHO WILL TALK TO THE VICTIM. THE CENTER STRIVES TO PROVIDE A WELCOMING, CHILD-FRIENDLY ENVIRONMENT WHERE CHILDREN/DEPENDENT ADULTS CAN FEEL SAFE AND BE INTERVIEWED BY A TRAINED PROFESSIONAL. THERE IS ONGOING COLLABORATION WITH EXTERNAL COMMUNITY PARTNERS AND OTHER HOSPITAL SERVICES INCLUDING SUBSPECIALTY CLINICS, PATIENT AND FAMILY SERVICES, INTERPRETER SERVICES, RADIOLOGY, DIAGNOSTIC CLINICAL LABORATORIES, CHILD LIFE SERVICES AND PASTORAL CARE. THE CENTER WORKS CLOSELY WITH LAW ENFORCEMENT, CPS AND DISTRICT ATTORNEYS' OFFICES IN THEIR INVESTIGATIVE EFFORTS OF CHILD MALTREATMENT. COLLABORATIVE EFFORTS INCLUDE CASE CONSULTATION AND MONTHLY SUSPECT CHILD ABUSE AND NEGLECT (SCAN) MEETINGS FACILITATED BY OUR CHILD ADVOCACY CLINIC IN AN EFFORT TO TRACK, MONITOR AND ADVOCATE FOR THE HEALTH AND SAFETY OF AT-RISK CHILDREN THROUGHOUT THE VALLEY. FOR PREVENTION EDUCATION, THE CENTER COLLABORATES WITH INTERNAL AND EXTERNAL PARTNERS TO PROVIDE EDUCATION TO PARENTS, CAREGIVERS, HEALTHCARE PERSONNEL, TEACHERS AND MANDATED REPORTERS OF SUSPECTED CHILD MALTREATMENT. THESE PARTNERS INCLUDE VALLEY CHILDREN'S TRAUMA DEPARTMENT'S INJURY PREVENTION TEAM, SAFE KIDS, CHILD ABUSE PREVENTION COUNCILS OF CALIFORNIA, COMPREHENSIVE YOUTH SERVICES, CPS, EXCEPTIONAL PARENTS UNLIMITED, SEXUAL ASSAULT RESPONSE TEAMS (SART) AND COUNTY PUBLIC HEALTH DEPARTMENTS. POISON CONTROL THE CENTRAL CALIFORNIA POISON CONTROL CENTER IS LOCATED ON THE VALLEY CHILDREN'S CAMPUS AND RECEIVED A DONATION OF OFFICE SPACE FROM VALLEY CHILDREN'S. THE CENTER ANSWERS CALLS FROM THROUGHOUT THE REGION AND PROVIDES EXPERT ADVICE AND INFORMATION REGARDING EXPOSURE TO POTENTIALLY HARMFUL SUBSTANCES. THE PHONES ARE STAFFED 24 HOURS A DAY, 7 DAYS A WEEK. IN ADDITION TO PROVIDING EMERGENCY TELEPHONE ADVICE REGARDING POISON EXPOSURES, THE POISON CONTROL CENTER OPERATES SEVERAL PROGRAMS CRITICAL TO A CULTURALLY DIVERSE, AGRICULTURALLY BASED COMMUNITY LIKE THE CENTRAL VALLEY. THE CENTER HAS BEEN EXPRESSLY RESPONSIVE TO THE GROWING AND LARGELY UNDERSERVED LATINO POPULATION BY DEVELOPING SPECIALIZED TEACHING TOOLS AND PROGRAM INTERVENTIONS IN SPANISH, AND PROVIDING CUSTOMIZED TRAININGS FOR COMMUNITY HEALTH WORKERS IN SPANISH. ALSO, THE CENTER CONTRACTS WITH THE STATE DEPARTMENT OF PESTICIDE REGULATION (DPR) TO ASSIST PHYSICIANS IN COMPLYING WITH MANDATORY REPORTING REQUIREMENTS FOR PESTICIDE EXPOSURES. THE POISON CONTROL CENTER ALSO PROVIDES CASE DATA AND INFORMATION ON THE HEALTH ISSUES RELATED TO PESTICIDE EXPOSURE IN CALIFORNIA.NEEDS NOT ADDRESSEDTAKING INTO CONSIDERATION BOTH VALLEY CHILDREN'S EXISTING RESOURCES AND AS WELL AS COMMUNITY RESOURCES, VALLEY CHILDREN'S WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA INCLUDING: ORAL HEALTH, SUBSTANCE USE, CLIMATE AND HEALTH/ENVIRONMENTAL POLLUTION, HOUSING AND HOMELESSNESS, EDUCATION, ECONOMIC SECURITY, SEXUALLY TRANSMITTED INFECTIONS, ALZHEIMER'S DISEASE, AND COMMUNICABLE DISEASES. KNOWING THAT THERE ARE NOT SUFFICIENT RESOURCES TO ADDRESS ALL THE COMMUNITY HEALTH NEEDS, VALLEY CHILDREN'S CHOSE TO CONCENTRATE ON THOSE HEALTH NEEDS THAT CAN MOST EFFECTIVELY BE ADDRESSED GIVEN THE ORGANIZATION'S AREAS OF FOCUS AND EXPERTISE. THIS IMPLEMENTATION STRATEGY REPORT IS NOT EXHAUSTIVE OF EVERYTHING VALLEY CHILDREN'S DOES TO ENHANCE THE HEALTH OF ITS COMMUNITY. VALLEY CHILDREN'S WILL CONTINUE TO LOOK FOR OPPORTUNITIES TO ADDRESS COMMUNITY NEEDS WHERE IT CAN APPROPRIATELY CONTRIBUTE TO ADDRESSING THOSE NEEDS.
PART V, SECTION B, LINE 13H:	FACILITY REPORTING GROUP - A200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-350% FPG - LOW INCOME DISCOUNT NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.350% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 350% OF FPG AND THEY HAVE NOT RECEIVED A DISCOUNTED RATE FROM THE HOSPITAL AS A RESULT OF THEIR THIRD-PARTY INSURANCE COVERAGE AND THEIR ANNUAL OUT-OF-POCKET MEDICAL EXPENSES. FOR THE PRIOR 12 MONTHS EXCEED 10% OF THEIR FAMILY'S ANNUAL INCOME. NO MORE THAN APPLICABLE MEDI CAL RATES IN EFFECT AT DATE OF SERVICE. WHERE MEDI CAL RATES CANNOT BE DETERMINED 75% DISCOUNT FROM CHARGES.PROMPT PAY DISCOUNT: VALLEY CHILDREN'S WILL EXTEND A 45% PROMPT PAY DISCOUNT TO THOSE SELF-PAY PATIENTS WHO WISH TO PAY THEIR ENTIRE OUTSTANDING BALANCE IMMEDIATELY. INSURED PATIENTS WITH NON-COVERED SERVICES WHICH ARE DEEMED MEDICALLY NECESSARY AND WISH TO PAY THEIR OUTSTANDING BALANCE IMMEDIATELY WILL BE ELIGIBLE FOR A 45% DISCOUNT UPON REQUEST.
PART V, LINE 16A, FAP WEBSITE:	HTTPS://WWW.VALLEYCHILDRENS.ORG/PATIENTS-AND-FAMILIES/RECORDS-BILLING/FINANCIAL-AID
PART V, LINE 16B, FAP APPLICATION WEBSITE:	HTTPS://WWW.VALLEYCHILDRENS.ORG/PATIENTS-AND-FAMILIES/RECORDS-BILLING/FINANCIAL-AID
PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:	HTTPS://WWW.VALLEYCHILDRENS.ORG/PATIENTS-AND-FAMILIES/RECORDS-BILLING/FINANCIAL-AID
PART V, LINE 16J, FAP OTHER INFORMATION:	ADDITIONALLY THE POLICY IS SENT BY US POSTAL SERVICE TO COMMUNITY AGENCIES TO BE DISTRIBUTED.VALLEY CHILDREN'S MAINTAINS A LIST OF PROVIDERS IN A DOCUMENT SEPARATE FROM THE FINANCIAL ASSISTANCE POLICY. MEMBERS OF THE PUBLIC MAY READILY OBTAIN A COPY FREE OF CHARGE, BOTH ONLINE AND ON PAPER, AS REQUIRED BY IRS NOTICE 2015-46. THE LINK TO THE WEBSITE IS:HTTPS://WWW.VALLEYCHILDRENS.ORG/FIND-A-DOCTOR/FIND-A-DOCTOR

Schedule H (Form 990) 2021

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) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 7:	CHARITY CARE AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE DECISION SUPPORT SYSTEM WAS USED TO CALCULATE COST-TO-CHARGE FOR DETERMINING UNREIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THIS DECISION SUPPORT SYSTEM ADDRESSES ALL PATIENT SEGMENTS (I.E INPATIENT, OUTPATIENT, ETC.).
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 10,952,809.
PART III, LINE 4:	FOOTNOTE DESCRIBING BAD DEBT EXPENSE: SEE PAGE 12, NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS.COSTING METHODOLOGY:ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND REVIEW OF LARGE BALANCE SELF-PAY ACCOUNTS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBT IF SUBSEQUENTLY COLLECTED. THE COST OF BAD DEBT WRITE-OFFS WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF.
PART III, LINE 8:	MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2022 MEDICARE COST REPORT. MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE SERVICES. ADDITIONALLY, THE MAJORITY OF THE HOSPITAL'S MEDICARE PATIENTS WOULD BE COVERED BY MEDI CAL IF THEY DID NOT FALL UNDER THE MEDICARE COVERAGE OPTION.
PART III, LINE 9B:	COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE; INSURANCE COLLECTION ATTEMPTS CONTINUE AS APPROPRIATE.
PART VI, LINE 2:	COMMUNITY HEALTH NEEDS ASSESSMENT: VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). CONSISTENT WITH STATE AND FEDERAL LAW, VALLEY CHILDREN'S HOSPITAL COMPLETES A FORMAL CHNA AT LEAST ONCE EVERY THREE YEARS. VALLEY CHILDREN'S HOSPITAL'S 2022 COMMUNITY BENEFITS PROGRAM IS BUILT UPON THE OUTCOMES OF A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT THAT INCLUDED THE FOLLOWING ACTIVITIES:VALLEY CHILDREN'S 2019 CHNA WAS BASED ON A JOINT NEEDS ASSESSMENT FOR FRESNO, KINGS, MADERA AND TULARE COUNTIES. VALLEY CHILDREN'S PARTNERED WITH 15 HOSPITALS TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. THE CHNA WAS COORDINATED BY THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA, AND INCLUDED A THOROUGH REVIEW OF SECONDARY DATA AS WELL AS SIGNIFICANT COMMUNITY ENGAGEMENT THROUGH SURVEYS, FOCUS GROUPS AND KEY STAKEHOLDER INTERVIEWS. ADDITIONALLY, VALLEY CHILDREN'S STAFF ENGAGED REGULARLY WITH A HOST OF COMMUNITY-BASED ORGANIZATIONS AND INITIATIVES THAT KEPT US CLOSE TO THE ISSUES IMPACTING THE HEALTH AND WELLBEING OF CHILDREN IN THE REGION.
PART VI, LINE 3:	ENROLLMENT IN HEALTH INSURANCEVALLEY CHILDREN'S IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM OR VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S STAFF ASSISTED THE FAMILIES WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES.
PART VI, LINE 4:	COMMUNITY INFORMATION: AS THE ONLY PEDIATRIC NETWORK OF ITS KIND IN ALL OF CENTRAL CALIFORNIA, VALLEY CHILDREN'S SERVICE AREA EXTENDS FROM SAN JOAQUIN COUNTY IN THE NORTH TO KERN COUNTY IN THE SOUTH, AND SERVES MUCH OF THE CENTRAL COAST AND EASTERN SIERRA AS WELL. VALLEY CHILDREN'S SERVICE AREA IS FOCUSED ON THOSE SEVEN COUNTIES THAT COLLECTIVELY ACCOUNT FOR MORE THAN 90% OF VALLEY CHILLDREN'S INPATIENT AND OUTPATIENT VOLUME. THOSE COUNTIES ARE FRESNO, KERN, KINGS, MADERA, MERCED, STANISLAUS AND TULARE. ACCORDING TO WWW.KIDSDATA.ORG, MORE THAN 1/4 OF CHILDREN LIVING IN THESE SEVEN COUNTIES LIVE IN POVERTY, 3/4 ARE AN ETHNICITY OTHER THAN CAUCASIAN AND CLOSE TO 1/5 LIVE IN FAMILIES WHERE ENGLISH IS NOT THE PRIMARY LANGUAGE SPOKEN AT HOME. IN 2022, VALLEY CHILDREN'S HOSPITAL HAD 10,496 INPATIENT ADMISSIONS, 86,895 EMERGENCY DEPARTMENT VISITS AND 279,027 HOSPITAL-BASED OUTPATIENT SPECIALTY CARE CENTER, REGIONAL SPECIALTY CARE CENTER, AND PRIMARY CARE CENTER VISITS. MEDI-CAL BENEFITS COVERED 73.8% OF THE HOSPITAL'S TOTAL INPATIENT AND OUTPATIENT VISITS AT VALLEY CHILDREN'S HOSPITAL IN 2022.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTHACCESS TO PRIMARY AND PREVENTIVE CARE FOR AT-RISK CHILDRENPEDIATRIC PHYSICIAN RESIDENTS PARTICIPATING IN VALLEY CHILDREN'S PEDIATRIC RESIDENCY PROGRAM PROVIDED PRIMARY AND PREVENTIVE HEALTHCARE SERVICES TO AT-RISK CHILDREN IN FRESNO COUNTY AS A PART OF THE FRESNO COUNTY SUPERINTENDENT OF SCHOOLS' (FCSOS) MOBILE HEALTH UNIT (MHU). DESIGNED TO HELP ENSURE THAT CHILDREN ARE HEALTHY AND ABLE TO LEARN, THE MHU VISITED 38 DIFFERENT SCHOOLS IN 2022 INCLUDING MANY LOCATED IN RURAL AND LOW-INCOME COMMUNITIES, AND AS PART OF THESE VISITS, 1,001 CHILDHOOD VACCINATIONS WERE ADMINISTERED AND 315 SPORTS PHYSICALS WERE PERFORMED.ADAPTIVE SPORTS PROGRAMVALLEY CHILDREN'S ADAPTIVE SPORTS PROGRAM PROVIDED FREE RECREATIONAL AND ATHLETIC EXPERIENCES FOR CHILDREN, ADOLESCENTS AND YOUNG ADULTS WITH DISABILITIES, REGARDLESS OF WHETHER THEY HAVE BEEN OR ARE CURRENTLY PATIENTS AT VALLEY CHILDREN'S. THE PROGRAM, THE ONLY ONE OF ITS KIND IN CENTRAL CALIFORNIA, IS DESIGNED FOR INDIVIDUALS WITH PHYSICAL IMPAIRMENTS AND CONDITIONS RANGING FROM CEREBRAL PALSY, SPINAL CORD INJURIES AND AMPUTATIONS. DISABLED YOUTH, UP TO AGE 21, WERE ESPECIALLY ENCOURAGED TO ATTEND. IN 2022, APPROXIMATELY 120 CHILDREN PARTICIPATED IN A VARIETY OF ACTIVITIES INCLUDING CANOEING, KAYAKING AND ROCK CLIMBING.FOOD FOR FAMILIES VALLEY CHILDREN'S DIETARY TEAM PROVIDED MEAL COUPONS TO BREASTFEEDING MOMS WHOSE INFANTS WERE AT VALLEY CHILDREN'S. ADDITIONALLY, THROUGH A PROGRAM CALLED MEALS FROM THE HEART, WHICH IS SPONSORED BY RONALD MCDONALD CHARITIES OF CENTRAL CALIFORNIA, VALLEY CHILDREN'S SOCIAL WORK TEAM PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. THE SOCIAL WORK TEAM ALSO WORKED CLOSELY WITH THE CALIFORNIA CHILDREN'S SERVICES PROGRAM TO PROVIDE FOOD FOR ELIGIBLE FAMILIES. FOOD SECURITY - CENTRAL CALIFORNIA FOOD BANK PARTNERSHIPIN MARCH 2022, VALLEY CHILDREN'S ENTERED INTO A THREE-YEAR PARTNERSHIP WITH THE CENTRAL CALIFORNIA FOOD BANK TO SUPPORT ACCESS TO HEALTHY AND NUTRITIOUS FOOD FOR CHILDREN AND FAMILIES ACROSS OUR SERVICE AREA. THROUGH THE PARTNERSHIP, VALLEY CHILDREN'S HAS COMMITTED FUNDING OVER THREE YEARS THAT SUPPORTS THE FOLLOWING INTERVENTIONS: A) FOOD DISTRIBUTIONS TO UP TO 70 FAMILIES WITH CHILDREN BEING SERVED BY VALLEY CHILDREN'S HOME CARE. QUALIFYING FAMILIES RECEIVE ONE FOOD BOX PER MONTH: B) FOOD DISTRIBUTIONS TO UP TO 100 FAMILIES EACH YEAR THROUGH A FOOD PANTRY AT WEST FRESNO ELEMENTARY SCHOOL: AND C) SUPPORT FOR THE FIRST FRUITS MARKET AT CITY CENTER IN FRESNO THAT WILL BE AVAILABLE TO LOW-INCOME FAMILIES WITH CHILDREN TO ACCESS NUTRITIOUS FOOD, FREE OF CHARGE, IN A SETTING MUCH LIKE ANY NEIGHBORHOOD GROCERY STORY.HELP ME GROWHELP ME GROW IS A SYSTEM USED THROUGHOUT THE UNITED STATES TO HELP CHILDREN REACH THEIR OPTIMAL DEVELOPMENT BY KINDERGARTEN. HELP ME GROW PROGRAMS INCLUDE A CENTRALIZED INTAKE AND REFERRAL PROCESS, COMMUNITY OUTREACH TO PROMOTE EARLY INTERVENTION SYSTEMS, TARGETED OUTREACH TO CHILD CARE AND CHILD HEALTH PROVIDERS, AND THE COLLECTION AND ANALYSIS OF DATA TO IMPROVE THE SYSTEM.IN 2022, VALLEY CHILDREN'S AND ITS PRIMARY CARE PRACTICES IN KERN COUNTY AND SEPARATELY IN MERCED COUNTY PARTNERED WITH STAKEHOLDERS IN BOTH COUNTIES TO IMPLEMENT HELP ME GROW PROGRAMS. VALLEY CHILDREN'S HAS BEEN AN ACTIVE PARTICIPANT IN FRESNO COUNTY'S HELP ME GROW PROGRAM FOR A NUMBER OF YEARS. ALSO IN 2022, VALLEY CHILDREN'S CONVENED STAKEHOLDERS FROM ACROSS ITS SERVICE AREA TO EXPLORE OPPORTUNITIES TO COLLABORATE REGIONALLY ON SOME OF THE HELP ME GROW PROCESSES. SCHOOLS FOR HEALTHY THRIVING STUDENTSIN JANUARY 2022, VALLEY CHILDREN'S GUILDS CENTER FOR COMMUNITY HEALTH, IN PARTNERSHIP WITH THE CENTER FOR WELLNESS AND NUTRITION, LAUNCHED SCHOOLS FOR HEALTHY THRIVING STUDENTS PHASE 2. THIS IS A TWO-YEAR INITIATIVE THAT AIMS TO ENGAGE SUPERINTENDENTS, BOARD MEMBERS AND WELLNESS CHAMPIONS FROM SCHOOL DISTRICTS IN FRESNO COUNTY AND MADERA COUNTY TO PROVIDE THEM WITH THE KNOWLEDGE, SKILLS, TECHNICAL ASSISTANCE AND RESOURCES NEEDED TO EFFECTIVELY DEVELOP AND IMPLEMENT LOCAL SCHOOL WELLNESS POLICIES. THE U.S. DEPARTMENT OF AGRICULTURE REQUIRES THAT SCHOOL DISTRICTS PARTICIPATING IN THE NATIONAL SCHOOL LUNCH PROGRAM AND/OR SCHOOL BREAKFAST PROGRAM DEVELOP A WELLNESS POLICY.SCHOOLS FOR HEALTHY THRIVING STUDENTS FOCUSES EFFORTS ON THE CENTERS FOR DISEASE AND CONTROL AND PREVENTION'S WHOLE SCHOOL, WHOLE COMMUNITY, WHOLE CHILD FRAMEWORK (WSCC). THE WSCC MODEL IS STUDENT-CENTERED AND EMPHASIZES THE ROLE OF THE COMMUNITY IN SUPPORTING THE SCHOOL, THE CONNECTIONS BETWEEN HEALTH AND ACADEMIC ACHIEVEMENT AND THE IMPORTANCE OF EVIDENCE-BASED SCHOOL POLICIES AND PRACTICES.A TOTAL OF 17 SCHOOL DISTRICTS FROM FRESNO COUNTY AND MADERA COUNTY ARE PARTICIPATING IN THIS INITIATIVE, WHICH IS JOINTLY FUNDED BY VALLEY CHILDREN'S AND NO KID HUNGRY. SPECIFIC GOALS OF THE INITIATIVE ARE TO: A) INCREASE KNOWLEDGE OF THE WHOLE SCHOOL, WHOLE COMMUNITY, WHOLE CHILD FRAMEWORK; B) INCREASE THE NUMBER OF SCHOOL DISTRICTS ADOPTING LOCAL SCHOOL WELLNESS POLICIES THAT INCORPORATE EVIDENCE-BASED PRACTICES; AND C) INSTITUTE A REGULAR, ONGOING PROCESS BY WHICH THE PARTICIPATING DISTRICTS MONITOR THEIR PERFORMANCE, SHARE PRACTICES AND DEVELOP ACCOUNTABILITY FOR COMPREHENSIVE AND ONGOING IMPLEMENTATION OF THEIR WELLNESS POLICIES.VALLEY CHILDREN'S, ALONG WITH MADERA UNIFIED SCHOOL DISTRICT (ONE OF THE DISTRICTS PARTICIPATING IN THIS INITIATIVE), AND THE CENTER FOR WELLNESS AND NUTRITION, WERE INVITED TO PRESENT THEIR FINDINGS AT THE ACTION FOR HEALTHY KIDS NATIONAL CONFERENCE IN CHICAGO. THE INVITATION TO PRESENT AT THE CONFERENCE SPEAKS TO THE IMPORTANCE OF THIS WORK AND THE POSITIVE CONTRIBUTIONS WE ARE HAVING ON CHILD HEALTH AND WELLNESS.MENTAL HEALTHMENTAL HEALTH IS ONE OF THE MOST PRESSING NEEDS FACING CHILDREN IN CALIFORNIA. CHILDREN LIVING IN VALLEY CHILDREN'S SERVICE AREA ARE PARTICULARLY UNDERSERVED DUE TO THE GEOGRAPHY, PROVIDER SHORTAGES AND LIMITED COMMUNITY-BASED SERVICES. IN 2022 VALLEY CHILDREN'S DEMONSTRATED ITS COMMITMENT TO MEETING THE MENTAL HEALTH NEEDS OF CHILDREN IN A NUMBER OF WAYS, INCLUDING THOSE LISTED BELOW AND IN PART V, SECTION B, LINE 11.ADVERSE CHILDHOOD EXPERIENCES (ACES) PROJECTIN SEPTEMBER 2022, VALLEY CHILDREN'S OLIVEWOOD PEDIATRICS IN MERCED WAS THE RECIPIENT OF AN ACES AWARE PRACTICE PATHFINDER GRANT, WHICH WILL CONTINUE THROUGH NOVEMBER 2023. THE GOALS OF THE GRANT ARE THREEFOLD: 1) STRENGTHEN PARTNERSHIPS AMONG HEALTHCARE PROVIDERS, COMMUNITY-BASED ORGANIZATIONS, AND MEDI-CAL MANAGED CARE PLANS TO SCREEN AND RESPOND TO ACES; 2) DEVELOP NEW, EVIDENCE-BASED SERVICES TO PREVENT AND TREAT TOXIC STRESS PHYSIOLOGY AND ACE-ASSOCIATED HEALTH CONDITIONS; AND 3) BUILD A SUSTAINABLE WORKFORCE THAT SUPPORTS SCREENING AND PREVENTION OF ACES.ADDITIONALLY, VALLEY CHILDREN'S IMPLEMENTED UNIVERSAL ACES SCREENINGS IN ALL OF ITS PRIMARY CARE PRACTICES IN SUMMER 2022.BEHAVIORAL HEALTH SCHOOL LIAISONTHROUGH FUNDING FROM THE FRESNO COUNTY SUPERINTENDENT OF SCHOOLS, VALLEY CHILDREN'S HIRED AN ON-SITE BEHAVIORAL HEALTH SCHOOL LIAISON. THE LIAISON COLLABORATED WITH AREA SCHOOL DISTRICTS TO ENSURE THAT CHILDREN PRESENTING TO OUR EMERGENCY DEPARTMENT AND INPATIENT UNITS WITH MENTAL HEALTH NEEDS RECEIVE APPROPRIATE RESOURCES AND SUPPORT WHEN THEY RETURN TO SCHOOL. THIS IS A VOLUNTARY PROGRAM AND VALLEY CHILDREN'S IS WORKING TO ENHANCE COMMUNICATION AND USE OF RESOURCES FOR CHILDREN SEEN AT VALLEY CHILDREN'S AND THEIR RE-ENTRY TO SCHOOL.ADDITIONALLY, VALLEY CHILDREN'S CONTINUED TO SUPPORT 360ME, AN INITIATIVE THAT IS DESIGNED TO PROVIDE FAMILIES, SCHOOLS, AND COMMUNITIES WITH TOOLS AND RESOURCES TO MAKE SURE WE ARE DOING ALL THAT WE CAN TO SAFEGUARD BOTH OUR CHILDREN'S PHYSICAL HEALTH AND THEIR MENTAL HEALTH. 360ME INTENTIONALLY HELPS STAKEHOLDERS RECOGNIZE AND UNDERSTAND THE MANY CONNECTIONS BETWEEN MENTAL AND PHYSICAL WELLNESS AND TO REDUCE THE STIGMA SOCIETY INCORRECTLY ASSOCIATES WITH MENTAL HEALTH. UNIVERSAL SCREENINGIN JANUARY 2022, VALLEY CHILDREN'S INITIATED UNIVERSAL SCREENING FOR SUICIDE RISK FOR EVERY CHILD, AGES 12 AND OLDER, WHO WAS SEEN IN OUR EMERGENCY DEPARTMENT, DAY SURGERY OR ADMITTED TO AN INPATIENT UNIT. ANY CHILD WHO WAS DETERMINED TO BE AT MODERATE OR HIGH FOR RISK FOR SUICIDE RECEIVED AN IN-DEPTH ASSESSMENT BY A VALLEY CHILDREN'S SOCIAL WORKER THAT INCLUDED EITHER THE CREATION OF A SAFETY PLAN FOR HOME OR TRANSFER TO AN ACUTE PSYCHIATRIC FACILITY FOR HIGHER LEVEL OF CARE.(PART VI, LINE 5 CONTINUED BELOW)
PART VI, LINE 6:	N/A
PART VI, LINE 7, REPORTS FILED WITH STATES	CA
PART VI, LINE 5 (CONTINUED):	REGIONAL CAPACITYIN SEPTEMBER 2019, VALLEY CHILDREN'S ANNOUNCED A PARTNERSHIP WITH UNIVERSAL HEALTH SERVICES (UHS), ONE OF THE NATION'S LARGEST AND MOST RESPECTED PROVIDERS OF BEHAVIORAL HEALTH SERVICES. UNDER THE PARTNERSHIP, UHS WILL CONSTRUCT, OWN AND OPERATE AN 81,600-SQUARE-FOOT, 128-BED BEHAVIORAL HEALTH HOSPITAL FOR CHILDREN AND ADULTS IMMEDIATELY ADJACENT TO THE VALLEY CHILDREN'S HOSPITAL CAMPUS IN MADERA. THE FACILITY WILL INCLUDE A 24-BED INPATIENT UNIT FOR CHILDREN AND ADOLESCENTS, AGES 5-17, REPRESENTING A 49% INCREASE IN AVAILABLE BEDS FOR KIDS FROM KERN TO SAN JOAQUIN COUNTIES. THE HOSPITAL IS EXPECTED TO OPEN BY FALL 2023.VALLEY CHILDREN'S RESPONSE TO COVID-19SINCE THE START OF COVID-19, VALLEY CHILDREN'S HAS RECOGNIZED THAT IT HAS A CRITICAL ROLE TO PLAY NOT ONLY IN MEETING THE HEALTH NEEDS OF ITS PATIENTS AND ITS WORKFORCE, BUT ALSO IN HELPING THE BROADER COMMUNITY MEET THE CHALLENGES CREATED BY THE PANDEMIC. WHILE THE NEED WAS NOT AS GREAT IN 2022 DUE TO THE DECLINE IN THE NUMBER OF COVID-19 CASES, VALLEY CHILDREN'S PROVIDED THE FOLLOWING SUPPORT IN 2022:- COVID-19 TEST SAMPLE PROCESSING: VALLEY CHILDREN'S PROCESSED MORE THAN 5,000 COVID-19 TESTING SAMPLES FOR FIVE DIFFERENT COMMUNITY-BASED PROVIDERS AND ORGANIZATIONS THAT LACKED ADEQUATE LABORATORY CAPACITY OF THEIR OWN.- VALLEY CHILDREN'S PROVIDED CRITICAL FINANCIAL SUPPORT FOR THOSE ORGANIZATIONS WORKING HARD TO ADDRESS A VARIETY OF NEEDS AND CHALLENGES THAT CHILDREN AND FAMILIES WERE FACING DUE TO THE PANDEMIC, INCLUDING INADEQUATE ACCESS TO HEALTHY FOODS AND AN INCREASE IN CHILD TRAUMA.THE MISSION OF VALLEY CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND IS AN INDEPENDENT NON PROFIT ORGANIZATION GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES WHICH IS THEREFORE ACCOUNTABLE TO OUR COMMUNITY AND ONLY OUR COMMUNITY.

Schedule H (Form 990) 2021

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
VALLEY CHILDREN'S HOSPITAL

Employer identification number
94-1294954

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) CHILDREN'S MOVEMENT OF FRESNO 4949 E KINGS CANYON RD STE 202 FRESNO,CA93727	87-2074641	501(C)(3)	7,500	SPONSORSHIP
(2) MAKE A WISH 2800 CLUB CENTER DRIVE SACRAMENTO,CA95835	68-0027351	501(C)(3)	7,500	SPONSORSHIP
(3) BUDDHIST TZU CHI 3998 N ANN AVE FRESNO,CA93727	94-2952782	501(C)(3)	10,000	SPONSORSHIP
(4) COURT APPOINTED SPECIAL ADVOCATES 2300 TULARE ST SUITE 210 FRESNO,CA93721	77-0401361	501(C)(3)	10,000	SPONSORSHIP
(5) WEST FRESNO FAMILIY 1802 E CALIFORNIA AVE FRESNO,CA93706	77-0577093	501(C)(3)	10,000	DONATION
(6) FOUNDATION FCOE 1111 VAN NESS AVENUE 3RD FLR FRESNO,CA93721	80-0381096	501(C)(3)	12,500	SPONSORSHIP
(7) STANISLAUS CTY CRADLE TO CAREER PARTNERSHIP 1100 H STREET MODESTO,CA95354	68-0483054	501(C)(3)	12,500	DONATION
(8) CATHOLIC CHARITIES 149 N FULTON ST FRESNO,CA93701	94-1678938	501(C)(3)	15,000	DONATION
(9) MARTIN PARK INC 700 VAN NESS BOX 120 FRESNO,CA93721	81-5002925	501(C)(3)	30,000	DONATION
(10) FRESNO METRO MINISTRY 4270 N BLACKSTONE AVE STE 212 FRESNO,CA93726	94-2181848	501(C)(3)	50,000	DONATION
(11) MARJAREE MASON CENTER 1600 M STREET FRESNO,CA93721	94-1156639	501(C)(3)	65,000	DONATION
(12) PUBLIC HEALTH INSTITUTION 555 12TH STREET 2ND FLOOR STE 290 OAKLAND,CA94607	94-1646278	501(C)(3)	75,000	SCHOOL HEALTH & WELLNESS CONSORTIUM
(13) VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA,CA93636	46-4150987	501(C)(3)	2,822,839	DONATION
(14) VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA,CA93636	46-4158433	501(C)(3)	1,045,000	DONATION

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2021

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

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

(1) NURSING SCHOLARSHIP	11	22,000
(2) EDUCATION SCHOLARSHIP - RESPIRATORY FOCUS	2	2,000
(3) CAFETERIA MEALS	12085		74,323	FMV	MEAL COUPONS FOR PATIENT FAMILIES
(4) TAXI, BUS AND TRANSIT SERVICES	8733		166,145	BOOK	SUBSIDIZATION OF BUS AND TRANSIT SERVICES
(4)
(5)
(6)
(7)

Part IV

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

Return Reference

Explanation

PART I, LINE 2:

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

Schedule I (Form 990) 2021

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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

2021

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

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

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2021

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, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1TODD SUNTRAPAK CEO	(i) (ii)	1,678,574 ------------- 0	1,599,443 ------------- 0	1,829,751 ------------- 0	27,540 ------------- 0	38,122 ------------- 0	5,173,430 ------------- 0	1,500,000 ------------- 0
2MICHELE R WALDRON SVP, CFO	(i) (ii)	537,549 ------------- 0	582,657 ------------- 0	1,720,800 ------------- 0	26,517 ------------- 0	23,390 ------------- 0	2,890,913 ------------- 0	1,500,000 ------------- 0
3BEVERLY HAYDEN-PUGH SVP, CLINICAL INT, PATIENT	(i) (ii)	520,722 ------------- 0	507,690 ------------- 0	647,896 ------------- 0	113,739 ------------- 0	18,886 ------------- 0	1,808,933 ------------- 0	616,663 ------------- 0
4NATALE PONTICELLO JR SVP, CHIEF PEOPLE OFFICER	(i) (ii)	403,980 ------------- 0	272,741 ------------- 0	668,889 ------------- 0	92,996 ------------- 0	2,646 ------------- 0	1,441,252 ------------- 0	644,745 ------------- 0
5DAVID CHRISTENSEN SVP, CPE & PRES VCMG	(i) (ii)	758,833 ------------- 0	496,230 ------------- 0	34,402 ------------- 0	27,540 ------------- 0	29,354 ------------- 0	1,346,359 ------------- 0	0 ------------- 0
6JANE WILLSON SVP, CHIEF STRATEGY OFFICER	(i) (ii)	433,098 ------------- 0	293,703 ------------- 0	258,757 ------------- 0	97,867 ------------- 0	8,004 ------------- 0	1,091,429 ------------- 0	208,283 ------------- 0
7MICHAEL GOLDRING SVP STRATEGIC PARTNERSHIPS	(i) (ii)	486,458 ------------- 0	339,192 ------------- 0	74,516 ------------- 0	27,540 ------------- 0	10,429 ------------- 0	938,135 ------------- 0	0 ------------- 0
8DAVID HODGE JR VP HOSPITAL OPERATIONS	(i) (ii)	444,619 ------------- 0	258,652 ------------- 0	45,134 ------------- 0	94,214 ------------- 0	29,354 ------------- 0	871,973 ------------- 0	43,410 ------------- 0
9KEVIN SHIMAMOTO VP AND ADVISOR TO CIO	(i) (ii)	421,652 ------------- 0	251,915 ------------- 0	91,316 ------------- 0	93,072 ------------- 0	7,679 ------------- 0	865,634 ------------- 0	66,954 ------------- 0
10KAREN DAHL VP, MED AFFAIRS & PHYS DEV	(i) (ii)	424,673 ------------- 0	255,996 ------------- 0	84,101 ------------- 0	89,005 ------------- 0	8,974 ------------- 0	862,749 ------------- 0	62,893 ------------- 0
11WILLIAM CHALTRAW SVP AND CHIEF LEGAL OFFICER	(i) (ii)	442,749 ------------- 0	305,700 ------------- 0	43,734 ------------- 0	22,517 ------------- 0	29,754 ------------- 0	844,454 ------------- 0	0 ------------- 0
12LYNN ASHBECK SVP, CHIEF COMMUNITY IMPACT	(i) (ii)	410,825 ------------- 0	262,724 ------------- 0	79,001 ------------- 0	89,897 ------------- 0	0 ------------- 0	842,447 ------------- 0	62,372 ------------- 0
13JOEL BROWNELL MD VP, CHIEF MEDICAL INFO OFF	(i) (ii)	339,324 ------------- 0	213,845 ------------- 0	87,875 ------------- 0	78,565 ------------- 0	24,136 ------------- 0	743,745 ------------- 0	67,006 ------------- 0
14STEPHANIE VANCE VP, FINANCE	(i) (ii)	354,465 ------------- 0	184,841 ------------- 0	51,593 ------------- 0	77,723 ------------- 0	29,354 ------------- 0	697,976 ------------- 0	44,296 ------------- 0
15JOLIE LIMON VP ACAD AFFAIRS, DIO & CHI	(i) (ii)	357,673 ------------- 0	220,328 ------------- 0	20,934 ------------- 0	85,828 ------------- 0	9,409 ------------- 0	694,172 ------------- 0	0 ------------- 0
16DANIELLE BARRY SVP, CHIEF OP INTEG	(i) (ii)	330,519 ------------- 0	175,668 ------------- 0	83,943 ------------- 0	57,722 ------------- 0	32,104 ------------- 0	679,956 ------------- 0	57,763 ------------- 0
17DAVID SINGH VP, COO OF VCMG	(i) (ii)	286,636 ------------- 0	203,037 ------------- 0	91,742 ------------- 0	81,841 ------------- 0	15,939 ------------- 0	679,195 ------------- 0	54,437 ------------- 0
18JESSIE HUDGINS VP, FACILITIES & SUPPORT SERVICES	(i) (ii)	293,795 ------------- 0	182,907 ------------- 0	96,125 ------------- 0	75,930 ------------- 0	10,812 ------------- 0	659,569 ------------- 0	48,837 ------------- 0
19BRIAN SMULLIN VP, MANAGED CARE (THRU 09/22)	(i) (ii)	298,521 ------------- 0	178,177 ------------- 0	61,945 ------------- 0	69,193 ------------- 0	23,140 ------------- 0	630,976 ------------- 0	60,830 ------------- 0
20VICKY TILTON VP PATIENT CARE SERVICES & ASST CNO	(i) (ii)	299,191 ------------- 0	136,038 ------------- 0	9,920 ------------- 0	11,471 ------------- 0	29,158 ------------- 0	485,778 ------------- 0	0 ------------- 0
21AMANDA PATTERSON EXEC DIREC & DEPUTY GEN CO	(i) (ii)	232,276 ------------- 0	101,252 ------------- 0	328 ------------- 0	12,175 ------------- 0	28,561 ------------- 0	374,592 ------------- 0	0 ------------- 0
22YVONNE WOOD MANAGER PATIENT THROUGHPUT	(i) (ii)	314,659 ------------- 0	0 ------------- 0	274 ------------- 0	27,093 ------------- 0	31,854 ------------- 0	373,880 ------------- 0	0 ------------- 0
23RAED KHOURY VP, QUAL, PATIENT SAFETY	(i) (ii)	216,456 ------------- 0	92,683 ------------- 0	17,918 ------------- 0	15,963 ------------- 0	29,354 ------------- 0	372,374 ------------- 0	0 ------------- 0
24RATAN MILEVOJ VP MKTG, COMM, INNOVATION	(i) (ii)	227,238 ------------- 0	44,426 ------------- 0	20,079 ------------- 0	15,472 ------------- 0	28,983 ------------- 0	336,198 ------------- 0	0 ------------- 0
25JOSEPH EGAN VP & CIO	(i) (ii)	213,602 ------------- 0	32,523 ------------- 0	21,447 ------------- 0	21,023 ------------- 0	37,568 ------------- 0	326,163 ------------- 0	0 ------------- 0
26JULIE MACIAS DIRECTOR, ACCOUNTING & REPORTING	(i) (ii)	214,442 ------------- 0	47,501 ------------- 0	468 ------------- 0	20,899 ------------- 0	30,004 ------------- 0	313,314 ------------- 0	0 ------------- 0
27ADAM VAN DUSON EXEC DIR, FOUNDATION	(i) (ii)	197,308 ------------- 0	82,897 ------------- 0	18,260 ------------- 0	10,759 ------------- 0	793 ------------- 0	310,017 ------------- 0	0 ------------- 0
28DAVID NALCHAJIAN FORMER BOARD MEMBER	(i) (ii)	300,000 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	300,000 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

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 4B	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE 1) A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP), 2) A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES AND 3) A NONCONTRIBUTORY, NONQUALIFIED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT CALLED THE DEFINED CONTRIBUTION SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN (DCSERP), 4) A SPLIT DOLLAR LIFE INSURANCE PROGRAM AVAILABLE TO CERTAIN KEY EXECUTIVES (SEE SCHEDULE L PART V FOR A BROADER DESCRIPTION) AND 5) AN ADDITIONAL DEFERRED COMPENSATION PLAN BENEFITTING CERTAIN KEY EXECUTIVES. DAVID HODGE JR, DANIELLE BARRY, LYNNE ASHBECK, BRIAN SMULLIN, STEPHANIE VANCE AND RAED KHOURY WERE ELIGIBLE TO CONTRIBUTE TO THE DEFERRED COMPENSATION PLAN, BUT NO CONTRIBUTIONS WERE MADE. $1,009,840 WAS PAID OUT OF THE DCSERP PLAN DURING THE YEAR. EMPLOYER CONTRIBUTIONS TO THE DCSERP AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR CALENDAR YEAR 2021 ARE AS FOLLOWS: BEVERLY HAYDEN-PUGH - DCSERP $86,199; CHANGE IN SERP ACTUARIAL VALUE $0. JESSIE HUDGINS - DCSERP $48,390; CHANGE IN SERP ACTUARIAL VALUE $0. JANE WILLSON - DCSERP $70,327; CHANGE IN SERP ACTUARIAL VALUE $0. DAVID SINGH - DCSERP $54,301; CHANGE IN SERP ACTUARIAL VALUE $0. STEPHANIE VANCE - DCSERP $48,708; NOT ELIGIBLE FOR SERP. NATALIE PONTICELLO - DCSERP $65,456; NOT ELIGIBLE FOR SERP. JOEL BROWNELL - DCSERP $56,725; NOT ELIGIBLE FOR SERP. KAREN DAHL - DCSERP $67,313; NOT ELIGIBLE FOR SERP. KEVIN SHIMAMOTO - DCSERP $65,626; NOT ELIGIBLE FOR SERP. DANIELLE BARRY - DCSERP $46,322; NOT ELIGIBLE FOR SERP. BRIAN SMULLIN - DCSERP $47,353; NOT ELIGIBLE FOR SERP. DAVID HODGE - DCSERP $67,570; NOT ELIGIBLE FOR SERP. LYNNE ASHBECK - DCSERP $62,357; NOT ELIGIBLE FOR SERP. JOLIE LIMON - DCSERP $58,288; NOT ELIGIBLE FOR SERP. MICHAEL GOLDRING, WILLIAM CHALTRAW, JR, DAVID CHRISTENSEN, TODD SUNTRAPAK, AND MICHELE WALDRON PARTICIPATE IN THE SPLIT-DOLLAR LIFE INSURANCE PROGRAM. TODD SUNTRAPAK, MICHELE WALDRON, BEVERLY HAYDEN-PUGH AND NATALIE PONTICELLO PARTICIPATE IN A 457F RABBI TRUST DEFERRED COMPENSATION PLAN. THE FOLLOWING AMOUNTS PAID DURING THE 2021 CALENDAR YEAR: TODD SUNTRAPAK - $1,600,081 MICHELE WALDRON - $1,500,093 BEVERLY HAYDEN-PUGH - $530,443 NATALIE PONTICELLO - $577,688
PART I, LINE 5	AN EXECUTIVE INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON BOTH NETWORK WIDE AND INDIVIDUAL GOALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING REVENUE, OPERATIONAL AND QUALITY RESULTS OF THE HOSPITAL AND ITS RELATED ENTITIES. THE INCENTIVE PLAN HAS BEEN APPROVED BY THE COMPENSATION COMMITTEE OF THE VALLEY CHILDREN'S HEALTHCARE BOARD OF TRUSTEES. THE COMMITTEE REVIEWS THE FORECASTED PAYOUTS AT THE END OF EACH YEAR BASED ON THE FINANCIAL AND OPERATING RESULTS.
PART I, LINE 6	SEE EXPLANATION FOR LINE 5, ABOVE

Schedule J (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No
(1) TODD SUNTRAPAK	CURRENT OFFICER	SEE BELOW		X	11,109,107	11,363,215		No	Yes		Yes
(2) MICHELE WALDRON	CURRENT OFFICER	SEE BELOW		X	8,771,634	8,972,275		No	Yes		Yes
(3) DAVID CHRISTENSEN	CURRENT KEY EMPLOYEE	SEE BELOW		X	5,282,545	5,403,377		No	Yes		Yes
(4) WILLIAM CHALTRAW	CURRENT KEY EMPLOYEE	SEE BELOW		X	2,122,641	2,171,194		No	Yes		Yes
(5) MICHAEL GOLDRING	CURRENT KEY EMPLOYEE	SEE BELOW		X	5,498,581	5,624,355		No	Yes		Yes
(6) TODD SUNTRAPAK	CURRENT OFFICER	LOAN FOR RESIDENCE AS A RETENTION INCENTIVE IN LIEU OF OTHER COMPENSATION		X	5,000,000	5,000,000		No	Yes		Yes
Total ............... $						38,534,416

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

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

Part V

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

Return Reference

Explanation

PART II, COLUMN C:

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

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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

2021

Open to Public
Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Return Reference	Explanation
FORM 990, PART III, LINE 4A:	STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE I. DESCRIPTION OF PROGRAM SERVICE ONE MORE THAN 70 YEARS AGO, OUR FIVE FOUNDING MOTHERS HAD A DREAM TO BUILD A HOSPITAL IN THE CENTRAL VALLEY JUST FOR CHILDREN. VALLEY CHILDREN'S HEALTHCARE HAS GROWN AND FLOURISHED EVER SINCE, CARING FOR GENERATIONS OF CHILDREN SINCE 1952. MISSION THE MISSION OF VALLEY CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. VISION OUR VISION CAPTURES THE PATH WE'VE TRAVELED AND SHOWCASES OUR COMMITMENT AND PASSION TO BE THE BEST. OUR VISION IS TO CONTINUE TO PROVIDE THE NATION'S BEST HEALTHCARE FOR KIDS AND TO BECOME THE NATION'S BEST CHILDREN'S HOSPITAL. CORE VALUES THE FOLLOWING CORE ORGANIZATIONAL VALUES GUIDE THE INVESTMENTS AND SUPPORT PROVIDED BY VALLEY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM. EXCELLENCE: WE ARE DEDICATED, DISCIPLINED AND DEMONSTRATE HIGH STANDARDS AS WE STRIVE TO BE THE BEST. WE TAKE OWNERSHIP AND EMPOWER OURSELVES TO DELIVER AN EXCEPTIONAL EXPERIENCE, EVERY INTERACTION, EVERY TIME. COMPASSIONATE CARE: WE ARE PRESENT IN EVERY INTERACTION AND RESPOND TO OTHERS WITH WARMTH AND KINDNESS. INTEGRITY: WE ARE HONEST AND ETHICAL, DEMONSTRATE HIGH STANDARDS OF PERSONAL CONDUCT, KEEP OUR WORD AND TAKE RESPONSIBILITY FOR OUR ACTIONS. INNOVATION: WE LOOK FOR WAYS TO LEARN AND MAKE THINGS BETTER AND ARE PROBLEM SOLVERS. COLLABORATION: WE CONTRIBUTE TO, SUPPORT AND RESPECT DECISIONS THAT ARE MADE BY OUR TEAMS AND THE ORGANIZATION. WE BUILD AND PROMOTE POSITIVE WORKING RELATIONSHIPS AND TEAMWORK. STEWARDSHIP: WE ARE ACCOUNTABLE FOR EFFECTIVELY MANAGING OUR TIME AND THE ORGANIZATION'S RESOURCES. WE SHARE RESOURCES TO ACHIEVE THE BEST OUTCOME. COMMITMENT TO THE COMMUNITY VALLEY CHILDREN'S IS CENTRAL CALIFORNIA'S ONLY HIGH-QUALITY, COMPREHENSIVE HEALTH CARE NETWORK DEDICATED TO CHILDREN, FROM BEFORE BIRTH TO YOUNG ADULTHOOD, AS WELL AS TO HIGH RISK PREGNANT WOMEN, AND AS SUCH PLAYS A VITAL ROLE IN MEETING THE HEALTH CARE NEEDS OF SOME OF OUR REGION'S SICKEST AND MOST MEDICALLY VULNERABLE RESIDENTS. VALLEY CHILDREN'S NETWORK IS ANCHORED BY A 330-BED STAND-ALONE CHILDREN'S HOSPITAL IN MADERA PLUS THREE NEONATAL UNITS (28 BEDS IN TOTAL) LOCATED ACROSS THE CENTRAL VALLEY. IN ADDITION, VALLEY CHILDREN'S HEALTHCARE NETWORK INCLUDES SPECIALTY CARE CENTERS, PEDIATRIC PRIMARY CARE PRACTICES, AND WOMEN'S HEALTH SERVICES. VALLEY CHILDREN'S CONSISTENTLY RANKS AT THE TOP OF ITS PEER GROUP FOR QUALITY PATIENT OUTCOMES AS EVIDENCED BY THE FOLLOWING; A) RECOGNITION BY THE LEAP FROG GROUP AS ONE OF THE NATION'S TOP CHILDREN'S HOSPITALS FOR EXCELLENCE IN PATIENT SAFETY AND QUALITY; B) BEACON AWARD FOR EXCELLENCE IN CRITICAL CARE, AND: C) U.S. NEWS AND WORLD REPORT RECOGNITION IN 2022-2023 AS ONE OF THE NATION'S BEST CHILDREN'S HOSPITALS INCLUDING NEONATOLOGY, PEDIATRIC GASTROENTEROLOGY & GASTROINTESTINAL SURGERY, PEDIATRIC NEUROLOGY & NEUROSURGERY, PEDIATRIC ORTHOPEDICS, PEDIATRIC PULMONOLOGY & LUNG SURGERY AND PEDIATRIC UROLOGY. WHILE PROVIDING EXCEPTIONAL HEALTHCARE IS THE SINGLE GREATEST CONTRIBUTION VALLEY CHILDREN'S MAKES FOR CHILDREN AND THEIR FAMILIES, VALLEY CHILDREN'S ALSO RECOGNIZES THAT IT IS UNIQUELY POSITIONED TO SUPPORT THE NEEDS OF CHILDREN IN OTHER WAYS AS WELL. TO HELP ADVANCE ITS COMMUNITY-BASED WORK, VALLEY CHILDREN'S LAUNCHED THE GUILDS CENTER FOR COMMUNITY HEALTH IN NOVEMBER 2019. THE CENTER IS THE FIRST OF ITS KIND IN THE CENTRAL VALLEY TO BRIDGE THE EXCEPTIONAL CARE KIDS RECEIVE WITHIN OUR NETWORK AND THE HEALTH IMPACTS OUR CHILDREN EXPERIENCE WHERE THEY LIVE, LEARN AND PLAY. VALLEY CHILDREN'S RECOGNIZES THAT THE HEALTH OF OUR CHILDREN IS IMPACTED BY SOCIAL DETERMINANTS SUCH AS PHYSICAL ENVIRONMENT, HEALTH BEHAVIORS AND ECONOMIC STATUS. ACCORDING TO RESEARCH, OF ALL THE FACTORS THAT INFLUENCE OUR HEALTH, ONLY 20% ARE LINKED TO THE CLINICAL CARE WE RECEIVE AND 80% ARE RELATED TO THESE SOCIAL DETERMINANTS. THE GUILDS CENTER FOR COMMUNITY HEALTH IS AN INVESTMENT IN THAT 80%. II. SERVICE AREA DEMOGRAPHICS AND PATIENT VOLUME SERVICE AREA DEMOGRAPHICS AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, VALLEY CHILDREN'S HOSPITAL'S SERVICE AREA EXTENDS FROM SACRAMENTO COUNTY IN THE NORTH TO KERN COUNTY IN THE SOUTH, AND SERVES MUCH OF THE CENTRAL COAST AND EASTERN SIERRA AS WELL. VALLEY CHILDREN'S HOSPITAL'S PATIENT VOLUME IN 2022, VALLEY CHILDREN'S HOSPITAL HAD 10,496 INPATIENT ADMISSIONS, 86,895 EMERGENCY DEPARTMENT VISITS AND 279,027 HOSPITAL BASED OUTPATIENT SPECIALTY CARE CENTER, REGIONAL SPECIALTY CARE CENTER, PRIMARY CARE CENTER, AND URGENT CARE VISITS. MEDI-CAL COVERED 73.8% OF VALLEY CHILDREN'S TOTAL INPATIENT VISITS.
FORM 990, PART III, LINE 4A	III. COMMUNITY BENEFITS PROGRAM IN FY 2021, VALLEY CHILDREN'S HOSPITAL PROVIDED COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS WITHIN ITS SERVICE AREA. INJURY PREVENTION PROGRAM IN 2022, VALLEY CHILDREN'S INJURY PREVENTION PROGRAM RECORDED 1,250 CONTACTS WITH COMMUNITY MEMBERS DURING 14 COMMUNITY-BASED TEACHING EVENTS COVERING THE FOLLOWING TOPICS: ATV SAFETY, CAR SAFETY, CAR SEAT AND CHILD PASSENGER SAFETY, CARBON MONOXIDE POISON PREVENTION, CONCUSSIONS, FIRE PREVENTION, GUN STORAGE SAFETY, HALLOWEEN SAFETY, HOME SAFETY, LEAD POISON PREVENTION, OVERUSE INJURIES, POISON PREVENTION, RAILROAD SAFETY, SAFE SLEEP, SNAKE BITES, TEEN DRIVING, TOY SAFETY, VAPING, VEHICULAR HEAT STROKE PREVENTION AND WATER SAFETY. COMMUNITY-BASED EDUCATION AND OUTREACH VALLEY CHILDREN'S PEDIATRIC RESIDENTS PROVIDED EDUCATION ON ASTHMA AND OTHER RESPIRATORY ISSUES IMPACTING SCHOOL-AGED CHILDREN AND CARDIAC ISSUES EXPERIENCED IN THE SCHOOL SETTING. CHILD ABUSE PREVENTION THE GUILDS OF VALLEY CHILDREN'S CHILD ABUSE PREVENTION AND TREATMENT CENTER'S MISSION IS TO PROVIDE COMPREHENSIVE SERVICES TO CHILDREN, DEPENDENT ADULTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY, CHILD-FRIENDLY PROGRAM, AND TO MEET THE PHYSICAL AND EMOTIONAL NEEDS OF VICTIMS WITH ABUSE CONSIDERATIONS. THE GUILDS CHILD ABUSE PREVENTION AND TREATMENT CENTER INCLUDES THE CHILD ADVOCACY CLINIC, WHICH OPERATES FIVE DAYS A WEEK AND SEES APPROXIMATELY 900 CHILDREN EACH YEAR. THE CENTER'S PROVIDERS ARE AVAILABLE SEVEN DAYS A WEEK, 24 HOURS A DAY FOR EMERGENCY COVERAGE. THE CENTER INCLUDES AN INPATIENT COMPONENT THAT EVALUATES APPROXIMATELY 100 CHILDREN ANNUALLY IN THE PEDIATRIC EMERGENCY DEPARTMENT, ACUTE-CARE FLOORS AND PEDIATRIC INTENSIVE CARE UNIT. IN ADDITION TO THE MEDICAL SERVICES OFFERED, THE CENTER HAS A TEAM OF SOCIAL WORKERS AND A LICENSED MENTAL HEALTH CLINICIAN THAT PROVIDE PSYCHO-SOCIAL ASSESSMENT, LINKAGES TO COMMUNITY SERVICES, AND TRAUMA THERAPY. FOR PREVENTION EDUCATION, THE CENTER CONTINUED TO COLLABORATE IN 2022 WITH INTERNAL AND EXTERNAL PARTNERS TO PROVIDE EDUCATION TO PARENTS, CAREGIVERS, HEALTHCARE PERSONNEL, TEACHERS, MANDATED REPORTERS, AND OTHERS. THESE PARTNERS INCLUDED VALLEY CHILDREN'S TRAUMA DEPARTMENT'S INJURY PREVENTION TEAM AND EMERGENCY DEPARTMENT, SAFE KIDS OF CENTRAL CALIFORNIA, CHILD ABUSE PREVENTION COUNCILS OF CALIFORNIA, CPS, DISTRICT ATTORNEY'S OFFICES, LOCAL LAW ENFORCEMENT AGENCIES, SEXUAL ASSAULT RESPONSE TEAMS (SART), VICTIM ADVOCACY GROUPS AND COUNTY PUBLIC HEALTH DEPARTMENTS. HEALTHCARE SUPPORT SERVICES ENROLLMENT IN HEALTH INSURANCE VALLEY CHILDREN'S IDENTIFIED AND PROVIDED ENROLLMENT ASSISTANCE TO UNINSURED AND UNDER-INSURED PATIENTS WHO QUALIFIED FOR MEDI-CAL, CALIFORNIA CHILDREN'S SERVICES PROGRAM OR VALLEY CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY WAS DETERMINED, VALLEY CHILDREN'S STAFF ASSISTED THE FAMILIES WITH COMPLETING NECESSARY APPLICATIONS AND SUBMITTING THEM TO THE APPROPRIATE AGENCIES. FOOD FOR FAMILIES VALLEY CHILDREN'S DIETARY DEPARTMENT PROVIDED MEAL COUPONS TO BREASTFEEDING MOMS WHOSE INFANTS WERE AT VALLEY CHILDREN'S. ADDITIONALLY, THROUGH A PROGRAM CALLED MEALS OF THE HEART, WHICH IS SPONSORED BY RONALD MCDONALD CHARITIES OF CENTRAL CALIFORNIA, VALLEY CHILDREN'S SOCIAL WORK TEAM PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. THE SOCIAL WORK TEAM ALSO WORKED CLOSELY WITH THE CALIFORNIA CHILDREN'S SERVICES PROGRAM TO PROVIDE FOOD FOR ELIGIBLE FAMILIES. TRANSPORTATION GIVEN THE CENTRAL VALLEY'S LARGELY RURAL LANDSCAPE AND HIGH CONCENTRATION OF POVERTY, TRANSPORTATION HAS LONG BEEN A CHALLENGE FOR MANY FAMILIES. VALLEY CHILDREN'S CONTINUED TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND ACCESS TO CARE. VALLEY CHILDREN'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING GAS CARDS, TAXI VOUCHERS, AMTRAK TICKETS AND BUS TOKENS. VALLEY CHILDREN'S ALSO SUBSIDIZED BUS AND OTHER PUBLIC TRANSIT SERVICES FROM THE CITY OF FRESNO AND KINGS COUNTY. SOCIAL AND ENVIRONMENTAL IMPROVEMENT ACTIVITIES FOOD SECURITY - CENTRAL CALIFORNIA FOOD BANK PARTNERSHIP IN MARCH 2022, VALLEY CHILDREN'S ENTERED INTO A THREE-YEAR PARTNERSHIP WITH THE CENTRAL CALIFORNIA FOOD BANK TO SUPPORT ACCESS TO HEALTHY AND NUTRITIOUS FOOD FOR CHILDREN AND FAMILIES ACROSS OUR SERVICE AREA. THROUGH THE PARTNERSHIP, VALLEY CHILDREN'S HAS COMMITTED FUNDING OVER THREE YEARS THAT SUPPORTS THE FOLLOWING INTERVENTIONS: A) FOOD DISTRIBUTIONS TO UP TO 70 FAMILIES WITH CHILDREN BEING SERVED BY VALLEY CHILDREN'S HOME CARE. QUALIFYING FAMILIES RECEIVE ONE FOOD BOX PER MONTH: B) FOOD DISTRIBUTIONS TO UP TO100 FAMILIES EACH YEAR THROUGH A FOOD PANTRY AT WEST FRESNO ELEMENTARY SCHOOL: AND C) SUPPORT FOR THE FIRST FRUITS MARKET AT CITY CENTER IN FRESNO THAT WILL BE AVAILABLE TO LOW-INCOME FAMILIES WITH CHILDREN TO ACCESS NUTRITIOUS FOOD, FREE OF CHARGE, IN A SETTING MUCH LIKE ANY NEIGHBORHOOD GROCERY STORY.
FORM 990, PART III, LINE 4A	HELP ME GROW HELP ME GROW IS A SYSTEM USED THROUGHOUT THE UNITED STATES TO HELP CHILDREN REACH THEIR OPTIMAL DEVELOPMENT BY KINDERGARTEN. HELP ME GROW PROGRAMS INCLUDE A CENTRALIZED INTAKE AND REFERRAL PROCESS, COMMUNITY OUTREACH TO PROMOTE EARLY INTERVENTION SYSTEMS, TARGETED OUTREACH TO CHILD CARE AND CHILD HEALTH PROVIDERS, AND THE COLLECTION AND ANALYSIS OF DATA TO IMPROVE THE SYSTEM. IN 2022, VALLEY CHILDREN'S AND ITS PRIMARY CARE PRACTICES IN KERN COUNTY AND SEPARATELY IN MERCED COUNTY PARTNERED WITH STAKEHOLDERS IN BOTH COUNTIES TO IMPLEMENT HELP ME GROW PROGRAMS. VALLEY CHILDREN'S HAS BEEN AN ACTIVE PARTICIPANT IN FRESNO COUNTY'S HELP ME GROW PROGRAM FOR A NUMBER OF YEARS. ALSO IN 2022, VALLEY CHILDREN'S CONVENED STAKEHOLDERS FROM ACROSS ITS SERVICE AREA TO EXPLORE OPPORTUNITIES TO COLLABORATE REGIONALLY ON SOME OF THE HELP ME GROW PROCESSES. SCHOOLS FOR THRIVING AND HEALTHY STUDENTS IN JANUARY 2022, VALLEY CHILDREN'S GUILDS CENTER FOR COMMUNITY HEALTH, IN PARTNERSHIP WITH THE CENTER FOR WELLNESS AND NUTRITION, LAUNCHED SCHOOLS FOR HEALTHY THRIVING STUDENTS PHASE 2. THIS IS A TWO-YEAR INITIATIVE THAT AIMS TO ENGAGE SUPERINTENDENTS, BOARD MEMBERS AND WELLNESS CHAMPIONS FROM SCHOOL DISTRICTS IN FRESNO COUNTY AND MADERA COUNTY TO PROVIDE THEM WITH THE KNOWLEDGE, SKILLS, TECHNICAL ASSISTANCE AND RESOURCES NEEDED TO EFFECTIVELY DEVELOP AND IMPLEMENT LOCAL SCHOOL WELLNESS POLICIES. THE U.S. DEPARTMENT OF AGRICULTURE REQUIRES THAT SCHOOL DISTRICTS PARTICIPATING IN THE NATIONAL SCHOOL LUNCH PROGRAM AND/OR SCHOOL BREAKFAST PROGRAM DEVELOP A WELLNESS POLICY. SCHOOLS FOR HEALTHY THRIVING STUDENTS FOCUSES EFFORTS ON THE CENTERS FOR DISEASE AND CONTROL AND PREVENTION'S WHOLE SCHOOL, WHOLE COMMUNITY, WHOLE CHILD FRAMEWORK (WSCC). THE WSCC MODEL IS STUDENT-CENTERED AND EMPHASIZES THE ROLE OF THE COMMUNITY IN SUPPORTING THE SCHOOL, THE CONNECTIONS BETWEEN HEALTH AND ACADEMIC ACHIEVEMENT AND THE IMPORTANCE OF EVIDENCE-BASED SCHOOL POLICIES AND PRACTICES. A TOTAL OF 17 SCHOOL DISTRICTS FROM FRESNO COUNTY AND MADERA COUNTY ARE PARTICIPATING IN THIS INITIATIVE, WHICH IS JOINTLY FUNDED BY VALLEY CHILDREN'S AND NO KID HUNGRY. SPECIFIC GOALS OF THE INITIATIVE ARE TO: A) INCREASE KNOWLEDGE OF THE WHOLE SCHOOL, WHOLE COMMUNITY, WHOLE CHILD FRAMEWORK; B) INCREASE THE NUMBER OF SCHOOL DISTRICTS ADOPTING LOCAL SCHOOL WELLNESS POLICIES THAT INCORPORATE EVIDENCE-BASED PRACTICES; AND C) INSTITUTE A REGULAR, ONGOING PROCESS BY WHICH THE PARTICIPATING DISTRICTS MONITOR THEIR PERFORMANCE, SHARE PRACTICES AND DEVELOP CCOUNTABILITY FOR COMPREHENSIVE AND ONGOING IMPLEMENTATION OF THEIR WELLNESS POLICIES. VALLEY CHILDREN'S, ALONG WITH MADERA UNIFIED SCHOOL DISTRICT (ONE OF THE DISTRICTS PARTICIPATING IN THIS INITIATIVE), AND THE CENTER FOR WELLNESS AND NUTRITION, WERE INVITED TO PRESENT THEIR FINDINGS AT THE ACTION FOR HEALTHY KIDS NATIONAL CONFERENCE IN CHICAGO. THE INVITATION TO PRESENT AT THE CONFERENCE SPEAKS TO THE IMPORTANCE OF THIS WORK AND THE POSITIVE CONTRIBUTIONS WE ARE HAVING ON CHILD HEALTH AND WELLNESS. INFANT HEALTH CLINICAL PARTNERSHIP PROGRAM VALLEY CHILDREN'S CLINICAL PARTNERSHIP PROGRAM BRINGS TOGETHER INSTITUTIONS FOCUSED ON ENHANCING NEONATAL AND PEDIATRIC CARE, REGARDLESS OF WHETHER THE ILL OR INJURED CHILD BECOMES A VALLEY CHILDREN'S PATIENT. THIS EFFORT HELPED PREVENT CHILDREN FROM BEING TRANSFERRED OR REFERRED UNNECESSARILY TO VALLEY CHILDREN'S, AND HELPED TO QUICKLY IDENTIFY WHEN A CHILD NEEDS ADVANCED PEDIATRIC CARE. WITH IMPROVED COMMUNICATION AND TOOLS, THE PROGRAM DECREASED STRESS FOR PATIENTS AND FAMILIES AND INCREASED PROVIDER CONFIDENCE IN PROVIDING PEDIATRIC CARE, WHILE ENHANCING PERFORMANCE AT VALLEY CHILDREN'S AND THE PARTNERING PROVIDER. THE GOALS OF OUR CLINICAL PARTNERSHIP INCLUDED: -IMPROVED QUALITY AND CONFIDENCE IN PROVIDING PEDIATRIC CARE -MORE CARE DELIVERED CLOSER TO HOME -ENHANCED, COORDINATED CARE -IMPROVED ACCESS TO VALLEY CHILDREN'S HOSPITALISTS, SPECIALISTS, RESOURCES AND NURSING AND ANCILLARY CLINICAL EXPERTISE IN 2022, VALLEY CHILDREN'S SUPPORTED 17 INPATIENT CLINICAL PARTNERS AND, AS A PART OF THAT SUPPORT, CONVENED 16 TRAINING AND EDUCATION EVENTS THAT DREW MORE THAN 600 ATTENDEES. THE AVERAGE INVESTMENT OF TIME FOR EACH PARTNER FACILITY WAS MORE THAN 300 HOURS ANNUALLY. MENTAL HEALTH MENTAL HEALTH IS ONE OF THE MOST PRESSING NEEDS FACING CHILDREN IN CALIFORNIA. CHILDREN LIVING IN VALLEY CHILDREN'S SERVICE AREA ARE PARTICULARLY UNDERSERVED DUE TO THE GEOGRAPHY, PROVIDER SHORTAGES, AND LIMITED COMMUNITY-BASED SERVICES. IN 2022, VALLEY CHILDREN'S DEMONSTRATED ITS COMMITMENT TO MEETING THE MENTAL HEALTH NEEDS OF CHILDREN IN A NUMBER OF WAYS, INCLUDING THOSE LISTED BELOW. COMMUNITY-BASED EDUCATION AND OUTREACH VALLEY CHILDREN'S STAFF PROVIDED TEEN SUICIDE PREVENTION EDUCATION TO STUDENTS AND STAFF AT AREA HIGH SCHOOLS. IN ADDITION, VALLEY CHILDREN'S STAFF EITHER LED OR PARTICIPATED IN A NUMBER OF COMMUNITY-BASED INITIATIVES, INCLUDING SERVING AS MEMBERS OF THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND THE MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE, AS WELL AS CHAIRING COMMUNITY CONVERSATIONS, A COMMUNITY-WIDE PARTNERSHIP ADDRESSING ISSUES OF MENTAL HEALTH, HOMELESSNESS, AND THEIR IMPACT ON FAMILIES. ADDITIONALLY, VALLEY CHILDREN'S CONTINUED TO SUPPORT 360ME, AN INITIATIVE THAT IS DESIGNED TO PROVIDE FAMILIES, SCHOOLS AND COMMUNITIES WITH TOOLS AND RESOURCES TO MAKE SURE WE ARE DOING ALL THAT WE CAN TO SAFEGUARD OUR CHILDREN'S PHYSICAL AND MENTAL HEALTH. 360ME INTENTIONALLY HELPS STAKEHOLDERS RECOGNIZE AND UNDERSTAND THE MANY CONNECTIONS BETWEEN MENTAL AND PHYSICAL WELLNESS AND TO REDUCE THE STIGMA SOCIETY INCORRECTLY ASSOCIATES WITH MENTAL HEALTH. REGIONAL CAPACITY IN SEPTEMBER 2019, VALLEY CHILDREN'S ANNOUNCED A PARTNERSHIP WITH UNIVERSAL HEALTH SERVICES (UHS), ONE OF THE NATION'S LARGEST AND MOST RESPECTED PROVIDERS OF HOSPITAL AND HEALTHCARE SERVICES. UNDER THE PARTNERSHIP, UHS WILL CONSTRUCT, OWN AND OPERATE AN 81,600-SQUARE-FOOT, 128-BED BEHAVIORAL HEALTH HOSPITAL FOR CHILDREN AND ADULTS IMMEDIATELY ADJACENT TO THE VALLEY CHILDREN'S HOSPITAL CAMPUS IN MADERA. THE FACILITY WILL INCLUDE A 24-BED INPATIENT UNIT FOR CHILDREN AND ADOLESCENTS, AGES 5 -17, REPRESENTING A 49% INCREASE IN AVAILABLE BEDS FOR KIDS FROM KERN TO SAN JOAQUIN COUNTIES. THE HOSPITAL IS EXPECTED TO OPEN IN BY FALL 2023.
FORM 990, PART III, LINE 4B:	STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO COMMITMENT TO MEDI-CAL - VALLEY CHILDREN'S HOSPITAL'S COMMITMENT TO SERVING ITS COMMUNITY IS EVIDENCED BY THE LARGE NUMBER OF PATIENTS SERVES THAT ARE COVERED BY MEDI-CAL. IN 2022, 74% OF HOSPITAL INPATIENT DAYS WERE COVERED BY MEDI-CAL. THE COMBINED NET EFFECT OF TOTAL MEDI-CAL REIMBURSEMENT AND DISPROPORTIONATE SHARE FUNDING IN RELATION TO THE COST OF THESE SERVICES RESULTED IN A NET LOSS TO THE HOSPITAL IN 2022 OF $112,156,093. THIS FIGURE IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS, AND ALSO EXCLUDES THE REVENUE AND EXPENSES ASSOCIATED WITH THE HOSPITAL FEE PROGRAM, WHICH IS DESCRIBED IN MORE DETAIL BELOW. HOSPITAL FEE PROGRAM - IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING VALLEY CHILDREN'S HOSPITAL, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. THE PROGRAM WAS FUNDED BY A QUALITY ASSURANCE FEE PAID BY HOSPITALS THAT THE STATE THEN USES TO COLLECT ADDITIONAL FEDERAL FUNDING. HOSPITAL FEE PROGRAMS LIKE CALIFORNIA'S ARE ALLOWABLE UNDER FEDERAL LAW, AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROVED CALIFORNIA'S PROGRAM. IN 2022, VALLEY CHILDREN'S HOSPITAL RECOGNIZED NET REVENUE FROM THE HOSPITAL'S QUALITY ASSURANCE PROGRAM IN EXCESS OF THE UNPAID COST OF MEDI-CAL IN FISCAL YEAR 2022 AND THEREFORE HAS REPORTED $0 UNPAID COSTS OF MEDI-CAL. CHARITY CARE - IN KEEPING WITH OUR MISSION, VALLEY CHILDREN'S HOSPITAL CONTINUES TO ACCEPT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2022, CHILDREN'S HOSPITAL PROVIDED $181,952 IN CHARITY CARE. THE AMOUNT REPRESENTS COSTS ASSOCIATED WITH PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES IN RELATION TO THE COST OF THESE SERVICES. CHARITY CARE INCLUDES COUNTY INDIGENT AND FREE CARE, WHICH IS BASED ON THE PATIENT'S INABILITY TO PAY FOR SERVICES. IN ORDER TO ASSIST FAMILIES WITH ONGOING CARE NEEDS, VALLEY CHILDREN'S HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES PATIENT FAMILIES TO APPLY FOR APPROPRIATE GOVERNMENT FUNDING IN CONJUNCTION WITH APPLYING FOR FINANCIAL ASSISTANCE (CHARITY CARE). AS A RESULT, MANY FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS AND DO NOT ULTIMATELY REQUIRE CHARITY CARE. THE HOSPITAL'S CHARITY CARE AMOUNT IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS.
FORM 990, PART VI, SECTION A, LINE 2	LISA SMITTCAMP AND BILL SMITTCAMP HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION A, LINE 6	THE AMENDED AND RESTATED BYLAWS OF VALLEY CHILDREN'S HOSPITAL, EFFECTIVE 10/17/13, ESTABLISHED VALLEY CHILDREN'S HEALTHCARE AS THE SOLE MEMBER OF THE CORPORATION. CERTAIN MEMBER RIGHTS, INCLUDING THE RIGHT TO APPROVE, FIX THE NUMBER, ELECT, AND REMOVE ELECTED TRUSTEES, ARE INCLUDED IN THESE BYLAWS.
FORM 990, PART VI, SECTION A, LINE 7A	SEE ANSWER FOR LINE 6 ABOVE
FORM 990, PART VI, SECTION A, LINE 7B	SEE ANSWER FOR LINE 6 ABOVE
FORM 990, PART VI, SECTION B, LINE 11B	A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED.
FORM 990, PART VI, SECTION B, LINE 12C	THE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS.
FORM 990, PART VI, SECTION B, LINE 15	AS PROVIDED BY THE VALLEY CHILDREN'S HEALTHCARE BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE NETWORK AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE
FORM 990, PART VI, SECTION C, LINE 19	A COPY OF VALLEY CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF VALLEY CHILDREN'S HOSPITAL IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE ANNUAL FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11G	PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 72,567,626. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 72,567,626. PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 109,594. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 109,594. CONSULTING & MANAGEMENT FEES - ON PARENT: PROGRAM SERVICE EXPENSES 13,838,102. MANAGEMENT AND GENERAL EXPENSES 282,962. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,121,064.
FORM 990, PART XI, LINE 9:	PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -177,995. PASS-THROUGH INVESTMENT INCOME 937,452.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	14
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	3,909
6	Total number of volunteers (estimate if necessary) .............	6	359
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	-937,452
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	1,565,833

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	79,253,958	48,366,824
9	Program service revenue (Part VIII, line 2g) .........	648,316,638	1,039,778,586
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	36,634,301	31,738,502
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,041,477	8,555,197
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	772,246,374	1,128,439,109
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	819,181	5,311,220
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)	341,070,272	353,708,857
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)....	347,600,290	415,230,372
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	689,489,743	774,250,449
19	Revenue less expenses. Subtract line 18 from line 12.......	82,756,631	354,188,660
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,106,349,301	2,061,981,246
21	Total liabilities (Part X, line 26).............	633,568,106	378,845,445
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,472,781,195	1,683,135,801

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 148,469,026 including grants of $ 5,311,220 ) (Revenue $ 725,567,902 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ 445,714,849 including grants of $ ) (Revenue $ 314,210,684 )
	SEE SCHEDULE O

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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses594,183,875

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	24,998,751	0	2,031,862

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	23,510,857
e	Government grants (contributions)		1e	23,514,083

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,341,884

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

h Total. Add lines 1a-1f.......		48,366,824

		Business Code
2a	PATIENT SERVICES	900099	1,020,256,073	1,020,256,073
b	HOME CARE 340B PROGRAM	900099	13,613,657	13,613,657
c	MANAGEMENT SERVICES	541610	5,015,014	5,015,014
d	LAB SERVICES	900099	893,842	893,842
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,039,778,586

3 Investment income (including dividends, interest, and othersimilar amounts) ......			16,184,376		-937,452	17,121,828
4 Income from investment of tax-exempt bond proceeds			798,507			798,507
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,070,235	6a
b	Less: rental expenses		678,676	6b
c	Rental income or (loss)		391,559	6c
d	Net rental income or (loss).......			391,559			391,559
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	73,813	156,531,074	7a
b	Less: cost or other basis and sales expenses	110,201	141,739,067	7b
c	Gain or (loss)	-36,388	14,792,007	7c
d	Net gain or (loss).........			14,755,619			14,755,619
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	280,889
b	Less: cost of goods sold ..		10b	113,463
c	Net income or (loss) from sales of inventory..			167,426			167,426
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		900099	2,360,907			2,360,907
b
c
d	All other revenue ....			5,635,305			5,635,305
e	Total. Add lines 11a–11d ......			7,996,212
12	Total revenue. See instructions.....			1,128,439,109	1,039,778,586	-937,452	41,231,151

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	5,042,079	5,042,079
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	269,141	269,141
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	20,019,174		20,019,174
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........	223,530,251	173,942,325	49,587,926
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	15,328,124	11,920,779	3,407,345
9	Other employee benefits .......	75,232,188	52,921,001	22,311,187
10	Payroll taxes ...........	19,599,120	14,123,865	5,475,255
11	Fees for services (non-employees):
a	Management ......	4,256,602	151	4,256,451
b	Legal .........	1,435,927		1,435,927
c	Accounting ...........	252,779		252,779
d	Lobbying ...........	153,750		153,750
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	3,707,670		3,707,670
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	86,798,284	86,405,728	392,556
12	Advertising and promotion ....	2,843,615	43,604	2,800,011
13	Office expenses .......	123,457,582	114,518,887	8,938,695
14	Information technology ......	8,149,863	6,025,763	2,124,100
15	Royalties ..
16	Occupancy ...........	8,173,142	6,075,202	2,097,940
17	Travel ............	429,151	180,683	248,468
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	213,242	76,633	136,609
20	Interest ...........	11,315,701	8,790,532	2,525,169
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	34,025,067	18,467,174	15,557,893
23	Insurance ...	7,820,655		7,820,655
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	HOSPITAL FEE PROGRAM	67,729,264	67,729,264
b	PURCHASED SERVICES	32,738,303	15,637,635	17,100,668
c	BAD DEBT	10,952,809	10,952,809
d	UBI TAXES	234,000	234,000
e	All other expenses	10,542,966	826,620	9,716,346
25	Total functional expenses. Add lines 1 through 24e	774,250,449	594,183,875	180,066,574	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 ........			585,034	1	885,991
2	Savings and temporary cash investments .........			614,804,090	2	646,160,966
3	Pledges and grants receivable, net ......			678,187	3	777,563
4	Accounts receivable, net .............			116,296,007	4	111,218,980
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				33,199,334	5	38,534,416
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			13,923,281	8	13,677,924
9	Prepaid expenses and deferred charges ......			42,312,174	9	13,822,499
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	801,440,087
b	Less: accumulated depreciation	10b	400,836,709	360,812,108	10c	400,603,378
11	Investments—publicly traded securities .			540,953,167	11	461,048,891
12	Investments—other securities. See Part IV, line 11 .....			241,129,101	12	206,266,947
13	Investments—program-related. See Part IV, line 11 ..			43,530,304	13	45,306,074
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			98,126,514	15	123,677,617
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,106,349,301	16	2,061,981,246

17	Accounts payable and accrued expenses .....	81,559,043	17	96,249,707
18	Grants payable ...		18
19	Deferred revenue .........	259,601,117	19	0
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	292,407,946	25	282,595,738
26	Total liabilities. Add lines 17 through 25..	633,568,106	26	378,845,445

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,452,137,851	27	1,650,610,632
28	Net assets with donor restrictions ...........	20,643,344	28	32,525,169
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	1,472,781,195	32	1,683,135,801
33	Total liabilities and net assets/fund balances ........	2,106,349,301	33	2,061,981,246

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) HERNDON TEMPERANCE LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 81-2808671	REAL PROPERTY	CA	720,228	7,422,005	VALLEY CHILDREN'S HOSPITAL

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)VALLEY CHILDREN'S HEALTHCARE FOUNDATION 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 94-2797447	PHILANTHROPY/FUNDRAISING FOR VALLEY CHILDREN'S HEALTHCARE & RELATED ENTITIES	CA	501(C)(3)	LINE 7	VALLEY CHILDREN'S HEALTHCARE		No
(2)VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 46-4150987	HEALTH CARE	CA	501(C)(3)	LINE 10	VALLEY CHILDREN'S HEALTHCARE		No
(3)VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 46-4158433	HEALTH CARE	CA	501(C)(3)	LINE 12C, III-FI	N/A		No

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) FOWLER BUSINESS & PROFESSIONAL PARK LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 47-1813772	REAL ESTATE INVESTMENT	CA	N/A	RELATED	738,704	15,312,875	Yes			Yes		50.000 %
(2) COMPASS HEALTH ADMINISTRATORS LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 82-2891309	BENEFIT ADMIN	CA	N/A					No			No

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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	(k) Percentage ownership