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
2021
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
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

 

No
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
 
 
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) . . . 		    3,235,914 61,708 3,174,206 0.240 %
b Medicaid (from Worksheet 3, column a) . . . . .     515,075,463 515,075,463   0 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     6,898,432 772 6,897,660 0.510 %
d Total Financial Assistance and Means-Tested Government Programs . . . . .     525,209,809 515,137,943 10,071,866 0.750 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     41,678,985 23,711,292 17,697,693 1.340 %
f Health professions education (from Worksheet 5) . . .     22,056,105 8,510,271 13,545,834 1.010 %
g Subsidized health services (from Worksheet 6) . . . .     49,575,540 19,810,805 29,764,735 2.220 %
h Research (from Worksheet 7) .     28,952,024 20,422,658 8,529,366 0.640 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     6,499 0 6,499 0 %
j Total. Other Benefits . .     142,269,153 72,455,026 69,544,127 5.210 %
k Total. Add lines 7d and 7j .     667,478,962 587,592,969 79,615,993 5.960 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development     479,602 250,000 229,602 0.020 %
9 Other            
10 Total     479,602 250,000 229,602 0.020 %
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
 
No
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
17,306,542
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
4,849,293
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
-1,108,606
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
4,360,062
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-5,468,668
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) 2021
Schedule H (Form 990) 2021
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?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 and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 RADY CHILDREN'S HOSPITAL SAN DIEGO
3020 CHILDRENS WAY MC 5133
SAN DIEGO,CA92123
WWW.RCHSD.ORG
80000028 		X   X X   X X      
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
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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)
RADY CHILDREN'S HOSPITAL SAN DIEGO
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 21
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 Yes  
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 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE PART V SECTION C
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) 2021
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Schedule H (Form 990) 2021
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Part VFacility Information (continued)

Financial Assistance Policy (FAP)
RADY CHILDREN'S HOSPITAL SAN DIEGO
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
HTTPS://WWW.RCHSD.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/
b
HTTPS://WWW.RCHSD.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
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Part VFacility Information (continued)

Billing and Collections
RADY CHILDREN'S HOSPITAL SAN DIEGO
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) 2021
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Schedule H (Form 990) 2021
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Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
RADY CHILDREN'S HOSPITAL SAN DIEGO
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) 2021
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Schedule H (Form 990) 2021
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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
RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 5: THE CHNA IS IMPLEMENTED AND MANAGED BY A STANDING CHNA COMMITTEE COMPRISED OF REPRESENTATIVES FROM SEVEN HOSPITALS AND HEALTH SYSTEMS. RADY CHILDREN'S HOSPITAL-SAN DIEGO COLLABORATED WITH OTHER HOSPITALS AND HEALTH SYSTEMS IN SAN DIEGO COUNTY TO COMPLETE A COLLABORATIVE CHNA (THE SAN DIEGO CHNA). THE SAN DIEGO CHNA PROCESS WAS FACILITATED BY THE HOSPITAL ASSOCIATION OF SAN DIEGO & IMPERIAL COUNTIES (HASD&IC). HASD&IC CONVENED A CHNA ADVISORY WORKGROUP, WHICH INCLUDED REPRESENTATIVES FROM PARTICIPATING HOSPITAL AND HEALTH SYSTEMS AND PROVIDED GUIDANCE REGARDING RESEARCH APPORACH AND COMMUNITY ENGAGEMENT. THE GOAL OF THE COMMUNITY ENGAGEMENT PROCESS WAS TO SOLICIT INPUT FROM A WIDE RANGE OF STAKEHOLDERS FACING INEQUITIES IN SAND DIEGO COUNTY. SPECIAL EFFORTS WERE MADE TO INCLUDE COMMUNITY MEMBERS FROM GROUPS THAT EXPERIENCE HEALTH DISPARITIES AND SERVICE PROVIDERS WHO WORK WITH THOSE VULNERABLE POPULATIONS. INPUT FROM THE COMMUNITY WAS GATHERED THORUGH WORKING WITH COMMUNITY HEALTH WORKERS TO CONDUCT INTERVIEWS WITH COMMUNITY MEMBERS AND CONDUCTING FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH COMMUNITY MEMBERS, COMMUNITY HEALTH WORKERS, COMMUNITY-BASED ORGANIZATIONS, SERVICE PRODVIDERS, CIVIC LEADERS, AND HEALTH CARE LEADERS.
RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 6A: COLLABORATION WITH OTHER HOSPITALS AND HEALTH SYSTEMS WERE COORDINATED THROUGH THE HASD&IC.
RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 11: COMMUNITY HEALTH NEEDS ADDRESSED: THE CHNA SERVED AS THE RESOURCE DOCUMENT FOR THE REVIEW OF HEALTH NEEDS AS IT PROVIDED DATA ON THE SCOPE AND SEVERITY OF ISSUES AND INCLUDED COMMUNITY INPUT ON THE HEALTH NEEDS. THE COMMUNITY PRIORITIZATION OF NEEDS WAS ALSO TAKEN INTO CONSIDERATION. AS A RESULT OF THE REVIEW OF NEEDS AND APPLICATION OF THE ABOVE CRITERIA, RADY CHILDREN'S WILL ADDRESS THE FOLLOWING NEEDS AS THEY FOCUS ON THE HEALTH OF CHILDREN AND THEIR FAMILIES: -ACCESS TO HEALTH CARE -BEHAVIORAL HEALTH (INCLUDING MENTAL HEALTH, SUBSTANCE USE AND EDUCATION-RELATED CONCERNS) -CHRONIC CONDITIONS (INCLUDING OVERWEIGHT AND OBESITY) -INJURY PREVENTION FOR EACH HEALTH NEED THE HOSPITAL PLANS TO ADDRESS, THE IMPLEMENTATION STRATEGY DESCRIBES THE FOLLOWING: ACTIONS THE HOSPITAL INTENDS TO TAKE, INCLUDING PROGRAMS AND RESOURCES IT PLANS TO COMMIT, ANTICIPATED IMPACTS OF THESE ACTIONS, AND PLANNED COLLABORATION BETWEEN THE HOSPITAL AND OTHER ORGANIZATIONS. SEE PAGES 9-14 OF THE IMPLEMENTATION STRATEGY FOR FULL DESCRIPTION OF ACTIONS THE HOSPITAL INTENDS TO TAKE, INCLUDING PROGRAMS AND RESOURCES IT PLANS TO COMMIT, ANTICIPIATED IMPACT OF THESE ACTIONS, AND PLANNED COLLABORATION BETWEEN THE HOSPITAL AND OTHER ORGANIZATIONS. NEEDS NOT ADDRESSED: SINCE RADY CHILDREN'S CANNOT DIRECTLY ADDRESS ALL THE HEALTH NEEDS PRESENT IN THE COMMUNITY, WE WILL CONCENTRATE ON THOSE HEALTH NEEDS THAT WE CAN MOST EFFECTIVELY ADDRESS GIVEN OUR AREAS OF FOCUS AND EXPERTISE. TAKING EXISTING HOSPITAL AND COMMUNITY RESOURCES INTO CONSIDERATION, RADY CHILDREN'S WILL NOT DIRECTLY ADDRESS THE REMAINING HEALTH NEEDS IDENTIFIED IN THE CHNA, INCLUDING COVID-19, ECONOMIC STABILITY, EDUCATION, HOUSING AND HOMELESSNESS, AND SEXUAL BEHAVIORS.
RADY CHILDREN'S HOSPITAL SAN DIEGO PART V, SECTION B, LINE 16J: ALL LANGUAGE REGARDING THE POLICY IS COMMUNICATED TO PATIENTS VIA SIGNAGE IN ALL ADMITTING AREAS. AT THE POINT OF REGISTRATION, ALL PATIENTS RECEIVE BROCHURES EXPLAINING THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS; ALL INITIAL STATEMENTS TO UNINSURED PATIENTS INCLUDES VERBIAGE INFORMING PATIENTS OF THE FACILITY'S FINANCIAL ASSISTANCE PROGRAM AND A COPY OF THE CHARITY CARE APPLICATION. A SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?22
Name and address Type of Facility (describe)
1 1 - RADY CHILDREN'S DEVELOPMENT SERVICES
11752 EL CAMINO REAL SUITE 100
SAN DIEGO,CA92130 		DEVELOPMENTAL AND BEHAVIORAL SERVICES
2 2 - RADY CHILDREN'S SPECIALISTS OF SD
25485 MEDICAL CENTER DRIVE SUITE
100
MURRIETA,CA92562 		CLINIC
3 3 - CHADWICK CENTER FOR CHILDREN & FAMILIES
333 H ST SUITE 3010
CHULA VISTA,CA91910 		TRAUMA COUNSELING
4 4 - SANFORD CHILDREN'S CLINIC
3605 VISTA WAY SUITE 130
OCEANSIDE,CA92056 		CLINIC
5 5 - RADY CHILDREN'S SPECIALISTS OF SD
3605 VISTA WAY SUITE 172
OCEANSIDE,CA92056 		CLINIC/ URGENT CARE
6 6 - RADY CHILDREN'S HEALTH SERVICES
3665 KEARNY VILLA ROAD
SAN DIEGO,CA92123 		DEVELOPMENTAL AND BEHAVIORAL SERVICES
7 7 - RADY CHILDREN'S SPECIALISTS OF SD
385 W MAIN STREET
EL CENTRO,CA92243 		CLINIC
8 8 - RADY CHILDREN'S HEALTH SERVICES
386 EAST H STREET SUITE 202
CHULA VISTA,CA91910 		CLINIC/ URGENT CARE
9 9 - RADY CHILDREN'S URGENT CARE
4305 UNIVERSITY AVE 150
SAN DIEGO,CA92105 		CLINIC/ URGENT CARE
10 10 - CITY HEIGHTS WELLNESS CENTER
4440 WIGHTMAN STREET SUITE 200
SAN DIEGO,CA92105 		WELLNESS CENTER
11 11 - RADY CHILDREN'S SPECIALISTS OF SD
477 NORTH EL CAMINO REAL BUILDING D
ENCINITAS,CA92024 		CLINICS
12 12 - RADY CHILDREN'S URGENT CARE
5565 GROSSMONT CENTER DRIVE
BUILDING 2
LA MESA,CA91942 		URGENT CARE
13 13 - RADY CHILDREN'S SPECIALISTS OF SD
625 WEST CITRACADO PARKWAY
ESCONDIDO,CA92025 		CLINICS/ URGENT CARE
14 14 - RADY CHILDREN'S SPECIALISTS OF SD
2204 EL CAMINO REAL SUITE 102
OCEANSIDE,CA92054 		CLINIC
15 15 - RADY CHILDREN'S HOSPITAL
7910 FROST SUITE 140
SAN DIEGO,CA92123 		CLINICS
16 16 - RADY CHILDREN'S HOSPITAL
7920 FROST SUITE 140
SAN DIEGO,CA92123 		CLINICS
17 17 - NELSON FAMILY PAVILION
8001 FROST STREET
SAN DIEGO,CA92123 		CLINICS
18 18 - RADY CHILDREN'S HOSPITAL
8010 FROST SUITE 140
SAN DIEGO,CA92123 		CLINICS
19 19 - RADY CHILDREN'S HOSPITAL
8110 BIRMINGHAM DRIVE
SAN DIEGO,CA92123 		CLINICS
20 20 - HOMECARE
8291 AERO PLACE SUITE 130
SAN DIEGO,CA92123 		HOME HEALTHCARE
21 21 - POLINSKY CHILDREN'S CENTER MED CLINIC
9400 RUFFIN COURT BUILDING
SAN DIEGO,CA92123 		CLINIC
22 22 - RADY CHILDREN'S URGENT CARE
25170 HANCOCK AVE 1ST FLOOR
MURRIETA,CA92562 		URGENT CARE
Schedule H (Form 990) 2021
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Schedule H (Form 990) 2021
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 7: THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, THE COST TO CHARGE RATIO WAS CALCULATED USING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES AND APPLIED TO THOSE CATEGORIES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S DETAILED FINANCIAL INFORMATION.
PART II, COMMUNITY BUILDING ACTIVITIES: RADY CHILDREN'S CENTER FOR HEALTHIER COMMUNITIES PROVIDES THE FACES FOR THE FUTURE PROGRAM AT A LOCAL HIGH SCHOOL. THE FACES PROGRAM IS A YOUTH AND FUTURE HEALTHCARE WORKFORCE DEVELOPMENT PROGRAM THAT PREPARES UNDERREPRESENTED, ETHNICALLY DIVERSE YOUTH FOR CAREERS IN ALL AREAS OF THE HEALTH PROFESSIONS. THE PROGRAM ALSO AIMS TO ASSIST LOCAL PUBLIC SCHOOLS IN MOTIVATING AND PREPARING UNDERREPRESENTED HIGH SCHOOL STUDENTS FOR ENTRY INTO COLLEGE, HEALTHCARE/RESEARCH CAREERS AND OTHER VIABLE EMPLOYMENT OPPORTUNITIES IN THE HEALTHCARE INDUSTRY. THE PARTICIPATING STUDENTS ROTATE THROUGH CLINICAL DEPARTMENTS AT RADY CHILDREN'S HOSPITAL -SAN DIEGO AND RECEIVE MENTORSHIP.
PART III, LINE 2: FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, RCHSD RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED, OR ON THE BASIS OF DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY. ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF RCHSD'S UNINSURED PATIENTS ARE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. RCHSD RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS RELATED TO UNINSURED PATIENTS IN THE PERIOD SERVICES ARE PROVIDED. RCHSD RECORDS IMPLICIT PRICE CONCESSIONS BASED UPON THE HISTORICAL EXPERIENCE, AS WELL AS COLLECTION TRENDS FOR MAJOR PAYOR TYPES.
PART III, LINE 3: RCHSD DOES NOT TREAT ANY PART OF THE BAD DEBT AS COMMUNITY BENEFIT EXPENSE.
PART III, LINE 4: SEE PAGE 13-17 OF THE AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8: THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 ARE DETERMINED USING A PRO FORMA COST REPORT AS DESCRIBED IN PART I, LINE 7 ABOVE. THE ORGANIZATION BELIEVES THAT THE TEFRA COST LIMITATION SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BASED ON THE INPATIENT COST OVER THE TEFRA LIMITS.
PART III, LINE 9B: IN ITS BILLING AND COLLECTION ACTIVITY, RADY CHILDREN'S HOSPITAL - SAN DIEGO TREATS ALL PATIENTS AND PATIENT FAMILIES OR REPRESENTATIVES WITH FAIRNESS, DIGNITY AND RESPECT. RCHSD DOES NOT UTILIZE WAGE GARNISHMENTS, LIENS ON A PATIENT'S PRIMARY RESIDENCE, OR WRIT OF BODY ATTACHMENTS IN ITS COLLECTION ACTIVITIES. RCHSD ONLY UTILIZES THOSE OUTSIDE OR THIRD PARTY COLLECTION AGENCIES THAT AGREE TO COMPLY WITH APPLICABLE STATE AND FEDERAL LAWS AND WITH RCHSD POLICIES, AND RCHSD DEBT COLLECTION STANDARDS AND PRACTICES. IN DETERMINING THE DEBT THAT RCHSD SEEKS TO RECOVER, RCHSD WILL CONSIDER ONLY THE INCOME AND CERTAIN MONETARY ASSETS OF THE PATIENT/GUARANTOR ELIGIBLE FOR THE RCHSD FINANCIAL ASSISTANCE PROGRAM. IN MAKING THIS DETERMINATION, RCHSD WILL NOT CONSIDER RETIREMENT OR DEFERRED COMPENSATION PLANS (EITHER QUALIFIED OR NON-QUALIFIED UNDER THE INTERNAL REVENUE CODE), THE FIRST $10,000 OR THE REMAINING 50 PERCENT OF THEPATIENT/GUARANTOR'S MONETARY ASSETS. RCHSD SHALL NOT SEND AN ACCOUNT TO A COLLECTION AGENCY IF THE PATIENT HAS A PENDING APPLICATION FOR THE RCHSD FINANCIAL ASSISTANCE PROGRAM OR GOVERNMENT-SPONSORED INSURANCE PROGRAM OR IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL BY NEGOTIATING AN INTEREST FREE, EXTENDED PAYMENT PLAN OR BY MAKING REGULAR PARTIAL PAYMENTS OF A REASONABLE AMOUNT. A "PENDING APPLICATION" IS DEFINED AS AN APPLICATION THAT HAS BEEN FULLY COMPLETED AND INCLUDES COPIES OF THE REQUIRED DOCUMENTATION BY THE PATIENT/GUARANTOR, SUBMITTED TO THE RELEVANT PUBLIC AGENCY IN THE CASE OF GOVERNMENT PROGRAMS AND TO RCHSD IN THE CASE OF THE RCHSD FINANCIAL ASSISTANCE PROGRAM. IF A PATIENT ACCOUNT IS SENT TO COLLECTIONS AND IT IS DETERMINED THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE PATIENT ACCOUNT IS REMOVED FROM THE COLLECTION PROCESS AND THE FINANCIAL ASSISTANCE APPLICATION PROCESS IS IMPLEMENTED.
PART VI, LINE 2: NEEDS ASSESSMENTCONTINUING A LONGSTANDING COMMITMENT TO ADDRESS COMMUNITY HEALTH NEEDS IN SAN DIEGO, RADY CHILDREN'S AND OTHER HEALTHCARE SYSTEMS RECONVENED THROUGH THE HOSPITAL ASSOCIATION OF SAN DIEGO AND IMPERIAL COUNTIES (HASD&IC) TO COMPLETE A 2022 TRIENNIAL COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE CHNA IDENTIFIES AND PRIORITIZES THE MOST CRITICAL HEALTH-RELATED NEEDS OF SAN DIEGO COUNTY AND INCLUDES FEEDBACK FROM COMMUNITY RESIDENTS IN VULNERABLE NEIGHBORHOODS.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCERCHSD PROVIDES WRITTEN INFORMATION ABOUT THE AVAILABILITY OF THE RCHSD FINANCIAL ASSISTANCE PROGRAM, INCLUDING A BROCHURE THAT IS DISSEMINATED THROUGHOUT OUR PATIENT CLINICS. THIS INFORMATION IS PROVIDED AT PATIENT REGISTRATION, INCLUDING PATIENT INFORMATIONAL MATERIALS, EMERGENCY DEPARTMENT, OUTPATIENT CLINICS, AND PATIENT FINANCIAL SERVICES. IN ADDITION, A STATEMENT REGARDING THE FINANCIAL ASSISTANCE PROGRAM IS INCLUDED ON PATIENT BILLING STATEMENTS. WRITTEN NOTICE IS PROVIDED TO POTENTIALLY ELIGIBLE PATIENTS DURING THE REGISTRATION PROCESS OR AS SOON AS POSSIBLE THEREAFTER AND DURING THE BILLING PROCESS. THIS INFORMATION IS PROVIDED IN ENGLISH AND SPANISH AND IS TRANSLATED FOR PATIENTS/GUARANTORS WHO SPEAK OTHER LANGUAGES. NOTIFICATION OF FINANCIAL ASSISTANCE DISCUSSES, AT A MINIMUM, THE FOLLOWING: - IF A PATIENT MEETS CERTAIN INCOME REQUIREMENTS, THE PATIENT MAY BE ELIGIBLE FOR A GOVERNMENT-SPONSORED HEALTH INSURANCE PROGRAM OR THE RCHSD FINANCIAL ASSISTANCE PROGRAM. IDENTIFICATION OF RCHSD FINANCIAL COUNSELING - PATIENT FINANCIAL SERVICES PHONE NUMBER WITH HOURS OF AVAILABILITY SO THAT PATIENTS MAY CALL TO OBTAIN FURTHER INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM. RADY CHILDREN'S PROVIDES HEALTHCARE SUPPORT SERVICES TO THE COMMUNITY THROUGH THE FINANCIAL COUNSELING TEAM. RADY CHILDREN'S FINANCIAL COUNSELORS PROACTIVELY EXPLORE AND ASSIST PATIENTS/GUARANTORS IN APPLYING FOR HEALTH INSURANCE COVERAGE FROM PUBLIC AND PRIVATE PAYMENT PROGRAMS. - THE RCHSD WEBSITE PROVIDES INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM, AND THE FINANCIAL ASSISTANCE POLICY AND FINANCIAL ASSISTANCE PROGRAM APPLICATION ARE POSTED ON THE RCHSD WEBSITE.
PART VI, LINE 4: COMMUNITY INFORMATIONSAN DIEGO COUNTY (SAN DIEGO) IS THE SECOND MOST POPULOUS OF CALIFORNIA'S 58 COUNTIES, AND THE FIFTH LARGEST COUNTY IN THE UNITED STATES AND IS CURRENTLY HOME TO 3.4 MILLION RESIDENTS. THE REGION IS SOCIALLY AND ETHNICALLY DIVERSE, WITH OVER 20% OF THE POPULATION UNDER THE AGE OF EIGHTEEN AND ON AVERAGE, 201,000 VETERAN RESIDE HERE. WHILE THE MEDIAN HOUSEHOLD INCOME IS APPROXIMATELY $84,000, OVER 10% OF PERSONS ARE LIVING BELOW POVERTY LEVEL; CHILDREN UNDER AGE 18 ARE DISPROPORTIONATELY AFFECTED. IN ADDITION, 37% OF PERSONS SPEAK A LANGUAGE OTHER THAN ENGLISH AT HOME. RADY CHILDREN'S HOSPITAL SAN DIEGO (THE HOSPITAL) IS A REGIONAL TERTIARY AND QUATERNARY REFERRAL CENTER AND PROVIDES COMPREHENSIVE INPATIENT AND OUTPATIENT ACUTE, PSYCHIATRIC AND INTENSIVE CARE PEDIATRIC SERVICES. THE HOSPITAL ALSO IS THE SOLE PEDIATRIC PROVIDER AND DESIGNATED PEDIATRIC TRAUMA CENTER FOR SAN DIEGO COUNTY AND IS THE PRIMARY SOURCE OF PEDIATRIC AND NEONATAL INTENSIVE CARE SERVICES FOR BOTH SAN DIEGO AND IMPERIAL COUNTIES. ALSO, RCHSD IS THE PEDIATRIC SAFETY NET HOSPITAL FOR THE REGION WITH A MEDI-CAL PAYOR MIX HOVERING OVER 50%. RCHSD SERVES AS THE TEACHING HOSPITAL FOR THE SCHOOL OF MEDICINE AT THE UNIVERSITY OF CALIFORNIA, SAN DIEGO (UCSD) AND, IN 2001, RCHSD AND UCSD AMALGAMATED WHERE RCHSD BECAME THE PEDIATRIC PROVIDER OF INPATIENT AND OUTPATIENT MEDICAL AND SURGERY SERVICES AND CERTAIN OTHER CLINICAL SERVICES FOR UCSD PEDIATRIC PATIENTS. THERE ARE THREE LARGE HEALTH SYSTEMS OPERATING IN SAN DIEGO, SHARP HEALTHCARE, SCRIPPS HEALTH AND KAISER PERMANENTE, AS WELL AS OTHER HOSPITAL PROVIDERS. TO HELP CARE FOR PEDIATRIC PATIENTS, RCHSD COLLABORATES WITH SHARP HEALTHCARE, SCRIPPS HEALTH AND PALOMAR POMERADO HEALTH THROUGH AFFILIATED PROGRAM AGREEMENTS.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHE RADY CHILDREN'S HOSPITAL - SAN DIEGO IS GOVERNED BY A 26-MEMBER BOARD OF TRUSTEES. THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPRISED OF PERSONS REPRESENTING THE SAN DIEGO COMMUNITY, WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION. RCHSD EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. RCHSD APPLIES ITS SURPLUS FUNDS TO SUPPORT THE HIGHEST AND MOST URGENT NEEDS OF THE ORGANIZATION AND THE COMMUNITY INCLUDING IMPROVING PATIENT CARE; PROVIDING SUPPORT FOR OUR PATIENTS' FAMILIES; RESEARCH; DEVELOPMENTAL SERVICES; MENTAL HEALTH SERVICES; CHILD ABUSE PREVENTION AND TREATMENT SERVICES; EDUCATION PROGRAMS; AND PURCHASING STATE-OF-THE ART EQUIPMENT AND TECHNOLOGY TO FURTHER ENHANCE PATIENT CARE. RCHSD PROMOTES THE HEALTH OF THE COMMUNITY IT SERVES THROUGH A VARIETY OF MECHANISMS. THE RCHSD COMMUNITY BENEFIT REPORT FOR FISCAL YEAR 2021 (JULY 1, 2021 THROUGH JUNE 30, 2022) PROVIDES DETAILED INFORMATION ON OVER 30 PROGRAMS AND RELATED ACTIVITIES RCHSD CONDUCTS EACH YEAR TO IMPROVE PATIENT'S HEALTH STATUS. FROM PROVIDING FREE MEDICAL EDUCATION TRAINING SEMINARS TO COMMUNITY-BASED PHYSICIANS AND OTHER HEALTH PROVIDERS, SUPPORT GROUPS, PARENT EDUCATIONAL RESOURCE MATERIALS, PEDIATRIC RESEARCH, TO PROGRAMS DIRECTED TO IMPROVE THE HEALTH NEEDS OF PATIENTS, RCHSD USES A MULTI-PRONGED APPROACH TO PROVIDE BENEFIT TO THE COMMUNITY.
PART VI, LINE 7, REPORTS FILED WITH STATES CA
Schedule H (Form 990) 2021
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