TY 2018 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) RUSSELL C BROWN...................................................................... TRUSTEE	3.0 ................. 0.0	X
(2) W VERNON BURKE JR...................................................................... TRUSTEE	3.0 ................. 1.0	X
(3) HAROLD D CARTER...................................................................... VICE CHAIRMAN	4.0 ................. 1.0	X	X
(4) RONALD L CARTER...................................................................... TRUSTEE	4.0 ................. 1.0	X
(5) STEPHEN F CROSS...................................................................... TRUSTEE	3.0 ................. 1.0	X
(6) KENNETH C CURRY...................................................................... TRUSTEE	2.0 ................. 0.0	X
(7) DAN F DAVIDSON...................................................................... TRUSTEE	4.0 ................. 0.0	X
(8) JOSEPH M DEALY JR...................................................................... TRUSTEE	3.0 ................. 0.0	X
(9) CLAUDE O ERVIN...................................................................... TRUSTEE	4.0 ................. 0.0	X
(10) JERRY C GILMORE...................................................................... VP & ASSIST SECRETARY	4.0 ................. 1.0	X	X
(11) W M GOWER...................................................................... TRUSTEE	4.0 ................. 0.0	X
(12) TOM L HIGGINS...................................................................... TRUSTEE	3.0 ................. 0.0	X
(13) BRACK JONES JR...................................................................... TRUSTEE	3.0 ................. 0.0	X
(14) JAMES E LANEY...................................................................... VP & TREASURER	4.0 ................. 0.0	X	X
(15) ROBERT C MADISON...................................................................... TRUSTEE	3.0 ................. 0.0	X
(16) BERT V MASSEY II...................................................................... TRUSTEE	5.0 ................. 0.0	X
(17) DOUGLAS S MAXEY...................................................................... TRUSTEE	3.0 ................. 0.0	X

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) JOHN C NOBLES........................................................................ TRUSTEE	4.0 .......................0.0	X					0	0	0
(19) ROBERT A NORTHCUTT PhD........................................................................ TRUSTEE	4.0 .......................1.0	X					0	0	0
(20) JAMES D NYFELERSR........................................................................ TRUSTEE	3.0 .......................0.0	X					0	0	0
(21) LYNDON L OLSON JR........................................................................ CHAIRMAN & TRUSTEE	6.0 .......................1.0	X	X				0	0	0
(22) JAMES C PENN........................................................................ TRUSTEE	4.0 .......................0.0	X					0	0	0
(23) MICHAEL K PICKENS........................................................................ TRUSTEE	4.0 .......................0.0	X					0	0	0
(24) RONALD L SKAGGS........................................................................ VP & SECRETARY	4.0 .......................0.0	X	X				0	0	0
(25) JEFF W SMITH........................................................................ TRUSTEE	4.0 .......................0.0	X					0	0	0
(26) GUY F STOVALL JR........................................................................ VP & ASSIST. SECRETARY	3.0 .......................0.0	X	X				0	0	0
(27) JOE H TYDLASKA........................................................................ TRUSTEE	3.0 .......................0.0	X					0	0	0
(28) H FINLAY WATKINS........................................................................ TRUSTEE	4.0 .......................0.0	X					0	0	0
(29) RALPH WAYNE........................................................................ TRUSTEE	3.0 .......................0.0	X					0	0	0
(30) MICHAEL L WIGGINS PhD........................................................................ TRUSTEE	3.0 .......................1.0	X					0	0	0
(31) JOHN E WOOD........................................................................ TRUSTEE	3.0 .......................0.0	X					0	0	0
(32) M DOUGLAS ADKINS........................................................................ VICE CHAIRMAN	4.0 .......................1.0	X	X				0	0	0
(33) W EUGENE BROOKSHIRE........................................................................ TRUSTEE	3.0 .......................1.0	X					0	0	0
(34) LEE DRAIN........................................................................ VICE CHAIRMAN(DECEASED 2/2019)	4.0 .......................1.0	X	X				0	0	0
(35) DANIEL H CHAPMAN........................................................................ VP (Resigned 2/2019)	4.0 .......................1.0	X	X				0	0	0
(36) THOMAS F GRIFFIN........................................................................ TRUSTEE (RESIGNED 1/2019)	3.0 .......................0.0	X					0	0	0
(37) ROBERT L WALKER........................................................................ PRESIDENT/CEO	40.0 .......................1.0		X				998,716	0	24,478
(38) MARK G BATEMAN........................................................................ SR VP, PUBLIC RELATIONS	35.0 .......................5.0		X				417,804	0	44,891
(39) MATTHEW S CHANCE........................................................................ SR VP, OPERATIONS	40.0 .......................1.0		X				332,387	0	52,945
(40) LORI L DALTON........................................................................ SR VP, GENERAL COUNSEL	40.0 .......................2.0		X				512,337	0	52,068
(41) WILLIAM R HUSTON........................................................................ SR VP, CFO	40.0 .......................2.0		X				617,905	0	29,320
(42) FREDRIC D RICHMOND........................................................................ SR VP, CHIEF INVESTMENT OFFICE	40.0 .......................0.0		X				423,512	0	48,222
(43) STEPHANIE K BRIGGER........................................................................ VP, DEVELOPMENT	35.0 .......................5.0		X				219,106	0	80,807
(44) LESLIE A CLONCH........................................................................ VP, CHIEF INFORMATION OFFICER	40.0 .......................0.0		X				405,585	0	50,722
(45) ASHLEY C GIVENS........................................................................ VP, DEVELOPMENT/EVENTS	35.0 .......................5.0		X				131,994	0	48,635
(46) ELLEN E HAYNES........................................................................ VP, MAJOR GIFTS	35.0 .......................5.0		X				209,255	0	22,882
(47) JEREMY L HOWELL........................................................................ VP, NORTH CAMPUS	40.0 .......................0.0		X				237,165	0	44,743
(48) JENNY J JOHNSON........................................................................ VP, REVENUE CYCLE	40.0 .......................0.0		X				176,116	0	28,985
(49) DONALD E KATZ........................................................................ VP, FACILITIES	40.0 .......................0.0		X				314,172	0	139,293
(50) KRISTINA L KEEVER-SMITH........................................................................ VP, INVESTMENTS	40.0 .......................2.0		X				255,087	0	43,203
(51) DEBRA A SAYLES RN........................................................................ VP & CNO	40.0 .......................0.0		X				355,783	0	11,322
(52) CONNIE B WRIGHT........................................................................ VP, HR (RESIGNED 6/2020)	40.0 .......................0.0		X				280,157	0	36,147
(53) JEAN A ALLEN........................................................................ CONTROLLER	40.0 .......................2.0		X				193,617	0	35,095
(54) DANIEL J SUCATO MDMS........................................................................ CHIEF OF STAFF (SEE SCH J**)	40.0 .......................1.0			X			932,098	33,600	367,261
(55) B STEPHENS RICHARDS MD........................................................................ CMO (SEE SCH j*)	40.0 .......................0.0			X			883,675	0	479,112
(56) LORI KAROL MD TERM 62020........................................................................ ASSIST COS & COQ (SEE SCH J*)	40.0 .......................2.0			X			847,487	35,200	333,790
(57) KARL E RATHJEN MD........................................................................ ASSIST COS (SEE SCH J**)	35.0 .......................5.0			X			518,880	32,900	155,091
(58) PHILIP L WILSON MD........................................................................ ASSIST COS (SEE SCH J**)	40.0 .......................2.0			X			722,944	45,500	167,994
(59) MOLLY E DEMPSEY MD........................................................................ CMIO (SEE SCH J**)	40.0 .......................0.0			X			596,316	0	192,340
(60) AMY L MCINTOSH MD........................................................................ ORTHOPEDIC SURGEON	40.0 .......................1.0				X		766,243	40,000	57,773
(61) BRANDON A RAMO MD........................................................................ ORTHOPEDIC SURGEON	40.0 .......................1.0				X		744,256	54,850	50,722
(62) ROBERT L WIMBERLY MD........................................................................ ORTHOPEDIC SURGEON	40.0 .......................1.0				X		739,438	47,850	28,288
(63) HENRY B ELLIS MD........................................................................ ORTHOPEDIC SURGEON	40.0 .......................1.0				X		734,460	52,950	55,722
(64) ANTHONY I RICCIO MD........................................................................ ORTHOPEDIC SURGEON	40.0 .......................1.0				X		720,646	40,300	52,967
(65) JC MONTGOMERY JR........................................................................ PRESIDENT EMERITUS (RET. 6/18)	8.0 .......................0.0					X	304,014	0	2,806
(66) JOHN A HERRING MD........................................................................ CHIEF OF STAFF EMERITUS	40.0 .......................0.0					X	563,885	0	22,057
(67) CHARLES E JOHNSTON MD........................................................................ ASSIST COS EMERITUS	40.0 .......................0.0					X	737,307	0	22,287
(68) LAWSON A COPLEY MD........................................................................ FORMER CMIO (SEE SCH J**)	1.0 .......................40.0					X	27,772	697,809	231,024
(69) JOHN G BIRCH MD........................................................................ FORMER ORTHOPEDIC SURGEON	0.0 .......................0.0					X	341,156	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
HCBECK LTD, 1807 ROSS STE 500 DALLAS,TX752018006	CONSTRUCTION	65,474,254
UTSW MEDICAL CENTER, LOCK BOX 845477 DALLAS,TX752845477	RESEARCH & MEDICAL	2,034,146
HKS INC, POB 731121 DALLAS,TX753731121	ARCHITECTURAL	1,821,323
VAN BERKOM ASSOC, 1130 SHERBROOKE ST WEST STE 1005 MONTREAL,QUEBECH3A 2M8 CA	INVESTMENT MNGMNT	1,323,833
NORTHERN TRUST CO, 500 S LASALLE CHICAGO,IL60675	INVESTMENT MNGMNT	1,213,756
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 51

- 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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2018

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(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 2018 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—2018. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2017. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2018. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2017. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 3

Part III

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2014	(b) 2015	(c) 2016	(d) 2017	(e) 2018	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

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

Section C. Computation of Public Support Percentage

Public support percentage for 2018 (line 8, column (f) divided by line 13, column (f)) .........

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

Section D. Computation of Investment Income Percentage

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

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

19a

331/3% support tests—2018. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2017. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990 or 990-EZ) 2018

Page 4

Part IV

Supporting Organizations

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

Section A. All Supporting Organizations

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

10a

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

10a

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

10b

Schedule A (Form 990 or 990-EZ) 2018

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

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

11a

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

11b

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

11c

Section B. Type I Supporting Organizations

Yes

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

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

Yes

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2018

Page 6

Part V

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

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

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

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

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

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

Schedule A (Form 990 or 990-EZ) 2018

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2018 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

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

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

Schedule A (Form 990 or 990-EZ) 2018

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

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

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2018

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

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

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

Name of organization Texas Scottish Rite Hospital for Crippled Children

Part I	Contributors (See instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2018)

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

Page 3

Name of organization Texas Scottish Rite Hospital for Crippled Children		Employer identification number 75-0818178

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

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

Page 4


Name of organization Texas Scottish Rite Hospital for Crippled Children			Employer identification number 75-0818178
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

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

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

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

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

OMB No. 1545-0047

2018

Open to Public
Inspection

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

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

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

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

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

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

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

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I-A

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

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

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

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

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2018

Page 2

Part II-A

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

A Check SchCMd Bullet

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

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

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

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

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

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2018

Page 3

Part II-B

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

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

(a)

Yes

(b)

Amount

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

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

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

Yes

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

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

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

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

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

Yes

14,773

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

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

Yes

162,023

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

176,796

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

Return Reference	Explanation
PART II-B, LINE 1B AND 1G	MANAGEMENT ACTIVITIES ROBERT WALKER AND LORI DALTON MET WITH MEMBERS OF CONGRESS AND/OR STAFF AND HAD ASSOCIATED EXPENSES INCLUDING TRAVEL AND ASSOCIATED COMPENSATION IN THE AMOUNT OF $14,773.
PART II-B, LINE 1I	OTHER ACTIVITIES PER CHILDREN'S HOSPITAL ASSOCIATION, DALLAS REGIONAL CHAMBER AND TEXAS HOSPITAL ASSOCIATION, $17,697 OF THE HOSPITAL'S DUES WERE ALLOCATED TO LOBBYING. THE HOSPITAL RETAINED THE SERVICES OF GREENBERG TRAURIG LLP TO MEET WITH VARIOUS STATE AND FEDERAL LEGISLATORS OR STAFF AND INCURRED EXPENSES IN THE AMOUNT OF $144,326.

Schedule C (Form 990 or 990EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2018

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	164,029,028	159,673,309	125,526,503	112,800,210	120,595,294
b	Contributions ...	1,935,008,594	18,347,909	32,469,355	8,057,633	6,843,791
c	Net investment earnings, gains, and losses	63,090,266	5,735,433	11,892,042	8,144,805	-7,546,608
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	100,851,484	19,727,623	10,214,591	3,476,145	7,092,267
f	Administrative expenses ....
g	End of year balance ......	2,061,276,404	164,029,028	159,673,309	125,526,503	112,800,210

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

Board designated or quasi-endowment SchDMd Bullet

94.000 %

Permanent endowment SchDMd Bullet

4.000 %

Temporarily restricted endowment SchDMd Bullet

2.000 %

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

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

Yes

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

3a(i)

Yes

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

3a(ii)

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 .....	47,111,438		47,111,438
b	Buildings ....	296,156,224	109,359,446	186,796,778
c	Leasehold improvements	1,661,615	914,432	747,183
d	Equipment ....	134,876,121	82,136,941	52,739,180
e	Other .....	184,040		184,040
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				287,578,619

Schedule D (Form 990) 2018

Page 3

Part VII

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

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

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes	0
ACCRUED PENSION COSTS	80,287,660
MANAGEMENT BENEFIT PLAN	12,971,009
EMPLOYEE BENEFITS PAYABLE	1,605,360
RESERVE FOR MALPRACTICE CLAIMS	1,137,553
CHARITABLE GIFT ANNUITIES	3,700,973
TRUST OBLIGATIONS	9,258,355
RESERVE FOR RESTORATION PLAN	47,096,916
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	156,057,826
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2018

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
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

ENDOWMENT FUNDS

SCHEDULE D, PART V, LINE 1B, COL (A) IN 2019, MANAGEMENT DETERMINED THAT A MAJOR PORTION OF THE ORGANIZATION'S UNRESTRICTED FUNDS, SHOULD HAVE BEEN BOARD DESIGNATED. AS A RESULT, $1.9 BILLION HAS BEEN INCLUDED ON LINE 1B, COLUMN (A) TO REFLECT THIS DECISION. INTENDED USE OF ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 THE INCOME FROM THE ORGANIZATION'S FUNDS WITH DONOR RESTRICTIONS AND FUNDS BOARD DESIGNATED ARE USED TO SUPPORT THE OPERATIONS OF THE MEDICAL, RESEARCH AND EDUCATION PROGRAMS OF THE HOSPITAL.

CONSOLIDATED AUDIT FOOTNOTE 16 - INCOME TAXES

SCHEDULE D, PART X, LINE 2 U.S. GAAP REQUIRES MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAX AUTHORITY. THE HOSPITAL HAS ANALYZED THE TAX POSTIONS TAKEN AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2019 AND 2018, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOSPITAL BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE TAX AUTHORITIES FOR YEARS PRIOR TO 2016.

Schedule D (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization
Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I

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

For grantmakers. Does the organization maintain records to substantiate the amount of its grants and

other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used

to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

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

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	East Asia and the Pacific	Investments		74,622
	Europe (Including Iceland and Greenland)	Investments		691,545
	North America	Investments		5,362
	Central America and the Caribbean	Investments		204,103,143
	South America	Investments		78
	Europe (Including Iceland and Greenland)	Investments	INVEST MGMT FEES	3,357
	East Asia and the Pacific	Program Services	CONFERENCES, TRAINING	65,551
	Europe (Including Iceland and Greenland)	Program Services	CONFERENCES, TRAINING	86,582
	North America	Program Services	CONFERENCES, TRAINING	24,177
	Central America and the Caribbean	Program Services	CONFERENCES, TRAINING	4,486
	South America	Program Services	CONFERENCES, TRAINING	8,398
	Middle East and North Africa	Program Services	CONFERENCES, TRAINING	29,300
	South Asia	Program Services	CONFERENCES, TRAINING	15,002




3a	Sub-total .....			205,111,603
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)			205,111,603

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

Schedule F (Form 990) 2018

Page 2

Part II

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

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

2	Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......
3	Enter total number of other organizations or entities .......................

Schedule F (Form 990) 2018

Schedule F (Form 990) 2018Page 3

Part III

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

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2018

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2018

Page 5

Part V

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

ReturnReference	Explanation
PART I, LINE 3, COLUMN F	ACTIVITIES PER REGION THESE AMOUNTS REPRESENT $204,874,750 OF INVESTMENTS AT YEAR END AND $236,853 IN EXPENDITURES BASED ON THE ACCRUAL METHOD OF ACCOUNTING. SEE DETAIL BY REGION BELOW: INVESTMENTS BY REGION: EAST ASIA AND THE PACIFIC $ 74,622 EUROPE $ 691,545 NORTH AMERICA $ 5,362 SOUTH AMERICA $ 78 CENTRAL AMERICA & THE CARIBBEAN $ 204,103,143 TOTAL $ 204,874,750 EXPENSE BY REGION: EAST ASIA AND THE PACIFIC $ 65,551 EUROPE $ 89,939 NORTH AMERICA $ 24,177 CENTRAL AMERICA & THE CARIBBEAN $ 4,486 SOUTH AMERICA $ 8,398 MIDDLE EAST & NORTH AMERICA $ 29,300 SOUTH ASIA $ 15,002 TOTAL $ 236,853

Schedule F (Form 990) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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

2018

Open to Public Inspection

Name of the organization
Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I

Fundraising Activities. Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990 or 990-EZ) 2018

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 AUCTION 10/19 (event type)	(b) Event #2 AUCTION 10/18 (event type)	(c) Other events 92 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	664,653	470,847	2,475,647	3,611,147
2	Less: Contributions . . . .	583,653	400,200	1,933,070	2,916,923
3	Gross income (line 1 minus line 2) . . . . . .	81,000	70,647	542,577	694,224

4	Cash prizes . . . . .
5	Noncash prizes . . . .			33,775	33,775
6	Rent/facility costs . . . .			140,117	140,117
7	Food and beverages . . .	2,127	4,778	190,004	196,909
8	Entertainment . . . .	11,650		200	11,850
9	Other direct expenses . . .	53,096	160,727	462,655	676,478
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				1,059,129
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-364,905

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .			16,100	16,100

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

16,100

Enter the state(s) in which the organization conducts gaming activities: TX

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

THE STATE OF TEXAS DOES NOT REQUIRE SUCH A LICENSE FOR OCCASSIONAL GAMING ACTIVITIES (UP TO TWO PER YEAR).

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990 or 990-EZ) 2018

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

100.000 %

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

JENNIFER DEASON CONTROLLER TSRHC

Address

2222 WELBORN ST
DALLAS,TX75219

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

N/A

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

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 1000 %

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? . . . . . . . . .

Yes

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

Yes

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) . . .	20,510,206		20,510,206	9.420 %
b	Medicaid (from Worksheet 3, column a) . . . . .	62,125,140	28,145,174	33,979,966	15.600 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	82,635,346	28,145,174	54,490,172	25.020 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	11,483,592		11,483,592	5.270 %
f	Health professions education (from Worksheet 5) . . .	1,459,204	56,753	1,402,451	0.640 %
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .	18,677,084	1,027,653	17,649,431	8.100 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	2,112,534		2,112,534	0.970 %
j	Total. Other Benefits . .	33,732,414	1,084,406	32,648,008	14.980 %
k	Total. Add lines 7d and 7j .	116,367,760	29,229,580	87,138,180	40.000 %

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

Schedule H (Form 990) 2018

Page

Part II

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

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
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	821,346	821,346	0.380 %
10	Total	821,346	821,346	0.380 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

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. ......

5,896,018

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).....

2,697

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

2,310

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

387

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 2018

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)							Other (describe)
1	TEXAS SCOTTISH RITE HOSPITAL 2222 WELBORN ST DALLAS,TX75219 www.scottishritehospital.org 000054	X	X	X	X	X	ORTHOPEDIC, neurodevelopment & musculoskeletal

Schedule H (Form 990) 2018

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	TX SCOT RITE HOSPITAL FOR 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...............

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

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): SEE SCHEDULE H, PART V, SECTION C

Other website (list url):

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

Other (describe in Section C)

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

Yes

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

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

If "Yes" (list url):

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

10b

Yes

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2018

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	TX SCOT RITE HOSPITAL FOR 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 999.99%

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.scottishritehospital.org

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

www.scottishritehospital.org

A plain language summary of the FAP was widely available on a website (list url):
www.scottishritehospital.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) 2018

Page 6

Part VFacility Information (continued)

Billing and Collections

	TX SCOT RITE HOSPITAL FOR 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

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

Processed incomplete and complete FAP applications

Made presumptive eligibility determinations

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2018

Page 7

Part VFacility Information (continued)

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

	TX SCOT RITE HOSPITAL FOR 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) 2018

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 5	TSRHC AND BKD CONSULTING, LLP ("BKD") COLLABORATED TO CONDUCT AND ASSESS THE NEEDS OF THE COMMUNITY IN PRODUCING THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT. BKD IS ONE OF THE LARGEST CPA AND ADVISORY FIRMS IN THE UNITED STATES, WITH APPROXIMATELY 2,000 PARTNERS AND EMPLOYEES IN 40 OFFICES. BKD SERVES MORE THAN 900 HOSPITALS AND HEALTH CARE SYSTEMS ACROSS THE COUNTRY. PRIMARY DATA WAS OBTAINED FROM PATIENT SURVEYS, PATIENT FOCUS GROUPS AND KEY STAKEHOLDERS. BKD CONDUCTED A HEALTH SURVEY THAT WAS SENT IN ELECTRONIC FORMAT, TO MORE THAN 9,000 CURRENT AND FORMER TSRHC PATIENTS. TWO HUNDRED FORTY-SEVEN PATIENT FAMILIES PROVIDED INPUT THROUGH THE HEALTH SURVEY, WHICH WAS AVAILABLE IN BOTH ENGLISH AND SPANISH. SEVENTY-TWO PERCENT OF THE SURVEY RESPONDENTS INDICATED THEY LIVED IN THE CHNA COMMUNITY. IN ADDITION, TSRHC CONDUCTED TWO PATIENT FOCUS GROUPS TO SOLICIT INPUT FROM PATIENTS' FAMILIES REGARDING THE HEALTH NEEDS OF THEIR CHILDREN. THE PATIENT FOCUS GROUPS WERE CONDUCTED ON JUNE 10, 2019 AND JUNE 11, 2019 AT TSRHC'S DALLAS CAMPUS AND FRISCO CAMPUS. NINE QUESTIONS WERE ASKED AND DISCUSSED, THEN UTILIZED TO HELP GATHER DATA FROM THE PARTICIPANTS. INPUT WAS COLLECTED FROM 25 KEY STAKEHOLDERS THROUGH IN-PERSON INTERVIEWS AND ELECTRONIC SURVEYS IN JUNE 2019. THESE KEY STAKEHOLDERS WERE DETERMINED BASED ON THEIR SPECIALIZED KNOWLEDGE OR EXPERTISE IN PUBLIC HEALTH, THEIR INVOLVEMENT WITH UNDERSERVED AND MINORITY POPULATIONS OR THEIR AFFILIATION WITH LOCAL GOVERNMENT, SCHOOLS AND INDUSTRY. THESE INTERVIEWS ARE INTENDED TO ASCERTAIN OPINIONS AMONG INDIVIDUALS WHO ARE LIKELY TO BE KNOWLEDGEABLE ABOUT THE COMMUNITY AND INFLUENTIAL OVER THE OPINIONS OF OTHERS ABOUT HEALTH CONCERNS IN THE COMMUNITY. SECONDARY DATA ASSESSED FACTORS SUCH AS DEMOGRAPHICS, SOCIOECONOMIC INDICATORS (HOUSEHOLD INCOME AND POVERTY, INSURANCE COVERAGE AND CHILDREN LIVING IN SINGLE-PARENT HOUSEHOLDS) AND COMMUNITY HEALTH STATUS INDICATORS RELEVANT TO THE SERVICES PROVIDED BY TSRHC (RATES FOR CONDITIONS TREATED BY TSRHC, NUMBER OF CHILDREN IN TEXAS WITH DISABILITIES AND RATE FOR HEALTH ISSUES IDENTIFIED BY STAKEHOLDERS AND PATIENTS SUCH AS ASTHMA AND OBESITY). SOME OF THE SECONDARY DATA SOURCES, INCLUDED BUT NOT LIMITED TO TEXAS DEMOGRAPHIC CENTER, TEXAS KIDS COUNT DATA, ROBERT WOOD JOHNSON FOUNDATION AND TEXAS DEPARTMENT OF STATE HEALTH SERVICES. A LIST OF IDENTIFIED NEEDS WAS DEVELOPED USING FINDINGS OBTAINED THROUGH THE COLLECTION OF PRIMARY AND SECONDARY DATA. THE FOLLOWING FACTORS WERE USED TO PRIORITIZE THE IDENTIFIED HEALTH NEEDS: SIZE OF THE PROBLEM, SERIOUSNESS OF THE PROBLEM, IMPACT OF THE ISSUES ON VULNERABLE POPULATIONS, HOW IMPORTANT THE ISSUE IS TO THE COMMUNITY, AND THE PREVALENCE OF COMMON THEMES. MEMBERS OF TSRHC'S MANAGEMENT PROVIDED INPUT REGARDING RATINGS FOR THE FACTORS DESCRIBED ABOVE.
PART V, SECTION B, LINE 6B	TSRHC ENGAGED THE SERVICES OF BKD TO ASSESS THE NEEDS OF THE COMMUNITY AND COLLABORATED WITH BKD IN PRODUCING THE HOSPITAL'S CHNA REPORT. PART V, SECTION B, LINE 7A HTTPS://SCOTTISHRITEFORCHILDREN.ORG/GETATTACHMENT/B6C3EAA2-1811-41B6-A4B8- 408CFDF02ECB/2019-COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 11	NEEDS IDENTIFIED IN RECENTLY CONDUCTED CHNA AS PART OF THE CHNA, TSRHC AND BKD CONDUCTED THE ASSESSMENT FROM MAY 2019 TO SEPTEMBER 2019. THE PRIMARY AND SECONDARY DATA GATHERED WAS THEN ANALYZED TO IDENTIFY SIGNIFICANT HEALTH NEEDS FOR THE COMMUNITY SERVED BY TSRHC. AS A RESULT OF THE ANALYSIS, EIGHT HEALTH NEEDS WERE IDENTIFIED AS BEING SIGNIFICANT TO THE COMMUNITY. THE IDENTIFIED HEALTH NEEDS WERE SUBSEQUENTLY GROUPED AND PRIORITIZED BY HOSPITAL MANAGEMENT INTO THREE PRIORITY AREAS BASED ON THEIR OVERALL ASSESSMENT OF THE QUALITATIVE AND QUANTITATIVE DATA. TSRHC WILL FOCUS ON THE IDENTIFIED AREAS WHERE THE HOSPITAL CAN MOST EFFECTIVELY USE ITS EXPERTISE AND RESOURCES TO HAVE SIGNIFICANT IMPACT. THESE THREE AREAS ARE: 1. IMPROVE ACCESS TO HEALTH CARE SERVICES 2. IMPROVE COORDINATION OF CARE 3. IMPROVE CHILD HEALTH STATUS TSRHC STRATEGIES FOR IMPROVING ACCESS TO HEALTH CARE SERVICES: A: AFFORDABILITY OF SERVICES/FINANCIAL STRESS NEARLY 235,000 CHILDREN IN THE COMMUNITY UNDER THE AGE OF 19 DO NOT HAVE INSURANCE ACCORDING TO 2017 DATA. MANY OF THE PATIENT SURVEY RESPONDENTS RANKED "AFFORDABILITY OF SERVICES AND FINANCIAL STRESS ON THE FAMILY" AS THE BIGGEST CHALLENGE FACED BY PATIENT SURVEY RESPONDENTS. FAMILIES DESIRED MORE INFORMATION AND INCREASED UNDERSTANDING REGARDING FINANCIAL ASSISTANCE OPTIONS AVAILABLE TO THEM. OUR OBJECTIVE IS TO INCREASE COMMUNITY AND PATIENT FAMILY AWARENESS OF THE FINANCIAL ASSISTANCE AVAILABLE AT TSRHC AND RESOURCES IN THE COMMUNITY. THE ANTICIPATED IMPACT IS FOR MORE PATIENT FAMILIES TO ENROLL IN OUR FINANCIAL ASSISTANCE PROGRAM AND/OR HAVE ACCESS TO RESOURCES FOR INSURANCE COVERAGE. THE STRATEGIES WE WILL BE IMPLEMENTING TO ADDRESS AFFORDABILITY OF SERVICES/FINANCIAL STRESS ARE: 1. CONTINUE OUTREACH AND EDUCATION TO SCHOOLS, PHYSICIAN OFFICES, EDUCATIONAL CONFERENCES, AND FREE/INCOME BASED CLINICS THAT ARE DELIVERING SERVICES AND WORKING IN UNDERSERVED COMMUNITIES 2. IMPROVE AND EXPAND COMMUNICATION OF OUR FINANCIAL ASSISTANCE PROGRAM 3. CONTINUE TO CONNECT PATIENTS TO ORGANIZATIONS THAT PROVIDE RESOURCES FOR INSURANCE COVERAGE RESOURCES/POTENTIAL PARTNERS TSRHC WILL CONTINUE TO DEDICATE INTERNAL RESOURCES AS WELL AS MAINTAIN AND EXPAND COLLABORATIONS WITHIN THE COMMUNITY TO MEET THE PRIORITIZED HEALTH NEED WITH LOCAL SCHOOL DISTRICTS, PHYSICIAN OFFICES, EDUCATIONAL CONFERENCES, FREE/INCOME BASED CLINICS, AND EDUCATE REGARDING RESOURCES AVAILABLE TO IMPROVE ACCESS FOR INSURANCE COVERAGE. B: ACCESS TO SERVICES NORTH TEXAS HAS A LACK OF SPECIALISTS AND SERVICES IN THE UNDERSERVED AREAS OF THE COMMUNITY. THERE IS A SHORTAGE OF PROVIDERS WHO ACCEPT MEDICAID, AND 36.6% OF CHILDREN IN OUR CHNA COMMUNITY ARE ENROLLED IN MEDICAID. PATIENT SURVEY RESPONDENTS RANKED "AVAILABILITY OF SERVICES CLOSE TO HOME" AS THE SECOND HIGHEST RANKED CHALLENGE RELATED TO ACCESS FACED BY PATIENT SURVEY RESPONDENTS. OUR OBJECTIVE IS TO INCREASE COMMUNITY ACCESS AND REDUCE BARRIERS TO OUR SERVICES. THE ANTICIPATED IMPACT IS TO TREAT MORE CHILDREN THAT HAVE LIMITED ACCESS TO CARE WITHIN OUR SCOPE OF SERVICES AROUND THE METROPLEX. THE STRATEGIES WE WILL BE IMPLEMENTING TO INCREASE ACCESS TO SERVICES ARE: 1. CONTINUE TO EVALUATE ADDITIONAL ACCESS POINTS TO INCREASE PATIENT ACCESS TO OUR SERVICES IN UNDERSERVED AREAS 2. FURTHER DEVELOP COMMUNITY PARTNERSHIP WITH NOT-FOR-PROFIT ENTITIES TO INCREASE AWARENESS AND BRING SERVICES OUT TO THE COMMUNITY 3. ELIMINATE BARRIERS TO SCHEDULING APPOINTMENTS AND TIMELY CARE 4. CONTINUE OUTREACH EFFORTS TO BRING AWARENESS OF OUR SERVICES AND EXPAND REACH RESOURCES/POTENTIAL PARTNERS TSRHC WILL CONTINUE TO DEDICATE INTERNAL RESOURCES AS WELL AS MAINTAIN AND EXPAND COLLABORATIONS WITHIN THE COMMUNITY TO MEET THE PRIORITIZED HEALTH NEED WITH LOCAL SCHOOL DISTRICTS, YMCA NORTH TEXAS, YOUTH SPORT GROUPS, PHYSICIAN OFFICES, HEALTH SYSTEMS, URGENT CARE FACILITIES, EDUCATIONAL CONFERENCES AND SCHOOL NURSES. TSRHC STRATEGIES FOR IMPROVING COORDINATION OF CARE: LACK OF COORDINATED CARE CONTINUES TO BE A CHALLENGE FACED BY PATIENT FAMILIES. FEEDBACK FROM THE PATIENT FOCUS GROUPS THAT WERE CONDUCTED HIGHLIGHTED A DESIRE FOR HELP NAVIGATING TREATMENT FOR THEIR CHILD. OUR OBJECTIVE IS TO INCREASE COMMUNICATION AND COORDINATION OF CARE AMONG PROVIDERS AND PATIENT FAMILIES. THE ANTICIPATED IMPACT IS FOR BETTER COORDINATION OF CARE THAT IS EFFICIENT AND EFFECTIVE ACROSS OUR ORGANIZATION AND EASE OF NAVIGATING THROUGH HEALTH CARE SYSTEM FOR PATIENT FAMILIES. THE STRATEGIES WE WILL BE IMPLEMENTING TO IMPROVE COORDINATION OF CARE ARE: 1. EXPAND CURRENT TRANSITION OF CARE PROGRAM TO ADDITIONAL COMPLEX DIAGNOSES TO IMPROVE THE COORDINATION FROM PEDIATRIC TO ADULT CARE 2. EVALUATE WAYS TO IMPROVE CARE COORDINATION RESOURCES/POTENTIAL PARTNERS TSRHC WILL CONTINUE TO DEDICATE INTERNAL RESOURCES AS WELL AS MAINTAIN AND EXPAND COLLABORATIONS WITHIN THE COMMUNITY TO MEET THE PRIORITIZED HEALTH NEED WITH ADULT PROVIDERS/FACILITIES, PEDIATRIC PROVIDERS, AND SCHOOL NURSES TO IMPROVE COORDINATION OF CARE. TSRHC STRATEGIES FOR IMPROVING CHILD HEALTH STATUS: A: HEALTH EDUCATION AND FAMILY SUPPORT PATIENT FAMILIES ARE OFTEN ISOLATED AND WOULD LIKE TO BE CONNECTED WITH OTHER PATIENT FAMILIES WITH SIMILAR EXPERIENCES. MANY DESIRE INFORMATION TO HELP THEM IDENTIFY AVAILABLE RESOURCES IN THE COMMUNITY TO ASSIST IN THE TREATMENT AND CARE OF THEIR CHILD. OUR OBJECTIVE IS TO BRING AWARENESS TO THE COMMUNITY ABOUT THE SERVICES PROVIDED BY TSRHC AND ITS FAMILY RESOURCE CENTER (FRC), WORK WITH KEY LOCAL SUPPORT GROUPS AND PROVIDE PATIENT EDUCATION MATERIALS TO PATIENT FAMILIES REGARDING ADDITIONAL RESOURCES THAT ARE AVAILABLE HERE AND IN THE COMMUNITY. THE ANTICIPATED IMPACT IS FOR A MORE INFORMED COMMUNITY AND PATIENT FAMILIES ON SERVICES PROVIDED AND RESOURCES AVAILABILITY. THE STRATEGIES WE WILL BE IMPLEMENTING TO INCREASE HEALTH EDUCATION AND FAMILY SUPPORT ARE: 1. INCREASE OUR PATIENT FAMILIES AND COMMUNITY AWARENESS ABOUT TSRHC FAMILY RESOURCE CENTER 2. EVALUATE BEST WAYS TO BUILD CONNECTIONS WITH KEY LOCAL SUPPORT GROUPS 3. ENHANCE OUR ONLINE PRESENCE FOR PATIENT EDUCATION MATERIALS BY WEBSITE ENGAGEMENT AND OTHER MEDIA PLATFORMS 4. INCREASE EDUCATION AND AWARENESS THROUGH COMMUNITY PARTNERSHIPS RESOURCES/POTENTIAL PARTNERS TSRHC WILL CONTINUE TO DEDICATE INTERNAL RESOURCES AS WELL AS MAINTAIN AND EXPAND COLLABORATIONS WITHIN THE COMMUNITY TO MEET THE PRIORITIZED HEALTH NEED WITH YMCA NORTH TEXAS, LOCAL SUPPORT GROUPS, COMMUNITY PARTNERS, SCHOOL DISTRICTS, COACHES/ATHLETIC TRAINERS, SCHOOL NURSES, AND YOUTH SPORT GROUPS WITH THE GOAL OF PROVIDING AND CONNECTING THE COMMUNITY TO SERVICES AND RESOURCES PROVIDED BY TSRHC. B: MENTAL HEALTH AND BEHAVIORAL CONDITIONS THERE IS A SHORTAGE OF MENTAL HEALTH SERVICES AND PROVIDERS WITHIN THE COMMUNITY. PATIENT SURVEY RESPONDENTS AND PATIENT FOCUS GROUP PARTICIPANTS RANKED "MENTAL HEALTH/BEHAVIORAL" AS ONE OF THE MOST IMPORTANT HEALTH ISSUES IMPACTING CHILDREN. OUR OBJECTIVE IS TO IMPROVE ACCESS TO MENTAL/BEHAVIORAL HEALTH SERVICES FOR OUR PATIENT POPULATION AND SUPPORT/PROVIDE ADDITIONAL RESOURCES/CARE THAT MAY BE NEEDED. THE ANTICIPATED IMPACT IS TO INCREASE OUR PATIENT FAMILIES ACCESS TO MENTAL/BEHAVIORAL HEALTH PROVIDERS AND RESOURCES. THE STRATEGIES WE WILL BE IMPLEMENTING TO IMPROVE ACCESS TO MENTAL AND BEHAVIORAL HEALTH SERVICES ARE: 1. PILOT PSYCHOLOGY TELEMEDICINE 2. PROVIDE ADDITIONAL PSYCHOLOGY SUPPORT IN SPECIALTY AREAS TO MEET PATIENT NEEDS 3. CONTINUE TO EVALUATE HOW WE ASSESS AT RISK MENTAL HEALTH BEHAVIORS RESOURCES/POTENTIAL PARTNERS TSRHC WILL CONTINUE TO DEDICATE INTERNAL RESOURCES AS WELL AS MAINTAIN AND EXPAND COLLABORATIONS WITHIN THE COMMUNITY TO MEET THE PRIORITIZED HEALTH NEED BY COMMITTING TO PROVIDING RESOURCES AND PARTNERING WITH OTHER HEALTH CARE PROVIDERS AS APPROPRIATE FOR THE NEEDS OF OUR PATIENT POPULATION. C: OBESITY/UNHEALTHY EATING/LACK OF PHYSICAL ACTIVITY OVER EIGHTEEN PERCENT OF HIGH SCHOOL STUDENTS IN TEXAS ARE OBESE. ACCESS TO HEALTHY FOODS ARE A CHALLENGE FOR THOSE WHO LIVE IN POVERTY. OBESITY, UNHEALTHY EATING, AND LACK OF PHYSICAL ACTIVITY WERE RANKED THE FIFTH, THIRD, AND SECOND HIGHEST BY PATIENT SURVEY RESPONDENTS, RESPECTIVELY. OUR OBJECTIVE IS TO IMPROVE THE OVERALL HEALTH OF OUR PATIENT POPULATION AND PROVIDE THEM THE RESOURCES TO MAKE HEALTHIER CHOICES. THE ANTICIPATED IMPACT IS FOR A HEALTHIER PATIENT POPULATION WHO HAVE ACCESS TO RESOURCES SUCH AS FOOD AND EDUCATION. THE STRATEGIES WE WILL BE IMPLEMENTING TO IMPROVE THE OVERALL HEALTH OF OUR PATIENT POPULATION: 1. SUPPORT AND REFER TO WEIGHT MANAGEMENT PROGRAMS 2. EXPLORE TOOLS WITHIN THE ELECTRONIC HEALTH RECORD THAT WOULD ENHANCE WEIGHT MANAGEMENT FOLLOW UP 3. CREATE PATIENT EDUCATION MATERIALS THAT PROVIDE A LIST OF FOOD PANTRIES, COMMUNITY GARDENS, FOOD ASSISTANCE TO PATIENT FAMILIES 4. SPONSOR COMMUNITY RELATED COOKING CLASSES 5. IMPLEMENT AND DEVELOP SPORTS NUTRITION PROGRAM INTO OUR SERVICES 6. CONTINUE TO PROVIDE COMMUNITY LEISURE RESOURCES TO INCREASE PHYSICAL ACTIVITY AND SOCIAL EN
PART V, SECTION B, LINE 20E	NEITHER THE HOSPITAL NOR ANY AUTHORIZED THIRD PARTY PERFORMED ANY OF THE ACTIONS SET FORTH IN LINE 19 (A-E).

Schedule H (Form 990) 2018

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?1
Name and address		Type of Facility (describe)
1	SCOTTISH RITE FOR CHLDRN ORTHOPEDIC & SP 5700 DALLAS PARKWAY FRISCO,TX75034	OUTPATIENT CLINIC DEPARTMENT OF HOSPITAL
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2018

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
PART I, LINE 3C	ELIGIBILITY FOR FINANCIAL ASSISTANCE SINCE ITS FOUNDING IN 1921, TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN ("TSRHC") PROVIDED CARE TO PATIENTS WITH NEEDS WITHIN THE HOSPITAL'S SCOPE OF SERVICES AT NO CHARGE. AS THE HOSPITAL BEGAN ACCEPTING REIMBURSEMENT IN OCTOBER 2012, IT IMPLEMENTED A NEW CHARITY CARE/FINANCIAL ASSISTANCE POLICY. FINANCIALLY INDIGENT PATIENTS, OR THOSE WHOSE INCOME IS LESS THAN OR EQUAL TO 200 PERCENT OF THE FEDERAL POVERTY GUIDELINES (FPG), ARE ELIGIBLE FOR A 100 PERCENT DISCOUNT. ADDITIONALLY, MEDICALLY INDIGENT PATIENTS ARE ALSO ELIGIBLE FOR DISCOUNTED CARE, WITH ELIGIBILTY BASED ON FPG AND MEDICAL EXPENSES AND ABILITY TO PAY.
PART I, LINE 6A	COMMUNITY BENEFIT REPORT FOR FISCAL YEAR ENDING SEPTEMBER 30, 2019, A COMMUNITY BENEFIT REPORT WILL BE FILED WITH THE STATE OF TEXAS. THE COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST.
PART I, LINE 7	COSTING METHODOLOGY LINES 7(A) AND (B) COMMUNITY BENEFIT EXPENSE IN COLUMN (C) WERE CALCULATED USING WORKSHEET 2: RATIO OF PATIENT CARE COST TO CHARGES. LINES 7(E), (F), AND (H) COMMUNITY BENEFIT EXPENSE WERE CALCULATED USING A STEP-DOWN ALLOCATION METHOD.
PART II, LINE 9	COMMUNITY BUILDING ACTIVITIES TSRHC ENGAGES IN COMMUNITY BUILDING ACTIVITIES SUCH AS THERAPEUTIC RECREATION OUTREACH PROGRAMS, WHICH HELP CONNECT PATIENTS TO RESOURCES IN THE COMMUNITY AND PROMOTE HEALTH. FOR EXAMPLE, THE HOSPITAL PROVIDES SPORTS AND RECREATION CAMPS SUCH AS LEARN TO GOLF, A PROGRAM THAT PROVIDES THE TOOLS AND INSTRUCTION NEEDED FOR YOUNG PATIENTS TO EXPERIENCE THE REHABILITATIVE BENEFITS OF THE GAME OF GOLF; SUMMER ALL STARS, WHICH EMPHASIZES FUN, FITNESS, HEALTHY COMPETITION AND TEAM SPIRIT THROUGH INCLUSIVE SPORTS AND ACTIVITIES, SUCH AS BASKETBALL, GOLF AND TENNIS; AND CHANCE TO DANCE, A PROGRAM DESIGNED TO INTRODUCE HOSPITAL PATIENTS TO VARIOUS TYPES OF DANCE, INCLUDING MODERN, JAZZ, SALSA AND BALLET. EIGHT SPECIALTY CAMPS ARE AVAILABLE FOR CHILDREN UP TO THE AGE OF 17, INCLUDING CAMPS FOR PATIENTS WITH TUBEROUS SCLEROSIS COMPLEX, UPPER LIMB DIFFERENCES, SPINA BIFIDA, JUVENILE ARTHRITIS AND HAND DIFFERENCES. THESE PROGRAMS ARE DESIGNED TO EMPOWER PARTICIPANTS IN THEIR DAILY LIVES AND HAVE A POSITIVE, ENDURING EFFECT ON SELF-ESTEEM. THE HOSPITAL ALSO HOSTS VARIOUS PEER AND PARENT SUPPORT GROUPS FOR THE COMMUNITY SUCH AS PALS (PROSTHETICS AND LIMB SUPPORT), ETC. THE HOSPITAL HOSTS VARIOUS ANNUAL EVENTS FOCUSED ON COMMUNITY DEVELOPMENT. THESE INCLUDE FARM & RANCH DAY, BIKE RODEO AND CHILD SAFETY DAY, WHICH ARE HELD AT NO CHARGE TO PARTICIPANTS. THESE EVENTS ARE FOCUSED ON EDUCATION AND PREVENTION. TSRHC REGULARLY ENGAGES WITH THE COMMUNITY, EDUCATING YOUNG ATHLETES, PARENTS, COACHES AND SCHOOL DISTRICTS ABOUT SPORTS SAFETY, INJURY PREVENTION AND CONCUSSION MANAGEMENT AT HEALTH FAIRS AND COACHING CLINICS. THE HOSPITAL CONNECTS WITH THE COMMUNITY THROUGH THEIR T. BOONE PICKENS TRAINING AND CONFERENCE CENTER BY HOSTING MANY EVENTS TO EDUCATE AND INFORM COMMUNITY MEMBERS ON VARIOUS MEDICAL AND NON-MEDICAL TOPICS. THROUGH THE CONFERENCE CENTER, WE HOSTED MORE THAN 2,000 MEETINGS BY EXTERNAL GROUPS IN FISCAL YEAR 2019. THIS INCLUDES MEETINGS REGARDING CHILD HEALTH CARE ORGANIZED BY THE DALLAS-FORT WORTH HOSPITAL COUNCIL, ADVANCED MEDICAL TRAINING FOR NURSES AND PHYSICIANS IN CONJUNCTION WITH UT SOUTHWESTERN MEDICAL CENTER AND GATHERINGS OF PATIENT/FAMILY SUPPORT GROUPS FOR THOSE UNDERGOING TREATMENT FOR A CONDITION TREATED AT THE HOSPITAL.
PART III, SECTION A, LINE 2	METHODOLOGY TO DETERMINE BAD DEBT BAD DEBT EXPENSE IS COMPRISED OF ACTUAL UNCOLLECTIBLE AMOUNTS PLUS AN ALLOWANCE BASED ON HISTORICAL DATA. DISCOUNTS ARE NOT INCLUDED IN BAD DEBT. PART III, SECTION A, LINE 3 BAD DEBT EXCLUSION OF FINANCIAL ASSISTANCE BAD DEBT EXPENSE DOES NOT INCLUDE ANY COSTS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER FINANCIAL ASSISTANCE POLICY.
PART III, SECTION A, LINE 4	THE HOSPITAL MAINTAINS ALLOWANCES FOR UNCOLLECTIBLE ACCOUNTS FOR ESTIMATED LOSSES RESULTING FROM A PAYOR'S INABILITY TO MAKE PAYMENTS ON ACCOUNTS. THE HOSPITAL ASSESSES THE REASONABLENESS OF THE ALLOWANCE ACCOUNT BASED ON HISTORICAL WRITE-OFFS, CASH COLLECTIONS, THE AGING OF THE ACCOUNTS AND OTHER ECONOMIC FACTORS. ACCOUNTS ARE WRITTEN OFF WHEN COLLECTION EFFORTS ARE UNSUCCESSFUL. MANAGEMENT CONTINUALLY MONITORS AND ADJUSTS ITS ALLOWANCES ASSOCIATED WITH ITS RECEIVABLES. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR THE YEARS ENDED SEPTEMBER 30, 2019 AND 2018, WAS APPROXIMATELY $365,539 AND $720,922 RESPECTIVELY.
PART III, SECTION B, LINE 8	MEDICARE ALLOWABLE COSTS THE ESTIMATED COSTS OF PROVIDING CHARITY CARE SERVICES TO MEDICARE PATIENTS ARE BASED ON A CALCULATION WHICH APPLIES A RATIO OF COSTS TO CHARGES AS DETERMINED ON PART I, WORKSHEET 2. THE RATIO OF COSTS TO CHARGES IS CALCULATED BASED ON TOTAL EXPENSES DIVIDED BY GROSS PATIENT SERVICES REVENUE.
PART III, SECTION C, LINE 9B	COLLECTION PRACTICES A PATIENT'S ACCOUNT WILL BE REVIEWED FOR FINANCIAL ASSISTANCE ELIGIBILITY AND THE APPROPRIATE APPLICATION OF ANY APPLICABLE THIRD-PARTY PAYMENT, AND/OR DISCOUNTS BEFORE INITIATING A STATEMENT TO THE PATIENT. ONCE A PATIENT QUALIFIES FOR FINANCIAL ASSISTANCE, THE PATIENT SHALL BE NOTIFIED OF THE AMOUNT QUALIFYING UNDER THE POLICY, AND NO FURTHER BILLING ACTIONS SHALL BE TAKEN FOR AMOUNTS QUALIFYING UNDER THE POLICY. AFTER A PATIENT'S ACCOUNT BALANCE IS REDUCED BY ANY DISCOUNTS AVAILABLE UNDER THIS POLICY, THE PATIENT WILL BE RESPONSIBLE FOR THE REMAINDER OF HIS OR HER OUTSTANDING ACCOUNT BALANCE. THE HOSPITAL WILL SEND THREE POST DISCHARGE BILLING STATEMENTS OVER A 120-DAY PERIOD.
PART VI, LINE 2	NEEDS ASSESSMENT IN ADDITION TO THE CHNA REPORTED IN PART V, SECTION B, THE HOSPITAL IS AN ACTIVE PARTICIPANT IN VARIOUS DALLAS-FORT WORTH HOSPITAL COUNCIL ACTION GROUPS. A MEMBER OF THE HOSPITAL LEADERSHIP TEAM CHAIRS THE HEALTHCARE COLLABORATIVE WITH THE COUNCIL. THROUGH THE COLLABORATIVE, THE OTHER MAJOR HOSPITAL REPRESENTATIVES WITHIN THE COMMUNITY COME TOGETHER TO GATHER AND ANALYZE DATA, RESOURCES, DISPARITIES AND ACCESS NEEDS, WHILE STRATEGIZING SOLUTIONS FOR CLOSING IDENTIFIED GAPS. IN RECENT YEARS, UNDERTAKINGS OF THIS COLLABORATIVE HAVE INCLUDED A HEALTH NEEDS ASSESSMENT RELATED TO MENTAL HEALTH ACCESS AND SUBSTANCE ABUSE, AS WELL AS THE CREATION, OPTIMIZATION AND MAINTENANCE OF A SEARCHABLE MENTAL HEALTH RESOURCE GUIDE, AVAILABLE THROUGH A PUBLIC WEBSITE. THROUGH ADDITIONAL SUBGROUPS, OTHER HEALTH NEEDS ASSESSMENTS AND ACTION PLANS HAVE BEEN CREATED TO ADDRESS MENTAL HEALTH FIRST AID TRAINING, OBESITY AND HEALTH LITERACY. THE HOSPITAL MAINTAINS REPRESENTATION AND CONTRIBUTIONS ON THE MENTAL HEALTH AND HEALTH LITERACY SUBGROUPS.
PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FAMILIES ARE CONTACTED BY FAMILY SERVICES COUNSELORS PRIOR TO EACH PATIENT'S SCHEDULED SURGICAL PROCEDURES, INPATIENT VISITS, MRI, CT AND ORTHOTICS AND PROSTHETICS TO INFORM THEM ABOUT THE FINANCIAL ASSISTANCE PROGRAM AND TO ASSESS THEIR POTENTIAL QUALIFICATION FOR FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS. FAMILIES ARE NOTIFIED UPON CHECK-IN FOR OUTPATIENT APPOINTMENTS THAT FAMILY SERVICES COUNSELORS ARE AVAILABLE TO OFFER THE SAME APPLICATION. THE FACILITY HAS ALSO POSTED SPECIFICS ABOUT AVAILABLE FINANCIAL ASSISTANCE AT REGISTRATION, IN MAJOR WAITING AREAS, PUBLICATION IN THE HOSPITAL MAGAZINE, HOSPITAL WEBSITE AND A SUMMARY PRINTED IN ENGLISH AND SPANISH THAT IS INSERTED INTO EACH FAMILY'S ANNUAL FOLDER. IN ADDITION, EACH POST-DISCHARGE BILLING STATEMENT WILL NOTIFY THE PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS, INCLUDING A PHONE NUMBER FOR INQUIRIES ABOUT FINANCIAL ASSISTANCE AND A WEBSITE WHERE ADDITIONAL INFORMATION CAN BE OBTAINED. INFORMATION REGARDING THIS POLICY AND HOW TO APPLY FOR FINANCIAL ASSISTANCE WILL ALSO BE PROVIDED DURING PHONE CONVERSATIONS WITH PATIENTS REGARDING FINANCIAL CHARGES AND/OR ACCOUNT BALANCES.
PART VI, LINE 4	COMMUNITY INFORMATION THE COMMUNITY SERVED BY TSRHC CAN BEST BE DEFINED BY UNDERSTANDING ITS PATIENT POPULATION AND CLINICAL FOCUS. THE HOSPITAL IS A 501(C)(3) PEDIATRIC ORTHOPEDIC HOSPITAL IN DALLAS, TEXAS, AND AN OUTPATIENT DEPARTMENT OF THE HOSPITAL INCLUDING AN AMBULATORY SURGERY CENTER IN FRISCO, TEXAS, WHICH TREATS PEDIATRIC ORTHOPEDIC CONDITIONS, SPORTS INJURIES, FRACTURES, AS WELL AS CERTAIN RELATED ARTHRITIC AND NEUROLOGICAL DISORDERS AND DYSLEXIA/LEARNING DISORDERS. TSRHC PROVIDES PREMIER PEDIATRIC ORTHOPEDIC AND DYSLEXIA SERVICES TO PEDIATRIC PATIENTS FOR WHOM THE SERVICES PROVIDED BY THE HOSPITAL OFFER HOPE OF IMPROVEMENT. THOUGH THE HOSPITAL IS DEDICATED TO PROVIDING CARE TO CHILDREN FROM AROUND THE STATE OF TEXAS AND THROUGHOUT THE U.S., A MAJORITY OF ITS PATIENTS LIVE IN AN 11-COUNTY GEOGRAPHIC AREA LOCATED IN NORTH TEXAS, WHICH ACCOUNTS FOR MORE THAN 80 PERCENT OF THE HOSPITAL'S PATIENTS. DEFINING ITS PRIMARY COMMUNITY WILL ALLOW THE HOSPITAL TO MORE EFFECTIVELY FOCUS ITS RESOURCES TO ADDRESS IDENTIFIED SIGNIFICANT HEALTH NEEDS TARGETING AREAS OF GREATEST NEED AND HEALTH DISPARITIES. ACCORDING TO THE CENSUS BUREAU, THE 2019 ESTIMATED POPULATION FOR THE PRIMARY SERVICE AREA WAS 7,318,614 PEOPLE. BASED ON 2018 CENSUS BUREAU DATA, THE MEDIAN HOUSEHOLD INCOME FOR THE PRIMARY SERVICE AREA WAS $68,802. IN 2017, APPROXIMATELY 26 PERCENT OF THE PRIMARY SERVICE AREA POPULATION WAS 18 YEARS OR YOUNGER.
PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH MEDICAL CARE IS PROVIDED TO CHILDREN WITH ORTHOPEDIC AND RELATED CONDITIONS NOT TREATED AT OTHER MEDICAL FACILITIES. MANY PROVIDERS AT TSRHC RECEIVE REFERRALS FROM PHYSICIANS AND CHILDREN'S HOSPITALS IN THE PRIMARY SERVICE AREA BECAUSE THE PATIENT'S CONDITION IS EITHER TOO ACUTE OR IN SOME CASES, SO RARE, THE REFERRING FACILITY DOES NOT HAVE ADEQUATELY TRAINED OR EXPERIENCED STAFF TO PROVIDE THE NECESSARY CARE. THE HOSPITAL HAS A PROCESS TO DETERMINE IF IT IS THE APPROPRIATE FACILITY TO MEET A CHILD'S CLINICAL NEEDS. THE PROCESS BEGINS WITH A TELEPHONE CALL, REQUEST THROUGH THE WEBSITE, REFERRAL FROM A PHYSICIAN, OR AN APPLICATION FOR SERVICES. AN INTERNAL MECHANISM IS UTILIZED TO DETERMINE IF TSRHC CAN APPROPRIATELY MEET THE NEEDS OF THE CHILD. WHEN TSRHC IS UNABLE TO PROVIDE SERVICES, TSRHC, AS PART OF ITS CARE COORDINATION SERVICES, IDENTIFIES REFERRAL RESOURCES THAT ARE PROVIDED TO THE FAMILY. IN ADDITION TO GENERAL PEDIATRIC ORTHOPEDIC SERVICES, THE PEDIATRIC ORTHOPEDIC SERVICES FOR WHICH PATIENTS ARE PRIMARILY REFERRED TO THE HOSPITAL INCLUDE SCOLIOSIS AND SPINE DISORDERS, CLUBFOOT AND OTHER FOOT DISORDERS, REDUCTION DEFICITS (LIMB LENGTHENING), HAND AND UPPER LIMB DIFFERENCES, HIP DISORDERS, SPORTS MEDICINE, FRACTURES, PROGRAMS RELATED TO CONGENITAL LIMB DEFICIENCES AND AMPUTATIONS, NEUROLOGY, RHEUMATOLOGY AND PEDIATRIC DEVELOPMENTAL DISABILITIES TREATED IN ADDITION OR RELATED TO OTHER ORTHOPEDIC CONDITIONS. RESEARCH: SINCE OPENING ITS DOORS IN 1921, TSRHC HAS STRIVED TO DISCOVER NEW AND BETTER WAYS TO CARE FOR CHILDREN AFFECTED BY PEDIATRIC ORTHOPEDIC CONDITIONS AND CERTAIN RELATED NEUROLOGICAL DISORDERS. THE HOSPITAL'S DEDICATED RESEARCH CENTER, THE SARAH M. AND CHARLES E. SEAY CENTER FOR MUSCULOSKELETAL RESEARCH, IS MADE UP OF SIX CENTERS FOR EXCELLENCE SUPPORTED BY RESEARCH DIVISIONS AND CORE FACILITIES: SCOLIOSIS AND SPINE; CLUBFOOT AND FOOT DISORDERS; HIP DISORDERS; LIMB LENGTH DISCREPANCIES; HAND DIFFERENCES; AND SPORTS MEDICINE. THROUGH THE YEARS, TSRHC RESEARCHERS AND PHYSICIANS HAVE GENERATED MORE THAN 30 PATENTS AND MADE IMPORTANT DISCOVERIES THAT HAVE HELPED CHILDREN WORLDWIDE. THESE FINDINGS AND INNOVATIONS ALLOW THE MEDICAL COMMUNITY TO FORM NEW HYPOTHESES TO EXPLAIN WHAT CAUSES CERTAIN CONDITIONS WHILE PROVIDING TOOLS FOR FUTURE RESEARCH. THE MAJOR DISCOVERIES AND RESEARCH APPLICATIONS AT TSRHC INCLUDE: THE FIRST GENE ASSOCIATED WITH IDIOPATHIC SCOLIOSIS; TWO MORE GENETIC MARKERS OF THE CONDITION; THE TSRH SILO 5.5 SPINAL SYSTEM; THE TRUE/LOK EXTERNAL FIXATION SYSTEM; AND THE TRUE/LOK HEXAPOD SYSTEM. THE HOSPITAL IS COMMITTED TO TRANSLATING ITS SCIENTIFIC DISCOVERIES INTO IMPROVED CARE AND TREATMENT OUTCOMES FOR CHILDREN WITH MUSCULOSKELETAL CONDITIONS. TO THAT END, THE HOSPITAL HAS LAUNCHED A MULTIDISCIPLINARY CENTER FOR PEDIATRIC BONE BIOLOGY AND TRANSLATIONAL RESEARCH. THE CENTER INCLUDES 3,200 SQUARE FEET OF LABORATORIES AND OFFICES DEDICATED TO BONE-RELATED RESEARCH. IN COLLABORATION WITH UT SOUTHWESTERN MEDICAL CENTER, RESEARCHERS WILL EXPLORE THE ROOT CAUSES OF BONE DISORDERS WITH A "BENCH TO BEDSIDE" TRANSLATIONAL RESEARCH AND TREATMENT APPROACH. IN ADDITION, IT WILL FURTHER EXPAND THE FACILITY'S ROLE AS A TRAINING SITE FOR FELLOWS, VISITING SCIENTISTS AND STUDENTS AND WILL ALSO HOST INTERNATIONAL GATHERINGS DEDICATED TO COLLABORATIVE RESEARCH THAT WILL BENEFIT CHILDREN THROUGHOUT THE COMMUNITY AND AROUND THE WORLD. MEDICAL EDUCATION: FOR 38 YEARS, IN ASSOCIATION WITH THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER, TSRHC HAS PROVIDED AN EXTRAORDINARY EDUCATIONAL EXPERIENCE IN THE FIELD OF PEDIATRIC ORTHOPEDICS TO PROMISING ORTHOPEDIC SURGEONS. NEARLY 200 PHYSICIANS HAVE BENEFITED FROM THE FELLOWSHIP IN PEDIATRIC ORTHOPEDICS AND SCOLIOSIS, GOING ON TO HOLD PRESTIGIOUS MEDICAL POSITIONS ACROSS THE COUNTRY AND AROUND THE WORLD. IN ADDITION TO THE FELLOWSHIP PROGRAM, THE HOSPITAL PARTICIPATES IN RESIDENCY TRAINING PROGRAMS IN NEUROLOGY, RHEUMATOLOGY, ORTHOPEDICS, PSYCHOLOGY, RADIOLOGY AND PEDIATRIC DEVELOPMENT DISABILITIES. THE HOSPITAL ALSO HAS VARIOUS AFFILIATION PROGRAMS FOR EDUCATION IN PHYSICAL THERAPY, OCCUPATIONAL THERAPY, PROSTHETICS AND VARIOUS OTHER DISCIPLINES. FAMILY RESOURCE CENTER: THE CHRISTI CARTER URSCHEL FAMILY RESOURCE CENTER'S MISSION IS TO PROVIDE HEALTH INFORMATION AND SUPPORT RESOURCES TO PATIENTS AND FAMILIES IN ORDER TO HELP THEM MAKE INFORMED HEALTH CARE DECISIONS AND IMPROVE THEIR QUALITY OF LIFE. TSRHC UNDERSTANDS THAT FAMILIES WHOSE CHILDREN ARE DIAGNOSED WITH MEDICAL CONDITIONS HAVE MANY QUESTIONS, AND THE FAMILY RESOURCE CENTER CAN HELP THE TSRHC PATIENTS AND FAMILIES FIND ANSWERS. THE CENTER SERVES AN AVERAGE OF 2,000 FAMILIES ANNUALLY. FAMILY ROOM AND CHAPEL: THE FAMILY ROOM IS PRIMARILY UTILIZED BY PATIENT FAMILIES AS A COMFORTABLE SURGERY WAITING AREA, WHILE THE CHAPEL LOCATED NEXT DOOR PROVIDES A PLACE OF WORSHIP WITH NONDENOMINATIONAL SERVICES EACH SUNDAY. CHILD LIFE SERVICES: CHILD LIFE SPECIALISTS FOCUS ON EACH PATIENT AND THEIR FAMILY'S SPECIFIC NEEDS BY PROMOTING OPTIMAL PSYCHOSOCIAL DEVELOPMENT AND EDUCATIONAL NEEDS OF CHILDREN AND TEENAGERS TO HELP REDUCE FEAR AND PROMOTE COPING DURING THEIR VISIT. THEY PROVIDE SERVICES SUCH AS PREPARATION AND SUPPORT FOR MEDICAL PROCEDURES, EDUCATION ABOUT DIAGNOSIS, COPING TECHNIQUES TO USE DURING MEDICAL EXPERIENCES, ENGAGEMENT IN MEDICAL PLAY, OUTLETS FOR SELF-EXPRESSION AND SUPPORT FOR BROTHERS AND SISTERS. FAMILY SERVICES DEPARTMENT: THE FAMILY SERVICES DEPARTMENT SERVES AS A SUPPORTS CENTER FOR PATIENTS AND THEIR FAMILIES WHILE THEY ARE RECEIVING TREATMENT AT TSRHC. FAMILY SERVICES INCLUDES THESE AREAS: MEDICAL SOCIAL WORK FOR RESOURCES AND REFERRALS, FINANCIAL ASSISTANCE PROGRAMS AND FAMILY SERVICES COUNSELING, LANGUAGE INTERPRETATION AND TRANSLATION SERVICES, AND COORDINATION OF OFF-SITE MEDICAL SERVICES. RESOURCES TO ADDRESS CHILD HEALTH STATUS: SOCIAL WORKERS AND MEDICAL CONSULT COORDINATORS HELP FAMILIES ARRANGE TO RECEIVE FOLLOW-UP CARE FOR THE SERVICES ORDERED BY THE MEDICAL STAFF. PATIENT FAMILIES CHOOSE THEIR VENDOR(S) FROM A LIST OF VENDORS PROVIDED BY SOCIAL WORKERS BASED ON LOCATION AND THE PATIENT'S FUNDING SOURCE. THESE SERVICES INCLUDE WEIGHT MANAGEMENT, OUTPATIENT PHYSICAL REHAB, HOME HEALTH SERVICES, DURABLE MEDICAL EQUIPMENT, MEDICAL SUPPLIES, TESTING AND SPECIALISTS AND MENTAL HEALTH. TSRHC'S PATIENT EDUCATION IS CREATED AND MAINTAINED BY AN INTERDISCIPLINARY TEAM OF PHYSICIANS, NURSES AND ANCILLARY SERVICES THROUGHOUT THE ORGANIZATION. THIS ROBUST LIBRARY OF MATERIALS INCLUDES EDUCATION PIECES ON SPECIFIC SURGERIES, CONDITIONS, AND MEDICAL PROCESSES, ALONG WITH MORE GENERAL AND BASIC HEALTH EDUCATION. AVAILABLE IN BOTH ENGLISH AND SPANISH, OVER 700 PIECES OF EDUCATION ARE AVAILABLE FOR STAFF USE TO PROVIDE TO PATIENTS AND FAMILIES. THE MATERIAL IS WRITTEN BY TSRHC STAFF AND MANAGED BY THE PATIENT EDUCATION COMMITTEE, WITH OVERSIGHT BY THE PATIENT EDUCATION ADVISORY BOARD. REFERRAL TO OTHER PROVIDERS: WHEN TSRHC IS UNABLE TO PROVIDE SERVICES, TSRHC IDENTIFIES EXTERNAL RESOURCES THAT ARE AVAILABLE TO THE FAMILY. EXAMPLES OF EXISTING HEALTH CARE PROGRAMS WITHIN THE COMMUNITY AVAILABLE TO ADDRESS THE IDENTIFIED NEEDS INCLUDE BUT ARE NOT LIMITED TO: CHILDREN'S HEALTH; UT SOUTHWESTERN MEDICAL CENTER; COOK CHILDREN'S MEDICAL CENTER; MEDICAL CITY CHILDREN'S HOSPITAL; BAYLOR INSTITUTE FOR IMMUNOLOGY RESEARCH; TEXAS CHILD NEUROLOGY; AND ATHENA DIAGNOSTICS. RESOURCES TO ADDRESS COORDINATION OF CARE: RESOURCE DETAILS ARE MAINTAINED BY THE TSRHC SOCIAL WORK TEAM, IN THE RESOURCE DIRECTORY, FOUND ON THE HOSPITAL'S STAFF INTRANET PAGE. RESOURCES FOUND WITHIN THIS DIRECTORY INCLUDE VENDOR INFORMATION FOR SERVICES SUCH AS DURABLE MEDICAL EQUIPMENT, MEDICAL SUPPLIES, CUSTOM EQUIPMENT, HOME NURSING SERVICES, SPECIALTY THERAPIES (EXAMPLES: AQUATIC, EQUESTRIAN THERAPY), NUTRITION SUPPLIES, OUTPATIENT AND INPATIENT BEHAVIORAL HEALTH RESOURCES, SOCIAL SKILLS TRAINING AND PSYCHIATRY. THIS INFORMATION IS SEARCHABLE BY THE SERVICE NEEDED, COUNTIES SERVED AND INSURANCE ACCEPTED. OTHER COORDINATION EFFORTS INCLUDE SOCIAL WORK RESPONSE TO TRANSITION PLANNING, SCHOOL ACCOMMODATIONS, ACCESS TO HEALTH CARE, PSYCHOSOCIAL SUPPORT AND PARENT ADVOCACY. TSRHC TRANSITIONS PATIENTS TO ADULT PROVIDERS AS THEY APPROACH THE AGE OF 18. A GROUP OF TSRHC SOCIAL WORKERS, NURSES, ADMINISTRATORS AND MEDICAL STAFF WORK TO TRANSITION TSRHC PATIENTS TO ENSURE THAT ALL PATIENTS NEEDING ADDITIONAL COORDINATION AS THEY AGE OUT OF SERVICES RECEIVE THE NECESSARY ASSISTANCE. CATEGORIES OF CARE WITH WHICH STAFF HELPS TRANSITION PATIENTS TO ADULT CARE INCLUDE LEGAL AND GUARDIANSHIP, PRIMARY AND SPECIALTY CARE, FUNDING, EDUCATION AND/OR VOCATIONAL PROGRAMS. MEDICAID TRANSPORTATION: SOCIAL WORKERS IN THE TSRHC FAMILY SERVICES DEPARTMENT ARE AVAILABLE TO HELP FAMILIES UNDERSTAND AND NAVIGATE THE PROCESSES FOR MEDICAID TRANSPORTATION ASSISTANCE, LODGING AND MEALS, WHEN ELIGIBLE FOR THESE SERVICES. SOUTHWEST AIRLINES TICKET VOUCH
PART VI, LINE 7	STATE FILINGS OF COMMUNITY BENEFIT FOR FISCAL YEAR ENDING SEPTEMBER 30, 2019, A COMMUNITY BENEFIT REPORT WAS FILED WITH THE STATE OF TEXAS.

Schedule H (Form 990) 2018

Additional Data

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

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

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

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Texas Scottish Rite Hospital for Crippled
Children

Employer identification number
75-0818178

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) PEDI-ORTHO HEALTH CORPORATION 2222 WELBORN ST DALLAS,TX75219	75-2665759	501(c)(3)	90,465	0			MEDICAL CARE AND RESEARCH
(2) DALLAS SAFETY NET SUPPORT CORPORATION 1441 N BECKLEY DALLAS,TX75203	82-3131059	501(c)(3)	2,112,535	0			DALLAS COUNTY INDIGENT CARE

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2018

Page 2

Part III

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

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

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

Part IV

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

Return Reference

Explanation

USE OF GRANT FUNDS

SCHEDULE I, PART I, LINE 2 THE GRANT TO PEDI-ORTHO HEALTH CORPORATION, A RELATED MEDICAL ENTITY, IS TO SUPPORT THE SERVICES PROVIDED BY THE CORPORATION. THE HOSPITAL, AS A SOLE MEMBER, MONITORS THE ACTIVITIES OF THE ENTITY WHICH PROVIDES PEDICATRIC PHYSICIAN SERVICES TO LOCAL MEDICAL FACILITIES THAT PROVIDE EMERGENCY CARE FOR CHILDREN. THE ENTITY IS INDEPENDENTLY AUDITED ANNUALLY AND THE HOSPITAL RECEIVES A COPY OF THE AUDITED FINANCIAL STATEMENTS. THE HOSPITAL PROVIDES FUNDING TO DALLAS SAFETY NET SUPPORT CORPORATION TO SUPPORT LOCAL HOSPITALS IN THE DALLAS COMMUNITY. THE CORPORATION IS MONITORED BY REVIEW OF THE ANNUAL IRS FORM 990.

Schedule I (Form 990) 2018

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

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

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

Attach to Form 990.
SchJMediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2018

Page 2

Part II

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

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

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1ROBERT L WALKER PRESIDENT/CEO	(i) (ii)	896,807 ------------- 0	0 ------------- 0	101,909 ------------- 0	0 ------------- 0	24,478 ------------- 0	1,023,194 ------------- 0	16,176 ------------- 0
2MARK G BATEMAN SR VP, PUBLIC RELATIONS	(i) (ii)	370,132 ------------- 0	0 ------------- 0	47,672 ------------- 0	16,484 ------------- 0	28,407 ------------- 0	462,695 ------------- 0	0 ------------- 0
3MATTHEW S CHANCE SR VP, OPERATIONS	(i) (ii)	298,719 ------------- 0	0 ------------- 0	33,668 ------------- 0	16,500 ------------- 0	36,445 ------------- 0	385,332 ------------- 0	0 ------------- 0
4LORI L DALTON SR VP, GENERAL COUNSEL	(i) (ii)	471,167 ------------- 0	0 ------------- 0	41,170 ------------- 0	16,500 ------------- 0	35,568 ------------- 0	564,405 ------------- 0	0 ------------- 0
5WILLIAM R HUSTON SR VP, CFO	(i) (ii)	557,788 ------------- 0	0 ------------- 0	60,117 ------------- 0	16,500 ------------- 0	12,820 ------------- 0	647,225 ------------- 0	0 ------------- 0
6FREDRIC D RICHMOND SR VP, CHIEF INVESTMENT OFFICE	(i) (ii)	387,820 ------------- 0	0 ------------- 0	35,692 ------------- 0	16,500 ------------- 0	31,722 ------------- 0	471,734 ------------- 0	0 ------------- 0
7STEPHANIE K BRIGGER VP, DEVELOPMENT	(i) (ii)	195,077 ------------- 0	0 ------------- 0	24,029 ------------- 0	66,432 ------------- 0	14,375 ------------- 0	299,913 ------------- 0	0 ------------- 0
8LESLIE A CLONCH VP, CHIEF INFORMATION OFFICER	(i) (ii)	361,397 ------------- 0	0 ------------- 0	44,188 ------------- 0	16,500 ------------- 0	34,222 ------------- 0	456,307 ------------- 0	0 ------------- 0
9ASHLEY C GIVENS VP, DEVELOPMENT/EVENTS	(i) (ii)	127,697 ------------- 0	0 ------------- 0	4,297 ------------- 0	17,746 ------------- 0	30,889 ------------- 0	180,629 ------------- 0	0 ------------- 0
10ELLEN E HAYNES VP, MAJOR GIFTS	(i) (ii)	185,642 ------------- 0	0 ------------- 0	23,613 ------------- 0	11,566 ------------- 0	11,316 ------------- 0	232,137 ------------- 0	0 ------------- 0
11JEREMY L HOWELL VP, NORTH CAMPUS	(i) (ii)	212,829 ------------- 0	------------- 0	24,336 ------------- 0	13,514 ------------- 0	31,229 ------------- 0	281,908 ------------- 0	0 ------------- 0
12JENNY J JOHNSON VP, REVENUE CYCLE	(i) (ii)	175,715 ------------- 0	0 ------------- 0	401 ------------- 0	10,706 ------------- 0	18,279 ------------- 0	205,101 ------------- 0	0 ------------- 0
13DONALD E KATZ VP, FACILITIES	(i) (ii)	284,529 ------------- 0	0 ------------- 0	29,643 ------------- 0	102,316 ------------- 0	36,977 ------------- 0	453,465 ------------- 0	0 ------------- 0
14KRISTINA L KEEVER-SMITH VP, INVESTMENTS	(i) (ii)	243,470 ------------- 0	0 ------------- 0	11,617 ------------- 0	41,824 ------------- 0	1,379 ------------- 0	298,290 ------------- 0	0 ------------- 0
15DEBRA A SAYLES RN VP & CNO	(i) (ii)	297,684 ------------- 0	0 ------------- 0	58,099 ------------- 0	0 ------------- 0	11,322 ------------- 0	367,105 ------------- 0	0 ------------- 0
16CONNIE B WRIGHT VP, HR (RESIGNED 6/2020)	(i) (ii)	259,604 ------------- 0	0 ------------- 0	20,553 ------------- 0	15,831 ------------- 0	20,316 ------------- 0	316,304 ------------- 0	0 ------------- 0
17JEAN A ALLEN CONTROLLER	(i) (ii)	180,769 ------------- 0	0 ------------- 0	12,848 ------------- 0	10,733 ------------- 0	24,362 ------------- 0	228,712 ------------- 0	0 ------------- 0
18DANIEL J SUCATO MDMS CHIEF OF STAFF (SEE SCH J**)	(i) (ii)	851,738 ------------- 33,600	0 ------------- 0	80,360 ------------- 0	335,099 ------------- 0	32,162 ------------- 0	1,299,359 ------------- 33,600	0 ------------- 0
19B STEPHENS RICHARDS MD CMO (SEE SCH j*)	(i) (ii)	697,554 ------------- 0	0 ------------- 0	186,121 ------------- 0	455,325 ------------- 0	23,787 ------------- 0	1,362,787 ------------- 0	0 ------------- 0
20LORI KAROL MD TERM 62020 ASSIST COS & COQ (SEE SCH J*)	(i) (ii)	657,243 ------------- 35,200	0 ------------- 0	190,244 ------------- 0	299,823 ------------- 0	33,967 ------------- 0	1,181,277 ------------- 35,200	0 ------------- 0
21KARL E RATHJEN MD ASSIST COS (SEE SCH J**)	(i) (ii)	486,289 ------------- 32,900	0 ------------- 0	32,591 ------------- 0	144,036 ------------- 0	11,055 ------------- 0	673,971 ------------- 32,900	0 ------------- 0
22PHILIP L WILSON MD ASSIST COS (SEE SCH J**)	(i) (ii)	664,949 ------------- 45,500	0 ------------- 0	57,995 ------------- 0	145,707 ------------- 0	22,287 ------------- 0	890,938 ------------- 45,500	0 ------------- 0
23JOHN A HERRING MD CHIEF OF STAFF EMERITUS	(i) (ii)	521,004 ------------- 0	0 ------------- 0	42,881 ------------- 0	0 ------------- 0	22,057 ------------- 0	585,942 ------------- 0	0 ------------- 0
24CHARLES E JOHNSTON MD ASSIST COS EMERITUS	(i) (ii)	599,472 ------------- 0	0 ------------- 0	137,835 ------------- 0	0 ------------- 0	22,287 ------------- 0	759,594 ------------- 0	52,163 ------------- 0
25LAWSON A COPLEY MD FORMER CMIO (SEE SCH J**)	(i) (ii)	27,772 ------------- 641,879	0 ------------- 0	0 ------------- 55,930	0 ------------- 197,502	0 ------------- 33,522	27,772 ------------- 928,833	0 ------------- 0
26MOLLY E DEMPSEY MD CMIO (SEE SCH J**)	(i) (ii)	568,544 ------------- 0	0 ------------- 0	27,772 ------------- 0	181,793 ------------- 0	10,547 ------------- 0	788,656 ------------- 0	0 ------------- 0
27AMY L MCINTOSH MD ORTHOPEDIC SURGEON	(i) (ii)	664,793 ------------- 40,000	0 ------------- 0	101,450 ------------- 0	16,500 ------------- 0	41,273 ------------- 0	824,016 ------------- 40,000	0 ------------- 0
28BRANDON A RAMO MD ORTHOPEDIC SURGEON	(i) (ii)	669,169 ------------- 54,850	0 ------------- 0	75,087 ------------- 0	16,500 ------------- 0	34,222 ------------- 0	794,978 ------------- 54,850	0 ------------- 0
29ROBERT L WIMBERLY MD ORTHOPEDIC SURGEON	(i) (ii)	663,530 ------------- 47,850	0 ------------- 0	75,908 ------------- 0	16,500 ------------- 0	11,788 ------------- 0	767,726 ------------- 47,850	0 ------------- 0
30HENRY B ELLIS MD ORTHOPEDIC SURGEON	(i) (ii)	659,660 ------------- 52,950	0 ------------- 0	74,800 ------------- 0	16,500 ------------- 0	39,222 ------------- 0	790,182 ------------- 52,950	0 ------------- 0
31ANTHONY I RICCIO MD ORTHOPEDIC SURGEON	(i) (ii)	653,424 ------------- 40,300	0 ------------- 0	67,222 ------------- 0	16,500 ------------- 0	36,467 ------------- 0	773,613 ------------- 40,300	0 ------------- 0
32JC MONTGOMERY JR PRESIDENT EMERITUS (RET. 6/18)	(i) (ii)	191,419 ------------- 0	0 ------------- 0	112,595 ------------- 0	0 ------------- 0	2,806 ------------- 0	306,820 ------------- 0	87,714 ------------- 0
33JOHN G BIRCH MD FORMER ORTHOPEDIC SURGEON	(i) (ii)	162,827 ------------- 0	0 ------------- 0	178,329 ------------- 0	0 ------------- 0	0 ------------- 0	341,156 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2018

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

FORM 990, PART VII & SCHEDULE J FOOTNOTE

*PREVIOUSLY VESTED IN NON-QUALIFIED PENSION PLAN AND ACCRUED ADDITIONAL TAXABLE BENEFITS IN CALENDAR 2018. SCHEDULE J, PART I, LINE 1A TRAVEL FOR COMPANIONS (INCLUDED ON SCH J, PART II, COL B (III) & W-2, BOX 5) J. ANTHONY HERRING $715 ANTHONY RICCIO $800 DANIEL J. SUCATO $800 CHARLES JOHNSTON $800 B. STEPHENS RICHARDS $800 LORI KAROL $800 SCHEDULE J, PART I, LINE 1A SOCIAL DUES THE ORGANIZATION PAID A PORTION OF SOCIAL CLUB DUES FOR AN EMPLOYEE. THIS REIMBURSEMENT WAS INCLUDED AS TAXABLE INCOME ON SCHEDULE J, PART II, COL B (III) & W-2, BOX 5. JC MONTGOMERY, JR $1,598 **SCHEDULE J, PART I, LINE 4B THE RESTORATION OF RETIREMENT INCOME PLAN (RRIP) IS A NON-QUALIFIED PLAN PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN EMPLOYEES OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN (TSRHC) AND A RELATED ENTITY, WHOSE BENEFITS UNDER THE TAX-QUALIFIED RETIREMENT PLAN HAVE BEEN LIMITED BY THE MAXIMUM BENEFIT AND MAXIMUM COMPENSATION LIMITATIONS IMPOSED UNDER THE TAX-QUALIFIED RETIREMENT PLAN IN ORDER TO COMPLY WITH THE INTERNAL REVENUE CODE. THE TOTAL ACCUMULATED BENEFIT THAT HAS ACCRUED FOR A PARTICIPANT UNDER THE RRIP NORMALLY BECOMES VESTED AND TAXABLE TO A PARTICIPANT WHEN HE OR SHE EITHER HAS ATTAINED AGE 55 AND COMPLETED 15 YEARS OF SERVICE OR ATTAINS AGE 65. THE BENEFIT ACCRUALS FOR A PARTICIPANT AFTER THE DATE OF INITIAL VESTING ARE TAXABLE TO THE PARTICIPANT WHEN AND AS ACCRUED. RRIP BENEFITS BECOME PAYABLE AFTER TERMINATION OF EMPLOYMENT. UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEES ARE NON-VESTED PARTICIPANTS WHO ARE ACCRUING AN ANNUAL BENEFIT IN 2018. (INCLUDED ON SCH J, PART II, COL C) DANIEL SUCATO $268,353 KARL RATHJEN $ 77,017 MOLLY DEMPSEY $110,922 LAWSON COPLEY $ 132,305 EMPLOYEE OF RELATED ENTITY PHILIP WILSON $ 93,571 UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEES HAVE PREVIOUSLY VESTED IN THE RRIP AND ACCRUED ADDITIONAL BENEFITS DURING 2018, WHICH ARE SUBJECT TO TAXATION, IN THE FOLLOWING AMOUNTS. (INCLUDED IN SCH J, PART II, COL B (III) & W-2, BOX 5) B. STEPHENS RICHARDS $119,306 LORI KAROL $129,401 UNDER THE TERMS OF THE RRIP, THE FOLLOWING EMPLOYEES HAVE RETIRED AND RECEIVED PAYMENTS FROM THE PLAN WHICH ARE SUBJECT TO TAXATION, IN THE FOLLOWING AMOUNT. (INCLUDED IN SCH J, PART II, COL B (III) & W-2, BOX 5) JC MONTGOMERY, JR $71,102 JOHN BIRCH, MD $162,827 THE MANAGEMENT BENEFIT PLAN IS A NON-QUALIFIED PLAN PROVIDING SUPPLEMENTAL RETIREMENT BENEFITS TO CERTAIN ELIBIGLE EMPLOYEES WHO BECAME PARTICIPANTS PRIOR TO 1988. MONTHLY RETIREMENT INCOME BENEFITS BECOME PAYABLE UNDER THE PLAN COMMENCING AT AGE 65 (OR EARLIER DISABILITY), AND ARE TAXABLE TO PARTICIPANTS WHEN AND AS PAID. UNDER THE TERMS OF THE MANAGEMENT BENEFIT PLAN, THE FOLLOWING EMPLOYEES RECEIVED PAYMENTS IN 2018. (INCLUDED ON SCH J, PART II, COL F AND W-2, BOX 1 AND 5) ROBERT WALKER $32,352 JOHN BIRCH $85,416 CHARLES JOHNSTON $128,511 THE FLEXIBLE BENEFITS PLAN IS A NON-QUALIFIED PLAN PROVIDING LIFE INSURANCE, DISABILITY INSURANCE, LONG-TERM CARE INSURANCE AND/OR RETIREMENT BENEFITS TO ELIGIBLE EMPLOYEES OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN ITSRHC) AND A RELATED ENTITY, AT THEIR ELECTION. THE INSURANCE PREMIUM AND RETIREMENT ACCOUNT CONTRIBUTION AMOUNTS ALLOCATED TO A PARTICIPANT UNDER THIS PLAN FOR EACH YEAR ARE TAXABLE TO THE PARTICIPANT FOR SUCH YEAR. THE EARNINGS ON RETIREMENT ACCOUNT CONTRIBUTIONS BECOME TAXABLE TO A PARTICIPANT WHEN PAID OR MADE AVAILABLE TO THE PARTICIPANT. UNDER THE TERMS OF THE FLEXIBLE BENEFITS PLAN, THE FOLLOWING EMPLOYEES WERE TAXED ON THE FOLLOWING AMOUNTS FOR CALENDAR YEAR 2018. (INCLUDED IN SCH J, PART II, COL 8 (III), AND W-2, BOX 5) AMY MCINTOSH $28,249 B. STEPHENS RICHARDS $31,185 BRANDON RAMO $28,249 CHARLES JOHNSTON $27,145 CONNIE WRIGHT $11,385 DANIEL SUCATO $36,835 DEBBIE SAYLES $12,515 DONALD KATZ $11,495 ELLEN HAYNES $ 8,539 FREDERICK RICHMOND $16,686 J. ANTHONY HERRING $23,625 JEAN ALLEN $ 8,068 JEREMY HOWELL $ 9,502 KARL RATHJEN $21,446 KRISTINA KEEVER-SMITH $10,382 LAWSON COPLEY $27,427 (EMPLOYED BY RELATED ENTITY) LESLIE CLONCH $15,759 LORI DALTON $17,613 LORI KAROL $28,429 MARK BATEMAN $16,686 MATT CHANCE $13,210 MOLLIE DEMPSEY $25,771 PHILIP WILSON $28,249 ROBERT WALKER $37,076 STEPHANIE BRIGGER $ 8,575 WILLIAM HUSTON $17,381 HENRY ELLIS $28,249 ANTHONY RICCIO $28,249 JC MONTGOMERY, JR $18,720

Schedule J (Form 990) 2018

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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 the latest information.

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization
Texas Scottish Rite Hospital for Crippled
Children

Employer identification number
75-0818178

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	CITY OF PARKER TX CULTURAL EDUCATION FACILITIES	27-0365113	000000000	12-30-2010	23,000,000	CONSTRUCT & EQUIP POWER PLANT		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	0
2 Amount of bonds legally defeased ..............	0
3 Total proceeds of issue ..................	23,000,000
4 Gross proceeds in reserve funds .............	0
5 Capitalized interest from proceeds .............	2,459,679
6 Proceeds in refunding escrows ...............	0
7 Issuance costs from proceeds ...............	111,125
8 Credit enhancement from proceeds .............	-1,044,914
9 Working capital expenditures from proceeds .............	0
10 Capital expenditures from proceeds .............	22,735,606
11 Other spent proceeds .............	0
12 Other unspent proceeds .............	0
13 Year of substantial completion .............	2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X
15 Were the bonds issued as part of 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) 2018

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?
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 .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...
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?.............
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? .............
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? ........

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 ..........	JP MORGAN CHASE
c Term of hedge .........	10 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X

Schedule K (Form 990) 2018

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 IV, LINE 2B:	Arbitrage - Exception to rebate Construction fund exempt from rebate based on two year spend down rules.

Schedule K (Form 990) 2018

Additional Data

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I

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

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

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

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

Part II

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

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






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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2018

Page 2

Part IV

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

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) DODGE CARTER RESIGNED 12019	GRANDSON TO TRUSTEE	33,180	EMPLOYEE/NON-OFFICER OF TSRHC		No

Part V

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

Return Reference	Explanation
BUSINESS TRANSACTIONS	SCHEDULE L, PART IV DODGE CARTER IS THE GRANDSON OF HAROLD D. CARTER, TRUSTEE.

Schedule L (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..	X	1	4,870	MARKET VALUE
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	12	304,094	MARKET VALUE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .	X	1	384,000	MARKET VALUE
16 Real estate—Commercial ..	X	2	4,527,000	MARKET VALUE
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Mineral Interests )	X	2	9	0
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

30a

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

30a

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

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

32a

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

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

32a

Yes

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2018)

Page 2

Part II

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

Return Reference	Explanation
SCHEDULE M, PART I, LINE 32A	SOLICITATION, PROCESSING, OR SALE OF NONCASH CONTRIBUTIONS TSRHC USES THIRD PARTY BROKERS TO SELL DONATED SECURITIES AND OTHER THIRD PARTY SPECIALISTS TO SELL OTHER NONCASH DONATIONS OF VEHICLES, REAL ESTATE AND OTHER ASSETS.

Schedule M (Form 990) (2018)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public
Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

Return Reference	Explanation
DOING BUSINESS AS	FORM 990, BOX C TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN PROGRAM SERVICES - PATIENT CARE (CONT.) FORM 990, PART III, LINE 4 THE NEUROLOGY PROGRAM PROVIDES CARE IN SPECIALIZED CLINICS FOR ORTHOPEDIC PATIENTS WHO HAVE RELATED NEUROLOGICAL DISORDERS AND NEUROMUSCULAR DISEASES SUCH AS TUBEROUS SCLEROSIS. THE PEDIATRIC DEVELOPMENTAL DISABILITIES PROGRAM INCLUDES OUTPATIENT CLINIC VISITS FOR THE DIAGNOSIS AND TREATMENT OF CONDITIONS SUCH AS SPINA BIFIDA AND CEREBRAL PALSY. ALL PROGRAMS, INCLUDING ORTHOPEDIC, NEUROLOGY AND LEARNING DISORDERS, TAKE AN INTERDISCIPLINARY APPROACH TO PROVIDING THE BEST POSSIBLE FAMILY-CENTERED CARE. PROGRAM SERVICES - RESEARCH (CONT.) FORM 990, PART III, LINE 4B HOSPITAL RESEARCHERS HAVE STRIVED TO DISCOVER NEW AND BETTER WAYS TO CARE FOR CHILDREN, AND HAVE GENERATED MORE THAT 30 PATENTS. THEY HAVE MADE IMPORTANT DISCOVERIES THAT HAVE HELPED CHILDREN WORDWIDE, INCLUDING DISCOVERING THE FIRST GENE ASSOCIATED WITH IDIOPATHIC SCOLIOSIS AND TWO MORE GENETIC MARKERS OF THE CONDITION. THROUGH RESEARCH, NEW DEVICES AND TREATMENT SYSTEMS HAVE BEEN CREATED, INCLUDING THE TSRH SILO 5.5 SPINAL SYSTEM, THE TRUE/LOK EXTERNAL FIXATION SYSTEM AND THE TRUE/LOK HEXAPOD SYSTEM. PROGRAM SERVICES - EDUCATION (CONT.) FORM 990, PART III, LINE 4C FOR 38 YEARS, IN ASSOCIATION WITH THE UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER, THE HOSPITAL HAS PROVIDED AN EXTRAORDINARY EDUCATIONAL EXPERIENCE IN THE FIELD OF PEDIATRIC ORTHOPEDICS TO PROMISING ORTHOPEDIC SURGEONS. NEARLY 200 PHYSICIANS HAVE BENEFITED FROM THE HOSPITAL'S FELLOWSHIP IN PEDIATRIC ORTHOPEDICS AND SCOLIOSIS, WITH MANY GOING ON TO HOLD PRESTIGIOUS MEDICAL POSITIONS ACROSS THE COUNTRY AND AROUND THE WORLD. IN ADDITION, PHYSICIANS FROM SOME OF THE MAJOR HAND CENTERS HAVE TRAINED AT THE HOSPITAL IN THE SUB-SPECIALTY OF PEDIATRIC HAND SURGERY. THE HOSPITAL ALSO PARTICIPATES IN RESIDENCY TRAINING PROGRAMS IN NEUROLOGY, RHEUMATOLOGY, PSYCHOLOGY, RADIOLOGY AND PEDIATRIC DEVELOPMENTAL DISABILITIES. AFFILIATION PROGRAMS IN NURSING, PHYSICAL THERAPY, PROSTHETICS AND OTHER DISCIPLINES ALSO EXIST. FAMILY AND BUSINESS RELATIONSHIPS FORM 990, PART VI, SECTION A, LINE 2 LYNDON L. OLSON AND RON CARTER HAVE A BUSINESS RELATIONSHIP. J. ANTHONY HERRING, MD, CHARLES E. JOHNSTON, MD, LORI KAROL, MD, B. STEPHENS RICHARDS, MD, KARL E. RATHJEN, MD, PHILIP L. WILSON, MD, LAWSON A. B. COPLEY, MD, AMY MCINTOSH, MD, BRANDON RAMO, MD, R. LANE WIMBERLY, MD, ANTHONY RICCIO, MD, HENRY ELLIS, MD, AND DANIEL J. SUCATO, MD, HAVE A BUSINESS RELATIONSHIP WITH ROBERT WALKER, WILLIAM HUSTON AND LORI DALTON IN THAT THE PHYSICIANS ARE DIRECTORS OF PEDI-ORTHO HEALTH CORPORATION, AN ENTITY FOR WHICH TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN IS THE SOLE MEMBER, IN WHICH THE LATTER INDIVIDUALS SERVE AS OFFICERS. LORI DALTON AND KRISTINA KEEVER-SMITH HAVE A BUSINESS RELATIONSHIP IN THAT THEY ARE EMPLOYED BY TEXAS SCOTTISH HOSPITAL FOR CHILDREN AND ALSO SERVE AS OFFICERS OF LEGACY SCHOLARSHIP FUND, A RELATED ENTITY. ROBERT L. WALKER, LORI DALTON, WILLIAM HUSTON AND KARL RATHJEN HAVE A BUSINESS RELATIONSHIP IN THAT THEY ARE EMPLOYED BY TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN AND ALSO SERVE AS OFFICERS OF TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN FOUNDATION AN ENTITY FOR WHICH TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN IS THE SOLE MEMBER. GOVERNING DOCUMENTS FORM 990, PART VI, SECTION A, LINE 4 IN APRIL 2019 THE BOARD OF TRUSTEES APPROVED THE AMENDMENT AND RESTATEMENT OF THE BYLAWS AND CERTIFICATE OF FORMATION. THE AMENDMENT CHANGED THE COMPOSITION AND NUMBER OF TRUSTEES, PROVIDED FOR THE TRANSITION TO THE REVISED NUMBER OF TRUSTEES, ADDRESSED THE ROLE OF THE GOVERNANCE COMMITTEE, REVISED THE METHOD OF AMENDING THE BYLAWS, AND MADE CHANGES IN THE LANGUAGE REGARDING OFFICERS.
Process used to review the Form 990	FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED INTERNALLY IN CONJUNCTION WITH OUTSIDE ACCOUNTANTS AND THEN REVIEWED BY MANAGEMENT. A COPY OF THE FORM 990 IS PROVIDED TO THE AUDIT AND COMPLIANCE COMMITTEE FOR REVIEW AND DISCUSSION. THE FORM 990 IS PROVIDED TO THE BOARD THROUGH ACCESS TO A SECURE PORTAL FOR REVIEW BEFORE IT IS FILED. COMPLIANCE WITH WRITTEN CONFLICT OF INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION ANNUALLY REQUIRES OFFICERS, KEY EMPLOYEES AND TRUSTEES TO COMPLETE A CONFLICTS OF INTEREST FORM DISCLOSING ACTUAL OR POTENTIAL CONFLICTS OF INTEREST IN COMPLIANCE WITH THE ORGANIZATION'S CONFLICTS OF INTEREST POLICY. ADDITIONALLY, THESE INDIVIDUALS ARE TO REPORT ANY NEW MATTERS THAT ARISE DURING THE YEAR IF THEY BECOME AWARE OF A TRANSACTION THAT IS UNDER CONSIDERATION THAT PRESENTS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. ANNUALLY THE GENERAL COUNSEL PREPARES AND SUBMITS A SUMMARY OF THE DISCLOSED POTENTIAL CONFLICTS TO THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. ADDITIONALLY, AT THE TIME A KEY STAFF MEMBER IS HIRED OR PROMOTED TO A POSITION WITH ADMINISTRATIVE OR MANAGEMENT RESPONSIBILITIES, THE ORGANIZATION PROVIDES THE INDIVIDUAL WITH A COPY OF THE CONFLICTS OF INTEREST POLICY AND THE INDIVIDUAL IS REQUIRED TO COMPLETE A CONFLICTS OF INTEREST DISCLOSURE FORM. ALL MATERIAL FACTS SURROUNDING CONTRACTS, TRANSACTIONS, OR ARRANGEMENTS INVOLVING A CONFLICT OF INTEREST ARE TO BE DISCLOSED TO ENSURE THAT THE CONTRACT, TRANSACTION OR ARRANGEMENT IS FAIR TO THE HOSPITAL AT THE TIME IT IS AUTHORIZED, APPROVED OR RATIFIED.
PROCESS FOR DETERMINING COMPENSATION	FORM 990, PART VI, SECTION B, LINE 15A AND 15B THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES ANNUALLY REVIEWS AND APPROVES SALARIES AND BENEFITS FOR OFFICERS, MEMBERS OF THE MEDICAL STAFF AND KEY EMPLOYEES OF THE ORGANIZATION. THE HOSPITAL REVIEWS VARIOUS EXECUTIVE/PHYSICIAN COMPENSATION SURVEYS, INCLUDING DATA FROM PEDIATRIC HOSPITALS AND PHYSICIAN PRACTICES ON BOTH A LOCAL AND NATIONAL BASIS. BI-ANNUALLY, AN INDEPENDENT CONSULTANT REVIEWS SALARIES AND BENEFITS OF OFFICERS, PHYSICIANS AND KEY EMPLOYEES. THIS REVIEW WAS LAST UNDERTAKEN IN FISCAL YEAR 2019 FOR OFFICERS AND MEDICAL STAFF. GOVERNING DOCUMENT, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTERST POLICY AND FINANCIAL STATEMENTS ARE MAINTAINED BY THE HOSPITAL AND ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
RECONCILIATION OF NET ASSETS	FORM 990, PART XI, LINE 9 PENSION LIABILITY ADJUSTMENT $ 39,499,818 CHANGE IN BENEFICIAL INTERESTS IN TRUSTS $ 6,316,332 TOTAL $ 45,816,150

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2018

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2018

Open to Public Inspection

Name of the organization

Texas Scottish Rite Hospital for Crippled
Children

Employer identification number

75-0818178

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)PEDI-ORTHO HEALTH CORPORATION 2222 WELBORN ST DALLAS,TX75219 75-2665759	PHYSICIANS	TX	501(c)(3)	9	TSRH	Yes
(2)TSRHC SCHOLARSHIP FD (DBA LEGACY SCHLRP) 2222 WELBORN ST DALLAS,TX75219 75-2106637	SCHOLARSHIPS	TX	501(c)(3)	7	NA		No
(3)TEXAS SCOTTISH RITE HOSPITAL TRUST C/O JPMORGAN CHASE POB 3038 MILWAUKEE,WI53201 75-6013875	SUPPORT ORG	WI	501(c)(3)	12D, III-O	NA		No
(4)TSRH FOR CHILDREN FOUNDATION 2222 WELBORN ST DALLAS,TX75219 46-0683787	SUPPORT ORG	TX	501(c)(3)	7	TSRHC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2018

Page 2

Part III

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

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

Part IV

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

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

Schedule R (Form 990) 2018

Page 3

Part V

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) PEDI-ORTHO HEALTH CORPORATION	b	90,465	MARKET
(2) PEDI-ORTHO HEALTH CORPORATION	L	945,948	MARKET
(3) PEDI-ORTHO HEALTH CORPORATION	M	58,966	MARKET
(4) PEDI-ORTHO HEALTH CORPORATION	Q	1,356,891	MARKET
(5) TSRH FOR CHILDREN FOUNDATION	C	317,005	MARKET
(6) PEDI-ORTHO HEALTH FOUNDATION	O	65,762	MARKET

Schedule R (Form 990) 2018

Page 4

Part VI

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

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

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

Schedule R (Form 990) 2018

Page 5

Part VII

Supplemental Information

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

Return Reference	Explanation

Schedule R (Form 990) 2018

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: IMPROVING THE LIVES OF CHILDREN WITH ORTHOPEDIC RELATED CONDITIONS THROUGH PATIENT CARE, RESEARCH AND EDUCATION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	33
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	32
5	Total number of individuals employed in calendar year 2018 (Part V, line 2a) ......	5	1,300
6	Total number of volunteers (estimate if necessary) .............	6	1,028
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	2,884,587
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	38,963,246	41,749,432
9	Program service revenue (Part VIII, line 2g) .........	73,837,695	82,372,618
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	120,707,583	104,077,841
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	179,590,274	134,755,657
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	413,098,798	362,955,548
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	1,977,511	2,203,000
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)	117,759,961	127,855,760
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 14,475,165
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	75,894,106	93,617,192
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	195,631,578	223,675,952
19	Revenue less expenses. Subtract line 18 from line 12.......	217,467,220	139,279,596
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,946,249,361	3,071,405,778
21	Total liabilities (Part X, line 26).............	162,548,074	202,672,595
22	Net assets or fund balances. Subtract line 21 from line 20.....	2,783,701,287	2,868,733,183

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 145,798,045 including grants of $ 2,203,000 ) (Revenue $ 82,372,618 )
	PATIENT CARE TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN IS ONE OF THE NATION'S LEADING PEDIATRIC CENTERS FOR THE TREATMENT OF ORTHOPEDIC CONDITIONS, CERTAIN RELATED ARTHRITIC AND NEUROLOGICAL DISORDERS AND LEARNING DISORDERS, SUCH AS DYSLEXIA. PATIENTS RECEIVE TREATMENT REGARDLESS OF THE FAMILY'S ABILITY TO PAY. THE ORTHOPEDICS PROGRAM INCLUDES OUTPATIENT CLINIC VISITS AND INPATIENT STAYS FOR THE DIAGNOSIS AND TREATMENT OF SUCH CONDITIONS AS SCOLIOSIS, CLUBFOOT, DISLOCATED HIP, LEGG-PERTHES, LIMB-LENGTH DIFFERENCES AND LIMB DEFICIENCIES, HAND DIFFERENCES AND SPORTS INJURIES. (CONTINUED ON SCHEDULE O.)

4b	(Code: ) (Expenses $ 13,312,526 including grants of $ 0 ) (Revenue $ 0 )
	RESEARCH THE HOSPITAL'S DEDICATED RESEARCH CENTER, THE SARAH M. AND CHARLES E. SEAY CENTER FOR MUSCULOSKELETAL RESEARCH, IS MADE UP OF SIX CENTERS OF EXCELLENCE - SCOLIOSIS AND SPINE DISORDERS, CLUBFOOT AND FOOT DISORDERS, HIP DISORDERS, LIMB LENGTH AND RECONSTRUCTION, HAND DIFFERENCES AND SPORTS MEDICINE - SUPPORTED BY RESEARCH DIVISIONS AND CORE FACILITIES. (CONTINUED ON SCHEDULE O.)

4c	(Code: ) (Expenses $ 6,846,448 including grants of $ 0 ) (Revenue $ 0 )
	EDUCATION TEXAS SCOTTISH RITE HOSPITAL FOR CHILDREN FUNCTIONS AS A PREMIER TEACHING INSTITUTION, PROVIDING COMPREHENSIVE EDUCATION AND TRAINING TO ORTHOPEDIC RESIDENTS AND POST-GRADUATE ORTHOPEDIC FELLOWS. IN ADDITION, THE HOSPITAL CONTRIBUTES TO THE EDUCATION OF ALLIED HEALTH PROFESSIONALS BY PROVIDING CLINICAL EXPERIENCE AND DIDACTIC EDUCATION FOR STUDENTS AS WELL AS CONTINUING EDUCATION FOR HEALTH CARE PROFESSIONALS. THE HOSPITAL IS CURRENTLY AFFILIATED WITH 57 INSTITUTIONS, INCLUDING COLLEGES, UNIVERSITIES AND TECHNICAL TRAINING PROGRAMS. (CONTINUED ON SCHEDULE O.)

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses165,957,019

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	16,261,275	1,080,959	3,012,992

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	2,916,923
d	Related organizations		1d
e	Government grants (contributions)		1e	566,865

f	All other contributions, gifts, grants, and similar amounts not included above		1f	38,265,644

g	Noncash contributions included in lines 1a - 1f:$ 5,219,973
h Total. Add lines 1a-1f.......		41,749,432

		Business Code
2a	OUTPATIENT REVENUE	622310	133,090,748	133,090,748	0	0
b	INPATIENT REVENUE	622310	70,744,601	70,744,601	0	0
c	DEDUCTIONS FROM REVENUE	622310	-126,715,508	-126,715,508	0	0
d	OTHER PATIENT RELATED REV	622310	5,252,777	5,252,777	0	0
e
f	All other program service revenue.
g	Total. Add lines 2a–2f ....		82,372,618

3 Investment income (including dividends, interest, and othersimilar amounts) ......			79,560,925		1,542,538	78,018,387
4 Income from investment of tax-exempt bond proceeds			0
5 Royalties...........			118,806,971			118,806,971
		(ii) Personal	(i) Real
6a	Gross rents		458,599
b	Less: rental expenses		63,270
c	Rental income or (loss)	0	395,329
d	Net rental income or (loss)......			395,329			395,329
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,692,377	479,385,718
b	Less: cost or other basis and sales expenses	1,484,312	456,076,867
c	Gain or (loss)	1,208,065	23,308,851
d	Net gain or (loss).....			24,516,916		30,074	24,486,842
8a	Gross income from fundraising events (not including $ 2,916,923of contributions reported on line 1c). See Part IV, line 18 ....
	a		694,224
b	Less: direct expenses ...b		1,059,129
c	Net income or (loss) from fundraising events..			-364,905			-364,905
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a		16,100
b	Less: direct expenses ...b		0
c	Net income or (loss) from gaming activities..			16,100			16,100
10a	Gross sales of inventory, less returns and allowances ..
	a		4,671,448
b	Less: cost of goods sold ..b		2,494,720
c	Net income or (loss) from sales of inventory..			2,176,728		1,255,268	921,460
Business Code			Miscellaneous Revenue
11a	SURFACE DAMAGE/WATER SALE		110000	6,397,139	0	0	6,397,139
b	LEASE BONUS REVENUE		211110	7,205,128	0	0	7,205,128
c	HUNTING PERMITS		112111	44,200	0	44,200	0
d	All other revenue ....			78,967	0	12,507	66,460
e	Total. Add lines 11a–11d ......			13,725,434
12	Total revenue. See Instructions......			362,955,548	82,372,618	2,884,587	235,948,911

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	2,203,000	2,203,000
2	Grants and other assistance to domestic individuals. See Part IV, line 22	0	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, line 15 and 16.	0	0
4	Benefits paid to or for members	0	0
5	Compensation of current officers, directors, trustees, and key employees ....	12,211,543	3,558,366	7,101,813	1,551,364
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	86,695,166	73,321,503	8,466,085	4,907,578
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	10,665,034	9,349,694	698,483	616,857
9	Other employee benefits .......	12,977,113	10,976,952	1,257,009	743,152
10	Payroll taxes ...........	5,306,904	4,498,043	508,224	300,637
11	Fees for services (non-employees):
a	Management ......	0			0
b	Legal .........	719,084	37,213	681,871	0
c	Accounting ...........	477,107	0	477,107	0
d	Lobbying ...........	176,796	0	176,796	0
e	Professional fundraising services. See Part IV, line 17	0			0
f	Investment management fees ......	5,035,291	0	5,035,291	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	9,175,398	5,956,312	2,970,570	248,516
12	Advertising and promotion ....	3,830,802	0	18,990	3,811,812
13	Office expenses .......	8,095,555	5,978,998	1,086,535	1,030,022
14	Information technology ......	8,576,790	6,886,932	1,421,498	268,360
15	Royalties ..	0	0	0	0
16	Occupancy ...........	7,171,375	5,885,871	1,114,398	171,106
17	Travel ............	898,561	664,399	213,836	20,326
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .	0	0	0	0
19	Conferences, conventions, and meetings ....	326,687	232,942	87,938	5,807
20	Interest ...........	849,244	720,954	94,363	33,927
21	Payments to affiliates .......	0	0	0	0
22	Depreciation, depletion, and amortization ..	20,418,280	18,206,992	1,658,647	552,641
23	Insurance ...	829,264	70,790	758,474	0
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL & OTHER SUPPLIES	17,898,154	17,408,058	277,036	213,060
b	RANCH OPERATIONS	2,913,276	0	2,913,276	0
c	BAD DEBT EXPENSE	5,896,018	0	5,896,018	0
d	CGA ACTUARIAL EXPENSE	278,982	0	278,982	0
e	All other expenses	50,528		50,528
25	Total functional expenses. Add lines 1 through 24e	223,675,952	165,957,019	43,243,768	14,475,165
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).	0

1	Cash–non-interest-bearing ........			3,333,287	1	7,782,050
2	Savings and temporary cash investments .........			0	2	0
3	Pledges and grants receivable, net ......			11,873,695	3	11,200,763
4	Accounts receivable, net .............			35,592,800	4	36,662,225
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L .............
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L ..............
				0	6	0
7	Notes and loans receivable, net ....			9,332	7	8,034
8	Inventories for sale or use ........			5,526,955	8	3,570,799
9	Prepaid expenses and deferred charges ......			7,686,043	9	7,108,582
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	479,989,438
b	Less: accumulated depreciation	10b	192,410,819	270,865,697	10c	287,578,619
11	Investments—publicly traded securities .			2,525,773,487	11	2,629,992,287
12	Investments—other securities. See Part IV, line 11 .....			124,670	12	124,670
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 ...........			85,463,395	15	87,377,749
16	Total assets. Add lines 1 through 15 (must equal line 34)...			2,946,249,361	16	3,071,405,778

17	Accounts payable and accrued expenses .....	24,916,057	17	20,743,856
18	Grants payable ...	0	18	0
19	Deferred revenue .........	518,360	19	2,870,913
20	Tax-exempt bond liabilities .........	23,000,000	20	23,000,000
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	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	114,113,657	25	156,057,826
26	Total liabilities. Add lines 17 through 25..	162,548,074	26	202,672,595

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	2,657,069,737	27	2,741,292,740
28	Temporarily restricted net assets ...........	54,385,822	28	53,229,036
29	Permanently restricted net assets	72,245,728	29	74,211,407
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	2,783,701,287	33	2,868,733,183
34	Total liabilities and net assets/fund balances ........	2,946,249,361	34	3,071,405,778

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .	Yes	No