Form990
Click to see attachment
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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 07-01-2021 , and ending 06-30-2022
BCheck if applicable:
CName of organization
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
 
Doing business as
SIBLEY MEMORIAL HOSPITAL
 
Number and street (or P.O. box if mail is not delivered to street address)
5255 LOUGHBORO RD NW
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
WASHINGTON, DC20016
D Employer identification number

53-0196602
E Telephone number

G Gross receipts $ 552,142,974
F Name and address of principal officer:
KIMBERLY ELYANOW
5255 LOUGHBORO RD NW
WASHINGTON,DC20016
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SIBLEY.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: 1891
M State of legal domicile: DC
Part I
Summary
Activities  & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 29
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 27
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 2,763
6 Total number of volunteers (estimate if necessary) ............. 6 0
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 97,748
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 24,349,215 33,373,723
9 Program service revenue (Part VIII, line 2g) ......... 433,549,196 467,411,008
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 87,582,537 42,027,817
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 10,588,420 9,060,783
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 556,069,368 551,873,331
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 518,332 7,094,486
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 173,720,255 184,545,750
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 287,956,818 302,325,172
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 462,195,405 493,965,408
19 Revenue less expenses. Subtract line 18 from line 12....... 93,873,963 57,907,923
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,473,123,330 1,400,679,075
21 Total liabilities (Part X, line 26)............. 392,139,502 381,042,357
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,080,983,828 1,019,636,718
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: SEE SCHEDULE O
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 $ 118,114,571 including grants of $ 0 ) (Revenue $ 99,988,525 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $ 81,882,815 including grants of $ 0 ) (Revenue $ 82,249,771 )
SEE SCHEDULE O
4c (Code:   ) (Expenses $ 41,219,318 including grants of $ 0 ) (Revenue $ 36,829,104 )
SEE SCHEDULE O
(Code:   ) (Expenses $ 186,610,238 including grants of $ 7,094,486 ) (Revenue $ 248,245,860 )
4d Other program services (Describe in Schedule O.)
(Expenses $ 186,610,238 including grants of $ 7,094,486 ) (Revenue $ 248,245,860 )
4e Total program service expensesMediumBullet427,826,942
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 IClick to see attachment.............
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 IIIClick to see attachment..
5
 
No
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 IClick to see attachment.........................
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 IIClick to see attachment....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D,
Part IIIClick to see attachment..............
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 IVClick to see attachment..............
9
Yes
 
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 V......
10
 
No
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 VIIClick to see attachment.......
11b
Yes
 
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 VIIIClick to see attachment.......
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
Click to see attachment......................
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........Click to see attachment
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...............
24a
 
No
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
 
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
 
 
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
 
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 .... Click to see attachment
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.......................Click to see attachment
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 IIClick to see attachment...........
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 IIIClick to see attachment.........................
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......................Click to see attachment
28a
Yes
 
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
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
 
No
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
 
No
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............. Click to see attachment
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 VIClick to see attachment
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
308
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
2,763
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
 
No
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
29
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
27
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
 
No
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
 
 
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
 
No
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
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
DC
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:
MediumBulletKIMBERLY ELYANOW VP CFO-NCR5255 LOUGHBORO RD NW   WASHINGTON,DC20016 (202) 537-4000
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) KEVIN W SOWERS MSN RN FAA......................................................................
CORPORATE VICE CHAIRMAN
5.00
.................
55.00
X           0 1,909,575 21,374
(2) CAOLYN CARPENTER MHA FACHE......................................................................
PRESIDENT OF CAP.REGION, TRUSTEE
30.00
.................
30.00
X   X       0 889,950 107,978
(3) MAYA AJMERA......................................................................
TRUSTEE
5.00
.................
0.00
X           0 0 0
(4) WILLIAM B BARTON JR ESQ......................................................................
TRUSTEE, VICE CHAIR
5.00
.................
1.00
X           0 0 0
(5) ROBERT BRANSON......................................................................
TRUSTEE
5.00
.................
0.00
X           0 0 0
(6) RICHARD E MORRIS......................................................................
TRUSTEE, TREASURER
5.00
.................
1.00
X   X       0 0 0
(7) JOSHUA AMMERMAN MD......................................................................
TRUSTEE
5.00
.................
1.00
X           0 0 0
(8) REV DAVID A ARGO PHD......................................................................
TRUSTEE
5.00
.................
1.00
X           0 0 0
(9) GEOFFREY D BROWN......................................................................
TRUSTEE
5.00
.................
0.00
X           0 0 0
(10) J RENE CARTER......................................................................
TRUSTEE, SECRETARY
5.00
.................
1.00
X   X       0 0 0
(11) ANDREI CERNA MD......................................................................
TRUSTEE
5.00
.................
1.00
X           0 0 0
(12) DONNA CRYER ESQ......................................................................
TRUSTEE
5.00
.................
0.00
X           0 0 0
(13) MICHAEL K FARR......................................................................
TRUSTEE
5.00
.................
1.00
X           0 0 0
(14) HARRY HERTZ PHD......................................................................
TRUSTEE
5.00
.................
0.00
X           0 0 0
(15) DALE H HOSCHEIT ESQ......................................................................
TRUSTEE
5.00
.................
1.00
X           0 0 0
(16) JOHN CASTELLANI......................................................................
TRUSTEE
5.00
.................
0.00
X           0 0 0
(17) JUDY KOVLER......................................................................
TRUSTEE
5.00
.................
0.00
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) ROBERT L MALLETT........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(19) PRISCILLA I PAGANO........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(20) THOMAS J SCHAEFER........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(21) MARTIN G PAUL MD........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(22) ROBERT S SILBERMAN........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(23) PAUL STERN PHD........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(24) DEOBRAH TRAUTMAN PHD........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(25) EDWARD J MILLER JR........................................................................
TRUSTEE, CHAIRMAN
5.00
.......................15.00
X           0 0 0
(26) THEODORE DEWEESE MD........................................................................
TRUSTEE
5.00
.......................10.00
X           0 0 0
(27) JOAN LEWIS........................................................................
TRUSTEE, VICE CHAIR
5.00
.......................0.00
X           0 0 0
(28) CAPRICIA MARSHALL........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(29) TRENOR WILLIAMS........................................................................
TRUSTEE
5.00
.......................0.00
X           0 0 0
(30) MARTIN BASSO........................................................................
VICE PRESIDENT FINANCE, CEO
30.00
.......................30.00
    X       0 715,393 102,353
(31) HASAN ZIA MD........................................................................
PRESIDENT
59.00
.......................1.00
    X       0 685,847 123,396
(32) JENNIFER ABELE MD........................................................................
VICE PRESIDENT MEDICAL AFFAIRS & CMO
60.00
.......................1.00
    X       0 502,882 36,663
(33) LAURA HENDRICKS- JACKSON........................................................................
VICE PRESIDENT PATIENT CARE & CNO
60.00
.......................1.00
    X       0 345,212 94,441
(34) CAROLINE SHAFA........................................................................
VICE PRESIDENT OPERATIONS
60.00
.......................0.00
    X       0 367,183 39,416
(35) POUNEH RAZAVI........................................................................
BREAST IMAGER RADIOLOGIST
40.00
.......................0.00
        X   539,220 0 29,607
(36) SARA SHAYLOR........................................................................
BREAST IMAGER RADIOLOGIST
40.00
.......................0.00
        X   466,284 0 29,091
(37) SANDRA POLIN........................................................................
BREAST IMAGER RADIOLOGIST
40.00
.......................0.00
        X   463,670 0 7,727
(38) ARMAN FIROUZI........................................................................
SURGICAL HOUSE OFFICER
40.00
.......................0.00
        X   418,746 0 21,776
(39) NICOLA SATER........................................................................
PSYCHIATRIST
40.00
.......................0.00
        X   276,476 0 17,705
(40) RONALD R PETERSON........................................................................
FORMER OFFICER
0.00
.......................0.00
          X 0 1,275,825 0
(41) QUEENIE PLATER........................................................................
FORMER OFFICER
0.00
.......................0.00
          X 0 206,896 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 2,164,396 6,898,763 631,527
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 MediumBullet420
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
Yes
 
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
AYA HEALTHCARE INC

5930 CORNERSTONE CT W STE 300
SAN DIEGO,CA92121
STAFFING SERVICES 2,044,432
TRUSTED HEALTH INC

PO BOX 7775
SAN FRANCISCO,CA941207775
STAFFING SERVICES 1,728,345
HEFFRON COMPANY

4940 NICHOLSON CT STE 100
KENSINGTON,MD20895
PLUMBING, HEATING, & A/C CONTRACTORS 969,879
ALLIANT STAFFING LLC

3 BETHESDA METRO CTR STE 460
BETHESDA,MD208146369
STAFFING SERVICES 855,578
LANDIVAR & ASSOCIATES LLC

2350 DUKE ST STE B
ALEXANDRIA,VA22314
CONSTRUCTION 781,476
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet61
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue
(B)
Related or
exempt
function
revenue
(C)
Unrelated
business
revenue
(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 24,853,231
e Government grants (contributions)1e 8,520,492
f All other contributions, gifts, grants, and similar amounts not included above1f  
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 33,373,723
 Program Service RevenueAmt Business Code
2a PATIENT REVENUE 621990 449,059,069 449,059,069    
b ASSISTED LIVING 623000 18,254,191 18,254,191    
c LAB REVENUE 621500 97,748   97,748  
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 467,411,008
 OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 16,824,223     16,824,223
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   2,074,173 6a
b Less: rental expenses   0 6b
c Rental income or (loss)   2,074,173 6c
d Net rental income or (loss).......MediumBullet 2,074,173     2,074,173
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   25,285,078 7a
b Less: cost or other basis and sales expenses 81,484 0 7b
c Gain or (loss) -81,484 25,285,078 7c
d Net gain or (loss).........MediumBullet 25,203,594     25,203,594
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 355,379
b Less: cost of goods sold .. 10b 188,159
c Net income or (loss) from sales of inventory..MediumBullet 167,220     167,220
Business Code Miscellaneous Revenue
11a PARKING LOT 812930 1,458,657     1,458,657
b CAFETERIA/VENDING 722515 1,008,636     1,008,636
c EDUCATION PROGRAM 624100 320,060     320,060
d All other revenue .... 4,032,037     4,032,037
e Total. Add lines 11a–11d ...... MediumBullet 6,819,390
12 Total revenue. See instructions.....MediumBullet 551,873,331 467,313,260 97,748 51,088,600
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 .... 7,094,486 7,094,486
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 ...........        
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........ 153,624,035 140,287,997 13,336,038  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 4,932,241 4,504,075 428,166  
9 Other employee benefits ....... 12,097,033 11,046,895 1,050,138  
10 Payroll taxes ........... 13,892,441 12,686,444 1,205,997  
11 Fees for services (non-employees):        
a Management ...... 55,201   55,201  
b Legal ......... 283,829   283,829  
c Accounting ........... 44,841   44,841  
d Lobbying ........... 92,127   92,127  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ...... 2,515,206   2,515,206  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 32,250,706 30,882,844 1,367,862  
12 Advertising and promotion .... 588,453 15,531 572,922  
13 Office expenses ....... 16,670,019 12,293,004 4,377,015  
14 Information technology ...... 2,799,592 2,556,561 243,031  
15 Royalties ..        
16 Occupancy ........... 8,281,982 7,563,027 718,955  
17 Travel ............ 358,535 565 357,970  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 182,932 167,052 15,880  
20 Interest ........... 10,010,347 10,010,347    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 41,127,101 37,556,875 3,570,226  
23 Insurance ... 4,172,732 3,956,932 215,800  
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 DIRECT PATIENT SUPPLIES 121,997,182 121,997,182 0  
b PURCHASED SERVICES 54,405,670 19,423,701 34,981,969  
c DIETARY-CATERING 3,848,133 3,462,528 385,605  
d PROVIDER TAX 1,418,530 1,295,388 123,142  
e All other expenses 1,222,054 1,025,508 196,546  
25 Total functional expenses. Add lines 1 through 24e 493,965,408 427,826,942 66,138,466 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 ........ 89,335,895 1 122,659,363
2 Savings and temporary cash investments ......... 37,482,719 2 50,818,348
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 53,106,298 4 62,246,687
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 .......
  5  
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) ...
  6  
7 Notes and loans receivable, net ........... 2,389,972 7 480,000
8 Inventories for sale or use ............ 9,279,222 8 9,791,074
9 Prepaid expenses and deferred charges ...... 3,813,388 9 3,671,597
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 767,810,235
b Less: accumulated depreciation 10b 286,271,875 508,060,032 10c 481,538,360
11 Investments—publicly traded securities .   11  
12 Investments—other securities. See Part IV, line 11 ..... 671,999,082 12 587,122,225
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 97,656,722 15 82,351,421
16 Total assets. Add lines 1 through 15 (must equal line 33)... 1,473,123,330 16 1,400,679,075
Liabilities 17 Accounts payable and accrued expenses ..... 53,111,257 17 54,650,595
18 Grants payable ...   18  
19 Deferred revenue ......... 1,265,767 19 1,266,914
20 Tax-exempt bond liabilities .........   20  
21 Escrow or custodial account liability. Complete Part IV of Schedule D 1,857,116 21 490,214
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 .........
  22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ..   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D 335,905,362 25 324,634,634
26 Total liabilities. Add lines 17 through 25.. 392,139,502 26 381,042,357
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 .......... 1,077,228,485 27 1,015,883,751
28 Net assets with donor restrictions ........... 3,755,343 28 3,752,967
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 ........... 1,080,983,828 32 1,019,636,718
33 Total liabilities and net assets/fund balances ........ 1,473,123,330 33 1,400,679,075
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
551,873,331
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
493,965,408
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
57,907,923
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
1,080,983,828
5
Net unrealized gains (losses) on investments ...............
5
-136,504,425
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
17,249,392
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
1,019,636,718
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:  
Software Version:  
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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:  
Software Version:  
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number
53-0196602
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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:  
Software Version:  
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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) ......................    
b Total lobbying expenditures to influence a legislative body (direct lobbying) ........................    
c Total lobbying expenditures (add lines 1a and 1b) ............................................................    
d Other exempt purpose expenditures ...............................................................................    
e Total exempt purpose expenditures (add lines 1c and 1d) ..................................................    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.
   
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) .................................................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ...................................................................................................................

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          
b Lobbying ceiling amount
(150% of line 2a, column(e))
 
c Total lobbying expenditures          
d Grassroots nontaxable amount          
e Grassroots ceiling amount
(150% of line 2d, column (e))
 
f Grassroots lobbying expenditures          
Schedule C (Form 990) 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? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
Yes
 
60,000
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
32,127
j
Total. Add lines 1c through 1i ....................................................................................................
92,127
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
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
PART II-B, LINE 1: DIRECT CONTACT: SIBLEY MEMORIAL HOSPITAL RETAINS LEGAL COUNSEL TO PERFORM LOBBYING ACTIVITIES ON ITS BEHALF. THE LOBBYING ACTIVITIES RELATE TO PRESERVING AND PROTECTING THE HOSPITAL'S INTERESTS WITH REGARDS TO MATTERS AFFECTING HEALTH CARE AND HEALTH FACILITIES. OTHER ACTIVITIES: SIBLEY MEMORIAL HOSPITAL PAID ITS PARENT CORPORATION, THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION $24,000 DURING FISCAL YEAR ENDED JUNE 30, 2022 TO SUPPORT THEIR LOBBYING ACTIVITIES. JOHNS HOPKINS OFFICE OF GOVERNMENT AND COMMUNITY AFFAIRS (GCA) SERVES JOHNS HOPKINS UNIVERSITY AND MEDICINE, JOHNS HOPKINS HEALTH SYSTEM AND AFFILIATES. THE PRIMARY PURPOSE OF THIS DEPARTMENT IS TO MAINTAIN CONTACT WITH ELECTED AND APPOINTED STATE OFFICIALS, AND OCCASIONAL FEDERAL OFFICIALS, REGARDING ISSUES WHICH IMPACT JOHNS HOPKINS HEALTH SYSTEM AND ITS AFFILIATES AS WELL AS THE HEALTHCARE INDUSTRY IN GENERAL. THE ORGANIZATION ALSO PAID CERTAIN DUES OR MEMBERSHIP FEES TO VARIOUS PROFESSIONAL ASSOCIATIONS, STATE HOSPITAL ASSOCIATIONS, AND OTHER PROFESSIONAL MEDICAL SOCIETIES WHO ALLOCATE A PORTION OF THOSE DUES TOWARDS LOBBYING EXPENSES. FOR FY22, THE ORGANIZATION HAS CONFIRMED THAT $8,127 OF SUCH DUES WERE ALLOCATED TOWARDS LOBBYING ACTIVITIES.
Schedule C (Form 990) 2021


Additional Data


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Software Version:  

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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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 ....          
b Contributions ...          
c Net investment earnings, gains, and losses          
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ...
         
f Administrative expenses ....          
g End of year balance ......          
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 Bullet  
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)
 
 
(ii) Related organizations .................
3a(ii)
 
 
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 .....   50,974,870 50,974,870
b Buildings ....   348,626,067 119,330,809 229,295,258
c Leasehold improvements   108,713 85,890 22,823
d Equipment ....   353,103,320 161,633,971 191,469,349
e Other .....   14,997,265 5,221,205 9,776,060
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 481,538,360
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) JOINT VENTURES
687,820 F

(B) OTHER SECURITIES
586,434,405 F
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 587,122,225
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)DUE FROM OTHERS 2,317,090
(2)OTHER ASSETS 8,672,231
(3)LIMITED USE ASSETS 66,180,804
(4)DUE FROM AFFILIATES 5,094,303
(5)OPERATING LEASE RIGHT-OF-USE ASSETS 86,993
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 82,351,421
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  
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 324,634,634
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
PART IV, LINE 2B: THE HOSPITAL ACTS AS ADMINISTRATOR/TRUSTEE FOR A CHARITABLE GIFT ANNUITY (CGA) PROGRAM. THE ASSETS ARE CUSTODIED WITH THE FIDUCIARY TRUST COMPANY. DONORS MAKE ARRANGEMENTS WITH THE HOSPITAL AND THE CUSTODIAN TO MAKE A ONE-TIME CONTRIBUTION TO THE CGA. PERIODIC ANNUITY PAYMENTS ARE THEN MADE TO THE DONOR OVER THE LIFETIME OF THE DONOR. THE HOSPITAL INCLUDES ON ITS BALANCE SHEET THE MARKET VALUE OF THE ASSETS CONTRIBUTED BY ALL DONORS IN THE PROGRAM. THE HOSPITAL ALSO INCLUDES A LIABILITY FOR ESTIMATED PAYMENTS CALCULATED TO BE PAID TO ITS DONORS IN FUTURE YEARS. THE ASSETS ARE INVESTED IN FIXED INCOME AND EQUITY SECURITIES, MONITORED REGURARLY BY THE HOSPITAL'S INVESTMENT COMMITTEE. FOR FISCAL YEAR ENDING JUNE 30, 2022, THE MARKET VALUE OF THE ASSETS DECREASED BY $2,294,154.
PART X, LINE 2: FASB'S GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES CLARIFIES THE ACCOUNTING FOR UNCERTAINTY OF INCOME TAX POSITIONS. THIS GUIDANCE DEFINES THE THRESHOLD FOR RECOGNIZING TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS AS "MORE LIKELY THAN NOT" THAT THE POSITION IS SUSTAINABLE, BASED ON ITS TECHNICAL MERITS. THIS GUIDANCE ALSO PROVIDES GUIDANCE ON THE MEASUREMENT, CLASSIFICATION AND DISCLOSURE OF TAX RETURN POSITIONS IN THE FINANCIAL STATEMENTS. THERE WAS NO IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2022 AND 2021.
Schedule D (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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
 
No
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
 
 
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) . . .
    3,946,228 0 3,946,228 0.800 %
b Medicaid (from Worksheet 3, column a) . . . . .     31,906,297 25,428,288 6,478,009 1.310 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .     0 0    
d Total Financial Assistance and Means-Tested Government Programs . . . . .     35,852,525 25,428,288 10,424,237 2.110 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     3,628,275 210,464 3,417,811 0.690 %
f Health professions education (from Worksheet 5) . . .     1,491,830 261,399 1,230,431 0.250 %
g Subsidized health services (from Worksheet 6) . . . .     31,452,877 21,239,100 10,213,777 2.070 %
h Research (from Worksheet 7) .     1,446,153 11,452 1,434,701 0.290 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     2,313,055 0 2,313,055 0.470 %
j Total. Other Benefits . .     40,332,190 21,722,415 18,609,775 3.770 %
k Total. Add lines 7d and 7j .     76,184,715 47,150,703 29,034,012 5.880 %
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     675,337 0 675,337 0.140 %
4 Environmental improvements     0 0    
5 Leadership development and
training for community members
    0 0    
6 Coalition building     0 0    
7 Community health improvement advocacy     0 0    
8 Workforce development     0 0    
9 Other     0 0    
10 Total     675,337   675,337 0.140 %
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
10,468,028
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
0
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
94,731,722
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
153,061,301
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-58,329,579
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?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 SIBLEY MEMORIAL HOSPITAL
5255 LOUGHBORO RD NW
WASHINGTON,DC20016
WWW.HOPKINSMEDICINE.ORG
HFD01-0213
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)
SIBLEY MEMORIAL HOSPITAL
Name of hospital facility or letter of facility reporting group  
Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):
1
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 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10 Yes  
a If "Yes" (list url): SEE SUPPLEMENTAL INFORMATION
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)
SIBLEY MEMORIAL HOSPITAL
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
SEE SUPPLEMENTAL INFORMATION
b
SEE SUPPLEMENTAL INFORMATION
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
SIBLEY MEMORIAL HOSPITAL
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)
SIBLEY MEMORIAL HOSPITAL
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
SIBLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: SIBLEY MEMORIAL HOSPITAL COMPLETED A COMMUNITY HEALTH NEEDS ASSESSMENT IN ASSOCIATION WITH DC HEALTH MATTERS COLLABORATIVE. QUANTITATIVE WORK INCLUDED PULLING DATA FROM SOURCES SUCH AS BRFSS, THE YOUTH RISK BEHAVIOR SURVEY, AMERICAN COMMUNITY SURVEY AND CLARITAS, TO NAME A FEW. IN ADDITION, WE REVIEWED MEDSTAR'S CHNA SURVEY THAT CONTAINED THE RESULTS OF COMMUNITY INPUT SESSIONS WITH 4,702 PARTICIPANTS.
SIBLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 6A: CHILDREN'S NATIONAL AND HOWARD UNIVERSITY HOSPITAL
SIBLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 6B: FEDERALLY QUALIFIED HEALTH CENTERS (FQHC) INCLUDE: MARY'S CENTER, UNITY HEALTH, COMMUNITY OF HOPE, AND BREAD FOR THE CITY. EX-OFFICIO MEMBERS INCLUDE: DC HOSPITAL ASSOCIATION, DC BEHAVIORAL HEALTH ASSOCIATION, AND DC PRIMARY CARE ASSOCIATION. SEE APPENDIX 1 FOR MORE INFORMATION. PAST MEMBERSHIP INCLUDED PROVIDENCE HOSPITAL WHICH HAS SINCE CLOSED AND HSC HEALTHCARE SYSTEM WHICH RECENTLY MERGED WITH CHILDREN'S HOSPITAL.
SIBLEY MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT REVEALED THREE PRIMARY AREAS OF NEED: MENTAL WELL-BEING, EQUITABLE ACCESS TO CARE, AND COMMUNITY-BASED WORKFORCE DEVELOPMENT (INCLUDING RETENTION AND DEVELOPMENT OF HEALTHCARE WORKFORCE AS WELL AS COMMUNITY ECONOMIC DEVELOPMENT). THESE NEEDS WILL BE ADDRESSED OVER THE STANDARD THREE-YEAR PERIOD WITH A COMMUNITY HEALTH IMPROVEMENT PLAN THAT WAS PUBLISHED IN NOVEMBER 2022.
PART V, SECTION B, LINE 7A HTTPS://WWW.HOPKINSMEDICINE.ORG/SIBLEY-MEMORIAL-HOSPITAL/COMMUNITY-HEALTH/NEEDS-ASSESSMENT.HTML
PART V, SECTION B, LINE 10A HTTPS://WWW.HOPKINSMEDICINE.ORG/SIBLEY-MEMORIAL-HOSPITAL/COMMUNITY-HEALTH/NEEDS-ASSESSMENT.HTML
PART V, SECTION B, LINE 16A HTTPS://WWW.HOPKINSMEDICINE.ORG/PATIENT_CARE/BILLING-INSURANCE/ASSISTANCE-SERVICES/ASSISTANCE_POLICIES.HTML
PART V, SECTION B, LINE 16B HTTPS://WWW.HOPKINSMEDICINE.ORG/PATIENT_CARE/BILLING-INSURANCE/ASSISTANCE-SERVICES/ASSISTANCE_POLICIES.HTML
PART V, SECTION B, LINE 16C HTTPS://WWW.HOPKINSMEDICINE.ORG/PATIENT_CARE/BILLING-INSURANCE/ASSISTANCE-SERVICES/ASSISTANCE_POLICIES.HTML
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
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?1
Name and address Type of Facility (describe)
1 1 - GRAND OAKS
5901 MACARTHUR BLVD NW
WASHINGTON,DC20016
ASSISTED LIVING FACILITY
2
3
4
5
6
7
8
9
10
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
PART I, LINE 3C: SEE DETAILS IN SCH H, PART V, SECTION B, LINE 13.
PART I, LINE 7: A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A-7B (FINANCIAL ASSISTANCE AND UNREIMBURSED MEDICAID). THE AMOUNTS FOR LINES 7E-7I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND WOULD NOT BE BASED ON A COST-TO CHARGE RATIO.
PART I, LINE 7G: THERE ARE NO COSTS REPORTED THAT ARE ATTRIBUTABLE TO A PHYSICIANS CLINIC.
PART II, COMMUNITY BUILDING ACTIVITIES: WARD INFINITYWARD INFINITY IS A COMMUNITY-FOCUSED INITIATIVE DEVELOPED BY SIBLEY MEMORIAL HOSPITAL, PART OF JOHNS HOPKINS MEDICINE, AIMING TO REDUCE HEALTH DISPARITIES FOR MINORITIZED RESIDENTS LIVING IN ECONOMICALLY VULNERABLE COMMUNITIES IN WASHINGTON D.C. THROUGH THE CREATION OF COMMUNITY-DRIVEN SOLUTIONS. THE MISSION OF WARD INFINITY IS TO PARTNER WITH WARDS 7 AND 8 RESIDENTS WITH COMPELLING IDEAS ON IMPROVING HEALTH OUTCOMES IN THESE WARDS AND ACCELERATE THEIR CAPACITY TO RADICALLY IMPROVE HEALTH AND WELL-BEING. GOALS INCLUDE THE REDUCTION OF HEALTH DISPARITIES, IMPROVING SOCIAL DETERMINANTS OF HEALTH, INCREASING INCLUSION, AND BUILDING TRUST BY LISTENING AND RESPONDING TO THE NEEDS OF VULNERABLE COMMUNITIES. WARD INFINITY PROVIDES SUPPORT, TRAINING, AND $25,000 IN SEED MONEY FOR THESE COMMUNITY HEALTH INNOVATORS THROUGH A RESIDENCY PROGRAM. RESIDENTS WORK WITH SIBLEY EMPLOYEES SPECIALLY TRAINED IN INNOVATION AND HEALTH DESIGN AND THE WARD INFINITY ADVISORY COUNCIL, A GROUP OF COMMUNITY AND GOVERNMENT LEADERS, TO CONSTRUCT TARGETED, CREATIVE IDEAS TO ADDRESS HEALTH DISPARITIES IN THEIR NEIGHBORHOODS. EACH TEAM DEVELOPS A PROJECT THAT ADDRESSES HEALTH ISSUES IN THE COMMUNITY RANGING FROM LACK OF ACCESS TO FRESH FOODS TO IMPROVING HOUSING OPTIONS TO USING TECHNOLOGY TO IMPROVE HEALTH LITERACY. AT THE CONCLUSION OF THE PROGRAM, EACH TEAM OF COMMUNITY HEALTH INNOVATORS IN RESIDENCE PRESENT THEIR SOLUTIONS AND ENGAGE IN A COMMUNITY TOWN HALL DISCUSSION TO HELP THEM TRANSITION FROM PROTOTYPING TO PROJECT IMPLEMENTATION. SIBLEY, PART OF JOHNS HOPKINS MEDICINE CONTINUES TO HOST PROGRAM GRADUATES AND OTHER EARLY-STAGE ENTREPRENEURS OF COLOR FROM WARDS 7 AND 8 TO HEAR FROM AN EXPERT PANEL OF STARTUPS, ENTREPRENEURS AND MINORITY-OWNED BUSINESSES ON KEY PRINCIPLES TO DRIVE ENTREPRENEURIAL SUCCESS. SIBLEY PARTNERS WITH DISTRICT GOVERNMENT AND PRIVATE PHILANTHROPISTS IN THESE EFFORTS. DC ANCHOR PARTNERSHIPSIBLEY MEMORIAL HOSPITAL IS A FOUNDING MEMBER OF THE DC COMMUNITY ANCHOR PARTNERSHIP (DCAP), A COLLABORATIVE OF PROMINENT INSTITUTIONS COMMITTED TO EQUITABLE ECONOMIC DEVELOPMENT IN THE DISTRICT OF COLUMBIA. THE GROUP'S FOCUS IS PROCUREMENT WITH DC MINORITY-OWNED BUSINESS ENTERPRISES (MBES) TO CREATE JOBS, INCOME, AND WEALTH FOR, IN PARTICULAR, RESIDENTS OF COLOR IN DC, WHILE SUPPORTING A STRONG LOCAL ECONOMY AND BUSINESS NEEDS OF INSTITUTIONS. SIBLEY SENIOR ASSOCIATION AND CLUB MEMORYDURING THE ONGOING PANDEMIC, SIBLEY CONTINUED TO INCREASE VIRTUAL OPPORTUNITIES FOR PROGRAMMING FOR VULNERABLE OLDER ADULTS. IN PARTICULAR, THOSE LIVING WITH ALZHEIMER'S DISEASE AND RELATED DEMENTIA, AS WELL AS THEIR FAMILIES WERE PROVIDED ADDITIONAL CRITICAL SUPPORT DURING THESE CHALLENGING TIMES. IN 2023, A HYBRID STRUCTURE RETAINS VIRTUAL PROGRAMMING AND ADDS IN-PERSON ENGAGEMENT.
PART III, LINE 2: THE PROVISION FOR BAD DEBTS IS BASED UPON A COMBINATION OF THE PAYOR SOURCE, THE AGING OF RECEIVABLES AND MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS, TRENDS IN HEALTH INSURANCE COVERAGE, AND OTHER COLLECTION INDICATORS.
PART III, LINE 3: SMH DOES NOT REPORT AN ESTIMATE FOR THE PORTION OF BAD DEBT EXPENSE THAT MAY BE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. SMH TAKES THE POSITION THAT AMPLE OPPORTUNITY AND ASSISTANCE IS PROVIDED TO THE PATIENT TO QUALIFY UNDER THE FINANCIAL ASSISTANCE POLICY. IF SUFFICIENT INFORMATION IS NOT PROVIDED, THEN SMH MUST ASSUME THE PATIENT DOES NOT QUALIFY.
PART III, LINE 4: THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION AND AFFILIATES AUDITED FINANCIAL STATEMENTS PAGE 18.
PART III, LINE 8: SIBLEY MEMORIAL HOSPITAL TREATS PATIENTS WITH MANY INSURANCE CARRIERS. HOWEVER, SMH'S MEDICARE INPATIENT VOLUME IS AMONG THE HIGHEST RATIO AMONG DISTRICT OF COLUMBIA HOSPITALS. ALTHOUGH PROVIDING THE BEST POSSIBLE CARE TO OUR MEDICARE PATIENTS CREATES A FINANCIAL LOSS, WE RELIEVE THE GOVERNMENT AND SURROUNDING OTHER HOSPITALS OF THE FINANCIAL BURDEN OF TREATING THESE PATIENTS INSURED BY THE MEDICARE PROGRAM. PART OF THE MISSION OF OUR HOSPITAL IS TO SERVE ITS ELDERLY PATIENTS WITHIN THE COMMUNITY THROUGH VARIOUS PROGRAMS THAT ARE DESIGNED TO EDUCATE AND IMPROVE THEIR HEALTH STATUS. THE HOSPITAL FEELS THAT PROVIDING THESE PROGRAMS HAS CONTRIBUTED TO THE IMPROVEMENT OF HEALTH OVERALL WITHIN THE COMMUNITY.
PART III, LINE 9B: WHEN A PATIENT ASKS FOR CHARITY CARE OR FINANCIAL ASSISTANCE, THE PATIENT MUST COMPLETE AN APPLICATION AND PROVIDE FINANCIAL INFORMATION THAT WOULD DEMONSTRATE FINANCIAL NEED. THE APPLICATION IS REVIEWED BY FINANCIAL COUNSELORS FOR ELIGIBILITY.
PART VI, LINE 3: SIBLEY PUBLISHED A NOTICE OF AVAILABILITY OF ITS UNCOMPENSATED CARE OBLIGATION IN A NEWSPAPER OF GENERAL CIRCULATION IN THE DISTRICT OF COLUMBIA. SIBLEY SUBMITTED A COPY OF SUCH NOTICE TO SHPDA. A NOTICE ANNOUNCING THE AVAILABILITY OF UNCOMPENSATED CARE WAS POSTED IN PLAIN VIEW IN THE PATIENT REGISTRATION SITES, ADMISSIONS DEPARTMENT, THE BUSINESS OFFICE AND THE EMERGENCY DEPARTMENT. THE NOTICE IS PUBLISHED IN ENGLISH AND SPANISH AND ANY OTHER LANGUAGE WHICH IS THE USUAL LANGUAGE OF HOUSEHOLDS OF TEN PERCENT OR MORE OF THE POPULATION OF THE DISTRICT OF COLUMBIA. SIBLEY COMMUNICATES THE CONTENTS OF THE POSTED NOTICE TO ANY PERSON WHO SIBLEY HAS REASON TO BELIEVE CANNOT READ THE NOTICE. NOTICE OF AVAILABILITY IS ALSO POSTED ON THE HOSPITALS WEBSITE.
PART VI, LINE 4: SIBLEY IS LOCATED IN WASHINGTON, D.C., AN URBAN AREA, AND CONSIDERS THE DISTRICT OF COLUMBIA ITS PRIMARY COMMUNITY BENEFIT SERVICE AREA FROM (DC QUICK FACTS 2022, MOST RECENT DATA). POPULATION: 671,803 (UP FROM 2019) MEDIAN HOUSEHOLD INCOME: $93,547 % RESIDENTS NON-WHITE: 54.1% % RESIDENTS WHO ARE UNINSURED (MEDICAID EXCLUDED): 3.2% # OF HOSPITALS SERVING THE DISTRICT OF COLUMBIA: 7 (SIBLEY, HOWARD, CHILDREN'S, GEORGE WASHINGTON, GEORGETOWN, NATIONAL REHAB, ST. ELIZABETH'S) # OF FEDERAL RECOGNIZED MEDICALLY UNDERSERVED AREAS/POPULATIONS: 7
PART VI, LINE 5: THE SIBLEY SENIOR ASSOCIATION PROMOTES HEALTH EDUCATION AND SUPPORT IN EVERY WARD OF THE DISTRICT OF COLUMBIA, INCLUDING THE FEDERALLY RECOGNIZED MEDICALLY UNDERSERVED AREAS/POPULATIONS. SERVICES ARE PROVIDED AT NO CHARGE. SERVICES INCLUDE SUPPORT GROUPS, CLINICAL SEMINARS, SUCH AS THE DISCUSSING THE FACTS SERIES, AND OUR CLUB MEMORY PROGRAM, WHICH IS A STIGMA-FREE SOCIAL ENGAGEMENT GROUP DESIGNED TO REDUCE ISOLATION AND BUILD COMMUNITY FOR BOTH PERSONS WITH ALZHEIMER'S DISEASE AND RELATED DEMENTIAS AND THEIR CARE PARTNERS, AMONG OTHER HEALTH LITERACY BUILDING PROGRAMS. CANCER SURVIVORSHIP, SUPPORT, AND EDUCATION IS PROVIDED TO THE GENERAL PUBLIC, REGARDLESS OF WHETHER OR NOT THEY CHOOSE SIBLEY AS THEIR HEALTH CARE PROVIDER. YOGA, MEDITATION AND MINDFULNESS, REIKI, SUPPORT GROUPS, CANCER EDUCATION, ART THERAPY AND WRITING GROUPS ARE PROVIDED IN ADDITION TO CARE COORDINATION.THE MATERNAL HEALTH ACCESS PROGRAM AT SIBLEY HAS BEEN DEVELOPED TO ADDRESS DISPARITIES IN MATERNAL AND NEONATAL MORBIDITY AND MORTALITY IN THE DISTRICT OF COLUMBIA. THE PROGRAM EXPANDS EARLY IDENTIFICATION OF HIGH-RISK WOMEN, ESTABLISH A CLINICAL CARE COORDINATION PROGRAM, AND DEVELOP INNOVATIVE METHODS TO MONITOR PREGNANCY WITH THE GOAL OF IMPROVING BOTH MATERNAL AND NEONATAL OUTCOMES.
PART VI, LINE 6: THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION (JHHSC) IS INCORPORATED IN THE STATE OF MARYLAND TO, AMONG OTHER THINGS, FORMULATE POLICY AMONG AND PROVIDE CENTRALIZED MANAGEMENT FOR JHHSC AND AFFILIATES (JHHS). JHHS IS ORGANIZED AND OPERATED FOR THE PURPOSE OF PROMOTING HEALTH BY FUNCTIONING AS A PARENT HOLDING COMPANY OF AFFILIATES WHOSE COMBINED MISSION IS TO PROVIDE PATIENT CARE IN THE TREATMENT AND PREVENTION OF HUMAN ILLNESS WHICH COMPARES FAVORABLY WITH THAT RENDERED BY ANY OTHER INSTITUTION IN THIS COUNTRY OR ABROAD.JHHSC IS THE SOLE MEMBER OF THE JOHNS HOPKINS HOSPITAL (JHH), AN ACADEMIC MEDICAL CENTER, JOHNS HOPKINS BAYVIEW MEDICAL CENTER, INC. (JHBMC), A COMMUNITY BASED TEACHING HOSPITAL AND LONG-TERM CARE FACILITY, HOWARD COUNTY GENERAL HOSPITAL, INC. (HCGH), A COMMUNITY BASED HOSPITAL, SUBURBAN HOSPITAL, INC. (SHI), A COMMUNITY BASED HOSPITAL, SIBLEY MEMORIAL HOSPITAL (SMH), A D.C. COMMUNITY BASED HOSPITAL, AND JOHNS HOPKINS ALL CHILDRENS HOSPITAL, INC (JHACH), A FL ACADEMIC CHILDRENS HOSPITAL.
PART VI, LINE 7, REPORTS FILED WITH STATES DC
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number
53-0196602
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) DISTRICT OF COLUMBIA HOSPITAL ASSOCIATION
1152 15TH ST NW STE 900
WASHINGTON,DC20005
52-1135713 501(C)(6) 5,600 0     COMMUNITY PROGRAM SUPPORT
(2) LIGHTHOUSE DC
1850 WYOMING AVE NW UNIT 1
WASHINGTON,DC20009
81-5313985 501(C)(3) 20,000 0     COVID RECOVERY PROGRAM
(3) UNITY HEALTH CARE
1100 NEW JERSEY AVE SE SUITE 500
WASHINGTON,DC20003
52-1572431 501(C)(3) 10,000 0     COMMUNITY PROGRAM SUPPORT
(4) MEDICI ROAD
1629 K ST NW SUITE 300
WASHINGTON,DC20006
81-3752369 501(C)(3) 35,500 0     COMMUNITY PROGRAM SUPPORT
(5) WASSUP TE LLC
200 RHODE ISLAND AVE NE
WASHINGTON,DC20002
86-2114415 N/A 35,500 0     COMMUNITY PROGRAM SUPPORT
(6) A WIDER CIRCLE
10325 KENSINGTON PARKWAY 70
KENSINGTON,MD20895
52-2345144 501(C)(3) 15,000 0     COMMUNITY PROGRAM SUPPORT
(7) INFINITE POSSIBILITIES INTERNATIONAL
3953 AMES ST NE
WASHINGTON,DC20019
47-2051705 501(C)(3) 28,052 0     COMMUNITY PROGRAM SUPPORT
(8) HEALTHY HOME PEDIATRICS LLC
3709 S ST SE
WASHINGTON,DC20020
83-3088825 N/A 26,500 0     COMMUNITY PROGRAM SUPPORT
(9) DYNAMIC SOLUTIONS FOR THE AGING LLC
1885 TUBMAN RD SE
WASHINGTON,DC20020
26-1127588 N/A 25,500 0     COMMUNITY PROGRAM SUPPORT
(10) JANE BANCROFT ROBINSON FOUNDATION
5255 LOUGHBORO RD NW
WASHINGTON,DC20016
27-3818431 501(C)(3) 6,877,622 0     PROMOTING & ADVANCING HEALTHCARE
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
6
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
4
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
PART I, LINE 2: THE PROCEDURES IN PLACE TO MONITOR THE USE OF GRANT FUNDS GIVEN TO THE ORGANIZATIONS LISTED CONSIST OF ANNUAL STATUS REPORTS. THESE REPORTS WILL CONTAIN A) PROGRESS ON THE RESEARCH CONDUCTED, B) FULL ACCOUNTING OF FUNDS SPENT, C) ACHIEVEMENT OF MEASURABLE OUTCOMES AND ANY CHANGES FROM THE ORIGINAL PROPOSAL, D) DATA GATHERING AND THE METHODS OR STRATEGIES USED, AND E) FINDINGS AND CONCLUSIONS. IN ADDITION, THE GRANTEES ARE REQUIRED TO MAINTAIN ACCOUNTING RECORDS WITH PRUDENT RECORD-KEEPING PROCEDURES AS REQUIRED BY ANY APPLICABLE FEDERAL, STATE, OR LOCAL LAWS, RULES OR REGULATIONS. THE GRANTOR (SIBLEY HOSPITAL) RESERVES THE RIGHT TO HAVE ACCESS TO AND EXAMINE ALL BOOKS AND RECORDS TO ASCERTAIN IF GRANT FUNDS ARE BEING DISBURSED PURSUANT TO THE TERMS OF THE AGREEMENTS.
Schedule I (Form 990) 2021



Additional Data


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Software Version:  


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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
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
Yes
 
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
1KEVIN W SOWERS MSN RN FAA
CORPORATE VICE CHAIRMAN
(i)

(ii)
0
-------------
1,201,889
0
-------------
690,648
0
-------------
17,038
0
-------------
9,436
0
-------------
11,938
0
-------------
1,930,949
0
-------------
0
2RONALD R PETERSON
FORMER OFFICER
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
1,275,825
0
-------------
0
0
-------------
0
0
-------------
1,275,825
0
-------------
0
3CAOLYN CARPENTER MHA FACHE
PRESIDENT OF CAP.REGION, TRUSTEE
(i)

(ii)
0
-------------
678,539
0
-------------
202,500
0
-------------
8,911
0
-------------
78,124
0
-------------
29,854
0
-------------
997,928
0
-------------
0
4MARTIN BASSO
VICE PRESIDENT FINANCE, CEO
(i)

(ii)
0
-------------
471,207
0
-------------
105,248
0
-------------
138,938
0
-------------
83,379
0
-------------
18,974
0
-------------
817,746
0
-------------
0
5HASAN ZIA MD
PRESIDENT
(i)

(ii)
0
-------------
523,010
0
-------------
156,443
0
-------------
6,394
0
-------------
100,091
0
-------------
23,305
0
-------------
809,243
0
-------------
0
6POUNEH RAZAVI
BREAST IMAGER RADIOLOGIST
(i)

(ii)
411,093
-------------
0
126,933
-------------
0
1,194
-------------
0
2,075
-------------
0
27,532
-------------
0
568,827
-------------
0
0
-------------
0
7JENNIFER ABELE MD
VICE PRESIDENT MEDICAL AFFAIRS & CMO
(i)

(ii)
0
-------------
417,089
0
-------------
80,915
0
-------------
4,878
0
-------------
9,436
0
-------------
27,227
0
-------------
539,545
0
-------------
0
8SARA SHAYLOR
BREAST IMAGER RADIOLOGIST
(i)

(ii)
388,653
-------------
0
76,225
-------------
0
1,406
-------------
0
3,702
-------------
0
25,389
-------------
0
495,375
-------------
0
0
-------------
0
9SANDRA POLIN
BREAST IMAGER RADIOLOGIST
(i)

(ii)
385,903
-------------
0
76,833
-------------
0
934
-------------
0
2,126
-------------
0
5,601
-------------
0
471,397
-------------
0
0
-------------
0
10ARMAN FIROUZI
SURGICAL HOUSE OFFICER
(i)

(ii)
406,372
-------------
0
11,000
-------------
0
1,374
-------------
0
10,495
-------------
0
11,281
-------------
0
440,522
-------------
0
0
-------------
0
11LAURA HENDRICKS- JACKSON
VICE PRESIDENT PATIENT CARE & CNO
(i)

(ii)
0
-------------
276,850
0
-------------
64,260
0
-------------
4,102
0
-------------
84,517
0
-------------
9,924
0
-------------
439,653
0
-------------
0
12CAROLINE SHAFA
VICE PRESIDENT OPERATIONS
(i)

(ii)
0
-------------
291,545
0
-------------
71,851
0
-------------
3,787
0
-------------
24,137
0
-------------
15,279
0
-------------
406,599
0
-------------
0
13NICOLA SATER
PSYCHIATRIST
(i)

(ii)
180,363
-------------
0
95,060
-------------
0
1,053
-------------
0
7,796
-------------
0
9,909
-------------
0
294,181
-------------
0
0
-------------
0
14QUEENIE PLATER
FORMER OFFICER
(i)

(ii)
0
-------------
0
0
-------------
0
0
-------------
206,896
0
-------------
0
0
-------------
0
0
-------------
206,896
0
-------------
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
PART I, LINES 4A-B SEVERANCE PAYMENTS: QUEENIE PLATER $206,895.89 A SELECT GROUP OF SENIOR LEADERS OF THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION (JHHSC) PARTICIPATE IN SUPPLEMENTAL RETIREMENT/DEFERRED COMPENSATION PROGRAMS, INCLUDING SOME LEGACY ARRANGEMENTS THAT ARE NO LONGER AVAILABLE TO NEW HIRES. PRE-2011 PARTICIPANTS RECEIVE CASH PAYMENTS EACH YEAR DETERMINED WITH REFERENCE TO THEIR SERVICE WITH JHHSC AND THEIR FINAL AVERAGE COMPENSATION. AS OF JANUARY 2019, FUTURE CASH PAYMENTS ARE MADE ACCORDING TO A FIXED SCHEDULE FOR THESE PARTICIPANTS. POST-2011 PARTICIPANTS ACCRUE BENEFITS UNDER A DEFINED CONTRIBUTION FORMULA WHERE CONTRIBUTIONS ARE TIERED BY POSITION LEVEL. CONTRIBUTIONS MADE IN 2018 AND PRIOR YEARS GENERALLY VEST AFTER THE LATER OF FIVE YEARS OF SERVICE WITH JHHSC OR THREE YEARS OF PLAN PARTICIPATION; CONTRIBUTIONS MADE IN 2019 AND FUTURE YEARS VEST THREE YEARS AFTER EACH CONTRIBUTION IS MADE, WITH FULL VESTING ON THE LATER OF AGE 65 OR THREE YEARS OF PLAN PARTICIPATION. ALL CONTRIBUTIONS VEST ON DEATH, DISABILITY OR INVOLUNTARY TERMINATION WITHOUT CAUSE. IF A PARTICIPANT VOLUNTARILY TERMINATES EMPLOYMENT OR IS TERMINATED BY THE EMPLOYER FOR CAUSE PRIOR TO THE APPLICABLE VESTING DATE, THE PARTICIPANT'S ENTIRE NON-VESTED BENEFIT IS FORFEITED ALL OF THESE ARRANGEMENTS WERE APPROVED, IN ADVANCE, BY AN INDEPENDENT COMPENSATION COMMITTEE, WHICH BASED ITS DECISION ON DATA PROVIDED BY AN INDEPENDENT COMPENSATION CONSULTANT. PARTICIPANTS' INTERESTS UNDER THESE ARRANGEMENTS ARE NOT GUARANTEED OR SECURED AT ANY WAY AND AT ALL TIMES ARE SUBJECT TO CLAIMS OF EMPLOYER'S BANKRUPTCY/INSOLVENCY CREDITORS. THE FOLLOWING INDIVIDUALS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A RECEIVED PAYMENT FROM ONE OR MORE SUPPLEMENTAL RETIREMENT/DEFERRED COMPENSATION PROGRAMS, WITH PAYMENTS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III); THE TOTAL OF AMOUNTS PAYABLE DURING 2021 BUT REPORTED AS DEFERRED COMPENSATION IN COLUMN (C) IN PREVIOUS YEARS IS REPORTED IN SCHEDULE J, PART II, COLUMN (F). THE AMOUNTS BELOW MAY REFLECT ANNUAL CASH PAYMENTS OR MULTIPLE YEARS OF ACCRUALS THAT VESTED IN 2021. MARTY BASSO $112,508 IN ADDITION TO THOSE LISTED ABOVE, RONALD PETERSON RECEIVED PAYMENT FROM A SUPPLEMENTAL RETIREMENT PROGRAM THAT WAS IN PLACE PRIOR TO 1986 AND SUBJECT TO DIFFERENT TAX RULES. MR. PETERSON ACCRUED BENEFITS OVER A 40+ YEAR CAREER AT JOHNS HOPKINS HEALTH SYSTEM AND THE BENEFIT HAS BEEN REPORTED ON THE FORM 990 TWICE ALREADY: ONCE WHEN ACCRUED AND AGAIN WHEN INCLUDED AS TAXABLE INCOME FOR MEDICARE TAX PURPOSES. BENEFITS ARE PAID AS AN ANNUITY TO MR. PETERSON OVER HIS REMAINING LIFETIME AND TAXED FOR INCOME TAX PURPOSES AS PAID. UNDER FORM 990 REPORTING REQUIREMENTS, MR. PETERSON'S BENEFIT IS REQUIRED TO BE REPORTED A THIRD TIME WHEN PAID. DURING 2021, MR. PETERSON RECEIVED A PAYMENT OF $1,275,825; THIS AMOUNT IS REPORTED IN SCHEDULE J, PART II, COLUMN (B)(III).
PART I, LINE 7 ANNUAL INCENTIVE PLAN: EXECUTIVES PARTICIPATE IN AN ANNUAL INCENTIVE PLAN THAT REWARDS PARTICIPANTS FOR THE ACHIEVEMENT OF ORGANIZATION OBJECTIVES APPROVED BY THE JOHNS HOPKINS MEDICINE COMPENSATION COMMITTEE EACH YEAR, INCLUDING FINANCIAL AND NON-FINANCIAL MEASURES. A PORTION OF THE OVERALL AWARD IS DETERMINED BASED ON INDIVIDUAL PERFORMANCE. DEPENDENT TUITION REIMBURSEMENT: DUE TO THEIR CLOSE COLLABORATION WITH THE JOHNS HOPKINS UNIVERSITY (JHU), JHHSC PROVIDES LEADERS WITH DEPENDENT TUITION REIMBURSEMENT ON A SIMILAR BASIS AS THEIR JHU COUNTERPARTS. DEPENDENT TUITION REIMBURSEMENT IS TAXABLE FOR JHHSC EMPLOYEES. THE DEPENDENT MUST BE ENROLLED FULL TIME AT AN APPROVED, ACCREDITED COLLEGE OR UNIVERSITY AND IN GOOD ACADEMIC STANDING. PAYMENT IS LIMITED TO FOUR YEARS OF FULL TIME, UNDERGRADUATE STUDY PER DEPENDENT CHILD. TUITION REIMBURSEMENT: TUITION REIMBURSEMENT IS AVAILABLE TO EMPLOYEES THAT WORK 20 HOURS OR MORE A WEEK FOR UP TO A MAXIMUM BENEFIT OF $10,000 PER ACADEMIC YEAR. TO RECEIVE REIMBURSEMENT, ELIGIBLE EMPLOYEES MUST PURSUE A COURSE OF STUDY AT AN ACCREDITED UNIVERSITY OR COLLEGE THAT LEADS TO A LICENSURE, DEGREE, OR MEETS THE NECESSITY RELATED TO CURRENT POSITION OR ANOTHER POSITION WITHIN THE ORGANIZATION.
Schedule J (Form 990) 2021

Additional Data


Software ID:  
Software Version:  
Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
Part I
Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e) Original principal amount (f) Balance due (g) In default? (h) Approved by board or committee? (i) Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990) 2021
Schedule L (Form 990) 2021
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) JOSHUA AMMERMAN
 
TRUSTEE 288,324 SEE PART VMR. AMMERMAN IS THE PRESIDENT AND HAS AN OWNERSHIP INTEREST IN WASHINGTON NEUROSURGICAL ASSOCIATES ("WNA"). SMH PAID WNA FOR ADMINISTRATIVE SERVICES.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990) 2021


Additional Data


Software ID:  
Software Version:  




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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
Return Reference Explanation
FORM 990, PART I, LINE 1 SIBLEY MEMORIAL HOSPITAL IN WASHINGTON, D.C., A MEMBER OF JOHNS HOPKINS MEDICINE, HAS A DISTINGUISHED HISTORY OF SERVING THE COMMUNITY SINCE ITS FOUNDING IN 1890. AS A NOT-FOR-PROFIT, FULL-SERVICE COMMUNITY HOSPITAL, SIBLEY OFFERS SURGICAL, OBSTETRIC, PSYCHIATRIC, ONCOLOGIC AND SKILLED NURSING INPATIENT SERVICES, AS WELL AS A 24-HOUR STATE-OF-THE-ART EMERGENCY DEPARTMENT. SIBLEY'S MISSION IS TO DELIVER EXCELLENCE AND COMPASSIONATE CARE -EVERY PERSON -EVERY TIME. SIBLEY'S VISION IS TO BE THE ROLE MODEL FOR INNOVATION IN HEALTHCARE AND WELLNESS FOR ALL. SIBLEY'S CORE VALUES ARE 1) EXCELLENCE & DISCOVERY, 2) LEADERSHIP AND INTEGRITY, 3) DIVERSITY & INCLUSION AND 4) RESPECT AND COLLEGIALITY.
FORM 990, PART I, LINE 8 PURSUANT TO THE CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT, SIBLEY MEMORIAL HOSPITAL, INC. RECOGNIZED $6,199,808 OF FUNDING FROM THE PROVIDER RELIEF FUND ADMINISTERED BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION, AN AGENCY OF THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES DURING FY22. THIS AMOUNT HAS BEEN RECOGNIZED AS GRANT REVENUE ON PART I, LINE 8 OF THE ORGANIZATION'S FORM 990.
FORM 990, PART III, LINE 1 SIBLEY MEMORIAL HOSPITAL IN WASHINGTON, D.C., A MEMBER OF JOHNS HOPKINS MEDICINE, HAS A DISTINGUISHED HISTORY OF SERVING THE COMMUNITY SINCE ITS FOUNDING IN 1890. AS A NOT-FOR-PROFIT, FULL-SERVICE COMMUNITY HOSPITAL, SIBLEY OFFERS SURGICAL, OBSTETRIC, PSYCHIATRIC, ONCOLOGIC AND SKILLED NURSING INPATIENT SERVICES, AS WELL AS A 24-HOUR STATE-OF-THE-ART EMERGENCY DEPARTMENT. SIBLEY'S MISSION IS TO DELIVER EXCELLENCE AND COMPASSIONATE CARE EVERY PERSON EVERY TIME. SIBLEY'S VISION IS TO BE THE ROLE MODEL FOR INNOVATION IN HEALTHCARE AND WELLNESS FOR ALL. SIBLEY'S CORE VALUES ARE 1) EXCELLENCE & DISCOVERY, 2) LEADERSHIP AND INTEGRITY, 3) DIVERSITY & INCLUSION AND 4) RESPECT AND COLLEGIALITY.
FORM 990, PART III, LINE 4A OUTPATIENT CANCER: THE CANCER SPECIALISTS AT SIBLEY MEMORIAL HOSPITAL PROVIDE SURGICAL, RADIATION AND MEDICAL ONCOLOGY SERVICES IN THE WASHINGTON, D.C. METRO AREA. AS PART OF THE SIDNEY KIMMEL COMPREHENSIVE CANCER CENTER, PATIENTS ARE ABLE TO RECEIVE THE WORLD RENOWNED TREATMENTS, INCLUDING CLINICAL TRIALS AND IMMUNOTHERAPY, OF JOHNS HOPKINS MEDICINE WITHOUT LEAVING THE REGION. SIBLEY'S ONCOLOGY DEPARTMENT IS PART OF THE ONLY CANCER CENTER IN MARYLAND TO CARRY THE NATIONAL CANCER INSTITUTE'S DESIGNATION AS A COMPREHENSIVE CANCER CENTER, AND ONE OF JUST 41 SUCH CENTERS IN THE U.S. THE CANCER CARE PROVIDED BY THE ONCOLOGY TEAM AT SIBLEY IS INTEGRATED WITH THE CENTER AT THE JOHNS HOPKINS HOSPITAL AND OTHER JOHNS HOPKINS ONCOLOGY LOCATIONS. THIS GIVES THE LOCAL TEAM OF PHYSICIANS ACCESS TO THE NEWEST THERAPIES, TREATMENTS AND RESEARCH TO ASSIST IN DEVELOPING AND DELIVERING A TREATMENT PLAN TAILORED TO PATIENTS' INDIVIDUAL NEEDS. SHOULD THE TREATMENT PLAN CALL FOR SURGERY, RADIATION THERAPY, OR OTHER SERVICES, OR TEAM WORKS WITH THE PATIENT TO COORDINATE EVERY ASPECT OF CARE. MEDICAL ONCOLOGY THE JOHNS HOPKINS KIMMEL CANCER CENTER AT SIBLEY MEMORIAL HOSPITAL BRINGS THE MOST ADVANCED SCIENCE AND MEDICINE, INCLUDING CUTTING EDGE IMMUNOTHERAPY AND CLINICAL TRIALS, TO THE REGION. OUR PHYSICIANS WORK WITH PHYSICIAN SCIENTISTS SO THAT NEW TREATMENTS CAN BE QUICKLY TRANSLATED FROM THE LAB TO PATIENTS. RADIATION ONCOLOGY THE RADIATION ONCOLOGY DEPARTMENT AT THE SIBLEY CANCER CENTER IS AN INNOVATIVE PROGRAM WITH NATIONALLY RECOGNIZED EXPERTS IN THE FIELD. DOCTORS AND STAFF WILL TAKE AS MUCH TIME AS NECESSARY TO HELP PATIENTS AND THEIR FAMILIES UNDERSTAND THEIR OPTIONS AND FEEL COMFORTABLE WITH THEIR CHOICES. ONCE THE PATIENT, ALONG WITH THEIR PHYSICIAN, HAVE AGREED TO MOVE FORWARD WITH RADIATION ONCOLOGY, THE NEXT STEPS IN IDENTIFYING THE BEST TREATMENT PLAN INVOLVES GETTING TO KNOW THE PATIENT AND THEIR FAMILY IN ORDER TO BEST UNDERSTAND THE PATIENT'S MEDICAL SITUATION. TO SCHEDULE THIS CONSULTATION WITH ONE OF OUR RADIATION ONCOLOGY SPECIALISTS, THE PATIENT NEEDS A REFERRAL FROM THEIR PRIMARY CARE PHYSICIAN OR FROM A MEDICAL SPECIALIST SUCH AS AN UROLOGIST, SURGEON, OR MEDICAL ONCOLOGIST. THE CONSULTATION PROCESS WILL DETERMINE IF RADIATION THERAPY WOULD BE BENEFICIAL FOR THE PATIENT. IF THE PATIENT IS A CANDIDATE FOR RADIATION THERAPY AND CONSENTS TO BEGIN TREATMENT, THE NEXT STEP IN THE CLINICAL PROCESS IS THE SCHEDULING OF A CT SIMULATION PROCEDURE. THE NURSING TEAM WILL CONTACT THE PATIENT WITH INSTRUCTIONS TO PREPARE FOR THE SIMULATION APPOINTMENT. SIBLEY OFFERS THE FOLLOWING RADIATION THERAPY OPTIONS: PROTON THERAPY (THE PROTON THERAPY CENTER IS ONE OF THE LARGEST AND MOST ADVANCED CENTERS IN THE U.S. WITH THREE TREATMENT ROOMS AND MORE THAN 30 SPECIALISTS, THE CENTER COMBINES THE UNSURPASSED EXPERTISE OF THE TEAM, INNOVATIVE TECHNOLOGY AND ADVANCEMENTS IN RESEARCH TO PROVIDE TAILORED CANCER TREATMENTS FOR CHILDREN AND ADULTS). CONVENTIONAL RADIATION THERAPY 3D CONFORMAL INTENSITY-MODULATED IMAGE-GUIDED BRACHYTHERAPY ACTIVE BREATHING COORDINATOR
FORM 990, PART III, LINE 4B PERIOPERATIVE SERVICES: PERFORMING WELL OVER 10,000 SURGERIES ANNUALLY, SIBLEY OFFERS A BROAD SPECTRUM OF INPATIENT AND OUTPATIENT SURGICAL SERVICES TO SERVE ITS PATIENTS. SURGEONS PROVIDE ADVANCED SURGICAL TREATMENTS INCLUDING MINIMALLY INVASIVE PROCEDURES AND PRECISE IMAGING TECHNOLOGY DURING OPERATIONS. OUTPATIENT SURGICAL PROCEDURES ARE GENERALLY PERFORMED AT THE AMBULATORY SURGERY CENTER LOCATED ADJACENT TO THE HOSPITAL WHILE SURGERIES REQUIRING AN OVERNIGHT STAY ARE PERFORMED AT THE MAIN OPERATING ROOM FACILITY. THE AMBULATORY SURGERY CENTER HAS 4 OPERATING ROOMS WHILE THE MAIN OPERATING ROOM FACILITY HAS 11 OPERATING ROOMS. SIBLEY IS THE AREA LEADER IN IMPLEMENTING ADVANCED MEDICAL TECHNOLOGY IN ITS OPERATING SUITES, INCLUDING HIGH-DEFINITION VIDEO TECHNOLOGY AND ROBOTICS. EXPERIENCED SURGICAL PERSONNEL WORK TOGETHER WITH LEADING SURGEONS TO PROVIDE CONSISTENT, EXCELLENT SURGICAL CARE. COMMON TYPES OF SURGICAL SERVICES PROVIDED INCLUDE BREAST SURGERY, GYNECOLOGY, HEPATO-PANCREATO-BILIARY SURGERY, NEUROSURGERY, OBSTETRICS, ORTHOPEDIC SURGERY, OTOLARYNGOLOGY-HEAD AND NECK SURGERY, PLASTIC SURGERY, SURGICAL ONCOLOGY, THORACIC SURGERY, THYROID AND PARATHYROID SURGERY AND VASCULAR SURGERY. SIBLEY IS ALSO RECOGNIZED LEADER IN ORTHOPEDICS. A LEADING NATIONAL HEALTHCARE RESEARCH ORGANIZATION RATED SIBLEY'S ORTHOPEDIC SERVICES AMONG THE BEST IN THE NATION. SIBLEY IS RANKED AMONG THE TOP 100 HOSPITAL PROGRAMS IN THE COUNTRY FOR HIP REPLACEMENT AND IS A BENCHMARK HOSPITAL FOR SUCCESSFUL HIP REPLACEMENT SURGERIES, ACCORDING TO HCIA. OVER 60 ARTHROSCOPIC SURGERIES ARE PERFORMED EACH WEEK AT SIBLEY. ENDOSCOPIC SERVICES ARE ALSO PROVIDED AT THE ENDOSCOPY SUITE AT SIBLEY. THERE IS A SIX-ROOM SUITE PROVIDING A FULL RANGE OF ENDOSCOPIC SERVICES TO INDIVIDUALS UNDERGOING DIAGNOSTIC OR THERAPEUTIC PROCEDURES ON AN OUTPATIENT OR INPATIENT BASIS. THE FACILITY OFFERS THE HIGHEST LEVEL OF QUALITY CARE FOR ITS PATIENTS BEFORE, DURING AND AFTER EXAMINATIONS. THE PHYSICIANS ARE ALL BOARD CERTIFIED AND THE SPECIALIZED NURSING STAFF IS HIGHLY TRAINED AND A.C.L.S CERTIFIED. SIBLEY'S COMMITMENT IS TO ENSURE THE SAFETY OF PATIENTS PROVIDING THE MOST TECHNOLOGICALLY ADVANCED POSSIBLE SETTING. THE PROCEDURE ROOMS ARE NEWLY EQUIPPED WITH STATE-OF-THE-ART EQUIPMENT, INCLUDING HIGH-DEFINITION ENDOSCOPES, DIGITAL IMAGING, FLAT SCREEN MONITORS AND COMPUTER-GENERATED REPORTS. THESE ALLOW PHYSICIANS TO DETECT, SAMPLE AND REMOVE ABNORMAL TISSUES EVEN SMALL AND HARD-TO-FIND FLAT OR SLIGHTLY RAISED POLYPS. A FULL RANGE OF SERVICES IS OFFERED ON THE UNIT TO DIAGNOSE, TREAT AND MANAGE DIGESTIVE AND RESPIRATORY DISORDERS, INCLUDING ESOPHAGEAL, GASTRIC, SMALL INTESTINE, COLONIC, RECTAL, LIVER, BILIARY TRACT, PANCREATIC AND LUNG. ENDOSCOPIC PROCEDURES OFFERED INCLUDE UPPER ENDOSCOPY, CAPSULE ENDOSCOPY, COLONOSCOPY, FLEXIBLE SIGMOIDOSCOPY, ERCP, ANORECTAL MANOMETRY, BRONCHOSCOPY, ENDOSCOPIC ULTRASOUND (EUS), AND ENDOBRONCHIAL ULTRASOUND (EBUS).
FORM 990, PART III, LINE 4C WOMAN/INFANT SERVICES: SIBLEY IS THE MOST TRUSTED HOSPITAL IN THE WASHINGTON D.C. AREA FOR MOMS AND DADS-TO-BE DELIVERING MORE BABIES THAN ANY OTHER HOSPITAL IN THE DISTRICT WITH OVER 4,000 DELIVERIES ANNUALLY. THE SPACE IS DESIGNED FROM THE GROUND UP TO DELIVER A SPECIAL BIRTHING EXPERIENCE THAT COMBINES EXCEPTIONAL COMFORT AND AMENITIES WITH THE LATEST MEDICAL TECHNOLOGY. THE MOTHER ALONG WITH HER PARTNER WILL LABOR, GIVE BIRTH AND RECOVER IN ONE LOCATION. AMENITIES IN EACH ROOM INCLUDE A BIRTHING BED, ROCKING AND RECLINING CHAIRS, TELEPHONE, TELEVISION AND A SHOWER WITH WATER MASSAGE. DEDICATED NURSES WORK ALONGSIDE THE PATIENT'S PHYSICIAN TO HELP THE PATIENT STAY COMFORTABLE AND TO OFFER EXPERT GUIDANCE AND SUPPORT DURING THE LABOR AND BIRTH OF THE CHILD AS WELL AS DURING RECOVERY. RIGHT AFTER THE BABY IS BORN, THE NURSE WILL PUT THE BABY ON THE MOTHER'S CHEST. THE FIRST HOURS OF SNUGGLING SKIN-TO-SKIN LET THE MOTHER AND HER BABY GET TO KNOW EACH OTHER. SIBLEY ALSO HAS INTERNATIONAL BOARD-CERTIFIED LACTATION CONSULTANTS WHO WILL VISIT THE PATIENT DURING THEIR STAY AND OFFER SPECIALIZED SUPPORT. BREASTFEEDING CLASSES ARE OFFERED DAILY. NEONATOLOGISTS AND NEONATAL NURSES ATTEND ALL COMPLICATED DELIVERIES AND COMPLETE AN INITIAL ASSESSMENT ON ALL NEWBORNS IN THE FIRST HOURS OF LIFE. IF THE BABY SHOULD REQUIRE SPECIALIZED MEDICAL CARE, SIBLEY'S SPECIAL CARE NURSERY HAS A TEAM OF EXPERIENCED NEONATAL NURSES AND NEONATOLOGISTS WHO ARE HERE 24-HOURS-A-DAY, SEVEN-DAYS-A-WEEK. THE SPECIAL CARE NURSERY IS EQUIPPED WITH ADVANCED TECHNOLOGY AND IS ABLE TO DELIVER OPTIMAL AROUND-THE-CLOCK CARE TO BABIES WITH SPECIAL MEDICAL NEEDS. PARENTS ARE WELCOME IN THE SPECIAL CARE NURSERY 24-HOURS-A-DAY AND ARE ENCOURAGED TO SPEND AS MUCH TIME AS POSSIBLE WITH THEIR BABY. CHILDBIRTH CLASSES ARE ALSO OFFERED AT SIBLEY AND ARE DESIGNED TO HELP EDUCATE PREGNANT WOMEN AND THEIR FAMILIES ABOUT OPTIONS DURING CHILDBIRTH AND HOW TO SUPPORT WOMEN DURING LABOR. CLASSES ARE TAUGHT BY CERTIFIED CHILDBIRTH EDUCATORS (CEE). THERE ARE MANY CHOICES FOR FIRST-TIME AND REPEAT PARENTS. PARENTS WILL HAVE AN OPPORTUNITY TO LEARN HOW TO PREPARE FOR LABOR AND BIRTH AND HOW TO CARE FOR THEIR NEWBORN IN THE FIRST WEEKS OF LIFE. MATERNAL-FETAL MEDICINE (MFM) SERVICES ARE ALSO OFFERED AT SIBLEY AND PROVIDE COMPREHENSIVE CARE TO WOMEN AND THEIR FAMILIES THROUGHOUT PREGNANCY. SIBLEY'S EXPERTS ARE SPECIALLY TRAINED TO CARE FOR WOMEN WITH HIGH-RISK PREGNANCIES, AND OFFER PRENATAL CARE, GENETIC COUNSELING, FETAL ULTRASOUND, AND DIAGNOSIS AND TREATMENT OF RARE PREGNANCY COMPLICATIONS. THE GOAL AS CAREGIVERS IS TO PROVIDE OUR PATIENTS WITH THE SUPPORT AND EDUCATION THAT THEY NEED TO DELIVER A HEALTHY BABY. MFM PROVIDES THE FOLLOWING SERVICES: ANTEPARTUM TESTING O BIOPHYSICAL PROFILE O NONSTRESS TEST (NST) FETAL ULTRASOUND AND DIAGNOSTIC PROCEDURES O AMNIOCENTESIS O COMBINED FIRST-TRIMESTER NUCHAL TRANSLUCENCY SCREENING O CVS O DOPPLER O FETAL ECHOCARDIOGRAPHY O FETAL NEUROSONOLOGY O OBSTETRIC ULTRASOUND GENETIC COUNSELING: PRENATAL DIAGNOSIS AND TREATMENT CENTER MATERNAL TRANSPORT PROGRAM
FORM 990, PART VI, SECTION A, LINE 6 JOHNS HOPKINS HEALTH SYSTEM CORPORATION, A IRC 501(C)(3) TAX EXEMPT ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF THE LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES.
FORM 990, PART VI, SECTION A, LINE 7A JOHNS HOPKINS HEALTH SYSTEM CORPORATION, A IRC 501(C)(3) TAX EXEMPT PARENT ORGANIZATION OF LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES ELECTS THE MAJORITY OF THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B THE GOVERNING BODY OF SIBLEY MEMORIAL HOSPITAL IS EMPOWERED BY ITS BY-LAWS TO MAKE CERTAIN DECISIONS; ALL OTHER DECISIONS ARE SUBJECT TO APPROVAL OF THE PARENT ORGANIZATION JOHNS HOPKINS HEALTH SYSTEM CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE FORM 990 WAS PROVIDED TO THE FINANCE COMMITTEE BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL HAS AN EXISTING POLICY WHICH SPECIFICALLY ADDRESSES POTENTIAL CONFLICT(S) OF INTEREST FOR DECISION MAKERS AT ALL LEVELS WITHIN ITS BORDERS. THIS COVERAGE INCLUDES MEMBERS OF THE GOVERNING BOARD, ADMINISTRATION, MEDICAL STAFF, AND ALL OTHER EMPLOYEES. DISCLOSURE FORMS ASKING FOR POTENTIAL CONFLICTS OF INTEREST ARE DISTRIBUTED AT LEAST ANNUALLY SO THAT APPROPRIATE ACTION MAY BE TAKEN TO ENSURE THAT SUCH POTENTIAL CONFLICTS DO NOT INFLUENCE IMPORTANT DECISIONS. THE HOSPITAL'S BOARD MEMBERS ARE ASKED TO SUBMIT DISCLOSURE FORMS SEMI-ANNUALLY AND ON A CASE-BY-CASE BASIS. THE GOVERNING BOARD, SENIOR MANAGEMENT, AND THE EXECUTIVE COMMITTEE OF THE MEDCAL STAFF (AS APPROPRATE) BEAR RESPONSIBILITY FOR ADDRESSING AND REVIEWING ALL POTENTIAL CONFLICTS AND TAKING APPROPRIATE ACTION. WHEN CONFLICTS DO ARISE, THE MATTER IS BROUGHT BEFORE THE APPROPRIATE GOVERNING BODY AND DISCUSSED, AND THE CONFLICT IS ELIMINATED.
FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES AN INDEPENDENT COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY, APPROVAL BY THE BOARD AND CONTEMPORANEOUS WRITTEN SUBSTANTIATION OF THE DECISION-MAKING PROCESS WHEN DETERMINING COMPENSATION FOR THE CEO AND OTHER OFFICERS OF THE ORGANIZATION.
FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY 338,731. NET ASSETS RELEASED FOR PPE 745,056. SMHF EQUITY INVESTMENT 16,167,983. RESTRICTED INTEREST -2,378.
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:  
Software Version:  
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
LUCY WEBB HAYES NATIONAL TRAINING SCHOOL
FOR DEACONESSES & MISSIONARIES
Employer identification number

53-0196602
Part I
Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Total income


(e)
End-of-year assets


(f)
Direct controlling
entity











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


(b)
Primary activity


(c)
Legal domicile (state
or foreign country)

(d)
Exempt Code section


(e)
Public charity status
(if section 501(c)(3))

(f)
Direct controlling
entity

(g)
Section 512(b)(13) controlled entity?
Yes No
(1)JOHNS HOPKINS HEALTH SYSTEM CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
52-1465301
SUPPORTING ORGANIZATION MD 501(C)(3) LINE 12C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(2)JOHNS HOPKINS BAYVIEW MEDICAL CENTER INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
52-1341890
HOSPITAL MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(3)JOHNS HOPKINS COMMUNITY PHYSICIANS INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
52-1467441
HEALTHCARE SERVICES MD 501(C)(3) LINE 12C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(4)JOHNS HOPKINS MEDICAL SERVICES CORPORATION
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
52-1232569
HEALTHCARE SERVICES MD 501(C)(3) LINE 12B, II JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(5)THE JOHNS HOPKINS HOSPITAL
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
52-0591656
HOSPITAL MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(6)SUBURBAN HOSPITAL HEALTHCARE SYSTEM INC
8600 OLD GEORGETOWN ROAD

BETHESDA,MD20814
52-2052354
HEALTHCARE SERVICES MD 501(C)(3) LINE 12C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(7)SUBURBAN HOSPITAL INC
8600 OLD GEORGETOWN ROAD

BETHESDA,MD20814
52-0610545
HOSPITAL MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(8)HOWARD COUNTY GENERAL HOSPITAL INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
52-2093120
HOSPITAL MD 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(9)THE STACY MARK REED FOUNDATION
5255 LOUGHBORO ROAD NW

WASHINGTON,DC20016
27-3818765
FINANCIAL SUPPORT DC 501(C)(3) LINE 12B, II LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES
 
Yes
 
(10)SIBLEY MEMORIAL HOSPITAL FOUNDATION
5255 LOUGHBORO ROAD NW

WASHINGTON,DC20016
45-0562642
FINANCIAL SUPPORT DC 501(C)(3) LINE 7 LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES
 
Yes
 
(11)THE JANE BANCROFT ROBINSON FOUNDATION
5255 LOUGHBORO ROAD NW

WASHINGTON,DC20016
27-3818431
FINANCIAL SUPPORT DC 501(C)(3) LINE 12C, III-FI LUCY WEBB HAYES NATIONAL TRAINING SCHOOL FOR DEACONESSES & MISSIONARIES
 
Yes
 
(12)POTOMAC HOME SUPPORT INC
6001 MONTROSE ROAD NO 1020

ROCKVILLE,MD20852
52-1750383
HOME HEALTH CARE MD 501(C)(3) LINE 12B, II N/A
 
No
(13)SIBLEY SUBURBAN HOME HEALTH AGENCY
6001 MONTROSE ROAD NO 307

ROCKVILLE,MD20852
52-1450142
HOME HEALTH CARE MD 501(C)(3) LINE 10 POTOMAC HOME SUPPORT INC
 
 
No
(14)PEDIATRIC PHYSICIAN SERVICES INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
59-3425191
PEDIATRIC MEDICAL SERVICES FL 501(C)(3) LINE 10 ALL CHILDREN'S HEALTH SYSTEM INC
 
 
No
(15)JOHNS HOPKINS ALL CHILDREN'S FOUNDATION INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
59-2481738
FOUNDATION FL 501(C)(3) LINE 7 ALL CHILDREN'S HEALTH SYSTEM INC
 
 
No
(16)JOHNS HOPKINS ALL CHILDREN'S HOSPITAL INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
59-0683252
HOSPITAL FL 501(C)(3) LINE 3 JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(17)ALL CHILDREN'S RESEARCH INSTITUTE INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
59-2481742
RESEARCH FL 501(C)(3) LINE 4 ALL CHILDREN'S HEALTH SYSTEM INC
 
 
No
(18)KIDS HOME CARE INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
59-3476049
HOME HEALTH CARE FL 501(C)(3) LINE 10 ALL CHILDREN'S HEALTH SYSTEM INC
 
 
No
(19)WEST COAST NEONATOLOGY INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
59-3398308
HEALTHCARE SERVICES FL 501(C)(3) LINE 10 ALL CHILDREN'S HEALTH SYSTEM INC
 
 
No
(20)ALL CHILDREN'S HEALTH SYSTEM INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
59-2481740
MANAGEMENT SERVICES FL 501(C)(3) LINE 12C, III-FI JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
 
No
(21)SUBURBAN HOSPITAL FOUNDATION INC
8600 OLD GEORGETOWN ROAD

BETHESDA,MD20814
52-2019696
FUNDRAISING/SUPPORTING ORGANIZATION MD 501(C)(3) LINE 12A, I SUBURBAN HOSPITAL INC
 
 
No
(22)HOWARD HOSPITAL FOUNDATION INC
3910 KESWICK RD SOUTH BLDG 4TH FL S

BALTIMORE,MD21211
52-1072778
FUNDRAISING/SUPPORTING ORGANIZATION MD 501(C)(3) LINE 12C, III-FI HOWARD COUNTY GENERAL HOSPITAL
 
 
No
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
(1) OPHTHALMOLOGY ASSOCIATES LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-1890957
OPHTHALMOLOGY SERVICES MD N/A
        No     No  
(2) JOHNS HOPKINS HEALTHCARE LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-1899357
MEDICAL SERVICES MD N/A
        No     No  
(3) JHMI UTILITIES LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
20-2814243
UTILITY FACILITIES MD N/A
        No     No  
(4) JOHNS HOPKINS MEDICINE INTERNATIONAL LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-2144849
MEDICAL SVCS MD N/A
        No     No  
(5) HOWARD COUNTY NEONATAL SERVICES SERIES

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-2239401
NEONATAL HEALTH MD N/A
        No     No  
(6) JOHNS HOPKINS SURGERY CENTER SERIES

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
20-8707724
SURGERY MD N/A
        No     No  
(7) WEST COUNTY MEDICAL LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
27-5234888
REAL ESTATE MD N/A
        No     No  
(8) JOHNS HOPKINS MEDICINE ALLIANCE FOR PATIENTS

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
46-2866692
HEALTHCARE SVC MD N/A
        No     No  
(9) HEALTHCARE SUPPLY CHAIN INNOVATIONS LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
47-2509307
GROUP PURCHASING MD N/A
        No     No  
(10) JOHNS HOPKINS HEALTH CARE AND SURGERY CENTER DEVELOPMENT LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
82-1388814
LEASING REAL PROPERTY MD N/A
        No     No  
(11) MARYLAND HEALTH ADVANTAGE LLC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
81-3898700
HOLDING COMPANY DE N/A
        No     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) HSI MEDICAL SERVICES CORPORATION

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-1847705
HEALTHCARE-SLEEP DIAGNOSTICS MD N/A
C         No
(2) HOWARD COUNTY HEALTH SERVICES INC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-1434783
HEALTHCARE MANAGEMENT MD N/A
C         No
(3) JOHNS HOPKINS MEDICAL MANAGEMENT CORPORATION

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-1250028
NURSING SERVICES MD N/A
C         No
(4) JOHNS HOPKINS EMPLOYER HEALTH PROGRAM

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-1947678
BENEFIT PLANS MD N/A
C         No
(5) TCAS INC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
52-1979344
NURSING SERVICES MD N/A
C         No
(6) SUBURBAN HEALTH ENTERPRISES INC

8600 OLD GEORGETOWN ROAD
BETHESDA,MD20814
52-2052352
MEDICAL OFFICE LEASING AND RELEASING MD N/A
C         No
(7) SSA HOLDCO INC

3910 KESWICK RD SOUTH BLDG 4TH FL S
BALTIMORE,MD21211
81-1040476
INVESTMENT PA JOHNS HOPKINS HEALTH SYSTEM CORPORATION
 
C         No
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
 
No
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
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
Yes
 
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
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
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
 
No
o Sharing of paid employees with related organization(s) ............................
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses ............................
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses ............................
1q
Yes
 
r Other transfer of cash or property to related organization(s) ............................
1r
Yes
 
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) THE JANE BANCROFT ROBINSON FOUNDATION

B 6,877,622 FMV
(2) THE JANE BANCROFT ROBINSON FOUNDATION

C 415,000 FMV
(3) THE JANE BANCROFT ROBINSON FOUNDATION

Q 1,299,149 FMV
(4) SIBLEY MEMORIAL HOSPITAL FOUNDATION

Q 13,235,021 FMV
(5) STACY MARK REED FOUNDATION

C 24,438,231 FMV

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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