TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)
(1) JOYCE ABOUSSIE...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(2) SUSAN MACK AGUILLARD MD...................................................................... VOTING DIRECTOR	8.00 ................. 4.00	X
(3) MAHIR AWDEH MD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(4) JOSEPH S AYOUB JR ESQ...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(5) PAUL J AYOUB ESQ...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(6) FREDERICK M AZAR MD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(7) JAMES B BARKATE...................................................................... VOTING DIRECTOR	4.00 ................. 8.00	X
(8) MARTHA PERINE BEARD...................................................................... VOTING DIRECTOR	4.00 ................. 8.00	X
(9) SHERYL BOURISK...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(10) ROBERT A BREIT MD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(11) TERRY BURMAN...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(12) ANN M DANNER...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(13) JOSEPH M DEVIVO...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(14) FRED P GATTAS III PHARMD...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(15) RUTH GAVIRIA...................................................................... VOTING DIRECTOR	4.00 ................. 4.00	X
(16) CHRISTOPHER GEORGE MD...................................................................... VOTING DIRECTOR	8.00 ................. 4.00	X
(17) JUDY HABIB...................................................................... VOTING DIRECTOR	4.00 ................. 8.00	X

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(18) GABRIEL GABY HADDAD MD........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(19) PAUL K HAJAR........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(20) CHUCK HAJJAR........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(21) FOUAD HAJJAR MD........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(22) FREDERICK R HARRIS JR MD........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(23) BRUCE B HOPKINS........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(24) J DAVID KARAM II........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(25) SHARON L MCCOLLAM........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(26) MICHAEL D MCCOY........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(27) ROBERT T MOLINET ESQ........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(28) RAMZI NUWAYHID........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(29) THOMAS PENN III........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(30) CHRISTINA M RASHID........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(31) CAMILLE F SARROUF JR ESQ........................................................................ VOTING DIRECTOR	8.00 .......................4.00	X				0	0	0
(32) JOSEPH C SHAKER........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(33) JOSEPH G SHAKER........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(34) GEORGE A SIMON II........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(35) MICHAEL SIMON........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(36) PAUL J SIMON........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(37) TONY THOMAS........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(38) RICHARD M UNES........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(39) PAUL H WEIN ESQ........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(40) THOMAS WERTZ........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(41) SUSAN R WINDHAM-BANNISTER........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(42) TAMA ZAYDON........................................................................ VOTING DIRECTOR	4.00 .......................4.00	X				0	0	0
(43) RICHARD C SHADYAC JR........................................................................ EX-OFFICIO DIRECTOR	1.00 .......................55.00	X				0	840,195	118,691
(44) JAMES R DOWNING........................................................................ PRESIDENT/CEO	55.00 .......................1.00	X	X			1,134,497	0	144,053
(45) PATRICIA A KEEL........................................................................ SVP/CFO	55.00 .......................0.00		X			595,248	0	85,631
(46) JAMES I MORGAN........................................................................ EVP/SCIENTIFIC DIRECTOR	55.00 .......................0.00		X			717,786	0	56,554
(47) ELLIS NEUFELD........................................................................ EVP/CLINICAL DIRECTOR	55.00 .......................0.00		X			741,883	0	163,760
(48) MARY ANNA QUINN........................................................................ EVP/CHIEF ADMIN. OFFICER	55.00 .......................0.00		X			470,968	0	53,994
(49) CHARLES M ROBERTS........................................................................ EVP/DIRECTOR CANCER CENTER	55.00 .......................0.00		X			774,908	0	155,598
(50) CARLOS RODRIGUEZ-GALINDO........................................................................ EVP/CHAIR	55.00 .......................0.00		X			703,187	0	71,325
(51) ANDREW DAVIDOFF........................................................................ CHAIR	55.00 .......................0.00			X		833,933	0	60,767
(52) DAVID ELLISON........................................................................ CHAIR	55.00 .......................0.00			X		735,746	0	109,717
(53) AMAR J GAJJAR........................................................................ CHAIR	55.00 .......................0.00			X		707,462	0	48,386
(54) THOMAS E MERCHANT........................................................................ CHAIR	55.00 .......................0.00			X		889,223	0	64,327
(55) CHING-HON PUI........................................................................ CHAIR	55.00 .......................0.00			X		740,117	0	37,545
(56) WILLIAM E EVANS........................................................................ FACULTY/FORMER PRESIDENT/CEO	55.00 .......................0.00				X	681,292	0	41,325

(A) Name and business address	(B) Description of services	(C) Compensation
FLINTCO LLC 2179 HILLSHIRE CIRCLE MEMPHIS,TN38133	CONSTRUCTION CONTRACTOR	93,282,711
CS3 INC 8634 LADURL DRIVE BARTLETT,TN38133	GENERAL CONTRACTOR	7,676,755
BELZ CONSTRUCTION SERVICES 100 PEABODY PLACE SUITE 1400 MEMPHIS,TN38103	CONSTRUCTION CONTRACTOR	7,621,080
METHODIST HEALTHCARE MEMPHIS 1265 UNION AVE MEMPHIS,TN38104	MEDICAL SERVICES	6,601,217
MICROSOFT CORPORATION ONE MICROSOFT WAY REDMOND,WA98052	SOFTWARE SUPPORT	6,424,547
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 270

- 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 the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv), 170(b)(1)(A)(vi), and 170(b)(1)(A)(ix)
(Complete only if you checked the box on line 5, 7, 8, or 9 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	674,808,276	895,523,715	753,145,680	851,803,301	974,758,247	4,150,039,219
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	674,808,276	895,523,715	753,145,680	851,803,301	974,758,247	4,150,039,219
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.						4,150,039,219

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
7	Amounts from line 4..	674,808,276	895,523,715	753,145,680	851,803,301	974,758,247	4,150,039,219
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	7,579,828	11,681,881	4,641,541	11,308,521	14,733,405	49,945,176
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	7,390,478	6,775,862	20,138,461	7,598,809	9,873,680	51,777,290
11	Total support. Add lines 7 through 10						4,251,761,685

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

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 2018 (line 6, column (f) divided by line 11, column (f)) .........

97.610 %

Public support percentage for 2017 Schedule A, Part II, line 14 ...............

97.170 %

16a

33 1/3% support test—2018. 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—2017. 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—2018. 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—2017. 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) 2018

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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2017 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2018 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2017 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2018. 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—2017. 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) 2018

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) 2018

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) 2018

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) 2018

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 2018 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-2018	(iii) Distributable Amount for 2018
1 Distributable amount for 2018 from Section C, line 6
2 Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2018:
a From 2013.......
b From 2014.......
c From 2015.......
d From 2016.......
e From 2017.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2018 distributable amount
i Carryover from 2013 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2018 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2018 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2018, 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 2018. 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 2019. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2014......
b Excess from 2015.....
c Excess from 2016.....
d Excess from 2017.....
e Excess from 2018.....

Schedule A (Form 990 or 990-EZ) (2018)

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation
PART II, SECTION B, LINE 10:	EXPLANATION FOR OTHER INCOME: 2014 $ 3,534,638 - CAFETERIA/VENDING $ 1,454,365 - CHGME/CHCA $ 2,401,475 - OTHER REVENUE $ 7,390,478 - TOTAL OTHER INCOME 2015 $ 3,709,328 - CAFETERIA/VENDING $ 1,683,327 - CHGME/CHCA $ 1,383,207 - OTHER REVENUE $ 6,775,862 - TOTAL OTHER INCOME 2016 $ 8,152,422 - BOND DEFEASANCE GAIN $ 4,086,280 - CAFETERIA/VENDING $ 2,058,124 - CHGME/CHCA $ 5,841,635 - OTHER REVENUE $ 20,136,461 - TOTAL OTHER INCOME 2017 $ 4,288,072 - CAFETERIA/VENDING $ 2,351,842 - CHGME/CHCA $ 327,751 - HHMI $ 631,144 - OTHER REVENUE $ 7,598,809 - TOTAL OTHER INCOME 2018 $ 4,454,476 - CAFETERIA/VENDING $ 2,344,673 - CHGME/CHCA $ 363,869 - HHMI $ 2,710,662 - OTHER REVENUE $ 9,873,680 - TOTAL OTHER INCOME

Return Reference

Explanation

PART II, SECTION B, LINE 10:

EXPLANATION FOR OTHER INCOME: 2014 $ 3,534,638 - CAFETERIA/VENDING $ 1,454,365 - CHGME/CHCA $ 2,401,475 - OTHER REVENUE $ 7,390,478 - TOTAL OTHER INCOME 2015 $ 3,709,328 - CAFETERIA/VENDING $ 1,683,327 - CHGME/CHCA $ 1,383,207 - OTHER REVENUE $ 6,775,862 - TOTAL OTHER INCOME 2016 $ 8,152,422 - BOND DEFEASANCE GAIN $ 4,086,280 - CAFETERIA/VENDING $ 2,058,124 - CHGME/CHCA $ 5,841,635 - OTHER REVENUE $ 20,136,461 - TOTAL OTHER INCOME 2017 $ 4,288,072 - CAFETERIA/VENDING $ 2,351,842 - CHGME/CHCA $ 327,751 - HHMI $ 631,144 - OTHER REVENUE $ 7,598,809 - TOTAL OTHER INCOME 2018 $ 4,454,476 - CAFETERIA/VENDING $ 2,344,673 - CHGME/CHCA $ 363,869 - HHMI $ 2,710,662 - OTHER REVENUE $ 9,873,680 - TOTAL OTHER INCOME

Schedule A (Form 990 or 990-EZ) 2018

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

2018

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

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

Special Rules

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

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

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

Caution. An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018) Page 2

Name of organization ST JUDE CHILDREN'S RESEARCH HOSPITAL INC

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	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) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 3

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

Part II	Noncash Property (See instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Page 4


Name of organization ST JUDE CHILDREN'S RESEARCH HOSPITAL INC			Employer identification number 62-0646012
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

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

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

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...............................
c	Total lobbying expenditures (add lines 1a and 1b) ...................................................................
d	Other exempt purpose expenditures ........................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

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

Yes

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

Yes

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

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

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

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

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

Yes

21,139

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

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

Yes

63,229

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

84,368

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

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

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

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

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

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

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

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

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

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

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

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

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

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

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

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	LINE 1A) A ST. JUDE PATIENT/FAMILY TRAVELED TO DC ON BEHALF OF ST. JUDE TO ADVOCATE WITH CONGRESS FOR INCREASED NIH FUNDING; LINE 1B) ST. JUDE EMPLOYS A DIRECTOR OF GOVERNMENT AFFAIRS; LINE 1G) AMOUNT LISTED IS PRORATED SALARY OF DIRECTOR OF GOVERNMENT AFFAIRS PLUS TRAVEL EXPENSES; LINE 1I) AMOUNT LISTED IS RELATED TO PRORATED RETAINER FEES FOR DIRECT AND STATE LEGISLATIVE CONTACTS AS WELL AS PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING FOR THE CHGME PROGRAM.

Return Reference

Explanation

PART II-B, LINE 1:

LINE 1A) A ST. JUDE PATIENT/FAMILY TRAVELED TO DC ON BEHALF OF ST. JUDE TO ADVOCATE WITH CONGRESS FOR INCREASED NIH FUNDING; LINE 1B) ST. JUDE EMPLOYS A DIRECTOR OF GOVERNMENT AFFAIRS; LINE 1G) AMOUNT LISTED IS PRORATED SALARY OF DIRECTOR OF GOVERNMENT AFFAIRS PLUS TRAVEL EXPENSES; LINE 1I) AMOUNT LISTED IS RELATED TO PRORATED RETAINER FEES FOR DIRECT AND STATE LEGISLATIVE CONTACTS AS WELL AS PROFESSIONAL DUES ATTRIBUTABLE TO LOBBYING FOR THE CHGME PROGRAM.

Schedule C (Form 990 or 990EZ) 2018

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 the latest information.

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

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

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

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

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

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

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

Yes No

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

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

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

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 SFAS 116 (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) 2018

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 ....	1,024,698,330	965,253,422	873,056,599	873,885,134	915,104,075
b	Contributions ...	4,864,242	21,281,957	12,552,432	2,341,719	2,970,640
c	Net investment earnings, gains, and losses	64,664,085	92,690,065	103,475,245	-72,118	8,222,632
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	38,875,713	54,527,114	23,830,854	3,098,136	52,412,213
f	Administrative expenses ....
g	End of year balance ......	1,055,350,944	1,024,698,330	965,253,422	873,056,599	873,885,134

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Temporarily restricted endowment SchDMd Bullet

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

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

Yes

(i) unrelated organizations .................

3a(i)

Yes

(ii) related organizations .................

3a(ii)

Yes

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

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....	1,208,060,491	597,826,180	610,234,311
c	Leasehold improvements
d	Equipment ....	456,298,014	310,124,244	146,173,770
e	Other .....	14,042,381	7,223,277	6,819,104
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				763,227,185

Schedule D (Form 990) 2018

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)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

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

(a) Description				(b) Book value
(1) INTEREST IN NET ASSETS OF AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC				5,366,070,585
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				5,366,070,585

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
SELF INSURANCE LIABILITY	1,792,643
WORKERS COMPENSATION	1,181,465
OWNER CONTROLLED INSURANCE PROGRAM	223,366
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	3,197,474
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) 2018

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	823,030,750
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	77,592
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	580,106,392
e	Add lines 2a through 2d .....................			2e	580,183,984
3	Subtract line 2e from line 1..................			3	242,846,766
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	865,122,365
c	Add lines 4a and 4b....................			4c	865,122,365
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	1,107,969,131

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	1,021,442,301
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e	0
3	Subtract line 2e from line 1...................		3	1,021,442,301
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c	0
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5	1,021,442,301

Part XIII

Supplemental Information

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

Return Reference	Explanation
PART V, LINE 4:	THE ENDOWMENT FUNDS ARE HELD BY AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES, INC., A RELATED ORGANIZATION, AND ARE USED TO SUPPORT THE FUTURE NEEDS OF ST. JUDE.
PART X, LINE 2:	AS OF JUNE 30, 2019, THE ORGANIZATION HAD NOT IDENTIFIED ANY UNCERTAIN TAX POSITIONS UNDER ASC TOPIC 740, INCOME TAXES, REQUIRING ADJUSTMENTS TO ITS COMBINED FINANCIAL STATEMENTS. IN THE EVENT THE ORGANIZATION WERE TO RECOGNIZE INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS, IT WOULD BE RECOGNIZED IN THE COMBINED FINANCIAL STATEMENTS AS A GENERAL EXPENSE. GENERALLY, TAX YEARS ENDING 2016 THROUGH 2019 ARE OPEN TO EXAMINATION BY THE FEDERAL AND STATE TAXING AUTHORITIES, RESPECTIVELY. THERE ARE NO INCOME TAX EXAMINATIONS CURRENTLY IN PROCESS.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	CHANGE IN INTEREST IN NET ASSETS OF ALSAC WITHOUT DONOR RESTRICTIONS 580,106,392.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	CONTRIBUTION - SUPPORT RECEIVED FROM ALSAC 865,122,365.

Schedule D (Form 990) 2018

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

2018

Open to Public Inspection

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

Employer identification number

62-0646012

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to 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 region	(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	1,866,373
	EAST ASIA AND THE PACIFIC	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	5,567,836
	EUROPE (INCLUDING ICELAND & GREENLAND)	0	1	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	1,361,828
	MIDDLE EAST AND NORTH AFRICA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	3,975,072
	NORTH AMERICA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	847,849
	RUSSIA AND NEIGHBORING STATES	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	144,889
	SOUTH AMERICA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	1,353,167
	SOUTH ASIA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	41,604
	SUB-SAHARAN AFRICA	0	0	PROGRAM SERVICES	RESEARCH / EDUCATION AND TRAINING	57,716








3a	Sub-total .....	0	1			15,158,618
b	Total from continuation sheets to Part I ...					57,716
c	Totals (add lines 3a and 3b)	0	1			15,216,334

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2018

Schedule F (Form 990) 2018

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(c) Region	(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

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) 2018

Schedule F (Form 990) 2018Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

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

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

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

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

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

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

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

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

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

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

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

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	88,740,793	1,022,538	87,718,255	8.590 %
b	Medicaid (from Worksheet 3, column a) . . . . .	152,707,177	31,541,618	121,165,559	11.860 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	8,545,802	1,717,417	6,828,385	0.670 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	249,993,772	34,281,573	215,712,199	21.120 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	25,592,681	0	25,592,681	2.510 %
f	Health professions education (from Worksheet 5) . . .	15,603,972	280,344	15,323,628	1.500 %
g	Subsidized health services (from Worksheet 6) . . . .	28,429,296	0	28,429,296	2.780 %
h	Research (from Worksheet 7) .	387,337,440	96,291,900	291,045,540	28.490 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	1,840,087	0	1,840,087	0.180 %
j	Total. Other Benefits . .	458,803,476	96,572,244	362,231,232	35.460 %
k	Total. Add lines 7d and 7j .	708,797,248	130,853,817	577,943,431	56.580 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2018

Schedule H (Form 990) 2018

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	100,244	100,244	0.010 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	18,014	18,014	0 %
8	Workforce development	20,848	20,848	0 %
9	Other
10	Total	139,106	139,106	0.010 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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

1,100,000

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

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

819,608

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

-819,608

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

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

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

Schedule H (Form 990) 2018

Page

Part VFacility Information

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

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

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

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 18

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

Yes

6 a

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

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

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

Yes

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

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

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 18

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

Yes

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

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

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

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

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

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

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE PART V, SECTION C

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

SEE PART V, SECTION C

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

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

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

Yes

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

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs

Made a reasonable effort to orally notify individuals about the FAP and FAP application process

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

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

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 5: THE ST. JUDE FISCAL YEAR 2019 CHNA BUILDS UPON THE FISCAL YEAR 2013 AND 2016 CHNAS AND REFLECTS THE ACTIVITIES IDENTIFIED IN THE ST. JUDE FISCAL YEAR 2016 COMMUNITY BENEFIT IMPLEMENTATION PLAN. THE FISCAL YEAR 2019 CHNA WAS LED BY AN INTERNAL TEAM OF ST. JUDE STAFF MEMBERS. THE LEADERSHIP OF THIS TEAM ENGAGED HEALTH RESOURCES IN ACTION (HRIA), A NON-PROFIT PUBLIC HEALTH CONSULTANCY ORGANIZATION, TO CONDUCT THE CHNA. THE NEW CHNA IDENTIFIED THE IMPORTANCE OF PARTNERSHIPS AND COLLABORATION WITH OTHER ORGANIZATIONS TO MEET THE HEALTH NEED AND MEDICAL NEEDS OF CHILDREN, INCLUDING THE SHELBY COUNTY HEALTH DEPARTMENT, METHODIST LE BONHEUR HEALTHCARE, AND BAPTIST MEMORIAL HEALTH CARE AND REGIONAL ONE HEALTH. EACH INSTITUTION IS WORKING TO ALIGN ITS ASSESSMENT AND PLANNING PROCESSES, WHEN APPROPRIATE, AND TO COORDINATE ACTIVITIES RELATED TO DATA COLLECTION.TO DEVELOP A SOCIAL, ECONOMIC, AND HEALTH PORTRAIT OF THE COMMUNITY SERVED BY ST. JUDE FOR THE GREATER MEMPHIS AREA AND NATIONALLY, HRIA REVIEWED EXISTING DATA DRAWN FROM LOCAL, STATE, AND NATIONAL SOURCES. TO GAIN MORE LOCAL-LEVEL DATA, ST. JUDE WORKED WITH THE SHELBY COUNTY HEALTH DEPARTMENT TO OBTAIN DEMOGRAPHIC, ECONOMIC, AND HEALTH DATA FOR SHELBY COUNTY. HRIA CONDUCTED QUALITATIVE RESEARCH WITH INTERNAL AND EXTERNAL ST. JUDE STAKEHOLDERS AS WELL AS PATIENTS AND FAMILY MEMBERS SERVED IN ORDER TO SUPPLEMENT QUANTITATIVE FINDINGS WITH PERCEPTIONS OF COMMUNITY STRENGTHS AND ASSETS, THEIR PRIORITY HEALTH CONCERNS, AND SUGGESTIONS FOR FUTURE PROGRAMMING AND SERVICES.FOCUS GROUPS FOCUS GROUPS WERE CONDUCTED WITH CURRENT AND FORMER ST. JUDE PATIENTS, PATIENT CAREGIVERS, AND ST. JUDE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF. DIFFERENT TOPIC AREAS WERE EXPLORED BASED ON THE UNIQUE EXPERIENCES OF EACH OF THE GROUPS. THE PATIENT AND CAREGIVER FOCUS GROUPS, CONDUCTED WITH CURRENT PATIENTS AND REPRESENTATIVES OF THE PATIENT FAMILY ADVISORY COUNCIL, EXPLORED THE EXTENT TO WHICH ST. JUDE IS MEETING THE NEEDS OF CHILDREN WITH CATASTROPHIC ILLNESSES AND OPPORTUNITIES TO BRIDGE PATIENT NEEDS IN THE FUTURE. THE CLINICAL, RESEARCH, AND ADMINISTRATIVE STAFF FOCUS GROUPS EXPLORED THESE TOPICS AS WELL AS SPECIFIC ISSUES RELATED TO THE GREATER MEMPHIS COMMUNITY. A SEMI-STRUCTURED MODERATOR'S GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. WHILE SIMILAR, SEPARATE GUIDES WERE USED FOR THE CAREGIVER AND PATIENT FOCUS GROUPS SO THAT THEY WERE AGE AND DEVELOPMENTALLY APPROPRIATE. EACH FOCUS GROUP WAS FACILITATED BY AN EXPERIENCED HRIA STAFF MEMBER, WHILE A NOTE-TAKER TOOK DETAILED NOTES DURING THE DISCUSSION. ON AVERAGE, FOCUS GROUPS LASTED 30-90 MINUTES. BEFORE THE START OF THE GROUPS, HRIA EXPLAINED THE PURPOSE OF THE STUDY TO PARTICIPANTS AND PARTICIPANTS HAD AN OPPORTUNITY TO ASK QUESTIONS. THEY WERE ALSO NOTIFIED VERBALLY THAT GROUP DISCUSSIONS WOULD REMAIN CONFIDENTIAL, AND NO RESPONSES WOULD BE CONNECTED TO THEM PERSONALLY. PARTICIPANTS WERE RECRUITED BY ST. JUDE STAFF, WHO ARRANGED ALL LOGISTICS FOR THE ONSITE FOCUS GROUPS.MEDICAL EXECUTIVE COMMITTEE - ELIZABETH ADDERSON, MD, INFECTIOUS DISEASES - DORALINA ANGHELESCU, MD, ANESTHESIOLOGY - MICHAEL BISHOP, MD, ONCOLOGY, SOLID TUMOR - ROBIN DIAZ, JD, CHIEF LEGAL COUNSEL - SARA FEDERICO, MD, ONCOLOGY, SOLID TUMOR - WILLIAM GREENE, PHARMD, VICE PRESIDENT, PHARMACEUTICAL SERVICES - RAY MORRISON, MD, ICU, CRITICAL CARE-PULMONARY MEDICINE - ROBIN MUTZ, RN, SVP, CHIEF NURSING EXECUTIVE - TRACY PARKS, DIRECTOR, QUALITY MANAGEMENT - RICHARD ROCHESTER, MANAGER BMT/CT CLINIC - JOHN SANDLUND, MD, ONCOLOGY, LEUKEMIA/LYMPHOMA - BRANDON TRIPLETT, MD, BONE MARROW TRANSPLANT AND CELL THERAPY - JOSHUA WOLF, MD, INFECTIOUS DISEASES NURSING - MIKE BURGESS, PEDIATRIC ONCOLOGY NURSE III WKD, INPATIENT, BONE MARROW TRANSPLANT - LORI CHRISTION, INPATIENT UNIT MANAGER - JASMIN ELIZARRARAS, PEDIATRIC ONCOLOGY NURSE I, INPATIENT - CAMILLE FILOROMO, BSN, MED, PHD, RN, NEA-BC, SENIOR DIRECTOR OF CLINICAL EXPERIENCE - ANGEL PARKER, INPATIENT UNIT COORDINATOR - BOB SCHROEDER, INTERIM UNIT MANAGER, ICU - NICOLE WRIGHT, NURSING PROFESSIONAL DEVELOPMENT EDUCATOR I ST. JUDE PATIENT FAMILY ADVISORY COUNCIL - TEN MEMBERS OF THE COUNCIL PARTICIPATED ADOLESCENT ST. JUDE PATIENTS - FIVE PATIENTS PARTICIPATED KEY INFORMANT INTERVIEWS HRIA CONDUCTED 26 INTERVIEWS; 11 WERE INTERNAL REPRESENTATIVES OF ST. JUDE HOSPITAL AND 15 WERE EXTERNAL REPRESENTATIVES. INTERVIEWEES REPRESENT A RANGE OF SECTORS, INCLUDING LEADERS IN HEALTH CARE AND HEALTH RESEARCH, GOVERNMENT, AND SOCIAL SERVICE ORGANIZATIONS FOCUSING ON VULNERABLE POPULATIONS. A SEMI-STRUCTURED INTERVIEW GUIDE WAS USED ACROSS ALL DISCUSSIONS TO ENSURE CONSISTENCY IN THE TOPICS COVERED. INTERVIEWS WERE APPROXIMATELY 30 MINUTES IN LENGTH. INTERNAL KEY INFORMANT INTERVIEWS - ROBERT CLARK, MS, FACHE, CHIEF GOVERNMENT AFFAIRS OFFICER - JANICE ENGLISH, DIRECTOR, PATIENT AND FAMILY EXPERIENCE OFFICE - COLETTE HENDRICKS, VP-CLINICAL OPERATIONS - MELISSA M. HUDSON, MD, DIRECTOR, CANCER SURVIVORSHIP DIVISION - MELISSA JONES, DIRECTOR, CANCER CENTER OPERATION - PAT KEEL, SVP/CFO - ELLIS NEUFELD, MD, PHD, EVP/CLINICAL DIRECTOR - CAROLYN RUSSO, MD, ASSOCIATE MEMBER/MEDICAL DIRECTOR AFFILIATE PROGRAM - VICTOR SANTANA, MD, MEMBER/SVP CLINICAL TRIALS - DANA WALLACE, DIRECTOR, CANCER CENTER ADMINISTRATION - SHEILA ANDERSON, RN, TRANSITION NURSE CASE MANAGER, HEMATOLOGY EXTERNAL KEY INFORMANT INTERVIEWS - CARLA BAKER, RN, PROJECT DIRECTOR, MEMPHIS BREAST CANCER EQUITY CONSORTIUM, COMMON TABLE HEALTH ALLIANCE - AMY DANIELS, SENIOR VICE PRESIDENT OF INVESTOR RELATIONS, MEMPHIS CHAMBER OF COMMERCE - JOAN HAN, MD, DIRECTOR, PEDIATRIC OBESITY PROGRAM, LE BONHEUR CHILDREN'S HOSPITAL - ALISA HAUSHALTER, DNP, RN, PHNA-BC, DIRECTOR, SHELBY COUNTY HEALTH DEPARTMENT - MICHELLE HEIL, SENIOR MANAGER, HOSPITAL SYSTEMS, AMERICAN CANCER SOCIETY, NORTH CENTRAL REGION - ANITA LARKIN, MSN, RN, CLINICAL DIRECTOR, METHODIST LE BONHEUR - MARIAN LEVY, DRPH, RD, FAND, ASSOCIATE DEAN, UNIVERSITY OF MEMPHIS SCHOOL OF PUBLIC HEALTH - VALERIE NAGOSHINER, CHIEF OF STAFF, TENNESSEE DEPARTMENT OF HEALTH - GARY SHORB, EXECUTIVE DIRECTOR, THE URBAN CHILD INSTITUTE - ANDREANA SMITH, DIRECTOR OF CLINICAL ADMINISTRATION, CHURCH HEALTH CENTER - WEBB A. SMITH, PHD, CLINICAL EXERCISE PHYSIOLOGIST, HEALTHY LIFESTYLES CLINIC, LE BONHEUR CHILDREN'S HOSPITAL - JAMILA SMITH-YOUNG, DNP, MPH, CPNP-AC, NURSE PRACTITIONER, UT LE BONHEUR PEDIATRIC SPECIALISTS DIVISION OF PEDIATRIC ENDOCRINOLOGY - CHARLES SNYDER, PHD, MPH, DIRECTOR, HEALTH DISPARITIES EDUCATION AND COMMUNITY ENGAGEMENT, UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER - KATY SPURLOCK, DEPUTY DIRECTOR, THE URBAN CHILD INSTITUTE - ROBIN WOMEODU, MD, FACP, CHIEF MEDICAL OFFICER, METHODIST UNIVERSITY HOSPITAL
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 13H: SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 15E: SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL	PART V, SECTION B, LINE 20E: ST. JUDE DOES NOT TAKE ANY OF THE COLLECTION ACTIONS DESCRIBED IN PART V, SECTION B, LINE 19 BECAUSE ST. JUDE COVERS ALL TREATMENTS, COPAYS, DEDUCTIBLES, COINSURANCE AND ANY OTHER COST SHARING OBLIGATIONS THAT ARE NOT COVERED BY INSURANCE. ST. JUDE TAKES NO ACTION TO COLLECT FROM PATIENTS OR THEIR FAMILIES AND DOES NOT REPORT TO CREDIT AGENCIES.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL:	PART V, SECTION B, LINE 11: ST. JUDE CHILDREN'S RESEARCH HOSPITALCOMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN UPDATE (06/30/19)ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC. CONDUCTED AND ADOPTED ITS THIRD COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) DURING FISCAL YEAR 2019 AND INTENDS TO ADDRESS THE FOLLOWING SIGNIFICANT HEALTH NEEDS, LISTED IN ORDER OF PRIORITY:IMPROVING ACCESS TO CARE- PALLIATIVE CARE- SERVICES AND RESOURCES FOR CAREGIVERSIMPROVING COORDINATION OF CARE- TRANSITION OF PATIENTS FROM PEDIATRIC TO ADULT HEALTHCARE- OUTPATIENT CARE EXPERIENCE TRANSITION OF CARE FROM SPECIALTY TO PRIMARY CARE PROVIDERS- OUTPATIENT CARE EXPERIENCE PHYSICIAN COORDINATION OF CAREIMPROVING CHILD HEALTH STATUS- COMMUNITY HEALTH EDUCATION- PREVENTING VIRUS-ASSOCIATED CANCERS THROUGH INCREASED HPV VACCINATION- HIV COLLABORATION WITH COMMUNITY COALITION- CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY AND PHYSICAL ACTIVITYNO ACTIONS WERE TAKEN DURING FISCAL YEAR 2019 TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IDENTIFIED THROUGH ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC.'S MOST RECENTLY CONDUCTED CHNA IN FISCAL YEAR 2019. THE THIRD CHNA WAS CONDUCTED AND ADOPTED AT THE END OF FISCAL YEAR 2019; THEREFORE, THESE HEALTH NEEDS WILL BE ADDRESSED OVER THE NEXT THREE TAX YEARS.ALL SIGNIFICANT HEALTH NEEDS IDENTIFIED IN ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC.'S MOST RECENTLY CONDUCTED CHNA ARE BEING ADDRESSED.ST. JUDE CHILDREN'S RESEARCH HOSPITAL, INC. DID TAKE THE FOLLOWING ACTIONS DURING FISCAL YEAR 2019 WITH RESPECT TO ITS PREVIOUSLY CONDUCTED CHNA IN FISCAL YEAR 2016:ST. JUDE: PATIENT POPULATION AND CLINICAL FOCUSTHE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST. JUDE IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CANCER AND BLOOD DISORDERS, AND CHILDREN AND ADOLESCENTS WITH HIV INFECTION. IT SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. ST. JUDE TREATS CHILDREN AND YOUNG ADULTS WITH NEWLY DIAGNOSED OR SUSPECTED PEDIATRIC CANCER, HIV INFECTIONS OR CERTAIN HEMATOLOGIC OR GENETIC DISEASES. WE ACCEPT MOST PATIENTS OUTSIDE OUR PRIMARY MARKET BASED ON A REFERRAL FROM THEIR PHYSICIAN OR AN AFFILIATE CLINIC, THEIR AGE, AND THEIR ABILITY TO ENROLL IN AN OPEN CLINICAL TRIAL. IN ADDITION TO BEING TREATED AT ST. JUDE, PATIENTS MAY HAVE THE OPTION TO RECEIVE CARE AT ONE OF OUR EIGHT REGIONAL AFFILIATE CLINICS.ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. MORE SPECIFICALLY, APPROXIMATELY 8,600 PATIENTS ARE SEEN AT ST. JUDE ANNUALLY FOR ACTIVE THERAPY, TREATMENT-COMPLETION MONITORING, SURVIVORSHIP SUPPORT, OR PARTICIPATION IN RESEARCH PROGRAMS. THE HOSPITAL IS LICENSED FOR 80 INPATIENT BEDS AND CURRENTLY STAFFS 73 BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS WHO MAY HAVE BEEN ADMITTED AS INPATIENTS AT MOST HOSPITALS TO BE TREATED AS OUTPATIENTS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES, DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA AIR FILTRATION, INFECTION-RESISTANT SURFACES, AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES.THE ST. JUDE AFFILIATE PROGRAM MAKES TREATMENTS DEVELOPED AS CLINICAL TRIALS AT ST. JUDE CHILDREN'S RESEARCH HOSPITAL AVAILABLE TO MORE CHILDREN BY OFFERING MUCH OF THE CARE CLOSE TO HOME. THE ST. JUDE AFFILIATE PROGRAM IS A NETWORK OF PEDIATRIC HEMATOLOGY-ONCOLOGY CLINICS, HOSPITALS, AND IN SOME CASES, UNIVERSITIES UNITED TO EXTEND THE MISSION OF ST. JUDE. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF OF ST. JUDE TO DELIVER STATE-OF-THE-ART CARE AND INNOVATIVE CLINICAL TRIALS TO CHILDREN WITH CANCER AND BLOOD DISORDERS.ST. JUDE ALSO OPERATES ST. JUDE GLOBAL. ITS MISSION IS TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE THROUGH THE SHARING OF KNOWLEDGE, TECHNOLOGY, AND ORGANIZATIONAL SKILLS. THERE ARE 3 OVERRIDING GOALS:- TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION- TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES- TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE.ST. JUDE IS A RESEARCH ORGANIZATION, AND THERE ARE TIMES WHEN BASIC RESEARCH DISCOVERIES PERTAIN TO DISEASES THAT ARE BEYOND THE SCOPE OF DISEASES TREATED AS A PRIMARY DIAGNOSIS AT ST. JUDE.FOR THE PURPOSES OF THIS REPORT, THE FOCUS IS SOLELY ON THOSE DISEASES FOR WHICH CHILDREN ARE ADMITTED TO ST. JUDE FOR TREATMENT.CONSISTENT WITH ST. JUDE'S PREVIOUS CHNA, THE FINDINGS IN 2016 HIGHLIGHTED THE ISSUES OF ACCESS TO CARE; CHILDHOOD CANCER; SICKLE CELL DISEASE AND HEMATOLOGY PATIENTS; LIVING WITH HIV AND AIDS; NEEDS OF THE PATIENTS' FAMILIES AND CAREGIVERS; POST TREATMENT AND CARE TRANSITION; HEALTH STATUS OF THE MEMPHIS COMMUNITY AND ADDITIONAL GAPS FOR THE GENERAL PEDIATRIC POPULATION. ST. JUDE HAS CHOSEN TO ADDRESS THESE NEEDS IN THREE GENERAL AIMS: IMPROVING ACCESS TO CARE, ENHANCING COORDINATION OF CARE AND IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDREN. THESE AIMS, WHICH OFTEN ADDRESS MULTIPLE ISSUES IDENTIFIED IN THE CHNA, WERE CHOSEN BECAUSE THEY ARE ALIGNED WITH OUR MISSION AND OUR CAPABILITIES. BELOW ARE THE THREE AIMS AND CORRESPONDING INITIATIVES DEVELOPED.AIM #1 IMPROVING ACCESS TO CAREPEDIATRIC HEALTH NEED:ACCESS TO AFFORDABLE HEALTH INSURANCE COVERAGEHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, MANAGED CARE DEPARTMENTANTICIPATED OUTCOME:UNINSURED PATIENTS WILL BE OFFERED ASSISTANCE REGARDING ENROLLMENT IN GOVERNMENTAL OR OTHER PROGRAMS.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO PROVIDE ASSISTANCE TO FAMILIES WITH ENROLLMENT.2. PERIODIC REVIEW OF IDENTIFICATION AND SCREENING PROCESSES TO ENSURE ALL UNINSURED PATIENTS ARE OFFERED ASSISTANCE.3. WORK WITH PATIENTS TRANSITIONING TO CARE POST ST. JUDE.SELECTED ACCOMPLISHMENTS:THE AGREEMENT WITH FIRSTSOURCE SOLUTIONS USA, LLC DBA MEDASSIST IS RENEWED ANNUALLY. MEDASSIST IS THE VENDOR USED TO HELP UNINSURED PATIENTS OBTAIN MEDICAID OR OTHER INSURANCE.AN AUDIT OF THE SCREENING PROCESS HAS BEEN DEVELOPED AND WILL CONTINUE TO BE CONDUCTED ON A MONTHLY BASIS TO ENSURE THAT ALL FAMILIES ARE GIVEN ASSISTANCE WITH THE SCREENING AND ENROLLMENT PROCESS.FY19:- 99.66% OF ST. JUDE'S UNINSURED PATIENTS WERE OFFERED ASSISTANCE.- 153 UNINSURED PATIENTS WERE ENROLLED IN HEALTH PLANS.- LESS THAN 1% OF UNINSURED PATIENTS WERE NOT CONTACTED BECAUSE THEY WERE ONLY BRIEFLY AT ST. JUDE.PEDIATRIC HEALTH NEED:PALLIATIVE CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF ONCOLOGY, DIVISION OF QUALITY OF LIFE AND PALLIATIVE CAREANTICIPATED OUTCOME:CONTINUE TO TRAIN CLINICIANS IN PALLIATIVE CARE MEDICINE (PCM) AND OFFER EDUCATIONAL OPPORTUNITIES FOR PCM.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. RECRUIT AND TRAIN TWO PHYSICIAN FELLOWS IN THE PALLIATIVE CARE TRAINING PROGRAM.2. PROVIDE TRAINING IN PALLIATIVE CARE FOR ADVANCED PRACTICE HEALTHCARE PERSONNEL THROUGH TARGETED CONFERENCES AND OTHER EDUCATIONAL OPPORTUNITIES INCLUDING END-OF-LIFE NURSING EDUCATION CONSORTIUM (ELNEC) CONFERENCE, AN INSTITUTION-DEVELOPED QUALITY OF LIFE SEMINAR (QOL), AND A 2-DAY PEDIATRIC ONCOLOGY PALLIATIVE CARE CONFERENCE.3. EDUCATE COMMUNITY PROVIDERS ABOUT PCM THROUGH COMMUNITY-BASED BRIDGING PROGRAMS FOR HOME HEALTH AND HOSPICE CARE THROUGH THE QUALITY OF LIFE FOR ALL KIDS PROGRAM VIA A THREE-HOUR DIDACTIC CURRICULUM.4. ENHANCE TRAINING OPPORTUNITIES WITH ST. JUDE AFFILIATES.SELECTED ACCOMPLISHMENTS:- EACH YEAR THE PALLIATIVE CARE TRAINING PROGRAM HAS BEEN SUCCESSFUL IN RECRUITING AND TRAINING TWO PHYSICIAN FELLOWS.- PALLIATIVE CARE MEDICINE FELLOWSHIP NOW TRAINS 5 MD'S PER YEAR.- ENROLLMENT: FY16 FY17 FY18ELNEC 32 78 35QOLA 37 29 45PPOS 325 340*PPOS - PEDIATRIC PALLIATIVE ONCOLOGY SYMPOSIUM
IN ADDITION, ALL BEDSIDE NURSES ARE REQUIRED TO COMPLETE ELNEC WITHIN THREE	YEARS. ALSO, INPATIENT AND OUTPATIENT NURSES ARE REQUIRED AND SUPPORTED TO COMPLETE BOTH SEMINARS (A TOTAL OF 24.5 CEUS IN PCM).- COMMUNITY PROVIDER EDUCATION HAPPENS TWICE A MONTH THROUGH ST. JUDE'S COMBINED FELLOWSHIP PROGRAM BOARD REVIEW SERIES. EACH SESSION AVERAGES 10 ATTENDEES RANGING FROM GRADUATE STUDENTS TO MEDICAL STUDENTS TO ADVANCED CLINICIANS.- THE SJ AFFILIATE STAFF ARE INVITED TO PARTICIPATE IN ELNEC, THE QOL SEMINAR AND THE PEDIATRIC PALLIATIVE ONCOLOGY SYMPOSIUM AT NO COST, AND ARE INCLUDED IN THE NUMBERS CITED ABOVE.- REGULAR PRESENTER IN AFFILIATE NURSING CONFERENCE.- 2 RESEARCH ARTICLES RESULTED FROM THIS CHNA AND CAN BE FOUND IN EXHIBIT 1.PEDIATRIC HEALTH NEED:HEALTHCARE OF CHILDHOOD CANCER SURVIVORSHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ONCOLOGY DIVISION, CANCER SURVIVORSHIP DEPARTMENTANTICIPATED OUTCOME:PROVIDE CANCER SURVIVORSHIP INFORMATION TO BOTH CAREGIVERS AND SURVIVORS VIA SURVIVORS' DAY CONFERENCE AND ST. JUDE LIFE. THE ST. JUDE LIFE PROGRAM WILL INCREASE ENROLLMENT WITHIN A DEFINED COHORT UNTIL ALL ELIGIBLE SURVIVORS HAVE BEEN APPROACHED.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. PROVIDE WORKSHOPS AND SPEAKERS THAT OFFER INFORMATION ABOUT AVAILABLE RESOURCES.2. GIVE SURVIVORS AND THEIR FAMILIES THE OPPORTUNITY TO LEARN FROM OTHER SURVIVORS.3. ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH HEALTHCARE POST-TREATMENT.4. OFFER AN ONLINE RESOURCE FOLLOWING THE CONFERENCE FOR CONTINUOUS FLOW OF SURVIVORSHIP INFORMATION.5. ASSESS LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS.6. USE INFORMATION FROM THESE STUDIES TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTION.SELECTED ACCOMPLISHMENTS:THE ST. JUDE FACULTY PROVIDE LECTURES AND PARTICIPATE IN WORKSHOPS RELATED TO A VARIETY OF SURVIVORSHIP ISSUES. AUDIENCES INCLUDE HEALTH CARE PROVIDERS OF SURVIVORS, SURVIVORS AND THEIR FAMILIES.- 3 LECTURES/WORKSHOPS PROVIDED BY MELISSA M. HUDSON AND CAN BE FOUND IN EXHIBIT 1.- 1 LECTURE/WORKSHOP PROVIDED BY DANIEL MULROONEY AND CAN BE FOUND IN EXHIBIT 1.- 5 LECTURES/WORKSHOPS PROVIDED BY MATTHEW EHRHARDT AND CAN BE FOUND IN EXHIBIT 1.STORIES OF RESILIENT SURVIVORS AND RESOURCES AVAILABLE TO OVERCOME PHYSICAL AND PSYCHOSOCIAL CHALLENGES OF SURVIVORSHIP HAVE BEEN FEATURED IN THE ST. JUDE LIFETIME COHORT LIFELINE AND LONG-TERM FOLLOW-UP STUDY NEWSLETTERS.- ENSURE THAT SURVIVORS UNDERSTAND HOW TO APPROACH HEALTHCARE POST-TREATMENT.SURVIVORS AND THEIR FAMILIES ATTENDING THE AFTER COMPLETION OF THERAPY (ACT) AND ST. JUDE LIFETIME COHORT CLINICS ROUTINELY RECEIVE COUNSELING ABOUT THEIR HEALTH HISTORY, CANCER-RELATED HEALTH RISKS, HEALTH SCREENING RECOMMENDED FOR THEIR SPECIFIC CANCER TREATMENT EXPOSURES, AND METHODS OF RISK REDUCTION. A SURVIVORSHIP CARE PLAN IS PROVIDED AT THE FIRST EVALUATION THAT DETAILS THE CANCER DIAGNOSIS, TREATMENT, MAJOR HEALTH EVENTS THAT HAVE OCCURRED DURING AND AFTER THERAPY, CANCER-RELATED HEALTH RISKS, AND RECOMMENDED HEALTH SCREENING. THE SURVIVORSHIP CARE PLAN IS UPDATED AFTER EVERY HEALTH EVALUATION.- FOR SURVIVORS WHO DO NOT WISH TO PARTICIPATE IN THE ACT OR ST. JUDE LIFETIME COHORT PROGRAMS, THESE SAME SERVICES ARE AVAILABLE THROUGH THE ST. JUDE ALUMNUS PROGRAM OFFICE.- SURVIVORSHIP STAFF ARE INVOLVED IN MULTIDISCIPLINARY EFFORTS TO INTRODUCE AND CONSISTENTLY ADDRESS SURVIVORSHIP TRANSITION ISSUES, PARTICULARLY PSYCHOSOCIAL AND REHABILITATION NEEDS, AT EARLIER TIME POINTS AFTER DIAGNOSIS. THEIR EFFORTS ARE REFLECTED IN THE NEWLY DEVELOPED TRANSITION ONCOLOGY PROGRAM.PERIODIC BRIEF PUBLICATIONS FEATURE SURVIVOR STORIES AND EDUCATIONAL TOPICS:- LONG-TERM FOLLOW-UP NEWSLETTERS (AVAILABLE AT HTTPS://LTFU.STJUDE.ORG/) ARE PUBLISHED ON A QUARTERLY BASIS.- LIFELINE NEWSLETTERS (AVAILABLE AT HTTPS://WWW.STJUDE.ORG/TREATMENT/SURVIVORSHIP/PARTICIPATE-IN- ST-JUDE-LIFE-STUDY/LIFELINE-NEWSLETTER.HTML) ARE PUBLISHED SEMIANNUALLY.PEDIATRIC HEALTH NEED:COMMUNITY EDUCATIONHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, COMMUNICATIONS & PUBLIC RELATIONS DEPARTMENTANTICIPATED OUTCOME:INCREASE THE NUMBER OF RADIO EDUCATION SPOTS, ARTICLES AND SOCIAL MEDIA REGARDING HEALTHCARE RESOURCES AND HEALTHCARE CAREERS ANNUALLY.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. ST. JUDE PROFESSIONALS WILL PROVIDE INFORMATION AND RESOURCES ABOUT SICKLE CELL DISEASE, HIV, CANCER, FLU, AND OTHER PEDIATRIC LIFE-THREATENING DISEASES.2. OFFER EDUCATIONAL OPPORTUNITIES AND OTHER INFORMATION ABOUT HEALTHCARE CAREERS. SELECTED ACCOMPLISHMENTS:ST. JUDE PROFESSIONALS PROVIDING INFORMATION AND RESOURCES:- ST. JUDE CONDUCTED 30-SECOND EDUCATIONAL RADIO SPOTS IN FY19. TOPICS INCLUDED: HIV VOICES PROJECT, AIDS SUPPORT, SICKLE CELL STEP, BLOOD DONOR CENTER AND THE HPV VACCINE FOR CANCER PREVENTION.- ST. JUDE FOCUSED EDUCATION EFFORTS ON PROMOTING THE HPV VACCINE. EFFORTS INCLUDED CONCENTRATED MEDIA RELATIONS PITCHING, DEDICATED SOCIAL MEDIA POSTS, BLOGS AND A RADIO PSA.- MEDIA RELATIONS EFFORTS RESULTED IN A NUMBER OF ST. JUDE PROFESSIONALS BEING INTERVIEWED THIS YEAR ON COMMUNITY SUBJECTS INCLUDING HIV, HPV VACCINATION, SLEEP HEALTH, FLU AWARENESS AND REMINDERS TO GET THE FLU VACCINE. INFORMATION FROM DR. RICHARD WEBBY AND HIS TEAM ABOUT THE FLU VACCINE APPEARED IN MORE THAN 240 NEWS PIECES, INCLUDING TWO LOCAL MEMPHIS STORIES.- "PROMISE" MAGAZINE IS MAILED TO BETWEEN 250,000 AND 300,000 READERS EACH QUARTER, INCLUDING DONORS, EMPLOYEES, PATIENTS, PEER INSTITUTIONS, CEOS OF FORTUNE 500 COMPANIES, SELECT MEDIA AND INDIVIDUALS WHO SUBSCRIBE THROUGH OUR ONLINE SUBSCRIPTION FORM. ALL THE ARTICLES APPEAR ONLINE, WHERE THEY HAVE AN EVEN WIDER READERSHIP. AN E-NEWSLETTER VERSION OF "PROMISE" IS ALSO SENT TO NEARLY 10,000 SUBSCRIBERS QUARTERLY.- APPROXIMATELY 120 LOCAL HIGH SCHOOL STUDENTS AND TEACHERS VISITED ST. JUDE IN FEBRUARY 2019 FOR THE FOURTH ANNUAL SCIENCE SCHOLARS OF TOMORROW SYMPOSIUM. THE DAY-LONG EVENT FEATURED SCIENTIFIC PRESENTATIONS AND TOURS OF LABORATORIES, CLINICS AND CORE FACILITIES, ENABLING STUDENTS TO INTERACT WITH SCIENTISTS AND CLINICIANS.- MORE THAN 9,000 CANCER SURVIVORS, INCLUDING LOCAL MEMPHIS RESIDENTS, RECEIVED PACKAGES CELEBRATING CANCER SURVIVORSHIP, INCLUDING A PAMPHLET ABOUT BEING A SURVIVOR AND WHERE TO FIND IMPORTANT INFORMATION.- 6 ARTICLES RELATED TO COMMUNITY EDUCATION WERE PUBLISHED IN "PROMISE" MAGAZINE AND CAN BE FOUND IN EXHIBIT 1.PEDIATRIC HEALTH NEED:ST. JUDE AFFILIATE NETWORKHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, AFFILIATE PROGRAM OFFICEANTICIPATED OUTCOME:THE ST. JUDE AFFILIATE NETWORK SHOULD BE MAINTAINED TO EXPAND OPPORTUNITIES FOR SERVICES TO A LARGER NUMBER OF CHILDREN. THE NUMBER OF PATIENTS ENROLLED IN ST. JUDE PRIMARY THERAPEUTIC PROTOCOLS FROM THE AFFILIATE CLINICS WILL INCREASE.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO ENHANCE OPERATIONS AND INCREASE PATIENT VISITS AT ALL CLINICS.SELECTED ACCOMPLISHMENTS:- ESTABLISHED ST. JUDE CENTRAL INSTITUTIONAL REVIEW BOARD TO FACILITATE LOCAL ENROLLMENT IN PRIMARY THERAPEUTIC CLINICAL TRIALS.- COMPLETED SEVERAL QUALITY IMPROVEMENT INITIATIVES WHICH RESULTED IN MAINTENANCE OF CERTIFICATION CREDIT.- PROVIDED FORMAL QUALITY IMPROVEMENT TRAINING FOR AFFILIATE STAFF.- CREATED PATIENT NAVIGATOR POSITION TO IMPROVE PATIENT TRANSITION TO AFFILIATE SITES.- DEVELOPED QUARTERLY EDUCATIONAL WEBINAR SERIES.
AIM #2 ENHANCING COORDINATION OF CARE	PEDIATRIC HEALTH NEED:PHYSICIAN COORDINATION OF CAREHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ST. JUDE AFFILIATE INSTITUTIONS, ALL DOMESTIC AND INTERNATIONAL REFERRING CLINICIANS AND CENTERSANTICIPATED OUTCOME:IMPROVE CONTINUITY OF CARE BY ENHANCING COMMUNICATION TOOLS AND EFFORTS TO PROVIDE PHYSICIANS WITH UNPARALLELED ACCESS TO PATIENT INFORMATION.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO IMPROVE THE CLINICIAN PORTAL TO PERMIT REFERRING AND AFFILIATED PHYSICIANS' CONVENIENT ACCESS TO PATIENT INFORMATION, IN ACCORDANCE WITH APPLICABLE LAW.SELECTED ACCOMPLISHMENTS:- CLINICIAN PORTAL WORK IS ONGOING. EXTERNAL PHYSICIAN TESTING HAS BEEN COMPLETED AND FEEDBACK HAS BEEN RECEIVED.- IN A LIMITED SCOPE, ST. JUDE PROVIDERS NOW HAVE THE ABILITY VIA DIRECT EMAIL (ENCRYPTED PROVIDER DIRECTORY DEVELOPED FOR SECURE DATA EXCHANGE) TO SEND AN ELECTRONIC SUMMARY OF CARE, ALONG WITH OTHER DOCUMENTS AS ATTACHMENTS, TO OUTSIDE PHYSICIANS TO WHOM WE ARE REFERRING OUR PATIENTS. WE WILL ALSO BE ABLE TO RECEIVE AN ELECTRONIC TRANSITION OF CARE DOCUMENT FROM OUTSIDE PROVIDERS AND AFFILIATES WHO ARE REFERRING A PATIENT TO ST. JUDE. THIS WILL BE ROLLING OUT IN A LIMITED AVAILABILITY THROUGH THE END OF THE YEAR SINCE IT REQUIRES OUTSIDE PROVIDERS TO HAVE A SPECIAL SECURE CONNECTION. - PROVIDERS IN THE AFFILIATE PROGRAM NOW HAVE ACCESS TO THEIR PATIENTS' ST. JUDE ELECTRONIC MEDICAL RECORD.PEDIATRIC HEALTH NEED:TRANSITION OF PATIENTS FROM PEDIATRIC TO ADULT HEALTHCARE SERVICEHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, DEPARTMENT OF HEMATOLOGY, CLINICAL HEMATOLOGY DIVISION, DIGGS-KRAUS SICKLE CELL CENTER AT REGIONAL ONE HEALTH, METHODIST HEALTHCARE COMPREHENSIVE SICKLE CELL CENTER (MCSCC)ANTICIPATED OUTCOME:INCREASE THE NUMBER OF PATIENTS WITH SICKLE CELL DISEASE WHO ESTABLISH SUSTAINED ADULT CARE AFTER LEAVING PEDIATRIC CARE AT ST. JUDE.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. CONTINUE TO WORK WITH ADULT SICKLE CELL CENTERS IN THE COMMUNITY TO ENHANCE A SEAMLESS TRANSITION FROM PEDIATRIC CARE.2. ENHANCE ADOLESCENT AND YOUNG ADULTS (AYA) TRANSITION CLINICS WITH CO-LOCATION OF PEDIATRIC AND ADULT HEMATOLOGY PROVIDERS.3. AUGMENT FORMAL PROGRAMMING AND PLANNING PROCESSES FOR ADOLESCENTS WITH HEMATOLOGIC AND ONCOLOGIC DISEASES, THROUGH DEVELOPMENT OF DISEASE EDUCATIONAL CURRICULUM AND TRAINING MODULES TO FOSTER INCREASED ADOLESCENT AUTONOMY AND MEDICAL LITERACY.SELECTED ACCOMPLISHMENTS:BELOW, 2017 AND 2018 ARE INCLUDED DUE TO A LAG IN DATA. 2017- 43 PATIENTS GRADUATED FROM ST. JUDE BY DECEMBER 2017.- 38 TRANSFERRED TO ADULT CENTERS, FOR A RATE OF ADULT CARE PLACEMENT OF 88% (5 NEVER ESTABLISHED CARE WITH ADULT PROVIDER).- 12-MONTH RETENTION IN ADULT CARE: 79%.- 1 EXPIRED: TRANSFERRED TO ADULT CARE 5/9/17, INITIAL ADULT APPOINTMENT 6/22/17, EXPIRED 2/7/18 (MCSCC).- 7 WERE LOST TO FOLLOW UP/DISCONTINUED ADULT CARE AFTER TRANSFERRING OUT OF ST. JUDE.- 24-MONTH RETENTION IN ADULT CARE: NEED TO WAIT UNTIL END OF 2019 TO CALCULATE FINAL RATE.2018- 33 PATIENTS GRADUATED FROM ST. JUDE BY DECEMBER 2018.- 31 TRANSFERRED TO ADULT CENTERS, FOR A RATE OF ADULT CARE PLACEMENT OF 94%. - NOT INCLUDED IS 4 THAT RECEIVED LETTERS AND 1 RELOCATED. 31 OF 33 ESTABLISHED CARE.- ADULT CARE RETENTION: AT THE END OF 2019 WE WILL HAVE THE 12-MONTH ADULT CARE RETENTION DATA FOR 2018, AND AT THE END OF 2020 WE WILL HAVE THE 24-MONTH ADULT CARE RETENTION DATA FOR 2018.AIM #3 IMPROVING CHILD HEALTH STATUS THROUGH HEALTHY LIFESTYLE EDUCATION AND PREVENTION FOR CHILDRENPEDIATRIC HEALTH NEED:CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY, AND PHYSICAL ACTIVITYHEALTH FACILITIES INVOLVED:ST. JUDE CHILDREN'S RESEARCH HOSPITAL, GLOBAL PEDIATRIC MEDICINEANTICIPATED OUTCOME:INCREASE THE NUMBER OF STUDENTS AND TEACHERS PARTICIPATING IN ST. JUDE CANCER AND HEALTHY LIVING EDUCATION PROGRAM.ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED:1. EVALUATE THE EFFECTIVENESS OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN CURRICULUM AT INCREASING CHILDREN'S KNOWLEDGE OF CANCER AND HEALTHY LIVING TOPICS (NUTRITION, EXERCISE, SUN PROTECTION, AVOIDING TOBACCO).2. PARTNER WITH LOCAL EDUCATION AGENCIES TO DISSEMINATE CANCER AND HEALTHY LIVING EDUCATIONAL PROGRAMS. SELECTED ACCOMPLISHMENTS:- OVER 2,000 MEMPHIS-AREA K-12 STUDENTS RECEIVED HEALTHY LIFESTYLES EDUCATION: THE ST. JUDE CANCER EDUCATION AND OUTREACH PROGRAM PROVIDES STUDENTS IN GRADES K-12 EDUCATION AND POSITIVE REINFORCEMENT TO HELP PROMOTE HEALTHY LIFESTYLE CHOICES AND TO REDUCE A CHILD'S LIFETIME RISK OF CANCER. THE PROGRAM SPECIFICALLY ADDRESSES OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. DURING THE 2018-2019 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM PARTNERED WITH 19 SCHOOLS TO DELIVER EDUCATIONAL CONTENT TO OVER 2,000 K-12 STUDENTS IN THE MEMPHIS AREA.- 1 RESEARCH ARTICLE RESULTED FROM THIS EVALUATION.EXHIBIT 1
LECTURES PROVIDED:	HEALTHCARE OF CHILDHOOD CANCER SURVIVORS- AMERICAN ACADEMY OF PEDIATRICS, NATIONAL CONFERENCE & EXHIBITION, "AFTER THE CANCER CRISIS: LONG TERM ISSUES FOR CHILDHOOD CANCER SURVIVORS", ORLANDO, FLORIDA, NOVEMBER 5, 2018.- AMERICAN SOCIETY OF PEDIATRIC HEMATOLOGY ONCOLOGY ANNUAL MEETING, LUMINARY SPEAKER, "THE ROLE OF SURVIVORSHIP RESEARCH IN ADVANCING CHILDHOOD CANCER CARE AND QUALITY OF SURVIVAL", NEW ORLEANS, LOUISIANA, MAY 4, 2019.- ADOLESCENT AND YOUNG ADULT LYMPHOMA SCIENTIFIC WORKSHOP AND INAUGURAL AYA LYMPHOMA CONSORTIUM MEETING, HEALTH OUTCOMES AND SURVIVORSHIP RESEARCH OF AYA LYMPHOMA, CHICAGO, ILLINOIS, MAY 15, 2019.- STATE OF THE HEART: CARDIO-ONCOLOGY AT ST. JUDE, ST. JUDE GRAND ROUNDS, ST. JUDE CHILDREN'S RESEARCH HOSPITAL MEMPHIS, TN, FEBRUARY 14, 2019.- SURVIVING CHILDHOOD CANCER. ST. JUDE MIDWEST AFFILIATE PEDIATRIC CANCER SURVIVORSHIP CONFERENCE, PEORIA, IL, JANUARY 2019.- CANCER SURVIVORSHIP AND THE AFTER COMPLETION OF THERAPY CLINIC. ST. JUDE MIDWEST AFFILIATE ASSOCIATION OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSES (APHON), PEORIA, IL, JANUARY 2019.- CANCER SURVIVORSHIP: LATE HEALTH EFFECTS, RISK-BASED SCREENING, AND OPTIMIZING CARE DELIVERY. CHILDREN'S HOSPITAL OF ILLINOIS/UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE PEDIATRIC GRAND ROUNDS, PEORIA, IL, JANUARY 2019.- CANCER SURVIVORSHIP: LATE HEALTH EFFECTS, RISK-BASED SCREENING, AND OPTIMIZING CARE DELIVERY. SANFORD CHILDREN'S HOSPITAL PEDIATRIC GRAND ROUNDS, SIOUX FALLS, SD, MAY 2019.- OBESITY AND THE METABOLIC SYNDROME IN CHILDHOOD CANCER SURVIVORS. ST. JUDE CHILDREN'S RESEARCH HOSPITAL AFFILIATE PHYSICIANS' CONFERENCE, MEMPHIS, TN, MAY 2019."PROMISE" MAGAZINE ARTICLES PUBLISHED:COMMUNITY EDUCATION- FIELD OF GENES: HISPANIC CHILDREN AND ALL (SPRING 2019)- FLU FIGHTERS: HOW THE IMMUNE SYSTEM PROTECTS INFANTS FROM INFLUENZA (WINTER 2019)- LI-FRAUMENI: STRENGTH IN NUMBERS (AUTUMN 2018)- EXERCISE YOUR OPTIONS (AUTUMN 2018)- BRAIN BOOSTER (AUTUMN 2018)- PARTNERS FOR HIV PREVENTION (SUMMER 2018)RESEARCH ARTICLES PUBLISHED:PALLIATIVE CARE- KAYE, E., APPLEGARTH, J., GATTAS, M., KIEFER, A., REYNOLDS, J., ZALUD, K., & BAKER, J. (2019) HOSPICE NURSES REQUEST PEDIATRIC-SPECIFIC EDUCATIONAL RESOURCES AND TRAINING PROGRAMS TO IMPROVE CARE FOR CHILDREN AND FAMILIES IN THE COMMUNITY: QUALITATIVE DATA ANALYSIS FROM A POPULATION-LEVEL SURVEY. PALLIATIVE MEDICINE, DOI: 10.1177/0269216319866576- KAYE, E., GATTAS, M., KIEFER, A., REYNOLDS, J., ZALUD, K., LI, C., LU, Z., & BAKER, J. (2019) PROVISION OF PALLIATIVE AND HOSPICE CARE TO CHILDREN IN THE COMMUNITY: A POPULATION STUDY OF HOSPICE NURSES. JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, DOI HTTPS://DOI.ORG/10.1016/J.JPAINSYMMAN.2018.10.509CHILD KNOWLEDGE OF CANCER PREVENTION, NUTRITION, OBESITY, AND PHYSICAL ACTIVITY- AYERS, K., LI, Z., VILLALOBOS, A., & KLOSKY, J. (2019) EVALUATION OF THE ST. JUDE CANCER EDUCATION FOR CHILDREN PROGRAM ON CANCER RISK AWARENESS, ATTITUDES, AND BEHAVIORAL INTENTIONS AMONG FOURTH-GRADE SCIENCE STUDENTS: COMPARISONS BETWEEN RACIALLY IDENTIFIABLE/HIGH-POVERTY SCHOOLS AND RACIALLY DIVERSE/AFFLUENT SCHOOLS. JOURNAL OF CANCER EDUCATION, DOI: 10.1007/S13187-019-1476-3.
ST. JUDE CHILDREN'S RESEARCH HOSPITAL:	PART V, SECTION B, LINE 7A: THE CHNA REPORT WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 10A: THE HOSPTIAL FACILITY'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY IS AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/ABOUT-ST-JUDE/FINANCIALS/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 14: ST. JUDE CURRENTLY DOES NOT BILL NOR PURSUE PAYMENT FOR ANY ST. JUDE PATIENT; THEREFORE, ST. JUDE DOES NOT HAVE A BASIS FOR CALCULATING AMOUNTS CHARGED TO PATIENTS.ST. JUDE CHILDREN'S RESEARCH HOSPITAL: PART V, SECTION B, LINE 16A: THE FAP WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTMLST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16B: BASED ON THE FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL- ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML), ST. JUDE DOES NOT HAVE AN APPLICATION FORM.ST. JUDE CHILDREN'S RESEARCH HOSPITAL:PART V, SECTION B, LINE 16C: A PLAIN LANGUAGE SUMMARY WAS MADE WIDELY AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML

Schedule H (Form 990) 2018

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?
Name and address		Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2018

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Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 3C:	NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. WE DO NOT NEED TO DETERMINE ELIGIBILITY FOR THIS ASSISTANCE. BY DEFAULT, ALL PATIENTS ARE ELIGIBLE TO RECEIVE MEDICAL CARE AND SUPPORT SERVICES AT NO COST. ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. BILLING INSURANCE FOR THE COSTS THAT WOULD BE DUE AT ANY OTHER HOSPITAL ALLOWS ST. JUDE TO CONTINUE DOING SOME OF THE MOST ADVANCED RESEARCH IN THE WORLD. IT ALSO ALLOWS ST. JUDE TO PAY FOR TREATMENTS, COPAYMENTS, DEDUCTIBLES, COINSURANCE, AND ANY OTHER COSTS INSURANCE DOES NOT COVER. TO ENSURE FAMILIES ARE MAKING USE OF ALL RESOURCES FOR WHICH THEY ARE ELIGIBLE, WE HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. DOING SO ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE ALSO CONTRACT WITH A VENDOR TO PROVIDE CERTIFIED APPLICATION COUNSELOR SERVICES TO ASSIST FAMILIES APPLYING FOR HEALTH INSURANCE COVERAGE THROUGH FEDERAL OR STATE FACILITATED MARKETPLACES.
PART I, LINE 7:	COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. COST-TO-CHARGE RATIO USED FOR LINE 7A FINANCIAL ASSISTANCE AT COST, LINE 7B MEDICAID, AND LINE 7C COSTS OF OTHER MEANS-TESTED GOVERNMENT PROGRAMS. SOME CHIPS VOLUME IS INCLUDED IN MEDICAID IN PART I, LINE 7B BECAUSE IN MANY STATES THE CHIPS PROGRAMS ARE MANAGED BY THE SAME THIRD PARTY ADMINISTRATORS, AND IT IS DIFFICULT TO DISTINGUISH BETWEEN CHIPS AND MEDICAID COVERAGE.
PART I, LINE 7G:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL INCLUDED AS SUBSIDIZED HEALTH SERVICES SUPPORT FOR EIGHT AFFILIATE CLINICS TOTALING APPROXIMATELY $9.6 MILLION.
PART II, COMMUNITY BUILDING ACTIVITIES:	THE ST. JUDE CHILDREN'S RESEARCH HOSPITAL PRESIDENT AND CEO IS A MEMBER OF MEMPHIS TOMORROW. MEMPHIS TOMORROW IS AN ASSOCIATION OF CHIEF EXECUTIVE OFFICERS OF MEMPHIS' LARGEST ENTERPRISES. THE PURPOSE IS TO BRING TOP BUSINESS LEADERS TOGETHER WITH GOVERNMENT AND CIVIC LEADERS TO FOSTER ECONOMIC PROSPERITY FOR ALL WHO LIVE IN OUR COMMUNITY. THEIR INITIATIVES ARE FOCUSED IN THOSE AREAS WHICH DIRECTLY IMPACT ECONOMIC GROWTH AND OPPORTUNITY, INCLUDING HUMAN CAPITAL DEVELOPMENT, INDUSTRY DEVELOPMENT, AND PUBLIC SAFETY. ST. JUDE ALSO PARTICIPATES WITH MEMPHIS FAST FORWARD WHOSE STRATEGIES ARE BASED ON THE PREMISE THAT ECONOMIC GROWTH AND PROSPERITY, AND IMPROVED QUALITY OF LIFE, WILL FOLLOW ONCE MEMPHIS AND SHELBY COUNTY SUCCESSFULLY ADDRESS THE BASICS: GOOD JOBS, QUALITY EDUCATION, SAFE STREETS AND EFFICIENT GOVERNMENT.ST. JUDE IS A MEMBER OF THE ASPIRING FOR PURCHASING EXCELLENCE (APEX) ASSOCIATION OF MEMPHIS. APEX IS AN ASSOCIATION OF PURCHASING AND PROCUREMENT PROFESSIONALS FROM MEMPHIS ORGANIZATIONS WHOSE PURPOSE IS TO PROMOTE BEST PRACTICES IN SUPPLIER DIVERSITY. ADDITIONALLY, ST. JUDE IS SILVER SPONSOR FOR THE MID-SOUTH MINORITY BUSINESS COUNCIL (MMBC) ECONOMIC DEVELOPMENT FAIR. THE MMBC SERVES AS THE MID-SOUTH'S FOREMOST MINORITY BUSINESS DEVELOPMENT ORGANIZATION. THE MMBC HELPS TO DEVELOP A STRONG MINORITY AND WOMEN BUSINESS COMMUNITY IN AN EFFORT TO IMPACT ECONOMICALLY THE ENTIRE MID-SOUTH REGION.THE PEDIATRIC ONCOLOGY EDUCATION PROGRAM BRINGS FIFTY TO SIXTY STUDENTS EACH SUMMER FOR INTERNSHIPS IN BASIC SCIENCE OR CLINICAL RESEARCH. ADDITIONALLY, EXPERIENTIAL LEARNING INTERNSHIPS ARE STRUCTURED BY AND MANAGED BY ACADEMIC PROGRAMS IN MANY AREAS FROM SCIENCE TO ACCOUNTING. THERE ARE ANOTHER 150 STUDENTS INVOLVED IN THESE INTERNSHIPS. THESE PROGRAMS SUPPORT INCREASING THE AWARENESS OF CAREERS IN RESEARCH SCIENCE, HEALTHCARE, OR HEALTHCARE MANAGEMENT AND CONTRIBUTE TO PREPARING STUDENTS TO ENTER THESE CAREERS.THE CLINICAL EDUCATION AND TRAINING OFFICE HOSTS FORTY TO FIFTY STUDENTS ANNUALLY AS PATIENT CARE OBSERVERS. THESE STUDENTS ARE AT DIFFERENT STAGES OF TRAINING AND ARE FROM UNDERGRADUATE COLLEGES OR PROFESSIONAL HEALTHCARE SCHOOLS INCLUDING MEDICAL SCHOOLS. THE OBSERVERS ARE DECIDING ON OR CONFIRMING A DESIRE TO PURSUE A CAREER IN HEALTHCARE.THE FAMILY, GUEST, AND VOLUNTEER SERVICES DEPARTMENT PROVIDES SUMMER PROGRAMS FOR HIGH SCHOOL STUDENTS AND YEAR-ROUND PROGRAMS FOR COLLEGE STUDENTS. BOTH OF THESE PROGRAMS DRIVE ENTRY INTO HEALTH CAREERS. THE DEPARTMENT ALSO ENGAGES TWELVE FULL-TIME INTERNS, 4 EACH SEMESTER, WHO ARE EMBEDDED ON THE TEAM AND PREPARED FOR CAREERS IN NON-PROFIT LEADERSHIP OR HEALTHCARE MANAGEMENT.THE OFFICE OF LEGAL SERVICES OFFERS LEGAL INTERNSHIPS TO LOCAL (UNIVERSITY OF MEMPHIS, OLE MISS) LAW STUDENTS DURING THE ACADEMIC YEAR AND TO NATIONAL LAW SCHOOLS DURING THE SUMMER. INTERNS PERFORM LEGAL RESEARCH; DRAFT MEMORANDA, LETTERS, AND OTHER DOCUMENTS; DRAFT AND REVIEW CONTRACTUAL AGREEMENTS; PREPARE PRESENTATIONS TO ST. JUDE PERSONNEL; AND ASSIST WITH DRAFTING POLICIES. INTERNS ALSO LEARN THROUGH OBSERVATION OF AND PARTICIPATION IN DAY-TO-DAY LAW PRACTICE ACTIVITIES, INCLUDING LEGAL PROCEEDINGS, NEGOTIATIONS, MEETINGS, TRAININGS, AND COUNSELING SESSIONS. WHEN POSSIBLE, INTERNS WORK WITH CLIENT DEPARTMENTS AND DEPARTMENTAL STAFF TO GATHER INFORMATION AND TO GAIN INSIGHT INTO AND UNDERSTANDING OF RESEARCH, CLINICAL, BUSINESS, AND HEALTH CARE OPERATIONS. IN ADDITION, MEMBERS OF THE OFFICE OF LEGAL SERVICES ENGAGED IN THE FOLLOWING ACTIVITIES WITHIN THE MEMPHIS AND LARGER TENNESSEE COMMUNITIES:- VOLUNTEERED AT A SATURDAY LEGAL CLINIC ORGANIZED BY MEMPHIS AREA LEGAL SERVICES.- SERVED AS CHAIR OF THE HEALTH LAW & POLICY ADVISORY BOARD OF THE CECIL C. HUMPHREYS SCHOOL OF LAW, UNIVERSITY OF MEMPHIS.- PRESENTED ON "LAW AND BIOETHICS" AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW IN MARCH 2019.- PRESENTED ON "PRESCRIBING CONTROLLED SUBSTANCES IN TN: UNDERSTANDING NEW STANDARDS AND LAWS AMIDST THE OPIOID EPIDEMIC" AT THE TENNESSEE ATTORNEYS MEMO LAW CONFERENCE IN NOVEMBER 2018.- PLANNED A HEALTH LAW NETWORKING EVENT AT THE UNIVERSITY OF MEMPHIS'S CECIL C. HUMPHREYS SCHOOL OF LAW.- SERVED ON THE TENNESSEE BAR ASSOCIATION HEALTH LAW SECTION EXECUTIVE COUNCIL.- SERVED ON THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION BOARD.- PARTICIPATED IN AN ATTORNEY HEALTH LAW PANEL AT THE CECIL C. HUMPHREYS SCHOOL OF LAW, UNIVERSITY OF MEMPHIS.- HOSTED SESSIONS AT ST. JUDE FOR THE EMBARK PROGRAM, WHICH IS PART OF THE NEW MEMPHIS INSTITUTE. EMBARK IS A 3-MONTH ENGAGEMENT THAT EMPOWERS HIGH PERFORMING TWENTYSOMETHINGS (2-7 YEARS INTO THEIR CAREERS) TO GROW AS LEADERS AND TO BUILD RELATIONSHIPS AS THEY PREPARE TO MAKE A DIFFERENCE IN MEMPHIS.- PARTICIPATED IN A PROFESSIONAL SPEED NETWORKING EVENT FOR COLLEGE STUDENTS AND RECENT GRADUATES IN MEMPHIS THROUGH THE NEW MEMPHIS INSTITUTE.FINALLY, THE CHIEF GOVERNMENT AFFAIRS OFFICER WORKED IN COLLABORATION WITH LEGAL STAFF AND OUTSIDE ADVOCACY GROUPS TO SUPPORT EFFORTS TO CREATE A STATE PALLIATIVE CARE/QUALITY OF LIFE ADVISORY COUNCIL.THE ST. JUDE CHIEF GOVERNMENT AFFAIRS OFFICER CONTINUES TO SERVE ON THE BOARD OF DIRECTORS OF THE MEMPHIS RIVER PARKS PARTNERSHIP (MRPP). THE MRPP IS A NON-PROFIT ORGANIZATION THAT, UNDER A LONG-TERM CONTRACT WITH THE CITY OF MEMPHIS, MANAGES ALL THE PARKS ALONG A 5-MILE STRETCH OF THE MEMPHIS RIVERFRONT INCLUDING ALONG DOWNTOWN MEMPHIS AND MUD ISLAND RIVER PARK. ELEMENTS ALONG THE RIVER FOSTER HEALTHY LIFESTYLES INCLUDING RIVERFIT, A SERIES OF PHYSICAL FITNESS CHALLENGES, AND A PLAYGROUND DESIGNED SPECIFICALLY FOR CHILDREN AT BEALE ST. LANDING, THE ONLY CHILD-DESIGNATED PLAYGROUND ON THE MEMPHIS RIVERFRONT. THE MRPP IS ALSO WORKING WITH THE CITY OF MEMPHIS TO IMPLEMENT A SERIES OF IMPROVEMENTS DESIGNED TO TIE THE RIVERFRONT CLOSER TO WORKERS AND RESIDENTS OF DOWNTOWN MEMPHIS TO MAKE ACCESS TO RIVERFRONT AMENITIES EASIER FOR ALL CITIZENS OF MEMPHIS AND TOURISTS VISITING THE CITY. AS PART OF THESE ADVOCACY EFFORTS, MRPP WAS AWARDED $10M IN STATE FUNDING TO UPGRADE TOM LEE PARK ON THE MEMPHIS RIVER FRONT.THE ST. JUDE CHIEF GOVERNMENT AFFAIRS OFFICER CONTINUES TO SERVE ON THE BOARD OF COMMISSIONERS OF THE MEMPHIS AREA TRANSIT AUTHORITY (MATA). IN THIS CAPACITY, HE HELPS TO PROMOTE THE HEALTH OF THE COMMUNITY BY ADVOCATING FOR POLICIES THAT ENABLE ENHANCED MOBILITY FOR A LARGER PERCENTAGE OF THE POPULATION OF MEMPHIS AND SHELBY COUNTY.THE CHIEF LEGAL OFFICER PARTICIPATES ON COMMITTEES OF THE MEMPHIS CHILD ADVOCACY CENTER, WHICH HELPS LOCAL CHILDREN FIND SAFETY AND HEALING (INCLUDING ACCESS TO A MENTAL HEALTH PROFESSIONAL) AFTER A REPORT OF SEXUAL OR OTHER SEVERE ABUSE AND OFFERS ABUSE PREVENTION TRAINING TO COMMUNITY VOLUNTEERS AND PARENTS.THE CHIEF LEGAL OFFICER SERVES AS CHAIR OF THE ADVISORY BOARD OF THE INSTITUTE FOR HEALTH LAW & POLICY OF THE CECIL C. HUMPHREYS UNIVERSITY OF MEMPHIS SCHOOL OF LAW, WHICH ENDEAVORS TO ADDRESS UNMET HEALTH LAW NEEDS OF THE LOCAL COMMUNITY AND WORK WITH COMMUNITY LEADERS TO PROACTIVELY ADDRESS HEALTH POLICY NEEDS.THE SENIOR ASSOCIATE COUNSEL IS THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION'S ELECTED REPRESENTATIVE TO THE BOARD OF THE MEMPHIS BAR ASSOCIATION. THE ASSOCIATE COUNSEL SERVES ON THE MEMPHIS BAR ASSOCIATION HEALTH LAW SECTION BOARD. THE ASSOCIATE COUNSEL CHAIRS THE COMMUNITY AFFAIRS COMMITTEE OF THAT SECTION AND THE CHIEF LEGAL OFFICER IS AN ACTIVE MEMBER OF THE COMMITTEE, WHICH ANNUALLY SPONSORS A SATURDAY LEGAL CLINIC PROVIDING UNREPRESENTED MEMBERS OF THE COMMUNITY AN OPPORTUNITY TO MEET WITH A VOLUNTEER ATTORNEY AND DISCUSS LEGAL ISSUES, INCLUDING THOSE THAT HAVE AN IMPACT ON PERSONAL HEALTH. THE MANAGER OF THE CANCER EDUCATION PROGRAM IN THE DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE (GPM) DEDICATES 80% OF HER TIME, AND THE COORDINATOR FOR CANCER EDUCATION DEDICATES 100% OF HER TIME TO CANCER EDUCATION OUTREACH, INCLUDING ACTIVITIES SUCH AS K-12 CURRICULUM DEVELOPMENT, SCHOOL VISITS FOR CANCER AND HEALTHY LIVING EDUCATION, CAREER TALKS, TEACHER TRAINING WORKSHOPS AND PUBLIC-ACCESS WEBSITE DEVELOPMENT.
PART III, LINE 2:	BAD DEBT EXPENSE IS EQUAL TO CHARGES ON ACCOUNTS DETERMINED TO BE UNCOLLECTIBLE. SEE NARRATIVE FOR PART 1, LINE 3C REGARDING THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 4:	BAD DEBT EXPENSE EXPLANATION IN FINANCIAL STATEMENTS FOOTNOTES IS AS FOLLOWS: NET PATIENT SERVICE REVENUES AND RECEIVABLES - NO FAMILY EVER PAYS THE HOSPITAL FOR THE CARE THEIR CHILD RECEIVES. ACCORDINGLY, NET PATIENT SERVICE REVENUE CONSISTS ONLY OF ESTIMATED NET REALIZABLE AMOUNTS FROM THIRD-PARTY PAYORS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE REVENUE ADJUSTMENTS (IF NECESSARY) DUE TO FUTURE AUDITS, REVIEWS, AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE CONSIDERED IN THE RECOGNITION OF REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED, AND SUCH AMOUNTS ARE ADJUSTED AS AMOUNTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS. PATIENT SERVICE REVENUE HAS BEEN REDUCED BY ADJUSTMENTS FOR UNCOLLECTIBLE ACCOUNTS TOTALING APPROXIMATELY $1,100,000 AND $773,000 IN 2019 AND 2018, RESPECTIVELY. ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER BAD DEBT EXPENSE A COMMUNITY BENEFIT.
PART III, LINE 8:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL DOES NOT CONSIDER THE MEDICARE SHORTFALL A COMMUNITY BENEFIT. THE COST TO CHARGE RATIO WAS USED TO DETERMINE MEDICARE ALLOWABLE COSTS OF CARE.
PART III, LINE 9B:	ALL PATIENTS ACCEPTED FOR ST. JUDE TREATMENT RECEIVE CARE WHETHER OR NOT THEY OR THEIR FAMILIES CAN PAY FOR IT. ST. JUDE DOES HAVE A BILLING SYSTEM, BUT PATIENTS DO NOT RECEIVE BILLS. IF THE PATIENT HAS INSURANCE, ST. JUDE BILLS THE INSURANCE PLAN OR OTHER ORGANIZATION THAT PAYS HEALTH COSTS. THIS IS SET FORTH IN OUR FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/ LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML).
PART VI, LINE 2:	ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS FOR CHILDHOOD CANCERS AND OTHER CATASTROPHIC DISEASES IN CHILDREN. CANCERPEDIATRIC CANCERS ARE RARE COMPARED TO ADULT CANCERS. ONLY 11,060 NEW CASES ARE EXPECTED TO OCCUR AMONG CHILDREN 14 YEARS OF AGE AND YOUNGER IN 2019; HOWEVER, CANCER IS THE LEADING CAUSE OF DISEASE-RELATED DEATH IN U.S. CHILDREN (FOOTNOTE 1). THE PRINCIPAL FOCUS OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS CANCER. SEVENTY-FIVE PERCENT OF ALL RESOURCES AT ST. JUDE ARE INVESTED IN ELUCIDATING BASIC BIOLOGICAL MECHANISMS OF PEDIATRIC CANCERS, AND TRANSLATING THIS KNOWLEDGE INTO IMPROVED DIAGNOSTIC TOOLS AND CURATIVE THERAPIES, WHILE MINIMIZING LONG-TERM SIDE EFFECTS. AS THE FIRST AND ONLY NATIONAL CANCER INSTITUTE-DESIGNATED COMPREHENSIVE CANCER CENTER FOCUSED EXCLUSIVELY ON CHILDREN, ST. JUDE SERVES AS A NATIONAL RESOURCE FOR RESEARCH AND TREATMENT OF PEDIATRIC CANCERS. OUR INITIATIVES ARE DESIGNED TO IMPACT PEDIATRIC CANCER TREATMENT ON A LOCAL, REGIONAL, NATIONAL AND GLOBAL SCALE.OUR CANCER PATIENTS COME FROM ALL OVER THE UNITED STATES AND ABROAD; HOWEVER, 66% OF THE NEW CANCER PATIENTS WE REGISTER RESIDE IN THE ST. JUDE CATCHMENT AREA, WHICH INCLUDES A 180-MILE RADIUS AROUND ST. JUDE LOCATED IN MEMPHIS, TN AND A 100-MILE RADIUS AROUND EACH OF OUR EIGHT AFFILIATES. THESE EIGHT AFFILIATES ARE LOCATED IN HUNTSVILLE, AL, CHARLOTTE, NC, JOHNSON CITY, TN, BATON ROUGE, LA, SHREVEPORT, LA, TULSA, OK, SPRINGFIELD, MO, AND PEORIA, IL. THE CATCHMENT POPULATION IS GENERALLY CHARACTERIZED BY A HIGHER PROPORTION OF NON-HISPANIC BLACK/AFRICAN-AMERICAN RACE, LOWER PROPORTION OF HISPANIC ETHNICITY, LOWER HOUSEHOLD INCOMES AND HOME VALUES, AND LOWER PROPORTION WITH AN EDUCATION BEYOND HIGH SCHOOL. APPROXIMATELY 4.9% OF THE POPULATION LIVE IN RURAL AREAS (BY RUCA CODE 10). TAKEN TOGETHER, THIS DIVERSE POPULATION INCLUDES MANY WITH LIMITED RESOURCES WHO ARE MEDICALLY UNDERSERVED. THROUGH ST. JUDE'S FOUNDING POLICY - THAT NO PATIENT BE DENIED TREATMENT BASED ON RACE, ETHNICITY, RELIGION, OR A FAMILY'S INABILITY TO PAY - AND WITH THE PROVISION OF RESOURCES TO OFFSET THE COSTS OF TRANSPORTATION AND HOUSING DURING CLINIC VISITS AND TREATMENT, WE REMOVE BARRIERS IN ACCESS TO OUR CUTTING-EDGE CLINICAL RESEARCH TRIALS AND EXCEPTIONAL CLINICAL CARE. ALL PEDIATRIC PATIENTS IN OUR CATCHMENT AREA ARE ACCEPTED TO ST. JUDE FOR TREATMENT OF THEIR CANCER.THE DEMOGRAPHICS OF THE PEDIATRIC CANCER POPULATION TREATED AT ST. JUDE CLOSELY MATCH THOSE OF OUR CATCHMENT AREA (BASED ON 2010 DATA FROM THE US CENSUS BUREAU) AND ALIGN WITH THE ESTIMATED INCIDENCE OF PEDIATRIC CANCER IN REPRESENTED RACIAL AND ETHNIC GROUPS (BASED ON SURVEILLANCE EPIDEMIOLOGY AND END RESULTS [SEER] 2009 DATA), CONFIRMING THAT ST. JUDE IS CLOSELY ALIGNED WITH THE NEEDS OF THE POPULATION IT SERVES. DEMOGRAPHICS FROM THE ST. JUDE PEDIATRIC CANCER COHORT ARE COMPARED WITH THE DEMOGRAPHICS OF THE CATCHMENT AREA ANNUALLY TO MONITOR DEMOGRAPHIC REPRESENTATION OF OUR CANCER PATIENTS IN RELATION TO THE AREA THAT WE SERVE.THERE ARE NO KNOWN DIFFERENCES IN PEDIATRIC CANCER INCIDENCE BY GEOGRAPHIC REGION IN THE U.S. CONSEQUENTLY, IT IS NOT POSSIBLE TO CATER OUR CLINICAL TRIALS TO TARGET PEDIATRIC CANCERS SPECIFICALLY PREVALENT IN OUR CATCHMENT AREA. WHILE NUMEROUS ADULT CANCERS HAVE BEEN SHOWN TO HAVE HIGH VARIATION IN INCIDENCE RATES ACROSS RACES AND ETHNICITIES, THE SITUATION IS LESS CLEAR IN PEDIATRIC CANCER, WHERE FEWER DISCREPANCIES HAVE BEEN IDENTIFIED. ALTHOUGH OUR CATCHMENT AREA HAS A HIGHER PROPORTION OF AFRICAN-AMERICAN PATIENTS THAN THE GENERAL U.S. POPULATION, THERE ARE VERY FEW EXAMPLES OF PEDIATRIC CANCERS IN WHICH THE INCIDENCE IS HIGHER IN RACIAL AND/OR ETHNIC MINORITIES (FOOTNOTES 2 AND 3). CONSEQUENTLY OUR RESEARCH AND CLINICAL TRIALS ADDRESS THE MOST PRESSING PROBLEMS IN PEDIATRIC CANCER. ST. JUDE OFFERS THERAPEUTIC TRIALS FOR THE TOP PEDIATRIC CANCERS (FOOTNOTE 1) INCLUDING ACUTE LYMPHOBLASTIC LEUKEMIA, MEDULLOBLASTOMA, NEUROBLASTOMA, HODGKIN LYMPHOMA, RETINOBLASTOMA, RHABDOMYOSARCOMA AND OTHERS. MANY OF THESE TRIALS ARE INSTITUTIONALLY SPONSORED; HOWEVER, ST. JUDE ALSO PARTICIPATES IN A NUMBER OF CLINICAL TRIALS CONSORTIA PROVIDING OUR CANCER PATIENTS ACCESS TO A VARIETY OF THERAPEUTIC STUDIES. PEDIATRIC CANCER PATIENTS MAY EXPERIENCE TREATMENT-RELATED SIDE EFFECTS MANY YEARS AFTER DIAGNOSIS. THE CHILDHOOD CANCER SURVIVOR STUDY AND ST. JUDE LIFE ARE TWO STUDIES, ACTIVE AT ST. JUDE, ASSESSING LATE EFFECTS OF CANCER THERAPY ON PEDIATRIC CANCER SURVIVORS. INFORMATION FROM THESE STUDIES WILL BE USED TO DEFINE RISK GROUPS FOR VARIOUS LATE EFFECTS AND ASSESS INTERVENTIONS.A KEY AREA THAT ST. JUDE IS PROMOTING IN OUR CATCHMENT AREA AND BEYOND IS PREVENTION OF HPV-RELATED CANCERS. THE AMERICAN CANCER SOCIETY AND OTHER ORGANIZATIONS HAVE PUT FORTH THE GOAL TO ERADICATE HPV-RELATED CANCERS THROUGH VACCINATION AND SCREENING. NEARLY 80 MILLION INDIVIDUALS IN THE U.S. - 1 OUT OF EVERY 4 PEOPLE - ARE INFECTED WITH HUMAN PAPILLOMAVIRUS (HPV). APPROXIMATELY 34,800 CANCERS ATTRIBUTABLE TO HPV OCCUR EACH YEAR (FOOTNOTE 4). U.S. VACCINATION RATES REMAIN SIGNIFICANTLY LOWER FOR HPV THAN FOR OTHER RECOMMENDED ADOLESCENT VACCINES. IN 2017, TENNESSEE'S COMBINED HPV VACCINATION COVERAGE FOR MALES AND FEMALES AGES 13-17 IS ONLY 56%, WHICH RANKS 46TH IN THE NATION. BY GENDER, FEWER THAN 50% OF GIRLS AND APPROXIMATELY 30% OF BOYS AGES 13-17 ARE UP-TO-DATE ON THE HPV VACCINE SERIES (FOOTNOTE 5). RESIDENTS OF TENNESSEE AND THE MID-SOUTH HAVE AMONG THE HIGHEST INCIDENCES OF HPV-RELATED CANCERS IN THE COUNTRY (FOOTNOTE 6). AS THE ONLY NCI-DESIGNATED CANCER CENTER DEVOTED SOLELY TO CHILDREN, ST. JUDE IS COMMITTED TO TAKING ON A NEW LEADERSHIP ROLE IN PROTECTING YOUNG PEOPLE FROM PREVENTABLE HPV-ASSOCIATED CANCERS LATER IN LIFE. RECENTLY, ST. JUDE LAUNCHED HPV AWARENESS EFFORTS INCLUDING EDUCATION AT LOCAL SCHOOLS, OUTREACH TO NEWS MEDIA, DEVELOPMENT OF WEB CONTENT, AND PARTNERING WITH OTHER NCI-DESIGNATED CANCER CENTERS TO ENDORSE A GOAL OF ELIMINATING HPV-ASSOCIATED CANCERS IN THE UNITED STATES. OVER THE NEXT 5 YEARS, OUR PLAN IS TO SIGNIFICANTLY EXPAND OUR EFFORTS TO HAVE A GREATER IMPACT IN THE PROMOTION OF HPV VACCINATION IN OUR LOCAL CATCHMENT AREA, IN THE STATE OF TENNESSEE, AND NATIONALLY.ACCORDING TO THE AMERICAN CANCER SOCIETY, INDIVIDUALS WITH LOWER SOCIOECONOMIC STATUS HAVE HIGHER CANCER INCIDENCE RATES DUE TO ENGAGING IN LIFESTYLE BEHAVIORS THAT INCREASE CANCER RISK (FOOTNOTE 1). THE ST. JUDE CANCER EDUCATION FOR CHILDREN PROGRAM IS A LOCAL COMMUNITY EFFORT THAT USES EDUCATION AND POSITIVE REINFORCEMENT TO PROMOTE HEALTHY LIFESTYLE CHOICES THAT CAN HELP CHILDREN REDUCE THEIR RISK OF CANCER IN ADULTHOOD. EDUCATIONAL COMPONENTS OF THE PROGRAM SPECIFICALLY ADDRESS OBESITY, NUTRITION, SMOKING, AND SUN EXPOSURE, IMPORTANT ISSUES IN PROMOTING CHILDHOOD HEALTH AND PRIMARY CANCER PREVENTION. THE PROGRAM DEVELOPMENT IS OVERSEEN BY A MULTIDISCIPLINARY TEAM COMPOSED OF ST. JUDE FACULTY AND STAFF, LOCAL EDUCATORS, AND LOCAL HEALTH EXPERTS WHO WORK TOGETHER TO ENSURE THAT THE CONTENT ACHIEVES THE GOALS OF THE PROGRAM WHILE ALIGNING TO STATE AND NATIONAL EDUCATION STANDARDS. DURING THE 2017-2018 SCHOOL YEAR, THE SCHOOL OUTREACH TEAM WORKED WITH THE SHELBY COUNTY SCHOOL DISTRICT TO DELIVER CANCER AND HEALTHY LIVING EDUCATION PROGRAMS TO OVER 5,000 K-12 STUDENTS.(NOTE: THIS NARRATIVE FOR PART VI, LINE 2 IS CONTINUED BELOW.) - SEE PAGE 101/131
PART VI, LINE 3:	AS NOTED IN PART I, LINE 3C, NO FAMILY EVER PAYS ST. JUDE FOR TREATMENT. IN ADDITION, ST. JUDE PROVIDES AN UNPARALLELED LEVEL OF SUPPORT SERVICES AT NO COST TO FAMILIES. WE ALSO HAVE PROGRAMS TO ASSIST FAMILIES IN ENROLLING IN VARIOUS PUBLIC ASSISTANCE PROGRAMS FOR WHICH THEY MAY QUALIFY, INCLUDING BUT NOT LIMITED TO TENNCARE/MEDICAID, COVERKIDS, CHIPS AND SOCIAL SECURITY. FAMILIES ALSO HAVE ACCESS TO AN ONLINE EDUCATIONAL RESOURCE TITLED "YOU AND THE AFFORDABLE CARE ACT" (HTTPS://WWW.STJUDE.ORG/TREATMENT/PATIENT-RESOURCES/CAREGIVER-RESOURCES/PATIENT-FAMILY-EDUCATION-SHEETS/LEGAL-FINANCIAL/YOU-AND-THE-AFFORDABLE-CARE-ACT.HTML). THIS ENSURES AN APPROPRIATE SAFETY NET SHOULD THE FAMILY SEEK TREATMENT OUTSIDE OF ST. JUDE AND IT ALLOWS US TO BE GOOD STEWARDS OF DONOR DOLLARS. WE UTILIZE AN OUTSIDE CONTRACTOR TO PROVIDE APPLICATION ASSISTANCE. THE HOSPITAL'S FINANCIAL ASSISTANCE STATEMENT (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-STATEMENT.HTML) AND FINANCIAL ASSISTANCE POLICY (HTTPS://WWW.STJUDE.ORG/LEGAL/FINANCIAL-ASSISTANCE-POLICY.HTML) ARE POSTED ON THE HOSPITAL'S WEBSITE AND AVAILABLE AT REGISTRATION. THE DOCUMENTS ARE AVAILABLE IN ENGLISH AND SPANISH. FOR FAMILIES SPEAKING OTHER LANGUAGES, WE UTILIZE ONSITE INTERPRETER SERVICES AND/OR PROFESSIONAL CONTRACTED INTERPRETATION AND TRANSLATION SERVICES.
PART VI, LINE 4:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL IN MEMPHIS, TN, IS A SPECIALTY HOSPITAL THAT TREATS PEDIATRIC CATASTROPHIC DISEASES WITH A FOCUS ON CANCER AND BLOOD DISORDERS. PATIENTS AT ST. JUDE ARE REFERRED BY A PHYSICIAN, DIAGNOSED WITH A DISEASE CURRENTLY UNDER STUDY, AND ELIGIBLE FOR A RESEARCH PROTOCOL. ST. JUDE IS THE ONLY PEDIATRIC RESEARCH CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, INCLUDING CANCER AND BLOOD DISORDERS, WHERE FAMILIES NEVER PAY FOR TREATMENT NOT COVERED BY INSURANCE. IN FACT, NO FAMILY EVER PAYS ST. JUDE FOR ANYTHING. TRANSPORTATION, HOUSING AND FOOD ARE AMONG THE NO-COST SERVICES PROVIDED TO ENSURE FAMILIES COMING TO ST. JUDE CAN FOCUS ON THEIR CHILD. NO CHILD IS EVER DENIED TREATMENT DUE TO RACE, SEX, NATIONALITY, ETHNICITY, RELIGION, OR THE FAMILY'S ABILITY TO PAY.THE COMMUNITY SERVED BY ST. JUDE CAN BEST BE DEFINED BY UNDERSTANDING ST. JUDE'S PATIENT POPULATION AND SCOPE OF CLINICAL SERVICES. ST JUDE SERVES AS A NATIONAL REFERRAL CENTER FOR CHILDREN WITH CATASTROPHIC DISEASES, SUCH AS CANCER AS WELL AS A LOCAL REFERRAL CENTER FOR CHILDREN WITH CANCER, BLOOD DISORDERS, AND HIV/AIDS. IT DOES NOT ADMIT CHILDREN FOR ANY DIAGNOSTIC GROUPS OUTSIDE OF THESE SERVICES AND DOES NOT OFFER MEDICAL SERVICES BEYOND THOSE NECESSARY TO CARE FOR CHILDREN WITH THESE DISEASES. ST. JUDE DOES NOT HAVE AN EMERGENCY ROOM (ER). A REFERRAL FROM A MEDICAL PROFESSIONAL EXTERNAL TO ST. JUDE, TYPICALLY THE CHILD'S PEDIATRICIAN OR A PEDIATRIC SUBSPECIALIST, IS NECESSARY PRIOR TO ACCEPTING A PATIENT FOR TREATMENT TO ST. JUDE.ST. JUDE'S PRIMARY CLINICAL EFFORT CENTERS ON PROVIDING GROUND-BREAKING, RESEARCH-DRIVEN TREATMENTS. SPECIFICALLY, MORE THAN 8,600 PATIENTS ARE SEEN AT ST. JUDE YEARLY, MOST OF WHO ARE ENROLLED ON CLINICAL TRIALS FOR NEW TREATMENTS DEVELOPED BY ST. JUDE, AND WHO ARE TREATED ON A CONTINUOUS OUTPATIENT BASIS. THE HOSPITAL HAS 73 OPERATIONAL BEDS FOR PATIENTS REQUIRING HOSPITALIZATION DURING TREATMENT. IT SHOULD BE NOTED THAT ST. JUDE HAS DEVELOPED UNIQUE RESOURCES THAT ALLOW A SIGNIFICANT PORTION OF PATIENTS TO BE TREATED AS OUTPATIENTS WHO WOULD BE ADMITTED INTO INPATIENT UNITS AT MOST HOSPITALS. THIS IS ACCOMPLISHED THROUGH PATIENT HOUSING DEDICATED SOLELY TO ST. JUDE PATIENT FAMILIES DESIGNED WITH INFECTION CONTROL MEASURES SUCH AS HEPA FILTRATION, INFECTION-RESISTANT SURFACES AND OTHER MEDICAL SAFEGUARDS THAT ARE NOT AVAILABLE IN HOTELS OR PATIENTS' HOMES.ST. JUDE HAS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE TO EXTEND CARE AND BENEFITS TO MORE CHILDREN AND INCREASE THE NUMBER OF CHILDREN ABLE TO BE TREATED ON ST. JUDE CLINICAL TRIALS.ST. JUDE ALSO OPERATES AN INTERNATIONAL OUTREACH PROGRAM IN GLOBAL PEDIATRIC MEDICINE (GPM), AIMED AT IMPROVING SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, IMPLEMENTING NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND GENERATING INTERNATIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THERE ARE AN ESTIMATED 175,000 NEWLY DIAGNOSED CASES OF CHILDHOOD CANCER WORLDWIDE EACH YEAR, AND 84% OCCUR IN LOW- AND MIDDLE-INCOME COUNTRIES. CANCER IS EMERGING AS A MAJOR CAUSE OF CHILDHOOD DEATH IN ALL DEVELOPING COUNTRIES, REPLACING OTHER CAUSES OF CHILDHOOD MORTALITY (E.G. HIV, MALNUTRITION, INFECTIONS). DESPITE VAST IMPROVEMENTS IN THERAPY AND SURVIVAL IN HIGH-INCOME COUNTRIES OVER THE PAST 30 YEARS, AN ESTIMATED 60% DO NOT HAVE ACCESS TO ADEQUATE DIAGNOSIS AND MODERN CARE. ST. JUDE STRIVES TO ADDRESS THE NEEDS OF THOSE CHILDREN IN COUNTRIES THAT LACK SUFFICIENT RESOURCES AND HELP THEM MANAGE THEIR OWN BURDEN OF CASES EFFECTIVELY.WHILE SICK CHILDREN FROM AROUND THE WORLD HAVE TRAVELED TO OUR HOSPITAL IN MEMPHIS, RECEIVING TREATMENT IN THEIR OWN COUNTRIES IS MORE EFFICIENT AND LESS DISRUPTIVE FOR THEM AND THEIR FAMILIES. AS A RESULT OF OUR INTERNATIONAL EFFORTS, WE ARE ABLE TO REACH FAR MORE CHILDREN THAN WOULD EVER BE ABLE TO COME TO MEMPHIS. A BASIC HEALTHCARE INFRASTRUCTURE IS NEEDED TO SUPPORT PEDIATRIC ONCOLOGY PROGRAMS, WHICH IN TURN FURTHER IMPROVES THE DEVELOPMENT OF BASIC HEALTHCARE. AT THE LOCAL LEVEL, GPM DEVELOPS PARTNERSHIPS WITH MEDICAL INSTITUTIONS AND FUND-RAISING ORGANIZATIONS AND FACILITATES THE INVOLVEMENT OF GOVERNMENT AND OTHER ORGANIZATIONS TO SUPPORT KEY PROGRAMS AND THE EDUCATION OF LOCAL PERSONNEL. AT THE REGIONAL LEVEL, GPM DEVELOPS PROGRAMS THROUGH THE USE OF TECHNOLOGY AND FOSTERS REGIONAL AND INTERNATIONAL COLLABORATIONS WITH OTHER PEDIATRIC MEDICAL INSTITUTIONS. THE PRIMARY GOAL IS TO DEVELOP LOCAL AND REGIONAL SELF-SUFFICIENCY. THIS MODEL RESULTS IN SIGNIFICANT OVERALL IMPROVEMENT IN HEALTHCARE FACILITIES, THE LEVEL OF PRACTICE, THE CONFIDENCE OF HEALTHCARE PROVIDERS, AND LOCAL COMMUNITY INVOLVEMENT. ST. JUDE EMPHASIZES THE BUILDING OF REGIONAL EXPERTISE AND DIAGNOSTIC CAPABILITIES, WHICH PROVIDE A CRITICAL MASS OF PROFESSIONALS WHO CONTINUALLY LEARN FROM AND ASSIST EACH OTHER. COST EFFICIENCY IS ALSO REALIZED BECAUSE OF SHARED RESOURCES.ST. JUDE HAS PARTNERSHIPS WITH 28 MEDICAL INSTITUTIONS ACROSS 17 DIFFERENT COUNTRIES - BRAZIL, CHILE, CHINA, COSTA RICA, DOMINICAN REPUBLIC, ECUADOR, EL SALVADOR, GUATEMALA, HAITI, HONDURAS, JORDAN, LEBANON, MEXICO, NICARAGUA, PHILIPPINES, URUGUAY AND VENEZUELA.ST. JUDE WORKS WITH ITS PARTNERS TO DEVELOP EVIDENCED-BASED TREATMENT PROTOCOLS TAILORED TO REGIONAL NEEDS AND RESOURCES. ADDITIONALLY, ST. JUDE PHYSICIANS AND NURSES SERVE AS MENTORS TO CLINICAL PERSONNEL AT PARTNER SITES, PROVIDE LOCAL AND ONLINE TRAINING FOR ONCOLOGY CARE, DIAGNOSIS, AND SUPPORTIVE CARE, AND PARTICIPATE IN ONLINE MEETINGS TO DISCUSS CLINICAL CARE BEST PRACTICES. THE MAJORITY OF ONLINE MEETINGS AND TRAINING ARE PROVIDED VIA ST. JUDE'S WEB-BASED PLATFORM, ST. JUDE CURE4KIDSTM (C4K), A FREE RESOURCE FOR PEDIATRIC ONCOLOGY PROFESSIONALS, SCIENTISTS AND RESEARCHERS, REGARDLESS OF THEIR AFFILIATION WITH ST. JUDE OR ITS PARTNERS. IN ADDITION TO CONTENT THAT INCLUDES MORE THAN 1,657 ONLINE SEMINARS, 19 SELF-PACED COURSES, AND 51 INSTRUCTOR-LED COURSES, C4K PROVIDES ONLINE MEETING AND CONFERENCE SPACE. IN FY19, C4K HAD 31,640 CONTENT VIEWS WITH 4,273 UNIQUE REGISTERED USERS, AND HOSTED 1,791 MEETINGS WITH 1,793 UNIQUE PARTICIPANTS FROM 148 DIFFERENT COUNTRIES; THERE ARE 64 NCI CENTERS THAT PARTICIPATE IN C4K. FINALLY, ST. JUDE PARTNERS WITH LOCAL FUNDRAISING ORGANIZATIONS THAT SUPPORT THE MEDICAL PROGRAMS. THIS MODEL HAS PROVEN TO BE HIGHLY EFFECTIVE IN PROVIDING POOR CHILDREN IN DEVELOPING COUNTRIES ACCESS TO MODERN TREATMENT AND CARE.ST. JUDE IS ALSO A RESEARCH ORGANIZATION, WITH RESEARCH COVERING A BROADER SCOPE OF HEALTH ISSUES THAN THE DISEASES TREATED AS A PRIMARY DIAGNOSIS.THE HOSPITAL'S OUTREACH INCLUDES THE LOCAL MARKET, AFFILIATE INSTITUTIONS, OTHER AREAS OF THE UNITED STATES/U.S. TERRITORIES, AND THE INTERNATIONAL COMMUNITY. THE LOCAL MARKET ENCOMPASSES MEMPHIS, TENNESSEE AND THE SURROUNDING GEOGRAPHIC AREA WITH APPROXIMATELY 24% OF NEW ONCOLOGY PATIENTS RESIDING WITHIN THIS AREA.FY19 NEW CANCER PATIENTSPATIENT ORIGIN % OF TOTALMEMPHIS, TN AND SURROUNDING AREA 24%AFFILIATE REFERRAL 36%NATIONAL REFERRAL (OTHER AREAS OF U.S.) 29%INTERNATIONAL REFERRAL 11%GRAND TOTAL 100%THE ST. JUDE AFFILIATE PROGRAM (AP) IS A NETWORK OF EIGHT AFFILIATED PEDIATRIC HEMATOLOGY/ONCOLOGY CLINICS IN THE U.S., ALLOWING ST. JUDE PATIENTS TO BE TREATED CLOSER TO HOME AND TO INCREASE ENROLLMENT ON ST. JUDE CLINICAL TRIALS. THE PHYSICIANS AND STAFF AT THESE SITES WORK IN COLLABORATION WITH THE STAFF AT ST. JUDE TO DELIVER PROTOCOL RELATED CARE OR EVIDENCE BASED TREATMENT WHEN NOT PARTICIPATING IN A TRIAL TO PEDIATRIC HEMATOLOGY-ONCOLOGY PATIENTS, SO THAT PATIENTS CAN RECEIVE CARE CLOSER TO HOME. AFFILIATES ARE CURRENTLY LOCATED IN BATON ROUGE, LA, CHARLOTTE, NC, HUNTSVILLE, AL, JOHNSON CITY, TN, PEORIA, IL, SHREVEPORT, LA, SPRINGFIELD, MO, AND TULSA, OK. THE AFFILIATES' ENROLLMENT OF PATIENTS ON ST. JUDE CLINICAL TRIALS HELPS ST. JUDE FIND CURES FASTER AND SAVE MORE CHILDREN.(NOTE: THIS NARRATIVE FOR PART VI, LINE 4 IS CONTINUED BELOW.) - SEE PAGE 107/131
PART VI, LINE 5:	ST. JUDE CHILDREN'S RESEARCH HOSPITAL WAS OPENED IN 1962. OUR MISSION IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER, DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S INABILITY TO PAY. OUR VISION IS TO BE THE WORLD LEADER IN ADVANCING THE TREATMENT AND PREVENTION OF CATASTROPHIC DISEASES IN CHILDREN. THIS VISION IS PURSUED BY PROVIDING OUTSTANDING PATIENT CARE; BY CONDUCTING BASIC, TRANSLATIONAL AND CLINICAL RESEARCH DESIGNED TO ELUCIDATE BIOLOGICAL MECHANISMS, UNDERSTAND DISEASE PATHOGENESIS, IMPROVE DIAGNOSIS, ENHANCE TREATMENT OUTCOME, PREVENT DISEASES AND MINIMIZE ADVERSE CONSEQUENCES OF TREATMENT; AND BY EDUCATING HEALTH CARE AND SCIENTIFIC RESEARCH PROFESSIONALS. THROUGH THESE EFFORTS, WE SEEK TO CURE AND ENHANCE THE QUALITY OF LIFE FOR AN INCREASING NUMBER OF CHILDREN WHO COME TO US FOR TREATMENT BY EXPANDING AND SHARING KNOWLEDGE TO ADVANCE TREATMENT OF CHILDREN WITH CATASTROPHIC DISEASES WORLDWIDE, WHILE DEVELOPING STRATEGIES TO PREVENT CATASTROPHIC DISEASES IN CHILDREN.ST. JUDE COMBINES LABORATORY AND CLINICAL RESEARCH TO ADVANCE THE CARE OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES. THE FOCUS IS ON PROVIDING OUTSTANDING PATIENT CARE RESULTS AND ON RESEARCH FINDINGS THAT TRANSLATE INTO IMPROVED PATIENT OUTCOMES. ST. JUDE HAS AN ACADEMIC FACULTY ENGAGED IN A BROAD SPECTRUM OF RESEARCH, INCLUDING THERAPEUTIC TRIALS, INVESTIGATION OF DISEASE PATHOGENESIS AND DISCOVERY-ORIENTED BASIC RESEARCH.HOSPITAL OPERATIONS ARE OVERSEEN BY A BOARD OF GOVERNORS, MOST OF WHICH ARE NEITHER EMPLOYEES, INDEPENDENT CONTRACTORS, OR THEIR FAMILY MEMBERS. RESEARCH ACTIVITIES ARE REVIEWED ANNUALLY BY A SCIENTIFIC ADVISORY BOARD COMPOSED OF INTERNATIONALLY PROMINENT PHYSICIANS AND SCIENTISTS.ST. JUDE CONTRIBUTED TO THE BUILDING OF A STATE-OF-THE ART NEUROSURGICAL FACILITY FOR TREATING LOCAL PEDIATRIC PATIENTS AND ST. JUDE BRAIN TUMOR PATIENTS. THE FACILITY IS EQUIPPED WITH INTRA-OPERATIVE IMAGING EQUIPMENT (IMRI). WHEN PURCHASED, ONLY TWO NEUROSURGICAL FACILITIES IN THE UNITED STATES PROVIDED PATIENTS WITH THIS LEVEL OF TREATMENT, WHICH ALLOWS IMAGING TO TAKE PLACE DURING SURGICAL PROCEDURES. IMRI EQUIPMENT ALLOWS SURGEONS TO MAKE INFORMED DECISIONS DURING THE SURGERY. LIVE WEB CASTS ALLOW OTHERS TO VIEW PROCEDURES. OUR ASSISTANCE WITH THIS FACILITY HELPS ASSURE THAT CHILDREN IN THE AREA HAVE ACCESS TO THE BEST NEUROSURGICAL TREATMENT AVAILABLE.ST. JUDE COMPLETED THE FIRST PHASE OF THE PEDIATRIC CANCER GENOME PROJECT (PCGP) IN JANUARY 2013 - A COLLABORATION WITH WASHINGTON UNIVERSITY TO FIND CLUES TO THE CAUSES OF CHILDHOOD CANCER AND POTENTIAL NEW TREATMENTS AND CURES. THE PROJECT HAS RESULTED IN GROUNDBREAKING DISCOVERIES IN A NUMBER OF CHILDHOOD CANCERS INCLUDING RETINOBLASTOMA, MEDULLOBLASTOMA, NEUROBLASTOMA, DIFFUSE INTRINSIC PONTINE GLIOMA, TWO AGGRESSIVE FORMS OF LEUKEMIA AND LOW-GRADE GLIOMAS. IN DECEMBER 2012, THE PCGP WAS RECOGNIZED AS ONE OF TIME MAGAZINE'S TOP 10 MEDICAL BREAKTHROUGHS AND, IN 2013, AS ONE OF TIME MAGAZINE'S TOP 100 NEW SCIENTIFIC DISCOVERIES. THE SECOND PHASE OF PCGP EXAMINED THE CANCER SAMPLES FROM 300 CHILDREN AND FOCUSED ON DEFINING MUTATIONS THAT CONTRIBUTE TO TUMOR FORMATION, CHARACTERIZING THE STATE OF THE CANCER CELL'S EPIGENOME AND DESCRIBING HOW IT DIFFERED FROM WHAT IS SEEN IN THE NORMAL CELLS. THE SECOND PHASE ALSO INCLUDED A CLINICAL GENOMICS PROJECT CALLED GENOMES FOR KIDS THAT INVOLVED NEXT-GENERATION SEQUENCING FOR CHILDREN WITH CANCER. WHEN PHASE 2 IS COMPLETE, ST. JUDE HOPES TO HAVE A MODEL FOR HOW TO EXTEND GENOME SEQUENCING TO EVERY CHILDHOOD CANCER PATIENT IN THE UNITED STATES. FROM ITS BEGINNINGS IN 2010, THE PCGP IS THE LARGEST, BROADEST, PRIVATELY FUNDED SEQUENCING PROJECT FOR CHILDREN WITH CANCER AND HAS SEQUENCED MORE THAN 800 MATCHED PAIRS OF TUMOR AND HEALTHY GENOMES FROM YOUNG PATIENTS. THE PCGP HAS PROVIDED NEW DETAILS ABOUT THE MUTATIONS THAT UNDERLIE THE DEVELOPMENT AND GROWTH OF A RANGE OF CHILDHOOD CANCERS, AND HAS LAID THE FOUNDATION FOR IMPROVED DIAGNOSTIC TESTING AND THE NEXT GENERATION OF MORE EFFECTIVE, LESS-TOXIC THERAPIES. THE PROJECT HAS LED TO NEW DIRECTIONS IN RESEARCH INVOLVING HIGH-RISK LEUKEMIA, BRAIN AND SOLID TUMORS AS WELL AS NEW COMPUTATIONAL METHODS THAT HAVE BEEN SHARED FOR FREE WITH THE GLOBAL SCIENTIFIC COMMUNITY.THE CYCLOTRON (PARTICLE ACCELERATOR) AT ST. JUDE ENABLES RESEARCHERS TO TRACK THE GROWTH OF CANCER CELLS, PINPOINT THE PRODUCTION OF NEW DNA BY TUMOR CELLS AND STUDY THE HEARTS OF ADULT CHILDHOOD CANCER SURVIVORS RETURNING TO ST. JUDE FOR LIFETIME FOLLOW-UP. THE CYCLOTRON HELPS RESEARCHERS BETTER UNDERSTAND CHILDHOOD CANCER BY ENABLING THEM TO PRODUCE NEW, VERY SHORT-ACTING TRACERS.ST. JUDE USES THE SERVICES OF CHILDREN'S GMP, LLC (OF WHICH ST. JUDE IS THE SOLE MEMBER). CHILDREN'S GMP, LLC, MANAGES AND OPERATES A GOOD MANUFACTURING PRACTICE (GMP) FACILITY THAT ENGAGES IN THE PRODUCTION OF BIOLOGICS AND DRUGS FOR RESEARCH. THE GMP OFFERS RESOURCES TO STUDY RARE DISEASES OVERLOOKED BY PHARMACEUTICAL COMPANIES BECAUSE THERE IS LITTLE PROFIT IN MANUFACTURING DRUGS FOR LESSER- KNOWN DISEASES. THE FACILITY, OPERATING ACCORDING TO APPROVED FDA STANDARDS, ALLOWS DOCTORS TO TAILOR TREATMENTS SPECIFICALLY FOR AN INDIVIDUAL CHILD.THE CELL AND TISSUE IMAGING CENTER INCLUDES ELECTRON MICROSCOPY AND LIGHT MICROSCOPY. THE FACILITY PROVIDES INVESTIGATORS ACCESS TO TRANSMISSION ELECTRON MICROSCOPY, CONFOCAL LASER SCANNING MICROSCOPY, MULTIPHOTON MICROSCOPY, IMAGE ANALYSIS, CELL MICROINJECTION AND LIVE CELL IMAGING. THE FEI TECNAI 20 200KV FEG ELECTRON MICROSCOPE, WHICH CAN MAGNIFY AN OBJECT 700,000 TIMES, IS AT THE HEART OF THIS PROGRAM. THIS TECHNOLOGY ALLOWS RESEARCHERS TO GET A CLOSER LOOK AT CANCER TO BETTER UNDERSTAND HOW IT GROWS AND SPREADS AND RESPONDS TO THERAPY. USING THE ELECTRON MICROSCOPE, RESEARCHERS LEARN HOW CANCER CELLS BREAK AWAY FROM THE TUMOR AND SPREAD THROUGHOUT THE BODY.ST. JUDE IS HOME TO THE ONLY PROTON BEAM RADIATION THERAPY CENTER DEVOTED SOLELY TO TREATING CHILDREN WITH BRAIN TUMORS AND SEVERAL OTHER CHILDHOOD CANCERS. PROTON THERAPY IS LESS DAMAGING TO SURROUNDING HEALTHY TISSUE THAN OTHER CURRENT RADIATION THERAPIES. THIS EQUIPMENT ENABLES ST. JUDE TO PROVIDE THIS THERAPY IN A MORE INTEGRATED MANNER TO OUTPATIENTS AND ALLOW OUR RADIATION ONCOLOGISTS TO LEAD THE DEVELOPMENT OF NEW TREATMENTS WITH PROTONS.TO FURTHER PALLIATIVE SERVICES IN THE COMMUNITY, ST. JUDE PARTICIPATED WITH LE BONHEUR CHILDREN'S HOSPITAL IN DEVELOPING THE QUALITY OF LIFE FOR ALL KIDS PALLIATIVE PROGRAM FOR SERIOUSLY ILL CHILDREN. HOSPICE STAFF, BOTH IN THE HOME AND IN THE HOSPICE RESIDENCE, PROVIDES INTERDISCIPLINARY CARE TO CHILDREN THROUGHOUT THE ILLNESS TRAJECTORY AND CONCURRENT THERAPIES.ST. JUDE ADMINISTRATIVE LEADERS AND FACULTY MEMBERS OF THE DEPARTMENT OF PHARMACEUTICAL SCIENCES HAVE BEEN AT THE FOREFRONT OF BRINGING NATIONAL ATTENTION TO THE PEDIATRIC CANCER DRUG SHORTAGE TOPIC, ACTIVELY ENGAGING REGULATORY AND LEGISLATIVE BODIES TO UNDERSTAND THE IMPACT THESE DRUG SHORTAGES HAVE ON PEDIATRIC CARE AND RESEARCH. PRESENTATIONS OR WRITTEN TESTIMONY HAVE BEEN PROVIDED TO THE FDA CENTER FOR DRUG EVALUATION AND RESEARCH WORKSHOP, TWO SENATE HEARINGS, AND HEALTH SUBCOMMITTEE OF THE HOUSE COMMITTEE ON ENERGY AND COMMERCE.ST. JUDE FOCUSES ON EDUCATING AND TRAINING THE NEXT GENERATION OF DOCTORS, NURSES, RESEARCHERS AND ACADEMIC LEADERS. FROM PROGRAMS FOR HIGH SCHOOL STUDENTS TO THE POSTDOCTORAL LEVEL, THE HOSPITAL PLAYS A MAJOR ROLE IN PREPARING FUTURE LEADERS OF SCIENCE AND MEDICINE. IN ADDITION TO ONSITE EDUCATION, THE ST. JUDE GLOBAL PROVIDES AN EDUCATION AND COLLABORATION WEB SITE, CURE4KIDS(TM) (WWW.CURE4KIDS.ORG).VIA THE CONNECT2PROTECT PROGRAM, ST. JUDE COLLABORATES WITH CHURCHES, OTHER HEALTH CARE ORGANIZATIONS AND CIVIC GROUPS TO RAISE AWARENESS ABOUT PREVENTING THE SPREAD OF HIV/AIDS. THE PRIMARY TARGET IS THE AFRICAN-AMERICAN COMMUNITY, ALTHOUGH OTHER ETHNIC GROUPS ARE ALSO SERVED INCLUDING ASIAN, CAUCASIAN AND HISPANIC.THE FUNDRAISING SOURCE FOR ST. JUDE IS ALSAC, WHICH RAISES FUNDS SOLELY FOR THE HOSPITAL. BECAUSE OF THE HOSPITAL'S MISSION, PEOPLE NATIONWIDE CONTRIBUTE VIA TENS OF THOUSANDS OF FUNDRAISING EFFORTS. ALSAC CONTRIBUTED $865 MILLION IN FY19 TO SUPPORT ST. JUDE. VOLUNTEERS ENHANCE THE QUALITY OF PATIENT CARE BY PARTNERING WITH CLINICAL STAFF TO PROVIDE AN ADDITIONAL PERSONAL TOUCH. VOLUNTEERS ALSO HELP ENSURE A SAFE ENVIRONMENT. THEY LEND ASSISTANCE AND PROVIDE COMPASSIONATE CONCERN BY OFFERING A LISTENING EAR TO FAMILIES AT A TIME WHEN THEY NEED IT MOST. THEY ARE VITAL AMBASSADORS FOR THE HOSPITAL AND COMMUNITY.
PART VI, LINE 2 (CONTINUATION FROM 90/131):	HEMATOLOGYTHE GEOGRAPHIC CATCHMENT AREA FOR ST. JUDE ENCOMPASSES 21 COUNTIES IN WESTERN TENNESSEE INCLUDING MEMPHIS, AND AREAS IN EAST ARKANSAS, NORTH MISSISSIPPI, AND A FEW COUNTIES IN MISSOURI.MORE THAN 70,000 PEOPLE IN THE UNITED STATES HAVE SICKLE CELL DISEASE (SCD), AND IT IS ESTIMATED THAT MORE THAN 1 MILLION PEOPLE WORLDWIDE SUFFER FROM THE DISEASE. IT IS THE MOST FREQUENT GENETIC BLOOD DISORDER IN THE WORLD. ST. JUDE HAS ONE OF THE LARGEST PEDIATRIC SCD PROGRAMS IN THE COUNTRY AND PROVIDES COMPREHENSIVE TREATMENT AND EDUCATION TO ABOUT 900 CHILDREN WITH SCD IN THE GEOGRAPHIC CATCHMENT AREA. SCD IS DIAGNOSED BY STATE-WIDE NEWBORN SCREENING IN ALL 50 STATES. ST. JUDE HAS A PARTNERSHIP WITH NEWBORN SCREENING PROGRAMS IN TN AND MS THAT ENSURES A STABLE RELATIONSHIP AMONG PARENTS, PATIENTS, PRIMARY CARE PROVIDERS. ABOUT 50 NEWBORNS WITH SCD ARE IDENTIFIED EACH YEAR IN OUR GEOGRAPHIC CATCHMENT AREA. OUR SCD INFANT TODDLER PROGRAM CONTACTS AND ACCEPTS ALL CHILDREN DIAGNOSED WITH THE DISEASE IN OUR CATCHMENT AREA TO ITS COMPREHENSIVE CARE SERVICE. ADDITIONALLY, ST. JUDE PROVIDES TRAIT COUNSELING SERVICE TO INFANTS BORN WITH SICKLE CELL TRAIT TO 21 COUNTIES IN WESTERN TN. ST. JUDE PROVIDES CONFIRMATORY TESTING, EDUCATION AND COMPREHENSIVE CARE AND FOLLOW-UP THROUGHOUT CHILDHOOD FOR CHILDREN WITH SCD DISEASE. FROM BIRTH TO AGE 18 YEARS, PATIENTS ARE CLINICALLY EVALUATED AT LEAST EVERY 6 MONTHS, RECEIVE EDUCATION AND MULTI-DISCIPLINARY SERVICES ACCORDING TO STANDARDIZED TREATMENT AND EDUCATION GUIDELINES. SERVICES ALSO INCLUDE COMMUNITY OUTREACH AND EDUCATION OF THE LOCAL COMMUNITY. ST. JUDE HAS ESTABLISHED A FORMAL TRANSITION PROGRAM TO ADULT CARE FOR PATIENTS WITH SCD AND PROVIDES SUPPORT TO PATIENTS AND FAMILIES THROUGHOUT THE TRANSITION PROCESS BY WORKING CLOSELY WITH THE ADULT SCD PROGRAMS AT METHODIST UNIVERSITY HOSPITAL AND REGIONAL ONE HOSPITAL. IN THE PAST, THE SCD PROGRAM AT ST. JUDE HAS COLLABORATED WITH SEVERAL FEDERALLY QUALIFIED HEALTH CARE CENTERS, WITH COMMUNITY PRIMARY CARE PHYSICIANS, LATINO MEMPHIS (THE LARGEST HISPANIC SOCIAL AGENCY IN TENNESSEE), WITH THE SICKLE CELL FOUNDATION OF TENNESSEE (A COMMUNITY-BASED SCD ORGANIZATION), AND WITH REGIONAL SCD PROVIDERS TO ENSURE A MEDICAL HOME AND ADEQUATE SOCIAL SUPPORT FOR ALL SCD PATIENTS IN THE AREA. ST. JUDE ASSESSES PATIENT NEEDS THROUGH PARENT AND PATIENT SURVEYS, INTERACTIVE EDUCATION, MATERIALS REVIEW, AND GROUP DISCUSSIONS WITH PARENTS AND PATIENTS. ST. JUDE HAS AN ANNUAL SICKLE CELL EDUCATION DAY FOR PATIENTS WITH SICKLE CELL DISEASE AND THEIR FAMILIES/CAREGIVERS. MORE THAN 250 ATTEND THIS EVENT EVERY YEAR. ADDITIONALLY, ST. JUDE COLLABORATES WITH NATIONAL ORGANIZATIONS TO PROVIDE EDUCATION TO HEALTHCARE PROVIDERS AND PEOPLE WITH SICKLE CELL DISEASE TO INCREASE SICKLE CELL AWARENESS. ST. JUDE PROVIDES FREE EDUCATIONAL BOOKLETS AND BROCHURES (HARD COPY REQUEST OR DOWNLOAD) ON THE HEMATOLOGY WEBSITE AS WELL AS INTERACTIVE EDUCATIONAL VIDEOS. PEOPLE FROM THROUGHOUT THE US AND OTHER COUNTRIES UTILIZE THE EDUCATIONAL WEBSITE. ST. JUDE PARTICIPATES IN NUMEROUS HEALTH FAIRS, SCHOOL PROGRAMS, AND OTHER COMMUNITY EVENTS TO INCREASE KNOWLEDGE AND AWARENESS OF HEMATOLOGICAL DISORDERS AND THEIR IMPACT ON THE PATIENTS AND THE COMMUNITY.ST. JUDE ALSO PROVIDES CLINICAL SERVICES FOR APPROXIMATELY 800 CHILDREN PER YEAR WITH OTHER NON-MALIGNANT HEMATOLOGICAL DISORDERS THROUGH A STRONG RELATIONSHIP WITH LOCAL COMMUNITY PHYSICIANS. CHILDREN FROM THE GEOGRAPHIC CATCHMENT AREA OF ST. JUDE (AS OUTLINED ABOVE) WITH ILLNESSES SUCH AS HEMOPHILIA, APLASTIC ANEMIA, THROMBOSIS, THALASSEMIA, SPHEROCYTOSIS, AND IMMUNE THROMBOCYTOPENIC PURPURA AND OTHER NON- MALIGNANT HEMATOLOGIC DISORDERS ARE REFERRED TO AND RECEIVE STATE-OF-THE-ART CARE FROM ST. JUDE PHYSICIANS AND MEDICAL STAFF. ST. JUDE IS ONE OF A SELECT GROUP OF FEDERALLY RECOGNIZED PEDIATRIC HEMOPHILIA TREATMENT CENTERS AND PROVIDES STATE-OF-THE-ART COMPREHENSIVE CARE TO APPROXIMATELY 300 CHILDREN WITH BLEEDING AND THROMBOSIS DISORDERS.IN ADDITION TO PROVIDING AND CONTINUOUSLY IMPROVING STANDARDIZED CARE TO THESE PATIENT POPULATIONS, ST. JUDE HEMATOLOGY DEDICATES A SIGNIFICANT AMOUNT OF RESOURCES TO CLINICAL, TRANSLATIONAL, AND BASIC RESEARCH TO IMPROVE SURVIVAL AND DECREASE MORBIDITY OF CHILDREN WITH NON-MALIGNANT CHRONIC BLOOD DISEASES. MOST PATIENTS PARTICIPATE IN RESEARCH STUDIES, WHICH HAVE RESULTED IN MAJOR IMPROVEMENTS IN CLINICAL CARE. FOR EXAMPLE, RECENT RESULTS FROM THE BABY HUG TRIAL SHOWED THAT DAILY ORAL HYDROXYUREA IS SAFE AND EFFECTIVE FOR INFANTS AND YOUNG CHILDREN WITH SCD, WHICH LED TO THE RECOMMENDATION OF ITS GENERAL USE IN THIS SUBPOPULATION. ALSO, IN A FIRST-IN-MAN TRIAL, ST. JUDE HEMATOLOGY SHOWED THE SAFETY AND EFFICACY OF A NOVEL GENE TRANSFER AGENT CARRYING THE FACTOR IX GENE FOR TREATMENT OF HEMOPHILIA B; ALL TEN ADULT PARTICIPANTS WITH SEVERE HEMOPHILIA B HAD NO SERIOUS UNEXPECTED SIDE EFFECTS AND ALL PARTICIPANTS SHOWED AN INCREASE IN FACTOR IX LEVELS LEADING TO A SUBSTANTIAL REDUCTION IN THEIR BLEEDING TENDENCY. ADDITIONALLY, ST. JUDE HAS DEVELOPED A VECTOR FOR GENE TRANSFER TO TREAT CHILDREN WITH X LINKED SEVERE COMBINED IMMUNODEFICIENCY (X LINKED SCID) DISEASE WHICH HAS SHOWN PROMISE AS A CURE FOR THE DISEASE. FUTURE EFFORTS WILL CONTINUE TO FOCUS ON FINDING VIABLE CURES AND/OR TREATMENTS TO PREVENT COMPLICATIONS IN CHILDREN WITH SCD AND OTHER NON-MALIGNANT, CHRONIC HEMATOLOGIC DISEASES.HIVTHE CONNECT TO PROTECT (C2P) COMMUNITY COALITION LED BY MEMBERS OF THE HOSPITAL'S COMPREHENSIVE HIV PREVENTION AND TREATMENT PROGRAM FOR CHILDREN AND YOUTH, HAS SIGNIFICANTLY CONTRIBUTED TO THE STRONG COMMUNITY TIES THAT ST. JUDE HAS ESTABLISHED AND STRENGTHENED. LAUNCHED IN 2008, C2P IS MADE UP OF 25 PARTNER AGENCIES REPRESENTING A DIVERSE MIX OF STAKEHOLDERS FROM VARIOUS SECTORS IN MEMPHIS. THIS INCLUDES THE HEALTH DEPARTMENT, FAITH- AND COMMUNITY-BASED ORGANIZATIONS, SCHOOLS, BUSINESSES, YOUTH AND HEALTH CARE ORGANIZATIONS; ALL ALIGNED WITH THE COMMON GOAL OF OPTIMIZING HIV PREVENTION AND TREATMENT. THE STRENGTH OF THIS COALITION HAS BEEN TO PROVIDE A NON-THREATENING, COLLABORATIVE ENVIRONMENT WHERE INDIVIDUALS AND AGENCIES WITH DIFFERENT BACKGROUNDS AND PRIORITIES HAVE BEEN ABLE TO COLLABORATIVELY IMPLEMENT OVER 70 NEW POLICIES, PRACTICES AND PROGRAMS THAT IMPACT HIV PREVENTION AND TREATMENT IN YOUTH. IN THIS COALITION WE HAVE LEARNED AND SHARED BEST PRACTICES, AND TOGETHER, IDENTIFIED AND DEVELOPED NEW STRUCTURAL CHANGE OBJECTIVES TO ADDRESS IMPEDIMENTS THAT PREVENT YOUTH FROM MOVING ALONG THE HIV PREVENTION AND TREATMENT CARE CONTINUUM.HAVING ACCESS TO, AND COMMITMENT FROM, SUCH A DIVERSE GROUP OF PEOPLE AND ORGANIZATIONS HAS ALLOWED FOR SHARED RESPONSIBILITY IN TRANSFORMING THE HEALTH TRAJECTORY OF THE CITY. THE COALITION DESIGNED A STRATEGIC PLAN THAT SPECIFICALLY ADDRESSES YOUTH BARRIERS TO TESTING, TRANSITIONING TO ADULT CARE, PRE-EXPOSURE PROPHYLAXIS AND LINKAGE OF NEWLY DIAGNOSED HIV+ YOUTH TO MEDICAL CARE. AS BARRIERS ARE IDENTIFIED, MEMBERS ENGAGE IN DIALOGUE AND DISCUSSIONS WITH KEY STAKEHOLDERS, AND STRATEGIZE FOR POLICY AND PRACTICE CHANGES RELATED TO COMMONLY IDENTIFIED OBSTACLES SUCH AS DISCLOSURE, TIMELINES OF CONFIRMATORY TEST, MEDICATION/APPOINTMENT, SOCIAL DETERMINANTS AND ADHERENCE. SINCE IMPLEMENTING THE STRATEGIC MULTISITE INITIATIVE FOR LINKAGE AND ENGAGEMENT (SMILE) LINKAGE TO CARE PROGRAM IN 2010, WE HAVE BEEN ABLE TO ASSIST APPROXIMATELY 800 YOUTH AND YOUNG ADULTS WITH GETTING INTO MEDICAL CARE. THIS SUCCESS HAS GARNERED NATIONAL ATTENTION AND HAS BEEN RECOGNIZED BY THE CENTERS FOR DISEASE CONTROL AS A BEST PRACTICE MODEL. AS A RESULT, WE HAVE BEEN WORKING COLLABORATIVELY WITH THE SHELBY COUNTY HEALTH DEPARTMENT AND OTHER ADULT SPECIALTY CARE CLINICS, ON WAYS TO REPLICATE AND EXPAND OUR MODEL OF LINKAGE TO CARE AND TREATMENT THAT WE HAVE BUILT FOR YOUTH. THE GOAL IS THAT ALL NEWLY DIAGNOSED ADULTS CAN RECEIVE THE SAME TYPE OF SERVICE AND SUPPORT THAT WILL ENABLE THEM TO SUCCESSFULLY MOVE ALONG THE HIV CARE CONTINUUM.
IN AN EFFORT TO FURTHER SUPPORT THOSE PATIENTS THAT MATRICULATE	ALONG THE HIV CARE CONTINUUM, WE INSTITUTED A RETENTION IN CARE (RIC) PROGRAM THAT PROVIDES SUPPORT TO YOUTH AND YOUNG ADULT PATIENTS WHO FIND MAINTAINING CONSISTENT MEDICAL TREATMENT AND CARE A CHALLENGE. SINCE 2016, THE RIC COORDINATOR HAS CAREFULLY AND TACTFULLY WORKED TO ASSURE THAT APPROXIMATELY 20 PATIENTS ARE AS SUCCESSFUL AS POSSIBLE WITH TRANSITIONING TO ADULT MEDICAL CARE WITHOUT ANY GAPS OR DELAYS.OUR ABILITY TO FORGE STRONG PARTNERSHIPS AND INROADS IN THE PUBLIC AND PRIVATE SECTORS HAS ALSO ASSISTED US WITH OUR NEWEST RESEARCH INITIATIVE, INJECTABLE PREP (PRE-EXPOSURE PROPHYLAXIS) OR HPTN (HIV PREVENTION TRIALS NETWORK) 083. SINCE 2017, WE HAVE BEEN ABLE TO RECRUIT 93 UNINFECTED HIGH-RISK YOUNG ADULT VOLUNTEERS TO DETERMINE THE EFFICACY OF USING BIOMEDICAL PREVENTION IN OUR COMMUNITY AND MET OUR TWO YEAR RECRUITMENT GOAL (64) IN THE FIRST YEAR.FOR OVER A YEAR, C2P MEMBERS ALONGSIDE ST. JUDE COORDINATING CENTER STAFF, HAS BEEN SYSTEMATICALLY WORKING ON AN ENDING THE HIV EPIDEMIC IN MEMPHIS IMPLEMENTATION PLAN. RECOGNIZING THE STRENGTH AND VALUE OF THE INFRASTRUCTURE, MEMBERS COMMITTED TO CONTINUE CROSS-AGENCY COLLABORATION TO BUILD OUT A COMMUNITY DRIVEN PLAN THAT WOULD SUFFICIENTLY ADDRESS COMMUNITY NEEDS.
LASTLY, MEMBERS FROM THE COALITION HAVE CO-FACILITATED AND/OR PARTICIPATED	IN APPROXIMATELY 30 COMMUNITY BASED EDUCATIONAL AND TESTING EVENTS, AND RADIO/TELEVISION INTERVIEWS THAT HAVE IMPACTED WELL OVER 5,000 INDIVIDUALS IN MEMPHIS AND SURROUNDING AREAS. OUR HIV PREVENTION AND TREATMENT PROGRAM HAS REALLY VALUED THE STRONG AND BI-DIRECTIONAL COLLABORATION WITH COLLEAGUES IN THE COMMUNITY. WITH A SHARED FOCUS, WHAT WE HAVE BEEN ABLE TO ACHIEVE WITH OUR LINKAGE TO CARE, RETENTION IN CARE AND PREP EFFORTS, WOULD NOT HAVE BEEN FEASIBLE WITHOUT THIS TYPE OF COMMUNITY AGENCY BUY-IN AND SUPPORT.1. AMERICAN CANCER SOCIETY. CANCER FACTS & FIGURES 2019. ATLANTA: AMERICAN CANCER SOCIETY; 2019. 2. LIU ET AL. J CLIN ONCOL 34(14):1634-43, 2016.3. BHATIA ET AL. CANCER 122(15):2426-2439, 2016.4. HOW MANY CANCERS ARE LINKED WITH HPV EACH YEAR? CENTERS FOR DISEASE CONTROL AND PREVENTION.[ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/CASES.HTM.5. TEENVAXVIEW: 2017 ADOLESCENT HUMAN PAPILLOMAVIRUS (HPV) VACCINATION COVERAGE REPORT. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/VACCINES/IMZ- MANAGERS/COVERAGE/TEENVAXVIEW/DATA-REPORTS/HPV/DASHBOARD/2017.HTML.6. HPV-ASSOCIATED CANCER RATES BY STATE. CENTERS FOR DISEASE CONTROL AND PREVENTION. [ONLINE] HTTPS://WWW.CDC.GOV/CANCER/HPV/STATISTICS/STATE/INDEX.HTM.

Schedule H (Form 990) 2018

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

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

Employer identification number
62-0646012

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) UNIVERSITY OF TENNESSEE 50 NORTH DUNLAP MEMPHIS,TN38105	62-6001636	GOVERNMENT ENTITY	787,209	COLLABORATION AND SUPPORT AGREEMENT
(2) SAINT FRANCIS MEDICAL CENTER 530 NE GLEN OAK AVE PEORIA,IL61637	37-0662569	501(C)(3)	490,909	OPERATION OF ST. JUDE CLINIC
(3) CHURCH HEALTH CENTER OF MEMPHIS 1350 CONCOURSE AVE SUITE 142 MEMPHIS,TN38104	58-1716113	501(C)(3)	200,000	FINANCIAL SUPPORT
(4) FASEB SCIENCE RESEARCH 9650 ROCKVILLE PIKE BETHESDA,MD20814	52-0700497	501(C)(3)	15,000	SUPPORT HEMATOLOGIC MALIGNANCIES CONFERENCE
(5) NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS 600 13TH STREET NW SUITE 500 WASHINGTON,DC20005	58-2176067	501(C)(6)	13,900	CONTRIBUTION
(6) REGIONAL ONE HEALTHCARE FOUNDATION 877 JEFFERSON AVENUE MEMPHIS,TN38103	58-1737037	501(C)(3)	6,500	SPONSORSHIP

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

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

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

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

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

Schedule I (Form 990) 2018

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

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 in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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

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

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

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

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

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

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

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

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

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

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

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

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1RICHARD C SHADYAC JR EX-OFFICIO DIRECTOR	(i) (ii)	0 ------------- 790,449	0 ------------- 0	0 ------------- 49,746	0 ------------- 99,580	0 ------------- 19,111	0 ------------- 958,886	0 ------------- 46,182
2JAMES R DOWNING PRESIDENT/CEO	(i) (ii)	1,054,860 ------------- 0	150 ------------- 0	79,487 ------------- 0	120,250 ------------- 0	23,803 ------------- 0	1,278,550 ------------- 0	0 ------------- 0
3PATRICIA A KEEL SVP/CFO	(i) (ii)	586,894 ------------- 0	150 ------------- 0	8,204 ------------- 0	59,327 ------------- 0	26,304 ------------- 0	680,879 ------------- 0	0 ------------- 0
4JAMES I MORGAN EVP/SCIENTIFIC DIRECTOR	(i) (ii)	558,621 ------------- 0	150,150 ------------- 0	9,015 ------------- 0	30,250 ------------- 0	26,304 ------------- 0	774,340 ------------- 0	0 ------------- 0
5ELLIS NEUFELD EVP/CLINICAL DIRECTOR	(i) (ii)	736,703 ------------- 0	150 ------------- 0	5,030 ------------- 0	141,650 ------------- 0	22,110 ------------- 0	905,643 ------------- 0	0 ------------- 0
6MARY ANNA QUINN EVP/CHIEF ADMIN. OFFICER	(i) (ii)	461,803 ------------- 0	150 ------------- 0	9,015 ------------- 0	30,250 ------------- 0	23,744 ------------- 0	524,962 ------------- 0	0 ------------- 0
7CHARLES M ROBERTS EVP/DIRECTOR CANCER CENTER	(i) (ii)	773,267 ------------- 0	150 ------------- 0	1,491 ------------- 0	143,106 ------------- 0	12,492 ------------- 0	930,506 ------------- 0	0 ------------- 0
8CARLOS RODRIGUEZ-GALINDO EVP/CHAIR	(i) (ii)	624,364 ------------- 0	150 ------------- 0	78,673 ------------- 0	60,250 ------------- 0	11,075 ------------- 0	774,512 ------------- 0	0 ------------- 0
9ANDREW DAVIDOFF CHAIR	(i) (ii)	745,756 ------------- 0	18,250 ------------- 0	69,927 ------------- 0	30,250 ------------- 0	30,517 ------------- 0	894,700 ------------- 0	0 ------------- 0
10DAVID ELLISON CHAIR	(i) (ii)	712,822 ------------- 0	17,850 ------------- 0	5,074 ------------- 0	93,501 ------------- 0	16,216 ------------- 0	845,463 ------------- 0	0 ------------- 0
11AMAR J GAJJAR CHAIR	(i) (ii)	620,681 ------------- 0	28,250 ------------- 0	58,531 ------------- 0	30,250 ------------- 0	18,136 ------------- 0	755,848 ------------- 0	0 ------------- 0
12THOMAS E MERCHANT CHAIR	(i) (ii)	772,181 ------------- 0	18,050 ------------- 0	98,992 ------------- 0	30,250 ------------- 0	34,077 ------------- 0	953,550 ------------- 0	0 ------------- 0
13CHING-HON PUI CHAIR	(i) (ii)	703,277 ------------- 0	28,050 ------------- 0	8,790 ------------- 0	30,250 ------------- 0	7,295 ------------- 0	777,662 ------------- 0	0 ------------- 0
14WILLIAM E EVANS FACULTY/FORMER PRESIDENT/CEO	(i) (ii)	654,652 ------------- 0	17,850 ------------- 0	8,790 ------------- 0	30,250 ------------- 0	11,075 ------------- 0	722,617 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 1A	FIRST-CLASS TRAVEL: ONE FORMER OFFICER PURCHASED TWO FIRST CLASS TICKETS, TWO OFFICERS EACH PURCHASED ONE FIRST CLASS TICKET. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND ARE NOT RECORDED AS COMPENSATION. TRAVEL FOR COMPANIONS: FAMILY MEMBER OF ONE FORMER OFFICER, TRAVELS ON HOSPITAL BUSINESS AS REQUIRED BY THE POSITION. TRAVEL EXPENSES ARE REIMBURSED UNDER AN ACCOUNTABLE PLAN AND ARE NOT RECORDED AS COMPENSATION. TAX INDEMNIFICATION AND GROSS-UP PAYMENTS: A PAYMENT WAS ISSUED FOR RELOCATION FOR ONE OFFICER. THE APPLICABLE EXPENSE WAS GROSSED-UP AND INCLUDED IN THE EMPLOYEE'S W-2 AS ADDITIONAL TAXABLE COMPENSATION.
PART I, LINE 4B	THE ORGANIZATION ESTABLISHED A NON-QUALIFIED DEFERRED COMPENSATION PLAN PURSUANT TO CODE SECTION 457(F) OF THE INTERNAL REVENUE CODE. THE PLAN AMOUNTS ARE SUBJECT TO SUBSTANTIAL FUTURE SERVICE REQUIREMENTS TO THE ORGANIZATION AND ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. NO NONQUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR TO ANY LISTED PERSONS IN PART VII.
SCHEDULE J, PART II	RICHARD C. SHADYAC, JR. SERVES AS AN EX-OFFICIO VOTING DIRECTOR OF THE BOARD OF ST. JUDE. MR. SHADYAC IS EMPLOYED AS AN OFFICER OF ALSAC, A RELATED ORGANIZATION TO ST. JUDE. THE COMPENSATION SHOWN IN COLUMNS (B), (C), (D) AND (E) WAS PAID TO MR. SHADYAC BY ALSAC FOR HIS DUTIES AS CEO OF ALSAC.

Schedule J (Form 990) 2018

Additional Data

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

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

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






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

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) MARY RELLING	SEE PART V	529,674	EMPLOYMENT		No
(2) SUSANNA DOWNING	SEE PART V	71,398	EMPLOYMENT		No
(3) DIANE ROBERTS	SEE PART V	221,400	EMPLOYMENT		No
(4) JEREMY QUINN	SEE PART V	87,543	EMPLOYMENT		No

Part V

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

Return Reference	Explanation
SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	(A) NAME OF INTERESTED PERSON: MARY RELLING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF FORMER OFFICER (PRESIDENT AND CEO), WILLIAM E. EVANS.(C) AMOUNT OF TRANSACTION: $529,674(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO
SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	(A) NAME OF INTERESTED PERSON: SUSANNA DOWNING(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF PRESIDENT AND CEO, JAMES R. DOWNING.(C) AMOUNT OF TRANSACTION: $71,398(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO
SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	(A) NAME OF INTERESTED PERSON: DIANE ROBERTS(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, CHARLES M. ROBERTS.(C) AMOUNT OF TRANSACTION: $221,400(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO
SCHEDULE L, PART IV, BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS:	(A) NAME OF INTERESTED PERSON: JEREMY QUINN(B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: FAMILY MEMBER OF OFFICER, MARY ANNA QUINN.(C) AMOUNT OF TRANSACTION: $87,543(D) DESCRIPTION OF TRANSACTION: EMPLOYMENT(E) SHARING OF ORGANIZATION REVENUES? = NO

Schedule L (Form 990 or 990-EZ) 2018

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

2018

Open to Public
Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	FAMILY RELATIONSHIP AMONG DIRECTORS: JOSEPH S. AYOUB, JR., ESQ. AND PAUL J. AYOUB, ESQ.; GEORGE A. SIMON, II AND PAUL J. SIMON; ROBERT A. BREIT, MD AND JOSEPH G. SHAKER; JOSEPH C. SHAKER AND JOSEPH G. SHAKER; PAUL J. SIMON AND MICHAEL SIMON.
FORM 990, PART VI, SECTION A, LINE 4	ON SEPTEMBER 14, 2018, ST. JUDE CHILDREN'S RESEARCH HOSPITAL MADE THE FOLLOWING AMENDMENTS TO ITS BYLAWS: ARTICLE IV, SECTION 3 OF THE ST. JUDE BYLAWS WAS AMENDED TO REQUIRE THAT A MINIMUM OF 70% OF THE INDIVIDUALS ELECTED BOARD MEMBERS BE INDEPENDENT AND REPRESENT THE COMMUNITY IN ACCORDANCE WITH APPLICABLE LAW AND GOVERNANCE POLICIES ADOPTED BY THE INDEPENDENT MEMBERS OF THE BOARD. IN RELATED AMENDMENTS TO ITS COI POLICY, THE BOARD STATED A BOARD MEMBER IS "INDEPENDENT" IF HE/SHE WOULD BE CONSIDERED INDEPENDENT UNDER THE IRS' SECTION 501(C)(3) COMMUNITY BENEFIT STANDARD, AND PROVIDED GUIDANCE FOR THAT CONSIDERATION. ARTICLE VI, SECTION 1 OF THE ST. JUDE BYLAWS WAS AMENDED TO REQUIRE THAT ALL MEMBERS OF THE AUDIT, COMPENSATION, AND CONFLICT OF INTEREST COMMITTEES, AND 70% OF ALL OTHER COMMITTEES, BE INDEPENDENT AS DETERMINED IN ACCORDANCE WITH APPLICABLE LAW AND GOVERNANCE POLICIES ADOPTED BY THE INDEPENDENT MEMBERS OF THE BOARD. ARTICLE XVI, SECTION 1 OF THE ST. JUDE BYLAWS WAS AMENDED TO REQUIRE THAT NO MORE THAN TWO FAMILY MEMBERS AS DEFINED IN THE BYLAWS SHALL SERVE AS VOTING MEMBERS OF ANY BOARD COMMITTEE AT THE SAME TIME; AND TO UPDATE THE BOARD'S DEFINITION OF FAMILY MEMBER. ON JUNE 21, 2019, ST. JUDE CHILDREN'S RESEARCH HOSPITAL MADE THE FOLLOWING AMENDMENTS TO ITS BYLAWS: ARTICLE VI, SECTION 1, PARAGRAPH 3 OF THE ST. JUDE BYLAWS WAS AMENDED TO REDEFINE NOMINATING COMMITTEE MEMBERSHIP TO INCLUDE THE FOUR (4) MOST RECENT ACTIVE AND ELIGIBLE FORMER CHAIRS OF THE ALSAC AND HOSPITAL BOARDS AND THREE (3) OTHER VOTING MEMBERS WHO ARE NOT FORMER BOARD CHAIRS, EACH OF WHOM SHALL HAVE BEEN A VOTING MEMBER IN GOOD STANDING FOR A MINIMUM OF FIVE (5) CONSECUTIVE YEARS. IF A VOTING MEMBER HAS SERVED AS CHAIR OF BOTH THE ALSAC AND HOSPITAL BOARDS, ONLY HIS OR HER MOST RECENT TERM SHALL BE CONSIDERED FOR NOMINATING COMMITTEE MEMBERSHIP. A FORMER CHAIR OF THE ALSAC OR HOSPITAL BOARDS SHALL BE DEEMED TO BE ACTIVE AND ELIGIBLE FOR NOMINATING COMMITTEE MEMBERSHIP IF THEY ARE A VOTING MEMBER OF THE BOARD DURING THE PRIOR FISCAL YEAR. THE CEOS AND THE CURRENT CHAIRS AND VICE CHAIRS OF THE ALSAC AND HOSPITAL BOARDS ARE NOT ELIGIBLE TO SERVE AS MEMBERS OF THE NOMINATING COMMITTEE. ARTICLE VII OF THE ST. JUDE BYLAWS WAS AMENDED TO CREATE ACTIVE AND INACTIVE EMERITUS STATUS. ARTICLE VI, SECTION 1 OF THE ST. JUDE BYLAWS WAS AMENDED TO MERGE THE AUDIT AND LEGAL & COMPLIANCE COMMITTEES INTO AN AUDIT & COMPLIANCE COMMITTEE.
FORM 990, PART VI, SECTION B, LINE 11B	IN FEBRUARY OF EACH YEAR, THE AUDIT COMMITTEE AND OFFICERS OF THE BOARD ARE PROVIDED WITH A DRAFT COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES. THE AUDIT COMMITTEE MEETS WITH ITS TAX PREPARER TO REVIEW THE DRAFT FORM 990 BEFORE IT IS FILED WITH THE IRS. ADDITIONALLY THE COMPENSATION COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE COMPENSATION SECTIONS OF THE FORM 990, AND THE CONFLICT OF INTEREST COMMITTEE OF THE BOARD IS PROVIDED WITH A DRAFT COPY OF THE CONFLICT-OF-INTEREST SECTIONS OF THE FORM 990 FOR REVIEW BEFORE THE FINALIZED DOCUMENT IS FILED WITH THE IRS. EACH VOTING MEMBER OF THE BOARD IS PROVIDED WITH A FINAL COPY OF THE FORM 990 AND ALL REQUIRED SCHEDULES BEFORE IT IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	NEW BOARD MEMBERS ARE GIVEN A COPY OF THE BOARD OF GOVERNOR'S CONFLICT OF INTEREST POLICY AND COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM. THERE IS A CONFLICT OF INTEREST COMMITTEE OF THE BOARD THAT REVIEWS THE ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENTS THAT ARE COMPLETED BY EACH BOARD MEMBER AND DISCUSSES AND RESOLVES CONFLICTS OF INTEREST, WITH OPPORTUNITY FOR APPEAL TO THE FULL BOARD. IN ADDITION, THE ORGANIZATION HAS A CHIEF COMPLIANCE OFFICER AND COMPLIANCE DEPARTMENT, WHICH ADMINISTER THE CONFLICT OF INTEREST DISCLOSURE PROCESS FOR ALL EMPLOYEES IN CLINICAL, RESEARCH, AND SELECT ADMINISTRATIVE DEPARTMENTS, AS WELL AS EMPLOYEES IDENTIFIED AS SUPERVISORS OR WHO HAVE PURCHASING AUTHORITY. ALL SUCH EMPLOYEES COMPLETE CONFLICT OF INTEREST TRAINING AND A CONFLICT OF INTEREST DISCLOSURE ANNUALLY. THE COMPLIANCE OFFICER ENSURES EMPLOYEES MEET THESE REQUIREMENTS AND REVIEWS SUBMITTED DISCLOSURES. DISCLOSURES IDENTIFIED AS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARE ADDRESSED BY THE COMPLIANCE OFFICE WITH INVOLVEMENT OF THE INSTITUTIONAL CONFLICT OF INTEREST COMMITTEE AS APPROPRIATE. DEPENDING ON THE FACTS AND CIRCUMSTANCES, THE ACTIVITY MAY BE MANAGED PURSUANT TO A MANAGEMENT PLAN, OR PROHIBITED.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD'S COMPENSATION COMMITTEE COMMISSIONS ANNUAL THIRD PARTY SALARY SURVEYS TO DETERMINE COMPENSATION FOR THE FOLLOWING OFFICERS: CHIEF EXECUTIVE OFFICER, SCIENTIFIC DIRECTOR, CANCER CENTER DIRECTOR, CHIEF ADMINISTRATIVE OFFICER, CHIEF FINANCIAL OFFICER, CLINICAL DIRECTOR, CHIEF GOVERNANCE OFFICER/CORPORATE SECRETARY, CHIEF LEGAL OFFICER, AND CHAIR, DEPARTMENT OF GLOBAL PEDIATRIC MEDICINE. IN ADDITION, FIVE EMPLOYEES ARE CONSIDERED "DISQUALIFIED" BECAUSE THEY ARE FORMER EXECUTIVES OR RELATIVES OF CURRENT OR FORMER EXECUTIVES, AND THEIR COMPENSATION THEREFORE FALLS WITHIN THE COMPENSATION COMMITTEE'S PURVIEW. ALL CHANGES TO OFFICERS' SALARIES ARE APPROVED BY THE COMPENSATION COMMITTEE AND REPORTED TO THE BOARD. THE LAST REVIEW WAS COMPLETED IN DECEMBER 2019.
FORM 990, PART VI, SECTION C, LINE 19	FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST, GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE ONLY AS REQUIRED BY APPLICABLE STATE LAW.
FORM 990, PART XI, LINE 9:	CHANGE IN INTEREST IN NET ASSETS OF ALSAC WITHOUT DONOR RESTRICTIONS 580,106,392. CHANGE IN INTEREST IN NET ASSETS OF ALSAC WITH DONOR RESTRICTIONS 90,106,130.
ADDITIONAL HEALTH NEEDS IDENTIFIED	IN ADDITION TO THE ACTIONS OUTLINED WITH THE PREVIOUSLY CONDUCTED 2015 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IMPLEMENTATION PLAN, ST. JUDE HAS ALSO CHOSEN TO ADDRESS THE FOLLOWING HEALTH NEEDS: PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #1 OF THE CHNA): TRANSITION ONCOLOGY PROGRAM HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL, ACT CLINIC, TRANSITION ONCOLOGY PROGRAM (TOP) ANTICIPATED OUTCOME: PROVIDE PROSPECTIVE, SYSTEMATIC, TRANSITION-RELATED SERVICES FOR ONCOLOGY PATIENTS ACROSS THE CONTINUUM OF CARE THAT WILL SUPPORT TRANSITIONS FROM ACTIVE THERAPY TO TREATMENT AND FROM TREATMENT COMPLETION TO ACT. ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. IDENTIFY AND IMPLEMENT APPROPRIATE MANAGEMENT AND OPERATIONS STRUCTURE, AND BEGIN STAFFING THE PROGRAM. 2. CLOSELY MONITOR RESOURCES TO STAFF THE CLINIC TO ITS FULLEST FORM, AND COMPLETE AN ASSESSMENT AFTER THE FIRST 18 MONTHS OF OPERATION TO ENSURE THAT THE PROGRAM IS MEETING ITS PURPOSE. 3. EVALUATE IMPACT ON INTERPRETER SERVICES, CLINICAL INFORMATICS, REHABILITATION SERVICES, CLINIC SPACE, HOUSING, AND TRAVEL COSTS. 4. EVALUATE RESOURCES IN ACT IN ANTICIPATION OF AN INCREASE IN ACT PATIENT VOLUMES. SELECTED ACCOMPLISHMENTS: - PROGRAM IS FULLY OPERATIONAL (AS OF DECEMBER 1, 2018). IN THE FIRST 6 MONTHS, WE WORKED WITH 185 PATIENTS. - WE ARE NEARLY FULLY-STAFFED WITH THREE NURSE PRACTITIONERS, THREE SCHOOL LIAISONS, TWO SOCIAL WORKERS, AND A REHAB SERVICES COORDINATOR. OUR PSYCHOLOGIST WILL START SEPTEMBER 2019. - PRIOR TO THE END OF THERAPY, PATIENTS MEET THE NURSE PRACTITIONER NAVIGATOR FOR AN INTRODUCTION TO THE PROGRAM, HAVE INITIAL VISITS WITH PSYCHOLOGY, SCHOOL LIAISON (IF SCHOOL-AGE), REHAB COORDINATOR (IF APPLICABLE), AND NP NAVIGATOR. AT THE END OF THERAPY, PATIENTS MEET WITH SOCIAL WORKER AND NP NAVIGATOR. NP NAVIGATOR MAKES PHONE CONTACT WITH FAMILY TO PROSPECTIVELY ASSESS FOR CONCERNS BETWEEN APPOINTMENTS. SUBSEQUENT APPOINTMENTS WITH TOP TEAM MEMBERS ARE SCHEDULED AS NEEDED. PATIENTS WHO DO NOT RECEIVE PSYCHOLOGICAL TESTING AS PART OF THEIR TREATMENT PROGRAM ARE ELIGIBLE FOR ABBREVIATED TESTING TO SCREEN FOR COGNITIVE CONCERNS. - 18-MONTH ASSESSMENT PLANNED FOR JUNE 2020. - OUTCOMES AND MEASUREMENT STRATEGIES ARE STILL BEING DEFINED. PEDIATRIC HEALTH NEED (ALIGNING WITH AIM #3 OF THE CHNA): PREVENTING VIRUS-ASSOCIATED CANCERS THROUGH INCREASED HPV VACCINATION (HEALTH STATUS OF THE MEMPHIS COMMUNITY) HEALTH FACILITIES INVOLVED: ST. JUDE CHILDREN'S RESEARCH HOSPITAL ANTICIPATED OUTCOME: INCREASE THE VACCINATION RATES FOR HPV. ACTION ITEMS TO MEET IDENTIFIED HEALTH NEED: 1. IMPLEMENT GOALS, STRATEGIES, AND ACTIONS FOR AN HPV INITIATIVE. SELECTED ACCOMPLISHMENTS: THE ST. JUDE TEAM LOOKED FOR OPPORTUNITIES TO NETWORK WITH EXPERTS IN THE FIELD INCLUDING ATTENDING EUROGIN 2018 INTERNATIONAL MULTIDISCIPLINARY HPV CONGRESS IN DECEMBER 2018 AND BECAME INVOLVED IN THE HPV NATIONAL ROUNDTABLE AND TWO OF ITS SUBCOMMITTEES, STATE COALITIONS AND INTEGRATED DELIVERY SYSTEMS (IDS): - ST. JUDE SERVED AS THE HOST SITE FOR THE INAUGURAL MEETING OF THE INTEGRATED DELIVERY SYSTEMS (IDS) TASK GROUP FROM THE NATIONAL HPV ROUNDTABLE ON JANUARY 24, 2019. REPRESENTATIVES FROM THE CENTERS FOR DISEASE CONTROL, HEALTH AND HUMAN SERVICES, AMERICAN CANCER SOCIETY (ACS) AND HEALTH SYSTEMS ACROSS THE COUNTRY GATHERED AT ST. JUDE FOR A WORKING MEETING TO STRATEGIZE ON ENGAGEMENT OF IDSS TO INCREASE HPV VACCINE UPTAKE. - WE WERE ALSO INVITED TO PARTICIPATE IN THE HPV STATE COALITION LEADERS MEETING AT UNIVERSITY OF ALABAMA, BIRMINGHAM (UAB) ON MARCH 4-5, 2019. - VOLUNTEERED TO AUTHOR A JOINT HPV VACCINE SUPPORT STATEMENT TO BE USED AS AN EDUCATION AND PARTNERSHIP BUILDING TOOL WITH LAWMAKERS/POLICY MAKERS IN TENNESSEE ON BEHALF OF OUR STATE COALITION MEMBERS. THE DRAFT FOR THIS JOINT STATEMENT IS CURRENTLY WITH VANDERBILT INGRAM CANCER CENTER FOR REVIEW. - ST. JUDE WAS INVITED TO PARTICIPATE AS A PARTNER AT A CONGRESSIONAL BRIEFING TITLED "LET'S END HPV-RELATED CANCERS" IN WASHINGTON D.C. TO BE HELD ON JUNE 27TH. SPONSORS INCLUDE AACR, MOFFITT CANCER CENTER AND THE BIDEN CANCER INITIATIVE. THIS BRIEFING WILL BE FOLLOWED BY A TWO-HOUR STRATEGY SESSION HOSTED BY THE BIDEN CANCER INITIATIVE WHERE ST. JUDE WILL HAVE A SEAT AT THE TABLE. STRATEGY SUMMIT: THE ALL-DAY INTERACTIVE MEETING WAS HELD ON MAY 6TH AT ST. JUDE TO GUIDE STRATEGY AND IMPLEMENTATION OF THE HPV BLUE SKY INITIATIVE. A TOTAL OF MORE THAN 60 INDIVIDUALS, INCLUDING INTERNAL LEADERSHIP, EXTERNAL EXPERTS AND LOCAL STAKEHOLDERS, PARTICIPATED IN THE WORKSHOP. THE DAY FEATURED TALKS FROM INTERNATIONALLY RECOGNIZED EXPERTS IN HPV AS WELL AS IN-DEPTH FACILITATED SMALL GROUP DISCUSSIONS AMONG EXTERNAL, LOCAL AND INTERNAL STAKEHOLDERS. DR. MELISSA HUDSON WAS COMMISSIONED TO LEAD THE SEARCH COMMITTEE FOR THE FACULTY DIRECTOR OF THE INITIATIVE. THE SEARCH COMMITTEE WILL MEET IN EARLY JULY TO BEGIN SCHEDULING ONSITE INTERVIEWS.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

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

2018

Open to Public Inspection

Name of the organization

ST JUDE CHILDREN'S RESEARCH HOSPITAL
INC

Employer identification number

62-0646012

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CHILDREN'S GMP LLC 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 47-4475625	VACCINE MANUFACTURER	TN	1,446,385	3,090,916	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC
(2) THANKS & GIVING LLC 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 20-1310435	ROYALTY INCOME FROM RECORD SALES	TN	0	10,632	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC
(3) THE RIGHT WORDS LLC 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 95-4878579	ROYALTY INCOME FROM BOOK SALES	NY	0	0	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC
(4) ST JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES 262 DANNY THOMAS PLACE MEMPHIS,TN381053678 81-3240987	HIGHER EDUCATION	TN	1,534	731,953	ST JUDE CHILDREN'S RESEARCH HOSPITAL INC

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)AMERICAN LEBANESE SYRIAN ASSOCIATED CHARITIES INC 501 ST JUDE PLACE MEMPHIS,TN381053678 35-1044585	SOLICIT SUPPORT FOR OPERATION OF ST. JUDE	IL	501(C)(3)	7	N/A		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

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

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No

Schedule R (Form 990) 2018

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

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

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

Yes

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

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

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

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

Yes

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

Yes

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

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2018

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) 2018

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) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE MISSION OF ST. JUDE CHILDREN'S RESEARCH HOSPITAL IS TO ADVANCE CURES, AND MEANS OF PREVENTION, FOR PEDIATRIC CATASTROPHIC DISEASES THROUGH RESEARCH AND TREATMENT. CONSISTENT WITH THE VISION OF OUR FOUNDER DANNY THOMAS, NO CHILD IS DENIED TREATMENT BASED ON RACE, RELIGION OR A FAMILY'S ABILITY TO PAY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	44
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	41
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	5,440
6	Total number of volunteers (estimate if necessary) .............	6	4,003
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	851,803,301	974,758,247
9	Program service revenue (Part VIII, line 2g) .........	117,420,862	109,172,619
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-7,463,705	-556,846
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	18,895,861	24,595,111
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	980,656,319	1,107,969,131
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	4,312,073	1,538,019
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)	505,567,014	545,749,401
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)....	440,836,545	474,154,881
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	950,715,632	1,021,442,301
19	Revenue less expenses. Subtract line 18 from line 12.......	29,940,687	86,526,830
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,434,170,902	6,214,238,431
21	Total liabilities (Part X, line 26).............	131,298,150	154,548,735
22	Net assets or fund balances. Subtract line 21 from line 20.....	5,302,872,752	6,059,689,696

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 490,685,639 including grants of $ 1,291,319 ) (Revenue $ 113,964,801 )
	PATIENT CARE: THE HOSPITAL PROVIDED 19,394 INPATIENT DAYS OF CARE DURING THE YEAR. OUR BONE MARROW TRANSPLANTATION PROGRAM ACCOUNTED FOR 3,968 OR 20% OF THOSE INPATIENT DAYS. PATIENTS MADE 81,759 CLINIC VISITS DURING THE YEAR.

4b	(Code: ) (Expenses $ 436,938,714 including grants of $ 246,700 ) (Revenue $ )
	RESEARCH: THE CURRENT BASIC SCIENCE AND CLINICAL RESEARCH AT THE HOSPITAL INCLUDES WORK IN GENE THERAPY, CHEMOTHERAPY, THE BIOCHEMISTRY OF NORMAL AND CANCEROUS CELLS, RADIATION TREATMENT, BLOOD DISEASES, RESISTANCE TO THERAPY, VIRUSES, HEREDITARY DISEASES, INFLUENZA, PEDIATRIC AIDS AND PHYSIOLOGICAL EFFECTS OF CATASTROPHIC ILLNESSES.

4c	(Code: ) (Expenses $ 29,338,061 including grants of $ ) (Revenue $ )
	EDUCATION AND TRAINING: AS PART OF ITS MISSION, THE HOSPITAL HAS DEVELOPED A GLOBAL INITIATIVE (ST. JUDE GLOBAL) TO IMPROVE THE SURVIVAL RATES OF CHILDREN WITH CANCER AND OTHER CATASTROPHIC DISEASES WORLDWIDE. ST. JUDE GLOBAL ACCOMPLISHES THIS BY SHARING KNOWLEDGE, TECHNOLOGY AND ORGANIZATIONAL SKILLS, HELPING TO IMPLEMENT NEW APPROACHES TO TREAT PEDIATRIC CANCER GLOBALLY, AND DEVELOPING REGIONAL NETWORKS COMMITTED TO ERADICATING CANCER IN CHILDREN. THIS MISSION WILL BE ACHIEVED BY FOCUSING ON THREE OVERRIDING GOALS: (1) TO TRAIN THE CLINICAL WORKFORCE THAT WILL BE REQUIRED TO MEET OUR MISSION, (2) TO DEVELOP AND STRENGTHEN HEALTH SYSTEMS AND PATIENT-CENTERED INITIATIVES THAT ENCOMPASS THE ENTIRE CONTINUUM OF CARE REQUIRED FOR CHILDREN WITH CANCER AND NON-MALIGNANT HEMATOLOGICAL DISEASES, AND (3) TO ADVANCE KNOWLEDGE IN GLOBAL PEDIATRIC ONCOLOGY AND HEMATOLOGY THROUGH RESEARCH TO SUSTAIN A CONTINUOUS IMPROVEMENT IN THE LEVEL AND QUALITY OF CARE DELIVERED AROUND THE GLOBE. THESE INITIATIVES ARE SPEARHEADED BY ST. JUDE EXPERTS WHO WORK CLOSELY WITH HEALTHCARE PROFESSIONALS AT OUR PARTNER SITES. IN ADDITION, A GRADUATE PROGRAM IS OFFERED THROUGH A WHOLLY-OWNED SUBSIDIARY, ST. JUDE CHILDREN'S RESEARCH HOSPITAL GRADUATE SCHOOL OF BIOMEDICAL SCIENCES, LLC, TO EDUCATE AND TRAIN FUTURE GENERATIONS OF SCIENTISTS SEEKING TO UNDERSTAND THE MOLECULAR BASIS OF HUMAN DISEASE AND DEVELOP NOVEL THERAPIES BASED ON THAT UNDERSTANDING.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses956,962,414

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	9,726,250	840,195	1,211,673

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	865,122,365
e	Government grants (contributions)		1e	93,978,570

f	All other contributions, gifts, grants, and similar amounts not included above		1f	15,657,312

g	Noncash contributions included in lines 1a - 1f:$
h Total. Add lines 1a-1f.......		974,758,247

		Business Code
2a	PATIENT CARE	621110	109,172,619	109,172,619
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		109,172,619

3 Investment income (including dividends, interest, and othersimilar amounts) ......			11,974			11,974
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			14,721,431			14,721,431
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	54,586	298,814
b	Less: cost or other basis and sales expenses	681,608	240,612
c	Gain or (loss)	-627,022	58,202
d	Net gain or (loss).....			-568,820	-627,022		58,202
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	CAFETERIA/VENDING		722514	4,454,476			4,454,476
b	CHGME/CHCA		900099	2,344,673	2,344,673
c	HHMI		900099	363,869	363,869
d	All other revenue ....			2,710,662	2,710,662
e	Total. Add lines 11a–11d ......			9,873,680
12	Total revenue. See Instructions......			1,107,969,131	113,964,801	0	19,246,083

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	1,538,019	1,538,019
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, line 15 and 16.
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	5,957,031	3,388,304	2,568,727
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	705,647	705,647
7	Other salaries and wages	417,581,913	386,631,522	30,950,391
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	25,959,964	24,035,860	1,924,104
9	Other employee benefits .......	66,802,869	61,851,565	4,951,304
10	Payroll taxes ...........	28,741,977	26,611,675	2,130,302
11	Fees for services (non-employees):
a	Management ......	28,661,610	26,611,090	2,050,520
b	Legal .........	1,517,331	1,408,778	108,553
c	Accounting ...........	202,470	187,985	14,485
d	Lobbying ...........	84,368		84,368
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	99,709,207	86,684,812	13,024,395
12	Advertising and promotion ....	906,842	841,964	64,878
13	Office expenses .......	2,629,666	2,588,790	40,876
14	Information technology ......	36,721,571	34,094,423	2,627,148
15	Royalties ..
16	Occupancy ...........	34,371,101	29,213,940	5,157,161
17	Travel ............	14,879,075	14,052,143	826,932
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,588,699	1,171,854	416,845
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	90,990,394	80,942,881	10,047,513
23	Insurance ...	1,742,428	1,226,920	515,508
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	PHARMACEUTICAL SUPPLIES	60,477,062	59,536,996	940,066
b	LABORATORY SUPPLIES	51,359,042	50,560,708	798,334
c	UBI TAXES	93,875	0	93,875
d	ALLOCATION ADJUSTMENTS	0	20,883,545	-20,883,545
e	All other expenses	48,220,140	42,192,993	6,027,147
25	Total functional expenses. Add lines 1 through 24e	1,021,442,301	956,962,414	64,479,887	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 ........			1,110,291	1	4,118,944
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......			22,491,694	3	29,362,954
4	Accounts receivable, net .............			21,703,486	4	21,028,537
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
					6
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........			7,732,327	8	9,042,686
9	Prepaid expenses and deferred charges ......			13,941,837	9	19,016,975
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,678,400,886
b	Less: accumulated depreciation	10b	915,173,701	669,110,408	10c	763,227,185
11	Investments—publicly traded securities .			2,222,796	11	2,370,565
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			4,695,858,063	15	5,366,070,585
16	Total assets. Add lines 1 through 15 (must equal line 34)...			5,434,170,902	16	6,214,238,431

17	Accounts payable and accrued expenses .....	112,276,799	17	137,164,440
18	Grants payable ...		18
19	Deferred revenue .........	15,399,715	19	14,186,821
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 current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	3,621,636	25	3,197,474
26	Total liabilities. Add lines 17 through 25..	131,298,150	26	154,548,735

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	4,201,630,278	27	4,972,521,523
28	Temporarily restricted net assets ...........	76,544,144	28	0
29	Permanently restricted net assets	1,024,698,330	29	1,087,168,173
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	5,302,872,752	33	6,059,689,696
34	Total liabilities and net assets/fund balances ........	5,434,170,902	34	6,214,238,431

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