| FORM 990, PART I, LINE 6 - TOTAL NUMBER OF VOLUNTEERS: 721 |
VOLUNTEERS PLAY A MAJOR ROLE IN CARRYING OUT OUR MISSION. THE NUMBER REPORTED ON LINE 6 RELATES TO [A] VOLUNTEERS WITH SERVICE HOURS AT OUR MAIN CAMPUS, WHICH IS SPECIFICALLY TRACKED, PLUS [B] VOLUNTEERS AT OUR FACILITIES LOCATED THROUGHOUT THE COMMUNITY, THESE ARE ESTIMATED BASED ON KNOWN NUMBER OF HOURS AT ALL LOCATIONS. OUR VOLUNTEERS ARE A MIXTURE OF BOTH FULL AND PART TIME. IN 2020, NATIONWIDE CHILDREN'S HOSPITAL RECEIVED 12,577 HOURS OF VOLUNTEER TIME. THIS CONSISTED OF AN ARRAY OF SERVICES INCLUDING HELP IN MANY PATIENT CARE AREAS, OUR INFORMATION DESK, THE RESEARCH INSTITUTE, AND VARIOUS FAMILY SUPPORT AREAS. NOT INCLUDED IN THIS NUMBER ARE MANY VOLUNTEERS IN THE COMMUNITY WHO IN 2020 SPENT A TOTAL OF 12,461 HOURS CREATING ITEMS FOR OUR PATIENTS AND VISITING THE HOSPITAL TO PROVIDE ACTIVITIES FOR BOTH PATIENTS AND FAMILIES. NCH onsite volunteer service was stopped on March 13, 2020 due to the COVID-19 pandemic and did not resume the rest of 2020. As a result, the total number of volunteers decreased in 2020 from prior years. FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION NATIONWIDE CHILDREN'S HOSPITAL (NCH) BELIEVES THAT NO CHILD SHOULD BE REFUSED NECESSARY CARE AND ATTENTION FOR LACK OF ABILITY TO PAY. UPON THIS FUNDAMENTAL BELIEF, NCH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY PATIENT CARE, ADVOCACY FOR CHILDREN AND FAMILIES, PEDIATRIC RESEARCH, EDUCATION OF PATIENTS, FAMILIES AND FUTURE PROVIDERS, AND OUTSTANDING SERVICE TO ACCOMMODATE THE NEEDS OF PATIENTS AND FAMILIES. |
| FORM 990, PART III, LINE 4A - PROGRAM SERVICE ACTIVITY #1 |
Patient care Nationwide Children's Hospital is one of the country's largest freestanding pediatric health care systems, providing wellness, preventive, diagnostic, treatment and rehabilitative care for infants, children, adolescents and adult patients with congenital disease. Nationwide Children's main campus is located near downtown Columbus, Ohio, and houses a 549-bed inpatient facility, emergency department and outpatient clinics. Patient care services are also available in various locations throughout central Ohio via urgent care locations, outpatient clinics, primary care centers and mobile clinics. Nationwide Children's also brings expertise to other central Ohio hospitals by leasing and operating another 130 neonatal intensive and special care nursery beds. In 2020, Nationwide Children's had more than 1.3 million visits from 49 states and 43 countries. Nationwide Children's discharged approximately 13,889 patients during 2020 for a total of 141,504 inpatient days. Patient care was provided by 1,563 medical staff, and the total hospital staff grew to 13,207 employees. Nationwide Children's is nationally ranked in all 10 specialties by U.S. News and World Report and is on the honor roll list of "America's Best Children's Hospitals." Specialized services that draw patients nationally and internationally include: Cardiology and Cardiothoracic Surgery (The Heart Center); Hematology, Oncology & Blood and Marrow Transplant; Gastroenterology, Hepatology, and Nutrition; Neonatal Medicine; Pediatric Intensive Care; Burn/Trauma; Infectious Diseases; Neurosciences; Center for Colorectal and Pelvic Reconstruction; and Pediatric Rehabilitation. Other services include inpatient and outpatient surgical services including Urology, Neurosurgery, Plastic Surgery, Orthopedics, Otolaryngology, Dentistry; Pulmonary Medicine; Nephrology and Endocrinology; as well as General Medicine. At the cornerstone of Nationwide Children's mission is the commitment to provide high quality services to patients regardless of their ability to pay. In fact, Nationwide Children's provides more than $260 million in charity care and community benefit services annually. In 2020, Nationwide Children's accomplished this principal by providing approximately $25.6 million in Charity Care assistance and $188 million of unreimbursed Medicaid for a total of over $213.8 million in uncompensated care. Approximately 52% of Nationwide Children's patient population is covered by Medicaid. Additionally, Nationwide Children's subsidized losses on its Behavioral Health and Homecare Programs in 2020. Outpatient Behavioral Health services are provided in Close-to-Home centers, and as community-based mental health services provided in schools, child welfare, juvenile court, community centers and patient homes. Nationwide Children's provides Behavioral Health services among 10 crisis stabilization beds in an attempt to avoid an inpatient admission. Inpatient Behavioral Health services are provided in a 56-bed inpatient psychiatric unit. In 2020, Nationwide Children's continued the construction of the Big Lots Behavioral Health Pavilion dedicated exclusively to child and adolescent mental health. The building, which opened March 10, 2020, features inpatient services, intensive outpatient services and research all under one roof. The Pavilion will ramp up to 48 inpatient beds and has a 16-bed Youth Crisis Stabilization Unit, a Psychiatric Crisis Department with a 10-bed Extended Observation Suite, teaching and conference space. Nationwide Children's Hospital Homecare is the only pediatric hospital-based home health agency in central Ohio providing home health care to patients, birth through age 21. Contracted with all major payors, including Medicaid managed care plans, the Homecare team provides pediatric patients with skilled pediatric nursing support at home, as well as answering many other clinical needs such as occupational therapy, physical therapy and speech therapy. Homecare has an onsite pharmacy for compounded sterile and specialty medications, home medical equipment and supplies. Social workers and a chaplain round out the support available for patients. There were 5,738 home nursing visits in 2020. The depth and breadth of services offered at Nationwide Children's spans the depth and breadth of child health. From looking for evidence-based ways to effectively address social determinants of health and health equity to providing daily care for patients with chronic or life-threatening conditions, the experts and specialists at Nationwide Children's are supported by a programmatic infrastructure that enables them to meet the needs of various patient populations. Two programs of note include the Ohio Better Birth Outcomes (OBBO) collaborative and the Central Ohio Poison Control Center. Nationwide Children's is a lead partner in the OBBO collaborative, which is a partnership of four hospital health systems in Franklin County, Ohio, as well as the Columbus Public Health Department and PrimaryOne Health. Through the partnership, OBBO is devoted to using evidence-based interventions to reduce infant mortality rates. The group's key initiatives include improving reproductive health, expanding access to prenatal care and enhancing clinical quality initiatives to reduce prematurity. The Central Ohio Poison Center at Nationwide Children's provides Ohio residents with state-of-the-art poison prevention, assessment and treatment. Services are available to the public, medical professionals, industry and human services agencies. The poison center handled more than 54,000 poison exposure calls in 2020. Experts in the center provide confidential, free emergency poisoning treatment advice 24/7. Patient safety is an organizational priority and cornerstone of Nationwide Children's Hospital's commitment to children. Our quality and safety efforts are organized into the nationally recognized Zero Hero program. Current initiatives include: 1. Leading national pediatric quality and safety efforts BY TRAINING THE NEXT GENERATION OF QUALITY IMPROVEMENT (QI) LEADERS through our QI fellowship and disseminating QI knowledge and science through the Pediatric Quality and Safety Journal, established at Nationwide Children's Hospital. 2. Expanding a focus on communication in interdisciplinary health teams. 3. Establishing the first health care focused "Safety II" program emphasizing what goes right and how to replicate it throughout the institution. 4. Developing a diagnostic error program to reduce missed or unidentified health issues. 5. Focusing our Quality, Safety and Service Strategic Plan on Simulation, Communication, Big Data Analytics, Antibiotic Stewardship and Clinical Pathways. |
| FORM 990, PART III, LINE 4B - PROGRAM SERVICE ACTIVITY #2 |
Research The Abigail Wexner Research Institute (AWRI) at Nationwide Children's Hospital is one of the largest and top-ten most NIH-funded freestanding pediatric research facilities in the United States. It is housed in three buildings on the Nationwide Children's campus, occupying over 500,000 square feet of dedicated research space. A fourth research building, under construction and slated to open in 2023, will add approximately 285,000 square feet of space to seamlessly integrate clinical care and research. As a dynamic, collaborative, state-of-the-art environment for world-class child health research, AWRI brings together more than 1,308 research institute employees and 195 faculty with $50,000 or more in research funding support across campus. In 2020, 12 new research-focused faculty joined AWRI, including Maryam Fouladi, MD, a renowned brain tumor expert. With her arrival as co-executive director of the Neuro-Oncology Program, CONNECT, the international consortium for neuro-oncology clinical trials, is now based at Nationwide Children's. Jerry Mendell, MD, principal investigator in the Center for Gene Therapy and one of the lead scientists behind the first systemic gene therapy approved by the Food and Drug Administration (FDA), was also elected to the National Academy of Medicine. To signify the hospital and research institute's commitment to diversity, inclusion and health equity from the lab to the clinic and beyond, AWRI's Center for Innovation in Pediatric Practice was also rededicated in 2020. Now named the Center for Child Health Equity and Outcomes Research and led by Deena Chisolm, PhD, the center aims to reduce health disparities and achieve best outcomes for all children and families. Another AWRI center, the Center for Injury Research and Policy (CIRP), is one of only nine centers in the United States currently designated as an Injury Control Research Center (ICRC) by the Centers for Disease Control and Prevention. ICRCs are funded for five-year cycles through an externally reviewed, competitive process. CIRP is the only ICRC focusing on research and prevention of injuries to children and adolescents and has been continually funded by the CDC since 1999. In 2020, AWRI was one of four institutions that received a $1 million Innovation Fund from nonprofit foundation Additional Ventures to form a large-scale research collaboration centered on identifying new avenues to functionally cure patients with single ventricle heart defects (SVDs). Additionally, the Nationwide Foundation's 2020 gift of $10 million to the Nationwide Foundation Pediatric Innovation Fund at Nationwide Children's Hospital provides funding for Nationwide Children's proven Healthy Neighborhoods Healthy Families (HNHF) community health and economic improvement program concentrated on Columbus' Linden neighborhood. The 2020 gift also supported the creation and funding of the Nationwide Foundation Endowed Research Chair of Health Equity Research, awarded to Dr. Chisolm, and the Nationwide Foundation Chair of Innovation in Behavioral Health Research, awarded to Jeff Bridge, PhD, director of the Center for Suicide Prevention and Research at Nationwide Children's Hospital, recognizing his pioneering work in suicide prevention, the epidemiology of suicidal behavior in young people and improving the quality of care for suicidal youth and adolescents who have attempted suicide. The 2020 funding was also used to acquire additional equipment and technology to advance genomic research in the hospital's Steve and Cindy Rasmussen Institute for Genomic Medicine, which remains one of the few programs in pediatric personalized genomic medicine in the United States and focuses on genomics as the root cause of many childhood diseases. Facioscapulohumeral muscular dystrophy (FSHD), which affects up to 870,000 individuals world-wide, is a progressive, life-long disease with no treatments available to alter its course. It arises from genetic and epigenetic changes that result in expression of the DUX4 gene, which is normally "off" in healthy muscle. When expressed, DUX4 activates pathways associated with cell death, oxidative stress, impaired muscle differentiation and muscle atrophy. Scott Harper, PhD, principal investigator in the Center for Gene Therapy, and his lab team have been dedicated to understanding the role of DUX4 in FSHD and developing potential therapies that can target it. In 2020, they identified a way to silence DUX4 expression in human cells, including those derived from FSHD patient muscles, and published a proof-of-concept study in Molecular Therapy: Nucleic Acids. To translate this approach to clinical care, safety and efficacy studies in the Harper Lab's TIC-DUX4 mouse model are ongoing. In 2020, researchers also made several advancements in understanding biofilms and the components that stabilize them and transferred those basic science discoveries to a novel platform technology. Biofilms are "slimy" matrices of extracellular DNA (eDNA) that connect and protect colonies of bacteria from the immune system and antibiotics. These colonies adhere to each other or to surfaces in the body, such as the inner ear, respiratory tract, oral cavity, gastrointestinal tract or urinary tract, and serve as a reservoir to fuel chronic and recurrent infections. In fact, according to the Centers for Disease Control and Prevention (CDC), bacteria in biofilms are responsible for approximately 80% of human bacterial infections and can be up to 1,000 times more resistant to antibiotics than those that are "free-living." Steve Goodman, PhD, a principal investigator in the Center for Microbial Pathogenesis in the Abigail Wexner Research Institute at Nationwide Children's Hospital, and his colleagues, Lauren Bakaletz, PhD, the center's director, and Santiago Partida-Sanchez, PhD, also a principal investigator in the center, have identified several elements key to stabilizing biofilms' structures and developed novel therapies that can dismantle and remove them. In a report published in Proceedings of the National Academy of Sciences the investigators showed Holliday junction (HJ)-like structures form the vertices where strands of eDNA cross in the lattice structure of biofilms. DNABII, a key bacterial DNA-binding protein, fortifies these structures by binding to these HJs and locking them in place. In another 2020 paper, published in EBioMedicine, they demonstrated how DNABII-directed antibodies can rapidly disrupt existing biofilms and prevent new ones from forming. The platform technology described in the study has the potential to transform clinical management of a multitude of biofilm-mediated diseases that evade effective intervention. Through the support of the Office of Technology Commercialization, this biofilm-disrupting technology has been licensed to Clarametyx Biosciences, Inc., a preclinical stage biotechnology company developing targeted, immune-enabling biologic therapies to counter persistent infections associated with biofilms, to support the first-in-human clinical trial. Drs. Bakaletz and Goodman are co-inventors of the technology and co-chairs of the Clarametyx scientific advisory board. |
| FORM 990, PART III, LINE 4B - CONTINUED |
Inflammation of the lower respiratory tract caused by respiratory syncytial virus (RSV) is the leading cause of hospitalizations for children younger than 2 years old around the world - yet RSV is so common that almost everyone becomes infected with it during their first three years of life and many more children are not hospitalized. Researchers at Nationwide Children's compared the immune profiles of infants with mild RSV disease to those with severe infections to understand why some infants became sicker than others - with the ultimate goal of designing vaccine candidates that stimulate the more protective response found in some patients. In 2015, a research team led by Octavio Ramilo, MD, chief of Infectious Diseases, Asuncion Mejias, MD, PhD, attending physician in Infectious Diseases, and Mark Peeples, PhD, all principal investigators in the Center for Vaccines and Immunity at Nationwide Children's, received a $6.75 million grant from the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, to study these immune responses. The team has published more than 35 peer reviewed publications and greatly added to the knowledge about RSV and immune responses in infants. In a 2020 study published in Science Translational Medicine, the researchers used a systems analysis approach to integrate blood transcriptional profiling and immune cell phenotyping with measurement of viral loads and clinical data from children with RSV infection and found children with mild disease (managed as outpatients) actually had higher RSV loads measured in the upper respiratory tract than those who were hospitalized for their infections. Patients who had larger amounts of virus in nasal secretions during acute infections had a more robust mucosal immune response that was associated with better outcomes, rather than with more severe disease. These findings have led to clinical insights - among babies who were hospitalized, those that received systemic steroids, which reduce the activity of the immune system, had worse outcomes, indicating that for children with severe RSV infection, treatment with steroids should be avoided - and have now informed the design and evaluation of new RSV vaccine candidates and research into other infectious diseases, including COVID-19. The insights revealed by this research into the forms of a virus that induce a better immune response has informed COVID-19 vaccine development. Another 2020 study expanded on 2015 research to demonstrate that nonoperative management of uncomplicated appendicitis is a safe and effective option in a variety of healthcare systems. Appendicitis the most common cause for emergency abdominal surgery in childhood, affecting 80,000 children in the United States each year. Research published in JAMA by the Midwest Pediatric Surgery Consortium (led by Peter Minneci, MD, and Katherine Deans, MD, co-founders and directors of the Center for Surgical Outcomes Research at Nationwide Children's Hospital), however, found that the condition can be treated successfully with antibiotics alone. Of 1,068 patients from 10 health centers enrolled in the study, 67.1% of those who elected to initially manage their care through antibiotics alone experienced no harmful side effects and did not later require an appendectomy by their one-year follow-up. Patients in the nonoperative group experienced an average of 6.6 disability days (days of missed activities such as school, athletics and vacations), compared to the 10.9 days in the surgery group. Nonoperative management was also associated with fewer disability days for caregivers. Both the patients who elected to undergo surgery and those who chose nonoperative management with antibiotics alone reported similar health care satisfaction at 30 days and quality of life at 1 year. While appendectomies are well-tested and trusted procedures, offering a non-operative option to patients and their families allows clinical care teams to move away from a one-size-fits-all model of appendicitis care and offer treatment options based on a child or family's values and preferences. Researchers from the Center for Injury Research and Policy and the Sleep Disorders Center at Nationwide Children's Hospital have conducted a series of studies to identify smoke alarm signals that would more effectively awaken children and other members of the household in the event of a fire, when there is a narrow window of time for everyone to safely evacuate a burning building without injury. In 2020, the fifth study in this series, published in Pediatric Research, found that alarms with a male voice, female voice, or hybrid voice-tone alarms woke 85-89% of children and prompted 84-89% to "escape," compared with 56% woken and 55% escaped for the high-frequency tone alarm. The median time to escape for the male voice, female voice, and hybrid voice-tone alarms was 12-13 seconds, compared to more than a minute and a half - 96.5 seconds - for the high-frequency tone alarm. The study authors concluded that there were no significant differences in the effectiveness of the male voice, female voice or hybrid alarms when compared with each other, but they all significantly out-performed the high-frequency tone alarm. Children sleep longer and deeper and require louder sounds to awaken than adults, so a smoke alarm that reduces the amount of time it takes for them to wake up and escape could reduce residential fire-related injuries and deaths among children old enough to perform self-rescue. Overall, approximately 2,266 Institutional Review Board (IRB) approved protocols were in progress during 2020, ranging from small studies designed to collect information about a disease to those that investigate potential new treatments or procedures at the forefront of clinical innovation and discovery. More than 1,600 papers were published in 2020 by Nationwide Children's scientists in peer-reviewed medical and scientific journals. |
| FORM 990, PART III, LINE 4C - PROGRAM SERVICE ACTIVITY #3 |
Education As an academic medical center, the Hospital's mission includes preparing the next generation of pediatric healthcare providers. In 2020, 600 Ohio State University ("OSU") faculty members trained 375 medical students, 150 dental students, 300 Hospital-sponsored medical, surgical and dental residents, and nearly 600 physician and dental trainees from other institutions. The Hospital has been the primary pediatric teaching site of the OSU College of Medicine for more than 50 years. In 2020, the Hospital sponsored 36 accredited medical/dental residency and fellowship programs, 31 accredited by the Accreditation Council for Graduate Medical Education; 5 accredited by other organizations. The Hospital has 34 additional fellowships for which no national accreditation currently exists. These programs train pediatric specialists to meet 21st century healthcare needs in such diverse pediatric programs as neuromuscular genetics, epilepsy surgery, bone marrow transplant, colorectal surgery, advanced heart failure and cardiac transplant, and quality and safety leadership. Given the accelerating national shortage of pediatric subspecialists, recruitment is an important outcome for the Hospital's education investment. In 2020, 7 physician specialties recruited 8 fellows to open junior faculty positions. 100% of graduating residents seeking pediatric fellowships successfully secured positions to continue their academic career. Education also helps fill national gaps in midlevel providers who are essential to safe, high quality, 24/7 team-based care. For over 30 years, the Hospital has educated neonatal nurse practitioners and advanced practice nurses. Increased demand has resulted in acute national shortages and, in 2018, led the Hospital to start two new programs: (1) a neonatal physician assistant program; and (2) a pediatric child psychiatry nurse residency, the first such program in the country. The Children's Hospitals Graduate Medical Education Payment Program ("CHGME") is a federal program that underwrites some of the expenses freestanding children's hospitals incur to train physician and dental residents in accredited programs. The Hospital received approximately $8 million in 2020, for a total of over $23 million in expenses underwritten over the past three years, from CHGME. In 2020, approximately 1,500 nursing students, 176 paramedic students, and over 520 other students from allied health disciplines such as pharmacy, speech and language pathology, occupational therapy, psychology, child life, and social work received their pediatric education at the Hospital. In addition to OSU, the Hospital has affiliations with over 400 other universities, hospitals, and institutions. The Hospital also offers mentoring, shadowing, young scientist, STEMM (science, technology, engineering, mathematics and medicine), and/or minority recruitment programs within 160 school districts. The Hospital offers professional education programs to improve and sustain delivery of high quality pediatric care to all children. In 2020, it awarded continuing medical education credits to approximately 25,500 physicians and 16,100 nurses/allied health professionals; offered 806 contact hours of continuing nursing education, awarding 16,236 nursing contact hours; and organized 44 local, regional, national and international conferences. In 2020, the Hospital taught 6,900 multidisciplinary participants in over 700 simulation sessions. The Hospital works closely with local healthcare providers, including 19 affiliate hospitals, to standardize pediatric care throughout Ohio. In 2020, the Hospital provided 85 outreach education sessions for 1,200 participants. Another 1,500 health care providers received Pediatric Advanced Life Support training from the Hospital. Since 2012, the Hospital's PREP (Personal Responsibility Education Program) trained staff in over 50 agencies to educate very high risk adolescents in juvenile justice and foster care. Patient, family, and community education are very important to health and wellbeing. In 2020, approximately 40,000 children and adults participated in Hospital-sponsored education, specialty camps, health fairs, and other education events. The Hospital distributed over 500,000 patient education teaching tools for children and families. The Family Health Information Center provided multimedia health education materials to more than 1,200 families. The Hospital is working to improve population health. One initiative, called "SPARK," is an evidence-based, no-cost kindergarten readiness program for families living near the Hospital. On a monthly basis, children receive a new book, lesson activities customized to their needs, and educational supplies, along with home or group-based which switched to a virtual model during COVID. Ninety-six percent of the children in the program demonstrate kindergarten readiness at program completion vs. 33% pre-program. The Hospital continues to educate every hospital and medical staff member on quality tools. The Hospital's Quality Improvement Essentials course is nationally recognized for training the next generation of quality improvement ("QI") leaders. Since 2010, the Hospital has trained nearly 500 healthcare professionals from the Hospital as well as Children's National Medical Center (Washington DC), Children's Hospital King's Daughter's (Norfolk), Children's Healthcare of Atlanta, University Hospitals Rainbow Babies & Children's Hospital (Cleveland) and Oschner Medical Center (New Orleans), and Driscoll Children's Hospital (Corpus Christi). The Hospital was the first children's hospital designated by the American Board of Medical Specialties as a Multi-specialty Portfolio Program Sponsor. Since 2012, over 800 physicians (and hundreds of other team members) have engaged in 245 different QI projects for credit at no charge to physicians. |
| FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICE ACTIVITIES |
Child Advocacy: Nationwide Children's Hospital is committed to serving our community. Through advocacy and volunteering efforts across the organization, employees work in the community to improve health outcomes for all children, not just those who are patients here. Because of our commitment to health equity and best outcomes for every child, we are naturally inclined to advocate in diverse ways in support of children everywhere. Advocacy efforts to achieve this goal are multifaceted. From working with legislators to ensure health care coverage for children to working with community partners to advance community wellness, efforts include but are not limited to: Pediatric Health Care Legislation and Policies: Nationwide Children's actively promotes legislation and policies that support pediatric health care locally and nationally. Nationwide Children's, in conjunction with the Children's Hospital Association, advocates for protecting access to health care for children through Medicaid and the Children's Health Insurance Program (CHIP). Additionally, through the Child Health Patient Safety Organization, Nationwide Children's is working to improve hospital and national patient, family and employee safety efforts. Nationwide Children's also trains the next generation of child health advocates by offering a Government Relations "rotation" to the hospital's residents. Educational sessions and events, including the annual Resident Advocacy Day at the Ohio Statehouse, introduce future pediatricians to policy issues surrounding child health. In 2020, Nationwide Children's made special efforts to urge for increased federal funding for the Children's Hospital Graduate Medical Education Program, supporting the training of residents and fellows. Research Advocacy Efforts: While over-the-counter analgesic medications like ibuprofen and acetaminophen are widely considered safe and are easily accessible, a 2020 study from Nationwide Children's Hospital found a sharp increase in the number and rate of suicide-related calls to U.S. Poison Control Centers over a nearly two-decade period involving those medications. The increase was driven particularly by females, ages 6 to 19. The findings from the hospital's Center for Injury Research and Policy and Central Ohio Poison Center led experts to call for changes in packaging, so that large doses of over-the-counter analgesics would be less accessible. It also led to recommendations from suicide prevention experts that could help parents and pediatricians mitigate the risk for young people. Another crucial piece of research advocacy from Nationwide Children's led the Centers for Medicare and Medicaid to create a new official billing code for adult congenital heart disease (ACHD) in March of 2020. The code allows board-certified ACHD subspecialists to bill for the distinctive care they give. An analysis from The Heart Center at Nationwide Children's and other institutions helped show the importance of board-certified ACHD specialists and clinical care teams. The new code is expected to help the subspecialty grown and result in improved patient care. Child Safety: The work of The Center for Family Safety and Healing (TCFSH) is dedicated to reducing the occurrence of child abuse and all aspects of family violence, including child abuse and neglect, teen dating abuse, domestic violence and elder abuse. The center has a one-stop, coordinated response to family violence for individuals and families through its collaboration with key community agencies. TCFSH offers a continuum of research-based prevention, assessment, intervention and treatment programs for individuals who have experienced family violence. In 2020, TCFSH had 1,463 visits to the Child Assessment Center and 501 Nationwide Children's inpatient consults. The center's Training and Advocacy Department (TAD) provides educational and training opportunities regarding family violence to individuals and organizations in the community. The goal is to help community members recognize the warning signs of family violence, respond appropriately to someone who may be experiencing family violence, and make a referral to provide support. In 2020, TAD served 58 organizations throughout the community and conducted 381 trainings. TCFSH also created a Direct Assistance Fund in April 2020 to help families at increased risk as a result of the COVID-19 pandemic. The fund addresses food insecurity, emergency housing, utilities and immediate safety needs. The fund served 428 families in its first nine months. Telehealth: When COVID-19 ignited stay-at-home orders, public and private insurers quickly relaxed the rules for covering telehealth visits. Nationwide Children's responded in kind by rapidly expanding their telehealth capacity and training. Nationwide Children's was a few months into a two-to-three-year plan to expand telehealth access across the institution. That plan was immediately fast tracked to bring providers in every outpatient service online for telehealth. Between mid-March and mid-June, more than 100,000 telehealth visits had been completed. In post-visit surveys, 96% of families said telehealth improves their access to care. They experienced a number of savings as a result of telehealth expansion, including fewer days taken off work and fewer hours spent traveling. Throughout the implementation process, continuing through the pandemic and beyond, researchers at Nationwide Children's are looking at how telehealth impacts care and access to care. Publications about telehealth from experts in many service lines show the broad impact and possible future uses for this important health care tool. Neighborhood Revitalization: Employees, faculty and staff at Nationwide Children's are all invested in the community surrounding the hospital's main campus. From volunteering to clean up local parks to spending time at the area's food bank or free store, employees are most engaged in the community through the Healthy Neighborhoods Healthy Families (HNHF) initiative. HNHF at Nationwide Children's collaborates with community partners to focus on five key areas: Education, Affordable Housing, Economic Development, Community Enrichment, and Health and Wellness. Education - One of the neighborhood challenges uncovered by the Health Care Needs Assessment, performed in collaboration with Franklin County, was access to preschool education for kindergarten readiness. The HNHF initiative at Nationwide Children's offers a kindergarten readiness program, called SPARK, where staff worked with caregivers and children to learn appropriate tools for working toward kindergarten readiness together. In 2020, 98% of children were kindergarten-ready based on pre-and post-test scores. Nationwide Children's educational focus led to more than 60 employees from across the hospital, including research, clinical and hospital employees, participating as mentors virtually through neighborhood schools and organizations in 2020. Mentors spend one hour weekly with their mentee in deliberate activities and discussion. In addition, 51 local high school students participated in the Upward Bound Math and Science program in 2020. All participants graduated from high school and 76% of those students went on to become first-generation college attendees. Housing Projects - Housing is a vital part of a healthy community. The vacancy rate experienced by the neighborhood surrounding the hospital was a concern for many residents. HNHF, working in tandem with community partners, has made an impact in this area. In 2020, 3 homes were completed for ownership through the Central Ohio Community Land Trust, 11 units were created for rental occupancy and 12 homeowners were provided with grants for exterior improvements. In addition, six homes were constructed as part of the newly formed Central Ohio Community Land Trust. Since 2008, more than 400 homes have been impacted through rehabilitations, home improvement grants and new builds. The hospital's continued financial commitment to HNHF has helped to support the construction of safe, decent, and affordable housing. Economic Development - More than 150 residents of the zip codes surrounding the hospital were employed by Nationwide Children's Hospital in 2020 as a result of workforce development and strategic recruitment efforts by the hospital. More than 1,000 Nationwide Children's Hospital residents retain employment from the HNHF zip codes. Nationwide Children's also started free IRS/VITA tax clinics for residents making under $65,000 to help them access tax credits and refunds. A total of 54 families were served, resulting in more than $77,000 in federal and state refunds. |
| FORM 990, PART III, LINE 4D - CONTINUED |
Community Enrichment - Since 2015, more than 75 leaders have graduated from the South Side Neighborhood Leadership Academy, which supports residents in their continued growth as change agents in the community. A total of 11 leaders graduated in 2020. In addition, over 50 non-profits, businesses, and neighborhood organizations convened as the South Side Thrive Collaborative (SSTC). SSTC partners aim to improve economic mobility, housing stability and health for all. Health and Wellness - School-based Nationwide Children's health clinics and the Mobile Care Centers had nearly 5,300 patients in 2020, despite COVID-19 shutting down schools, while school-based behavioral health had more than 9,600 visits during 2020. In addition, approximately 45 caregivers (teen and adults) attended Positive Parenting Program (Triple P) workshops from the South Side and Linden neighborhoods. HNHF Expansion - Along with its transformational efforts in the communities surrounding the hospital, Nationwide Children's announced in 2020 a large expansion to another traditionally at-risk Columbus neighborhood, Linden. The HNHF expansion will leverage lessons learned on the South Side of Columbus to expand housing options, develop business and improve health in the Linden community. One house in Linden was a recipient of the home repair grant program in 2020 and the tax clinic opportunity was offered in the Linden neighborhood. |
| FORM 990, PART VI, LINE 2 - DESCRIPTION OF RELATIONSHIPS |
A BUSINESS RELATIONSHIP EXISTS BETWEEN THE FOLLOWING DIRECTORS OF NATIONWIDE CHILDREN'S HOSPITAL: C. ROBERT KIDDER, JOSEPH A. CHLAPATY, AND ALEX FISCHER. A BUSINESS RELATIONSHIP EXISTS BETWEEN THE FOLLOWING DIRECTORS OF NATIONWIDE CHILDREN'S HOSPITAL: ALEX FISCHER, C. ROBERT KIDDER, AND TIMOTHY C. ROBINSON. A BUSINESS RELATIONSHIP EXISTS BETWEEN THE FOLLOWING DIRECTORS OF RINCH: THOMAS WALKER AND TIMOTHY C. ROBINSON. A BUSINESS RELATIONSHIP EXISTS BETWEEN THE FOLLOWING DIRECTORS/OFFICERS OF NATIONWIDE CHILDREN'S HOSPITAL FOUNDATION: THOMAS N. BRIGDON, TIMOTHY C. ROBINSON, RHONDA COMER, LUKE BROWN, AND STEPHEN TESTA. FORM 990, PART VI, LINE 6 - DESCRIPTION OF CLASSES OF MEMBERS NATIONWIDE CHILDREN'S HOSPITAL, INC. (THE PARENT ORGANIZATION OF THE GROUP) IS THE SOLE MEMBER OF THE MAJORITY OF THE SUBORDINATE ORGANIZATIONS IN THE GROUP EXEMPTION. SOME OF THE SUBORDINATE ORGANIZATIONS ARE NON-PROFIT SUBSIDIARIES OF THE LARGEST SUBORDINATE ORGANIZATION, NATIONWIDE CHILDREN'S HOSPITAL. FORM 990, PART VI, LINE 7A - CLASSES OF PERSONS AND THEIR RIGHTS NATIONWIDE CHILDREN'S HOSPITAL, INC. IS THE PARENT CORPORATION WITH VOTING CONTROL OVER THE SUBORDINATE ORGANIZATIONS. FORM 990, PART VI, LINE 7B - DECISIONS REQUIRING APPROVAL BY MEMBERS NATIONWIDE CHILDREN'S HOSPITAL, INC. WILL OVERSEE THE OPERATIONS OF AND WILL PERFORM CERTAIN SERVICES FOR ITS SUBORDINATE ORGANIZATIONS. NCH INC. WILL COORDINATE EXPANSION OF THE GROUP PROGRAMS AND ASSETS AND WILL DETERMINE IF ADDITIONAL ENTITIES WILL BE NEEDED WITHIN THE GROUP. |
| FORM 990, PART VI, LINE 11B - PROCESS USED TO REVIEW 990 |
THIS FORM 990 WAS REVIEWED PRIOR TO FILING BY NATIONWIDE CHILDREN'S HOSPITAL CHIEF EXECUTIVE OFFICER/BOARD DIRECTOR; CHIEF FINANCIAL OFFICER/BOARD TREASURER; SENIOR VICE PRESIDENT OF LEGAL SERVICES / BOARD SECRETARY; AND THE FINANCE COMMITTEE CHAIR. IN ADDITION, THIS RETURN WAS MADE AVAILABLE TO THE ENTIRE FINANCE COMMITTEE OF THE BOARD AND MADE AVAILABLE UPON REQUEST TO THE BOARD. FORM 990, PART VI, LINE 12C - PROCESS TO MONITOR FOR CONFLICTS OF INTEREST NCH POLICY REQUIRES THAT STAFF MEMBERS, MANAGEMENT AND BOARD MEMBERS REPORT CONFLICTS OF INTEREST OR COMMITMENT AT THE TIME THE CONFLICT ARISES. MANAGEMENT AND BOARD MEMBERS ARE ALSO REQUIRED TO COMPLETE DISCLOSURE FORMS ANNUALLY, REGARDLESS OF THE EXISTENCE OF CONFLICT. ALL DISCLOSURES ARE REVIEWED BY THE CORPORATE COMPLIANCE OFFICER OR THE BOARD SECRETARY. IF A CONFLICT EXISTS, A CONFLICT MANAGEMENT PLAN MAY BE PUT IN PLACE TO MITIGATE THE CONFLICT. STAFF, MANAGEMENT AND BOARD MEMBERS ARE PROHIBITED FROM VOTING ON ANY MATTERS WITH RESPECT TO WHICH THE INDIVIDUAL HAS DISCLOSED A POTENTIAL CONFLICT OF INTEREST. FORM 990, PART VI, LINE 15A - PROCESS FOR DETERMINING COMPENSATION OF CEO IN THE FIRST QUARTER OF 2020, NCH HELD ITS ANNUAL MEETING FOR THE PURPOSE OF COMPENSATION REVIEW. FOR THE CEO, THERE IS A MEETING OF THE MANAGEMENT DEVELOPMENT/COMPENSATION COMMITTEE WHERE THE MEMBERS REVIEW MARKET DATA PROVIDED BY OUTSIDE CONSULTANTS AND DECIDE ON A RECOMMENDED SALARY ADJUSTMENT THAT INCLUDES CONSIDERATION OF THE CEO'S PERFORMANCE. THEN, THIS RECOMMENDATION IS BROUGHT TO THE FULL BOARD AND THE BOARD TAKES INTO ACCOUNT THIS RECOMMENDATION, THE CEO'S PERFORMANCE, AND APPROVALS ARE MADE. CONTEMPORANEOUS MINUTES ARE KEPT AT ALL BOARD MEETINGS AND COMMITTEE MEETING ACTIVITIES AND DECISIONS ARE ALSO DOCUMENTED. FORM 990, PART VI, LINE 15B - DETERMINING COMP OF OFFICERS & KEY EMPLOYEES IN THE FIRST QUARTER OF 2020, NCH HELD ITS ANNUAL MEETING FOR THE PURPOSE OF COMPENSATION REVIEW. FOR OFFICERS AND KEY EMPLOYEES OTHER THAN THE CEO, THERE IS A MEETING OF THE MANAGEMENT DEVELOPMENT/COMPENSATION COMMITTEE OF THE BOARD. AT THAT TIME, MARKET SURVEY DATA PROVIDED BY OUTSIDE CONSULTANTS AND/OR OUTSIDE SOURCES IS REVIEWED TO DETERMINE COMPENSATION OR COMPENSATION ADJUSTMENTS FOR THESE POSITIONS, THE CEO'S INPUT IS CONSIDERED AS IT RELATES TO INDIVIDUAL PERFORMANCE FOR THESE INDIVIDUALS, AND INCREMENTAL ADJUSTMENTS ARE RECOMMENDED, THE GROUP DELIBERATES, AND THE APPROVALS ARE MADE. CONTEMPORANEOUS MINUTES ARE KEPT AT ALL BOARD MEETINGS AND COMMITTEE MEETING ACTIVITIES AND DECISIONS ARE ALSO DOCUMENTED. FORM 990, PART VI, LINE 19 - AVAIL OF GOV DOCS, COI POLICY, & FIN STMTS NATIONWIDE CHILDREN'S HOSPITAL'S (NCH) FINANCIAL STATEMENTS ARE DISCLOSED ON THE ELECTRONIC MUNICIPAL MARKET ACCESS WEBPAGE AND THE ARTICLES OF INCORPORATION ARE ON THE OHIO SECRETARY OF STATE'S WEBPAGE. CURRENTLY, NCH DOES NOT MAKE ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. FORM 990, PART VII, SECTION A, LINE 1A, COLUMN (B)- AVERAGE HOURS PER WEEK FOR NATIONWIDE CHILDREN'S HOSPITAL EMPLOYEES THAT ARE MEMBERS OF VARIOUS BOARDS AND HOLD SEVERAL POSITIONS WITHIN THE ORGANIZATION, THE HOURS LISTED REPRESENT THE NUMBER OF HOURS THAT INDIVIDUAL DEVOTES TO ALL THE ENTITIES INCLUDED WITHIN THE NATIONWIDE CHILDREN'S HOSPITAL GROUP RETURN. THE GOVERNING BOARD OF NATIONWIDE CHILDREN'S HOSPITAL, INC. AND NATIONWIDE CHILDREN'S HOSPITAL IS A JOINT BOARD AND MEMBERS SERVE ON THESE BOARDS CONCURRENTLY. |
| FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS |
Effect of Adoption of SFAS No. 158 (363,726) NET CHANGE IN INTEREST RATE SWAP AGREEMENTS (11,893,368) TECHNOLOGY INVESTMENTS 107,438 TRANSFER FROM PARTNERS FOR KIDS 56,803,257 SWAP TERMINATION PAYMENT 1,874,638 OTHER (8,723,615) ____________ TOTAL OTHER CHANGES IN NET ASSETS 37,804,624 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:PROFESSIONAL SERVICES TOTAL FEES:90318152 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:NICU LEASED SALARIES & MED SVC TOTAL FEES:49705148 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:RESEARCH SUBCONTRACT EXPENSE TOTAL FEES:9340209 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:CONSULTATION FEES TOTAL FEES:4901228 |
| FORM 990 PART IX LINE 11G |
DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:46513618 |
Attach to Form 990 or 990-EZ.