TY 2017 Form 990

(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)
(1) JOYCE ABOUSSIE...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(2) SUSAN MACK AGUILLARD MD...................................................................... VOTING DIRECTOR	8.00 ................. 4.00	X
(3) MAHIR AWDEH MD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(4) JOSEPH S AYOUB JR ESQ...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(5) PAUL J AYOUB ESQ...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(6) FREDERICK M AZAR MD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(7) JAMES B BARKATE...................................................................... VOTING DIRECTOR	4.00 ................. 8.00	X
(8) MARTHA PERINE BEARD...................................................................... VOTING DIRECTOR	4.00 ................. 8.00	X
(9) SHERYL BOURISK...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(10) ROBERT A BREIT MD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(11) TERRY BURMAN...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(12) ANN M DANNER...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(13) JOSEPH M DEVIVO...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(14) FRED P GATTAS III PHARMD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(15) RUTH GAVIRIA...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(16) CHRISTOPHER GEORGE MD...................................................................... VOTING DIRECTOR	8.00 ................. 4.00	X
(17) JUDY HABIB...................................................................... VOTING DIRECTOR	4.00 ................. 8.00	X

(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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(18) GABRIEL GABY HADDAD MD........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(19) PAUL K HAJAR........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(20) CHUCK HAJJAR........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(21) FOUAD HAJJAR MD........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(22) FREDERICK R HARRIS JR MD........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(23) BRUCE B HOPKINS........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(24) J DAVID KARAM II........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(25) SHARON L MCCOLLAM........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(26) MICHAEL D MCCOY........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(27) ROBERT T MOLINET ESQ........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(28) RAMZI NUWAYHID........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(29) THOMAS PENN III........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(30) CHRISTINA M RASHID........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(31) CAMILLE F SARROUF JR ESQ........................................................................ VOTING DIRECTOR	8.00 .......................4.00	X				0	0	0
(32) JOSEPH C SHAKER........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(33) JOSEPH G SHAKER........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(34) GEORGE A SIMON II........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(35) MICHAEL SIMON........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(36) PAUL J SIMON........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(37) TONY THOMAS........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(38) RICHARD M UNES........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(39) PAUL H WEIN ESQ........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(40) THOMAS WERTZ........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(41) TAMA ZAYDON........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(42) RICHARD SHADYAC JR........................................................................ EX-OFFICIO DIRECTOR	1.00 .......................55.00	X				0	794,032	99,557
(43) JAMES R DOWNING........................................................................ PRESIDENT/CEO	55.00 .......................1.00	X	X			1,058,448	0	144,500
(44) PATRICIA A KEEL........................................................................ SVP/CFO	55.00 .......................0.00		X			633,157	0	84,957
(45) JAMES I MORGAN........................................................................ EVP/SCIENTIFIC DIRECTOR	55.00 .......................0.00		X			540,847	0	57,000
(46) ELLIS NEUFELD........................................................................ EVP/CLINICAL DIRECTOR	55.00 .......................0.00		X			811,492	0	117,999
(47) MARY ANNA QUINN........................................................................ EVP/CHIEF ADMIN OFFICER	55.00 .......................0.00		X			445,639	0	399,741
(48) CHARLES M ROBERTS........................................................................ EVP/DIRECTOR CANCER CENTER	55.00 .......................0.00		X			780,623	0	163,941
(49) CARLOS RODRIGUEZ-GALINDO........................................................................ EVP/CHAIR	55.00 .......................0.00		X			602,659	0	146,198
(50) ANDREW DAVIDOFF........................................................................ CHAIR	55.00 .......................0.00			X		1,304,122	0	61,557
(51) CHARALAMPOS KALODIMOS........................................................................ CHAIR	55.00 .......................0.00			X		862,969	0	21,036
(52) THOMAS E MERCHANT........................................................................ CHAIR	55.00 .......................0.00			X		822,323	0	67,616
(53) RAUL C RIBEIRO........................................................................ FACULTY	55.00 .......................0.00			X		974,588	0	42,061
(54) STEPHEN W WHITE........................................................................ CHAIR	55.00 .......................0.00			X		809,046	0	103,615
(55) WILLIAM E EVANS........................................................................ FACULTY/FORMER PRESIDENT/CEO	55.00 .......................0.00				X	681,292	0	41,198

(A) Name and business address	(B) Description of services	(C) Compensation
FLINTCO LLC 2179 HILLSHIRE CIRCLE MEMPHIS,TN38133	CONSTRUCTION CONTRACTOR	16,730,625
BELZ CONSTRUCTION SERVICES 100 PEABODY PLACE SUITE 1400 MEMPHIS,TN38103	CONSTRUCTION COTRACTOR	12,946,531
THE CRUMP FIRM INC 81 MONROE AVE SUITE 100 MEMPHIS,TN38103	ARCHITECT	10,091,203
CERNER CORP 2800 ROCKCREEK PARKWAY KANSAS CITY,MO64117	SOFTWARE SUPPORT	8,346,513
METHODIST HEALTHCARE MEMPHIS 1265 UNION AVE MEMPHIS,TN38104	MEDICAL SERVICES	8,045,433
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 244

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

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 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross 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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	611,432,510	674,808,276	895,523,715	753,145,680	851,803,301	3,786,713,482
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	611,432,510	674,808,276	895,523,715	753,145,680	851,803,301	3,786,713,482
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.						3,786,713,482

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..	611,432,510	674,808,276	895,523,715	753,145,680	851,803,301	3,786,713,482
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	24,413,935	7,579,828	11,681,881	4,641,541	11,308,521	59,625,706
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 VI.)..	8,697,307	7,390,478	6,775,862	20,138,461	7,598,809	50,600,917
11	Total support. Add lines 7 through 10						3,896,940,105

Gross receipts from related activities, etc. (see instructions) ..................

558,989,512

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 6, column (f) divided by line 11, column (f)) .........

97.170 %

Public support percentage for 2018 Schedule A, Part II, line 14 ...............

97.190 %

16a

33 1/3% support test—2019. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2018. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2019. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2019 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2018 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2019 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2018 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2019. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2018. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked 12a of Part I, complete Sections A and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete Sections A, D, and E. If you checked 12d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 12a or 12b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2019 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2019	(iii) Distributable Amount for 2019
1 Distributable amount for 2019 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2019:
a From 2014.......
b From 2015.......
c From 2016.......
d From 2017.......
e From 2018.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2019 distributable amount
i Carryover from 2014 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2019 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2019 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2020. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2015.....
b Excess from 2016.....
c Excess from 2017.....
d Excess from 2018.....
e Excess from 2019.....

Schedule A (Form 990 or 990-EZ) (2019)

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
PART II, SECTION B, LINE 10:	EXPLANATION FOR OTHER INCOME: 2013 $ 3,314,275 - CAFETERIA/VENDING $ 1,955,292 - CHGME/CHCA $ 3,427,740 - OTHER REVENUE $ 8,697,307 - TOTAL OTHER INCOME 2014 $ 3,534,638 - CAFETERIA/VENDING $ 1,454,365 - CHGME/CHCA $ 2,401,475 - OTHER REVENUE $ 7,390,478 - TOTAL OTHER INCOME 2015 $ 3,709,328 - CAFETERIA/VENDING $ 1,683,327 - CHGME/CHCA $ 1,383,207 - OTHER REVENUE $ 6,775,862 - TOTAL OTHER INCOME 2016 $ 8,152,422 - BOND DEFEASANCE GAIN $ 4,086,280 - CAFETERIA/VENDING $ 2,058,124 - CHGME/CHCA $ 5,841,635 - OTHER REVENUE $ 20,136,461 - TOTAL OTHER INCOME 2017 $ 4,288,072 - CAFETERIA/VENDING $ 2,351,842 - CHGME/CHCA $ 327,751 - HHMI $ 631,144 - OTHER REVENUE $ 7,598,809 - TOTAL OTHER INCOME

Return Reference

Explanation

PART II, SECTION B, LINE 10:

EXPLANATION FOR OTHER INCOME: 2013 $ 3,314,275 - CAFETERIA/VENDING $ 1,955,292 - CHGME/CHCA $ 3,427,740 - OTHER REVENUE $ 8,697,307 - TOTAL OTHER INCOME 2014 $ 3,534,638 - CAFETERIA/VENDING $ 1,454,365 - CHGME/CHCA $ 2,401,475 - OTHER REVENUE $ 7,390,478 - TOTAL OTHER INCOME 2015 $ 3,709,328 - CAFETERIA/VENDING $ 1,683,327 - CHGME/CHCA $ 1,383,207 - OTHER REVENUE $ 6,775,862 - TOTAL OTHER INCOME 2016 $ 8,152,422 - BOND DEFEASANCE GAIN $ 4,086,280 - CAFETERIA/VENDING $ 2,058,124 - CHGME/CHCA $ 5,841,635 - OTHER REVENUE $ 20,136,461 - TOTAL OTHER INCOME 2017 $ 4,288,072 - CAFETERIA/VENDING $ 2,351,842 - CHGME/CHCA $ 327,751 - HHMI $ 631,144 - OTHER REVENUE $ 7,598,809 - TOTAL OTHER INCOME

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019) Page 2

Name of organization ST JUDE CHILDREN'S RESEARCH HOSPITAL INC

Part I Contributors	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
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 3

Name of organization ST JUDE CHILDREN'S RESEARCH HOSPITAL INC		Employer identification number 62-0646012

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) (2019)

Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

Page 4


Name of organization ST JUDE CHILDREN'S RESEARCH HOSPITAL INC			Employer identification number 62-0646012
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose 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

(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

(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

(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) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV (see instructions for definition of “political campaign activities")

Political campaign activity expenditures (see instructions) .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities (see instructions) ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

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-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2019

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(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? ...................................................................................................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2016	(b) 2017	(c) 2018	(d) 2019	(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) 2019

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 on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

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:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Yes

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Yes

20,605

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

62,011

Total. Add lines 1c through 1i ....................................................................................................

82,616

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

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

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

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."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	LINE 1B) ST. JUDE EMPLOYS A DIRECTOR OF GOVERNMENT AFFAIRS; LINE 1G) AMOUNT LISTED IS PRORATED SALARY OF DIRECTOR OF GOVERNMENT AFFAIRS PLUS TRAVEL EXPENSES; LINE 1I) AMOUNT LISTED IS RELATED TO PRORATED RETAINER FEES FOR DIRECT AND STATE LEGISLATIVE CONTACTS AS WELL AS PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING FOR THE CHGME PROGRAM.

Schedule C (Form 990 or 990EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on 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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

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)? .............................

Yes No

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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB 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.

If the organization elected, as permitted under FASB 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)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2019

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


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

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

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" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	965,253,422	873,056,599	873,885,134	915,104,075	843,843,273
b	Contributions ...	21,281,957	12,552,432	2,341,719	2,970,640	1,097,137
c	Net investment earnings, gains, and losses	92,690,065	103,475,245	-72,118	8,222,632	121,617,552
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	54,527,114	23,830,854	3,098,136	52,412,213	51,453,887
f	Administrative expenses ....
g	End of year balance ......	1,024,698,330	965,253,422	873,056,599	873,885,134	915,104,075

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

Yes

(ii) Related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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" on 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 .....
b	Buildings ....	1,072,930,987	551,379,204	521,551,783
c	Leasehold improvements
d	Equipment ....	435,519,226	293,417,281	142,101,945
e	Other .....	11,819,985	6,363,305	5,456,680
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				669,110,408

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on 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........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on 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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)INTEREST IN NET ASSETS OF AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC				4,695,858,063
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				4,695,858,063

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	3,621,636
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) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	774,002,857
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	90,775
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	550,657,594
e	Add lines 2a through 2d .....................			2e	550,748,369
3	Subtract line 2e from line 1..................			3	223,254,488
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	757,401,831
c	Add lines 4a and 4b....................			4c	757,401,831
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	980,656,319

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1	950,715,632
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	0
3	Subtract line 2e from line 1...................		3	950,715,632
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	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	950,715,632

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
PART V, LINE 4:	THE ENDOWMENT FUNDS ARE HELD BY AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC., A RELATED ORGANIZATION, AND ARE USED TO SUPPORT THE FUTURE NEEDS OF ST. JUDE.
PART X, LINE 2:	AS OF JUNE 30, 2018, THE ORGANIZATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS UNDER ASC TOPIC 740, INCOME TAXES, REQUIRING ADJUSTMENTS TO ITS COMBINED FINANCIAL STATEMENTS. IN THE EVENT THE ORGANIZATION WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AS A GENERAL EXPENSE. GENERALLY, TAX YEARS ENDING IN 2015 THROUGH 2018 ARE OPEN TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES, RESPECTIVELY. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CHANGE IN INTEREST IN UNRESTRICTED NET ASSETS OF ALSAC 550,657,594.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	CONTRIBUTION - SUPPORT RECEIVED FROM ALSAC 755,384,652. NET ASSETS TRANSFERRED FROM ALSAC 2,017,179.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization
ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.

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? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

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 the region	(d) Activities conducted in region (by type) (such as, 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 the region	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA & THE CARIBBEAN	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	2,059,852
	EAST ASIA AND THE PACIFIC	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	3,880,595
	EUROPE (INCLUDING ICELAND AND GREENLAND)	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	480,768
	MIDDLE EAST AND NORTH AFRICA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	4,294,023
	NORTH AMERICA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	562,337
	RUSSIA AND NEIGHBORING STATES	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	18,889
	SOUTH AMERICA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	1,185,385
	SOUTH ASIA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	1,612









3a	Sub-total ....	0	0			12,483,461
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			12,483,461

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2019

Schedule F (Form 990) 2019

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on 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 noncash assistance	(h) Description of noncash assistance	(i) Method of valuation (book, FMV, appraisal, other)

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 .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2019

Schedule F (Form 990) 2019Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on 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 noncash assistance	(g) Description of noncash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2019

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2019

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
PART I, LINE 3:	EXPENDITURES ARE RECORDED ON AN ACCRUAL BASIS. PAYMENTS ARE ISSUED BASED ON CONTRACTUAL OBLIGATIONS UPON RECEIPT OF SUPPORTING DOCUMENTATION.

Schedule F (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

100% 150% 200% Other %

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: . . . . . . . .

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

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"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

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? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .	82,232,400	437,689	81,794,711	8.600 %
b	Medicaid (from Worksheet 3, column a) . . . . .	142,079,478	31,173,380	110,906,098	11.670 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	11,276,642	2,524,151	8,752,491	0.920 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	235,588,520	34,135,220	201,453,300	21.190 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	20,383,627		20,383,627	2.140 %
f	Health professions education (from Worksheet 5) . . .	12,659,463	273,821	12,385,642	1.300 %
g	Subsidized health services (from Worksheet 6) . . . .	28,089,119		28,089,119	2.950 %
h	Research (from Worksheet 7) .	374,887,708	82,891,685	291,996,023	30.710 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2,142,358		2,142,358	0.230 %
j	Total. Other Benefits . .	438,162,275	83,165,506	354,996,769	37.330 %
k	Total. Add lines 7d and 7j .	673,750,795	117,300,726	556,450,069	58.520 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2019

Schedule H (Form 990) 2019

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	77,361	77,361	0.010 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	6,334	6,334	0 %
8	Workforce development	22,855	22,855	0 %
9	Other
10	Total	106,550	106,550	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

773,000

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

Enter Medicare allowable costs of care relating to payments on line 5.....

465,779

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-465,779

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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 .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	ST JUDE CHILDREN'S RESEARCH HOSPITAL 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 WWW.STJUDE.ORG TN STATE LICENSE NUMBER 0000000113	X	X	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ST JUDE CHILDREN'S RESEARCH HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ST JUDE CHILDREN'S RESEARCH HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of %
and FPG family income limit for eligibility for discounted care of %

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	ST JUDE CHILDREN'S RESEARCH HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	ST JUDE CHILDREN'S RESEARCH HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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? ...............................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 5: ST. JUDE'S 2016 CHNA BUILDS UPON THE 2013 CHNA AND REFLECTS THE ACTIVITIES IDENTIFIED IN ST. JUDE'S 2013 COMMUNITY BENEFIT IMPLEMENTATION PLAN. THE 2016 CHNA WAS LED BY AN INTERNAL TEAM OF ST. JUDE STAFF MEMBERS. THE LEADERSHIP OF THIS TEAM ENGAGED HEALTH RESOURCES IN ACTION (HRIA), A NON-PROFIT PUBLIC HEALTH CONSULTANCY ORGANIZATION, TO CONDUCT THE CHNA. IN AN EFFORT TO DEVELOP A SOCIAL, ECONOMIC, AND HEALTH PORTRAIT OF THE COMMUNITY SERVED BY ST. JUDE FOR THE GREATER MEMPHIS AREA AND NATIONALLY, HRIA REVIEWED EXISTING DATA DRAWN FROM LOCAL, STATE, AND NATIONAL SOURCES. HRIA CONDUCTED QUALITATIVE RESEARCH WITH INTERNAL AND EXTERNAL ST. JUDE STAKEHOLDERS AS WELL AS PATIENTS AND FAMILY MEMBERS SERVED IN ORDER TO SUPPLEMENT QUANTITATIVE FINDINGS WITH PERCEPTIONS OF COMMUNITY STRENGTHS AND ASSETS, THEIR PRIORITY HEALTH CONCERNS, AND SUGGESTIONS FOR FUTURE PROGRAMMING AND SERVICES.FOCUS GROUPS FOCUS GROUPS WERE CONDUCTED WITH CURRENT AND FORMER ST. JUDE PATIENTS, PATIENT CAREGIVERS, AND ST. JUDE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF. DIFFERENT TOPIC AREAS WERE EXPLORED BASED ON THE UNIQUE EXPERIENCES OF EACH OF THE GROUPS. THE PATIENT AND CAREGIVER FOCUS GROUPS, CONDUCTED WITH CURRENT PATIENTS AND REPRESENTATIVES OF THE FAMILY ADVISORY AND QUALITY OF LIFE/PALLIATIVE CARE STEERING COUNCILS, EXPLORED THE EXTENT TO WHICH ST. JUDE IS MEETING THE NEEDS OF CHILDREN WITH CATASTROPHIC ILLNESSES AND OPPORTUNITIES TO BRIDGE PATIENT NEEDS IN THE FUTURE. THE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF FOCUS GROUP EXPLORED THESE TOPICS AS WELL AS SPECIFIC ISSUES RELATED TO THE GREATER MEMPHIS COMMUNITY. A SEMI-STRUCTURED MODERATOR'S GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. WHILE SIMILAR, SEPARATE GUIDES WERE USED FOR THE CAREGIVER AND PATIENT FOCUS GROUPS SO THAT THEY WERE AGE AND DEVELOPMENTALLY APPROPRIATE. EACH FOCUS GROUP WAS FACILITATED BY AN EXPERIENCED HRIA STAFF MEMBER, WHILE A NOTE-TAKER TOOK DETAILED NOTES DURING THE DISCUSSION. ON AVERAGE, FOCUS GROUPS LASTED 30-90 MINUTES. BEFORE THE START OF THE GROUPS, HRIA EXPLAINED THE PURPOSE OF THE STUDY TO PARTICIPANTS AND PARTICIPANTS HAD AN OPPORTUNITY TO ASK QUESTIONS. THEY WERE ALSO NOTIFIED VERBALLY THAT GROUP DISCUSSIONS WOULD REMAIN CONFIDENTIAL, AND NO RESPONSES WOULD BE CONNECTED TO THEM PERSONALLY. PATIENT FOCUS GROUP PARTICIPANTS RECEIVED A $30 GIFT CERTIFICATE AS WELL AS FOOD AND BEVERAGES IN APPRECIATION FOR THEIR TIME. PARTICIPANTS WERE RECRUITED BY ST. JUDE STAFF, WHO ARRANGED ALL LOGISTICS FOR THE ONSITE FOCUS GROUPS.MEDICAL EXECUTIVE COMMITTEE/CLINICAL COUNCIL (INTERNAL) - EMILY BROWNE, DIRECTOR, PROFESSIONAL DEVELOPMENT AND APP - ANDREW M. DAVIDOFF, MD, CHAIR, SURGERY DEPARTMENT - PAM DOTSON, SVP, PATIENT CARE SERVICES/CNO - JANICE ENGLISH, DIRECTOR, NURSING - PATRICIA FLYNN, MD, MEMBER, SVP, MEDICAL DIRECTOR QUALITY AND PATIENT CARE - WILLIAM L. GREENE, PHARM D, CHIEF PHARMACEUTICAL OFFICER - LIZA JOHNSON, MD, STAFF PHYSICIAN, HOSPITALIST - PAT KEEL, SVP, CHIEF FINANCIAL OFFICER - CINDY LEKHY, VP, CLINICAL OPERATIONS - MONIKA METZGER, MD, REGIONAL DIRECTOR, CENTRAL AND SOUTH AMERICA REGIONS, INTERNATIONAL OUTREACH PROGRAM - SEAN PHIPPS, PHD, CHAIR, PSYCHOLOGY DEPARTMENT - ULRIKE REISS, MD, DIRECTOR, CLINICAL HEMATOLOGY DIVISION - GILES W. ROBINSON, MD, ASSISTANT MEMBER, ONCOLOGY DEPARTMENT - VICTOR SANTANA, MD, MEMBER, VP, CLINICAL TRIALS ADMINISTRATION - RON SMITH, VP, SCIENTIFIC OPERATIONS - ELAINE TUOMANEN, MD, CHAIR, DEPARTMENT OF INFECTIOUS DISEASES FAMILY ADVISORY COUNCIL AND QUALITY OF LIFE/PALLIATIVE CARE STEERING COUNCIL (INTERNAL AND EXTERNAL, SOME FAMILY MEMBERS AND FORMER PATIENTS ARE ALSO ST. JUDE EMPLOYEES), N=5ADOLESCENT PATIENTS, N=4 KEY INFORMANT INTERVIEWS HRIA CONDUCTED 16 INTERVIEWS; 6 WERE INTERNAL TO THE ST. JUDE HOSPITAL AND 10 WERE EXTERNAL REPRESENTATIVES. INTERVIEWEES REPRESENT A RANGE OF SECTORS, INCLUDING LEADERS IN HEALTH CARE AND HEALTH RESEARCH, GOVERNMENT, AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS. SIMILAR TO THE FOCUS GROUPS, A SEMI-STRUCTURED INTERVIEW GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. INTERVIEWS WERE APPROXIMATELY 30 MINUTES IN LENGTH. INTERNAL KEY INFORMANT INTERVIEWS - CAROLYN RUSSO, MD, MEDICAL DIRECTOR AFFILIATE PROGRAM - JUSTIN BAKER, CHIEF, DIVISION OF QUALITY OF LIFE AND PALLIATIVE CARE - MARTHA PERINE BEARD, CHAIR, ST. JUDE BOARD OF GOVERNORS - FRAN GREESON, DIRECTOR OF SOCIAL WORK AND JANA KING, DIRECTOR OF DOMICILIARY SERVICES - MICHAEL LINK, MD, CHAIR, ST. JUDE SCIENTIFIC ADVISORY BOARD- ALICIA HUETTEL, DIRECTOR OF FAMILY CENTERED CARE EXTERNAL KEY INFORMANT INTERVIEWS - DR. JOHNATHAN MCCULLERS, CHAIR, DEPARTMENT OF PEDIATRICS, UTHSC/LE BONHEUR CHILDREN'S HOSPITAL - JENNIFER MARSHALL PEPPER, HIV/RYAN WHITE, SHELBY COUNTY - DR. DAVID STERN, DEAN UTHSC COLLEGE OF MEDICINE - DR. BARRY GOLDSPIEL, ACTING CHIEF, PHARMACY DEPARTMENT, CHIEF, CLINICAL PHARMACY SPECIALIST SECTION, NIH - DRS. NADA ELMAGBOUL AND ROBIN WOMEODU, SICKLE CELL DISEASE PROGRAM METHODIST LE BONHEUR HEALTHCARE - VALERIE NAGOSHINER, DEPUTY COMMISSIONER, TN DEPARTMENT OF HEALTH - ANGELA MOORE, PH COORDINATOR, COMMUNITY HEALTH PLANNING, SHELBY COUNTY HEALTH DEPARTMENT - JENNIFER MYRICK, HEALTH SYSTEMS MANAGER, AMERICAN CANCER SOCIETY MID-SOUTH - DEE WIMBERLY, CAROL WEIDENHOFFER, HUGH JONES, ZACHARY HIDINGER, ANDREA TUTOR, METHODIST LE BONHEUR HEALTHCARE CHNA TEAM - DR. MARTIN WHITSIDE, TENNESSEE CANCER COALITION
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 13H: SEE NARRATIVE FOR PART I, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 15E: SEE NARRATIVE FOR PART I, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 20E: ST. JUDE DOES NOT TAKE ANY OF THE COLLECTION ACTIONS DESCRIBED IN PART V, SECTION B, LINE 19 BECAUSE ST. JUDE COVERS ALL TREATMENTS, COPAYS, DEDUCTIBLES, COINSURANCE AND ANY OTHER COST SHARING OBLIGATIONS THAT ARE NOT COVERED BY INSURANCE. ST. JUDE TAKES NO ACTION TO COLLECT FROM PATIENTS OR THEIR FAMILIES AND DOES NOT REPORT TO CREDIT AGENCIES.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL:	PART V, SECTION B, LINE 11: ST. JUDE CHILDREN'S RESEARCH HOSPITALCOMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN UPDATE (06/30/18) ST. JUDE: PATIENT POPULATION AND CLINICAL FOCUSTHE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST. JUDE IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CANCER AND BLOOD DISORDERS, AND CHILDREN AND ADOLESCENTS WITH HIV INFECTION. IT SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. ST. JUDE TREATS CHILDREN AND YOUNG ADULTS WITH NEWLY DIAGNOSED OR SUSPECTED PEDIATRIC CANCER, HIV INFECTIONS, OR CERTAIN HEMATOLOGIC OR GENETIC DISEASES. WE ACCEPT MOST PATIENTS OUTSIDE OUR PRIMARY MARKET ON THE BASIS OF A REFERRAL FROM THEIR PHYSICIAN OR AN AFFILIATE CLINIC, THEIR AGE, AND THEIR ABILITY TO ENROLL IN AN OPEN CLINICAL TRIAL. IN ADDITION TO BEING TREATED AT ST. JUDE, PATIENTS MAY HAVE THE OPTION TO RECEIVE CARE AT ONE OF OUR EIGHT REGIONAL AFFILIATE CLINICS.ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. MORE SPECIFICALLY, APPROXIMATELY 7,800 PATIENTS ARE SEEN AT ST. JUDE ANNUALLY FOR ACTIVE THERAPY, TREATMENT-COMPLETION MONITORING, SURVIVORSHIP SUPPORT, OR PARTICIPATION IN RESEARCH PROGRAMS. THE HOSPITAL IS LICENSED FOR 80 INPATIENT BEDS AND CURRENTLY STAFFS 69 BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS WHO MAY HAVE BEEN ADMITTED AS INPATIENTS AT MOST HOSPITALS TO BE TREATED AS OUTPATIENTS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES, DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA AIR FILTRATION, INFECTION-RESISTANT SURFACES, AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES.THE ST. JUDE AFFILIATE PROGRAM MAKES TREATMENTS DEVELOPED AS CLINICAL TRIALS AT ST. JUDE CHILDREN'S RESEARCH HOSPITAL AVAILABLE TO MORE CHILDREN BY OFFERING MUCH OF THE CARE CLOSE TO HOME. THE ST. JUDE AFFILIATE PROGRAM IS A NETWORK OF PEDIATRIC HEMATOLOGY-ONCOLOGY CLINICS, HOSPITALS, AND IN SOME CASES, UNIVERSITIES UNITED TO EXTEND THE MISSION OF ST. JUDE. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF OF ST. JUDE TO DELIVER STATE-OF-THE-ART CARE AND INNOVATIVE CLINICAL TRIALS TO CHILDREN WITH CANCER AND BLOOD DISORDERS. ST. JUDE ALSO OPERATES ST. JUDE GLOBAL. ITS MISSION IS TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE THROUGH THE SHARING OF KNOWLEDGE, TECHNOLOGY, AND ORGANIZATIONAL SKILLS. THERE ARE 3 OVERRIDING GOALS:- TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION- TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES- TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE.ST. JUDE IS A RESEARCH ORGANIZATION, AND THERE ARE TIMES WHEN BASIC RESEARCH DISCOVERIES PERTAIN TO DISEASES THAT ARE BEYOND THE SCOPE OF DISEASES TREATED AS A PRIMARY DIAGNOSIS AT ST. JUDE.FOR THE PURPOSES OF THIS REPORT, THE FOCUS IS SOLELY ON THOSE DISEASES FOR WHICH CHILDREN ARE ADMITTED TO ST. JUDE FOR TREATMENT.CONSISTENT WITH ST. JUDE'S PREVIOUS CHNA, THE FINDINGS IN 2016 HIGHLIGHTED THE ISSUES OF ACCESS TO CARE, CHILDHOOD CANCER, SICKLE CELL DISEASE AND HEMATOLOGY PATIENTS, LIVING WITH HIV AND AIDS, NEEDS OF THE PATIENTS' FAMILIES AND CAREGIVERS, POST TREATMENT AND CARE TRANSITION, HEALTH STATUS OF THE MEMPHIS COMMUNITY, AND ADDITIONAL GAPS FOR THE GENERAL PEDIATRIC POPULATION. ST. JUDE HAS CHOSEN TO ADDRESS THESE NEEDS IN THREE GENERAL FOCUS AREAS: IMPROVING ACCESS TO CARE, ENHANCING COORDINATION OF CARE, AND IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDREN. THESE INITIATIVES, WHICH OFTEN ADDRESS MULTIPLE ISSUES IDENTIFIED IN THE CHNA, WERE CHOSEN BECAUSE THEY ARE ALIGNED WITH OUR MISSION AND OUR CAPABILITIES. BELOW ARE THE THREE FOCUS AREAS, INITIATIVES, AND CORRESPONDING ISSUES FOR THE NEXT YEAR.AIM #1 IMPROVING ACCESS TO CAREPEDIATRIC HEATH NEED:ACCESS TO AFFORDABLE HEALTH INSURANCE COVERAGEHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MANAGED CARE DEPARTMENTANTICIPATED OUTCOME:ASSIST UNINSURED PATIENTS WITH ENROLLING IN FUNDING FOR WHICH THEY QUALIFY.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. RENEW CONTRACT WITH VENDOR TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO ASSIST PATIENT FAMILIES APPLYING FOR HEALTH INSURANCE COVERAGE THROUGH THE FEDERALLY FACILITATED MARKETPLACE.2. CONDUCT AN AUDIT OF THE SCREENING PROCESS TO VALIDATE COMPLIANCE. MAKE PROCESS ADJUSTMENTS AS NEEDED.SELECTED ACCOMPLISHMENTS:- THE AGREEMENT WITH FIRSTSOURCE SOLUTIONS USA, LLC (DBA MEDASSIST) IS RENEWED ANNUALLY. MEDASSIST IS THE VENDOR USED TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO UNINSURED PATIENTS. - AN AUDIT OF THE SCREENING PROCESS IS CONDUCTED MONTHLY TO ENSURE THAT ALL FAMILIES ARE GIVEN ASSISTANCE WITH THE SCREENING AND ENROLLMENT PROCESS. IN FY18, 87% OF UNINSURED PATIENTS WERE OFFERED ASSISTANCE, AND FOURTEEN UNINSURED PATIENTS WERE ENROLLED IN HEALTH PLANS. THE REMAINING 13% WERE NOT CONTACTED BECAUSE THEY WERE IN THE AFTER COMPLETION OF THERAPY PROGRAM AND WERE NOT HERE LONG.PEDIATRIC HEALTH NEED:PALLIATIVE CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF ONCOLOGY, DIVISION OF QUALITY OF LIFE AND PALLIATIVE CAREANTICIPATED OUTCOME:INCREASE THE NUMBER OF CLINICIANS TRAINED IN PALLIATIVE CARE MEDICINE (PCM) AND EDUCATIONAL OPPORTUNITIES FOR PCM.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. RECRUIT AND TRAIN TWO PHYSICIAN FELLOWS IN THE PALLIATIVE CARE TRAINING PROGRAM.2. PROVIDE TRAINING IN PALLIATIVE CARE FOR ADVANCED PRACTICE HEALTHCARE PERSONNEL THROUGH TARGETED CONFERENCES AND OTHER EDUCATIONAL OPPORTUNITIES, INCLUDING THE END-OF-LIFE NURSING EDUCATION CONSORTIUM (ELNEC) CONFERENCE, AN INSTITUTION-DEVELOPED QUALITY OF LIFE SEMINAR (QOLA), AND A 2-DAY PEDIATRIC ONCOLOGY PALLIATIVE CARE CONFERENCE.3. EDUCATE COMMUNITY PROVIDERS ABOUT PCM THROUGH COMMUNITY-BASED BRIDGING PROGRAMS FOR HOME HEALTH AND HOSPICE CARE THROUGH THE QUALITY OF LIFE FOR ALL KIDS PROGRAM VIA A THREE-HOUR DIDACTIC CURRICULUM.4. ENHANCE TRAINING OPPORTUNITIES WITH ST. JUDE AFFILIATES.SELECTED ACCOMPLISHMENTS:- IN COMBINATION WITH THE UTHSC PALLIATIVE CARE FELLOWSHIP, WE ARE TRAINING THREE PEDIATRIC PALLIATIVE CARE PHYSICIAN FELLOWS IN ACADEMIC YEAR 2018-2019.- ENROLLMENT: FY16 FY17 FY18ELNEC 32 78 38QOLA 37 29 25PPOS 325 300+ *PPOS - PEDIATRIC PALLIATIVE ONCOLOGY CARE CONFERENCE- BEDSIDE NURSES ARE REQUIRED TO COMPLETE ELNEC WITHIN THREE YEARS. INPATIENT AND OUTPATIENT NURSES ARE REQUIRED AND SUPPORTED TO COMPLETE BOTH SEMINARS, A TOTAL OF 24.5 CEUS IN PCM.- A THREE-HOUR DIDACTIC CURRICULUM HAS BEEN HELD TWICE MONTHLY THROUGH OUR COMBINED FELLOWSHIP PROGRAM. AN AVERAGE OF 10 ATTENDEES, INCLUDING GRADUATE STUDENTS, MEDICAL STUDENTS, ADVANCED CLINICIANS, AND OTHERS, ARE PRESENT FOR EACH SESSION.- THE DIVISION OF QUALITY OF LIFE AND PALLIATIVE CARE FACULTY HOSTED A TOTAL OF 5 POE STUDENTS THROUGHOUT THE SUMMER, INVOLVING THEM IN ONGOING EDUCATIONAL EFFORTS. IN ADDITION, WE HOSTED APPROXIMATELY 8 GRADUATE STUDENTS FOR PALLIATIVE CARE ROTATIONS. - THE SJ AFFILIATE STAFF ARE INVITED TO PARTICIPATE IN ELNEC, THE QOL SEMINAR, AND THE PEDIATRIC PALLIATIVE ONCOLOGY SYMPOSIUM AT NO COST AND ARE INCLUDED IN THE NUMBERS CITED ABOVE.PEDIATRIC HEALTH NEED:HEALTHCARE OF CHILDHOOD CANCER SURVIVORSHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF ONCOLOGY, DIVISION OF CANCER SURVIVORSHIPANTICIPATED OUTCOME:PROVIDE CANCER SURVIVORSHIP INFORMATION TO BOTH CAREGIVERS AND SURVIVORS VIA SURVIVORS' DAY CONFERENCE AND ST. JUDE LIFE
ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:	1. PROVIDE WORKSHOPS AND SPEAKERS THAT OFFER INFORMATION ABOUT AVAILABLE RESOURCES.2. GIVE SURVIVORS AND THEIR FAMILIES THE OPPORTUNITY TO LEARN FROM OTHER SURVIVORS.3. ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH POST TREATMENT HEALTHCARE.4. OFFER AN ONLINE RESOURCE FOLLOWING THE CONFERENCE FOR A CONTINUOUSFLOW OF SURVIVORSHIP INFORMATION.5. ASSESS LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS.6. USE INFORMATION FROM THESE STUDIES TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTIONS.SELECTED ACCOMPLISHMENTS:1. PROVIDE WORKSHOPS AND SPEAKERS THAT OFFER INFORMATION ABOUT AVAILABLE RESOURCES:THE ST. JUDE FACULTY PROVIDE LECTURES AND PARTICIPATE IN WORKSHOPS RELATED TO A VARIETY OF SURVIVORSHIP ISSUES. AUDIENCES INCLUDE SURVIVORS' HEALTHCARE PROVIDERS, SURVIVORS, AND SURVIVORS' FAMILIES.LECTURES/WORKSHOPS PROVIDED BY MELISSA M. HUDSON:- YOU ARE THE KEY TO HPV CANCER PREVENTION. SHELBY COUNTY SCHOOL SYSTEM HEALTH ADVISORY COUNCIL MEETING, JANUARY 18, 2018- CANCER OUTCOMES AND SURVIVORSHIP (ICOS) AND THE CENTER FOR OUTCOMES AND EFFECTIVENESS RESEARCH AND EDUCATION (COERE), "THE ROLE OF SURVIVORSHIP RESEARCH IN ADVANCING CHILDHOOD CANCER CARE AND QUALITY OF SURVIVAL," UNIVERSITY OF ALABAMA, BIRMINGHAM, BIRMINGHAM, ALABAMA, FEBRUARY 19, 2018 - ST. JUDE PEDIATRIC HEMATOLOGY-ONCOLOGY FELLOWS' ROUNDS, "THE ROLE OF SURVIVORSHIP RESEARCH IN ADVANCING CHILDHOOD CANCER CARE AND QUALITY OF SURVIVAL," MEMPHIS, TENNESSEE, APRIL 2, 2018LECTURES/WORKSHOPS PROVIDED BY DANIEL MULROONEY:- CARDIOVASCULAR SEQUELAE OF CHILDHOOD CANCER THERAPY AND IMPLICATIONS FOR ADULT HEALTH, RADIATION RESEARCH SOCIETY, CANCUN, MEXICO, OCTOBER 16, 2017 - THE PAST, PRESENT, AND FUTURE OF CANCER SURVIVORSHIP, AFFILIATE PHYSICIANS' CONFERENCE, ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MEMPHIS, TENNESSEE, APRIL 7, 2018 - CARING FOR AND LEARNING FROM SURVIVORS OF CHILDHOOD CANCER, MINNESOTA CHILDHOOD CANCER SURVIVORSHIP SYMPOSIUM, UNIVERSITY OF MINNESOTA, MINNEAPOLIS, MINNESOTA, APRIL 27, 2018 2. GIVE SURVIVORS AND THEIR FAMILIES THE OPPORTUNITY TO LEARN FROM OTHER SURVIVORS:ST. JUDE HOSTS PERIODIC CELEBRATIONS OF SURVIVORSHIP ATTENDED BY SURVIVORS, FAMILIES, AND FRIENDS. THE EVENT PROVIDES A FORUM TO CELEBRATE SURVIVORSHIP, EDUCATE ATTENDEES ABOUT HEALTH EFFECTS OF CHILDHOOD CANCER AND RESEARCH PROGRESS IN THIS AREA, AND SHARE INFORMATION ABOUT HEALTH RESOURCES. ST. JUDE SURVIVOR DAY ACTIVITIES, SEPTEMBER 9, 2017: INSPIRATIONAL CANCER SURVIVOR DR. WENDY HARPHAM SHARED HER SURVIVORSHIP EXPERIENCES IN THE KEYNOTE ADDRESS ENTITLED "HAPPINESS IN A STORM." SURVIVORSHIP STAFF AND DR. HARPHAM LED WORKSHOPS FOCUSING ON HOPE AND RESILIENCY IN OVERCOMING THE OBSTACLES ASSOCIATED WITH THE CANCER EXPERIENCE AND ITS AFTERMATH.3. ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH HEALTHCARE POST TREATMENT:SURVIVORS AND THEIR FAMILIES ATTENDING THE AFTER COMPLETION OF THERAPY AND ST. JUDE LIFETIME COHORT CLINICS ROUTINELY RECEIVE COUNSELING ABOUT THEIR HEALTH HISTORY, CANCER-RELATED HEALTH RISKS, HEALTH SCREENING RECOMMENDED FOR THEIR SPECIFIC CANCER TREATMENT EXPOSURES, AND METHODS OF RISK REDUCTION. A SURVIVORSHIP CARE PLAN IS PROVIDED AT THE FIRST EVALUATION THAT DETAILS THE CANCER DIAGNOSIS, TREATMENT, MAJOR HEALTH EVENTS THAT HAVE OCCURRED DURING AND AFTER THERAPY, CANCER-RELATED HEALTH RISKS, AND RECOMMENDED HEALTH SCREENING. THE SURVIVORSHIP CARE PLAN IS UPDATED AFTER EVERY HEALTH EVALUATION. FOR SURVIVORS WHO DO NOT WISH TO PARTICIPATE IN THE ACT OR ST. JUDE LIFETIME COHORT PROGRAMS, THESE SAME SERVICES ARE AVAILABLE THROUGH THE ST. JUDE ALUMNUS PROGRAM OFFICE.SURVIVORSHIP STAFF HAVE BEEN INVOLVED IN MULTIDISCIPLINARY EFFORTS TO INTRODUCE AND CONSISTENTLY ADDRESS SURVIVORSHIP TRANSITION ISSUES, PARTICULARLY PSYCHOSOCIAL AND REHABILITATION NEEDS, AT EARLIER TIME POINTS AFTER DIAGNOSIS. THEIR EFFORTS ARE REFLECTED IN THE NEWLY DEVELOPED TRANSITION ONCOLOGY PROGRAM.4. OFFER AN ONLINE RESOURCE FOLLOWING THE CONFERENCE FOR A CONTINUOUS FLOW OF SURVIVORSHIP INFORMATION:PERIODIC BRIEF PUBLICATIONS FEATURE SURVIVOR STORIES AND EDUCATIONAL TOPICS:- LONG-TERM FOLLOW-UP NEWSLETTERS AND BRIEFS (AVAILABLE AT HTTPS://LTFU.STJUDE.ORG/) ARE PUBLISHED ON A QUARTERLY BASIS.- LIFELINE NEWSLETTERS (AVAILABLE AT HTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/PARTICIPATE-IN-ST-JUDE-LIFE-STUDY/LIFELINE-NEWSLETTER.HTML) ARE PUBLISHED SEMIANNUALLY.- OTHER SURVIVORSHIP RESOURCES ARE AVAILABLE AT: HTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/PARTICIPATE-IN-ST-JUDE-LIFE-STUDY/HANDOUTS.HTMLHTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/LIFE-AFTER-CANCER.HTML MORTON LM, SAMPSON JN, ARMSTRONG GT, CHEN TH, HUDSON MM, KARLINS E, DAGNALL CL, LI SA, WILSON CL, SRIVASTAVA DK, LIU W, KANG G, OEFFINGER KC, HENDERSON TO, MOSKOWITZ CS, GIBSON TM, MERINO DM, WONG JR, HAMMOND S, NEGLIA JP, TURCOTTE LM, MILLER J, BOWEN L, WHEELER WA, LEISENRING WM, WHITTON JA, BURDETTE L, CHUNG C, HICKS BD, JONES K, MACHIELA MJ, VOGT A, WANG Z, YEAGER M, NEALE G, LEAR M, STRONG LC, YASUI Y, STOVALL M, WEATHERS RE, SMITH SA, HOWELL R, DAVIES SM, RADLOFF GA, ONEL K, BERRINGTON DE GONZALEZ A, INSKIP PD, RAJARAMAN P, FRAUMENI JF, BHATIA S, CHANOCK SJ, TUCKER MA, ROBISON LL. GENOME-WIDE ASSOCIATION STUDY TO IDENTIFY SUSCEPTIBILITY LOCI THAT MODIFY RADIATION-RELATED RISK FOR BREAST CANCER AFTER CHILDHOOD CANCER. J NATL CANCER INST. 2017 NOV 1;109(11).CHEUNG YT, BRINKMAN TM, MULROONEY DA, MZAYEK Y, LIU W, BANERJEE P, PANOSKALTSIS-MORTARI A, SRIVASTAVA DK, PUI CH, ROBISON LL, HUDSON MM, KRULL KR. IMPACT OF SLEEP, FATIGUE AND SYSTEMIC INFLAMMATION ON NEUROCOGNITIVE AND BEHAVIORAL OUTCOMES IN LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA. CANCER. 2017 SEP 1;123(17):3410-3419.CHEMAITILLY W, LI Z, KRASIN MJ, BROOKE RJ, WILSON CL, GREEN DM, KLOSKY JL, BARNES N, CLARK KL, FARR JB, FERNANDEZ-PINEDA I, BISHOP MW, METZGER M, PUI CH, KASTE SC, NESS KK, SRIVASTAVA DK, ROBISON LL, HUDSON MM, YASUI Y, SKLAR CA. PREMATURE OVARIAN INSUFFICIENCY IN CHILDHOOD CANCER SURVIVORS: A REPORT FROM THE ST. JUDE LIFETIME COHORT. J CLIN ENDOCRINOL METAB. 2017 JUL 1;102(7):2242-2250.MULROONEY DA, SOLIMAN EZ, LU L, EHRHARDT MJ, DUPREZ DA, LUEPKER RV, ARMSTRONG GT, JOSHI VM, GREEN DM, SRIVASTAVA DK, KRASIN MJ, MORRIS GS, ROBISON LL, HUDSON MM, NESS KK. ELECTROCARDIOGRAPHIC ABNORMALITIES IN ADULT SURVIVORS OF CHILDHOOD CANCER: A CROSS-SECTIONAL STUDY FROM THE ST. JUDE LIFETIME COHORT. AM HEART J. 2017 JUL;189:19-27VUOTTO SC, OJHA RP, LI C, KIMBERG C, KLOSKY JL, KRULL KR, SRIVASTAVA DK, ROBISON LL, HUDSON MM, BRINKMAN TM. THE ROLE OF BODY IMAGE DISSATISFACTION IN THE ASSOCIATION BETWEEN TREATMENT-RELATED SCARRING OR DISFIGUREMENT AND PSYCHOLOGICAL DISTRESS IN ADULT SURVIVORS OF CHILDHOOD CANCER. PSYCHO-ONCOLOGY. 2018 JAN;27(1):216-222ARMSTRONG GT, TOLE JJ, PIANA R, SANTUCCI A, LEATHERS J, NESS KK, MULROONEY DA, GREEN DM, JOSHI, VM, ROBISON LL, HUDSON MM, LENIHAN D. EXERCISE RIGHT HEART CATHETERIZATION FOR PULMONARY HYPERTENSION IDENTIFIED ON SCREENING ECHOCARDIOGRAPHY IN ADULT SURVIVORS OF CHILDHOOD CANCER: A REPORT FROM THE ST. JUDE LIFETIME COHORT. PEDIATR BLOOD CANCER. 2018 JAN;65(1).STUDAWAY A, OJHA RP, BRINKMAN TM, ZHANG N, BAASSIRI M, BANERJEE P, EHRHARDT MJ, SRIVASTAVA D, ROBISON LL, HUDSON MM, KRULL KR. CHRONIC HEPATITIS C VIRUS INFECTION AND NEUROCOGNITIVE FUNCTION IN ADULT SURVIVORS OF CHILDHOOD CANCER. CANCER. 2017 NOV 15;123(22):4498-4505.INTERIANO RB, KASTE SC, LI C, SRIVASTAVA DK, RAO BN, WARNER WC JR, GREEN DM, KRASIN MJ, ROBISON LL, DAVIDOFF AM, HUDSON MM, FERNANDEZ-PINEDA I, NESS KK. ASSOCIATIONS BETWEEN TREATMENT, SCOLIOSIS, PULMONARY FUNCTION, AND PHYSICAL PERFORMANCE IN LONG-TERM SURVIVORS OF SARCOMA. J CANCER SURVIV. 2017 OCT;11(5):553-561.EHRHARDT MJ, MULROONEY DA, LI C, BAASSIRI MJ, BJORNARD K, SANDLUND JT, BRINKMAN TM, HUANG IC, SRIVASTAVA DK, NESS KK, ROBISON LL, HUDSON MM, KRULL KR. NEUROCOGNITIVE, PSYCHOSOCIAL, AND QUALITY-OF-LIFE OUTCOMES IN ADULT SURVIVORS OF CHILDHOOD NON-HODGKIN LYMPHOMA. CANCER. 2018 JAN 15;124(2):417-425.BHAKTA N, LIU Q, NESS KK, BAASSIRI M, EISSA H, YEO F, CHEMAITILLY W, EHRHARDT MJ, BASS J, BISHOP MW, SHELTON K, LU L, HUANG S, LI Z, CARON E, LANCTOT J, HOWELL C, FOLSE T, JOSHI V, GREEN DM, MULROONEY DA, ARMSTRONG GT, KRULL KR, BRINKMAN TM, KHAN RB, SRIVASTAVA DK, HUDSON MM, YASUI Y, ROBISON LL. THE CUMULATIVE BURDEN OF SURVIVING CHILDHOOD CANCER: AN INITIAL REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY (SJLIFE). LANCET. 2017 DEC 9;390(10112):2569-2582EISSA HM, LU L, BAASSIRI M, BHAKTA N, EHRHARDT MJ, TRIPLETT BM, GREEN DM, MULROONEY DA, ROBISON LL, HUDSON MM, NESS KK. CHRONIC DISEASE BURDEN AND FRAILTY IN SURVIVORS OF CHILDHOOD HSCT: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. BLOOD ADV. 2017 NOV 7;1(24):2243-2246.
LIU W, CHEUNG YT, BRINKMAN TM, BANERJEE P, SRIVASTAVA D, NOLAN VG, ZHANG H,	GURNEY JG, PUI CH, ROBISON LL, HUDSON MM, KRULL KR. BEHAVIORAL SYMPTOMS AND PSYCHIATRIC DISORDERS IN CHILD AND ADOLESCENT LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH CHEMOTHERAPY ONLY. PSYCHO-ONCOLOGY. 2018 JUN;27(6):1597-1607.LIU W, CHEUNG YT, CONKLIN HM, JACOLA LM, SRIVASTAVA D, NOLAN VG, ZHANG H, GURNEY JG, HUANG IC, ROBISON LL, PUI CH, HUDSON MM, KRULL KR. EVOLUTION OF NEUROCOGNITIVE FUNCTION IN LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA TREATED WITH CHEMOTHERAPY ONLY. J CANCER SURVIV. 2018 JUN;12(3):398-406.IM C, NESS KK, KASTE SC, CHEMAITILLY W, MOON W, SAPKOTA Y, BROOKE RJ, HUDSON MM, ROBISON LL, YASUI Y, WILSON CL. GENOME-WIDE SEARCH FOR HIGHER ORDER EPISTASIS AS MODIFIERS OF TREATMENT EFFECTS ON BONE MINERAL DENSITY IN CHILDHOOD CANCER SURVIVORS. EUR J HUM GENET. 2018 FEB;26(2):275-286.HOWELL CR, WILSON CL, EHRHARDT MJ, PARTIN RE, KASTE SC, LANCTOT JQ, PUI CH, ROBISON LL, HUDSON MM, NESS KK. CLINICAL IMPACT OF SEDENTARY BEHAVIORS IN ADULT SURVIVORS OF ACUTE LYMPHOBLASTIC LEUKEMIA: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. CANCER. 2018 MAR 1;124(5):1036-1043GIBSON TM, LI Z, GREEN DM, ARMSTRONG GT, MULROONEY DA, SRIVASTAVA D, BHAKTA N, NESS KK, HUDSON MM, ROBISON LL. BLOOD PRESSURE STATUS IN ADULT SURVIVORS OF CHILDHOOD CANCER: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. CANCER EPIDEMIOL BIOMARKERS PREV. 2017 DEC;26(12):1705-1713.ALLEN J, WILLARD VW, KLOSKY JL, LI C, SRIVASTAVA DK, ROBISON LL, HUDSON MM, PHIPPS S. POSTTRAUMATIC STRESS-RELATED PSYCHOLOGICAL FUNCTIONING IN ADULT SURVIVORS OF CHILDHOOD CANCER. J CANCER SURVIV. 2018 APR;12(2):216-223.CHOW EJ, CHEN Y, HUDSON MM, FEIJEN EAM, KREMER LC, BORDER WL, GREEN DM, MEACHAM LR, MULROONEY DA, NESS KK, OEFFINGER KC, RONCKERS CM, SKLAR CA, STOVALL M, VAN DER PAL HJ, VAN DIJK IWEM, VAN LEEUWEN FE, WEATHERS RE, ROBISON LL, ARMSTRONG GT, YASUI Y. PREDICTION OF ISCHEMIC HEART DISEASE AND STROKE IN SURVIVORS OF CHILDHOOD CANCER. J CLIN ONCOL. 2018 JAN 1;36(1):44-52.FELLAH S, CHEUNG YT, SCOGGINS MA, ZOU P, SABIN ND, PUI CH, ROBISON LL, HUDSON MM, OGG RJ, KRULL KR. BRAIN ACTIVITY ASSOCIATED WITH ATTENTION DEFICITS FOLLOWING CHEMOTHERAPY FOR CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA. J NATL CANCER INST. 2018 MAY 21. [EPUB AHEAD OF PRINT].HUANG IC, KLOSKY JL, YOUNG CM, MURPHY SE, KRULL KR, SRIVASTAVA DK, HUDSON MM, ROBISON LL. MISCLASSIFICATION OF SELF-REPORTED SMOKING. PEDIATR BLOOD CANCER. 2018; E27240.FERNANDEZ-PINEDA I, DAVIDOFF AM, LU L, RAO BN, WILSON CL, SRIVASTAVA DK, KLOSKY JL, METZGER ML, KRASIN MJ, NESS KK, PUI CH, ROBISON LL, HUDSON MM, SKLAR CA, GREEN DM, CHEMAITILLY W. IMPACT OF OVARIAN TRANSPOSITION BEFORE PELVIC IRRADIATION ON OVARIAN FUNCTION AMONG LONG-TERM SURVIVORS OF CHILDHOOD HODGKIN LYMPHOMA: A REPORT FROM THE ST. JUDE LIFETIME COHORT STUDY. PEDIATRI BLOOD CANCER. 2018 MAY 11: E27232.HUANG IC, BRINKMAN TM, MULLINS L, PUI CH, ROBISON LL, HUDSON MM, KRULL KR. CHILD SYMPTOMS, PARENT BEHAVIORS, AND FAMILY STRAIN IN LONG-TERM SURVIVORS OF CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA. PSYCHO-ONCOLOGY 2018;27(8):2031-8.MONAHAN K, LENIHAN D, BRITTAIN EL, SALIBA L, PIANA RN, ROBISON LL, HUDSON MM, ARMSTRONG GT. THE RELATIONSHIP BETWEEN PULMONARY ARTERY WEDGE PRESSURE AND PULMONARY BLOOD VOLUME DERIVED FROM CONTRAST ECHOCARDIOGRAPHY: A PROOF-OF-CONCEPT STUDY. ECHOCARDIOGRAPHY. 2018 MAY 14. [EPUB AHEAD OF PRINT].5 & 6. AS OF SEPTEMBER 30, 2018, 5,657 SURVIVORS HAVE BEEN ENROLLED ON THE ST. JUDE LIFETIME COHORT STUDY. AMONG 3,866 ENROLLED 10+ YEAR SURVIVORS 18+ YEARS OF AGE, 3,489 SURVIVORS HAVE COMPLETED ONE OR MORE COMPREHENSIVE EVALUATION WITH PARTICIPATION RATES REMAINING HIGH (92% OF THOSE CONTACTED AND 85% OF TOTAL ELIGIBLE). AMONG 5-YEAR SURVIVORS IN THE EXPANDED ELIGIBLE COHORT, 1,791 PARTICIPANTS HAVE BEEN RECRUITED (AVERAGING 29 SURVIVOR REGISTRATIONS PER MONTH IN LAST YEAR). IN ADDITION, 652 CONTROL SUBJECTS HAVE BEEN RECRUITED, OF WHOM 600 HAVE COMPLETED COMPREHENSIVE EVALUATIONS.PEDIATRIC HEALTH NEED:COMMUNITY EDUCATIONHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, COMMUNICATIONS & PUBLIC RELATIONS DEPARTMENTANTICIPATED OUTCOME:IMPROVED HEALTH OUTCOMES AND COMMUNITY UNDERSTANDING OF HEALTH CARE RESOURCES AND HEALTH CARE CAREERSACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. ST. JUDE PROFESSIONALS WILL PROVIDE INFORMATION AND RESOURCES ABOUT SICKLE CELL DISEASE, HIV, CANCER, FLU, AND OTHER PEDIATRIC LIFE-THREATENING DISEASES.2. INVENTORY EDUCATIONAL OPPORTUNITIES ABOUT HEALTHCARE CAREERS ALREADY AVAILABLE FROM ST. JUDE TO DETERMINE AREAS OF FOCUS.SELECTED ACCOMPLISHMENTS:ST. JUDE PROFESSIONALS PROVIDING INFORMATION AND RESOURCES:- ST. JUDE CONDUCTED MORE THAN 75 30-SECOND EDUCATIONAL RADIO SPOTS IN FY18. TOPICS INCLUDED THE HIV VOICES PROJECT, AIDS SUPPORT, SICKLE CELL TRANSITION E-LEARNING PROGRAM (STEP), BLOOD DONOR CENTER, AND THE HPV VACCINE FOR CANCER PREVENTION. - IN ADDITION, ST. JUDE DISTRIBUTED PUBLIC SERVICE ANNOUNCEMENT SCRIPTS TO INCREASE AWARENESS ABOUT THE HPV VACCINE TO LOCAL MEMPHIS AND REGIONAL RADIO STATIONS IN FY18.- ALSO, ST. JUDE SUBMITTED A PUBLIC SERVICE ANNOUNCEMENT IN MAY 2018 TO INVITE THE COMMUNITY TO A SYMPOSIUM ABOUT SICKLE CELL DISEASE. - MEDIA RELATIONS EFFORTS RESULTED IN A NUMBER OF ST. JUDE PROFESSIONALS BEING INTERVIEWED THIS YEAR ON COMMUNITY SUBJECTS, INCLUDING FLU AWARENESS AND REMINDERS TO GET THE FLU VACCINE. INFORMATION FROM DR. RICHARD WEBBY AND HIS TEAM ABOUT THE FLU VACCINE APPEARED IN MORE THAN 1,000 NEWS PIECES, INCLUDING 13 LOCAL MEMPHIS STORIES. - "PROMISE" MAGAZINE IS ONE VEHICLE USED BY THE ST. JUDE COMMUNICATIONS AND PUBLIC RELATIONS DEPARTMENT TO EDUCATE THE PUBLIC ABOUT SICKLE CELL DISEASE, HIV, CANCER AND OTHER DISEASES. EACH QUARTER, "PROMISE" IS MAILED TO BETWEEN 250,000 AND 300,000 READERS, INCLUDING DONORS, EMPLOYEES, PEER INSTITUTIONS, CEOS OF FORTUNE 500 COMPANIES, SELECT MEDIA, AND INDIVIDUALS WHO SUBSCRIBE THROUGH OUR ONLINE SUBSCRIPTION FORM. ALL THE ARTICLES APPEAR ONLINE, WHERE THEY HAVE AN EVEN WIDER READERSHIP. AN E-NEWSLETTER VERSION OF "PROMISE" IS ALSO SENT TO NEARLY 10,000 SUBSCRIBERS QUARTERLY.A FEW OF THE EDUCATIONAL ARTICLES IN "PROMISE" MAGAZINE ARE LISTED:- THE SUMMER 2018 "PROMISE" INCLUDED A STORY ON HOW ST. JUDE PARTNERS WITH THE COMMUNITY TO BRING CUTTING-EDGE HIV PREVENTION AND EDUCATION TO AT-RISK YOUTH.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SUMMER-2018/PARTNERS-FOR-HIV-PREVENTION.HTML- THE SPRING 2018 "PROMISE" FEATURED AN ARTICLE ON OUR SCHOOL LIAISON SERVICES THAT HELP PATIENTS MAKE A SEAMLESS TRANSITION BACK TO THE CLASSROOM. THE ARTICLE FEATURED A LOCAL BOY WHO HAD COMPLETED TREATMENT AND RETURNED TO HIS MEMPHIS CLASSROOM.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SPRING-2018/SCHOOL-LIAISON-SERVICES-HELP-KIDS-GO-BACK-TO-SCHOOL.HTML- THE SPRING 2018 ISSUE ALSO INCLUDED AN ARTICLE ABOUT USING VIRTUAL REALITY FOR RELIEF OF PAIN FROM SICKLE CELL DISEASE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SPRING-2018/VIRTUAL-REALITY-A-DISTRACTION-FROM-SICKLE-CELL-PAIN.HTML- THE WINTER 2018 ISSUE FEATURED AN ARTICLE ABOUT HYDROXYUREA TREATMENT FOR KIDS WITH SICKLE CELL DISEASE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/WINTER-2018/HYDROXYUREA-WHEN-MORE-IS-BETTER.HTML- THE AUTUMN 2017 "PROMISE" INCLUDED A FEATURE ON FLU SURVEILLANCE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/AUTUMN-2017/KEEPING-FLU-AT-BAY.HTML- ST. JUDE HAS A PRESENCE ON SOCIAL MEDIA AS @STJUDERESEARCH ACROSS EIGHT PLATFORMS, WITH A TOTAL OF MORE THAN 38,000 FOLLOWERS. THE GOAL FOR SOCIAL MEDIA IS TO INCREASE THE RECOGNITION AND UNDERSTANDING OF ST. JUDE SCIENCE, MEDICINE, AND TRANSLATIONAL RESEARCH BY HIGHLIGHTING SCIENTIFIC AND MEDICAL STUDIES, SUCCESSES, PROJECTS, AND PROGRAMS. THE PLATFORMS ALSO FEATURE CAREER OPPORTUNITIES FOR RESEARCH AND CLINICAL CARE STAFF. THE AUDIENCE IS CURRENT AND POTENTIAL PHYSICIANS, SCIENTISTS, CLINICIANS, POSTDOCS, REFERRING PHYSICIANS, AND PATIENTS AND THEIR FAMILIES. WITHIN THE LAST YEAR, FEATURED TOPICS HAVE RANGED FROM CHILDHOOD CANCER FACTS TO PALLIATIVE CARE AWARENESS TO OPENINGS FOR SPECIALTY CANCER CLINICS.EDUCATIONAL OPPORTUNITIES ABOUT HEALTH CARE CAREERS:- THE SUMMER 2018 EDITION OF "PROMISE" INCLUDED AN UPDATE ON THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES, THE FIRST DEGREE-GRANTING PROGRAM EVER ESTABLISHED ON THE ST. JUDE CAMPUS.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SUMMER-2018/FROM-STUDENT-TO-SCIENTIST-ST-JUDE-GRADUATE-SCHOOL.HTML- THE SPRING 2018 ISSUE OF "PROMISE" INCLUDED AN ARTICLE ON ST. JUDE AS AN EMPLOYER AND WHY EMPLOYEES ENJOY THEIR CAREERS IN HEALTH CARE.HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/STORIES/PROMISE-MAGAZINE/SPRING-2018/ST-JUDE-EMPLOYEES-THE-HEARTBEAT-OF-THE-HOSPITAL.HTML
- APPROXIMATELY 120 LOCAL HIGH SCHOOL STUDENTS AND TEACHERS VISITED ST.	JUDE IN MARCH 2018 FOR THE THIRD ANNUAL SCIENCE SCHOLARS OF TOMORROW SYMPOSIUM. THE DAY-LONG EVENT FEATURED SCIENTIFIC PRESENTATIONS AND TOURS OF LABORATORIES, CLINICS, AND CORE FACILITIES, ENABLING STUDENTS TO INTERACT WITH SCIENTISTS AND CLINICIANS.- MORE THAN 300 CANCER SURVIVORS, INCLUDING LOCAL MEMPHIS RESIDENTS, ATTENDED SURVIVORS DAY IN SEPTEMBER 2017, WHERE THEY RECEIVED INFORMATION ABOUT CANCER SURVIVORSHIP, SOCIAL WORK, EDUCATION, AND MORE.PEDIATRIC HEALTH NEED:ST. JUDE AFFILIATE NETWORKHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, AFFILIATE PROGRAM OFFICEANTICIPATED OUTCOME:THE ST. JUDE AFFILIATE NETWORK SHOULD BE MAINTAINED TO EXPAND OPPORTUNITIES FOR SERVICES TO A LARGER NUMBER OF CHILDREN.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. EVALUATE OPPORTUNITIES TO EXPAND TO ADDITIONAL LOCATIONS.2. ENHANCE OPERATIONS AND INCREASE PATIENT VISITS AT ALL CLINICS.3. INCREASE ACCRUALS ON ST. JUDE CLINICAL TRIALS.4. ENHANCE THE PATIENT EXPERIENCE AND ENSURE HIGH-QUALITY CARE.SELECTED ACCOMPLISHMENTS:- THE NUMBER OF PATIENTS ENROLLED IN ST. JUDE PRIMARY THERAPEUTIC PROTOCOLS FROM THE AFFILIATE CLINICS HAS INCREASED EACH YEAR:FY15 62 FY16 69 (+11%)FY17 106 (+54%)FY18 107 (+.01%)- THE SICKLE CELL CLINICAL RESEARCH AND INTERVENTION PROGRAM HAS BEEN ACTIVELY ENROLLING AT THE BATON ROUGE, CHARLOTTE, AND PEORIA AFFILIATE CLINICS, WITH ~20% OF ACCRUALS FROM THE AFFILIATE AREAS.- THE REDUCTION IN TIME-TO-ANTIBIOTICS IN IMMUNOCOMPROMISED CHILDREN QUALITY IMPROVEMENT PROJECT WAS SUCCESSFULLY COMPLETED.- AN AMBULATORY IMPLANTED CATHETER CARE BUNDLE WAS INSTITUTED AT ALL EIGHT AFFILIATES, WITH REDUCTIONS IN CENTRAL LINE INFECTIONS.- A PATIENT NAVIGATOR POSITION WAS ESTABLISHED TO IMPROVE THE PATIENT EXPERIENCE.AIM #2 ENHANCING COORDINATION OF CAREPEDIATRIC HEALTH NEED:PHYSICIAN COORDINATION OF CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITALST. JUDE AFFILIATE INSTITUTIONSALL DOMESTIC AND INTERNATIONAL REFERRING CLINICIANS AND CENTERSANTICIPATED OUTCOME:IMPROVE CONTINUITY OF CARE BY ENHANCING COMMUNICATION TOOLS AND EFFORTS TO PROVIDE PHYSICIANS WITH UNPARALLELED ACCESS TO PATIENT INFORMATION.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO IMPROVE THE CLINICIAN PORTAL TO PERMIT REFERRING AND AFFILIATED PHYSICIANS' CONVENIENT ACCESS TO PATIENT INFORMATION, IN ACCORDANCE WITH APPLICABLE LAW. SELECTED ACCOMPLISHMENTS:- PROVIDERS IN THE AFFILIATE PROGRAM NOW HAVE FULL ACCESS TO THE ST. JUDE ELECTRONIC MEDICAL RECORD. - CLINICIAN PORTAL WORK IS ONGOING. A VENDOR HAS BEEN SELECTED TO BEGIN DEVELOPMENT OF PATIENTSAFE. PROCESSES ARE UNDERWAY TO INVITE PHYSICIANS TO HAVE ACCOUNTS AND ASSIGN THEM USERNAMES AND PASSWORDS. THERE IS AN ON-GOING REVIEW PROCESS TO FINALIZE THAT PHYSICIANS CONTINUE TO HAVE ACTIVE PATIENT CARE RELATIONSHIPS WITH ST. JUDE PATIENTS.- DESIGNED AND TESTED A WEB PORTAL TO BE USED BY REFERRING AND AFFILIATED PHYSICIANS TO ACCESS PATIENT RECORDS AND IMPROVE COMMUNICATION. POLICIES AND PROCEDURES ARE BEING DRAFTED, AND AN IMPLEMENTATION COMMITTEE HAS BEEN FORMED.- METRICS TO QUALIFY TIMELY ENTRY AND CLINICIAN USAGE ARE ALSO BEING DEFINED. A REFERRING PHYSICIAN TASK FORCE (COMPRISED OF CLINICAL DIRECTOR, CLINICAL SERVICE LEADERS, FACULTY MEMBERS, AND CLINICAL AND ADMINISTRATIVE PROCESS LEADERS [INFORMATION SCIENCES, HEALTH INFORMATION MANAGEMENT, PHYSICIAN/PATIENT REFERRAL OFFICE]) IS CURRENTLY REVIEWING COMMUNICATION PROCESSES BY CLINICAL SERVICES TO ENSURE COMPLIANCE WITH THE COMMUNICATION POLICY FOR EXTERNAL CLINICIANS. THERE HAS ALSO BEEN AN EFFORT TO EXTEND AN INVITATION TO THE AFFILIATE PHYSICIANS TO PARTICIPATE REMOTELY IN WEEKLY MULTIDISCIPLINARY CONFERENCES TO AID IN COMMUNICATION AND SERVE AS AN OPPORTUNITY FOR TRAINING. PEDIATRIC HEALTH NEED:TRANSITION OF PATIENTS FROM PEDIATRIC TO ADULT HEALTHCARE SERVICESHEALTH FACILITIES INVOLVED:SICKLE CELL DISEASE PROGRAM - ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF HEMATOLOGY, CLINICAL HEMATOLOGY DIVISIONDIGGS-KRAUS SICKLE CELL CENTER AT REGIONAL ONE HEALTHMETHODIST HEALTHCARE COMPREHENSIVE SICKLE CELL CENTER (MCSCC)ANTICIPATED OUTCOME:INCREASE THE NUMBER OF PATIENTS WITH SICKLE CELL DISEASE WHO ESTABLISH SUSTAINED ADULT CARE AFTER LEAVING PEDIATRIC CARE AT ST. JUDE.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1.CONTINUE TO WORK WITH ADULT SICKLE CELL CENTERS IN THE COMMUNITY TO ENHANCE A SEAMLESS TRANSITION FROM PEDIATRIC CARE.2. ENHANCE ADOLESCENT AND YOUNG ADULTS (AYA) TRANSITION CLINICS WITH CO-LOCATION OF PEDIATRIC AND ADULT HEMATOLOGY PROVIDERS.3. AUGMENT FORMAL PROGRAMMING AND PLANNING PROCESSES FOR ADOLESCENTS WITH HEMATOLOGIC AND ONCOLOGIC DISEASES BY DEVELOPING DISEASE EDUCATIONAL CURRICULUM AND TRAINING MODULES TO FOSTER INCREASED ADOLESCENT AUTONOMY AND MEDICAL LITERACY.SELECTED ACCOMPLISHMENTS:- FY18 - 59 PATIENTS TRANSITIONED TO ADULT CARE.1. CONTINUE TO WORK WITH ADULT SICKLE CELL CENTERS IN THE COMMUNITY TO ENHANCE A SEAMLESS TRANSITION FROM PEDIATRIC CARE. WE CONTINUE TO PROVIDE THE QUARTERLY TEEN TRANSITION TOUR TO THE ADULT PROVIDERS IN MEMPHIS. LAST YEAR, 27 PATIENTS WITH SICKLE CELL DISEASE PARTICIPATED.A MONTHLY TRANSITION SKILLS LAB WAS IMPLEMENTED TO EQUIP YOUNG ADULTS WITH LIFE SKILLS THAT ARE NECESSARY AS THEY MOVE INTO THE ADULT REALM. LAST YEAR, 15 PATIENTS WITH SICKLE CELL DISEASE PARTICIPATED.DURING SKILLS LAB - THE TEENAGERS LEARN:A. HOW TO SCHEDULE A DOCTOR'S APPOINTMENTB. HOW TO ORDER MEDICATION REFILLC. HOW TO ACCESS INSURANCE BENEFITS D. WHAT A CO-PAY IS2. ENHANCE ADOLESCENT AND YOUNG ADULTS (AYA) TRANSITION CLINICS WITH CO-LOCATION OF PEDIATRIC AND ADULT HEMATOLOGY PROVIDERS. WE CONTINUE TO PROVIDE CO-LOCATION OF CARE FOR RECENTLY TRANSITIONED PATIENTS WITH SICKLE CELL DISEASE WHO CHOOSE TO CONTINUE CARE AT THE METHODIST COMPREHENSIVE SICKLE CELL CENTER. 3. AUGMENT FORMAL PROGRAMMING AND PLANNING PROCESSES FOR ADOLESCENTS WITH HEMATOLOGIC AND ONCOLOGIC DISEASES BY DEVELOPING DISEASE EDUCATIONAL CURRICULUM AND TRAINING MODULES TO FOSTER INCREASED ADOLESCENT AUTONOMY AND MEDICAL LITERACY.SINCE 2017, EDUCATION HAS BEEN DEVELOPED ON VARIOUS TOPICS, WITH THE GOAL OF INCREASING THE MEDICAL LITERACY AMONG PATIENTS WITH SICKLE CELL DISEASE.THE FOLLOWING TOPICS ARE PROVIDED TO ALL TRANSITIONING PATIENTS: A. COMPLICATIONS OF SICKLE CELL DISEASE AND HOW TO MANAGE THEM.B. WHAT ARE BLOOD COUNTS?C. WHAT IS BONE MARROW TRANSPLANT?AIM #3 IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDRENPEDIATRIC HEALTH NEED:CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY, AND PHYSICAL ACTIVITYHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, GLOBAL PEDIATRIC MEDICINEANTICIPATED OUTCOME:INCREASE THE NUMBER OF STUDENTS AND TEACHERS PARTICIPATING IN ST. JUDE CANCER AND HEALTHY LIVING EDUCATION PROGRAM.INCREASE THE KNOWLEDGE THAT CHILDREN HAVE ON CANCER AND HEALTHY LIVING TOPICS (NUTRITION, EXERCISE, SUN PROTECTION, AVOIDING TOBACCO)WITH PRE AND POST QUIZZES. IMPROVE ATTITUDES OF CHILDREN TOWARD HEALTHY LIVING PRACTICES (AVOIDING SMOKING, BETTER NUTRITION HABITS, MORE EXERCISE, AVOIDING EXCESSIVE SUN) USING SURVEY INSTRUMENTS.
ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:	1. EVALUATE THE EFFECTIVENESS OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN CURRICULUM AT INCREASING CHILDREN'S KNOWLEDGE OF CANCER AND HEALTHY LIVING TOPICS (NUTRITION, EXERCISE, SUN PROTECTION, AVOIDING TOBACCO). 2. EVALUATE THE EFFECTIVENESS OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN CURRICULUM AT IMPROVING CHILDREN'S ATTITUDES TOWARDS HEALTHY LIVING PRACTICES (AVOIDING SMOKING, BETTER NUTRITION HABITS, MORE EXERCISE, AVOIDING EXCESSIVE SUN).3. PARTNER WITH LOCAL EDUCATION AGENCIES TO DISSEMINATE CANCER AND HEALTHY LIVING EDUCATIONAL PROGRAMS.SELECTED ACCOMPLISHMENTS:1. DEVELOP A FORMAL PROFESSIONAL DEVELOPMENT TRAINING SERIES FOR K-12 EDUCATORS INTERESTED IN INCORPORATING CANCER EDUCATION CONCEPTS INTO THEIR CLASSROOM CURRICULUM. THE ST. JUDE CANCER EDUCATORS CLASSROOM (SJCEC) IS A YEAR-LONG WORKSHOP SERIES THAT AIMS TO PROVIDE K-12 LEADERS AND EDUCATORS WITH VARIOUS FRAMEWORKS AND STRATEGIES FOR IMPROVING SCIENCE EDUCATION PEDAGOGY AND REDUCING STEREOTYPE THREATS THAT PREVENT INDIVIDUALS FROM UNDERREPRESENTED BACKGROUNDS FROM PURSUING CAREERS IN BIOMEDICAL RESEARCH. IN THIS INNOVATIVE APPROACH TO PROFESSIONAL DEVELOPMENT, PARTICIPANTS EXPLORED WAYS TO WEAVE TOGETHER SOCIAL AND EMOTIONAL LEARNING WITH SCIENCE EDUCATION IN A WAY THAT ENCOURAGES STUDENTS TO THINK CRITICALLY AND CREATIVELY, FOSTERS A FEARLESSNESS TO TACKLE WHAT ARE OFTEN BELIEVED TO BE UNSOLVABLE PROBLEMS, AND PROMOTES POSITIVE SELF-IDENTITIES THAT ENCOURAGE STUDENTS FROM UNDERREPRESENTED BACKGROUNDS TO PURSUE CAREERS IN BIOMEDICAL RESEARCH.THE SJCEC PILOT PROGRAM TOOK PLACE DURING THE 2017-2018 ACADEMIC YEAR WITH A GROUP OF 15 K-12 EDUCATORS AND 2 PROFESSIONAL LEARNING COACHES (PLCS) FROM 7 SCHOOLS THAT PREDOMINANTLY SERVE STUDENTS FROM LOW SOCIOECONOMIC BACKGROUNDS AND STUDENTS OF COLOR. ALL PARTICIPANTS WERE EMPLOYEES IN THE SHELBY COUNTY SCHOOL DISTRICT. LEARNING IN THIS PILOT PROGRAM TOOK PLACE THROUGH FOUR ONE-DAY INTERACTIVE WORKSHOPS AND A WEEK-LONG SUMMER COLLABORATIVE WORKSHOP.WORKSHOP 1: ENSURING A HIGH-QUALITY SCIENCE EDUCATION FOR ALL STUDENTS THIS WORKSHOP INTRODUCED TEACHERS TO PRACTICES AND METHODS THAT MAKE SCIENCE CONCEPTS RELEVANT TO ALL STUDENTS. PARTICIPANTS CONSIDERED SOME OF THE CHALLENGES AND BARRIERS TO STUDENT LEARNING IN RACIALLY IDENTIFIABLE SCHOOLS AND HIGH-POVERTY SCHOOLS AND BRAINSTORMED METHODS FOR OVERCOMING THESE BARRIERS.WORKSHOP 2: FOSTERING THINKING IN THE SCIENCE CLASSROOMTHIS WORKSHOP INTRODUCED EDUCATORS TO METHODS FOR FOSTERING THINKING IN THE SCIENCE CLASSROOM. PARTICIPANTS WERE ASKED TO REFLECT ON THEIR OWN CLASSROOM ENVIRONMENT AND TO IDENTIFY AREAS OF STRENGTH AND WEAKNESS.WORKSHOP 3: 3-DIMENSIONAL LESSON PLANNINGTHIS WORKSHOP GUIDED TEACHERS THROUGH THE NATIONAL ACADEMIES OF SCIENCES' A FRAMEWORK FOR K-12 SCIENCE EDUCATION TO EXPLORE CURRENT SHIFTS IN SCIENCE EDUCATION. PARTICIPANTS WORKED IN GRADE-LEVEL TEAMS TO IDENTIFY 3-DIMENSIONAL LESSONS WITHIN CANCER RESEARCH THEMES.WORKSHOP 4: CURRICULUM MAPPING AND ASSESSMENT PLANNINGTHIS WORKSHOP GUIDED TEACHERS THROUGH THE PROCESS OF CURRICULUM MAPPING AND ASSESSMENT PLANNING. PARTICIPANTS MODIFIED EXISTING CURRICULUM MAPS TO INCORPORATE 3-DIMENSIONAL LESSONS WITHIN CANCER RESEARCH THEMES AND CONNECT THEM TO TENNESSEE STATE SCIENCE STANDARDS.SUMMER COLLABORATIVE:THE SUMMER COLLABORATIVE WAS AN INTENSIVE, WEEK-LONG CURRICULUM DEVELOPMENT WORKSHOP. PARTICIPANTS WORKED IN SCHOOL TEAMS TO DESIGN 3-DIMENSIONAL LESSON PLANS FOCUSED ON CANCER EDUCATION THEMES. LESSONS INTEGRATED CONCEPTS FROM THE CULTURE OF THINKING (COT) PEDAGOGY WITH THE SCIENCE SCHOLARS OF TOMORROW (SSOT) CURRICULAR ITEMS. SEVERAL THEMES EMERGED THROUGHOUT THESE WORKSHOPS THAT DIRECTLY TIE TO NEGATIVE SELF-STEREOTYPES THAT CAN INHIBIT STUDENTS FROM UNDERREPRESENTED POPULATIONS FROM PURSUING CAREERS IN SCIENCE. THESE INCLUDE:- STUDENTS' FEELINGS OF HOPELESSNESS - FIXED MINDSETS (AND HOPELESSNESS) FORMED AS A RESULT OF LOW INCOME MOBILITY RATES IN MEMPHIS AND GENERATIONAL POVERTY- STUDENTS FEEL AS THOUGH THE SCHOOL IS PREPARING THEM FOR PRISON (THE SCHOOL-TO-PRISON PIPELINE WAS MENTIONED)- THE INVENTION OF COUNTER-CULTURES THAT PROVIDE A SPACE WHERE STUDENTS FEEL THAT THEY CAN SUCCEED (COUNTER-CULTURES ARE SUBCULTURES WHOSE VALUES AND NORMS OF BEHAVIOR ARE SUBSTANTIALLY DIFFERENT FROM THOSE OF MAINSTREAM SOCIETY, OFTEN IN OPPOSITION TO MAINSTREAM CULTURAL MORES)- STUDENTS OFTEN FAIL TO SEE HOW SCIENCE IS RELATED TO SOCIAL CHANGE AND WILL OFTEN WORK HARDER IN SOCIAL STUDIES AND HISTORY CLASSES THAN MATH AND SCIENCE CLASSES AS A RESULT. (THIS TIES TO A LACK OF UNDERSTANDING OF HOW SCIENCE IS RELEVANT TO THEM AND THEIR COMMUNITY, WHICH HAS SEVERAL IMPLICATIONS FOR CHALLENGES IN MINORITY INCLUSION ON CLINICAL TRIALS AS WELL.)PARTICIPANTS ALSO BRAINSTORMED PROGRAMMATIC EFFORTS TO REDUCE STEREOTYPE THREAT IN THEIR CLASSROOMS. THROUGH THESE CONVERSATIONS, FOUR ESSENTIAL COMPONENTS TO PROGRAMMATIC EFFORTS WERE IDENTIFIED:- PROVIDE COUNTER-STEREOTYPES: STUDENTS NEED TO SEE EXAMPLES OF UNDER REPRESENTED MINORITIES (URMS) PARTICIPATING IN SCIENTIFIC RESEARCH.- SUSTAIN INTERACTION: WHETHER THROUGH ONLINE/VIRTUAL INTERACTIONS, SCIENTIST VISITS TO THE CLASSROOM, OR FIELD TRIPS, STUDENTS NEED SUSTAINED INTERACTION WITH ST. JUDE/SCIENCE IN ORDER TO VIEW IT AS A POSSIBLE CAREER OPTION.- START YOUNG: STEREOTYPE THREAT BEGINS EARLY. MOST STUDENTS HAVE DECIDED WHETHER OR NOT THEY ARE GOOD AT/LIKE SOMETHING BY MIDDLE SCHOOL. WE NEED TO ENGAGE STUDENTS THROUGHOUT THE K-12 SPECTRUM WITH SUSTAINED EFFORTS THAT COUNTER STEREOTYPE THREATS.- ENGAGE ALL SCHOOL STAKEHOLDERS: SCHOOL ADMINISTRATORS NEED EDUCATION ON WHY SCIENCE AND STEM SHOULD BE AN IMPORTANT FOCUS IN K-5 CLASSROOMS IN ADDITION TO NUMERACY AND LITERACY. PARENTS NEED EDUCATION ON HOW TO SUPPORT A CHILD INTERESTED IN STEM CAREERS AS WELL AS COUNTER-STEREOTYPES THAT DEMONSTRATE THAT URM CHILDREN CAN HAVE SUCCESSFUL CAREERS IN SCIENCE. TEACHERS NEED GRADE-LEVEL PROFESSIONAL DEVELOPMENT RELATED TO HIGH-LEVEL SCIENCE CONCEPTS AND RESOURCES FOR TEACHING STUDENTS HIGH-LEVEL SCIENCE.THE SUMMER COLLABORATIVE YIELDED A VARIETY OF IDEAS AND STRATEGIES FOR IMPLEMENTING 3-DIMENSIONAL SCIENCE LESSONS IN THE CLASSROOM. THESE VARIED BASED ON GRADE-LEVEL AND SUBJECT TAUGHT, BUT ALL INVOLVED THE INCORPORATION OF CASE-BASED/PROBLEM-BASED LESSONS THAT CENTER AROUND A REAL-WORLD SCENARIO. THE ST. JUDE CANCER EDUCATION AND OUTREACH TEAM WILL CONTINUE TO WORK WITH THESE EDUCATORS FOR AT LEAST 3 YEARS FOLLOWING THE WORKSHOP SERIES TO CONTINUE TO HELP GROW AND FOSTER A CULTURE OF THINKING IN THE CLASSROOM, PROVIDE NECESSARY RESOURCES TO PROMOTE HIGH-QUALITY SCIENCE IN THE CLASSROOM THROUGH THE CANCER EDUCATION IN THE CLASSROOM LOAN KIT PROGRAM, AND COORDINATE SCIENTIST VISITS TO THE CLASSROOM THROUGH THE ST. JUDE SCIENCE AMBASSADORS PROGRAM. 2. PARTNER WITH LOCAL EDUCATION AGENCIES TO DISSEMINATE CANCER AND HEALTHY LIVING EDUCATIONAL PROGRAMS.THE ST. JUDE CANCER EDUCATION AND OUTREACH PROGRAM IS A SCHOOL-BASED OUTREACH PROGRAM THAT USES EDUCATION AND POSITIVE REINFORCEMENT TO HELP PROMOTE HEALTHY LIFESTYLE CHOICES AND TO REDUCE A CHILD'S LIFETIME RISK OF DEVELOPING CANCER. THE PROGRAM'S EDUCATIONAL OBJECTIVES ARE TO (A) EDUCATE ELEMENTARY SCHOOL CHILDREN ABOUT CANCER AND DISPEL COMMON MISCONCEPTIONS, (B) EDUCATE ABOUT AND PROMOTE HEALTHY LIFESTYLE CHOICES THAT CAN HELP CHILDREN REDUCE THEIR RISK OF CANCER IN ADULTHOOD, AND (C) INSPIRE AN INTEREST IN SCIENCE AND SCIENTIFIC CAREERS. IT SPECIFICALLY ADDRESSES OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. DURING THE 2017-2018 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM PARTNERED WITH 19 SCHOOLS TO DELIVER EDUCATIONAL CONTENT TO OVER 5,000 K-12 STUDENTS IN THE MEMPHIS AREA.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL:	PART V, SECTION B, LINE 7A: THE CHNA REPORT WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 10A: THE HOSPTIAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 14: ST. JUDE CURRENTLY DOES NOT BILL NOR PURSUE PAYMENT FOR ANY ST. JUDE PATIENT; THEREFORE, ST. JUDE DOES NOT HAVE A BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS.ST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16A: THE FAP WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16B: BASED ON THE FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY(HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML), ST. JUDE DOES NOT HAVE AN APPLICATION FORM.ST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML

Schedule H (Form 990) 2019

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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?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

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Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 3C:	NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. WE DO NOT NEED TO DETERMINE ELIGIBILITY FOR THIS ASSISTANCE. BY DEFAULT, ALL PATIENTS ARE ELIGIBLE TO RECEIVE MEDICAL CARE AND SUPPORT SERVICES AT NO COST. ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. BILLING INSURANCE FOR THE COSTS THAT WOULD BE DUE AT ANY OTHER HOSPITAL ALLOWS ST. JUDE TO CONTINUE DOING SOME OF THE MOST ADVANCED RESEARCH IN THE WORLD. IT ALSO ALLOWS ST. JUDE TO PAY FOR TREATMENTS, COPAYMENTS, DEDUCTIBLES, COINSURANCE, AND ANY OTHER COSTS INSURANCE DOES NOT COVER.TO ENSURE FAMILIES ARE MAKING USE OF ALL RESOURCES FOR WHICH THEY ARE ELIGIBLE, WE HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. DOING SO ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE ALSO CONTRACT WITH A VENDOR TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO ASSIST FAMILIES APPLYING FOR HEALTH INSURANCE COVERAGE THROUGH FEDERAL OR STATE FACILITATED MARKETPLACES.
PART I, LINE 7:	COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. COST-TO-CHARGE RATIO USED FOR LINE 7A FINANCIAL ASSISTANCE AT COST, LINE 7B MEDICAID, AND LINE 7C COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS.SOME CHIPS VOLUME IS INCLUDED IN MEDICAID IN PART I, LINE 7B BECAUSE IN MANY STATES THE CHIPS PROGRAMS ARE MANAGED BY THE SAME THIRD PARTY ADMINISTRATORS, AND IT IS DIFFICULT TO DISTINGUISH BETWEEN CHIPS AND MEDICAID COVERAGE.
PART I, LINE 7G:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL INCLUDED AS SUBSIDIZED HEALTH SERVICES SUPPORT FOR EIGHT AFFILIATE CLINICS TOTALING APPROXIMATELY $10.8 MILLION.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL CEO IS A MEMBER OF MEMPHIS TOMORROW. MEMPHIS TOMORROW IS AN ASSOCIATION OF CHIEF EXECUTIVE OFFICERS OF MEMPHIS' LARGEST ENTERPRISES. THE PURPOSE IS TO BRING TOP BUSINESS LEADERS TOGETHER WITH GOVERNMENT AND CIVIC LEADERS TO FOSTER ECONOMIC PROSPERITY FOR ALL WHO LIVE IN OUR COMMUNITY. THEIR INITIATIVES ARE FOCUSED IN THOSE AREAS WHICH DIRECTLY IMPACT ECONOMIC GROWTH AND OPPORTUNITY, INCLUDING: HUMAN CAPITAL DEVELOPMENT, INDUSTRY DEVELOPMENT, AND PUBLIC SAFETY. ST. JUDE ALSO PARTICIPATES WITH MEMPHIS FAST FORWARD WHOSE STRATEGIES ARE BASED ON THE COMMON SENSE PREMISE THAT ECONOMIC GROWTH AND PROSPERITY, AND IMPROVED QUALITY OF LIFE, WILL FOLLOW ONCE MEMPHIS AND SHELBY COUNTY SUCCESSFULLY ADDRESS THE BASICS: GOOD JOBS, QUALITY EDUCATION, SAFE STREETS AND EFFICIENT GOVERNMENT. THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL CEO IS A MEMBER OF THE CHAIRMAN'S CIRCLE. THE CHAIRMAN'S CIRCLE ENGAGES MEMPHIS BUSINESS LEADERS ON ISSUES THAT AFFECT MEMPHIS AND THE MID-SOUTH. THE CHAIRMAN'S CIRCLE'S 100+ MEMBERS REPRESENT MORE THAN 100,000+ EMPLOYEES IN THE MEMPHIS BUSINESS COMMUNITY. ITS MISSION IS TO MAKE MEMPHIS GREAT BY USING OUR COLLECTIVE STRENGTHS AS COMMUNITY AND BUSINESS LEADERS TO CREATE A CLEAR PATH TO POSITIVE CHANGE IN MEMPHIS AND THE MID-SOUTH. ST. JUDE IS A MEMBER OF THE ASPIRING FOR PURCHASING EXCELLENCE (APEX) ASSOCIATION OF MEMPHIS. APEX IS AN ASSOCIATION OF PURCHASING AND PROCUREMENT PROFESSIONALS FROM MEMPHIS ORGANIZATIONS WHOSE PURPOSE IS TO PROMOTE BEST PRACTICES IN SUPPLIER DIVERSITY. ADDITIONALLY, ST. JUDE IS SILVER SPONSOR FOR THE MID-SOUTH MINORITY BUSINESS COUNCIL (MMBC) ECONOMIC DEVELOPMENT FAIR. THE MMBC SERVES AS THE MID-SOUTH'S FOREMOST MINORITY BUSINESS DEVELOPMENT ORGANIZATION. THE MMBC HELPS TO DEVELOP A STRONG MINORITY AND WOMEN BUSINESS COMMUNITY IN AN EFFORT TO IMPACT ECONOMICALLY THE ENTIRE MID-SOUTH REGION. THE PEDIATRIC ONCOLOGY EDUCATION PROGRAM BRINGS FIFTY TO SIXTY STUDENTS EACH SUMMER FOR INTERNSHIPS IN BASIC SCIENCE OR CLINICAL RESEARCH. ADDITIONALLY, EXPERIENTIAL LEARNING INTERNSHIPS ARE STRUCTURED BY AND MANAGED BY ACADEMIC PROGRAMS IN MANY AREAS FROM SCIENCE TO ACCOUNTING. THERE ARE ANOTHER 150 STUDENTS INVOLVED IN THESE INTERNSHIPS. THESE PROGRAMS SUPPORT INCREASING THE AWARENESS OF CAREERS IN RESEARCH SCIENCE, HEALTHCARE, OR HEALTHCARE MANAGEMENT AND CONTRIBUTE TO PREPARING STUDENTS TO ENTER THESE CAREERS. THE CLINICAL EDUCATION AND TRAINING OFFICE HOSTS FORTY TO FIFTY STUDENTS ANNUALLY AS PATIENT CARE OBSERVERS. THESE STUDENTS ARE AT DIFFERENT STAGES OF TRAINING AND ARE FROM UNDERGRADUATE COLLEGES OR PROFESSIONAL HEALTHCARE SCHOOLS INCLUDING MEDICAL SCHOOLS. THE OBSERVERS ARE DECIDING ON OR CONFIRMING A DESIRE TO PURSUE A CAREER IN HEALTHCARE. THE FAMILY, GUEST, AND VOLUNTEER SERVICES DEPARTMENT PROVIDES SUMMER PROGRAMS FOR HIGH SCHOOL AND COLLEGE STUDENTS THAT DRIVE ENTRY INTO HEALTH CAREERS.THE OFFICE OF LEGAL SERVICES OFFERS LEGAL INTERNSHIPS TO LOCAL (UNIVERSITY OF MEMPHIS, OLE MISS) LAW STUDENTS DURING THE ACADEMIC YEAR AND TO NATIONAL LAW SCHOOLS DURING THE SUMMER. INTERNS PERFORM LEGAL RESEARCH; DRAFT MEMORANDA, LETTERS, AND OTHER DOCUMENTS; DRAFT AND REVIEW CONTRACTUAL AGREEMENTS; PREPARE PRESENTATIONS TO ST. JUDE PERSONNEL; AND ASSIST WITH DRAFTING POLICIES. INTERNS ALSO LEARN THROUGH OBSERVATION OF AND PARTICIPATION IN DAY-TO-DAY LAW PRACTICE ACTIVITIES, INCLUDING LEGAL PROCEEDINGS, NEGOTIATIONS, MEETINGS, TRAININGS, AND COUNSELING SESSIONS. WHEN POSSIBLE, INTERNS WORK WITH CLIENT DEPARTMENTS AND DEPARTMENTAL STAFF TO GATHER INFORMATION AND TO GAIN INSIGHT INTO AND UNDERSTANDING OF RESEARCH, CLINICAL, BUSINESS, AND HEALTH CARE OPERATIONS.IN ADDITION, MEMBERS OF THE OFFICE OF LEGAL SERVICES ENGAGED IN THE FOLLOWING ACTIVITIES WITHIN THE MEMPHIS AND LARGER TENNESSEE COMMUNITIES:- FIVE LAWYERS VOLUNTEERED AT A SATURDAY LEGAL CLINIC ORGANIZED BY MEMPHIS AREA LEGAL SERVICES.- CO-PRESENTED ON "PEDIATRIC BIOETHICS AND THE LAW," AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW, FEBRUARY 2018. - PRESENTED ON FUNDAMENTALS OF PROTECTION OF HUMAN SUBJECTS IN RESEARCH AT A PROGRAM BY THE HEALTH LAW SOCIETY AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW IN NOVEMBER 2017. - PRESENTED AT THE TENNESSEE BAR ASSOCIATION ANNUAL HEALTH LAW PRIMER IN OCTOBER 2017. - PRESENTED A WEBINAR FOR THE TENNESSEE BAR ASSOCIATION ON "CONTROLLED SUBSTANCE PRESCRIBING: EVOLVING STANDARDS DURING THE OPIOID EPIDEMIC" IN SEPTEMBER 2017. - SERVED AS A PANELIST AT THE SOCIETY FOR HUMAN RESOURCE MANAGEMENT - MEMPHIS MEETING IN MARCH 2018. - PLANNED A HEALTH LAW NETWORKING EVENT AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW.- SERVED ON THE TENNESSEE BAR ASSOCIATION HEALTH LAW SECTION EXECUTIVE COUNCIL.FINALLY, THE CHIEF GOVERNMENT AFFAIRS OFFICER WORKED IN COLLABORATION WITH LEGAL STAFF AND OUTSIDE ADVOCACY GROUPS TO SUPPORT EFFORTS TO CREATE A STATE PALLIATIVE CARE/QUALITY OF LIFE ADVISORY COUNCIL.THE ST. JUDE CHIEF GOVERNMENT AFFAIRS OFFICER CONTINUES TO SERVE ON THE BOARD OF DIRECTORS OF THE MEMPHIS RIVER PARKS PARTNERSHIP (MRPP), FORMERLY KNOWN AS THE RIVERFRONT DEVELOPMENT CORPORATION (RDC). THE MRPP IS A NON-PROFIT ORGANIZATION THAT, UNDER A LONG-TERM CONTRACT WITH THE CITY OF MEMPHIS, MANAGES ALL THE PARKS ALONG A 5-MILE STRETCH OF THE MEMPHIS RIVERFRONT INCLUDING ALONG DOWNTOWN MEMPHIS AND MUD ISLAND RIVER PARK. ELEMENTS ALONG THE RIVER FOSTER HEALTHY LIFESTYLES INCLUDING RIVERFIT, A SERIES OF PHYSICAL FITNESS CHALLENGES, AND A PLAYGROUND DESIGNED SPECIFICALLY FOR CHILDREN AT BEALE ST. LANDING, THE ONLY CHILD-DESIGNATED PLAYGROUND ON THE MEMPHIS RIVERFRONT. THE MRPP IS ALSO WORKING WITH THE CITY OF MEMPHIS TO IMPLEMENT A SERIES OF IMPROVEMENTS DESIGNED TO TIE THE RIVERFRONT CLOSER TO WORKERS AND RESIDENTS OF DOWNTOWN MEMPHIS TO MAKE ACCESS TO RIVERFRONT AMENITIES EASIER FOR ALL CITIZENS OF MEMPHIS AND TOURISTS VISITING THE CITY.THIS PAST YEAR THE CHIEF GOVERNMENT AFFAIRS OFFICER WAS ALSO APPOINTED TO SERVE ON THE BOARD OF COMMISSIONERS OF THE MEMPHIS AREA TRANSIT AUTHORITY (MATA) BY MEMPHIS MAYOR JIM STRICKLAND. IN THIS CAPACITY, HE HELPS TO PROMOTE THE HEALTH OF THE COMMUNITY BY ADVOCATING FOR POLICIES THAT ENABLE ENHANCED MOBILITY FOR A LARGER PERCENTAGE OF THE POPULATION OF MEMPHIS AND SHELBY COUNTY.THE CHIEF LEGAL OFFICER PARTICIPATES ON COMMITTEES OF THE MEMPHIS CHILD ADVOCACY CENTER, WHICH HELPS LOCAL CHILDREN FIND SAFETY AND HEALING (INCLUDING ACCESS TO A MENTAL HEALTH PROFESSIONAL) AFTER A REPORT OF SEXUAL OR OTHER SEVERE ABUSE, AND OFFERS ABUSE PREVENTION TRAINING TO COMMUNITY VOLUNTEERS AND PARENTS. THE CHIEF LEGAL OFFICER SERVES AS CHAIR OF THE ADVISORY BOARD OF THE INSTITUTE FOR HEALTH LAW & POLICY OF THE CECIL C. HUMPHREYS UNIVERSITY OF MEMPHIS SCHOOL OF LAW, WHICH ENDEAVORS TO ADDRESS UNMET HEALTH LAW NEEDS OF THE LOCAL COMMUNITY AND WORK WITH COMMUNITY LEADERS TO PROACTIVELY ADDRESS HEALTH POLICY NEEDS.THE SENIOR ASSOCIATE COUNSEL IS THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION'S ELECTED REPRESENTATIVE TO THE BOARD OF THE MEMPHIS BAR ASSOCIATION. THE ASSOCIATE COUNSEL SERVES ON THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION BOARD. THE ASSOCIATE COUNSEL CHAIRS THE COMMUNITY AFFAIRS COMMITTEE OF THAT SECTION AND THE CHIEF LEGAL OFFICER IS AN ACTIVE MEMBER OF THE COMMITTEE, WHICH ANNUALLY SPONSORS A SATURDAY LEGAL CLINIC PROVIDING UNREPRESENTED MEMBERS OF THE COMMUNITY AN OPPORTUNITY TO MEET WITH A VOLUNTEER ATTORNEY AND DISCUSS LEGAL ISSUES, INCLUDING THOSE THAT HAVE AN IMPACT ON PERSONAL HEALTH.THE MANAGER OF THE CANCER EDUCATION PROGRAM IN THE DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE (GPM) DEDICATES 80% OF HER TIME, AND THE COORDINATOR FOR CANCER EDUCATION DEDICATES 100% OF HER TIME TO CANCER EDUCATION OUTREACH, INCLUDING ACTIVITIES SUCH AS K-12 CURRICULUM DEVELOPMENT, SCHOOL VISITS FOR CANCER AND HEALTHY LIVING EDUCATION, CAREER TALKS, TEACHER TRAINING WORKSHOPS AND PUBLIC-ACCESS WEBSITE DEVELOPMENT.
PART III, LINE 2:	BAD DEBT EXPENSE IS EQUAL TO CHARGES ON ACCOUNTS DETERMINED TO BE UNCOLLECTIBLE. SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4:	BAD DEBT EXPENSE EXPLANATION IN FINANCIAL STATEMENTS FOOTNOTES IS AS FOLLOWS:NET PATIENT SERVICE REVENUES AND RECEIVABLES - NO FAMILY EVER PAYS THE HOSPITAL FOR THE CARE THEIR CHILD RECEIVES. ACCORDINGLY, NET PATIENT SERVICE REVENUE CONSISTS ONLY OF ESTIMATED NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS (IF NECESSARY) DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED AS AMOUNTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PATIENT SERVICE REVENUE HAS BEEN REDUCED BY ADJUSTMENTS FOR UNCOLLECTIBLE ACCOUNTS TOTALING APPROXIMATELY $773,000 AND $512,000 IN 2018 AND 2017, RESPECTIVELY.ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER BAD DEBT EXPENSE A COMMUNITY BENEFIT.
PART III, LINE 8:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER THE MEDICARE SHORTFALL A COMMUNITY BENEFIT. THE COST TO CHARGE RATIO WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE.
PART III, LINE 9B:	ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. THIS IS SET FORTH IN OUR FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/ LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML).
PART VI, LINE 2:	ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. CANCERPEDIATRIC CANCERS ARE RARE COMPARED TO ADULT CANCERS. ONLY 10,590 NEW CASES ARE EXPECTED TO OCCUR AMONG CHILDREN 14 YEARS OF AGE AND YOUNGER IN 2018; HOWEVER, CANCER IS THE LEADING CAUSE OF DISEASE-RELATED DEATH IN U.S. CHILDREN (FOOTNOTE 1). THE PRINCIPAL FOCUS OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS CANCER. SEVENTY-FIVE PERCENT OF ALL RESOURCES AT ST. JUDE ARE INVESTED IN ELUCIDATING BASIC BIOLOGICAL MECHANISMS OF PEDIATRIC CANCERS, AND TRANSLATING THIS KNOWLEDGE INTO IMPROVED DIAGNOSTIC TOOLS AND CURATIVE THERAPIES, WHILE MINIMIZING LONG-TERM SIDE EFFECTS. AS THE FIRST AND ONLY NATIONAL CANCER INSTITUTE-DESIGNATED COMPREHENSIVE CANCER CENTER FOCUSED EXCLUSIVELY ON CHILDREN, ST. JUDE SERVES AS A NATIONAL RESOURCE FOR RESEARCH AND TREATMENT OF PEDIATRIC CANCERS. OUR INITIATIVES ARE DESIGNED TO IMPACT PEDIATRIC CANCER TREATMENT ON A LOCAL, REGIONAL, NATIONAL AND GLOBAL SCALE. OUR CANCER PATIENTS COME FROM ALL OVER THE UNITED STATES AND ABROAD; HOWEVER, 66% OF THE NEW CANCER PATIENTS WE REGISTER RESIDE IN THE ST. JUDE CATCHMENT AREA, WHICH INCLUDES A 180-MILE RADIUS AROUND ST. JUDE LOCATED IN MEMPHIS, TN AND A 100-MILE RADIUS AROUND EACH OF OUR EIGHT AFFILIATES. THESE EIGHT AFFILIATES ARE LOCATED IN HUNTSVILLE, AL, CHARLOTTE, NC, JOHNSON CITY, TN, BATON ROUGE, LA, SHREVEPORT, LA, TULSA, OK, SPRINGFIELD, MO, AND PEORIA, IL. THE CATCHMENT POPULATION IS GENERALLY CHARACTERIZED BY A HIGHER PROPORTION OF NON-HISPANIC BLACK/AFRICAN-AMERICAN RACE, LOWER PROPORTION OF HISPANIC ETHNICITY, LOWER HOUSEHOLD INCOMES AND HOME VALUES, AND LOWER PROPORTION WITH AN EDUCATION BEYOND HIGH SCHOOL. APPROXIMATELY 4.9% OF THE POPULATION LIVE IN RURAL AREAS (BY RUCA CODE 10). TAKEN TOGETHER, THIS DIVERSE POPULATION INCLUDES MANY WITH LIMITED RESOURCES WHO ARE MEDICALLY UNDERSERVED. THROUGH ST. JUDE'S FOUNDING POLICY--THAT NO PATIENT BE DENIED TREATMENT BASED ON RACE, ETHNICITY, RELIGION, OR A FAMILY'S INABILITY TO PAY--AND WITH THE PROVISION OF RESOURCES TO OFFSET THE COSTS OF TRANSPORTATION AND HOUSING DURING CLINIC VISITS AND TREATMENT, WE REMOVE BARRIERS IN ACCESS TO OUR CUTTING-EDGE CLINICAL RESEARCH TRIALS AND EXCEPTIONAL CLINICAL CARE. ALL PEDIATRIC PATIENTS IN OUR CATCHMENT AREA ARE ACCEPTED TO ST. JUDE FOR TREATMENT OF THEIR CANCER.THE DEMOGRAPHICS OF THE PEDIATRIC CANCER POPULATION TREATED AT ST. JUDE CLOSELY MATCH THOSE OF OUR CATCHMENT AREA (BASED ON 2010 DATA FROM THE US CENSUS BUREAU) AND ALIGN WITH THE ESTIMATED INCIDENCE OF PEDIATRIC CANCER IN REPRESENTED RACIAL AND ETHNIC GROUPS (BASED ON SURVEILLANCE EPIDEMIOLOGY AND END RESULTS [SEER] 2009 DATA), CONFIRMING THAT ST. JUDE IS CLOSELY ALIGNED WITH THE NEEDS OF THE POPULATION IT SERVES. DEMOGRAPHICS FROM THE ST. JUDE PEDIATRIC CANCER COHORT ARE COMPARED WITH THE DEMOGRAPHICS OF THE CATCHMENT AREA ANNUALLY TO MONITOR DEMOGRAPHIC REPRESENTATION OF OUR CANCER PATIENTS IN RELATION TO THE AREA THAT WE SERVE. THERE ARE NO KNOWN DIFFERENCES IN PEDIATRIC CANCER INCIDENCE BY GEOGRAPHIC REGION IN THE U.S. CONSEQUENTLY, IT IS NOT POSSIBLE TO CATER OUR CLINICAL TRIALS TO TARGET PEDIATRIC CANCERS SPECIFICALLY PREVALENT IN OUR CATCHMENT AREA. WHILE NUMEROUS ADULT CANCERS HAVE BEEN SHOWN TO HAVE HIGH VARIATION IN INCIDENCE RATES ACROSS RACES AND ETHNICITIES, THE SITUATION IS LESS CLEAR IN PEDIATRIC CANCER, WHERE FEWER DISCREPANCIES HAVE BEEN IDENTIFIED. ALTHOUGH OUR CATCHMENT AREA HAS A HIGHER PROPORTION OF AFRICAN-AMERICAN PATIENTS THAN THE GENERAL U.S. POPULATION, THERE ARE VERY FEW EXAMPLES OF PEDIATRIC CANCERS IN WHICH THE INCIDENCE IS HIGHER IN RACIAL AND/OR ETHNIC MINORITIES (FOOTNOTES 2 AND 3). CONSEQUENTLY OUR RESEARCH AND CLINICAL TRIALS ADDRESS THE MOST PRESSING PROBLEMS IN PEDIATRIC CANCER. ST. JUDE OFFERS THERAPEUTIC TRIALS FOR THE TOP PEDIATRIC CANCERS (FOOTNOTE 1) INCLUDING ACUTE LYMPHOBLASTIC LEUKEMIA, MEDULLOBLASTOMA, NEUROBLASTOMA, HODGKIN LYMPHOMA, RETINOBLASTOMA, RHABDOMYOSARCOMA AND OTHERS. MANY OF THESE TRIALS ARE INSTITUTIONALLY SPONSORED; HOWEVER, ST. JUDE ALSO PARTICIPATES IN A NUMBER OF CLINICAL TRIALS CONSORTIA PROVIDING OUR CANCER PATIENTS ACCESS TO A VARIETY OF THERAPEUTIC STUDIES. PEDIATRIC CANCER PATIENTS MAY EXPERIENCE TREATMENT-RELATED SIDE EFFECTS MANY YEARS AFTER DIAGNOSIS. THE CHILDHOOD CANCER SURVIVOR STUDY AND ST. JUDE LIFE ARE TWO STUDIES, ACTIVE AT ST. JUDE, ASSESSING LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS. INFORMATION FROM THESE STUDIES WILL BE USED TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTIONS.WHEN CONSIDERING HEALTH-RELATED FACTORS, OUR CATCHMENT POPULATION IS CHARACTERIZED AS HAVING HIGH RATES OF TOBACCO USE, HIGH PREVALENCE OF OVERWEIGHT/OBESITY, AND LOW PHYSICAL ACTIVITY LEVEL. ALTHOUGH THESE FEATURES ARE NOT KNOWN TO AFFECT THE INCIDENCE OF ANY TYPE OF PEDIATRIC CANCER, THEY ARE IMPORTANT FOR HEALTH OUTCOMES.ANOTHER KEY AREA THAT ST. JUDE IS PROMOTING IN OUR CATCHMENT AREA AND BEYOND IS PREVENTION OF HPV-RELATED CANCERS. THE AMERICAN CANCER SOCIETY AND OTHER ORGANIZATIONS HAVE PUT FORTH THE GOAL TO ERADICATE HPV-RELATED CANCERS THROUGH VACCINATION AND SCREENING. NEARLY 80 MILLION INDIVIDUALS IN THE U.S. - 1 OUT OF EVERY 4 PEOPLE - ARE INFECTED WITH HUMAN PAPILLOMAVIRUS (HPV). APPROXIMATELY 31,500 CANCERS ATTRIBUTABLE TO HPV OCCUR EACH YEAR (FOOTNOTE 4). U.S. VACCINATION RATES REMAIN SIGNIFICANTLY LOWER FOR HPV THAN FOR OTHER RECOMMENDED ADOLESCENT VACCINES. IN 2017, TENNESSEE'S COMBINED HPV VACCINATION COVERAGE FOR MALES AND FEMALES AGES 13-17 IS ONLY 56%, WHICH RANKS 46TH IN THE NATION. BY GENDER, FEWER THAN 50% OF GIRLS AND APPROXIMATELY 30% OF BOYS AGES 13-17 ARE UP-TO-DATE ON THE HPV VACCINE SERIES (FOOTNOTE 5). RESIDENTS OF TENNESSEE AND THE MID-SOUTH HAVE AMONG THE HIGHEST INCIDENCES OF HPV-RELATED CANCERS IN THE COUNTRY (FOOTNOTE 6). AS THE ONLY NCI-DESIGNATED CANCER CENTER DEVOTED SOLELY TO CHILDREN, ST. JUDE IS COMMITTED TO TAKING ON A NEW LEADERSHIP ROLE IN PROTECTING YOUNG PEOPLE FROM PREVENTABLE HPV-ASSOCIATED CANCERS LATER IN LIFE. RECENTLY, ST. JUDE LAUNCHED HPV AWARENESS EFFORTS INCLUDING EDUCATION AT LOCAL SCHOOLS, OUTREACH TO NEWS MEDIA, DEVELOPMENT OF WEB CONTENT, AND PARTNERING WITH OTHER NCI-DESIGNATED CANCER CENTERS TO ENDORSE A GOAL OF ELIMINATING HPV-ASSOCIATED CANCERS IN THE UNITED STATES. OVER THE NEXT 5 YEARS, OUR PLAN IS TO SIGNIFICANTLY EXPAND OUR EFFORTS TO HAVE A GREATER IMPACT IN THE PROMOTION OF HPV VACCINATION IN OUR LOCAL CATCHMENT AREA, IN THE STATE OF TENNESSEE, AND NATIONALLY.ACCORDING TO THE AMERICAN CANCER SOCIETY, INDIVIDUALS WITH LOWER SOCIOECONOMIC STATUS HAVE HIGHER CANCER INCIDENCE RATES DUE TO ENGAGING IN LIFESTYLE BEHAVIORS THAT INCREASE CANCER RISK (FOOTNOTE 1). THE ST. JUDE CANCER EDUCATION FOR CHILDREN PROGRAM IS A LOCAL COMMUNITY EFFORT THAT USES EDUCATION AND POSITIVE REINFORCEMENT TO PROMOTE HEALTHY LIFESTYLE CHOICES THAT CAN HELP CHILDREN REDUCE THEIR RISK OF CANCER IN ADULTHOOD. EDUCATIONAL COMPONENTS OF THE PROGRAM SPECIFICALLY ADDRESS OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. THE PROGRAM DEVELOPMENT IS OVERSEEN BY A MULTIDISCIPLINARY TEAM COMPOSED OF ST. JUDE FACULTY AND STAFF, LOCAL EDUCATORS, AND LOCAL HEALTH EXPERTS WHO WORK TOGETHER TO ENSURE THAT THE CONTENT ACHIEVES THE GOALS OF THE PROGRAM WHILE ALIGNING TO STATE AND NATIONAL EDUCATION STANDARDS. DURING THE 2017-2018 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM WORKED WITH THE SHELBY COUNTY SCHOOL DISTRICT TO DELIVER CANCER AND HEALTHY LIVING EDUCATION PROGRAMS TO OVER 5,000 K-12 STUDENTS.(NOTE: THIS NARRATIVE FOR PART VI, LINE 2 IS CONTINUED BELOW.) - SEE PAGE 109/116
PART VI, LINE 3:	AS NOTED IN PART I, LINE 3C, NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. IN ADDITION, ST. JUDE PROVIDES AN UNPARALLELED LEVEL OF SUPPORT SERVICES AT NO COST TO FAMILIES. WE ALSO HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. FAMILIES ALSO HAVE ACCESS TO AN ONLINE EDUCATIONAL RESOURCE TITLED "YOU AND THE AFFORDABLE CARE ACT" (HTTPS://WWW.STJUDE.ORG/TREATMENT/PATIENT-RESOURCES/CAREGIVER-RESOURCES/PATIENT-FAMILY-EDUCATION-SHEETS/LEGAL-FINANCIAL/YOU-AND-THE-AFFORDABLE-CARE-ACT.HTML). THIS ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE UTILIZE AN OUTSIDE CONTRACTOR TO PROVIDE APPLICATION ASSISTANCE. THE HOSPITAL'S FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML) ARE POSTED ON THE HOSPITAL'S WEBSITE AND AVAILABLE AT REGISTRATION. THE DOCUMENTS ARE AVAILABLE IN ENGLISH AND SPANISH. FOR FAMILIES SPEAKING OTHER LANGUAGES, WE UTILIZE ONSITE INTERPRETER SERVICES AND/OR PROFESSIONAL CONTRACTED INTERPRETATION AND TRANSLATION SERVICES.
PART VI, LINE 4:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL IN MEMPHIS, TN, IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CATASTROPHIC DISEASES WITH A FOCUS ON CANCER AND BLOOD DISORDERS. PATIENTS AT ST. JUDE ARE REFERRED BY A PHYSICIAN, DIAGNOSED WITH A DISEASE CURRENTLY UNDER STUDY, AND ELIGIBLE FOR A RESEARCH PROTOCOL. ST. JUDE IS THE ONLY PEDIATRIC RESEARCH CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, INCLUDING CANCER AND BLOOD DISORDERS, WHERE FAMILIES NEVER PAY FOR TREATMENT NOT COVERED BY INSURANCE. IN FACT, NO FAMILY EVER PAYS ST. JUDE FOR ANYTHING. TRANSPORTATION, HOUSING AND FOOD ARE AMONG THE NO-COST SERVICES PROVIDED TO ENSURE FAMILIES COMING TO ST. JUDE CAN FOCUS ON THEIR CHILD. NO CHILD IS EVER DENIED TREATMENT DUE TO RACE, SEX, NATIONALITY, ETHNICITY, RELIGION, OR THE FAMILY'S ABILITY TO PAY. THE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST. JUDE SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, SUCH AS CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. IT DOES NOT ADMIT CHILDREN FOR ANY DIAGNOSTIC GROUPS OUTSIDE OF THESE SERVICES AND DOES NOT OFFER MEDICAL SERVICES BEYOND THOSE NECESSARY TO CARE FOR CHILDREN WITH THESE DISEASES. ST. JUDE DOES NOT HAVE AN EMERGENCY ROOM (ER). A REFERRAL FROM A MEDICAL PROFESSIONAL EXTERNAL TO ST. JUDE, TYPICALLY THE CHILD'S PEDIATRICIAN OR A PEDIATRIC SUBSPECIALIST, IS NECESSARY PRIOR TO ACCEPTING A PATIENT FOR TREATMENT TO ST. JUDE. ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS. SPECIFICALLY, MORE THAN 7,800 PATIENTS ARE SEEN AT ST. JUDE YEARLY, MOST OF WHO ARE ENROLLED ON CLINICAL TRIALS FOR NEW TREATMENTS DEVELOPED BY ST. JUDE, AND WHO ARE TREATED ON A CONTINUOUS OUTPATIENT BASIS. THE HOSPITAL HAS 69 OPERATIONAL BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS TO BE TREATED AS OUTPATIENTS WHO WOULD BE ADMITTED INTO INPATIENT UNITS AT MOST HOSPITALS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA FILTRATION, INFECTION-RESISTANT SURFACES AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES. ST. JUDE HAS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE TO EXTEND CARE AND BENEFITS TO MORE CHILDREN AND INCREASE THE NUMBER OF CHILDREN ABLE TO BE TREATED ON ST. JUDE CLINICAL TRIAL.ST. JUDE ALSO OPERATES AN INTERNATIONAL OUTREACH PROGRAM IN GLOBAL PEDIATRIC MEDICINE (GPM), AIMED AT IMPROVING SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, IMPLEMENTING NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND GENERATING INTERNATIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THERE ARE AN ESTIMATED 175,000 NEWLY DIAGNOSED CASES OF CHILDHOOD CANCER WORLDWIDE EACH YEAR, AND 84% OCCUR IN LOW- AND MIDDLE-INCOME COUNTRIES. CANCER IS EMERGING AS A MAJOR CAUSE OF CHILDHOOD DEATH IN ALL DEVELOPING COUNTRIES, REPLACING OTHER CAUSES OF CHILDHOOD MORTALITY (E.G. HIV, MALNUTRITION, INFECTIONS). DESPITE VAST IMPROVEMENTS IN THERAPY AND SURVIVAL IN HIGH-INCOME COUNTRIES OVER THE PAST 30 YEARS, AN ESTIMATED 60% DO NOT HAVE ACCESS TO ADEQUATE DIAGNOSIS AND MODERN CARE. ST. JUDE STRIVES TO ADDRESS THE NEEDS OF THOSE CHILDREN IN COUNTRIES THAT LACK SUFFICIENT RESOURCES AND HELP THEM MANAGE THEIR OWN BURDEN OF CASES EFFECTIVELY. WHILE SICK CHILDREN FROM AROUND THE WORLD HAVE TRAVELED TO OUR HOSPITAL IN MEMPHIS, RECEIVING TREATMENT IN THEIR OWN COUNTRIES IS MORE EFFICIENT AND LESS DISRUPTIVE FOR THEM AND THEIR FAMILIES. AS A RESULT OF OUR INTERNATIONAL EFFORTS, WE ARE ABLE TO REACH FAR MORE CHILDREN THAN WOULD EVER BE ABLE TO COME TO MEMPHIS. A BASIC HEALTHCARE INFRASTRUCTURE IS NEEDED TO SUPPORT PEDIATRIC ONCOLOGY PROGRAMS, WHICH IN TURN FURTHER IMPROVES THE DEVELOPMENT OF BASIC HEALTHCARE. AT THE LOCAL LEVEL, GPM DEVELOPS PARTNERSHIPS WITH MEDICAL INSTITUTIONS AND FUND-RAISING ORGANIZATIONS AND FACILITATES THE INVOLVEMENT OF OTHER AND GOVERNMENT ORGANIZATIONS TO SUPPORT KEY PROGRAMS AND THE EDUCATION OF LOCAL PERSONNEL. AT THE REGIONAL LEVEL, GPM DEVELOPS PROGRAMS THROUGH THE USE OF TECHNOLOGY AND FOSTERS REGIONAL AND INTERNATIONAL COLLABORATIONS WITH OTHER PEDIATRIC MEDICAL INSTITUTIONS. THE PRIMARY GOAL IS TO DEVELOP LOCAL AND REGIONAL SELF-SUFFICIENCY. THIS MODEL RESULTS IN SIGNIFICANT OVERALL IMPROVEMENT IN HEALTHCARE FACILITIES, THE LEVEL OF PRACTICE, THE CONFIDENCE OF HEALTHCARE PROVIDERS, AND LOCAL COMMUNITY INVOLVEMENT. ST. JUDE EMPHASIZES THE BUILDING OF REGIONAL EXPERTISE AND DIAGNOSTIC CAPABILITIES, WHICH PROVIDE A CRITICAL MASS OF PROFESSIONALS WHO CONTINUALLY LEARN FROM AND ASSIST EACH OTHER. COST EFFICIENCY IS ALSO REALIZED BECAUSE OF SHARED RESOURCES.ST. JUDE HAS PARTNERSHIPS WITH 28 MEDICAL INSTITUTIONS ACROSS 17 DIFFERENT COUNTRIES - BRAZIL, CHILE, CHINA, COSTA RICA, DOMINICAN REPUBLIC, ECUADOR, EL SALVADOR, GUATEMALA, HAITI, HONDURAS, JORDAN, LEBANON, MEXICO, NICARAGUA, PHILIPPINES, URUGUAY AND VENEZUELA. ST. JUDE WORKS WITH ITS PARTNERS TO DEVELOP EVIDENCED-BASED TREATMENT PROTOCOLS TAILORED TO REGIONAL NEEDS AND RESOURCES. ADDITIONALLY, ST. JUDE PHYSICIANS AND NURSES SERVE AS MENTORS TO CLINICAL PERSONNEL AT PARTNER SITES, PROVIDE LOCAL AND ONLINE TRAINING FOR ONCOLOGY CARE, DIAGNOSIS, AND SUPPORTIVE CARE, AND PARTICIPATE IN ONLINE MEETINGS TO DISCUSS CLINICAL CARE BEST PRACTICES. THE MAJORITY OF ONLINE MEETINGS AND TRAINING ARE PROVIDED VIA ST. JUDE'S WEB-BASED PLATFORM, ST. JUDE CURE4KIDSTM (C4K), A FREE RESOURCE FOR PEDIATRIC ONCOLOGY PROFESSIONALS, SCIENTISTS AND RESEARCHERS, REGARDLESS OF THEIR AFFILIATION WITH ST. JUDE OR ITS PARTNERS. IN ADDITION TO CONTENT THAT INCLUDES MORE THAN 1,600 ONLINE SEMINARS, 18 SELF-PACED COURSES, AND 40 INSTRUCTOR-LED COURSES, C4K PROVIDES ONLINE MEETING AND CONFERENCE SPACE. IN FY18, C4K HAD 45,585 CONTENT VIEWS WITH 7,640 UNIQUE REGISTERED USERS, AND HOSTED 2,274 MEETINGS WITH 2,104 UNIQUE PARTICIPANTS FROM 150 DIFFERENT COUNTRIES; THERE ARE 64 NCI CENTERS THAT PARTICIPATE IN C4K. FINALLY, ST. JUDE PARTNERS WITH LOCAL FUNDRAISING ORGANIZATIONS THAT SUPPORT THE MEDICAL PROGRAMS. THIS MODEL HAS PROVEN TO BE HIGHLY EFFECTIVE IN PROVIDING POOR CHILDREN IN DEVELOPING COUNTRIES ACCESS TO MODERN TREATMENT AND CARE.ST. JUDE IS ALSO A RESEARCH ORGANIZATION, WITH RESEARCH COVERING A BROADER SCOPE OF HEALTH ISSUES THAN THE DISEASES TREATED AS A PRIMARY DIAGNOSIS. THE HOSPITAL'S OUTREACH INCLUDES THE LOCAL MARKET, AFFILIATE INSTITUTIONS, OTHER AREAS OF THE UNITED STATES/U.S. TERRITORIES, AND THE INTERNATIONAL COMMUNITY. THE LOCAL MARKET ENCOMPASSES MEMPHIS, TENNESSEE AND THE SURROUNDING GEOGRAPHIC AREA WITH APPROXIMATELY 25% OF NEW ONCOLOGY PATIENTS RESIDING WITHIN THIS AREA. FY18 NEW CANCER PATIENTSPATIENT ORIGIN % OF TOTALMEMPHIS, TN AND SURROUNDING AREA 25%AFFILIATE REFERRAL 39%NATIONAL REFERRAL (OTHER AREAS OF U.S.) 28%INTERNATIONAL REFERRAL 8%GRAND TOTAL 100%THE ST. JUDE AFFILIATE PROGRAM (AP) IS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE TO EXTEND CARE AND BENEFITS TO MORE CHILDREN AND INCREASE THE NUMBER OF CHILDREN ABLE TO BE TREATED ON ST. JUDE CLINICAL TRIALS CLOSER TO HOME. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF AT ST. JUDE TO DELIVER PROTOCOL RELATED CARE OR EVIDENCE BASED TREATMENT WHEN NOT PARTICIPATING IN A TRIAL TO PEDIATRIC HEMATOLOGY-ONCOLOGY PATIENTS, SO THAT PATIENTS CAN RECEIVE CARE CLOSER TO HOME. AFFILIATES ARE CURRENTLY LOCATED IN BATON ROUGE, LA, CHARLOTTE, NC, HUNTSVILLE, AL, JOHNSON CITY, TN, PEORIA, IL, SHREVEPORT, LA, SPRINGFIELD, MO, AND TULSA, OK. THE AFFILIATES' ENROLLMENT OF PATIENTS ON ST. JUDE CLINICAL TRIALS HELPS ST. JUDE FIND CURES FASTER AND SAVE MORE CHILDREN. (NOTE: THIS NARRATIVE FOR PART VI, LINE 4 IS CONTINUED BELOW.) - SEE PAGE 115/116
PART VI, LINE 5:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL WAS OPENED IN 1962. OUR MISSION IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER, DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S INABILITY TO PAY. OUR VISION IS TO BE THE WORLD LEADER IN ADVANCING THE TREATMENT AND PREVENTION OF CATASTROPHIC DISEASES IN CHILDREN. THIS VISION IS PURSUED BY PROVIDING OUTSTANDING PATIENT CARE; BY CONDUCTING BASIC, TRANSLATIONAL AND CLINICAL RESEARCH DESIGNED TO ELUCIDATE BIOLOGICAL MECHANISMS, UNDERSTAND DISEASE PATHOGENESIS, IMPROVE DIAGNOSIS, ENHANCE TREATMENT OUTCOME, PREVENT DISEASES AND MINIMIZE ADVERSE CONSEQUENCES OF TREATMENT; AND BY EDUCATING HEALTH CARE AND SCIENTIFIC RESEARCH PROFESSIONALS. THROUGH THESE EFFORTS, WE SEEK TO CURE AND ENHANCE THE QUALITY OF LIFE FOR AN INCREASING NUMBER OF CHILDREN WHO COME TO US FOR TREATMENT BY EXPANDING AND SHARING KNOWLEDGE TO ADVANCE TREATMENT OF CHILDREN WITH CATASTROPHIC DISEASES WORLDWIDE, WHILE DEVELOPING STRATEGIES TO PREVENT CATASTROPHIC DISEASES IN CHILDREN.ST. JUDE COMBINES LABORATORY AND CLINICAL RESEARCH TO ADVANCE THE CARE OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES. THE FOCUS IS ON PROVIDING OUTSTANDING PATIENT CARE RESULTS AND ON RESEARCH FINDINGS THAT TRANSLATE INTO IMPROVED PATIENT OUTCOMES. ST. JUDE HAS AN ACADEMIC FACULTY ENGAGED IN A BROAD SPECTRUM OF RESEARCH, INCLUDING THERAPEUTIC TRIALS, INVESTIGATION OF DISEASE PATHOGENESIS AND DISCOVERY-ORIENTED BASIC RESEARCH.HOSPITAL OPERATIONS ARE OVERSEEN BY A BOARD OF GOVERNORS, MOST OF WHICH ARE NEITHER EMPLOYEES, INDEPENDENT CONTRACTORS, OR THEIR FAMILY MEMBERS. RESEARCH ACTIVITIES ARE REVIEWED ANNUALLY BY A SCIENTIFIC ADVISORY BOARD COMPOSED OF INTERNATIONALLY PROMINENT PHYSICIANS AND SCIENTISTS.ST. JUDE CONTRIBUTED TO THE BUILDING OF A STATE-OF-THE ART NEUROSURGICAL FACILITY FOR TREATING LOCAL PEDIATRIC PATIENTS AND ST. JUDE BRAIN TUMOR PATIENTS. THE FACILITY IS EQUIPPED WITH INTRA-OPERATIVE IMAGING EQUIPMENT (IMRI). WHEN PURCHASED, ONLY TWO NEUROSURGICAL FACILITIES IN THE UNITED STATES PROVIDED PATIENTS WITH THIS LEVEL OF TREATMENT, WHICH ALLOWS IMAGING TO TAKE PLACE DURING SURGICAL PROCEDURES. IMRI EQUIPMENT ALLOWS SURGEONS TO MAKE INFORMED DECISIONS DURING THE SURGERY. LIVE WEB CASTS ALLOW OTHERS TO VIEW PROCEDURES. OUR ASSISTANCE WITH THIS FACILITY HELPS ASSURE THAT CHILDREN IN THE AREA HAVE ACCESS TO THE BEST NEUROSURGICAL TREATMENT AVAILABLE.ST. JUDE COMPLETED THE FIRST PHASE OF THE PEDIATRIC CANCER GENOME PROJECT (PCGP) IN JANUARY 2013 - A COLLABORATION WITH WASHINGTON UNIVERSITY TO FIND CLUES TO THE CAUSES OF CHILDHOOD CANCER AND POTENTIAL NEW TREATMENTS AND CURES. THE PROJECT HAS RESULTED IN GROUNDBREAKING DISCOVERIES IN A NUMBER OF CHILDHOOD CANCERS INCLUDING RETINOBLASTOMA, MEDULLOBLASTOMA, NEUROBLASTOMA, DIFFUSE INTRINSIC PONTINE GLIOMA, TWO AGGRESSIVE FORMS OF LEUKEMIA AND LOW-GRADE GLIOMAS. IN DECEMBER 2012, THE PCGP WAS RECOGNIZED AS ONE OF TIME MAGAZINE'S TOP 10 MEDICAL BREAKTHROUGHS AND, IN 2013, AS ONE OF TIME MAGAZINE'S TOP 100 NEW SCIENTIFIC DISCOVERIES. THE SECOND PHASE OF PCGP EXAMINED THE CANCER SAMPLES FROM 300 CHILDREN AND FOCUSED ON DEFINING MUTATIONS THAT CONTRIBUTE TO TUMOR FORMATION, CHARACTERIZING THE STATE OF THE CANCER CELL'S EPIGENOME AND DESCRIBING HOW IT DIFFERED FROM WHAT IS SEEN IN THE NORMAL CELLS. THE SECOND PHASE ALSO INCLUDED A CLINICAL GENOMICS PROJECT CALLED GENOMES FOR KIDS THAT INVOLVED NEXT-GENERATION SEQUENCING FOR CHILDREN WITH CANCER. WHEN PHASE 2 IS COMPLETE, ST. JUDE HOPES TO HAVE A MODEL FOR HOW TO EXTEND GENOME SEQUENCING TO EVERY CHILDHOOD CANCER PATIENT IN THE UNITED STATES. FROM ITS BEGINNINGS IN 2010, THE PCGP IS THE LARGEST, BROADEST, PRIVATELY FUNDED SEQUENCING PROJECT FOR CHILDREN WITH CANCER AND HAS SEQUENCED MORE THAN 800 MATCHED PAIRS OF TUMOR AND HEALTHY GENOMES FROM YOUNG PATIENTS. THE PCGP HAS PROVIDED NEW DETAILS ABOUT THE MUTATIONS THAT UNDERLIE THE DEVELOPMENT AND GROWTH OF A RANGE OF CHILDHOOD CANCERS, AND HAS LAID THE FOUNDATION FOR IMPROVED DIAGNOSTIC TESTING AND THE NEXT GENERATION OF MORE EFFECTIVE, LESS-TOXIC THERAPIES. THE PROJECT HAS LED TO NEW DIRECTIONS IN RESEARCH INVOLVING HIGH-RISK LEUKEMIA, BRAIN AND SOLID TUMORS AS WELL AS NEW COMPUTATIONAL METHODS THAT HAVE BEEN SHARED FOR FREE WITH THE GLOBAL SCIENTIFIC COMMUNITY.THE CYCLOTRON (PARTICLE ACCELERATOR) AT ST. JUDE ENABLES RESEARCHERS TO TRACK THE GROWTH OF CANCER CELLS, PINPOINT THE PRODUCTION OF NEW DNA BY TUMOR CELLS AND STUDY THE HEARTS OF ADULT CHILDHOOD CANCER SURVIVORS RETURNING TO ST. JUDE FOR LIFETIME FOLLOW-UP. THE CYCLOTRON HELPS RESEARCHERS BETTER UNDERSTAND CHILDHOOD CANCER BY ENABLING THEM TO PRODUCE NEW, VERY SHORT-ACTING TRACERS.ST. JUDE USES THE SERVICES OF CHILDREN'S GMP, LLC (OF WHICH ST. JUDE IS THE SOLE MEMBER). CHILDREN'S GMP, LLC, MANAGES AND OPERATES A GOOD MANUFACTURING PRACTICE (GMP) FACILITY THAT ENGAGES IN THE PRODUCTION OF BIOLOGICS AND DRUGS FOR RESEARCH. THE GMP OFFERS RESOURCES TO STUDY RARE DISEASES OVERLOOKED BY PHARMACEUTICAL COMPANIES BECAUSE THERE IS LITTLE PROFIT IN MANUFACTURING DRUGS FOR LESSER-KNOWN DISEASES. THE FACILITY, OPERATING ACCORDING TO APPROVED FDA STANDARDS, ALLOWS DOCTORS TO TAILOR TREATMENTS SPECIFICALLY FOR AN INDIVIDUAL CHILD.THE CELL AND TISSUE IMAGING CENTER INCLUDES ELECTRON MICROSCOPY AND LIGHT MICROSCOPY. THE FACILITY PROVIDES INVESTIGATORS ACCESS TO TRANSMISSION ELECTRON MICROSCOPY, CONFOCAL LASER SCANNING MICROSCOPY, MULTIPHOTON MICROSCOPY, IMAGE ANALYSIS, CELL MICROINJECTION AND LIVE CELL IMAGING. THE FEI TECNAI 20 200KV FEG ELECTRON MICROSCOPE, WHICH CAN MAGNIFY AN OBJECT 700,000 TIMES, IS AT THE HEART OF THIS PROGRAM. THIS TECHNOLOGY ALLOWS RESEARCHERS TO GET A CLOSER LOOK AT CANCER TO BETTER UNDERSTAND HOW IT GROWS AND SPREADS AND RESPONDS TO THERAPY. USING THE ELECTRON MICROSCOPE, RESEARCHERS LEARN HOW CANCER CELLS BREAK AWAY FROM THE TUMOR AND SPREAD THROUGHOUT THE BODY.ST. JUDE IS HOME TO THE ONLY PROTON BEAM RADIATION THERAPY CENTER DEVOTED SOLELY TO TREATING CHILDREN WITH BRAIN TUMORS AND SEVERAL OTHER CHILDHOOD CANCERS. PROTON THERAPY IS LESS DAMAGING TO SURROUNDING HEALTHY TISSUE THAN OTHER CURRENT RADIATION THERAPIES. THIS EQUIPMENT ENABLES ST. JUDE TO PROVIDE THIS THERAPY IN A MORE INTEGRATED MANNER TO OUTPATIENTS AND ALLOW OUR RADIATION ONCOLOGISTS TO LEAD THE DEVELOPMENT OF NEW TREATMENTS WITH PROTONS. TO FURTHER PALLIATIVE SERVICES IN THE COMMUNITY, ST. JUDE PARTICIPATED WITH LE BONHEUR CHILDREN'S HOSPITAL IN DEVELOPING THE QUALITY OF LIFE FOR ALL KIDS PALLIATIVE PROGRAM FOR SERIOUSLY ILL CHILDREN. HOSPICE STAFF, BOTH IN THE HOME AND IN THE HOSPICE RESIDENCE, PROVIDES INTERDISCIPLINARY CARE TO CHILDREN THROUGHOUT THE ILLNESS TRAJECTORY AND CONCURRENT THERAPIES.ST. JUDE ADMINISTRATIVE LEADERS AND FACULTY MEMBERS OF THE DEPARTMENT OF PHARMACEUTICAL SCIENCES HAVE BEEN AT THE FOREFRONT OF BRINGING NATIONAL ATTENTION TO THE PEDIATRIC CANCER DRUG SHORTAGE TOPIC, ACTIVELY ENGAGING REGULATORY AND LEGISLATIVE BODIES TO UNDERSTAND THE IMPACT THESE DRUG SHORTAGES HAVE ON PEDIATRIC CARE AND RESEARCH. PRESENTATIONS OR WRITTEN TESTIMONY HAVE BEEN PROVIDED TO THE FDA CENTER FOR DRUG EVALUATION AND RESEARCH WORKSHOP, TWO SENATE HEARINGS, AND HEALTH SUBCOMMITTEE OF THE HOUSE COMMITTEE ON ENERGY AND COMMERCE. ST. JUDE FOCUSES ON EDUCATING AND TRAINING THE NEXT GENERATION OF DOCTORS, NURSES, RESEARCHERS AND ACADEMIC LEADERS. FROM PROGRAMS FOR HIGH SCHOOL STUDENTS TO THE POSTDOCTORAL LEVEL, THE HOSPITAL PLAYS A MAJOR ROLE IN PREPARING FUTURE LEADERS OF SCIENCE AND MEDICINE. IN ADDITION TO ONSITE EDUCATION, THE ST. JUDE GLOBAL PROVIDES AN EDUCATION AND COLLABORATION WEB SITE, CURE4KIDS(TM) (WWW.CURE4KIDS.ORG). VIA THE CONNECT2PROTECT PROGRAM, ST. JUDE COLLABORATES WITH CHURCHES, OTHER HEALTH CARE ORGANIZATIONS AND CIVIC GROUPS TO RAISE AWARENESS ABOUT PREVENTING THE SPREAD OF HIV/AIDS. THE PRIMARY TARGET IS THE AFRICAN-AMERICAN COMMUNITY, ALTHOUGH OTHER ETHNIC GROUPS ARE ALSO SERVED INCLUDING ASIAN, CAUCASIAN AND HISPANIC.THE FUNDRAISING SOURCE FOR ST. JUDE IS ALSAC, WHICH RAISES FUNDS SOLELY FOR THE HOSPITAL. BECAUSE OF THE HOSPITAL'S MISSION, PEOPLE NATIONWIDE CONTRIBUTE VIA TENS OF THOUSANDS OF FUNDRAISING EFFORTS. ALSAC CONTRIBUTED $755 MILLION IN FY18 TO SUPPORT ST. JUDE.VOLUNTEERS ENHANCE THE QUALITY OF PATIENT CARE BY PARTNERING WITH CLINICAL STAFF TO PROVIDE AN ADDITIONAL PERSONAL TOUCH. VOLUNTEERS ALSO HELP ENSURE A SAFE ENVIRONMENT. THEY LEND ASSISTANCE AND PROVIDE COMPASSIONATE CONCERN BY OFFERING A LISTENING EAR TO FAMILIES AT A TIME WHEN THEY NEED IT MOST. THEY ARE VITAL AMBASSADORS FOR THE HOSPITAL AND COMMUNITY.
PART VI, LINE 2 (CONTINUATION FROM 98/116):	HEMATOLOGYTHE GEOGRAPHIC CATCHMENT AREA FOR ST. JUDE ENCOMPASSES 21 COUNTIES IN WESTERN TENNESSEE INCLUDING MEMPHIS, AND AREAS IN EAST ARKANSAS, NORTH MISSISSIPPI, AND A FEW COUNTIES IN MISSOURI. MORE THAN 70,000 PEOPLE IN THE UNITED STATES HAVE SICKLE CELL DISEASE (SCD), AND IT IS ESTIMATED THAT MORE THAN 1 MILLION PEOPLE WORLDWIDE SUFFER FROM THE DISEASE. IT IS THE MOST FREQUENT GENETIC BLOOD DISORDER IN THE WORLD. ST. JUDE HAS ONE OF THE LARGEST PEDIATRIC SCD PROGRAMS IN THE COUNTRY AND PROVIDES COMPREHENSIVE TREATMENT AND EDUCATION TO ABOUT 900 CHILDREN WITH SCD IN THE GEOGRAPHIC CATCHMENT AREA. SCD IS DIAGNOSED BY STATE-WIDE NEWBORN SCREENING IN ALL 50 STATES. ST. JUDE HAS A PARTNERSHIP WITH NEWBORN SCREENING PROGRAMS IN TN AND MS THAT ENSURES A STABLE RELATIONSHIP AMONG PARENTS, PATIENTS, PRIMARY CARE PROVIDERS. ABOUT 50 NEWBORNS WITH SCD ARE IDENTIFIED EACH YEAR IN OUR GEOGRAPHIC CATCHMENT AREA. OUR SCD INFANT TODDLER PROGRAM CONTACTS AND ACCEPTS ALL CHILDREN DIAGNOSED WITH THE DISEASE TO ITS COMPREHENSIVE CARE SERVICE. ADDITIONALLY, ST. JUDE PROVIDES TRAIT COUNSELING SERVICE TO INFANTS BORN WITH SICKLE CELL TRAIT TO 21 COUNTIES IN WESTERN TN. ST. JUDE PROVIDES CONFIRMATORY TESTING, EDUCATION AND COMPREHENSIVE CARE AND FOLLOW-UP THROUGHOUT CHILDHOOD FOR CHILDREN WITH SCD DISEASE. FROM BIRTH TO AGE 18 YEARS, PATIENTS ARE CLINICALLY EVALUATED AT LEAST EVERY 6 MONTHS, RECEIVE EDUCATION AND MULTI-DISCIPLINARY SERVICES ACCORDING TO STANDARDIZED TREATMENT AND EDUCATION GUIDELINES. SERVICES ALSO INCLUDE COMMUNITY OUTREACH AND EDUCATION OF THE LOCAL COMMUNITY. ST. JUDE HAS ESTABLISHED A FORMAL TRANSITION PROGRAM TO ADULT CARE FOR PATIENTS WITH SCD AND PROVIDES SUPPORT TO PATIENTS AND FAMILIES THROUGHOUT THE TRANSITION PROCESS BY WORKING CLOSELY WITH THE ADULT SCD PROGRAMS AT METHODIST UNIVERSITY HOSPITAL AND REGIONAL ONE HOSPITAL. IN THE PAST, THE SCD PROGRAM AT ST. JUDE HAS COLLABORATED WITH SEVERAL FEDERALLY QUALIFIED HEALTH CARE CENTERS, WITH COMMUNITY PRIMARY CARE PHYSICIANS, LATINO MEMPHIS (THE LARGEST HISPANIC SOCIAL AGENCY IN TENNESSEE), WITH THE SICKLE CELL FOUNDATION OF TENNESSEE (A COMMUNITY-BASED SCD ORGANIZATION), AND WITH REGIONAL SCD PROVIDERS TO ENSURE A MEDICAL HOME AND ADEQUATE SOCIAL SUPPORT FOR ALL SCD PATIENTS IN THE AREA. ST. JUDE ASSESSES PATIENT NEEDS THROUGH PARENT AND PATIENT SURVEYS, INTERACTIVE EDUCATION, MATERIALS REVIEW, AND THROUGH GROUP DISCUSSIONS WITH PARENTS AND PATIENTS.ST. JUDE ALSO PROVIDES CLINICAL SERVICES FOR APPROXIMATELY 800 CHILDREN PER YEAR WITH OTHER NON-MALIGNANT HEMATOLOGICAL DISORDERS THROUGH A STRONG RELATIONSHIP WITH LOCAL COMMUNITY PHYSICIANS. CHILDREN FROM THE GEOGRAPHIC CATCHMENT AREA OF ST. JUDE (AS OUTLINED ABOVE) WITH ILLNESSES SUCH AS HEMOPHILIA, APLASTIC ANEMIA, THROMBOSIS, THALASSEMIA, SPHEROCYTOSIS, AND IMMUNE THROMBOCYTOPENIC PURPURA AND OTHER NON-MALIGNANT HEMATOLOGIC DISORDERS ARE REFERRED TO AND RECEIVE STATE-OF THE-ART CARE FROM ST. JUDE PHYSICIANS AND MEDICAL STAFF. ST. JUDE IS ONE OF A SELECT GROUP OF FEDERALLY RECOGNIZED PEDIATRIC HEMOPHILIA TREATMENT CENTERS AND PROVIDES STATE-OF-THE-ART COMPREHENSIVE CARE TO APPROXIMATELY 300 CHILDREN WITH BLEEDING AND THROMBOSIS DISORDERS.IN ADDITION TO PROVIDING AND CONTINUOUSLY IMPROVING STANDARDIZED CARE TO THESE PATIENT POPULATIONS, ST. JUDE HEMATOLOGY DEDICATES A SIGNIFICANT AMOUNT OF RESOURCES TO CLINICAL, TRANSLATIONAL, AND BASIC RESEARCH TO IMPROVE SURVIVAL AND DECREASE MORBIDITY OF CHILDREN WITH NON-MALIGNANT CHRONIC BLOOD DISEASES. MOST PATIENTS PARTICIPATE IN RESEARCH STUDIES, WHICH HAVE RESULTED IN MAJOR IMPROVEMENTS IN CLINICAL CARE. FOR EXAMPLE, RECENT RESULTS FROM THE BABY HUG TRIAL SHOWED THAT DAILY ORAL HYDROXYUREA IS SAFE AND EFFECTIVE FOR INFANTS AND YOUNG CHILDREN WITH SCD, WHICH LED TO THE RECOMMENDATION OF ITS GENERAL USE IN THIS SUBPOPULATION. ALSO, IN A FIRST-IN-MAN TRIAL, ST. JUDE HEMATOLOGY SHOWED THE SAFETY AND EFFICACY OF A NOVEL GENE TRANSFER AGENT CARRYING THE FACTOR IX GENE FOR TREATMENT OF HEMOPHILIA B; ALL TEN ADULT PARTICIPANTS WITH SEVERE HEMOPHILIA B HAD NO SERIOUS UNEXPECTED SIDE EFFECTS AND ALL PARTICIPANTS SHOWED AN INCREASE IN FACTOR IX LEVELS LEADING TO A SUBSTANTIAL REDUCTION IN THEIR BLEEDING TENDENCY. ADDITIONALLY, ST. JUDE HAS DEVELOPED A VECTOR FOR GENE TRANSFER TO TREAT CHILDREN WITH X LINKED SEVERE COMBINED IMMUNODEFICIENCY (X LINKED SCID) DISEASE WHICH HAS SHOWN PROMISE AS A CURE FOR THE DISEASE. FUTURE EFFORTS WILL CONTINUE TO FOCUS ON FINDING VIABLE CURES AND/OR TREATMENTS TO PREVENT COMPLICATIONS IN CHILDREN WITH SCD AND OTHER NON-MALIGNANT, CHRONIC HEMATOLOGIC DISEASES.HIVIN 1987, ST. JUDE'S FOUNDING FATHER, DANNY THOMAS DECLARED AIDS A CATASTROPHIC ILLNESS. IT WAS THEN THAT THE COMPREHENSIVE HIV CARE AND PREVENTION PROGRAM FOR CHILDREN AND YOUTH WAS ESTABLISHED. THE PROGRAM, LOCATED IN THE MEMPHIS METROPOLITAN STATISTICAL AREA, IS IN A COMMUNITY WHERE DESPITE ADVANCES IN TREATMENT, AVAILABILITY OF RAPID HIV TESTING, AND THE INCREASE IN EVIDENCE-BASED PREVENTION INTERVENTIONS, NEW INFECTION RATES REMAIN HIGH FOR MINORITIES, MALES (79%), AND YOUNG ADULTS AGES 15-34 (63%). SINCE ITS BEGINNING, THE HIV CLINICAL AND RESEARCH PROGRAM HAS PROVIDED EXCEPTIONAL CARE TO PERINATALLY-INFECTED INFANTS AND CHILDREN AND AN EXCELLENT YOUTH-FOCUSED HIV PROGRAM FOR YOUTH AGES 13 TO 21. THE SERVICES INCLUDE A STANDALONE LABORATORY THAT SUPPORTS THE HIV/AIDS CLINICAL & RESEARCH PROGRAMS, COMPREHENSIVE MEDICAL CARE, CASE MANAGEMENT SERVICES, A FULL PHARMACY, PATIENT ADVOCACY, PSYCHOSOCIAL, AND SPIRITUAL SUPPORT FOR PATIENTS AND THEIR FAMILIES. OUR STRONG COMMUNITY INFRASTRUCTURE, FORMALLY ESTABLISHED 12 YEARS AGO, IS COMMITTED TO THE CAUSE OF HIV EDUCATION AND PREVENTION IN THE COMMUNITY. OUR COMMUNITY COALITION, CONNECT TO PROTECT (C2P), CONTINUES TO HAVE 23 CONSISTENT AND ACTIVE MEMBERS THAT REPRESENT AIDS SERVICE ORGANIZATIONS, LOCAL GOVERNMENT, FAITH-BASED AND SOCIAL SERVICE ORGANIZATIONS. QUARTERLY, THE COALITION MEMBERS CONTINUE TO IDENTIFY AT-RISK YOUTH AND CREATE A PROFILE OF AVAILABLE COMMUNITY RESOURCES BASED ON ELIMINATING BARRIERS TO BEING LINKED TO AND RETAINED IN CARE. IN ADDITION TO DEVELOPING A SOLID HIV PREVENTION PLAN, COALITION MEMBERS, ALONGSIDE OUR CLINICAL RESEARCH STAFF, HAVE CO-FACILITATED AND/OR PARTICIPATED IN APPROXIMATELY 95 OUTREACH EVENTS, TRAININGS, AND SPEAKING ENGAGEMENTS REACHING ABOUT 2,688 PEOPLE FOR THE YEAR OF 2018.WORKING TO ALIGN THE STRATEGIC PLAN WITH THE HIV CONTINUUM OF CARE THAT SPECIFICALLY ADDRESSES YOUTH BARRIERS TO TESTING, SURVEILLANCE REPORTING AND LINKAGE OF NEWLY DIAGNOSED HIV+ YOUTH TO MEDICAL CARE IN RESOURCE POOR COMMUNITIES HAS BEEN A STRONG ASSET TO OUR COMMUNITY INFRASTRUCTURE. FOR THIS CALENDAR YEAR, OUR STRATEGIC MULTISITE INITIATIVE FOR LINKAGE AND ENGAGEMENT (SMILE) INTO CARE EFFORTS RESULTED IN APPROXIMATELY 71% (88/124) OF NEWLY DIAGNOSED HIV+ YOUTH BEING ENGAGED IN MEDICAL CARE AND 92% (81/88) OF THEM BEING RETAINED IN CARE. THIS SUCCESS SPEAKS TO STRATEGIC COMMUNITY MOBILIZATION, PARTNER AGENCY PARTICIPATION AND IMPROVED ACCESS TO CARE FOR NEWLY DIAGNOSED HIV POSITIVE YOUTH. PARTICIPANTS IN THE SMILE PROGRAM RECEIVE ASSISTANCE WITH LINKAGE AND ENGAGEMENT IN CARE SERVICES, SPECIALIZED CASE MANAGEMENT, CRISIS INTERVENTION, AND INDIVIDUALIZED COMMUNITY SERVICE AND RESOURCE REFERRALS AS INDIVIDUAL BARRIERS ARE IDENTIFIED. THE SMILE PROGRAM DATA HAS BEEN USED TO FACILITATE CONTINUED DIALOGUE WITHIN THE C2P COALITION. THE INTEGRATION OF BOTH PROGRAMS HAS ENCOURAGED THE COALITION TO PRIORITIZE ALIGNMENT OF THE STRATEGIC PLAN WITH THE HIV CARE CONTINUUM THEREBY IMPROVING ENGAGEMENT AND RETENTION IN CARE OUTCOMES FOR INDIVIDUALS THAT PARTICIPATE IN THE SMILE PROGRAM.OUR COMMUNITY BASED PREVENTATIVE RESEARCH PROTOCOL, HIV PREVENTION TRIALS NETWORK (HPTN) 083, IMPLORES A COMMUNITY BASED PARTICIPATORY RESEARCH (CBPR) APPROACH TO HELP REACH ELIGIBLE AT-RISK YOUTH AND YOUNG ADULTS. WE RECEIVED BUY-IN AND SUPPORT FROM VARIOUS STAKEHOLDERS BY HOSTING COMMUNITY BASED HIV TESTING EVENTS THAT OFFER LINKAGE INTO CARE FOR NEWLY DIAGNOSED HIV+ YOUTH AND LINK TO PRE-EXPOSURE PROPHYLAXIS (PREP) FOR THOSE WHO PRESENT HIV NEGATIVE. THIS PAST YEAR, THE HIV PREVENTION TEAM, SUCCESSFULLY LED 25 STAKEHOLDER/GATEKEEPER MEETINGS THAT FOCUSED ON PLANNING AND COORDINATING SPECIFIC OUTREACH AND EDUCATIONAL STRATEGIES. THIS YIELDED EIGHT (6 SMALL AND 2 LARGE SCALE EVENTS (E.G., TRANS AWARENESS PANEL DISCUSSION AND GALA, MINI BALL EVENTS, A KARAOKE DAY PARTY, AND A COMMUNITY KICKBALL GAME) THAT REACHED OVER 599 YOUTH AND YOUNG ADULTS. AS A RESULT, THERE HAVE BEEN APPROXIMATELY 75 INDIVIDUALS APPROACHED AS ELIGIBLE STUDY PARTICIPANTS AND APPROXIMATELY 45 ENROLLED THIS CALENDAR YEAR. THIS BRINGS OUR TOTAL NUMBER OF HPTN STUDY PARTICIPANTS TO 86.
LASTLY, WE HAVE STARTED A RETENTION IN CARE PROGRAM THAT WORKS	SIMULTANEOUSLY WITH THE SOCIAL WORK TEAM TO FORMULATE A CARE PLAN IN PREPARATION FOR TRANSITIONING PATIENTS FROM ADOLESCENT CARE TO ADULT CARE. THE PRIMARY NURSE PRACTITIONER, ASSIGNED SOCIAL WORKER, AND RETENTION IN CARE COORDINATOR REVIEW BEHAVIORS, BARRIERS, AND AREAS IN NEED OF SPECIAL ATTENTION TO HELP PROMOTE AND ENCOURAGE SUCCESSFUL TRANSITION. THIS CALENDAR YEAR, THE COORDINATOR ASSISTED WITH AND IS CURRENTLY FOLLOWING APPROXIMATELY 32 PATIENTS WITH TRANSITION AND CURRENTLY WORKS WITH 120 PATIENTS TO SUCCESSFULLY ASSURE THEY ARE RETAINED IN MEDICAL CARE. 1. AMERICAN CANCER SOCIETY. CANCER FACTS & FIGURES 2018. ATLANTA: AMERICAN CANCER SOCIETY; 2018.2. LIU ET AL. J CLIN ONCOL 34(14):1634-43, 2016.3. BHATIA ET AL. CANCER 122(15):2426-2439, 2016.4. HOW MANY CANCERS ARE LINKED WITH HPV EACH YEAR? CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/CASES.HTM.5. TEENVAXVIEW: 2017 ADOLESCENT HUMAN PAPILLOMAVIRUS (HPV) VACCINATION COVERAGE REPORT. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/VACCINES/IMZ-MANAGERS/COVERAGE/TEENVAXVIEW/DATA-REPORTS/HPV/DASHBOARD/2017.HTML.6. HPV-ASSOCIATED CANCER RATES BY STATE. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/STATE/INDEX.HTM.
PART VI, LINE 4 (CONTINUATION FROM 104/116):	ST. JUDE PROVIDES FINANCIAL SUPPORT FOR CLINICAL OPERATIONS TO ENSURE EXCELLENT QUALITY OF CARE THAT MEETS ST. JUDE PROTOCOL GUIDELINES AND TO PROVIDE PATIENT ASSISTANCE. THE AP AND OTHER STAFF ASSIST THE AFFILIATES IN THE DEVELOPMENT OF NEW PEDIATRIC HEMATOLOGY-ONCOLOGY PROGRAMS; PROVIDE MONITORING AND CONSULTATION TO IMPROVE PATIENT CARE AND CLINICAL PROCESSES FOR THE AFFILIATE CLINIC AND CHILDREN'S HOSPITAL; AND PROVIDE NUMEROUS EDUCATIONAL OFFERINGS AND MENTORING FOR AFFILIATE STAFF. IN ADDITION, ST. JUDE HAS MANY PROCESSES TO ENSURE GOOD CONTINUITY OF CARE BETWEEN THE AFFILIATES AND ST. JUDE. THE AFFILIATES' CLINICAL RECORDS FOR SHARED PATIENTS ARE AVAILABLE IN ST. JUDE MEDICAL RECORDS AND EVERY AFFILIATE HAS ACCESS TO ST. JUDE ELECTRONIC MEDICAL RECORDS OF SHARED PATIENTS. THE AFFILIATES ALSO HAVE ACCESS TO ALL ELECTRONIC RESOURCES, E.G. PATIENT EDUCATION MATERIALS, RESEARCH PROTOCOLS, CLINICAL GUIDELINES AND RESOURCES; EVERYTHING ON THE ST. JUDE INTRANET. IN ADDITION TO ASSISTING THE AFFILIATES, ST. JUDE PROVIDES CONSULTATION SERVICES FOR MORE THAN 3,000 NATIONAL AND 900 INTERNATIONAL PHYSICIAN REQUESTS. FOR FY18 PATIENT CONSULTATIONS BY CONTINENT TOTALED 3,937 AS FOLLOWS:CONTINENT NUMBER OF PATIENT CONSULTATIONSNORTH AMERICA (INCL. CENTRALAMERICA AND CARIBBEAN) 3,234SOUTH AMERICA 134EUROPE 153AFRICA 29ASIA 320AUSTRALIA 55 UNKNOWN LOCATION 12TOTAL 3,937

Schedule H (Form 990) 2019

Additional Data

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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," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number
62-0646012

Part I

General Information on Grants and Assistance

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? ........................

Yes No

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 Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on 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 section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) UNIVERSITY OF TENNESSEE 50 NORTH DUNLAP MEMPHIS,TN38105	62-6001636	GOVERNMENT ENTITY	1,144,497	COLLABORATION AND SUPPORT AGREEMENT
(2) SAINT FRANCIS MEDICAL CENTER 530 NE GLEN OAK AVE PEORIA,IL61637	37-0662569	501(C)(3)	490,909	OPERATION OF ST. JUDE CLINIC
(3) CHURCH HEALTH CENTER OF MEMPHIS 1350 CONCOURSE AVE SUITE 142 MEMPHIS,TN38104	58-1716113	501(C)(3)	100,000	FINANCIAL SUPPORT
(4) NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS 600 13TH STREET NW SUITE 500 WASHINGTON,DC20005	58-2176067	501(C)(6)	7,800	CONTRIBUTION
(5) OUR LADY OF THE LAKE REGIONAL MEDICAL CENTER 777 HENNESY BLVD BATON ROUGE,LA70808	72-0423651	501(C)(3)	2,000,000	FINANCIAL SUPPORT
(6) GORDON RESEARCH CONFERENCES 512 LIBERTY LANE WEST KINGSTON,RI028921502	26-0150662	501(C)(3)	6,000	INTRINSICALLY DISORDERED PROTEINS AND DNA TOPOISOMERASES IN BIOLOGY AND MEDICINE CONFERENCES
(7) UNIVERSITY HEALTH SHREVEPORT 1505 KINGS HIGHWAY SHREVEPORT,LA71103	80-0944985	501(C)(3)	517,464	COLLABORATION AND SUPPORT AGREEMENT
(8) BELMONT UNIVERSITY 1900 BELMONT BLVD NASHVILLE,TN37212	62-0465076	501(C)(3)	8,950	TN HEALTH CARE HALL OF FAME CONFERENCE
(9) CENTER FOR MEDICAL TECHNOLOGY POLICY 401 E PRATT STREET SUITE 631 BALTIMORE,MD21202	27-1203017	501(C)(3)	10,000	FINANCIAL SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

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) 2019

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on 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 noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

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
PART I, LINE 2:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS ACTIVELY INVOLVED WITH THE DONEE. THROUGH THIS ACTIVE INVOLVEMENT, THE ORGANIZATIONS ARE MONITORED TO ENSURE THE SUPPORT IS USED APPROPRIATELY.

Schedule I (Form 990) 2019

Additional Data

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on 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 .........

Yes

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 on Line 1a? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on 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 ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2019

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 on 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 in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1RICHARD SHADYAC JR EX-OFFICIO DIRECTOR	(i) (ii)	0 ------------- 790,468	0 ------------- 0	0 ------------- 3,564	0 ------------- 80,445	0 ------------- 19,112	0 ------------- 893,589	0 ------------- 0
2JAMES R DOWNING PRESIDENT/CEO	(i) (ii)	978,811 ------------- 0	150 ------------- 0	79,487 ------------- 0	119,700 ------------- 0	24,800 ------------- 0	1,202,948 ------------- 0	0 ------------- 0
3PATRICIA A KEEL SVP/CFO	(i) (ii)	564,121 ------------- 0	50,350 ------------- 0	18,686 ------------- 0	57,658 ------------- 0	27,299 ------------- 0	718,114 ------------- 0	0 ------------- 0
4JAMES I MORGAN EVP/SCIENTIFIC DIRECTOR	(i) (ii)	531,766 ------------- 0	150 ------------- 0	8,931 ------------- 0	29,700 ------------- 0	27,300 ------------- 0	597,847 ------------- 0	0 ------------- 0
5ELLIS NEUFELD EVP/CLINICAL DIRECTOR	(i) (ii)	582,932 ------------- 0	190,150 ------------- 0	38,410 ------------- 0	89,583 ------------- 0	28,416 ------------- 0	929,491 ------------- 0	0 ------------- 0
6MARY ANNA QUINN EVP/CHIEF ADMIN OFFICER	(i) (ii)	436,558 ------------- 0	150 ------------- 0	8,931 ------------- 0	375,000 ------------- 0	24,741 ------------- 0	845,380 ------------- 0	0 ------------- 0
7CHARLES M ROBERTS EVP/DIRECTOR CANCER CENTER	(i) (ii)	736,703 ------------- 0	150 ------------- 0	43,770 ------------- 0	141,100 ------------- 0	22,841 ------------- 0	944,564 ------------- 0	0 ------------- 0
8CARLOS RODRIGUEZ-GALINDO EVP/CHAIR	(i) (ii)	598,887 ------------- 0	150 ------------- 0	3,622 ------------- 0	134,700 ------------- 0	11,498 ------------- 0	748,857 ------------- 0	0 ------------- 0
9ANDREW DAVIDOFF CHAIR	(i) (ii)	713,319 ------------- 0	17,850 ------------- 0	572,953 ------------- 0	29,700 ------------- 0	31,857 ------------- 0	1,365,679 ------------- 0	189,272 ------------- 0
10CHARALAMPOS KALODIMOS CHAIR	(i) (ii)	281,458 ------------- 0	540,150 ------------- 0	41,361 ------------- 0	2,167 ------------- 0	18,869 ------------- 0	884,005 ------------- 0	0 ------------- 0
11THOMAS E MERCHANT CHAIR	(i) (ii)	734,883 ------------- 0	17,850 ------------- 0	69,590 ------------- 0	29,700 ------------- 0	37,916 ------------- 0	889,939 ------------- 0	0 ------------- 0
12RAUL C RIBEIRO FACULTY	(i) (ii)	382,851 ------------- 0	17,850 ------------- 0	573,887 ------------- 0	29,700 ------------- 0	12,361 ------------- 0	1,016,649 ------------- 0	0 ------------- 0
13STEPHEN W WHITE CHAIR	(i) (ii)	360,041 ------------- 0	27,850 ------------- 0	421,155 ------------- 0	29,700 ------------- 0	73,915 ------------- 0	912,661 ------------- 0	0 ------------- 0
14WILLIAM E EVANS FACULTY/FORMER PRESIDENT/CEO	(i) (ii)	654,652 ------------- 0	17,850 ------------- 0	8,790 ------------- 0	29,700 ------------- 0	11,498 ------------- 0	722,490 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2019

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
PART I, LINE 1A	FIRST-CLASS TRAVEL: ONE FORMER OFFICER PURCHASED ONE FIRST CLASS TICKET, THE ECONOMY PORTION WAS REIMBURSED BY THE HOST AND ONLY THE UPGRADE PORTION OF $598.67 WAS PAID WITH ST. JUDE FUNDS. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND NOT RECORDED AS COMPENSATION. TRAVEL FOR COMPANIONS: FAMILY MEMBER OF ONE FORMER OFFICER, TRAVELS ON HOSPITAL BUSINESS AS REQUIRED BY THE POSITION. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND NOT RECORDED AS COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: A PAYMENT WAS ISSUED FOR DEPENDENT TUITION FOR TWO OFFICERS. THE APPLICABLE EXPENSE WAS GROSSED-UP AND INCLUDED IN THE EMPLOYEE'S W-2 AS ADDITIONAL TAXABLE COMPENSATION.
PART I, LINE 4B	THE ORGANIZATION ESTABLISHED A NON-QUALIFIED DEFERRED COMPENSATION PLAN PURSUANT TO CODE SECTION 457(F) OF THE INTERNAL REVENUE CODE. THE PLAN AMOUNTS ARE SUBJECT TO SUBSTANTIAL FUTURE SERVICE REQUIREMENTS TO THE ORGANIZATION AND ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. PAYMENTS WERE MADE TO THE FOLLOWING LISTED PERSONS IN PART VII UNDER THE NON-QUALIFIED DEFERRED COMPENSATION PLAN DURING THE YEAR: RAUL C. RIBEIRO - $565,425 STEPHEN W. WHITE - $412,456
SCHEDULE J, PART II:	RICHARD C. SHADYAC, JR. SERVES AS AN EX-OFFICIO VOTING DIRECTOR OF THE BOARD OF ST. JUDE. MR. SHADYAC IS EMPLOYED AS AN OFFICER OF ALSAC, A RELATED ORGANIZATION TO ST. JUDE. THE COMPENSATION SHOWN IN COLUMNS (B), (C), (D) AND (E) WAS PAID TO MR. SHADYAC BY ALSAC FOR HIS DUTIES AS CEO OF ALSAC.

Schedule J (Form 990) 2019

Additional Data

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) 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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting 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) 2019

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) MARY RELLING	SEE PART V	528,041	EMPLOYMENT		No
(2) SUSANNA DOWNING	SEE PART V	59,348	EMPLOYMENT		No
(3) DIANE ROBERTS	SEE PART V	212,895	EMPLOYMENT		No
(4) JEREMY QUINN	SEE PART V	73,845	EMPLOYMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference

Explanation

SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:

(A) NAME OF INTERESTED PERSON: MARY RELLING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF FORMER OFFICER (PRESIDENT AND CEO), WILLIAM E. EVANS.(C) AMOUNT OF TRANSACTION: $528,041(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO(A) NAME OF INTERESTED PERSON: SUSANNA DOWNING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF PRESIDENT AND CEO, JAMES R. DOWNING.(C) AMOUNT OF TRANSACTION: $59,348(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO(A) NAME OF INTERESTED PERSON: DIANE ROBERTS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, CHARLES M. ROBERTS.(C) AMOUNT OF TRANSACTION: $212,895(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO(A) NAME OF INTERESTED PERSON: JEREMY QUINN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, MARY ANNA QUINN.(C) AMOUNT OF TRANSACTION: $73,845(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO

Schedule L (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...	X	1	2,017,179	COST OR SELLING PRICE
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2019)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, COLUMN (B):	THE NUMBER IN COLUMN (B) REFERS TO THE NUMBER OF CONTRIBUTIONS.

Schedule M (Form 990) (2019)

Additional Data

Software ID:
Software Version:

- TIN:

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	FAMILY RELATIONSHIP AMONG DIRECTORS: JOSEPH S. AYOUB, JR., ESQ. AND PAUL J. AYOUB, ESQ.; GEORGE A. SIMON, II AND PAUL J. SIMON; ROBERT A. BREIT, MD AND JOSEPH G. SHAKER; JOSEPH C. SHAKER AND JOSEPH G. SHAKER; PAUL J. SIMON AND MICHAEL SIMON.
FORM 990, PART VI, SECTION A, LINE 4	ON JUNE 23, 2018, ST. JUDE CHILDREN'S RESEARCH HOSPITAL AMENDED ARTICLE IV, SECTION 3, PARAGRAPH 1 OF ITS BYLAWS TO REDUCE THE MAXIMUM NUMBER OF ELECTED BOARD MEMBERS FROM 55 TO 45 AS OF JULY 1, 2018.
FORM 990, PART VI, SECTION B, LINE 11B	IN FEBRUARY OF EACH YEAR, THE AUDIT COMMITTEE AND OFFICERS OF THE BOARD ARE PROVIDED WITH A DRAFT COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES. THE AUDIT COMMITTEE MEETS WITH ITS TAX PREPARER TO REVIEW THE DRAFT FORM 990 BEFORE IT IS FILED WITH THE IRS. ADDITIONALLY THE COMPENSATION COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE COMPENSATION SECTIONS OF THE FORM 990, AND THE CONFLICT OF INTEREST COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE CONFLICT-OF-INTEREST SECTIONS OF THE FORM 990 FOR REVIEW BEFORE THE FINALIZED DOCUMENT IS FILED WITH THE IRS. EACH VOTING MEMBER OF THE BOARD IS PROVIDED WITH A FINAL COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	NEW BOARD MEMBERS ARE GIVEN A COPY OF THE BOARD OF GOVERNOR'S CONFLICT OF INTEREST POLICY AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. THERE IS A CONFLICT OF INTEREST COMMITTEE OF THE BOARD THAT REVIEWS THE ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT ARE COMPLETED BY EACH BOARD MEMBER AND DISCUSSES AND RESOLVES CONFLICTS OF INTEREST, WITH OPPORTUNITY FOR APPEAL TO THE FULL BOARD. IN ADDITION, THE ORGANIZATION HAS A CHIEF COMPLIANCE OFFICER AND COMPLIANCE DEPARTMENT, WHICH ADMINISTER THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR ALL EMPLOYEES IN CLINICAL, RESEARCH, AND SELECT ADMINISTRATIVE DEPARTMENTS, AS WELL AS EMPLOYEES IDENTIFIED AS SUPERVISORS OR WHO HAVE PURCHASING AUTHORITY. ALL SUCH EMPLOYEES COMPLETE CONFLICT OF INTEREST TRAINING AND A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE COMPLIANCE OFFICER ENSURES EMPLOYEES MEET THESE REQUIREMENTS AND REVIEWS SUBMITTED DISCLOSURES. DISCLOSURES IDENTIFIED AS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARE ADDRESSED BY THE COMPLIANCE OFFICE WITH INVOLVEMENT OF THE INSTITUTIONAL CONFLICT OF INTEREST COMMITTEE AS APPROPRIATE. DEPENDING ON THE FACTS AND CIRCUMSTANCES, THE ACTIVITY MAY BE MANAGED PURSUANT TO A MANAGEMENT PLAN, OR PROHIBITED.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD'S COMPENSATION COMMITTEE COMMISSIONS ANNUAL THIRD PARTY SALARY SURVEYS TO DETERMINE COMPENSATION FOR THE FOLLOWING OFFICERS: CHIEF EXECUTIVE OFFICER, SCIENTIFIC DIRECTOR, CANCER CENTER DIRECTOR, CHIEF ADMINISTRATIVE OFFICER, CHIEF FINANCIAL OFFICER, CLINICAL DIRECTOR, CHIEF GOVERNANCE OFFICER/CORPORATE SECRETARY, CHIEF LEGAL OFFICER, AND CHAIR, DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE. IN ADDITION, FIVE EMPLOYEES ARE CONSIDERED "DISQUALIFIED" BECAUSE THEY ARE FORMER EXECUTIVES OR RELATIVES OF CURRENT OR FORMER EXECUTIVES, AND THEIR COMPENSATION THEREFORE FALLS WITHIN THE COMPENSATION COMMITTEE'S PURVIEW. ALL CHANGES TO OFFICERS' SALARIES ARE APPROVED BY THE COMPENSATION COMMITTEE AND REPORTED TO THE BOARD. THE LAST REVIEW WAS COMPLETED IN DECEMBER 2018.
FORM 990, PART VI, SECTION C, LINE 19	FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE ONLY AS REQUIRED BY APPLICABLE STATE LAW.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN UNRESTRICTED NET ASSETS OF ALSAC 550,657,594. CHANGE IN INTEREST IN RESTRICTED NET ASSETS OF ALSAC 62,266,520.
ADDITIONAL HEALTH NEEDS IDENTIFIED	IN ADDITION TO THE HEALTH NEEDS OUTLINED IN ITS 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN, ST. JUDE HAS ALSO CHOSEN TO ADDRESS THE FOLLOWING HEALTH NEEDS: PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #1 OF THE CHNA): TRANSITION ONCOLOGY PROGRAM HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ACT CLINIC, TRANSITION ONCOLOGY PROGRAM (TOP) ANTICIPATED OUTCOME: PROVIDE PROSPECTIVE, SYSTEMATIC, TRANSITION-RELATED SERVICES FOR ONCOLOGY PATIENTS ACROSS THE CONTINUUM OF CARE THAT WILL SUPPORT TRANSITIONS FROM ACTIVE THERAPY TO TREATMENT AND FROM TREATMENT COMPLETION TO ACT. ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. IDENTIFY AND IMPLEMENT APPROPRIATE MANAGEMENT AND OPERATIONS STRUCTURE, AND BEGIN STAFFING THE PROGRAM. 2. CLOSELY MONITOR RESOURCES TO STAFF THE CLINIC TO ITS FULLEST FORM, AND COMPLETE AN ASSESSMENT AFTER THE FIRST 18 MONTHS OF OPERATION TO ENSURE THAT THE PROGRAM IS MEETING ITS PURPOSE. 3. EVALUATE IMPACT ON INTERPRETER SERVICES, CLINICAL INFORMATICS, REHABILITATION SERVICES, CLINIC SPACE, HOUSING, AND TRAVEL COSTS. 4. EVALUATE RESOURCES IN ACT IN ANTICIPATION OF AN INCREASE IN ACT PATIENT VOLUMES. PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #3 OF THE CHNA): PREVENTING VIRUS-ASSOCIATED CANCERS THROUGH INCREASED HPV VACCINATION (HEALTH STATUS OF THE MEMPHIS COMMUNITY) HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL ANTICIPATED OUTCOME: INCREASE THE VACCINATION RATES FOR HPV VACCINE LOCALLY AND STATE-WIDE ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. CREATE A TASK FORCE TO GATHER INFORMATION ABOUT CURRENT INITIATIVES AND PROGRAMS IN MEMPHIS, ACROSS TENNESSEE, AND NATIONALLY AND TO EVALUATE PUBLISHED STUDIES ON PROGRAM APPROACHES. 2. DEVELOP GOALS, STRATEGIES, AND ACTIONS FOR A HPV VACCINATION INITIATIVE. SELECTED ACCOMPLISHMENTS: 1. CREATE A TASK FORCE TO GATHER INFORMATION ABOUT CURRENT INITIATIVES AND PROGRAMS IN MEMPHIS, ACROSS TENNESSEE, AND NATIONALLY AND TO EVALUATE PUBLISHED STUDIES ON PROGRAM APPROACHES. OVER THE PAST YEAR, A TASK FORCE WAS CREATED BY THE CANCER CENTER AT ST. JUDE. LEADERSHIP INCLUDED MELISSA HUDSON, MD, AND MELISSA JONES. SEVERAL ACTIONS WERE COMPLETED TO GATHER INFORMATION AND LEARN ABOUT PROGRAMS IN PLACE AND THE IMPACT THESE PROGRAMS HAVE ON HPV VACCINATION RATES. INFORMATION WAS ALSO GATHERED TO UNDERSTAND POTENTIAL BARRIERS AS WELL AS LOCAL AND STATE-WIDE SUPPORT FOR A BROADER INITIATIVE. ACTIONS COMPLETED INCLUDE: - PARTICIPATED IN STATEWIDE HPV MEETING IN NASHVILLE - ENGAGED SHELBY COUNTY SCHOOLS, TNAAP, AND HPV CANCER FREE TENNESSEE (TN DEPT OF HEALTH) - HOSTED WEST TN CHAPTER MEETING - MET WITH AND LOBBIED SENATORS, HEALTH COMMISSIONER, AND GOVERNOR ON IMPORTANCE OF VACCINE - ATTENDED THE NCI CANCER CENTER HPV VACCINE MEETING IN JUNE - COMPLETED PUBLIC RELATIONS EFFORTS TO RAISE AWARENESS - COMPLETED A REVIEW OF THE LITERATURE - INTERVIEWED AND GATHERED INFORMATION ON NATIONAL PROGRAMS 2. DEVELOP GOALS, STRATEGIES, AND ACTIONS FOR A HPV VACCINATION INITIATIVE. THE TASK FORCE ALSO WORKED OVER THIS PAST YEAR TO DEVELOP A MORE COMPREHENSIVE PROGRAM AND STRATEGY. A LARGER CONCEPT HAS BEEN DEVELOPED THAT WILL BE REVIEWED AND EVALUATED FOR IMPLEMENTATION IN FY20. THE PROPOSAL IS FOCUSED ON ACHIEVING THE AMERICAN CANCER SOCIETY'S AND OTHER ORGANIZATIONS' GOAL OF ELIMINATING HPV-RELATED CANCERS THROUGH VACCINATION AND SCREENING. THIS GOAL AND VISION WAS ENDORSED BY ALL NCI-DESIGNATED CANCER CENTERS IN JUNE 2018. THE PROGRAM IS FOCUSED ON DEVELOPING AND DEPLOYING STRATEGICALLY ALIGNED INITIATIVES IN THREE CRITICAL AND INTERCONNECTED DOMAINS OF COMMUNITY, HEALTHCARE PROVIDERS AND SYSTEMS, AND PUBLIC POLICY. THERE ARE EIGHT GOALS OUTLINED IN THE PLAN. FURTHER REVIEW OF THE PLAN WILL OCCUR EARLY IN FY19, WITH ANTICIPATED INCLUSION IN THE FY20 BUDGET.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

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 GMP LLC 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 47-4475625	VACCINE MANUFACTURER	TN	433,875	1,312,451	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC
(2) THANKS & GIVING LLC 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 20-1310435	ROYALTY INCOME FROM RECORD SALES	TN	0	10,632	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC
(3) THE RIGHT WORDS LLC 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 95-4878579	ROYALTY INCOME FROM BOOK SALES	NY	0	0	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC
(4) ST JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 81-3240987	HIGHER EDUCATION	TN	7,319	827,699	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC

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?
(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	Yes	No
(1)AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES INC 501 ST JUDE PLACE MEMPHIS,TN38105 35-1044585	SOLICIT SUPPORT FOR OPERATION OF ST. JUDE	IL	501(C)(3)	7	N/A		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2019

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	(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?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No

Schedule R (Form 990) 2019

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

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 .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

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

Schedule R (Form 990) 2019

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

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) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S ABILITY TO PAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	43
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	41
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	5,185
6	Total number of volunteers (estimate if necessary) .............	6	3,950
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	138,854

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	753,145,680	851,803,301
9	Program service revenue (Part VIII, line 2g) .........	124,099,314	117,420,862
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-1,169,284	-7,463,705
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	24,726,224	18,895,861
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	900,801,934	980,656,319
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	4,956,619	4,312,073
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)	462,005,025	505,567,014
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	390,060,200	440,836,545
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	857,021,844	950,715,632
19	Revenue less expenses. Subtract line 18 from line 12.......	43,780,090	29,940,687
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	4,787,635,534	5,434,170,902
21	Total liabilities (Part X, line 26).............	127,718,358	131,298,150
22	Net assets or fund balances. Subtract line 21 from line 20.....	4,659,917,176	5,302,872,752

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 457,825,537 including grants of $ 4,160,447 ) (Revenue $ 113,179,305 )
	PATIENT CARE: THE HOSPITAL PROVIDED 19,202 INPATIENT DAYS OF CARE DURING THE YEAR. OUR BONE MARROW TRANSPLANTATION PROGRAM ACCOUNTED FOR 4,407 OR 23% OF THOSE INPATIENT DAYS. PATIENTS MADE 79,024 CLINIC VISITS DURING THE YEAR.

4b	(Code: ) (Expenses $ 410,716,516 including grants of $ 146,126 ) (Revenue $ )
	RESEARCH: THE CURRENT BASIC SCIENCE AND CLINICAL RESEARCH AT THE HOSPITAL INCLUDES WORK IN GENE THERAPY, CHEMOTHERAPY, THE BIOCHEMISTRY OF NORMAL AND CANCEROUS CELLS, RADIATION TREATMENT, BLOOD DISEASES, RESISTANCE TO THERAPY, VIRUSES, HEREDITARY DISEASES, INFLUENZA, PEDIATRIC AIDS AND PHYSIOLOGICAL EFFECTS OF CATASTROPHIC ILLNESSES.

4c	(Code: ) (Expenses $ 21,767,276 including grants of $ 5,500 ) (Revenue $ )
	EDUCATION AND TRAINING: AS PART OF ITS MISSION, THE HOSPITAL HAS DEVELOPED A GLOBAL INITIATIVE (ST. JUDE GLOBAL) TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE GLOBAL ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, HELPING TO IMPLEMENT NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND DEVELOPING REGIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THIS MISSION WILL BE ACHIEVED BY FOCUSING ON THREE OVERRIDING GOALS: (1) TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION, (2) TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES, AND (3) TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE. THESE INITIATIVES ARE SPEARHEADED BY ST. JUDE EXPERTS WHO WORK CLOSELY WITH HEALTHCARE PROFESSIONALS AT OUR PARTNER SITES. IN ADDITION, A GRADUATE PROGRAM IS OFFERED THROUGH A WHOLLY-OWNED SUBSIDIARY, ST. JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES, LLC, TO EDUCATE AND TRAIN FUTURE GENERATIONS OF SCIENTISTS SEEKING TO UNDERSTAND THE MOLECULAR BASIS OF HUMAN DISEASE AND DEVELOP NOVEL THERAPIES BASED ON THAT UNDERSTANDING.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses890,309,329

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	10,327,205	794,032	1,550,976

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	757,401,831
e	Government grants (contributions)		1e	82,755,154

f	All other contributions, gifts, grants, and similar amounts not included above		1f	11,646,316

g	Noncash contributions included in lines 1a - 1f:$		1g	2,017,179

h Total. Add lines 1a-1f.......		851,803,301

		Business Code
2a	PATIENT CARE	621110	117,420,862	117,420,862
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		117,420,862

3 Investment income (including dividends, interest, and othersimilar amounts) ......			11,469			11,469
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			11,297,052			11,297,052
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	37,928	369,380	7a
b	Less: cost or other basis and sales expenses	7,590,222	292,260	7b
c	Gain or (loss)	-7,552,294	77,120	7c
d	Net gain or (loss).........			-7,475,174	-7,552,294		77,120
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA/VENDING		722514	4,288,072			4,288,072
b	CHGME/CHCA		900099	2,351,842	2,351,842
c	HHMI		900099	327,751	327,751
d	All other revenue ....			631,144	631,144
e	Total. Add lines 11a–11d ......			7,598,809
12	Total revenue. See instructions.....			980,656,319	113,179,305	0	15,673,713

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	4,311,573	4,311,573
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	500	500
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	6,085,991	3,217,948	2,868,043
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	799,828	722,828	77,000
7	Other salaries and wages........	387,908,704	358,975,889	28,932,815
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	23,815,628	22,039,300	1,776,328
9	Other employee benefits .......	60,458,204	55,948,828	4,509,376
10	Payroll taxes ...........	26,498,659	24,522,213	1,976,446
11	Fees for services (non-employees):
a	Management ......	24,129,726	22,548,266	1,581,460
b	Legal .........	2,499,010	2,335,225	163,785
c	Accounting ...........	320,997	299,959	21,038
d	Lobbying ...........	82,616		82,616
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	92,493,428	81,585,900	10,907,528
12	Advertising and promotion ....	729,512	681,700	47,812
13	Office expenses .......	2,541,058	2,495,428	45,630
14	Information technology ......	32,959,451	30,799,292	2,160,159
15	Royalties ..
16	Occupancy ...........	35,929,278	30,447,214	5,482,064
17	Travel ............	12,417,773	11,675,859	741,914
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	2,204,122	1,680,718	523,404
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	86,661,284	77,373,949	9,287,335
23	Insurance ...	1,926,949	1,409,067	517,882
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	PHARMACEUTICAL SUPPLIES	52,287,399	51,348,474	938,925
b	LABORATORY SUPPLIES	49,243,057	48,358,799	884,258
c	TELEPHONE	1,453,871	1,246,308	207,563
d	ALLOCATION ADJUSTMENTS	0	18,503,310	-18,503,310
e	All other expenses	42,957,014	37,780,782	5,176,232
25	Total functional expenses. Add lines 1 through 24e	950,715,632	890,309,329	60,406,303	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 if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			21,110	1	1,110,291
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			20,889,800	3	22,491,694
4	Accounts receivable, net .............			19,183,301	4	21,703,486
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			7,505,346	8	7,732,327
9	Prepaid expenses and deferred charges ......			16,177,850	9	13,941,837
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,520,270,198
b	Less: accumulated depreciation	10b	851,159,790	638,878,938	10c	669,110,408
11	Investments—publicly traded securities .			2,045,240	11	2,222,796
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			4,082,933,949	15	4,695,858,063
16	Total assets. Add lines 1 through 15 (must equal line 33)...			4,787,635,534	16	5,434,170,902

17	Accounts payable and accrued expenses .....	113,161,164	17	112,276,799
18	Grants payable ...		18
19	Deferred revenue .........	11,299,828	19	15,399,715
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
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	3,257,366	25	3,621,636
26	Total liabilities. Add lines 17 through 25..	127,718,358	26	131,298,150

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........		27
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	4,659,917,176	32	5,302,872,752
33	Total liabilities and net assets/fund balances ........	4,787,635,534	33	5,434,170,902

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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately 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; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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) .	Yes	No
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). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
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 separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No