Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
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OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 01-01-2021 , and ending 12-31-2021
BCheck if applicable:
CName of organization
Children's Hospital Colorado
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
13123 EAST 16TH AVENUE
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
AURORA, CO80045
D Employer identification number

84-0166760
E Telephone number

G Gross receipts $ 1,555,750,005
F Name and address of principal officer:
JENA HAUSMANN
13123 EAST 16TH AVENUE
AURORA,CO80045
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHILDRENSCOLORADO.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1908
M State of legal domicile: CO
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 27
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 26
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 9,745
6 Total number of volunteers (estimate if necessary) ............. 6 2,481
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 6,289,545
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 455,916
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 67,569,948 16,960,678
9 Program service revenue (Part VIII, line 2g) ......... 1,329,405,373 1,524,146,221
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 2,639,776 2,433,591
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) -10,215,125 12,209,515
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 1,389,399,972 1,555,750,005
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 435,050 608,800
14 Benefits paid to or for members (Part IX, column (A), line 4).....   0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 699,222,900 741,839,172
16a Professional fundraising fees (Part IX, column (A), line 11e) .....   0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 687,826,052 742,566,732
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,387,484,002 1,485,014,704
19 Revenue less expenses. Subtract line 18 from line 12....... 1,915,970 70,735,301
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 2,079,968,900 2,139,104,268
21 Total liabilities (Part X, line 26)............. 1,052,733,473 1,033,296,496
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,027,235,427 1,105,807,772
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 1,264,694,407 including grants of $ 608,800 ) (Revenue $ 1,524,146,221 )
ROUTINE INPATIENT SERVICES; ANCILLARY INPATIENT SERVICES SUCH AS LAB, RADIOLOGY, OPERATING ROOM, RECOVERY ROOM, CENTRAL SUPPLIES, ETC.; OUTPATIENT SERVICES SUCH AS EMERGENCY ROOM, MULTI-SPECIALTY AMBULATORY SERVICES INCLUDING ORTHO CLINIC, ONCOLOGY CLINIC, ETC. SEE SCHEDULE O FOR ADDITIONAL INFORMATION.
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 expensesMediumBullet1,264,694,407
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part I.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part III..
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part I.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part II....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part III..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IV..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see list of attachments
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I ....
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part II...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part III.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....
28b
 
No
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
33
Yes
 
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
35b
Yes
 
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2.............
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VI
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
87
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
9,745
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
Yes
 
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
27
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
26
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
Yes
 
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
Yes
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletJEFFREY HARRINGTON13123 EAST 16TH AVENUE   Aurora,CO80045 (720) 777-1234
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) Jena Hausmann
 
President and CEO
 40.0
.................
7.0 		X   X       1,957,036 0 333,397
(2) Annita Menogan
 
Borad Member
 1.0
.................
0.0 		X           0 0 0
(3) Anthony Spikes
 
Board Member
 1.0
.................
0.0 		X           0 0 0
(4) Barth Whitham
 
Board Member
 1.0
.................
4.0 		X           0 0 0
(5) Brian Smith
 
Board Member
 1.0
.................
0.0 		X           0 0 0
(6) Bruce Wagner
 
Board Member
 1.0
.................
0.0 		X           0 0 0
(7) Craig Ponzio
 
Board Member
 1.0
.................
0.0 		X           0 0 0
(8) David Honeyfield
 
Board Member/Treasurer
 1.0
.................
4.0 		X           0 0 0
(9) David Hoover
 
Board Member/Chair
 1.0
.................
7.0 		X           0 0 0
(10) Donald Elliman
 
Board Member
 1.0
.................
4.0 		X           0 0 0
(11) Fred Taylor
 
Board Member
 1.0
.................
7.0 		X           0 0 0
(12) Jack Wold
 
Board Member/Chair Elect
 1.0
.................
4.0 		X           0 0 0
(13) Jim Johnson
 
Board Member
 1.0
.................
0.0 		X           0 0 0
(14) John Ikard
 
Board Member (Pt-Yr)
 1.0
.................
0.0 		X           0 0 0
(15) John Reilly MD
 
Board Member
 1.0
.................
0.0 		X           0 0 0
(16) Judith Koff
 
Board Member
 1.0
.................
0.0 		X           0 0 0
(17) KRISTIN RICHARDSON
 
BOARD MEMBER (PT-YR)
 1.0
.................
0.0 		X           0 0 0
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W-2/1099-MISC/1099-NEC) 		(E)
Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) Laura Barton
 
Board Member
 1.0
.......................3.0 		X           0 0 0
(19) Leroy Williams
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(20) Martha Middlemist MD
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(21) Megan Fearnow
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(22) Melissa McDowell
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(23) Michael Gould
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(24) Mike Asher
 
Board Member
 1.0
.......................7.0 		X           0 0 0
(25) Phyllis Wise
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(26) Rick Stoddard
 
Board Member
 1.0
.......................3.0 		X           0 0 0
(27) Rob Joyce
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(28) Robert Cuculich
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(29) Shen Nagel MD
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(30) Soledad Hurst
 
Board Member (Pt-Yr)
 1.0
.......................0.0 		X           0 0 0
(31) Victoria Quintana
 
Board Member
 1.0
.......................0.0 		X           0 0 0
(32) Jeffrey Harrington
 
SVP and CFO
 40.0
.......................7.0 		    X       976,764 0 176,820
(33) Michelle Lucero
 
Chief Legal Officer, General Counsel/Secretary
 40.0
.......................4.0 		    X       712,075 0 154,478
(34) Dana Moore
 
SVP and CIO
 40.0
.......................0.0 		      X     643,946 0 159,246
(35) David Biggerstaff
 
EVP and COO
 40.0
.......................0.0 		      X     1,048,237 0 201,231
(36) Elizabeth Rodriguez
 
SVP Chief HR Officer
 40.0
.......................0.0 		      X     591,168 0 127,920
(37) Raphe Schwartz
 
SVP and Chief Strategy Officer
 40.0
.......................0.0 		      X     582,123 0 143,292
(38) Amy Feaster
 
VP IT Associate CIO
 40.0
.......................0.0 		        X   571,323 0 105,746
(39) Gregory Raymond
 
SVP Colorado Springs President
 40.0
.......................0.0 		        X   490,086 0 130,644
(40) Margaret Sabin
 
Past President Colorado Springs
 40.0
.......................0.0 		        X   725,043 0 133,013
(41) Patricia Givens
 
SVP Patient Care Svcs & CNO
 40.0
.......................0.0 		        X   563,295 0 108,354
(42) Suzanne Jaeger
 
SVP Experience and Access
 40.0
.......................0.0 		        X   536,513 0 135,399
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 9,397,609 0 1,909,540
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet1,122
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
UNIVERSITY OF COLORADO MEDICINE

13199 EAST MONTVIEW BLVD
AURORA,CO80045 		PHYSICIAN SERVICES 123,820,853
UNIVERSITY OF COLORADO DENVER

13123 EAST 16TH AVE
BOD B-219
AURORA,CO80045 		EDUCATION SERVICES 25,004,005
UNIVERSITY HOSPITAL

12605 E 16TH AVE
AURORA,CO80045 		PHYS/MEDICAL SERVICE 16,119,604
CROTHALL HEALTHCARE INC

13028 COLLECTION CENTER DRIVE
CHICAGO,IL60693 		ENVIRONMENTAL SVCS 11,465,638
HSS SECURITY LLC

990 S BROADWAY 100
DENVER,CO80209 		SECURITY SERVICES 6,377,913
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet130
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 5,629,468
e Government grants (contributions)1e 11,331,210
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 16,960,678
Program Service RevenueAmt Business Code
2a NET PATIENT SERVICES REVENUE 622110 1,406,487,518 1,406,487,518    
b RESEARCH FUNDING 541900 12,880,270 12,880,270    
c LAB BILLING 561000 5,623,723 411,380 5,212,343  
d CAFETERIA 722210 3,964,172 3,964,172    
e PARKING LOT REVENUE 461790 1,850,521 1,850,521    
f All other program service revenue. 93,340,017 92,262,815 1,077,202 0
g Total. Add lines 2a–2f .....MediumBullet 1,524,146,221
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 2,749,295     2,749,295
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   974,430 6a
b Less: rental expenses     6b
c Rental income or (loss) 0 974,430 6c
d Net rental income or (loss).......MediumBullet 974,430     974,430
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   -315,704 7a
b Less: cost or other basis and sales expenses     7b
c Gain or (loss) 0 -315,704 7c
d Net gain or (loss).........MediumBullet -315,704     -315,704
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..MediumBullet      
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..MediumBullet        
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..MediumBullet        
Business Code Miscellaneous Revenue
11a GAIN/LOSS INTEREST RATE SWAPS   11,235,085     11,235,085
b            
c            
d All other revenue .... 0 0 0 0
e Total. Add lines 11a–11d ...... MediumBullet 11,235,085
12 Total revenue. See instructions.....MediumBullet 1,555,750,005 1,517,856,676 6,289,545 14,643,106
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 608,800 608,800
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 7,807,733 6,613,961 1,193,772  
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........ 598,501,033 506,992,519 91,508,514  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 19,542,932 16,554,893 2,988,039  
9 Other employee benefits ....... 72,568,888 61,473,383 11,095,505  
10 Payroll taxes ........... 43,418,586 36,780,051 6,638,535  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 1,556,694   1,556,694  
c Accounting ........... 39,299   39,299  
d Lobbying ........... 613,412 613,412    
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 131,090   131,090  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 235,686,713 199,651,119 36,035,594 0
12 Advertising and promotion .... 12,532,065 10,615,960 1,916,105  
13 Office expenses ....... 3,444,392 2,917,758 526,634  
14 Information technology ...... 26,065,932 22,080,551 3,985,381  
15 Royalties ..        
16 Occupancy ........... 31,551,195 26,727,138 4,824,057  
17 Travel ............ 1,192,230 1,009,943 182,287  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 326,317 276,424 49,893  
20 Interest ........... 20,753,490 17,580,361 3,173,129  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 85,755,158 72,643,523 13,111,635  
23 Insurance ... 8,797,872 7,452,711 1,345,161  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a MEDICAL/PHARM SUPPLIES 221,559,782 187,684,141 33,875,641  
b HOSPITAL PROVIDER FEE 52,381,324 52,381,324    
c EQUIPMENT RENTAL & MAINT 16,759,499 14,197,036 2,562,463  
d FOOD 5,205,620 4,409,701 795,919  
e All other expenses 18,214,648 15,429,698 2,784,950 0
25 Total functional expenses. Add lines 1 through 24e 1,485,014,704 1,264,694,407 220,320,297 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 105,016,227 1 83,407,260
2 Savings and temporary cash investments .........   2  
3 Pledges and grants receivable, net ...... 5,310,490 3 4,574,150
4 Accounts receivable, net ............. 228,394,577 4 257,006,364
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 ...........   7  
8 Inventories for sale or use ............ 19,275,525 8 23,889,438
9 Prepaid expenses and deferred charges ...... 14,063,149 9 17,827,786
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,982,980,029
b Less: accumulated depreciation 10b 743,944,798 1,264,974,424 10c 1,239,035,231
11 Investments—publicly traded securities . 217,776,448 11 285,642,294
12 Investments—other securities. See Part IV, line 11 ..... 6,447,302 12 10,182,528
13 Investments—program-related. See Part IV, line 11 .. 0 13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 218,710,758 15 217,539,217
16 Total assets. Add lines 1 through 15 (must equal line 33)... 2,079,968,900 16 2,139,104,268
Liabilities 17 Accounts payable and accrued expenses ..... 194,641,853 17 198,596,342
18 Grants payable ... 6,430,891 18 10,739,125
19 Deferred revenue ......... 70,472 19 410,272
20 Tax-exempt bond liabilities ......... 649,514,254 20 653,395,104
21 Escrow or custodial account liability. Complete Part IV of Schedule D   21  
22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
0 22 0
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties .. 17,431,479 24 17,064,602
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 184,644,524 25 153,091,051
26 Total liabilities. Add lines 17 through 25.. 1,052,733,473 26 1,033,296,496
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 881,287,198 27 957,626,627
28 Net assets with donor restrictions ........... 145,948,229 28 148,181,145
Organizations that do not follow FASB ASC 958, check here MediumBullet 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 ........... 1,027,235,427 32 1,105,807,772
33 Total liabilities and net assets/fund balances ........ 2,079,968,900 33 2,139,104,268
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
1,555,750,005
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
1,485,014,704
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
70,735,301
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,027,235,427
5
Net unrealized gains (losses) on investments ...............
5
-1,962,110
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
9,799,154
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,105,807,772
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID: 21014044
Software Version: 2021v4.2
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number

84-0166760
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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  
12
12
 
13
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
14
14
 
15
15
 
16a
b
17a
b
18
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) 2021

Schedule A (Form 990) 2021
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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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) right arrow (a) 2017 (b) 2018 (c) 2019 (d) 2020 (e) 2021 (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 on 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.)..            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).
8
 
 
9a
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.
9a
 
 
b
Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.
9b
 
 
c
Did a disqualified person (as defined on 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.
9c
 
 
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
 
 
b
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) 2021

Schedule A (Form 990) 2021
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?
11a
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
A 35% controlled entity of a person described on 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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
Did the activities described on 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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990) 2021

Schedule A (Form 990) 2021
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 2021 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-2021 		(iii)
Distributable
Amount for 2021
1 Distributable amount for 2021 from Section C, line 6  
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI).
See instructions.		  
3 Excess distributions carryover, if any, to 2021:
a From 2016.......  
b From 2017.......  
c From 2018.......  
d From 2019.......  
e From 2020.......  
fTotal of lines 3a through e  
g Applied to underdistributions of prior years  
h Applied to 2021 distributable amount  
i Carryover from 2016 not applied (see
instructions) 		 
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.  
4Distributions for 2021 from Section D, line 7:
$  
a Applied to underdistributions of prior years  
b Applied to 2021 distributable amount  
c Remainder. Subtract lines 4a and 4b from line 4.  
5 Remaining underdistributions for years prior to
2021, 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 2021. 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 2022. Add lines
3j and 4c. 		 
8 Breakdown of line 7:
a Excess from 2017.....  
b Excess from 2018.....  
c Excess from 2019.....  
d Excess from 2020.....  
e Excess from 2021.....  
Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021
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) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2021
Name of the organization
Children's Hospital Colorado
 
Employer identification number

84-0166760
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... 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) (2021)
Schedule B (Form 990) (2021) Page 2
Name of organization
Children's Hospital Colorado
  		Employer identification number
84-0166760
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


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)
Schedule B (Form 990) (2021)
Page 3
Name of organization
Children's Hospital Colorado
  		Employer identification number

84-0166760
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) (2021)
Schedule B (Form 990) (2021)
Page 4
Name of organization
Children's Hospital Colorado
  		Employer identification number

84-0166760
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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) (2021)
Additional Data


Software ID: 21014044
Software Version: 2021v4.2
SCHEDULE C
(Form 990)

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 BulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
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 Colorado
 
Employer identification number

84-0166760
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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.
Cat. No. 50084S
Schedule C (Form 990) 2021

Schedule C (Form 990) 2021
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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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) ...................... 79,581 0
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................ 533,831 0
c Total lobbying expenditures (add lines 1a and 1b) ............................................................ 613,412 0
d Other exempt purpose expenditures ............................................................................... 1,264,080,995 0
e Total exempt purpose expenditures (add lines 1c and 1d) .................................................. 1,264,694,407 0
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000 0
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 0
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................ 0 0
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................ 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? ...................................................................................................................

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) 2018 (b) 2019 (c) 2020 (d) 2021 (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 515,459 614,169 541,563 613,412 2,284,603
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 62,898 107,453 90,731 79,581 340,663
Schedule C (Form 990) 2021


Schedule C (Form 990) 2021
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
1
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:
a
Volunteers? ...........................................................................................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
 
c
Media advertisements? ...................................................................................................
 
 
 
d
Mailings to members, legislators, or the public? .............................................................................
 
 
 
e
Publications, or published or broadcast statements? ...........................................................
 
 
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
 
 
i
Other activities? ...................................................................................................................
 
 
 
j
Total. Add lines 1c through 1i ....................................................................................................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
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) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
2021
Open to Public Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number

84-0166760
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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) 2021

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 53,372,712 48,474,391 41,279,296 44,803,998 39,760,313
b Contributions ...          
c Net investment earnings, gains, and losses 6,486,957 5,882,427 8,349,894 -2,040,626 5,959,341
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		582,885 883,405 1,059,492 1,390,736 826,784
f Administrative expenses .... 117,107 100,701 95,307 93,340 88,872
g End of year balance ...... 59,159,677 53,372,712 48,474,391 41,279,296 44,803,998
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100 %
c
Term endowment SchDMd Bullet  
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
Yes
 
(ii) Related organizations .................
3a(ii)
 
No
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
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 .....   70,323,552 70,323,552
b Buildings ....   1,246,341,343 357,515,877 888,825,466
c Leasehold improvements   39,346,247 13,526,190 25,820,057
d Equipment ....   614,997,806 371,170,702 243,827,104
e Other .....   11,971,081 1,732,029 10,239,052
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 1,239,035,231
Schedule D (Form 990) 2021

Schedule D (Form 990) 2021
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
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet  
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
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
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)OPERATING LEASES 72,236,803
(2)TAMMEN TRUST 59,159,677
(3)MISC. RECEIVABLES 32,044,674
(4)OTHER NON CURRENT ASSETS 17,833,320
(5)INTERCOMPANY OTHER AFFILIATES 16,155,316
(6)457 ASSETS 11,138,707
(7)MISC. NOTE RECEIVABLES 6,494,768
(8)SELF INSURANCE TRUST LT REC. 2,475,952
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 217,539,217
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  
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 153,091,051
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) 2021

Schedule D (Form 990) 2021
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
Schedule D, Part V, Line 4 Intended uses of endowment funds THE HOSPITAL IS THE INCOME BENEFICIARY OF THE H.H. TAMMEN TRUST, A PERPETUAL TRUST UNDER WHICH THE HOSPITAL HAS THE IRREVOCABLE RIGHT TO RECEIVE THE INCOME EARNED ON THE TRUST ASSETS IN PERPETUITY. FUNDS ARE USED TO SUPPORT HOSPITAL ACTIVITIES.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote MANAGEMENT REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS.
Schedule D (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
2021
Open to Public Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number

84-0166760
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (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) . . . 		    6,754,614 955,649 5,798,965 0.39 %
b Medicaid (from Worksheet 3, column a) . . . . .     630,322,508 415,583,912 214,738,596 14.46 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .         0 0 %
d Total Financial Assistance and Means-Tested Government Programs . . . . . 0 0 637,077,122 416,539,561 220,537,561 14.85 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     31,545,664 5,426,118 26,119,546 1.76 %
f Health professions education (from Worksheet 5) . . .     34,650,954 9,346,035 25,304,919 1.70 %
g Subsidized health services (from Worksheet 6) . . . .     40,025,519 32,389,978 7,635,541 0.51 %
h Research (from Worksheet 7) .     28,964,422 8,201,360 20,763,062 1.40 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     1,156,265   1,156,265 0.08 %
j Total. Other Benefits . . 0 0 136,342,824 55,363,491 80,979,333 5.45 %
k Total. Add lines 7d and 7j . 0 0 773,419,946 471,903,052 301,516,894 20.30 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing         0 0 %
2 Economic development         0 0 %
3 Community support         0 0 %
4 Environmental improvements     50,274 11,021 39,253 0 %
5 Leadership development and
training for community members		     53,695   53,695 0 %
6 Coalition building         0 0 %
7 Community health improvement advocacy         0 0 %
8 Workforce development     951,099 142,000 809,099 0.05 %
9 Other         0 0 %
10 Total 0 0 1,055,068 153,021 902,047 0.06 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
9,855,457
3
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. ......
3
9,343,371
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
2,130,088
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
3,048,535
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-918,447
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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) 2021
Schedule H (Form 990) 2021
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?5Name, 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) 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS
13123 EAST 16TH AVENUE
AURORA,CO80045
WWW.CHILDRENSCOLORADO.ORG
010417 		X   X X   X X     A
2 CHCO - SOUTH CAMPUS
1811 PLAZA DRIVE
HIGHLANDS RANCH,CO80129
WWW.CHILDRENSCOLORADO.ORG
01F105 		X   X X   X X     A
3 CHCO - AT PARKER ADVENTIST HOSPITAL
9395 CROWN CREST BLVD
PARKER,CO80138
WWW.CHILDRENSCOLORADO.ORG
13Z405 		X   X       X   Hospital Unit or Hospital-within-Hospital A
4 CHCO - COLORADO SPRINGS
4090 BRIARGATE PARKWAY
COLORADO SPRINGS,CO80920
WWW.CHILDRENSCOLORADO.ORG
01b436 		X   X X   X X     A
5 CHCO - NORTH CAMPUS
469 STATE HIGHWAY 7
BROOMFIELD,CO80023
WWW.CHILDRENSCOLORADO.ORG
017MU3 		X   X X   X X      
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
A
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 No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 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 ................. 5 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.................................. 6a Yes  
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): WWW.CHILDRENSCOLORADO.ORG
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
A
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/
b
www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
A
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
A
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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)
CHCO - NORTH CAMPUS
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): 		5
Yes No
Community Health Needs Assessment
1 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?........................ 1 Yes  
2 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............... 2 Yes  
3 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...................... 3   No
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20  
5 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 ................. 5    
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.................................. 6a    
b 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. ............................ 6b    
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7    
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8    
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20  
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10    
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b    
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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) 2021
Schedule H (Form 990) 2021
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
CHCO - NORTH CAMPUS
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/
b
www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 6
Part VFacility Information (continued)

Billing and Collections
CHCO - NORTH CAMPUS
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
CHCO - NORTH CAMPUS
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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
Schedule H, Part V, Section B, Line 3E CHCO - Colorado Springs was placed into service in May 2019. A single Schedule H, Part V, Section B was completed for facility reporting group A. The following hospital facilities are included in facility reporting Group A: (1) Children's Hospital Colorado (CHCO) - Anschutz (2) CHCO - South Campus (3) CHCO - At Parker Adventist Hospital (4) CHCO - Colorado Springs In 2021, Children's Hospital Colorado conducted two Community Health Needs Assessments (CHNA's). A joint assessment was conducted for licensed hospital facilities in the Denver Metro area, which included CHCO -Anschutz Medial Campus, CHCO - South Campus, and CHCO - AT Parker Adventist (hospital unit license). A second CHNA was conducted for the CHCO - Colorado Springs hospital, licensed in 2019. This meets the requirement that newly licensed hospital facilities complete a CHNA by the last day of the second taxable year. Both CHNA's were approved by the Children's Hospital Colorado Board of Directors on December 16, 2021. Children's Hospital Colorado included in each of the CHNA's reports a prioritized list and description of the community's significant health needs identified through the CHNA process. In both the Anschutz and Colorado Springs CHNA's, child mental health emerged as the top community concern through every method of data collection included in the assessments. Children's Hospital Colorado will address this community driven priority through a commitment of resources with specific programs and services as outlined in the corresponding implementation plans. "2021 CHNA's: https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/"
Schedule H, Part V, Section B, Line 5 Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 5 APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. Children's Colorado embraced the opportunity to engage with our community, better understand their interests and concerns, and design programs that directly respond to community needs. The primary purpose of the assessment is to fulfill our mission of improving the health of all Colorado children. The assessments connect us with communities and identifies priorities for our community-focused health goals and programs. Our methods for the 2021 CHNA's were informed by previous CHNAs and feedback we received on our 2018 CHNA from key stakeholders. We gathered both primary and secondary data for our communities and, when possible, gathered data that would demonstrate the impact of the COVID pandemic on community health and well-being. Additionally, in response to our 2018 CHNA feedback, Children's Colorado revised our prior data collection approach in two main ways: 1) gathered secondary data first to inform our primary data collection strategy and 2) developed a more dedicated approach to equity in our data collection process. For the first revision, we used our secondary data to inform what primary data we would collect that could provide context to and fill gaps from the secondary data. For the second revision, we examined our practices for data collection, analysis and communication with an awareness of the historical impacts, potential biases, and explored more demographic data, such as race, ethnicity, sexual orientation, and intersectionality to better understand the disparate impacts of health across populations. We then embarked on a significant community engagement process to understand prevailing interests and concerns in the neighborhoods and counties our hospitals serve. We prioritized input from families of color, families that speak diverse languages, and families facing barriers to care due to socioeconomic conditions. Through collaborations, caregiver surveys, stakeholder interviews, and community meetings, we were able to gain input from a diverse cross-section of the community. Data collection instruments are in the appendix of each of the CHNA's. Stakeholder Interviews: Stakeholders provide critical insights regarding the root causes of community health needs, as well as context and nuance that is often missed in secondary data. Stakeholders included leaders and representatives of ethnically diverse, medically underserved populations, as well as local health departments and agencies that gather data and other information relevant to current community health needs. We conducted a total of 54 interviews. A detailed list of stakeholder names, roles, and organizations are listed in each of the CHNA's. Caregiver Survey: This survey provided an opportunity to hear from parents and caregivers of children aged 0 to 25 living in counties where we have facilities and most of our patient population resides. To ensure that a broad cross-section of the community had an opportunity to respond, we had the survey reviewed through several channels to assess literacy level and cultural responsiveness. The survey was translated into eight languages: Amharic, Arabic, Burmese, English, French, Karen, Somali and Spanish to gain greater input from the community. For the Anschutz (Denver Metro area) CHNA, we hired four cultural connectors to collect caregiver survey data in Burmese, Karen, Nepali, Spanish, Swahili and French. For our Colorado Springs CHNA, we partnered with Catholic Charities to gather caregiver surveys to expand accessibility from diverse community members. In total, we collected 498 caregiver surveys to inform our work. Health Care Worker Survey: This survey was administered to pediatric providers: physicians, nurses and allied health professionals. Approximately 30% of respondents were physicians and 25% were registered nurses. Community Meetings: We held a series of community meetings to present the data we'd gathered from internal and external sources, as well as the results of our interviews and surveys. Participants asked questions and advocated for the issues they found most compelling, then voted for their top health and social issues. Details on these community meetings can be found in each of the CHNA's. Prioritization of Health Needs: Once our teams completed collection of primary and secondary data, including input from seven community meetings, the final step of the assessment was to seek input on how to prioritize the needs identified. Our Population Health committee, comprising both clinical and nonclinical leaders at Children's Colorado, carefully considered prioritization criteria and agreed on six key factors: impact, community importance, viability, sustainability, scale, and health equity. Mental health emerged as the top community concern through every method of data collection included in this assessment. Caregivers, health care team members, and community leaders all reported that mental of children in our community is a critical issue. Internal utilization data and public health surveillance data demonstrate a continued and increasing need for mental health and suicide prevention services for children and youth in Colorado, including services that address disparities in mental health outcomes within populations. Mental health has long been identified as a health priority among our community stakeholders as persistent systemic challenges have prevented mental health parity from being achieved. As Children's Colorado joins our community partners in embracing whole child, whole health approaches to child health, we recognize the need to place a consistent focus on mental health to meaningfully integrate mental health into our holistic approaches to care. Children's Colorado recognizes that the public health needs of the community are extensive, and many needs are not explicitly addressed through our priority and goals. Access to health care, including mental health services, and several social determinants of health were identified as top needs by the community and within the data, such as food insecurity, housing, access to benefits, mother and infant health, and economic issues. Work will continue to address other needs as identified by the community and highlighted throughout this reporting.
Schedule H, Part V, Section B, Line 6a Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 6a APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. For the joint 2021 CHNA, Children's Colorado defined community as all children aged 0 to 25 living in the four-county area from which most of the hospital's patient population resides and in which we have facilities: Adams, Arapahoe, Denver, and Douglas Counties. Within these counties, Children's Colorado has three licensed hospital facilities located at the Anschutz Medical Campus, South Campus, and Parker Adventist Campus and our associated networks of care. The Colorado Springs Hospital CHNA defined community as all children aged 0 to 25 living in the El Paso County area from which most of the hospital's patient population resides and in which we have facilities.
Schedule H, Part V, Section B, Line 7 Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 7D APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. The CHNA is posted on the hospital's external facing website and is made available upon request either digitally or written format. As part of the CHNA communication plan, results of the CHNA and the subsequent implementation plan are shared at various stakeholder meetings and community forums with the goal of identifying opportunities to engage in collaborative efforts to address areas of need. A dedicated community benefit email also provides an opportunity for input and questions. In 2019, the State of Colorado enacted HB19-1320, Hospital Community Benefit Accountability. A pivotal requirement of the legislation is an annual community benefit public meeting. The purpose of the public meeting is to inform the community of the hospital's community benefit expenditures, provide an opportunity for the community to learn about the most recent CHNA and the strategies that address the identified priority needs. The community is also provided the opportunity to advise on health and social service needs that continue to be of concern for the community.
Schedule H, Part V, Section B, Line 11 Facility A, 1 Facility A, 1 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL FACILITIES INCLUDED IN GROUP A. To create the 2019 implementation plan, Children's Colorado used the information gathered through our 2018 CHNA and incorporated additional insights from five strategic planning sessions with internal and external community partners. A framework was developed that focused on five types of activities which had the most potential to impact child health outcomes: education and training, direct services and support, screening, referrals and navigation, and policy and advocacy. The priority health needs addressed in the 2019 implementation plan are mental and behavioral health, injury prevention, prematurity, asthma and respiratory health, obesity, nutrition, and physical activity. The plan outlines our three-year goals and objectives for each of the priorities and details the strategies that are identified to address these complex needs. Each of these objectives is quantifiable and time-limited, which allows for effective evaluation. The 2019 Community Health Implementation Plan (CHIP) and the 2019-2022 CHIP Evaluation https://www.childrenscolorado.org/community/community-health/community-health-needs-assessment/ Children's Hospital Colorado recognizes that the health needs of children in our community are extensive. As we transition to the 2022 implementation plan the five health priorities identified through the 2018 CHNA process will remain as sustaining priorities. The highlighted activities are examples of work addressing the five priorities and is not all inclusive of our extensive community-level work. Nutrition: Children's Colorado is acutely aware of the inextricable link between access to quality, affordable, nutritious food, and health. This is particularly important in serving communities with higher rates of poverty who struggle with food security. The Food as Medicine initiative at CHCO aims to integrate the importance of nutrition and health by not only providing food, but also education to help connect food to health. This is done by screening families, identifying those who identify as food insecure and providing resources and education to help overcome barriers to access. In 2021, the Healthy Roots Food Clinic received 1,149 referrals from primary care clinics in our Health Pavilion and served 2,851 people (1,237 children and 1,614 adults). One hundred percent of visits were "successful," meaning that all families who sought food were provided nutritious groceries and basic food education. In the summer of 2021, we launched pilot replications of the Healthy Roots Food Clinic and Resource Connect model in two schools within the Aurora Public School district (APS). The program is implemented in partnership with the communities we serve. At Children's Colorado's Aurora Public School food clinic partnership sites, we served approximately 1,185 students in 2021. Both schools are part of the APS ACTION Zone, a network of five schools that serves 4,200+ students, roughly 10% of all APS students, and demographics include: Students come from 50+ different countries and speak over 150 languages, 66% of students are Hispanic, 15% Black, 12% Asian, 1% Native American and 4% White, 82% qualified for Free or Reduced Lunch, 75% English Language Developers. Asthma and Respiratory Health: The community-based asthma programs in the Breathing Institute within Children's Colorado focuses on reducing emergency department visits and inpatient admissions among asthma patients by improving families' ability to appropriately manage their children's asthma at home. Research shows that the incidence of asthma and outcomes for children with asthma are related to the environments in which they live, their social determinants of health, and their ability to make healthy choices. The AsthmaCOMP program has demonstrated significant improvement in clinical asthma outcomes including improved school attendance rates, reduced frequency of asthma symptoms and decreased ER/Urgent Care visits for asthma. The program has also helped train school nurses to become certified asthma educators. In 2021, this team completed 162 visits with students in 41 elementary schools. Of these students, 94% are eligible for free or reduced school lunch, 84% are insured by Medicaid, 87% identify as Black, Indigenous, or other people of color, and one in four have a caregiver who is Spanish speaking only. The Just Keep Breathing program has four community health navigators and a nurse dedicated to conducting asthma education in the home setting. The program focuses on improving care for pediatric patients with high-risk asthma in Metro Denver; this year they were able to serve families in rural communities using telehealth. The navigators conduct multiple home visits with each family, focusing on tailored health education, care coordination, barrier identification and navigation, and environmental assessment and remediation. In 2021, 183 eligible patients were identified, 87 of those patients enrolled in the program, and the team completed 79 home visits. Due to the COVID-19 pandemic, all visits were completed by telehealth. Prematurity: Children's Colorado's Black Health Initiative (BHI), centers around community voices and experiences to develop a framework for interrelated projects and services to improve African American patient and family experiences and health outcomes. At the forefront of this work, Children's Colorado collaborates directly with Black families and community members to conceptualize and pilot programs to address infant mortality. Borne out of the crucial need to have community members' experiences inform how health care providers address issues of healthy equity in health care settings, BHI partnered with the Center for Advancing Professional Excellence (CAPE) within the University of Colorado School of Medicine to develop provider trainings that immerse providers in simulated scenarios developed by community members. These trainings are an effort to shine a light on the challenges that African American woman face in clinical settings and bridge the gaps that can result in negative patient experiences and poor patient outcomes. By engaging providers in practice-based simulated visits, providers are immersed in situations that increase their appreciation for the needs of their patients, while building their skills around how to meaningfully address their patients' needs in a culturally responsive manner. Injury Prevention: In 2021, the car seat program at Children's Colorado distributed 205 harnessed car seats and 42 booster seats. Additionally, car seat installation/inspections were conducted for more than 350 children in conventional car seats and consultations were provided for more than 50 children with special healthcare needs requiring adaptive car seats. Car seat checks were conducted in 14 languages with help from Spanish-speaking Child Passenger Safety Technicians (CPST) along with virtual and in-person translation support. Three Safe Kids CPST certification courses were conducted, certifying 15 hospital employees and 34 community partners as CPSTs to support car seat education in the community. Safe sleep initiatives included distributing 37 pack-n-play cribs to families without safe sleep spaces and 1,380 sleep sacks to patient families through the Child Health Clinic. Forty medication lock boxes and 60 gun trigger locks were donated to community partners who work directly with populations in need of these resources. Educational resources were also provided to families on poison prevention and gun safety. Sixty-three bike helmets were distributed to families and 189 low-cost bike helmets were sold through our hospital-based Safety Store. Mental and Behavioral Health: In 2021, our Government Affairs team coordinated virtual or written testimony from 32 experts on pending legislation at committee hearings, trained 154 new advocates at our 11th Annual Speak Up for Kids Day, and empowered constituents to send almost 646 emails to state lawmakers on pending kids' health legislation. Advocacy and policy change is critical in increasing equable health care access. An example of our statewide advocacy work included advocacy to improve behavioral healthcare services for children.
Schedule H, Part V, Section B, Line 11 Facility A, 2 Facility A, 2 - THE FOLLOWING DESCRIPTION FOR SCHEDULE H, PART V, SECTION B, LINE 11 APPLIES TO ALL FACILITIES INCLUDED IN GROUP (CONT.). In 2021, the Government Affairs team worked with partners to build a better system of care for all children, youth, and families. We supported House Bill 1097 to help implement a key recommendation of the Colorado Behavioral Health Task Force to create a Behavioral Health Administration, a new state agency to lead, promote and coordinate Colorado's behavioral health priorities. We also worked to expand access to behavioral healthcare for children and youth by supporting House Bill 1021 to fund behavioral health services provided by peer support professionals and House Bill 1258, which provided access to up to six telehealth therapy appointments for all school aged children regardless of insurance coverage. professionals and House Bill 1258, which provided access to up to six telehealth therapy appointments for all school aged children regardless of insurance coverage.
Schedule H, Part V, Section B, Line 2 CHCO - NORTH CAMPUS WAS PLACED INTO SERVICE IN MARCH 2020. A CHNA IS SCHEDULED TO BE COMPLETED IN DECEMBER 2022 FOR OUR NORTH CAMPUS HOSPITAL LICENSED IN 2020. THIS MEETS THE IRS REQUIREMENT THAT NONPROFIT HOSPITALS TO COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITHIN THE FIRST 2 YEARS OF LICENSING TO BE COMPLETED BY THE LAST DAY OF THE SECOND TAXABLE YEAR.
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?12
Name and address Type of Facility (describe)
1 CHILDREN'S HOSPITAL CO OP SPECIALTY CARE
4125 BRIARGATE PKWY
COLORADO SPRINGS,CO80920 		SPECIALTY CARE, ONCOLOGY CLINICS, URGENT CARE
2 CHILDREN'S CO HEALTH PAVILION
860 NORTH POTOMAC CIRCLE
AURORA,CO80011 		OT/PT, SPEECH & AUDIOLOGY, MULTI-SPECIALTY CLINICS,DENTAL CLINCIS, SPECIALTY PHARMACY
3 CHILDREN'S HOSPITAL CO - THERAPY CARE
9139 SOUTH RIDGELINE BLVD 100
HIGHLANDS RANCH,CO80129 		REHABILITATION & THERAPY SERVICES
4 CHILDREN'S HOSPITAL CO - THERAPY CARE
8401 ARISTA PLACE
BROOMFIELD,CO80021 		OT/PT, SPEECH & AUDIOLOGY SERVICES
5 KIDSTREET
860 N POTOMAC CIR
AURORA,CO80011 		REHABILITATION & THERAPY SERVICES
6 CHILDREN'S HOSPITAL CO - SPECIALTY CARE
9399 CROWN CREST BLVD SUITE 300
PARKER,CO80138 		SPECIALTY CARE, SPORTS MEDICINE
7 CHILDREN'S HOSPITAL CO - THERAPY CARE
PRINTERS PARK MEDICAL PLAZA
COLORADO SPRINGS,CO80910 		OT/PT, SPEECH & AUDIOLOGY SERVICES
8 CHILDREN'S HOSPITAL CO - UPTOWN
1830 FRANKLIN ST
DENVER,CO80218 		EMERGENCY CARE, UC, OP SPCLTY, DIAGNOSTIC, OBSERVATION LICENSEDC CMTY CLINIC 18M127
9 CHILDREN'S HOSPITAL CO - THERAPY CARE
19284 COTTONWOOD DRIVE
PARKER,CO80138 		OT/PT, SPEECH & AUDIOLOGY SERVICES
10 CHILDREN'S HOSPITAL CO - ORTHOPEDIC CARE
9094 E MINERAL AVE SUITE 110
CENTENNIAL,CO80112 		ORTHOPEDIC CARE, RADIOLOGY SERVICES, SPORTS MEDDICINE
11 CHILDREN'S HOSPITAL CO - UC & OP CARE
3455 LUTHERAN PKWY
WHEATRIDGE,CO80033 		URGENT CARE, SPECIALIST CARE SPORTS MEDICINE
12 CHILDREN'S HOSPITAL CO - THERAPY CARE
704 FORTINO BOULEVARD SUITE A
PUEBLO,CO81008 		SPEECH THERAPY, LEARNING DISABILITIES
Schedule H (Form 990) 2021
Schedule H (Form 990) 2021
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
Schedule H, Part I, Line 6a CHILDREN'S COLORADO PUBLISHES AN ANNUAL COMMUNITY BENEFIT REPORT. THE 2021 REPORT WILL BE PUBLISHED AFTER THE FINALIZATION OF THE 2021 SCHEDULE H 990 REPORTING. THE 2020 REPORT CAN BE FOUND AT HTTPS://WWW.CHILDRENSCOLORADO.ORG/COMMUNITY/COMMUNITY-HEALTH/. PRIOR TO THE COMPLETION OF THE REPORT A DISTRIBUTION LIST OF COMMUNITY MEMBERS, PARTNERS AND STATE AND LOCAL OFFICIALS IS DEVELOPED, AND THE REPORT IS DISTRIBUTED UPON COMPLETION. COINCIDING WITH THE PHYSICAL DISTRIBUTION THE REPORT IS THEN PUBLISHED ON THE CHCO WEBSITE.
Schedule H, Part I, Line 7 IN 2021, CHILDREN'S HOSPITAL COLORADO PROVIDED $301,516,894 IN BENEFIT TO THE COMMUNITY. MEDICAID AT CHILDREN'S HOSPITAL COLORADO ACCOUNTED FOR $214,738,596 OF NET COMMUNITY BENEFIT EXPENSE WITH $5,798,965 IN FINANCIAL ASSISTANCE. OTHER BENEFITS ACCOUNTED FOR $80,979,333 IN NET COMMUNITY BENEFIT EXPENSE. OF THAT $26,119,546 IN COMMUNITY HEALTH IMPROVEMENT, $25,304,919 IN HEALTH PROFESSION EDUCATION, $7,635,541 IN SUBSIDIZED HEALTH SERVICES, $20,763,062 IN RESEARCH AND $1,156,265 IN CASH AND IN-KIND CONTRIBUTIONS FOR COMMUNITY BENEFIT. INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THOSE WHICH CHILDREN'S HOSPITAL COLORADO PROVIDES TO ITS PATIENT POPULATION AT A LOSS. IN 2021, PROGRAMS ASSOCIATED WITH THESE LOSSES ARE REHABILITATION, NEONATOLOGY AND OTHOPEDICS. THE NUMBER REFLECTED IN SUBSIDIZED HEALTH SERVICES EXCLUDES BAD DEBT, MEDICAID AND OTHER MEANS TESTED PROGRAMS SHORTFALLS AND FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL COLORADO IS COMMITTED TO SERVING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.
Schedule H, Part VI, Line 5 Continuation To address the depth and breadth of community health Children's Colorado continues to build on our long and strong record of collaborating with community-based organizations, K-12, academic institutions, and governmental and non-governmental organizations, with the goal of improving health outcomes and reducing health disparities for children and their families. Additionally, significant resources were allocated in 2021 to support efforts to engage community members advocating for access to healthcare as well as providing educational sessions for both policymakers and advocates on child health issues of importance. Children's Colorado engages in an array of activities addressing community health needs that are not counted in our Schedule H 990 reporting due to IRS guidelines for reporting community benefit. Nonetheless, numerous other investments and activities are designed to benefit the communities we serve. Below, please find details of some of these additional community activities and investments. COVID-19 The COVID-19 pandemic has presented challenges that will have long lasting effects on both the field of pediatric healthcare and the lives of the patients and families we serve. Since March 2020, Children's Colorado has been committed to a systematic response to the COVID-19 pandemic. In addition to maintaining our focus on providing exceptional, quality care for patients and families, Children's Colorado has dedicated financial, people and physical resources to help mitigate the effects of the pandemic on our community. The state has been able to rely on Children's Colorado's dedicated partnership to support the COVID-19 response and to improve the health of Colorado's children and families. At the request of the governor and state public health department, Children's Colorado rapidly instituted a COVID-19 response infrastructure that included mobile testing sites, lab services, public health education resources and webinars for medical professionals as well as community members, mask decontamination for community-based providers, lab services for community-based testing, and shared medical supplies to manage statewide needs. Throughout the pandemic, our system was committed to providing the most up-to date family-friendly information and resources to support kids and families through the pandemic including operating a coronavirus hotline where our clinical teams answered questions about COVID-19 symptoms, vaccines and where to access healthcare. In 2021, there were 12 pages on our website dedicated to sharing the latest information on essential COVID-19 topics with parents and caregivers, with more than 551,000 unique visitors to those pages. COVID-19 vaccine deliberation resources were also created for caregivers and translated into the top eight languages of patient families who utilize our primary care clinics. The 2020-2021 and 2021-2022 school years were particularly challenging for the school and childcare sites we serve. Early in the pandemic, the school health nursing team found that some needs like fielding calls from educators and parents with questions about how to manage a child's diabetes or asthma - could be met virtually, via telehealth. The school health nursing team continued to serve as an advisory partner for school staff and parents throughout the pandemic, delivering trainings and consultations virtually for both individual health needs and systemwide safety guidance. Additionally, after the state issued their public health guidance to schools in September 2020, Children's continued to offer these town halls and participation grew to nearly 700 registered participants from across Colorado. These town halls became an effective venue to share the latest information on the COVID-19 vaccine and equip school leaders with the information they need to encourage it among their staff and school community. This school leader town hall series conducted 34 virtual meetings between April 2020 and December 2021. Children's Colorado opened a COVID-19 vaccine clinic in December 2020, initially serving frontline healthcare workers and community providers, then school staff and eventually opened our clinic to patients and the public throughout 2021. We administered more than 140,000 COVID-19 vaccines in 2021. Additionally, we hosted the Colorado Department of Public Health and Environment's mobile vaccine busses on each of our hospital campuses during the pediatric vaccine rollouts in late 2021 and plan to again beginning in June 2022 when the youngest age group (6 months+) is authorized. The provided summary does not fully capture the investment of financial resources and staff time to rapidly build and implement new infrastructure, clinic operations, public health education initiatives, research programs and cross-system activities that continued to be necessary in the second year of the COVID-19 pandemic. Social Determinants of Health The immediate impact of the pandemic imposed complex social and economic challenges for many families. The complexity of needs continued to be paramount throughout 2021. Critical needs included baby formula, diapers, food, utility assistance, housing and eviction prevention, and public benefits. Prior to the pandemic, Children's Colorado had systems in place to address social determinants of health within our walls and in the community and we were able to rapidly adjust to address the most pressing needs of our families and the community. Health Navigation is a patient-centric evidence-based model focused on addressing the social determinants of health. Navigators reduce barriers that keep patients from getting timely treatment by identifying patient needs and supporting them in accessing clinical, financial, or social supports. More than 20 navigators work in multiple clinical and primary care settings across our health care system. In 2021, resource support was provided to 13,855 unique patients and their families. In 2019, Children's Colorado opened Resource Connect in our Health Pavilion facility. Resource Connect anchors the Children's Colorado's strategy for population health-delivering healthcare that lasts beyond a clinic visit and enhances care for patient and families by creating a centralized place to access their most common social needs. The services provided through Resource Connect promote equitable access to the resources that all families. This is all accomplished through robust partnerships between Children's Hospital Colorado and community-based organizations. In 2021, Children's Colorado providers and other team members referred nearly 1,700 families to Resource Connect. More than 85% of Children's Colorado's Health Pavilion patients are insured by Medicaid/publicly funded insurance or underinsured/not insured. Families seen at the Health Pavilion are ethnically and racially diverse; many identify as Latino and there is a growing population of immigrant families from Africa, Nepal, and southeast Asia. Approximately 60% of children seen are age 3 and under. As a not-for-profit hospital, Children's Colorado is proud to provide investments that respond to community needs and serve our community. This summary is a snapshot of our responsiveness to community need. Another component of addressing community need is ensuring equitable access to health care for all children. Children's Colorado provides more health care services to children covered by Colorado Medicaid than any other provider in the State. In 2021, the health insurance coverage mix among our patient population included 48% of patients covered by Medicaid, 43.6% managed/commercial care, 6.5% other government programs, and 1.8% self-pay, indigent, or uninsured. Oral Health Promotion and Community Outreach Although, oral health has not been identified as a priority through the Community Health Needs Assessment process the community has expressed concern about the cost and lack of providers in their communities. In response, the Child Health Advocacy Institute provides various oral health services to increase access to dental care, help address barriers, and improve the oral health of children in our community. The strategies include oral health promotion through community outreach, increasing access to care by providing preventive oral health services at the School-Based Dental Clinic (SBDC) and increasing preventive dental services at primary medical visits. There were approximately 440 patient encounters in the SBDC with 444 referrals from the SBHCs. The majority of referrals (44%) qualified for the Aurora Public Schools Dental Program Fund, followed by Medicaid (24%).
Schedule H, Part VI, Line 7 IN 2019, COLORADO LAWMAKERS PASSED HB19-1320 REQUIRING NONPROFIT HOSPITALS TO SUBMIT AN ANNUAL COMMUNITY BENEFIT REPORT.
Schedule H, Part II, Line 10 IN 2021, CHILDREN'S HOSPITAL COLORADO PROVIDED $ 902,047 IN COMMUNITY BUILDING ACTIVITIES. THESE ACTIVITIES ARE DESIGNED TO PROMOTE THE HEALTH OF THE BROADER COMMUNITY. WE CONTINUE TO BUILD ON OUR LONG AND STRONG RECORD OF COLLABORATION WITH COMMUNITY GROUPS, BUSINESSES, ACADEMIC INSTITUTIONS AND GOVERNMENTAL AND NON-GOVERNMENTAL ORGANIZATIONS, WITH THE GOAL OF IMPROVING HEALTH OUTCOMES AND REDUCING HEALTH DISPARITIES FOR CHILDREN AND THEIR FAMILIES.
Schedule H, Part VI, Line 5 CONTINUATION 2 Over 3,000 oral health promotion items have been distributed within the community including toothbrushes, toothpaste, oral health education, toothbrushing charts, and books. Four virtual parent coffees and school events, three Back-to-School events, and a city-wide community event were attended. Screening events happened at three schools. A total of over 300 students received oral health education and 134 students received screenings. Planning for an additional 5 school screening events for the remaining 2021- 2022 school year also occurred. Pediatric Mental Health Institute At Children's Colorado, our commitment to mental health has been longstanding and unwavering. Child and youth mental health is a top priority for us across the entire organization. But the mental health crisis in Colorado is still growing and continues to challenge children and families, as well as Children's Colorado's care teams and our system's capacity. Children's Colorado is one of the most comprehensive providers of youth mental health services in Colorado, treating kids from all 64 counties. Across four hospitals, we treat the most children in crisis through our emergency departments, are one of the largest providers of outpatient care and provide inpatient care to the most complex pediatric patients. Children's Colorado is stepping up as a trusted community resource to help fill the gaps in Colorado's public systems. * We hosted 53 virtual lunch-and-learn sessions reaching more than 520 providers. * More than 60 community mental health education events were hosted, directed toward parents, schools, coaches, and other adults. * More than 70,000 kids are reached by our school nurse consultation program, which provides mental health consultations across hundreds of schools and childcare centers. * We crafted more than 20 state policy initiatives aimed at prevention and comprehensive, community-based youth mental health treatment options. Other Health Profession Education As part of our mission to improve the health of children, Children's Colorado offers a broad spectrum of training, education, and certification programs for healthcare professionals, aimed at developing and sustaining pediatric expertise. In addition to providing training opportunities in clinical settings we provide a wide range of professional development opportunities to support community-based health care professionals As a Level One Trauma Center, we also connect with first responders, hospital providers and other medical facilities via our Outreach and Education team. Many of these providers live and work in rural communities across Colorado and the surrounding six states. Our team leverages evidence-based research and guidelines developed by Children's Colorado to provide training opportunities that often change the way Emergency Medical Services teams respond to pediatric emergencies, helping them achieve improved outcomes. Workforce Development Founded at Children's in 1998, the Medical Career Collaborative program (MC2), is a hands-on learning program that serves low-income minority youth interested in pursuing a career in the health care field. MC2 serves as an educational and supportive outlet for high achieving and driven students who often lack necessary supports in their communities. The program's mission of helping high school students from diverse backgrounds explore the world of healthcare and discover the opportunities available to them in the medical industry, is a strategic program as part of HR's workforce development efforts. As the program invests in these students it is essentially increasing the diversity and cultural awareness of the healthcare workforce as it builds the next generation of professionals here at Children's Colorado and in the community. Medical Faculty Profile Our open medical staff arrangement allows community practitioners to hold privileges at our hospitals, and more than half of our approximately 1,700 medical staff of providers and advanced practice nurses are community-based. Among the thousands of referring providers throughout our seven-state region, these community staff members are frontline partners not only in establishing a seamless continuum of care for our young patients, but in providing training opportunities in primary care for the medical students and residents who will become tomorrow's pediatric professionals. Through our affiliation with family medicine residency programs in Colorado and Wyoming, we're able to provide pediatric rotation at our hospitals, which offers significant benefit to a region with a large rural population and a shortage of rural care providers. These affiliations also ensure that a primary care perspective is central to our strategies for providing the region's children with the broadest spectrum of care. Research Research is woven into Children's Colorado's mission to improve the health of children through the provision of high-quality, coordinated programs of patient care, education, research, and advocacy. We offer our patients the most innovative treatments available, and in affiliation with the University of Colorado School of Medicine, Children's Colorado has been a national center for pediatric research for more than 50 years. Our Pediatric Clinical Translational Research Center accelerates the translation of innovative science to get advanced treatments to patients more quickly. Our physician-scientists have pioneered seminal research in the treatment of pediatric liver disease, infectious disease and vaccines, pediatric and adolescent HIV and AIDS, cystic fibrosis, pulmonary hypertension, pediatric cardiology, and neonatology. Board of Directors At the time of filing this form 990, Children's Hospital Colorado's Board of Directors is made up of twenty-six volunteers and the associated executive leaders from the hospital and affiliated institutions. Board service is a commitment to help further the hospital's mission of improving the health of children through the provision of high quality, coordinated programs of patient care, education, research, and advocacy. Kids are Our Bottom Line As a non-profit organization, surplus funds are invested back into providing health care services and resources to the community, including but not limited to new patient care locations and equipment, expanded programs and services, community health promotion, research, and training of physicians, nurses, and other allied health professionals.
Schedule H, Part VI, Line 6 AFFILIATIATED HC SYSTEM - N/A
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount THE ORGANIZATION RECOGNIZES NET PATIENT SERVICE REVENUE IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 606, REVENUE FROM CONTRACTS WITH CUSTOMERS. THE ADOPTION OF ASC 606 RESULTED IN CHANGES TO THE PRESENTATION FOR NET PATIENT SERVICES REVENUE RELATED TO UNINSURED OR UNDERINSURED PATIENTS. UNDER ASC 606, THE ESTIMATED UNCOLLECTABLE AMOUNTS DUE FROM THESE PATIENTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE, RATHER THAN AS A PROVISION FOR BAD DEBTS, AND ARE BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE. OTHER THAN THESE CHANGES IN PRESENTATION, THE ADOPTION OF ASC 606 DID NOT HAVE A MATERIAL IMPACT ON THE OVERALL FINANCIAL STATEMENTS OF THE ORGANIZATION. EXPANDED DISCLOSURES REQUIRED BY ASC 606 ARE INCLUDED WITHIN NOTE 4, NET PATIENT SERVICES REVENUE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology CHILDREN'S HOSPITAL INACTIVATES AR BALANCES BETWEEN 150-175 DAYS AFTER THE FIRST BILLING CYCLE. ACCOUNTS ARE REFERRED TO COLLECTION AGENCIES FOR RECOVERY. THE HOSPITAL DOES NOT REPORT ANY BAD DEBT AMOUNT IN COMMUNITY BENEFIT.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE ORGANIZATION RECOGNIZES NET PATIENT SERVICE REVENUE IN ACCORDANCE WITH ACCOUNTING STANDARDS CODIFICATION (ASC) 606, REVENUE FROM CONTRACTS WITH CUSTOMERS. THE ADOPTION OF ASC 606 RESULTED IN CHANGES TO THE PRESENTATION FOR NET PATIENT SER VICES REVENUE RELATED TO UNINSURED OR UNDERINSURED PATIENTS. UNDER ASC 606, THE ESTIMATED UNCOLLECTABLE AMOUNTS DUE FROM THESE PATIENTS ARE GENERALLY CONSIDERED IMPLICIT PRICE CONCESSIONS THAT ARE A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE, RATHER THAN AS A PROVISION FOR BAD DEBTS, AND ARE BASED PRIMARILY ON HISTORICAL COLLECTION EXPERIENCE. OTHER THAN THESE CHANGES IN PRESENTATION, THE ADOPTION OF ASC 606 DID NOT HAVE A MATERIAL IMPACT ON THE OVERALL FINANCIAL STATEMENTS OF THE ORGANIZATION. EXPANDEDDISCLOSURES REQUIRED BY ASC 606 ARE INCLUDED WITHIN NOTE 4, NET PATIENT SERVICES REVENUE.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE SHORTFALL REPORTED IN LINE 7 REPRESENTS MEDICARE SHORTFALLS FOR HIGH NEED PEDIATRIC PATIENTS SERVED BY CHILDREN'S HOSPITAL COLORADO. IF CHILDREN'S HOSPITAL COLORADO DID NOT SUBSIDIZE THE HIGHLY SPECIALIZED CARE, ACCESS FOR THIS POPULATION WOULD BE LIMITED, THUS WE VIEW THIS CARE AS COMMUNITY BENEFIT. THE HOSPITAL UTILIZED COST TO CHARGE RATIO METHODOLOGY TO ARRIVE AT THIS NUMBER. THE AMOUNT INCLUDES ALL COSTS LESS ALL PAYMENTS RECEIVED.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance YES, THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. PRIOR TO DEBT REFERRALS, ACCOUNTS ARE REVIEWED FOR ALL THIRD-PARTY PAYER ELIGBILITY PRIOR TO QUALIFYING FOR ANY CHARITY CARE OR FINANCIAL ASSISTANCE. ONCE THE PATIENT'S RESPONSIBILITY IS VALIDATED, THE HOSPITAL PROVIDES SLIDING SCALE DISCOUNTS BASED ON INCOME AND/OR EXPENSES. PARENTS WHOSE CHILDREN DO NOT QUALIFY FOR MEDICAID CAN ALSO APPLY FOR THIS DISCOUNT PLAN. THE HOSPITAL HAS A DEDICATED FINANCIAL COUNSELING/SERVICES DEPARTMENT WHO WORK CLOSELY WITH PARENTS TO ESTABLISH PAYMENT PLANS.
Schedule H, Part V, Section B, Line 16a FAP website A - CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS: Line 16a URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - NORTH CAMPUS: Line 16a URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/;
Schedule H, Part V, Section B, Line 16b FAP Application website A - CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS: Line 16b URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - NORTH CAMPUS: Line 16b URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website A - CHILDREN'S HOSPITAL COLORADO (CHCO) - ANSCHUTZ MEDICAL CAMPUS: Line 16c URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/; - CHCO - NORTH CAMPUS: Line 16c URL: www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/;
Schedule H, Part VI, Line 2 Needs assessment IN ADDITION TO THE CHNA, CHILDREN'S HOSPITAL COLORADO REGULARLY ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITY WE SERVE. ACROSS THE HOSPITAL, NUMEROUS INTERNAL AND EXTERNAL DATA SOURCES ARE REGULARLY MONITORED AND UTILIZED TO IDENTIFY TRENDS AND OPPORTUNITIES TO IMPACT CHILD HEALTH. ADDITIONALLY, HOSPITAL STAFF DEDICATES SIGNIFICANT TIME TO SERVING ON COMMUNITY BOARDS AND OTHER COMMUNITY GROUPS THAT ASSESS HEALTH NEEDS OF THE COMMUNITY AND PROACTIVELY PARTICIPATES IN THE HEALTH IMPROVEMENT EFFORTS LED BY THESE PARTNERS. IN 2018, CHCO FORMALIZED A POPULATION HEALTH STRATEGY. THE GOAL IS THE CREATION AND OPERATION OF A COMMUNITY BASEDPARTNER DRIVEN NETWORK OF CARE. THIS NETWORK BOTH EXPANDS ACCESS TO TRADITIONAL PEDIATRIC HEALTHCARE AND EXPANDS ACCESS TO NON-TRADITIONAL CARE THAT ADDRESSES A CHILD'S TOTAL PICTURE OF HEALTH. A COMMUNITY BASED, PARTNER DRIVEN NETWORK OF CARE REQUIRES IDENTIFYING PARTNERS THAT WILL ENGAGE IN A TRANSFORMATIVE SYSTEM OF CARE, ONE THAT ALLOWS A PEDIATRIC SPECIALTY HOSPITAL TO WORK WITH COMMUNITY BASED PARTNERS TO GENERATE IMPROVED HEALTH FOR ALL KIDS IN A TARGETED REGION, DESPITE NEVER BEING PATIENTS OR HAVING LIMITED INTERACTIONS WITH THAT HOSPITAL. THE NETWORK SUPPORTS IMPROVEMENTS IN THE DELIVERY OF TRADITIONAL HEALTHCARE SERVICES, LIKE THE NUMBER OF IMMUNIZATIONS, WELL-CHILD VISITS, ORAL HEALTH SCREENINGS AND BEHAVIORAL HEALTH INTERVENTIONS. IN ADDITION, SUPPORTING IMPROVEMENTS IN SOCIAL CONDITIONS IMPACTING HEALTH SUCH AS INCREASED ATTENDANCE AT SCHOOL, INCREASED ACCESS TO NUTRITIONAL FOOD AND SUSTAINED ACCESS TO STABLE HOUSING. THIS WORK WILL INFORM HOW WE ESTABLISH EFFECTIVE HEALTH SYSTEM-COMMUNITY BASED ORGANIZATION COLLABORATIONS WHILE WORKING TOWARD LONG-TERM SUSTAINABILITY IN HOW HEALTH CARE IS DELIVERED TO THE CHILDREN AND FAMILIES WE SERVE.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance CHILDREN'S HOSPITAL COLORADO HAS A PROCESS FOR INFORMING AND EDUCATING FAMILIES ABOUT HOW THEY MAY BE BILLED FOR PATIENT CARE AND THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL COLORADO'S FULL TIME PATIENT FINANCIAL COUNSELORS ARE DEDICATED TO WORKING WITH FAMILIES TO PROVIDE GUIDANCE REGARDING AVAILABLE FINANCIAL ASSISTANCE WHICH ENSURES THAT ITS PATIENT POPULATION RECEIVES THE CRITICAL CARE IT NEEDS. ADDITIONALLY, CHILDREN'S HOSPITAL COLORADO PROVIDES PATIENT ASSISTANCE TO HELP IDENTIFY COMMUNITY-BASED RESOURCES, FACILITATE SERVICES AND PROVIDE APPROPRIATE REFERRAL ASSISTANCE TO HELP WITH CONTINUITY OF CARE. INPATIENT PROCESS: THIS PROCESS APPLIES TO PATIENTS WHO ARE BEING ADMITTED FOR OBSERVATION, SURGERY OR OTHER INPATIENT SERVICES. IF THE PATIENT IS PRE-SCHEDULED, CHILDREN'S HOSPITAL COLORADO PATIENT ACCESS WORKS TO CONTACT THE FAMILY PRIOR TO ADMISSION TO ARRANGE FOR A FINANCIAL SCREENING APPOINTMENT. REGARDLESS OF WHETHER AN APPOINTMENT IS SET PRIOR TO ADMISSION, THE PATIENT FINANCIAL COUNSELING TEAM WORKS WITH THE FAMILY TO DETERMINE THEIR SELF-PAY STATUS (EITHER NON-COMMERCIAL OR GOVERNMENT INSURANCE) AND SUBSEQUENTLY WORKS WITH THEM TO SCREEN FOR FINANCIAL ASSISTANCE OPTIONS. OUTPATIENT PROCESS: WHEN A PATIENT SCHEDULES A NON-EMERGENT OR URGENT OUTPATIENT CLINIC VISIT, THEY WILL IDENTIFY THEMSELVES AS SELF-PAY IF THEY DO NOT HAVE EITHER COMMERCIAL OR GOVERNMENT INSURANCE. AT THIS POINT, THEY ARE GIVEN TWO OPTIONS: (1) PAY A $200 DEPOSIT AT THE TIME OF APPOINTMENT AND BE BILLED ANY REMAINING BALANCE OR (2) SCHEDULE TIME WITH PATIENT FINANCIAL COUNSELING FOR ASSISTANCE. IF THE PATIENT WAS SEEN IN THE EMERGENCY DEPARTMENT OR URGENT CARE WITHOUT THE PRE-SCREEN, THEY STILL CAN APPLY FOR FINANCIAL ASSISTANCE WITH THE PATIENT FINANCIAL COUNSELING OFFICE. ALL SELF-PAY FAMILIES ARE AUTOMATICALLY GIVEN A 35 PERCENT DISCOUNT. CHILDREN'S HOSPITAL COLORADO HAS A FORMAL POLICY REGARDING ELIGIBILITY CRITERIA FOR CHARITY CARE. THE DECISION TO PROVIDE CHARITY CARE WILL BE, IN ALL CASES, BASED ON A REVIEW OF THE INCOME, ASSETS AND LIABILITIES OF THE FAMILY AT THE TIME OF ADMISSION TO THE HOSPITAL OR CLINIC. THE LEVELS OF CHARITY CARE AND FINANCIAL ASSISTANCE PROVIDED BY CHILDREN'S HOSPITAL COLORADO WILL BE DETERMINED BASED ON FEDERAL POVERTY GUIDELINES WHICH MAY BE ADJUSTED UP TO 200 PERCENT AND REVISED FROM TIME TO TIME. FAMILIES WITH ADJUSTED GROSS INCOME BETWEEN 200 PERCENT AND 400 PERCENT OF FEDERAL POVERTY GUIDELINES MAY ALSO BE CONSIDERED FOR CHARITY CARE WITH A CAP FOR OUT-OF-POCKET RESPONSIBILITY. DETERMINATION OF ELIGIBILITY WILL BE EFFECTIVE FOR SIX MONTHS AND APPLY TO ALL PATIENTS REGARDLESS OF IMMIGRATION STATUS. CHILDREN'S COLORADO WORKS TO PROVIDE NECESSARY HOSPITAL-RELATED SERVICES CONSISTENT WITH ITS MISSION, ITS STATUS AS A NONPROFIT HOSPITAL AND ITS STEWARDSHIP RESPONSIBILITY TO ITS DONORS. CHILDREN'S HOSPITAL COLORADO'S FINANCIAL ASSISTANCE PUBLIC POLICY AND PLAIN LANGUAGE SUMMARY ARE available at www.childrenscolorado.org/your-visit/insurance-financial-resources/financial-assistance-programs/.
Schedule H, Part VI, Line 4 Community information Across Colorado, approximately 1.3 million children under the age of 18 represent 22% of the population. It is estimate that three in ten households in Colorado have children. Our Anschutz Medical Campus, South Campus, and location at Parker Adventist all sit within the Denver Metro area. Most of our admissions and outpatient visits come from children living in four Metro Denver counties: Arapahoe, Adams, Denver, and Douglas. Aurora, Colorado, the location of our Anschutz Medical Campus, is the third most populous city in Colorado and spans three counties: Adams, Arapahoe, and Douglas. With 20% of residents born outside the country and 33% who speak a language other than English at home, Aurora is one of the most diverse municipalities in the state. Children's Colorado, Colorado Springs, opened May 28, 2019. The facility is southern Colorado's first pediatric-only hospital, providing more than 175,000 children with pediatric care closer to home. Colorado Springs is the second-most populated city in Colorado. The city is located in El Paso County, which surpassed the City and County of Denver as the state's most populous county as of the 2020 Census. Census Bureau data from 2019 shows that 10% of children under the age of 18 in El Paso County live below the poverty line. United States Army, Air Force and Space Force bases are situated in the county, which leads to a significant presence of military families and adds to the diversity of population.
Schedule H, Part VI, Line 7 State filing of community benefit report CO
Schedule H (Form 990) 2021
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
2021
Open to Public
Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number
84-0166760
Part I
General Information on Grants and Assistance
1
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? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) CHEYENNE FRONTIER DAYS INC
PO Box 2477
Cheyenne,WY82003 		83-0297781 501(c)(3) 18,300       General Program Support
(2) CHEYENNE MOUNTAIN ZOOLOGICAL SOCIETY
4250 Cheyenne Mtn Zoo Rd
Col Spr,CO80906 		84-0407039 501(c)(3) 81,000       General Program Support
(3) CHILDRENS MUSEUM OF DENVER INC
2121 Childrens Museum Dr
Denver,CO80211 		84-0658142 501(c)(3) 30,000       General Program Support
(4) CITY OF COLORADO SPRINGS
PO 1575 MC 250
Colorado Springs,CO80901 		84-6000573 501(c)(3) 15,000       General Program Support
(5) COLORADO RUSH SOCCER
8101 S Shaffer Pkwy 103
Littleton,CO80127 		84-1411827 501(c)(3) 15,000       General Program Support
(6) COLORADO SPRINGS YOUTH SPORTS
2212 Exec Cir
Colorado Springs,CO80906 		84-1350101 501(c)(3) 8,000       General Program Support
(7) DENVER BOTANIC GARDENS
909 York Street
Denver,CO80206 		84-0440359 501(c)(3) 7,500       General Program Support
(8) DENVER MUSEUM OF NATURE & SCIENCE
2001 Colorado Blvd
Denver,CO802055798 		84-0518447 501(c)(3) 12,500       General Program Support
(9) DENVER ZOO
2300 Steele Street
Denver,CO80205 		84-0502539 501(c)(3) 80,000       General Program Support
(10) FORT COLLINS MUSEUM OF DISCOVERY
408 Mason Court
Fort Collins,CO80524 		74-2541265 501(c)(3) 10,000       General Program Support
(11) GOLD CROWN FOUNDATION INC
1743 Wazee Street Ste 300
Denver,CO80202 		74-2422126 501(c)(3) 45,000       General Program Support
(12) Papua New Guinea Tribal Foundation
121 South Nevada Ave
Montrose,CO81401 		27-1334147 501(c)(3) 60,000       General Program Support
(13) PIKES PEAK CHILDRENS MUSEUM
2565 Airport Road
Colorado Springs,CO80910 		20-3451384 501(c)(3) 10,500       General Program Support
(14) PIKES PEAK LIBRARY DISTRICT FOUNDATION
1175 Chapel Hills Drive
Colorado Springs,CO80920 		11-3690724 501(c)(3) 12,000       General Program Support
(15) PIKES PEAK OR BUST RODEO
104 S Cascade Ave 200B
Colorado Springs,CO80903 		84-1589318 501(c)(3) 6,000       General Program Support
(16) REAL COLORADO
8200 South Akron St Ste 122
Centennial,CO80112 		74-2392779 501(c)(3) 24,000       General Program Support
(17) RONALD MCDONALD HOUSE CHARITIES
4223 Royal Pine Drive
Colorado Springs,CO80920 		84-1013843 501(c)(3) 14,500       General Program Support
(18) SWITCHBACKS FC
234 N Tejon St
Colorado Springs,CO80903 		46-4110067 501(c)(3) 35,000       General Program Support
(19) TRAILS AND OPEN SPACE COALITION
702 E Boulder Street 200
Colorado Springs,CO80903 		84-1156471 501(c)(3) 10,000       General Program Support
(20) WOW CHILDRENS MUSEUM WORLD OF WONDER LTD
110 N Harrison Ave
Lafayette,CO80026 		84-1421537 501(c)(3) 10,000       General Program Support
(21) YMCA OF METROPOLITAN DENVER
2625 S Colorado Blvd
Denver,CO80222 		84-0402696 501(c)(3) 30,000       General Program Support
(22) YMCA OF NORTHERN COLORADO & BOULDER VALL
2800 Dagny Way
Lafayette,CO80026 		84-0459944 501(c)(3) 12,000       General Program Support
(23) YMCA OF THE PIKES PEAK REGION
316 North Tejon St
Colorado Springs,CO80903 		84-0404266 501(c)(3) 32,500       General Program Support
(24) YOUNG AMERICANS CENTER FOR FINANCIAL
3550 E First Ave
Denver,CO80206 		84-1564926 501(c)(3) 10,000       General Program Support
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
24
3
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) 2021

Schedule I (Form 990) 2021
Page 2
Part III
Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Number of
recipients		 (c) Amount of
cash grant		 (d) Amount of
noncash assistance		 (e) Method of valuation (book,
FMV, appraisal, other)		 (f) Description of noncash assistance
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. CHILDREN'S HOSPITAL COLORADO RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT EXEMPT ORGANIZATIONS TO MONITOR THE USE OF FUNDS AS INTENDED.
Schedule I (Form 990) 2021



Additional Data


Software ID: 21014044
Software Version: 2021v4.2


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet Attach to Form 990.
SchJMediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number

84-0166760
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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 .....
1b
 
 
2
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? ....
2
 
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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, 1099-MISC compensation, and/or 1099-NEC (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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1Jena Hausmann
 
President and CEO 		(i)

(ii)		 1,097,532
-------------
0 		575,978
-------------
0 		283,526
-------------
0 		307,630
-------------
0 		25,767
-------------
0 		2,290,433
-------------
0 		279,909
-------------
0
2Jeffrey Harrington
 
SVP and CFO 		(i)

(ii)		 605,812
-------------
0 		225,153
-------------
0 		145,799
-------------
0 		161,348
-------------
0 		15,472
-------------
0 		1,153,584
-------------
0 		136,902
-------------
0
3Michelle Lucero
 
Chief Legal Officer, General Counsel/Secretary 		(i)

(ii)		 461,649
-------------
0 		146,366
-------------
0 		104,060
-------------
0 		137,907
-------------
0 		16,571
-------------
0 		866,553
-------------
0 		97,484
-------------
0
4David Biggerstaff
 
EVP and COO 		(i)

(ii)		 650,387
-------------
0 		282,931
-------------
0 		114,919
-------------
0 		176,537
-------------
0 		24,694
-------------
0 		1,249,468
-------------
0 		110,026
-------------
0
5Dana Moore
 
SVP and CIO 		(i)

(ii)		 476,641
-------------
0 		160,085
-------------
0 		7,220
-------------
0 		136,238
-------------
0 		23,008
-------------
0 		803,192
-------------
0 		0
-------------
0
6Elizabeth Rodriguez
 
SVP Chief HR Officer 		(i)

(ii)		 381,289
-------------
0 		132,609
-------------
0 		77,270
-------------
0 		107,671
-------------
0 		20,249
-------------
0 		719,088
-------------
0 		68,393
-------------
0
7Raphe Schwartz
 
SVP and Chief Strategy Officer 		(i)

(ii)		 419,767
-------------
0 		159,068
-------------
0 		3,288
-------------
0 		120,297
-------------
0 		22,995
-------------
0 		725,415
-------------
0 		0
-------------
0
8Margaret Sabin
 
Past President Colorado Springs 		(i)

(ii)		 463,500
-------------
0 		159,908
-------------
0 		101,635
-------------
0 		132,995
-------------
0 		18
-------------
0 		858,056
-------------
0 		81,198
-------------
0
9Patricia Givens
 
SVP Patient Care Svcs & CNO 		(i)

(ii)		 366,690
-------------
0 		114,203
-------------
0 		82,402
-------------
0 		108,336
-------------
0 		18
-------------
0 		671,649
-------------
0 		66,346
-------------
0
10Suzanne Jaeger
 
SVP Experience and Access 		(i)

(ii)		 339,519
-------------
0 		110,692
-------------
0 		86,302
-------------
0 		117,328
-------------
0 		18,071
-------------
0 		671,912
-------------
0 		81,213
-------------
0
11Gregory Raymond
 
SVP Colorado Springs President 		(i)

(ii)		 342,841
-------------
0 		95,996
-------------
0 		51,249
-------------
0 		107,649
-------------
0 		22,995
-------------
0 		620,730
-------------
0 		49,291
-------------
0
12Amy Feaster
 
VP IT Associate CIO 		(i)

(ii)		 293,136
-------------
0 		82,225
-------------
0 		195,962
-------------
0 		98,200
-------------
0 		7,546
-------------
0 		677,069
-------------
0 		189,347
-------------
0
Schedule J (Form 990) 2021

Schedule J (Form 990) 2021
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
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE FOLLOWING INDIVIDUALS RECEIVED PAYOUTS FROM A 457(F) SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN: SUZANNE JAEGER $81,213 AMY FEASTER $189,348 GREGORY RAYMOND $49,291 JEFFREY HARRINGTON $136,902 JENA HAUSMANN $279,909 PATRICIA GIVENS $66,346 MICHELLE LUCERO $97,484 DAVID BIGGERSTAFF $110,026 ELIZABETH RODRIGUEZ $68,393 MARGARET SABIN $81,198
Schedule J, Part I, Line 7 Non-fixed payments CERTAIN INDIVIDUALS ARE ELIGIBLE TO PARTICIPATE IN THE INCENTIVE PLAN FOR CHILDREN'S COLORADO, THE COMPONENTS OF WHICH INCLUDE ACHIEVEMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE GOALS. BECAUSE THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS RESERVES THE RIGHT TO CHANGE, AMEND OR TERMINATE THIS PLAN AT ANY TIME, FOR ANY REASON, AT ITS SOLE DISCRETION AND BECAUSE OF CERTAIN OTHER CONDITIONS OF THE PLAN, LINE 7 REGARDING "NON-FIXED PAYMENTS" IS ANSWERED YES. NOTE THAT PRIOR TO THE PAYMENT OF ANY AMOUNTS TO AN INDIVIDUAL WHO IS CONSIDERED A DISQUALIFIED PERSON, THE COMPENSATION COMMITTEE SHALL CERTIFY IN WRITING THE EXTENT TO WHICH THE PERFORMANCE FACTORS ESTABLISHED BY THE COMPENSATION COMMITTEE HAVE BEEN SATISFIED AND SHALL APPROVE THE PAYMENT OF SUCH BONUSES TO SUCH INDIVIDUALS. SEE PART VI, LINES 15A AND 15B FOR ADDITIONAL INFORMATION ON EXECUTIVE COMPENSATION.
Schedule J (Form 990) 2021

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Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet 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.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number
84-0166760
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
Yes No Yes No Yes No
A COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648AL52 08-14-2013 309,252,566 SERIES 2013 - SEE PART VI   X   X   X
B COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648A7J8 05-24-2016 200,724,807 SERIES 2016A & 2016C - SEE PART VI   X   X   X
C COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648A8D0 05-24-2016 70,300,000 SERIES 2016B - SEE PART VI   X   X   X
D COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 000000000 03-27-2019 20,000,000 SERIES 2019A - SEE PART VI   X   X   X
COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648FMY7 11-04-2019 235,360,000 SERIES 2019BCD - SEE PART VI   X   X   X
COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648FPT5 07-01-2020 105,685,000 SERIES 2020A-B - SEE PART VI   X   X   X
COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 000000000 07-29-2021 20,000,000 SERIES 2021a - SEE PART VI   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 237,105,000 33,195,000 1,310,245 7,634,708
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 309,252,566 200,724,807 70,300,000 20,000,000
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,844,600 1,519,986 300,000 58,500
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 197,052,966 80,000,000 70,000,000 19,941,500
11 Other spent proceeds ............. 110,355,000 119,204,821    
12 Other unspent proceeds .............   25,707    
13 Year of substantial completion ............. 2013 2019 2019 2019
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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?                
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?                
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 ....SchKMediumBullet        
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 ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 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) 2021

Schedule K (Form 990) 2021
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 .......... JP MORGAN
  		 
  		 
  		 
 
c Term of hedge ......... 2490 %      
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
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?   X   X   X   X
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 I, Column (f) Description of purpose BOND A - HOSPITAL REVENUE BONDS SERIES 2013 THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2008B AND 2008C BONDS. BOND B - HOSPITAL REVENUE BONDS SERIES 2016A & 2016C THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2004C AND 2004D BONDS. BOND C - HOSPITAL REVENUE BONDS SERIES 2016B THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS. BOND D - HOSPITAL REVENUE BONDS SERIES 2019A THE PURPOSE OF THIS BOND ISSUE WAS TO PURCHASE EQUIPMENT. BOND E - HOSPITAL REVENUE BONDS SERIES 2019BCD THE PURPOSE OF THIS BOND ISSUE WAS TO REFUND SERIES 2013B, 2013C1 AND 2013C2. BOND F - HOSPITAL REVENUE BONDS SERIES 2020A-B THE PURPOSE OF THIS BOND ISSUE IS TO REFUND SERIES 2008A & 2010A BONDS. BOND G - HOSPITAL REVENUE BONDS SERIES 2021A THE PURPOSE OF THIS BOND ISSUE IS TO FINANCE CAPITAL EQUIPMENT.
Schedule K, Part IV, Line 2c Date of rebate computation Bond A (Series 2013): May 23, 2018 Bond B (SERIES 2016A & 2016C): November 9, 2021 Bond C (SERIES 2016B): November 17, 2021
Schedule K (Form 990) 2021

Additional Data


Software ID: 21014044
Software Version: 2021v4.2


Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
SchKMediumBullet 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.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number
84-0166760
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
Yes No Yes No Yes No
A COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648AL52 08-14-2013 309,252,566 SERIES 2013 - SEE PART VI   X   X   X
B COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648A7J8 05-24-2016 200,724,807 SERIES 2016A & 2016C - SEE PART VI   X   X   X
C COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648A8D0 05-24-2016 70,300,000 SERIES 2016B - SEE PART VI   X   X   X
D COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 000000000 03-27-2019 20,000,000 SERIES 2019A - SEE PART VI   X   X   X
COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648FMY7 11-04-2019 235,360,000 SERIES 2019BCD - SEE PART VI   X   X   X
COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 19648FPT5 07-01-2020 105,685,000 SERIES 2020A-B - SEE PART VI   X   X   X
COLORADO HEALTH FACILITIES AUTHORITY
  		84-0752932 000000000 07-29-2021 20,000,000 SERIES 2021a - SEE PART VI   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 237,105,000 33,195,000 1,310,245 7,634,708
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 309,252,566 200,724,807 70,300,000 20,000,000
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 1,844,600 1,519,986 300,000 58,500
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 197,052,966 80,000,000 70,000,000 19,941,500
11 Other spent proceeds ............. 110,355,000 119,204,821    
12 Other unspent proceeds .............   25,707    
13 Year of substantial completion ............. 2013 2019 2019 2019
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 2020, 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 2020, 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) 2021

Schedule K (Form 990) 2021
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?                
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?                
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 ....SchKMediumBullet        
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 ......... SchKMediumBullet        
6 Total of lines 4 and 5 ............. 0 % 0 % 0 % 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) 2021

Schedule K (Form 990) 2021
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 .......... JP MORGAN
  		 
  		 
  		 
 
c Term of hedge ......... 2490 %      
d Was the hedge superintegrated? ......                
e Was the hedge terminated? ........                
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?   X   X   X   X
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 I, Column (f) Description of purpose BOND A - HOSPITAL REVENUE BONDS SERIES 2013 THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2008B AND 2008C BONDS. BOND B - HOSPITAL REVENUE BONDS SERIES 2016A & 2016C THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS AND TO REFUND SERIES 2004C AND 2004D BONDS. BOND C - HOSPITAL REVENUE BONDS SERIES 2016B THE PURPOSE OF THIS BOND ISSUE WAS TO FINANCE LONG-TERM PROJECTS. BOND D - HOSPITAL REVENUE BONDS SERIES 2019A THE PURPOSE OF THIS BOND ISSUE WAS TO PURCHASE EQUIPMENT. BOND E - HOSPITAL REVENUE BONDS SERIES 2019BCD THE PURPOSE OF THIS BOND ISSUE WAS TO REFUND SERIES 2013B, 2013C1 AND 2013C2. BOND F - HOSPITAL REVENUE BONDS SERIES 2020A-B THE PURPOSE OF THIS BOND ISSUE IS TO REFUND SERIES 2008A & 2010A BONDS. BOND G - HOSPITAL REVENUE BONDS SERIES 2021A THE PURPOSE OF THIS BOND ISSUE IS TO FINANCE CAPITAL EQUIPMENT.
Schedule K, Part IV, Line 2c Date of rebate computation Bond A (Series 2013): May 23, 2018 Bond B (SERIES 2016A & 2016C): November 9, 2021 Bond C (SERIES 2016B): November 17, 2021
Schedule K (Form 990) 2021

Additional Data


Software ID: 21014044
Software Version: 2021v4.2

SCHEDULE O
(Form 990)

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
2021
Open to Public
Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number

84-0166760
Return Reference Explanation
Form 990, Part I, Line 6 FROM TEENAGERS TO GREAT GRANDPARENTS, FROM HOMEMAKERS TO PROFESSIONAL ATHLETES, CHILDREN'S HOSPITAL COLORADO VOLUNTEERS ENCOMPASS ALL WALKS OF LIFE AND ALL INCOME LEVELS, EACH VOLUNTEER WITH SOMETHING UNIQUE TO OFFER. OUR DIVERSE GROUP OF VOLUNTEERS HAS ONE THING IN COMMON, HOWEVER, THE DESIRE TO HELP SICK CHILDREN AND THEIR FAMILIES. CHILDREN'S HOSPITAL COLORADO IS FORTUNATE TO HAVE HUNDREDS OF DEDICATED VOLUNTEERS WHO WORK REGULARLY, FROM SEVERAL HOURS A YEAR TO SEVERAL HOURS A WEEK, TO PROVIDE BETTER CARE FOR THE CHILDREN OF CHILDREN'S HOSPITAL COLORADO. THE ASSOCIATION OF VOLUNTEERS THE VOLUNTEERS AT CHILDREN'S HOSPITAL COLORADO ARE ALL PART OF A GROUP CALLED CHILDREN'S HOSPITAL COLORADO ASSOCIATION OF VOLUNTEERS (AOV). THE AOV COORDINATES PLACEMENTS FOR VOLUNTEERS AND ENSURES THAT COMPLETE ORIENTATION AND TRAINING IS PROVIDED TO ALL VOLUNTEERS. OUR VOLUNTEER'S SKILLS AND INTERESTS ARE ALL SO APPRECIATED AND WE TRY TO PLACE EVERYONE IN A ROLE THAT SUITS THEM AND OUR NEEDS. THE EXAMPLES BELOW ARE JUST SOME OF THE WAYS THAT OUR VOLUNTEERS CONTRIBUTE: - VOLUNTEERS ARE ACTIVE AT THE HOSPITAL ON THE ANSCHUTZ MEDICAL CAMPUS, THE SOUTH CAMPUS, HIGHLANDS RANCH THERAPY CARE CENTER, BRIARGATE, COLORADO SPRINGS HOSPITAL AND THE NORTH CAMPUS. - VOLUNTEERS SPEND TIME WITH OUR PATIENTS BY HOLDING, COMFORTING, PLAYING WITH THEM AND MAKING THEM LAUGH. - VOLUNTEERS BRING SPECIALLY-SCREENED DOGS TO PROVIDE ANIMAL-ASSISTED THERAPY FOR THE PRESCRIPTION PET PROGRAM. - SPECIALLY TRAINED VOLUNTEERS SERVE AS AMBASSADORS WITH THE WELCOME PROGRAM. VOLUNTEERS GREET NEWLY ADMITTED PATIENT FAMILIES UPON THEIR ARRIVAL AND INTRODUCE THEM TO THE HOSPITAL'S MANY AMENITIES. THE GOAL IS TO PROVIDE A WARM AND WELCOMING ENVIRONMENT AND TO ANSWER ANY NON-MEDICAL QUESTIONS. - THE WINE EVENT IS THE ASSOCIATION OF VOLUNTEERS' SIGNATURE EVENT. THE SPECIAL EVENING FEATURES A SILENT AND LIVE AUCTION OF FINE WINES AND EXPERIENCES WITH ALL PROCEEDS BENEFITING THE MATERNAL FETAL MEDICINE PROGRAM. - MANY GROUPS OF VOLUNTEERS DO NOT SPEND TIME DIRECTLY WITH OUR PATIENTS, BUT PERFORM MORE ADMINISTRATIVE DUTIES, WHICH CAN BE JUST AS IMPORTANT TO THE DAY-TO-DAY OPERATIONS OF CHILDREN'S HOSPITAL COLORADO. - TEENAGERS BETWEEN 13 AND 18 YEARS OF AGE PARTICIPATE IN THE JUNIOR VOLUNTEER PROGRAM. THEY SUPPORT THE HOSPITAL BY WORKING IN SEVERAL DEPARTMENTS AS WELL AS SUPPORTING FUNDRAISING ACTIVITIES. - VOLUNTEERS ALSO ASSIST IN FUNDRAISING BY STAFFING CHILDREN'S HOSPITAL COLORADO GIFT SHOP AND LA CACHE. - CHAPTER VOLUNTEERS IN THE COMMUNITY ARE VERY ACTIVE IN FUNDRAISING EVENTS THROUGHOUT THE YEAR THAT HELP TO FUND SPECIAL EQUIPMENT, FACILITIES AND PROGRAMS FOR THE PATIENTS OF CHILDREN'S HOSPITAL COLORADO.
Form 990, Part III, Line 4a CONTINUATION (3) The CCBD has several active Quality & Process Improvement initiatives underway in 2021 which will continue into 2022 to include, but not limited to: * The CCBD areas of patient care patient satisfaction meet or exceed all other patient care areas within Children's Hospital Colorado. * Standardizing an approach to screening for transfusion-associated iron overload increasing the number of patients identified and treated for this complication and preventing long-term toxicities. * Preventing blood stream infections in patients with a central line/catheter. * Improving time to antibiotics for patients receiving cancer care that present with fever and neutropenia (low white blood cell count) in all settings: Emergency Department & Outpatient clinic. * Decreasing the rate of clostridium difficile infections resulting in decreased mortality, decreased length of inpatient hospital stay and decreased cost for both community and hospital onset. * Increase reliability rates of Chemotherapy administered: both prescribing and administration process. * Successful Foundation for the Accreditation of Cellular Therapy (FACT) re-accreditation and continuous preparation for future surveys. FACT accreditation is a threshold for excellence in cellular therapy within the bone marrow or cord blood transplant (BMT) patient population. * A multidisciplinary process improvement working group has been implemented to streamline the peripheral stem cell collection process for increased provider and family satisfaction. ORTHOPEDICS The Orthopedics Institute (OI) at Children's Hospital Colorado consistently provides cutting edge orthopedic care to children throughout Colorado and the seven-state surrounding region, as well as patients from across the U.S. and around the world. As the only Level 1 pediatric trauma center in the seven-state region, the Orthopedics team cares for the most complex orthopedic trauma patients. Regularly recognized as a top program by U. S. News & World Report, our team of providers have expertise in the complete range of orthopedic conditions from broken bones and concussions to complex conditions like cerebral palsy and osteogenesis imperfecta. The OI has a history of setting the standard in pediatric orthopedic care by pioneering new treatments and innovative research. We were one of the first programs in the world to help children with physical disabilities participate in recreational activities when we created the Adaptive Recreation for Child Health (ARCH) program in the 1960's. The Center for Gait Movement Analysis, established in 1999, is the only center in our region and one of just 40 in the nation which offers 3D motion capture technology to facilitate treatment planning and evaluation. The OI also developed the Musculoskeletal Research Center (MRC), dedicated to advancing the field of pediatric orthopedics by continuously improving clinical outcomes, finding new cures, and testing new technologies. In 2021, the Orthopedics Institute completed 60,497 clinic visits across our network of care. This was accomplished via our provider team of 16 board certified pediatric orthopedic surgeons, 6 board certified sports medicine physicians, 3 certified pediatric nurse practitioners, and 19 certified physician assistants. We additionally have a team of dedicated orthopedic nurses, athletic trainers, orthopedic technicians, and medical assistants supporting patient care in our 12 distinct programs and 6 multidisciplinary clinics. We closely partner with disciplines such as Rehabilitation and Therapy Services, Radiology, Social Work, Psychology, Nutrition, and others to ensure that our patients get the holistic care needed to maximize their health potential. We offer specialized pediatric equipment in our clinics such as the EOS Imaging system, a safer low radiation x-ray for progressive spine, hip, and leg disorders which may require multiple imaging exams over time. EOS images can be used to create 3D reconstructions to plan a more personalized surgery for our patients. Many of our providers are also trained to use our musculoskeletal ultrasound machines. This safe and non-invasive imaging equipment assists with the evaluation and diagnosis of a variety of conditions as well as increases the accuracy of guided injections to over 90%. When surgery is the necessary method of treatment, our patients and families can be confident they have access to one of the safest, most experienced pediatric orthopedic surgery teams in the country. In 2021, our surgeons completed 4,281 procedures in operating rooms with specialized pediatric equipment. In addition to our orthopedic expertise, our surgical cases are performed in collaboration with board certified pediatric anesthesia providers and patients are cared for before, during, and after their procedure by nurses with specialized training in pediatric perioperative care. Each procedure is individualized to the anticipated growth and development of the patient. We offer a variety of innovative surgeries for scoliosis, sports injuries, orthopedic oncology, cerebral palsy, limb differences and more. Our spine program is one of only a few in the world to use real-time navigation and robotics during complex spine surgeries. Real-time navigation creates a virtual model of the spine in the operating room which allows surgeons to place spinal implants precisely and minimize damage to surrounding blood vessels, nerves, and the spinal cord. The robot acts as a guide for the surgeon, helping them make certain they are placing screws in the correct position along the spine. 2021 Orthopedics Institute Quality and Process Improvement Initiatives: * Reach 90% compliance with less than 60-minute turnaround time for intra-operative cell count results * 80% of adolescent idiopathic scoliosis patients will have a T5-T12 early post operative kyphosis of 20 degrees * Decrease intra-operative and post-operative allogenic packed red blood cell transfusion rate for bilateral VDRO and/or unilateral or bilateral pelvic osteotomy to less than 10% * Patients diagnosed with an ACL tear who start PT within 2 weeks of their diagnosis equal to or greater than 60% * Increase the percentage of adequately communicated referrals between outreach AT's and the clinical team to 80% * Develop standard work ensuring 100% of tumor patients' families are contacted the day of the patient's referral, and the patient is seen in clinic/biopsied within 72 business hours of contact * Have a skin injury rate of <1% for cast removal in the GOP program * Have a less than 2% incidence of deep surgical site infection for open hip procedures * Develop standard work ensuring 80% of patients are operated on in <10 days from time of hand injury * Increase the number of patients undergoing supervised exercise testing and receiving individualized exercise prescription within 7 days of initial Concussion program visit from baseline of <5% to target of >50%
Form 990, Part VI, Line 1a Delegate broad authority to a committee CHILDREN'S HOSPITAL COLORADO'S EXECUTIVE COMMITTEE CONSISTS OF THE BOARD CHAIR, CHAIR ELECT, CHIEF EXECUTIVE OFFICER, SECRETARY, BOARD TREASURER, CORPORATE TREASURER, IMMEDIATE PAST CHAIR, THE CHAIR OF THE CHILDREN'S HOSPITAL COLORADO FOUNDATION, THE CHANCELLOR (OR DESIGNEE) AND UP TO TWO (2) ADDITIONAL SEATS TO BE FILLED BY THE BOARD CHAIR. THE EXECUTIVE COMMITTEE HAS ALL THE POWERS OF THE BOARD OF DIRECTORS, EXCEPT AS LIMITED BY LAW, DURING THE PERIOD BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED BY THE BOARD.
Form 990, Part VI, Line 6 Classes of members or stockholders CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL COLORADO.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE WRITTEN CONSENT OF CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS REQUIRED TO APPROVE THE BOARD OF DIRECTORS OF CHILDREN'S HOSPITAL COLORADO.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM AS THE SOLE MEMBER HAS CERTAIN APPROVAL POWERS AS DESCRIBED IN THE AMENDED AND RESTATED BYLAWS DATED SEPTEMBER 22, 2011 AND AMENDED MOST RECENTLY IN FEBRUARY 2017.
Form 990, Part VI, Line 11b Review of form 990 by governing body CHILDREN'S HOSPITAL COLORADO'S FINANCE DEPARTMENT WORKS CLOSELY WITH HUMAN RESOURCES, CORPORATE COMPLIANCE, LEGAL AND PUBLIC RELATIONS TO GATHER ALL THE DATA REQUIRED TO COMPLETE THE FORM 990. THE DIRECTOR OF ACCTG. & REPORTING CONDUCTS A REVIEW WITH THE CFO PRIOR TO THE DRAFT BEING DISTRIBUTED TO THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE MADE, THE FORM IS SIGNED BY THE CFO, REVIEWED BY THE AUDIT COMMITTEE, AND A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS VIA A SECURED WEBSITE.
Form 990, Part VI, Line 12c Conflict of interest policy BOARD MEMBERS ARE REQUIRED TO DISCLOSE, ON AN ANNUAL BASIS, POTENTIAL CONFLICTS OF INTEREST PURSUANT TO THE WRITTEN POLICIES OF CHILDREN'S HOSPITAL COLORADO (CHCO) AND CHILDREN'S HOSPITAL COLORADO FOUNDATION (CHCF). ALL EMPLOYEES AND BOARD MEMBERS MUST PROMPTLY PROVIDE A WRITTEN DESCRIPTION OF MATERIAL FACTS OF AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO CORPORATE COMPLIANCE AND/OR GENERAL COUNSEL ON THE APPROPRIATE DISCLOSURE FORM. SUCH DISCLOSURE WILL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF THE CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. POLICIES AND PROCEDURES FOR DISCLOSING CONFLICTS OF INTEREST ARE TO BE FOLLOWED ACCORDING TO THE INDIVIDUAL'S FUNCTION, IN COMPLIANCE WITH STATE AND FEDERAL REGULATIONS. COMPLETED DISCLOSURE FORMS ARE SUBJECT TO AUDIT REVIEW BY LEGAL, THE CORPORATE COMPLIANCE PROGRAM, AND THE COMPLIANCE AND BUSINESS ETHICS COMMITTEE OF THE BOARD OF DIRECTORS. FAILURE TO COMPLY WITH CONFLICT OF INTEREST POLICIES MAY LEAD TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR WORKING RELATIONSHIP WITH THE CHILDREN'S HOSPITAL COLORADO. ONCE THE COMPLIANCE AND BUSINESS ETHICS (CABE) COMMITTEE HAS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WITH RESPECT TO AN AGREEMENT/CONTRACT THEN: 1. THE (CABE) COMMITTEE WILL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER CHILDREN'S HOSPITAL COULD OBTAIN A MORE ADVANTAGEOUS AGREEMENT/CONTRACT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES AND, IF APPROPRIATE, WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT. 2. IN CONSIDERING WHETHER TO ENTER THE PROPOSED AGREEMENT/CONTRACT, THE CABE COMMITTEE MAY APPROVE SUCH CONTRACT, TRANSACTION OR ARRANGEMENT ONLY IF THE DISINTERESTED PERSON OR COMMITTEE DETERMINE BY A MAJORITY VOTE THAT: - THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT IS IN CHILDREN'S COLORADO'S BEST INTERESTS AND FOR COLORADO CHILDREN'S OWN BENEFIT; AND - THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO CHILDREN'S HOSPITAL COLORADO (CHCO), CONSIDERING, AMONG OTHER RELEVANT FACTORS, WHETHER CHCO COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES.
Form 990, Part VI, Line 15a Process to establish compensation of top management official CHILDREN'S HOSPITAL COLORADO HAS AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS THAT REVIEWS AND APPROVES ANY PROPOSED INCREASES RELATED TO ANY OFFICERS AND KEY EMPLOYEES OF THE COMPANY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE ALONG WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EACH YEAR. ONCE A CHANGE IN COMPENSATION IS APPROVED, FORMAL DOCUMENTS ARE COMPLETED AND MINUTES OF THE MEETING ARE PREPARED, REVIEWED AND APPROVED. EXECUTIVE COMPENSATION PROGRAMS FOR CHILDREN'S HOSPITAL COLORADO (CHCO) ARE DESIGNED TO ATTRACT AND RETAIN TOP EXECUTIVE TALENT. PROGRAM OBJECTIVES INCLUDE: -MAINTAIN EXECUTIVE PAY RANGES THAT REFLECT MARKET AND INTERNAL ALIGNMENT -ESTABLISH PAY FOR INDIVIDUAL EXECUTIVES BASED ON SKILLS, EXPERIENCE AND/OR PERFORMANCE HISTORY -PROVIDE ANNUAL PAY INCREASE TO REWARD INDIVIDUAL PERFORMANCE AND MAINTAIN MARKET COMPETITIVENESS -UTILIZE INCENTIVE PAY TO REWARD THE EXECUTIVE'S ABILITY TO ALIGN DIVISIONAL PERFORMANCE TO ORGANIZATIONAL PERFORMANCE -PROMOTE THE HEALTH AND WELLNESS OF EXECUTIVES AND THEIR FAMILIES, WHILE PROVIDING FAMILY FRIENDLY PROGRAM OPTIONS CONSISTENT WITH CHCO MISSION -MAINTAIN OVERALL PROGRAM AFFORDABILITY AND SUSTAINABILITY FOR THE ORGANIZATION THE EXECUTIVE COMPENSATION PACKAGE CONSISTS OF BASE PAY, INCENTIVE PAY, AND BENEFITS (MEDICAL, DENTAL, VISION, LIFE, DISABILITY, RETIREMENT, AND VOLUNTARY BENEFIT PROGRAMS). CHCO DEFINES MARKET COMPETITIVENESS BASED ON COMPARISONS WITH A PEER GROUP CONSISTING OF NATIONAL PEDIATRIC AND REGIONAL HEALTH SYSTEMS THAT ARE SIMILAR IN SIZE AND COMPLEXITY. IN DETERMINING MARKET COMPETITIVENESS, CHCO PARTNERS WITH AN EXTERNAL EXECUTIVE COMPENSATION CONSULTANT TO GATHER AND ASSESS MARKET DATA FROM INDEPENDENT COMPENSATION AND BENEFIT SURVEYS THAT REFLECT FUNCTIONALLY COMPARABLE POSITIONS IN THE PEER GROUP. AS NEEDED, THE EXTERNAL EXECUTIVE COMPENSATION CONSULTANT WILL PROVIDE RECOMMENDATIONS TO HELP RESOLVE DIFFICULTIES IN RECRUITING AND RETAINING EXECUTIVES OR ENSURE CRITICAL BUSINESS OR STRATEGIC ISSUES ARE ADDRESSED. 2021 CUSTOM PEER GROUP -TEXAS CHILDREN'S HOSPITAL (HOUSTON, TX) -THE CHILDREN'S HOSPITAL OF PHILADELPHIA (PHILADELPHIA, PA) -BOSTON CHILDREN'S HOSPITAL (BOSTON, MA) -CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER (CINCINNATI, OH) -NATIONWIDE CHILDREN'S HOSPITAL (COLUMBUS, OH) -CHILDREN'S HEALTHCARE OF ATLANTA (ATLANTA, GA) -COOK CHILDREN'S HEALTH CARE SYSTEM (FORT WORTH, TX) -CHILDREN'S HEALTH SYSTEM OF TEXAS (DALLAS, TX) -SEATTLE CHILDREN'S (SEATTLE, WA) -CHILDREN'S MERCY KANSAS CITY (KANSAS CITY, MO) -CHILDREN'S NATIONAL HEALTH SYSTEM (WASHINGTON, DC) -RADY CHILDREN'S HOSPITAL - SAN DIEGO (SAN DIEGO, CA) -CHILDREN'S HOSPITAL LOS ANGELES (LOS ANGELES, CA) -ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO (CHICAGO, IL) -CHILDREN'S WISCONSIN (MILWAUKEE, WI) -CHILDREN'S HOSPITALS AND CLINICAL OF MINNESOTA (MINNEAPOLIS, MN) -PHOENIX CHILDREN'S HOSPITAL (PHOENIX, AZ) -CHOC CHILDREN'S (ORANGE, CA) -ARKANSAS CHILDREN'S HOSPITAL (LITTLE ROCK, AR) -UCHEALTH (AURORA, CO) -CENTURA HEALTH (CENTENNIAL, CO) -SCL HEALTH (BROOMFIELD, CO) -ST. LUKE'S HEALTH SYSTEM (BOISE, ID) THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2021.
Form 990, Part VI, Line 15b Process to establish compensation of other employees CHILDREN'S HOSPITAL COLORADO HAS AN EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS THAT REVIEWS AND APPROVES ANY PROPOSED INCREASES RELATED TO ANY OFFICERS AND KEY EMPLOYEES OF THE COMPANY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE ALONG WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EACH YEAR. ONCE A CHANGE IN COMPENSATION IS APPROVED, FORMAL DOCUMENTS ARE COMPLETED AND MINUTES OF THE MEETING ARE PREPARED, REVIEWED AND APPROVED. EXECUTIVE COMPENSATION PROGRAMS FOR CHILDREN'S HOSPITAL COLORADO (CHCO) ARE DESIGNED TO ATTRACT AND RETAIN TOP EXECUTIVE TALENT. PROGRAM OBJECTIVES INCLUDE: -MAINTAIN EXECUTIVE PAY RANGES THAT REFLECT MARKET AND INTERNAL ALIGNMENT -ESTABLISH PAY FOR INDIVIDUAL EXECUTIVES BASED ON SKILLS, EXPERIENCE AND/OR PERFORMANCE HISTORY -PROVIDE ANNUAL PAY INCREASE TO REWARD INDIVIDUAL PERFORMANCE AND MAINTAIN MARKET COMPETITIVENESS -UTILIZE INCENTIVE PAY TO REWARD THE EXECUTIVE'S ABILITY TO ALIGN DIVISIONAL PERFORMANCE TO ORGANIZATIONAL PERFORMANCE -PROMOTE THE HEALTH AND WELLNESS OF EXECUTIVES AND THEIR FAMILIES, WHILE PROVIDING FAMILY FRIENDLY PROGRAM OPTIONS CONSISTENT WITH CHCO MISSION -MAINTAIN OVERALL PROGRAM AFFORDABILITY AND SUSTAINABILITY FOR THE ORGANIZATION THE EXECUTIVE COMPENSATION PACKAGE CONSISTS OF BASE PAY, INCENTIVE PAY, AND BENEFITS (MEDICAL, DENTAL, VISION, LIFE, DISABILITY, RETIREMENT, AND VOLUNTARY BENEFIT PROGRAMS). CHCO DEFINES MARKET COMPETITIVENESS BASED ON COMPARISONS WITH A PEER GROUP CONSISTING OF NATIONAL PEDIATRIC AND REGIONAL HEALTH SYSTEMS THAT ARE SIMILAR IN SIZE AND COMPLEXITY. IN DETERMINING MARKET COMPETITIVENESS, CHCO PARTNERS WITH AN EXTERNAL EXECUTIVE COMPENSATION CONSULTANT TO GATHER AND ASSESS MARKET DATA FROM INDEPENDENT COMPENSATION AND BENEFIT SURVEYS THAT REFLECT FUNCTIONALLY COMPARABLE POSITIONS IN THE PEER GROUP. AS NEEDED, THE EXTERNAL EXECUTIVE COMPENSATION CONSULTANT WILL PROVIDE RECOMMENDATIONS TO HELP RESOLVE DIFFICULTIES IN RECRUITING AND RETAINING EXECUTIVES OR ENSURE CRITICAL BUSINESS OR STRATEGIC ISSUES ARE ADDRESSED. 2021 CUSTOM PEER GROUP -TEXAS CHILDREN'S HOSPITAL (HOUSTON, TX) -THE CHILDREN'S HOSPITAL OF PHILADELPHIA (PHILADELPHIA, PA) -BOSTON CHILDREN'S HOSPITAL (BOSTON, MA) -CINCINNATI CHILDREN'S HOSPITAL MEDICAL CENTER (CINCINNATI, OH) -NATIONWIDE CHILDREN'S HOSPITAL (COLUMBUS, OH) -CHILDREN'S HEALTHCARE OF ATLANTA (ATLANTA, GA) -COOK CHILDREN'S HEALTH CARE SYSTEM (FORT WORTH, TX) -CHILDREN'S HEALTH SYSTEM OF TEXAS (DALLAS, TX) -SEATTLE CHILDREN'S (SEATTLE, WA) -CHILDREN'S MERCY KANSAS CITY (KANSAS CITY, MO) -CHILDREN'S NATIONAL HEALTH SYSTEM (WASHINGTON, DC) -RADY CHILDREN'S HOSPITAL - SAN DIEGO (SAN DIEGO, CA) -CHILDREN'S HOSPITAL LOS ANGELES (LOS ANGELES, CA) -ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO (CHICAGO, IL) -CHILDREN'S WISCONSIN (MILWAUKEE, WI) -CHILDREN'S HOSPITALS AND CLINICAL OF MINNESOTA (MINNEAPOLIS, MN) -PHOENIX CHILDREN'S HOSPITAL (PHOENIX, AZ) -CHOC CHILDREN'S (ORANGE, CA) -ARKANSAS CHILDREN'S HOSPITAL (LITTLE ROCK, AR) -UCHEALTH (AURORA, CO) -CENTURA HEALTH (CENTENNIAL, CO) -SCL HEALTH (BROOMFIELD, CO) -ST. LUKE'S HEALTH SYSTEM (BOISE, ID) THE COMPENSATION REVIEW PROCESS WAS LAST COMPLETED IN 2021.
Form 990, Part VI, Line 19 Required documents available to the public THESE DOCUMENTS ARE MADE AVAILABLE UPON REASONABLE REQUEST.
Form 990, Part VIII, Line 2f Other Program Service Revenue - Total Revenue: 93340017, Related or Exempt Function Revenue: 92262815, Unrelated Business Revenue: 1077202, Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees PHYSICIAN SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 24377413, Fundraising Expenses: ; PURCHASED SERVICES - Total Expense: 66910358, Program Service Expense: 56680021, Management and General Expenses: 10230337, Fundraising Expenses: ; CONSULTING FEES - Total Expense: 2796886, Program Service Expense: 2369253, Management and General Expenses: 427633, Fundraising Expenses: ; OTHER - Total Expense: 6541769, Program Service Expense: 5541558, Management and General Expenses: 1000211, Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances EQUITY TRANSFER FROM CHCHS - 8840299; EQUITY TRANSFER FROM FOUNDATION - 48996624; CHANGE IN PERPETUAL TRUST - 5786965; OTHER CHANGES IN NET ASSETS - -8824734; EQUITY TRANSFER TO CHCHS - -45000000;
FORM 990, PART III, LINE 4A CONTINUATION (1) CHILDREN'S HOSPITAL COLORADO (CHCO) works collaboratively with its affiliates as an academic medical center to fulfill a joint mission to provide excellent services and the best health outcomes for children, through teaching, research, clinical care and community support services. CHCO is committed TO INCLUSION AND BELONGING IN OUR WORKFORCE AND IN OUR COMMUNITY. WE STRIVE FOR EVERYONE TO FEEL VALUED. The following section describes CHCO's program service accomplishments for each of the three largest program services, as measured by expense. NEONATOLOGY For more than 50 years, the Neonatal Intensive Care Unit (NICU) at Children's Hospital Colorado (CHCO) has been a nationally recognized leader in the treatment of critically ill infants. The leading-edge Level IV NICU (the highest distinction by the American Academy of Pediatrics), at Children's Hospital Colorado, provides 82 critical care beds specifically for this patient population. The NICU provides excellence in care for infants throughout Colorado and the mountain state region. Named one of the country's top centers by U.S. News & World Report, our Level IV Neonatal Intensive Care Unit offers the highest level of care to more than 1,400 newborns every year -one of the largest centers in the region. We care for any condition affecting a newborn, no matter how rare or critical that condition may be. Therapies include extra corporeal membrane oxygenation (ECMO), continuous renal replacement (CRRT), genetic testing, and neonatal surgery. Volumes matter. Children's Colorado's NICU is among the highest volume centers in the U.S. for high-complexity patients, meaning we see more and treat more neonates with complex congenital conditions and severe complications of prematurity than most other centers. The NICU cares for both premature and term infants with a variety condition, including hypoxic respiratory failure, infections, hematological, neurological, cardiovascular, and metabolic disorders. Infants with single major or multiple anomalies requiring diagnostic evaluation or surgical intervention are often treated in the NICU. Our survival rates rank among the best in the nation. Our high volumes not only allow for the development of highly specialized teams and standardized approaches to care, they also build our surgical and medical sub-specialists' experience and expertise. The Neonatology team has pioneered many critical developments in neonatal clinical care including surfactant replacement for premature infants, inhaled nitric oxide therapy for pulmonary hypotension, therapeutic hypothermia for perinatal brain injury, optimal nutrition for low-birth-weight infants and innovative care following fetal surgery. Collectively, the neonatologists and PhD research faculty published 117 articles in 2021. Throughout a visit, a baby and their family stay together in an environment we specifically designed to feel as much like home as possible. Families are integral to the care delivered. Key areas of focus include developmentally supportive care of the newborn, primary nursing and a family centered care approach. Parents are encouraged to participate in daily rounds and in all aspects of care. There is a Family Advisory Council to support current families and provide perspective on the patient experience. The clinical care team in the NICU is comprised of Neonatologists, Neonatal Nurse Practitioners, specialty trained nurses, respiratory therapists, pharmacists, physical, speech and occupational therapists, lactation specialists, neonatal nutrition, social work, chaplains, and case managers. Specialty consultants include neurology, pulmonology, genetics, gastroenterology, nutrition, metabolic, endocrinology, hematology, cardiology and cardiovascular surgery, general pediatric surgery, renal, ophthalmology, orthopedics and ear, nose and throat specialists. Children's Hospital Colorado neonatologists have diverse expertise caring for an array of complex conditions. The Section of Neonatology provides full clinical support for infants and their families at multiple hospitals in the Denver metropolitan area including Children's Hospital Colorado, University of Colorado Hospital and Denver Health Medical Center. The 41 board-certified neonatologists are nationally and internationally recognized leaders in neonatal care as well as clinical and scientific research. With advances in technology, the NICU team can provide teleconferencing for referring providers and/or parents who may not be present to provide optimal communication. They can also provide tele-NICU services to hospitals in rural areas to ensure those infants are properly treated in their home community and transferred only when appropriate. The NICU team continuously reviews quality and patient safety data focusing on excellence in patient outcomes. The NICU leadership team meets bimonthly for Quality Rounds, promoting engagement of front-line staff. This avenue elicits great discussions among staff regarding what is going well as well as in identifying opportunities and creative ideas for improvement. The NICU team promotes the safest environment possible with key communication in safety huddles each shift to review details of our safety and quality improvement work. Optimal communication with a large multidisciplinary team is one of our key strategies to promote the highest quality care possible. NICU Quality and Process Improvement Initiatives: * Family experience scores consistently at 80% or greater. Parents are invited to rounds with the NICU team daily. Our goal is to partner with parents in their child's plan of care. The CHCO NICU is involved in a regional quality collaborative to improve family engagement and satisfaction within NICU's. There is a strong foundation of Primary nursing as the model of care. * Ongoing key quality initiatives include focusing on a sustained decrease in unplanned extubations, patient identification events, pressure injuries, adverse medication events and peripheral intravenous catheter extravasations. * There is major focus on infection prevention practices and hand washing compliance among the large multidisciplinary team in the NICU. * Significant focus on the prevention of central line associated blood stream infections (CLABSI's). Our goal is to sustain a CLABSI rate of 2/1000-line days or less in 2022. The rate for 2021 was 1.39/1000 line days. There is ongoing auditing of compliance to the CLABSI bundle regarding prevention measures and significant attention to best practices related to CLABSI prevention. Line days totaled 6490 in 2021, demonstrating the complex, high acuity NICU patient population. * The Lactation program focuses on a goal of 82% or greater of NICU infants receiving breast milk while hospitalized and upon discharge. In addition, there are several other quality projects with a nutrition focus lead by Clinician Nutrition, Lactation and the broader multi-disciplinary team. * Following clinical outcomes of infants delivered in the Labor and Delivery Care Unit at CHCO and admitted to the NICU. * Trending data from codes/resuscitations in the NICU with processes identified for improvement, including high fidelity, multi-disciplinary code simulations and standardization of processes within the resuscitation for improved teamwork, communication and outcomes. * A standardized, evidenced based approach to caring for infants in the Small Baby Unit within the NICU. Key clinical outcomes are tracked and reviewed in this population. * Close follow up of infants treated with surgical interventions, hypothermic therapy for neonatal encephalopathy, unique ventilation strategies, Supporting Preemie Respiratory Outcomes (SPROUT) Transitional Team, extracorporeal membrane oxygenation (ECMO), inhaled nitric oxide (iNO), continuous renal replacement therapy (CRRT) and peritoneal dialysis.
FORM 990, PART III, LINE 4A CONTINUATION (2) CENTER FOR CANCER AND BLOOD DISORDERS Children's Hospital Colorado's (CHCO) Center for Cancer and Blood Disorders (CCBD) has one of the best pediatric hematology, oncology, and bone marrow transplant programs in the country. The CCBD has been ranked in the Top 10 programs by US News & World Report, and the only Top 10 ranked program in the 12 surrounding states and in the western half of the United States. The Center provides care for many pediatric cancers & blood disorders including: Leukemias and Lymphomas, Solid Tumors, Central Nervous System tumors, Hemophilia & Thrombosis, General Hematology, Hemoglobinopathies, immunohematology and immunodeficiencies, Experimental Therapeutics/Phase I Clinical Trials, and Bone Marrow Transplant & Cell Therapy. Helping children realize their full potential is also achieved through our Wellness Program, Adolescent & Young Adult care, onco-fertility, our survivorship program Helping Oncology Patients Excel (HOPE) as well as a transition clinic for survivors of childhood cancer who are transitioning to adult medical care. Every year we see between 300-350 new cancer diagnoses and over 200 new hematology patients. The CCBD provided approximately 27,116 outpatient visits in 2021, seeking to serve the Colorado community, as well as our 7-state region. Of these visits approximately 90% of patients were from Colorado while the remaining almost 10% were from the 7-state region or beyond. Our Anschutz facility location saw approximately 18,365 of the total visits, with our infusion center volume at 1,750 infusions. Our Network of Care sites in Highlands Ranch, Colorado Springs, and Broomfield had patient visits in 2021 of 8,128 of which 3,076 were infusions for CCBD and other services such as Neurology, Gastroenterology, Rheumatology, and Nephrology. Because of the depth and breadth of CCBD outpatient services, a large number of our clinic and infusion visits mean that many children can be cared for on an outpatient basis instead of being admitted to the hospital. Limiting hospitalization when possible is our high priority to enable our families live healthier lives. Our expansion of services to Broomfield and other Network of Care sites has allowed us to provide care closest to home for our patients in those regions. CCBD Inpatient had 8,913 patient days recorded in 2021; 5.8% of these occurred at Children's Hospital Colorado, Colorado Springs. The Anschutz Medical Campus inpatient unit had a total of 5,970 inpatient Hematology and Oncology patient days and 2,422 BMT patient days recorded. National/Regional Presence: CCBD has faculty with medical licenses in other states around the region including NM, MT, SD, WY, and TX to ensure we can provide care to patients where their needs can be best met and expand to telehealth services to accommodate patient and family needs. Our outreach clinics on the Western Slope bring sub-specialty expertise to many patients who may not be able to travel to the Denver metro area. We host bi-weekly Bone Marrow Transplant (BMT) teleconferences with cancer programs in New Mexico. Our CCBD nursing program travels throughout the region and provides virtual teaching to train other hospital nurse staff on best practices in chemotherapy administration. Our telemedicine efforts have grown since the pandemic, to ensure distance is not a barrier to providing the care our patients need. Our Hemophilia & Thrombosis Center (HTC) provides comprehensive care clinics throughout the region and is part of the University of Colorado Hemophilia and Thrombosis Center, one of the world's premier programs for treatment of clotting and bleeding disorders in adults and children. Our HTC faculty successfully treated rural out of state patients via telemedicine and are beginning to revitalize in-person outreach clinics across the state and region. CCBD faculty comprise the pediatric component of the Colorado Sickle Cell Treatment and Research Center, service as the primary source of specialty expertise and comprehensive care for children and adults living with hemoglobinopathies. CCBD is acknowledged by Optum as a Center of Excellence for both Cancer Care as well as Bone Marrow Transplant. We are the only pediatric Foundation for the Accreditation of Cellular Therapy (FACT) program in a 16-state region, which brings us the capacity to deliver the most sophisticated stem cell transplant and chimeric antigen receptor T (CAR- T) cell immunotherapy. Continued expansion of the application of CAR-T therapy has also advanced in both the targeted antibodies and different diseases. Our Neuro-Oncology and Experimental Therapeutics programs draw patients nationally and internationally for treatment and clinical trials that are available in only a few centers in the world. Multi & Interdisciplinary Care: CCBD is privileged to have a dedicated Wellness program. This interdisciplinary team is comprised of specialists in Social Work, Psychology, Child Life, Family Navigation, Creative Arts Therapy, Chaplaincy, and Learning Specialists. The Wellness program benefits families and patients by integrating and coordinating clinical services to meet every family's needs at the individual level and increases possibilities for prevention/intervention and on-going care and connection. The CCBD is a home for multiple sub-programs within Oncology, Hematology and BMT. Our Vascular Anomalies Center is a national and regional leader. This interdisciplinary team evaluates and treats vascular anomalies in children. The team includes specialists from Otolaryngology (ear, nose, and throat), Plastic Surgery, Dermatology, Hematology, Pediatric General Surgery, and Interventional Radiology. This program exemplifies our priority to put the patient first. Our specialists coordinate their care in one patient appointment to minimize the number of visits needed to evaluate and treat the patient's condition. Other sub-programs include a variety of multi-disciplinary programs such as Polyposis Program (inherited diseases involving tissue growth) and Spots and Dots (Young Women's Bleeding Clinic). The interdisciplinary program for children with retinoblastoma, the most common tumor of the eye in children, brings together experts in ocular surgery at University of Colorado Hospital and our pediatric oncology experts in the CCBD, is the only program for this multi-disciplinary eye cancer care in a 12-state region. Our HOPE Survivorship Program was one of the first in the nation and remains one of the only programs in the region, to focus specifically on cancer survivorship. Patients treated for cancer, especially at a young age, can experience long term side effects including heart and lung complications, hormone disorders, secondary cancers, learning disabilities, and many others. Our program supports these patients long after their cancer treatment has finished with a team including oncologists, social workers, dieticians, neuropsychologists, genetic counselors, and nurses. Quality Improvement: The CCBD is committed to developing quality improvement as a core clinical strategy by continually advancing the effectiveness, efficiency, safety, experience, and coordination of the care it provides to its patients. The Clinical Effectiveness Collaborative (CEC) is broadly representative, multidisciplinary and guides the range of activities and initiatives through which the CCBD is pursuing its clinical, operational, value-driven, and financial improvement goals. One primary function of the CEC is to review and provide feedback related to clinical and operational improvement projects, including measures, PI methods, and project alignment across the CCBD and CHC.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990) 2021


Additional Data


Software ID: 21014044
Software Version: 2021v4.2
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
Children's Hospital Colorado
 
Employer identification number

84-0166760
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity
(1) CHILDREN'S NORTH SURGERY CENTER
469 STATE HIGHWAY 7
SUITE 2
BROOMFIELD,CO80023
26-2394578 		O/P SURGERY CO 28,033 0 CH-COLORADO
 
(2) 5314 INSURANCE COMPANY LLC
677 ALA MOANA BLVD
SUITE 316
HONOLULU,HI96813
84-3975618 		CAPTIVE INS. HI 5,104,521 24,423,202 CH-COLORADO
 








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?
Yes No
(1)CHILDREN'S HOSPITAL COLORADO HLTH SYSTEM
13123 EAST 16TH AVE

AURORA,CO80045
45-4182666 		HEALTHCARE CO 501(c)(3) Type III-FI NA
 
 
No
(2)The Children's Hospital Colorado Foundation
13123 EAST 16TH AVE

AURORA,CO80045
84-0813462 		FOUNDATION CO 501(c)(3) 7 CHCHS
 
Yes
 










For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) PEDIATRIC CARE NETWORK CHCH LLC

13123 EAST 16TH AVE
AURORA,CO80045
81-3554450 		HEALTHCARE CO CH-COLORADO
  		C Corporation 2,250,730 4,417,950 100 % Yes  
(2) PERPETUAL TRUST

 
 
HOSPITAL SUPPORT CO CH-COLORADO
  		        Yes  










Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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
No
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 .....................
1a
Yes
 
b Gift, grant, or capital contribution to related organization(s) ............................
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
Yes
 
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
Yes
 
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
Yes
 
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) CHILDRENS HOSPITAL COLORADO FOUNDATION

 C 5,629,468 ACCRUAL





Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
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) 2021

Additional Data


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