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)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(1) DEAN ALLEN...................................................................... TRUSTEE	4.00 ................. 0.00	X
(2) JOEL BENOLIEL...................................................................... TREASURER	3.00 ................. 0.00	X	X
(3) SUSAN BETCHER...................................................................... TRUSTEE	2.00 ................. 0.00	X
(4) JILL BRUBAKER MD...................................................................... TRUSTEE	1.00 ................. 0.00	X
(5) PAT CHAR...................................................................... TRUSTEE	1.00 ................. 0.00	X
(6) MICHAEL DELMAN...................................................................... TRUSTEE	4.00 ................. 0.00	X
(7) ROY DIAZ PHD...................................................................... TRUSTEE	3.00 ................. 0.00	X
(8) COLIN FOX PHD...................................................................... TRUSTEE	5.00 ................. 0.00	X
(9) DEBORAH HAUG...................................................................... TRUSTEE	2.00 ................. 0.00	X
(10) JUDY HOLDER...................................................................... TRUSTEE	4.00 ................. 0.00	X
(11) CYNTHIA HUFFMAN...................................................................... TRUSTEE	2.00 ................. 0.00	X
(12) MONA LEE LOCKE...................................................................... TRUSTEE	3.00 ................. 0.00	X
(13) PATRICIA LOERA...................................................................... SECRETARY	2.00 ................. 0.00	X	X
(14) SUSAN MASK...................................................................... CHAIR-ELECT	5.00 ................. 0.00	X	X
(15) JEFF NITTA...................................................................... TRUSTEE	4.00 ................. 0.00	X
(16) JUDITH PIERCE...................................................................... TRUSTEE	3.00 ................. 0.00	X
(17) MICHAEL REEVES...................................................................... TRUSTEE	2.00 ................. 0.00	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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) NANCY SENSENEY........................................................................ CHAIR	10.00 .......................2.00	X	X				0	0	0
(19) MICHELE SMITH........................................................................ TRUSTEE	2.00 .......................3.00	X					0	0	0
(20) CHARLES STEVENS........................................................................ TRUSTEE	4.00 .......................0.00	X					0	0	0
(21) MOYA VASQUEZ........................................................................ TRUSTEE	3.00 .......................0.00	X					0	0	0
(22) ALVIN WINTERROTH........................................................................ TRUSTEE	2.00 .......................0.00	X					0	0	0
(23) JEFF SPERRING MD........................................................................ CEO/NON-VOTING EX OFFICIO TRUSTEE	16.00 .......................39.00		X				288,680	870,720	255,556
(24) KELLY WALLACE........................................................................ SENIOR VP & CFO THRU DEC 2017	14.00 .......................41.00		X				163,546	504,249	120,155
(25) SUZANNE BEITEL........................................................................ SENIOR VP & CHIEF FINANCIAL OFFICER	14.00 .......................41.00		X				30,286	96,739	8
(26) LISA HAYWARD........................................................................ SR VP & GENERAL COUNSEL	55.00 .......................0.00			X			423,609	3,272	100,643
(27) WARREN HEWITT........................................................................ VP - FINANCE	14.00 .......................41.00			X			77,407	236,290	40,124
(28) SAMANTHA SLOANE........................................................................ CONTROLLER	12.00 .......................38.00				X		51,135	158,025	20,755
(29) DONNA REINHART........................................................................ DIRECTOR OF TREASURY SERVICES	20.00 .......................20.00				X		42,189	150,866	15,004
(30) MICHAEL JOO........................................................................ CORPORATE ACCOUNTANT	40.00 .......................0.00				X		107,672	1,206	34,399
(31) DEBRA PALMER-SEILER........................................................................ SR ACCOUNTANT, TREASURY	40.00 .......................0.00				X		104,606	2,712	23,325
(32) THOMAS HANSEN MD........................................................................ FORMER CEO	0.00 .......................3.50					X	0	107,944	14,591
(33) SANFORD MELZER MD........................................................................ FORMER SR VP-CHIEF STRATEGY OFFICER	0.00 .......................55.00					X	0	679,923	125,474
(34) JODI LONG........................................................................ FORMER ASSOCIATE GENERAL COUNSEL	0.00 .......................45.00					X	0	294,926	33,819

(A) Name and business address	(B) Description of services	(C) Compensation
WELLINGTON MANAGEMENT COMPANY LLP 2800 CONGRESS STREET BOSTON,MA02210	INVESTMENT MANAGEMENT	777,647
SANDERSON ASSET MANAGEMENT 250 S WACKER DRIVE STE 220 CHICAGO,IL60606	INVESTMENT MANAGEMENT	541,873
HIGHCLERE INTERNATIONAL INVESTORS 253 BAYBERRY LANE WESTPORT,CT06880	INVESTMENT SERVICES	416,594
MONTICELLO ASSOCIATES INC 1800 LARIMER STREET STE 2100 DENVER,CO80202	INVESTMENT CONSULTING	300,000
LIME ROCK RESOURCES 1111 BAGBY STREET STE 4600 HOUSTON,TX77002	INVESTMENT MANAGEMENT	149,860
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 6

- 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

SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

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.") ..	85,550,850	16,448,308	3,481,940	3,911,423	13,741,277	123,133,798
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	85,550,850	16,448,308	3,481,940	3,911,423	13,741,277	123,133,798
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.						123,133,798

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..	85,550,850	16,448,308	3,481,940	3,911,423	13,741,277	123,133,798
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	5,789,988	4,396,810	4,690,718	5,481,967	4,407,309	24,766,792
9	Net income from unrelated business activities, whether or not the business is regularly carried on..			1,424,823	845,917	192,721	2,463,461
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..		80,585	74,305	15,524		170,414
11	Total support. Add lines 7 through 10						150,534,465

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

67,134,233

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)) .........

81.800 %

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

80.230 %

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
SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:	PROPERTY TAX REFUND - 2014 AMOUNT: $ 80,585. 2015 AMOUNT: $ 74,305. 2016 AMOUNT: $ 15,524.

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

SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

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 SEATTLE CHILDREN'S HEALTHCARE SYSTEM

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
RESTRICTED	,	$ RESTRICTED	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 SEATTLE CHILDREN'S HEALTHCARE SYSTEM		Employer identification number 91-1250116

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 SEATTLE CHILDREN'S HEALTHCARE SYSTEM			Employer identification number 91-1250116
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 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

SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

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 ....	403,524,000	357,825,000	331,943,000	337,769,000	310,474,000
b	Contributions ...	745,000	454,000	232,000	203,000	239,000
c	Net investment earnings, gains, and losses	31,759,000	48,663,000	29,179,000	-2,586,000	30,295,000
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	3,440,000	3,418,000	3,529,000	3,443,000	3,239,000
f	Administrative expenses ....
g	End of year balance ......	432,588,000	403,524,000	357,825,000	331,943,000	337,769,000

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

Board designated or quasi-endowment SchDMd Bullet

85.510 %

Permanent endowment SchDMd Bullet

10.430 %

Term endowment SchDMd Bullet

4.060 %

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)

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

3a(ii)

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

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 .....	705,855	3,995,929		4,701,784
b	Buildings ....		1,025,445	264,529	760,916
c	Leasehold improvements		194,795	40,487	154,308
d	Equipment ....		10,976	2,287	8,689
e	Other .....		3,607	1,503	2,104
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					5,627,801

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 (A) POOLED INVESTMENTS	298,776,505	C
(B) CHARITABLE REMAINDER UNITRUSTS	801,080	C
(C) PERPETUAL & TESTAMENTARY TRUSTS	141,658,894	C
(D) GIFT ANNUITIES	2,912,609	C
(E) LIFE ESTATE	724,729	C
(F) DEFERRED COMPENSATION PLANS	2,612,817	C
(G) OTHER ALTERNATIVE INVESTMENTS	178,792	C
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	447,665,426

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
(1)INVESTMENT IN SCCA	160,677,333	C
(2)INVESTMENT IN SYZYGY LLC	3,657,110	C
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)	164,334,443

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

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	5,711,988
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
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS) AND SEATTLE CHILDREN'S HOSPITAL (SCH) SHARE IN A UNIFIED ENDOWMENT FUND (UEF) THAT IS MANAGED BY SCHS. SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S TEMPORARILY AND PERMANENTLY RESTRICTED ASSETS REFLECT ENDOWMENTS WHOSE PURPOSE IS TO SUPPORT THE HOSPITAL.

PART X, LINE 2:

THE INTERNAL REVENUE SERVICE HAS GRANTED SCHS, AND EACH OF THE CONTROLLED CORPORATIONS LISTED ABOVE, EXEMPTION FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE (IRC) AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3) OF THE IRC FORMED TO OPERATE FOR CHARITABLE, EDUCATIONAL, SCIENTIFIC, AND MEDICAL PURPOSES. DURING 2018 AND 2017, SCHS DID NOT RECORD ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS.

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
SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

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)	(f) Total expenditures for and investments in the region
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS	110,004,142
	NORTH AMERICA	0	0	INVESTMENTS	2,109,429















3a	Sub-total ....	0	0		112,113,571
b	Total from continuation sheets to Part I ...	0	0		0
c	Totals (add lines 3a and 3b)	0	0		112,113,571

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:	THE ACCRUAL METHOD WAS USED TO ACCOUNT FOR INVESTMENTS.

Schedule F (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

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

Yes

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)
1JEFF SPERRING MD CEO/NON-VOTING EX OFFICIO TRUSTEE	(i) (ii)	214,211 ------------- 642,632	72,000 ------------- 216,000	2,469 ------------- 12,088	221,967 ------------- 10,125	5,866 ------------- 17,598	516,513 ------------- 898,443	0 ------------- 0
2KELLY WALLACE SENIOR VP & CFO THRU DEC 2017	(i) (ii)	132,286 ------------- 396,858	31,260 ------------- 93,780	0 ------------- 13,611	84,415 ------------- 14,175	5,391 ------------- 16,174	253,352 ------------- 534,598	0 ------------- 0
3LISA HAYWARD SR VP & GENERAL COUNSEL	(i) (ii)	346,123 ------------- 0	72,000 ------------- 707	5,486 ------------- 2,565	69,862 ------------- 0	30,781 ------------- 0	524,252 ------------- 3,272	0 ------------- 0
4WARREN HEWITT VP - FINANCE	(i) (ii)	63,880 ------------- 191,640	13,300 ------------- 39,902	227 ------------- 4,748	4,725 ------------- 14,175	5,306 ------------- 15,918	87,438 ------------- 266,383	0 ------------- 0
5SAMANTHA SLOANE CONTROLLER	(i) (ii)	44,322 ------------- 137,244	6,813 ------------- 20,650	0 ------------- 131	2,109 ------------- 6,326	3,080 ------------- 9,240	56,324 ------------- 173,591	0 ------------- 0
6DONNA REINHART DIRECTOR OF TREASURY SERVICES	(i) (ii)	42,162 ------------- 43,314	27 ------------- 83	0 ------------- 107,469	3,223 ------------- 3,223	4,279 ------------- 4,279	49,691 ------------- 158,368	0 ------------- 0
7THOMAS HANSEN MD FORMER CEO	(i) (ii)	0 ------------- 104,762	0 ------------- 0	0 ------------- 3,182	0 ------------- 7,677	0 ------------- 6,914	0 ------------- 122,535	0 ------------- 0
8SANFORD MELZER MD FORMER SR VP-CHIEF STRATEGY OFFICER	(i) (ii)	0 ------------- 447,319	0 ------------- 219,651	0 ------------- 12,953	77,745 ------------- 18,900	0 ------------- 28,829	77,745 ------------- 727,652	0 ------------- 0
9JODI LONG FORMER ASSOCIATE GENERAL COUNSEL	(i) (ii)	0 ------------- 255,945	0 ------------- 38,411	0 ------------- 570	0 ------------- 18,647	0 ------------- 15,172	0 ------------- 328,745	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	THE CHIEF EXECUTIVE OFFICER IS PROVIDED MEMBERSHIP TO THE RAINIER CLUB. ANNUAL DUES ARE REPORTED AS TAXABLE COMPENSATION.
PART I, LINES 4A-B	THE FOLLOWING PARTICIPATED IN, OR RECEIVED PAYMENT FROM, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: JEFF SPERRING MD - $218,592 DEFERRED COMPENSATION KELLY WALLACE - $79,690 DEFERRED COMPENSATION LISA HAYWARD - $56,536 DEFERRED COMPENSATION SANFORD MELZER MD - $77,745 DEFERRED COMPENSATION THE FOLLOWING RECEIVED A SEVERANCE PAYMENT: DONNA REINHART - $101,932

Schedule J (Form 990) 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

SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

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 .	X	17	415,220	MARKET VALUE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....	X	5	2,736,170	MARKET VALUE
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 ...
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?

Yes

32a

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

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

32a

Yes

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):	LINE 9 - 17 CONTRIBUTIONS OF VARIOUS AMOUNTS OF SECURITIES; LINE 11 - 5 CONTRIBUTIONS OF TRUST INTERESTS
PART I, LINE 32B:	SEATTLE CHILDREN'S HOSPITAL FOUNDATION AND SEATTLE CHILDREN'S HOSPITAL GUILD ASSOCIATION (RELATED ORGANIZATIONS) SOLICIT BOTH CASH AND NON-CASH GIFTS ON BEHALF OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM (SCHS).

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

SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

Return Reference	Explanation
FORM 990, PART I, LINE 6:	22 MEMBERS OF THE BOARD OF TRUSTEES PERFORM THEIR DUTIES UNCOMPENSATED.
FORM 990, PART VI, SECTION A, LINE 2	JEFF SPERRING HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, SUZANNE BEITEL, JOEL BENOLIEL, SUSAN BETCHER, JILL BRUBAKER, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, COLIN FOX, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, MONA LEE LOCKE, PATRICIA LOERA, SUSAN MASK, JEFF NITTA, JUDITH PIERCE, MICHAEL REEVES, NANCY SENSENEY, MICHELE SMITH, CHARLES STEVENS, KELLY WALLACE, MOYA VASQUEZ, AND ALVIN WINTERROTH. WARREN HEWITT HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, SUZANNE BEITEL, JOEL BENOLIEL, SUSAN BETCHER, JILL BRUBAKER, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, COLIN FOX, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, MONA LEE LOCKE, PATRICIA LOERA, SUSAN MASK, JEFF NITTA, JUDITH PIERCE, MICHAEL REEVES, NANCY SENSENEY, MICHELE SMITH, JEFF SPERRING, CHARLES STEVENS, KELLY WALLACE, MOYA VASQUEZ, AND ALVIN WINTERROTH. KELLY WALLACE HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, SUZANNE BEITEL, JOEL BENOLIEL, SUSAN BETCHER, JILL BRUBAKER, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, COLIN FOX, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, MONA LEE LOCKE, PATRICIA LOERA, SUSAN MASK, JEFF NITTA, JUDITH PIERCE, MICHAEL REEVES, NANCY SENSENEY, MICHELE SMITH, CHARLES STEVENS, MOYA VASQUEZ, AND ALVIN WINTERROTH. SUZANNE BEITEL HAS A BUSINESS RELATIONSHIP WITH DEAN ALLEN, JOEL BENOLIEL, SUSAN BETCHER, JILL BRUBAKER, PAT CHAR, MICHAEL DELMAN, ROY DIAZ, COLIN FOX, DEBORAH HAUG, JUDY HOLDER, CYNTHIA HUFFMAN, MONA LEE LOCKE, PATRICIA LOERA, SUSAN MASK, JEFF NITTA, JUDITH PIERCE, MICHAEL REEVES, NANCY SENSENEY, MICHELE SMITH, CHARLES STEVENS, MOYA VASQUEZ, AND ALVIN WINTERROTH.
FORM 990, PART VI, SECTION B, LINE 11B	MANAGEMENT AND INDEPENDENT TAX PROFESSIONALS PRESENT AND REVIEW THE FORM 990 WITH THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE OF THE BOARD OF TRUSTEES. AFTER REVIEW BY THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE AND PRIOR TO FILING THE FORM 990 WITH THE INTERNAL REVENUE SERVICE, THE ENTIRE BOARD OF TRUSTEES RECEIVES A COPY OF THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12C	THE CONFLICT OF INTEREST POLICY OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM REQUIRES AN ANNUAL SURVEY OF ALL BOARD MEMBERS OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM, MEMBERS OF THE MEDICAL LEADERSHIP, STAFF MEMBERS OCCUPYING ROLES WITH A DEGREE OF AUTHORITY AND MEMBERS OF SEATTLE CHILDREN'S HOSPITAL'S PHARMACY AND THERAPEUTICS COMMITTEE. THE SENIOR VICE PRESIDENT/GENERAL COUNSEL OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM, ACTING UNDER THE OVERSIGHT OF THE AUDIT AND CORPORATE RESPONSIBILITY COMMITTEE OF THE BOARD OF TRUSTEES, OVERSEES THE REVIEW OF ALL DISCLOSURES AND ESTABLISHES AND OVERSEES ANY NECESSARY MANAGEMENT PLANS RELATED TO THEM. IN GENERAL, WHEN A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE THEMSELVES FROM PARTICIPATION IN ANY BOARD DISCUSSION OR OTHER DECISION MAKING REGARDING THE TRANSACTION AND REFRAIN FROM VOTING ON OR DECIDING ANY ISSUES RELATING TO THE CONFLICTING INTEREST. ANY PERSON COVERED BY THE POLICY WHO ENGAGES IN CONDUCT THAT VIOLATES THE POLICY OR PURSUES A TRANSACTION OR EVENT FOLLOWING DISAPPROVAL BY THE BOARD OR THE CHIEF EXECUTIVE OFFICER MAY, IN THE DISCRETION OF THE BOARD OR THE CHIEF EXECUTIVE OFFICER IN ACCORDANCE WITH THEIR RESPECTIVE AUTHORITY, BE REMOVED IMMEDIATELY FROM HIS OR HER DUTIES WITH SEATTLE CHILDREN'S HEALTHCARE SYSTEM AND/OR TERMINATED IN HIS OR HER EMPLOYMENT.
FORM 990, PART VI, SECTION B, LINE 15	EXECUTIVE COMPENSATION FALLS WITHIN THE PURVIEW OF THE MANAGEMENT DEVELOPMENT AND COMPENSATION COMMITTEE ("MDCC") OF THE BOARD OF TRUSTEES. PURSUANT TO THE BOARD-APPROVED MDCC CHARTER, THE MDCC ENGAGES AN INDEPENDENT THIRD-PARTY CONSULTANT EXPERT IN THE COMPENSATION OF EXECUTIVES AND OTHER TOP MANAGERS OF NONPROFIT HOSPITALS AND HEALTH CARE SYSTEMS. WITH APPROPRIATE COMPARABILITY DATA PROVIDED BY ITS CONSULTANT (COMPRISING MARKET DATA REGARDING COMPENSATION PAID FOR COMPARABLE SERVICES IN COMPARABLE ORGANIZATIONS), THE MDCC ENGAGES IN AN ANNUAL REVIEW AND ASSESSMENT OF THE SEATTLE CHILDREN'S HEALTHCARE SYSTEM EXECUTIVE COMPENSATION PROGRAM (BASE, INCENTIVE COMPENSATION, AND EMPLOYER-PAID BENEFITS) TO DETERMINE COMPETITIVENESS. BASED ON THIS EXPERT ANALYSIS AND ON RELEVANT PERFORMANCE INFORMATION FOR THE EXECUTIVES IN QUESTION AND THE ORGANIZATION AS A WHOLE, THE MDCC PRESENTS A RECOMMENDATION TO THE BOARD REGARDING THE TOTAL COMPENSATION PACKAGE FOR EACH OF THE AFFECTED EXECUTIVES, INCLUDING THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND KEY EMPLOYEES. THE FULL BOARD REVIEWS THE RECOMMENDATIONS AS WELL AS ALL RELEVANT COMPARABILITY DATA AND THE GOALS OF THE ORGANIZATION IN MAKING ITS FINAL DECISION. IN DOING SO IT RELIES ON THE EXPERT ANALYSIS TO DETERMINE THAT COMPENSATION IS REASONABLE AND WITHIN THE "BOUNDS OF COMPETITIVE PRACTICE". ALL DELIBERATIONS AND DECISIONS OF THE MDCC AND FULL BOARD ARE DOCUMENTED IN THE BOOKS AND RECORDS IN ACCORDANCE WITH GENERAL ADMINISTRATIVE PROVISIONS AND PROCEDURES WITHIN THE BYLAWS. THE PROCESS FOLLOWED BY THE MDCC AND THE FULL BOARD SATISFIES BEST GOVERNANCE PRACTICES AND ALSO MEETS THE REGULATORY REQUIREMENTS NECESSARY TO CREATE A REBUTTABLE PRESUMPTION OF REASONABLENESS WITH RESPECT TO THE BOARD'S DECISION.
FORM 990, PART VI, SECTION C, LINE 19	SEATTLE CHILDREN'S HEALTHCARE SYSTEM MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII:	INDIVIDUALS REPORTED AS FORMER OFFICERS, KEY EMPLOYEES, OR HIGHLY COMPENSATED EMPLOYEES OF SEATTLE CHILDREN'S HEALTHCARE SYSTEM ARE NO LONGER CURRENT EMPLOYEES OF THE ORGANIZATION AND THEREFORE NO COMPENSATION IS REPORTED IN PART VII, COLUMN (D). HOWEVER, SINCE THEY WERE REPORTED ON THE ORGANIZATION'S RETURN WITHIN THE LAST FIVE YEARS AND ARE STILL EMPLOYEES AND CONTINUE TO RECEIVE COMPENSATION FROM RELATED ORGANIZATIONS, THEY ARE REQUIRED TO BE DISCLOSED ALONG WITH THEIR COMPENSATION IN PART VII, COLUMNS (E) AND (F).
FORM 990, PART IX, COLUMN (D):	ALTHOUGH SEATTLE CHILDREN'S HEALTHCARE SYSTEM HAS SUBSTANTIAL CONTRIBUTION REVENUE, IT DOES NOT INCUR FUNDRAISING EXPENSES. ALL FUNDRAISING ACTIVITIES AND CONTRIBUTIONS TO SEATTLE CHILDREN'S HEALTHCARE SYSTEM ARE CONDUCTED BY RELATED ORGANIZATIONS. SEE ADDITIONAL DESCRIPTION FOR SCHEDULE M, LINE 32.
SEATTLE CHILDREN'S COMMUNITY BENEFIT REPORT 2018-2019	LETTER FROM OUR CHIEF EXECUTIVE OFFICER OUR FUTURE DEPENDS ON THE POTENTIAL OF TODAY'S CHILDREN. YET MANY OBSTACLES STAND IN THEIR WAY TO A HEALTHY, FULFILLING LIFE. INADEQUATE ACCESS TO MENTAL HEALTH CARE, TOO FEW SAFE PLACES TO PLAY, AND POOR NUTRITION AND OBESITY ARE JUST SOME OF THE CHALLENGES THAT CAN DETERMINE A CHILD'S LIFELONG PHYSICAL AND EMOTIONAL HEALTH. AT SEATTLE CHILDREN'S, WE SEEK TO BUILD ON COMMUNITY AND FAMILY STRENGTHS IN ORDER TO OVERCOME THE MYRIAD CHALLENGES KIDS FACE - IMMEDIATELY AND OVER THE LONG HAUL. OUR TOP PRIORITY IS TO PROVIDE THE BEST AND SAFEST CARE WE CAN FOR THE CHILDREN AND FAMILIES WE SERVE. THROUGHOUT OUR REGION AND BEYOND, WE REPRESENT THE PROMISE OF HOPE, CARE AND CURES. THAT PROMISE DRIVES EVERYTHING WE DO. NOT JUST AT THE HOSPITAL BEDSIDE, BUT WHEREVER THERE ARE OPPORTUNITIES TO KEEP FAMILIES SAFE AND HEALTHY. WE ADVOCATE FOR ESSENTIAL RESOURCES, GET PEDIATRIC SPECIALISTS CLOSER TO WHERE CHILDREN LIVE, TRAIN THE NEXT GENERATION OF CHILD AND ADOLESCENT HEALTH EXPERTS, PROMOTE EQUITY AND COMMUNITY HEALTH, AND RESEARCH NEW WAYS TO TREAT AND CURE CHILDHOOD DISEASES. WE'VE ACHIEVED MANY SUCCESSES BY WORKING WITH FAMILIES, COMMUNITY PARTNERS, PUBLIC HEALTH OFFICIALS AND MANY OTHERS. THIS REPORT HIGHLIGHTS SOME OF OUR MOST RECENT EFFORTS TO KEEP OUR PROMISE TO CHILDREN AND FAMILIES. THANK YOU FOR BEING PART OF OUR JOURNEY. SINCERELY, JEFF SPERRING, MD CEO, SEATTLE CHILDREN'S
WHAT IS COMMUNITY BENEFIT?	A COMMUNITY BENEFIT IS A PROGRAM OR SERVICE THAT MEETS AT LEAST ONE OF THESE OBJECTIVES: - IMPROVES ACCESS TO HEALTHCARE. - ENHANCES THE HEALTH OF THE COMMUNITY. - ADVANCES MEDICAL OR HEALTH KNOWLEDGE. - RELIEVES OR REDUCES THE BURDEN OF GOVERNMENT OR OTHER COMMUNITY EFFORTS. COMMUNITY BENEFITS ARE CLASSIFIED AS UNCOMPENSATED CARE, RESEARCH, HEALTH PROFESSIONS EDUCATION AND COMMUNITY HEALTH IMPROVEMENT. COMMUNITY BENEFIT IS ALSO THE BASIS OF THE TAX-EXEMPTION OF NONPROFIT HOSPITALS. LEARN MORE ABOUT HOW WE CONTRIBUTE TO THE COMMUNITY AT WWW.SEATTLECHILDRENS.ORG/COMMUNITYBENEFIT TOTAL 2018 INVESTMENT IN THE COMMUNITY: $231,668,000* UNCOMPENSATED CARE & MEDICAID SHORTFALL*: $146,667,000 HEALTH PROFESSIONS EDUCATION: $30,328,000 RESEARCH: $41,828,000 COMMUNITY PROGRAMS AND SERVICES: $12,845,000 DOES NOT INCLUDE GRANTS AND CONTRIBUTIONS SEATTLE CHILDREN'S RECEIVED THAT SUPPORT COMMUNITY BENEFIT PROGRAMS. ** REFLECTS COSTS AFTER SUBTRACTING PAYMENTS FROM MEDICAID, DONATIONS, AND GRANTS SEATTLE CHILDREN'S RECEIVED THAT SUPPORT THESE PROGRAMS, INCLUDING A $40 MILLION ONE-TIME DONATION SUPPORTING UNCOMPENSATED CARE.
COMMUNITY PROGRAMS AND SERVICES	OUR MISSION ISN'T LIMITED TO HELPING CHILDREN AND FAMILIES WHO COME TO US. WE GO TO THEM WITH SERVICES AND PROGRAMS THAT MEET THEIR NEEDS WHERE THEY LIVE. WORKING WITH OTHERS IN THE COMMUNITY, WE TACKLE THE ROOT CAUSES OF ILLNESS AND INJURY, ADVOCATE FOR FAMILY VOICES AND PROMOTE CHANGES THAT BUILD ON STRENGTHS AND MAKE COMMUNITIES SAFER AND HEALTHIER. FOSTERING WELLNESS AND COMMUNITY THROUGH SOCCER WHEN IS SOCCER PRACTICE MORE THAN SOCCER PRACTICE? WHEN THE PLAYERS ARE LEARNING SOCIAL-EMOTIONAL SKILLS THEY CAN USE BOTH ON AND OFF THE FIELD. THAT'S THE GOAL OF A SOCCER WELLNESS PROGRAM FOR 7-13 YEAR-OLD KIDS STARTED BY MARK FADOOL, DIRECTOR OF MENTAL HEALTH SERVICES AT THE ODESSA BROWN CHILDREN'S CLINIC. DEVELOPED IN PARTNERSHIP WITH THE RAINIER VISTA BOYS AND GIRLS CLUB AND LED BY COACHES FROM THE NOWLAND PREMIER SOCCER ACADEMY, THE PROGRAM OFFERS SIX WEEKLY SESSIONS FOR KIDS HELD FOUR TIMES A YEAR. THE PROGRAM PROVIDES ACCESS TO PREMIER-LEVEL COACHING THAT WOULD BE UNAFFORDABLE TO MANY CHILDREN, BUT THE DRIVING FORCE WAS A REQUEST FROM THE RAINIER VISTA BOYS AND GIRLS CLUB FOR HELP PROVIDING MENTAL HEALTH SUPPORT TO YOUTH DEALING WITH A HOST OF STRESSORS. FADOOL SEES THE SOCCER WELLNESS PROGRAM AS A WAY TO DELIVER A FUN AND INNOVATIVE SOCIAL-EMOTIONAL PROGRAM TO KIDS LIVING IN SOUTHEAST SEATTLE. THE PROGRAM HAS BEEN ABLE TO PROVIDE ADDITIONAL SUPPORT TO THE UNDERSERVED EAST AFRICAN COMMUNITY BY THE USE OF SOCCER'S WORLDWIDE POPULARITY. ALL COACHES RECEIVE TRAINING IN SUPPORTING SOCIAL-EMOTIONAL HEALTH AND PROVIDE TIME BEFORE AND AFTER PRACTICE FOR PLAYERS TO REFLECT ON BEHAVIORAL GOALS LIKE BEING A GOOD TEAMMATE. NOT ALL KIDS NEED THE EXTRA SUPPORT, BUT ALL KIDS CAN BENEFIT FROM IMPROVED SOCIAL AND EMOTIONAL SKILLS WHILE HAVING FUN," FADOOL SAID. THE STRENGTH TO COPE PARENTS NEED PATIENCE AND COMPASSION - NOT JUST TOWARD THEIR CHILDREN BUT TOWARD THEMSELVES. THAT'S ESPECIALLY TRUE FOR PARENTS OF CHILDREN WITH CHRONIC CONDITIONS OR SPECIAL NEEDS. THEY MUST JUGGLE FREQUENT MEDICAL APPOINTMENTS, MAKE SURE THEIR CHILD'S NEEDS ARE BEING MET AND COPE WITH ANY MENTAL OR BEHAVIORAL HEALTH CHALLENGES THAT MAY ARISE. SHAYLA COLLINS IS ONE OF DOZENS OF SUCH PARENTS WHO HAVE LEARNED HOW TO MANAGE THE ADDED STRESS, ANXIETY AND FRUSTRATION THROUGH THE FINDING STRENGTH FOR THE LONG HAUL CLASS OFFERED BY ODESSA BROWN CHILDREN'S CLINIC. "THE CLASS TAUGHT ME IT'S OK TO FEEL SOMETHING, BUT RATHER THAN IMMEDIATELY REACT, I NEED TO GIVE MYSELF TIME TO PAUSE AND FIGURE OUT HOW - OR IF - I WANT TO RESPOND," SAYS SHAYLA, WHO BECAME A CLASS FACILITATOR HERSELF AFTER TAKING PART IN THE FIRST CLASS IN 2017. THE FIVE-WEEK CLASS, WHICH IS OFFERED IN ENGLISH AND SPANISH, EMPHASIZES MINDFULNESS AND SELF-COMPASSION - CONCEPTS THAT HELP PARENTS MAINTAIN A HEALTHY EMOTIONAL BALANCE AS THEY CARE FOR THEIR KIDS WHILE ALSO FACING OTHER ISSUES. "MANY OF THE FAMILIES WHO PARTICIPATE ARE IMMIGRANTS, REFUGEES AND PEOPLE WHO ARE FACING POVERTY OR OTHER ADVERSITY," SAYS KIM ARTHUR, WHO COORDINATES THE CLASSES. "THERE ARE A LOT OF PROGRAMS TO HELP CHILDREN WITH CHRONIC CONDITIONS, BUT WE FIND THAT PARENTS ARE EAGER TO CONNECT AND GET SUPPORT TOO."
RESEARCH	OUR RESEARCH BRINGS HOPE TO CHILDREN AND FAMILIES BATTLING DISEASES THAT CAN'T BE CURED WITH CURRENT THERAPIES. WE WORK IN THE LABORATORY AND AT THE BEDSIDE TO TRANSLATE OUR DISCOVERIES INTO BETTER WAYS TO PREVENT, TREAT AND ELIMINATE PEDIATRIC DISEASE FOR OUR PATIENTS AND FOR CHILDREN AROUND THE WORLD. OVERCOMING VACCINE HESITANCY DR. DOUG OPEL DEVELOPED A SURVEY SEVERAL YEARS AGO TO IDENTIFY FAMILIES AT RISK OF FALLING BEHIND ON THEIR CHILDHOOD VACCINATION SCHEDULE. THE PARENT ATTITUDES ABOUT CHILDHOOD VACCINES (PACV) WAS A TOOL TO HELP HIM STUDY WHY THAT HAPPENS AND HOW TO INTERVENE. OPEL IS NOW LOOKING AT WHETHER THE SURVEY CAN PLAY A DIRECT ROLE IN IMPROVING VACCINATION RATES. BY MAKING IT PART OF WELL-CHILD VISITS DOCTORS CAN ADDRESS THE SPECIFIC CONCERNS OF FAMILIES WHO THE SURVEY IDENTIFIES AS VACCINE-HESITANT. MORE THAN 150 FAMILIES IN 24 CLINICS AROUND WESTERN WASHINGTON TOOK PART IN A RANDOMIZED PILOT STUDY LED BY OPEL WITH FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH. FAMILIES RECEIVED EITHER THE PACV SURVEY OR A GENERAL SURVEY WITH NO MENTION OF VACCINES AT THEIR TWO-MONTH AND SIX-MONTH CHECKUPS. THE PACV SURVEY PROVIDED DOCTORS - WHO HAVE A LOT OF GROUND TO COVER DURING AN APPOINTMENT - WITH A HEADS UP ABOUT WHICH FAMILIES MIGHT BE VACCINE-HESITANT AND WHAT ISSUES TO DISCUSS. THE RESULTS OF THE STUDY ARE BEING ANALYZED TO SEE IF TAKING THE PACV SURVEY ULTIMATELY RESULTED IN HIGHER RATES OF VACCINE COMPLIANCE BY THE TIME A CHILD WAS EIGHT MONTHS OLD. EVEN IF IT DOESN'T, THIS STUDY IS AN IMPORTANT FIRST STEP TO IDENTIFYING INNOVATIVE WAYS TO HELP PROMOTE VACCINE ACCEPTANCE. "THE CURRENT MEASLES OUTBREAK IS JUST ONE EXAMPLE OF WHY IT'S CRITICAL TO HELP VACCINE-HESITANT FAMILIES UNDERSTAND THE BENEFITS OF VACCINATING THEIR CHILD," OPEL SAYS. ARMING T CELLS TO FIGHT HIV MODERN DRUGS SUPPRESS THE POTENTIALLY DEADLY HIV VIRUS, BUT COME WITH NEGATIVE SIDE EFFECTS RANGING FROM NAUSEA TO MORE SERIOUS CONDITIONS LIKE LIVER COMPLICATIONS - AN INCREASED CONCERN FOR YOUNG PATIENTS BECAUSE THEY HAVE TO BEAR THE BURDEN OF TREATMENT LONGER THAN PEOPLE WHO ARE INFECTED AS ADULTS. T CELLS ARE A CRUCIAL PART OF THE BODY'S IMMUNE SYSTEM, BUT HIV DESTROYS THEIR ABILITY TO FIGHT INFECTIONS. DRS. THOR WAGNER AND DAVID RAWLINGS USED GENE EDITING TO SHOW THAT T CELLS CAN BE PROGRAMMED TO BOTH KILL AND RESIST HIV IN HUMAN BLOOD SAMPLES. THEY USED A SPECIFIC ENZYME TO DAMAGE THE GENE THAT CONTROLS A RECEPTOR ON THE T CELL SURFACE TARGETED BY HIV, ELIMINATING THE RECEPTOR AND PREVENTING THE VIRUS FROM INVADING THE CELL. AT THE SAME TIME, THEY INTRODUCED A NEW GENE THAT GIVES THE T CELL VIRUS-KILLING CAPABILITIES. IF FUTURE RESEARCH PROVES THE TREATMENT SAFE, DOCTORS COULD TAKE T CELLS FROM AN HIV POSITIVE PATIENT, MODIFY THEM TO KILL AND RESIST HIV, AND THEN RETURN THEM TO THE PATIENT. "WE HOPE THIS TREATMENT CAN PREVENT THE NEED FOR HIV DRUGS THAT HAVE NEGATIVE SIDE EFFECTS FOR PEOPLE WHO NEED THEM TO STAY ALIVE," RAWLINGS SAYS.
HEALTH PROFESSIONS EDUCATION	PROVIDING CHILDREN AND FAMILIES WITH THE BEST CARE POSSIBLE DEPENDS ON SURROUNDING THEM WITH HIGHLY TRAINED DOCTORS, NURSES AND OTHER HEALTH CARE PROVIDERS. AS HOME TO THE UNIVERSITY OF WASHINGTON'S PEDIATRIC RESIDENCY AND FELLOWSHIP PROGRAMS AND A TRAINING GROUND FOR NURSES AND OTHER PROVIDERS, SEATTLE CHILDREN'S HELPS THE NEXT GENERATION OF HEALTH PROFESSIONALS GAIN INVALUABLE EXPERIENCE WORKING BESIDE WORLD-CLASS SPECIALISTS. WE ALSO OFFER CONTINUING EDUCATION AND OUTREACH TO HEALTHCARE PROVIDERS ALREADY CARING FOR KIDS IN OUR COMMUNITY. FELLOWSHIPS DRIVE CHANGE A SIMPLE QUESTION ASKED BY TWO YOUNG NURSES MAY LEAD TO CHANGES ACROSS SEATTLE CHILDREN'S THANKS TO THE HOSPITAL'S NURSING EVIDENCE BASED PRACTICE (EBP) FELLOWSHIP. SOON AFTER BEING HIRED IN 2016, OLIVIA KERWIN AND SAMANTHA KUNZE GARCIA BECAME CONCERNED THAT IMPLICIT - OR UNCONSCIOUS - BIAS BY NURSES MIGHT BE AFFECTING PATIENTS AND FAMILIES OF LOW-INCOME AND/OR MINORITY STATUS. THEY APPLIED FOR THE NURSING EBP FELLOWSHIP TO TAKE A CLOSER LOOK AT THE ISSUE. THE FELLOWSHIP PROVIDES COACHING TO NURSES AS THEY WORK ON A PROJECT RELEVANT TO THEIR UNIT. FELLOWS MEET WITH A MENTOR FOR TWO HOURS A MONTH AND ARE PAID TO WORK ON THEIR PROJECT FOR AN ADDITIONAL SIX HOURS A MONTH. ABOUT 45 NURSES HAVE TAKEN PART IN THE EIGHT-MONTH PROGRAM SO FAR. AFTER REVIEWING MORE THAN 160 ARTICLES ABOUT IMPLICIT BIAS IN HEALTHCARE SETTINGS, KERWIN AND KUNZE GARCIA APPROACHED SENIOR NURSING LEADERS WHO APPROVED THEIR IDEA TO DEVELOP AN EQUITY, DIVERSITY AND INCLUSION (EDI) TRAINING FOR ALL SEATTLE CHILDREN'S NURSES. "IN THE BEGINNING WE WERE REALLY JUST HOPING TO BEGIN A CONVERSATION," KERWIN SAYS. "IT WAS INCREDIBLE THAT SEATTLE CHILDREN'S NURSING LEADERS WERE WILLING TO LISTEN TO AND WORK WITH US." PATHWAY TO ADVOCACY DOCTORS IN TRAINING AT SEATTLE CHILDREN'S AND THE UNIVERSITY OF WASHINGTON WHO WANT TO DEVELOP SKILLS IN SPECIFIC AREAS CAN PURSUE THEIR PASSIONS THROUGH SEVERAL TRAINING PATHWAYS. THE RESIDENT EDUCATION AND ADVOCACY FOR CHILD HEALTH (REACH) PATHWAY TEACHES RESIDENTS HOW TO PROTECT AND IMPROVE THE HEALTH OF COMMUNITIES BY UNDERSTANDING AND RESPONDING TO A COMMUNITY'S PARTICULAR NEEDS. RESIDENTS BEGIN BY LEARNING TO ASSESS COMMUNITY HEALTH NEEDS, PLAN PROGRAMS AND EVALUATE RESULTS. THEY GAIN SKILLS AND UNDERSTANDING RELATED TO HEALTH POLICY, THE SOCIAL DETERMINANTS OF HEALTH AND DATA COLLECTION/ANALYSIS/REPORTING. THEY COMPLETE THEIR TRAINING BY APPLYING THEIR NEW SKILLS DURING A ROTATION IN ONE OF TWO LOCATIONS - THE YAKIMA VALLEY FARM WORKERS CLINIC IN THE SMALL EASTERN WASHINGTON TOWN OF TOPPENISH OR IN KISII, KENYA, WHERE THEY WORK ALONGSIDE RESIDENTS FROM THE UNIVERSITY OF NAIROBI. THE REACH PATHWAY IS A WIN-WIN. RESIDENTS GAIN DESIRED SKILLS WHILE THEIR TRAINING LOCATIONS BENEFIT FROM THEIR TIME AND TALENTS AS THEY ADVOCATE FOR UNDERSERVED POPULATIONS.
UNCOMPENSATED CARE	FAMILIES WITH A SERIOUSLY ILL OR INJURED CHILD ALREADY HAVE ENOUGH ON THEIR MINDS. THEY SHOULD NOT HAVE TO WORRY ABOUT HOW TO PAY THE MOUNTAIN OF MEDICAL BILLS THAT CAN PILE UP EVEN IF THEY HAVE INSURANCE. OUR FINANCIAL ASSISTANCE FUND FILLS THE GAP BETWEEN WHAT FAMILIES CAN AFFORD TO PAY AND THE COST OF HELPING THEIR CHILD LIVE THE FULLEST LIFE POSSIBLE. IN 2018 WE PROVIDED OVER $146 MILLION IN UNCOMPENSATED CARE TO CHILDREN IN WASHINGTON, ALASKA, MONTANA AND IDAHO. FUND LIFTS FINANCIAL BURDEN DANI COLE WILL NEVER FORGET GETTING INTO AN ELEVATOR AT SEATTLE CHILDREN'S WITH HER HUSBAND JAMES AND THEIR DAUGHTER. JAMES WAS HOLDING [HIS DAUGHTER'S] HAND AS SHE LAY IN A HOSPITAL BED BEING PUSHED BY A NURSE. THEY WERE ON THEIR WAY TO THE EIGHTH FLOOR - THE CANCER UNIT. "ALL I COULD THINK ABOUT WAS HOW CAN THIS BE POSSIBLE?" DANI RECALLS. "HOW CAN OUR BRIGHT ANGEL HAVE A TUMOR WRAPPED AROUND HER SPINE?" AT 2 YEARS OLD, THE CHILD HAD BEEN DIAGNOSED WITH NEUROBLASTOMA, A FORM OF CANCER FOUND MOSTLY IN CHILDREN THAT OCCURS WHEN SPECIAL NERVE CELLS CALLED NEUROBLASTS MATURE INTO TUMOR CELLS INSTEAD OF NORMALLY FUNCTIONING NERVE CELLS. THE NEWS CAUSED THE BOTTOM TO FALL OUT OF THEIR WORLD. ON TOP OF THE SHEER TERROR THEY FELT HEARING WORDS LIKE "MASS AND "TUMOR," THEY WERE DEVASTATED TO LEARN THAT THE MEDICAL CARE REQUIRED TO SAVE HER WOULD QUICKLY EAT UP THE LIFETIME MAXIMUM OF THEIR INSURANCE COVERAGE. "WHILE I WAS STILL TRYING TO PROCESS THE FACT THAT OUR LITTLE GIRL HAD CANCER, I HAD NO IDEA HOW WE WERE GOING TO AFFORD HER TREATMENT, LET ALONE PAY OUR MORTGAGE, OUR CAR PAYMENT AND ALL OF OUR DAY-TO-DAY BILLS," DANI SAYS. THEN THEY FOUND OUT THEY QUALIFIED FOR FINANCIAL ASSISTANCE FROM THE UNCOMPENSATED CARE FUND AT SEATTLE CHILDREN'S. AT FIRST, THEY DIDN'T APPEAR TO QUALIFY, BUT WHEN DANI TOLD A TEAM MEMBER FROM THE FINANCIAL ASSISTANCE PROGRAM SHE WAS TAKING THE YEAR OFF TO CARE FOR [HER LITTLE GIRL], THE DROP IN INCOME MADE THEM ELIGIBLE. "YOU CAN'T IMAGINE THE WEIGHT OFF OUR SHOULDERS WHEN WE REALIZED THE FUND WOULD PICK UP ANYTHING OUR INSURANCE WOULDN'T - AND THAT WE COULD FOCUS ENTIRELY ON GETTING [OUR DAUGHTER] WELL," SAYS HER MOM. OVER THE NEXT 18 MONTHS, SHE SPENT MORE THAN 200 NIGHTS AT SEATTLE CHILDREN'S FOR TREATMENT THAT INCLUDED THREE SURGERIES, FIVE ROUNDS OF CHEMOTHERAPY, 20 ROUNDS OF RADIATION, A STEM CELL TRANSPLANT AND A TYPE OF IMMUNOTHERAPY. IT WAS A LONG AND GRUELING JOURNEY, BUT IT SAVED HER LIFE. "THROUGH IT ALL, WE NEVER HAD TO ASK ABOUT COST WHEN OUR CARE TEAM RECOMMENDED TESTS AND TREATMENTS," DANI SAYS. "WITHOUT SEATTLE CHILDREN'S FINANCIAL ASSISTANCE WE WOULD HAVE GONE INTO DEBT AND LOST OUR HOME. TO THIS DAY, I HAVE ZERO IDEA HOW MUCH THE TREATMENT COST, BUT WE ARE FOREVER GRATEFUL."
OUR COMMUNITY BENEFIT PRIORITIES	WE WORK WITH PARTNERS IN THE COMMUNITY TO ADDRESS FOUR URGENT HEALTH NEEDS IDENTIFIED BY OUR 2016-2019 COMMUNITY HEALTH ASSESSMENT. HERE ARE SOME OF OUR RECENT ACCOMPLISHMENTS IN EACH OF THE FOUR PRIORITY AREAS.
MENTAL AND BEHAVIORAL HEALTH	WE ARE COMMITTED TO HELPING ALL CHILDREN GET THE MENTAL HEALTH CARE THEY NEED. OUR MENTAL AND BEHAVIORAL HEALTH EXPERTS NOT ONLY DIAGNOSE AND TREAT PROBLEMS LIKE ANXIETY AND DEPRESSION, THEY STRIVE TO UNDERSTAND THEM AND FIND BETTER WAYS TO HELP CHILDREN AND FAMILIES PREVENT AND OVERCOME THEM. WORKING WITH PARTNERS, WE EXPAND THE CAPACITY OF THE COMMUNITY TO PROVIDE SERVICES THAT ARE ESSENTIAL TO A CHILD'S WELL-BEING. FIRST AID FOR KIDS IN CRISIS MANY PEOPLE KNOW HOW TO SAVE A LIFE BY PERFORMING CPR, BUT FEW KNOW HOW TO HAVE A CONVERSATION WITH AN ADOLESCENT STRUGGLING WITH DEPRESSION OR ADDICTION - A SKILL THAT CAN ALSO SAVE A LIFE. A NEW CLASS OFFERED AT SEATTLE CHILDREN'S GIVES PARENTS AND OTHER ADULTS WHO INTERACT WITH YOUNG PEOPLE SKILLS TO HELP AN ADOLESCENT WHO IS EXPERIENCING A MENTAL HEALTH CHALLENGE. YOUTH MENTAL HEALTH FIRST AID IS AN EVIDENCE BASED PROGRAM THAT PROVIDES PRACTICAL INFORMATION ABOUT COMMON YOUTH MENTAL HEALTH ISSUES, ADOLESCENT DEVELOPMENT AND HOW TO SUPPORT YOUNG PEOPLE IN CRISIS AND NON-CRISIS SITUATIONS. PARTICIPANTS PRACTICE ASKING DIFFICULT QUESTIONS SUCH AS, "ARE YOU THINKING ABOUT KILLING YOURSELF? AND LEARN THAT ASKING SOMEONE IF THEY ARE AT RISK OF SUICIDE DOES NOT PUT THE IDEA IN THEIR HEAD. LAURA CROOKS, SEATTLE CHILDREN'S FORMER SENIOR DIRECTOR OF PATIENT AND FAMILY EXPERIENCE AND NOW CEO AT CHILDREN'S VILLAGE IN YAKIMA, WA WAS INSTRUMENTAL IN BRINGING THE CLASS TO SEATTLE CHILDREN'S AFTER LOSING HER OWN SON TO SUICIDE. "THE YOUTH MENTAL HEALTH FIRST AID CLASS HELPS YOU UNDERSTAND WHEN THERE'S REALLY A PROBLEM," SHE SAYS. "WE'D LIKE TO SEE THIS CLASS BECOME AS PREVALENT AS CPR. EVERYONE SHOULD TAKE IT." YOUTH MENTAL HEALTH FIRST AID CLASS AT SEATTLE CHILDREN'S IS TAUGHT IN PARTNERSHIP WITH USA YOUTH MENTAL HEALTH FIRST AID, CHAD'S LEGACY PROJECT, AND KING COUNTY. VIDEO CHAT REFERRALS BOOST ACCESS WHEN CHILDREN NEED MENTAL HEALTH CARE, PRIMARY CARE PROVIDERS REFER THEM TO MENTAL HEALTH PROVIDERS. AS SIMPLE AS THAT SOUNDS, MANY PARENTS STRUGGLE TO COMPLETE THE FIRST STEP OF THE MENTAL HEALTH INTAKE PROCEDURE. RECENT RESEARCH LED BY DR. TUMAINI COKER FOUND THAT A VIDEO CHAT REFERRAL PROCESS DEVELOPED BY AN ACADEMIC-COMMUNITY PARTNERED RESEARCH TEAM INCREASED THE ODDS THREEFOLD THAT PARENTS WOULD FINISH THE SCREENING NECESSARY TO GET MENTAL HEALTH CARE FOR THEIR CHILD. FUNDED BY THE PATIENT-CENTERED OUTCOMES RESEARCH INSTITUTE, THE STUDY AIMED TO IMPROVE ACCESS TO MENTAL HEALTH CARE FOR FAMILIES IN UNDERSERVED AREAS. NEARLY 350 PARENTS OF CHILDREN AGES 5-12 PARTICIPATED IN THE RANDOMIZED TRIAL. NEARLY 90% OF THE CHILDREN WERE LATINX AND ALL WERE COVERED BY MEDICAID. THE VIDEO CHAT REFERRAL PROCESS PROVIDES PARENTS WITH MORE PERSONAL SUPPORT THAN THE USUAL TELEPHONE REFERRALS. AT THE PRIMARY CARE CLINIC, PARENT ARE SHOWN A FIVE-MINUTE VIDEO ABOUT WHAT TO EXPECT, MEET WITH A CARE COORDINATOR, AND THEN SCHEDULE A VIDEO CHAT WITH A SCREENER FROM THE MENTAL HEALTH CENTER. DURING THE CHAT, PARENTS CAN SEE THE SCREENER ASKING THE QUESTIONS, WHICH CAN MAKE THEM FEEL MORE COMFORTABLE ABOUT SHARING PERSONAL INFORMATION.
SUICIDE AND VIOLENCE PREVENTION	SEATTLE CHILDREN'S WORKS TO PROMOTE FIREARM SAFETY AND ADDRESS THE UNDERLYING CAUSES OF YOUTH VIOLENCE AND SUICIDE. WE GIVE AWAY FREE FIREARM SAFE STORAGE DEVICES AT COMMUNITY EVENTS AS WELL AS AT THE HOSPITAL, AND WE ACT PROACTIVELY TO PREVENT SUICIDE WITHIN THE POPULATION WE SERVE. ASKING LIFESAVING QUESTIONS BETWEEN 2007 AND 2016, THE SUICIDE RATE FOR BOYS AGE 10-14 HAD DOUBLED; FOR GIRLS AGE 10-14 OVER THE SAME TIME PERIOD, THE SUICIDE RATE HAS TRIPLED. SEATTLE CHILDREN'S CREATED A NEW CLINICAL SERVICES PATHWAY TO GUIDE PROVIDERS IN SCREENING, ASSESSING AND REFERRING YOUTH FOR SUICIDE RISK. ALL CHILDREN 10 AND OLDER ADMITTED TO THE HOSPITAL OR EMERGENCY ROOM ARE NOW ASKED FOUR QUESTIONS ABOUT SELF-HARM, DEATH AND DYING. "MANY KIDS WHO ARE EXPERIENCING SUICIDAL IDEATION OR THOUGHTS ABOUT HARMING THEMSELVES DON'T DISCLOSE THIS UNTIL THEY ENGAGE IN THE BEHAVIOR," SAID CLINICAL PSYCHOLOGIST MOLLY ADRIAN. "WE BELIEVE THAT ASKING ALL CHILDREN THESE QUESTIONS WILL HELP US CATCH THE THREAT EARLY AND BETTER RESPOND TO AND TREAT THE DISTRESS THAT IS CREATING THE URGE TO DIE." IF A CHILD IS FOUND TO BE AT RISK, THEIR HEALTH PROVIDER DISCUSSES THE FINDINGS WITH THE FAMILY, HELPS THEM CREATE A CRISIS PREVENTION PLAN AND TRANSFERS CARE TO A MENTAL HEALTH PROVIDER THROUGH A WARM HANDOFF IN WHICH THE PROVIDERS AND THE FAMILY ARE ALL PRESENT. SUICIDE SCREENING WILL EXPAND BEYOND THE HOSPITAL TO INCLUDE ALL SEATTLE CHILDREN'S PATIENT CARE SITES. IN ADDITION, THE MAJORITY OF SEATTLE CHILDREN'S CARE PROVIDERS WILL RECEIVE SIX HOURS OF SUICIDE PREVENTION TRAINING. ALL OF THESE STEPS ALIGN WITH THE GOALS OF THE NATIONAL ZERO SUICIDE INITIATIVE, WHICH CHALLENGES HEALTH SYSTEMS TO MAKE IMPROVEMENTS THAT CAN PREVENT DEATH BY SUICIDE OF INDIVIDUALS UNDER THEIR CARE. SAFER FIREARM STORAGE MENTAL HEALTH ISSUES SUCH AS DEPRESSION ARE A MAJOR RISK FACTOR FOR SUICIDE - MORE SO IF THERE IS A FIREARM IN THE HOUSE AND IF IT IS NOT SAFELY STORED. A STUDY LED BY DR. NEIL USPAL GATHERED INFORMATION ABOUT FIREARM OWNERSHIP AND SAFE STORAGE PRACTICES FROM FAMILIES WHOSE CHILD SOUGHT MENTAL HEALTH CARE IN OUR EMERGENCY DEPARTMENT OR INPATIENT PSYCHIATRY AND BEHAVIORAL MEDICINE UNIT. WHEN DATA ANALYSIS IS COMPLETE, USPAL'S STUDY WILL SHOW WHETHER GIVING FAMILIES A FREE FIREARM STORAGE DEVICE - EITHER A LOCK BOX OR A TRIGGER LOCK - AFFECTS WHETHER THE DEVICE IS BEING USED. "WE WERE WORRIED THAT NOBODY WOULD WANT TO BE IN THE STUDY BECAUSE WE ASKED PRETTY SPECIFIC QUESTIONS ABOUT PEOPLE'S FIREARMS SUCH AS HOW MANY THEY OWN, WHERE THEY STORE THEM, AND WHERE THEY STORE AMMUNITION," USPAL SAYS. "BUT ONCE WE EXPLAINED THE STUDY AND WHY IT WAS IMPORTANT, PEOPLE WERE VERY INTERESTED IN PARTICIPATING." SEPARATE FROM THE STUDY, THE INPATIENT PSYCHIATRY AND BEHAVIORAL MEDICINE UNIT NOW OFFERS A FREE FIREARM STORAGE DEVICE TO FIREARM OWNING FAMILIES OF ALL CHILDREN. THE ODESSA BROWN CHILDREN'S CLINIC AND THE AMBULATORY PSYCHIATRIC CLINICS ALSO OFFER FREE FIREARM STORAGE DEVICES TO THE FAMILIES THEY SERVE.
HEALTHY EATING, ACTIVE LIVING AND FOOD SECURITY	NUTRITIOUS FOOD AND PHYSICAL ACTIVITY ARE ESSENTIAL FOR CHILDREN TO GROW UP STRONG AND HEALTHY. WE WORK ALONGSIDE THE COMMUNITY TO FIGHT HUNGER, IMPROVE ACCESS TO NUTRITIOUS FOOD AND INCREASE OPPORTUNITIES FOR CHILDREN AND FAMILIES TO BE PHYSICALLY ACTIVE. FIGHTING FOOD INSECURITY DURING FINANCIAL HARDSHIPS, FAMILIES MAKE DIFFICULT TRADE-OFFS. FAMILIES REDUCE THEIR FOOD QUALITY AND VARIETY, EVEN SKIPPING MEALS, IN ORDER TO MAKE ENDS MEET. THE LACK OF STEADY NUTRITION CAUSED BY FOOD INSECURITY (HUNGER) HAMPERS A SICK CHILD'S HEALING AND ABILITY TO STAY WELL. CHILDREN WITH CHRONIC ILLNESSES ALSO HAVE SPECIAL DIETARY NEEDS, WHICH CAN BE COSTLY, AND MIGHT NOT BE COVERED AT COMMUNITY FOOD BANKS. PARENTS AND CAREGIVERS OF CHILDREN WITH CHRONIC ILLNESS MAY FACE LOSS OF INCOME IF THEY REDUCE THEIR WORK HOURS TO CARE FOR KIDS. A GROWING NUMBER OF SPECIALTY CLINICS WITHIN SEATTLE CHILDREN'S NOW ASK FAMILIES ABOUT FOOD INSECURITY. FAMILIES WHO WANT HELP ARE GIVEN A TWO-DAY SUPPLY OF NUTRITIOUS FOOD FROM OUR FOOD PANTRY, WHICH IS SUPPORTED BY DONORS, GRANTS, THE HOSPITAL, AND A PARTNERSHIP WITH NORTHWEST HARVEST. TO HELP FAMILIES WITH ONGOING FOOD RESOURCES, WE LINK THEM TO WITHINREACH, A LOCAL NONPROFIT THAT CONNECTS PEOPLE WITH THE SOCIAL SERVICES THEY NEED TO STAY SAFE AND HEALTHY. A SURVEY OF FAMILIES FROM TWO CLINICS SERVING CHILDREN WITH END-STAGE KIDNEY DISEASE SHOWED A CORRELATION BETWEEN IMPROVED FOOD SECURITY AND FEWER HOSPITALIZATIONS AND INFECTIONS. OBESITY TIED TO NEIGHBORHOOD TRAITS CHILDHOOD OBESITY CONTINUES TO BE A SERIOUS HEALTH CONCERN IN THE UNITED STATES, PUTTING CHILDREN AT GREATER RISK FOR DEVELOPING CONDITIONS LIKE HEART DISEASE AND TYPE 2 DIABETES. RESEARCH LED BY DR. BRIAN SAELENS FOUND THAT A CHILD'S WEIGHT STATUS CHANGES OVER TIME BASED ON THE AVAILABILITY OF NUTRITIOUS FOOD AND THE OPPORTUNITY FOR PHYSICAL ACTIVITY IN THE NEIGHBORHOOD WHERE THEY LIVE. THE STUDY INVOLVED MORE THAN 600 CHILDREN AGES 8-13 IN SEATTLE/KING COUNTY AND SAN DIEGO COUNTY. WHEN HE BEGAN HIS RESEARCH SAELENS FOUND THAT CHILDREN WERE MORE LIKELY TO BE OVERWEIGHT OR OBESE IN NEIGHBORHOODS WITH NO PARKS OR LOW QUALITY PARKS AND NO SUPERMARKETS OR A HIGH CONCENTRATION OF FAST FOOD RESTAURANTS. THEY ALSO WERE MORE SEDENTARY AND CONSUMED MORE CALORIES. THE OPPOSITE WAS TRUE FOR CHILDREN LIVING IN NEIGHBORHOODS WITH AT LEAST ONE HIGH-QUALITY PARK, AT LEAST ONE SUPERMARKET, A SMALLER CONCENTRATION OF FAST FOOD RESTAURANTS AND MORE OPPORTUNITIES TO WALK. AFTER FOLLOWING UP TWO YEARS LATER, SAELENS FOUND THAT CHILDREN IN THE LESS FAVORABLE NEIGHBORHOODS - I.E. LACKING ACCESS TO NUTRITIOUS FOOD AND OPPORTUNITIES FOR PHYSICAL ACTIVITY - HAD BECOME EVEN MORE LIKELY TO HAVE WEIGHT ISSUES. MEANWHILE, THE OPPOSITE WAS TRUE FOR THOSE IN THE MORE FAVORABLE NEIGHBORHOODS SAELENS HOPES HIS RESEARCH WILL HELP CHANGE THE WAY NEIGHBORHOODS GROW AND DEVELOP. "ACTIVITY AND HEALTHY EATING AREN'T ALWAYS AT THE FOREFRONT OF OUR MINDS WHEN WE THINK ABOUT HOW THINGS ARE BUILT," HE SAYS.
COORDINATED CARE FOR CHILDREN AND TEENS WITH CHRONIC CONDITIONS	CARING FOR CHILDREN WITH COMPLEX CHRONIC CONDITIONS REQUIRES PROVIDERS IN THE HOSPITAL AND IN THE COMMUNITY TO WORK AS A TEAM TO ADDRESS THEIR MANY MEDICAL ISSUES. WE STRIVE TO COORDINATE A CHILD'S CARE ACROSS ALL SERVICES, SUPPORT FAMILIES AS THEY CARE FOR THEIR CHILD OUTSIDE THE HOSPITAL AND HELP CHILDREN MAKE A SUCCESSFUL TRANSITION TO ADULT CARE. TLC FOR KIDS WITH MEDICAL COMPLEXITY RAISING A CHILD WITH MEDICAL COMPLEXITY IS AN ENORMOUS CHALLENGE. THEY NEED ONGOING CARE FOR MULTIPLE CHRONIC CONDITIONS AND FACE MANY MEDICAL AND PSYCHO-SOCIAL ISSUES OVER TIME. WE LIFT SOME OF THE WEIGHT FROM A FAMILY'S SHOULDERS THROUGH TLC - SHORT FOR TRANSITIONAL LONGITUDINAL CARE. THIS PROGRAM PREPARES FAMILIES TO GO HOME AFTER HOSPITAL STAYS AND COORDINATES CARE FOR THEIR CHILD GOING FORWARD. WE ASSIGN EACH FAMILY A REGISTERED NURSE CARE MANAGER TO SERVE AS A SINGLE POINT OF CONTACT FOR ALL THEIR NEEDS AND QUESTIONS. "IT COULD BE A MEDICATION ISSUE, AN EQUIPMENT ISSUE, A FINANCIAL ISSUE OR A SCHOOL ISSUE," SAYS KATHY MULLIN, DIRECTOR OF CARE COORDINATION AT SEATTLE CHILDREN'S. "THE REGISTERED NURSE CASE MANAGER CAN ASSIST FAMILIES NAVIGATE THE SYSTEM TO ANSWER THEIR QUESTIONS AND OBTAIN THE HELP THEY NEED FROM SEATTLE CHILDREN'S AND IN THE COMMUNITY." THE PROGRAM IS ESPECIALLY HELPFUL TO FAMILIES WHO ARE JUST STARTING THEIR JOURNEY WITH A CHILD WITH MEDICAL COMPLEXITY. "EVERY STEP IS NEW TO THEM AND IT GIVES THEM PEACE OF MIND TO KNOW THERE IS SOMEBODY THEY CAN CALL," SAYS ERIN MARTIN, ONE OF THE PROGRAM'S REGISTERED NURSE CARE MANAGERS. PREPARING FAMILY CAREGIVERS THE HEALING PROCESS DOESN'T END AT THE HOSPITAL. MUCH OF A CHILD'S RECOVERY TAKES PLACE AT HOME UNDER THE CARE OF THEIR FAMILY. THAT'S WHY WE CONTINUALLY WORK TO IMPROVE THE HOSPITAL-TO-HOME TRANSITION. DR. ARTI DESAI RECENTLY CREATED AN OUTCOME MEASURE TO ASSESS HOW WELL THE HOSPITAL PREPARES FAMILIES TO CARE FOR THEIR CHILD AT HOME AND SUPPORTS THEM AFTER DISCHARGE. DR. DESAI INTERVIEWED PATIENT FAMILIES TO UNCOVER EIGHT CONCEPTS THAT WERE MOST IMPORTANT TO THEM DURING THE HOSPITAL-TO-HOME TRANSITION. "THE MEASURE ASKS ABOUT THINGS LIKE DID THEY GET ENOUGH DISCHARGE EDUCATION, DID THEY FEEL CONFIDENT WHEN THEY GOT HOME, WERE THEIR FOLLOW-UP PROVIDERS INFORMED ABOUT THE CARE THEY RECEIVED IN THE HOSPITAL," DR. DESAI SAYS. THE HOSPITAL COLLECTS FEEDBACK ON THESE OUTCOMES THROUGH A SHORT SURVEY GIVEN TO FAMILIES. "OUR MAIN GOAL IS TO GIVE FAMILIES A VOICE IN TELLING US HOW WELL WE'RE PREPARING THEM TO DEAL WITH A CHALLENGING TIME IN THEIR LIFE," DR. DESAI SAYS. THIS SURVEY, AND OTHER MEASURES SHE HAS DEVELOPED WITH COLLEAGUES, HAVE GUIDED EFFORTS TO IMPROVE THE DISCHARGE INSTRUCTIONS FAMILIES RECEIVE FROM THE HOSPITAL SO THEY CAN BETTER MANAGE THEIR CHILD'S CARE AT HOME. IN ADDITION, DR. DESAI IS WORKING TO ENSURE THAT UP-TO-DATE CARE PLANS FOR CHILDREN WITH MEDICAL COMPLEXITY - WHO HAVE CHRONIC CONDITIONS THAT REQUIRE CLOSELY COORDINATED CARE FROM MULTIPLE SPECIALISTS - ARE READILY AVAILABLE TO OTHER PROVIDERS ONCE A CHILD LEAVES THE HOSPITAL.

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

SEATTLE CHILDREN'S HEALTHCARE SYSTEM

Employer identification number

91-1250116

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) SYZYGY PROPERTIES LLC PO BOX 5371 MS RC-507 SEATTLE,WA981455005 91-1250116	REAL ESTATE MANAGEMENT	WA	527,302	5,187,591	SEATTLE CHILDREN'S HEALTHCARE SYSTEM

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)SEATTLE CHILDREN'S HOSPITAL PO BOX 5371 MS RC-507 SEATTLE,WA981455005 91-0564748	PEDIATRIC MEDICAL CARE	WA	501(C)(3)	LINE 3	SEATTLE CHILDREN'S HEALTHCARE SYSTEM	Yes
(2)SEATTLE CHILDREN'S HOSPITAL FOUNDATION PO BOX 5371 MS RC-507 SEATTLE,WA981455005 91-1156519	FUNDRAISING	WA	501(C)(3)	LINE 7	SEATTLE CHILDREN'S HEALTHCARE SYSTEM	Yes
(3)SEATTLE CHILDREN'S HOSPITAL GUILD ASSN PO BOX 5371 MS RC-507 SEATTLE,WA981455005 91-1394056	FUNDRAISING, CHILD ADVOCACY, AND PEDIATRIC HEALTH AWARENESS	WA	501(C)(3)	LINE 7	SEATTLE CHILDREN'S HEALTHCARE SYSTEM	Yes
(4)CHILDREN'S RETAIL PO BOX 5371 MS RC-507 SEATTLE,WA981455005 91-1998909	THRIFT STORES	WA	501(C)(3)	LINE 12A, I	SEATTLE CHILDREN'S HEALTHCARE SYSTEM	Yes
(5)CHILDREN'S HEALTH NETWORK PO BOX 5371 MS RC-507 SEATTLE,WA981455005 91-1226716	PEDIATRIC HEALTHCARE SERVICES	WA	501(C)(3)	LINE 12A, I	SEATTLE CHILDREN'S HEALTHCARE SYSTEM	Yes

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
(1) CHARITABLE REMAINDER UNITRUSTS (6)	INVESTMENTS	WA	SEATTLE CHILDREN'S HEALTHCARE SYSTEM				Yes
(2) CHARITABLE REMAINDER UNITRUSTS (5)	INVESTMENTS	WA	N/A					No
(3) CHARITABLE REMAINDER UNITRUST (1)	INVESTMENTS	AK	N/A					No
(4) CHARITABLE REMAINDER UNITRUSTS (3)	INVESTMENTS	CA	N/A					No
(5) CHARITABLE REMAINDER UNITRUST (1)	INVESTMENTS	FL	N/A					No
(6) CHARITABLE REMAINDER ANNUITY TRUSTS (1)	INVESTMENTS	WA	N/A					No
(7) PERPETUAL TRUSTS (2)	INVESTMENTS	WA	SEATTLE CHILDREN'S HEALTHCARE SYSTEM				Yes
(8) PERPETUAL TRUSTS (6)	INVESTMENTS	WA	N/A					No
(9) POOLED INCOME FUND (1)	INVESTMENTS	WA	N/A					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 .....................

Yes

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) ............................

Yes

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

Yes

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) ......................

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) .................

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

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

Yes

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

Yes

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

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

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

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) SEATTLE CHILDREN'S HOSPITAL	A	135,052	ACTUAL RENT
(2) SEATTLE CHILDREN'S HOSPITAL FOUNDATION	C	13,542,037	ACTUAL CONTRIBUTION
(3) CHILDREN'S RETAIL	C	168,898	ACTUAL CONTRIBUTION
(4) PERPETUAL TRUST	C	74,237	ACTUAL CONTRIBUTION
(5) PERPETUAL TRUST	C	80,712	ACTUAL CONTRIBUTION
(6) SEATTLE CHILDREN'S HOSPITAL	D	19,766,206	ACTUAL RECEIVABLE
(7) SEATTLE CHILDREN'S HOSPITAL FOUNDATION	E	1,267,655	ACTUAL PAYABLE
(8) SEATTLE CHILDREN'S HOSPITAL GUILD ASSN	E	223,155	ACTUAL PAYABLE
(9) CHILDREN'S RETAIL	E	56,393	ACTUAL PAYABLE
(10) SEATTLE CHILDREN'S HOSPITAL	P	997,750	ACTUAL EXPENSES

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:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	3,911,423	13,741,277
9	Program service revenue (Part VIII, line 2g) .........	10,206,314	17,113,969
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	20,445,635	26,357,730
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	14,780	-59,189
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	34,578,152	57,153,787
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
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)	2,067,790	4,428,139
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)....	2,826,093	3,430,298
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	4,893,883	7,858,437
19	Revenue less expenses. Subtract line 18 from line 12.......	29,684,269	49,295,350
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	816,917,192	877,916,795
21	Total liabilities (Part X, line 26).............	6,944,411	6,478,611
22	Net assets or fund balances. Subtract line 21 from line 20.....	809,972,781	871,438,184

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,976,799 including grants of $ 0 ) (Revenue $ 16,978,917 )
	SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S PROGRAM OPERATING COSTS ARE RELATED TO ACTIVITIES INCURRED TO PROVIDE, DIRECTLY OR INDIRECTLY, HEALTH CARE OR HEALTH RELATED SERVICES APPROPRIATE FOR THE SPECIAL NEEDS OF INFANTS, CHILDREN AND ADOLESCENTS, DELIVERING AND IMPROVING THE DELIVERY OF THOSE SERVICES AND/OR THE QUALITY OF THOSE SERVICES THROUGH RESEARCH, EDUCATION, AND CHILD ADVOCACY. PROGRAM REVENUE IS PRIMARILY RELATED TO SEATTLE CHILDREN'S HEALTHCARE SYSTEM'S PROGRAM RELATED JOINT VENTURE WITH SEATTLE CANCER CARE ALLIANCE (SCCA), A NOT-FOR-PROFIT CORPORATION FORMED IN 1998 BY SEATTLE CHILDREN'S HEALTHCARE SYSTEM, THE UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE, AND FRED HUTCHINSON CANCER RESEARCH CENTER FOR THE PURPOSE OF OFFERING A COMPREHENSIVE PROGRAM OF INTEGRATED CANCER CARE SERVICES.

4b	(Code: ) (Expenses $ 153,879 including grants of $ 0 ) (Revenue $ 135,052 )
	OCCUPANCY AND OTHER COSTS RELATED TO THE OPERATION OF THE SAND POINTMEDICAL CENTER BUILDING WHICH IS RENTED TO SEATTLE CHILDREN'S HOSPITAL.THE RENTED SPACE IS USED TO DELIVER HEALTHCARE SERVICES TO INFANTS,CHILDREN AND ADOLESCENTS.

4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses2,130,678

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	1,289,130	3,106,872	783,853

		Business Code
2a	SERVICES THROUGH SCCA	900099	16,410,667	16,410,667
b	MEDICAL CLINIC RENTAL	900099	568,250	568,250
c	RENT FROM AFFILIATES	900099	135,052	135,052
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		17,113,969

1	Briefly describe the organization’s mission or most significant activities: THE PROVISION OF QUALITY HEALTH CARE SERVICES TO INFANTS, CHILDREN AND ADOLESCENTS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	20
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	14
6	Total number of volunteers (estimate if necessary) .............	6	22
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	233,424
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	192,721

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	13,741,277
e	Government grants (contributions)		1e

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

g	Noncash contributions included in lines 1a - 1f:$		1g	3,151,390

h Total. Add lines 1a-1f.......		13,741,277

3 Investment income (including dividends, interest, and othersimilar amounts) ......			4,369,584			4,369,584
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		37,725	6a
b	Less: rental expenses		96,914	6b
c	Rental income or (loss)		-59,189	6c
d	Net rental income or (loss).......			-59,189			-59,189
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	918,923	493,496,988	7a
b	Less: cost or other basis and sales expenses	753,855	471,673,910	7b
c	Gain or (loss)	165,068	21,823,078	7c
d	Net gain or (loss).........			21,988,146		233,424	21,754,722
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
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			57,153,787	17,113,969	233,424	26,065,117

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
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. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,765,317	1,765,317
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	1,114,522		1,114,522
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	925,205		925,205
9	Other employee benefits .......	335,504		335,504
10	Payroll taxes ...........	287,591	99,527	188,064
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	51,504		51,504
c	Accounting ...........	204,652		204,652
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,357,700		1,357,700
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	168,620	3,281	165,339
12	Advertising and promotion ....
13	Office expenses .......	3,433	3,433
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	1,096,703	85,248	1,011,455
17	Travel ............	1,089		1,089
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	675		675
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	61,917	61,917
23	Insurance ...	71,565		71,565
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	UBI TAXES	88,913		88,913
b	LICENSES AND TAXES	25		25
c
d
e	All other expenses	323,502	111,955	211,547
25	Total functional expenses. Add lines 1 through 24e	7,858,437	2,130,678	5,727,759	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 ........				1
2	Savings and temporary cash investments .........			6,703,446	2	0
3	Pledges and grants receivable, net ......			275,457	3	229,288
4	Accounts receivable, net .............			11,678,774	4	3,264,960
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 ............				8
9	Prepaid expenses and deferred charges ......				9
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	5,936,607
b	Less: accumulated depreciation	10b	308,806	6,461,326	10c	5,627,801
11	Investments—publicly traded securities .			202,201,193	11	229,942,273
12	Investments—other securities. See Part IV, line 11 .....			421,654,011	12	447,665,426
13	Investments—program-related. See Part IV, line 11 ..			148,486,105	13	164,334,443
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			19,456,880	15	26,852,604
16	Total assets. Add lines 1 through 15 (must equal line 33)...			816,917,192	16	877,916,795

17	Accounts payable and accrued expenses .....	473,192	17	440,710
18	Grants payable ...		18
19	Deferred revenue .........	56,967	19	325,913
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	6,414,252	25	5,711,988
26	Total liabilities. Add lines 17 through 25..	6,944,411	26	6,478,611

	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 ...........	809,972,781	32	871,438,184
33	Total liabilities and net assets/fund balances ........	816,917,192	33	877,916,795

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