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Shriners Hospitals for Children is a network of 22 non-profit hospitals across North America. Children with orthopedic conditions, burns, spinal cord injuries, and cleft lip and palate are eligible for care and receive all services in a family-centered environment, regardless of the patients’ ability to pay.
Headquartered in Tampa, Florida, the hospitals, known as "The World's Greatest Philanthropy," are owned and operated by Shriners International, formerly known as the Ancient Arabic Order of the Nobles of the Mystic Shrine, a Freemasonry-related organization simply known today as the Shriners. Patients must be minors under the age of 18 and are not required to have any familial affiliation with the Shriners order nor Freemasonry.
In 1920, the Imperial Session of the Shriners was held in Portland, Oregon. During that session the membership unanimously passed a resolution to establish what at the time was called the Shriners Hospital for Crippled Children system. The first hospital in the system opened in 1922 in Shreveport, Louisiana. It provided pediatric orthopedic care.
In 1962, the Shriners of North America allocated $10 million to establish three hospitals that specialized in the treatment and rehabilitation of burned children. After visiting 21 university-based medical institutions, the decision was made to build their first pediatric burn hospital on the campus of the University of Texas Medical Branch in Galveston, Texas.
Today, treatment areas cover a wide range of pediatric orthopedics, including scoliosis, limb discrepancies, clubfoot, hip dysplasia, and juvenile idiopathic arthritis, as well as cerebral palsy, spina bifida (myelomeningocele), and other neurological conditions that affect ambulation and movement. Three of the hospitals provide spinal cord injury rehabilitation that is developmentally appropriate for children and adolescents, with adventure and adapted sports programs, activity-based rehabilitation, aquatherapy, animal-assisted therapy, and other innovative programs. Four of the hospitals (Boston, Galveston, Cincinnati, and Sacramento) provide world-famous care for children with burns, as well as treating a variety of skin conditions such as epidermolysis bullosa and toxic epidermal necrolysis. The Boston, Chicago, and Portland hospitals also provide treatment for children with craniofacial conditions, especially facial clefts. The hospital in Sacramento is the only hospital in the Shriners' system that focuses on all three areas of treatment (burns, orthopedics, and spinal cord injuries), as well as research. The Sacramento hospital also houses its own orthotics and prosthetics lab and development facilities. All care at Shriners Hospitals is provided by interdisciplinary teams who work closely together to integrate the expertise of all the appropriate healthcare disciplines in one building. Transportation to the hospitals is often provided free of charge by Shriner-drivers across the country. Children accepted for treatment become part of the Shriners Hospital system until their 18th or, sometimes, their 21st, birthday, eligible for both inpatient and outpatient treatment for all facets of their disability.
While the overwhelming emphasis of the hospitals is to provide medical care to children regardless of the family's ability to pay, the mission of the hospitals also includes research on the conditions treated and the education of medical professionals, including medical residents and fellows, nurses, physical, recreation, and occupational therapists, speech and language pathology, psychologists, social workers, and child life specialists.
In 1994, the Chronicle of Philanthropy, an industry publication, released the results of the largest study of charitable and non-profit organization popularity and credibility. The study showed that the Shriners Hospitals were ranked as the 9th "most popular charity/non-profit in America" of over 100 charities researched with 40% of Americans over the age of 12 choosing "Love" and "Like A Lot" for the Shriners Hospitals.
In September 2008, the Shriner's Hospital in Galveston sustained significant damage from Hurricane Ike. The hospital was closed for renovation at that time, and care for children with acute burns was provided at other Shriners Hospitals for Children.
On Dec. 13, 2009, the Shriner's Hospital in Galveston reopened with a grand reopening celebration and plans to continue to be able to provide excellent care for burn patients in the area.
Shriners Hospitals for Children owns $7,866,399 in assets, according to Charity Watch. Joseph Krajbich, M.D. Orthopedic Surgeon and head of Shriners Hospitals for Children, received $807,917 salary/compensation from the charity. This is the 18th most money given by any charity to the head of a charity, according to Charity Watch. The money included $401,435 retirement and other deferred compensation.
On April 9, 2009, Ralph Semb, Chairman of the Board of Trustees of Shriners Hospitals for Children, said, "Unless we do something, the clock is ticking and within five to seven years we'll probably be out of the hospital business and not have any hospitals."
Douglas Maxwell, the hospitals' CEO, stated in July 2009 that some of the facilities may be downgraded to outpatient surgical centers, and will begin accepting insurance payments (for most care) for the first time in the hospitals' 87-year history. Maxwell said children suffering from burns, orthopedic conditions, spinal cord injuries and cleft palates will continue to be treated without charge to their families. Maxwell said, "We've not changed who we are. We will always take care of children the best we can." 
The Shriners had considered closing facilities in Shreveport, Louisiana; Greenville, South Carolina; Erie, Pennsylvania; Spokane, Washington; Springfield, Massachusetts and Galveston, Texas, eliminating a total of 225 beds. However in July, the Shriners National Convention voted to repair and reopen the Galveston facility, which was closed after Hurricane Ike struck in September 2008.
Despite an endowment that declined from $8 billion to $5 billion in less than a year because of the sputtering economy, Maxwell said he and other Shriners are confident the hospital system will be able to remain solvent in the long term.
In 2010, Shriners International decided to begin accepting third party insurance for patients. Billing started in 2011 but insurance is not required. Qualified patients are still accepted regardless of the family's ability to pay.
According to its Form 990, as of 2006, the Shriners Hospitals had an endowment of $10.2 billion. By April 2009, their endowment had gone down to $5 billion due to the recession and reductions in charitable donations.
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