SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet Attach to Form 990.
MediumBullet Go to www.irs.gov/Form990EZ for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public Inspection
Name of the organization
SEATTLE CHILDREN'S HOSPITAL
 
Employer identification number

91-0564748
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
b
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: . . . . . . . .
3b
Yes
 
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
No
c
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? . . . . . . . . . . . . .
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) . . . 		1 19,342 10,589,000 647,000 9,942,000 0.590 %
b Medicaid (from Worksheet 3, column a) . . . . . 20 194,411 606,352,000 377,142,000 229,210,000 13.540 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . . 21 213,753 616,941,000 377,789,000 239,152,000 14.130 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4). 84   11,723,587 2,883,690 8,839,897 0.520 %
f Health professions education (from Worksheet 5) . . . 97   46,818,844 9,361,461 37,457,383 2.210 %
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) . 7   228,016,343 155,016,807 72,999,536 4.310 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . . 16   1,071,616 263,831 807,785 0.050 %
j Total. Other Benefits . . 204   287,630,390 167,525,789 120,104,601 7.090 %
k Total. Add lines 7d and 7j . 225 213,753 904,571,390 545,314,789 359,256,601 21.220 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 1   7,000 0 7,000 0 %
3 Community support 7   382,320 76,672 305,648 0.020 %
4 Environmental improvements 4   15,520 0 15,520 0 %
5 Leadership development and
training for community members		 1   1,359 0 1,359 0 %
6 Coalition building 4   7,866 0 7,866 0 %
7 Community health improvement advocacy            
8 Workforce development 9   1,242,118 125,811 1,116,307 0.070 %
9 Other 1   10,000 0 10,000 0 %
10 Total 27   1,666,183 202,483 1,463,700 0.090 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
917,895
3
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. ......
3
0
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
6,576,162
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
8,890,321
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-2,314,159
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 SEATTLE CHILDREN'S HOSPITAL
4800 SAND POINT WAY NE
SEATTLE,WA98105
WWW.SEATTLECHILDRENS.ORG
178019356 		X X X X   X X      
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
SEATTLE CHILDREN'S HOSPITAL
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 18
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.SEATTLECHILDRENS.ORG/COMMUNITYHEALTHASSESSMENT
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
SEATTLE CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEATTLECHILDRENS.ORG/CLINICS/PAYING-FOR-CARE/FINANCIAL-ASSISTANCE
b
FINASST.SEATTLECHILDRENS.ORG
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 6
Part VFacility Information (continued)

Billing and Collections
SEATTLE CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
SEATTLE CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 8
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference Explanation
SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 3J: SEATTLE CHILDREN'S CONDUCTED ITS THIRD COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2019 TO COVER THE FISCAL PERIOD ENDING 2019-2022 (TAX YEARS 2018-2021) IN ORDER TO:- INVOLVE STAKEHOLDERS AND THE COMMUNITY TO IDENTIFY AND ANALYZE COMMUNITY HEALTH NEEDS AND ASSETS IN ORDER TO PRIORITIZE THESE NEEDS AND TO PLAN AND ACT UPON SIGNIFICANT UNMET COMMUNITY HEALTH NEEDS.- MORE DEEPLY UNDERSTAND HEALTH AND SAFETY ISSUES FACING UNDERSERVED AND UNDER RESOURCED POPULATIONS WHO EXPERIENCE HEALTH INEQUITIES, USING EXISTING DATA AND THE PERSPECTIVES OF COMMUNITY STAKEHOLDERS AND FAMILIES.- IDENTIFY AND DOCUMENT COMMUNITY STRENGTHS, EXISTING PROGRAMS, AND ACTIVITIES THAT ARE HELPING THE COMMUNITY THRIVE.- INFORM OUR COMMUNITY BENEFIT EFFORTS BY DETERMINING WHERE THE COMMUNITY NEEDS ALIGN WITH SEATTLE CHILDREN'S STRATEGIC PLAN, GOALS, OR AREAS IN WHICH WE HAVE SIGNIFICANT EXPERTISE.THROUGH THIS CHNA, WE HAVE GAINED A BETTER UNDERSTANDING OF THE NEEDS AND RESOURCES OF THE COMMUNITIES WE SERVE. THE NEEDS ASSESSMENT LAYS THE FOUNDATION FOR OUR COMMUNITY HEALTH IMPLEMENTATION STRATEGIES, WHICH GUIDE HOW WE WILL CONTINUE TO FULFILL OUR COMMITMENT TO CHILDREN, TEENS AND FAMILIES, IN PARTNERSHIP WITH HEALTH ORGANIZATIONS, GOVERNMENT, BUSINESSES, COMMUNITY BASED ORGANIZATIONS AND COMMUNITIES.SEATTLE CHILDREN'S CHNA HIGHLIGHTS JUST A FEW OF THE MANY DEDICATED GOVERNMENT, NONPROFIT AND PRIVATE ORGANIZATIONS SERVING OUR COMMUNITY'S MOST VULNERABLE POPULATIONS. ORGANIZATIONS SUCH AS THE HEALTHY KING COUNTY COALITION, THE CHILDHOOD OBESITY PREVENTION COALITION AND THE HEALTH COALITION FOR CHILDREN AND YOUTH ARE POWERFUL ADVOCATES FOR CHILDREN AND FAMILIES. ORGANIZATIONS AND PROVIDERS LIKE COMMUNITY HEALTH CLINICS, UNIVERSITY OF WASHINGTON, HARBORVIEW MEDICAL CENTER, YAKIMA CHILDREN'S VILLAGE, YOUTHCARE, CENTER FOR CHILD AND YOUTH JUSTICE, UNITED WAY, CASCADE BICYCLE CLUB, SEATTLE PARKS AND RECREATION, THE CHILDREN'S ALLIANCE, SOLID GROUND, AND WITHINREACH OFFER EDUCATION, ADVOCACY, CLINICAL CARE, RESEARCH AND/OR DIRECT SERVICES TO HELP CHILDREN, YOUTH AND FAMILIES GET THE HEALTHCARE, HEALTH AND WELL BEING AND PREVENTIVE SERVICES THEY NEED. STATE AND LOCAL PUBLIC HEALTH DEPARTMENTS ARE KEY TO GETTING ESSENTIAL DATA AND TO HELPING FOSTER PROGRAM, POLICY, ENVIRONMENTAL AND SYSTEM CHANGE.IN THE CHNA, THE FOLLOWING THEMES EMERGED FROM OUR QUALITATIVE RESEARCH:- ACCESSIBLE MENTAL AND BEHAVIORAL HEALTH SERVICES FOR CHILDREN, TEENS AND YOUNG ADULTS CONTINUES TO BE AN UNMET NEED IN MANY COMMUNITIES, ESPECIALLY FOR NON-ENGLISH SPEAKERS AND FAMILIES LIVING IN RURAL AREAS.- OVER THE LAST DECADE, RATES OF DEPRESSION AMONG YOUTH HAVE INCREASED BY AS MUCH AS 30% ACROSS THE WASHINGTON, ALASKA, MONTANA AND IDAHO (WAMI) REGION. SUICIDE RATES HAVE ALSO BEEN ON THE RISE, WITH ABOUT 1 IN 10 HIGH SCHOOLERS REPORTING THAT THEY HAD ATTEMPTED SUICIDE.- INJURIES, BOTH UNINTENTIONAL AND INTENTIONAL, CONTINUE TO HURT, HARM AND HOSPITALIZE CHILDREN IN THE REGION. MOTOR VEHICLE COLLISIONS, DROWNING, AND POISONINGS ARE SOME OF THE LEADING CAUSES OF UNINTENTIONAL INJURY.-MANY FAMILIES ACROSS THE REGION STRUGGLE TO AFFORD HEALTHY FOODS AND OTHER BASIC NEEDS WHEN FACED WITH HIGH HOUSING, CHILD CARE AND HEALTHCARE COSTS. LIVING WAGES IN SOME COMMUNITIES MAY NOT BE KEEPING PACE WITH THESE COSTS.- THE MAJORITY OF HIGH SCHOOL STUDENTS ARE NOT MEETING THE DAILY PHYSICAL ACTIVITY RECOMMENDATION AND DO NOT CONSUME THE RECOMMENDED AMOUNT OF FRUITS AND VEGETABLES EACH DAY. - DIFFICULTIES NAVIGATING THE HEALTHCARE SYSTEM AND FINDING RELIABLE AND AFFORDABLE TRANSPORTATION TO GET TO AND FROM APPOINTMENTS CONTINUE TO BE BARRIERS TO ACCESSING CARE; AS DO SHORTAGES OF LOCAL SUBSPECIALTY SERVICES AND LONG WAITLISTS FOR AVAILABLE SERVICES.- CIGARETTE SMOKING RATES AMONG HIGH SCHOOL STUDENTS CONTINUE TO DECLINE, BUT THE RATE OF ELECTRONIC VAPOR PRODUCT USE HAS STAYED STEADY OR INCREASED ACROSS THE WAMI REGION. RATES OF ALCOHOL, MARIJUANA AND OTHER DRUG USE VARY ACROSS THE REGION.- COORDINATED CARE AND COMMUNICATION BETWEEN HEALTHCARE PROVIDERS, SCHOOLS AND FAMILIES IS CRITICAL TO GOOD HEALTH. THIS IS ESPECIALLY IMPORTANT FOR CHILDREN AND YOUTH WITH SPECIAL HEALTHCARE NEEDS.- HEALTH DISPARITIES ARE CAUSED BY INEQUITIES AND EXIST ACROSS THE REGION BY RACE, ETHNICITY, GENDER, GEOGRAPHY, SOCIOECONOMIC STATUS, ENVIRONMENTAL FACTORS, HEALTH LITERACY AND DISABILITY. TO MEET THE DIVERSE NEEDS IN OUR COMMUNITY, CULTURALLY RELEVANT SERVICES ARE NEEDED.ASSESSMENT RESULTS HAVE VALIDATED OUR EXISTING WORK AND HAVE HELPED US PRIORITIZE WHERE AND HOW TO FOCUS OUR NEW WORK. GIVEN THE COMPLEXITY OF COMMUNITY NEEDS AND THE FINITE RESOURCES AVAILABLE TO MEET THEM, WE HAVE DIFFICULT CHOICES. WE BELIEVE THAT BY WORKING IN PARTNERSHIP WITH OTHERS, OUR EFFORTS WILL BE AMPLIFIED THROUGHOUT THE COMMUNITY.FOR SEATTLE CHILDREN'S COMMUNITY HEALTH IMPLEMENTATION STRATEGIES, AND AS A DIRECT RESULT OF THE CHNA, WE HAVE IDENTIFIED FOUR PRIORITY AREAS:- MENTAL AND BEHAVIORAL HEALTH- SUICIDE & INJURY PREVENTION- ECONOMIC SECURITY- HEALTHY LIFESTYLES (HEALTHY EATING, ACTIVE LIVING AND FOOD SECURITY)WE HAVE SUSTAINED FOUR OTHER COMMUNITY BENEFIT PROGRAMS:- ACCESS AND CARE COORDINATION- ADOLESCENT HEALTH- PROGRAMS AND SERVICES FOR CHILDREN WITH SPECIAL NEEDS- FAMILY EDUCATION AND RESOURCESOUR PRIORITIES HAVE BEEN APPROVED BY THE SEATTLE CHILDREN'S HOSPITAL GOVERNING BOARD OF TRUSTEES AND INCORPORATED INTO THE HOSPITAL'S OPERATING, COMMUNITY OUTREACH AND STRATEGIC INITIATIVES. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE ON OUR WEBSITE:WWW.SEATTLECHILDRENS.ORG/COMMUNITYHEALTHASSESSMENTTHE COMMUNITY HEALTH IMPLEMENTATION STRATEGIES ARE AVAILABLE ON OUR WEBSITE:WWW.SEATTLECHILDRENS.ORG/COMMUNITYBENEFIT
SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 5: IN THE 2019 COMMUNITY HEALTH NEEDS ASSESSMENT (TAX YEARS 2018-2021), SEATTLE CHILDREN'S COMPILED EXISTING CHILD AND ADOLESCENT HEALTH DATA TO DESCRIBE DETERMINANTS OF HEALTH AND SOLICITED DIRECT FEEDBACK FROM COMMUNITY STAKEHOLDERS AND FAMILIES. TO GATHER INFORMATION AND ASSESS COMMUNITY NEEDS AND STRENGTHS, WE:- CONDUCTED A REVIEW OF PUBLIC HEALTH INDICATORS AND AREA DEMOGRAPHICS FROM EXISTING SOURCES.- PROVIDED AN ONGOING DATA ANALYSIS WITH OUR LOCAL PUBLIC HEALTH DEPARTMENT(S) INCLUDING THE HIRING OF TWO SUMMER MASTERS IN PUBLIC HEALTH STUDENTS, CO-SUPERVISED BY THE PUBLIC HEALTH SEATTLE KING COUNTY DEPARTMENT'S ASSESSMENT, POLICY DEVELOPMENT AND EVALUATION UNIT AND THE COMMUNITY HEALTH & BENEFIT TEAM AT SEATTLE CHILDREN'S TO HELP US CONDUCT AND AUTHOR THE ASSESSMENT.- ENGAGED WITH COALITIONS THAT HAVE EXPERTISE ADDRESSING HEALTH NEEDS, HAVE DIVERSE MEMBERSHIP, AND HAVE A REGIONAL OR SUB-REGIONAL FOCUS. OTHER STAKEHOLDERS INCLUDED THOSE REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY; REPRESENTATIVES OF MEDICALLY UNDER-RESOURCED, LOW-INCOME POPULATIONS, PEOPLE OF COLOR, AND/OR POPULATIONS WITH CHRONIC DISEASES, INCLUDING REPRESENTATIVES FROM LOCAL HEALTH DEPARTMENTS AND FROM THE KING COUNTY ACCOUNTABLE COMMUNITY OF HEALTH, HEALTHIERHERE.- WE HOSTED LISTENING SESSIONS WITH YOUTH, PARENTS, CAREGIVERS AND EXPERTS ON SPECIFIC TOPICS; AND REVIEWED RECENT REPORTS ON LOCAL AND STATE HEALTH NEEDS. - TO IDENTIFY COMMUNITY CONCERNS AND ASSETS, SEATTLE CHILDREN'S WORKED WITH PEDIATRICIANS IN THEIR SECOND YEAR OF RESIDENCY WHO, AS A PART OF THEIR TRAINING, TAKE A MONTH-LONG ROTATION IN THE COMMUNITY HEALTH AND BENEFIT DIVISION OF THE EXTERNAL AFFAIRS AND GUEST SERVICES DEPARTMENT AT SEATTLE CHILDREN'S. THESE RESIDENTS INTERVIEWED STAKEHOLDERS, CONSULTED RECENT COMMUNITY-BASED REPORTS AND PULLED INFORMATION FROM PREVIOUS HOSPITAL CHNAS FOR THE GEOGRAPHIC AREAS THEY WORKED IN FOR THE MONTH.- BETWEEN 2016 AND 2019, THESE PEDIATRICIANS AND THE COMMUNITY HEALTH AND BENEFIT TEAM MEMBERS AT SEATTLE CHILDREN'S WHO TRAINED THEM CONDUCTED 26 LISTENING SESSIONS ACROSS THE WAMI REGION WITH PARENTS OR CAREGIVERS OF CHILDREN AGES 0 TO 21. WE CONDUCTED ALL OF OUR LISTENING SESSIONS IN ENGLISH, AND PROVIDED SPANISH TRANSLATION AT THREE EVENTS, SOMALI TRANSLATION AT FIVE EVENTS, AMHARIC TRANSLATION AT FIVE EVENTS, OROMO TRANSLATION AT ONE EVENT AND VIETNAMESE TRANSLATION AT ONE EVENT. ADDITIONALLY, WE VISITED EIGHT COMMUNITIES THAT WERE URBAN, SUBURBAN OR RURAL, INCLUDING VILLAGES, TO LEARN ABOUT COMMUNITY HEALTH CHALLENGES. - IN ADDITION, WE INTERVIEWED 172 KEY INFORMANTS IN THE WASHINGTON, ALASKA, MONTANA AND IDAHO (WAMI) REGION.- APPROXIMATELY 70% OF THE PARTICIPANTS TAKING PART IN THESE MEETINGS AND LISTENING GROUPS SELF IDENTIFIED AS EITHER LOW-INCOME, PEOPLE OF COLOR, OR FROM MEDICALLY UNDERSERVED COMMUNITIES OR IDENTIFIED AS REPRESENTING THESE POPULATIONS.WE USED TWO FRAMEWORKS: THE SOCIAL-ECOLOGICAL AND THE SPECTRUM OF PREVENTION MODELS TO GATHER BACKGROUND ON AREAS OF NEED. WE ALSO REVIEWED EXISTING STRENGTHS, PROGRAMS AND SERVICES THAT FOCUS ON CHILD AND TEEN HEALTH AND SAFETY ISSUES.
SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 7D: SEATTLE CHILDREN'S EMAILED AN ELECTRONIC COPY OF THE CHNA TO ANYONE UPON REQUEST, INCLUDING THOSE WHO OPTED IN TO RECEIVE ONE AT OUR COMMUNITY BENEFIT FORUMS.
SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 11: OUR 2019 CHNA (APPLICABLE TO TAX YEARS 2018-2021) CENTERS ON THE NEEDS OF FAMILIES, CHILDREN AND YOUTH IN WASHINGTON, ALASKA, MONTANA AND IDAHO (WAMI). OUR CHNA IDENTIFIED FOUR SIGNIFICANT NEEDS, ALL OF WHICH ARE BEING ADDRESSED BY SEATTLE CHILDREN'S PROGRAMMING. BELOW IS AN ACCOUNTING OF THE NEEDS IDENTIFIED AND OUR RESPONSE TO EACH.THE CHNA RESEARCH YIELDED THE FOLLOWING ABOUT THE HEALTH NEEDS OF THE COMMUNITY WE SERVE, BUT IT SHOULD BE KNOWN THAT ACROSS THE WAMI REGION, MANY OF THESE RATES VARY BY RACE, ETHNICITY, GENDER, GEOGRAPHY, BEING IN A RURAL OR URBAN AREA, SOCIOECONOMIC STATUS, ENVIRONMENTAL FACTORS, HEALTH LITERACY AND DISABILITY:MENTAL AND BEHAVIORAL HEALTH:IN WASHINGTON, 25% OF STUDENTS IN 8TH GRADE, 30% OF STUDENTS IN 10TH GRADE AND 28% OF STUDENTS IN 12TH GRADE REPORTED EXPERIENCING DEPRESSIVE FEELINGS. ALSO, OF CHILDREN AGES 2 TO 17, 12% HAVE ONE OR MORE EMOTIONAL, BEHAVIORAL OR DEVELOPMENTAL CONDITION. IN ADDITION TO OUR BED EXPANSION IN OUR PSYCHIATRY AND BEHAVIORAL MEDICINE UNIT, WE HAVE EXPANDED THE PARTNERSHIP ACCESS LINE (PAL), A TELEPHONE-BASED CHILD MENTAL HEALTH CONSULTATION SYSTEM THAT ALLOWS PRIMARY CARE PROVIDERS, NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS TO TREAT KIDS WHILE KEEPING THEM CLOSER TO HOME. CHILD PSYCHIATRISTS AFFILIATED WITH THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE AND SEATTLE CHILDREN'S HOSPITAL PROVIDE RAPID CONSULTATION RESPONSES DURING BUSINESS HOURS FOR ANY TYPE OF MENTAL HEALTH ISSUE THAT ARISES WITH ANY CHILD. FURTHER, WE HAVE EXPANDED TELEMENTAL HEALTH THAT ALLOWS CHILDREN IN CERTAIN UNDERSERVED COMMUNITIES IN THE REGION TO SPEAK WITH A PSYCHIATRIST THROUGH VIDEO CONFERENCING. WE HAVE LAUNCHED THE WASHINGTON'S MENTAL HEALTH REFERRAL SERVICE FOR CHILDREN AND TEENS WHICH CONNECTS FAMILIES WITH OUTPATIENT PROVIDERS LOCALLY WHO HAVE OPENINGS IN THEIR SCHEDULE AND CAN MEET A CHILD'S SPECIALTY NEEDS AND INSURANCE COVERAGE OR LACK THEREOF. ANY WASHINGTON FAMILY CAN USE THIS FREE SERVICE AND WE MAKE REFERRALS FOR CHILDREN AND TEENS 17 AND YOUNGER.LAST, WE HAVE RENEWED OUR FOCUS TO UPSTREAM EFFORTS AROUND MENTAL AND BEHAVIORAL HEALTH SUCH AS OUR POSITIVE PARENTING SERIES AND OUR ODESSA BROWN CHILDREN'S CLINIC PROGRAMMING AROUND MOVEMENT AND SOCCER TO SUPPORT THE RELATIONSHIP BETWEEN BEING HEALTHY AND ACTIVE WITH POSITIVE MENTAL HEALTH APPROACHES.SUICIDE AND INJURY PREVENTION:SUICIDE BY FIREARM, DROWNING, POISONING AND MOTOR VEHICLE CRASHES ARE THE LEADING CAUSES OF DEATH AND INJURY AMONG ADOLESCENTS ACROSS THE WAMI REGION. SUICIDE RATES CONTINUE TO RISE AND FIREARMS ACCOUNT FOR OVER HALF OF THESE DEATHS. DROWNINGS MOST OFTEN OCCUR WHILE SWIMMING, BOATING OR PLAYING IN OR NEAR WATER. POISONS INCLUDE MEDICINES, CLEANING PRODUCTS AND LIQUID NICOTINE. CORRECTLY USED, CHILD SAFETY SEATS CAN REDUCE THE RISK OF DEATH BY 71%, YET MORE THAN HALF ARE USED INCORRECTLY. THESE INJURIES AND DEATHS ARE PREVENTABLE.WE HAVE HELPED DEVELOP SUICIDE AND INJURY PREVENTION TACTICS WHERE WE TAILOR OUR MESSAGE ACCORDING TO THE DEVELOPMENTAL LEVEL, KNOWLEDGE, BELIEFS AND BEHAVIORS OF EACH GROUP WE SERVE. IN ADDITION, WE HAVE FOUNDED THE FIREARM TRAGEDY PREVENTION NETWORK IN WASHINGTON STATE. WE HOST MULTIPLE EVIDENCE-BASED, FREE, SAFE FIREARM STORAGE GIVEAWAY EVENTS WHERE WE DISTRIBUTE LOCK BOXES AND TRIGGER LOCKS IN ORDER TO SAFELY STORE FIREARMS AS A WAY TO PREVENT SUICIDE AND PROVIDE ONE MECHANISM FOR LETHAL MEANS RESTRICTION. IN ADDITION, OUR SECURITY TEAM OFFERS DE-ESCALATION TRAININGS ACROSS THE STATE AND OUR RESEARCH INSTITUTE PURSUES RESEARCH PROJECTS ALIGNED WITH YOUTH SUICIDE, INJURY AND FIREARM TRAGEDY PREVENTION. OUR RESEARCHERS COLLABORATE WITH STATEWIDE PARTNERS TO STUDY THE COURSE AND MANAGEMENT OF DEPRESSION IN YOUNG PEOPLE AND TO STUDY SUICIDAL/SELF-HARMING ADOLESCENTS. OUR PROTECTION ADVOCACY AND OUTREACH TEAM FOCUSES ON CHILD ABUSE PREVENTION, INCLUDING STATEWIDE DISSEMINATION AND TRAINING FOR THE EVIDENCE-BASED PERIOD OF PURPLE CRYING. WE HOST CAR SEAT CHECK EVENTS WHERE TECHNICIANS WORK ALONGSIDE PARENTS AND CAREGIVERS TO ENSURE CAR SEATS ARE PROPERLY INSTALLED AND SHARE THE CORRECT WAY TO SAFELY SECURE A CHILD IN A MOTOR VEHICLE. WE ALSO HOST LOW COST CAR SEAT AND BOOSTER SEAT SALES WITH EDUCATION AND DEMONSTRATION IN OUR FAMILY RESOURCE CENTER. ADDITIONALLY, WE HAVE CONTINUED TO USE OUR EXPERTISE AROUND DROWNING TO IMPLEMENT OPEN-WATER DROWNING PREVENTION STRATEGIES IN PARTNERSHIP WITH MEMBERS OF THE STATEWIDE DROWNING PREVENTION NETWORK, PUBLIC HEALTH, SAFE KIDS AND THROUGH COMMUNITY ORGANIZATIONS INCLUDING HEAD START.HEALTHY LIFESTYLES:OF WASHINGTON HIGH SCHOOL STUDENTS, 11% ARE OBESE AND 14% ARE OVERWEIGHT. POOR DIET AND PHYSICAL ACTIVITY ARE RISK FACTORS FOR BECOMING OVERWEIGHT OR OBESE. EATING FEWER MEALS AT HOME, INCREASED AVAILABILITY AND AFFORDABILITY OF UNHEALTHY FOOD, AND INCREASED PORTION SIZES CAN CONTRIBUTE TO POOR DIET AMONG YOUTH. FOOD INSECURITY AND OBESITY CAN AFFECT THE SAME YOUTH SINCE FOOD INSECURITY IS LARGELY ATTRIBUTED TO LOW INCOME, AND UNDER-RESOURCED COMMUNITIES OFTEN LACK ACCESS TO PLACES SUCH AS PARKS THAT PROMOTE HEALTHY EXERCISE. ALSO, WHEN PEOPLE EAT LESS OR SKIP MEALS TO STRETCH FOOD BUDGETS, THEY MAY OVEREAT WHEN FOOD IS AVAILABLE, OR FILL UP ON AFFORDABLE MEALS HIGH IN FAT, BUT LOW IN NUTRITIONAL VALUE.FOR THESE REASONS, WE HAVE HELPED TAILOR A HEALTH EDUCATION AND NUTRITION COURSE FOR FAMILIES. AT OUR HOSPITAL CAMPUS, WE HAVE BEGUN OFFERING HEALTHIER FOOD OPTIONS FOR STAFF AND FAMILIES, ELIMINATED SUGAR SWEETENED BEVERAGES FROM OUR CAFES, DEVELOPED A TEACHING GARDEN, AND INSTALLED WATER BOTTLE FILLING SITES. WE ARE EXPANDING THE NUMBER OF CLINICS WHERE WE SCREEN FOR FOOD INSECURITY AND HAVE OPENED A FOOD PANTRY ON CAMPUS FOR FAMILIES. WE ARE CONTINUALLY INVESTING IN CULTURALLY AND COMMUNITY TAILORED PROGRAMS TO PROMOTE FOOD AFFORDABILITY AS WELL AS COOKING AND EATING AT HOME. ADDITIONALLY, WE HAVE PARTNERED WITH THE PUBLIC HEALTH DEPARTMENT AND THE HEALTHY KING COUNTY COALITION TO ADDRESS HEALTHY EATING AND ACTIVE LIVING INITIATIVES IN THE COMMUNITIES WE SERVE. WE HAVE ALSO LAUNCHED A 7-5-2-1-0 HEALTHY EATING CURRICULUM THAT WE OFTEN PRESENT AT LOCAL HEALTH FAIRS AND EVENTS IN THE REGION ALONGSIDE OUR ODESSA BROWN CHILDREN'S CLINIC PROGRAMMING ABOUT MINDFULNESS AND NUTRITION.ECONOMIC SECURITY AND BASIC NEEDS:MEETING CHILDREN'S BASIC NEEDS IS CRITICAL TO PROVIDE A FOUNDATION FOR LIFE-LONG HEALTH. THE COMMUNITY ADDRESSED SEVERAL NEEDS INCLUDING AFFORDABLE HOUSING AND CHILDCARE AND AN INCREASE IN PUBLIC TRANSPORTATION, PUBLIC SAFETY AND LIVING WAGES. SOME FAMILIES ALSO DISCUSSED THE COST OF HEALTHCARE SERVICES AND TRAVEL FOR CARE, AND HOW IT IMPACTED THEIR ABILITY TO AFFORD OTHER BASIC NEEDS. CHILD AND TEEN HEALTH ARE INFLUENCED BY A VARIETY OF ENVIRONMENTAL AND SOCIAL FACTORS. SOCIAL RISK FACTORS, SUCH AS POVERTY, RACE AND ETHNICITIES, ARE ASSOCIATED WITH POORER HEALTH OUTCOMES FOR CHILDREN. APPROXIMATELY 14% OF WASHINGTON CHILDREN LIVE IN HOUSEHOLDS UNDER THE POVERTY THRESHOLD. CHILDREN EXPERIENCING POVERTY ARE MORE LIKELY TO ENTER SCHOOL BEHIND THEIR PEERS, SCORE LOWER ON ACHIEVEMENT TESTS, EARN LESS AS ADULTS, AND HAVE WORSE HEALTH OUTCOMES. THIS PATTERN IS ESPECIALLY CLEAR FOR THE POOREST AND YOUNGEST CHILDREN AND THOSE WHO REMAIN IN POVERTY A LONG TIME. THERE IS STRONG EVIDENCE LINKING INCOME AND HEALTH THAT SUGGESTS THAT POLICIES PROMOTING ECONOMIC EQUITY MAY HAVE BROAD HEALTH EFFECTS. WE KNOW THAT INCOME INFLUENCES HEALTH THROUGH VARIOUS CLINICAL, BEHAVIORAL, SOCIAL AND ENVIRONMENTAL WAYS. INCOME INEQUALITY HAS GROWN SUBSTANTIALLY IN RECENT YEARS, WHICH EXACERBATES HEALTH INEQUITIES IN KING COUNTY AND THE WAMI REGION.AS SUCH, OUR GOALS IN THIS AREA ARE TO BECOME AN ANCHOR INSTITUTION THROUGH PLACE-BASED WORK AND INVESTMENTS LOCALLY AND REGIONALLY. THIS MEANS DOCUMENTING A MEASURED INCREASE IN OUR LOCAL, DIVERSE HIRING, ESPECIALLY FROM UNDER-RESOURCED COMMUNITIES IN OUR REGION. WE HAVE SIMILAR GOALS FOR PURCHASED SERVICES AND SUPPLIES AS WELL AS MEASUREABLES OF LOCAL AND DIVERSE HIRING IN EACH OF OUR CONSTRUCTION PROJECTS. WE PLAN ON DEVELOPING AND MAINTAINING LOCAL HOUSING SUPPORTS, SUPPORTING THE MEDICAL LEGAL PARTNERSHIP, REDEVELOPING THE NEW ODESSA BROWN CHILDREN'S CLINIC FOR HEALTH CARE AND MIXED USE AND PARTNERING WITH COMMUNITY TRANSPORTATION SUPPORTS TO REMOVE BARRIERS TO ACCESSING CARE. WE CONTINUE TO CONTRACT WITH OUR LOCAL MEDICAID TRANSPORTATION PROVIDER, HOPELINK, TO STAFF A DESK AT THE HOSPITAL AND FACILITATE RIDES FOR FAMILIES TO AND FROM THEIR APPOINTMENTS.ASSESSMENT RESULTS HAVE VALIDATED OUR EXISTING WORK AND HAVE HELPED US PRIORITIZE WHERE AND HOW TO FOCUS OUR CHNA. HOWEVER, GIVEN THE COMPLEXITY OF COMMUNITY NEEDS AND THE FINITE RESOURCES AVAILABLE TO MEET THEM, WE HAVE DIFFICULT CHOICES. WE BELIEVE THAT BY WORKING IN PARTNERSHIP WITH OTHERS, OUR EFFORTS WILL HAVE RIPPLE EFFECTS THROUGHOUT THE COMMUNITY.
SEATTLE CHILDREN'S HOSPITAL PART V, SECTION B, LINE 13H: DUE TO SOCIOECONOMIC OR OTHER FACTORS SUCH AS KNOWLEDGE THAT THE PATIENT IS HOMELESS, THE STANDARD APPLICATION PROCESS FOR FINANCIAL ASSISTANCE IN RARE CASES MAY NOT BE COMPLETED. IN CASES WHERE A PATIENT CAN BE REASONABLY PRESUMED TO QUALIFY FOR FINANCIAL ASSISTANCE IN THE ABSENCE OF RECEIVING ALL REQUIRED INFORMATION, THE VICE PRESIDENT OF REVENUE CYCLE OR THE CHIEF FINANCIAL OFFICER, OR THEIR DELEGATE, MAY ALSO APPROVE PATIENT ACCOUNT BALANCE WRITE-OFFS TO FINANCIAL ASSISTANCE.
PART V, SECTION B, LINE 3E: AS STATED, SEATTLE CHILDREN'S CONDUCTED ITS THIRD COMPREHENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN 2019 TO COVER THE FISCAL PERIOD ENDING 2019-2022 (TAX YEARS 2018-2021). IN THIS CHNA, WE LOOKED AT AND ANALYZED OVER 150 INDICIES OF PEDIATRIC HEALTH STATUS AND OUTCOMES IN THE WASHINGTON, ALASKA, MONTANA AND IDAHO REGION. AS IDENTIFIED THROUGH THE CHNA, THE PRIORITIZED AND SIGNIFICANT HEALTH NEEDS FOR THE PEDIATRIC POPULATION WE SERVE OVER THIS TIME PERIOD ARE: MENTAL AND BEHAVIORAL HEALTH, SUICIDE AND INJURY PREVENTION, ECONOMIC SECURITY AND HEALTHY LIFESTYLES (AN OVERARCHING TERM MEANING SPECIFICALLY HEALTHY EATING, ACTIVE LIVING AND FOOD SECURITY). IN ALIGNMENT WITH OUR ORGANIZATIONAL MISSION TO PROVIDE HOPE, CARE AND CURES TO HELP EVERY CHILD LIVE THE HEALTHIEST AND MOST FULFILLING LIFE POSSIBLE, OUR CHNA LEANS INTO OUR VALUES OF EXCELLENCE, INTEGRITY, COLLABORATION, EQUITY AND INNOVATION TO BE A LEADER IN PEDIATRIC HEALTH AND WELLNESS THROUGHOUT OUR COMMUNITY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?22
Name and address Type of Facility (describe)
1 1 - RESEARCH INST JACK R MACDONALD BLDG
1900 NINTH AVE
SEATTLE,WA98101 		PEDIATRIC RESEARCH
2 2 - RESEARCH INSTITUTE BUILDING CURE
1920 TERRY AVE
SEATTLE,WA98101 		PEDIATRIC RESEARCH
3 3 - RESEARCH INSTITUTE 307 WESTLAKE
307 WESTLAKE AVE N
SEATTLE,WA98109 		PEDIATRIC RESEARCH
4 4 - RESEARCH INSTITUTE WEST 8TH
2001 EIGHTH AVE SUITE 400
SEATTLE,WA98121 		PEDIATRIC RESEARCH
5 5 - RESEARCH INSTITUTE OLIVE LAB
1100 OLIVE WAY SUITE 100
SEATTLE,WA98101 		PEDIATRIC RESEARCH
6 6 - RESEARCH INSTITUTE MET PARK WEST
1100 OLIVE WAY
SEATTLE,WA98101 		PEDIATRIC RESEARCH
7 7 - BELLEVUE CLINIC & SURGERY CENTER
1500 116TH AVE NE
BELLEVUE,WA98004 		CLINIC, SUB SPECIALTY SERVICES, URGENT CARE AND SURGERY CENTER
8 8 - SEATTLE CHILDREN'S HOME CARE SERVICES
2525 220TH STREET SE SUITE 101
BOTHELL,WA98201 		PEDIATRIC HOME CARE SERVICES THAT SUPPORT HOSPITAL
9 9 - SEATTLE CHILDREN'S SOUTH CLINIC
34920 ENCHANTED PARKWAY S
FEDERAL WAY,WA98003 		AMBULATORY CLINIC PROVIDING PRIMARY, CARDIOLOGY AND SUB SPECIALTY CARE
10 10 - SEATTLE CHILDREN'S NORTH CLINIC
1815 13TH ST
EVERETT,WA98201 		CLINIC, SUB SPECIALTY SERVICES, AND URGENT CARE
11 11 - SEATTLE CHILDREN'S AT OVERLAKE
1135 116TH AVE NE SUITE 400
BELLEVUE,WA98004 		SUB SPECIALTY CARE
12 12 - ODESSA BROWN CHILDREN'S CLINIC
2101 E YESLER WAY
SEATTLE,WA98122 		AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALTY CARE
13 13 - SEATTLE CHILDREN'S AUTISM CENTER
4909 25TH AVE NE
SEATTLE,WA98105 		AUTISM CLINIC
14 14 - SOUTH SOUND CARDIOLOGY CEDAR MED CTR
1901 S CEDAR ST SUITE 103
TACOMA,WA98405 		CARDIOLOGY CLINIC
15 15 - SOUTH SOUND CARDIOLOGY CLEAR CREEK
9800 LEVIN RD NW SUITE 204
SILVERDALE,WA98383 		CARDIOLOGY CLINIC
16 16 - SEATTLE CHILDREN'S OLYMPIA CLINIC
615 LILLY ROAD MEDICAL BLDG SUITE
140
OLYMPIA,WA98506 		AMBULATORY CLINIC PROVIDING PRIMARY, CARDIOLOGY AND SUB SPECIALTY CARE
17 17 - ADOLESCENT MEDICINE AT SPRINGBROOK
4540 SAND POINT WAY NE BLDG 1 STE
200
SEATTLE,WA98105 		ADOLESCENT MEDICAL CLINIC
18 18 - PEDIATRIC CARDIOLOGY OF MONTANA
2510 BOBCAT WAY
GREAT FALLS,MT59405 		CARDIOLOGY CLINIC
19 19 - PEDIATRIC CARDIOLOGY OF ALASKA
3841 PIPER ST SUITE T345
ANCHORAGE,AK99508 		CARDIOLOGY CLINIC
20 20 - SEATTLE CHILDREN'S TRI-CITIES CLINIC
900 STEVENS DR SUITE 204
RICHLAND,WA99352 		AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALTY CARE
21 21 - SEATTLE CHILDREN'S WENATCHEE CLINIC
526 N CHELAN AVE SUITE B
WENATCHEE,WA98801 		PEDIATRIC MEDICAL CLINIC
22 22 - CHILDREN'S ORTHOTICS & PROSTHETICS
4575 SAND POINT WAY NE SUITE 106
SEATTLE,WA98105 		AMBULATORY CLINIC PROVIDING PRIMARY AND SUB SPECIALTY CARE
Schedule H (Form 990) 2019
Schedule H (Form 990) 2019
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: SEATTLE CHILDREN'S HOSPITAL (SEATTLE CHILDREN'S) USES THE FEDERAL POVERTY GUIDELINES (FPG) AS ITS PRIMARY CRITERIA FOR QUALIFYING PATIENTS WHO APPLY FOR FINANCIAL ASSISTANCE. FAMILIES WHO RESIDE IN OUR REGION WITH INCOME BELOW OR EQUAL TO 400% FPG BASED ON THEIR FAMILY SIZE QUALIFY FOR FINANCIAL ASSISTANCE. FURTHERMORE, SEATTLE CHILDREN'S RECOGNIZES THAT FAMILIES WHO HAVE HIGH BALANCES, EVEN WITH HIGHER INCOMES, CAN EXPERIENCE FINANCIAL HARDSHIP. RESPONSIBLE PARTIES WHOSE INCOME IS BETWEEN 400% AND 599% FPG, WHO HAVE INCURRED SIGNIFICANT ACCOUNT BALANCES, AND WHO ARE NOT ELIGIBLE FOR FUNDING FROM OTHER SOURCES ARE ALSO ELIGIBLE FOR SLIDING SCALE FINANCIAL ASSISTANCE WHEREBY THEY ARE RESPONSIBLE FOR PAYING A PERCENTAGE OF THEIR BILL WHICH IS PROPORTIONATELY DISCOUNTED BASED ON THEIR INCOME AND SEATTLE CHIDREN'S FINANCIAL ASSISTANCE FUNDS THE REMAINING BALANCES. FAMILIES WHO RECEIVE A DENIAL OF FINANCIAL ASSISTANCE BASED ON THE FPG AND FAMILY SIZE INFORMATION ARE ALLOWED TO APPEAL THE DENIAL BY PROVIDING INFORMATION ABOUT ADDITIONAL CIRCUMSTANCES IMPACTING THEIR FINANCIAL SITUATION SUCH AS EXCESSIVE MEDICAL DEBT. THE VICE PRESIDENT OF REVENUE CYCLE OR CHIEF FINANCIAL OFFICER, OR THEIR DELEGATE, MAY ADMINISTRATIVELY APPROVE FINANCIAL ASSISTANCE BASED ON THIS ADDITIONAL INFORMATION. THESE SAME INDIVIDUALS CAN ALSO GRANT FINANCIAL ASSISTANCE IN SPECIAL CASES BASED ON SOCIOECONOMIC OR OTHER FACTORS SUCH AS KNOWLEDGE THAT THE PATIENT IS HOMELESS, OR DUE TO OTHER REASONS WHEN THE STANDARD APPLICATION PROCESS FOR FINANCIAL ASSISTANCE IS NOT LIKELY TO BE SUCCESSFULLY COMPLETED EVEN THOUGH THE PATIENT CAN BE REASONABLY PRESUMED TO QUALIFY FOR FINANCIAL ASSISTANCE.
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 $ 1,929,087.
PART I, LINE 6: SEATTLE CHILDREN'S PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THIS REPORT IS AVAILABLE TO THE GENERAL PUBLIC. SEATTLE CHILDREN'S APPLIES THE CATHOLIC HEALTH ASSOCIATION PRINCIPLES AND USES THE "CBISA LYONS" SOFTWARE TO ACCUMULATE THE INFORMATION INCLUDED IN ITS ANNUAL COMMUNITY BENEFIT REPORT. SEE SCHEDULE O FOR THE FULL 2019 COMMUNITY BENEFIT REPORT OR VISIT WWW.SEATTLECHILDRENS.ORG/COMMUNITYBENEFIT.
PART I, LINE 7: THE MISSION OF SEATTLE CHILDREN'S HOSPITAL IS TO PROVIDE EXCELLENT PATIENT CARE FOR CHILDREN, TO ENGAGE IN INNOVATIVE RESEARCH THAT WILL IMPROVE THE HEALTH OF CHILDREN, TO TRAIN THE NEXT GENERATION OF PHYSICIANS, OTHER HEALTHCARE WORKERS AND SCIENTISTS WHO WILL ADVANCE THE HEALTH OF CHILDREN, AND TO ADVOCATE FOR THE HEALTHCARE NEEDS OF CHILDREN. AS PART OF ITS MISSION, SEATTLE CHILDREN'S IS COMMITTED TO CARING FOR CHILDREN IN ITS SERVICE AREA IRRESPECTIVE OF ABILITY TO PAY AND TO OTHERWISE IDENTIFY AND HELP TO MEET THE HEALTHCARE NEEDS OF CHILDREN IN THE COMMUNITY.FINANCIAL ASSISTANCE REPRESENTS THE ESTIMATED COST OF CARE PROVIDED TO CHILDREN WHO ARE UNINSURED OR UNDERINSURED AND WHOSE FAMILIES CANNOT AFFORD TO PAY FOR THEIR MEDICAL CARE. SEATTLE CHILDREN'S PROVIDES FINANCIAL ASSISTANCE IN ACCORDANCE WITH ITS FINANCIAL ASSISTANCE POLICY BASED ON FAMILY NEED AND MAINTAINS RECORDS TO IDENTIFY THE LEVEL OF ASSISTANCE IT PROVIDES. THE DETERMINATION OF FAMILY NEED IS EVALUATED DURING A PATIENT'S COURSE OF CARE AND CAN BE UPDATED AFTER CARE IS COMPLETE. BECAUSE SEATTLE CHILDREN'S DOES NOT PURSUE COLLECTION OF THESE AMOUNTS DETERMINED TO QUALIFY AS FINANCIAL ASSISTANCE, THEY ARE NOT REPORTED AS REVENUE. THE ESTIMATED COST OF FINANCIAL ASSISTANCE PROVIDED IS BASED ON A RATIO OF HOSPITAL TOTAL PATIENT CARE COSTS AS A PERCENTAGE OF HOSPITAL TOTAL GROSS PATIENT CARE CHARGES. THIS COST RATIO IS APPLIED TO GROSS CHARGES RELATED TO CHARITY CARE SERVICES, RESULTING IN THE ESTIMATED COST OF PROVIDING FINANCIAL ASSISTANCE.MEDICAID PAYMENT SHORTFALL REPRESENTS THE ESTIMATED COST OF PROVIDING SERVICES TO PATIENTS COVERED UNDER MEDICAID IN EXCESS OF PAYMENTS RECEIVED. THE ESTIMATED COST OF SERVICES PROVIDED TO MEDICAID PATIENTS IS BASED ON A RATIO OF HOSPITAL TOTAL PATIENT CARE COSTS AS A PERCENTAGE OF HOSPITAL TOTAL GROSS PATIENT CARE CHARGES. THIS COST RATIO IS APPLIED TO GROSS CHARGES RELATED TO SERVICES PROVIDED TO MEDICAID PATIENTS, RESULTING IN THE ESTIMATED COST OF PROVIDING CARE TO THESE PATIENTS.OTHER BENEFITS REPRESENT THE COSTS OF PROVIDING PROGRAMS, NET OF DIRECT OFFSETTING REVENUES, FOR THE BENEFIT OF THE ENTIRE COMMUNITY. THESE BENEFITS INCLUDE RESEARCH, HEALTH PROFESSIONS EDUCATION AND VARIOUS OTHER COMMUNITY-BASED HEALTHCARE PROGRAMS.
PART II, COMMUNITY BUILDING ACTIVITIES: AS PART OF OUR MISSION TO PROVIDE HOPE, CARE AND CURES TO HELP EVERY CHILD LEAD THEIR HEALTHIEST AND MOST FULLFILLING LIFE POSSIBLE, SEATTLE CHILDREN'S MAKES PROACTIVE AND STRATEGIC INVESTMENTS TO HELP CHILDREN AND FAMILIES BE AND STAY HEALTHY IN THE PLACES WHERE THEY LIVE, PLAY AND LEARN. WE WORK WITH OUR COMMUNITIES TO ADDRESS SOME OF THE DETERMINANTS OF HEALTH SUCH AS EDUCATION, HOUSING, ACCESS TO HEALTHY AFFORDABLE FOOD, SOCIAL SUPPORTS AND THE BUILT ENVIRONMENT. SOME EXAMPLES OF OUR COMMUNITY BUILDING ACTIVITIES INCLUDE:- ODESSA BROWN CHILDREN'S CLINIC (OBCC) IS A COMMUNITY CLINIC OF SEATTLE CHILDREN'S. CHILDREN FROM BIRTH THROUGH AGE 21 RECEIVE CARE FROM A TEAM OF SPECIALLY TRAINED PEDIATRIC CARE PROVIDERS. LOCATED IN SEATTLE'S CENTRAL DISTRICT WITH EXPANSION PLANS FOR A NEW CLINIC FURTHER SOUTH, OBCC PROVIDES MEDICAL, DENTAL AND MENTAL HEALTH SERVICES TO OVER 40,000 PATIENTS A YEAR, FOCUSING ESPECIALLY ON FAMILIES IN LOW-INCOME COMMUNITIES. OBCC'S MODEL FOR CARE IS UNIQUE AND ADDRESSES THE SOCIAL, ECONOMIC AND ENVIRONMENTAL ROOTS OF ILLNESS.- EVEN DURING AND DESPITE COVID-19, OUR CLINICAL AND NON-CLINICAL STAFF AND PROVIDERS PROVIDE MENTORING AND SHADOWING OPPORTUNITIES THAT DISCUSS EMPLOYMENT OPPORTUNITIES IN HEALTHCARE TO UNDER RESOURCED STUDENTS AND PEOPLE FROM DIVERSE BACKGROUNDS. ONE OF THE PROGRAMS WE OFFCER REACHES OUT TO PEOPLE WHO ARE PLANNING TO ATTEND MEDICAL SCHOOL TO INCREASE THEIR SKILL SET WHEN APPLYING. IN ADDITION, WE PROVIDE NEONATAL AND PEDIATRIC CLINICAL TRAINING TO RESPIRATORY THERAPISTS AT LOCAL COLLEGES, EVEN VIRTUALLY. OUR GOAL IS TO TRAIN RESPIRATORY THERAPISTS TO PROPERLY ASSESS PATIENTS FOR RESPIRATORY INTERVENTIONS. ONCE THESE THERAPISTS ARE CREDENTIALED AND LICENSED, THEY WILL JOIN EMERGENCY RESPONSE TEAMS AND THEIR SKILLS TO ASSESS PEDIATRIC PATIENTS WILL HAVE A VALUABLE IMPACT IN CASE OF EMERGENCY RESPONSE DEPLOYMENT. WITH CERTAIN TYPES OF DISASTERS AND GLOBAL PANDEMICS, WE ANTICIPATE THE NEED FOR PROFESSIONALS WHO CAN ASSESS THE NEED FOR AND ADMINISTER COMPLEX RESPIRATORY THERAPY TREATMENTS TO PEDIATRIC PATIENTS, SO THE TYPE OF TRAINING WE OFFER IS CRUCIAL. - ADDITIONALLY, SEATTLE CHILDREN'S OFFERS MEDICAL OBSERVERSHIPS AND SHADOWING OPPORTUNITIES WHEREBY INDIVIDUALS WITH OR WITHOUT PRIOR MEDICAL EDUCATION CAN OBSERVE MEDICAL PROFESSIONALS AS THEY CARE FOR PATIENTS AND FAMILIES FOR A SPECIFIC PERIOD OF TIME. WHILE OBSERVERS ARE VISITORS AND NOT INVOLVED IN PATIENT CARE, PARTICIPANTS ARE EXPOSED TO DIFFERENT MEDICAL PROFESSIONS AND ARE OFTEN INSPIRED TO PURSUE A CAREER IN HEALTH CARE DELIVERY. ALSO, THE SEATTLE CHILDREN'S RESEARCH INSTITUTE IS COMMITTED TO HELPING TRAIN THE NEXT GENERATION OF MEDICAL RESEARCHERS AND TO HELPING UNDERREPRESENTED STUDENTS PARTICIPATE IN THAT TRAINING. OUR OFFICE FOR TEACHING, EDUCATION AND RESEARCH ("OTER") LAUNCHED A SUMMER INTERNSHIP PROGRAM FOR UNDERREPRESENTED UNDERGRADUATE STUDENTS. THE PROGRAM RECEIVED MORE THAN 700 APPLICANTS, OF WHICH, 36 STUDENTS WERE GIVEN AN OPPORTUNITY TO ENGAGE IN BASIC, CLINICAL AND/OR TRANSLATIONAL RESEARCH UNDER THE MENTORSHIP OF EXPERIENCED RESEARCHERS AND PRINCIPAL INVESTIGATORS. INTERNS LEARNED NEW RESEARCH METHODOLOGIES, BECAME EXPERIENCED WITH LAB EQUIPMENT, WORKED WITH DATA, CONDUCTED THEIR OWN RESEARCH PROJECTS AND SUBMITTED AN ABSTRACT OF THEIR RESEARCH AT THE END OF THEIR INTERNSHIP. PROJECTS RANGED FROM THE EFFECTS OF SLEEP DEPRIVATION ON EPILEPSY IN A MOUSE MODEL, TO THE SOCIAL IMPACT OF PEDIATRIC SKIN DISORDERS, TO WHY PARENTS ARE STILL REFUSING AND DELAYING VACCINES. INTERNS ALSO ATTENDED A SERIES OF TRAINING SESSIONS ON READING SCHOLARLY ARTICLES, WRITING INDIVIDUAL DEVELOPMENT PLANS, CREATING LINKEDIN PROFILES AND OTHER USEFUL PROFESSIONAL SKILLS.- SEATTLE CHILDREN'S HOSTS THE SCIENCE ADVENTURE LAB. THE SCIENCE ADVENTURE LAB IS A CUSTOM-BUILT, MOBILE SCIENCE LAB OUTFITTED WITH RESEARCH GRADE EQUIPMENT AND SPACE FOR UP TO 30 STUDENTS AT A TIME. THE MOBILE LAB TRAVELS TO SCHOOLS ACROSS WASHINGTON TO PROVIDE INNOVATIVE, HANDS-ON SCIENCE CURRICULUM TO STUDENTS IN GRADES FOUR THROUGH TWELVE REACHING 4,935 CHILDREN IN 2020. INSIDE, STUDENTS PERFORM SCIENCE EXPERIMENTS AND LEARN ABOUT CAREERS IN SCIENCE AND HEALTH CARE. MANY OF THE SCHOOLS ARE IN RURAL AREAS AND/OR HAVE HIGH NUMBERS OF LOW INCOME CHILDREN. THE SCIENCE ADVENTURE LAB PROGRAM OFFERS A VARIETY OF DIFFERENT CURRICULUM MODULES FROM WHICH TEACHERS CAN SELECT. EACH MODULE USES HANDS-ON ACTIVITIES TO TEACH SCIENCE CONTENT WHILE ADDRESSING KEY ISSUES IN PEDIATRIC HEALTH SUCH AS ASTHMA, CONCUSSIONS, NUTRITION AND THE CONNECTION BETWEEN GENES AND HEALTH. IN ADDITION TO THE MOBILE LAB, OUR SCIENCE EDUCATION DEPARTMENT HOSTS HIGH SCHOOL STUDENTS FOR CAREERS IN BIOMEDICAL RESEARCH AND HEALTH CARE THROUGH A YEAR-LONG ACADEMIC PROGRAM, A RESEARCH TRAINING PROGRAM WHEREBY HIGH SCHOOL STUDENTS FROM UNDER REPRESENTED GROUPS APPLY FOR POSITIONS IN OUR RESEARCH TRAINING PROGRAM. WE ALSO HOST THE SCIENCE DISCOVERY LAB AT OUR BUILDING CURE SITE WHERE STUDENTS OF ANY AGE CAN PARTICIPATE IN AUTHENTIC SCIENCE IN A LAB EMBEDDED IN OUR RESEARCH INSTITUTE ITSELF. - ADDITIONALLY, SEATTLE CHILDREN'S IS COMMITTED TO CONTRIBUTING TO TRANSPORTATION IMPROVEMENTS IN NORTHEAST SEATTLE AND BEYOND. THROUGH OUR LIVABLE STREETS INITIATIVE, WE WORK WITH OUR COMMUNITY ON PROJECTS SUCH AS UPGRADES TO LOCAL STREETS SO THAT THEY ARE SAFE FOR PEDESTRIANS AND BIKERS OF ALL AGES AND ABILITIES; INTELLIGENT TRANSPORTATION SYSTEMS THAT USE TECHNOLOGY TO GIVE DRIVERS MORE INFORMATION; AND INTERSECTION IMPROVEMENTS THAT INCREASE SAFETY FOR ALL USERS. IN 2020, OUR COMMUNITY BUILDING WORK INCLUDED COLLABORATION WITH OTHER COMMUNITY PARTNERS SUCH AS FORTERRA AND PLANTED 260 TREES TO SEQUESTER 1,300 TONS OF CARBON.- WE HAVE ALSO INCREASED OUR COMMUNITY BUILDING EFFORTS AMONGST HOSPITAL DEPARTMENTS AND COMMUNITY GROUPS IN THE REGION. EXAMPLES OF OUR INCLUSION NETWORKS ARE: Q POD (LGBTQ) NETWORK, THE GREEN TEAM (SUSTAINABILITY) NETWORK, THE PARENTING NETWORK AND THE BLACK AND AFRICAN HERITAGE NETWORK. THESE GROUPS HAVE PARTNERED WITH COMMUNITY BASED ORGANIZATIONS TO DEVELOP AND SUPPORT PROGRAMMING AS LED BY LOCAL LEADERS AND INVEST IN COMMUNITY BUILDING EFFORTS ON BEHALF OF SEATTLE CHILDREN'S. SOME OF THESE EFFORTS INCLUDE FUNDING SUPPORTIVE HOUSING INITIATIVES AND SUBSIDIZING THE COST OF HOUSING FOR OUR MOST UNDERSERVED RESIDENTS THROUGH THE HOUSING SOLUTIONS FOR HOPE GUILD.- WE ALSO PROVIDE SPONSORSHIPS TO COMMUNITY ORGANIZATIONS THAT SUPPORT CHILDREN, YOUTH AND FAMILIES BY PROVIDING QUALITY CHILDHOOD EDUCATION, WORKFORCE DEVELOPMENT, YOUTH DEVELOPMENT AND PARENTING SKILLS. WE ALSO PARTNER WITH COMMUNITY BASED ORGANIZATIONS AND COALITIONS THAT ADVOCATE FOR COMMUNITY HEALTH IMPROVEMENT, PROVIDE ECONOMIC DEVELOPMENT AND REVITALIZATION, AND HELP MAKE COMMUNITIES SAFER AND HEALTHIER. THIS WORK IS CAPTURED BY THE ORGANIZATION'S ANCHOR MISSION WHEREBY WE ARE WORKING TO ALIGN OUR INSTITUTIONAL ASSETS TO MEANINGFULLY IMPACT THE ECONOMIC AND SOCIAL FACTORS IN OUR COMMUNITY THAT CREATE HEALTH - GOOD JOBS AND DECENT WAGES; SAFE AND AFFORDABLE HOUSING; AND A HEALTHY, CLEAN, AND SAFE ENVIRONMENT.
PART III, LINE 2: THE TOTAL AMOUNT OF BAD DEBT EXPENSE PROVIDED IS BASED ON THE RATIO OF TOTAL PATIENT CARE COSTS AS A PERCENTAGE OF GROSS PATIENT CARE CHARGES. THIS COST RATIO IS APPLIED TO GROSS BAD DEBT EXPENSE, RESULTING IN BAD DEBT EXPENSE AT COST. SEATTLE CHILDREN'S CHARACTERIZES SELF PAY AS BAD DEBT WHEN A FAMILY IS EITHER NOT ELIGIBLE OR HAS NOT APPLIED FOR FINANCIAL ASSISTANCE AND IS UNWILLING OR UNABLE TO PAY AN OUTSTANDING ACCOUNT BALANCE. THE MOST COMMON PATIENT BAD DEBT SCENARIOS INCLUDE UNPAID SELF PAY PORTIONS OF ACCOUNT BALANCES AFTER INSURANCE OR THIRD PARTY ASSISTANCE PAYMENTS OR UNPAID ACCOUNT BALANCES AFTER A BANKRUPTCY FILING. SEATTLE CHILDREN'S IS SENSITIVE TO THE FINANCIAL HEALTH OF FAMILIES AND RECOGNIZES THAT FAMILY FINANCIAL CONCERNS MAY NOT ALWAYS BE EFFECTIVELY COMMUNICATED. SEATTLE CHILDREN'S IS COMMITTED TO MANAGING COLLECTION EFFORTS INTERNALLY, IN A RESPECTFUL MANNER AND WITHOUT USING EXTERNAL COLLECTION OR CREDIT AGENCIES, EXCEPT IN LIMITED CIRCUMSTANCES SUCH AS INTERNATIONAL PATIENTS. SINCE ALL COLLECTION EFFORTS ARE MANAGED INTERNALLY, IN A RESPECTFUL MANNER, SEATTLE CHILDREN'S DOES NOT DISCLOSE ITS COLLECTION PRACTICE IN THE FOOTNOTES OF THE FINANCIAL STATEMENTS.
PART III, LINE 4: THE METHOD FOR DETERMINING UNCOLLECTIBLE ACCOUNTS IS DISCUSSED IN THE SECTION OF FOOTNOTE 9 TITLED "PATIENT ACCOUNTS RECEIVABLE," WHICH IS FOUND ON PAGE 29 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8: MEDICARE ALLOWABLE COSTS ARE OBTAINED DIRECTLY FROM THE MEDICARE COST REPORT AND ARE DETERMINED IN ACCORDANCE WITH THE MEDICARE PRINCIPLES OF REIMBURSEMENT. THE MAJORITY OF SEATTLE CHILDREN'S MEDICARE PATIENTS ARE CHILDREN WITH END STAGE RENAL DISEASE (ESRD) THAT INCLUDES DIALYSIS CARE AND OFTEN A KIDNEY TRANSPLANT ALONG WITH OTHER RELATED SERVICES. THE ESRD CARE OFTEN RESULTS IN A LONGER LENGTH OF STAY AND HIGHER ACUITY. MEDICARE REIMBURSEMENT FOR THESE SERVICES IS SUBJECT TO THE LIMITS OF THE TAX EQUITY AND FISCAL RESPONSIBILITY ACT, WHICH ARE OFTEN BELOW SEATTLE CHILDREN'S COST. THE ACTUAL SHORTFALL IN COST REIMBURSEMENT SHOULD AT LEAST BE TREATED AS COMMUNITY BENEFIT.
PART III, LINE 9B: SEATTLE CHILDREN'S REVENUE CYCLE DEPARTMENT USES A STANDARD, RESPECTFUL PROCEDURE FOR RESOLVING UNPAID PATIENT BALANCES. A. THE STANDARD PROCESS INCLUDES OFFERING FINANCIAL ASSISTANCE TO ELIGIBLE FAMILIES.B. SEATTLE CHILDREN'S PROVIDES A STANDARD 25% DISCOUNT ON HEALTH CARE SERVICES TO PATIENTS WHO ARE UNINSURED IN ACCORDANCE WITH ORGANIZATIONAL POLICIES AND PROCEDURES. THIS DISCOUNT ALIGNS WITH OR IS LOWER THAN DISCOUNTS PROVIDED TO COMMERCIAL INSURERS.C. ADDITIONALLY, SEATTLE CHILDREN'S ATTEMPTS TO ACCOMMODATE U.S. FAMILIES WHO DESIRE TO SET UP REASONABLE INTEREST-FREE PAYMENT PLANS.D. IF A PATIENT ACCOUNT BALANCE REMAINS UNPAID AFTER STANDARD INTERNAL COLLECTION PROCEDURES HAVE BEEN FOLLOWED, AND IF THE FAMILY HAS NOT APPLIED FOR OR DOES NOT QUALIFY FOR SEATTLE CHILDREN'S FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE WILL BE WRITTEN OFF AS BAD DEBT IN ACCORDANCE WITH STANDARD PROCEDURAL TIMELINES. - UPON RECEIPT OF A PERSONAL BANKRUPTCY NOTICE, SEATTLE CHILDREN'S IDENTIFIES ANY OUTSTANDING ACCOUNT BALANCES FOR THE ASSOCIATED PATIENT AND WRITES OFF THESE BALANCES AS BAD DEBT. - SEATTLE CHILDREN'S FINANCE DEPARTMENT MONITORS THE PORTION OF OUTSTANDING ACCOUNTS RECEIVABLE THAT IS CLASSIFIED AS BAD DEBT FOR SIGNIFICANT VARIANCES. - SEATTLE CHILDREN'S STANDARD PRACTICE IS TO COLLECT ON OUTSTANDING PATIENT ACCOUNTS USING INTERNAL RESOURCES. 1. REPORTS ARE NOT SENT TO CREDIT AGENCIES. 2. COLLECTION AGENCIES WILL NOT BE USED TO COLLECT ANY OUTSTANDING PATIENT ACCOUNT EXCEPT AS SPECIFICALLY AUTHORIZED BY THE SENIOR DIRECTOR OF REVENUE CYCLE. 3. THE USE OF COLLECTION AGENCIES WILL ONLY BE PERMITTED IN VERY RARE SCENARIOS WHERE THE FAMILY RESIDES OUTSIDE OF SEATTLE CHILDREN'S SERVICE AREA (E.G., INTERNATIONAL PATIENTS). 4. SEATTLE CHILDREN'S WILL NOT FILE A LIEN AGAINST A PATIENT'S OR FAMILY'S PRIMARY RESIDENCE TO SECURE PAYMENT ON PATIENT ACCOUNT BALANCES.
PART VI, LINE 2: AS PART OF SEATTLE CHILDREN'S STRATEGIC PLAN DEVELOPMENT, WE HAVE DONE RESEARCH TO IDENTIFY SPECIALTY CARE, MENTAL HEALTH AND EMERGENCY CARE ACCESS AND SHORTAGE ISSUES INCLUDING BOTH SERVICES AND STAFFING; ASSESS THE ONGOING NEED FOR UNCOMPENSATED CARE SUPPORT; AND DETERMINE POTENTIAL PARTNERSHIPS TO BETTER ADDRESS THE HEALTH CARE NEEDS OF ALL CHILDREN IN OUR REGION. ADDITIONALLY, NUMEROUS PROGRAMS AND DEPARTMENTS IN THE HOSPITAL CONDUCT NEEDS ASSESSMENTS TO IDENTIFY HEALTH PROMOTION, HEALTH CARE AND HEALTH DISPARITIES THAT IMPACT THE HEALTH OF CHILDREN AND FAMILIES.
PART VI, LINE 3: INFORMATION ABOUT OUR FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE TO EVERY FAMILY THAT COMES TO SEATTLE CHILDREN'S, WHETHER FOR AN INPATIENT STAY, CLINIC VISIT, SURGERY OR THROUGH THE EMERGENCY DEPARTMENT. BOTH APPLICATION FORMS AND SIGNAGE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE AVAILABLE IN ENGLISH, SPANISH, VIETNAMESE, RUSSIAN, AND SOMALI. IN PERSON INTERPRETERS AND THE HOSPITAL'S SPEAK LINE, WHICH ACCESSES TELEPHONE INTERPRETATION, HELP PROVIDE INFORMATION TO FAMILIES WITH LIMITED ENGLISH PROFICIENCY INFORMATION ABOUT FINANCIAL ASSISTANCE. AN APPLICATION FORM IS ALSO AVAILABLE ON THE HOSPITAL WEBSITE. ALL REGISTRATION DESKS HAVE FINANCIAL ASSISTANCE INFORMATION VISIBLE AND AVAILABLE. EVERY INPATIENT AND EMERGENCY DEPARTMENT FAMILY IS OFFERED FINANCIAL ASSISTANCE INFORMATION, WHETHER OR NOT THEY HAVE INSURANCE. ALL HOSPITAL BILLS INCLUDE A STATEMENT ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE IF HELP IS NEEDED IN PAYING A BILL, REGARDLESS OF INSURANCE STATUS.FINANCIAL COUNSELORS ARE AVAILABLE TO MEET INDIVIDUALLY WITH FAMILIES TO HELP DETERMINE WHAT ASSISTANCE THEY MAY QUALIFY FOR AND TO HELP THEM COMPLETE AND SUBMIT FORMS. THE FINANCIAL COUNSELORS RECEIVE INFORMATION THROUGH THE SCHEDULING SYSTEM THAT IDENTIFIES UNINSURED OR UNDERINSURED FAMILIES. FINANCIAL COUNSELORS CONTACT FAMILIES TO CLARIFY ASSISTANCE AVAILABLE AND TO OFFER THEIR HELP WITH APPLYING FOR ASSISTANCE. THEY HELP FAMILIES DETERMINE IF THEY QUALIFY FOR OTHER SOURCES OF FUNDING, INCLUDING MEDICAID AND QUALIFIED HEALTH PLANS SOLD ON THE STATE INSURANCE EXCHANGE. SOCIAL WORKERS ALSO HELP SCREEN FAMILIES FOR FINANCIAL NEEDS AND REFER PATIENTS TO FINANCIAL COUNSELORS.
PART VI, LINE 4: SEATTLE CHILDREN'S SERVES AS THE PEDIATRIC AND ADOLESCENT MEDICAL CENTER FOR WASHINGTON, ALASKA, IDAHO, AND MONTANA, THE LARGEST GEOGRAPHICAL AREA OF ANY CHILDREN'S HOSPITAL IN THE UNITED STATES. WE PRIMARILY SERVE CHILDREN FROM BIRTH TO 21 YEARS OLD, MOST OF WHOM ARE FROM WASHINGTON STATE. OVER 53% OF OUR PATIENTS ARE UNINSURED OR INSURED BY MEDICAID OR THE CHILDRENS HEALTH INSURANCE PROGRAM (KNOWN AS CHIP OR APPLE HEALTH FOR KIDS IN WASHINGTON STATE). IN 2020, 18% OF OUR PATIENTS CAME FROM SEATTLE, 31% FROM KING COUNTY, 47% FROM LOCATIONS IN WASHINGTON STATE OUTSIDE KING COUNTY, 3% FROM ALASKA, MONTANA AND IDAHO AND 1% FROM AREAS OUTSIDE THE REGION. THESE AREAS ARE URBAN, SUBURBAN AND RURAL. OF THE MORE THAN 7.5 MILLION RESIDENTS OF WASHINGTON STATE, NEARLY 25% ARE UNDER 20 YEARS OLD. WASHINGTON STATE DATA ALSO SHOWS THAT 13.5% OF THE POPULATION ARE FOREIGN-BORN WITH 19% SPEAKING A LANGUAGE OTHER THAN ENGLISH AT HOME. OF THE 1.6 MILLION CHILDREN UNDER THE AGE OF 18 IN WASHINGTON STATE, 21% OF THEM ARE OF HISPANIC OR LATINO ORIGIN. ALSO, 18% OF CHILDREN IN WASHINGTON STATE AND 15% OF CHILDREN IN KING COUNTY LIVE IN POVERTY AND 7% OF WASHINGTONIANS (5% KING COUNTY) LIVE IN EXTREME POVERTY. ALMOST HALF OF ALL WASHINGTON RESIDENTS ON MEDICAID ARE CHILDREN OR TEENS. WHILE MEDICAID EXPANSION HAS PLAYED A ROLE IN REDUCING THE UNINSURED RATE IN WASHINGTON STATE, DATA TELLS US THAT 5.5% OF THE WASHINGTON STATE POPULATION IS UNINSURED (400,000 INDIVIDUALS OF ALL AGES) EVEN AFTER THE AFFORDABLE CARE AND PATIENT PROTECTION ACT AND MEDICAID EXPANSION. FOR CHILDREN WHO REMAIN UNINSURED IN WASHINGTON STATE, WE BELIEVE THAT MOST ARE LIKELY ELIGIBLE FOR APPLE HEALTH FOR KIDS, ALTHOUGH THEIR PARENTS MAY NOT BE AWARE OF THEIR ELIGIBILITY. AS THE PEDIATRIC AND ADOLESCENT MEDICAL CENTER FOR WASHINGTON, ALASKA, IDAHO, AND MONTANA, SEATTLE CHILDREN'S HOSPITAL HAS SPECIALIZED IN MEETING THE UNIQUE PHYSICAL, EMOTIONAL AND DEVELOPMENTAL NEEDS OF CHILDREN FROM INFANCY THROUGH YOUNG ADULTHOOD. THROUGH THE COLLABORATION OF PHYSICIANS AND OTHER CARE PROVIDERS IN NEARLY 60 PEDIATRIC SUBSPECIALTIES, WE PROVIDE INPATIENT, OUTPATIENT, DIAGNOSTIC, SURGICAL, REHABILITATIVE, BEHAVIORAL, EMERGENCY AND OUTREACH SERVICES - REGARDLESS OF A FAMILY'S ABILITY TO PAY. WHILE 96% OF OUR PATIENTS HAIL FROM WASHINGTON STATE, THE STATE ITSELF HAS 47 MEDICALLY UNDERSERVED AREAS AND POPULATIONS THROUGHOUT ITS 39 COUNTIES.
PART VI, LINE 5: SEATTLE CHILDREN'S IS GOVERNED BY A BOARD OF TRUSTEES, CONSISTING OF BETWEEN 20-30 VOTING TRUSTEES WHO ARE MEMBERS OF THE LOCAL COMMUNITY. SEATTLE CHILDREN'S FUNCTIONS THROUGH COMMITTEES THAT ARE STAFFED WITH TRUSTEES OF RESPECTIVE BOARDS WHO HAVE SIGNIFICANT EXPERIENCE AND SKILLS REQUIRED BY THAT COMMITTEE, AND IN SOME CASES INCLUDE OUTSIDE MEMBERS WHO ARE NOT TRUSTEES WHEN THEIR KNOWLEDGE OR EXPERIENCE WOULD CONTRIBUTE TO THE WORK OF THE COMMITTEE. SEATTLE CHILDREN'S ALSO EXTENDS MEDICAL STAFF PRIVILEGES TO CERTAIN QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OF ITS DEPARTMENTS. SEATTLE CHILDREN'S ALSO HAS REGIONAL STRATEGIC AFFILIATIONS WITH THE FOLLOWING ENTITIES:- UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE (UWSOM)SEATTLE CHILDREN'S HAS HAD A FORMAL AFFILIATION WITH THE UWSOM SINCE 1974. SEATTLE CHILDREN'S HOSPITAL PROVIDES THE PEDIATRIC COMPONENT OF THE UWSOM UNDERGRADUATE MEDICAL EDUCATION PROGRAM AS WELL AS THE HOSPITAL-BASED PEDIATRIC TRAINING EXPERIENCE FOR ALL POST-GRADUATE PROGRAMS.THE UWSOM, A REGIONAL RESOURCE FOR WASHINGTON, WYOMING, ALASKA, MONTANA, AND IDAHO, IS A NATIONALLY AND INTERNATIONALLY RECOGNIZED LEADER IN MEDICAL EDUCATION, PATIENT CARE, SCIENTIFIC RESEARCH AND COMMUNITY SERVICE. THE UWSOM HAS 30 DEPARTMENTS, MANY CENTERS AND NUMEROUS AFFILIATIONS THROUGHOUT THE FIVE-STATE REGION. THE UWSOM OFFERS EXTENSIVE TRAINING PROGRAMS IN THE BASIC MEDICAL SCIENCES, PRIMARY CARE AND THE SPECIALTIES OF CLINICAL MEDICINE. IT HAS A FULL-TIME REGULAR AND RESEARCH FACULTY OF APPROXIMATELY 2,400. IN ADDITION TO TRAINING FUTURE PHYSICIANS, THE FACULTY ALSO TEACHES GRADUATE AND UNDERGRADUATE STUDENTS IN MANY DISCIPLINES, AND 4,600 VOLUNTEER AND PART-TIME CLINICAL FACULTY MEMBERS TEACH STUDENTS IN TOWNS AND CITIES ACROSS THE REGION. THE UWSOM IS AFFILIATED WITH THE 450-BED UNIVERSITY OF WASHINGTON MEDICAL CENTER AND THE 413-BED HARBORVIEW MEDICAL CENTER, WITH WHICH SEATTLE CHILDREN'S HOSPITAL SHARES A DESIGNATION AS A PEDIATRIC LEVEL I TRAUMA CENTER.- CHILDREN'S UNIVERSITY MEDICAL GROUP (CUMG)SEATTLE CHILDREN'S HEALTHCARE SYSTEM AND THE UNIVERSITY OF WASHINGTON (THE "UW") JOINTLY CONTROL CUMG, A WASHINGTON NONPROFIT CORPORATION AND A 501(C)(3) ORGANIZATION. CUMG IS A PEDIATRIC PRACTICE PLAN THAT EMPLOYS AND MANAGES THE CLINICAL PRACTICES OF APPROXIMATELY 500 PROFESSIONAL MEMBERS WHO ARE BOTH MEMBERS OF SEATTLE CHILDREN'S HOSPITAL MEDICAL STAFF AND PEDIATRIC FACULTY MEMBERS OF THE UWSOM.- PROVIDENCE-CHILDREN'S NEONATAL SERVICES, LLC (PCNS)SEATTLE CHILDREN'S PARTICIPATES IN A JOINT VENTURE WITH PROVIDENCE EVERETT MEDICAL CENTER (PEMC), AN UNRELATED COMMUNITY-BASED HOSPITAL LOCATED IN EVERETT, WASHINGTON. CHILDREN'S AND PEMC EACH OWN A 50% INTEREST IN PROVIDENCE-CHILDREN'S NEONATAL SERVICES, LLC. PCNS MANAGES THE OPERATIONS OF THE NEONATAL INTENSIVE CARE UNIT AT PEMC AND PROVIDES NEONATAL NURSE PRACTITIONER SERVICES TO PEMC.- SEATTLE CANCER CARE ALLIANCE (SCCA)THE SEATTLE CANCER CARE ALLIANCE, A WASHINGTON NONPROFIT CORPORATION AND 501(C)(3) ORGANIZATION, OFFERS A COMPREHENSIVE PROGRAM OF INTEGRATED CANCER CARE SERVICES. ITS MEMBERS ARE SEATTLE CHILDREN'S HEALTHCARE SYSTEM, UW, AND FRED HUTCHINSON CANCER RESEARCH CENTER. SCCA OPERATES AN AMBULATORY CANCER CARE SERVICES FACILITY AND A 20-BED LICENSED HOSPITAL INSIDE UWMC.
Schedule H (Form 990) 2019
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