TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) MARK A WALLACE BOARD MEMBER / CHAIR / PRESIDENT / CEO	36.0 ................. 4.0	X	X		7,963,997	0	883,136
(2) CATHERINE GORDON MD BOARD MEMBER THROUGH 04/26/2022 / PHYSICIAN / IN-CHIEF	1.0 ................. 4.0	X			0	0	0
(3) DANIEL R DIPRISCO BOARD MEMBER / EXECUTIVE VICE PRESIDENT	38.0 ................. 2.0	X			1,524,741	0	313,766
(4) DEAN B ANDROPOULOS MD BOARD MEMBER / PHYSICIAN / IN-CHIEF	1.0 ................. 2.0	X			138,300	0	234,300
(5) ERIC K WILLIAMS MD BOARD MEMBER	1.0 ................. 2.0	X			0	0	0
(6) JACQUELINE R WARD BOARD MEMBER / SENIOR VICE PRESIDENT / CHIEF NURSING OFFICER	40.0 ................. 0	X			1,004,393	0	112,908
(7) James Versalovic MD PHD BOARD MEMBER / PHYSICIAN / IN-CHIEF	1.0 ................. 3.0	X			149,100	0	421,000
(8) Jeffrey Shilt MD BOARD MEMBER AS OF 04/27/2022 / PHYSICIAN	1.0 ................. 2.0	X			0	0	0
(9) Lara Shekerdemian MD BOARD MEMBER AS OF 04/27/2022	1.0 ................. 2.0	X			0	0	0
(10) Larry Hollier MD BOARD MEMBER / PHYSICIAN / IN-CHIEF	1.0 ................. 2.0	X			1,339,926	0	0
(11) MARK W MULLARKEY BOARD MEMBER / EXECUTIVE VICE PRESIDENT	27.0 ................. 13.0	X			1,995,786	0	403,207
(12) MICHAEL A BELFORT MD PHD BOARD MEMBER / PHYSICIAN / IN-CHIEF	1.0 ................. 3.0	X			184,200	0	312,150
(13) MICHELLE M RILEY-BROWN BOARD MEMBER / EXECUTIVE VICE PRESIDENT	36.0 ................. 4.0	X			2,002,384	0	441,553
(14) THIERRY HUISMAN MD BOARD MEMBER / PHYSICIAN / IN-CHIEF	1.0 ................. 39.0	X			0	868,276	445,397
(15) WELDON W GAGE BOARD MEMBER / EXECUTIVE VICE PRESIDENT / CHIEF FINANCIAL OFFICER	39.0 ................. 1.0	X			2,285,833	0	469,997
(16) LANCE A LIGHTFOOT BOARD SECRETARY / SENIOR VICE PRESIDENT	32.0 ................. 8.0		X		1,570,769	0	351,599
(17) IVETT T SHAH SENIOR VICE PRESIDENT THROUGH 09/28/2022	39.0 ................. 1.0			X	920,577	0	85,397

(A) Name and business address	(B) Description of services	(C) Compensation
BAYLOR COLLEGE OF MEDICINE 1 BAYLOR PLAZA HOUSTON,TX77030	PHYSCN & FACULTY SVC	83,700,661
MCKESSON PLASMA AND BIOLOGICS LLC 16578 COLLECTIONS CENTER DRIVE CHICAGO,IL60693	HEALTH SOLUTIONS	52,682,728
TRUSTED HEALTH INC 604 MISSION ST STE 500 SAN FRANCISCO,CA94105	EMPLOYMENT AGENCY	21,209,769
KINETIX LLC 50 GLENLAKE PKWY STE 625 ATLANTA,GA30328	RECRUITING SERVICES	9,086,218
WORLD WIDE TECHNOLOGY 1 WORLD WIDE WAY ST LOUIS,MO63146	INFORMATION TECHNOLOGY SERVICES	6,198,974
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 255

- TIN:

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

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

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

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

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

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

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

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

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

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

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

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

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

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 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)		(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)		(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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

Schedule A (Form 990) 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)		(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)		(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.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

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

Schedule A (Form 990) 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

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

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

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

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

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

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

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

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

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

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

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

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

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

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).

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

Did one or more disqualified persons (as defined 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.

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.

10a

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

10a

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

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

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

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

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

11b

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

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

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

Section C. Type II Supporting Organizations

Yes

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

Section D. All Type III Supporting Organizations

Yes

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

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

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

Section E. Type III Functionally-Integrated Supporting Organizations

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

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

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

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

Activities Test. Answer lines 2a and 2b below.

Yes

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

Did the activities described 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.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

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

Schedule A (Form 990) 2021

Page 6

Part V

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

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

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

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

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

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

Schedule A (Form 990) 2021

Page 7

Part V

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

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

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

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

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

OMB No. 1545-0047

2021

Name of the organization

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization TEXAS CHILDREN'S HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization TEXAS CHILDREN'S HOSPITAL		Employer identification number 74-1100555

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 TEXAS CHILDREN'S HOSPITAL			Employer identification number 74-1100555
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2021)

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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 Bullet

Go 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

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

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

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

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

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

Yes No

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

Yes No

If "Yes," describe in Part IV.

Part I-C

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

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

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

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

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

Yes No

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

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

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

Cat. No. 50084S

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 Bullet

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

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

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

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

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

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

Yes

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

Yes

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

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

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

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

Yes

432,296

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

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

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

Yes

54,286

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

486,582

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

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

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	TEXAS CHILDREN'S HOSPITAL (TCH) MAINTAINS A GOVERNMENT RELATIONS DEPARTMENT THAT ADVOCATES FOR PUBLIC POLICY AT THE LOCAL, STATE, AND FEDERAL LEVEL. TCH SUPPORTS POLICIES THAT PROMOTE THE HEALTH OF CHILDREN AND WOMEN, BUILD HIGH QUALITY PEDIATRIC AND WOMEN'S HEALTHCARE SYSTEMS, AND ADVOCATE FOR HEALTH COVERAGE FOR CHILDREN AND WOMEN. IN ADDITION TO ADVOCACY, THE GOVERNMENT RELATIONS DEPARTMENT PROVIDES EDUCATION ON THE UNIQUE NEEDS OF PEDIATRIC AND WOMEN'S HEALTHCARE PATIENTS AND FAMILIES. TEXAS CHILDREN'S HOSPITAL PAID DUES TO THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH) AND TEXAS HOSPITAL ASSOCIATION (THA), OF WHICH A PORTION WAS ATTRIBUTABLE TO LOBBYING ACTIVITIES.

Return Reference

Explanation

Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY

TEXAS CHILDREN'S HOSPITAL (TCH) MAINTAINS A GOVERNMENT RELATIONS DEPARTMENT THAT ADVOCATES FOR PUBLIC POLICY AT THE LOCAL, STATE, AND FEDERAL LEVEL. TCH SUPPORTS POLICIES THAT PROMOTE THE HEALTH OF CHILDREN AND WOMEN, BUILD HIGH QUALITY PEDIATRIC AND WOMEN'S HEALTHCARE SYSTEMS, AND ADVOCATE FOR HEALTH COVERAGE FOR CHILDREN AND WOMEN. IN ADDITION TO ADVOCACY, THE GOVERNMENT RELATIONS DEPARTMENT PROVIDES EDUCATION ON THE UNIQUE NEEDS OF PEDIATRIC AND WOMEN'S HEALTHCARE PATIENTS AND FAMILIES. TEXAS CHILDREN'S HOSPITAL PAID DUES TO THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH) AND TEXAS HOSPITAL ASSOCIATION (THA), OF WHICH A PORTION WAS ATTRIBUTABLE TO LOBBYING ACTIVITIES.

Schedule C (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


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

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

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

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

Yes No

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

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

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

Yes No

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

Part III

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

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

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

(i)

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

(ii)

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

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

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

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....	222,836,472	201,207,680	185,987,863	185,000,713	160,839,511
b	Contributions ...	5,802,275	7,327,318	7,506,964	6,077,225	13,640,542
c	Net investment earnings, gains, and losses	-35,377,485	22,980,171	16,097,647	2,446,808	17,439,098
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....	9,303,736	8,678,697	8,384,794	7,536,883	6,918,438
g	End of year balance ......	183,957,526	222,836,472	201,207,680	185,987,863	185,000,713

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

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

100 %

Term endowment SchDMd Bullet

0 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	0	159,112,150		159,112,150
b	Buildings ....	0	1,674,044,594	497,288,494	1,176,756,100
c	Leasehold improvements	0	56,438,515	41,065,375	15,373,140
d	Equipment ....	0	1,907,227,826	1,288,173,650	619,054,176
e	Other .....	0	332,443,324	106,460,687	225,982,637
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..					2,196,278,203

Schedule D (Form 990) 2021

Page 3

Part VII

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

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

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.)

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)INVESTMENT IN TEXAS CHILDREN'S HOSPITAL FOUNDATION
(2)TCH INSURANCE COMPANY REBATE RECEIVABLE
(3)MISC RECEIVABLES
(4)PREPAID MISSION SUPPORT
(5)DUE FROM AFFILIATES
(6)DISPROPORTIONATE RECEIVABLE
(7)WAIVER RECEIVABLE
(8)BREAKDOWN IN PROCESS
(9)INVESTMENT IN TEXAS CHILDREN'S HOSPITAL FOUNDATION				2,400,361,854
(10)TCH INSURANCE COMPANY REBATE RECEIVABLE				51,424,987
(11)MISC RECEIVABLES				76,855,938
(12)INTEREST RATE SWAP				5,720,226
(13)DUE FROM AFFILIATES				189,143,682
(14)WAIVER RECEIVABLE				15,867,681
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				2,739,374,368

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
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	393,273,114
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

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference	Explanation
Schedule D, Part V, Line 4 Intended uses of endowment funds	TEXAS CHILDREN'S HOSPITAL ENDOWMENT FUNDS ARE PERMANENTLY RESTRICTED FUNDS IN WHICH THE PRINCIPAL IS HELD IN PERPETUITY AND INVESTED FOR GROWTH AND THE INCOME GENERATED IS CONSUMED IN THE FURTHERANCE OF TEXAS CHILDREN'S EXEMPT PURPOSE.
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS AS OF SEPTEMBER 30, 2022 OR 2021.

Schedule D (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Attach to Form 990. Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

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

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

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

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

Yes

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

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

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	Sub-Saharan Africa	0	0	Program Services	Patient care services	4,195,284
	Europe (Including Iceland and Greenland)	0	0	Program Services	Patient Care Services	731,690















3a	Sub-total ....	0	0			4,926,974
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	0			4,926,974

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2021

Schedule F (Form 990) 2021

Page 2

Part II

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

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

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

Schedule F (Form 990) 2021

Schedule F (Form 990) 2021Page 3

Part III

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

Part III can be duplicated if additional space is needed.

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

Schedule F (Form 990) 2021

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2021

Page 5

Part V

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

ReturnReference	Explanation
Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements	EUROPE (INCLUDING ICELAND AND GREENLAND)-Accrual; SUB-SAHARAN AFRICA-Accrual

Schedule F (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

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

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

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

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

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

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

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

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

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

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)		(ii) Activity	(iii) Did fundraiser have custody or control of contributions?		(iv) Gross receipts from activity	(v) Amount paid to (or retained by) fundraiser listed in col. (i)	(vi) Amount paid to (or retained by) organization
			Yes	No
	COMMUNITY COUNSELING SERVICE 527 MADISON AVENUE FIFTH FLOOR NEW YORK, NY10022	CAMPAIGN MANAGEMENT SERVICES		No		114,339	-114,339
	CATHEXIS PARTNERS 122 CELEBRATION BLVD CELEBRATION, FL34747	IT SERVICES		No		65,694	-65,694
	WARD & AMES SPECIAL EVENTS 7500 SAN FELIPE STE 350 HOUSTON, TX77063	EVENT COORDINATOR		No		230,554	-230,554
	RKD GROUP 3400 WATERVIEW PARKWAY RICHARDSON, TX75080	DIRECT MAIL		No		2,498,879	-2,498,879
	DINI SPHERIS 2727 ALLEN PARKWAY STE 1650 HOUSTON, TX77019	FUNDRAISING CONSULTING SERVICES		No		132,684	-132,684
	CHILDREN'S MIRACLE NETWORK HOSPITALS 205 W 700 ST SALT LAKE CITY, UT84101	FUNDRAISING		No		592,725	-592,725




Total . . . . . . . . . . . . . . . . . . . .					0	3,634,875	-3,634,875

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

CA, CO, CT, DE, FL, GA, AL, HI, ID, IL, IN, IA, KS, KY, LA, ME, AK, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, OR, PA, AZ, RI, SC, SD, TN, TX, UT, VT, VA, AR, WA, WV, WI, WY

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

Cat. No. 50083H

Schedule G (Form 990) 2021

Page 2

Part II

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

		(a) Event #1 BAD PANTS GOLF TOURNAMENT (event type)	(b) Event #2 AN EVENING WITH BASEBALL LEGENDS (event type)	(c) Other events 2 (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	393,325	687,535	507,977	1,588,837
2	Less: Contributions . . . .	306,925	624,791	479,782	1,411,498
3	Gross income (line 1 minus line 2) . . . . . .	86,400	62,744	28,195	177,339

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	135,372	337,207	119,977	592,556
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .				592,556
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .				-415,217

Part III

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

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

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

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

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

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

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

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

YesNo

If "No," explain:

10a

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

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

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

YesNo

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

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

YesNo

Indicate the percentage of gaming activity conducted in:

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

13a

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

13b

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

Name

Address

15a

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

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

YesNo

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

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

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

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

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

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

YesNo

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

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

Part IV

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

Return Reference	Explanation

Schedule G (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

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

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

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

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

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

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .			30,813,924	1,047,270	29,766,654	0.91 %
b	Medicaid (from Worksheet 3, column a) . . . . .			1,624,188,085	1,099,409,577	524,778,508	16.11 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .			35,031,660	14,727,599	20,304,061	0.62 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	1,690,033,669	1,115,184,446	574,849,223	17.64 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			21,608,910	4,302,197	17,306,713	0.53 %
f	Health professions education (from Worksheet 5) . . .			65,822,521	4,612,544	61,209,977	1.88 %
g	Subsidized health services (from Worksheet 6) . . . .			16,847,514	6,779,174	10,068,340	0.31 %
h	Research (from Worksheet 7) .			119,294,534	33,722,464	85,572,070	2.63 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .			8,349,849	162,390	8,187,459	0.25 %
j	Total. Other Benefits . .	0	0	231,923,328	49,578,769	182,344,559	5.60 %
k	Total. Add lines 7d and 7j .	0	0	1,921,956,997	1,164,763,215	757,193,782	23.24 %

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	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing			0	0	0 %
2	Economic development			72,900	72,900	0 %
3	Community support			195,403	195,403	0.01 %
4	Environmental improvements			0	0	0 %
5	Leadership development and training for community members			150,000	150,000	0 %
6	Coalition building			750	750	0 %
7	Community health improvement advocacy			46,797	46,797	0 %
8	Workforce development			0	0	0 %
9	Other			92,500	92,500	0 %
10	Total	0	0	558,350	558,350	0.02 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

7,861,862

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

9,448,819

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

-1,586,957

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

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

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

Yes

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

Yes

Part IV

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

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

Schedule H (Form 990) 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)
1	TEXAS CHILDREN'S HOSPITAL 6621 FANNIN STREET HOUSTON,TX77030 WWW.TEXASCHILDRENS.ORG 000117	X	X	X	X	X	X

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)

	TEXAS CHILDREN'S 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):

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

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

Yes

6 a

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

Yes

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

Yes

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

Yes

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

Hospital facility’s website (list url): https://www.texaschildrens.org/about-us/community-benefit-efforts/reports-community-health-needs

Other website (list url):

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

Other (describe in Section C)

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

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

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

Yes

If "Yes" (list url): https://www.texaschildrens.org/about-us/community-benefit-efforts/reports-community-health-needs

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	TEXAS CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

See Part VI

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

See Part VI

A plain language summary of the FAP was widely available on a website (list url):
See Part VI

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	TEXAS CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 7

Part VFacility Information (continued)

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

	TEXAS CHILDREN'S HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 3E	Prioritized Community Health Needs Texas Children's identified four key health needs through an extensive process including but not limited to key informant interviews, focus groups and community meeting surveillance. A team of graduate students from the UTHealth School of Public Health then utilized extant data sources and academic literature to investigate each of these health needs. The findings were brought before the hospital's Community Benefits Workgroup (CBW) on July 15, 2022, for guidance on prioritizing them from the hospital's Network of Care perspective. The CBW consists of physicians and administrative leaders across the Texas Children's Network of Care, who provide critical guidance to the Community Benefits Department regarding community health issues. Their guidance is shaped by the institution's mission to create a healthier future for children and women throughout our global community by leading in patient care, education and research. It is also shaped by the four core values of Texas Children's: to embrace freedom, lead tirelessly, live compassionately and amplify unity.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Texas Children's Hospital. To assess the health needs of the community that Texas Children's serves, a Community Health Needs Assessment (CHNA) team was established, which included members from the Texas Children's Community Benefits department, a consultant from The University of Texas School of Public Health and UT Public Health students from Fundamentals and Applications of Geographic Information Systems (GIS) and Community Assessment Methods classes from the Fall 2021 through Fall 2022 semesters. The CHNA team embarked on a year and a half-long effort to solicit and consider input from persons who represent the broad interests of Greater Houston, including those with special knowledge of or expertise in public health. This involved a host of qualitative data-gathering efforts, which included key informant interviews, focus groups and community meeting surveillance. Key Informant Interviews The CHNA team engaged with more than 20 organizations in Greater Houston that represent the broad interests of the community Texas Children's serves. These organizations represented a variety of sectors that interface with vulnerable populations. After establishing rapport with representatives from each organization and describing the CHNA project, the team invited each partner to participate in a recorded virtual interview. Trained interviewers from the team used the Key Informant Interview Guide (Appendix A), developed from previous CHNAs, updated with time relevant questions, to ensure consistency and validity and utilized probing questions to further detail as needed when conducting the interviews. These key informant interviews were conducted for approximately 30-60 minutes. Questions included background of the interviewees' organizations, community health status and concerns, healthy living, access to health care and social services, COVID-19's impact on access to health care and social services and community health issues, ways to improve community health and advice for Texas Children's team members as they develop their community health implementation strategy for 2023-2025 to address top health concerns. Qualitative data was coded using descriptive and in vivo codes to generate prominent themes that arose in the data (see Analysis). Each interview recording was run through Cisco WebEx's text to speech software, which produced a written transcript for each interview as well as word clouds of the most used words/phrases for key questions. Focus Groups The CHNA team also conducted focus groups with community members who represent the broad interests of the Texas Children's service area. These focus groups were aimed at collecting qualitative data. The team planned, scheduled, coordinated and facilitated these focus groups according to the project timeline, utilizing virtual meeting platforms to ensure participants' safety while including as many community voices as possible. Community Meeting Surveillance The CHNA team reviewed and documented the findings of several community-based meetings to understand community health needs and issues within the Texas Children's service area. The Community Meeting Surveillance Guide (Appendix C) was utilized as a guide to collect information at meetings such as relevant issues and topics specifically referring to underserved women and children. These meetings included several community meetings for the Mayor's Complete Communities Initiative. Ongoing Participation in Local Community Health Initiatives Texas Children's Department of Community Benefits participates in several community health initiatives, workgroups, and councils throughout Greater Houston providing ongoing insight into the health needs of the communities we serve.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - Texas Children's Hospital. To assess the health needs of the community that Texas Children's serves, a Community Health Needs Assessment (CHNA) team was established, which included members from the Texas Children's Community Benefits department, a consultant from The University of Texas School of Public Health and UT Public Health students from Fundamentals and Applications of GIS and Community Assessment Methods classes from the Fall 2021 through Fall 2022 semesters. No other hospital facilities were involved in these efforts.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - Texas Children's Hospital. The CHNA was conducted with The University of Texas School of Public Health.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Texas Children's Hospital. HOW TEXAS CHILDREN'S IS ADDRESSING NEEDS IDENTIFIED IN ITS 2022 CHNA Texas Children's 2022 Community Health Needs Assessment identified four key community health issues needing specific Hospital expertise and resources, prioritized in the following order: 1. Mental and Behavioral Health 2. Social Determinants of Health a. Economic stability b. Food insecurity c. Access to care d. Health literacy 3. Maternal Health 4. Chronic Disease and Unhealthy Lifestyle Texas Children's is addressing these needs by employing the strategies outlined in the Texas Children's 2023-2025 Community Health Implementation Strategy. This strategy, developed by the CBW and reviewed and endorsed by the Board of Trustees, presents current actions Texas Children's is taking to address these needs in addition to proposed actions and strategies. Mental and Behavioral Health Current and planned actions to address this issue: Action 1 - Support the community with resources, evidence-based tools, and trainings in prevention and early intervention in mental and behavioral health. * Through clinical services, training and education, research and community programs, the Division of Public Health Pediatrics is leading a larger effort to reframe how children and families receive care and services that mitigate adversities and that foster resilience within our community. Texas Children's Hospital offers trainings related to behavioral health in the community through partnerships with Public Health Pediatrics and the Behavioral Health department. * The Gatekeeper Training program was specially designed to teach Texas Children's and Baylor College of Medicine employees how to identify warning signs of suicide and to provide tools for navigating these difficult situations. More than 13,000 team members have completed this training and report feeling more comfortable about engaging in challenging conversations related to suicide. All new onboarding employees receive this as required training as well. * Texas Children's Health Plan is establishing partnerships with Aldine ISD and additional Houston area school systems to provide education on mental health for adolescents. Action 2 - Explore the logistics of continuing and expanding services provided in current Texas Children's mental and behavioral health programs. * Texas Children's Hospital and The Menninger Clinic have partnered to address the mental health epidemic adolescents are facing in the wake of the COVID-19 pandemic and crisis warnings sounded by the U.S. Surgeon General. This new affiliation will expand access to inpatient care for Houston patients ages 12 to 17 experiencing a behavioral health crisis. * Texas Children's is expanding behavioral health services in the Greater Houston area. Recent philanthropic support has allowed Texas Children's to hire behavioral health specialists in Texas Children's Pediatrics (TCP) practices in Fort Bend County. The ultimate goal is to add more behavioral health specialists in TCP practices throughout the Greater Houston area. * Texas Children's Behavioral Support team supports partnerships with the community and care management to establish community connections for discharge planning, including school partnerships, community providers for therapeutic and psychiatric needs and long-term care facilities when indicated. Action 3 - Support initiatives, programs and screenings to increase identification of mental and behavioral health issues. Expanded suicide risk screening has proven to optimize identification of adults and children at risk of suicide (Bryan et al., 2023). * Texas Children's screens patients for suicide ideation in inpatient areas, Emergency Centers and Behavioral Health care clinics and locations. * Texas Children's Government Relations continues to identify opportunities for Texas Children's physician experts and leaders to advocate at the state legislature by participating in various committee hearings with a focus on pediatric mental health in Texas. * At the federal level, Texas Children's is actively engaged in advocacy on the following legislative proposals: S. 4472, Health Care Capacity for Pediatric Mental Health Act H.R. 4943, Children's Mental Health Infrastructure Act H.R. 4944, Helping Kids Cope Act H.R. 7236, Strengthening Kids Mental Health Now Act Social Determinants of Health Current and planned actions to address this issue: Action 1 - Support programs and partnerships that improve quality of life and health outcomes across communities living in poverty. Research shows socioeconomic factors alone may account for 47% of health outcomes, while health behaviors, clinical care and the physical environment account for 34%, 16% and 3% of health outcomes, respectively (Whitman et al., 2022). * In response to community needs and community feedback, in 2022 the Division of Public Health Pediatrics launched upSTART, a suite of community-based programs offered to families with young children that addresses early brain development, social determinants of health, mental health and maternal health. Licensed nurses, social workers, community health workers, speech-language pathologists and parent educators work together to provide education and training and connect families to community resources. * Texas Children's plans to establish a strategic partnership with a non-profit or community agency which addresses food insecurity in the Greater Houston Area. Action 2 - Support efforts to screen families for social determinants of health and connect families to resources. * Findhelp.org is a free-for-use search engine to connect social services providers with the people they serve. Using zip code information, it connects users with a list of social service categories including food, housing, care, and transit. This tool facilitates referrals, establishes connections and supports quick follow-up and close referral loops. * The Center for Child Health Policy and Advocacy received grant funding through Episcopal Health Foundation which allowed implementation of a bundle of interventions to improve neurocognitive and developmental outcomes in young children at risk for health inequities. This bundle will use an intergenerational care model, focused on the needs of young children and their parents, to maximize benefits to the child. Two major upstream factors significantly associated with poor neurocognitive and developmental outcomes in children will be addressed - maternal mental health and household food insecurity. The program includes integrated screening for food insecurity, social needs, and mental health needs with direct connections to behavioral health clinicians and/or Houston Food Bank Navigators (respectively). Action 3- Participate in community-based collaborative efforts to support access to basic needs and social determinants of health. * Drs. Claire Bocchini and Michelle Lopez are members of the Board of Directors of CHILDREN AT RISK, a non-partisan research and advocacy nonprofit dedicated to understanding and addressing the root causes of child poverty and inequality. Established in 1989 by Houston child advocates and researchers, it has grown into a statewide organization tackling Texas children's and families' most pressing needs. Texas Children's Hospital has been a continuing sponsor for CHILDREN AT RISK, contributing to ongoing initiatives such as this. * Dr. Nancy Correa sits on the Steering Committee of the Health Equity Collective, a multi-sector effort focused on creating a more equitable health ecosystem in Greater Houston. The Collective has over 400 members representing over 140 organizations and more than 50 coalitions aligned with a shared mission to establish an impactful, sustainable, data-driven system to promote health equity and address the social drivers of health outcomes. Through this data sharing ecosystem, we aim to implement a comprehensive population-level approach to understand and effectively and efficiently address SDOH across the Greater Houston area. Action 4- Leverage partnerships and services to support community-based organizations focused on improving health insurance coverage and education in vulnerable communities. * Texas Children's Health Plan (TCHP) identifies geographic-specific partnerships with over 30 organizations, including nonprofit groups, community organizations, social services, school districts and police departments. Through these partnerships, community outreach events are facilitated to assist families with applications for the Children's Health Insurance Programs (CHIP) and Medicaid Programs. (See continuation of Part V, Line 11)
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - Texas Children's Hospital. Maternal Health Current actions and plans to address this issue: Action 1 - Support and expand partnerships and programs which offer support services for pregnant women and new mothers. * Texas Children's Center for Childhood Injury Prevention - The Safe at Home Program focuses on infant safe sleep, home safety and water safety education and teaches parents how to childproof their homes and identify potential drowning hazards that may cause injury to their children. * upWORDS2 is offered to parents who have participated in the upWORDS program and are seeking additional sessions on early brain development and positive parenting. * upLIFT: Many mothers experience symptoms of depression and anxiety during pregnancy and in the year after giving birth. Through upLIFT, a licensed social worker meets with the mother in her home. * Family Connects supports families of newborns and is delivered in their homes by a registered nurse. The nurses support parents in caring for their newborns, conduct health assessments of the baby and the mother from the comfort of the home, answer questions about caring for the newborn(s), identify parent needs and help connect families with community services and resources virtually. Up to eight sessions are provided to support the new mother in learning new tools and strategies to help ease symptoms of depression and anxiety. * TCHP has established a workgroup to increase information about the importance of mental health and resources. Action 2- Support initiatives which focus on reducing racial inequalities in accessing maternal health resources. * Continued support for The Harris County Child Fatality Review Team (CFRT): The CFRT is led by Public Health Pediatrics. It brings together local partners to review child mortality from a public health perspective in order to identify trends and strategies to decrease preventable child deaths. * Maintaining an active Patient & Family Advisory Council. Texas Children's believes patients and families are important partners in care and our allies for quality, safety and an optimal patient experience. We are committed to providing patient- and family-centered care that is tailored to meet the unique needs of our population. The Department of Patient and Family Engagement aims to enhance communication and strengthen collaboration with patients and families at both the micro (bedside) and macro (organizational) levels. Our Specialists work to engage patients and families to serve as Advisors on a wide variety of hospital projects, committees, and strategic initiatives, helping ensure the consumer voice is a guiding force in all that we do. * Texas Children's Government Relations Department. In its mission to ensure that Texas children have access to effective, high quality, comprehensive and appropriately funded health care, Texas Children's Government Relations Department actively advocates for increased access to public programs designed to serve children and their families. Hospital leadership regularly shares its voice at the local, state and national levels to increase awareness of issues that shape public policy related to children's health. * TCHP held a cultural competency focus group in December 2022 and heard from members about an increasing focus on mental health (across Black and Hispanic groups) but a lack of awareness of benefits. Action 3- Advocate for the support, access, and expansion of Medicaid coverage for mothers' post-partum. * Texas Children's Government Relations continues to identify opportunities for Texas Children's physician experts and leaders to advocate at the state legislature by participating in various legislative committee hearings with a focus on maternal health in Texas. Chronic Disease and Unhealthy Lifestyle Current and planned actions to address this issue: Action 1 - Support and connect families with low-cost/no-cost community resources to support healthy eating and physical activity in neighborhoods. According to the 2018 Physical Activity Guidelines Advisory Committee Scientific Report, strong evidence demonstrates that, in children and adolescents, higher amounts of physical activity are associated with more favorable status for multiple health indicators (Physical Activity Guidelines, 2018). Additionally, it was concluded in the Youth Risk Behavior Survey that more opportunities are needed for children to learn about a healthy diet and physical activity. It was also suggested that communities work together to create positive environmental changes (Youth Risk Behavior Survey, 2019). * Current collaborations include the Texas Children's Health Plan, Texas Children's Pediatrics, Houston Food Bank, Kids Meals and various food pantries across Houston. * Texas Children's works with Episcopal Health Foundation, City of Houston Parks Department and the Memorial Hermann Community Benefit Corporation to improve park space in the Alief area of Houston, an economically disadvantaged community that is part of the Mayor's Complete Communities initiative. Community Benefit resources and foundations are utilized to support and enhance programming and equipment at a park in Alief and track utilization and health outcomes over time. Action 2 - Support opportunities aimed to better inform, educate, and engage the public regarding chronic disease prevention and management. According to the CDC, approximately two in five children ages 6-17 have a chronic health condition such as asthma, diabetes or epilepsy. The CDC recommends a coordinated effort between children, their families, community groups, social service agencies, schools and medical providers to manage chronic diseases in this population (CDC, 2023). * The Children's Nutrition Research Center (CNRC) is a unique cooperative venture between Texas Children's, Baylor College of Medicine and the U.S. Department of Agriculture/Agricultural Research Service. The CNRC has over 40 faculty members conducting nutrition-related research. Research goals center on establishing evidence-based guidelines promoting health, growth and development through optimal nutrition. These guidelines are for use by physicians, parents and others responsible for the care and feeding of children. * Texas Children's operates mobile clinics to provide trusted, high-quality medical services to children who may not have the access or opportunity to receive health care. This fleet of mobile clinics travels to low-income, largely Hispanic neighborhoods to provide comprehensive health care to underserved children. They provide free care to children from newborn to 18 years of age and are open to the public; children do not have to attend the school where the clinic is parked to receive care. * TCHP has a partnership with Harris County Public Health Department to remediate known environmental asthma triggers for high-risk asthma members. Action 3- Provide culturally appropriate support for healthy lifestyles in underserved communities. According to studies, "there has been a growing awareness that providing culturally sensitive pediatric primary care, especially during well-child visits, is a potentially modifiable way to address health care disparities and promote health equity (Okoniewski, MD 2022). * Texas Children's plans to establish a strategic partnership with a nonprofit or community agency which addresses the community regarding chronic disease prevention and management in the Greater Houston Area.
Schedule H, Part V, Section B, Line 16 Facility , 1	Facility , 1 - Texas Children's Hospital. A notice of the financial assistance policy is posted in the Hospital's emergency rooms, waiting rooms and admissions offices.
Schedule H, Part V, Section B, Line 20 Facility , 1	Facility , 1 - Texas Children's Hospital. Line 20A is not checked because the Hospital does not perform any Extraordinary Collection Actions.

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?5
Name and address		Type of Facility (describe)
1	Vannie Cook Children's Cancer and Hematology Clinic 101 W Expressway 83 McAllen,TX78503	Community Based Outpatient / Diagnostic Clinic
2	SuperKids and Ronald McDonald Care Mobile Clinics 8080 N Stadium Drive Houston,TX77054	Community Based Mobile Clinics
3	Primary Care Practice at Palm Center 5400 Griggs Road Suite 101 Houston,TX77021	Community Based Outpatient / Diagnostic Clinic
4	Texas Children's Pavilion for Women - Obstetrics & Gynecology Pearland 9003 Broadway Street Pearland,TX77584	Community Based Outpatient / Diagnostic Clinic
5	Texas Children's Specialty Care - Upper Kirby 3023 Kirby Drive Suite 201 Houston,TX77098	Community Based Outpatient / Diagnostic Clinic
6
7
8
9
10

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part VI, Line 7 State filing of community benefit report	Additional information: The Hospital files the Annual Statement of Community Benefits Standard (ASCBS), the State of Texas' community benefit reporting for not-for-profit hospitals. For the fiscal year ended September 30, 2022, the Hospital reported $545,567,905 as the total annual charity and community benefit in its ASCBS. Differences between Schedule H and the ASCBS are stated below. The resulting difference of $211,626 (in $1000's) between the ASCBS and the amounts recorded in Part I line 7 are due primarily to varying reporting requirements as outlined below (in $1000's): ASCBS does not include LPPF taxes. Additionally, the ASCBS RCC is calculated using 2021 financial information. $234,058. ASCBS includes financial assistance provided to community by related organizations $(4,403) ASCBS includes the unreimbursed cost of community building activities $(1,042) ASCBS includes the unreimbursed cost of Medicare and Champus $(16,987) Total variance between Part I line 7 and ASCBS $211,626.
Schedule H, Part VI, Line 5 Promotion of Community Health	Continued from prior response on schedule H, Part VI, Line 5 b. In 2019, our $350 million expansion, the Lester and Sue Smith Legacy Tower, completed its first full year operation. The Hospital's new home for surgery, critical care and Texas Children's Heart Center was designed to help meet the increasing demand for the highly-specialized, critical and medically-complex pediatric care that few centers in the country can provide. It enhances patient care by giving caregivers and families in critical and progressive care areas much-needed additional space. The tower houses a 130-bed intensive care unit, new operating rooms with the latest technology and a cardiovascular intensive care unit. Additionally, in December 2020, Texas Children's opened a first-of-its-kind dedicated facility designed by and for adults with congenital heart disease. The 27,000-square-foot space, situated on the 24th floor of Lester and Sue Smith Legacy Tower, is entirely managed by the dedicated Adult Congenital Heart team. Our multidisciplinary team of specialists are trained in both pediatric and adult congenital heart disease. We work closely with patients on the wide spectrum of challenges that congenital heart disease patients face throughout their lives. This innovative approach to care is unprecedented, and another step forward for the no. 1 ranked hospital for cardiology and heart surgery by U.S. News & World Report. The facility includes 16 universal care beds equipped for all levels of treatment, integrated inpatient/outpatient space, a cardiac rehabilitation gym, and a diagnostics lab. Demand for the level of care Texas Children's provides continues to grow - here in our local community and far beyond Houston. Further expanding the Heart Center allows Texas Children's to advance quality, service and safety, improve the patient and family experience, and expand access to expert cardiac care. c. Texas Children's Hospital West Campus serves one of the fastest growing pediatric populations in the country. As the population grows, so has this community hospital. To meet the needs of these diverse neighborhoods, the Hospital continues to look at its patients and engage community-based organizations and leaders to determine what programs, services and initiatives may make the most impact in west Houston. In 2022, Texas Children's Hospital provided pediatric care with over 435,000 visits at the West Campus. The campus provides subspecialty outpatient care including physician visits, therapy services, and a full complement of diagnostic services. The Hospital has 86 inpatient beds, which includes a 22 bed pediatric intensive care unit and remains the only 24/7 dedicated pediatric emergency center in the west Houston area. The hospital continues to operate a state of the art Special Isolation Unit to care for those patients with highly contagious diseases such as Ebola. In addition, a 28,500 square foot, state-of-the-art sports medicine clinic continues to serve the Greater Houston area with physicians specialized in Orthopedics and Sports Medicine, and with dedicated physical therapists focusing on the unique needs of a pediatric athlete. In an effort to focus on our most vulnerable patients, West Campus continues to utilize its Complex Care Clinic to support patients with complex medical needs including care coordination needs, medical fragility, technology dependence, and increased health care utilization. To meet the need for providing increased access to diagnostic services, West Campus operates an Interventional Radiology Suite providing a wide range of image-guided minimally invasive procedures such as Needle Biopsies, and the placement of central lines, feeding and drainage tubes for abscess or other abnormal collections of pus/fluid in the body. The patients most commonly served by this department include those with Hypersalivation, Varicocele, deep Vein thrombosis, Cystic Fibrosis, foreign body removal and Venous system related diseases. West Campus continues to offer the largest pediatric sleep center, with 15 beds dedicated to pediatric sleep medicine with an accompanying sleep clinic. In response to the pandemic in 2020, West Campus was the first facility to accept and treat a COVID-19 patient within the Texas Children's system; in addition the facility offers COVID-19 drive through testing to support ongoing clinical operations with approximately 100 patients tested per day in the height of the pandemic. d. Texas Children's Health Plan operates two Centers for Children and Women, family-centered medical homes for TCHP members located within two of Houston's most underserved areas, Greenspoint and Sharpstown. The facilities offer primary pediatric and obstetric care, pediatric optometry and dentistry and onsite imaging, speech therapy, lab and pharmacy. TCHP provides STAR Kids, a Medicaid-managed care plan for children and young adults up to 21 years old with disabilities. The STAR Kids program offers the same benefits as Medicaid plus many extra services, including long-term support, service coordination through the STAR Kids health plan, and help in the home to optimize the environment for the child with disabilities, among other benefits. e. The Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children's Hospital is the world's first comprehensive pediatric neurological research center devoted to collaborative efforts to understand neurological conditions like autism, cerebral palsy and epilepsy - a class of disorders that together are expected to exceed more than a half-trillion dollars annually in healthcare costs. The NRI includes more than 400,000 square feet of advanced research and office space, including a new laboratory floor, a customized nuclear MRI suite and additional vivarium space. f. At Texas Children's, we believe in providing women, mothers and babies quality health care at every important stage of their lives. We call this model "family-centered care." Texas Children's Pavilion for Women brings together obstetricians, gynecologists, oncologists, surgeons, geneticists and nurses from the Hospital and Baylor College of Medicine, to accomplish this purpose. With high-risk births on the rise nationally, our renowned experts and specialists focus on furthering obstetrical research. We also provide advanced treatment, including level IV neonatal intensive care units to give premature and sick babies more extensive support and care. g. The Feigin Tower is the Hospital's central hub for pediatric research. The Hospital is an internationally recognized leader in pediatric research and continues to be a leading recipient of pediatric grant funding through the National Institutes of Health (NIH). With total external and internal funding of more than $189 million annually, researchers conduct more than 1,750 clinical, basic science and translational research projects to identify groundbreaking treatments and cures for childhood diseases.
Schedule H, Part V, Section B, Line 16 Hospital Facilities - FAP WEBSITE	The website for Schedule H, Part V, Lines 16a-c is: https://www.texaschildrens.org/patients-and-visitors/insurance-and-billing-assistance/financial-arrangements
Schedule H, Part V, Section A HOSPITAL FACILITIES	The Hospital is licensed by the Texas Department of State Health Services under license number 000117. The Hospital is comprised of multiple buildings on three campuses. All are included under one license number; therefore, the Hospital is one hospital facility.
Schedule H, Part I, Line 7g Subsidized Health Services	The Hospital has included four hospital-based outpatient clinical services (The Developmental Pediatrics and Autism Center, Renal Outpatient Services, Special Needs Primary Care Clinic, and Mental Health Services - includes pediatric and maternal services) and four stand-alone clinics (the Mobile Clinic Outreach Program, Pediatric Dentistry, the Primary Care practice at Palm Center, and the Vannie E. Cook Jr. Children's Cancer and Hematology Clinic) as subsidized health services in Part I, Line 7g. Gross expenses of $16,847,514, offsetting revenue of $6,779,174 and net expenses of $10,068,340 are included in that line. The stand-alone clinics include gross expenses of $8,060,543, offsetting revenue of $2,110,823 and net expenses of $5,949,720 in line 7g. These clinics qualify as subsidized health services because they provide care and services to vulnerable, low income populations whose communities lack primary care services and programs. The Texas Children's Autism Center and Meyer Center for Developmental Pediatrics provide diagnostic services for children suspected of having an Autism Spectrum Disorder, Developmental Delay, Intellectual Disabilities, Learning problems, etc. These multidisciplinary centers are comprised of developmental pediatricians, neurologists, psychologists and psychiatrists who work collaboratively to provide a comprehensive diagnostic evaluation. They also have a social work team to help families obtain resources in the community and school not provided at the Hospital. The Autism Center and The Meyer Center for Developmental Pediatrics are housed in the same location and have over 3,000 patient visits annually. Renal Outpatient Services - Services started in 1980 in response to community needs for chronic hemodialysis for children. Approximately 80 chronic patients are seen annually by pediatric nephrologists and undergo dialysis treatment at the hospital or at home in order to improve their health outcomes while maintaining a child's normalcy of school and activities with friends. In addition to chronic end stage renal dialysis patients, approximately 4,350 patients are treated in pheresis and renal clinics. The Special Needs Primary Care Clinic provides a medical home, case management and social services for children with very complex underlying medical conditions. These patients have difficulty finding a general pediatrician to oversee their care and tend to utilize emergency rooms and subspecialists for routine care. The Psychiatry Service serves patients with a wide variety of psychiatric conditions often which are comorbid. Services include diagnostic assessments and treatment of complex anxiety and mood disorders, Tourette's syndrome, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder, medication management for children with Autism Spectrum Disorders, among other conditions. The Service also has a consult liaison service to the inpatient units of the Hospital. The Service has approximately 5,100 patient visits annually. The Psychology Service serves patients with varying degrees of assessment and treatment needs. Services include neuropsychological testing, cognitive assessments, treatment in the areas of pre-school and school age disruptive behavior, anxiety and mood disorders, and complex ADHD. The Psychology Service works closely with other services within Texas Children's Hospital, both inpatient and outpatient, in helping patients adjust to and manage complicated or serious medical diagnoses. The Service has approximately 700 patient visits annually. Mobile Clinic Outreach Program -The Hospital's mobile clinics partner with underserved schools in the city and travel to low-income neighborhoods to provide free health care to children and adolescents from birth to age 18 who do not have insurance. As part of its goal to build a community of healthy children, the Hospital operates mobile clinics to provide trusted, high-quality medical services to children who normally might not have the opportunity to receive health care. In 2021, the COVID-19 pandemic limited the program to providing car-side immunization only services. In 2022, the mobile clinics conveniently and safely provided vaccines at 400 events covering over 140 different locations in Greater Houston. The mobile clinics provided approximately 6,500 free immunizations to all Texas Vaccines for Children-eligible patients. Additionally, we were able to help families apply for public health insurance, such as Medicaid, CHIP and the Harris Health Eligibility Card. We also provide referrals for social services and affordable permanent medical homes. Pediatric Dentistry Services - Community based dentists are generally not equipped to treat dental patients with special needs that often require treatment in the operating room or heavy sedation. The Pediatric Dental Clinic at Texas Children's Hospital (Dental Clinic) was developed to care for these children. The Dental Clinic is primarily focused on patients with cardiac issues, cancer, neurologic disorders and other medical issues. Approximately 71% of the patients seen in the Dental Clinic are insured through Medicaid. In 2022, the Dental Clinic had over 4,900 patient visits which included approximately 500 operating room cases. Additionally, the Pediatric Orthodontic Clinic at Texas Children's Hospital (Orthodontic Clinic) treats children who have congenital anomalies and/or cleft palates in conjunction with the Plastic Surgery department. In 2022, the Orthodontic Clinic had over 3,100 patient visits with approximately 62% insured through Medicaid. The Vannie E. Cook Jr. Children's Cancer and Hematology Clinic (Vannie Cook Clinic) is located in McAllen, Texas and is a joint effort between the Vannie E. Cook Jr. Cancer Foundation, Baylor College of Medicine and Texas Children's Cancer and Hematology Centers. The Vannie Cook Clinic offers treatment to children along the Mexico border in South Texas who suffer from cancer and blood disorders. It is the only comprehensive pediatric cancer treatment facility in South Texas. Many of these patients previously would have traveled to San Antonio or Houston for their treatment, a hardship physically, emotionally and financially for them and their families. It is a comprehensive care facility offering diagnostic and cancer treatment services, cancer genetic counseling and a long-term survivorship program which follows childhood cancer survivors through adulthood. Most of the patients (75%) are from low-income, uninsured or underinsured families. Every year, the clinic staff sees approximately 1,200 patients and of these patients, approximately 600 are newly diagnosed. Texas Children's Hospital Primary Care Practice at Palm Center provides comprehensive routine and preventive health care, including well child check-ups, sick visits, sports physicals, immunizations and management of chronic pediatric medical conditions. Texas Children's Hospital Primary Care Practice at Palm Center serves as the largest Texas Children's Hospital and Baylor College of Medicine practice that provides primary care experience for pediatric medical students and residents. This clinic's location in the Palm Center neighborhood in Houston's Third Ward offers a great opportunity to serve the community while modeling best practices to the next generation of pediatricians. Third Ward is a historically African American community with a rich history and cultural legacy along with a renewed sense of purpose and commitment. The clinic's location offers free parking and is conveniently located at the Palm Center Station on the MetroRail's Purple Line.
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	0
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	For Part 1, Line 7, Texas Children's Hospital (Hospital) applied the ratio of patient care costs (RCC) to charges derived from Worksheet 2 to the charges the Hospital forgave pursuant to the financial assistance policy (FAP) (line 7a), Medicaid charges (line 7b), other means-tested charges (line 7c) and research patient care charges (line 7h). Worksheets 1, 2, 3, 4, 5, 6, 7 & 8 and the corresponding instructions have been used as the primary basis for completing Part 1, Line 7. For each subsidized health service, the Hospital used the RCC for Medicaid cost report line 90.00 Outpatient Clinics where the subsidized health service cost centers reside and applied it to the respective gross patient charges to calculate community benefit expense. The exception to the above is Renal Outpatient Services. Costs incurred for Renal Outpatient Services reside in multiple cost centers and multiple Medicaid cost report lines. The RCC for the related Medicaid cost report line where the actual gross patient charges were recorded was used to calculate community benefit expense for Renal Outpatient Services. For each subsidized stand-alone clinic, the Hospital calculated a specific ratio of patient care costs to charges using the same method prescribed in worksheet 2 and applied it to the respective clinics' gross patient charges to calculate community benefit expenses. For Part 1, Line 7, the Hospital applied indirect cost ratios from the 2022 Medicaid cost report to direct program expense to determine total community benefit expense related to community health improvement services and community benefit operations (line 7e), health professional education programs other than Graduate Medical Education (GME) (line 7f) and in-kind contributions (line 7i). The indirect cost ratios computed from the 2022 Medicaid cost report are both comprehensive and a good proxy of the associated overhead costs. For Part 1, Line 7f, the Hospital included the direct and indirect expense from the 2022 Medicaid cost report for state accredited and nationally accredited GME programs. For Part 1, Line 7h, the Hospital included the direct and indirect expense from the 2022 Medicaid cost report for research. No industry-sponsored research activities are included in line 7h.
Schedule H, Part II Community Building Activities	The Hospital's community building activities promote the health of the communities served and support organizations focused on the root causes of health problems (e.g., poverty and homelessness) and vulnerable populations (e.g., children with special healthcare needs). Vulnerable Population Economic Improvement (Line 2) Net Community Building Expense Cristo Rey Work Study Program $ 72,900 TOTAL $ 72,900 Community Support Activities (Line 3) Net Community Building Expense Ronald McDonald House Houston $ 75,000 Project Joy & Hope $ 20,000 Sam Houston Area Council - Boy Scouts of America $ 20,000 Candlelighters Childhood Cancer Family Alliance $ 15,000 Lifeline Chaplaincy $ 15,000 The Sanctuary Foster Care Services $ 10,298 Covenant House $ 10,000 Houston Angels $ 5,245 Down Syndrome Association $ 5,150 Bo's Place $ 5,100 SEARCH - Houston without Homeless $ 5,000 YES to YOUTH - Montgomery County Youth Services $ 5,000 Avondale House $ 2,510 AJF - Ashley Jadine Foundation $ 1,070 BakerRipley $ 780 Houston Jewish Family Foundation $ 250 TOTAL $ 195,403 Leadership Development and Training for Community Member Activities (Line 5) Net Community Building Expense Junior League of Houston $ 120,000 American Leadership Forum $ 20,000 Jack and Jill of America $ 10,000 TOTAL $ 150,000 Coalition Building Activities (Line 6) Net Community Building Expense The Woodforest Charitable Foundation $ 750 TOTAL $ 750 Community Health Improvement Advocacy Activities (Line 7) Net Community Building Expense Texas Liver Foundation $ 15,000 Hand to Hold $ 10,000 Children At Risk $ 10,000 Change Happens! $ 5,000 Texas Medical Association $ 3,500 Interfaith of The Woodlands $ 2,500 Colon Cancer Coalition $ 797 TOTAL $ 46,797 Other (Line 9) Net Community Benefit Expenses SIRE - Therapeutic Horsemanship $ 25,000 Houston Children's Charity $ 25,000 Center for Pursuit $ 17,500 Texas Hearing Institute $ 15,000 The Brookwood Community $ 10,000 TOTAL $ 92,500
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	In accordance with HFMA Statement 15 and ASU 2014-09, Topic 606, Bad debt expense represents the difference between the standard rates (or explicit contracted rates) and the amounts expected to be collected from a third-party payor after all reasonable collection efforts have been exhausted. Also in accordance with HFMA Statement 15 and ASU 2014-09, Topic 606, Bad debt expense is calculated as the charges written off (at full established rate), less any indirect funds received to offset charges written off.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	Bad debt attributable to patients eligible under financial assistance policy: The Hospital does not contend that any of its bad debt expense is attributable to the organization's financial assistance policy (FAP) or should be considered a community benefit. Robust screening processes are used in determining FAP-eligibility and financial assistance amounts are not expected to result in cash flows. All uncollected charges attributable to patients eligible under the organization's FAP are included in line 7a (at cost).
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Footnote describing accounts receivables (page 14) of audited financial statements: Patient accounts receivable include reductions for explicit contractual agreements, discounts provided to uninsured and underinsured patients, implicit price concessions, and charity adjustments and are recorded on an accrual basis at net realizable value in the consolidated balance sheets. The estimate of patient accounts receivable is based primarily on Texas Children's historical collection and write-off experience and the aging of patient accounts receivables. Changes in business and economic conditions, trends in federal, state and private employer health care coverage, and other collection indicators are also taken into consideration when estimating price concessions each quarter. Footnote describing Net Patient Service Revenue, and implicit price concessions based on historical collection rates (page 38) of audited financial statements: Net patient service revenues are recorded as goods and services are provided at the transaction price estimated by Texas Children's to reflect the total consideration due from patients and third-party payors. The transaction price, which involves significant estimates, is determined based on Texas Children's standard charges for the goods and services provided with a reduction recorded for price concessions, which include discounts based on third party contractual arrangements and patient discounts, as well as implicit price concessions based on historical collection rates. As performance obligations are met (i.e.: room, board, ancillary services, level of care, etc.), net patient service revenue is recognized based upon an allocated transaction price as goods and services are provided to the patient. In instances where performance obligations are across multiple periods, the transaction price is allocated by applying an estimated implicit and explicit rate to gross charges based on the separate performance obligations or the patient's length of stay. Substantially all performance obligations have a duration of less than one year. Texas Children's has elected to apply the optional exemption provided in Accounting Standards Codification 606-10-50-14(a) and is not required to disclose the aggregate amount of the transaction price allocated to performance obligations that are unsatisfied or partially satisfied at the end of the reporting period, which are primarily related to inpatient acute care services.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	The sources used to determine the amount reported as Medicare Allowable Costs on Part III, line 6 was the Hospital's 2022 Medicare cost report and supporting work papers. Substantial shortfalls typically arise from payments that are less than the cost to provide the care or services and do not include any amounts relating to inefficient or poor management. The Hospital accepts Medicare patients seeking pediatric or women's health services, as reflected on the year-end Medicare cost report, with the knowledge that there may be shortfalls. IRS Revenue Ruling 69-545, which established the community benefit standards for nonprofit hospitals, implies that treating Medicare patients is a community benefit and states that if a hospital serves patients with governmental health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Patients who have qualified for financial assistance, if the discount is less than 100%, will be responsible for payment of any applicable hospital charges at a reduced rate. If the patient does not pay the amount and fails to renegotiate a payment plan (if applicable), the uncollected balance will be considered an implicit price concession. Provisions for estimated retroactive adjustments under such programs are provided in the period the related services are rendered, adjusted in future periods as final settlements are determined, and are included in other current assets. The Hospital may use reasonable efforts to collect outstanding patient receivables which include but are not limited to: telephone calls, email and couriered written correspondence. The Hospital does not engage in extraordinary actions to force collections on patient accounts.
Schedule H, Part V, Section B, Line 16a FAP website	- TEXAS CHILDREN'S HOSPITAL: Line 16a URL: See Part VI;
Schedule H, Part V, Section B, Line 16b FAP Application website	- TEXAS CHILDREN'S HOSPITAL: Line 16b URL: See Part VI;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- TEXAS CHILDREN'S HOSPITAL: Line 16c URL: See Part VI;
Schedule H, Part VI, Line 2 Needs assessment	In addition to the CHNA, Texas Children's Hospital's Community Benefits department structure and purpose includes engaging with internal and external partners in the development of community partnerships. Community Benefits maintains strong relationships with community-facing internal stakeholders including Injury Prevention, Public Health Pediatrics, and Texas Children's Health Plan. Additionally, Community Benefits actively participates in external Greater Houston area coalitions focused on community health needs such as Health Equity Collective, Understanding Houston, Children at Risk, and Maternal Mortality and Morbidity Review Committees (MMRCs). This team also identifies new programs, funding opportunities and reporting community benefit programs' progress, outcomes and evaluation. To accomplish this, Community Benefits employs the ICARE framework: * Identify community health needs as they arise. * Collect data. * Align the Texas Children's community-related efforts with identified needs. * Recognize components of Texas Children's that provide quality community-related services * Enhance community-related health efforts across the entire system. A Community Benefits Workgroup, comprised of physician and administrative leaders from across Texas Children's, works in collaboration with the Community Benefits department. The CBW is charged with determining how best to address identified community needs. Members/Leaders in the Hospital's supported programs created to address existing community health needs provide critical guidance to the Community Benefits department on how best to measure program success and continued support, or expansion of these efforts to other areas of the community.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	All patients who receive services at the Hospital or their families are notified of their rights and responsibilities and the availability of government or hospital sponsored programs if financial assistance is needed. * Information is provided during inpatient and outpatient registration where materials are always available in both English and Spanish. * Notices of the Hospital's financial assistance program are posted in public waiting and registration areas, including Admissions, Emergency Center, outpatient clinics and other prominent areas. A variety of language services are available upon request. * The Hospital's Financial Assistance Policy, Financial Assistance Application and a plain language summary of the Financial Assistance Policy are posted on Texas Children's Hospital's public website in both English and Spanish. The site directs patient families to contact admissions counselors and financial counselors in the Admissions department for more information about available financial options and resources. * Financial counselors are available to determine eligibility for government and/or hospital-sponsored financial assistance. Financial counselors receive training on eligibility requirements for financial assistance and government programs. * State Out-stationed Eligibility Workers (OEW) are on-site to support the government-sponsored assistance program application process. * Referrals for charity consideration may originate with the scheduling, pre-service, customer service departments, hospital social workers and clinicians, external providers and through self-referral. These referrals are directed to the appropriate department's financial counselors who discuss options, including charity assistance. * Financial counselors also contact patients arriving via the Emergency Center after appropriate medical screenings to discuss eligibility for government programs like Medicaid, CHIP, CSHCN and charity assistance.
Schedule H, Part VI, Line 4 Community information	Given the services provided to patients from around the world, the Hospital defines its community as local, national and international. In regards to the CHNA, the Hospital focuses on addressing local needs. For community benefit reporting purposes, Texas Children's Hospital defines the community it serves as the Houston-The Woodlands-Sugar Land Metropolitan Statistical Area (MSA), also known as "Greater Houston." An MSA - defined by the U.S. Office of Management and Budget (OMB) and used by the Census Bureau and other federal government agencies for statistical purposes - is a geographical region with a high population density and close economic ties throughout the area. While the Texas Children's Hospital Network of Care treats patients from around the globe, most of our patients (90.9% in Fiscal Year 2019) come from Greater Houston. In terms of land area, Greater Houston is approximately 9,440 square miles, making it larger than the states of New Hampshire (9,350 sqm), New Jersey (8,721 sqm), Connecticut (5,543 sqm), Delaware (2,489 sqm) and Rhode Island (1,545 sqm). For more in depth information on each county in the Hospital's community benefits service area, including demographic profiles, please refer to the Hospital's CHNA online: https://www.texaschildrens.org/about-us/community-benefit-efforts/reports-community-health-needs In general, Texas Children's focuses community benefit efforts in neighborhoods with high concentrations of poverty because poverty is linked to many other social determinants of health. Several research institutions have developed indexes to better understand neighborhood-level factors beyond poverty that can affect health outcomes. These indexes include the CDC's Social Vulnerability Index (SVI), Ohio State University's Childhood Opportunity Index (COI), and HRSA/The University of Wisconsin's Area Deprivation Index (ADI). These indexes often score neighborhoods based on a variety of factors related to socioeconomic status to paint a more comprehensive picture of the disadvantages faced by neighborhood residents. Texas Children's uses the Area Deprivation Index to identify the most vulnerable neighborhoods in our service area because it is based on the most current data of all of the indexes. Additionally, it provides data at a higher spatial resolution, the census block group, compared to other indexes that oftentimes use census tracts or zip codes. The ADI was developed by HRSA over twenty years ago for county-level use, but has since been adapted and validated to the census block group level by researchers at the University of Wisconsin-Madison. The ADI ranks each census block group in each state from 1 to 10 based socioeconomic factors, such as income, education, employment, and housing quality. Census block groups that receive a score of 1 are the lowest on the ADI, and are the least disadvantaged neighborhoods, while census block groups that receive a score of 10 are the highest on the ADI and are the most disadvantaged neighborhoods.
Schedule H, Part VI, Line 5 Promotion of community health	As a leader in pediatrics and women's health, the Hospital continues its mission to serve the community through preeminent research, education and patient care. This ongoing commitment ensures the health and well-being of the youngest and most vulnerable members of the community, whether they reside in nearby neighborhoods or on the other side of the world. In addition to the information supplied in other sections of this document, the following are examples of the Hospital's ongoing commitment to the community it serves: 1) Texas Children's Board of Trustees is composed of representatives who reside in the greater Houston community and are not employees of the hospital. Many Trustees are business and civic leaders who are active in other local charitable organizations. 2) The Hospital extends medical staff privileges to all qualified non-hospital-based physicians from the community. Privileges are granted in accordance with medical staff bylaws. 3) Emphasizing its world-class expertise in highly specialized fields, the Hospital operates Centers of Excellence in oncology, cardiology and neonatology. Ranked second among all children's hospitals nationally by U.S. News & World Report, Texas Children's Hospital is the only children's hospital in Texas to receive the prestigious Honor Roll designation. In the 2022 U.S. News survey - which uses data from 2021 - the Hospital ranked in the top ten in eight subspecialties, #1 in the nation in Pulmonology, and #1 in the nation in cardiology/heart surgery for the sixth year in a row. As a national leader among pediatric institutions, the Hospital has multidisciplinary expertise in some of the most complex medical challenges facing children today. 4) As part of its responsiveness to the community, the Hospital operates and supports several advisory committees, comprised of community members and patient families. These groups consult with Hospital representatives on a wide range of topics designed to increase the quality of care and services provided. 5) The Hospital invests its operating margin in capital projects and programmatic initiatives focused on improving patient care, medical education and research. 6) The Hospital served as a training center for nursing students, supporting approximately 1,700 candidates in 2022. Although these trainees are not obligated to remain at the Hospital upon certification, they gain valuable knowledge for their careers in pediatrics. 7) Texas Children's Medical Legal Partnership (MLP) promotes the health of vulnerable, low-income populations by addressing legal needs that affect patient health. In fiscal year 2022, there were a total of over 200 consultations. The MLP brings together lawyers, doctors and social workers when a legal situation is required. A staff attorney and volunteers provide free legal advice to patients and families on a variety of legal matters including improving housing conditions, obtaining guardianships for adult children or unrelated caregivers and securing public school accommodations for children with disabilities. MLP also connects patient families with volunteer attorneys to represent them. 8) The Hospital's 24/7 transport service, the Kangaroo Crew, comprises a fixed-wing aircraft and ground ambulance medical service providing coordinated patient assessment, necessary intervention and safe, rapid transport of critically ill or injured patients. All transport service personnel are specially trained in pediatric/neonatal transport medicine and safety in accordance with Federal Aviation Administration (FAA) and Texas Department of State Health Services guidelines. 9) The transport service team is a member of the Pediatric Disaster Coalition (Coalition), a planning group that consists of subject matter experts from freestanding children's hospitals, facilities with dedicated pediatric/neonatal units, pediatric specialty transport organizations, local and state public health and federal partners. The Coalition shares recommendations and technical guidance with other healthcare facilities throughout the state, as well as federal agencies and other national organizations including Child Health Care Association (CHCA), Children's Hospital Association (CHA), Association of Air Medical Services (AAMS) and American Academy of Pediatrics (AAP) Section on Transport Medicine. 10) At Texas Children's Hospital, we are committed not only to providing the best possible care, but also to expanding that care-reaching out to more children and families and providing more specialized services where they are most needed. The Hospital is committed to creating a healthier future for children and women throughout our global community by leading in patient care, education and research: a. This region has embraced Texas Children's Hospital The Woodlands since we opened the doors in 2017. We have brought world class pediatric care closer to home for the North Region's patient and families. This pediatric hospital campus increases access to pediatric subspecialty care within the following services: adolescent medicine and physical rehabilitation, allergy and immunology, cardiology, cancer and hematology, dermatology, developmental pediatrics, diabetes and endocrinology, gastroenterology, hepatology and nutrition, genetics, infectious disease, neonatology, neurology, neurosurgery, ophthalmology, orthopedics, otolaryngology, palliative care, pediatric and adolescent gynecology, pediatric surgery, plastic surgery, psychiatry, psychology, pulmonology, rheumatology, sports medicine and urology. Hospital facilities include 25 emergency center rooms, 74 outpatient rooms, five radiology rooms, Six operating rooms and 46 acute care beds, 14 pediatric intensive care and 14 neonatal intensive care beds with plans allowing for expansion up to 200 beds. Pediatric Emergency Services are available 24 hours a day, open every day, and are provided regardless of ability to pay. Additional hospital services include: radiology, pathology, sleep center, infusion center, helipad access, audiology, cardiac stress tests, echosonography, pulmonary diagnostics, developmental physical, occupational and speech therapy and sports physical therapy as well as motion gait analysis and fetal medicine testing. Along with serving families throughout The Woodlands area, the Hospital serves families throughout Greater North Houston and north of Houston including Montgomery, Angelina, Walker, Brazos, Grimes, Madison, Liberty, Harris, Polk, San Jacinto, Trinity and Hardin counties. (SEE CONTINUATION OF PART VI, LINE 5)
Schedule H, Part VI, Line 6 Affiliated health care system	The Hospital is affiliated with Texas Children's Pediatrics (TCP, EIN 76-0460242) in promoting health care in the community served. TCP is one of the nation's largest pediatric primary care networks. With 50 practices in the Greater Houston area, 13 in Austin, and 1 in College station, TCP pediatricians serve approximately 25 percent of Houston's children, helping treat and prevent infectious illnesses. Eight TCP practices, identified as the Community Cares Program, are located in medically underserved neighborhoods and provide consistent care for little or no cost to more than 43,000 children who otherwise would seek services from emergency rooms or go without care. In addition to providing high quality, affordable primary care, each Community Cares practice is uniquely designed to meet the needs of the diverse communities they serve. Using the medical home model of care, we provide: wrap-around services that eliminate logistical, cultural and social barriers to access care; counseling and educational services with emphasis on risk behaviors; on-site social workers and specialists who provide assistance signing up for Medicaid/CHIP or other Affordable Care Act providers; partnerships with local dentists, pharmacies and other services to ensure comprehensive affordable health care is provided; extra support and guidance for parents to promote total health and well-being of children. In addition to providing care to children in our community during normal business hours, TCP through its subsidiary, Texas Children's Urgent Care (TCUC, EIN 47-2029489), provides urgent care when kids get sick at night or on the weekends. As of the end of 2022, there were ten TCUC sites around the greater Houston area and one location in South Austin as well as our telemedicine virtual care option. These sites provide families with convenient access to care when it is needed most, and saves them time and money from seeking out inappropriate use of emergency center care. Our three busiest locations are located adjacent to our Medical Center EC, West Camps EC, and Woodlands Campus EC. These locations have helped redirect patients to seeking care in a more appropriate setting, as well as reducing the cost of care from the patient side. The impact has been tremendous on reducing the low acuity visits being treated in our Emergency Center. Texas Children's Health Plan (TCHP, EIN 76-048264) is the largest and most frequently selected provider of Children's Medicaid/CHIP coverage in the region. TCHP was founded in 1996 by Texas Children's Hospital making it the nation's first health maintenance organization (HMO) created just for children. Through a contractor role with the Texas Health and Human Services Commission (HHSC), Texas Children's Health Plan provides STAR/Medicaid and Children's Health Insurance Program (CHIP) to pregnant women, teens and children in Houston and surrounding areas. Starting in November 2016, Texas Children's Health Plan also provides STAR Kids to children and young adults under the age of 21 with disabilities. As of September 2022, the Health Plan has over 590,000 members. The staff and network of over 4,300 primary care physicians, 6,800 specialists and 118 hospitals that provide acute care and inpatient and outpatient behavioral health and substance abuse treatment are committed to providing excellent service and patient care to TCHP members. The Hospital is Baylor College of Medicine's primary pediatric training hospital, with one of the largest pediatric residency programs in the country. The hospital's medical staff consists of approximately 1,750 board-certified, primary care physicians, OBGYN physicians, pediatric subspecialists and pediatric-surgical subspecialists. Together, the Hospital and Baylor College of Medicine represent one of the most active and best funded pediatric research programs in the country. Baylor College of Medicine investigators at the Hospital are conducting innovative research in nearly every pediatric subspecialty with the goal of quickly translating discoveries into breakthrough treatments for children everywhere.
Schedule H, Part VI, Line 7 State filing of community benefit report	TX

Schedule H (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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

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
TEXAS CHILDREN'S HOSPITAL

Employer identification number
74-1100555

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) TCH Pediatric Associates Inc PO BOX 300630 0 Houston,TX77230	76-0460242	501(c)(3)	7,000,000	Free healthcare for indigent pediatric patients
(2) Ronald McDonald House 1907 Holcombe Blvd 0 Houston,TX77030	74-1984499	501(c)(3)	150,000	General support
(3) The Cynthia Woods Mitchell Pavilion 2005 Lake Robbins Drive 0 The Woodlands,TX77380	76-0276606	501(c)(3)	125,000	Support for the 2021 Children's Festival event
(4) Junior League of Houston 1811 Briar Oaks Ln 0 Houston,TX77027	74-1185659	501(c)(3)	120,000	General support
(5) Sports Authority Foundation 701 Avenida de las Americas Suite 450 Houston,TX77010	82-2157834	501(c)(3)	100,000	Support for Final Four event in Houston
(6) YMCA of Greater Houston 2600 North Loop West 0 Houston,TX77092	74-1109737	501(c)(3)	89,700	General support, support for The Woodlands YMCA Trunk n' Treat event, and support for the YMCA Run Thru the Woods event
(7) Cristo Rey Work Study Program 6700 Mount Carmel St 0 Houston,TX77087	26-3739361	501(c)(3)	72,900	General support
(8) Upper Kirby District Foundation 3120 Southwest Freeway Suite 102 Houston,TX77098	80-0472449	501(c)(3)	65,000	Support for the Levy Park Conservancy Family Movie Night Series and Summer Block Party Series
(9) Houston Zoo Inc 1513 Cambridge 0 Houston,TX77030	74-1590271	501(c)(3)	60,000	General support
(10) March of Dimes 3000 Weslayan Suite 100 Houston,TX77027	13-1846366	501(c)(3)	55,000	Support for the 2022 March for Babies initiatives in Houston, Fort Bend, and Montgomery County
(11) Houston Defender Network 12401 South Post Oak 0 Houston,TX77063	76-0238885	For Profit	53,400	Support for the State Of Black Women Health Forum
(12) Texas Medical Center Orchestra (TMCO) PO Box 980983 0 Houston,TX77098	76-0669727	501(c)(3)	50,000	General support
(13) The Cure Starts Now 10280 Chester Road 0 Cincinnati,OH45215	26-0269131	501(c)(3)	50,000	Support for the 2022 Hearts For MK initiative
(14) Girl Scouts 12012 Park Thirty-Five Circle 0 Austin,TX78753	74-1109644	501(c)(3)	45,000	General support and support for the Success to Significance 2021 event
(15) AFP - Association for Fundraising Professionals Greater Houston 4300 Wilson Boulevard Suite 300 Arlington,VA222034167	94-3011524	501(c)(3)	43,705	General support
(16) Good Samaritan Foundation 3355 W Alabama St Suite 1025 Houston,TX77098	74-1235398	501(c)(3)	39,500	General support
(17) American Heart Association - AHA 10060 Buffalo Speedway 0 Houston,TX770541302	13-5613797	501(c)(3)	35,000	General support
(18) Blue Bird Circle 615 W Alabama 0 Houston,TX77055	74-1405134	501(c)(3)	35,000	General support
(19) Houston Food Bank 535 Portwall St 0 Houston,TX770291332	74-2181456	501(c)(3)	35,000	General support
(20) Friends of the ABC Zilker Park Kite Festival Inc PO BOX 41856 0 Austin,TX787040031	47-1324551	501(c)(3)	30,000	Support for the ABC Kite Fest
(21) Hydrocephalus Association 4340 East West Highway Suite 905 Bethesda,MD20814	94-3000301	501(c)(3)	30,000	General support and support for the HA Connect 2022 National Conference on Hydrocephalus
(22) Institute for Spirituality and Health 8100 Greenbriar 0 Houston,TX77054	74-1246255	501(c)(3)	30,000	Support for the Via Colori Houston 2022 Event
(23) Round Rock ISD Partners in Education Foundation 595 Round Rock West Dr Suite 404 Round Rock,TX78681	74-2488709	501(c)(3)	30,000	General support
(24) Doctors For Change 2900 Weslayan Street Suite 400 Houston,TX77027	41-2212976	501(c)(3)	25,875	General support
(25) Know Autism Foundation 6430 Richmond Ave Suite 410 Houston,TX77057	46-2573522	501(c)(3)	25,747	Support for the As I Am Festival
(26) Easter Seals Greater Houston 4500 Bissonnet Suite 340 Bellaire,TX774013006	74-1238418	501(c)(3)	25,563	Support for the Easter Seals' Annual Walk With Me event
(27) Asia Society 725 Park Avenue 0 New York,NY100215088	13-3234632	501(c)(3)	25,000	General support
(28) Astros Foundation 501 Crawford St 0 Houston,TX77002	74-2793078	501(c)(3)	25,000	General support
(29) Evelyn Rubenstein Jewish Community Center of Houston (ERJCC) 5601 S Braeswood Blvd 0 Houston,TX77096	13-1740507	501(c)(3)	25,000	General support
(30) Greater Houston Women's Chamber of Commerce 3201 Kirby Dr 0 Houston,TX77098	26-1536004	501(c)(6)	25,000	Support for the Greater Houston Women's Chamber of Commerce Hall of Fame Event and support for the Greater Houston Women's Chamber of Commerce Conference for Women 2022
(31) Houston Children's Charity 230 Westcott St 0 Houston,TX77007	76-0135741	501(c)(3)	25,000	General support
(32) SIRE - Therapeutic Horsemanship 11211 Katy Freeway Suite 660 Houston,TX77079	74-2168515	501(c)(3)	25,000	General support
(33) The Marfan Foundation 22 Manhasset Avenue 0 Port Washington,NY11050	52-1265361	501(c)(3)	25,000	General support
(34) The Rise School 5618 H Mark Crosswell Jr St 0 Houston,TX77021	76-0606866	501(c)(3)	25,000	General support
(35) Alpha Kappa Alpha Sorority Incorporated 5656 South Stony Island Avenue 0 Chicago,IL60637	36-3201654	501(c)(7)	20,000	General support
(36) American Leadership Forum 3101 Richmond Avenue 0 Houston,TX77098	76-0284248	501(c)(3)	20,000	General support
(37) Project Joy & Hope PO Box 5111 0 Pasadena,TX77508	76-0646721	501(c)(3)	20,000	General support
(38) Sam Houston Area Council - Boy Scouts of America 2225 North Loop West 0 Houston,TX77008	76-0239833	501(c)(3)	20,000	Support for the 2022 Sam Houston Area Council Friends of Scouting Campaign - Sports Breakfast Team
(39) Center for Pursuit 810 Marston St 0 Houston,TX77019	74-1272417	501(c)(3)	17,500	General support
(40) Athletes and Causes - HelpCureHD 12551 Franklin Rd 0 Thonotosassa,FL33592	47-2377003	501(c)(3)	15,000	General support
(41) Austin Smiles 9415 Burnet Rd Suite 207 Austin,TX78758	74-2479196	501(c)(3)	15,000	General support
(42) Candlelighters Childhood Cancer Family Alliance 12919 Southwest Freeway Suite 100 Stafford,TX77477	76-0367440	501(c)(3)	15,000	Support for the 2022 Lights of Courage event
(43) Capital Factory Properties LLC 701 Brazos St 0 Austin,TX78701	45-5547792	For Profit	15,000	Support for the 2022 Austin Startup Week event
(44) Hope and Healing Center & Institute (HHCI) 717 Sage Road 0 Houston,TX77056	45-3305276	501(c)(3)	15,000	General support
(45) Kids' Meals 330 Garden Oaks Blvd 0 Houston,TX770185502	76-0330447	501(c)(3)	15,000	Support for the Kids' Meals 2022 Harvest Event
(46) Lifeline Chaplaincy 1415 Southmore Blvd 0 Houston,TX77004	76-0504483	501(c)(3)	15,000	General support
(47) The Periwinkle Foundation 3000 Richmond Ave Suite 340 Houston,TX77098	76-0093914	501(c)(3)	15,000	General support
(48) Texas Hearing Institute 3100 Shenandoah St 0 Houston,TX77021	74-6003178	501(c)(3)	15,000	General support
(49) Texas Liver Foundation 2429 Bissonnet Number 30 Houston,TX77005	85-1898778	501(c)(3)	15,000	General support
(50) The Children's Assessment Center (CAC) 2500 Bolsover St 0 Houston,TX77005	76-0458780	501(c)(3)	15,000	General support
(51) The Faris Foundation 13135 Dairy Ashford Rd Ste 560 Sugar Land,TX774783689	83-3109684	501(c)(3)	15,000	General support
(52) The Thinkery 1830 Simond Ave 0 Austin,TX78723	74-2288789	501(c)(3)	15,000	General support
(53) Katy ISD Education Foundation 6301 South Stadium Lane 0 Katy,TX77494	80-0732375	501(c)(3)	11,100	General support and support for the Katy ISD food insecurity program
(54) Great Southwest Equestrian Center 515 Post Oak Blvd No 1000 Houston,TX77027	81-3819013	501(c)(3)	10,300	General support
(55) Houston Junior Woman's Club PO Box 19684 0 Houston,TX772249684	23-7045947	501(c)(3)	10,300	General support
(56) The Sanctuary Foster Care Services 1350 E NASA Parkway Suite 210 Houston,TX77058	82-5440662	501(c)(3)	10,298	General support
(57) Texans Care for Children 1106 Clayton Lane 0 Austin,TX78723	75-2687008	501(c)(3)	10,020	General support
(58) Angelman Syndrome Foundation 3015 E New York Street Suite A2 285 Aurora,IL60504	59-3092842	501(c)(3)	10,000	Support for the Angelman Syndrome Foundation 2022 National Walk
(59) Brighter Bites PO BOX 25456 0 Houston,TX772655456	47-4070026	501(c)(3)	10,000	General support
(60) Championship Hearts Foundation 8310 Shoregrove Dr 0 Humble,TX77346	81-1986712	501(c)(3)	10,000	General support
(61) Children At Risk 2900 Weslayan St Suite 400 Houston,TX77027	76-0360533	501(c)(3)	10,000	General support
(62) Covenant House 461 Eighth Avenue 0 New York,NY10001	13-2725416	501(c)(3)	10,000	Support for the Sleep Out to End Youth Homelessness event
(63) Epilepsy Foundation 2401 Fountain View Dr 900 Houston,TX77057	74-2141084	501(c)(3)	10,000	General support
(64) Hand to Hold 12325 Hymeadow Dr Suite 4 102 Austin,TX78750	27-3802900	501(c)(3)	10,000	General support
(65) Jack and Jill of America 1930 17th St NW 0 Washington,DC20009	51-0224656	501(c)(3)	10,000	General support
(66) JDRF - Juvenile Diabetes Research Foundation 1776 Yorktown 0 Houston,TX77056	23-1907729	501(c)(3)	10,000	General support
(67) KIPP Texas Public Schools 10711 KIPP WAY DR 0 Houston,TX770992675	01-0639602	501(c)(3)	10,000	General support
(68) The Menninger Clinic 12301 Main Street 0 Houston,TX77035	37-1453409	501(c)(3)	20,000	General support
(69) Sky High 9800 Richmond Ave Ste 335 Houston,TX77042	26-0465972	501(c)(3)	10,000	General support
(70) The Brookwood Community 1752 FM 1489 0 Brookshire,TX77423	74-1587672	501(c)(3)	10,000	Support for The Brookwood Community Inspiring Purpose Event
(71) The Crohn's & Colitis Foundation 386 Park Avenue South 0 New York,NY10016	13-6193105	501(c)(3)	10,000	General support
(72) The Ensemble Theater 3535 Main Street 0 Houston,TX77002	74-1941943	501(c)(3)	10,000	General support
(73) The Immunization Partnership PO Box 5168 0 Katy,TX77491	76-0695612	501(c)(3)	10,000	General support
(74) Fore the Cure 9568 Doliver Dr 0 Houston,TX770631011	47-2874715	501(c)(3)	8,000	General support
(75) Nora's Home 8300 El Rio St 0 Houston,TX77054	62-1763895	501(c)(3)	8,000	General support
(76) Buffalo Bayou Partership 1019 Commerce Street Suite 200 Houston,TX77002	76-0183954	501(c)(3)	6,000	General support
(77) His Grace Foundation PO Box 722 0 Tomball,TX77377	20-0585227	501(c)(3)	6,000	General support
(78) South Montgomery County Woodlands Chamber of Commerce 9320 Lakeside Blvd Suite 200 The Woodlands,TX77381	74-2053667	501(c)(6)	8,500	General support
(79) Houston Angels PO Box 420966 0 Houston,TX77242	84-4233396	501(c)(3)	5,245	General support
(80) Turn It Gold 14053 Memorial Dr Ste 142 Houston,TX770796826	46-2319604	501(c)(3)	5,181	General support
(81) Down Syndrome Association of Houston 7115 West Tidwell Rd Building K 109 Houston,TX77092	23-7203655	501(c)(3)	5,150	General support
(82) Bo's Place 10050 Buffalo Speedway 0 Houston,TX77054	76-0326979	501(c)(3)	5,100	General support

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 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) FELLOWSHIPS	6	450,000
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference	Explanation
Schedule I, Part I, Line 1 DESCRIPTION OF GRANT SELECTION CRITERIA	TEXAS CHILDREN'S HOSPITAL REQUIRES ALL REQUESTS TO BE IN WRITING AND BE SUBMITTED TO THE OFFICE OF DEVELOPMENT FOR EVALUATION. THE DIRECTOR OF DEVELOPMENT MAKES A RECOMMENDATION FOR RECOGNITION OF EACH CONTRIBUTION TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF TEXAS CHILDREN'S HOSPITAL FOR FINAL APPROVAL.
Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.	AFTER THE SPONSORSHIP/DONATION IS MADE, WE RECEIVE AN ACKNOWLEDGMENT LETTER WITH A RECEIPT OF THE GIFT. TYPICALLY THIS LETTER TELLS US HOW THE MONEY WILL BE USED AT THEIR PARTICULAR ORGANIZATION.

Schedule I (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 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
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1BENJAMIN B MELSON FORMER BOARD MEMBER, OFFICER & EXECUTIVE VICE PRESIDENT	(i) (ii)	0 ------------- 0	0 ------------- 0	100,873 ------------- 0	0 ------------- 0	1,264 ------------- 0	102,137 ------------- 0	0 ------------- 0
2MARK A WALLACE BOARD MEMBER / CHAIR / PRESIDENT / CEO	(i) (ii)	2,212,643 ------------- 0	4,655,373 ------------- 0	1,095,981 ------------- 0	849,357 ------------- 0	33,778 ------------- 0	8,847,132 ------------- 0	1,426,455 ------------- 0
3DEAN B ANDROPOULOS MD BOARD MEMBER / PHYSICIAN / IN-CHIEF	(i) (ii)	0 ------------- 0	138,300 ------------- 0	0 ------------- 0	234,300 ------------- 0	0 ------------- 0	372,600 ------------- 0	0 ------------- 0
4MICHAEL A BELFORT MD PHD BOARD MEMBER / PHYSICIAN / IN-CHIEF	(i) (ii)	0 ------------- 0	184,200 ------------- 0	0 ------------- 0	312,150 ------------- 0	0 ------------- 0	496,350 ------------- 0	0 ------------- 0
5DANIEL R DIPRISCO BOARD MEMBER / EXECUTIVE VICE PRESIDENT	(i) (ii)	544,740 ------------- 0	894,600 ------------- 0	85,402 ------------- 0	293,755 ------------- 0	20,011 ------------- 0	1,838,507 ------------- 0	406,065 ------------- 0
6WELDON W GAGE BOARD MEMBER / EXECUTIVE VICE PRESIDENT / CHIEF FINANCIAL OFFICER	(i) (ii)	825,941 ------------- 0	1,342,300 ------------- 0	117,591 ------------- 0	440,244 ------------- 0	29,753 ------------- 0	2,755,829 ------------- 0	635,833 ------------- 0
7Larry Hollier MD BOARD MEMBER / PHYSICIAN / IN-CHIEF	(i) (ii)	0 ------------- 0	1,339,926 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	1,339,926 ------------- 0	800,000 ------------- 0
8THIERRY HUISMAN MD BOARD MEMBER / PHYSICIAN / IN-CHIEF	(i) (ii)	0 ------------- 709,644	0 ------------- 135,500	0 ------------- 23,131	0 ------------- 404,419	0 ------------- 40,978	0 ------------- 1,313,673	0 ------------- 0
9MARK W MULLARKEY BOARD MEMBER / EXECUTIVE VICE PRESIDENT	(i) (ii)	678,185 ------------- 0	1,094,400 ------------- 0	223,201 ------------- 0	361,391 ------------- 0	41,816 ------------- 0	2,398,993 ------------- 0	541,094 ------------- 0
10MICHELLE M RILEY-BROWN BOARD MEMBER / EXECUTIVE VICE PRESIDENT	(i) (ii)	737,366 ------------- 0	1,179,200 ------------- 0	85,817 ------------- 0	392,704 ------------- 0	48,849 ------------- 0	2,443,936 ------------- 0	574,869 ------------- 0
11James Versalovic MD PHD BOARD MEMBER / PHYSICIAN / IN-CHIEF	(i) (ii)	0 ------------- 0	149,100 ------------- 0	0 ------------- 0	421,000 ------------- 0	0 ------------- 0	570,100 ------------- 0	0 ------------- 0
12JACQUELINE R WARD BOARD MEMBER / SENIOR VICE PRESIDENT / CHIEF NURSING OFFICER	(i) (ii)	407,987 ------------- 0	523,200 ------------- 0	73,206 ------------- 0	88,261 ------------- 0	24,647 ------------- 0	1,117,301 ------------- 0	239,794 ------------- 0
13LANCE A LIGHTFOOT BOARD SECRETARY / SENIOR VICE PRESIDENT	(i) (ii)	598,669 ------------- 0	829,300 ------------- 0	142,800 ------------- 0	316,282 ------------- 0	35,316 ------------- 0	1,922,368 ------------- 0	408,819 ------------- 0
14IVETT T SHAH SENIOR VICE PRESIDENT THROUGH 09/28/2022	(i) (ii)	368,050 ------------- 0	508,100 ------------- 0	44,427 ------------- 0	75,250 ------------- 0	10,146 ------------- 0	1,005,974 ------------- 0	226,069 ------------- 0
15MATTHEW T GIROTTO SENIOR VICE PRESIDENT	(i) (ii)	355,563 ------------- 0	514,900 ------------- 0	92,180 ------------- 0	234,493 ------------- 0	54,438 ------------- 0	1,251,574 ------------- 0	259,348 ------------- 0
16TABITHA L RICE EXECUTIVE VICE PRESIDENT	(i) (ii)	474,720 ------------- 0	642,600 ------------- 0	84,747 ------------- 0	343,353 ------------- 0	37,357 ------------- 0	1,582,777 ------------- 0	363,622 ------------- 0
17LINDA W ALDRED SENIOR VICE PRESIDENT	(i) (ii)	587,019 ------------- 0	805,900 ------------- 0	545,629 ------------- 0	334,036 ------------- 0	27,996 ------------- 0	2,300,579 ------------- 0	469,477 ------------- 0
18MYRA L DAVIS SENIOR VICE PRESIDENT	(i) (ii)	657,886 ------------- 0	907,100 ------------- 0	97,613 ------------- 0	482,414 ------------- 0	31,645 ------------- 0	2,176,657 ------------- 0	456,978 ------------- 0
19KATHARINE O TITTLE SENIOR VICE PRESIDENT	(i) (ii)	380,703 ------------- 0	817,200 ------------- 0	315,262 ------------- 0	8,700 ------------- 0	10,585 ------------- 0	1,532,450 ------------- 0	518,717 ------------- 0
20KEITH C NELSON SENIOR VICE PRESIDENT / CIO	(i) (ii)	521,808 ------------- 0	719,200 ------------- 0	23,513 ------------- 0	373,894 ------------- 0	46,748 ------------- 0	1,685,164 ------------- 0	354,780 ------------- 0
21STANLEY W SPINNER MD VICE PRESIDENT / CHIEF MEDICAL OFFICER	(i) (ii)	362,176 ------------- 0	488,300 ------------- 0	82,372 ------------- 0	38,300 ------------- 0	33,305 ------------- 0	1,004,453 ------------- 0	258,804 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

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

Return Reference

Explanation

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan

457(F) PLAN: PAID/DEFERRED ALDRED, LINDA W 514,972 / 0 DAVIS, MYRA L 64,479 / 108,402 DIPRISCO, DANIEL R 61,846 / 95,630 GAGE, WELDON W 91,104 / 158,000 GIROTTO, MATTHEW T 69,773 / 48,979 HUISMAN, THIERRY A G M 0 / 4,350 LIGHTFOOT, LANCE A 118,966 / 96,611 MULLARKEY, MARK W 218,883 / 123,460 NELSON, KEITH C 0 / 82,240 RICE, TABITHA L 81,622 / 68,335 RILEY-BROWN, MICHELLE M 81,322 / 136,000 SHAH, IVETT T 20,840 / 48,868 SPINNER, STANLEY W 48,816 / 0 TITTLE, KATHARINE O 105,930 / 0 WALLACE, MARK A 463,800 / 0 WARD, JACQUELINE R 47,016 / 57,520 457(F): THE 457(F) PLAN IS A NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT ALLOWS ELIGIBLE EXECUTIVES, FROM THE ASSISTANT VICE PRESIDENT LEVEL TO CHIEF EXECUTIVE OFFICER, TO RECEIVE SUPPLEMENTAL EXECUTIVE RETIREMENT INCOME. FUNDS MAY BE CREDITED INTO THIS ACCOUNT FROM AN EMPLOYER CONTRIBUTION, CALCULATED BASED ON AN INDIVIDUAL'S TITLE AND BASE SALARY AS OF JANUARY 1. THESE EMPLOYER FUNDED CONTRIBUTIONS VEST THE EARLIER OF FIVE YEARS, OR THE ATTAINMENT OF AGE 60 AND 75-POINTS DETERMINED AS OF THEIR AGE AND YEARS OF SERVICE. THE 457(F) PLAN ALSO CONTAINS RESIDUAL LONG-TERM INCENTIVE PLAN CONTRIBUTIONS AND CAPITAL ACCUMULATION CONTRIBUTIONS FROM A FLEXIBLE BENEFIT ACCOUNT SURPLUS. THE LONG-TERM INCENTIVE CONTRIBUTIONS VEST AFTER THREE YEARS AND THE CAPITAL ACCUMULATION CONTRIBUTIONS VEST AFTER A MINIMUM OF 5 YEARS IN THE PLAN.

Schedule J (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
TEXAS CHILDREN'S HOSPITAL

Employer identification number
74-1100555

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009JX9	06-03-2015	225,732,600	REFUND AND REDEEM PRIOR ISSUES (1999B-1 SERIES ISSUED 07/20/99) AND BUILD HEALTH CARE FACILITIES.		X		X		X
B	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009KB5	06-03-2015	160,000,000	BUILD HEALTH CARE FACILITIES		X		X		X
C	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009MA5	07-10-2019	271,811,948	REFUND 2008-3 & SERIES 2009 & SERIES 2010		X		X		X
D	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009QY9	07-20-2021	399,037,888	BUILD HEALTHCARE FACILITIES & REFUND 2015-4		X		X		X
	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009RB8	07-20-2021	190,350,000	REFUND SERIES 2008-1 & SERIES 2008-2		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	50,720,000		0		26,400,000		0
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	225,732,600		160,000,000		271,811,948		399,037,888
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		178,136,681		0
7 Issuance costs from proceeds ...............	1,700,783		1,274,762		2,174,707		2,711,023
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	100,931,817		158,725,238		0		182,763,594
11 Other spent proceeds .............	123,100,000		0		91,500,560		96,325,000
12 Other unspent proceeds .............	0		0		0		117,238,271
13 Year of substantial completion .............	2018		2018		2019
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X			X	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X	X			X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X		X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0.09 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0.09 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X			X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X			X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
Schedule K, Part I, Column (c) Bond Issue B	ADDITIONAL CUSIP 414009KC3
Schedule K, Part I, Column (c) Bond Issue D	ADDITIONAL CUSIP 414009QZ6
Schedule K, Part II, Line 13 Bond Issue D	ISSUE USED TO REFUND SERIES 2015-4 ($96.3 MILLION); REMAINING PROCEEDS ALLOCATED TO PROJECT THAT HAS NOT COMPLETED.
Schedule K, Part IV, Line 2c COLUMN A	Issuer name: HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO The calculation for computing no rebate due was performed on 07/28/2020
Schedule K, Part IV, Line 2c COLUMN B	Issuer name: HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO The calculation for computing no rebate due was performed on 07/28/2020

Schedule K (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
TEXAS CHILDREN'S HOSPITAL

Employer identification number
74-1100555

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009JX9	06-03-2015	225,732,600	REFUND AND REDEEM PRIOR ISSUES (1999B-1 SERIES ISSUED 07/20/99) AND BUILD HEALTH CARE FACILITIES.		X		X		X
B	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009KB5	06-03-2015	160,000,000	BUILD HEALTH CARE FACILITIES		X		X		X
C	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009MA5	07-10-2019	271,811,948	REFUND 2008-3 & SERIES 2009 & SERIES 2010		X		X		X
D	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009QY9	07-20-2021	399,037,888	BUILD HEALTHCARE FACILITIES & REFUND 2015-4		X		X		X
	HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO	76-0337885	414009RB8	07-20-2021	190,350,000	REFUND SERIES 2008-1 & SERIES 2008-2		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	50,720,000		0		26,400,000		0
2 Amount of bonds legally defeased ..............	0		0		0		0
3 Total proceeds of issue ..................	225,732,600		160,000,000		271,811,948		399,037,888
4 Gross proceeds in reserve funds .............	0		0		0		0
5 Capitalized interest from proceeds .............	0		0		0		0
6 Proceeds in refunding escrows ...............	0		0		178,136,681		0
7 Issuance costs from proceeds ...............	1,700,783		1,274,762		2,174,707		2,711,023
8 Credit enhancement from proceeds .............	0		0		0		0
9 Working capital expenditures from proceeds .............	0		0		0		0
10 Capital expenditures from proceeds .............	100,931,817		158,725,238		0		182,763,594
11 Other spent proceeds .............	123,100,000		0		91,500,560		96,325,000
12 Other unspent proceeds .............	0		0		0		117,238,271
13 Year of substantial completion .............	2018		2018		2019
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X			X	X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X			X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X	X			X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X		X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %		0 %		0.09 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %		0 %		0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %		0.09 %		0 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X			X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X	X		X
b Exception to rebate? ........		X		X		X		X
c No rebate due? .........	X		X			X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
Schedule K, Part I, Column (c) Bond Issue B	ADDITIONAL CUSIP 414009KC3
Schedule K, Part I, Column (c) Bond Issue D	ADDITIONAL CUSIP 414009QZ6
Schedule K, Part II, Line 13 Bond Issue D	ISSUE USED TO REFUND SERIES 2015-4 ($96.3 MILLION); REMAINING PROCEEDS ALLOCATED TO PROJECT THAT HAS NOT COMPLETED.
Schedule K, Part IV, Line 2c COLUMN A	Issuer name: HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO The calculation for computing no rebate due was performed on 07/28/2020
Schedule K, Part IV, Line 2c COLUMN B	Issuer name: HARRIS COUNTY CULTURAL EDUCATION FACILITIES FIN CO The calculation for computing no rebate due was performed on 07/28/2020

Schedule K (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

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

Attach to Form 990.
Right pointing arrow large image

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	34,778	1,838,294	Market value
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( Equipment )	X	3	11,600	Cost
26 Other ( Tickets and Certificates )	X	12	15,840	Cost
27 Other ( Toys )	X	5	3,300	NONE
28 Other ( )

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

Yes

30a

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

30a

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

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

Yes

32a

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

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

32a

If "Yes," describe in Part II.

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

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

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

Return Reference	Explanation
Schedule M, Part I Explanations of reporting method for number of contributions	Securities - Publicly traded - COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS Other - Equipment COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS Other - Tickets and Certificates COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS Other - Toys COLUMN (B) REPRESENTS NUMBER OF CONTRIBUTIONS

Schedule M (Form 990) (2021)

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

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

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Return Reference	Explanation
Form 990, Part VI, Line 1a	Texas Children's is the parent entity of Texas Children's Hospital. Texas Children's board of directors retains significant reserved authorities (detailed in Part VI, Line 7b below) that allow it to provide strategic oversight and direction to Texas Children's Hospital and its affiliated entities. Texas Children's board is representative of the community served and is composed of 35 individuals, 34 of which are independent.
Form 990, Part VI, Line 6 Classes of members or stockholders	Texas Children's is the sole corporate member of Texas Children's Hospital.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	Texas Children's annually appoints the Organization's board of directors.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	PER THE ORGANIZATION'S BYLAWS THE MEMBER HAS CERTAIN RESERVED POWERS: -APPROVE, INTERPRET OR CHANGE THE PURPOSE OF THE CORPORATION. -FIX THE NUMBER, APPOINT OR REMOVE, WITH OR WITHOUT CAUSE, ANY DIRECTOR OF THE CORPORATION. -APPROVE THE MERGER, DISSOLUTION OR CONSOLIDATION OR REORGANIZATION OF THE CORPORATION. -APPROVE THE ACQUISITION, SALE, LEASE, TRANSFER, OR OTHER ALIENATION OF PROPERTY OF THE CORPORATION, OTHER THAN IN THE USUAL AND REGULAR COURSE OF THE CORPORATION'S BUSINESS, WHEN SUCH ACQUISITION, SALE, LEASE, TRANSFER OR OTHER ALIENATION IS ABOVE SPECIFIC FINANCIAL LEVELS SET IN ACCORDANCE WITH POLICIES ESTABLISHED FROM TIME TO TIME BY THE MEMBER. -APPROVE CAPITAL AND OPERATING BUDGETS OF THE CORPORATION. -ADOPTION OR AMENDMENT OF SALARIES OR OTHER COMPENSATION OF THE OFFICERS, PHYSICIAN EMPLOYEES AND INDEPENDENT CONTRACTOR PHYSICIANS OF THE CORPORATION. -APPROVE DEBT INCURRED BY THE CORPORATION, WHICH IS IN EXCESS OF SUCH LIMITS AS ARE ESTABLISHED BY THE MEMBER. -APPROVE THE DISPOSITION OF ASSETS OF THE CORPORATION AT THE TIME OF ITS DISSOLUTION. -APPROVE ANY LONG-RANGE FINANCIAL OR STRATEGIC PLANS FOR THE CORPORATION. -SELECTION OF THE CORPORATION'S AUDITORS. -DESIGNATION OF ADDITIONAL OR SUCCESSOR MEMBERS. -TAKE ANY ACTION WHICH WOULD BE INCONSISTENT WITH THE GOVERNING DOCUMENTS OR POLICIES OF THE MEMBER.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body	No such committees exist.
Form 990, Part VI, Line 11b Review of form 990 by governing body	Per a resolution approved by the member's board of trustees, the member board's audit, compliance, & risk committee has delegated authority to review the organization's completed Form 990 prior to filing. Please note the audit and compliance committee and the risk, management & insurance committee were consolidated into one Committee this year. Following the AC&R Committee's review and approval, the completed Form 990 are shared with the members of the organization's board of directors and board of trustees prior to filing with the IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	THE ORGANIZATION CONSISTENTLY MONITORS AND ENFORCES THE CONFLICT OF INTEREST POLICY THROUGH TWO SEPARATE PROCESSES, ONE THAT APPLIES TO THE BOARD MEMBERS, AND A SECOND THAT APPLIES TO OFFICERS AND KEY EMPLOYEES. 1) BOARD MEMBERS - PER THE ORGANIZATION'S BOARD-APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE MEMBER'S BOARD LEADERSHIP AND PRESENTED TO THE MEMBER'S AUDIT, COMPLIANCE, & RISK COMMITTEE. IF THE COMMITTEE DEEMS THERE ARE ANY SIGNIFICANT ISSUES, THE RESPONSES ARE THEN REVIEWED BY THE MEMBER BOARD'S EXECUTIVE COMMITTEE AND ANY REQUIRED ACTION ( RECUSEMENT FROM BOARD DELIBERATIONS RELATED TO THE CONFLICT, ETC. ) IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD-APPROVED CODE OF CONDUCT. 2) OFFICERS/KEY EMPLOYEES - PER THE ORGANIZATION'S BOARD APPROVED CONFLICTS REVIEW PROCESS, RESPONSES TO THE ANNUAL CONFLICTS QUESTIONNAIRE ARE REVIEWED BY THE COMPLIANCE SERVICES DEPARTMENT. IF THE DEPARTMENT DEEMS THERE ARE ANY SIGNIFICANT ISSUES, REQUIRED ACTION IS TAKEN IN ACCORDANCE WITH THE ORGANIZATION'S BOARD APPROVED CODE OF CONDUCT AND THE BOARD IS NOTIFIED OF SUCH ACTIONS.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	THE ANNUAL PROCESS FOR DETERMINING COMPENSATION INCLUDES: - REVIEW AND APPROVAL BY GOVERNING BODY AND COMPENSATION COMMITTEE, PROVIDED THAT PERSONS WITH A CONFLICT OF INTEREST WITH RESPECT TO THE COMPENSATION ARRANGEMENT AT ISSUE WERE NOT INVOLVED. - COMPARABLE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS IN FUNCTIONALLY COMPARABLE POSITIONS AT SIMILARLY SITUATED ORGANIZATIONS. - CONTEMPORANEOUS DOCUMENTATION AND RECORDKEEPING WITH RESPECT TO DELIBERATIONS AND DECISIONS REGARDING THE COMPENSATION AGREEMENT.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	Please refer to process described in Part VI, Line 15a.
Form 990, Part VI, Line 19 Required documents available to the public	ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
Form 990, Part VII, Section A INCENTIVE COMPENSATION	DRS. ANDROPOULOS, BELFORT, VERSALOVIC, AND HOLLIER WHILE EMPLOYED BY BAYLOR COLLEGE OF MEDICINE, SERVE AS IN-CHIEFS DIRECTING PATIENT CARE AT TEXAS CHILDREN'S HOSPITAL. DUE TO THEIR SENIOR LEADERSHIP ROLES, THEY ARE ELIGIBLE FOR INCENTIVE COMPENSATION BASED ON THEIR CONTRIBUTIONS TO ACHIEVING THE ORGANIZATION'S STRATEGIC GOALS. ALL COMPENSATION IS EARNED IN THEIR CAPACITY AS PHYSICIAN LEADERS.
Form 990, Part VIII, Line 2f Other Program Service Revenue	Restricted Funds Utilized - Total Revenue: 46661696, Related or Exempt Function Revenue: 46661696, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Other Revenues - Total Revenue: 42143168, Related or Exempt Function Revenue: 42143168, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0; Indirect Expense Reimbursement from Affiliates - Total Revenue: 16260832, Related or Exempt Function Revenue: 16260832, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other non-operating income - Total Revenue: 11634530, Related or Exempt Function Revenue: 11634530, Unrelated Business Revenue: 0, Revenue Excluded from Tax Under Sections 512, 513, or 514: 0;
Form 990, Part IX, Line 11g Other Fees	HEALTHCARE PROFESSIONAL SERVICES - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 15958907, Fundraising Expenses: 2116246; TCPSO HEALTHCARE PROGRAM SUPPORT - Total Expense: XXX-XX-XXXX, Program Service Expense: XXX-XX-XXXX, Management and General Expenses: 2153371, Fundraising Expenses: 40086; OTHER NON-HEALTHCARE PROFESSIONAL SERVICES - Total Expense: 71577507, Program Service Expense: 67708782, Management and General Expenses: 2686668, Fundraising Expenses: 1182057; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ; - Total Expense: , Program Service Expense: , Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	ACTUARIAL GAIN ON PENSION - 26828555; GRANT FUNDED CAPITAL - 66860; CHANGE IN BENEFICIAL INTEREST IN AFFILIATES - -XXX-XX-XXXX; CHANGE IN CHARITABLE GIFT ANNUITY - -29260; AUXILIARY RESTRICTED FUND - -2656164; FUND BALANCE ADJUSTMENT - -1308167; ASSETS RELEASED FROM RESTRICTION - -45289496; INVESTMENT IN AFFILIATES - XXX-XX-XXXX;

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

TEXAS CHILDREN'S HOSPITAL

Employer identification number

74-1100555

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)TEXAS CHILDREN'S GLOBAL PO BOX 300630 HOUSTON,TX77230 26-1482195	HEALTH CARE	TX	501(c)(3)	Type II	TEXAS CHILDREN'S		No
(2)TEXAS CHILDREN'S 1919 S BRAESWOOD 4TH FL HOUSTON,TX77030 76-0461578	PARENT	TX	501(c)(3)	Type II	NA		No
(3)TEXAS CHILDREN'S PHYSICIAN GROUP 6621 FANNIN STREET HOUSTON,TX77030 26-0834681	HEALTH CARE	TX	501(c)(3)	10	TEXAS CHILDREN'S		No
(4)TCH PEDIATRIC ASSOCIATES INC PO BOX 300630 HOUSTON,TX77230 76-0460242	HEALTH CARE	TX	501(c)(3)	10	TEXAS CHILDREN'S		No
(5)TEXAS CHILDREN'S HEALTH PLAN 6330 WEST LOOP SOUTH SUITE 800 8TH FLOOR BELLAIRE,TX77401 76-0486264	HEALTH CARE	TX	501(c)(3)	10	TEXAS CHILDREN'S		No
(6)TEXAS CHILDREN'S HOSPITAL FOUNDATION 6621 FANNIN STREET HOUSTON,TX77030 20-2380599	SUPPORTING ORG	TX	501(c)(3)	Type II	TEXAS CHILDREN'S		No
(7)TEXAS CHILDREN'S HEALTH PLAN - THE CENTER 6621 FANNIN STREET HOUSTON,TX77030 46-1392824	HEALTH CARE	TX	501(c)(3)	Type I	TEXAS CHILDREN'S HEALTH PLAN INC		No
(8)TEXAS CHILDREN'S URGENT CARE 1919 S BRAESWOOD BLVD 4TH FLOOR HOUSTON,TX77030 47-2029489	HEALTH CARE	TX	501(c)(3)	10	TCH PEDIATRIC ASSOCIATES INC		No
(9)THE GORDON AND MARY CAIN PEDIATRIC NEUROLOGY RESEARCH FOUNDATION 9 GREENWAY PLAZA HOUSTON,TX77046 76-0246858	SUPPORTING ORG	TX	501(c)(3)	Type I	TEXAS CHILDREN'S		No

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

Cat. No. 50135Y

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

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) TCH INSURANCE COMPANY LTD 23 LIME TREE BAY AVENUE GRAND CAYMANKY11102 CJ 98-0176652	INSURANCE	CJ	NA	C Corporation					No
(2) CVI GVF HOLDINGS 3 LTD UGLAND HOUSE SOUTH CHURCH STREET GEORGE TOWNKY11104 CJ 98-1078282	INVESTMENT	CJ	NA	C Corporation					No

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

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

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

Yes

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 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)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 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

Software ID:	21014044
Software Version:	2021v4.2

1	Briefly describe the organization’s mission or most significant activities: TO CREATE A HEALTHIER FUTURE FOR CHILDREN AND WOMEN THROUGHOUT OUR GLOBAL COMMUNITY BY LEADING IN PATIENT CARE, EDUCATION AND RESEARCH.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	14
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	3
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	13,557
6	Total number of volunteers (estimate if necessary) .............	6	378
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	68,143,860	90,377,913
9	Program service revenue (Part VIII, line 2g) .........	2,650,840,461	2,981,690,830
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	18,234,222	38,629,226
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	14,668,103	27,497,662
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,751,886,646	3,138,195,631
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	8,798,897	10,206,694
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	1,242,700,342	1,413,915,021
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	1,306,499	2,709,599
b	Total fundraising expenses (Part IX, column (D), line 25) 23,597,878
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,462,326,680	1,820,454,851
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	2,715,132,418	3,247,286,165
19	Revenue less expenses. Subtract line 18 from line 12.......	36,754,228	-109,090,534
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	7,172,261,535	6,762,073,162
21	Total liabilities (Part X, line 26).............	1,866,154,671	1,991,143,721
22	Net assets or fund balances. Subtract line 21 from line 20.....	5,306,106,864	4,770,929,441

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 2,891,468,520 including grants of $ 9,592,561 ) (Revenue $ 2,960,765,197 )
	PATIENT CARE: TEXAS CHILDREN'S HOSPITAL IS AN INTERNATIONALLY RECOGNIZED FULL-SERVICE PEDIATRIC HOSPITAL OPERATING THREE CAMPUSES IN THE HOUSTON AREA, THE LARGEST OF WHICH IS LOCATED IN THE TEXAS MEDICAL CENTER. ONE OF THE LARGEST PEDIATRIC HOSPITALS IN THE UNITED STATES, THE HOSPITAL IS CONSISTENTLY RANKED AS THE BEST CHILDREN'S HOSPITAL IN TEXAS, AND AMONG THE TOP IN THE NATION. TEXAS CHILDREN'S HAS GARNERED WIDESPREAD RECOGNITION FOR ITS EXPERTISE AND BREAKTHROUGHS IN PEDIATRIC AND WOMEN'S HEALTH. THE HOSPITAL INCLUDES TEXAS CHILDREN'S HOSPITAL; THE JAN AND DAN DUNCAN NEUROLOGICAL RESEARCH INSTITUTE; THE FEIGIN CENTER FOR PEDIATRIC RESEARCH; TEXAS CHILDREN'S PAVILION FOR WOMEN, A COMPREHENSIVE OBSTETRICS/GYNECOLOGY HOSPITAL FOCUSING ON HIGH-RISK BIRTHS; TEXAS CHILDREN'S HOSPITAL WEST CAMPUS, A COMMUNITY HOSPITAL IN SUBURBAN WEST HOUSTON; AND TEXAS CHILDREN'S HOSPITAL THE WOODLANDS, THE FIRST HOSPITAL DEVOTED TO CHILDREN'S CARE FOR COMMUNITIES NORTH OF HOUSTON, A SECOND COMMUNITY HOSPITAL THAT OPENED APRIL 2017. TEXAS CHILDREN'S HOSPITAL WILL BE OPENING A BRAND NEW SEPARATELY LICENSED CHILDREN'S HOSPITAL IN AUSTIN, TX PLANNED FOR FEBRUARY 2024. TEXAS CHILDREN'S PAVILION FOR WOMEN OFFERS A FULL SPECTRUM OF GYNECOLOGICAL AND MATERNAL AND FETAL MEDICINE SERVICES, INCLUDING AN ARRAY OF FETAL DIAGNOSTIC PROCEDURES AND HIGHLY SPECIALIZED FETAL SURGERIES, THREE PRIVATE OB/GYN PRACTICES, THE FAMILY FERTILITY CENTER, THE MENOPAUSE CENTER AND THE WOMEN'S PLACE - CENTER FOR REPRODUCTIVE PSYCHIATRY. DURING THE YEAR THE HOSPITAL OVERALL OPERATED 863 INPATIENT BEDS AND MORE THAN 130 AMBULATORY SPECIALTY CLINICS, SUPPORTED BY AN AWARD-WINNING MEDICAL STAFF CONSISTING OF MORE THAN 870 BOARD-CERTIFIED PEDIATRIC PHYSICIANS, OBSTETRICIANS AND GYNECOLOGISTS, ADULT SUBSPECIALISTS AND DENTISTS AND A DEDICATED AND HIGLY SKILLED NURSING AND SUPPORT STAFF OF MORE THAN 11,300. IN 2022, THE PAVLION PERFORMED APPROXIMATELY 6,745 DELIVERIES AND THE HOSPITAL SYSTEM EXCEEDED 1,785,700 OUTPATIENT CLINIC VISITS. THE ORGANIZATION ALSO CREATED TEXAS CHILDREN'S HEALTH PLAN, THE NATION'S FIRST HMO FOR CHILDREN; TEXAS CHILDREN'S PEDIATRICS, THE LARGEST PEDIATRIC PRIMARY CARE NETWORK IN THE COUNTRY; TEXAS CHILDREN'S URGENT CARE CLINICS THAT SPECIALIZE IN AFTER-HOURS CARE TAILORED SPECIFICALLY FOR CHILDREN; AND A GLOBAL HEALTH PROGRAM THAT'S PROVIDING CARE TO CHILDREN AND WOMEN ALL OVER THE WORLD. TEXAS CHILDREN'S HOSPITAL IS AFFILIATED WITH BAYLOR COLLEGE OF MEDICINE.

4b	(Code: ) (Expenses $ 119,294,534 including grants of $ 395,764 ) (Revenue $ 33,722,464 )
	RESEARCH: TEXAS CHILDREN'S/BAYLOR RESEARCHERS AT THE FEIGIN CENTER, THE JAN AND DAN DUNCAN NEUROLOGICAL RESEARCH INSTITUTE AND THE CHILDREN'S NUTRITION RESEARCH CENTER ARE CONDUCTING SOME OF THE MOST INNOVATIVE ONGOING RESEARCH IN A VARIETY OF AREAS FROM PEDIATRIC CARDIOLOGY TO INFECTIOUS DISEASES, NUTRITION, VACCINES AND PEDIATRIC NEUROLOGY AND NEUROGENETICS. DURING 2022, TEXAS CHILDREN'S INVESTED IN MORE THAN $119 MILLION IN OVER 1,957 CLINICAL, BASIC AND TRANSLATIONAL RESEARCH PROJECTS, EXPLORING A WIDE RANGE OF CHILDREN'S AND WOMEN'S HEALTH ISSUES. IN ADDITION, THE HOSPITAL CONTINUED ITS STRATEGIC FOCUS ON THE GROWTH AND SUCCESS OF ALL TEXAS CHILDREN'S RESEARCH ENDEAVORS THROUGH ENHANCED INFRASTRUCTURE, SUCH AS THE EXPANSION OF THE JAN AND DAN DUNCAN NEUROLOGICAL RESEARCH INSTITUTE WHERE INVESTIGATORS CAN ACCESS CUTTING EDGE IMAGING MODALITIES, SUCH AS TWO-PHOTON MICROSCOPY, AND STATE-OF-THE-ART NEUROPHYSIOLOGY AND BEHAVIORAL SCIENCE CORE RESOURCES.

4c	(Code: ) (Expenses $ 65,822,521 including grants of $ 218,369 ) (Revenue $ 13,722,268 )
	EDUCATION: THE HOSPITAL SERVES AS THE PRIMARY PEDIATRIC TEACHING FACILITY FOR BAYLOR COLLEGE OF MEDICINE (THEIR LONG-TERM ACADEMIC PARTNER). IN ADDITION, THE TEXAS CHILDREN'S PAVILION FOR WOMEN IS ONE OF THE PREMIER PRIVATE TRAINING HOSPITALS FOR BAYLOR COLLEGE OF MEDICINE'S DEPARTMENT OF OBSTECTRICS AND GYNECOLOGY. THE CLOSE AFFILIATION BETWEEN THE INSTITUTIONS EXTENDS THROUGH TEXAS CHILDREN'S OPERATIONS, BAYLOR FACULTY INCLUDING SERVICE CHIEFS, MEDICAL DIRECTORS AND STAFF PHYSICIANS ACROSS THE HOSPITAL'S 51 SUB-SPECIALTY CARE OFFERINGS. DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2022, THE HOSPITAL INVESTED MORE THAN $55 MILLION IN THE TRAINING OF OVER 1,300 TRAINEES IN 100 TRAINING PROGRAMS ROTATING AT TEXAS CHILDREN'S. BAYLOR AND TEXAS CHILDREN'S HAVE A PROVEN TRACK RECORD RECRUITING TRANSFORMATIVE PHYSICIAN-SCIENTISTS AND ONE OF THE STRONGEST PEDIATRIC RESIDENCY PROGRAMS IN THE COUNTRY. BAYLOR'S PEDIATRIC RESIDENCY PROGRAM IS THE LARGEST TRAINING GROUND FOR PEDIATRICS AND ONE OF THE MOST COMPETITIVE IN THE COUNTRY. MORE THAN 1,700 STUDENTS APPLY EACH YEAR FROM THE TOP MEDICAL SCHOOLS AROUND THE COUNTRY.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses3,076,585,575

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)				(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
(A) Name and title
(18) MATTHEW T GIROTTO SENIOR VICE PRESIDENT	39.0 .......................1.0	X			962,643	0	288,931
(19) TABITHA L RICE EXECUTIVE VICE PRESIDENT	40.0 .......................0.0	X			1,202,067	0	380,710
(20) KATHARINE O TITTLE SENIOR VICE PRESIDENT	40.0 .......................0.0		X		1,513,165	0	19,285
(21) KEITH C NELSON SENIOR VICE PRESIDENT / CIO	40.0 .......................0		X		1,264,521	0	420,642
(22) LINDA W ALDRED SENIOR VICE PRESIDENT	40.0 .......................0		X		1,938,548	0	362,032
(23) MYRA L DAVIS SENIOR VICE PRESIDENT	40.0 .......................0		X		1,662,599	0	514,058
(24) STANLEY W SPINNER MD VICE PRESIDENT / CHIEF MEDICAL OFFICER	38.0 .......................2.0		X		932,848	0	71,605
(25) BENJAMIN B MELSON FORMER BOARD MEMBER, OFFICER & EXECUTIVE VICE PRESIDENT	0.0 .......................0			X	100,873	0	1,264

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	30,657,269	868,276	6,532,936

1a	Federated campaigns..		1a	0
b	Membership dues..		1b	0
c	Fundraising events..		1c	1,411,498
d	Related organizations		1d	0
e	Government grants (contributions)		1e	15,251,841

f	All other contributions, gifts, grants, and similar amounts not included above		1f	73,714,574

g	Noncash contributions included in lines 1a - 1f:$		1g	1,869,034

h Total. Add lines 1a-1f.......		90,377,913

		Business Code
2a	NET PATIENT SERVICE REVENUE	622310	2,529,274,290	2,529,274,290	0	0
b	MEDICAID & SUPPLEMENTAL REIMBURSEMENTS	622310	98,026,038	98,026,038	0	0
c	PHARMACY REVENUE	622310	197,299,131	197,299,131	0	0
d	MANAGEMENT SERVICES	541611	36,912,960	36,912,960	0	0
e	RENTAL INCOME	900099	15,112,715	15,112,715	0	0
f	All other program service revenue.		105,065,696	105,065,696	0	0
g	Total. Add lines 2a–2f .....		2,981,690,830

3 Investment income (including dividends, interest, and othersimilar amounts) ......			38,455,685	0	0	38,455,685
4 Income from investment of tax-exempt bond proceeds			0	0	0	0
5 Royalties...........			0	0	0	0
		(ii) Personal	(i) Real
6a	Gross rents		227,913	6a
b	Less: rental expenses		67,944	6b
c	Rental income or (loss)	0	159,969	6c
d	Net rental income or (loss).......			159,969	0	0	159,969
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	139,453	6,005,331	7a
b	Less: cost or other basis and sales expenses	179,682	5,791,561	7b
c	Gain or (loss)	-40,229	213,770	7c
d	Net gain or (loss).........			173,541	0	0	173,541
8a	Gross income from fundraising events (not including $ 1,192,368of contributions reported on line 1c). See Part IV, line 18 ....
			8a	177,339
b	Less: direct expenses ...		8b	592,556
c	Net income or (loss) from fundraising events..			-415,217		0	-415,217
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	0
b	Less: direct expenses ...		9b	0
c	Net income or (loss) from gaming activities..			0	0	0	0
10a	Gross sales of inventory, less returns and allowances ..
			10a	3,056,594
b	Less: cost of goods sold ..		10b	1,822,784
c	Net income or (loss) from sales of inventory..			1,233,811	0	0	1,233,811
Business Code			Miscellaneous Revenue
11a	PARKING GARAGE REVENUE		812930	14,884,569	14,884,569	0	0
b				0	0	0	0
c				0	0	0	0
d	All other revenue ....			11,634,530	11,634,530	0	0
e	Total. Add lines 11a–11d ......			26,519,099
12	Total revenue. See instructions.....			3,138,195,631	3,008,209,929	0	39,607,789

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	9,756,694	9,756,694
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	450,000	450,000
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 ...........	50,971,311	50,971,311
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	203,010	203,010
7	Other salaries and wages........	1,095,373,742	1,027,054,927	60,185,903	8,132,912
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	46,495,187	44,250,870	1,904,913	339,404
9	Other employee benefits .......	139,812,538	130,586,131	8,280,541	945,866
10	Payroll taxes ...........	81,059,233	75,567,699	4,909,708	581,826
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	3,936,789	465,176	3,468,804	2,809
c	Accounting ...........	348,092	5,984	342,108
d	Lobbying ...........	486,582	2,339	484,243
e	Professional fundraising services. See Part IV, line 17	2,709,599			2,709,599
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	666,437,821	642,300,486	20,798,946	3,338,389
12	Advertising and promotion ....	37,804,680	36,155,746	959,817	689,117
13	Office expenses .......	63,193,581	58,623,643	4,378,262	191,676
14	Information technology ......	78,088,203	70,804,677	3,665,022	3,618,504
15	Royalties ..
16	Occupancy ...........	75,910,283	72,585,020	3,148,842	176,421
17	Travel ............	2,405,514	2,175,296	143,008	87,210
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	2,379,640	2,193,167	134,733	51,740
20	Interest ...........	19,058,508	18,421,771	495,464	141,273
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	162,531,379	160,538,818	1,621,978	370,583
23	Insurance ...	29,062,546	430,728	28,629,742	2,076
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	PHARMACEUTICAL SUPPLIES	251,700,478	251,700,478
b	MEDICAL/SURGICAL SUPPLIES	180,322,445	180,322,445
c	ENHANCED MISSION SUPPORT	174,058,397	174,058,397
d	RECRUITING	12,262,176	11,621,188	539,851	101,137
e	All other expenses	60,467,737	55,339,574	3,010,827	2,117,336
25	Total functional expenses. Add lines 1 through 24e	3,247,286,165	3,076,585,575	147,102,712	23,597,878
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			191,638,707	1	12,215,827
2	Savings and temporary cash investments .........				2	0
3	Pledges and grants receivable, net ......			113,730,006	3	120,757,779
4	Accounts receivable, net .............			486,043,933	4	662,812,637
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7	0
8	Inventories for sale or use ............			34,919,092	8	39,858,046
9	Prepaid expenses and deferred charges ......			169,854,044	9	220,654,022
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	4,129,266,409
b	Less: accumulated depreciation	10b	1,932,988,206	2,069,505,963	10c	2,196,278,203
11	Investments—publicly traded securities .			778,649,472	11	539,791,353
12	Investments—other securities. See Part IV, line 11 .....			36,329	12	18,403
13	Investments—program-related. See Part IV, line 11 ..			217,744,092	13	230,312,524
14	Intangible assets ...............				14	0
15	Other assets. See Part IV, line 11 ...........			3,110,139,897	15	2,739,374,368
16	Total assets. Add lines 1 through 15 (must equal line 33)...			7,172,261,535	16	6,762,073,162

17	Accounts payable and accrued expenses .....	488,148,988	17	578,015,245
18	Grants payable ...		18	0
19	Deferred revenue .........	65,002,249	19	65,849,699
20	Tax-exempt bond liabilities .........	1,146,722,160	20	953,406,476
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21	0
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	673,070	23	599,187
24	Unsecured notes and loans payable to unrelated third parties ..		24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	165,608,204	25	393,273,114
26	Total liabilities. Add lines 17 through 25..	1,866,154,671	26	1,991,143,721

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	4,865,603,963	27	4,357,629,020
28	Net assets with donor restrictions ...........	440,502,901	28	413,300,421
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29	0
30	Paid-in or capital surplus, or land, building or equipment fund ...		30	0
31	Retained earnings, endowment, accumulated income, or other funds		31	0
32	Total net assets or fund balances ...........	5,306,106,864	32	4,770,929,441
33	Total liabilities and net assets/fund balances ........	7,172,261,535	33	6,762,073,162

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