Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 07-01-2013 , 2013, and ending 06-30-2014
BCheck if applicable:
CName of organization
Children's Hospital
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
111 Michigan Avenue NW
Suite
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
Washington, DC20010
D Employer identification number

53-0196580
E Telephone number

G Gross receipts $ 1,019,730,769
F Name and address of principal officer:
KURT DOUGLAS NEWMAN MD
111 Michigan Avenue NW
Washington,DC20010
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.childrensnational.org
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1870
M State of legal domicile: DC
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: see schedule o.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 18
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 14
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 7,534
6 Total number of volunteers (estimate if necessary) ............. 6 1,451
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 1,176,750
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -263,339
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 24,876,905 15,746,236
9 Program service revenue (Part VIII, line 2g) ......... 939,338,067 964,559,428
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 1,926,045 2,726,062
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 3,891,674 522,306
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 970,032,691 983,554,032
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 2,415,133
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 564,441,141 565,408,241
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 381,165,008 372,391,003
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 945,606,149 940,214,377
19 Revenue less expenses. Subtract line 18 from line 12....... 24,426,542 43,339,655
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 993,489,726 1,012,567,155
21 Total liabilities (Part X, line 26)............. 586,092,278 559,761,603
22 Net assets or fund balances. Subtract line 21 from line 20..... 407,397,448 452,805,552
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: see schedule o.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 658,972,013 including grants of $ 2,415,133 ) (Revenue $ 958,586,930 )
CHILDREN'S HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER (CNMC) IS THE PARENT COMPANY OF THE HOSPITAL. CNMC AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE O FOR COMPLETE FY14 COMMUNITY BENEFIT REPORT.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet658,972,013
Form 990 (2013)
Form 990 (2013)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment........................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors (see instructions)? Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes," complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
 
No
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
If "Yes," complete Schedule D, Part VI.Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment.........................
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year?
If "Yes," complete Schedule D, Parts XI and XII Click to see attachment.................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
Yes
 
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IVClick to see attachment
15
Yes
 
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV... Click to see attachment
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H.... Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5 about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a................ Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
Yes
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I........ Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I................... Click to see attachment
25b
 
No
26
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, complete Schedule L, Part II.................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If "Yes," complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If "Yes," complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If "Yes,"
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If "Yes," complete Schedule L, Part IV... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
2,905
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
7,534
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?..........................
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletAE
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?............................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?............................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?............
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?..........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?.......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year. ....................
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
Form 990 (2013)
Form 990 (2013)
Page 6
Part VI
Governance, Management, and Disclosure For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI ..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year .....................
1a
18
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
14
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
DC
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletCORPORATE OFFICERS111 MICHIGAN AVENUE NWWASHINGTONDC20010 (301) 572-3502
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII ..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) CAROLYN A THORNELL........................................................................
BOARD CHAIRMAN
 2.0
.......................1.0 		X   X       0 0 0
(2) DEBRA L FRIEDMAN........................................................................
BOARD VICE CHAIRMAN
 2.0
.......................   		X   X       0 0 0
(3) GREGORY A O'DELL........................................................................
BOARD SECRETARY-TREASURER
 2.0
.......................1.0 		X   X       0 0 0
(4) KURT D NEWMAN MD........................................................................
PRESIDENT / CEO (CNMC)
 39.0
.......................16.0 		X   X       1,511,782 0 432,063
(5) DIANA ABNEY MD........................................................................
BOARD MEMBER (EXP: 12/31/13)
 1.0
.......................1.0 		X           0 0 0
(6) DEIDRE ADKINS........................................................................
BOARD MEMBER
 1.0
.......................   		X           0 0 0
(7) SCHONAY BARNETT-JONES........................................................................
BOARD MEMBER
 1.0
.......................   		X           0 0 0
(8) ELIZABETH DUGGAL........................................................................
BOARD MEMBER
 1.0
.......................   		X           0 0 0
(9) GAIL FEAGLES........................................................................
BOARD MEMBER
 1.0
.......................1.0 		X           0 0 0
(10) ALBERTO GOMEZ........................................................................
BOARD MEMBER
 1.0
.......................   		X           0 0 0
(11) RAHUL K SHAH MD........................................................................
BOARD MEMBER
 55.0
.......................   		X           424,358 0 14,891
(12) MARY HELEN THOMPSON........................................................................
BOARD MEMBER
 1.0
.......................   		X           0 0 0
(13) DAVID WHISTON DDS........................................................................
BOARD MEMBER
 1.0
.......................   		X           0 0 0
(14) BONNIE NORMAN........................................................................
BOARD MEMBER
 1.0
.......................1.0 		X           0 0 0
(15) DARLY DAVIS........................................................................
BOARD MEMBER (BEG: 01/01/14)
 1.0
.......................   		X           0 0 0
(16) MAE H GRENNAN........................................................................
BOARD MEMBER (BEG: 01/01/14)
 1.0
.......................1.0 		X           0 0 0
(17) CAROLINE VAN VLECK MD........................................................................
BOARD MEMBER (BEG: 01/01/14)
 1.0
.......................   		X           0 0 0
Form 990 (2013)
Form 990 (2013)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) DAVID WESSEL MD........................................................................
BRD MEMBER/CMO (BEG: 01/01/14)
 52.0
.......................3.0 		X           895,750 0 150,436
(19) DENICE CORA-BRAMBLE MD........................................................................
BRD MEMBER/CMO (BEG: 01/01/14)
 51.0
.......................4.0 		X           841,354 0 151,387
(20) DOUGLAS MYERS........................................................................
CHIEF FINANCIAL OFFICER
 44.0
.......................11.0 		    X       1,033,864 0 122,994
(21) MARK BATSHAW MD........................................................................
PHY IN CHIEF / CAO
 9.0
.......................46.0 		      X     1,213,279 0 327,794
(22) RAYMOND S SCZUDLO........................................................................
CHIEF LEGAL OFFICER
 51.0
.......................4.0 		      X     945,827 0 61,523
(23) ANTHONY SANDLER MD........................................................................
SVP CENTER OF EXCELLENCE
 53.0
.......................2.0 		      X     883,021 0 140,163
(24) ROGER PACKER MD........................................................................
SVP CENTER OF EXCELLENCE
 43.0
.......................12.0 		      X     758,369 0 131,404
(25) JOSEPH WRIGHT MD........................................................................
SVP CENTER OF EXCELLENCE
 52.0
.......................3.0 		      X     621,848 0 150,367
(26) MENDAL TUCHMAN MD........................................................................
CHIEF RESEARCH OFFICER
 5.0
.......................50.0 		      X     611,601 0 110,429
(27) GERARD MARTIN MD........................................................................
SVP CENTER OF EXCELLENCE
 53.0
.......................2.0 		      X     866,301 0 111,666
(28) PAM KING SAMS........................................................................
CHIEF DEVELOPMENT OFFICER
 5.0
.......................50.0 		      X     479,404 0 173,075
(29) MARY ANNE HILLIARD........................................................................
CHIEF RISK OFFICER
 54.0
.......................1.0 		      X     506,546 0 93,060
(30) ROBERTA ALESSI........................................................................
VP OPERATIONS
 54.0
.......................1.0 		      X     401,164 0 65,850
(31) KATHLEEN CHAVANU GORMAN........................................................................
CHIEF OPERATING OFFICER
 54.0
.......................1.0 		      X     761,117 0 88,925
(32) ELIZABETH FLURY........................................................................
CHIEF STRATEGY OFFICER
 52.0
.......................3.0 		      X     695,672 0 112,597
(33) BRIAN JACOBS MD........................................................................
CHIEF INFORMATION OFFICER
 54.0
.......................1.0 		      X     470,191 0 82,067
(34) MARY OTTOLINI MD PHD........................................................................
VICE CHAIR MED. EDUCATION
 54.0
.......................1.0 		      X     316,213 0 21,939
(35) LINDA TALLEY........................................................................
CHIEF NURSING OFFICER
 54.0
.......................1.0 		      X     305,291 0 23,402
(36) DARRYL VARNADO........................................................................
CHIEF PEOPLE OFFICER
 54.0
.......................1.0 		      X     418,610 0 70,978
(37) RICHARD JONAS MD........................................................................
Chief of Cardiac Surgery
 54.0
.......................1.0 		      X     1,856,744 0 195,230
(38) ROBERT KEATING MD........................................................................
CHIEF OF NEUROSURGERY
 55.0
.......................   		        X   856,324 0 109,880
(39) PETER KIM MD........................................................................
VP SHEIKH ZAYED INSTITUTE
 55.0
.......................   		        X   871,500 0 34,641
(40) H GIL RUSHTON MD........................................................................
CHIEF OF UROLOGY
 55.0
.......................   		        X   621,923 0 93,228
(41) JOHN MYSEROS MD........................................................................
NEUROSURGEON
 55.0
.......................   		        X   687,137 0 34,245
(42) TIMOTHY KANE MD........................................................................
CHIEF OF PEDIATRIC SURGERY
 55.0
.......................   		        X   694,794 0 21,911
(43) NELLIE ROBINSON........................................................................
FORMER CHIEF NURSING OFFICER
 55.0
.......................   		          X 703,545 0 60,661
(44) DAVID SPARKS........................................................................
FORMER VP FINANCE & CONTROLLER
 55.0
.......................   		          X 444,761 0 88,232
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 21,698,290 0 3,275,038
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet964
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
CERNER CORPORATION, PO BOX 412702KANSAS CITYMO641412702 IT SERVICES 9,016,550
COLONIAL PARKING, 2145 K STREET NWWASHINGTONDC20037 PARKING 4,072,097
ATLANTIC SERVICES GROUP, 2131 K STREET NWWASHINGTONDC20037 PARKING 3,762,084
NATIONAL NURSES SERVICE, DEPT L-9032COLUMBUSOH432609032 NURSING 3,246,672
FTI CONSULTING INC, PO BOX 418005BOSTONMA022418005 STRATEGIC OPS 3,220,310
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet260
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 15,746,236
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and
similar amounts not included above1f 		 
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 15,746,236
Program Service RevenueAmt Business Code
2a PATIENT REVENUE 621400 880,960,940 880,960,940    
b FEES AND CONTRACTS 900099 8,636,174 8,636,174    
c ALL OTHER PROGRAM SERVICES 900099 74,962,314 74,962,314    
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 964,559,428
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 3,274,153     3,274,153
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss) 0 0
d Net rental income or (loss).......MediumBullet 0      
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 35,610,646 18,000
b Less: cost or other basis and sales expenses 36,176,737  
c Gain or (loss) -566,091 18,000
d Net gain or (loss)..........MediumBullet -548,091     -548,091
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a PARTNERSHIP LOSS 621110 -5,470,790 -5,470,790    
b PARKING 812930 4,816,346     4,816,346
c LAB FEES 621500 1,176,750   1,176,750  
d All other revenue ....        
e Total. Add lines 11a–11d ...... MediumBullet 522,306
12 Total revenue. See Instructions......MediumBullet 983,554,032 959,088,638 1,176,750 7,542,408
Form 990 (2013)
Form 990 (2013)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 2,378,747 2,378,747
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 36,386 36,386
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 16,641,402   16,641,402 0
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 468,224,038 340,099,008 128,125,030  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 16,492,723 11,568,485 4,924,238  
9 Other employee benefits ....... 31,825,465 22,323,326 9,502,139  
10 Payroll taxes ........... 32,224,613 22,603,300 9,621,313  
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 1,881,805 1,319,954 561,851  
c Accounting ........... 795,458   795,458  
d Lobbying ........... 329,629   329,629  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 0      
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 58,093,745 40,748,676 17,345,069  
12 Advertising and promotion .... 5,204,426 3,650,539 1,553,887  
13 Office expenses ....... 9,092,096 6,377,466 2,714,630  
14 Information technology ...... 33,908,410 23,784,365 10,124,045  
15 Royalties .. 0      
16 Occupancy ........... 22,477,652 15,766,492 6,711,160  
17 Travel ............ 3,679,041 2,580,588 1,098,453  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 777,545 545,393 232,152  
20 Interest ........... 26,143,217 18,337,628 7,805,589  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 56,704,759 39,774,401 16,930,358  
23 Insurance .............. 28,657,219 20,101,024 8,556,195  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL SUPPLIES 82,174,459 57,628,741 24,545,718  
b BAD DEBT EXPENSE 19,100,353 19,100,353    
c REPAIRS AND MAINTENANCE 14,608,935 10,247,141 4,361,794  
d OVERHEAD 2,571,706   2,571,706  
e All other expenses 6,190,548   6,190,548  
25 Total functional expenses. Add lines 1 through 24e 940,214,377 658,972,013 281,242,364 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 0 1 0
2 Savings and temporary cash investments ......... 59,376,517 2 80,288,535
3 Pledges and grants receivable, net ........... 4,416,815 3 7,994,785
4 Accounts receivable, net ............. 186,580,547 4 175,816,200
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
0 5 0
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 6,910,911 8 7,410,283
9 Prepaid expenses and deferred charges .......... 5,824,315 9 11,035,619
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,030,278,246
b Less: accumulated depreciation ..... 10b 510,481,071 526,750,689 10c 519,797,175
11 Investments—publicly traded securities .......... 132,119,472 11 132,304,887
12 Investments—other securities. See Part IV, line 11 ..... 32,065,538 12 35,582,245
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 20,000 14 20,000
15 Other assets. See Part IV, line 11 ........... 39,424,922 15 42,317,426
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 993,489,726 16 1,012,567,155
Liabilities 17 Accounts payable and accrued expenses ......... 150,809,067 17 154,860,336
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 5,630,726 19 15,025,591
20 Tax-exempt bond liabilities ............. 411,076,761 20 406,619,378
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 75,342,852 23 75,257,136
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... -56,767,128 25 -92,000,838
26 Total liabilities. Add lines 17 through 25......... 586,092,278 26 559,761,603
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 407,397,448 27 452,805,552
28 Temporarily restricted net assets ........... 0 28 0
29 Permanently restricted net assets ........... 0 29 0
Organizations that do not follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds ........   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ........... 407,397,448 33 452,805,552
34 Total liabilities and net assets/fund balances ........ 993,489,726 34 1,012,567,155
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
983,554,032
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
940,214,377
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
43,339,655
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
407,397,448
5
Net unrealized gains (losses) on investments ...............
5
1,885,951
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
182,498
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
452,805,552
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII .............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2013)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions.
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) A person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the supported organization? ................
11g(i)
 
 
(ii) A family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) A 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) (iv) Is the organization in col. (i) listed in your governing document? (v) Did you notify the organization in col. (i) of your support? (vi) Is the organization in col. (i) organized in the U.S.? (vii) Amount of monetary support
Yes No Yes No Yes No
Total  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 2
Part II
Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..  
6 Public support. Subtract line 5 from line 4.  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).  
12
12
 
13
First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization, check this box and stop here.................................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 3
Part III
Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public support (Subtract line 7c from line 6.)  
Section B. Total Support
Calendar year (or fiscal year beginning in) right arrow (a) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) ..            
13 Total support. (Add lines 9, 10c, 11, and 12.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet $  
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
Children's Hospital
  		Employer identification number

53-0196580
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

   
RESTRICTED
RESTRICTED
RESTRICTED, RESTRICTEDRESTRICTED

$RESTRICTED


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
Children's Hospital
  		Employer identification number

53-0196580
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
Children's Hospital
  		Employer identification number

53-0196580
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
     
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.SchCMd Bullet Attach to Form 990 or Form 990-EZ.
SchCMd Bullet See separate instructions.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ...................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2013

Schedule C (Form 990 or 990-EZ) 2013
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
Calendar year (or fiscal year
beginning in) 		(a) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount          
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))		  
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
313,592
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
Yes
 
16,037
j
Total. Add lines 1c through 1i ...............................
329,629
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Return Reference Explanation
Paid Staff or Management Schedule C, Part II-B, Line 1b FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS
Direct Contact Schedule C, Part II-B, Line 1g THE LOBBYING ACTIVITIES ENGAGED IN BY CHILDREN'S HOSPITAL FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS. THOSE LOBBYING ACTIVITIES INCLUDE CONTINUAL MONITORING OF LEGISLATION VIA DISCUSSIONS WITH LEGISLATIVE STAFF, HOSTING EDUCATIONAL BRIEFING SESSIONS FOR MEMBERS OF CONGRESS, EXECUTIVE BRANCH, STATE AND LOCAL OFFICIALS/STAFF REGARDING CHILD HEALTH ISSUES, AND COORDINATING THE SUBMISSION OF CORRESPONDENCE/WRITTEN COMMENTS ON PROPOSED LEGISLATION AND REGULATIONS, AS WELL AS THE PRESENTATION OF TESTIMONY BEFORE LEGISLATIVE COMMITTEES. CHILDREN'S HOSPITAL ALSO DEVELOPS POLICY POSITIONS IN RESPONSE TO PROBLEMS AND OPPORTUNITIES IN THE PUBLIC SECTOR. EXPENSES TOTALED $313,592
OTHER ACTIVITIES SCHEDULE C, PART II-B, LINE 1i THE HOSPITAL IS A MEMBER OF THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH). NACH HAS CHILD ADVOCACY AND LEGISLATIVE ADVOCACY PROGRAMS.
Schedule C (Form 990 or 990EZ) 2013

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIII and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance ....          
b Contributions ........          
c Net investment earnings, gains, and losses          
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		         
f Administrative expenses ....          
g End of year balance ......          
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet  
c
Temporarily restricted endowment SchDMd Bullet  
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   1,440,758 1,440,758
b Buildings ................   84,952,732 72,343,534 12,609,198
c Leasehold improvements ............   768,170,456 337,158,047 431,012,409
d Equipment ................   173,718,080 99,693,180 74,024,900
e Other .................   1,996,220 1,286,310 709,910
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 519,797,175
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
CAPITAL LEASE OBLIGATIONS 9,327,169
DUE TO AFFILIATES -198,732,806
RESERVE FOR CLAIMS 41,339,326
OTHER LIABILITIES 47,721,762
SETTLEMENTS TO THIRD PARTY PAY 8,343,711




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet -92,000,838
2. Liability for uncertain tax positions In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII ..................................................
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
Liability for Uncertain Tax Position (ASC 740) Schedule D, Part X, Line 2 FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (MEDICAL CENTER), OF WHICH CHILDREN'S HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ON SUCH BASIS, THE EXEMPT ENTITIES WILL NOT INCUR ANY LIABILITY FOR FEDERAL INCOME TAXES, EXCEPT FOR POSSIBLE UNRELATED BUSINESS INCOME. THE MEDICAL CENTER EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THE MEDICAL CENTER HAD NO UNCERTAIN TAX POSITIONS DURING THE YEARS ENDED JUNE 30, 2014 AND 2013.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.Right pointing arrow large image Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.
1
For grantmakers.Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ...............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in region (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total expenditures
for and investments
in region
Middle East and North Africa   1 Program Services PATIENTS REFFERALS 269,072
Central America and the Caribbean     Program Services INSURANCE PREMIUMS 28,309,248
Sub-Saharan Africa     Grantmaking PATIENT SERVICES 36,386
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....   1 28,614,706
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)   1 28,614,706
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
Sub-Saharan Africa PATIENT CARE DEBT FORGIVENESS 36,386 WIRE     FMV
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter ....MediumBullet
 
3
Enter total number of other organizations or entities .......................MediumBullet
1
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A).......................................
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713)................................................
Schedule F (Form 990) 2013
Schedule F (Form 990) 2013
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
ReturnReference Explanation
Procedure for monitoring the use of grant funds outside of the US Schedule F, Part I, Line 2 Annually, a physician of Childrens Hospital travels to Uganda to provide specialized medical care for children. The physician is an employee of the hospital, and reports back on the activities to his department.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2013
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
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 income based criteria 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
Yes
 
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
 
No
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) .. 		    6,249,897   6,249,897 0.680 %
b Medicaid (from Worksheet 3,
column a) .... 		    68,057,934   68,057,934 7.390 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		    74,307,831   74,307,831 8.070 %
Other Benefits
 43 153,765 16,087,555 13,573,518 2,514,037 0.270 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		18 1,481 28,653,010 8,275,035 20,377,975 2.210 %
g Subsidized health services
(from Worksheet 6) .. 		1   5,017,649 4,110,394 907,255 0.100 %
h Research (from Worksheet 7) 1   8,824,338   8,824,338 0.960 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		5 596 179,800 8,140 171,660 0.020 %
j Total. Other Benefits .. 68 155,842 58,762,352 25,967,087 32,795,265 3.560 %
k Total. Add lines 7d and 7j . 68 155,842 133,070,183 25,967,087 107,103,096 11.630 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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 3 11,219 40,301 4,000 36,301  
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building 1 20 27,650 3,500 24,150  
7 Community health improvement advocacy            
8 Workforce development 3 31 176,848 16,500 160,348 0.020 %
9 Other            
10 Total 7 11,270 244,799 24,000 220,799 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 Heathcare 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
7,660,053
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
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
2,218,668
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
1,996,355
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
222,313
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) 2013
Schedule H (Form 990) 2013
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?1
Name, address, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 CHILDREN'S HOSPITAL
111 MICHIGAN AVE NW
WASHINGTON,DC20010 		X X X X X X X X    
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
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)
CHILDREN'S HOSPITAL
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 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 9.................... 1 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 13
3 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 Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................... 3 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If "No," explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a 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)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, 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) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 350.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If "Yes," indicate the FPG family income limit for eligibility for discounted care: 350.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If "Yes," indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
i
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 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 actions the hospital facility may take upon non-payment?....... 15 Yes  
16 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
17 Did the hospital facility or an authorized third 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?.......... 17   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires 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?.......... 19 Yes  
If "No," indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 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
21 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? ............................ 21   No
If "Yes," explain in Part VI.
22 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? ......................... 22   No
If "Yes," explain in Part VI.
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
Childrens Hospital - Facility Information Schedule H, Part V, Section B, Line 1J The community health needs assessment also includes illustrative maps/figures of assets and vulnerabilities related to specific health metrics, including but not limited to major outlet fast food locations per ward of the District, hospitals and primary care centers in the District, medically underserved areas in the District, and locations of primary care and mental health professionals shortage areas in the District. By providing this information this will assist in overall data analysis, program planning and informing decision making on important health related issues affecting the residents of Washington, DC. Schedule H,Part V, Section B, Line 3 In conducting the most recent CHNA, input was received via four focus groups conducted with key stakeholders who are advocates or providers of health and social services. Two of the groups focused on health and health service issues. The other two groups focused on social determinants and related social service issues that impact health. There was a total of 30 focus group participants including hospital patient advocates, case managers, Department of Health officials, and community-based health and social service stakeholders. Stakeholders were queried about a number of major issues, including what they viewed as priority health and social services needs for the city in general, the particular needs that were relevant to the populations they serve, and their specific recommendations for concrete steps that could be implemented to improve overall health and social services for residents. Social scientists from RAND developed the script for the focus groups. The focus group guide included additional information specifically the questions asked of focus groups' participants. The questions aligned with the health needs identified through the quantitative analyses, and were analyzed as part of the qualitative component of the community health needs assessment. In addition, RAND spearheaded the recruitment efforts of the focus groups to ensure representation of the community as a whole. RAND has records and access to all focus group participants' names along with the focus group guide on file and available upon request from RAND. Schedule H,Part V, Section B, Line 4 Children's National, through its membership in the DC Healthy Communities Collaborative, conducted the CHNA in participation with three additional non-profit hospitals: Howard University Hospital, Providence Hospital, Sibley Memorial Hospital; and three community health centers, two of which are Federally qualified health centers, Bread for the City, Community of Hope, and Unity Health Care, Inc. ANOTHER COMMUNITY HEALTH CENTER, MARY'S CENTER JOINED THE DC HEALTHY FAMILIES COLLABORATIVE AFTER THE NEEDS ASSESSMENT WAS CONDUCTED AND PARTICIPATED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN DEVELOPMENT PROCESS. The DC Healthy Communities Collaborative (DCHCC) works to eliminate health disparities and create health equity for all communities in the District of Columbia to realize one healthy Capital city. With the unique perspectives of each hospital and community health center, DCHCC members provided guidance and feedback respective to populations and neighborhoods served. Schedule H,Part V, Section B, Line 5d In addition to the broad distribution via the hospital's website and the DCHCC's DC Health Matters web portal, Children's National also participated in community-based meetings and forums to disseminate the CHNA report findings, and as part of the launch of the DCHM, a news release was distributed with URL information for viewing the CHNA report. Additionally, each DCHCC member organization has an electronic copy of the CHNA report on their website. Schedule H,Part V, Section B, Line 6i Children's Hospital adopted an implementation strategy, referred to as the Community Health Improvement Plan (CHIP) that addresses four of the six priority community health needs identified through the citywide CHNA. The CHIP is available online at: HTTP://CHILDRENSNATIONAL.ORG/~/MEDIA/CNHS-SITE/FILES/ABOUT/ADVOCACY/FINAL_ CHILDRENS_NATIONAL_CHIP_FY_20142016.ASHX Schedule H,Part V, Section B, Line 7 The DCHCC accepted the six top health issues -- Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, Asthma, Access to Care, and Stress-Related Conditions - that emerged through analyses of quantitative data sources (including the Behavioral Risk Factor Survey, Youth Behavioral Risk Survey, hospital discharge data, American Community Survey, and US Census data) and qualitative data (input from community representatives obtained during stakeholder focus groups). Members of the DCHCC deliberated and decided access to care and stress-related conditions should not be addressed as independent priority issues as they are systemic issues that impact all of the other priority health areas. Thus, the implementation strategy (Community Health Improvement Plan) addresses the remaining four priority issues: Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, and Asthma. In preparation for developing the implementation strategy, Children's National conducted a series of internal meetings with experts to assess its capacity to address and prioritize the identified health areas based on organizational strategy. With the organizational capacity identified and sanctioned, Children's National reconvened as part of the DCHCC process to develop the implementation strategy (Community Health Improvement Plan) as follows: conducted Gap and Strength, Weaknesses, Opportunities, and Threats (SWOT) analyses (for each health priority); prioritization of issues (to rank the health issues); creation of action plan; and monitoring of the action plan. DCHCC members included in their individual organization's implementation strategy (community health improvement plan) additional health issues that support their organization's mission, including but not limited to, access to care and stress-related conditions. Children's National added oral health and injury prevention to their implementation strategy. Each DCHCC member organization received approval of the implementation strategy (community health improvement plan) by their Board of Directors/Trustees. Children's National received approval by its Board on May 23, 2013. BY THE CLOSE OF FY14, THE DISTRICT OF COLUMBIA HEALTHY COMMUNITIES COLLABORATIVE ADDRESSED COMMUNITY HEALTH IMPROVEMENT IN THE AREAS OF MENTAL HEALTH/SUBSTANCE ABUSE, OBESITY/OVERWEIGHT, ASTHMA, AND SEXUAL/REPRODUCTIVE HEALTH. FACILITATION OF BEST PRACTICE STRATEGIES, ADDRESSING CONTINUING EDUCATION REQUIREMENTS FOR MEDICAL PRACTITIONERS, DEVELOPING ASSET MAPS SHOWCASING CITYWIDE RESOURCES, AND PROMOTING THE INTEGRATION OF MENTAL HEALTH SCREENING IN THE PRIMARY CARE SETTINGS ARE EXAMPLES OF WAYS THE DCHCC IS ADDRESSING THE NEEDS OF THE WASHINGTON, DC COMMUNITY.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
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?19
Name and address Type of Facility (describe)
1 CHILDREN'S OUTPATIENT CTR OF MONTGOMERY
9850 KEY WEST AVE
ROCKVILLE,MD20850 		REGIONAL OUTPATIENT CENTER
2 CHILDREN'S OUTPATIENT CTR OF NORTHERN VA
6565 ARLINGTON BLVD SUITE 200
FALLS CHURCH,VA22031 		REGIONAL OUTPATIENT CENTER
3 CHILDREN'S OUTPATIENT CTR IN LAUREL
13922 BALTIMORE AVE
LAUREL,MD20707 		REGIONAL OUTPATIENT CENTER
4 CHILDREN'S HEALTH CENTER - ADAMS MORGAN
1630 EUCLID STREET NW
WASHINGTON,DC20009 		HEALTH CENTERS
5 CHILDREN'S HEALTH CENTER - GOOD HOPE RD
2501 GOOD HOPE ROAD SE
WASHINGTON,DC20020 		HEALTH CENTERS
6 CHILDREN'S HEALTH CENTER - MLK JR AVE
3029 MARTIN LUTHER KING JR AVE SE
WASHINGTON,DC20032 		HEALTH CENTERS
7 CHILDREN'S OUTPATIENT CTR - UPR MARLBORO
9440 PENNSYLVANIA AVENUE
UPPER MARLBORO,MD20772 		REGIONAL OUTPATIENT CENTER
8 MOBILE VAN - HEALTH CARE
N/A
NA,DC20010 		MOBILE HEALTH CARE
9 CHILDREN'S OUTPATIENT CTR IN ANNAPOLIS
888 BESTGATE ROAD STE 320
ANNAPOLIS,MD21401 		REGIONAL OUTPATIENT CENTER
10 CHILDREN'S HEALTH CENTER - SHAW
2220 11TH STREET NW
WASHINGTON,DC20001 		HEALTH CENTERS
11 CHILDREN'S OUTPATIENT CTR SPRING VALLEY
4900 MASSACHUSETTS AVENUE NW
WASHINGTON,DC20016 		REGIONAL OUTPATIENT CENTER
12 CHILDREN'S NAT'L AMBULATORY SURGERY CTR
9850 KEY WEST AVENUE
ROCKVILLE,MD20850 		REGIONAL OUTPATIENT CENTER
13 CHILDREN'S OUTPATIENT CTR IN FREDERICK
5910 FREDERICK CROSSING LANE STE 1
FREDERICK,MD21704 		REGIONAL OUTPATIENT CENTER
14 MOBILE VAN - DENTAL
N/A
NA,DC20010 		MOBILE HEALTH CARE
15 CHILDREN'S HEALTH CENTER AT THEARC
1901 MISSISSIPPI AVE SE
WASHINGTON,DC20020 		HEALTH CENTERS
16 CHILDREN'S OUTPATIENT CTR MONTGOMERY CTY
15245 SHADY GROVE ROAD STE 350
ROCKVILLE,MD20858 		REGIONAL OUTPATIENT CENTER
17 CHILDREN'S OUTPATIENT CTR OF NORTHERN VA
3023 Hamaker Court suite 300
FAIRFAX,VA22031 		REGIONAL OUTPATIENT CENTER
18 CHILDREN'S NATIONAL IMAGING CENTER
9850 KEY WEST AVENUE Suite 110
ROCKVILLE,MD20850 		REGIONAL OUTPATIENT CENTER
19 CHILDREN'S NATIONAL SPECIALISTS OF VIRGI
3023 HAMAKER cOURT SUITE 500
FAIRFAX,VA22031 		HEALTH CENTER
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
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
Childrens Hospital - Facility Information Schedule H, Part V, Section B, Line 1J The community health needs assessment also includes illustrative maps/figures of assets and vulnerabilities related to specific health metrics, including but not limited to major outlet fast food locations per ward of the District, hospitals and primary care centers in the District, medically underserved areas in the District, and locations of primary care and mental health professionals shortage areas in the District. By providing this information this will assist in overall data analysis, program planning and informing decision making on important health related issues affecting the residents of Washington, DC. Schedule H,Part V, Section B, Line 3 In conducting the most recent CHNA, input was received via four focus groups conducted with key stakeholders who are advocates or providers of health and social services. Two of the groups focused on health and health service issues. The other two groups focused on social determinants and related social service issues that impact health. There was a total of 30 focus group participants including hospital patient advocates, case managers, Department of Health officials, and community-based health and social service stakeholders. Stakeholders were queried about a number of major issues, including what they viewed as priority health and social services needs for the city in general, the particular needs that were relevant to the populations they serve, and their specific recommendations for concrete steps that could be implemented to improve overall health and social services for residents. Social scientists from RAND developed the script for the focus groups. The focus group guide included additional information specifically the questions asked of focus groups' participants. The questions aligned with the health needs identified through the quantitative analyses, and were analyzed as part of the qualitative component of the community health needs assessment. In addition, RAND spearheaded the recruitment efforts of the focus groups to ensure representation of the community as a whole. RAND has records and access to all focus group participants' names along with the focus group guide on file and available upon request from RAND. Schedule H,Part V, Section B, Line 4 Children's National, through its membership in the DC Healthy Communities Collaborative, conducted the CHNA in participation with three additional non-profit hospitals: Howard University Hospital, Providence Hospital, Sibley Memorial Hospital; and three community health centers, two of which are Federally qualified health centers, Bread for the City, Community of Hope, and Unity Health Care, Inc. ANOTHER COMMUNITY HEALTH CENTER, MARY'S CENTER JOINED THE DC HEALTHY FAMILIES COLLABORATIVE AFTER THE NEEDS ASSESSMENT WAS CONDUCTED AND PARTICIPATED IN THE COMMUNITY HEALTH IMPROVEMENT PLAN DEVELOPMENT PROCESS. The DC Healthy Communities Collaborative (DCHCC) works to eliminate health disparities and create health equity for all communities in the District of Columbia to realize one healthy Capital city. With the unique perspectives of each hospital and community health center, DCHCC members provided guidance and feedback respective to populations and neighborhoods served. Schedule H,Part V, Section B, Line 5d In addition to the broad distribution via the hospital's website and the DCHCC's DC Health Matters web portal, Children's National also participated in community-based meetings and forums to disseminate the CHNA report findings, and as part of the launch of the DCHM, a news release was distributed with URL information for viewing the CHNA report. Additionally, each DCHCC member organization has an electronic copy of the CHNA report on their website. Schedule H,Part V, Section B, Line 6i Children's Hospital adopted an implementation strategy, referred to as the Community Health Improvement Plan (CHIP) that addresses four of the six priority community health needs identified through the citywide CHNA. The CHIP is available online at: HTTP://CHILDRENSNATIONAL.ORG/~/MEDIA/CNHS-SITE/FILES/ABOUT/ADVOCACY/FINAL_ CHILDRENS_NATIONAL_CHIP_FY_20142016.ASHX Schedule H,Part V, Section B, Line 7 The DCHCC accepted the six top health issues -- Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, Asthma, Access to Care, and Stress-Related Conditions - that emerged through analyses of quantitative data sources (including the Behavioral Risk Factor Survey, Youth Behavioral Risk Survey, hospital discharge data, American Community Survey, and US Census data) and qualitative data (input from community representatives obtained during stakeholder focus groups). Members of the DCHCC deliberated and decided access to care and stress-related conditions should not be addressed as independent priority issues as they are systemic issues that impact all of the other priority health areas. Thus, the implementation strategy (Community Health Improvement Plan) addresses the remaining four priority issues: Sexual Health, Mental Health and Substance Abuse, Obesity/Overweight, and Asthma. In preparation for developing the implementation strategy, Children's National conducted a series of internal meetings with experts to assess its capacity to address and prioritize the identified health areas based on organizational strategy. With the organizational capacity identified and sanctioned, Children's National reconvened as part of the DCHCC process to develop the implementation strategy (Community Health Improvement Plan) as follows: conducted Gap and Strength, Weaknesses, Opportunities, and Threats (SWOT) analyses (for each health priority); prioritization of issues (to rank the health issues); creation of action plan; and monitoring of the action plan. DCHCC members included in their individual organization's implementation strategy (community health improvement plan) additional health issues that support their organization's mission, including but not limited to, access to care and stress-related conditions. Children's National added oral health and injury prevention to their implementation strategy. Each DCHCC member organization received approval of the implementation strategy (community health improvement plan) by their Board of Directors/Trustees. Children's National received approval by its Board on May 23, 2013. BY THE CLOSE OF FY14, THE DISTRICT OF COLUMBIA HEALTHY COMMUNITIES COLLABORATIVE ADDRESSED COMMUNITY HEALTH IMPROVEMENT IN THE AREAS OF MENTAL HEALTH/SUBSTANCE ABUSE, OBESITY/OVERWEIGHT, ASTHMA, AND SEXUAL/REPRODUCTIVE HEALTH. FACILITATION OF BEST PRACTICE STRATEGIES, ADDRESSING CONTINUING EDUCATION REQUIREMENTS FOR MEDICAL PRACTITIONERS, DEVELOPING ASSET MAPS SHOWCASING CITYWIDE RESOURCES, AND PROMOTING THE INTEGRATION OF MENTAL HEALTH SCREENING IN THE PRIMARY CARE SETTINGS ARE EXAMPLES OF WAYS THE DCHCC IS ADDRESSING THE NEEDS OF THE WASHINGTON, DC COMMUNITY.
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Children's Hospital
 
Employer identification number
53-0196580
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) SAFE KIDS WORLDWIDE
1301 PENNSYLVANIA AVENUEwashingtn
WASHINGTON,DC20001 		52-1627574 501(c)(3)   2,378,747 FMV DEBT FORGIVENESS DEBT FORGIVENESS FORGIVENESS






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
Procedure for monitoring the use of grant funds in the US SCHEDULE I, PART I, Line 2 DURING THE YEAR, CHILDREN'S HOSPITAL MADE A CONTRIBUTION TO A RELATED ENTITY, Safe Kids Worldwide, WHICH IS ALSO TAX-EXEMPT UNDER IRC SECTION 501(C)(3) IN RECOGNITION AND FURTHERANCE OF THE SAFEKIDS CHARITABLE PURPOSES. Safe Kids Worldwide IS ORGANIZED AS A TYPE I SUPPORTING ORGANIZATION OF CHILDERN'S HOSPITAL.
Schedule I (Form 990) 2013


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
3
Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
Yes
 
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
Yes
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)KURT D NEWMAN MDPRESIDENT / CEO (CNMC) (i)
(ii)		 778,236
0 		708,157
0 		25,389
0 		343,885
0 		88,178
0 		1,943,845
0 		0
0
(2)RAHUL K SHAH MDBOARD MEMBER (i)
(ii)		 258,086
0 		165,678
0 		594
0 		12,750
0 		2,141
0 		439,249
0 		0
0
(3)DAVID WESSEL MDBRD MEMBER/CMO (BEG: 01/01/14) (i)
(ii)		 521,173
0 		349,703
0 		24,874
0 		95,250
0 		55,186
0 		1,046,186
0 		0
0
(4)DENICE CORA-BRAMBLE MDBRD MEMBER/CMO (BEG: 01/01/14) (i)
(ii)		 514,516
0 		305,508
0 		21,330
0 		95,250
0 		56,137
0 		992,741
0 		0
0
(5)DOUGLAS MYERSCHIEF FINANCIAL OFFICER (i)
(ii)		 563,087
0 		395,438
0 		75,339
0 		92,251
0 		30,743
0 		1,156,858
0 		0
0
(6)MARK BATSHAW MDPHY IN CHIEF / CAO (i)
(ii)		 602,517
0 		569,896
0 		40,866
0 		262,750
0 		65,044
0 		1,541,073
0 		0
0
(7)RAYMOND S SCZUDLOCHIEF LEGAL OFFICER (i)
(ii)		 437,187
0 		467,716
0 		40,924
0 		12,750
0 		48,773
0 		1,007,350
0 		0
0
(8)ANTHONY SANDLER MDSVP CENTER OF EXCELLENCE (i)
(ii)		 583,933
0 		296,336
0 		2,752
0 		72,750
0 		67,413
0 		1,023,184
0 		0
0
(9)ROGER PACKER MDSVP CENTER OF EXCELLENCE (i)
(ii)		 404,544
0 		325,117
0 		28,708
0 		77,334
0 		54,070
0 		889,773
0 		0
0
(10)JOSEPH WRIGHT MDSVP CENTER OF EXCELLENCE (i)
(ii)		 347,472
0 		252,667
0 		21,709
0 		103,856
0 		46,511
0 		772,215
0 		0
0
(11)MENDAL TUCHMAN MDCHIEF RESEARCH OFFICER (i)
(ii)		 322,297
0 		260,903
0 		28,401
0 		64,889
0 		45,540
0 		722,030
0 		0
0
(12)GERARD MARTIN MDSVP CENTER OF EXCELLENCE (i)
(ii)		 523,163
0 		333,572
0 		9,566
0 		61,783
0 		49,883
0 		977,967
0 		0
0
(13)PAM KING SAMSCHIEF DEVELOPMENT OFFICER (i)
(ii)		 317,988
0 		154,413
0 		7,003
0 		145,211
0 		27,864
0 		652,479
0 		0
0
(14)MARY ANNE HILLIARDCHIEF RISK OFFICER (i)
(ii)		 266,846
0 		214,407
0 		25,293
0 		57,196
0 		35,864
0 		599,606
0 		0
0
(15)ROBERTA ALESSIVP OPERATIONS (i)
(ii)		 271,162
0 		125,848
0 		4,154
0 		36,523
0 		29,327
0 		467,014
0 		0
0
(16)KATHLEEN CHAVANU GORMANCHIEF OPERATING OFFICER (i)
(ii)		 529,675
0 		212,659
0 		18,783
0 		74,867
0 		14,058
0 		850,042
0 		0
0
(17)ELIZABETH FLURYCHIEF STRATEGY OFFICER (i)
(ii)		 491,242
0 		202,060
0 		2,370
0 		80,694
0 		31,903
0 		808,269
0 		0
0
(18)BRIAN JACOBS MDCHIEF INFORMATION OFFICER (i)
(ii)		 362,702
0 		86,650
0 		20,839
0 		32,750
0 		49,317
0 		552,258
0 		0
0
(19)MARY OTTOLINI MD PHDVICE CHAIR MED. EDUCATION (i)
(ii)		 249,144
0 		64,231
0 		2,838
0 		12,669
0 		9,270
0 		338,152
0 		0
0
(20)LINDA TALLEYCHIEF NURSING OFFICER (i)
(ii)		 251,746
0 		52,027
0 		1,518
0 		10,936
0 		12,466
0 		328,693
0 		0
0
(21)DARRYL VARNADOCHIEF PEOPLE OFFICER (i)
(ii)		 275,479
0 		122,922
0 		20,209
0 		50,195
0 		20,783
0 		489,588
0 		0
0
(22)RICHARD JONAS MDChief of Cardiac Surgery (i)
(ii)		 1,078,661
0 		743,459
0 		34,624
0 		101,301
0 		93,929
0 		2,051,974
0 		0
0
(23)ROBERT KEATING MDCHIEF OF NEUROSURGERY (i)
(ii)		 757,280
0 		98,161
0 		883
0 		88,447
0 		21,433
0 		966,204
0 		0
0
(24)PETER KIM MDVP SHEIKH ZAYED INSTITUTE (i)
(ii)		 640,672
0 		229,310
0 		1,518
0 		12,750
0 		21,891
0 		906,141
0 		0
0
(25)H GIL RUSHTON MDCHIEF OF UROLOGY (i)
(ii)		 480,320
0 		136,126
0 		5,477
0 		60,249
0 		32,979
0 		715,151
0 		0
0
(26)JOHN MYSEROS MDNEUROSURGEON (i)
(ii)		 618,669
0 		67,478
0 		990
0 		12,750
0 		21,495
0 		721,382
0 		0
0
(27)TIMOTHY KANE MDCHIEF OF PEDIATRIC SURGERY (i)
(ii)		 564,871
0 		129,865
0 		58
0 		0
0 		21,911
0 		716,705
0 		0
0
(28)NELLIE ROBINSONFORMER CHIEF NURSING OFFICER (i)
(ii)		 304,004
0 		366,215
0 		33,326
0 		12,750
0 		47,911
0 		764,206
0 		0
0
(29)DAVID SPARKSFORMER VP FINANCE & CONTROLLER (i)
(ii)		 273,879
0 		143,587
0 		27,295
0 		42,515
0 		45,717
0 		532,993
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Return Reference Explanation
First-class or charter travel Schedule J, Part I, Line 1a FIRST CLASS OR CHARTER TRAVEL THE CEO PER HIS EMPLOYMENT CONTRACT IS ENTITLED TO (A) USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS, AND (B) TAKE HIS SPOUSE ON UP TO 7 TRIPS PER YEAR FOR CONFERENCES WHERE HER PRESENCE BENEFITS THE HOSPITAL AND ITS BUSINESS RELATIONS. HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL.
Tax indemnification and gross-up payments Schedule J, Part I, Line 1a TWO KEY EMPLOYEES AND ONE FORMER KEY EMPLOYEE RECEIVED CERTAIN SUPPLEMENTAL RETIREMENT BENEFITS, UPON APPROVAL OF THE COMPENSATION COMMITTEE, WHICH ARE INCREASED BY A TAX EQUALIZATION AMOUNT, WHICH IS SIGNIFICANTLY LESS THAN THE AMOUNT THAT WOULD BE DETERMINED BY A TAX GROSS UP OR INDEMNIFICATION METHOD. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT.
Health or social club dues or initiation fees Schedule J, Part I, Line 1a CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR HEALTH CLUB OR SOCIAL CLUB DUES. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT.
Personal services Schedule J, Part I, Line 1a CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT. THERE ARE NO EXPENDITURES FOR MAIDS, CHAUFFEURS OR CHEFS.
Supplemental nonqualified retirement plan Schedule J, Part I, Line 4b THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTALNON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C) AS PART OF DEFERRED COMPENSATION: MARK L. BATSHAW, MD $250,000 KURT D. NEWMAN, MD $331,135 DOUGLAS MYERS $79,501 ANTHONY SANDLER, MD $60,000 GERARD MARTIN, MD $49,033 DAVID WESSEL, MD $82,500 ROGER PACKER, MD $64,584 MENDAL TUCHMAN, MD $52,139 JOSEPH WRIGHT, MD $91,106 PAM KING SAMS $132,461 DENICE CORA-BRAMBLE, MD $82,500 DAVID SPARKS $29,765 MARY ANNE HILLIARD $44,446 ROBERTA ALESSI $24,808 ELIZABETH FLURY $75,002 KATHLEEN CHAVANU GORMAN $71,252 DARRYL VARNADO $45,003 BRAIN JACOBS, MD $20,000 RICHARD JONAS, MD $88,551 ROBERT KEATING, MD $75,697 H. GIL RUSHTON, MD $47,499
Non-fixed payments Schedule J, Part I, Line 7 THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT.
Initial contract exception Schedule J, Part I, Line 8 Certain individuals hired during the year have employment contracts which meet the initial contract exceptions described in the Treasury Regulations.
Schedule J (Form 990) 2013

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Children's Hospital
 
Employer identification number
53-0196580
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A DISTRICT OF COLUMBIA
  		53-6001131 254764GN7 10-26-2005 50,000,000 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
B DISTRICT OF COLUMBIA
  		53-6001131 254764GP2 10-26-2005 50,000,000 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
C DISTRICT OF COLUMBIA
  		53-6001131 254764GQ0 10-26-2005 50,000,000 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
D DISTRICT OF COLUMBIA
  		53-6001131 254764GX5 04-10-2008 3,555,193 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764GY3 04-10-2008 3,854,679 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764GZ0 04-10-2008 10,931,252 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764HA4 04-10-2008 73,663,982 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764HB2 04-10-2008 149,516,148 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 50,000,000 50,000,000 50,000,000 3,555,193
4 Gross proceeds in reserve funds . . . . . . . . . . . . 3,738,181 3,738,181 3,738,181 233,255
5 Capitalized interest from proceeds . . . . . . . . . . . 12,645,266 12,645,267 12,645,267 511,928
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 889,291 889,291 889,291 63,310
8 Credit enhancement from proceeds . . . . . . . . . . . 2,909,809 2,909,809 2,909,809 198,654
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 29,817,453 29,817,453 29,817,453 2,548,046
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? . . . . . X   X   X   X  
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .                
b Exception to rebate? . . . . . . . .                
c No rebate due? . . . . . . . .                
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X   X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X   X   X     X
b Name of provider . . . . . . . . . UBS
  		UBS
  		UBS
  		 
 
c Term of hedge . . . . . . . . . . 29.75 29.75 29.75  
d Was the hedge superintegrated? . . . . X   X   X     X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Children's Hospital
 
Employer identification number
53-0196580
Part I
Bond Issues
(a) Issuer name (b) Issuer EIN (c) CUSIP # (d) Date issued (e) Issue price (f) Description of purpose (g) Defeased (h) On
behalf of
issuer 		(i) Pool
financing
Yes No Yes No Yes No
A DISTRICT OF COLUMBIA
  		53-6001131 254764GN7 10-26-2005 50,000,000 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
B DISTRICT OF COLUMBIA
  		53-6001131 254764GP2 10-26-2005 50,000,000 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
C DISTRICT OF COLUMBIA
  		53-6001131 254764GQ0 10-26-2005 50,000,000 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
D DISTRICT OF COLUMBIA
  		53-6001131 254764GX5 04-10-2008 3,555,193 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764GY3 04-10-2008 3,854,679 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764GZ0 04-10-2008 10,931,252 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764HA4 04-10-2008 73,663,982 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
DISTRICT OF COLUMBIA
  		53-6001131 254764HB2 04-10-2008 149,516,148 CONSTRUCT AND RENOVATE FACILITIES   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 0 0 0 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 50,000,000 50,000,000 50,000,000 3,555,193
4 Gross proceeds in reserve funds . . . . . . . . . . . . 3,738,181 3,738,181 3,738,181 233,255
5 Capitalized interest from proceeds . . . . . . . . . . . 12,645,266 12,645,267 12,645,267 511,928
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 889,291 889,291 889,291 63,310
8 Credit enhancement from proceeds . . . . . . . . . . . 2,909,809 2,909,809 2,909,809 198,654
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 29,817,453 29,817,453 29,817,453 2,548,046
11 Other spent proceeds . . . . . . . . . . . . . . 0 0 0 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 0
13 Year of substantial completion . . . . . . . . . . . . 2009 2009 2009 2009
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . .   X   X   X   X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .   X   X   X   X
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?                
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0 % 0 % 0 % 0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . . SchKMediumBullet 0 % 0 % 0 % 0 %
6 Total of lines 4 and 5 . . . . . . . . . . . . . 0 % 0 % 0 % 0 %
7 Does the bond issue meet the private security or payment test? . . . . . X   X   X   X  
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.        
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2? . . . . . . . 		X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X   X   X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .                
b Exception to rebate? . . . . . . . .                
c No rebate due? . . . . . . . .                
If you checked "No rebate due" in line 2c, provide in
Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X   X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X   X   X     X
b Name of provider . . . . . . . . . UBS
  		UBS
  		UBS
  		 
 
c Term of hedge . . . . . . . . . . 29.75 29.75 29.75  
d Was the hedge superintegrated? . . . . X   X   X     X
e Was the hedge terminated? . . . . . .   X   X   X   X
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . .   X   X   X   X
b Name of provider . . . . . . . . . 0
  		0
  		0
  		0
 
c Term of GIC . . . . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .                
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X   X   X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
Schedule K (Form 990) 2013

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501(c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) DAVID WESSEL MD DIRECTOR HOUSING LOAN - COMP X   200,000 160,000   No Yes   Yes  
Total ......Small Bullet $ 160,000
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Return Reference Explanation
ORGANIZATION'S MISSION FORM 990, Part I, Line 1 TO IMPROVE HEALTH OUTCOMES FOR CHILDREN; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH, TO MEET NEEDS OF CHILDREN AND THEIR FAMILIES. Form 990, Part III, Line 1 TO IMPROVE HEALTH OUTCOMES FOR CHILDREN REGIONALLY, NATIONALLY, AND INTERNATIONALLY; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH, AND EDUCATION TO MEET UNIQUE NEEDS OF CHILDREN, ADOLESCENTS, AND THEIR FAMILIES. Program Services Part III, Line 4a Children's Mission Statement As the nation's children's hospital, the mission of Children's National Medical Center is to excel in Care, Advocacy, Research and Education. We accomplish this through: - Providing a quality health care experience for our patients and families. - Improving health outcomes for children regionally, nationally, and internationally. - Leading the creation of innovative solutions to pediatric health challenges. Children's Vision Statement As the nation's children's hospital, we will set the standard of excellence for the care of children. - We will serve as the voice for the most vulnerable among us: our children. - We will lead the quest to cure some of childhood's most devastating diseases. - We will prepare the nation's future leaders in child health. - We will be the children's hospital against which all others are measured. Children's Child-Centered Vision By incorporating feedback from our families, we have developed our first child-centered vision, which looks at the hospital experience through a child's eyes. Healing a child's body, mind and spirit takes more than medicine: it takes a team to fulfill a family's dream. - My hospital is a bright and happy place that feels like home. - My providers, my family, and I are a team, and everyone's job is important. - The way my hospital works is built around me. - My providers don't all look alike. - My hospital is my family's connection to everything I need for my health, whether they provide it or blaze trail it. About Children's National Children's National Medical Center is the premier provider of pediatric care in the Washington, DC, metropolitan area and is the only freestanding children's hospital between Philadelphia, Pittsburgh, Norfolk, and Atlanta. Serving the nation's children for 140 years, Children's National is a proven leader in the development and application of innovative new treatments for childhood illness and injury. Children's internationally recognized team of pediatric healthcare professionals care for more than 360,000 patients each year who come from throughout the region, nation and world. Serving as an advocate for all children, Children's is the largest non-governmental provider of pediatric care in the District of Columbia, providing more than $50 million in uncompensated care. In addition, Children's serves as the regional referral center for pediatric emergency, trauma, cancer, cardiac and critical care as well as neonatology, orthopedic surgery, neurology, and neurosurgery. Children's National is proudly ranked consistently among the best pediatric hospitals in America by US News & World Report and the Leapfrog Group, and has received Magnet designation by the ANCC. At Children's National Medical Center, we stand for children! Our vision of advancing the health and wellbeing of children has been the motivation behind a number of forward-focused initiatives aimed at creating a lasting standard for prevention and community education, coupled with top-notch treatment and continuous improvement. As always, the vision is carried out through a cadre of nationally recognized healthcare professionals, staff, and administrators who tirelessly serve the unique and diverse medical needs of the residents of the Washington, DC, metropolitan area and the broader community. Their work provides a unique perspective of the health improvements important for all children, in every family. With this in mind, the hospital is committed to building a universal blueprint for improving healthcare that can be replicated in health systems, hospitals, and clinics in communities across the country. The programs highlighted in this report provide a snapshot of the important work being done at Children's National every day to improve the health and wellbeing of kids and our communities. Every member of our team is committed to giving children and our communities the best chance for a healthy future, it's all we do. COMMUNITY BENEFIT REPORT CHILDREN'S NATIONAL IS DEDICATED TO FULFILLING ITS VISION OF SETTING THE STANDARD IN EXCELLENCE IN PEDIATRIC CARE, ADVOCACY, RESEARCH , AND EDUCATION, HERE IN THE NATION'S CAPITAL, AROUND THE COUNTRY, AND THROUGHOUT THE WORLD. AS PART OF OUR COMMITMENT TO OUR COMMUNITY, BELOW ARE SOME OF THE PROGRAMS THAT WERE IMPLEMENTED IN FY 2014. CENTRAL SOUTHERN MARYLAND MEDICAL PEDIATRIC SOCIETY ESTABLISHED IN 2012, THE CENTRAL SOUTHERN MEDICAL SOCIETY WAS CREATED TO PROVIDE A FORUM FOR CLINICIANS CARING FOR CHILDREN IN ANNE ARUNDEL, CALVERT, CHARLES, PRINCE GEORGE'S AND ST. MARY'S COUNTIES. THE SOCIETY'S FOCUS IS FOSTERING EDUCATION AND KNOWLEDGE SHARING AROUND CLINICAL ISSUES, BEST PRACTICES AND POLICY DECISIONS IMPACTING THE COMMUNITIES THEY SERVE IN AND AROUND CENTRAL SOUTHERN MARYLAND. IN 2014, THE SOCIETY CONVENED ON THREE OCCASIONS. THE TOPICS FOCUSED ON MENTAL AND BEHAVIORAL HEALTH, AUTISM, AND ASTHMA. DR. STEPHEN TEACH, DIRECTOR OF IMPACT DC, (IMPROVING PEDIATRIC ASTHMA CARE IN THE DISTRICT OF COLUMBIA) SPOKE AT THE LAST MEETING ON THE TOPIC OF CONTROLLING PEDIATRIC ASTHMA: PAST, PRESENT AND FUTURE. THE DISCUSSION FOCUSED ON UNDERSTANDING DISPARITIES IN ASTHMA CARE AND OUTCOMES, NATIONAL INSTITUTES OF HEALTH GUIDELINE BASED CARE IN AN AT-RISK PEDIATRIC POPULATION, AND THE ROLE OF IMMUNOMODULATORS IN PHENOTYPICALLY-DRIVEN ASTHMA CARE. MORE THAN 100 CLINICIANS ATTENDED THE SOCIETY'S MEETINGS, INCREASING PARTICIPATION BY ABOUT 10 PERCENT FROM THE FIRST YEAR. THE CENTRAL SOUTHERN MARYLAND PEDIATRIC MEDICAL SOCIETY IS COMMITTED TO EXTENDING THE VOICE OF CHILDREN AND FAMILIES OF THIS REGION THROUGH THE COLLECTIVE VOICE OF THE PEDIATRIC MEDICAL COMMUNITY. EAST OF THE RIVER LACTATION CENTER MEDICAL, PSYCHOLOGICAL AND ECONOMIC BENEFITS ARE CITED AS THE TOP REASONS TO BREASTFEED FOR THE FIRST SIX MONTHS OF LIFE, ACCORDING TO THE AMERICAN ACADEMY OF PEDIATRICS (AAP), THE AMERICAN ACADEMY OF FAMILY PHYSICIANS (AAFP), AND THE WORLD HEALTH ORGANIZATION. IN FACT, THESE ORGANIZATIONS ALSO RECOMMEND CONTINUED BREASTFEEDING AFTER INFANT FOODS ARE STARTED UNTIL AT LEAST 12 MONTHS OF AGE. THE EAST OF THE RIVER LACTATION CENTER WAS FORMED TO ASSIST MOTHERS IN THE WASHINGTON, DC AREA WITH REACHING THESE AND OTHER GOALS IN BREASTFEEDING. THROUGH COLLABORATION BETWEEN CHILDREN'S NATIONAL, THE WOMEN, INFANTS, AND CHILDREN (WIC) PROGRAM, AND THE DISTRICT OF COLUMBIA BREASTFEEDING COALITION THE PROGRAM AIMS TO ASSIST MOMS WITH PRENATAL BREASTFEEDING EDUCATION AND POST-PARTUM BREASTFEEDING SUPPORT. THE PROGRAM INCLUDES A FOUR-WEEK PRENATAL BREASTFEEDING EDUCATION CLASS FACILITATED BY A LACTATION CONSULTANT, A BREASTFEEDING PEER COUNSELOR AND A WIC NUTRITIONIST. CLASSROOM TOPICS INCLUDE, "GETTING STARTED", "BREASTFEEDING THE FIRST FEW WEEKS"," KEEPING THINGS GOING WHEN LIFE RETURNS", AND "BREASTFEEDING AFTER SIX MONTHS." COMMUNITY LACTATION SUPPORT SERVICES ARE ALSO OFFERED TO BREASTFEEDING FAMILIES FROM THE ENTIRE WASHINGTON, DC METROPOLITAN AREA. IN ADDITION, THE CENTER OFFERS MOM TO MOM BREASTFEEDING SUPPORT GROUPS AND BACK TO WORK BREASTFEEDING CONSULTS TO HELP BREASTFEEDING MOTHERS PREPARE TO RETURN TO WORK OR SCHOOL WHILE MEETING THEIR BREASTFEEDING GOALS. CLASSES ARE PROVIDED AT NO COST TO PARTICIPANTS. THE PROGRAM WAS FUNDED INITIALLY BY A GRANT FROM THE U.S. DEPARTMENT OF AGRICULTURE/WIC. IN 2013, THE W.K. KELLOGG FOUNDATION PROVIDED ADDITIONAL FUNDING TO SUPPORT RESEARCH EFFORTS AND SERVICES IN THE COMMUNITY. DURING 2014, THE CENTER PROVIDED SERVICES TO 445 MOMS WITH 71% OF THE MOM'S INITIATING BREASTFEEDING. FORTY PERCENT OF THE MOMS ENROLLED AND COMPLETED ALL THREE PRENATAL BREASTFEEDING EDUCATION CLASSES. S.T.A.B.L.E. AND CARDIAC S.T.A.B.L.E. SPECIAL ATTENTION AND SKILL IS A NECESSITY FOR NEWLY BORN INFANTS THAT BECOME ILL AT BIRTH. CHILDREN'S NATIONAL IS AT THE FOREFRONT IN HELPING TO EDUCATE HEALTH CARE PROVIDERS CARING FOR OUR SMALLEST COMMUNITY MEMBERS. THE S.T.A.B.L.E. PROGRAM WAS DEVELOPED TO MEET THE EDUCATIONAL NEEDS OF HEALTH CARE TEAMS - NURSES, PHYSICIANS, THERAPISTS AND ASSISTANTS WHO MUST DELIVER THIS IMPORTANT STABILIZATION CARE. S.T.A.B.L.E. STRESSES THE PROFESSIONAL RESPONSIBILITIES PROVIDERS HAVE TO CARE FOR SICK INFANTS AND STANDS FOR THE SIX ASSESSMENT AND CARE MODULES: SUGAR, TEMPERATURE, AIRWAY, BLOOD PRESSURE, LAB WORK AND EMOTIONAL SUPPORT. THE CARDIAC S.T.A.B.L.E. MODULE PROVIDES GUIDELINES FOR THE STABILIZATION OF NEONATES SUSPECTED TO HAVE CONG
Form 990 Review Process Form 990, Part VI, Line 11b THE RELEVANT COMMITTEES OF THE ORGANIZATION AND ITS PARENT ORGANIZATION, CNMC, REVIEW APPLICABLE PORTIONS OF THE FORM 990: The legal affairs and audit committee reviews the financial disclosures, the CNAPPI board reviews the public benefit sections, and the executive compensation committee reviews the compensation disclosures. The full board reviewed the entire Form 990. The completed Form 990 is made available to the board of Children's National Medical Center before filing.
Conflict of Interest Policy Monitoring & Enforcement Form 990, Part VI, Line 12c CHILDREN'S HOSPITAL REQUIRES THAT EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE COMPLETE A CONFLICT OF INTEREST FORM AT LEAST EVERY YEAR. IN ADDITION EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS INSTRUCTED AND REQUIRED TO AMEND THE CONFLICT OF INTEREST FORM IMMEDIATELY UPON A CHANGE IN STATUS OF ANY OF THE QUESTIONS ON THE FORM. THESE FORMS ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND CONFLICTS AND INTERESTS ARE NOTED. THE CHILDREN'S HOSPITAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY GOVERNING POLICIES FORM 990, PART VI, LINES 13 & 14 CHILDREN'S HOSPITAL IS GOVERNED BY THE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL MEDICAL CENTER ("CNMC"). THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY.
Process for Determining Compensation Form 990, Part VI, Line 15a THE EXECUTIVE COMPENSATION COMMITTEE OF THE CNMC BOARD OF DIRECTORS IS COMPRISED WHOLLY OF DISINTERESTED, INDEPENDENT BOARD MEMBERS. THE COMMITTEE HAS RETAINED INDEPENDENT OUTSIDE CONSULTANTS EXPERT ON COMPENSATION MATTERS. THE COMMITTEE DETERMINES ADJUSTMENTS IN COMPENSATION, INCLUDING BASE PAY, INCENTIVES, AND OTHER FORMS OF COMPENSATION FOR EACH PERSON DEEMED BY THE COMPENSATION COMMITTEE TO BE A "DISQUALIFIED PERSON" AS THAT TERM IS USED IN THE INTERMEDIATE SANCTION REGULATIONS OF THE IRS. THE COMMITTEE IS INFORMED IN ITS DECISION-MAKING BY COMPENSATION STUDIES AND COMPARISONS DONE BY THE INDEPENDENT CONSULTANT, AND RELIES UP "REASONABLENESS" OPINIONS FOR SUCH CONSULTANTS PRIOR TO OR CONTEMPORANEOUS WITH MAKING COMPENSATION DECISIONS. THE COMMITTEE MEETS 4-6 TIMES PER YEAR TO CONSIDER SUCH MATTERS.
How Documents are Made Available to the Public Form 990, Part VI, Line 19 CHILDREN'S HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED ON REQUEST.
OTHER CHANGES IN NET ASSETS FORM 990, PART XI, LINE 9 CP&A Partnership Capital Account Adjustment - $182,498 (Difference Between Income and Change in Capital Account per Schedule K-1).
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
Children's Hospital
 
Employer identification number

53-0196580
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) CHILDREN'S NATIONAL SPECIALISTS OF VA
111 MICHIGAN AVENUE NW
WASHINGTON,DC20010
26-4571100 		HEALTH CARE DC -907,255 0 NA
 










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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) CHILDREN'S RESEARCH INSTITUTE

111 MICHIGAN AVENUE NW

WASHINGTON,DC20010
52-1654453 		RESEARCH DC 501(C)(3) 9 CNMC
 
 
No
(2) CHILDREN'S NATIONAL MEDICAL CENTER

111 MICHIGAN AVENUE NW

WASHINGTON,DC20010
52-1640403 		HEALTH CARE DC 501(C)(3) 11B, II NA
 
 
No
(3) SAFE KIDS WORLDWIDE

1301 PENNSYLVANIA AVENUE NW

WASHINGTON,DC20004
52-1627574 		INJURY PRVNTN DC 501(C)(3) 11A, I CNMC
 
 
No
(4) CHILDREN'S HOSPITAL SELF-INSURANCE TRUST

111 MICHIGAN AVENUE NW

WASHINGTON,DC20010
52-1640399 		INSURANCE DC 501(C)(3) 11C, III-FI CNMC
 
 
No
(5) CHILDREN'S HOSPITAL FOUNDATION

111 MICHIGAN AVENUE NW

WASHINGTON,DC20010
52-1640402 		FUNDRAISING DC 501(C)(3) 7 CNMC
 
 
No
(6) BRAINY CAMPS ASSOCIATION

111 MICHIGAN AVENUE NW

WASHINGTON,DC20010
27-1547370 		CHILD CAMPS DC 501(C)(3) 11A, I CH
 
Yes
 
(7) CHILDREN'S NAT'L ADVOC & PUBLIC POLICY

111 MICHIGAN AVENUE NW

WASHINGTON,DC20010
27-1564354 		ADVOCACY DC 501(C)(3) 11B, II CNMC
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No
(1) CHILDREN'S PEDIATRICIANS ASSOC

111 MICHIGAN AVENUE NW
WASHINGTON,DC20010
52-2072589 		HEALTH CARE DC NA
  		r -834,052 1,834,914   No 0   No 50.000 %












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CHILDREN'S NATIONAL HEALTH NETWORK

111 MICHIGAN AVENUE NW
WASHINGTON,DC20010
52-1996521 		HEALTH CARE DC NA
  		C Corp 0 0     No
(2) SAFE KIDS WORLDWIDE LTD

PO BOX 916
ROAD TOWN TORTOLA    
VQ
INJURY PREVEN VQ NA
  		C Corp 0 0     No
(3) BEARACUDA RE

PO BOX 69 KY1-1102
GRANDCAYMAN    
CJ
REINSURANCE CJ NA
  		C Corp 0 0     No
(4) BEAR CUB REINSURANCE LTD

PO BOX 69 KY1-1102
GRANDCAYMAN    
CJ
REINSURANCE CJ NA
  		C Corp 0 0     No






Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) BRAINY CAMPS ASSOCIATION

 P 333,669 FMV
(2) BRAINY CAMPS ASSOCIATION

 R 398,599 FMV
(3) BEARACUDA RE

 R 28,309,248 FMV
(4) SAFE KIDS WORLDWIDE

 R 2,378,747 FMV
(5) SAFE KIDS WORLDWIDE

 q 335,856 FMV
(6) CHILDREN'S HOSPITAL SELF-INSURANCE TRUST

 s 6,188,064 FMV
(7) CHILDREN'S HOSPITAL FOUNDATION

 c 15,746,236 fmv
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V?UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


Software ID:  
Software Version: