TY 2020 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) RODRIGO LOPEZ...................................................................... INTERIM PRES/CEO THRU 9/7/20	40.00 ................. 0.00	X	X	795,096	9,018
(2) CHANDA CHACON...................................................................... PRESIDENT/CEO BEG 9/8/20	40.00 ................. 0.00	X	X	431,792	48,326
(3) DIANE DURAN...................................................................... CHAIR	1.00 ................. 0.00	X	X	0	0
(4) MARGARET HERSHISER...................................................................... VICE CHAIR	1.00 ................. 0.00	X	X	0	0
(5) SAMANTHA MOSSER...................................................................... SECRETARY	1.00 ................. 0.00	X	X	0	0
(6) JIM GREISCH...................................................................... TREASURER	1.00 ................. 0.00	X	X	0	0
(7) BRAD BRABEC MD...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(8) BRADLEY BRITIGAN MD...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(9) JOLEEN DAVID...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(10) DAVE DIAMOND...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(11) ROBERT DUNLAY MD...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(12) BRIAN FAHEY...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(13) MARK HASEBROOCK...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(14) JOHN JENKINS...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(15) STEVE LINDSAY...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(16) MICHAEL ROBINO...................................................................... MEMBER	1.00 ................. 0.00	X		0	0
(17) AMY RYAN...................................................................... MEMBER	1.00 ................. 0.00	X		0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC)
(18) STACY SCHOLTZ........................................................................ MEMBER	1.00 .......................0.00	X				0	0
(19) RYAN SEWELL MD........................................................................ MEMBER	1.00 .......................0.00	X				0	0
(20) JAYESH THAKKER MD........................................................................ MEMBER	1.00 .......................0.00	X				0	0
(21) SCOT THOMPSON........................................................................ MEMBER	1.00 .......................0.00	X				0	0
(22) KATHY ENGLISH........................................................................ EVP COO & CNO	40.00 .......................0.00		X			959,878	92,901
(23) CHRISTOPHER MALONEY MD........................................................................ EVP CCO & PIC	40.00 .......................0.00		X			901,904	99,224
(24) MICHAEL BROWN........................................................................ EVP STRAT & TRANS THRU 1/3/20	40.00 .......................0.00		X			799,601	1,010
(25) AMY HATCHER........................................................................ EVP & CFO	39.00 .......................1.00		X			618,442	82,992
(26) AMY BONES........................................................................ SVP & GENERAL COUNSEL	40.00 .......................0.00		X			521,930	61,122
(27) JEROLD VUCHAK........................................................................ SVP CHIEF INFO OFFICER	40.00 .......................0.00		X			457,604	58,104
(28) JANEL ALLEN........................................................................ SVP & CHIEF PEOPLE OFFICER	40.00 .......................0.00		X			347,086	67,027
(29) STEVEN C BURNHAM........................................................................ SVP PHYS NETWORKS THRU 1/3/20	40.00 .......................0.00		X			292,770	920
(30) SUZANNE NOCITA........................................................................ SVP & CHRO THRU 1/3/20	40.00 .......................0.00		X			259,106	843
(31) BRIAN ALLISON........................................................................ VP SURG SERVICES THRU 9/24/20	40.00 .......................0.00			X		478,269	15,551
(32) JAMIE DRAKE MD........................................................................ PHYSICIAN	40.00 .......................0.00			X		440,987	7,816
(33) NICOLE VILLARREAL MD........................................................................ PHYSICIAN	40.00 .......................0.00			X		461,040	26,527
(34) MALINDA BENDER MD........................................................................ PHYSICIAN	40.00 .......................0.00			X		452,998	10,705
(35) KARI KRENZER MD........................................................................ PHYSICIAN	40.00 .......................0.00			X		383,993	29,579
(36) RICHARD AZIZKHAN MD........................................................................ FORMER PRES/CEO	40.00 .......................0.00				X	969,020	0

(A) Name and business address	(B) Description of services	(C) Compensation
CHOICE SOLUTIONS LLC 7015 COLLEGE BLVD STE 300 OVERLAND PARK,KS66211	IT SERVICES	1,824,896
BAKER TILLY US LLP 4807 INNOVATE LN PO BOX 7398 MADISON,WI53707	CONSULTING SERVICES	1,499,130
UNMC PATHOLOGY 983135 NEBRASKA MEDICAL CENTER OMAHA,NE68198	LABS - OUTSOURCED	607,383
ALITHYA TRAVERCENT LLC 2425 N CENTRAL EXPRESSWAY STE 130 RICHARDSON,TX75080	CONSULTING SERVICES	455,599
ENT SPECIALISTS 720 N 129TH ST OMAHA,NE68154	CLINICAL/CALL SERVICES	395,217
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 31

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

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

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

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

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) 2020

Page 2

Part II

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

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2019 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2020. 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—2019. 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—2020. 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—2019. 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) 2020

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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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) 2016	(b) 2017	(c) 2018	(d) 2019	(e) 2020	(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 5 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 2020 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2019 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2020 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2019 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2020. 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—2019. 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) 2020

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) 2020

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 lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described in 11a above?

11b

A 35% controlled entity of a person described in line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2020

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 0.015 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 0.035	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) 2020

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2020 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2020	(iii) Distributable Amount for 2020
1 Distributable amount for 2020 from Section C, line 6
2 Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2020:
a From 2015.......
b From 2016.......
c From 2017.......
d From 2018.......
e From 2019.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2020 distributable amount
i Carryover from 2015 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2020 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2020 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2020, 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 2020. 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 2021. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2016.....
b Excess from 2017.....
c Excess from 2018.....
d Excess from 2019.....
e Excess from 2020.....

Schedule A (Form 990 or 990-EZ) (2020)

Schedule A (Form 990 or 990-EZ) 2020

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) 2020

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

2020

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020) Page 2

Name of organization CHILDREN'S HOSPITAL & MEDICAL CENTER

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 3

Name of organization CHILDREN'S HOSPITAL & MEDICAL CENTER		Employer identification number 47-0379754

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) (2020)

Schedule B (Form 990, 990-EZ, or 990-PF) (2020)

Page 4


Name of organization CHILDREN'S HOSPITAL & MEDICAL CENTER			Employer identification number 47-0379754
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) (2020)

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

2020

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

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

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) 2020

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.)		(a) Filing organization's totals	(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................	0
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................	85,016
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................	85,016
d	Other exempt purpose expenditures ...............................................................................	434,803,316
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................	434,888,332
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.	1,000,000
	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) .................................................	250,000
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................	0
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................	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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) Total

2a	Lobbying nontaxable amount	1,000,000	1,000,000	1,000,000	1,000,000	4,000,000

b	Lobbying ceiling amount (150% of line 2a, column(e))					6,000,000

c	Total lobbying expenditures	63,273	69,794	84,126	85,016	302,209

d	Grassroots nontaxable amount	250,000	250,000	250,000	250,000	1,000,000

e	Grassroots ceiling amount (150% of line 2d, column (e))					1,500,000

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2020

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

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

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

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

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

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

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

Schedule C (Form 990 or 990EZ) 2020

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2020

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 ....	92,781,994	88,066,716	80,139,900	71,680,964	53,221,748
b	Contributions ...	8,659,064	5,785,740	8,481,002	9,780,310	20,698,028
c	Net investment earnings, gains, and losses	650,201	768,122	127,409	338,557	249,787
d	Grants or scholarships ...	133,073	1,838,583	681,595	1,659,931	2,488,599
e	Other expenditures for facilities and programs ...	1,997,257	0	0
f	Administrative expenses ....			0
g	End of year balance ......	99,960,929	92,781,995	88,066,716	80,139,900	71,680,964

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

Board designated or quasi-endowment SchDMd Bullet

39.500 %

Permanent endowment SchDMd Bullet

8.100 %

Term endowment SchDMd Bullet

52.400 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	36,928,611		36,928,611
b	Buildings ....	294,017,897	130,049,277	163,968,620
c	Leasehold improvements	18,361,503	11,944,332	6,417,171
d	Equipment ....	142,637,427	112,411,639	30,225,788
e	Other .....	289,223,907	357,914	288,865,993
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				526,406,183

Schedule D (Form 990) 2020

Page 3

Part VII

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

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

Part VIII

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

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

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

Part IX

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

(a) Description				(b) Book value
(1)ESTIMATED THIRD-PARTY SETTLEMENTS				15,069,976
(2)RIGHT-OF-USE ASSETS-OPERATING, NET				16,378,324
(3)RIGHT-OF-USE ASSETS-FINANCING, NET				6,514,318
(4)INTERCOMPANY RECEIVABLE				15,634,668
(5)INVESTMENT IN DEFERRED COMPENSATION				4,421,870
(6)
(7)
(8)
(9)
(10)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				58,019,156

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
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	39,748,576
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) 2020

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

PART X, LINE 2:

FIN 48 FOOTNOTE THE COMPANY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED. CHANGES IN RECOGNITION OR MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. DURING 2020 OR 2019, THE COMPANY DID NOT RECORD ANY AMOUNTS RELATED TO UNCERTAIN TAX POSITIONS OR ANY ACCRUED INTEREST AND PENALTIES.

PART V, LINE 4

TO SUPPORT PROGRAMS, FUTURE CAPITAL IMPROVEMENTS, AND OPERATIONS OF CHILDREN'S HOSPITAL & MEDICAL CENTER.

Schedule D (Form 990) 2020

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

2020

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

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 %

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? . . . . . .

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) . . .	3,428,284		3,428,284	0.790 %
b	Medicaid (from Worksheet 3, column a) . . . . .	181,784,102	140,812,925	40,971,177	9.420 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	185,212,386	140,812,925	44,399,461	10.210 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	2,083,160	741,030	1,342,130	0.310 %
f	Health professions education (from Worksheet 5) . . .	21,705,171	1,371,847	20,333,324	4.680 %
g	Subsidized health services (from Worksheet 6) . . . .	170,941,340	110,779,308	60,162,032	13.830 %
h	Research (from Worksheet 7) .	1,419,098	0	1,419,098	0.330 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	618,156	80,000	538,156	0.120 %
j	Total. Other Benefits . .	196,766,925	112,972,185	83,794,740	19.270 %
k	Total. Add lines 7d and 7j .	381,979,311	253,785,110	128,194,201	29.480 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2020

Schedule H (Form 990) 2020

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	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	13,000	0	13,000	0 %
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building	2,500	0	2,500	0 %
7	Community health improvement advocacy
8	Workforce development
9	Other	640,531	161,416	479,115	0.110 %
10	Total	656,031	161,416	494,615	0.110 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

524,815

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).....

103,072

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

902,997

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

-799,925

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) 2020

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	CHILDREN'S HOSPITAL & MEDICAL CENTER 8200 DODGE STREET OMAHA,NE68114 WWW.CHILDRENSOMAHA.ORG 260005	X	X	X	X	X

Schedule H (Form 990) 2020

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)

	CHILDREN'S HOSPITAL & MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

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

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

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

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): SEE SCHEDULE H SUPPLEMENTAL INFORMATION

Other website (list url):

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

Other (describe in Section C)

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

Yes

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

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

Yes

If "Yes" (list url): SEE SCHEDULE H SUPPLEMENTAL INFORMATION

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2020

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	CHILDREN'S HOSPITAL & MEDICAL CENTER
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 200.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE PART V, SECTION C

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

SEE PART V, SECTION C

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

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 6

Part VFacility Information (continued)

Billing and Collections

	CHILDREN'S HOSPITAL & MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2020

Page 7

Part VFacility Information (continued)

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

	CHILDREN'S HOSPITAL & MEDICAL CENTER
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) 2020

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
CHILDREN'S HOSPITAL & MEDICAL CENTER	PART V, SECTION B, LINE 5: AS PART OF THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT SURVEY CONDUCTED ON BEHALF OF CHILDREN'S HOSPITAL & MEDICAL CENTER, BOYS TOWN NATIONAL RESEARCH HOSPITAL AND BUILDING HEALTHY FUTURES, KEY INFORMANTS (INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY) WERE CONTACTED BY EMAIL, INTRODUCED TO THE COMMUNITY HEALTH NEEDS ASSESSMENT KEY INFORMANT SURVEY AND PROVIDED A LINK TO TAKE THE SURVEY ONLINE; REMINDER EMAILS WERE SENT AS NEEDED TO INCREASE PARTICIPATION. SUPPORTING ORGANIZATIONS FOR THE CHNA INCLUDED: CHARLES DREW HEALTH CENTER, INC., DOUGLAS COUNTY HEALTH DEPARTMENT, LIVE WELL OMAHA, AND ONE WORLD COMMUNITY HEALTH CENTERS, INC.THESE POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS AMONG THE FAMILIES AND CHILDREN/ADOLESCENTS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. IN ALL, 166 COMMUNITY STAKEHOLDERS TOOK PART IN THE ONLINE KEY INFORMANT SURVEY, REPRESENTING COMMUNITY/BUSINESS LEADERS, PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, SOCIAL SERVICE PROVIDERS AND OTHER HEALTH CARE PROVIDERS. THESE KEY INFORMANTS REPRESENT ORGANIZATIONS THAT WORK WITH LOW-INCOME, MINORITY POPULATIONS, MEDICALLY UNDERSERVED POPULATIONS, AND INDIVIDUALS WITH CHRONIC DISEASE CONDITIONS.
CHILDREN'S HOSPITAL & MEDICAL CENTER	PART V, SECTION B, LINE 6A: BOYS TOWN NATIONAL RESEARCH HOSPITAL
CHILDREN'S HOSPITAL & MEDICAL CENTER	PART V, SECTION B, LINE 6B: BUILDING HEALTHY FUTURES, CHARLES DREW HEALTH CENTER, INC., DOUGLAS COUNTY HEALTH DEPARTMENT, LIVE WELL OMAHA, AND ONE WORLD COMMUNITY HEALTH CENTERS, INC.
CHILDREN'S HOSPITAL & MEDICAL CENTER	PART V, SECTION B, LINE 11: SEE SCHEDULE H SUPPLEMENTAL INFORMATION
CHILDREN'S HOSPITAL & MEDICAL CENTER	PART V, SECTION B, LINE 13B: CHILDREN'S RECOGNIZES THAT SOME PATIENTS WILL BE UNRESPONSIVE TO THE FINANCIAL ASSISTANCE APPLICATION PROCESS DUE TO A VARIETY OF REASONS INCLUDING BUT NOT LIMITED TO:1. LACK OF DOCUMENTATION REQUIRED TO COMPLY WITH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION REQUIREMENTS.2. LACK OF THE EDUCATIONAL LEVEL TO UNDERSTAND AND COMPLETE THE FINANCIAL ASSISTANCE APPLICATION.3. FEAR THAT INFORMATION GATHERED DURING THE APPLICATION PROCESS WILL BE USED IN THE COLLECTION PROCESS IN THE EVENT THAT THE APPLICATION IS DENIED.4. OUT OF STATE PATIENTS THAT DO NOT RESPOND TO COMPLETION OF A MEDICAID APPLICATION OR FINANCIAL ASSISTANCE APPLICATION.IN THE ABSENCE OF INFORMATION PROVIDED BY THE PATIENT OR IN CASES WHERE THE INFORMATION PROVIDED BY THE PATIENT IS INCOMPLETE, AN ASSESSMENT PROCESS UTILIZING A PREDICTIVE MODEL WILL BE DEPLOYED TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY. THE PREDICTIVE MODEL INCORPORATES INCOME AND HOUSEHOLD SIZE ESTIMATES, A SOCIO-ECONOMIC NEED FACTOR (WIC, SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM, HUD PROGRAMS), CENSUS BLOCK DATA, AS WELL AS INFORMATION ON HOME OWNERSHIP.THE APPLICATION OF THE PREDICTIVE SCORING PROCESS AND PRESUMPTIVE FINANCIAL ASSISTANCE WILL BE DEPLOYED PRIOR TO BAD DEBT ASSIGNMENT FOR ALL PATIENTS THAT HAVE NOT APPLIED FOR CHARITY CARE. CHILDREN'S IS NOT OBLIGATED TO NOTIFY THE PATIENT THAT THEY HAVE RECEIVED PRESUMPTIVE FINANCIAL ASSISTANCE.
CHILDREN'S HOSPITAL & MEDICAL CENTER	PART V, SECTION B, LINE 16J: THE POLICY IS PROVIDED TO THE PUBLIC IN SUMMARY AND THEY ARE DIRECTED TO VISIT THE CHILDREN'S HOSPITAL & MEDICAL CENTER WEBSITE FOR THE FULL POLICY.
CHILDREN'S HOSPITAL & MEDICAL CENTER	PART V, SECTION B, LINE 24: AT CHILDREN'S, COMMERCIAL INSURERS, GOVERNMENT PAYORS AND SELF-PAY BILLING PARTIES ARE ALL BILLED THE SAME GROSS CHARGE RATE FOR EACH SPECIFIC PROCEDURE PERFORMED. GROSS CHARGES ON AN FAP-PATIENT BILL ARE THEN DISCOUNTED ACCORDING TO THEIR FPG ELIGIBILITY WHICH REDUCES OR ELIMINATES THE AMOUNT THE PATIENT IS REQUIRED TO PAY.
SCHEDULE H, PART V, LINE 7A (SCHEDULE H SUPPLEMENTAL INFORMATION)	HTTPS://WWW.CHILDRENSOMAHA.ORG/GET-INVOLVED/ADVOCACY-OUTREACH/COMMUNITY-ADVOCACY/
SCHEDULE H, PART V, LINE 10A	HTTPS://WWW.CHILDRENSOMAHA.ORG/GET-INVOLVED/ADVOCACY-OUTREACH/COMMUNITY-ADVOCACY/
SCHEDULE H, PART V, LINE 11	ON NOVEMBER 29, 2018, THE BOARD OF DIRECTORS OF CHILDREN'S HOSPITAL & MEDICAL CENTER (CHILDREN'S), WHICH INCLUDES REPRESENTATIVES FROM THROUGHOUT THE COMMUNITY, MET TO DISCUSS THIS PLAN AND THE INTERNAL AND EXTERNAL PRIORITIZATION INPUT FOR ADDRESSING THE COMMUNITY HEALTH PRIORITIES IDENTIFIED THROUGH THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA).THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF CHILDREN'S. UPON REVIEW, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS APPROVED AND ADOPTED THIS CHNA AND INSTRUCTED CHILDREN'S CENTER FOR THE CHILD & COMMUNITY (THE CENTER) TO DEVELOP A NEW IMPLEMENTATION STRATEGY PLAN FOR 2019-2021 TO UNDERTAKE THESE MEASURES TO MEET THE HEALTH NEEDS OF THE COMMUNITY.SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY 2018BASED ON THE INFORMATION OBTAINED THROUGH THE CHILD & ADOLESCENT CHNA AND THE GUIDELINES SET FORTH IN HEALTHY PEOPLE 2020, THE FOLLOWING AREAS OF OPPORTUNITY REPRESENT THE SIGNIFICANT HEALTH NEEDS OF CHILDREN AND ADOLESCENTS IN THE COMMUNITY. FROM THESE DATA SETS, OPPORTUNITIES FOR CHILDREN'S HEALTH IMPROVEMENT EXIST IN THE AREA WITH REGARD TO THE FOLLOWING HEALTH ISSUES.AREAS OF OPPORTUNITY IDENTIFIED THROUGH THIS 2018 CHNA- ACCESS TO HEALTH SERVICES: * DIFFICULTY ACCESSING CHILDREN'S HEALTHCARE * FINDING A PHYSICIAN * APPOINTMENT AVAILABILITY * LACK OF TRANSPORTATION * COST OF PRESCRIPTIONS- COGNITIVE & BEHAVIORAL CONDITIONS: * AUTISM PREVALENCE * COGNITIVE & BEHAVIORAL CONDITIONS RANKED AS A TOP CONCERN IN THE ONLINE KEY INFORMANT SURVEY- DIABETES: * CHILDHOOD DIABETES PREVALENCE- INJURY & VIOLENCE: * AGE 1-4 MORTALITY * CHILDREN EXPOSED TO NEIGHBORHOOD VIOLENCE * CHILDREN FEELING UNSAFE AT SCHOOL OR GOING TO/FROM SCHOOL- MENTAL/BEHAVIORAL HEALTH: * SYMPTOMS OF DEPRESSION [AGES 5-17] * SUICIDE ATTEMPTS [HIGH SCHOOLERS] * DIAGNOSED ANXIETY [AGES 5-17] * CHRONIC WORRYING [AGES 5-17] * CHILD HAS DIFFICULTY SLEEPING [AGES 5-17] * LIVED WITH SOMEONE WITH SERIOUS MENTAL HEALTH ISSUES * FAMILY STAYS HOPEFUL IN DIFFICULT TIMES * MENTAL & EMOTIONAL HEALTH RANKED AS A TOP CONCERN IN THE ONLINE KEY INFORMANT SURVEY.- NEUROLOGICAL CONDITIONS: * BRAIN INJURIES/CONCUSSIONS- ORAL HEALTH: * CONDITION OF TEETH- NUTRITION, PHYSICAL ACTIVITY, & OBESITY: * OVERWEIGHT & OBESITY * FAST FOOD CONSUMPTION * NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT RANKED AS A TOP CONCERN IN THE ONLINE KEY INFORMANT SURVEY.- SEXUAL HEALTH: * GONORRHEA INCIDENCE [CHILDREN/ADULTS] * CHLAMYDIA INCIDENCE [CHILDREN/ADULTS] * CONDOM USE [HIGH SCHOOLERS] * USE OF BIRTH CONTROL [HIGH SCHOOLERS] * SEXUAL HEALTH RANKED AS A TOP CONCERN IN THE ONLINE KEY INFORMANT SURVEY.- TOBACCO, ALCOHOL & OTHER DRUGS: * MEMBER OF HOUSEHOLD SMOKES * DRINKING & DRIVING [HIGH SCHOOLERS] * LIFETIME ILLICIT DRUG USE [HIGH SCHOOLERS] * STEROIDS (NOT RX) * HEROIN- VISION, HEARING, & SPEECH CONDITIONS: * RECENT EYE EXAMS * CHRONIC EAR INFECTIONS * PREVALENCE OF SPEECH/LANGUAGE PROBLEMS * HEARING PROBLEMSBASED ON THE TOP HEALTH PRIORITIES IDENTIFIED THROUGH THE 2018 CHNA PROCESS - AND TAKING INTO ACCOUNT HOSPITAL RESOURCES AND OVERALL ALIGNMENT WITH THE HOSPITAL'S MISSION, GOALS, AND STRATEGIC PRIORITIES - CHILDREN'S IS COMMITTED TO ADDRESSING THE SIGNIFICANT HEALTH NEEDS IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH PROGRAMS, RESOURCES AND COLLABORATIONS TARGETING: * ACCESS TO HEALTH SERVICES * MENTAL/BEHAVIORAL HEALTH * SEXUAL HEALTH * NUTRITION, PHYSICAL ACTIVITY, & OBESITYIN ACKNOWLEDGING THE WIDE RANGE OF PRIORITY HEALTH ISSUES THAT EMERGED FROM THE CHNA PROCESS, CHILDREN'S DETERMINED THAT IT COULD ONLY EFFECTIVELY FOCUS ON THOSE WHICH IT DEEMED MOST PRESSING, MOST UNDER-ADDRESSED AND MOST WITHIN ITS ABILITY TO INFLUENCE.CHILDREN'S CREATED A 3-YEAR IMPLEMENTATION PLAN, TO BE CARRIED OUT FROM 2019 THROUGH 2021. THE IMPLEMENTATION PLAN ADDRESSES EACH STRATEGIC PRIORITY ACROSS OUR CONTINUUM OF CARE AND IDENTIFIES APPROPRIATE RESOURCES TO BE INCLUDED IN EACH YEAR'S APPROPRIATE BUDGET.2020 PROGRESS SUMMARYCHILDREN'S CONTINUES TO PROGRESS IN IMPLEMENTING THE ACTION PLAN THAT RESULTED FROM THE 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) FINDINGS. OUR TEAM IS WORKING COLLABORATIVELY ACROSS THE ORGANIZATION TO FOCUS ON HOSPITAL-BASED PROGRAMS AND SERVICES, COMMUNITY-BASED PROGRAMS AND PARTNERSHIPS THAT ADDRESS EACH PRIORITY HEALTH ISSUE IDENTIFIED THROUGH THE CHNA PROCESS, GUIDED BY KEY STRATEGIES AND SPECIFIC TACTICS. CHILDREN'S CENTER FOR THE CHILD & COMMUNITY SERVES AS THE INFRASTRUCTURE FOR COMMUNITY OUTREACH ACTIVITIES AND PROVIDES MANAGEMENT OF THE IMPLEMENTATION STRATEGY PLAN (ISP). WHILE EACH HEALTH ISSUE IS ENTIRELY UNIQUE, THERE IS A COMMON THREAD THAT CONNECTS THEM ALL: CHILDREN'S IS TASKED TO IMPROVE ACCESS TO HEALTH CARE SERVICES, OUTREACH AND EDUCATION TO THE COMMUNITY AND THE OVERALL PATIENT EXPERIENCE. CHILDREN'S CENTER FOR THE CHILD & COMMUNITYTHE CENTER IS A STATEWIDE COMMUNITY HEALTH OUTREACH HUB OF CHILDREN'S, PROVIDING THE INFRASTRUCTURE AND LEADERSHIP FOR BOTH THE INTERNAL AND EXTERNAL PARTNERSHIPS ASSOCIATED WITH THE PEDIATRIC CHNA PLANNING AND IMPLEMENTATION PROCESS.THE CENTER ALSO COLLABORATES WITH LOCAL, STATE, AND NATIONAL PARTNERS ON CHILD HEALTH STRATEGIES THAT HAVE BEEN IDENTIFIED IN THE COMMUNITY. ACTIVE PARTNERSHIPS ARE MAINTAINED WITH THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE NEBRASKA DEPARTMENT OF EDUCATION, UNIVERSITY OF NEBRASKA-EXTENSION, LOCAL PUBLIC HEALTH DEPARTMENTS AND MANY COMMUNITY-BASED ORGANIZATIONS. AN INVENTORY OF PARTNERING ORGANIZATIONS WAS COMPLETED WITH OVER 140 PARTNERS IDENTIFIED.COVID-19 BROUGHT MANY CHALLENGES RELATED TO IMPLEMENTATION OF THE ORGANIZATION'S ISP IN 2020. STAFF OBJECTIVES AND OPERATING PRACTICES THROUGHOUT THE ORGANIZATION WERE MODIFIED TO REDUCE THE RISK OF COVID-19 TRANSMISSION. AS A RESULT, QUARTERLY ISP MEETINGS WERE INITIALLY PAUSED, BUT RESUMED BY SUMMER 2020. DESPITE THE CHALLENGES, WORK PROGRESSED WITHIN ALL FOUR PRIORITY AREAS.PRIORITY HEALTH ISSUES: PROGRESS HIGHLIGHTSACCESS TO HEALTH CARE SERVICES - BUILDING UPON THE DEFINITION AND FRAMEWORK FOR "ACCESS TO CARE" ADOPTED BY THE ORGANIZATION IN 2019, THE ISP WORKGROUP FOR ACCESS TO CARE APPLIED THE FRAMEWORK TO THE 2018 CHNA DATA AND USED THE COMMUNITY ENGAGED ANALYSIS (CEA) PROCESS TO GAIN GREATER CLARITY REGARDING THE BARRIERS CHILDREN AND FAMILIES FACE WHEN ATTEMPTING TO REACH THE CARE THEY NEED. THE CEA PROCESS STEPS INCLUDED: * IDENTIFICATION OF 26 CHNA INDICATORS MEASURING VARIOUS ASPECTS OF "ACCESS" TO CARE * SELECTION OF THREE CRITERIA AND THEIR WEIGHTING FOR DATA ANALYSIS: 1. MAGNITUDE - HOW MANY CHILDREN ARE AFFECTED 2. DISPARITY - DISPROPORTIONATE IMPACT ON IDENTIFIED GROUPS 3. PERSISTENCE - IS THE PROBLEM IMPROVING OR GETTING WORSE * SELECTED THE NATIONAL HEALTH INTERVIEW SURVEY AS THE SOURCE FOR COMPARISON DATA AND BENCHMARKING * CONDUCTED FEASIBILITY TESTING - AS A RESULT OF THE CEA PROCESS, THREE PRIORITY INDICATORS HAD THE HIGHEST SCORES, AND WERE SELECTED FOR THE WORKGROUP'S FOCUS: * NEED FOR CARE COORDINATION * UNAWARE OF COMMUNITY MENTAL HEALTH RESOURCES * NO PREVENTIVE DENTAL CARE IN THE LAST YEAR- ISP WORKGROUP FOR ACCESS TO CARE UPDATED THEIR ACTION PLANS REFLECTING THE THREE PRIORITY AREAS, AND WORK BEGAN MOVING FORWARD: * NEED FOR CARE COORDINATION - CHILDREN'S HOSPITAL AND MEDICAL CENTER BEGAN CONVERSATIONS WITH UNITE NEBRASKA, A COMMUNITY DATA EXCHANGE OF HEALTH AND SOCIAL CARE PROVIDERS SPONSORED BY CYNCHEALTH. PARTNERS IN THE NETWORK ARE CONNECTED THROUGH A SHARED TECHNOLOGY PLATFORM, UNITE US, WHICH ENABLES THEM TO SEND AND RECEIVE ELECTRONIC REFERRALS, ADDRESS PEOPLE'S SOCIAL NEEDS, AND IMPROVE HEALTH ACROSS COMMUNITIES. AS OF DECEMBER 2020, AGREEMENTS WERE BEING FINALIZED, USERS WITHIN THE ORGANIZATION IDENTIFIED AND TRAINED, AND IMPLEMENTATION PLANNED.
SCHEDULE H, PART V, LINE 11 (CONT'D)	* UNAWARE OF COMMUNITY MENTAL HEALTH RESOURCES - ALIGNING TO THE WORK OF THE BEHAVIORAL HEALTH WORKGROUP, THE TWO WORKGROUPS COORDINATED EFFORTS AND RESOURCES. AS A RESULT, THE BEHAVIORAL HEALTH DEPARTMENT AND THE CENTER PARTNERED WITH REGION 6, AN ORGANIZATION RESPONSIBLE FOR MANY ASPECTS OF BEHAVIORAL HEALTH SERVICES WITHIN A FIVE-COUNTY AREA INCLUSIVE OF OMAHA, NEBRASKA. A LANDSCAPE ANALYSIS AND MAPPING OF SERVICES AVAILABLE TO SUPPORT CHILDREN AND FAMILIES WITH SOCIAL/EMOTIONAL, BEHAVIORAL AND/OR MENTAL HEALTH NEEDS WAS COMPLETED. AS A RESULT OF THE WORK, 87 DIFFERENT SERVICES ACROSS FIVE LEVELS OF CARE AND FIVE SECTORS (HEALTH, EDUCATION, MENTAL HEALTH, COMMUNITY, AND JUSTICE) WERE CATEGORIZED AND MAPPED. ADDITIONALLY, SEVEN ORGANIZATIONS PROVIDING REFERRAL AND NAVIGATION SUPPORT WERE IDENTIFIED, AND TWO OPEN-SOURCE WEBSITES WERE ASSESSED. FINDINGS OF THE PROJECT WERE PRESENTED TO THE SYSTEM OF CARE LEADERSHIP IN DECEMBER 2020, WITH PLANS TO DISSEMINATE THE INFORMATION THROUGHOUT 2021. * NO PREVENTIVE DENTAL CARE IN THE LAST YEAR - THE CEA DATA ANALYSIS FOUND A LACK OF ACCESS TO ORAL HEALTH CARE AMONG EARLY CHILDHOOD POPULATIONS, PARTICULARLY AMONG UNDERSERVED POPULATIONS, WAS THE PRIMARY DRIVER FOR THE INDICATOR'S HIGH SCORE. AS A RESULT, THE WORKGROUP AND CHILDREN'S PHYSICIANS PARTNERED WITH THE UNIVERSITY OF NEBRASKA MEDICAL CENTER'S COLLEGE OF DENTISTRY, THE NEBRASKA DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICES OF ORAL HEALTH, AND THE NEBRASKA COMMUNITY FOUNDATION TO INCREASE ORAL HEALTH AWARENESS AND EDUCATION BEGINNING AT SIX-MONTH WELL-CHILD VISITS. AS A RESULT, THE EARLY DENTAL HEALTH STARTER KIT PROJECT WAS LAUNCHED WITH A GOAL TO PACKAGE AND DISTRIBUTE 25,000 KITS THROUGH PEDIATRIC OFFICES THROUGHOUT THE STATE.- INJURY & VIOLENCE PREVENTION * IN 2020, COVID-19 PRECAUTIONS RESULTED IN A TEMPORARY SHUTDOWN OF THE CHILDREN'S CAR SEAT FITTING STATION. DURING THIS TIME, THE CHILDREN'S CAR SEAT TEAM INITIATED VIRTUAL CAR SEAT CHECKS AND PROVIDED CAR SEAT EDUCATION TO FAMILIES VIA ONLINE VIDEO SHARING. ONCE THE CAR SEAT FITTING STATION REOPENED, THE CAR SEAT TEAM RESUMED IN-PERSON APPOINTMENTS WITH ENHANCED SAFETY MEASURES. BY THE END OF THE YEAR, THE CHILDREN'S INJURY PREVENTION TEAM PROVIDED 280 CAR SEAT CHECKS IN THE CHILDREN'S FITTING STATION AND PROVIDED 98 SEATS TO FAMILIES. ADDITIONALLY, MANY COMMUNITY CAR SEAT EVENTS WERE ALSO CANCELLED DUE TO COVID-19 PRECAUTIONS. AT THE EVENTS THAT DID OCCUR CHILDREN'S PROVIDED ANOTHER 77 CAR SEAT CHECKS AT 18 COMMUNITY EVENTS AND PROVIDED 11 CAR SEATS TO FAMILIES. * CHILDREN'S CONTINUED TO ACTIVELY PROMOTE AND EXPLORE INCREASING THE NUMBER OF COMMUNITY PARTNERS TO HELP MEET THE DEMAND FOR CAR SEATS AND CAR SEAT EDUCATION. THROUGH THE 2020 SAFE KIDS GRANT, CHILDREN'S INJURY PREVENTION TEAM WORKED TO IMPROVE CAR SEAT EDUCATION, AND TO INCREASE THE NUMBER OF CHILD PASSENGER SAFETY TECHNICIANS (CPSTS) AND RESOURCES WITHIN COMMUNITY ORGANIZATIONS IN THE AREA. * ONE TREND THAT EMERGED DUE TO COVID-19 WAS AN INCREASE IN DOG BITES, POSSIBLY DUE TO THE HIGHER-THAN-USUAL AMOUNT OF TIME CHILDREN WERE SPENDING AT HOME IN THE PRESENCE OF DOGS. CHILDREN'S PARTNERED WITH THE NEBRASKA HUMANE SOCIETY TO DEVELOP DOG BITE SAFETY EDUCATION. IN ADDITION, THEY DEVELOPED A PRESS RELEASE HIGHLIGHTING THE INCREASE IN BITES AND WAYS TO PREVENT DANGEROUS INTERACTIONS BETWEEN CHILDREN AND DOGS. * CHILDREN'S CONTINUED TO PROMOTE WATER SAFETY/DROWNING PREVENTION THROUGH PARTNERSHIP WITH THE JOSHUA COLLINGSWORTH MEMORIAL FOUNDATION AND OMAHA PARKS & RECREATION. WITH MANY PUBLIC POOLS BEING CLOSED DUE TO COVID-19, EFFORTS WERE SHIFTED TO EDUCATING PARENTS AND CHILDREN ABOUT THE DANGERS OF SWIMMING IN OPEN WATER. * IN 2020, PROJECT AUSTIN CLOSED OUT THE YEAR WITH 1,043 ENROLLED PATIENTS SPANNING ACROSS SEVEN SURROUNDING STATES INCLUDING NEBRASKA, IOWA, KANSAS, MISSOURI, NORTH DAKOTA, SOUTH DAKOTA, AND WYOMING. THROUGHOUT THESE STATES, CHILDREN'S COLLABORATED WITH 273 EMERGENCY MEDICAL SYSTEMS AND 123 EMERGENCY DEPARTMENTS TO PROVIDE EMERGENCY MEDICAL PLANS TO CHILDREN WITH MEDICAL COMPLEXITIES.- VISION OUTREACH PROGRAMS * IN AUGUST 2018, CHILDREN'S LAUNCHED ITS VISIONMOBILE, A MOBILE VISION UNIT OUTFITTED ESPECIALLY FOR PEDIATRIC VISION CARE. THE VISIONMOBILE'S MISSION IS TO IMPROVE ACCESS TO VISION SERVICES FOR THE UNDERSERVED POPULATION. ITS WORK FIRST BEGAN WITH OMAHA PUBLIC SCHOOLS, AND THEN EXPANDED SERVICES IN 2019 TO NINE ADDITIONAL SCHOOL DISTRICTS AND NONPROFIT ORGANIZATIONS. THE PROGRAM TEAM INCLUDED A FULL-TIME OPTOMETRIST, AN OPTICIAN, AN OPHTHALMIC TECHNICIAN, AND A COORDINATOR WHO ALSO SERVES AS THE DRIVER. AS A RESULT OF THE COVID-19 PANDEMIC AND SCHOOL CLOSURES, THE VISIONMOBILE PAUSED SERVICES FOR SIX MONTHS. ONCE SCHOOLS REOPENED IN FALL 2020, THE VISIONMOBILE INCORPORATED ADDITIONAL SAFETY PROTOCOLS, AND RETURNED TO PROVIDING STUDENTS WITH EYE EXAMS AT A REDUCED CAPACITY. DURING 2020, THE VISIONMOBILE VISITED 50 SCHOOLS, PROVIDING COMPREHENSIVE EYE EXAMS FOR 788 STUDENTS AND PRESCRIBING 486 PAIRS OF GLASSES. CHILDREN'S ALSO PROVIDED AND DISPENSED MORE THAN 100 PAIRS OF GLASSES DUE TO EYEGLASSES BEING LOST OR BROKEN. * CHILDREN'S VISION SCREENING PROGRAM UTILIZED FIVE COLLEGES OF NURSING AND ALLIED HEALTH AND INTERDISCIPLINARY STUDIES STUDENTS TO PROVIDE THE MANPOWER TO CONDUCT MASS VISION SCREENINGS AT LOCAL OMAHA AREA SCHOOLS THAT ARE CATEGORIZED AS BEING IN HIGH POVERTY COMMUNITIES. A VISION SCREENING COORDINATOR PROVIDED OVERSIGHT AND COORDINATION OF THE EVENTS THAT TOOK PLACE. AS NOTED ABOVE, COVID-19 CAUSED THE VISIONMOBILE TO PAUSE SERVICES FOR SIX MONTHS. IN 2020, SERVICES EXPANDED TO TWO NEW SCHOOL DISTRICTS, AND 10,977 STUDENTS IN 38 SCHOOLS HAD VISION SCREENINGS. IN THE 2020 SCHOOL YEAR, 27 PERCENT OF THE CHILDREN FAILED THE VISION SCREENING AND REQUIRED A COMPREHENSIVE EYE EXAM, WHICH IS HIGHER THAN THE NATIONAL AVERAGE OF 25 PERCENT. 17 OF THE SCHOOLS SCREENED HAD NEVER RECEIVED VISION SERVICES FOR THEIR STUDENTS. * THE CHILD VISION COLLABORATIVE HAS BEEN CONVENED BY CHILDREN'S TO CONNECT WITH COMMUNITY CHILD VISION ADVOCATES. THIS GROUP REPRESENTS A WIDE RANGE OF 48 CURRENT STAKEHOLDERS, WHICH MEETS BIANNUALLY. THOSE STAKEHOLDERS CONSIST OF CLINICAL AND HEALTH SYSTEMS (FEDERALLY QUALIFIED HEALTH CENTERS & NON-PROFITS), SERVICE ORGANIZATIONS, COMMUNITY CHILD OR VISION ADVOCATES; SCHOOLS RECEIVING SERVICES, AND INSTITUTIONS THAT PROVIDE CLINICAL EDUCATION. PROGRAM EVALUATIONS FOR BOTH CHILDREN'S VISION INITIATIVES, THE VISION SCREENING PROGRAM AND VISIONMOBILE, HAVE BEEN COMMUNICATED TO GROUP STAKEHOLDERS.- ASTHMA & OTHER RESPIRATORY CONDITIONS * BEGINNING IN 2020, THE CHILDREN'S PULMONOLOGY DEPARTMENT, WITH SUPPORT FROM THE CENTER, DIRECTED THE NEBRASKA ASTHMA COALITION (NAC). THE NAC WAS CREATED TO IMPROVE HEALTH OUTCOMES AND QUALITY OF LIFE FOR ALL INDIVIDUALS AFFECTED BY ASTHMA THROUGH STATEWIDE COLLABORATION WITH THE VISION OF NEBRASKA BEING A PLACE WHERE THOSE AFFECTED BY ASTHMA THRIVE. CHILDREN'S SERVES AS A CONVENER OF PARTNERS WORKING TO PROVIDE STATE-WIDE ASTHMA COLLABORATION, RESOURCES, AND EDUCATION FOR NEBRASKA ASTHMATICS OF ALL AGES. * THE NOT ONE MORE LIFE (NOML) ASTHMA COMMUNITY OUTREACH PROGRAM DID NOT CONDUCT ASTHMA SCREENINGS IN 2020 DUE TO THE PANDEMIC. COLLABORATION WITH COMMUNITY PARTNERS IN THE NORTH OMAHA COMMUNITY WERE CONTINUED VIRTUALLY WITH MONTHLY AND BIMONTHLY MEETINGS WITH LOCAL COMMUNITY PARTNERS SUCH AS CHARLES DREW HEALTH CENTER, THE FAITH-BASED PASTOR ORGANIZATION: INTERDENOMINATIONAL MINISTERIAL ALLIANCE (IMA), AND THE BLACK FAMILY HEALTH AND WELLNESS ASSOCIATION, INC. * THE PARTNERSHIP BETWEEN CHILDREN'S AND CHARLES DREW HEALTH CENTER CONTINUED WITH SIGNIFICANT MOMENTUM AND DISCUSSIONS REGARDING AN ASTHMA PROVIDER TO BE POSITIONED AT THE PRIMARY CHARLES DREW HEALTH CLINIC AT GRANT STREET. DISCUSSIONS ALSO CONTINUED WITH REGARD TO PROVIDING SUPPORT TO THE FOUR OMAHA PUBLIC SCHOOL BASED HEALTH CLINICS OPERATED BY CHARLES DREW. THE CONTRACT WAS AGREED UPON IN EARLY 2021. * A GRANT TITLED "TOWARD A NEW MODEL OF PEDIATRIC ASTHMA CARE: SCOPING REVIEW AND COMMUNITY NEEDS ASSESSMENT IN AN UNDERSERVED URBAN POPULATION," WAS SUBMITTED AND APPROVED IN 2020. THIS PROJECT WAS DEVELOPED TO CREATE A RESEARCH COLLABORATION THAT CAN ADDRESS HEALTH DISPARITIES IN PEDIATRIC ASTHMA THROUGH EVIDENCE-BASED INTERVENTIONS. THE COMMUNITY NEEDS ASSESSMENT WILL INVOLVE VIRTUAL INDIVIDUAL AND GROUP INTERVIEWS WITH PROVIDERS, LEADERS, AND FAMILIES IN NORTH OMAHA.
SCHEDULE H, PART V, LINE 11 (CONT'D)	- EARLY CHILDHOOD HEALTH WITHIN COMMUNITIES * THE CENTER, THROUGH ITS COMMUNITY OF PARTNERS AND ITS AFFILIATION WITH THE NATIONAL HELP ME GROW (HMG) NETWORK, IMPLEMENTED A HELP ME GROW PILOT IN LINCOLN/LANCASTER COUNTY. HELP ME GROW NEBRASKA IS A SYSTEM BUILDING FRAMEWORK THAT LEVERAGES COMMUNITY STRENGTHS AND FOCUSES ON FAMILY-CENTERED SOLUTIONS.THE SYSTEM IS BUILT AROUND FOUR CORE COMPONENTS: 1. CHILD HEALTH PROVIDER OUTREACH PROVIDES OFFICE-BASED TRAINING TO SUPPORT EARLY DETECTION AND INTERVENTION AND USE OF THE HMG CALL CENTER. 2. COMMUNITY & FAMILY OUTREACH FACILITATES PROVIDER NETWORKING AND BOLSTERS CHILDREN'S HEALTHY DEVELOPMENT THROUGH FAMILIES. 3. CENTRALIZED ACCESS POINT SERVES AS A HUB TO LINK CHILDREN AND THEIR FAMILIES TO COMMUNITY-BASED SUPPORTS, WHILE PROVIDING SEAMLESS CARE COORDINATION. 4. DATA COLLECTION AND ANALYSIS HELPS IDENTIFY GAPS IN AND BARRIERS TO THE SYSTEM.A FULLY IMPLEMENTED HELP ME GROW PROGRAM INCLUDES A CENTRALIZED ACCESS POINT THAT ALLOWS FAMILIES/CARE GIVERS AND HEALTHCARE PROVIDERS TO CALL HELP ME GROW WITH QUESTIONS ABOUT CHILD DEVELOPMENT AND TO MAKE REFERRALS FOR EXISTING COMMUNITY RESOURCES AND CARE.- SCHOOL HEALTH * PROJECT ECHO SCHOOL HEALTH SERIES: OCTOBER 23, 2019 TO MARCH 18, 2020. THE SERIES INCLUDED TEN ONE-HOUR SESSIONS AROUND SCHOOL HEALTH TOPICS. THESE SESSIONS WERE RECORDED SO NURSES WHO MISSED THE WEBINARS WERE ABLE TO GO BACK AND WATCH AT A LATER DATE. CONTINUING EDUCATION CREDITS WERE ALSO EARNED FOR EACH INDIVIDUAL SESSION ATTENDED OR WATCHED VIA VIDEO. EACH SESSION WAS ATTENDED BY 70 TO 120 NURSES. * CREATED AN ASTHMA TOOLKIT FOR SCHOOLS WHICH INCLUDES: ASTHMA INHALER USE CHECKLIST, ENVIRONMENTAL TRIGGERS FOR SCHOOLS, ASTHMA COMMUNICATION FOR PROVIDERS, AND HOW TO USE AN INHALER WITH A SPACER EDUCATION SHEET. THESE WERE DISPERSED TO SCHOOLS FOR USE DURING THE 2020/21 SCHOOL YEAR. * CREATED AND BEGAN IMPLEMENTATION OF THE SCHOOL NURSE MENTOR PROGRAM WITH 18 MENTORS AND 33 MENTEES CREATING 33 MENTOR PAIRS DURING THE 2020/21 SCHOOL YEAR. * CDC HEALTHY SCHOOLS PROGRAM - CHILDREN'S PROVIDED EDUCATION AND TRAINING TO NINE TITLE I RURAL SCHOOLS ON CHRONIC HEALTH CONDITIONS. * SCHOOL HEALTH LEARNING COLLABORATIVE - CHILDREN'S PROVIDED FIVE LIVE AND RECORDED WEBINARS FOR SCHOOL NURSES ON ISSUES RELATED TO COVID-19. WE ALSO PROVIDED THE RESOURCES FROM THE SPEAKERS TO ASSIST PARTICIPANTS. * IN DECEMBER 2020, 250 HANDWASHING CAMPAIGN PACKETS WERE MAILED TO SCHOOL NURSES ACROSS THE STATE INCLUDING POSTERS, STICKERS, FLOOR AND MIRROR CLINGS, AND A T-SHIRT TO PROMOTE HANDWASHING AND INFECTION CONTROL.- LITERACY IMPROVEMENT PROGRAM: * THANKS TO A DONATION MADE TO CHILDREN'S PHYSICIANS (CP), FIVE CP CLINICS (COUNCIL BLUFFS, CREIGHTON, PLATTSMOUTH, SPRING VALLEY, AND UNMC) PARTICIPATED IN REACH OUT AND READ, A NATIONALLY RECOGNIZED PROGRAM WORKING TO IMPROVE LITERACY. IN 2020, 6,734 BOOKS WERE DISTRIBUTED DURING WELL VISITS (COUNCIL BLUFFS 1,547, CREIGHTON 1,585, PLATTSMOUTH 707, SPRING VALLEY 1,623, AND UNMC 1,272). * IN THE FALL OF 2020, THE CENTER BEGAN MEETING WITH REPRESENTATIVES OF RAISE ME TO READ IN OMAHA TO FIND AVENUES OF INFLUENCE, COLLABORATION, AND INTERSECTIONALITY IN OUR SHARED WORK TO POSITIVELY IMPACT EARLY LITERACY SUCCESS, EXTENDED LEARNING, AND SHOWING-UP IN OUR COMMUNITY. MENTAL AND BEHAVIORAL HEALTHIN ADDITION TO COMPLETING THE LANDSCAPE ANALYSIS AND MAPPING OF SOCIAL/EMOTIONAL, BEHAVIORAL, AND MENTAL HEALTH SERVICES SUPPORTING CHILDREN AND FAMILIES THROUGHOUT THE GREATER OMAHA AREA, THE MENTAL AND BEHAVIORAL HEALTH ISP WORKGROUP CONTINUED TO EXPAND ITS WORK THROUGHOUT THE YEAR.- THE PATIENT ASSISTANCE TEAM AT CHILDREN'S HOSPITAL & MEDICAL CENTER (PATCH) PROGRAM, LED BY THE BEHAVIORAL HEALTH AND CHILD LIFE TEAM, EXPANDED BEYOND PILOT STATUS THAT BEGAN IN 2019. THE PATCH PROGRAM DEVELOPS INDIVIDUAL CARE PLANS TO ASSIST IN MEDICAL PROCEDURES FOR CHILDREN ON THE AUTISM SPECTRUM. IN 2020, FIVE DEPARTMENTS WITHIN THE ENTERPRISE UTILIZED INDIVIDUAL CARE PLANS, AND OVER 400 PATIENTS HAD INDIVIDUALIZED CARE PLANS IN PLACE. INTERNALLY, FUTURE EXPANSION PLANS INCLUDE IMPLEMENTATION WITHIN MORE CSP AND CP OFFICES. EXTERNALLY, THE MODEL HAS BEEN SHARED WITH THREE OTHER HOSPITALS AND DISCUSSIONS HAVE BEGUN REGARDING COLLECTIVE DATA. - AUTISM SCREENING IN THE COMMUNITY PRIOR TO AGE TWO CONTINUED THROUGHOUT 2020, RESULTING IN THE CREATION OF PSA REGARDING THE 16 EARLY SIGNS OF THE CONDITION AND THE RELEASE OF AN AWARENESS VIDEO FOR PRIMARY CARE PROVIDERS.- CAPACITIES FOR TELEHEALTH SERVICES AND TELEMENTORING SUPPORTS WERE DEVELOPED AND EXPANDED SIGNIFICANTLY THROUGHOUT 2020. EXAMPLES OF SUCH SERVICES INCLUDE: * TELEPSYCHIATRY APPOINTMENTS IN THE KEARNEY CHILDREN'S PHYSICIANS CLINIC WERE CONSISTENTLY FILLED 75% OF THE TIME, MANY TIMES REACHING 100%. * 182 PATIENTS WITH INSULIN-DEPENDENT DIABETES MELLITUS AND CYSTIC FIBROSIS WERE IDENTIFIED AND PROVIDED TELEPSYCHOLOGY SERVICES, RESULTING IN REDUCED STRESSORS. * A TELE-PRESENTER WAS HIRED THROUGH CHILDREN'S PHYSICIANS TO CREATE MORE OPTIONS FOR MENTAL HEALTH PROVIDERS TO SUPPORT PRIMARY CARE PROVIDERS AND FACILITATE MENTAL HEALTH CARE. * TWO CHILD & ADOLESCENT PSYCHIATRISTS WITHIN THE BEHAVIORAL HEALTH DEPARTMENT PROVIDED 10-12 REAL-TIME PSYCHIATRIC CONSULTS TO 15 CHILDREN'S PHYSICIANS PROVIDERS EACH MONTH IN 2020. PROJECT ECHO COMPLETED A SECOND SERIES OF EIGHT SESSIONS ON THE TOPIC OF ANXIETY. 32 HEALTHCARE PROFESSIONALS ENROLLED IN THE SERIES AND 159 CONTINUING MEDICAL EDUCATION CREDITS WERE AWARDED UPON COMPLETION OF THE SERIES.SEXUAL HEALTH- BY JANUARY 2020, SEVEN OF THE NINE KEY ACTION ITEMS IDENTIFIED IN THE 2018 ISP REACHED THEIR GOALS. THEREFORE, THE ISP WORKGROUP FOR SEXUAL HEALTH RE-EVALUATED WHERE THE GROUP'S TIME AND ENERGIES WERE REQUIRED FOR THE CALENDAR YEAR. TO COMPLETE THIS WORK, THE CENTER, IN PARTNERSHIP WITH THRIVEVENTURES, CONDUCTED A LITERATURE REVIEW AND ANALYSIS OF LOCAL DATA TO INFORM ITS WHITE PAPER, "STATE OF ADOLESCENT SEXUAL HEALTH IN GREATER OMAHA." THE RESULTING DOCUMENT AND DATA FOUND NEBRASKA WAS ONE OF ONLY THREE STATES WITHOUT A BOARD-CERTIFIED ADOLESCENT HEALTH SPECIALIST LICENSED WITHIN THE STATE. RECOGNIZING THE GAP IN CARE, THE WORKGROUP SUPPORTED EFFORTS TO BRING THE SPECIALTY TO THE STATE. AS A RESULT, THE FOLLOWING WAS ACCOMPLISHED IN 2020: * EXPANDED MEMBERSHIP OF THE SEXUAL HEALTH ISP GROUP TO INCLUDE DR. AMY LACROIX, FROM CHILDREN'S PHYSICIANS, UNMC CAMPUS. DR. LACROIX IS AN EXPERT IN THE FIELD OF PROVIDING REPRODUCTIVE HEALTH CARE TO TEENS AND YOUNG ADULTS AND SERVES AS THE DIRECTOR OF ADOLESCENT AND SCHOOL HEALTH AT UNMC. * IN 2020, CHILDREN'S SPECIALTY PHYSICIANS SUCCESSFULLY RECRUITED A CHAIR OF ADOLESCENT HEALTH MEDICINE AND AN ADOLESCENT-TRAINED OB/GYN TO ADDRESS THE COMPLEX NEEDS OF TEENS AND YOUNG ADULTS. * IN PARTNERSHIP WITH THE WOMEN'S FUND OF OMAHA AND THE ADOLESCENT HEALTH PROJECT, CHILDREN'S PHYSICIANS IMPLEMENTED A NEW WEB-BASED PLATFORM, ACCESS GRANTED, CONNECTING ADOLESCENTS TO PROVIDERS FOR REPRODUCTIVE HEALTH CARE WHICH ALLOWED THEM TO MAKE APPOINTMENTS. UPON COMPLETING THE APPOINTMENT, THE ADOLESCENT PROVIDED FEEDBACK ABOUT THEIR EXPERIENCE.
SCHEDULE H, PART V, LINE 11 (CONT'D)	NUTRITION, PHYSICAL ACTIVITY & OBESITY- THE CENTER'S STRATEGIC EMPHASIS CONTINUED IN THE AREAS OF CHILDHOOD OBESITY PREVENTION, NUTRITION, PHYSICAL ACTIVITY, AND WEIGHT. DURING 2020, CHILDREN'S PREVENTING CHILDHOOD OBESITY (PCO) COMMUNITY GRANT PROGRAM CONTINUED THEIR LEARNING COLLABORATIVE LED BY THE CENTER AND THE GRETCHEN SWANSON CENTER FOR NUTRITION. THE COLLABORATIVE INCLUDED SKILL BUILDING AND TECHNICAL ASSISTANCE IN THE AREAS OF PLANNING, COMMUNITY ENGAGEMENT SUSTAINABILITY AND DATA MANAGEMENT. TEN GRANTS OF $25,000 WERE AWARDED TO COMMUNITY ORGANIZATIONS AND HEALTH DEPARTMENTS IN EASTERN NEBRASKA AND WESTERN IOWA FOR PROGRAMS THAT SUPPORT NUTRITION AND PHYSICAL ACTIVITY. THE SIXTH ROUND OF PCO FUNDING CONCLUDED ON DECEMBER 31, 2020. IN SEPTEMBER 2020, THE CENTER BEGAN PLANNING FOR THE SEVENTH ROUND OF FUNDING WHICH COMMENCED IN MARCH 2021.- CHILDREN'S CONTINUED TO BRING PHYSICAL ACTIVITY AND MINDFULNESS TOOLS INTO OMAHA AND SOUTHWEST IOWA METRO SCHOOLS WHILE EXPANDING INTO LANCASTER COUNTY AND PRIORITY RURAL DISTRICT CLASSROOMS THROUGH ITS SPONSORSHIP OF GONOODLE, AN ONLINE SUITE OF VIDEOS AND EDUCATIONAL SUPPORTS FOR LOCAL EDUCATORS. DURING THE FALL 2020 SEMESTER, THERE WERE 8,731 UNIQUE ACTIVE TEACHERS, 823 ACTIVE SCHOOLS AND 190,300 UNIQUE CLASSROOM STUDENTS USING THE PROGRAM. THIS REPRESENTED 76% OF THE ADDRESSABLE TEACHERS AND 96% OF THE ADDRESSABLE STUDENTS. STUDENTS SPENT MORE THAN 22.3 MILLION MINUTES GONOODLING, A 75% INCREASE OVER FALL 2019. ADDITIONALLY, GONOODLE OFFERED AN AT-HOME PLATFORM FOR PARENTS RESULTING IN 32,063 TOTAL ACTIVE FAMILY USERS WHO ACHIEVED OVER 1 MILLION TOTAL FAMILY ACTIVITY MINUTES.- CHILDREN'S CONTINUED TO PROVIDE GO NAP SACC (NUTRITION AND PHYSICAL ACTIVITY SELF-ASSESSMENT FOR CHILD CARE) TRAINING AND TECHNICAL ASSISTANCE TO CHILDCARE FACILITIES STATEWIDE. GO NAP SACC IS A PARTNERSHIP WITH NEBRASKA DEPARTMENT OF HEALTH & HUMAN SERVICES, NEBRASKA EXTENSION, NEBRASKA DEPARTMENT OF EDUCATION, AND CHI HEALTH, AND IS A COMPONENT OF THE NEBRASKA STEP UP TO QUALITY INITIATIVE. THE FOCUS OF THE GO NAP SACC PROCESS WAS TO WORK WITH CHILDCARE FACILITIES, BOTH HOMES AND CENTERS, TO HELP THEM IMPROVE THEIR NUTRITION AND PHYSICAL ACTIVITY POLICIES, PRACTICES, AND ENVIRONMENT. IN 2020, 30 GO NAP SACC TRAINERS REACHED 175 EARLY CARE & EDUCATION PROFESSIONALS IN 66 CHILDCARE CENTERS AND HOMES THAT CARE FOR APPROXIMATELY 3,000 CHILDREN. GO NAP SACC CONTINUED TO REACH CHILDCARE FACILITIES THROUGH COVID-19 IN 2020 BY TRANSITIONING THEIR TRAINING AND TECHNICAL ASSISTANCE TO BE VIRTUAL UTILIZING THE ZOOM PLATFORM.- IN 2020, CHILDREN'S, IN PARTNERSHIP WITH NEBRASKA EXTENSION, CHI HEALTH, FOUR FARMER'S MARKETS, THREE GROCERY STORES, AND ONE COMMUNITY SUPPORTED AGRICULTURE SITE, CONTINUED THE DOUBLE UP FOOD BUCKS PROGRAM IN LINCOLN AND OMAHA. THE EFFORT INCREASED THE PURCHASE OF FRESH FRUITS AND VEGETABLES BY SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) RECIPIENTS IN SELECT METRO AREAS. SPECIAL EFFORTS IN 2020 SECURED FEDERAL FUNDING FOR NEBRASKA DOUBLE UP FOOD BUCKS THROUGH TWO U.S.D.A. GUSNIP AWARDS. ONE WAS AWARDED TO THE NEBRASKA COMMUNITY FOUNDATION AS A STATEWIDE EFFORT TO EXPAND DUFB INTO RURAL AREAS WHILE SUPPORTING METRO AREAS (3-YEAR PROJECT). THE OTHER WAS AWARDED TO THE WELLBEING PARTNERS TO BETTER SUPPORT AND EXPAND INTO LATINX COMMUNITY RETAIL SPACES (1 YEAR PILOT). - CHILDREN'S WEIGHT AND WELLNESS SPECIALTY PROGRAM ASSISTED WITH THE DISSEMINATION OF THE ENERGY NUTRITION WORKBOOK AND VIDEOS. IN 2020, THESE EDUCATIONAL TOOLS WERE TRANSLATED INTO SPANISH, AND A NEW WEBPAGE WAS CREATED FOR EASY ACCESS.
SCHEDULE H, PART V, LINE 16A	HTTPS://WWW.CHILDRENSOMAHA.ORG/HOSPITAL-EXPERIENCE/BILLING-INSURANCE-MEDICAL RECORDS/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, LINE 16B	HTTPS://WWW.CHILDRENSOMAHA.ORG/HOSPITAL-EXPERIENCE/BILLING-INSURANCE-MEDICAL RECORDS/FINANCIAL-ASSISTANCE/
SCHEDULE H, PART V, LINE 16C	HTTPS://WWW.CHILDRENSOMAHA.ORG/HOSPITAL-EXPERIENCE/BILLING-INSURANCE-MEDICAL RECORDS/FINANCIAL-ASSISTANCE/

Schedule H (Form 990) 2020

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?2
Name and address		Type of Facility (describe)
1	1 - LINCOLN CLINIC 5930 VANDERVOORT DR STE A LINCOLN,NE68516	PEDIATRIC CLINIC
2	2 - CAROLYN SCOTT RAINBOW HOUSE 7825 FARNAM DRIVE OMAHA,NE68114	NO-COST ACCOMMODATIONS FOR FAMILIES OF PATIENTS
3
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6
7
8
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Schedule H (Form 990) 2020

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:	FEDERAL POVERTY GUIDELINES ARE USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. FINANCIAL ASSISTANCE IS AVAILABLE FOR MEDICALLY NECESSARY PROCEDURES AND SERVICES. SERVICES NOT ELIGIBLE FOR FINANCIAL ASSISTANCE INCLUDE COSMETIC AND OTHER ELECTIVE SERVICES. CERTIFICATION OR PROOF OF MEDICAID DENIAL IS A REQUIREMENT FOR FINANCIAL ASSISTANCE CONSIDERATION. FINANCIALLY RESPONSIBLE PARTIES WHO SUBMIT A COMPLETE AND VERIFIABLE APPLICATION FOR FINANCIAL ASSISTANCE WILL BE CONSIDERED FOR FREE OR REDUCED ASSISTANCE BASED ON FEDERAL POVERTY GUIDELINES (400% FPL LIMIT). FAMILIES THAT DO NOT QUALIFY FOR INCOME-BASED FINANCIAL ASSISTANCE THAT HAVE VERIFIABLE OUT OF POCKET MEDICAL DEBT GREATER THAN 20% OF GROSS INCOME MAY QUALIFY FOR CATASTROPHIC ASSISTANCE. PRESUMPTIVE ELIGIBILITY IS AVAILABLE IN A VARIETY OF CIRCUMSTANCES INCLUDING THE ABSENCE OF DOCUMENTATION REQUIRED TO COMPLY WITH THE TRADITIONAL FINANCIAL ASSISTANCE APPLICATION REQUIREMENTS. THE PREDICTIVE MODEL INCORPORATES INCOME AND HOUSEHOLD SIZE ESTIMATES, A SOCIO-ECONOMIC NEED FACTOR, CENSUS BLOCK DATA, AS WELL AS INFORMATION ON HOME OWNERSHIP.
PART I, LINE 6A:	THE COMMUNITY BENEFIT REPORT IS PREPARED BY THE ORGANIZATION. THE VALUES REPORTED IN THE 2020 COMMUNITY BENEFIT REPORT INCLUDE $3.4 MILLION IN FINANCIAL ASSISTANCE.
PART I, LINE 7:	EXPLANATION OF THE COSTING METHODOLOGY USED TO CALCULATE SUBSIDIZED HEALTH SERVICES: SUBSIDIZED HEALTH SERVICES WERE CALCULATED USING A COMBINATION OF CHILDREN'S HOSPITAL & MEDICAL CENTER'S COST ACCOUNTING SYSTEM AND A COST TO CHARGE RATIO CALCULATION SIMILAR TO WORKSHEET 2 IN THE SCHEDULE H INSTRUCTIONS. THE REPORTED SUBSIDIZED LOSS REPRESENTS THE DIFFERENCE IN NET REVENUE RECEIVED FROM ALL PAYORS LESS TOTAL OPERATING EXPENSES INCLUDING INDIRECT COSTS APPLICABLE TO EACH DEPARTMENT. UNREIMBURSED MEDICAID COSTS REPORTED ON LINE 7B AND OTHER OPERATING EXPENSE APPLICABLE TO THE DEPARTMENT REPORTED ELSEWHERE ON SCHEDULE H AS A COMMUNITY BENEFIT IS EXCLUDED FROM THE OPERATING EXPENSE TOTAL AS ARE BAD DEBT AND NON-PATIENT CARE EXPENSE ASSOCIATED WITH EACH DEPARTMENT. INDIRECT COSTS FOR EACH DEPARTMENT WERE CALCULATED BY APPLYING THE MEDICARE COST REPORT OVERHEAD RATE APPLICABLE TO THAT DEPARTMENT TO THE DEPARTMENT'S TOTAL OPERATING EXPENSES EXCLUDING UNREIMBURSED MEDICAID EXPENSES AND/OR ANY OTHER EXPENSE ALREADY REPORTED ELSEWHERE ON SCHEDULE H AS A COMMUNITY BENEFIT.
PART I, LINE 7G:	THE ORGANIZATION DID NOT INCLUDE COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS AS SUBSIDIZED HEALTH SERVICES.
PART II, COMMUNITY BUILDING ACTIVITIES:	CHILDREN'S HOSPITAL & MEDICAL CENTER SUPPORTED ECONOMIC DEVELOPMENT IN ITS SPONSORSHIP DONATIONS TO ORGANIZATIONS SUCH AS THE GREATER OMAHA CHAMBER OF COMMERCE. CHILDREN'S PARTICIPATED IN COALITION BUILDING ACTIVITIES SUCH AS THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS' COMMUNITY HEALTH AFFINITY GROUP. CHILDREN'S ALSO DEDICATED OVER $479 THOUSAND TO COMMUNITY BENEFIT OPERATIONS AND CHNA IMPLEMENTATION STRATEGY.
PART III, LINE 2:	DESCRIBE THE METHODOLOGY USED TO DETERMINE THE AMOUNTS REPORTED ON LINES 2 & 3: BAD DEBT EXPENSE AT 100% CHARGE VALUE WAS MULTIPLIED BY THE 2020 MEDICARE COST TO CHARGE RATIO TO ARRIVE AT AN APPROXIMATE COST VALUE.BAD DEBT EXPENSE AT 100% CHARGE VALUE $1,216,258MEDICARE COST TO CHARGE RATIO X .4315BAD DEBT EXPENSE AT COST $524,815ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY: THIS PROCESS INCLUDES IDENTIFYING FINANCIAL ASSISTANCE CODES CONGRUENT WITH THE FINANCIAL ASSISTANCE POLICY THAT WERE CHARGED TO BAD DEBT EXPENSE AT 100% CHARGE VALUE. THIS AMOUNT IS $0 FOR 2020 AND REFLECTS THE EFFORTS OF CHILDREN'S HOSPITAL & MEDICAL CENTER TO ENSURE THAT NO CHILD WITH A MEDICAL NEED IS TURNED AWAY DUE TO INABILITY TO PAY FOR HEALTH CARE.DESCRIBE HOW THE ORGANIZATION ACCOUNTS FOR DISCOUNTS OR PAYMENTS ON PATIENT ACCOUNTS IN DETERMINING BAD DEBT EXPENSE: BAD DEBT EXPENSE IS CREDITED FOR ANY PAYMENT RECEIVED ON ACCOUNTS PREVIOUSLY WRITTEN OFF.
PART III, LINE 4:	FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE COMPANY DETERMINES THE TRANSACTION PRICE ASSOCIATED WITH SERVICES ON THE BASIS OF CHARGES REDUCED BY IMPLICIT PRICE CONCESSIONS. IMPLICIT PRICE CONCESSIONS INCLUDED IN THE ESTIMATE OF THE TRANSACTION PRICE ARE BASED ON HISTORICAL COLLECTION EXPERIENCE FOR APPLICABLE PATIENT PORTFOLIOS. PATIENTS WHO MEET THE COMPANY'S CRITERIA FOR FREE "CHARITY" CARE ARE PROVIDED WITHOUT CHARGE; SUCH AMOUNTS ARE NOT REPORTED AS REVENUE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SETTLEMENTS WITH THIRD-PARTY PAYORS FOR RETROACTIVE ADJUSTMENTS DUE TO AUDITS, REVIEWS, OR INVESTIGATIONS ARE CONSIDERED VARIABLE CONSIDERATION AND ARE INCLUDED IN THE DETERMINATION OF THE ESTIMATED TRANSACTION PRICE FOR PROVIDING PATIENT CARE USING THE MOST LIKELY OUTCOME METHOD. THESE SETTLEMENTS ARE ESTIMATED BASED ON THE TERMS OF THE PAYMENT AGREEMENTS WITH THE PAYOR, CORRESPONDENCE FROM THE PAYOR, AND HISTORICAL SETTLEMENT ACTIVITY, INCLUDING AN ASSESSMENT TO ENSURE THAT IT IS PROBABLE THAT A SIGNIFICANT REVERSAL IN THE AMOUNT OF CUMULATIVE REVENUE RECOGNIZED WILL NOT OCCUR WHEN THE UNCERTAINTY ASSOCIATED WITH THE RETROACTIVE ADJUSTMENT IS SUBSEQUENTLY RESOLVED. ESTIMATED SETTLEMENTS ARE ADJUSTED IN FUTURE PERIODS AS NEW INFORMATION BECOMES AVAILABLE OR AS YEARS ARE SETTLED OR ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS, AND INVESTIGATIONS.
PART III, LINE 8:	MEDICARE2020 MEDICARE CHARGES REPORTED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS) IN THE PROVIDER STATISTICAL AND REIMBURSEMENT SYSTEM FOR PROVIDER FYE 12/31 WERE MULTIPLIED BY THE 2020 COST TO CHARGE RATIO TO ARRIVE AT AN APPROXIMATE COST OF CARE RELATED TO THE REIMBURSEMENT PAYMENTS REPORTED ON SCHEDULE H, PART III, LINE 5.
PART III, LINE 9B:	COLLECTION PRACTICESSELF-PAY ACCOUNTS WITH NO VERIFIABLE INSURANCE AND BALANCE AFTER INSURANCE ACCOUNTS ARE CONSIDERED FOR FINANCIAL ASSISTANCE THROUGHOUT THE COLLECTION PROCESS FOR THOSE GUARANTORS WHO ARE FINANCIALLY UNABLE TO PAY, EITHER THROUGH A GOVERNMENT PROGRAM OR THROUGH CHILDREN'S HOSPITAL & MEDICAL CENTER'S FINANCIAL ASSISTANCE PROGRAM. ALL CORRESPONDENCE, INCLUDING STATEMENTS AND COLLECTION LETTERS STATE THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE.
PART VI, LINE 2:	2-NEEDS ASSESSMENTCHILDREN'S HOSPITAL & MEDICAL CENTER (CHILDREN'S) USES NUMEROUS RESOURCES TO BENCHMARK, ALIGN AND CONDUCT ASSESSMENTS OF THE HEALTH CARE NEEDS OF CHILDREN IN THE COMMUNITIES WE SERVE. THESE RESOURCES INCLUDE FOCUSED STAKEHOLDER INPUT AND PRIORITIZATION, NATIONAL PUBLIC HEALTH (HEALTHY PEOPLE 2020) AND PEDIATRIC CARE STANDARDS. WE ALSO REVIEW DATA FROM THE AMERICAN ACADEMY OF PEDIATRICS, AS LISTED IN OUR 2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT, AND TRENDS AS IDENTIFIED BY CHILDREN'S HOSPITAL ASSOCIATION (CHA).DURING THE 2018 CHILD AND ADOLESCENT CHNA, ADDITIONAL COMMUNITY FEEDBACK ON PRIORITIZATION OF HEALTH NEEDS WAS OBTAINED WITH LEADERSHIP AND ACTIVE PARTICIPATION WITHIN THE DOUGLAS COUNTY MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) PROCESS AND THE LIVE WELL OMAHA'S 2018 CHANGEMAKER SUMMIT.DOUGLAS COUNTY HEALTH DEPARTMENT AND CHILDREN'S PARTNERED TO FACILITATE A SERIES OF STRATEGIC ASSESSMENTS (FORCES OF CHANGE ASSESSMENT, A LOCAL PUBLIC HEALTH SYSTEMS ASSESSMENT AND A COMMUNITY STRENGTHS AND THEMES ASSESSMENT) BY USING THE MAPP PROCESS. THIS FRAMEWORK APPLIES STRATEGIC THINKING TO THE PRIORITY HEALTH ISSUES TO IDENTIFY RESOURCES TO MEET THE CHALLENGES AND OPPORTUNITIES.ON NOVEMBER 5, 2018, FINDINGS FROM THIS CHNA WERE PRESENTED AT LIVE WELL OMAHA'S 2018 CHANGEMAKER SUMMIT. THE CHANGEMAKER SUMMIT IS THE REGION'S LARGEST MULTI-SECTOR HEALTH CONFERENCE, WHICH GATHERS MORE THAN 170 LEADERS FROM ACROSS DOUGLAS, SARPY, CASS, AND POTTAWATTAMIE COUNTIES TO CELEBRATE THE MILESTONES OF OUR COLLECTIVE WORK AND ADVANCE FUTURE WORK WHILE LEARNING FROM LOCAL, REGIONAL, AND NATIONAL EXPERTS. AT THIS EVENT, DATA WAS SHARED REFLECTING THE SIGNIFICANT HEALTH ISSUES IDENTIFIED FROM THE RESEARCH AND THE MAPP PROCESS.INDIVIDUALS' RATINGS FROM THIS SUMMIT YIELDED THE FOLLOWING PRIORITIZED LIST OF COMMUNITY HEALTH NEEDS FOR CHILDREN AND ADOLESCENTS IN THE OMAHA METRO AREA:1. MENTAL HEALTH2. NUTRITION, OBESITY & PHYSICAL ACTIVITY3. ACCESS TO HEALTH SERVICES4. SEXUAL HEALTH5. TOBACCO, ALCOHOL & OTHER DRUGSORGANIZATIONS SPONSORING OR SUPPORTING THIS CHNA WILL USE THE INFORMATION FROM THIS CHNA TO DEVELOP IMPLEMENTATION STRATEGIES TO ADDRESS THE SIGNIFICANT HEALTH NEEDS IN THE COMMUNITY. THE RESULTS OF THIS PRIORITIZATION EXERCISE WILL BE USED TO INFORM THE DEVELOPMENT OF ACTION PLANS TO GUIDE COMMUNITY HEALTH IMPROVEMENT EFFORTS IN THE COMING YEARS.BY USING THIS PROCESS IN CONNECTION WITH THE CHNA DATA, OUR COMMUNITY IS POSITIONED TO IMPROVE THE EFFICIENCY AND EFFECTIVENESS OF LOCAL PUBLIC HEALTH SYSTEMS ACROSS THE REGION.SEVERAL OTHER CURRENT CLINICAL ASSESSMENTS INCLUDE THE PEDI-BOOST RISK SCORE, A MEDICAL AND SOCIAL RISK SCREENING FOR ALL CHILDREN WHO MAKE AN ENCOUNTER WITH THE ENTERPRISE. FOR THOSE CHILDREN WITH HIGH OR RISING RISK, A COMPLETE PSYCHOSOCIAL ASSESSMENT IS PERFORMED BY OUR CARE TRANSITION TEAM OF SOCIAL WORKERS OR NURSE CASE MANAGERS IN THE OUTPATIENT AND INPATIENT SETTING. SEVERAL DEPARTMENTS ROUTINELY UTILIZE DEPRESSION SCREENING PHQ9 FOR THOSE YOUTH 12 AND OLDER. A POSTPARTUM DEPRESSION SCREENING OF BIRTH MOTHERS IS PERFORMED AT TWO WEEKS, TWO MONTHS, AND FOUR MONTHS DURING PRIMARY CARE WELL VISITS. IN 2019, A SCREENING QUESTION ABOUT TRANSPORTATION CHALLENGES WAS ADDED TO THE DOMESTIC VIOLENCE, FOOD INSECURITY AND HOUSING INSECURITY SCREENING QUESTIONS GIVEN AT EACH PRIMARY CARE WELL VISIT.INTERNAL RESOURCES THAT ASSIST WITH THE ASSESSMENT OF CHILD HEALTH NEEDS ARE CHILDREN'S FAMILY ADVISORY COUNCILS, THE CENTER FOR THE CHILD & COMMUNITY, SOCIAL WORKERS AND NURSE CASE MANAGERS, PHYSICIANS AND CLINICAL SERVICE UNITS, AND IT ANALYSTS/REPORTERS. AN ANALYSIS OF THE INFORMATION AND/OR DATA COLLECTED FROM THESE VARIOUS RESOURCES IS CONDUCTED TO IDENTIFY POTENTIAL GAPS IN CHILD HEALTH NEEDS IN THE COMMUNITIES SERVED. NEEDS THAT ALIGN WITH THE HOSPITAL'S MISSION AND CAPACITY ARE SELECTED FOR REVIEW BY ADMINISTRATION, WHICH PRIORITIZES NEEDS AND AUTHORIZES IMPLEMENTATION BASED ON THE SCOPE OR SERIOUSNESS OF THE PROBLEM, AVAILABILITY OF COMMUNITY RESOURCES, AVAILABILITY OF FUNDING, AND/OR ALIGNMENT WITH THE HOSPITAL'S EXPERTISE AND STRATEGIC GOALS.
PART VI, LINE 3:	3-PATIENT EDUCATION OF ELIGIBILITYFINANCIALLY RESPONSIBLE PARTIES WHO EXPERIENCE DIFFICULTY IN MEETING THEIR FINANCIAL OBLIGATIONS WILL BE ENCOURAGED TO AND ASSISTED IN APPLYING FOR FINANCIAL HELP THROUGH GOVERNMENT PROGRAMS AND OTHER POTENTIAL FUNDING SOURCES OR ALTERNATIVELY QUALIFIED FOR CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS IDEALLY DETERMINED EITHER PRIOR TO SERVICES BEING PROVIDED OR AT THE TIME SERVICES ARE RENDERED AND IS BASED UPON FAMILY/GUARANTOR INCOME, FAMILY SIZE AND OTHER SPECIAL CONSIDERATIONS. THE PRIMARY RESPONSIBILITY TO IDENTIFY FINANCIAL NEED IS WITH THE ACCESS CENTER PATIENT ADVOCATES, CENTRAL BILLING OFFICE AND SOCIAL WORK STAFF. THESE STAFF MEMBERS ARE TRAINED TO IDENTIFY PATIENT NEEDS AND ANSWER FINANCIAL ASSISTANCE QUESTIONS. THERE ARE SEVERAL POINTS IN THE PATIENT EXPERIENCE WHERE FINANCIAL ASSISTANCE RESOURCES ARE OFFERED. THE FIRST OCCURS AT THE PRE-REGISTRATION OF INPATIENT ADMITS AND OUTPATIENTS PRESENTING THROUGH CARES AND FOR THOSE PATIENTS SCHEDULED IN THE SPECIALTY PEDIATRIC CENTER CLINICS. ELIGIBILITY OF THE INSURED IS VALIDATED ELECTRONICALLY. THE BENEFIT DETAIL INCLUDING DEDUCTIBLE, COPAYMENT AND COINSURANCE AMOUNTS ARE DISCUSSED WITH THE FAMILY. ALL INDIVIDUALS WHO ARE FINANCIALLY UNABLE TO PAY ARE ENCOURAGED TO AND ASSISTED IN APPLYING FOR FINANCIAL HELP THROUGH GOVERNMENT PROGRAMS AND OTHER POTENTIAL FUNDING SOURCES OR ALTERNATIVELY QUALIFIED FOR CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. AT THE TIME OF REGISTRATION, INSURANCE IS DISCUSSED, AND FAMILIES AGAIN ARE OFFERED THE ASSISTANCE OF ACCESS CENTER PATIENT ADVOCATES WHO ARE AVAILABLE MONDAY THROUGH FRIDAY. ALL SELF-PAY FAMILIES ARE ENCOURAGED TO SPEAK TO AN ACCESS CENTER PATIENT ADVOCATE. CARE ESTIMATES OR QUESTIONS REGARDING ESTIMATE OF COST FOR UPCOMING TESTING ARE DIRECTED TO THE PATIENT ADVOCATES AND THESE SERVICES ARE AGAIN OFFERED PRIOR TO ENDING THE CONVERSATION. FINANCIAL ASSISTANCE INFORMATION IS ALSO LOCATED IN THE PATIENT HANDBOOKS. PATIENT STATEMENTS AND ALL CORRESPONDENCE INCLUDING BILLS, STATEMENTS, AND COLLECTION LETTERS STATE THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE. CHILDREN'S HOSPITAL & MEDICAL CENTER'S INTERNET WEBSITE ALSO OFFERS A FINANCIAL ASSISTANCE LINK THAT INFORMS READERS IF THEY ARE UNINSURED OR HAVE LIMITED INCOME, THEY MAY QUALIFY FOR FINANCIAL ASSISTANCE THROUGH GOVERNMENT PROGRAMS OR CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. THE WEBSITE EXPLAINS THAT DEPENDING ON INCOME LEVEL, ALL OR PART OF THE MEDICAL COSTS MAY BE FUNDED BY MEDICAID, AND, ALTERNATIVELY, IF THEY ARE DETERMINED NOT ELIGIBLE FOR MEDICAID AFTER PROVIDING ALL OF THE REQUIRED DOCUMENTATION, THEY MAY THEN APPLY FOR THE CHILDREN'S FINANCIAL ASSISTANCE PROGRAM. CONTACT NUMBERS FOR THE PATIENT ADVOCATES AND HOURS OF SERVICE ARE PROVIDED. THE WEBSITE INCLUDES COPIES OF CHILDREN'S FINANCIAL ASSISTANCE POLICY, THE FINANCIAL ASSISTANCE APPLICATION FORM AND THE PLAIN LANGUAGE SUMMARY IN ENGLISH, ARABIC, CHINESE, FRENCH, PERSIAN, SPANISH, AND VIETNAMESE. THE WEBSITE ALSO INCLUDES AMOUNTS GENERALLY BILLED IN ENGLISH. ALL OTHER BILLING, PAYMENT, AND FINANCIAL RESPONSIBILITY RELATED LINKS ON CHILDREN'S WEBSITE STATE THAT FINANCIAL ASSISTANCE MAY BE AVAILABLE.THE FINANCIAL ASSISTANCE POLICY IS CURRENTLY AVAILABLE ON THE CHILDREN'S HOSPITAL & MEDICAL CENTER WEBSITE AND IS ALSO AVAILABLE UPON REQUEST.HTTPS://WWW.CHILDRENSOMAHA.ORG/HOSPITAL-EXPERIENCE/BILLING-INSURANCE-MEDICAL-RECORDS/FINANCIAL-ASSISTANCE/
PART VI, LINE 4:	4-COMMUNITY INFORMATIONTHE HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF DOUGLAS AND SARPY COUNTIES IN NEBRASKA AND POTTAWATTAMIE COUNTY IN IOWA. THE PRIMARY SERVICE AREA HAS A CURRENT AGGREGATE POPULATION OF APPROXIMATELY 865,034. THE HOSPITAL'S SECONDARY SERVICE AREA CONSISTS OF EIGHT SURROUNDING COUNTIES IN NEBRASKA AND NINE SURROUNDING COUNTIES IN IOWA.FOR THE YEAR ENDED DECEMBER 31, 2020, 49.0% OF THE HOSPITAL'S INPATIENT DISCHARGES WERE FROM PATIENTS RESIDING IN THE THREE-COUNTY PRIMARY SERVICE AREA. PATIENTS RESIDING IN THE SEVENTEEN-COUNTY SECONDARY SERVICE AREA ACCOUNTED FOR 19.4% OF TOTAL HOSPITAL INPATIENT DISCHARGES DURING THIS SAME TIME PERIOD. THE REMAINING 31.6% OF TOTAL DISCHARGES WERE FROM PATIENTS RESIDING OUTSIDE THE PRIMARY AND SECONDARY SERVICE AREAS.2020 DEMOGRAPHIC SUMMARYOMAHA METRO MARKET AREA: DOUGLAS, SARPY, AND POTTAWATTAMIE COUNTIES SOURCES: ESRI (BASED ON US CENSUS BUREAU), UNITED STATES CENSUS BUREAU AND CHILDREN'S HOSPITAL AND MEDICAL CENTER PATIENT ENCOUNTER DATABASE.COMMUNITIES SERVED - URBAN, SUBURBAN AND RURAL# OF HOSPITALS SERVING COMMUNITY - 12TOTAL POPULATION 865,034PEDIATRIC POPULATION 215,725AVERAGE HOUSEHOLD INCOME $88,761PERCENT OF RESIDENTS BELOW FEDERAL POVERTY LEVELTOTAL POPULATION 9.4%UNDER AGE 18 10.8%PERCENT OF RESIDENTS ON MEDICAID 9.9%AGE POPULATION %OF TOTALLESS THAN 18 215,725 25.0%18 TO 24 79,416 9.2%25 TO 44 247,558 28.6%45 TO 64 202,729 23.4%65+ 119,606 13.8%TOTAL 865,034 100.0%RACE POPULATION %OF TOTALWHITE 643,370 74.4%HISPANIC 96,262 11.1%BLACK 71,602 8.3%ASIAN/PACIFIC ISLANDER 26,828 3.1%OTHER/2+ RACES 24,013 2.8%AM. IND/ALASKA NAT 2,959 0.3%TOTAL 865,034 100.0%FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREASAPPROXIMATE % OF PATIENTS FROM MEDICALLY UNDERSERVED AREAS: 14.1%COUNTY # OF CENSUS TRACTS* TOTAL CENSUS TRACTS % OF TOTALDOUGLAS 36 156 23.1%SARPY 12 43 27.9%POTTAWATTAMIE 3 30 10.0%TOTAL 51 229 22.3%*CENSUS TRACT IS A GEOGRAPHICAL DIVISION OF 500 TO 3,000 HOUSEHOLDS
PART VI, LINE 5:	PROUDLY SERVING CHILDREN SINCE 1948, CHILDREN'S HOSPITAL & MEDICAL CENTER (CHILDREN'S) MISSION IS TO IMPROVE THE LIFE OF EVERY CHILD THROUGH DEDICATION TO EXCEPTIONAL CLINICAL CARE, RESEARCH, EDUCATION AND ADVOCACY.CHILDREN'S CENTER FOR THE CHILD & COMMUNITY IS A STATEWIDE COMMUNITY OUTREACH HUB OF CHILDREN'S. THE CHILDREN'S CENTER FOR THE CHILD & COMMUNITY WAS LAUNCHED IN 2016 TO SERVE AS THE INFRASTRUCTURE FOR COMMUNITY HEALTH IMPROVEMENT, LEADING BOTH INTERNAL AND EXTERNAL PARTNERSHIPS AROUND PEDIATRICS COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) PLANNING AND IMPLEMENTATION.A LEADER IN PEDIATRIC HEALTH CARE, CHILDREN'S CONDUCTED MORE THAN 340,000 VISITS IN 2020. CHILDREN'S OFFERS UNIQUE RESOURCES TO CHILDREN ACROSS A THREE-STATE REGION AND BEYOND, AND IS THE ONLY FULL-SERVICE, PEDIATRIC HEALTH CARE CENTER IN NEBRASKA. IN ADDITION TO TRADITIONAL HOSPITAL-BASED SERVICES, SOME OF THE OTHER PROGRAMS AND SERVICES CHILDREN'S OFFERS TO PATIENTS ARE BEHAVIORAL HEALTH, REHAB SERVICES, HOME HEALTH, URGENT CARE, WEIGHT & WELLNESS, AND SPECIALTY CARE CLINICS. IN ADDITION, CHILDREN'S OFFERS PALLIATIVE CARE, FAMILY RESOURCES, CHILD LIFE SPECIALISTS, PASTORAL CARE, SOCIAL WORKERS, NURSE CASE MANAGERS, INTERPRETERS, FINANCIAL COUNSELORS, PATIENT ADVOCATES, AND OTHER PROGRAMS TO ENHANCE THE PATIENT EXPERIENCE.CHILDREN'S HAS ACHIEVED THE MAGNET DESIGNATION FOR NURSING EXCELLENCE, AND ITS PEDIATRIC AND NEONATAL INTENSIVE CARE UNITS HAVE EARNED A BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES, WHICH RECOGNIZES CRITICAL CARE UNITS WITH EXCELLENT PATIENT OUTCOMES THAT EXCEED NATIONAL BENCHMARKS. CHILDREN'S HAS BEEN NAMED BY U.S. NEWS & WORLD REPORT AS ONE OF THE NATION'S BEST CHILDREN'S HOSPITALS, NATIONALLY RANKED IN CARDIOLOGY AND HEART SURGERY, PULMONOLOGY AND LUNG SURGERY, GASTROENTEROLOGY AND GI SURGERY, AND UROLOGY. U.S. NEWS RECOGNIZES HOSPITALS WITH EXCELLENT SURVIVAL RATES, PATIENT SAFETY, SPECIALIZED STAFF, AND HOSPITAL REPUTATION. ALL OF THE CHILDREN'S PHYSICIANS PRIMARY CARE OFFICES HAVE ACHIEVED THE HIGHEST NCQA PATIENT CENTERED MEDICAL HOME (PCMH) CERTIFICATION. A PEDIATRIC AFFILIATION ESTABLISHED BETWEEN CHILDREN'S AND THE UNIVERSITY OF NEBRASKA MEDICAL CENTER COLLEGE OF MEDICINE (UNMC) SUPPORTS ENHANCEMENTS IN PEDIATRIC EDUCATION, RESEARCH, AND CLINICAL CARE. CHILDREN'S SERVES AS THE PRIMARY ACADEMIC MEDICAL TRAINING LOCATION FOR THE UNMC DEPARTMENT OF PEDIATRICS.IN 2020, CHILDREN'S PROVIDED MORE THAN $128 MILLION IN COMMUNITY BENEFITS, REPRESENTING 29% OF THE HOSPITAL'S OPERATING EXPENSES. TOTAL COMMUNITY BENEFITS PROVIDED IN 2020 INCLUDED THE FOLLOWING:- PROVIDED $3.4 MILLION IN FINANCIAL ASSISTANCE TO FAMILIES UNABLE TO PAY. WITH 45% OF PATIENT CARE REVENUES DEVOTED TO THE CARE OF LOW-INCOME CHILDREN ASSISTED BY MEDICAID, THE FY 2020 SHORTFALL BETWEEN MEDICAID REIMBURSEMENT AND THE COST OF PROVIDING CARE WAS $41 MILLION.- CONTRIBUTED $1.3 MILLION TOWARDS COMMUNITY HEALTH EDUCATION AIMED AT PROMOTING HEALTH AND PREVENTING ILLNESS AND INJURY MADE AVAILABLE THROUGH INJURY PREVENTION, OBESITY PREVENTION, PARENTING U EDUCATION CLASSES, OUTREACH EDUCATIONAL CLASSES, HEALTH FAIRS, JUST KIDS MAGAZINE, AND THE CONSUMER WEBSITE. CHILDREN'S GIVES BACK TO THE COMMUNITY THROUGH ADVOCACY SERVICES WHICH ARE AVAILABLE TO ANYONE SUSPECTING CHILD ABUSE OR NEGLECT, AND LODGING FOR FAMILIES OF OUT-OF-TOWN PATIENTS IS OFFERED AT THE CAROLYN SCOTT RAINBOW HOUSE AT NO COST.- CONTRIBUTED $20.3 MILLION IN PEDIATRIC HEALTH CARE EDUCATION COSTS TO EDUCATE TOMORROW'S HEALERS.- PROVIDED $538 THOUSAND IN CASH AND IN-KIND DONATIONS/SPONSORSHIPS TO BENEFIT THE BROADER COMMUNITY.
PART VI, LINE 6:	CHILDREN'S HOSPITAL & MEDICAL CENTER IS NOT AFFILIATED WITH A GREATER HEALTH CARE SYSTEM, BUT IS ITS OWN HEALTH CARE SYSTEM WHICH THE HOSPITAL OPERATES THE FOLLOWING RELATED ORGANIZATIONS:- CHILDREN'S HOSPITAL & MEDICAL CENTER FOUNDATION- CHILDREN'S PHYSICIANS- CHILDREN'S HEALTH NETWORK
SCHEDULE H, PART VI, LINE 7	THE CHILDREN'S HOSPITAL & MEDICAL CENTER COMMUNITY BENEFIT REPORT IS FILED IN THE STATE OF NEBRASKA THROUGH THE NEBRASKA HOSPITAL ASSOCIATION, AND IS AVAILABLE TO THE PUBLIC ON THE WEBSITE AT:HTTPS://WWW.CHILDRENSOMAHA.ORG/GET-INVOLVED/ADVOCACY-OUTREACH/COMMUNITY-ADVOCACY/

Schedule H (Form 990) 2020

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

2020

Open to Public
Inspection

Name of the organization
CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number
47-0379754

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) NE PEDIATRIC PRACTICE 8200 DODGE STREET OMAHA,NE68114	26-3064869	501(C)(3)	1,419,098	PEDIATRIC RESEARCH
(2) UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE 985520 NE MED CTR OMAHA,NE68198	47-0049123	501(C)(3)	3,443,271	SUPPORT FOR MED SCH
(3) NEBRASKA APPLESEED CENTER 941 O ST STE 920 LINCOLN,NE68508	47-0798343	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY
(4) CEDARS YOUTH SERVICES INC 6601 PIONEERS BLVD LINCOLN,NE68506	47-0551975	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY
(5) ONEWORLD COMMUNITY HEALTH CENTERS INC 4920 S 30TH ST STE 103 OMAHA,NE68107	47-0548990	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY
(6) HARRISON COUNTY HOME AND PUBLIC HEALTH 116 N SECOND AVE LOGAN,IA51546	42-6004889	GOVERNMENT	10,000	PREVENTION OF CHILDHOOD OBESITY
(7) SARPYCASS HEALTH DEPARTMENT 701 OLSON DR STE 101 PAPILLION,NE68045	27-0097150	GOVERNMENT	10,000	PREVENTION OF CHILDHOOD OBESITY
(8) FAMILY SERVICE ASSOCIATION OF LINCOLN 501 S 7TH ST LINCOLN,NE68508	47-0376584	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY
(9) INTERFAITH HEALTH SERVICE 1326 S 26TH ST OMAHA,NE68105	47-0832663	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY
(10) BOYS & GIRLS CLUBS OF THE MIDLANDS 2610 HAMILTON ST OMAHA,NE68131	47-0467350	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY
(11) CHICANO AWARENESS CENTER INC 4821 S 24TH ST OMAHA,NE68107	23-7208431	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY
(12) UNIVERSITY OF NEBRASKA EXTENSION 2000 VINE ST LINCOLN,NE68583	47-0049123	501(C)(3)	10,000	PREVENTION OF CHILDHOOD OBESITY

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) 2020

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	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance
(1) FINANCIAL ASSISTANCE TO PATIENTS IN NEED	8135	7,945,038	BOOK	WRITEOFF PAT ACCT
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference	Explanation
PART I, LINE 2:	CHILDREN'S HOSPITAL & MEDICAL CENTER HAS A WRITTEN FINANCIAL ASSISTANCE/CHARITY CARE POLICY. THE AMOUNT OF FINANCIAL ASSISTANCE AN INDIVIDUAL CAN RECEIVE IS BASED ON THE ANNUAL GROSS INCOME THRESHOLDS USING THE CURRENT FEDERAL POVERTY LEVEL GUIDELINES. GRANTS TO ORGANIZATIONS ARE ONLY DISTRIBUTED TO 501(C)(3) OR GOVERNMENT ORGANIZATIONS BASED ON THE HOSPITAL'S EVALUATION CRITERIA.

Schedule I (Form 990) 2020

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
Graphic Arrow

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

Attach to Form 990.
Graphic Arrow

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2020

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)
1KATHY ENGLISH EVP COO & CNO	(i) (ii)	491,934 ------------- 0	211,643 ------------- 0	256,301 ------------- 0	85,535 ------------- 0	7,366 ------------- 0	1,052,779 ------------- 0	236,909 ------------- 0
2CHRISTOPHER MALONEY MD EVP CCO & PIC	(i) (ii)	666,990 ------------- 0	225,083 ------------- 0	9,831 ------------- 0	98,588 ------------- 0	636 ------------- 0	1,001,128 ------------- 0	0 ------------- 0
3RICHARD AZIZKHAN MD FORMER PRES/CEO	(i) (ii)	0 ------------- 0	0 ------------- 0	969,020 ------------- 0	0 ------------- 0	0 ------------- 0	969,020 ------------- 0	0 ------------- 0
4RODRIGO LOPEZ INTERIM PRES/CEO THRU 9/7/20	(i) (ii)	507,692 ------------- 0	250,000 ------------- 0	37,404 ------------- 0	8,550 ------------- 0	468 ------------- 0	804,114 ------------- 0	0 ------------- 0
5MICHAEL BROWN EVP STRAT & TRANS THRU 1/3/20	(i) (ii)	18,860 ------------- 0	196,443 ------------- 0	584,298 ------------- 0	506 ------------- 0	504 ------------- 0	800,611 ------------- 0	0 ------------- 0
6AMY HATCHER EVP & CFO	(i) (ii)	438,255 ------------- 0	175,879 ------------- 0	4,308 ------------- 0	74,628 ------------- 0	8,364 ------------- 0	701,434 ------------- 0	0 ------------- 0
7AMY BONES SVP & GENERAL COUNSEL	(i) (ii)	375,919 ------------- 0	138,556 ------------- 0	7,455 ------------- 0	53,416 ------------- 0	7,706 ------------- 0	583,052 ------------- 0	0 ------------- 0
8JEROLD VUCHAK SVP CHIEF INFO OFFICER	(i) (ii)	342,681 ------------- 0	101,564 ------------- 0	13,359 ------------- 0	50,439 ------------- 0	7,665 ------------- 0	515,708 ------------- 0	0 ------------- 0
9BRIAN ALLISON VP SURG SERVICES THRU 9/24/20	(i) (ii)	146,857 ------------- 0	76,725 ------------- 0	254,687 ------------- 0	6,532 ------------- 0	9,019 ------------- 0	493,820 ------------- 0	0 ------------- 0
10NICOLE VILLARREAL MD PHYSICIAN	(i) (ii)	432,764 ------------- 0	26,250 ------------- 0	2,026 ------------- 0	6,994 ------------- 0	19,533 ------------- 0	487,567 ------------- 0	0 ------------- 0
11CHANDA CHACON PRESIDENT/CEO BEG 9/8/20	(i) (ii)	226,493 ------------- 0	150,000 ------------- 0	55,299 ------------- 0	44,869 ------------- 0	3,457 ------------- 0	480,118 ------------- 0	0 ------------- 0
12MALINDA BENDER MD PHYSICIAN	(i) (ii)	417,563 ------------- 0	33,250 ------------- 0	2,185 ------------- 0	8,384 ------------- 0	2,321 ------------- 0	463,703 ------------- 0	0 ------------- 0
13JAMIE DRAKE MD PHYSICIAN	(i) (ii)	412,543 ------------- 0	26,250 ------------- 0	2,194 ------------- 0	5,870 ------------- 0	1,946 ------------- 0	448,803 ------------- 0	0 ------------- 0
14JANEL ALLEN SVP & CHIEF PEOPLE OFFICER	(i) (ii)	300,657 ------------- 0	40,000 ------------- 0	6,429 ------------- 0	48,030 ------------- 0	18,997 ------------- 0	414,113 ------------- 0	0 ------------- 0
15KARI KRENZER MD PHYSICIAN	(i) (ii)	353,532 ------------- 0	28,000 ------------- 0	2,461 ------------- 0	8,389 ------------- 0	21,190 ------------- 0	413,572 ------------- 0	0 ------------- 0
16STEVEN C BURNHAM SVP PHYS NETWORKS THRU 1/3/20	(i) (ii)	14,060 ------------- 0	210,119 ------------- 0	68,591 ------------- 0	427 ------------- 0	493 ------------- 0	293,690 ------------- 0	0 ------------- 0
17SUZANNE NOCITA SVP & CHRO THRU 1/3/20	(i) (ii)	11,887 ------------- 0	180,130 ------------- 0	67,089 ------------- 0	828 ------------- 0	15 ------------- 0	259,949 ------------- 0	37,296 ------------- 0

Schedule J (Form 990) 2020

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

PART I, LINE 1A

RELOCATION AND COBRA ALLOWANCES WERE GROSSED-UP FOR CHANDA CHACON PER THE TERMS OF HER EMPLOYMENT CONTRACT.

PART I, LINES 4A-B

LINE 4A - SEVERANCE PAYMENTS THE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS DURING CALENDAR YEAR 2020: RICHARD AZIZKHAN, M.D. $969,020 MICHAEL BROWN $509,022 BRIAN ALLISON $226,215 STEVEN C. BURNHAM $40,000 LINE 4B - DEFERRED COMPENSATION THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN DURING 2020. THE AMOUNTS OF DEFERRED COMPENSATION DISTRIBUTED AND ACCRUED FOR EACH OF THE INDIVIDUALS DURING 2020 ARE AS FOLLOWS: CHRISTOPHER MALONEY, M.D. $90,038 ACCRUAL, $0 PLAN DISTRIBUTION KATHY ENGLISH $77,766 ACCRUAL, $236,909 PLAN DISTRIBUTION AMY HATCHER $66,078 ACCRUAL, $0 PLAN DISTRIBUTION AMY BONES $47,213 ACCRUAL, $0 PLAN DISTRIBUTION JEROLD VUCHAK $43,092 ACCRUAL, $0 PLAN DISTRIBUTION CHANDA CHACON $40,000 ACCRUAL, $0 PLAN DISTRIBUTION JANEL ALLEN $39,480 ACCRUAL, $0 PLAN DISTRIBUTION SUZANNE NOCITA $0 ACCRUAL, $37,296 PLAN DISTRIBUTION

Schedule J (Form 990) 2020

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2020

Open to Public
Inspection

Name of the organization
CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number
47-0379754

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	HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE	52-1440796	259230KT6	08-12-2008	100,881,609	REFUND BONDS (6/8/2007)	X			X		X
B	HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE	52-1440796	259230NJ5	03-14-2017	101,075,067	USED TO CONSTRUCT HUBBARD CENTER FOR CHILDREN		X		X		X
C	HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE	52-1440796		11-28-2017	26,885,000	REFUND BONDS (8/12/2008)		X		X		X
D	HOSPITAL AUTHORITY #2 OF DOUGLAS CO NE	52-1440796	259230PJ3	05-28-2020	109,497,288	HUBBARD / REFUND BONDS (9/10/2014)		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	67,955,000				9,575,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	100,892,260		104,280,765		26,885,000		109,498,512
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............							10,089
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	751,783		1,064,167		305,601		1,132,344
8 Credit enhancement from proceeds .............	24,826
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	2,755,000		103,216,598		26,579,399		83,365,213
11 Other spent proceeds .............	97,360,681						18,331,807
12 Other unspent proceeds .............							6,659,059
13 Year of substantial completion .............	2008				2008
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2019, a current refunding issue)? ........	X			X	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2019, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2020

Page 2

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		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X			X	X			X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X			X	X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X				X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X			X	X			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?	X				X
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 ....	0.200 %		0 %		0.200 %		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 .............	0.200 %		0 %		0.200 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X	X
b Exception to rebate? ........	X			X	X		X
c No rebate due? .........	X		X		X			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			X		X		X

Schedule K (Form 990) 2020

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?	X			X		X		X
b Name of provider ..........	MORGAN STANLEY
c Term of hedge .........	2500.0000000000 %
d Was the hedge superintegrated? ......		X
e Was the hedge terminated? ........		X
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
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?
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		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		X		X		X

Part Ⅵ

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

Return Reference	Explanation
SCHEDULE K, PART II, LINE 3	THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN E DUE TO INVESTMENT EARNINGS.
SCHEDULE K, PART IV, LINE 2C	DATE THE REBATE COMPUTATION WAS PERFORMED: 10/02/2017 (2008 BONDS) DATE THE REBATE COMPUTATION WAS PERFORMED: 02/28/2020 (2017 BONDS) DATE THE REBATE COMPUTATION WAS PERFORMED: 05/28/2018 (2017B BONDS)

Schedule K (Form 990) 2020

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Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2020

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

Part I

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

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

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

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

Part II

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

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






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

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2020

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) RICHARD AZIZKHAN MD	WIFE WAS EMPLOYEE	26,868	SEVERANCE		No
(2) RICHARD AZIZKHAN MD	SON IS EMPLOYEE	14,432	EMPLOYMENT		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2020

Additional Data

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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

2020

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

Return Reference	Explanation
FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS	THE HOSPITAL OPERATES A 145-BED PEDIATRIC HOSPITAL, WHICH INCLUDES SEVEN SURGICAL SUITES, TWO HYBRID HEART CATHERIZATION LABS, AN OUTPATIENT SURGERY CENTER, A HEART TRANSPLANT PROGRAM, A PEDIATRIC INTENSIVE CARE UNIT (PICU) AND A FETAL CARE CENTER THAT FOCUSES ON THE COORDINATION OF CARE FOR BABIES DIAGNOSED WITH COMPLEX CONGENITAL DEFECTS BEFORE BIRTH. CHILDREN'S HAS ACHIEVED THE MAGNET DESIGNATION FOR NURSING EXCELLENCE, AND ITS PEDIATRIC AND NEONATAL INTENSIVE CARE UNITS HAVE EARNED A BEACON AWARD FOR EXCELLENCE FROM THE AMERICAN ASSOCIATION OF CRITICAL CARE NURSES, WHICH RECOGNIZES CRITICAL CARE UNITS WITH EXCELLENT PATIENT OUTCOMES THAT EXCEED NATIONAL BENCHMARKS. IN 2020, THE HOSPITAL WAS RECOGNIZED BY U.S. NEWS AND WORLD REPORT FOR CARDIOLOGY AND HEART SURGERY, PULMONOLOGY AND LUNG SURGERY, GASTROENTEROLOGY AND GI SURGERY, AND UROLOGY. CHILDREN'S SPECIALTY PEDIATRIC CENTER OFFERS MORE THAN 50 OUTPATIENT SPECIALTY CLINICS, PROVIDING DIAGNOSTICS, TREATMENT, AND THERAPY. IN ADDITION, CHILDREN'S PROVIDES OUTPATIENT BEHAVIORAL HEALTH AND A FULL ARRAY OF PEDIATRIC HOME HEALTHCARE SERVICES TO CHILDREN AND ADOLESCENTS WHO HAVE IMMEDIATE OR LONG-TERM HEALTH CARE NEEDS, INCLUDING HOME MEDICAL EQUIPMENT RENTALS AND SALES, HOME HEALTH NURSING, IN-HOME PRIVATE DUTY NURSING AND HOME INFUSION THERAPY SERVICES. THE HOSPITAL IS HOME TO THE ONLY LEVEL IV NEONATAL INTENSIVE CARE UNIT AND THE ONLY DEDICATED PEDIATRIC EMERGENCY DEPARTMENT WITH LEVEL II PEDIATRIC TRAUMA DESIGNATION IN ITS SERVICE AREA. THE HOSPITAL ALSO PROVIDES SPECIALTY PEDIATRIC CARE SERVICES IN COMMUNITIES ACROSS A THREE-STATE REGION.
FORM 990, PART VI, SECTION B, LINE 11B	GOVERNANCE, MANANGEMENT, AND DISCLOSURE A COMPLETE COPY OF THE FORM 990, INCLUDING SCHEDULE J, IS MADE AVAILABLE TO THE EXECUTIVE COMMITTEE OF THE BOARD EXCLUDING THE MEDICAL STAFF PRESIDENT. THE FORM 990, EXCLUDING PART VII AND SCHEDULE J - COMPENSATION INFORMATION, IS MADE AVAILABLE TO THE REMAINDER OF THE BOARD OF DIRECTORS, INCLUDING THE MEDICAL STAFF PRESIDENT. BOTH ARE MADE AVAILABLE THROUGH THE DIRECTOR'S DESK WEBSITE PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	POLICIES THE CONFLICT OF INTEREST POLICY APPLIES TO ANY PERSON IN A POSITION TO EXERCISE INFLUENCE IN CONNECTION WITH ANY CONTRACT, TRANSACTION OR ARRANGEMENT PRESENTED TO THE BOARD OR A BOARD COMMITTEE FOR APPROVAL (COVERED PERSON). COVERED PERSON INCLUDES (BUT IS NOT LIMITED TO) ANY DIRECTOR, OFFICER, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWER, OR KEY EMPLOYEE/STAFF. ALL COVERED PERSONS MUST ANNUALLY SUBMIT A COMPLETED CONFLICT OF INTEREST QUESTIONNAIRE IN THE FORMAT PRESCRIBED BY THE GOVERNANCE COMMITTEE FROM TIME TO TIME. EACH COVERED PERSON SHALL ANNUALLY ACKNOWLEDGE IN WRITING THAT HE OR SHE (A) HAS RECEIVED A COPY OF THE POLICY; (B) HAS READ AND UNDERSTANDS THE POLICY; (C) AGREES TO COMPLY WITH THE POLICY; (D) UNDERSTANDS THAT THE POLICY APPLIES TO THE BOARD AND COMMITTEES; (E) UNDERSTANDS THAT CHILDREN'S IS A NOT-FOR-PROFIT ORGANIZATION THAT MUST ENGAGE PRIMARILY IN EXEMPT ACTIVITIES; (F) AGREES TO PROMPTLY REPORT TO THE CHAIR OF THE GOVERNANCE COMMITTEE, THE CONFLICT OF INTEREST/INDEPENDENCE DETERMINATION SUBCOMMITTEE (THE SUBCOMMITTEE) AND CHILDREN'S GENERAL COUNSEL ANY CHANGE TO MATTERS PREVIOUSLY DISCLOSED ON THE CONFLICT OF INTEREST QUESTIONNAIRE; AND (G) STATES THAT THE INFORMATION HE OR SHE WILL PROVIDE IN THE CONFLICT OF INTEREST QUESTIONNAIRE IS TRUE AND ACCURATE TO THE BEST OF HIS OR HER KNOWLEDGE AND BELIEF. A COVERED PERSON HAS A CONTINUING OBLIGATION TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST OR ANY SITUATIONS THAT COULD CREATE AN APPEARANCE OF A CONFLICT OF INTEREST. SUCH DISCLOSURE SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES OR WHENEVER IT INVOLVES A MATTER OF BOARD/COMMITTEE ACTION. DISCLOSURE MEANS PROMPTLY PROVIDING THE MATERIAL FACTS OF AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO THE CHAIR OF THE GOVERNANCE COMMITTEE, THE SUBCOMMITTEE AND CHILDREN'S GENERAL COUNSEL (IN WRITING IF TIME ALLOWS) OR TO THE BOARD OR BOARD COMMITTEE REVIEWING THE CONTRACT, TRANSACTION OR ARRANGEMENT. THE SUBCOMMITTEE WILL BE CONVENED TO CONSIDER THE DISCLOSURE. CERTAIN CIRCUMSTANCES, IN ADDITION TO FINANCIAL INTERESTS, COULD GIVE RISE TO A POTENTIAL CONFLICT OF INTEREST, INCLUDING INSTANCES WHERE THE ACTIONS OR ACTIVITIES OF AN INDIVIDUAL ON BEHALF OF CHILDREN'S ALSO INVOLVE OBTAINING A PERSONAL GAIN OR ADVANTAGE, OR COULD HAVE AN ADVERSE EFFECT ON CHILDREN'S INTERESTS. A COVERED PERSON MUST ALSO MAKE A DISCLOSURE WHENEVER HE OR SHE HAS A PERSONAL, NON-FAMILIAL RELATIONSHIP THAT COULD IMPACT, OR APPEAR TO IMPACT, THE BOARD MEMBER'S ABILITY TO EXERCISE THEIR INDEPENDENT JUDGMENT IN CARRYING OUT THE DIRECTOR'S FIDUCIARY RESPONSIBILITIES. ALSO, DISCLOSING OR USING INFORMATION RELATING TO CHILDREN'S BUSINESS FOR THE PERSONAL PROFIT OR ADVANTAGE OF AN INDIVIDUAL OR HIS OR HER FAMILY, OR OTHER COLLEAGUES OF THE DIRECTOR, OR DISCLOSING MATTERS DISCUSSED DURING BOARD OR COMMITTEE MEETINGS, COULD GIVE RISE TO A CLAIM OF CONFLICT AND MUST NOT OCCUR. A POTENTIAL CONFLICT OF INTEREST, OR THE APPEARANCE OF A CONFLICT OF INTEREST, DOES NOT NECESSARILY RISE TO THE LEVEL OF AN ACTUAL CONFLICT OF INTEREST, BUT ONCE RECOGNIZED, IT MUST IN EVERY CASE BE DISCLOSED AND EVALUATED. THE SUBCOMMITTEE WILL CONSIDER THE FOLLOWING FACTORS, AMONG OTHER RELEVANT FACTS, WHEN DETERMINING WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS: (I) THE PROXIMITY OF THE COVERED PERSON TO THE DECISION-MAKING AUTHORITY OF THE OTHER ENTITY INVOLVED IN THE TRANSACTION OR BUSINESS ARRANGEMENT; (II) THE MAGNITUDE OF THE FINANCIAL INTEREST OR PERSONAL INTEREST; (III) THE DEGREE TO WHICH THE COVERED PERSON MIGHT BENEFIT PERSONALLY IF A PARTICULAR TRANSACTION OR BUSINESS ARRANGEMENT WERE APPROVED; (IV) THE ABILITY OF THE COVERED PERSON TO MAKE AN INDEPENDENT DECISION BASED ONLY ON THE BEST INTEREST OF CHILDREN'S; AND (V) SUCH OTHER FACTORS THAT MAY BE RELEVANT TO THE PARTICULAR MATTER. THE SUBCOMMITTEE SHALL REVIEW EACH COMPLETED CONFLICT OF INTEREST QUESTIONNAIRE, AND MAY MAKE SUCH FURTHER INVESTIGATION OF POTENTIAL CONFLICTS AS IT MAY DETERMINE APPROPRIATE. THE SUBCOMMITTEE SHALL MAKE APPROPRIATE REPORTS TO THE BOARD CONCERNING ITS REVIEW, ANY FURTHER INVESTIGATION, AND ITS RECOMMENDATIONS TO THE BOARD REGARDING ANY POTENTIAL OR ACTUAL CONFLICT OF INTEREST, OR ANY APPEARANCE OF A CONFLICT OF INTEREST. WHENEVER A COVERED PERSON (OR A PERSON OTHER THAN THE COVERED PERSON) VOLUNTARILY IDENTIFIES OR DISCLOSES A POTENTIAL CONFLICT OF INTEREST, THE SUBCOMMITTEE SHALL FOLLOW THE SAME PROCEDURE OUTLINED ABOVE. TRANSACTIONS OR BUSINESS ARRANGEMENTS WITH COVERED PERSONS WITH CONFLICTS OF INTEREST MUST BE APPROVED IN ADVANCE BY A MAJORITY OF INDEPENDENT DIRECTORS, AT A MEETING AT WHICH A QUORUM IS PRESENT, THAT THE ARRANGEMENT OR TRANSACTION IS IN CHILDREN' S BEST INTEREST, IS FAIR AND REASONABLE TO CHILDREN'S AND THAT, AFTER REASONABLE INVESTIGATION, THE INDEPENDENT DIRECTORS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES. THE CONFLICTED DIRECTOR WILL RECUSE HIMSELF/HERSELF. IN CASES IN WHICH A COVERED PERSON HAS AN INTEREST OR A RELATIONSHIP THAT CALLS INTO QUESTION THE ABILITY OF THE COVERED PERSON TO ACT SOLELY IN CHILDREN'S BEST INTERESTS, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN, AT THE DISCRETION OF THE BOARD OR THE SUBCOMMITTEE: (A) THE COVERED PERSON WILL BE REQUIRED TO LEAVE THE MEETING FOR THE GENERAL DISCUSSION OF THE MATTER AND THE BOARD VOTE; (B) THE SUBCOMMITTEE CAN RECOMMEND TO THE BOARD THAT A DIRECTOR OR A MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS BE ASKED TO RESIGN IN THE EVENT A CONFLICT OF INTEREST IS SO SUBSTANTIAL THAT IT WOULD BE INCOMPATIBLE WITH CHILDREN'S BEST INTERESTS TO HAVE SUCH AN INDIVIDUAL ON ITS BOARD/SUBCOMMITTEE. IF THE BOARD/SUBCOMMITTEE BELIEVES A COVERED PERSON HAS FAILED TO COMPLY WITH THIS POLICY, THE BOARD SHALL INFORM THAT PERSON OF THE BASIS FOR ITS BELIEF AND GIVE THAT PERSON AN OPPORTUNITY TO ADDRESS THE ALLEGED FAILURE. AFTER HEARING THE RESPONSE AND CONDUCTING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED UNDER THE CIRCUMSTANCES, THE BOARD/SUBCOMMITTEE SHALL DETERMINE WHETHER SUCH PERSON HAS, IN FACT, VIOLATED THE DISCLOSURE REQUIREMENTS OF THE POLICY. IF THE BOARD DETERMINES THAT THERE HAS BEEN A VIOLATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION WHICH MAY INCLUDE REMOVAL FROM THE BOARD. AT ANY BOARD/SUBCOMMITTEE MEETING AT WHICH A CONFLICT OF INTEREST ISSUE IS ADDRESSED, THE MINUTES OF THE BOARD/SUBCOMMITTEE MEETING SHALL REFLECT THE PROCESS THAT WAS FOLLOWED, AND THE ACTIONS TAKEN BY THE BOARD/SUBCOMMITTEE.
FORM 990, PART VI, SECTION B, LINE 15	POLICIES EACH YEAR AN INDEPENDENT COMPANY CONDUCTS A MARKET ANALYSIS OF EXECUTIVE COMPENSATION. THIS INFORMATION IS PRESENTED TO THE COMPENSATION COMMITTEE. AN INDEPENDENT COMPANY ISSUES AN ANNUAL REASONABLENESS OPINION LETTER REGARDING THE APPROPRIATENESS OF THE EXECUTIVE PAY LEVELS. THE COMPENSATION COMMITTEE IS A SUB-COMMITTEE OF THE BOARD OF DIRECTORS. THE COMPENSATION COMMITTEE REVIEWS BASE PAY RANGES FOR ALL EXECUTIVES, INCLUDING THE CHIEF EXECUTIVE OFFICER, ALL EXECUTIVE VICE PRESIDENTS, SENIOR VICE PRESIDENTS, AND VICE PRESIDENTS. THE BOARD OF DIRECTORS RECEIVES A REPORT FROM THE COMMITTEE. THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR REVIEWING THE CEO'S PERFORMANCE WHICH AFFECTS HER PAY RATE INDIRECTLY.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNANCE, MANAGEMENT, AND DISCLOSURE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. THE CHILDREN'S HOSPITAL & MEDICAL CENTER AND AFFILIATES AUDITED FINANCIAL STATEMENTS CAN BE OBTAINED IN ADMINISTRATION.
FORM 990, PART XI, LINE 9:	CHANGE IN VALUE OF SPLIT INTEREST -176,677. CAPITAL TRANSFERS FOUNDATION 9,829,788. CAPITAL TRANSFERS CHILDREN'S HEALTH NETWORK -350,940.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2020

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

2020

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL & MEDICAL
CENTER

Employer identification number

47-0379754

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)CHILDREN'S HOSPITAL FOUNDATION 8200 DODGE STREET OMAHA,NE68114 47-6105603	FUNDRAISING	NE	501(C)(3)	LINE 7	CHMC	Yes
(2)CHILDREN'S PHYSICIANS 8200 DODGE STREET OMAHA,NE68114 47-0689372	PED CLINICS	NE	501(C)(3)	LINE 10	CHMC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2020

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?		(k) Percentage ownership
(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	(k) Percentage ownership

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	(h) Percentage ownership	(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	(h) Percentage ownership	Yes	No
(1) KENT INC 8200 DODGE STREET OMAHA,NE68114 47-0527928	REAL ESTATE	NE	CHMC	C		219,495	100.000 %	Yes
(2) CHILDREN'S HEALTH NETWORK 8200 DODGE STREET OMAHA,NE68114 36-3967578	HEALTH NETWORK	NE	CHMC	C			100.000 %	Yes

Schedule R (Form 990) 2020

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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) CHILDREN'S HOSPITAL FOUNDATION	C	3,379,264	BOOK
(2) CHILDREN'S HOSPITAL FOUNDATION	L	279,464	BOOK
(3) CHILDREN'S HOSPITAL FOUNDATION	S	14,639,249	BOOK
(4) CHILDREN'S PHYSICIANS	L	2,105,825	BOOK

Schedule R (Form 990) 2020

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2020

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) 2020

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE OCHILDREN'S HOSPITAL & MEDICAL CENTER DELIVERS EXTRAORDINARY CARE TO CHILDREN, EDUCATES HEALTH CARE PROFESSIONALS, AND PROMOTES PEDIATRIC RESEARCH.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	20
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2020 (Part V, line 2a) ......	5	3,489
6	Total number of volunteers (estimate if necessary) .............	6	237
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	-9,416
b	Net unrelated business taxable income from Form 990-T, line 39 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,091,756	20,733,019
9	Program service revenue (Part VIII, line 2g) .........	451,331,530	453,312,839
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-234,350	-630,962
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	14,666,521	13,126,356
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	469,855,457	486,541,252
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	12,864,067	12,907,407
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)	228,418,471	236,699,049
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 85,745
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	181,662,243	185,281,876
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	422,944,781	434,888,332
19	Revenue less expenses. Subtract line 18 from line 12.......	46,910,676	51,652,920
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	641,508,810	816,142,903
21	Total liabilities (Part X, line 26).............	291,519,183	405,370,024
22	Net assets or fund balances. Subtract line 21 from line 20.....	349,989,627	410,772,879

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 353,184,915 including grants of $ 12,907,407 ) (Revenue $ 465,783,572 )
	SEE SCHEDULE O

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses353,184,915

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	9,571,516	0	611,665

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	3,379,264
e	Government grants (contributions)		1e	17,237,355

f	All other contributions, gifts, grants, and similar amounts not included above		1f	116,400

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

h Total. Add lines 1a-1f.......		20,733,019

		Business Code
2a	NET PATIENT REVENUE	621110	453,312,839	453,312,839
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		453,312,839

3 Investment income (including dividends, interest, and othersimilar amounts) ......			-658,534			-658,534
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		665,039	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		665,039	6c
d	Net rental income or (loss).......			665,039			665,039
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,105,376		7a
b	Less: cost or other basis and sales expenses	2,077,804		7b
c	Gain or (loss)	27,572		7c
d	Net gain or (loss).........			27,572			27,572
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	MANAGEMENT FEE INCOME		541610	7,420,248	7,420,248
b	CAFETERIA INCOME		900099	1,407,669	1,407,669
c	CONTRACT SERVICES		541900	1,142,796	1,152,212	-9,416
d	All other revenue ....			2,490,604	2,490,604
e	Total. Add lines 11a–11d ......			12,461,317
12	Total revenue. See instructions.....			486,541,252	465,783,572	-9,416	34,077

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	4,962,369	4,962,369
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	7,945,038	7,945,038
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	7,077,440		7,077,440
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	182,932,087	158,720,090	24,211,997
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	9,926,985	8,617,987	1,308,998
9	Other employee benefits .......	24,233,782	19,157,165	5,076,617
10	Payroll taxes ...........	12,528,755	10,951,716	1,577,039
11	Fees for services (non-employees):
a	Management ......	2,486	2,486
b	Legal .........	478,226	441,944	36,282
c	Accounting ...........	420,494	100,575	319,919
d	Lobbying ...........	85,016		85,016
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	38,514,319	26,610,118	11,904,201
12	Advertising and promotion ....	2,018,089	811	2,017,278
13	Office expenses .......	58,674,821	57,540,617	1,048,602	85,602
14	Information technology ......	13,078,145	12,893,967	184,178
15	Royalties ..
16	Occupancy ...........	8,954,897	3,217,816	5,737,081
17	Travel ............	275,406	229,736	45,670
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	2,822,986	2,820,900	2,086
21	Payments to affiliates .......	27,303,937	27,303,937
22	Depreciation, depletion, and amortization ..	21,152,621	8,547,612	12,605,009
23	Insurance ...	1,103,796		1,103,796
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	BLDG & GROUND MAINT	3,100,326	156,715	2,943,611
b	EQUIPMENT MAINTENANCE	2,520,804	1,479,721	1,041,083
c	BANK & SERVICE FEES	1,123,521	133,989	989,532
d	PROF DUES & SUBS	1,081,295	392,781	688,514
e	All other expenses	2,570,691	956,825	1,613,723	143
25	Total functional expenses. Add lines 1 through 24e	434,888,332	353,184,915	81,617,672	85,745
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			7,245,584	1	13,249,294
2	Savings and temporary cash investments .........			66,312,294	2	98,738,463
3	Pledges and grants receivable, net ......			2,224,000	3	2,047,323
4	Accounts receivable, net .............			91,753,043	4	92,933,053
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			0	7	0
8	Inventories for sale or use ............			7,529,349	8	7,599,314
9	Prepaid expenses and deferred charges ......			7,475,819	9	9,650,955
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	781,169,345
b	Less: accumulated depreciation	10b	254,763,162	408,823,477	10c	526,406,183
11	Investments—publicly traded securities .			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			1,204,396	12	840,103
13	Investments—program-related. See Part IV, line 11 ..			0	13	6,659,059
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			48,940,848	15	58,019,156
16	Total assets. Add lines 1 through 15 (must equal line 33)...			641,508,810	16	816,142,903

17	Accounts payable and accrued expenses .....	84,742,439	17	104,284,072
18	Grants payable ...	0	18	0
19	Deferred revenue .........	114,378	19	455,999
20	Tax-exempt bond liabilities .........	171,220,477	20	256,689,926
21	Escrow or custodial account liability. Complete Part IV of Schedule D	0	21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	4,616,217	23	4,191,451
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	30,825,672	25	39,748,576
26	Total liabilities. Add lines 17 through 25..	291,519,183	26	405,370,024

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	347,765,627	27	408,725,556
28	Net assets with donor restrictions ...........	2,224,000	28	2,047,323
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	349,989,627	32	410,772,879
33	Total liabilities and net assets/fund balances ........	641,508,810	33	816,142,903