TY 2019 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) ALEC KING...................................................................... TREASURER FROM 9/1/19	1.0 ................. 54.0		X				0	1,407,862	40,127
(2) MARY ANNE HILLIARD...................................................................... SECRETARY FROM 9/1/19	1.0 ................. 54.0		X				0	823,324	32,736
(3) Nathaniel Beers...................................................................... Pres & CEO, Board Member	14.0 ................. 41.0	X	X				0	658,927	36,950
(4) Victor Fields...................................................................... Former EVP & CFO	14.0 ................. 41.0					X	0	358,489	38,532
(5) Donna Anthony...................................................................... EVP, Clinical Strategies	27.0 ................. 28.0			X			0	345,110	42,239
(6) Debbie Holson...................................................................... COO, Pediatric Center	55.0 ................. 0.0		X				0	263,668	39,003
(7) Kimberly Brown...................................................................... VP FINANCE/INT CFO TO 11/1/19	20.0 ................. 35.0		X				0	231,324	19,158
(8) Samar Maamoun...................................................................... Pediatrician	55.0 ................. 0.0				X		218,874	0	11,748
(9) Andrew Metinko...................................................................... Pediatrician	55.0 ................. 0.0				X		198,918	0	9,500
(10) Adam Winebarger...................................................................... VP of Patient Care Serv	55.0 ................. 0.0				X		167,586	0	4,929
(11) Anne Ruecktenwald...................................................................... Director of Outpat. Prog	55.0 ................. 0.0				X		158,714	0	9,476
(12) Esther Kagulu...................................................................... Registered Nurse	55.0 ................. 0.0				X		157,618	0	9,369
(13) Thomas W Chapman...................................................................... Former Pres & CEO HSCF	0.0 ................. 0.0					X	0	145,373	0
(14) Roger E Meyer...................................................................... Chairperson	1.0 ................. 1.0	X	X				0	0	0
(15) Michael D Ward...................................................................... Secretary/Treasurer	1.0 ................. 3.0	X	X				0	0	0
(16) Joan Christopher...................................................................... Board Member	1.0 ................. 0.0	X					0	0	0
(17) Marsha Regenstein...................................................................... Board Member	1.0 ................. 0.0	X					0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
ECLINICALWORKS LLC, PO Box 847950 BOSTON,MA22847	IT Consulting	210,004
HHS INTEGRATED FACILITIES MANAGEMEN, PO Box 734369 DALLAS,TX75373	Facilities mgmt	262,257
ABSOLUTE CONTROLS LLC, 1395 Crescent Spot Ct FREDERICK,MD21703	HVAC Consulting	172,424
SG OFFICE ASSOCIATES LLC, 2000 Tower Oaks Blvd 8th Floor ROCKVILLE,MD20852	Mgmt Consulting	454,847
ALTERNATIVE ENGINEERING CONSULTIN, 5530 Cheryl Lane CHESAPEAKE BEACH,MD20732	Eng. Consulting	146,098
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 7

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

The Hospital for Sick Children

Employer identification number

53-0204670

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2019

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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 2019 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

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

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

17a

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

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

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2019

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2015	(b) 2016	(c) 2017	(d) 2018	(e) 2019	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

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

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

Section D. Computation of Investment Income Percentage

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

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

19a

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2019

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 7

Part V

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2019

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2019

Name of the organization

The Hospital for Sick Children

Employer identification number

53-0204670

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2019)

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

Name of organization The Hospital for Sick Children

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

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

Page 3

Name of organization The Hospital for Sick Children		Employer identification number 53-0204670

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2019)

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

Page 4


Name of organization The Hospital for Sick Children			Employer identification number 53-0204670
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

The Hospital for Sick Children

Employer identification number

53-0204670

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2019

Page 2

Part III

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

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

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

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

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

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

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

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

1a	Beginning of year balance ....	46,461	57,543	49,918	46,336	45,770
b	Contributions ...
c	Net investment earnings, gains, and losses	4,644	-9,367	6,910	3,582	598
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	1,713	1,715	-715		32
g	End of year balance ......	49,392	46,461	57,543	49,918	46,336

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

100.000 %

Term endowment SchDMd Bullet

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

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

1a	Land .....	13,300,000		13,300,000
b	Buildings ....	13,800,000	368,000	13,432,000
c	Leasehold improvements
d	Equipment ....	1,548,125	70,700	1,477,425
e	Other .....	1,199,392	40,876	1,158,516
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				29,367,941

Schedule D (Form 990) 2019

Page 3

Part VII

InvestmentsOther Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value
(1)SUNTRUST SELF INSURANCE TRUST				2,515,460
(2)DUE FROM THIRD PARTY PAYERS				876,928
(3)DUE FROM AFFILIATES				4,408
(4)
(5)
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				3,396,796

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	0
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	30,953,378
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2019

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

INTENDED USES OF ENDOWMENT FUNDS

SCHEDULE D, PART V, LINE 4 THE ENDOWMENT FUND CORPUS IS PERMANENTLY RESTRICTED AND WILL REMAIN INVESTED. THE INCOME DERIVED FROM THE ENDOWMENT FUND IS TO BE USED BY THE PEDIATRIC CENTER TO SUPPORT CURRENT OPERATIONS.

LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740)

SCHEDULE D, PART X, LINE 2 THE FOLLOWING IS THE FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM THE CONSOLIDATED FINANCIALS FOR THE HSC FOUNDATION AND SUBSIDIARIES, IN WHICH THE HOSPITAL FOR SICK CHILDREN D/B/A HSC PEDIATRIC CENTER ("THE CENTER") WAS INCLUDED: THE FOUNDATION, THE CENTER, AND HSCSN HAVE BEEN RECOGNIZED AS PUBLIC CHARITIES GENERALLY EXEMPT FROM FEDERAL INCOME TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE"). HOLDINGS HAS BEEN RECOGNIZED AS TAX-EXEMPT UNDER SECTION 501(C)(2) OF THE CODE. HSCS, AND HOME CARE ARE CONSIDERED DISREGARDED ENTITIES FOR FEDERAL AND STATE INCOME TAX PURPOSES. EACH ORGANIZATION IS SUBJECT TO TAX ON INCOME UNRELATED TO ITS EXEMPT PURPOSE, UNLESS THAT INCOME IS OTHERWISE EXCLUDED BY THE CODE. EACH ORGANIZATION HAS PROCESSES PRESENTLY IN PLACE TO ENSURE THE MAINTENANCE OF ITS TAX-EXEMPT STATUS; TO IDENTIFY AND REPORT UNRELATED INCOME; TO DETERMINE ITS FILING AND TAX OBLIGATIONS IN JURISDICTIONS FOR WHICH IT HAS NEXUS; AND TO IDENTIFY AND EVALUATE OTHER MATTERS THAT MAY BE CONSIDERED TAX POSITIONS. THE SYSTEM FOLLOWS GUIDANCE THAT CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN, INCLUDING ISSUES RELATING TO FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT. THIS GUIDANCE PROVIDES THAT THE TAX EFFECTS FROM AN UNCERTAIN TAX POSITION CAN ONLY BE RECOGNIZED IN THE FINANCIAL STATEMENTS IF THE POSITION IS "MORE-LIKELY-THAN-NOT" TO BE SUSTAINED IF THE POSITION WERE TO BE CHALLENGED BY A TAXING AUTHORITY. THE ASSESSMENT OF THE TAX POSITION IS BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION, WITHOUT REGARD TO THE LIKELIHOOD THAT THE TAX POSITION MAY BE CHALLENGED. THE TAX YEARS ENDED DECEMBER 31, 2019, 2018, AND 2017 ARE STILL OPEN TO AUDIT FOR BOTH FEDERAL AND STATE PURPOSES. THE SYSTEM HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS.

Schedule D (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

The Hospital for Sick Children

Employer identification number

53-0204670

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:

Yes

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: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 500 %

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) . . .	188,630		188,630	0.470 %
b	Medicaid (from Worksheet 3, column a) . . . . .	30,827,699	27,084,485	3,743,214	9.290 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	31,016,329	27,084,485	3,931,844	9.760 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	26		26	0 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	26		26	0 %
k	Total. Add lines 7d and 7j .	31,016,355	27,084,485	3,931,870	9.760 %

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

Schedule H (Form 990) 2019

Page

Part II

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

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

1,681,566

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.....

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

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 %
1NA
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2019

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	The Hospital for Sick Children 1731 Bunker Hill Rd NE Washington,DC20017 www.hschealth.org HFD01-0	X	X

Schedule H (Form 990) 2019

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	THE HOSPITAL FOR SICK CHILDREN
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...............

Yes

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 19

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

Yes

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

Yes

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): hschealth.org/foundation/publications

Other website (list url): dchealthmatters.org

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 19

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

Yes

If "Yes" (list url): See Part V, Section C

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2019

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	THE HOSPITAL FOR SICK CHILDREN
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 200.%
and FPG family income limit for eligibility for discounted care of 500.%

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):

www.hschealth.org

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

www.hschealth.org

A plain language summary of the FAP was widely available on a website (list url):
www.hschealth.org

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 6

Part VFacility Information (continued)

Billing and Collections

	THE HOSPITAL FOR SICK CHILDREN
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2019

Page 7

Part VFacility Information (continued)

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

	THE HOSPITAL FOR SICK CHILDREN
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2019

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
HOSPITAL FACILITIES	SCHEDULE H, PART V, SECTION A THE HOSPITAL FOR SICK CHILDREN IS A SELF-CONTAINED PEDIATRIC SPECIALTY HOSPITAL. THE HOSPITAL FACILITY DOES NOT CHARGE ANY INDIVIDUALS THAT IT KNOWS ARE ELIGIBLE FOR FINANCIAL ASSISTANCE AN AMOUNT EQUAL TO THE GROSS CHARGE FOR ANY SERVICE. THE HOSPITAL USES THE CHARGE MASTER RATES FOR A SERVICE AS A STARTING POINT AGAINST WHICH THE DISCOUNTS MANDATED IN THE HOSPITAL FACILITY'S FINANCIAL ASSISTANCE POLICY ARE APPLIED TO DETERMINE THE AMOUNT ACTUALLY BILLED TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. THE HOSPITAL FACILITY WILL NOT COLLECT PAYMENT FROM ANY PATIENT ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY IN EXCESS OF THE REDUCED AMOUNT THAT IS ACTUALLY BILLED TO SUCH FINANCIAL ASSISTANCE PATIENT. ACQUISITION SCHEDULE H, PART V, LINE 2 THE HOSPITAL'S SOLE CORPORATE MEMBER, THE HSC FOUNDATION, WAS ACQUIRED BY CHILDREN'S NATIONAL MEDICAL CENTER EFFECTIVE SEPTEMBER 1, 2019. INPUT FROM PERSONS WHO REPRESENT THE COMMUNITY SCHEDULE H, PART V, SECTION B, LINE 5 THROUGH THE DISTRICT OF COLUMBIA HEALTHY COMMUNITIES COLLABORATIVE (DCHCC) INPUT WAS RECEIVED VIA SEVERAL KEY INFORMANT INTERVIEWS, FOCUS GROUPS, TOWN HALLS, AND ONLINE SURVEYS. THESE GROUPS CONSISTED OF COMMUNITY RESIDENTS, MEMBERS FROM THE LOCAL HEALTH CARE COMMUNITY, AND COMMUNITY AND GOVERNMENT AGENCIES REPRESENTING THE SOCIAL DETERMINANTS OF HEALTH SUCH AS THE DEPARTMENTS OF HOUSING, ECONOMICS, HEALTH CARE FINANCE, TRANSPORTATION, AND BEHAVIORAL HEALTH. THE STAKEHOLDER INTERVIEWS REPRESENTED 60 ORGANIZATIONS AND INCLUDED AN ADDITIONAL 31 KEY INFORMANT INTERVIEWS, 113 ONLINE SURVEYS, 40 FOCUS GROUP PARTICIPANTS, 80 COMMUNITY FORUMS ATTENDEES, 6 COUNCIL MEMBERS, 11 GOVERNMENT AGENCIES, AND 15 HOSPITALS AND CLINICS. STAKEHOLDERS PROVIDED INPUT ON SEVERAL QUESTIONS RELATED TO OVERALL HEALTH AND THE COMPONENTS OF A HEALTHY COMMUNITY. PARTICIPANTS ALSO COMMENTED ON WAYS TO IMPROVE THE STATUS OF HEALTH IN THE CITY, DISCUSSED WHAT PROGRAMS/SYSTEMS WERE WORKING, AND PROVIDED INSIGHT INTO ADDITIONAL RESOURCES NEEDED TO ADVANCE HEALTH IN THE DISTRICT OF COLUMBIA. CHNA CONDUCTED WITH MULTIPLE HOSPITAL FACILITIES SCHEDULE H, PART V, SECTION B, LINES 6A & 6B THE CHNA WAS CONDUCTED WITH MEMBERS OF THE DC HEALTH MATTERS COLLABORATIVE INCLUDING FIVE NON-PROFIT HOSPITALS: CHILDREN'S NATIONAL HOSPITAL, HSC HEALTH CARE SYSTEM, HOWARD UNIVERSITY HOSPITAL, PROVIDENCE HEALTH SYSTEM AND SIBLEY MEMORIAL HOSPITAL. HSC CONDUCTED THE CHNA WITH MEMBERS OF THE DC HEALTH MATTERS COLLABORATIVE THAT INCLUDES FIVE HOSPITALS AND FOUR FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) (BREAD FOR THE CITY, COMMUNITY OF HOPE, MARY'S CENTER, AND UNITY HEALTH CARE); AND TWO EX-OFFICIO MEMBERS (DC HOSPITAL ASSOCIATION AND DC PRIMARY CARE ASSOCIATION). THE DC DEPARTMENT OF HEALTH IS ALSO A PARTNER OF THE COLLABORATIVE. THE COLLABORATIVE WORKS TO ELIMINATE HEALTH DISPARITIES AND CREATE HEALTH EQUITY FOR ALL COMMUNITIES IN DC TO REALIZE ONE HEALTHY CAPITAL CITY. WITH THE UNIQUE PERSPECTIVES OF EACH HOSPITAL AND COMMUNITY HEALTH CENTER, COLLABORATIVE MEMBERS PROVIDED GUIDANCE AND FEEDBACK RESPECTIVE TO POPULATIONS AND NEIGHBORHOODS SERVED. CHNA and Implementation Strategy Schedule H, Part V, Section B, Lines 3 and 10 HSCPC ADOPTED THE DC HEALTH MATTERS 2019 CHNA AND CHIP DURING THE FISCAL YEAR ENDING 12/31/2019. SCHEDULE H IS COMPLETED USING THIS INFORMATION. THE 2019 CHIP CAN BE FOUND HERE: HTTP://WWW.DCHEALTHMATTERS.ORG/
HOW THE HOSPITAL ADDRESSES SIGNIFICANT NEEDS	SCHEDULE H, PART V, SECTION B, LINE 11 THE DC HEALTH MATTERS COLLABORATIVE (THE COLLABORATIVE) IS ADDRESSING THE FOLLOWING SIGNIFICANT NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) - MENTAL HEALTH, HEALTH LITERACY, PLACE-BASED CARE, AND CARE COORDINATION. WHILE THE COMMUNITY IDENTIFIED NINE HEALTH NEEDS, THE COLLABORATIVE SELECTED FOUR OF THE NINE PRIORITY NEEDS USING A STRUCTURED PRIORITIZATION PROCESS. THE PRIORITIZATION PROCESS SCORED EACH OF THE NEEDS ACCORDING TO 1) IMPORTANCE TO OUR COMMUNITY, 2) CAPACITY TO ADDRESS (AVAILABILITY OF FINANCIAL AND OTHER RESOURCES), 3) ALIGNMENT WITH ORGANIZATIONAL AND CITYWIDE MISSION AND 4) STRENGTH OF EXISTING INTERVENTION/COLLABORATIONS. A DESCRIPTION OF HOW HSC AND DCHCC ARE ADDRESSING THE FOUR SELECTED NEEDS IS DETAILED IN OUR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). IT IS IMPORTANT TO NOTE THAT THESE FOUR PRIORITIZED COMMUNITY NEEDS CUT ACROSS NEARLY ALL CLINICAL CONDITIONS AND OFTEN CONTRIBUTE TO POOR HEALTH OUTCOMES, PARTICULARLY FOR CHILDREN WITH MEDICAL COMPLEXITY. THE QUANTITATIVE DATA PRESENTED IN THE REPORT HELPED GUIDE THE COLLABORATIVE IN DECIDING WHICH OF THE PRIORITY AREAS TO INVEST OUR RESOURCES FOR THE GREATEST IMPACT. FURTHERMORE, BECAUSE THE COLLABORATIVE IS COMPRISED OF HEALTH CARE ORGANIZATIONS, IT WAS IMPORTANT TO ALIGN THE PRIORITY AREAS ON HEALTH RELATED MATTERS VERSUS SOME OF THE NON-HEALTH AREAS IN ORDER TO BRING ABOUT THE GREATEST OPPORTUNITY TO AFFECT CHANGE. EACH COLLABORATIVE MEMBER ORGANIZATION RECEIVED APPROVAL OF THE CHIP BY THEIR BOARD OF DIRECTORS, INCLUDING HSC.
ELIGIBILITY CRITERIA EXPLAINED IN THE FINANCIAL ASSISTANCE POLICY	SCHEDULE H, PART V, SECTION B, LINE 13B HSCPC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO INDIVIDUALS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED BY SEVERAL FACTORS, INCLUDING: THE INDIVIDUAL'S ANNUAL INCOME, FAMILY SIZE, AND LIQUID ASSETS, AS WELL AS WHETHER THE INDIVIDUAL IS COVERED BY GOVERNMENTAL OR OTHER INSURANCE. FREE CARE IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE, AND WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. DISCOUNTED CARE IS BASED ON A SLIDING DISCOUNTED SCALE OF GROSS CHARGES AND IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE AND WHOSE FAMILY INCOME IS BETWEEN 200% AND 500% OF THE POVERTY GUIDELINES. WHEN POSSIBLE, THE ORGANIZATION MAY MAKE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETED FINANCIAL ASSISTANCE APPLICATION. PRESUMPTIVE CHARITY CARE IS DETERMINED BASED ON DEFINED CRITERIA FOR DESTITUTE STATUS (HOMELESS, ILLEGAL ALIEN, INCARCERATED, ETC.). PATIENTS WITH SUFFICIENT ASSETS TO PAY FOR CARE WITHOUT BECOMING MEDICALLY INDIGENT MAY NOT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. HOWEVER, THE RESIDENCE WHERE A PATIENT AND/OR THE PATIENT'S FAMILY RESIDES, AUTOMOBILES NEEDED TO TRANSPORT ALL WORKING PARTIES TO AND FROM WORK, SAVINGS ACCOUNTS WITH LESS THAN TWO MONTHS OF INCOME AND RETIREMENT ACCOUNTS WITH LESS THAN $50,000 ARE ALWAYS EXEMPTED FROM CONSIDERATION AS ASSETS IN CONSIDERING WHETHER THE PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE. ONCE CHARITY CARE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS ON THE WRITTEN OFF PORTION OF THE ACCOUNT CEASE. IF THE PATIENT RECEIVES PARTIAL CHARITY CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. FURTHERMORE, HSCPC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO THE MEDICALLY INDIGENT, WHICH IS A SEPARATE, SUPPLEMENTAL DETERMINATION OF FINANCIAL ASSISTANCE FOR PATIENTS THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE PRIMARY SECTION OF THE FINANCIAL ASSISTANCE POLICY, BUT FOR WHOM THE RESULTING FINANCIAL LIABILITY FOR MEDICAL TREATMENT REPRESENTS A CATASTROPHIC LOSS. "CATASTROPHIC" IS DEFINED AS A SITUATION IN WHICH THE SELF-PAY PORTION OF THE HSCPC MEDICAL BILL IS GREATER THAN THE PATIENT'S ABILITY TO REPAY WITH CURRENT INCOME AND LIQUID ASSETS IN 18 MONTHS OR LESS. THE FACTORS TAKEN INTO CONSIDERATION WHEN EVALUATING A CATASTROPHIC ASSISTANCE APPLICATION ARE THE FOLLOWING: CURRENT MEDICAL DEBT, LIQUID ASSETS, LIVING EXPENSES, PROJECTED MEDICAL EXPENSES, ANNUAL INCOME, FAMILY SIZE, AND SPELL OF ILLNESS.
AVAILABILITY OF FINANCIAL ASSISTANCE POLICY	SCHEDULE H, PART V, SECTION B, LINE 16J HSCPC PUBLICIZES ITS FINANCIAL ASSISTANCE POLICY IN MANY DIFFERENT WAYS. FIRST, IT POSTS NOTICES REGARDING THE AVAILABILITY OF CHARITY CARE IN ADMISSIONS, PATIENT REGISTRATION, AND THE BUSINESS OFFICE. THE INFORMATION ON THE SIGNS IS IN BOTH ENGLISH AND SPANISH. IN ADDITION, THE POLICY IS DISTRIBUTED TO PATIENTS ON ADMISSION AND UPON REQUEST, AND IS AVAILABLE AT ALL PATIENT REGISTRATION DESKS AND IN ALL WAITING AREAS. FURTHERMORE, HSCPC, AS MANDATED BY ITS FINANCIAL ASSISTANCE POLICY, PUBLISHES A SUMMARY OF ITS FINANCIAL ASSISTANCE POLICY, ON AN ANNUAL BASIS, IN A NEWSPAPER OF GENERAL CIRCULATION IN THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS.
POLICY RELATING TO EMERGENCY MEDICAL CARE	SCHEDULE H, PART V, SECTION B, LINE 21D THE HSC PEDIATRIC CENTER IS A LONG-TERM PEDIATRIC HOSPITAL FACILITY, WHICH DOES NOT PROVIDE EMERGENCY MEDICAL CARE. HOWEVER, THE HSC PEDIATRIC CENTER HAS ADOPTED A TRANSFER POLICY PURSUANT TO WHICH THE HOSPITAL WILL HELP TO TRANSFER, AS APPROPRIATE, ANY PATIENTS SHOWING SYMPTOMS OF AN EMERGENCY TO AN ACUTE CARE HOSPITAL.
MAXIMUM AMOUNTS TO BE CHARGED TO FAP ELIGIBLE INDIVIDUALS	SCHEDULE H, PART V, SECTION B, LINE 22D THE HSC PEDIATRIC CENTER DETERMINED MAXIMUM AMOUNTS TO BE CHARGED TO FAP ELIGIBLE INDIVIDUALS IS NOT MORE THAN AMOUNTS GENERALLY BILLED TO INSURED PATIENTS. THE PROSPECTIVE MEDICAID METHOD WAS USED.

Schedule H (Form 990) 2019

Page 9

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?3
Name and address		Type of Facility (describe)
1	The HSC Outpatient Center 4500 Forbes Blvd Suite 100 Lanham,MD20706	Provides outpatient rehab SERVICES TO THE SPECIAL NEEDS COMMUNITY
2	The HSC Outpatient Center 14995 Shady Grove Rd Suite 200 Rockville,MD20850	Provides outpatient rehab SERVICES TO THE SPECIAL NEEDS COMMUNITY
3	The HSC Skilled Nursing Facility 1731 Bunker Hill Road NE Washington,DC20017	Facility that provides skilled nursing services to children & young adults through age 21
4
5
6
7
8
9
10

Schedule H (Form 990) 2019

Page 10

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
OTHER CRITERIA USED FOR DETERMINING ELIGIBILITY	SCHEDULE H, PART I, LINE 3C HSCPC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO INDIVIDUALS THAT QUALIFY UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED BY SEVERAL FACTORS, INCLUDING: THE INDIVIDUAL'S ANNUAL INCOME, FAMILY SIZE, AND LIQUID ASSETS, AS WELL AS WHETHER THE INDIVIDUAL IS COVERED BY GOVERNMENTAL OR OTHER INSURANCE. FREE CARE IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE, AND WHOSE FAMILY INCOME DOES NOT EXCEED 200% OF THE FEDERAL POVERTY GUIDELINES. DISCOUNTED CARE IS BASED ON A SLIDING DISCOUNTED SCALE OF GROSS CHARGES AND IS PROVIDED TO PATIENTS WHO ARE INELIGIBLE FOR GOVERNMENTAL OR OTHER INSURANCE COVERAGE AND WHOSE FAMILY INCOME IS BETWEEN 200% AND 500% OF THE POVERTY GUIDELINES. WHEN POSSIBLE, THE ORGANIZATION MAY MAKE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FREE OR DISCOUNTED CARE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETED FINANCIAL ASSISTANCE FORM. PRESUMPTIVE CHARITY CARE IS DETERMINED BASED ON DEFINED CRITERIA FOR DESTITUTE STATUS (HOMELESS, ILLEGAL ALIEN, INCARCERATED, ETC.). ONCE CHARITY CARE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE, OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS ON THE WRITTEN OFF PORTION OF THE ACCOUNT CEASE. IF THE PATIENT RECEIVES PARTIAL CHARITY CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. IN ADDITION, INDIVIDUALS THAT DO NOT QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY MAY STILL BE PROVIDED UP TO A 25% DISCOUNT ON BILLED SERVICES IN CERTAIN CIRCUMSTANCES.
FINANCIAL ASSISTANCE POLICY FOR THE MEDICALLY INDIGENT	SCHEDULE H, PART I, LINE 4 HSCPC HAS A FINANCIAL ASSISTANCE POLICY THAT PROVIDES FOR FREE OR DISCOUNTED CARE TO THE MEDICALLY INDIGENT, WHICH IS A SEPARATE, SUPPLEMENTAL DETERMINATION OF FINANCIAL ASSISTANCE FOR PATIENTS THAT ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THE PRIMARY SECTION OF THE FINANCIAL ASSISTANCE POLICY, BUT FOR WHOM THE RESULTING FINANCIAL LIABILITY FOR MEDICAL TREATMENT REPRESENTS A CATASTROPHIC LOSS. "CATASTROPHIC" IS DEFINED AS A SITUATION IN WHICH THE SELF-PAY PORTION OF THE HSCPC MEDICAL BILL IS GREATER THAN THE PATIENT'S ABILITY TO REPAY WITH CURRENT INCOME AND LIQUID ASSETS IN 18 MONTHS OR LESS. THE FACTORS TAKEN INTO CONSIDERATION WHEN EVALUATING A CATASTROPHIC ASSISTANCE APPLICATION ARE THE FOLLOWING: CURRENT MEDICAL DEBT, LIQUID ASSETS, LIVING EXPENSES, PROJECTED MEDICAL EXPENSES, ANNUAL INCOME, FAMILY SIZE, AND SPELL OF ILLNESS.
EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE	SCHEDULE H, PART I, LINE 7 THE COST OF CHARITY CARE WAS DETERMINED BY UTILIZING THE RATIO OF COST TO CHARGES CALCULATED ON WORKSHEET 2 APPLIED TO THE CHARGES WRITTEN OFF FOR PATIENTS QUALIFYING FOR CHARITY CARE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SCHEDULE H, PART I, LINE 7, COL (F) BAD DEBT EXPENSE EXCLUDED FROM FINANCIAL ASSISTANCE CALCULATION $1,681,566.
METHODOLOGY USED TO ESTIMATE BAD DEBT	SCHEDULE H, PART III, LINE 2 BAD DEBT EXPENSE IS DETERMINED BY ANALYZING PAST HISTORY AND IDENTIFYING TRENDS FOR EACH MAJOR PAYER SOURCE OF REVENUE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS NET OF ANY PAYMENTS OR DISCOUNTS MADE AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND BAD DEBT EXPENSE, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL RECORDS A SIGNIFICANT BAD DEBT EXPENSE IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE NET OF ANY PAYMENTS OF DISCOUNTS MADE. THE HOSPITAL REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
FAP ELIGIBLE PATIENT BAD DEBT CALCULATION METHODOLOGY	SCHEDULE H, PART III, LINE 3 THE HOSPITAL DOES NOT REPORT AN ESTIMATE FOR THE PORTION OF BAD DEBT EXPENSE THAT MAY HAVE BEEN LIKELY TO QUALIFY FOR FINANCIAL ASSISTANCE UNDER THE HOSPITAL'S CHARITY CARE POLICY. HSCPC TAKES THE POSITION THAT AMPLE OPPORTUNITY AND ASSISTANCE IS PROVIDED TO THE PATIENT TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. IF SUFFICIENT INFORMATION IS NOT PROVIDED THE HOSPITAL MUST ASSUME THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE.
FOOTNOTE IN ORGANIZATION'S FINANCIAL STATEMENTS DESCRIBING BAD DEBT	SCHEDULE H, PART III, LINE 4 THE FOOTNOTE TO THE ORGANIZATION'S FINANCIAL STATEMENTS (NOTE 2) THAT DESCRIBES BAD DEBT EXPENSE IS AS FOLLOWS: PROVISIONS FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CENTER ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY INSURANCE COVERAGE, THE CENTER ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE CENTER RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE CENTER REGULARLY PERFORMS HINDSIGHT PROCEDURES TO EVALUATE HISTORICAL WRITE-OFF AND COLLECTION EXPERIENCE THROUGHOUT THE YEAR TO ASSIST IN DETERMINING THE REASONABLENESS OF ITS PROCESS FOR ESTIMATING THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS.
SHORTFALL TREATED AS COMMUNITY BENEFIT AND COSTING METHOD USED	SCHEDULE H, PART III, LINE 8 HSCPC DOES NOT PARTICIPATE IN THE MEDICARE PROGRAM. PROVISIONS ON COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR ASSISTANCE SCHEDULE H, PART III, LINE 9B THE DETERMINATION OF A PATIENT'S QUALIFICATION UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY IS ATTEMPTED PRIOR TO THE PATIENT BEING DISCHARGED FROM THE HOSPITAL. THIS MAY INCLUDE A PROSPECTIVE DETERMINATION THAT CERTAIN PATIENTS QUALIFY FOR FINANCIAL ASSISTANCE, ALTHOUGH THE PATIENT HAS NOT SUBMITTED A COMPLETE FINANCIAL ASSISTANCE POLICY. AS SOON AS THE PATIENT'S FINANCIAL ASSISTANCE ELIGIBILITY HAS BEEN ESTABLISHED, THE PATIENT ACCOUNT IN WHOLE OR IN PART, IS WRITTEN-OFF AND ALL COLLECTION EFFORTS CEASE ON THE PORTION OF THE ACCOUNT THAT HAS BEEN WRITTEN-OFF. IF THE PATIENT RECEIVES DISCOUNTED CARE, ALL EFFORTS WILL BE MADE TO PLACE THAT PATIENT ON AN EXTENDED PAYMENT PLAN. FOR THOSE PATIENTS THAT DO NOT INITIALLY APPLY OR QUALIFY FOR FINANCIAL ASSISTANCE, THE ORGANIZATION CONTINUES TO MONITOR WHETHER THE PATIENT MAY QUALIFY FOR FINANCIAL ASSISTANCE THROUGHOUT THE COLLECTION PROCESS. IF THE PATIENT IS FOUND TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE AT ANY POINT (INCLUDING ONCE COLLECTION EFFORTS HAVE BEGUN), THE ORGANIZATION WILL APPROVE THE PATIENT FOR FINANCIAL ASSISTANCE IMMEDIATELY. NEEDS ASSESSMENT SCHEDULE H, PART VI, LINE 2 HSC PEDIATRIC CENTER USES A VARIETY OF METHODS TO ASSESS HEALTH CARE NEEDS OF THE COMMUNITY IT SERVES. NEEDS ARE IDENTIFIED THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT, PARTNERSHIPS AND COLLABORATIONS WITH OTHER MEDICAL, NON-PROFIT AND PUBLIC HEALTH AGENCIES. HSC PEDIATRIC CENTER ASSUMES THE RESPONSIBILITY OF LEADING THE REGION IN THE PROVISION OF CHRONIC CARE FOR PEDIATRIC PATIENTS AND IS TRUSTED THROUGHOUT ITS COMMUNITY AS A RESOURCE READY AND WILLING TO ADDRESS ESTABLISHED AND EMERGENT PEDIATRIC NEEDS WHEREVER AND HOWEVER THEY ARE IDENTIFIED. HSC PEDIATRIC CENTER'S CURRENT COMMUNITY NEEDS ASSESSMENT AND IMPLEMENTATION STRATEGY CAN BE FOUND AT WWW.DCHEALTHMATTERS.ORG. PATIENT EDUCATION SCHEDULE H, PART VI, LINE 3 THE HSC PEDIATRIC CENTER HAS A STRONG COMMITMENT TO PROVIDING SERVICES TO FAMILIES AT NO COST TO THEM IF AT ALL POSSIBLE. MANY OF THE FAMILIES WHO RECEIVE SERVICES FROM HSC HAVE ALREADY QUALIFIED FOR MEDICAID BY THE TIME OF THEIR ARRIVAL AT HSC DUE TO PRIOR SERVICES AT OTHER FACILITIES. IF A FAMILY ARRIVES AT HSC WITH PRIVATE INSURANCE, OFTEN TIMES THEY QUALIFY FOR MEDICAID BY THE TIME THEY ARE DISCHARGED TO CARE AT HOME. FAMILIES ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE AT THE TIME OF THEIR ADMISSION TO HSCPC. THEY ARE GIVEN WRITTEN COPIES OF THE STATEMENT: "NOTICE OF AVAILABILITY OF UNCOMPENSATED SERVICES" IN THE APPROPRIATE LANGUAGE. IF THEY BELIEVE THEY MAY BE IN NEED OF THE SERVICES, AN APPLICATION IS FILLED OUT AT THE TIME OF ADMISSION. IF A FAMILY DOES NOT QUALIFY FOR MEDICAID THEY WOULD BE ELIGIBLE TO PURSUE THE AVAILABLE UNCOMPENSATED SERVICES. IF PATIENTS ARE NOT ELIGIBLE FOR MEDICAID AND OTHER GOVERNMENTAL PROGRAMS SUBSEQUENT TO DISCHARGE, HSCPC BOTH INFORMS AND ATTEMPTS TO QUALIFY THEM PROSPECTIVELY FOR THE CHARITY CARE SERVICES PROVIDED BY HSCPC. THE HSC PEDIATRIC CENTER POSTS SIGNAGE ABOUT PATIENT RIGHTS AND FINANCIAL ASSISTANCE IN BOTH ENGLISH AND SPANISH. SEE BELOW FOR AN EXCERPT FROM THE SIGNAGE: PATIENTS, MEMBERS, CLIENTS, AND FAMILIES HAVE THE RIGHT TO: - EXPECT APPROPRIATE QUALITY CARE AND SERVICES REGARDLESS OF SEX, RACE, RELIGION, COLOR, CREED, ETHNIC ORIGIN, DISABILITY, SEXUAL PREFERENCE, GENDER IDENTITY OR SOURCE OF PAYMENT; - BE INFORMED, IN A TIMELY FASHION, OF ALL EXPENSES NOT COVERED BY THE PATIENT/MEMBER/CLIENT'S INSURANCE THAT WILL BE INCURRED BY THE PATIENT/MEMBER/CLIENT'S HEALTH CARE; - AN ACCOUNTING OF ALL DISCLOSURES. STAFF OF THE ORGANIZATION HELP IDENTIFY GOVERNMENT OR NON-PROFIT ASSISTANCE WHICH MAY BE AVAILABLE, AND THE ORGANIZATION WILL ASSIST PATIENTS' FAMILIES WITH APPLYING FOR SUCH PROGRAMS, SUCH AS MEDICAID. COMMUNITY INFORMATION SCHEDULE H, PART VI, LINE 4 TTHE HSC PEDIATRIC CENTER SERVES CHILDREN AND YOUNG ADULTS UP TO THE AGE OF 21 IN THE WASHINGTON DC METRO AREA WHO HAVE SPECIAL HEALTH CARE NEEDS. HSCPC SERVES THE WASHINGTON DC METRO AREA WHICH IS A DIVERSE COMMUNITY THAT COVERS TWO STATES AND THE DISTRICT OF COLUMBIA. OF THE DC SPECIAL NEEDS CHILDREN APPROXIMATELY 5,500 WERE ENROLLED IN HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC., HSCPC'S SISTER ORGANIZATION THAT PROVIDES CARE MANAGEMENT SERVICES TO CHILDREN WHO HAVE SSI OR SSI RELATED DIAGNOSES. THE PRIMARY CONDITIONS OF CHILDREN WITH SPECIAL HEALTH CARE NEEDS TREATED AT THE HSCPC ARE CONDITIONS REQUIRING LONGER TERM TRANSITIONAL CARE AND/OR SPECIALTY REHABILITATION CARE PRIOR TO THEIR DISCHARGE TO HOME OR NURSING/GROUP HOME. THESE CONDITIONS INCLUDE CEREBRAL PALSY, ANOXIC BRAIN DAMAGE, SPINA BIFIDA, FAILURE TO THRIVE RELATED TO PREMATURITY, CHRONIC LUNG DISEASE AND INTESTINAL OR OTHER FEEDING DISORDERS. IN 2019, APPROXIMATELY 75% OF HSCPC'S PATIENTS WERE COVERED BY MEDICAID (I.E. DC, MD OR VA MEDICAID). IN 2019, HSCPC PROVIDED 9,552 DAYS OF CARE. HSCPC ALSO PROVIDED ON AN OUTPATIENT BASIS MEDICAL CARE, APPROXIMATELY 22,288 VISITS IN 2019.
PROMOTION OF COMMUNITY HEALTH	SCHEDULE H, PART VI, LINE 5 WITH THE EXCEPTION OF THE CEO OF THE HSC FOUNDATION, WHO SERVES AS AN EX OFFICIO NON VOTING BOARD MEMBER, THE HSC PEDIATRIC CENTER'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR ITS AFFILIATES, NOR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS OR SPECIALTIES. THE ORGANIZATIONS SURPLUS FUNDS ARE USED TO FURTHER ITS EXEMPT PURPOSE, MEDICAL EDUCATION AND COMMUNITY PROGRAMS.
DESCRIPTION OF AFFILIATED GROUP	SCHEDULE H, PART VI, LINE 6 AS OF SEPTEMBER 1, 2019, THE HSC PEDIATRIC CENTER IS PART OF AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING OTHER TAX-EXEMPT ENTITIES: - CHILDREN'S NATIONAL MEDICAL CENTER - 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBILITY FOR HEALTH CARE SYSTEM - CHILDREN'S HOSPITAL FOUNDATION - 501(C)(3), FUNDRAISING - CHILDREN'S RESEARCH INSTITUTE - 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS - SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN - BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN - CHILDREN'S NATIONAL ADVOCACY & PUBLIC POLICY INC. - 501(C)(3), ADVOCATING FOR CHILDREN'S HEALTH ISSUES - CHILDREN'S HOSPITAL SELF-INSURANCE TRUST - 501(C)(3), PROVISION OF INSURANCE TO SYSTEM EACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL MEDICAL CENTER'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS. - CHILDREN'S SCHOOL SERVICES - 501(C)(3), SCHOOL NURSING SERVICES - CHILDREN'S HOSPITAL - 501(C)(3), HOSPITAL - HSC FOUNDATION - 501(C)(3), SUPPORT FOR THE HSC ENTITIES - HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS - 501(C)(3), HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES FOR YOUNG INDIVIDUALS WITH SPECIAL NEEDS
STATE FILING OF COMMUNITY BENEFIT REPORT	SCHEDULE H, PART VI, LINE 7 DC

Schedule H (Form 990) 2019

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

The Hospital for Sick Children

Employer identification number

53-0204670

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ..

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2019

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Nathaniel Beers Pres & CEO, Board Member	(i) (ii)	0 ------------- 608,927	0 ------------- 50,000	0 ------------- 0	0 ------------- 34,835	0 ------------- 2,115	0 ------------- 695,877	0 ------------- 0
2Victor Fields Former EVP & CFO	(i) (ii)	0 ------------- 358,489	0 ------------- 0	0 ------------- 0	0 ------------- 26,475	0 ------------- 12,057	0 ------------- 397,021	0 ------------- 0
3Debbie Holson COO, Pediatric Center	(i) (ii)	0 ------------- 263,668	0 ------------- 0	0 ------------- 0	0 ------------- 28,946	0 ------------- 10,057	0 ------------- 302,671	0 ------------- 0
4Kimberly Brown VP FINANCE/INT CFO TO 11/1/19	(i) (ii)	0 ------------- 231,324	0 ------------- 0	0 ------------- 0	0 ------------- 11,303	0 ------------- 7,855	0 ------------- 250,482	0 ------------- 0
5Donna Anthony EVP, Clinical Strategies	(i) (ii)	0 ------------- 345,110	0 ------------- 0	0 ------------- 0	0 ------------- 29,965	0 ------------- 12,274	0 ------------- 387,349	0 ------------- 0
6Andrew Metinko Pediatrician	(i) (ii)	198,918 ------------- 0	0 ------------- 0	0 ------------- 0	9,500 ------------- 0	0 ------------- 0	208,418 ------------- 0	0 ------------- 0
7Samar Maamoun Pediatrician	(i) (ii)	218,874 ------------- 0	0 ------------- 0	0 ------------- 0	10,088 ------------- 0	1,660 ------------- 0	230,622 ------------- 0	0 ------------- 0
8Thomas W Chapman Former Pres & CEO HSCF	(i) (ii)	0 ------------- 0	0 ------------- 0	0 ------------- 145,373	0 ------------- 0	0 ------------- 0	0 ------------- 145,373	0 ------------- 0
9Adam Winebarger VP of Patient Care Serv	(i) (ii)	167,586 ------------- 0	0 ------------- 0	0 ------------- 0	3,269 ------------- 0	1,660 ------------- 0	172,515 ------------- 0	0 ------------- 0
10Anne Ruecktenwald Director of Outpat. Prog	(i) (ii)	158,714 ------------- 0	0 ------------- 0	0 ------------- 0	7,956 ------------- 0	1,520 ------------- 0	168,190 ------------- 0	0 ------------- 0
11Esther Kagulu Registered Nurse	(i) (ii)	157,618 ------------- 0	0 ------------- 0	0 ------------- 0	7,924 ------------- 0	1,445 ------------- 0	166,987 ------------- 0	0 ------------- 0
12ALEC KING TREASURER FROM 9/1/19	(i) (ii)	0 ------------- 655,110	0 ------------- 629,498	0 ------------- 123,254	0 ------------- 14,000	0 ------------- 26,127	0 ------------- 1,447,989	0 ------------- 79,685
13MARY ANNE HILLIARD SECRETARY FROM 9/1/19	(i) (ii)	0 ------------- 482,118	0 ------------- 263,608	0 ------------- 77,598	0 ------------- 14,000	0 ------------- 18,736	0 ------------- 856,060	0 ------------- 50,567

Schedule J (Form 990) 2019

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

ARRANGEMENT USED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION

SCHEDULE J, PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION AND THAT RELATED ORGANIZATION USED THE FOLLOWING METHODS TO ESTABLISH THE CEO/PRESIDENT'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; AND 4) APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. ALL COMPENSATION PAID TO OFFICERS IS PAID BY A RELATED ORGANIZATION. EFFECTIVE SEPTEMBER 1, 2019, CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL) BECAME THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. COMMENCING IN 2020, THE ORGANIZATION AND ITS AFFILIATES WILL ADOPT THE EXECUTIVE COMPENSATION PRACTICE AND APPROVAL PROCESS OF CHILDREN'S NATIONAL MEDICAL CENTER, WHICH IS SUBSTANTIALLY SIMILAR TO THE PROCESS OUTLINED ABOVE.

SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN

SCHEDULE J, PART I, LINE 4B A RELATED ORGANIZATION MAINTAINS A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AS PART OF THE TOTAL COMPENSATION ARRANGEMENT FOR THE ORGANIZATION'S FORMER CEO, THOMAS CHAPMAN. THE SERP PLAN IS MEANT TO PROVIDE THOMAS CHAPMAN WITH A RETIREMENT BENEFIT FOR OVER 20 YEARS OF SERVICE PROVIDED TO THE RELATED ORGANIZATION. THE RELATED ORGANIZATION'S COMPENSATION COMMITTEE HAS CAREFULLY REVIEWED AND APPROVED THE SERP PLAN FOR THOMAS CHAPMAN AND CONCLUDED THAT THOMAS CHAPMAN'S ENTIRE COMPENSATION PACKAGE, INCLUDING THE BENEFITS PROVIDED BY THE SERP PLAN, IS REASONABLE WHEN COMPARED TO MARKET DATA.

Schedule J (Form 990) 2019

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization
The Hospital for Sick Children

Employer identification number
53-0204670

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	District of Columbia	53-6001131	254839J53	12-17-2010	11,525,000	Refund series 2005 bond		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	2,675,000
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	11,525,000
4 Gross proceeds in reserve funds .............	0
5 Capitalized interest from proceeds .............	0
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	0
8 Credit enhancement from proceeds .............	0
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	0
11 Other spent proceeds .............	11,525,000
12 Other unspent proceeds .............	0
13 Year of substantial completion .............	1992
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2018, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2018, an advance refunding issue)? ........		X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X

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

Cat. No. 50193E

Schedule K (Form 990) 2019

Page 2

Part Ⅲ

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............		X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X
b Exception to rebate? ........		X
c No rebate due? .........	X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....	X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........	0
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2019

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........	0
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
Schedule K, Part III, Line 7	ALL COSTS OF ISSUANCE WITH RESPECT TO THE BONDS WERE PAID FROM FUNDS OTHER THAN PROCEEDS OF THE BONDS.
Schedule K, Part IV, Line 2c - COlumn A	ISSUER NAME: DISTRICT OF COLUMBIA THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 7/27/2015.

Schedule K (Form 990) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

The Hospital for Sick Children

Employer identification number

53-0204670

Return Reference	Explanation
CHANGE IN CORPORATE STRUCTURE	ON SEPTEMBER 1, 2019, CHILDREN'S NATIONAL MEDICAL CENTER BECAME THE SOLE MEMBER OF THE HSC FOUNDATION. CHILDREN'S NATIONAL IS A DISTRICT OF COLUMBIA TAX-EXEMPT, NONSTOCK CORPORATION WHO ALONG WITH ITS SUBSIDIARIES, PROVIDE HEALTH CARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN THE DISTRICT OF COLUMBIA AND THE SURROUNDING METROPOLITAN AREA. NO CONSIDERATION WAS PAID BY CHILDREN'S NATIONAL. BOTH PRIOR TO AND IMMEDIATELY THEREAFTER, THE HSC FOUNDATION WAS AND REMAINS THE SOLE MEMBER OF THE HOSPITAL FOR SICK CHILDREN (DBA THE HSC PEDIATRIC CENTER AND REFERRED TO HEREIN AS "HSCPC.") DELEGATE BROAD AUTHORITY TO A COMMITTEE FORM 990, PART VI, SECTION A, LINE 1A UNDER THE FOUNDATION'S PRIOR BYLAWS, AND UNTIL SEPTEMBER 1, 2019, THE EXECUTIVE COMMITTEE OF THE HSC FOUNDATION, THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS THE POWER TO EXERCISE EACH AND ALL OF THE POWERS OF THE BOARD OF DIRECTORS IN THE SAME MANNER AND TO THE SAME EXTENT AS IF THE COMMITTEE WERE IN FACT THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH PREVIOUSLY ESTABLISHED POLICIES OR DIRECTIVES OF THE BOARD. HOWEVER, NOTHING CONTAINED IN THESE BYLAWS SHALL CONSTITUTE A DELEGATION TO THE EXECUTIVE COMMITTEE OF THE FOLLOWING POWERS OF THE BOARD OF DIRECTORS: TO INCREASE OR DECREASE THE NUMBER OF DIRECTORS; TO FILL VACANCIES ON OR REMOVE DIRECTORS FROM THE BOARD; TO ELECT OFFICERS; TO FILL OFFICERS' VACANCIES; TO REMOVE OFFICERS; TO SELL, ENCUMBER OR OTHERWISE DISPOSE OF ALL OR ANY MATERIAL PART OF THE ASSETS OF THE CORPORATION; TO MERGE OR CONSOLIDATE THE CORPORATION WITH ANOTHER ENTITY; OR TO AMEND THESE BYLAWS. ALL EXECUTIVE COMMITTEE MINUTES WILL BE PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS PRIOR TO THE NEXT MEETING OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN, VICE CHAIRMAN, SECRETARY AND TREASURER OF THE HSC FOUNDATION AND UP TO FOUR (4) ADDITIONAL AT-LARGE MEMBERS WHO MAY BE APPOINTED BY THE CHAIRMAN OF THE BOARD, IN HIS OR HER DISCRETION. THE PRESIDENT SHALL BE AN EX OFFICIO MEMBER OF THE COMMITTEE. EFFECTIVE SEPTEMBER 1, 2019, CHILDREN'S NATIONAL BECAME THE SOLE CORPORATE MEMBER OF THE HSC FOUNDATION. UPON THAT AFFILIATION, THE EXISTING BOARD COMMITTEES OF THE HSC FOUNDATION AND HSCPC BECAME ADVISORY ONLY. SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS FORM 990, PART VI, LINE 4 THE HSC FOUNDATION (THE FOUNDATION) IS THE SOLE CORPORATE MEMBER OF THE HOSPTIAL FOR SICK CHILDREN. ON SEPTEMBER 1, 2019, THE FOUNDATION AFFILIATED WITH CHILDREN'S NATIONAL MEDICAL CENTER. IN ACCORDANCE WITH AN AFFILIATION AGREEMENT BY AND BETWEEN THE FOUNDATION AND CHILDREN'S NATIONAL, CHILDREN'S NATIONAL BECAME THE SOLE CORPORATE MEMBER OF THE FOUNDATION. THE FOUNDATION AMENDED AND RESTATED ITS ARTICLES OF INCORPORATION TO DESIGNATE CHILDREN'S NATIONAL AS ITS SOLE MEMBER. ADDITIONALLY, THE FOUNDATION AND HSCPC AMENDED AND RESTATED ITS BYLAWS TO COMPLY WITH CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE. UNDER CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE, CHILDREN'S NATIONAL RETAINS CERTAIN AUTHORITY OVER SUBSIDIARY ENTITIES (INCLUDING SUBSIDIARIES OF SUBSIDIARIES). THE RETENTION OF AUTHORITY INCLUDES ITEMS SUCH AS: THE AUTHORITY TO AMEND A SUBSIDIARY'S GOVERNING DOCUMENTS, AUTHORIZE THE SALE OF SUBSTANTIALLY ALL ASSETS, APPOINT/REMOVE OFFICERS AND DIRECTORS, APPROVE BUDGETS, SET SIGNATURE AUTHORITY, AND ADOPT AN ENTERPRISE-WIDE COMPLIANCE PLAN. THE AFFILIATION AGREEMENT AND THE FOUNDATION'S AMENDED AND RESTATED BYLAWS ANTICIPATE A FIVE-YEAR INTEGRATION PERIOD, DURING SUCH PERIOD THE FOUNDATION AND CHILDREN'S NATIONAL WILL SHARE RESPONSIBILITY FOR CERTAIN AUTHORITIES THAT ARE OTHERWISE SET UNDER THE SYSTEM OF GOVERNANCE.
MEMBERS OR STOCKHOLDERS	FORM 990, PART VI, SECTION A, LINE 6 THE HSC FOUNDATION IS THE SOLE MEMBER OF THE HOSPITAL FOR SICK CHILDREN. AS OF SEPTEMBER 1, 2019, CHILDREN'S NATIONAL MEDICAL CENTER IS THE SOLE MEMBER OF THE HSC FOUNDATION.
ELECTION OF MEMBERS	FORM 990, PART VI, SECTION A, LINES 7A & 7B THE SOLE MEMBER (THE HSC FOUNDATION) SHALL HAVE ALL OF THE POWERS SPECIFIED IN THE ARTICLES OF INCORPORATION AND BYLAWS, INCLUDING THE POWER TO: (A) ESTABLISH THE HOSPITAL'S POLICIES AND GOALS, AND APPROVE THE BYLAWS INCLUDING ANY AMENDMENTS THERETO; (B) APPOINT AND REMOVE THE HOSPITAL'S BOARD OF DIRECTORS; (C) MONITOR THE DECISIONS OF THE HOSPITAL'S BOARDS OF DIRECTORS; AND (D) APPROVE THE HOSPITAL'S BUDGET. THE HSC FOUNDATION IS THE SOLE CORPORATE MEMBER OF THE HOSPTIAL FOR SICK CHILDREN. ON SEPTEMBER 1, 2019, THE FOUNDATION AFFILIATED WITH CHILDREN'S NATIONAL MEDICAL CENTER. EFFECTIVE SEPTEMBER 1, 2019 AND FOR A PERIOD OF FIVE YEARS THEREAFTER, THE MEMBERS OF THE FOUNDATION'S GOVERNING BODY TOGETHER WITH THE BOARD OF CHILDREN'S NATIONAL APPOINT THE MEMBERS OF HSCPC'S GOVERNING BODY. AFTER SEPTEMBER 1, 2024, CHILDREN'S NATIONAL WILL APPOINT MEMBERS OF THE HSCPC'S GOVERNING BODY. ON SEPTEMBER 1, 2019, AND BY MEANS OF AN AFFILIATION AGREEMENT, THE FOUNDATION AFFILIATED WITH CHILDREN'S NATIONAL. EFFECTIVE AS OF THAT DATE, THE FOUNDATION AND THE HSCPC AMENDED AND RESTATED THEIR BYLAWS TO COMPLY WITH CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE. UNDER CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE, CHILDREN'S NATIONAL RETAINS CERTAIN AUTHORITY OVER SUBSIDIARY (AND A SUBSIDIARY OF A SUBSIDIARY) ENTITIES. THE RETENTION OF AUTHORITY INCLUDES ITEMS SUCH AS: THE AUTHORITY TO AMEND A SUBSIDIARY'S GOVERNING DOCUMENTS, AUTHORIZATION OF THE SALE OF SUBSTANTIALLY ALL ASSETS, APPOINT/REMOVE OFFICERS AND DIRECTORS, APPROVE BUDGETS, SET SIGNATURE AUTHORITY, AND ADOPT AN ENTERPRISE-WIDE COMPLIANCE PLAN. THE AFFILIATION AGREEMENT AND THE FOUNDATION AND HSCPS'S AMENDED AND RESTATED BYLAWS ANTICIPATE A FIVE-YEAR INTEGRATION PERIOD, DURING SUCH PERIOD THE ORGANIZATION AND CHILDREN'S NATIONAL WILL SHARE RESPONSIBILITY FOR CERTAIN AUTHORITIES THAT ARE OTHERWISE SET UNDER THE SYSTEM OF GOVERNANCE. AFTER SEPTEMBER 1, 2024, CHILDREN'S NATIONAL WILL HAVE SOLE RESPONSIBILITY FOR AUTHORITY THAT IS RESERVED UNDER THE SYSTEM OF GOVERNANCE.
FORM 990 REVIEW PROCESS	FORM 990, PART VI, SECTION B, LINE 11B EFFECTIVE SEPTEMBER 1, 2019, CHILDREN'S NATIONAL MEDICAL CENTER BECAME THE SOLE CORPORATE MEMBER OF THE HSC FOUNDATION. THE HSC FOUNDATION IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM AND THEN REVIEWED BY SENIOR LEADERSHIP, INCLUDING THE ORGANIZATION'S CHIEF OPERATING OFFICER AND THE CFOS OF THE HSC FOUNDATION AND CHILDREN'S NATIONAL. ONCE COMMENTS FROM THE COO AND CFOS HAVE BEEN INCORPORATED INTO THE FORM 990, THE FORM 990 IS REVIEWED BY THE FINANCE & INVESTMENT COMMITTEE OF CHILDREN'S NATIONAL AND MADE AVAILABLE TO THE BOARD OF DIRECTORS PRIOR TO FILING.
CONFLICT OF INTEREST POLICY	FORM 990, PART VI, SECTION B, LINE 12C PRIOR TO SEPTEMBER 1, 2019, THE HSC FOUNDATION MAINTAINED A WRITTEN CONFLICT OF INTEREST POLICY THAT COVERS ITSELF AND ALL OF ITS DIRECT AND INDIRECT SUBSIDIARIES (INCLUDING THE HOSPITAL FOR SICK CHILDREN). UNDER THAT POLICY, WHENEVER A POTENTIAL CONFLICT ARISES FOR THE HOSPITAL FOR SICK CHILDREN BOARD OF DIRECTORS AND/OR OFFICERS, IT IS BROUGHT TO THE ATTENTION OF THE PRESIDENT AND EXECUTIVE COMMITTEE OF THE HSC FOUNDATION BOARD, WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, THE PRESIDENT AND EXECUTIVE COMMITTEE REPORTS TO THE HSC PEDIATRIC CENTER BOARD OF DIRECTORS REGARDING THE NATURE OF THE CONFLICT AND THAT PERSON IS THEREAFTER RECUSED FROM ANY DISCUSSION AND VOTE REGARDING THE MATTER. WHENEVER A POTENTIAL CONFLICT ARISES FOR EMPLOYEES OF THE HOSPITAL FOR SICK CHILDREN MANAGEMENT TEAM, IT WILL BE BROUGHT TO THE BOARD CHAIR BY THE PRESIDENT WHICH ANALYZES THE SITUATION AND MAKES A DETERMINATION OF WHETHER OR NOT AN ACTUAL CONFLICT EXISTS. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT EXISTS, STEPS WILL BE TAKEN TO ELIMINATE THE CONFLICT AND COMMUNICATED TO THE EMPLOYEE INVOLVED. THE BOARD CHAIR AND PRESIDENT WILL REPORT ALL CONFLICTS OF INTEREST TO THE EXECUTIVE COMMITTEE FOUNDATION. EFFECTIVE SEPTEMBER 1, 2019, CHILDREN'S NATIONAL MEDICAL CENTER BECAME THE SOLE CORPORATE MEMBER OF THE HSC FOUNDATION, THEREAFTER THE HSC FOUNDATION AND ITS SUBSIDIARIES BECAME SUBJECT TO THE CONFLICTS OF INTEREST POLICY OF CHILDREN'S NATIONAL. THAT POLICY IS SUBSTANTIALLY SIMILAR TO THE PROCESS SETOUT ABOVE; PROVIDED HOWEVER, THE CHILDREN'S NATIONAL POLICY REQUIRES THE COMPLETION OF AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM, AND, IF APPLICABLE A CONFLICT MANAGEMENT PLAN IS IMPLEMENTED INCONJUCTION WITH THE COMPLIANCE OFFICER OF CHILDREN' NATIONAL.
GOVERNING POLICIES	FORM 990, PART VI, LINES 13 & 14 EFFECTIVE SEPTEMBER 1, 2019 THE HSC FOUNDATION IS GOVERNED BY THE COMPLIANCE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL MEDICAL CENTER. THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY.
PROCESS FOR DETERMINING COMPENSATION	FORM 990, PART VI, SECTION B, LINES 15A AND 15B THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, THE HSC FOUNDATION, TO DETERMINE COMPENSATION OF THE ORGANIZATION'S CEO. IN ADDITION, THE ORGANIZATION DETERMINES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION, AS DISCUSSED BELOW. THE ORGANIZATION AND HSC FOUNDATION BOTH USE A FOUR STEP APPROACH TO EXECUTIVE COMPENSATION: 1. THE EXECUTIVE COMMITTEE IS MADE UP OF INDEPENDENT BOARD MEMBERS WITHOUT A CONFLICT OF INTEREST. THE COMMITTEE ESTABLISHES AND DETERMINES THE REASONABLENESS OF TOTAL COMPENSATION FOR THE SYSTEM'S DISQUALIFIED EXECUTIVES AND FORWARDS PROPOSED COMPENSATION TO THE FULL BOARD FOR APPROVAL. 2. PERIODICALLY, THE EXECUTIVE COMMITTEE WILL ENGAGE AN INDEPENDENT CONSULTANT TO PREPARE A DETAILED WRITTEN REPORT ON APPROPRIATE COMPARABILITY DATA FOR COMPARABLE POSITIONS. 3. THE EXECUTIVE COMMITTEE REVIEWS AND RELIES UPON THE REPORT OF THE INDEPENDENT CONSULTANT, ALONG WITH OTHER INDIVIDUAL AND MARKET DATA, THEN DEBATES AND FULLY DOCUMENTS ITS DECISION ABOUT WHAT IS REASONABLE COMPENSATION FOR DISQUALIFIED EXECUTIVES. 4. ONCE THE EXECUTIVE COMMITTEE DEVELOPS EXECUTIVE COMPENSATION RECOMMENDATIONS, THEY ARE PRESENTED TO THE SYSTEM'S FULL BOARD FOR APPROVAL. EFFECTIVE SEPTEMBER 1, 2019, CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL) BECAME THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. COMMENCING IN 2020, THE ORGANIZATION AND ITS AFFILIATES WILL ADOPT THE EXECUTIVE COMPENSATION PRACTICE AND APPROVAL PROCESS OF CHILDREN'S NATIONAL MEDICAL CENTER.
REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC	FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
OTHER CHANGES IN NET ASSETS OR FUND BALANCES	FORM 990, PART XI, LINE 9 Change in fair value of interest rate swap $23,644 Business Combination - Fair Value Adjustment $19,266,687 --------------------------------------------- ------------- Total $19,290,331

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2019

Open to Public Inspection

Name of the organization

The Hospital for Sick Children

Employer identification number

53-0204670

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

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)The HSC Foundation 111 Michigan Avenue NW Washington,DC20010 52-1346603	Healthcare	DC	501(c)(3)	12-III FI	CNMC		No
(2)Hlth Svcs for Children W Spec Needs 111 Michigan Avenue NW Washington,DC20010 52-1862406	Healthcare	DC	501(c)(3)	10	HSC Fndn		No
(3)2013 Holdings Inc 111 Michigan Avenue NW Washington,DC20010 27-2882469	Holding Co.	DC	501(c)(2)	N/A	HSC Fndn		No
(4)CHILDREN'S HOSPITAL FOUNDATION 111 MICHIGAN AVENUE NW Washington,DC20010 52-1640402	Fundraising	DC	501(c)(3)	7	CNMC		No
(5)CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVENUE NW Washington,DC20010 52-1640403	Healthcare	DC	501(c)(3)	12-III FI	NA		No
(6)SAFE KIDS WORLDWIDE 1255 23rd Street NW Washington,DC20037 52-1627574	INJURY PRVNTN	DC	501(c)(3)	7	CNMC		No
(7)CHILDREN'S HOSPITAL SELF-INSURANCE TRUST 111 MICHIGAN AVENUE NW Washington,DC20010 52-1640399	Insurance	DC	501(c)(3)	12-III FI	CH		No
(8)CHILDREN'S HOSPITAL 111 MICHIGAN AVENUE NW Washington,DC20010 53-0196580	Healthcare	DC	501(c)(3)	3	CNMC		No
(9)BRAINY CAMPS ASSOCIATION 111 MICHIGAN AVENUE NW Washington,DC20010 27-1547370	Child Camps	DC	501(c)(3)	12-I	CH		No
(10)CHILDREN'S NAT'L ADVOC & PUBLIC POLICY 111 MICHIGAN AVENUE NW Washington,DC20010 27-1564354	Advocacy	DC	501(c)(3)	12-II	CNMC		No
(11)CHILDREN'S SCHOOL SERVICES 111 MICHIGAN AVENUE NW Washington,DC20010 81-4291601	Nursing Svcs	DC	501(c)(3)	12-I	CNMC		No
(12)CHILDREN'S RESEARCH INSTITUTE 111 MICHIGAN AVENUE NW Washington,DC20010 52-1654453	Research	DC	501(c)(3)	10	CNMC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2019

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(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
(1) CPA 111 MICHIGAN AVE NW WASH,DC20010 52-2072589	HEALTH CARE	DC	NA	N/A
(2) 5253 NMTC LLC 111 MICHIGAN AVE NW WASH,DC20010 83-2873855	PROPERTY MGMT	DC	NA	N/A
(3) 5253 HTC LLC 111 MICHIGAN AVE NW WASH,DC20010 83-3044006	PROPERTY MGMT	DC	NA	N/A
(4) 54 NMTC LLC 111 MICHIGAN AVE NW WASH,DC20010 83-3358685	PROPERTY MGMT	DC	NA	N/A
(5) 54 HTC LLC 111 MICHIGAN AVE NW WASH,DC20010 83-3385522	PROPERTY MGMT	DC	NA	N/A

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) CHILDREN'S NATIONAL HEALTH NETWORK 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1996521	HEALTH CARE	DC	NA	C Corp				No
(2) BEARACUDA RE PO BOX 69 KY1-1102 GRAND CAYMAN CJ	REINSURANCE	CJ	NA	C Corp				No
(3) PEDIATRIC HEALTH NETWORK INC 111 MICHIGAN AVENUE NW Washington,DC20010 83-3415276	HEALTH CARE	DC	NA	C Corp				No
(4) BUILDING 5253 MANAGING MEMBER LLC 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 83-2081690	PROPERTY MGMT	DC	NA	C CORP				No
(5) BUILDING 54 MANAGING MEMBER LLC 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 83-3272918	PROPERTY MGMT	DC	NA	C CORP				No

Schedule R (Form 990) 2019

Page 3

Part V

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

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

Yes

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

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

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

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

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

Yes

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

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

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

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

Yes

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

Yes

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

Yes

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

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) 2019

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2019

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2019

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE HOSPITAL FOR SICK CHILDREN, DBA THE HSC PEDIATRIC CENTER ("HSCPC"), PROVIDES QUALITY CARE FOR YOUTH WITH SPECIAL HEALTH CARE NEEDS IN THE WASHINGTON, D.C. AND BALTIMORE AREAS.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	6
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	5
5	Total number of individuals employed in calendar year 2019 (Part V, line 2a) ......	5	319
6	Total number of volunteers (estimate if necessary) .............	6	177
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	75,973	175,413
9	Program service revenue (Part VIII, line 2g) .........	32,134,383	34,636,119
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	61,055	69,153
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	654,249	1,003,839
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	32,925,660	35,884,524
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,200	175
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)	17,489,024	20,758,193
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)....	20,253,841	21,200,371
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	37,744,065	41,958,739
19	Revenue less expenses. Subtract line 18 from line 12.......	-4,818,405	-6,074,215
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	20,170,811	40,262,009
21	Total liabilities (Part X, line 26).............	36,417,947	42,996,633
22	Net assets or fund balances. Subtract line 21 from line 20.....	-16,247,136	-2,734,624

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 26,042,166 including grants of $ 175 ) (Revenue $ 34,636,119 )
	TO PROVIDE QUALITY REHABILITATIVE AND TRANSITIONAL CARE FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IN A SUPPORTIVE, CULTURALLY COMPETENT, RESPECTFUL ENVIRONMENT, AND TO PARTICIPATE IN RELATED LOCAL, REGIONAL, AND NATIONAL PROJECTS WITH GOVERNMENT, PRIVATE, AND PHILANTHROPIC ORGANIZATIONS. IN 2019, HSCPC PROVIDED 9,552 DAYS OF CARE. HSCPC ALSO PROVIDED ON AN OUTPATIENT BASIS MEDICAL CARE, APPROXIMATELY 22,288 VISITS IN 2019.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses26,042,166

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	901,710	4,234,077	293,767

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W-2/1099-MISC)	(E) Reportable compensation from related organizations (W-2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Steve Riley........................................................................ Board Member	1.0 .......................0.0	X	0	0	0

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

f	All other contributions, gifts, grants, and similar amounts not included above		1f	175,413

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		175,413

		Business Code
2a	PATIENT SERVICE REVENUE	621300	32,743,985	32,743,985	0	0
b	DSH REVENUE	621300	1,892,134	1,892,134	0	0
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		34,636,119

3 Investment income (including dividends, interest, and othersimilar amounts) ......			69,153			69,153
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			0
		(ii) Personal	(i) Real
6a	Gross rents		13,896	6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	13,896	6c
d	Net rental income or (loss).......			13,896			13,896
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)			7c
d	Net gain or (loss).........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	0
b	Less: direct expenses ...		8b	0
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0
10a	Gross sales of inventory, less returns and allowances ..
			10a	0
b	Less: cost of goods sold ..		10b	0
c	Net income or (loss) from sales of inventory..			0
Business Code			Miscellaneous Revenue
11a	CAFETERIA VENDING		722210	104,486	0	0	104,486
b	SETTLEMENT INTEREST		900099	699,927	0	0	699,927
c	MISCELLANEOUS		900099	185,530	0	0	185,530
d	All other revenue ....
e	Total. Add lines 11a–11d ......			989,943
12	Total revenue. See instructions.....			35,884,524	34,636,119	0	1,072,992

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	175	175
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............	0
4	Benefits paid to or for members .......	0
5	Compensation of current officers, directors, trustees, and key employees ...........	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	0
7	Other salaries and wages........	17,425,962	15,983,812	1,442,150
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	589,003	531,936	57,067
9	Other employee benefits .......	1,504,118	1,133,046	371,072
10	Payroll taxes ...........	1,239,110	1,131,668	107,442
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	0
c	Accounting ...........	0
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	10,273		10,273
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	3,766,887	2,204,074	1,562,813
12	Advertising and promotion ....	2,064	2,064
13	Office expenses .......	142,111	85,667	56,444
14	Information technology ......	291,294	230,358	60,936
15	Royalties ..	0
16	Occupancy ...........	1,242,688	568,234	674,454
17	Travel ............	87,856	50,813	37,043
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0
19	Conferences, conventions, and meetings ....	51,084	15,205	35,879
20	Interest ...........	346,520		346,520
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization ..	1,372,540		1,372,540
23	Insurance ...	-55,252	231,013	-286,265
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	SHARED SERVICE ALLOCATION	9,451,180	0	9,451,180	0
b	BAD DEBT EXPENSE	1,943,222	1,943,222	0	0
c	MEDICAL SUPPLIES	1,041,318	1,041,318	0	0
d	FOOD	572,400	532,891	39,509	0
e	All other expenses	934,186	356,670	577,516
25	Total functional expenses. Add lines 1 through 24e	41,958,739	26,042,166	15,916,573	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 ........			0	1	0
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			0	3	0
4	Accounts receivable, net .............			5,663,525	4	6,587,436
5	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			165,912	8	184,859
9	Prepaid expenses and deferred charges ......			676,982	9	675,585
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	29,847,517
b	Less: accumulated depreciation	10b	479,576	9,658,793	10c	29,367,941
11	Investments—publicly traded securities .			112,935	11	49,392
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 ..			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			3,892,664	15	3,396,796
16	Total assets. Add lines 1 through 15 (must equal line 33)...			20,170,811	16	40,262,009

17	Accounts payable and accrued expenses .....	2,765,584	17	3,251,884
18	Grants payable ...	0	18	0
19	Deferred revenue .........	0	19	0
20	Tax-exempt bond liabilities .........	9,137,459	20	8,791,371
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ..	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	24,514,904	25	30,953,378
26	Total liabilities. Add lines 17 through 25..	36,417,947	26	42,996,633

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-16,477,642	27	-2,954,858
28	Net assets with donor restrictions ...........	230,506	28	220,234
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-16,247,136	32	-2,734,624
33	Total liabilities and net assets/fund balances ........	20,170,811	33	40,262,009