TY 2022 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)	(F) Estimated amount of other compensation from the organization and related organizations
(1) TODD SUNTRAPAK...................................................................... CEO	20.50 ................. 39.50	X	X			2,989,322	62,300
(2) BEVERLY HAYDEN-PUGH...................................................................... SVP/ADVR TO CEO (AS OF 3/23)	24.00 ................. 36.00			X		1,507,867	132,447
(3) MICHELE R WALDRON...................................................................... SVP, CFO	22.20 ................. 37.80		X			1,294,288	55,030
(4) NATALE PONTICELLO JR...................................................................... SVP/ADVR TO SVP & CPO (AS OF 3/23)	43.00 ................. 17.00			X		1,169,900	98,966
(5) DAVID CHRISTENSEN...................................................................... SVP, CPE & PRES VCMG	24.00 ................. 36.00			X		1,209,196	52,507
(6) JANE WILLSON...................................................................... SVP, CHIEF STRATEGY OFFICER	18.00 ................. 42.00			X		706,393	452,480
(7) DAVID HODGE JR...................................................................... VP, MEDICAL GROUP & ANCILLARY OP	35.00 ................. 25.00			X		658,346	128,812
(8) KEVIN SHIMAMOTO...................................................................... VP AND ADVISOR TO CIO	10.00 ................. 50.00				X	665,445	104,968
(9) DANIELLE BARRY...................................................................... SVP, COO	30.00 ................. 30.00			X		673,281	95,684
(10) KAREN DAHL...................................................................... VP, MED AFFAIRS & PHYS DEV	40.00 ................. 20.00				X	653,115	102,687
(11) MICHAEL GOLDRING...................................................................... SVP STRATEGIC PARTNERSHIPS	12.00 ................. 48.00				X	695,477	42,890
(12) LYNNE ASHBECK...................................................................... SVP, CHIEF COMMUNITY IMPACT OFF	18.00 ................. 42.00				X	622,039	94,212
(13) WILLIAM CHALTRAW JR...................................................................... SVP, CHIEF LEGAL OFFICER	12.00 ................. 48.00			X		656,447	52,018
(14) JOLIE LIMON...................................................................... VP ACAD AFFAIRS, DIO & CHI	50.00 ................. 10.00			X		541,229	97,151
(15) JOEL BROWNELL...................................................................... VP, CHIEF MED INFO OFF. (THRU 9/23)	40.00 ................. 20.00				X	532,621	103,839
(16) STEPHANIE VANCE...................................................................... VP, FINANCE	30.00 ................. 30.00			X		510,109	112,734
(17) JESSIE HUDGINS...................................................................... VP, FACILITIES & SUPPORT (THRU 1/23)	45.00 ................. 15.00			X		517,510	82,203

(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) JOSEPH EGAN........................................................................ VP & CIO	50.00 .......................10.00			X		406,743	0	63,648
(19) VICKY TILTON........................................................................ VP PATIENT CARE SVCS/CNO (AS OF 3/23)	50.00 .......................10.00			X		422,014	0	41,522
(20) KELLY BEALL........................................................................ SVP/CHIEF PEOPLE OFFICER (AS OF 3/23)	43.00 .......................17.00			X		314,797	0	49,482
(21) KELLIE DYER........................................................................ VP SUPPLY, CONSTR & FAC. (AS OF 1/23)	35.00 .......................15.00			X		248,345	0	26,560
(22) FAISAL RAZZAQI MD........................................................................ CHIEF OF STAFF/BOARD MEMBER	0.50 .......................0.50	X				62,500	0	0
(23) MIMI CHAO MD........................................................................ FORMER CHIEF OF STAFF	0.00 .......................				X	12,500	0	0
(24) DAN ADAMS........................................................................ BOARD TREASURER	0.50 .......................1.80	X	X			0	6,000	0
(25) JOSE ELGORRIAGA........................................................................ BOARD CHAIR	0.60 .......................1.40	X	X			0	0	0
(26) JEANNINE CAMPOS GRECH........................................................................ BOARD CHAIR (THRU 12/22)	1.00 .......................0.80	X	X			0	0	0
(27) MICHAEL HANSON........................................................................ BOARD VICE CHAIR	0.50 .......................1.80	X	X			0	0	0
(28) DANIELLE PARNAGIAN........................................................................ BOARD SECRETARY	0.50 .......................0.50	X	X			0	0	0
(29) RILEY WALTER........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(30) BILL SMITTCAMP........................................................................ BOARD MEMBER	0.50 .......................1.80	X				0	0	0
(31) DAN KOONTZ........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(32) MENDY LAVAL........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(33) SISSY DALENA WOOD........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(34) LISA SMITTCAMP........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(35) VALERIE VUICICH........................................................................ GUILD MEMBER	0.50 .......................0.50	X				0	0	0
(36) SUSAN BYERS........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(37) JARROD MARTINEZ........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(38) THOMAS PAGE MD........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(39) ALLISON KARAHADIAN........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(40) LUZ GONZALEZ MD........................................................................ BOARD MEMBER	0.50 .......................0.50	X				0	0	0
(41) KIM RUIZ BECK........................................................................ BOARD MEMBER (THRU 1/23)	1.00 .......................0.60	X				0	0	0
(42) NICO GENTILE........................................................................ BOARD MEMBER (THRU 11/22)	1.00 .......................	X				0	0	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	44,685,000
QUIRING GENERAL LLC 5118 E CLINTON WAY FRESNO,CA93727	CONSTRUCTION SERVICES	31,625,706
PEDIATRIC ANESTHESIA ASSOCIATES 6235 N FRESNO ST STE 103 FRESNO,CA93710	ANESTHESIA/CRITICAL CARE	15,092,527
SPAN CONSTRUCTION 3353 YEAGER DR MADERA,CA93637	CONSTRUCTION SERVICES	6,559,460
SODEXO INC & ASSOCIATES PO BOX 360170 PITTSBURGH,PA152516170	HOUSEKEEPING SERVICES	5,616,045
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 148

- 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.
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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

2022

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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 2022 (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—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

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) 2022

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) 2022

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) 2022

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 2022 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-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

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

2022

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) (2022)

Schedule B (Form 990) (2022) 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) (2022)

Schedule B (Form 990) (2022)

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) (2022)

Schedule B (Form 990) (2022)

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) (2022)

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

16,930

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

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

Yes

341,809

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

358,739

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 AND VALLEY CHILDREN'S HOSPITAL OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING OR INCREASING 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 $16,930 BROWNSTEIN HYATT FARBER SCHRECK $140,313 ASSOCIATION DUES RELATED TO LOBBYING NACH 31,958 AMERICAN SOCIETY HEALTHCARE ENGINEERING 82 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 351 CALIFORNIA CHAMBER OF COMMERCE 125 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 91,822 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 26,421 CHILDREN'S SPECIALTY CARE COALITION 3,791 FRESNO CHAMBER OF COMMERCE 275 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA 46,551 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $358,739

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 AND VALLEY CHILDREN'S HOSPITAL OF PENDING LEGISLATIVE PROPOSALS, AND REQUESTS FOR ASSISTANCE IN SUPPORTING ACCESS TO CHILDREN'S HEALTH CARE BY MAINTAINING OR INCREASING 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 $16,930 BROWNSTEIN HYATT FARBER SCHRECK $140,313 ASSOCIATION DUES RELATED TO LOBBYING NACH 31,958 AMERICAN SOCIETY HEALTHCARE ENGINEERING 82 ASSOCIATION OF AMERICAN MEDICAL COLLEGES 351 CALIFORNIA CHAMBER OF COMMERCE 125 CALIFORNIA CHILDREN'S HOSPITAL ASSOCIATION 91,822 CALIFORNIA HOSPITAL ASSOCIATION/AMERICAN HOSP ASSOC 26,421 CHILDREN'S SPECIALTY CARE COALITION 3,791 FRESNO CHAMBER OF COMMERCE 275 HOSPITAL COUNCIL OF NORTHERN & CENTRAL CALIFORNIA 46,551 NATIONAL ASSOCIATION OF EPILEPSY CENTERS 120 TOTAL EXPENDITURES RELATED TO LEGISLATIVE MATTERS $358,739

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 .....	70,118,669		70,118,669
b	Buildings ....	413,885,161	166,741,644	247,143,517
c	Leasehold improvements	3,554,557	3,553,961	596
d	Equipment ....	347,587,433	237,399,326	110,188,107
e	Other .....	45,963,138	28,358,307	17,604,831
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				445,055,720

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	92,930,080	F
(B) HEDGE FUNDS	95,946,826	F
(C) PRIVATE CAPITAL FUNDS	62,895,044	F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	251,771,950

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				10,436,424
(2)INSURANCE RECEIVABLE				12,671,037
(3)PROVIDER FEE RECEIVABLE				159,584,178
(4)457 TRUST FUNDS				4,960,090
(5)OTHER				14,061,503
(6)ADVANCE MED FOUNDATION				-18,296,994
(7)PREPAID LEASE ASSET				1,529,028
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				184,945,266

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.)	32,279,753
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

PART VII, LINE 3:

THE OVERALL FINANCIAL OBJECTIVES OF THE HOSPITAL'S INVESTMENT PORTFOLIO ARE TO 1) PRESERVE PRINCIPAL AND MAINTAIN PURCHASING POWER FOR A PORTION OF PORTFOLIO ASSETS IN ORDER TO PROVIDE A SOURCE OF FUNDING FOR STRATEGIC INVESTMENT AND ANNUAL ENDOWMENT DISTRIBUTIONS, AND 2) GROW A PORTION OF PORTFOLIO ASSETS TO IMPROVE THE FINANCIAL WELL-BEING OF VALLEY CHILDREN'S HEALTHCARE AND ITS SUBSIDIARIES. TO ACHIEVE THESE GOALS, THE PORTFOLIO IS INVESTED IN A VARIETY OF INVESTMENT VEHICLES INCLUDING, BUT NOT LIMITED TO, MUTUAL FUNDS, EXCHANGE TRADED FUNDS, SEPARATELY MANAGED ACCOUNTS, COMMINGLED FUNDS, US TREASURY NOTES, LIMITED PARTNERSHIPS, HEDGE FUNDS AND PRIVATE CAPITAL FUNDS

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

2022

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	137,661,677
	EUROPE (INCLUDING ICELAND & GREENLAND)	0	0	INVESTMENTS	23,380,447















3a	Sub-total ....	0	0		161,042,124
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		161,042,124

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022

Schedule F (Form 990) 2022

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) 2022

Schedule F (Form 990) 2022Page 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) 2022

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2022

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) 2022

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 20a.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

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) . . .	92,423		92,423	0.010 %
b	Medicaid (from Worksheet 3, column a) . . . . .	515,432,836	467,061,411	48,371,425	6.310 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	413,069	161,209	251,860	0.030 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	515,938,328	467,222,620	48,715,708	6.350 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	2,407,211		2,407,211	0.310 %
f	Health professions education (from Worksheet 5) . . .	14,706,137	1,659,807	13,046,330	1.700 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	1,371,405	474,807	896,598	0.120 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	966,714		966,714	0.130 %
j	Total. Other Benefits . .	19,451,467	2,134,614	17,316,853	2.260 %
k	Total. Add lines 7d and 7j .	535,389,795	469,357,234	66,032,561	8.610 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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. ......

3,178,201

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).....

128,925

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

239,984

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

-111,059

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) 2022

Page

Part VFacility Information

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

Schedule H (Form 990) 2022

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 22

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/COMMUNITY-BENEFIT

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 23

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

Yes

If "Yes" (list url): WWW.VALLEYCHILDRENS.ORG/ABOUT-US/COMMUNITY-BENEFIT

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) 2022

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 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

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) 2022

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) 2022

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) 2022

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 AIN CONDUCTING THE MOST RECENT CHNA, THE HOSPITAL FACILITY TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF 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 COUNTIESPRIMARY DATA WERE COLLECTED THROUGH SURVEYS, FOCUS GROUPS, AND KEY INFORMANT INTERVIEWS. THE SURVEY INCLUDED QUESTIONS TO DESCRIBE THE COMMUNITY, THE SOCIAL DETERMINANTS OF HEALTH AND HEALTH STATUS AND WAS AVAILABLE IN ENGLISH AND SPANISH. COMMUNITY ORGANIZATIONS DISTRIBUTED THE SURVEYS ONLINE AND IN PAPER FORMAT. 4,856 USABLE SURVEYS WERE RECEIVED. COMMUNITY-BASED ORGANIZATIONS AND OTHER GROUPS LED THE FOCUS GROUPS AND INTERVIEWS. COMMUNITY MEMBERS ATTENDED IN-PERSON OR VIRTUALLY ON ZOOM. FIFTY-NINE (59) FOCUS GROUPS ENGAGED 473 PERSONS FROM OCTOBER TO DECEMBER 2021. TARGET POPULATIONS FOR THE FOCUS GROUPS WERE MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS IN THE COMMUNITY. KEY INFORMANTS WERE CHOSEN FOR INTERVIEWS BASED ON THEIR KNOWLEDGE OF COMMUNITY HEALTH ISSUES. FIFTY (50) KEY INFORMANT INTERVIEWS WERE COMPLETED FROM OCTOBER TO DECEMBER 2021.KERN COUNTYPRIMARY DATA WERE COLLECTED THROUGH INTERVIEWS WITH COMMUNITY STAKEHOLDERS AND SURVEYS WITH COMMUNITY RESIDENTS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THIRTY (30) TELEPHONE INTERVIEWS WERE CONDUCTED FROM OCTOBER TO DECEMBER 2021. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH HEALTH AND WELLBEING IN KERN COUNTY WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITIES SERVED BY THE HOSPITAL. SURVEYS WERE DISTRIBUTED TO ENGAGE COMMUNITY RESIDENTS AND OBTAIN INPUT ON HEALTH AND SOCIAL NEEDS. THE SURVEY WAS AVAILABLE IN AN ELECTRONIC FORMAT AND IN A PAPER COPY FORMAT. THE ELECTRONIC AND PAPER SURVEYS WERE AVAILABLE IN ENGLISH AND SPANISH. THE SURVEYS WERE AVAILABLE FROM SEPTEMBER 13 TO NOVEMBER 15, 2021. DURING THIS TIME, 255 USABLE SURVEYS WERE COLLECTED. THE SURVEYS WERE DISTRIBUTED THROUGH HOSPITAL CHANNELS INCLUDING SOCIAL MEDIA. THE SURVEY WAS ALSO DISTRIBUTED TO COMMUNITY PARTNERS WHO MADE THEM AVAILABLE TO THEIR CLIENTS.MERCED COUNTYTHE ASSESSMENT INCORPORATED PRIMARY RESEARCH THROUGH A COMMUNITY HEALTH SURVEY AND AN ONLINE KEY INFORMANT SURVEY. THE SURVEYS WERE CONDUCTED VIA TELEPHONE (LANDLINE AND CELL PHONE) AND THROUGH ONLINE QUESTIONNAIRES. THE SAMPLE DESIGN USED FOR THIS EFFORT CONSISTED OF A RANDOM SAMPLE OF 300 INDIVIDUALS, AGES 18 AND OLDER, IN MERCED COUNTY. WHEN THE INTERVIEWS WERE COMPLETED, THEY WERE WEIGHTED IN PROPORTION TO THE ACTUAL POPULATION DISTRIBUTION TO APPROPRIATELY REPRESENT MERCED COUNTY AS A WHOLE.AN ONLINE KEY INFORMANT SURVEY SOLICITED INPUT FROM KEY INFORMANTS, THOSE INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY VALLEY CHILDREN'S HOSPITAL AND MERCY MEDICAL CENTER MERCED. THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. IN ALL, 69 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY.PARTICIPATION INCLUDED REPRESENTATIVES OF THE FOLLOWING ORGANIZATIONS:- ACE OVERCOMERS- ALL DADS MATTER- BEHAVIORAL HEALTH- CASTLE FAMILY HEALTH CENTERS- CENTRAL CALIFORNIA ALLIANCE FOR HEALTH- CENTRAL OPPORTUNITY CENTER CVOC- COURT APPOINTED SPECIAL ADVOCATES MERCED COUNTY- FAMILY RESOURCE COUNCIL- FIRST 5 MERCED COUNTY- HEAD START PROGRAM MERCED COUNTY OFFICE OF EDUCATION- MERCED CITY SCHOOL DISTRICT- MERCED COUNTY COMMUNITY ACTION AGENCY WIC- MERCED COUNTY DEPARTMENT OF PUBLIC HEALTH- MERCED COUNTY HUMAN SERVICES AGENCY, ALL MOMS MATTER- MERCED COUNTY HUMAN SERVICES AGENCY, EMPLOYMENT AND TRAINING BRANCH- MERCED COUNTY MENTAL HEALTH DEPT.- MERCED COUNTY OFFICE OF EDUCATION, CARING KIDS- MERCED COUNTY OFFICE OF EDUCATION, GROW PROGRAM- MERCED COUNTY OFFICE OF EDUCATION, MIGRANT EDUCATION- MERCED RESCUE MISSION- PEOPLE'S PROMISE- SIERRA VISTA CHILDREN AND FAMILY SERVICES- ST. VINCENT DE PAUL SOCIETY PLANADA- UNIVERSITY OF CALIFORNIA MERCED- VALLEY CRISIS CENTERSTANISLAUS COUNTYTWELVE (12) INTERVIEWS WERE CONDUCTED DURING JANUARY AND FEBRUARY 2022. INTERVIEW PARTICIPANTS INCLUDED A BROAD RANGE OF STAKEHOLDERS CONCERNED WITH THE HEALTH AND WELLBEING IN STANISLAUS COUNTY, WHO SPOKE TO ISSUES AND NEEDS IN THE COMMUNITY. ORGANIZATIONS WERE IDENTIFIED BASED ON THE ROLE THEY PLAYED IN THE COMMUNITY. INDIVIDUALS REPRESENTING ORGANIZATIONS THAT DELIVERED HEALTH AND RELATED SOCIAL SERVICES TO THE COMMUNITY AT-LARGE WERE SOLICITED FOR INVOLVEMENT. SOCIAL SERVICE/COMMUNITY SERVING ORGANIZATIONS, INCLUDING HEALTH CARE PROVIDERS (FQHCS), AND THE INDIVIDUALS REPRESENTING THEM, WERE ALSO RECRUITED FOR PARTICIPATION. THE LOCAL PUBLIC HEALTH AGENCY WAS RECRUITED FOR PARTICIPATION AND REPRESENTATIVES FROM THE HOSPITAL WERE INCLUDED.FOCUS GROUP PARTICIPANTS WERE IDENTIFIED FROM THE ORGANIZATIONS SERVING THE COMMUNITY'S MOST VULNERABLE POPULATIONS. IN SOME INSTANCES, WHERE A FOCUS GROUP WAS DIFFICULT TO CONVENE (DUE TO THE PANDEMIC), REPRESENTATIVES THAT WORKED DIRECTLY WITH VULNERABLE POPULATIONS WERE SOLICITED FOR INVOLVEMENT. THREE (3) FOCUS GROUPS ENGAGED 17 PEOPLE AND WERE HELD VIA ZOOM IN MARCH 2022. FOCUS GROUP PARTICIPANTS REPRESENTED COMMUNITY HEALTH WORKERS, STUDENTS, VOLUNTEERS AND OUTREACH WORKERS. KEY INFORMANTS WERE CHOSEN FOR INTERVIEWS BASED ON THEIR KNOWLEDGE OF COMMUNITY HEALTH ISSUES.
PART V, SECTION B	FACILITY REPORTING GROUP A
FACILITY REPORTING GROUP A CONSISTS OF:	- FACILITY 1: VALLEY CHILDREN'S HOSPITAL
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6A:	VALLEY CHILDREN'S HOSPITAL COLLABORATED WITH THE FOLLOWING HOSPITAL FACILITIES TO COMPLETE THE CHNA:FRESNO, KINGS, MADERA AND TULARE COUNTIES- SAINT AGNES MEDICAL CENTER AND COMMUNITY REGIONAL MEDICAL CENTER.KERN COUNTY- DIGNITY HEALTH (MERCY AND MEMORIAL HOSPITALS), ADVENTIST HEALTH (BAKERSFIELD, DELANO AND TEHACHAPI VALLEY), KERN MEDICAL, AND KAISER PERMANENTE.MERCED COUNTY- MERCY MEDICAL CENTER MERCED.STANISLAUS COUNTY- SUTTER HEALTH MEMORIAL MEDICAL CENTER.
FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 6B:	VALLEY CHILDREN'S HOSPITAL COLLABORATED WITH THE HOSPITAL COUNCIL OF NORTHERN AND CENTRAL CALIFORNIA TO COMPLETE THE CHNA.
PART V, LINE 7A, HOSPITAL FACILITY'S WEBSITE:	WWW.VALLEYCHILDRENS.ORG/ABOUT-US/COMMUNITY-BENEFIT
PART V, SECTION B, LINE 11	THE 2022 CHNA PROCESS INCLUDED COLLECTION AND ANALYSIS OF DATA SOURCES FOR THE HOSPITAL SERVICE AREA. SECONDARY DATA WERE COLLECTED FROM COUNTY AND STATE SOURCES TO PRESENT COMMUNITY DEMOGRAPHICS, SOCIAL DETERMINANTS OF HEALTH, ACCESS TO HEALTH CARE, BIRTH CHARACTERISTICS, ACUTE AND CHRONIC CONDITIONS, HEALTH BEHAVIORS, MENTAL HEALTH, AND SUBSTANCE USE. IN ADDITION, VALLEY CHILDREN'S CONDUCTED INTERVIEWS, FOCUS GROUPS AND SURVEYS WITH COMMUNITY STAKEHOLDERS AND RESIDENTS TO OBTAIN INPUT ON HEALTH NEEDS, BARRIERS TO CARE AND RESOURCES AVAILABLE TO ADDRESS THE IDENTIFIED HEALTH NEEDS. THE COLLECTED DATA WERE USED TO IDENTIFY SIGNIFICANT COMMUNITY NEEDS. GIVEN THE COMMUNITY INPUT SPECIFIC TO CHILD HEALTH, THE MAJOR NEEDS IDENTIFIED FOR CHILDREN THROUGHOUT THE SERVICE AREA INCLUDED THE FOLLOWING:- ACCESS TO HEALTH CARE INCLUDES ACCESS TO PRIMARY CARE, SPECIALTY CARE, PREVENTIVE CARE, AND TRANSPORTATION.- CHRONIC DISEASES INCLUDE PREVENTION, MANAGEMENT, AND TREATMENT OF CHRONIC DISEASES (DIABETES, ASTHMA, CANCER), CAREGIVER SUPPORT FOR CHILDREN EXPERIENCING CHRONIC DISEASES.- ECONOMIC INSECURITY INCLUDES POVERTY, BASIC NEEDS SERVICES, AND FOOD INSECURITY.- HOUSING AND HOMELESSNESS INCLUDE ACCESS TO SAFE AND AFFORDABLE HOUSING, AND ISSUES RELATED TO PERSONS WHO ARE EXPERIENCING HOMELESSNESS, INCLUDING HOUSING AVAILABILITY, SOCIAL SERVICES AND TRANSITIONAL CARE.- MATERNAL AND INFANT HEALTH INCLUDE TEEN PREGNANCY, PRENATAL CARE, LOW-BIRTH WEIGHT BIRTHS,PREMATURE BIRTHS, INFANT MORTALITY, AND BREASTFEEDING.- MENTAL HEALTH INCLUDES ANXIETY AND DEPRESSION, SEVERE MENTAL ILLNESS, ACCESS TO MENTAL HEALTHCARE AND SUPPORTIVE SERVICES, REDUCTION IN STIGMA AND AVAILABILITY OF MENTAL HEALTH CARE BEDS.- OBESITY/NUTRITION/PHYSICAL ACTIVITY INCLUDE ACCESS TO HEALTHY, AFFORDABLE FOOD, INCREASED ACCESS TO OUTDOOR ACTIVITIES.- PREVENTIVE CARE INCLUDES VACCINES, TESTING AND SCREENINGS.- SUBSTANCE USE AND MISUSE INCLUDE TOBACCO USE, VAPING, DRUG MISUSE AND ALCOHOL USE.- VIOLENCE AND INJURY PREVENTION INCLUDE ACCIDENTAL INJURIES, NEIGHBORHOOD SAFETY, REDUCTION IN CRIME, AND CHILD ABUSE.THE CHNA SERVED AS A RESOURCE DOCUMENT FOR THE REVIEW OF HEALTH NEEDS AS IT PROVIDED DATA ON THE SCOPE AND SEVERITY OF ISSUES AND INCLUDED COMMUNITY INPUT ON THE HEALTH NEEDS. THE COMMUNITY PRIORITIZATION OF NEEDS WAS ALSO TAKEN INTO CONSIDERATION. VALLEY CHILDREN'S IS ADDRESSING THE FOLLOWING NEEDS:- ACCESS TO HEALTH CARE (INCLUDING PREVENTIVE CARE)- CHRONIC DISEASES (INCLUDING OBESITY, NUTRITION, AND PHYSICAL ACTIVITY)- MATERNAL AND INFANT HEALTH- MENTAL HEALTH- VIOLENCE AND INJURY PREVENTIONACCESS TO CARE (INCLUDING PREVENTIVE CARE):ACCESS 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 PART OF THE FRESNO COUNTY SUPERINTENDENT OF SCHOOLS' MOBILE HEALTH UNIT (MHU). DESIGNED TO HELP ENSURE THAT CHILDREN ARE HEALTHY AND READY TO LEARN, THE MHU VISITED 31 DIFFERENT SCHOOLS IN 2023, INCLUDING MANY LOCATED IN RURAL AND LOW-INCOME COMMUNITIES. AS A PART OF THOSE VISITS, 1,164 CHILDHOOD VACCINATIONS WERE ADMINISTERED, AND 331 SPORTS PHYSICALS WERE PERFORMED.AFFORDABLE BROADBAND INTERNET ACCESSACCESS TO AFFORDABLE AND RELIABLE BROADBAND INTERNET SERVICE IS CRITICAL TO ENSURING THAT EVERYONE HAS ACCESS TO QUALITY HEALTH CARE INCLUDING INDIVIDUALS LIVING IN AREAS WHERE HEALTH CARE PROVIDERS AND SERVICES ARE IN SHORT SUPPLY.IN RECOGNITION OF THIS REALITY, VALLEY CHILDREN'S WAS ACTIVELY INVOLVED IN COMMUNITY-BASED EFFORTS TO IMPROVE ACCESS TO BROADBAND INCLUDING SERVING AS A MEMBER OF THE FRESNO COALITION FOR DIGITAL INCLUSION (FCDI) EXECUTIVE POLICY WORKGROUP. ESTABLISHED IN 2022, FCDI BRINGS TOGETHER INSTITUTIONS, LOCAL GOVERNMENT/PUBLIC AGENCIES AND COMMUNITY-BASED ORGANIZATIONS TO COLLABORATE WITH SHARED PURPOSE TOWARD EQUITABLE INTERNET ACCESS. THERE ARE PRESENTLY 29 ORGANIZATIONS AT THE TABLE REPRESENTING THE COUNTY AND CITY OF FRESNO, K-12, HIGHER EDUCATION, HEALTHCARE, HOUSING AND COMMUNITY-BASED ORGANIZATIONS. THE COALITION'S WORK IN 2023 INCLUDED ANALYSIS OF BROADBAND ACCESS GAPS IN FRESNO COUNTY AND ADVOCACY TO ENSURE THAT REGULATORS AND POLICY MAKERS WERE USING THE MOST ACCURATE DATA IN IDENTIFYING AREAS OF GREATEST NEED.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.TRANSPORTATIONGIVEN 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.EXPANDED ACCESS TO PEDIATRIC PRIMARY AND SPECIALTY CAREVALLEY CHILDREN'S MADE CASH CONTRIBUTIONS FOR THE PURCHASE OF CAPITAL-RELATED ITEMS TO BE USED TO INCREASE ACCESS TO HEALTHCARE SERVICES FOR CHILDREN THROUGHOUT THE REGION.CHRONIC DISEASE PREVENTION (INCLUDING OBESITY, NUTRITION AND PHYSICAL ACTIVITY)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 2023, APPROXIMATELY 70 CHILDREN PARTICIPATED IN A VARIETY OF ACTIVITIES INCLUDING WHEELCHAIR BASKETBALL, WHEELCHAIR TENNIS, WHEELCHAIR SOCCER, CANOEING/KAYAKING, ROCK CLIMBING, TRACK AND FIELD, AND SNOW AND WATER SKIING.FOOD FOR FAMILIESVALLEY CHILDREN'S DIETARY DEPARTMENT PROVIDED MEAL COUPONS TO BREASTFEEDING MOMS WHOSE INFANTS WERE AT VALLEY CHILDREN'S. ADDITIONALLY, VALLEY CHILDREN'S SOCIAL WORK TEAM PROVIDED PATIENTS' FAMILIES WHO WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL WITH MEAL COUPONS WHEN THE NEED WAS DETERMINED. 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 MONTHLY FOOD DISTRIBUTION AT WEST FRESNO MIDDLE SCHOOL, AND C) SUPPORT FOR THE FIRST FRUITS MARKET AT CITY CENTER IN FRESNO THAT IS AVAILABLE TO LOW-INCOME FAMILIES WITH CHILDREN TO ACCESS NUTRITIOUS FOOD, FREE OF CHARGE, IN A SETTING MUCH LIKE ANY NEIGHBORHOOD GROCERY STORY. REGARDING THE FOOD DISTRIBUTION TO VALLEY CHILDREN'S HOME CARE PATIENTS, HOME CARE STAFF DISTRIBUTED 8,492 POUNDS OF FOOD (THE EQUIVALENT OF 7,076 MEALS) TO 35 FAMILIES INCLUDING 90 CHILDREN IN THE PARTNERSHIP'S FIRST YEAR.REGARDING THE FOOD DISTRIBUTION AT WEST FRESNO MIDDLE SCHOOL, 23,055 POUNDS OF FOOD WERE DISTRIBUTED (THE EQUIVALENT OF 19,213 MEALS) TO 377 FAMILIES INCLUDING 1,382 CHILDREN IN THE FIRST YEAR OF THE PARTNERSHIP.FOOD SECURITY - MERCED PARTNERSHIPIN MERCED COUNTY, VALLEY CHILDREN'S OLIVEWOOD PEDIATRICS PRACTICE PARTNERED WITH COMMUNITY INITIATIVES FOR COLLECTIVE IMPACT AND THE MERCED COUNTY FOOD BANK TO HELP NEEDY FAMILIES ACCESS FOOD AT LOCAL GROCERY STORES. THROUGH THE PARTNERSHIP, VALLEY CHILDREN'S PROVIDERS SCREEN ALL CHILDREN ENROLLED IN MEDI-CAL AND THEIR FAMILIES FOR FOOD INSECURITY AND IF A FAMILY SCREENS POSITIVE FOR FOOD INSECURITY, THE PROVIDERS WILL GIVE THE FAMILY A COUPON THAT CAN BE USED AT ANY GROCERY STORE THAT ACCEPTS FOOD COUPONS TO HELP WITH THE PURCHASE OF STAPLES SUCH AS FRUITS, VEGETABLES AND DAIRY PRODUCTS.
PART V, SECTION B, LINE 11 (CONTINUED)	BLUE ZONES PROJECT BAKERSFIELDIN 2023, VALLEY CHILDREN'S PROVIDED FINANCIAL SUPPORT FOR THE BLUE ZONES BAKERSFIELD INITIATIVE, SUPPORTED ITS ADVOCACY EFFORTS, AND PARTICIPATED ON THE INITIATIVE'S STEERING COMMITTEE AND SCHOOL WELLNESS COMMITTEE.VALLEY CHILDREN'S HEALTHCARE, THROUGH ITS GUILDS CENTER FOR COMMUNITY HEALTH, JOINED ADVENTIST HEALTH AND OTHER STAKEHOLDERS TO LAUNCH BLUE ZONES PROJECT BAKERSFIELD. BASED ON THE NATIONAL BLUE ZONES PROJECT MODEL, THE BAKERSFIELD PROJECT IS A WELL-BEING IMPROVEMENT INITIATIVE DESIGNED TO MAKE HEALTHIER CHOICES EASIER BY ENCOURAGING CHANGES THAT LEAD TO HEALTHIER OPTIONS. WHEN INDIVIDUALS AND ORGANIZATIONS PARTICIPATE, THEIR SMALL CHANGES CONTRIBUTE TO HUGE BENEFITS: LOWERED HEALTH CARE COSTS, IMPROVED PRODUCTIVITY, AND A HIGHER QUALITY OF LIFE.BLUE ZONES BAKERSFIELD SUPPORTED INTERVENTIONS AND INITIATIVES THAT EMPOWER PEOPLE, INCENTIVIZE PLACES TO ENHANCE THE WAYS THEY PROMOTE HEALTH AND WELLNESS, AND IMPLEMENT POLICY THAT TRANSFORMS THE ENVIRONMENT. BLUE ZONES SUPPORTED COMMUNITY WALKING GROUPS, HOSTING COOKING DEMONSTRATIONS, AND IS WORKING ON A COMPREHENSIVE GRASS ROOTS ENGAGEMENT STRATEGY NEIGHBORHOOD BY NEIGHBORHOOD. BLUE ZONES WORKED WITH SCHOOLS, WORKSITES, GROCERY STORES AND RESTAURANTS, AND FAITH-BASED ORGANIZATIONS TO IMPLEMENT PRACTICES THAT MAKE IT EASIER FOR INDIVIDUALS TO MAKE HEALTHY CHOICES. BLUE ZONES SUPPORTED POLICY CHANGES THAT REDUCE TOBACCO USE, INCREASE THE AVAILABILITY OF HEALTHY FOODS, AND PROMOTE CHANGES TO THE BUILT ENVIRONMENT THAT MAKE IT EASIER AND SAFER FOR RESIDENTS TO TAKE ADVANTAGE OF AMENITIES SUCH AS PARKS, SIDEWALKS, BIKE PATHS, AND PUBLIC TRANSPORTATION.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 CHILDCARE AND CHILD HEALTH PROVIDERS, AND THE COLLECTION AND ANALYSIS OF DATA TO IMPROVE THE SYSTEM.IN SPRING 2023, VALLEY CHILDREN'S, IN PARTNERSHIP WITH FIRST 5 FRESNO, FIRST 5 KERN, AND FIRST 5 MERCED, ENGAGED THE SERVICES OF A CONSULTANT TO CONDUCT A STUDY REGARDING A POTENTIAL REGIONAL HELP ME GROW INITIATIVE. THE GOAL OF THIS STUDY WAS TO EVALUATE THE BENEFITS OF, AND DEVELOP A PLAN FOR, THE CREATION OF A REGIONAL INITIATIVE THAT PROMOTES COLLABORATION, CAPACITY BUILDING, ENHANCED SCREENING LEVELS, AND IMPROVED SYSTEMS OF CARE FOR ALL CHILDREN. THE STUDY, WHICH WAS COMPLETED IN NOVEMBER 2023, CONCLUDED THAT THERE WAS JUSTIFICATION FOR AND SUPPORT FOR A REGIONAL INITIATIVE AND PROVIDED A BLUE PRINT FOR CREATING A CENTRAL VALLEY HELP ME GROW PROGRAM. VALLEY CHILDREN'S IS CURRENTLY FACILITATING WORK TOWARDS CREATING THAT PROGRAM.EPILEPSY SUPPORT PROGRAMVALLEY CHILDREN'S EPILEPSY PROGRAM CONTINUED ITS COMMUNITY-BASED OUTREACH WORK IN 2023 BY PROVIDING THE FOLLOWING EDUCATION AND TRAINING TO KEY STAKEHOLDERS.- THE PROGRAM PROVIDED TRAINING TO 541 STAFF ACROSS 8 SCHOOL DISTRICTS ON SEIZURE PREPAREDNESS AND SAFETY AND PROVIDED 100 COMFORT CARE BACKPACKS TO SCHOOLS FOR STUDENTS WITH EPILEPSY.- THE PROGRAM FACILITATED 25 SEPARATE SUPPORT GROUPS THAT REACHED 26 TEENS AND 52 PARENTS.- THE PROGRAM'S SOCIAL MEDIA VIDEOS ON SEIZURE RESCUE MEDICATION WERE VIEWED OVER 68,000 TIMES AND WERE USED IN SCHOOL TRAININGS NATIONALLY PROVIDING INSTRUCTION TO SCHOOL STAFF ON HOW TO ADMINISTER EMERGENCY SEIZURE RESCUE MEDICATIONS.- THE PROGRAM PARTICIPATED IN A NUMBER OF COMMUNITY EVENTS THROUGH WHICH IT WAS ABLE TO PROVIDE EDUCATION AND PROMOTE AWARENESS REGARDING EPILEPSY TO OVER 3,800 INDIVIDUALS.- THE PROGRAM'S LEADERSHIP ALSO WAS ACTIVE IN PUBLIC POLICY AT A STATE AND FEDERAL LEVEL INCLUDING PROVIDING IMPORTANT EDUCATION AND INFORMATION TO THE CONGRESSIONAL EPILEPSY CAUCUS AND SERVING ON THE EPILEPSY ALLIANCE AMERICA BOARD OF DIRECTORS.SCHOOLS FOR THRIVING AND HEALTHY STUDENTSVALLEY CHILDREN'S AND THE GUILDS CENTER FOR COMMUNITY HEALTH, IN PARTNERSHIP WITH THE CENTER FOR WELLNESS AND NUTRITION AND NO KID HUNGRY, COMPLETED PHASE II OF SCHOOLS FOR HEALTHY AND THRIVING STUDENTS, WHICH SUPPORTED SCHOOL DISTRICTS IN THEIR EFFORTS TO UPDATE AND FULLY LEVERAGE SCHOOL WELLNESS POLICIES, INCLUDING POLICIES ADDRESSING PHYSICAL ACTIVITY AND NUTRITION.THE FRAMEWORK FOR THE WORK WAS THE CENTERS FOR DISEASE CONTROL AND PREVENTION'S WHOLE SCHOOL, WHOLE COMMUNITY, WHOLE CHILD MODEL (WSCC), A STUDENT-CENTERED TOOL FOR ADDRESSING HEALTH IN SCHOOLS. OF THE 17 PARTICIPATING SCHOOL DISTRICTS, 4 UPDATED THEIR SCHOOL DISTRICT WELLNESS POLICIES AND 14 UPDATED A WSCC RELATED POLICY.MATERNAL AND INFANT HEALTHCLINICAL PARTNERSHIP PROGRAMVALLEY 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 EXPERTISEIN 2023, VALLEY CHILDREN'S SUPPORTED 17 INPATIENT CLINICAL PARTNERS AND, AS A PART OF THAT SUPPORT, CONVENED 22 TRAINING AND EDUCATION EVENTS THAT DREW MORE THAN 750 ATTENDEES. THE AVERAGE INVESTMENT OF TIME FOR EACH HOSPITAL PARTNER WAS MORE THAN 300 HOURS ANNUALLY.SAFE SLEEP FOR INFANTSVALLEY CHILDREN'S CO-LEADS THE CENTRAL VALLEY SAFE SLEEP COALITION, IN CONJUNCTION WITH FIRST 5 FRESNO COUNTY. THE SAFE SLEEP COALITION IS A 9-COUNTY COLLABORATIVE FOCUSES ON PROVIDING CULTURALLY APPROPRIATE RISK REDUCTION EDUCATION AND RESOURCES ON SAFE INFANT SLEEP.IN SEPTEMBER 2023, THE COALITION HELD ITS FIRST LEARNING COLLABORATIVE GEARED TOWARD SAFE SLEEP EDUCATION FOR CHILDCARE CENTER PROVIDERS, LICENSED AND UNLICENSED IN-HOME CHILDCARE PROVIDERS, AND ANY FRIENDS, FAMILY OR NEIGHBORS WHO PROVIDE CARE TO INFANTS UNDER THE AGE OF 1 YEAR. THE FIRST COLLABORATIVE HOSTED OVER 200 LEARNERS FROM ALL 9 CENTRAL VALLEY COUNTIES AND WAS SIMULTANEOUSLY TRANSLATED INTO SPANISH TO PROVIDE MORE EQUITABLE ACCESS TO THIS CRITICAL INFORMATION. COMMUNITY SUPPORT VALLEY CHILDREN'S DONATED DIAPERS TO UNDERSERVED RESIDENTS.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 2023, VALLEY CHILDREN'S DEMONSTRATED ITS COMMITMENT TO MEETING THE MENTAL HEALTH NEEDS OF CHILDREN IN A NUMBER OF WAYS, INCLUDING THOSE LISTED BELOW.ADVERSE CHILDHOOD EXPERIENCES (ACES)VALLEY CHILDREN'S OLIVEWOOD PEDIATRICS PRACTICE IN MERCED RECEIVED CLOSE TO $622,000 IN GRANT FUNDING FROM THE CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES TO ADDRESS ACES THROUGH THE PRACTICE GRANT. THE AWARD WAS IN PARTNERSHIP WITH THE OFFICE OF THE CALIFORNIA SURGEON GENERAL, THE POPULATION HEALTH INNOVATION LAB, AND THE UCLA-UCSF ACES AWARE FAMILY RESILIENCE NETWORK, ALSO KNOWN AS UCANN. THE GOALS OF THE GRANT FOCUSED ON STRENGTHENING PARTNERSHIPS BETWEEN PRACTICES, COMMUNITY-BASED ORGANIZATIONS (CBOS), AND MANAGED MEDI-CAL HEALTH PLANS; AS WELL AS DEVELOPING NEW AND SUSTAINABLE SERVICES AND WORKFORCE EXPANSION. VALLEY CHILDREN'S OLIVEWOOD PEDIATRICS PARTNERED WITH ACE OVERCOMERS TO HIRE A CARE NAVIGATOR. CARE NAVIGATION SERVICES WERE PROVIDED TO PATIENTS FROM OLIVEWOOD PEDIATRICS AND ACE OVERCOMERS WHO EITHER SCREENED POSITIVE FOR RISK OF TOXIC STRESS OR HAD AN IDENTIFIED SOCIAL NEED, SUCH AS TRANSPORTATION ASSISTANCE.THE CARE NAVIGATOR, IN CONJUNCTION WITH ACE OVERCOMERS AND VALLEY CHILDREN'S, DID EXTENSIVE OUTREACH TO VARIOUS CLINICS AND PRACTICES REGARDING THE IMPORTANCE OF SCREENING AND REFERRAL.IN 2023, VALLEY CHILDREN'S OLIVEWOOD PEDIATRICS PRACTICE SCREENED CHILDREN FOR ACES, AND CONNECTED THOSE WHO SCREENED POSITIVE WITH NECESSARY SERVICES THROUGH CARE NAVIGATION.
PART V, SECTION B, LINE 11 (CONTINUED)	PARTNERSHIP THROUGH THE PRACTICE GRANT ALSO INCLUDED WORK WITH THE CALIFORNIA CONSORTIUM FOR PREVENTION AND INTERVENTION (CALCPI) TO DEVELOP SOCIAL-EMOTIONAL LEARNING TRAINING MODULES FOR TEACHERS, ADMINISTRATORS, SCHOOL STAFF, SERVICE PROVIDERS, PARENTS, AND EDUCATIONAL STAKEHOLDERS ACROSS MERCED COUNTY. THE MODULES WERE GEARED TOWARD EARLY ELEMENTARY (TK-2ND GRADE), LATE ELEMENTARY (3RD-5TH GRADE), MIDDLE SCHOOL (6TH-8TH GRADE), HIGH SCHOOL (9TH-12TH GRADE), PEER INTERVENTIONISTS, AND COMMUNITY HEALTH WORKERS AND ARE EASILY ACCESSIBLE TO RURAL COMMUNITIES OF MERCED COUNTY. THE COLLABORATION WITH CPI ALSO RESULTED IN ADDITIONAL SUPPORT OF FOSTER YOUTH THROUGH COLLABORATIVE WORK WITH COURT APPOINTED SPECIAL ADVOCATES OF MERCED COUNTY.THROUGH THE GRANT, VALLEY CHILDREN'S HELPED TO IDENTIFY PATIENTS AND FAMILIES AT RISK FOR POOR HEALTH OUTCOMES BECAUSE OF ACES AND TOXIC STRESS; EDUCATE PROVIDERS, STAFF AND COMMUNITY MEMBERS AROUND ACES AND TOXIC STRESS AND HOW TO INTERVENE; CONNECT FAMILIES TO NEEDED RESOURCES; AND BUILD RESILIENCE TO BREAK THE CYCLE.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 RECEIVED APPROPRIATE RESOURCES AND SUPPORT WHEN THEY RETURNED TO SCHOOL. THE PARTNERSHIP ENDED IN MAY 2023.YOUTH HEALTH AMBASSADORSIN MAY 2023, THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS) ANNOUNCED THE CHILD AND YOUTH RESILIENCE CHALLENGE. IN RESPONSE, VALLEY CHILDREN'S PROVIDED IN-KIND SUPPORT TO THE FRESNO COMMUNITY HEALTH IMPROVEMENT PARTNERSHIP (FCHIP) AND THEIR YOUTH LEADERSHIP COUNCIL (YLC) IN THE APPLICATION AND PLANNING OF A NOVEL CURRICULUM BY AND FOR YOUNG ADOLESCENTS BUILT AROUND STRESS BUSTERS WAYS TO MANAGE DAY-TO-DAY STRESS AND COUNTER TOXIC STRESS. THE CURRICULUM, TITLED "YOUTH HEALTH AMBASSADORS", IS A PILOT PROGRAM THAT INCLUDES EDUCATION AND COMMUNITY OUTREACH TO BUILD RESILIENCE, AND WAS ONE OF 14 FINALISTS SELECTED FROM OVER 500 APPLICATIONS FROM ACROSS THE US. COMMUNITY-BASED COLLABORATION AND EDUCATION IN SEPTEMBER 2022, VALLEY CHILDREN'S HEALTHCARE WAS SELECTED TO PARTICIPATE WITH 15 OTHER CHILDREN'S HOSPITALS IN A NATIONAL COLLABORATIVE AIMED AT PREVENTING YOUTH SUICIDE THROUGH IMPROVED HOSPITAL SCREENING, INTERNAL SYSTEMS OF CARE AND REGIONAL COMMUNITY COLLABORATIONS AIMED AND REDUCING YOUTH SUICIDE TO ZERO. AS THE COLLABORATIVE LEADERS---CARDINAL HEALTH FOUNDATION AND THE ZERO SUICIDE INITIATIVE---HAVE SAID, "ZERO SUICIDE IS THE ONLY GOAL TO STRIVE TOWARDS." REGIONAL COLLABORATIVES IN WHICH VALLEY CHILDREN'S PARTICIPATED INCLUDED THE FRESNO SUICIDE PREVENTION COLLABORATIVE AND THE MADERA COUNTY SUICIDE EDUCATION AND AWARENESS COLLABORATIVE THAT ADDRESSED ISSUES OF MENTAL HEALTH, HOMELESSNESS AND THE 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.VIOLENCE AND INJURY PREVENTIONCHILD ABUSE PREVENTIONVALLEY CHILDREN'S GUILDS CHILD ABUSE PREVENTION AND TREATMENT CENTER'S MISSION IS TO PROVIDE COMPREHENSIVE SERVICES TO CHILDREN, DEPENDENT ADULTS AND THEIR FAMILIES THROUGH A MULTIDISCIPLINARY, TRAUMA-INFORMED PROGRAM, AND TO MEET THE PHYSICAL AND EMOTIONAL NEEDS OF VICTIMS WITH ABUSE CONSIDERATIONS.THE CENTER IS RECOGNIZED IN CENTRAL CALIFORNIA AND AROUND THE STATE AS A LEADER IN ADVOCACY, INJURY PREVENTION AND ACADEMIC TRAINING. THE CENTER PRIDES ITSELF ON WORKING COLLABORATIVELY WITH PREVENTION AND INTERVENTION GROUPS THROUGHOUT THE STATE TO ENSURE THEY ARE ADDRESSING CHILD MALTREATMENT TO THE BEST OF THEIR ABILITY. THE CENTER IS CURRENTLY A MEMBER OF THE CHILD ADVOCACY CENTERS OF CALIFORNIA, CENTRAL CALIFORNIA COALITION OF CHILD ABUSE PREVENTION COUNCILS, AND THE RAY E. HELFER SOCIETY FOR CHILD ABUSE PEDIATRICS.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 ALSO ARE AVAILABLE SEVEN DAYS A WEEK, 24 HOURS A DAY FOR EMERGENCY COVERAGE. THE CENTER INCLUDES AN INPATIENT COMPONENT THAT EVALUATES AN ADDITIONAL 100 CHILDREN ANNUALLY IN THE PEDIATRIC EMERGENCY DEPARTMENT, ACUTE-CARE AND PEDIATRIC INTENSIVE CARE UNITS. 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.IN 2023, THE CENTER WORKED CLOSELY WITH LAW ENFORCEMENT, CHILD PROTECTIVE SERVICES AND DISTRICT ATTORNEYS' OFFICES IN THEIR INVESTIGATIVE EFFORTS OF CHILD MALTREATMENT. COLLABORATIVE EFFORTS INCLUDED CASE CONSULTATION AND MONTHLY SUSPECT CHILD ABUSE AND NEGLECT 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 CONTINUED TO COLLABORATE WITH INTERNAL AND EXTERNAL PARTNERS TO PROVIDE EDUCATION TO PARENTS, CAREGIVERS, HEALTHCARE PERSONNEL, TEACHERS AND MANDATED REPORTERS. THESE PARTNERS INCLUDED VALLEY CHILDREN'S TRAUMA DEPARTMENT'S INJURY PREVENTION TEAM AND EMERGENCY DEPARTMENT, SAFE KIDS CENTRAL CALIFORNIA, CHILD ABUSE PREVENTION COUNCILS OF CALIFORNIA, CHILD PROTECTIVE SERVICES, DISTRICT ATTORNEY'S OFFICES, LOCAL LAW ENFORCEMENT AGENCIES, SEXUAL ASSAULT RESPONSE TEAMS (SART), VICTIM ADVOCACY GROUPS AND COUNTY PUBLIC HEALTH DEPARTMENTS.INJURY PREVENTION PROGRAMUNINTENTIONAL INJURY IS THE NUMBER ONE KILLER OF CHILDREN ACROSS THE UNITED STATES AND AROUND THE WORLD. SAFE KIDS CENTRAL CALIFORNIA IS ONE OF 400 COALITIONS THAT ARE PART OF SAFE KIDS WORLDWIDE, AN EXTENSIVE NETWORK OF COALITIONS AND PARTNERS IN THE UNITED STATES AND AROUND THE WORLD TO REDUCE INJURIES FROM MOTOR VEHICLE, SPORTS, DROWNINGS, FALLS, BURNS, POISONINGS, AND MORE. AS THE LEAD AGENCY FOR SAFE KIDS CENTRAL CALIFORNIA, VALLEY CHILDREN'S IS PROUD TO BE A LEADER IN SUPPORTING PEDIATRIC INJURY PREVENTION EFFORTS THROUGHOUT CENTRAL CALIFORNIA AND IS COMMITTED TO PROVIDING RESOURCES TOWARD THESE EFFORTS. SAFE KIDS CENTRAL CALIFORNIA IS A COALITION OF 30 AGENCIES MADE UP OF HEALTHCARE, LAW ENFORCEMENT, SOCIAL SERVICES, EDUCATION, MEDIA, AND OTHER ORGANIZATIONS THAT ARE DEDICATED TO PREVENTING UNINTENTIONAL INJURY IN CHILDREN.IN 2023, VALLEY CHILDREN'S INJURY PREVENTION PROGRAM RECORDED 3,577 CONTACTS WITH COMMUNITY MEMBERS DURING 16 COMMUNITY-BASED TEACHING EVENTS ON THE FOLLOWING TOPICS: ATV SAFETY, CARBON MONOXIDE POISONING PREVENTION, CHILD PASSENGER SAFETY, CONCUSSIONS, GUN STORAGE SAFETY, HALLOWEEN SAFETY, HOME SAFETY, POISON PREVENTION, RAILROAD SAFETY, SAFE INFANT SLEEP, TEEN DRIVING, TOY SAFETY, VEHICLE SAFETY, VEHICULAR HEAT STROKE PREVENTION AND WATER SAFETY.IN ORDER TO ENSURE THAT CHILDREN WERE SAFE AT HOME, VALLEY CHILDREN'S DISTRIBUTED THE FOLLOWING SAFETY EQUIPMENT TO FAMILIES IN 2023.- 795 BICYCLE HELMETS- 26 GUN SAFETY LOCKS- 105 CAR SEATS AS A RESULT OF 188 CAR SEATS CHECKED AT 5 SEPARATE CAR SEAT CHECK EVENTSDISASTER PREPAREDNESSVALLEY CHILDREN'S DONATED SPACE TO THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH TO STORE PHARMACEUTICALS TO BE USED IN REGIONAL DISASTERS OR MEDICAL EMERGENCIES.POISON CONTROLTHE CENTRAL CALIFORNIA POISON CONTROL CENTER IS LOCATED ON THE VALLEY CHILDREN'S CAMPUS AND RECEIVED A DONATION OF OFFICE SPACE IN 2023 FROM VALLEY CHILDREN'S. THE CENTER ANSWERS CALLS 24 HOURS A DAY, SEVEN DAYS A WEEK, AND PROVIDES EXPERT ADVICE AND INFORMATION REGARDING EXPOSURE TO POTENTIALLY HARMFUL SUBSTANCES.NEEDS NOT ADDRESSEDSINCE VALLEY CHILDREN'S CANNOT DIRECTLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY, WE WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT WE CAN MOST EFFECTIVELY ADDRESS GIVEN OUR AREAS OF FOCUS AND EXPERTISE. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, VALLEY CHILDREN'S WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA, INCLUDING ECONOMIC INSECURITY, HOUSING AND HOMELESSNESS, AND SUBSTANCE USE.
PART V, SECTION B, LINE 13H:	FACILITY REPORTING GROUP - A200% OR LESS FEDERAL POVERTY GUIDELINES (FPG) - FULL CHARITABLE DISCOUNT $0 CHARGES.201%-400% 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.400% - HIGH MEDICAL COST DISCOUNT, INCOME FOR THE LAST 12 MONTHS DOES NOT EXCEED 400% 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) 2022

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) 2022

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 $ 9,601,391.
PART III, LINE 2:	COSTING METHODOLOGY:ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES. 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 4:	FOOTNOTE DESCRIBING BAD DEBT EXPENSE: SEE PAGE 17-20, NOTE 2 OF THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:	MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2023 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:	IN ADDITION TO PERFORMING THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE FACILITY HAS MADE ITS MOST RECENT FY2022 CHNA AVAILABLE ON ITS PUBLIC WEBSITE AND ASKS FOR PUBLIC COMMENTS TO SOLICIT ADDITIONAL INFORMATION AND INPUT ON COMMUNITY HEALTH NEEDS. FACILITY STAFF ACTIVELY PARTICIPATE IN LOCAL COLLABORATIVE GROUPS THAT CONVENE TO IDENTIFY AND ADDRESS COMMUNITY HEALTH AND WELFARE NEEDS. MEMBERS OF FACILITY STAFF SERVE ON COMMUNITY ORGANIZATION GOVERNING BOARDS AND ADVISORY BODIES TO PUBLIC HEALTH AGENCIES, AND INFORMATION OBTAINED FROM THIS ACTIVE COMMUNITY INVOLVEMENT FACTORS INTO IDENTIFICATION OF COMMUNITY HEALTH NEEDS.
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:	VALLEY CHILDREN'S HEALTHCARE IS CENTRAL CALIFORNIA'S ONLY HIGH-QUALITY, COMPREHENSIVE HEALTHCARE NETWORK DEDICATED TO CHILDREN, FROM BEFORE BIRTH TO YOUNG ADULTHOOD, AS WELL AS TO HIGH-RISK PREGNANT WOMEN, OFFERING HIGHLY SPECIALIZED MEDICAL AND SURGICAL SERVICES TO CARE FOR CONDITIONS RANGING FROM COMMON TO THE HIGHLY COMPLEX.VALLEY CHILDREN'S SERVICE AREA IS FOCUSED ON THE SEVEN COUNTIES THAT COLLECTIVELY ACCOUNT FOR MORE THAN 90% OF VALLEY CHILDREN'S INPATIENT AND OUTPATIENT VOLUME. THOSE COUNTIES ARE FRESNO, KERN, KINGS, MADERA, MERCED, STANISLAUS AND TULARE.THE TOTAL POPULATION OF VALLEY CHILDREN'S HOSPITAL'S SEVEN-COUNTY SERVICE AREA COUNTIES IS 3,454,760. DENSITIES RANGED FROM 72.74 PERSONS PER SQUARE MILE IN MADERA COUNTY TO 363.09 PERSONS PER SQUARE MILE IN STANISLAUS COUNTY. THE PERCENTAGE OF CHILDREN AND TEENS, AGES 0 TO 17, RANGED FROM 27.2% IN KINGS COUNTY AND STANISLAUS COUNTY TO 31.0% IN TULARE COUNTY, AS COMPARED TO CALIFORNIA AT 23.0%. THE PERCENTAGE OF ADULTS, AGES 18 TO 64, RANGED FROM 57.9% IN TULARE COUNTY TO 62.8% IN KINGS COUNTY. THE PERCENTAGE OF ADULTS, AGES 65 AND OLDER, RANGED FROM 10.0% IN KINGS COUNTY TO 13.8% IN MADERA COUNTY.AMONG SERVICE AREA COUNTIES, THE HISPANIC OR LATINO POPULATIONS RANGED FROM 46.3% IN STANISLAUS COUNTY TO 64.6% IN TULARE COUNTY. WHITE POPULATIONS RANGED FROM 27.6% IN MERCED COUNTY TO 41.9% IN STANISLAUS COUNTY. ASIAN POPULATIONS RANGED FROM 1.9% IN MADERA COUNTY TO 10.1% IN FRESNO COUNTY. BLACK OR AFRICAN AMERICAN POPULATIONS RANGED FROM 1.3% IN TULARE COUNTY TO 5.8% IN KINGS COUNTY.THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ANNUALLY UPDATES OFFICIAL POVERTY LEVELS. IN 2019, THE FEDERAL POVERTY LEVEL (FPL) WAS AN ANNUAL INCOME OF $12,490 FOR ONE PERSON AND $25,750 FOR A FAMILY OF FOUR. AMONG RESIDENTS OF THE SERVICE AREA COUNTIES, POVERTY RATES RANGED FROM 15.1% IN STANISLAUS COUNTY TO 23.8% IN TULARE COUNTY. LOW-INCOME RATES (200% OF FPL OR BELOW) IN THE SERVICE AREA RANGED FROM 37.9% IN STANISLAUS COUNTY TO 50.1% IN TULARE COUNTY. ADULTS, BELOW 200% FPL, RECEIVING FOOD STAMPS, RANGED FROM 11.0% IN KINGS COUNTY TO 32.0% IN FRESNO COUNTY. PARENTS OR GUARDIANS OF ELIGIBLE CHILDREN WHO PARTICIPATED IN THE WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM RANGED FROM 44.5% IN MADERA COUNTY TO 82.6% IN MERCED COUNTY.THE HEALTHY PEOPLE 2030 OBJECTIVE FOR HEALTH INSURANCE COVERAGE FOR ALL POPULATION GROUPS IS 92.1%. HEALTH INSURANCE COVERAGE FOR ALL POPULATIONS RANGED FROM 91.7% IN FRESNO, MADERA, AND MERCED COUNTIES TO 94.3% IN STANISLAUS COUNTY. HEALTH INSURANCE COVERAGE FOR CHILDREN AND YOUTH, AGES 0 TO 18, RANGED FROM 96.1% IN MADERA COUNTY TO 97.8% IN STANISLAUS COUNTY. CHILDREN AND YOUTH, AGES 0 TO 18, WHO HAD MEDICAID (MEDI-CAL) HEALTH INSURANCE COVERAGE RANGED FROM 43.2% IN STANISLAUS COUNTY TO 70.4% IN TULARE COUNTY. IN 2023, 74.2% OF VALLEY CHILDREN'S INPATIENT AND 73.6% OF OUTPATIENT VISITS WERE COVERED BY MEDICAID.ALL SERVICE AREA COUNTIES HAVE ONE OR MORE FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS.
PART VI, LINE 5:	PROMOTION OF COMMUNITY HEALTHTHE GOVERNING BOARD OF VALLEY CHILDREN'S HOSPITAL IS COMPRISED OF MEMBERS OF THE COMMUNITY. NONE OF THE GOVERNING BODY MEMBERS ARE COMPENSATED FOR THEIR BOARD SERVICE.THE HOSPITAL FACILITY MAINTAINS AN OPEN MEDICAL STAFF EXCEPT IN RARE INSTANCES WHEN A CLINICAL DEPARTMENT IS "CLOSED" IN ACCORDANCE WITH CALIFORNIA LAW FOR HOSPITAL-BASED SERVICES. AS A NONPROFIT ORGANIZATION, ANY SURPLUS FUNDS ARE INVESTED BACK INTO PROVIDING HEALTH CARE SERVICES AND RESOURCES TO THE COMMUNITY, INCLUDING BUT NOT LIMITED TO NEW PATIENT CARE LOCATIONS AND EQUIPMENT, EXPANDED PROGRAMS AND SERVICES, AND THE TRAINING OF PHYSICIANS, NURSES, AND OTHER HEALTH PROFESSIONALS. VALLEY CHILDREN'S PEDIATRIC RESIDENCY PROGRAM IS AFFILIATED WITH THE STANFORD UNIVERSITY SCHOOL OF MEDICINE AND PROVIDES GENERAL AND ADVANCED CLINICAL PEDIATRIC TRAINING. THE PROGRAM PLAYS A CRITICAL ROLE IN MEETING THE PEDIATRIC PHYSICIAN NEEDS OF THE CENTRAL VALLEY.THE RESEARCH PROGRAM AT VALLEY CHILDREN'S HOSPITAL CONSISTS OF NATIONAL MULTI-CENTER CLINICAL TRIALS AND LOCALLY GENERATED, PHYSICIAN-INITIATED RESEARCH STUDIES. OUR FOCUS IS TO PARTICIPATE IN STUDIES THAT ARE TAILORED TO MEET THE VARYING NEEDS OF OUR PATIENT POPULATION. VALLEY CHILDREN'S ONCOLOGY RESEARCH PROGRAM IS A MEMBER OF THE CHILDREN'S ONCOLOGY GROUP, AN INTERNATIONAL NETWORK OF CLINICAL TRIALS, WHICH IS FEDERALLY FUNDED BY THE NATIONAL CANCER INSTITUTE.
PART VI, LINE 6:	N/A
PART VI, LINE 7, REPORTS FILED WITH STATES	CA

Schedule H (Form 990) 2022

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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

2022

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) FOODLINK TULARE COUNTY 611 2ND ST EXETER,CA93221	94-2558802	501(C)(3)	7,500	SPONSORSHIP
(2) MAKE A WISH 351 W CROMWELL AVE STE 112-A FRESNO,CA93711	68-0027351	501(C)(3)	7,500	SPONSORSHIP
(3) UNITED WAY OF STANISLAUS COUNTY 422 MCHENRY AVE MODESTO,CA95354	94-1212129	501(C)(3)	7,500	DONATION
(4) BUDDHIST TZU CHI FOUNDATION 3898 N ANN AVE FRESNO,CA93727	94-2952782	501(C)(3)	10,000	SPONSORSHIP
(5) COURT APPOINTED SPECIAL ADVOCATES 2300 TULARE ST STE 210 FRESNO,CA93706	77-0401361	501(C)(3)	10,000	SPONSORSHIP
(6) SAN JOAQUIN RIVER PARKWAY 11605 OLD FRIANT RD FRESNO,CA93730	77-0196692	501(C)(3)	10,000	SPONSORSHIP
(7) WEST FRESNO FAMILY RESOURCE CENTER 1802 E CALIFORNIA AVE FRESNO,CA93706	77-0577093	501(C)(3)	10,000	SPONSORSHIP
(8) RONALD MCDONALD HOUSE 9161 RANDALL WAY MADERA,CA93636	94-2864490	501(C)(3)	10,000	SPONSORSHIP
(9) MARJAREE MASON CENTER 1600 M STREET FRESNO,CA93721	94-1156639	501(C)(3)	10,600	SPONSORSHIP
(10) THE BOYS & GIRLS CLUBS OF FRESNO COUNTY 540 N AUGUSTA AVE FRESNO,CA93701	94-1149171	501(C)(3)	15,000	DONATION
(11) CATHOLIC CHARITIES DIOCESE OF FRESNO 149 N FULTON ST FRESNO,CA93701	94-1678938	501(C)(3)	15,000	DONATION
(12) FRESNO MISSION 263 G ST FRESNO,CA93716	94-1279785	501(C)(3)	25,000	DONATION
(13) PUBLIC HEALTH INSTITUTE 555 12TH ST STE 600 OAKLAND,CA94607	94-1646278	501(C)(3)	25,000	SCHOOL HEALTH & WELLNESS CONSORTIUM
(14) FRESNO METROPOLITAN MINISTRY 3845 N CLARK STE 101 FRESNO,CA93726	94-2181848	501(C)(3)	50,000	SPONSORSHIP
(15) VALLEY CHILDREN'S MEDICAL GROUP 9300 VALLEY CHILDRENS PLACE MADERA,CA93636	46-4150987	501(C)(3)	535,698	DONATION
(16) VALLEY CHILDREN'S HEALTHCARE 9300 VALLEY CHILDRENS PLACE MADERA,CA93636	46-4158433	501(C)(3)	70,000	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) 2022

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	5	12,500
(2) EDUCATION SCHOLARSHIP - RESPIRATORY FOCUS	2	2,000
(3) CAFETERIA MEALS	13355		82,133	FMV	MEAL COUPONS FOR PATIENT FAMILIES
(4) TAXI, BUS AND TRANSIT SERVICES	11195		176,456	BOOK	SUBSIDIZATION OF BUS AND TRANSIT SERVICES
(5) CANCER SURVIVORSHIP SCHOLARSHIP	34	34,000
(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. CANCER SURVIVORSHIP SCHOLARSHIPS ARE DESIGNED TO HELP HOSPITAL PEDIATRIC CANCER SURVIVORS WITH THEIR COLLEGE/VOCATIONAL EDUCATION EXPENSES. A COMMITTEE REVIEWS APPLICATIONS ON AN ANNUAL BASIS AND APPROVES THE SCHOLARSHIP. ALL RECIPIENTS ARE CURRENT OR FORMER PATIENTS OF THE HOSPITAL'S CANCER AND BLOOD DISORDER CENTER. 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) 2022

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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

2022

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

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

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

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

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

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

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

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2022

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)	1,697,554 ------------- 0	1,055,670 ------------- 0	236,098 ------------- 0	28,380 ------------- 0	33,920 ------------- 0	3,051,622 ------------- 0	0 ------------- 0
2BEVERLY HAYDEN-PUGH SVP/ADVR TO CEO (AS OF 3/23)	(i) (ii)	541,784 ------------- 0	306,632 ------------- 0	659,451 ------------- 0	115,966 ------------- 0	16,481 ------------- 0	1,640,314 ------------- 0	626,884 ------------- 0
3MICHELE R WALDRON SVP, CFO	(i) (ii)	687,772 ------------- 0	348,416 ------------- 0	258,100 ------------- 0	29,403 ------------- 0	25,627 ------------- 0	1,349,318 ------------- 0	0 ------------- 0
4NATALE PONTICELLO JR SVP/ADVR TO SVP & CPO (AS OF 3/23)	(i) (ii)	434,793 ------------- 0	126,255 ------------- 0	608,852 ------------- 0	96,295 ------------- 0	2,671 ------------- 0	1,268,866 ------------- 0	578,763 ------------- 0
5DAVID CHRISTENSEN SVP, CPE & PRES VCMG	(i) (ii)	834,988 ------------- 0	239,546 ------------- 0	134,662 ------------- 0	28,380 ------------- 0	24,127 ------------- 0	1,261,703 ------------- 0	0 ------------- 0
6JANE WILLSON SVP, CHIEF STRATEGY OFFICER	(i) (ii)	450,116 ------------- 0	130,971 ------------- 0	125,306 ------------- 0	444,649 ------------- 0	7,831 ------------- 0	1,158,873 ------------- 0	72,764 ------------- 0
7DAVID HODGE JR VP, MEDICAL GROUP & ANCILLARY OP	(i) (ii)	480,639 ------------- 0	120,271 ------------- 0	57,436 ------------- 0	98,914 ------------- 0	29,898 ------------- 0	787,158 ------------- 0	55,573 ------------- 0
8KEVIN SHIMAMOTO VP AND ADVISOR TO CIO	(i) (ii)	431,175 ------------- 0	113,303 ------------- 0	120,967 ------------- 0	97,137 ------------- 0	7,831 ------------- 0	770,413 ------------- 0	68,205 ------------- 0
9DANIELLE BARRY SVP, COO	(i) (ii)	452,417 ------------- 0	123,694 ------------- 0	97,170 ------------- 0	62,936 ------------- 0	32,748 ------------- 0	768,965 ------------- 0	61,148 ------------- 0
10KAREN DAHL VP, MED AFFAIRS & PHYS DEV	(i) (ii)	449,135 ------------- 0	116,951 ------------- 0	87,029 ------------- 0	91,696 ------------- 0	10,991 ------------- 0	755,802 ------------- 0	64,717 ------------- 0
11MICHAEL GOLDRING SVP STRATEGIC PARTNERSHIPS	(i) (ii)	492,449 ------------- 0	145,234 ------------- 0	57,794 ------------- 0	28,380 ------------- 0	14,510 ------------- 0	738,367 ------------- 0	0 ------------- 0
12LYNNE ASHBECK SVP, CHIEF COMMUNITY IMPACT OFF	(i) (ii)	421,891 ------------- 0	117,478 ------------- 0	82,670 ------------- 0	94,212 ------------- 0	0 ------------- 0	716,251 ------------- 0	65,836 ------------- 0
13WILLIAM CHALTRAW JR SVP, CHIEF LEGAL OFFICER	(i) (ii)	465,919 ------------- 0	135,435 ------------- 0	55,093 ------------- 0	21,720 ------------- 0	30,298 ------------- 0	708,465 ------------- 0	0 ------------- 0
14JOLIE LIMON VP ACAD AFFAIRS, DIO & CHI	(i) (ii)	384,372 ------------- 0	99,128 ------------- 0	57,729 ------------- 0	87,503 ------------- 0	9,648 ------------- 0	638,380 ------------- 0	41,223 ------------- 0
15JOEL BROWNELL VP, CHIEF MED INFO OFF. (THRU 9/23)	(i) (ii)	356,198 ------------- 0	92,778 ------------- 0	83,645 ------------- 0	79,324 ------------- 0	24,515 ------------- 0	636,460 ------------- 0	67,035 ------------- 0
16STEPHANIE VANCE VP, FINANCE	(i) (ii)	361,498 ------------- 0	90,880 ------------- 0	57,731 ------------- 0	82,836 ------------- 0	29,898 ------------- 0	622,843 ------------- 0	45,688 ------------- 0
17JESSIE HUDGINS VP, FACILITIES & SUPPORT (THRU 1/23)	(i) (ii)	320,280 ------------- 0	84,276 ------------- 0	112,954 ------------- 0	77,569 ------------- 0	4,634 ------------- 0	599,713 ------------- 0	49,123 ------------- 0
18JOSEPH EGAN VP & CIO	(i) (ii)	318,926 ------------- 0	51,934 ------------- 0	35,883 ------------- 0	25,455 ------------- 0	38,193 ------------- 0	470,391 ------------- 0	0 ------------- 0
19VICKY TILTON VP PATIENT CARE SVCS/CNO (AS OF 3/23	(i) (ii)	327,795 ------------- 0	69,749 ------------- 0	24,470 ------------- 0	11,600 ------------- 0	29,922 ------------- 0	463,536 ------------- 0	0 ------------- 0
20KELLY BEALL SVP/CHIEF PEOPLE OFFICER (AS OF 3/23	(i) (ii)	262,969 ------------- 0	30,750 ------------- 0	21,078 ------------- 0	13,289 ------------- 0	36,193 ------------- 0	364,279 ------------- 0	0 ------------- 0
21KELLIE DYER VP SUPPLY, CONSTR & FAC. (AS OF 1/23	(i) (ii)	209,610 ------------- 0	30,525 ------------- 0	8,210 ------------- 0	17,254 ------------- 0	9,306 ------------- 0	274,905 ------------- 0	0 ------------- 0
22MIMI CHAO MD FORMER CHIEF OF STAFF	(i) (ii)	12,500 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	12,500 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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 3	VALLEY CHILDREN'S HOSPITAL RELIED ON A RELATED ORGANIZATION, VALLEY CHILDREN'S HEALTHCARE, TO ESTABLISH THE COMPENSATION AND BENEFITS USING ALL OF THE METHODS INCLUDED ON LINE 3 EXCEPT "FORM 990 OF OTHER ORGANIZATIONS AND "WRITTEN EMPLOYMENT CONTRACT."
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 USED AS A RETENTION TOOL FOR CERTAIN KEY EXECUTIVES. PARTICIPANTS OF THIS PROGRAM FORFEIT ELIGIBILITY FOR THE DCSERP (SEE SCHEDULE L PART V FOR A BROADER DESCRIPTION) AND 5) AN ADDITIONAL DEFERRED COMPENSATION PLAN BENEFITTING CERTAIN KEY EXECUTIVES. TODD SUNTRAPAK, DAVID HODGE JR, DANIELLE BARRY, LYNNE ASHBECK, STEPHANIE VANCE, VICKY TILTON, JOSEPH EGAN AND KELLIE DYER WERE ELIGIBLE TO CONTRIBUTE TO THE DEFERRED COMPENSATION PLAN, BUT NO CONTRIBUTIONS WERE MADE. $826,153 WAS PAID OUT OF THE DCSERP PLAN DURING THE YEAR. DCSERP PAYOUT AND EMPLOYER ACCRUAL TO THE DCSERP FOR CALENDAR YEAR 2022 ARE AS FOLLOWS: BEVERLY HAYDEN-PUGH - DCSERP PAYOUT $87,591; ACCRUAL $87,586 JESSIE HUDGINS - DCSERP PAYOUT $49,123; ACCRUAL $49,336 JANE WILLSON - DCSERP PAYOUT $72,764; ACCRUAL $72,760 STEPHANIE VANCE - DCSERP PAYOUT $45,688; ACCRUAL $54,456 NATALIE PONTICELLO - DCSERP PAYOUT $67,188; ACCRUAL $67,915 KAREN DAHL - DCSERP PAYOUT $64,717; ACCRUAL $69,447 KEVIN SHIMAMOTO - DCSERP PAYOUT $68,205; ACCRUAL $68,908 DANIELLE BARRY - DCSERP PAYOUT $61,148; ACCRUAL $51,336 JOEL BROWNELL - DCSERP PAYOUT $67,035; ACCRUAL $56,744 DAVID HODGE - DCSERP PAYOUT $55,573; ACCRUAL $69,638 LYNNE ASHBECK - DCSERP PAYOUT $65,836; ACCRUAL $65,832 JOLIE LIMON - DCSERP PAYOUT $41,223; ACCRUAL $59,123 MICHAEL GOLDRING, WILLIAM CHALTRAW, JR, DAVID CHRISTENSEN, TODD SUNTRAPAK, MICHELE WALDRON, DANIELLE BARRY, KELLY BEALL, AND VICKY TILTON PARTICIPATE IN THE SPLIT-DOLLAR LIFE INSURANCE PROGRAM IN LIEU OF THE DCSERP. BEVERLY HAYDEN-PUGH AND NATALIE PONTICELLO PARTICIPATE IN A 457F RABBI TRUST DEFERRED COMPENSATION PLAN. THE FOLLOWING AMOUNTS PAID DURING THE 2022 CALENDAR YEAR: BEVERLY HAYDEN-PUGH - $539,293 NATALIE PONTICELLO - $511,576 THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) WAS FROZEN IN 2011. NO NEW PARTICIPANTS WERE ALLOWED TO ENTER THE PLAN AND EXISTING PARTICIPANTS NO LONGER ACCRUED BENEFITS. JANE WILLSON, THE REMAINING ACTIVE PLAN PARTICIPANT, RECEIVED THE FINAL BENEFIT PAYMENT DUE FROM THE PLAN IN THE AMOUNT OF $343,609 DURING THE CALENDAR YEAR 2022.
PART I, LINE 7	AN INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON NETWORK WIDE GOALS TO QUALIFYING INDIVIDUALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING 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 AND APPROVES THE PLAN GOALS AT THE BEGINNING OF THE PLAN YEAR AND ACHIEVEMENT OF THESE GOALS, AND FORECASTED PAYOUTS, AT THE END OF EACH YEAR.

Schedule J (Form 990) 2022

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	OFFICER	SPLIT INTEREST INSURANCE		X	11,109,107	11,477,905		No	Yes		Yes
(2) MICHELE WALDRON	OFFICER	SPLIT INTEREST INSURANCE		X	9,721,634	10,021,972		No	Yes		Yes
(3) DAVID CHRISTENSEN	KEY EMPLOYEE	SPLIT INTEREST INSURANCE		X	5,282,545	5,457,914		No	Yes		Yes
(4) WILLIAM CHALTRAW	KEY EMPLOYEE	SPLIT INTEREST INSURANCE		X	2,122,641	2,193,108		No	Yes		Yes
(5) MICHAEL GOLDRING	HIGHEST COMPENSATED EMPLOYEE	SPLIT INTEREST INSURANCE		X	5,498,581	5,681,122		No	Yes		Yes
(6) TODD SUNTRAPAK	OFFICER	SEE BELOW STATEMENT 2		X	5,000,000	4,730,020		No	Yes		Yes
(7) DANIELLE BARRY	KEY EMPLOYEE	SPLIT INTEREST INSURANCE		X	5,061,842	5,126,537		No	Yes		Yes
(8) KELLY BEALL	KEY EMPLOYEE	SPLIT INTEREST INSURANCE		X	5,657,652	5,729,962		No	Yes		Yes
(9) VICKY TILTON	KEY EMPLOYEE	SPLIT INTEREST INSURANCE		X	4,494,584	4,552,029		No	Yes		Yes
(10) WILLIAM CHALTRAW	KEY EMPLOYEE	SPLIT INTEREST INSURANCE		X	3,140,219	3,180,354		No	Yes		Yes
Total ............... $						58,150,923

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:

STATEMENT 1: - THE HOSPITAL HAS ENTERED INTO LIFE INSURANCE-BASED ARRANGEMENTS WITH CERTAIN KEY EXECUTIVES. THE PURPOSE OF THESE ARRANGEMENTS IS TO RETAIN THE EXECUTIVES FOR A SPECIFIED PERIOD OF TIME AND THEREFORE ACCESS TO THIS BENEFIT IS SUBJECT TO EXTENDED VESTING REQUIREMENTS. THE HOSPITAL FULLY FUNDED THE PREMIUMS ON THE ASSOCIATED LIFE INSURANCE POLICIES AT IMPLEMENTATION AND THERE ARE NO ADDITIONAL FUNDING REQUIREMENTS. UNDER THE ARRANGEMENTS, THE HOSPITAL WILL ACCRUE INVESTMENT RETURNS AND INTEREST ON THE PREMIUMS PAID FOR THE LIFE INSURANCE POLICIES. UPON THE DEATH OF A COVERED EXECUTIVE, THE HOSPITAL WILL BE REPAID THE INVESTMENT AND ACCRUED RETURNS AND ANY REMAINING EXCESS PROCEEDS WILL BE DONATED TO THE HOSPITAL TO BE USED TO SERVE THE COMMUNITY AND OTHERWISE FULFILL ITS MISSION. THE VALUE OF THIS DONATION AS OF 9/30/23 IS ESTIMATED TO BE IN EXCESS OF $78.9M.STATEMENT 2: LOAN FOR RESIDENCE AS A RETENTION INCENTIVE IN LIEU OF OTHER COMPENSATION. ANNUAL LOAN FORGIVENESS REPRESENTS TAXABLE INCOME REPORTED IN SCHEDULE J PART II B (III) AS OTHER REPORTABLE COMPENSATION.

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 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. IN ADDITION, A MEETING IS HELD TO REVIEW THE FORM 990 AND PROVIDE FOR ADDITIONAL TIME TO ANSWER QUESTIONS. 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 VI, SECTION B, LINE 16B:	WHILE THERE IS NO WRITTEN POLICY OR PROCEDURE FOR THE ARRANGEMENT, ANY JOINT VENTURE IS REVIEWED BY LEGAL COUNSEL WHO CONSIDERS THE IMPACTS OF THE TAX-EXEMPT STATUS OF THE ORGANIZATION.
FORM 990, PART IX, LINE 11G	PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 85,242,832. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 85,242,832. PROFESSIONAL FEES - OTHER: PROGRAM SERVICE EXPENSES 22,060,357. MANAGEMENT AND GENERAL EXPENSES 70,200. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,130,557. CONSULTING & MANAGEMENT FEES - ON PARENT: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 250,570. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 250,570.
FORM 990, PART XI, LINE 9:	GAIN ON SALE OF ASSETS 6,866. PASS-THROUGH INVESTMENT INCOME -2,296,979.

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:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

VALLEY CHILDREN'S HOSPITAL

Employer identification number

94-1294954

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) HERNDON TEMPERANCE LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 81-2808671	REAL PROPERTY	CA	732,318	6,821,021	VALLEY CHILDREN'S HOSPITAL

Part II

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

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

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) FOWLER BUSINESS & PROFESSIONAL PARK LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 47-1813772	REAL ESTATE INVESTMENT	CA	N/A	RELATED	452,532	16,481,218	Yes			Yes		50.000 %
(2) COMPASS HEALTH ADMINISTRATORS LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 82-2891309	BENEFIT ADMIN	CA	N/A					No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) VALLEY CHILDREN'S HOLDINGS I LLC 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 37-1872422	HEALTHCARE	CA	N/A	C					No
(2) FOWLER BUSINESS & PROFESSIONAL PARK PROPERTY OWNERS ASSOCIATION 9300 VALLEY CHILDRENS PLACE MADERA,CA93636 30-1030354	PROPERTY OWNERS ASSOCIATION	CA	FOWLER BUSINESS & PROFESSIONAL PARK LLC	C		2,960	50.000 %		No

Schedule R (Form 990) 2021

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) VALLEY CHILDREN'S MEDICAL GROUP	B	535,698	COST
(2) VALLEY CHILDREN'S MEDICAL GROUP	M	59,666,435	COST

Schedule R (Form 990) 2021

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 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	18
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	3,957
6	Total number of volunteers (estimate if necessary) .............	6	277
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,296,979
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	2,432,528

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	48,366,824	9,460,031
9	Program service revenue (Part VIII, line 2g) .........	1,039,778,586	748,650,351
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	31,738,502	50,512,885
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	8,555,197	12,944,813
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,128,439,109	821,568,080
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	5,311,220	1,218,901
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)	353,708,857	369,980,125
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)....	415,230,372	404,558,073
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	774,250,449	775,757,099
19	Revenue less expenses. Subtract line 18 from line 12.......	354,188,660	45,810,981
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,061,981,246	2,141,940,535
21	Total liabilities (Part X, line 26).............	378,845,445	370,211,936
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,683,135,801	1,771,728,599

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 590,418,608 including grants of $ 1,218,901 ) (Revenue $ 748,650,351 )
	VALLEY CHILDREN'S HOSPITAL IS CENTRAL CALIFORNIA'S ONLY PEDIATRIC HOSPITAL, FEATURING THE REGION'S ONLY LEVEL IV NICU, A RENOWNED PEDIATRIC CANCER AND BLOOD DISEASES CENTER AND A PIONEERING HEART CENTER. WE WERE THE FIRST CHILDREN'S HOSPITAL WEST OF THE ROCKIES TO EARN THE MAGNET NURSING DESIGNATION - THE HIGHEST NURSING BENCHMARK - AND U.S. NEWS & WORLD REPORT RANKS US ONE OF THE NATION'S TOP CHILDREN'S HOSPITALS IN SEVEN SPECIALTIES. OUR TEAM OF 670 PHYSICIANS AND 3,500 STAFF MEMBERS PROVIDES HIGH-QUALITY CARE TO MORE THAN 1.3 MILLION CHILDREN IN THE REGION. SEE OUR COMPLETE COMMUNITY BENEFIT REPORT ON OUR WEBSITE AT WWW.VALLEYCHILDRENS.ORG/ABOUT-US/COMMUNITY BENEFIT.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses590,418,608

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	17,069,484	6,000	2,052,140

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	6,682,995
e	Government grants (contributions)		1e	2,041,225

f	All other contributions, gifts, grants, and similar amounts not included above		1f	735,811

g	Noncash contributions included in lines 1a - 1f:$		1g	23,507

h Total. Add lines 1a-1f.......		9,460,031

		Business Code
2a	PATIENT SERVICES	900099	729,393,794	729,393,794
b	HOME CARE 340B PROGRAM	900099	12,767,478	12,767,478
c	MANAGEMENT SERVICES	541610	6,358,252	6,358,252
d	LAB SERVICES	900099	130,827	130,827
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		748,650,351

3 Investment income (including dividends, interest, and othersimilar amounts) ......			45,000,954		2,296,979	42,703,975
4 Income from investment of tax-exempt bond proceeds			991,314			991,314
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,071,093	6a
b	Less: rental expenses		900,412	6b
c	Rental income or (loss)		170,681	6c
d	Net rental income or (loss).......			170,681			170,681
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	215,084	462,358,692	7a
b	Less: cost or other basis and sales expenses	12,288	458,040,871	7b
c	Gain or (loss)	202,796	4,317,821	7c
d	Net gain or (loss).........			4,520,617			4,520,617
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	347,412
b	Less: cost of goods sold ..		10b	114,873
c	Net income or (loss) from sales of inventory..			232,539			232,539
Business Code			Miscellaneous Revenue
11a	CAFETERIA REVENUE		900099	2,465,351			2,465,351
b
c
d	All other revenue ....			10,076,242			10,076,242
e	Total. Add lines 11a–11d ......			12,541,593
12	Total revenue. See instructions.....			821,568,080	748,650,351	2,296,979	61,160,719

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	905,798	905,798
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	313,103	313,103
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 ...........	16,288,559		16,288,559
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........	269,024,999	204,541,576	64,483,423
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	15,544,658	11,767,834	3,776,824
9	Other employee benefits .......	48,730,118	34,104,507	14,625,611
10	Payroll taxes ...........	20,391,791	14,885,391	5,506,400
11	Fees for services (non-employees):
a	Management ......	3,227,341	143,116	3,084,225
b	Legal .........	2,468,197		2,468,197
c	Accounting ...........	259,528		259,528
d	Lobbying ...........	140,313		140,313
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	3,586,116		3,586,116
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	107,623,959	107,303,189	320,770
12	Advertising and promotion ....	2,423,314	68,134	2,355,180
13	Office expenses .......	120,131,218	111,636,040	8,495,178
14	Information technology ......	8,293,056	6,072,837	2,220,219
15	Royalties ..
16	Occupancy ...........	8,839,016	6,780,012	2,059,004
17	Travel ............	734,200	232,776	501,424
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	263,583	58,135	205,448
20	Interest ...........	10,289,834	7,856,893	2,432,941
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	36,973,886	20,252,153	16,721,733
23	Insurance ...	6,031,328		6,031,328
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	38,061,845	38,061,845
b	PURCHASED SERVICES	33,760,888	15,004,771	18,756,117
c	BAD DEBT	9,601,391	9,601,391
d	UBI TAXES	150,000	150,000
e	All other expenses	11,699,060	679,107	11,019,953
25	Total functional expenses. Add lines 1 through 24e	775,757,099	590,418,608	185,338,491	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 ........			885,991	1	812,358
2	Savings and temporary cash investments .........			646,160,966	2	488,908,207
3	Pledges and grants receivable, net ......			777,563	3	968,363
4	Accounts receivable, net .............			111,218,980	4	103,018,092
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 .......
				38,534,416	5	58,150,923
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 ............			13,677,924	8	14,738,794
9	Prepaid expenses and deferred charges ......			13,822,499	9	11,904,486
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	881,108,958
b	Less: accumulated depreciation	10b	436,053,238	400,603,378	10c	445,055,720
11	Investments—publicly traded securities .			461,048,891	11	536,982,420
12	Investments—other securities. See Part IV, line 11 .....			206,266,947	12	251,771,950
13	Investments—program-related. See Part IV, line 11 ..			45,306,074	13	44,683,956
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			123,677,617	15	184,945,266
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,061,981,246	16	2,141,940,535

17	Accounts payable and accrued expenses .....	96,249,707	17	90,954,979
18	Grants payable ...		18
19	Deferred revenue .........		19
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 ..	254,735,818	23	246,977,204
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	27,859,920	25	32,279,753
26	Total liabilities. Add lines 17 through 25..	378,845,445	26	370,211,936

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,650,610,632	27	1,744,021,434
28	Net assets with donor restrictions ...........	32,525,169	28	27,707,165
	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 ...........	1,683,135,801	32	1,771,728,599
33	Total liabilities and net assets/fund balances ........	2,061,981,246	33	2,141,940,535

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