TY 2022 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) KURT D NEWMAN MD...................................................................... PRESIDENT / CEO (CNMC) TO 06/23	43.00 ................. 12.00	X	X		2,973,754	52,949
(2) AMY FREEMAN...................................................................... BOARD CHAIRMAN	2.00 ................. 1.00	X	X		0	0
(3) PAUL KALB MD...................................................................... BOARD VICE CHAIRMAN	1.00 ................. 0.00	X	X		0	0
(4) MARY GEN LEDECKY...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(5) ARTENCIA HAWKINS-BELL...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(6) HORACIO ROZANSKI...................................................................... BOARD MEMBER	2.00 ................. 4.00	X			0	0
(7) AMANDA LELAND...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(8) JERRY STOUCK...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(9) IVY WAFFORD DUKE...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(10) ELLIE HAMBURGER MD...................................................................... BOARD MEMBER FROM 7/22	1.00 ................. 0.00	X			0	0
(11) MARSHA REGENSTEIN...................................................................... BOARD MEMBER FROM 7/22	1.00 ................. 2.00	X			0	0
(12) ALDWIN LINDSAY...................................................................... EVP/CFO	37.00 ................. 18.00		X		1,068,278	124,440
(13) MARY ANNE HILLIARD...................................................................... EVP/CHIEF LEGAL OFFICER	38.00 ................. 17.00		X		944,536	109,508
(14) ANTHONY SANDLER MD...................................................................... SVP CENTER OF EXCELLENCE	45.00 ................. 10.00			X	1,728,225	203,233
(15) KATHLEEN CHAVANU GORMAN...................................................................... CHIEF OPERATING OFFICER	52.00 ................. 3.00			X	1,337,573	163,270
(16) DAVID WESSEL MD...................................................................... CHIEF MEDICAL OFFICER	54.00 ................. 1.00			X	1,271,732	83,599
(17) DEANN MARSHALL...................................................................... PRESIDENT OF FOUNDATION	1.00 ................. 54.00			X	1,008,716	52,819

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) ROGER PACKER MD........................................................................ SVP CENTER OF EXCELLENCE TO 3/23	53.00 .......................2.00	X			1,002,589	46,798
(19) CHARLES WEINSTEIN........................................................................ CHIEF REAL ESTATE OFFICER	54.00 .......................1.00	X			907,254	44,366
(20) MICHELLE M MCGUIRE........................................................................ CHIEF STRATEGY OFFICER	54.00 .......................1.00	X			818,934	129,748
(21) NATHANIEL BEERS MD........................................................................ PRESIDENT OF HSC	1.00 .......................54.00	X			821,699	120,412
(22) CATHERINE CODISPOTI MD........................................................................ CHIEF PEOPLE OFFICER	54.00 .......................1.00	X			821,117	46,293
(23) MATTHEW MACVEY........................................................................ CHIEF INFO OFFICER	54.00 .......................1.00	X			712,158	129,890
(24) VITTORIO GALLO PHD........................................................................ CHIEF RESEARCH OFFICER	15.00 .......................40.00	X			785,775	25,913
(25) LINDA TALLEY........................................................................ CHIEF NURSING OFFICER	54.00 .......................1.00	X			702,536	101,273
(26) ELIZABETH WELLS........................................................................ SVP CENTER OF EXCELLENCE FROM 3/23	54.00 .......................1.00	X			557,270	50,375
(27) YVES D'UDEKEM D'ACOZ MD........................................................................ CHIEF OF CARDIO SURGERY	55.00 .......................0.00		X		2,146,984	45,675
(28) ROBERT KEATING MD........................................................................ CHIEF OF NEUROSURGERY	55.00 .......................0.00		X		1,337,672	130,280
(29) TIMOTHY KANE MD........................................................................ CHIEF OF PEDIATRIC SURGERY	55.00 .......................0.00		X		1,144,904	44,128
(30) RICARDO MUNOZ MD........................................................................ CHIEF OF CARDIAC CRITICAL CARE	55.00 .......................0.00		X		1,120,177	88,259
(31) RAHUL SHAH MD........................................................................ SVP, HOSPITAL-BASED SPECIALTIES	54.00 .......................1.00		X		1,048,832	109,728
(32) MARK L BATSHAW MD........................................................................ FMR EVP & CHIEF ACADEMIC OFFICER	53.00 .......................2.00			X	761,072	162,760
(33) DARRYL VARNADO PHD........................................................................ FMR CHIEF PEOPLE OFFICER	54.00 .......................1.00			X	226,437	23,876
(34) DENICE CORA-BRAMBLE MD........................................................................ FMR CHIEF MEDICAL OFFICER	54.00 .......................1.00			X	305,556	56,381

(A) Name and business address	(B) Description of services	(C) Compensation
CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY,MO64117	INFORMATION TECHNOLOGY	49,451,266
PRESIDIO NETWORKED SOLUTIONS LLC PO BOX 822169 PHILADELPHIA,PA19182	INFORMATION TECHNOLOGY	3,529,340
TAG B VALET PARKING LLC 15 LEWIS STREET HARTFORD,CT06103	PARKING	2,605,926
BRSI LP 1111 NORTH LOOP WEST SUITE 1000 HOUSTON,TX77008	HEALTH CARE SERVICES	2,354,423
MORRISON MANAGEMENT SPECIALISTS INC 5801 PEACHTREE DUNWOODY RD ATLANTA,GA30342	PURCHASED FOOD SERVICES	2,289,858
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 174

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

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	24,932,071	85,105,614	58,540,048	66,496,859	53,753,566	288,828,158
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	24,932,071	85,105,614	58,540,048	66,496,859	53,753,566	288,828,158
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.						288,828,158

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(f) Total
7	Amounts from line 4..	24,932,071	85,105,614	58,540,048	66,496,859	53,753,566	288,828,158
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	5,535,245	7,995,875	11,995,360	13,818,827	12,071,637	51,416,944
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.)..	4,441,568	4,528,932	3,800,400	4,254,430	4,952,676	21,978,006
11	Total support. Add lines 7 through 10						362,223,108

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

6,447,015,267

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 2022 (line 6, column (f) divided by line 11, column (f)) .........

79.740 %

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

80.610 %

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

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) 2022

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) 2022

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) 2022

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 2022 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-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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, PART II, LINE 10, EXPLANATION OF OTHER INCOME:	PARKING - 2018 AMOUNT: $ 4,441,568. 2019 AMOUNT: $ 4,528,932. 2020 AMOUNT: $ 3,800,400. 2021 AMOUNT: $ 4,254,430. 2022 AMOUNT: $ 4,952,676.

Schedule A (Form 990) 2022

Additional Data

Software ID:
Software Version:

- 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

2022

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization 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) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization CHILDREN'S HOSPITAL		Employer identification number 53-0196580

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) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization CHILDREN'S HOSPITAL			Employer identification number 53-0196580
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) (2022)

Additional Data

Software ID:
Software Version:

- 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

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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

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

Yes

481,907

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

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

Yes

54,057

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

535,964

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 1A:	VOLUNTEERS COORDINATED THE PARTICIPATION OF THE PATIENT FAMILIES IN THE CHILDREN'S HOSPITAL ASSOCIATION FAMILY ADVOCACY DAY FOCUSED PRIMARILY ON PROTECTING HEALTH CARE SERVICES FOR CHILDREN.
SCHEDULE C, PART II-B, LINE 1B:	PAID STAFF OR MANAGEMENT FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR SERVICES FOR CHILDREN IN PUBLIC HEALTH PROGRAMS AND ADVANCE PUBLIC POLICY THAT SUPPORT THE HEALTH AND WELL-BEING OF CHILDREN.
SCHEDULE C, PART II-B, LINE 1G:	DIRECT CONTACT THE LOBBYING ACTIVITIES ENGAGED IN BY CHILDREN'S HOSPITAL FOCUS PRIMARILY ON EFFORTS TO IMPROVE THE LEVEL OF FUNDING FOR CHILDREN IN PUBLIC HEALTH PROGRAMS AND ADVANCE PUBLIC POLICY THAT SUPPORTS THE HEALTH AND WELL-BEING OF CHILDREN. THOSE LOBBYING ACTIVITIES INCLUDE CONTINUAL MONITORING OF LEGISLATION VIA DISCUSSIONS WITH LEGISLATIVE STAFF, HOSTING EDUCATIONAL BRIEFING SESSIONS FOR MEMBERS OF CONGRESS, EXECUTIVE BRANCH, STATE AND LOCAL OFFICIALS/STAFF REGARDING CHILD HEALTH ISSUES, AND COORDINATING THE SUBMISSION OF CORRESPONDENCE AND WRITTEN COMMENTS ON PROPOSED LEGISLATION AND REGULATIONS, AS WELL AS THE PRESENTATION OF TESTIMONY BEFORE LEGISLATIVE COMMITTEES. CHILDREN'S HOSPITAL ALSO DEVELOPS POLICY POSITIONS IN RESPONSE TO PROBLEMS AND OPPORTUNITIES IN THE PUBLIC SECTOR.
SCHEDULE C, PART II-B, LINE 1I:	OTHER ACTIVITIES THE HOSPITAL IS A MEMBER OF THE CHILDREN'S HOSPITAL ASSOCIATION (CHA), AMERICAN HOSPITAL ASSOCIATION (AHA), DISTRICT OF COLUMBIA HOSPITAL ASSOCIATION (DCHA), MARYLAND HOSPITAL ASSOCIATION (MHA) AND VIRGINIA HOSPITAL AND HEALTHCARE ASSOCIATION (VHHA). ALL OF THE INDUSTRY ASSOCIATIONS THAT THE HOSPITAL IS A MEMBER OF HAVE CHILD ADVOCACY AND LEGISLATIVE ADVOCACY PROGRAMS.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

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)

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

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

Part VI

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

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

1a	Land .....	22,186,326		22,186,326
b	Buildings ....	349,402,374	97,359,248	252,043,126
c	Leasehold improvements	937,565,509	682,850,552	254,714,957
d	Equipment ....	375,993,843	244,215,764	131,778,079
e	Other .....	120,137,458	4,482,893	115,654,565
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				776,377,053

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)DUE FROM AFFILIATES				544,762,337
(2)OPERATING ROU ASSETS				121,267,295
(3)DEFERRED COMPENSATION PLAN				4,330,810
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				670,360,442

Part X

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

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	425,480,656
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

PART X, LINE 2:

LIABILITY FOR UNCERTAIN TAX POSITIONS (ASC 740) FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL), OF WHICH CHILDREN'S NATIONAL HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: CHILDREN'S NATIONAL EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THERE WAS NO IMPACT ON CHILDREN'S NATIONAL'S FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2023 AND 2022 AS CHILDREN'S NATIONAL HAS NO UNCERTAIN TAX POSITIONS.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

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

Attach to Form 990. Right pointing arrow large image

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization
CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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
	MIDDLE EAST AND NORTH AFRICA	0	1	PROGRAM SERVICES	PATIENT REFERALS	987,409
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	PROGRAM SERVICES	INSRUANCE PREMIUMS	17,474,683















3a	Sub-total ....	0	1			18,462,092
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	1			18,462,092

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022

Schedule F (Form 990) 2022

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) 2022

Schedule F (Form 990) 2022Page 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) 2022

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2022

Page 5

Part V

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

ReturnReference	Explanation
PART III ACCOUNTING METHOD:
PART I, LINE 3, COLUMN F:	ACCOUNTING METHOD USED THE EXPENDITURES, PER REGION, ARE PRESENTED ON THE ACCRUAL BASIS OF ACCOUNTING.

Schedule F (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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 40000.0000000000 %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(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) . . .		7,613,697		7,613,697	0.510 %
b	Medicaid (from Worksheet 3, column a) . . . . .		763,509,119	618,053,207	145,455,912	9.760 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		771,122,816	618,053,207	153,069,609	10.270 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	101,024	6,209,635	2,364,604	3,845,031	0.260 %
f	Health professions education (from Worksheet 5) . . .	1,448	57,466,282	7,709,695	49,756,587	3.340 %
g	Subsidized health services (from Worksheet 6) . . . .		11,862,661	8,465,619	3,397,042	0.230 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	3,041	1,206,928		1,206,928	0.080 %
j	Total. Other Benefits . .	105,513	76,745,506	18,539,918	58,205,588	3.910 %
k	Total. Add lines 7d and 7j .	105,513	847,868,322	636,593,125	211,275,197	14.180 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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.

		(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development		66,084		66,084	0 %
3	Community support	3	77,667		77,667	0.010 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy		4,973		4,973	0 %
8	Workforce development	548	838,433	40,531	797,902	0.050 %
9	Other
10	Total	551	987,157	40,531	946,626	0.060 %

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. ......

26,932,186

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. ......

310,000

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

Section B. Medicare

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

2,138,139

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

2,348,671

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

-210,532

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) 2022

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	CHILDREN'S HOSPITAL 111 MICHIGAN AVE NW WASHINGTON,DC20010 WWW.CHILDRENSNATIONAL.ORG HFD01-0208	X	X	X	X	X	X	X	X

Schedule H (Form 990) 2022

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	CHILDREN'S HOSPITAL
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 22

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

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): WWW.CHILDRENSNATIONAL.ORG

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): WWW.CHILDRENSNATIONAL.ORG

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	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 400.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

WWW.CHILDRENSNATIONAL.ORG

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

WWW.CHILDRENSNATIONAL.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.CHILDRENSNATIONAL.ORG

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

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

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

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

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

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

Other (describe in Section C)

Schedule H (Form 990) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	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) 2022

Page 7

Part VFacility Information (continued)

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

	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) 2022

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
PART V, SECTION B, LINE 3J:	CHILDREN'S NATIONAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN PARTNERSHIP WITH THE HSC HEALTH CARE SYSTEM IN 2022. PRIOR ASSESSMENTS (2013, 2016 AND 2019) WERE CONDUCTED IN COLLABORATION WITH THE DC HEALTH MATTERS COLLABORATIVE, A COALITION OF WASHINGTON, D.C., HOSPITALS AND COMMUNITY HEALTH CENTERS THAT ENVISION AN EQUITABLE AND SUSTAINABLE STATE OF HEALTH FOR ALL DISTRICT OF COLUMBIA RESIDENTS. THIS 2022 CHNA IS DIFFERENT FROM OUR PRIOR ASSESSMENTS AS IT FOCUSES SPECIFICALLY ON CHILDREN, IS AN ASSESSMENT OF CHILDREN'S NATIONAL AND HSC'S PRIMARY SERVICE AREA (PSA) WHICH INCLUDES WASHINGTON, D.C., AND PARTS OF MARYLAND, AND APPLIES A STRONGER PEDIATRIC HEALTH EQUITY LENS BY UTILIZING THE CHILD OPPORTUNITY INDEX (COI). THE COI DEFINES OPPORTUNITY AS THE NEIGHBORHOOD RESOURCES THAT MATTER FOR A CHILD'S HEALTHY DEVELOPMENT. THE 29 INDICATORS FOCUS ON NEIGHBORHOOD FEATURES SUCH AS ACCESS TO HEALTHY FOOD, HIGH-QUALITY EDUCATION, PARKS AND PLAYGROUNDS. EACH NEIGHBORHOOD IS ASSIGNED A SCORE RANGING FROM 1 TO 100 TO INDICATE THE OPPORTUNITY IN THAT SPECIFIC NEIGHBORHOOD FOR CHILDREN TO REACH THEIR POTENTIAL. THE HIGHER THE SCORE, THE BETTER THE OPPORTUNITY A CHILD HAS TO DEVELOP IN A HEALTHY MANNER. THE COI HIGHLIGHTS THE INTERPLAY BETWEEN PLACE-AND RACE-BASED INEQUITIES AS LOW OPPORTUNITY NEIGHBORHOODS ARE OFTEN DISPROPORTIONATELY HOME TO CHILDREN OF COLOR.OUR CHNA FINDINGS REVEALED THAT CHILD OPPORTUNITY VARIES CONSIDERABLY WITHIN OUR SERVICE AREA. CHILD OPPORTUNITY IS LOWEST AND CRITICALLY LACKING IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS CERTAIN PRINCE GEORGE'S COUNTY NEIGHBORHOODS IN MARYLAND. IN ADDITION TO THE QUANTITATIVE DATA, WE IMPLEMENTED MANY COMMUNITY ENGAGEMENT EFFORTS TO GATHER QUALITATIVE DATA. WE INVITED RESIDENTS FROM OUR COMMUNITY, SPECIFICALLY THE NEIGHBORHOODS WE IDENTIFIED WITH THE LOWEST OPPORTUNITY SCORES, TO SHARE THEIR EXPERIENCES ON OPPORTUNITY IN THEIR COMMUNITIES. WE ENGAGED WITH YOUTH, PARENTS AND OLDER ADULTS IN OUR COMMUNITIES THROUGH VIRTUAL CONVERSATIONS, INPUT FORMS AND INTERVIEWS TO FURTHER INFORM OUR FINDINGS AND RECOMMENDATIONS SPECIFICALLY RELATED TO EDUCATION, HEALTH, AND ECONOMIC CONDITIONS. TO ELEVATE THE VOICE OF OUR YOUTH IN THIS ASSESSMENT, WE CREATED AN EIGHT-WEEK PHOTOVOICE PROGRAM TAILORED TO ADOLESCENTS. THE STUDENTS WERE ASKED TO USE THEIR CELL PHONES TO CAPTURE IMAGES THAT SHOWED THE ASSETS AND CHALLENGES THAT IMPACT HEALTH IN THEIR COMMUNITIES. THEY WORKED WITH THE FACILITATORS TO LEARN HOW TO USE THEIR VOICES TO PROMOTE POSITIVE CHANGE IN THEIR NEIGHBORHOODS. THE FOUR INDICATORS THAT SCORED AS THE HIGHEST PRIORITY INDICATORS ARE (1) EARLY CHILDHOOD EDUCATION, (2) HEALTH INSURANCE COVERAGE, (3) HEALTHY FOOD AND (4) EMPLOYMENT RATE.
PART V, SECTION B, LINE 5:	IN CONDUCTING THE MOST RECENT CHNA, CHILDREN'S NATIONAL CONSIDERED INPUT FROM COMMUNITY RESIDENTS, STAKEHOLDERS INCLUDING LEADERS IN HEALTHCARE AND COMMUNITY-BASED ORGANIZATIONS AND BUSINESS AND GOVERNMENT OFFICIALS INCLUDING THE DC HOSPITAL ASSOCIATION, PRINCE GEORGE'S COUNTY CHAMBER OF COMMERCE, DC PRIMARY CARE ASSOCIATION, CHILDREN'S LAW CENTER AND THE DC HEALTH MATTERS COLLABORATIVE. THROUGH OUR QUALITATIVE WORK WE HEARD FROM OVER 300 STAKEHOLDERS. WE CONDUCTED ELEVEN 60-MINUTE, VIRTUAL COMMUNITY CONVERSATIONS WITH 67 PARENTS AND CAREGIVERS LIVING IN THE PREVIOUSLY IDENTIFIED NEIGHBORHOODS WITH THE LOWEST OPPORTUNITY FOR CHILDREN IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS PRINCE GEORGE'S COUNTY, MD. THREE OF THE 11 COMMUNITY CONVERSATIONS WERE HELD IN SPANISH. THESE CONVERSATIONS PROVIDED PERSPECTIVES FROM NEIGHBORHOOD RESIDENTS ON HOW THEY VIEW THE IMPACT OF NEIGHBORHOOD CONDITIONS - SPECIFICALLY RELATED TO EDUCATION, HEALTH, AND ECONOMIC CONDITIONS - ON A CHILD'S OPPORTUNITY TO LIVE A HEALTHY AND PRODUCTIVE LIFE. WE CONDUCTED 33 KEY INFORMANT INTERVIEWS WITH A WIDE RANGE OF PEOPLE - INCLUDING COMMUNITY LEADERS, GOVERNMENT LEADERS, AND RESIDENTS - WHO HAD FIRSTHAND KNOWLEDGE ABOUT THE COMMUNITY. WE ALSO ISSUED A COMMUNITY INPUT FORM AS A WAY FOR RESIDENTS WHO MAY NOT HAVE BEEN ABLE TO PARTICIPATE IN PREVIOUS CONVERSATIONS AND INTERVIEWS TO PROVIDE THEIR INPUT. WE RECEIVED FEEDBACK FROM 88 NEIGHBORHOOD RESIDENTS ON WHICH INDICATORS SHOULD BE A PRIORITY, WHAT FACTORS IMPACT OPPORTUNITIES IN THEIR NEIGHBORHOOD, AND HOW HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS CAN WORK TOGETHER TO MAKE IMPROVEMENTS IN THESE AREAS. IN ADDITION TO THE COMMUNITY INPUT FORM, WE RECEIVED FEEDBACK FROM 156 HOSPITAL STAFF VIA A HOSPITAL INPUT FORM TO GAIN THEIR PERSPECTIVE ON WHICH OF THE 29 COI INDICATORS WE SHOULD SELECT AS "PRIORITY INDICATORS" FOR THE 2022 CHNA. ONCE THE PRIORITIES WERE SELECTED, WE HOSTED FOUR ADDITIONAL COMMUNITY CONVERSATIONS WITH 26 PARENTS AND CAREGIVERS LIVING IN PRIORITY NEIGHBORHOODS TO IDENTIFY SPECIFIC STRATEGIES TO IMPROVE ACCESS TO EARLY CHILDHOOD EDUCATION, HEALTHY FOOD, HEALTH INSURANCE AND HEALTH SERVICES AND EMPLOYMENT.
PART V, SECTION B, LINE 6A:	THE CHNA WAS CONDUCTED WITH THE HSC HEALTH CARE SYSTEM (HSC). BASED IN WASHINGTON, D.C., CHILDREN'S NATIONAL AND HSC ARE COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE FOR CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH COMPLEX MEDICAL CONDITIONS. OUR GOAL IS TO PROVIDE COMPREHENSIVE, FAMILY-CENTERED CARE THAT MEETS OUR PATIENTS' PHYSICAL, EMOTIONAL, AND PSYCHOLOGICAL NEEDS. WE STRIVE TO CREATE AN ENVIRONMENT WHERE EVERY FAMILY FEELS INCLUDED, RESPECTED, AND SUPPORTED. OUR TEAM OF PHYSICIANS, NURSES, AND OTHER HEALTHCARE PROVIDERS WORK TOGETHER TO ENSURE THE BEST OUTCOMES FOR OUR PATIENTS.
PART V, SECTION B, LINE 7D:	THE CHNA IS LOCATED ON THE HOSPITAL WEBSITE. CHILDREN'S NATIONAL ALSO SHARED FINDINGS AND ANNOUNCEMENTS ABOUT THE CHNA WITH CHILDREN'S NATIONAL LEADERSHIP AND BOARD MEMBERS. WE ALSO SHARED OUR CHNA AND IMPLEMENTATION STRATEGY (COMMUNITY HEALTH IMPROVEMENT PLAN) DURING COMMUNITY EVENTS SUCH AS OUR CELEBRATING OUR PARTNERS EVENT HELD IN JUNE 2023. DURING THIS EVENT, WE GATHERED WITH OUR COMMUNITY PARTNERS AND PROVIDED AN OVERVIEW OF OUR CHNA AND CHIP AND HELD A DISCUSSION ON THE IMPORTANCE OF PARTNERSHIPS TO ADVANCE COMMUNITY HEALTH IMPROVEMENT EFFORTS.PART V, SECTION B, LINE 8:CHILDREN'S HOSPITAL ADOPTED AN IMPLEMENTATION STRATEGY IN NOVEMBER 2022, REFERRED TO AS THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE CHIP IS AVAILABLE AT: HTTPS://CHILDRENSNATIONAL.ORG/ADVOCACY-AND-OUTREACH/CHILD-HEALTH-ADVOCACY-INSTITUTE/COMMUNITY-AFFAIRS/IMPROVING-COMMUNITY-HEALTH.
PART V, SECTION B, LINE 11:	FROM THE INSIGHT GAINED FROM THE COI AND OUR UNDERSTANDING OF OUR COMMUNITY PERSPECTIVES, WE PARED DOWN THE 29 COI INDICATORS TO FOUR INDICATORS THAT WILL BE OUR HOSPITAL'S FOCUS FOR THE NEXT THREE YEARS. TO GET TO THESE FOUR INDICATORS, WE USED A PROCESS MODELED OFF A WIDELY USED PRIORITIZATION METHOD, CALLED THE HANLON METHOD. THE PRIORITIZATION EXERCISE SCORED EACH INDICATOR BASED ON THE IMPORTANCE TO OUR COMMUNITY, IMPORTANCE TO OUR HOSPITALS, HOSPITAL'S CAPACITY TO ADDRESS THE INDICATOR, ALIGNMENT WITH THE HOSPITAL'S MISSION, AND HOSPITAL'S EXISTING WORK IN THE AREA. THE FOUR INDICATORS THAT SCORED AS THE HIGHEST PRIORITY INDICATORS ARE EARLY CHILDHOOD EDUCATION, HEALTH INSURANCE COVERAGE, HEALTHY FOOD AND EMPLOYMENT RATE.THE CHNA IDENTIFIED MANY NEEDS IN OUR COMMUNITY, HOWEVER, DUE TO PRACTICAL AND RESOURCE CONSTRAINTS, THE ORGANIZATION FOCUSED ITS RESOURCES ON THE TOP NEEDS IN WHICH THE ORGANIZATION CAN BE IMPACTFUL.WITH A FOCUS ON THE HIGHEST PRIORITY INDICATORS, WE DEVELOPED AN IMPLEMENTATION STRATEGY THAT WE CALL A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IN WHICH WE OUTLINE ACTIONS AND IDENTIFY RESOURCES TO RESPOND TO THE ASSESSMENT FINDINGS OVER THE NEXT THREE YEARS. TO CREATE THE CHIP, WE ENGAGED WITH OUR HOSPITAL EMPLOYEES, LOCAL COMMUNITIES AND AREA ORGANIZATIONS TO SHARE THESE FINDINGS AND IDENTIFY POLICY AND SYSTEMS CHANGES THAT WILL IMPROVE OPPORTUNITY LEVELS FOR CHILDREN LIVING IN LOW OPPORTUNITY NEIGHBORHOODS. IN THE 2022 CHIP, ADOPTED BY OUR HOSPITAL BOARD IN NOVEMBER 2022, WE OUTLINE NINE STRATEGIES THAT USE A VARIETY OF TACTICS TO IMPROVE OPPORTUNITY FOR CHILDREN LIVING IN WARDS 7 AND 8 IN WASHINGTON, D.C. AND PRINCE GEORGE'S COUNTY, MARYLAND INCLUDING ADVOCACY EFFORTS AND PROGRAMS AND PRACTICE.1. EARLY CHILDHOOD EDUCATION GOAL: BUILD A STRONGER EARLY CHILDHOOD EDUCATION COMMUNITYADVOCACY: ADVOCATE FOR HIGH QUALITY, AFFORDABLE ECE CENTERS WITH WELL COMPENSATED STAFFPROGRAMS AND PRACTICE: STRENGTHEN CONNECTIONS BETWEEN ECE AND HOSPITALS ABOUT THE REFERRAL PROCESS (E.G., WHAT'S AVAILABLE, HOW TO ENROLL, REQUIREMENTS FOR VOUCHERS, HELPING FAMILIES WHO HAVE CHILDREN WITH DISABILITIES, MATERIALS IN MULTIPLE LANGUAGES, ETC.)2. HEALTHY FOODGOAL: INCREASE ACCESS TO HEALTHY FOOD OPTIONSADVOCACY: ADVOCATE FOR FUNDING AND IMPROVED ACCESS TO HEALTHY FOOD OPTIONS IN THE COMMUNITYPROGRAMS AND PRACTICE: INCREASE ACCESS TO HEALTHY FOOD OPTIONS WITHIN THE HOSPITAL AND COMMUNITY THROUGH THE HOSPITAL CAFETERIA, FOOD PHARMACIES, FARMERS MARKETS AND OTHER INITIATIVESEXPAND FOOD INSECURITY SCREENINGS TO DETERMINE ELIGIBILITY FOR ENROLLMENT IN FOOD ACCESS PROGRAMS 3. HEALTH INSURANCE COVERAGEGOAL: IMPROVE ACCESS TO HEALTH CARE AND HEALTH INSURANCE COVERAGEADVOCACY: ADVOCATE FOR HIGH QUALITY AND EASILY ACCESSIBLE MENTAL HEALTH SERVICE CONTINUUM INCLUSIVE OF SUSTAINABLE PROMOTION, PREVENTION, EARLY INTERVENTION, TREATMENT, CRISIS AND RECOVERY SERVICES COVERED BY INSURANCEPROGRAMS AND PRACTICE: IMPROVE CARE COORDINATION WITHIN THE HOSPITAL AND WITH INSURANCE PROVIDERS AND COMMUNITY ORGANIZATIONS.4. EMPLOYMENT RATEGOAL: STRENGTHEN EMPLOYMENT OPPORTUNITIESPROGRAMS AND PRACTICE: SUSTAIN AND EXPAND HOSPITAL RESEARCH YOUTH ENGAGEMENT PROGRAMS AND JOB OPPORTUNITIES (INTERNSHIPS, TRAININGS, AND RESEARCH OPPORTUNITIES)CREATE JOB OPPORTUNITIES FOR PEOPLE WITH DISABILITIES, INCLUDING PARTNERING WITH ORGANIZATIONS TO PROVIDE SKILL-BASED TRAINING. WE WILL PARTNER WITH LOCAL AND REGIONAL ORGANIZATIONS, LIKE HEALTH DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS TO IMPLEMENT THE STRATEGIES OF THE CHIP. WE ALSO HAVE AN INTERNAL CHIP STRUCTURE TO ENSURE THE SUCCESS OF OUR INVESTMENTS IN CHANGING POLICY, IMPROVING PROGRAMS AND ALLOCATING RESOURCES MORE EQUITABLY. AS PART OF THIS STRUCTURE, WE FORMED THE CHIP STEERING COMMITTEE (LAUNCHED IN FEBRUARY 2023) COMPRISED OF REPRESENTATIVES FROM ACROSS CHILDREN'S NATIONAL AND HSC THAT PROVIDES STRATEGIC DIRECTION FOR THE CHIP AND CHAMPIONS ITS WORK. WE ALSO HAVE WORKGROUPS (LAUNCHED IN MARCH 2023) FOR EACH PRIORITY AREA, COMPRISED OF REPRESENTATIVES FROM ACROSS CHILDREN'S NATIONAL AND HSC THAT PROVIDES SUBJECT MATTER EXPERTISE FOR THE CHIP AND LEAD THE ACTIVITIES ACROSS THE FOUR PRIORITY AREAS. WORKGROUPS ARE LED BY TWO CO-LEADS THAT DRIVE THE AGENDA, MONITOR PROGRESS, AND REPORT TO THE STEERING COMMITTEE.

Schedule H (Form 990) 2022

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?22
Name and address		Type of Facility (describe)
1	1 - CHILDREN'S NAT'L AMBU SURGERY CTR 9850 KEY WEST AVENUE ROCKVILLE,MD20850	REGIONAL OUTPATIENT CENTER
2	2 - CHILDREN'S OUTPATIENT CTR FREDERICK 5285 WESTVIEW DRIVE SUITE 103 FREDERICK,MD21703	REGIONAL OUTPATIENT CENTER
3	3 - MOBILE VAN - DENTAL N/A NA,DC20010	MOBILE HEALTH CARE
4	4 - CHILDREN'S HEALTH CENTER AT THEARC 1801 MISSISSIPPI AVE SE WASHINGTON,DC20020	HEALTH CENTERS
5	5 - CHILDREN'S OUTPATIENT CTR MONTGOMERY 15245 SHADY GROVE ROAD SUITE 350 ROCKVILLE,MD20850	REGIONAL OUTPATIENT CENTER
6	6 - CHILDREN'S OUTPATIENT FREDRICKSBURG 1300 HOSPITAL DRIVE SUITE 201 FREDRICKSBURG,VA22401	REGIONAL OUTPATIENT CENTER
7	7 - CHILDREN'S NATIONAL IMAGING CENTER 9850 KEY WEST AVENUE SUITE 110 ROCKVILLE,MD20850	REGOINAL OUTPATIENT CENTER
8	8 - CHILDREN'S NATIONAL PULMONARY MED - R 9711 MEDICAL CENTER DRIVE SUITE 212 ROCKVILLE,MD20850	HEALTH CENTERS
9	9 - CHILDREN'S OUTPATIENT CTR HOWARD CITY 7625 MAPLE LAWN BLVD SUITE 230 FULTON,MD20759	REGOINAL OUTPATIENT CENTER
10	10 - FIGHT FOR CHILDREN SPORTS MED CTR 1 INVENTA PLACE SUITE 150 SILVER SPRING,MD20910	HEALTH CENTERS
11	11 - CHILDREN'S HEALTH CTR AT SHAW METRO 641 S STREET NW WASHINGTON,DC20001	HEALTH CENTERS
12	12 - CHILDREN'S HEALTH CTR AT WALTER REED 7125 13TH PLACE NW WASHINGTON,DC20012	HEALTH CENTERS
13	13 - CHILDREN'S OUTPATIENT CTR OF MONTGOMERY SHADY GROVE MEDICAL PARK ROCKVILLE,MD20850	REGIONAL OUTPATIENT CENTER
14	14 - CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 3023 HAMACKER COURT SUITE 300 FAIRFAX,VA22031	REGIONAL OUTPATIENT CENTER
15	15 - CHILDREN'S HEALTH CTR AT TAKOMA THEATRE 6833 4TH STREET NW WASHINGTON,DC20012	HEALTH CENTERS
16	16 - CHILDREN'S HEALTH CTR AT COLUMBIA HEI 3336 14TH STREET NW WASHINGTON,DC20010	HEALTH CENTERS
17	17 - CHILDREN'S HEALTH CENTER AT ANACOSTIA 2101 MARTIN LUTHER KING JR AVENUE SE WASHINGTON,DC20020	HEALTH CENTERS
18	18 - CHILDREN'S OUTPATIENT CTR PRINCE GEOR 2900 CAMPUS WAY NORTH LANHAM,MD20706	REGIONAL OUTPATIENT CENTER
19	19 - MOBILE VAN - HEALTH CARE N/A NA,DC20010	MOBILE HEALTH CARE
20	20 - CHILDREN'S OUTPATIENT CTR OF ANNAPOLIS 1730 WEST STREET SUITE 100 ANNAPOLIS,MD21401	REGIONAL OUTPATIENT CENTER
21	21 - CHILDREN'S NATIONAL EMERG DEPT UNIT 1310 SOUTHERN AVENUE SE1ST FLOOR WASHINGTON,DC20032	ED FACILITY
22	22 - CHILDREN'S OUTPATIENT CTR OF FRIENDSHIP 5028 WISCONSIN AVE SUITES 250 310 WASHINGTON,DC20016	REGIONAL OUTPATIENT CENTER

Schedule H (Form 990) 2022

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 3C:	ELIGIBILITY FOR CHARITY CARE PROGRAMCHILDREN'S NATIONAL USED THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR ITS CHARITY CARE PROGRAM. ELIGIBILITY WAS INCOME BASED AND NOT ASSET BASED.
PART I, LINE 6A:	CHILDREN'S NATIONAL MEDICAL CENTER ANNUAL REPORTCHILDREN'S NATIONAL HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS POSTED ON THE HOSPITAL WEBSITE AND HARD COPIES ARE MADE AVAILABLE AND DISTRIBUTED TO THE HOSPITAL'S KEY INTERNAL AND EXTERNAL STAKEHOLDERS. AS PART OF OUR COMMITMENT TO THE COMMUNITY, BELOW ARE SOME OF THE PROGRAMS AND ACTIVITIES THAT WERE CONDUCTED IN FY 2023.SCHOOL-FRIENDLY HEALTH SYSTEMEDUCATION IS A CRITICAL SOCIAL DETERMINANT OF HEALTH FOR CHILDREN AND IMPACTS LONG-TERM HEALTH AND ECONOMIC OUTCOMES. HEALTH SYSTEMS HAVE DEMONSTRATED THE ABILITY TO HELP CHILDREN ACHIEVE FULFILLING LEARNING EXPERIENCES THAT CONTRIBUTE TO BETTER ACADEMIC OUTCOMES AND SUCCESS (E.G., DECREASED HEALTH RELATED ABSENCES, MORE ACCESSIBLE SERVICES AND IMPROVED CARE COORDINATION IN SCHOOL). CHILDREN'S NATIONAL IS LEADING AN INITIATIVE TO DEVELOP SCHOOL-FRIENDLY HEALTH CARE SYSTEM PRINCIPLES TO HELP HOSPITALS AND HEALTH SYSTEMS DELIVER BETTER CARE AND PATIENT EXPERIENCE THAT ENHANCE CHILDREN'S PROSPECTS FOR IMPROVED HEALTH AND ACADEMIC SUCCESS. A SCHOOL-FRIENDLY HEALTH SYSTEM IS A HEALTH SYSTEM WORKING TO ENSURE ALL CHILDREN ACHIEVE OPTIMAL HEALTH AND REACH THEIR FULL ACADEMIC POTENTIAL. THE CHILD HEALTH ADVOCACY INSTITUTE'S SCHOOL HEALTH TEAM LEADS THIS EFFORT THROUGH COLLABORATION AND PARTNERSHIPS WITH LOCAL SCHOOL DISTRICTS, GROUPS THAT SUPPORT SCHOOLS SUCH AS GOVERNMENT, COMMUNITY-BASED, AND ADVOCACY ORGANIZATIONS, ALONG WITH MULTIDISCIPLINARY PROFESSIONALS.THE SCHOOL HEALTH TEAM AIMS TO SUPPORT STUDENT AND SCHOOL WELLNESS THROUGH COORDINATION AND PARTNERSHIPS BETWEEN THE HEALTH AND EDUCATION SECTORS. COORDINATION AND PARTNERSHIPS ARE AT THE SYSTEM OR ORGANIZATIONAL LEVEL BETWEEN THE HOSPITAL, LOCAL SCHOOL DISTRICTS AND RELEVANT GROUPS THAT SUPPORT SCHOOLS (GOVERNMENT, COMMUNITY-BASED ORGANIZATIONS, AND ADVOCACY ORGANIZATIONS). WE ACCOMPLISH THIS THROUGH:- COMMUNICATION: WE STRIVE FOR COMMUNICATION AND DATA-SHARING BETWEEN SCHOOLS AND THE HEALTH SYSTEM TO IMPROVE INDIVIDUAL AND POPULATION HEALTH IN SCHOOLS.- COORDINATION: WE ALIGN OUR SCHOOL-BASED WORK WITH COMMUNITY NEEDS AND EDUCATIONAL SYSTEM GOALS TO IMPROVE POPULATION HEALTH IN SCHOOLS THROUGH POLICY, ADVOCACY AND EVIDENCE-BASED FRAMEWORKS.- EDUCATION: WE EDUCATE OUR HEALTHCARE SYSTEM ON ACADEMIC ISSUES, AND WE EDUCATE THE SCHOOL SYSTEM ON CHILD HEALTH ISSUES.- DATA-DRIVEN: WE USE PROGRAM EVALUATION AND COMMUNITY-WIDE DATA TO GUIDE ALL ASPECTS OF OUR WORK AND TO IDENTIFY GAPS AND NEEDS.IN FY 2023, THE SCHOOL HEALTH TEAM ACCOMPLISHED THE FOLLOWING:- FACILITATED THE SCHOOL HEALTH COLLABORATIVE AND SCHOOL HEALTH ADVISORY COMMITTEE WORKGROUPS REACHING OVER 100 STAFF FROM ACROSS THE HOSPITAL AND DISSEMINATED MONTHLY SCHOOL HEALTH CONNECTIONS NEWSLETTERS FOR CHILDREN'S NATIONAL STAFF AND EDUCATION PARTNERS REACHING MORE THAN 200 INDIVIDUALS TO SHARE INFORMATION ON REGIONAL SCHOOL HEALTH EFFORTS AND INCREASE COORDINATION OF HOSPITAL-WIDE SCHOOL-BASED EFFORTS.- LAUNCHED A NATIONAL SCHOOL-FRIENDLY HEALTH SYSTEMS LEARNING COLLABORATIVE THAT ENGAGED MORE THAN 40 LEADERS FROM EIGHT HEALTH CARE ORGANIZATIONS AND PARTNERS TO UPDATE THE FRAMEWORK AND PRODUCE CASE EXAMPLES TO HELP DELIVER BETTER CARE AND PATIENT EXPERIENCE.- LED THE COLLABORATIVE FOR ATTENDANCE RESOURCES IN EDUCATION AND HEALTH (CARE-H) PROGRAM IN DISTRICT OF COLUMBIA PUBLIC SCHOOLS (DCPS) TO IMPROVE SCHOOL ATTENDANCE. THROUGH THIS EFFORT, CHILDREN'S NATIONAL LEADS A DATA-SHARING PARTNERSHIP WITH DC PUBLIC SCHOOLS SO THAT PILOT PRACTICES CAN RECEIVE STUDENT ATTENDANCE DATA FOR THEIR PATIENTS WHEN PARENTS CONSENT TO SHARING ATTENDANCE DATA. PRACTICES PROVIDE OUTREACH AND SUPPORT TO FAMILIES WHO ARE STRUGGLING WITH SCHOOL ATTENDANCE. THE PROGRAM HAS REACHED 14 PILOT SCHOOLS AND THREE PEDIATRIC PRACTICES, WHICH PROVIDED OVER 4000 MINUTES OF OUTREACH SUPPORT TO FAMILIES AND 98 REFERRALS TO MEDICAL AND SOCIAL RESOURCES TO SUPPORT SCHOOL ATTENDANCE. THE CARE-H PROGRAM ALSO CONVENED A NATIONAL ATTENDANCE DATA SHARING LEARNING COLLABORATIVE WITH MORE THAN 50 MEMBERS FROM 17 ORGANIZATIONS WITH 12 MEETINGS HELD SINCE 2021.- CONVENED MONTHLY STAKEHOLDER MEETINGS WITH DCPS AND SCHOOL HEALTH PARTNERS TO DISCUSS STRATEGIES TO INCREASE IMMUNIZATION RATES AND ADDRESS CRITICAL HEALTH AND EDUCATION CHALLENGES.- CONVENED A SCHOOL HEALTH POLICY COMMITTEE TO MONITOR THE POLICY LANDSCAPE LOCALLY AND AT THE FEDERAL LEVEL AND USE ADVOCACY AS A LEVER TO IMPROVE STUDENT HEALTH AND ACADEMIC OUTCOMES IN THE REGION AND NATIONALLY.RESOURCES AND SUPPORTS FOR PATIENTS WITH SICKLE CELL DISEASESICKLE CELL DISEASE AFFECTS APPROXIMATELY ONE IN EVERY 365 AFRICAN AMERICAN CHILDREN AND ONE IN EVERY 16,300 HISPANIC AMERICAN CHILDREN, MAKING IT THE MOST COMMONLY DIAGNOSED DISEASE IN NEWBORN SCREENINGS. CHILDREN'S NATIONAL TREATS NEARLY 1,400 CHILDREN A YEAR, MAKING US AMONG THE LARGEST SICKLE CELL PROGRAMS IN THE COUNTRY.ANNUALLY, HEMATOLOGY STAFF HOSTS A SICKLE CELL FAMILY EDUCATION SYMPOSIUM. THROUGH THE SYMPOSIUM, THE TEAM RAISES AWARENESS ABOUT SICKLE CELL DISEASE WITHIN THE BROADER COMMUNITY; PROVIDES FAMILIES WITH INFORMATION ABOUT SYMPTOMS, TREATMENTS, AND MANAGEMENT STRATEGIES; OFFERS SUPPORT AND FACILITATES CONNECTIONS BETWEEN FAMILIES; AND ENCOURAGES FAMILIES TO BE ADVOCATES. IN FY 2023, THE SYMPOSIUM HAD 50 PARTICIPANTS.CHILDREN'S NATIONAL ALSO PARTNERS WITH NEXT STEP TO CONDUCT STRIVE DC, A MENTORING AND ADVOCACY PROGRAM FOR TEENS THAT ARE LIVING WITH SICKLE CELL DISEASE. THROUGH THIS PROGRAM, TEENS BETWEEN THE AGES OF 13 TO 18 YEARS OF AGE RECEIVE HOMEWORK ASSISTANCE FROM LOCAL COLLEGE STUDENTS, GO ON FIELD TRIPS, AND LEARN FROM EACH OTHER. THE SICKLE CELL TEAM ALSO LEADS A SUPPORT GROUP FOR PARENTS. IN FY 2023, TWENTY PARENTS PARTICIPATED IN THE SUPPORT GROUP, SHARING STORIES AND ADVICE WITH EACH OTHER.COMMUNITY AWARENESS AND EDUCATIONFALLS CONTINUE TO BE THE NUMBER ONE MECHANISM OF INJURY SEEN AT CHILDREN'S NATIONAL IN FY 2023. THE DEPARTMENT OF TRAUMA AND BURN SURGERY AT CHILDREN'S NATIONAL IS EDUCATING THE COMMUNITY THROUGH THE IMPLEMENTATION OF A SOCIAL MEDIA CAMPAIGN FOCUSED ON THE PREVENTION OF FALL INJURIES. THROUGH THIS 3-YEAR INITIATIVE, THE TEAM HAS CREATED VIDEOS PROVIDING TIPS ON HOW TO DECREASE THE RISK OF FALL-RELATED INJURIES. IN FY 2023, THERE WERE OVER 130,000 TOTAL VIEWS OF VIDEOS WITH 103,000 OF THOSE VIEWING THE ENTIRE AD. OVER 36,000 PARENTS VIEWED THE VIDEOS.CHILDREN'S NATIONAL STAFF PARTNERS WITH LOCAL MEDIA OUTLETS TO BRING AWARENESS TO IMPORTANT HEALTH-RELATED TOPICS. OVER THE SUMMER, OUR LOCAL COMMUNITY EXPERIENCED BAD AIR QUALITY DUE TO THE CANADIAN WILDFIRES. THERE WERE MANY QUESTIONS FROM OUR COMMUNITY AND STAFF FROM OUR DIVISION OF EMERGENCY MEDICINE PROVIDED INFORMATION THROUGH MEDIA INTERVIEWS. COMMUNITY MEMBERS WERE INFORMED ON WAYS TO STAY SAFE AND WHEN THOSE WITH ASTHMA SHOULD RECEIVE CARE FROM THEIR PRIMARY CARE PROVIDER OR EMERGENCY DEPARTMENT.THE CHILDREN'S NATIONAL CHILD AND ADOLESCENT PROTECTION CENTER IS THE ONLY MEDICAL CENTER IN THE DISTRICT OF COLUMBIA WITH A TEAM OF HEALTH PROFESSIONALS DEDICATED TO THE VICTIMS AND SURVIVORS OF CHILD ABUSE AND THEIR FAMILIES. OUR PHYSICIANS AND STAFF CONDUCT LECTURES AND LEARNING SESSIONS TO EDUCATE THE LOCAL COMMUNITY ON THE EFFECTS OF CHILD ABUSE, INCLUDING IDENTIFICATION, TREATMENT AND PREVENTION. THE CENTER HOSTED THE DC REGIONAL ACADEMY ON FAMILY VIOLENCE: GENERATIONAL TRAUMA-BREAKING THE CYCLE IN MAY 2023. A HYBRID EVENT (IN-PERSON AND ZOOM) INCLUDED SESSIONS ON INFANT MENTAL HEALTH, THE STORIES OF MALE SURVIVORS OF SEXUAL TRAUMA, AND REDUCING HARM AND EXAMINING BIAS IN MANDATED REPORTING. OVER 100 PEOPLE PARTICIPATED IN THE SYMPOSIUM.ADVOCACY EDUCATION (HEALTH PROFESSIONS EDUCATION)AS PART OF CHILDREN'S NATIONAL HOSPITAL'S CARE MISSION TO EXCEL IN CARE, ADVOCACY, RESEARCH AND EDUCATION, THE CHILD HEALTH ADVOCACY INSTITUTE (CHAI) STRIVES TO TEACH STUDENTS, RESIDENTS, FELLOWS, FACULTY, AND OTHER STAFF THE MOST EFFECTIVE METHODS TO BECOME CHILD HEALTH ADVOCATES. THE CHAI PROVIDES EDUCATION AND EXPOSURE TO ADVOCACY OPPORTUNITIES AT THE INDIVIDUAL, COMMUNITY AND LEGISLATIVE LEVELS. 66 RESIDENTS AND OTHER STAFF PARTICIPATED IN THE FOLLOWING ACTIVITIES IN FY2023:
MOVING COMMUNITY CONVERSATIONS (COMMUNITY BUS TRIP) - FIRST-YEAR	PEDIATRIC RESIDENTS ARE PROVIDED A DEEPER UNDERSTANDING OF HOW SOCIAL DETERMINANTS OF HEALTH CONTRIBUTE TO HEALTH DISPARITIES. RESIDENTS TAKE A SCRIPTED ROUTE THROUGH WARDS 7 AND 8 AND COLUMBIA HEIGHTS (WARD 1) TO LEARN ABOUT COMMUNITY CHARACTERISTICS, BARRIERS THAT THEIR PATIENTS AND FAMILIES MAY EXPERIENCE AS WELL AS SOME COMMUNITY ASSETS THAT CAN HELP BUILD RESILIENCE AND PROMOTE GOOD HEALTH OUTCOMES. THE BUS TRIP ALSO EDUCATES PEDIATRIC RESIDENTS ON THE FINDINGS IN THE CHNA, THE STRATEGIES IN THE CHIP, AND THE RESOURCES IN THE COMMUNITY TO ADDRESS THE CHIP PRIORITY AREAS.INTERN ADVOCACY DAY - EMBEDDED IN THE CURRICULUM FOR FIRST-YEAR PEDIATRIC RESIDENTS AND OFFERED TO SENIOR RESIDENTS, FELLOWS, FACULTY, AND ALL STAFF, THIS YEAR-ROUND PROGRAM PROMOTES COMMUNITY-BASED LEARNING IN ADVOCACY AND FOOD INSECURITY. PARTICIPANTS SPEND A DAY VOLUNTEERING AT THE CAPITAL AREA FOOD BANK'S COMMUNITY GARDEN OR DISTRIBUTION CENTER, UNDERGO A FOOD INSECURITY SIMULATION ACTIVITY WHILE LEARNING HOW TO BEST CONNECT FAMILIES TO LOCAL RESOURCES, AND REFLECT ON THEIR PROFESSIONAL ROLE IN ADVOCACY. PARTICIPANTS DEMONSTRATE IMPROVED KNOWLEDGE OF ADVOCACY AND IMPROVED ADVOCACY-RELATED SELF-EFFICACY. THIS PROGRAM IS PARTICULARLY VALUABLE AS ACCESS TO HEALTHY FOOD IS ONE OF OUR COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) PRIORITY AREAS.
PART I, LINE 7A:	CHARITY AT COSTHOSPITAL AND PHYSICIAN CHARITY AMOUNTS REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS. PART I, LINE 7B:MEDICAIDHOSPITAL AND PHYSICIAN GROSS PATIENT REVENUE AND PAYMENT FROM FINANCIAL DECISION SUPPORT SYSTEMS WERE ADJUSTED TO COST USING THE COST TO CHARGES RATIO PER THE IRS INSTRUCTIONS. MEDICAID GRADUATE MEDICAL EDUCATION (GME) ADD-ON PAYMENTS WERE EXCLUDED AS THEY ARE REPORTED ON THE HEALTH EDUCATION LINE. CHILDREN'S NATIONAL GME INDIRECT MEDICAL EDUCATION (IME) PAYMENTS WERE INCLUDED AS PER 990 INSTRUCTIONS.PART I, LINE 7F:HEALTH EDUCATIONTHE HEALTH EDUCATION COST INCLUDES THE TOTAL COST OF INTERNS AND RESIDENTS FROM THE FY23 SUBMITTED MEDICARE COST REPORT. EDUCATION PAYMENTS AND RESIDENT FUNDING AMOUNTS OFFSET THE REPORTED EXPENSE. DC MEDICAID GME PAYMENTS WERE CALCULATED AND DEDUCTED FROM TOTAL MEDICAID PAYMENTS TO BE REPORTED ON THE LINE FOR HEALTH EDUCATION (PART I, LINE 7B).PART I, LINE 7G:SUBSIDIZED HEALTH SERVICESTHE HOSPITAL AND PHYSICIAN COMBINED SERVICE LINES FOR PROGRAMS IN UNDERSERVED AREAS WITH LOSSES WERE REPORTED AS SUBSIDIZED HEALTH SERVICES. TOTAL CHARGES WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO BASED ON THE IRS INSTRUCTIONS. THE CLAIMS PAYMENTS WERE NETTED AGAINST THE COST.COSTS ATTRIBUTABLE TO A PHYSICAL CLINIC:SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. THE SERVICES ARE PROVIDED DESPITE THE FINANCIAL LOSS TO MEET THE IDENTIFIED AND UNMET NEEDS OF THE COMMUNITY. IF THE SERVICES WERE NOT PROVIDED, THEY WOULD NOT BE AVAILABLE TO THE AREA OR WOULD RESULT IN THE GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION PROVIDING THE SERVICES. THE SUBSIDIZED HEALTH SERVICES AMOUNT IN PART I, LINE 7G INCLUDES $3,397,042 WHICH IS ATTRIBUTED TO THE PRIMARY CLINICAL SERVICES PROVIDED VIA CHILDREN'S NATIONAL HOSPITAL. CHILDREN'S HEALTH CENTERS PROVIDE PROGRAMS AND INITIATIVES INCLUDING COMPREHENSIVE AND HIGH-QUALITY PREVENTIVE SERVICES, IMPROVEMENT OF IMMUNIZATION RATES, AND COORDINATION OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THE AMOUNT INCLUDES SALARY, FRINGE, DIRECT, AND INDIRECT COSTS EXPENDED TO PROVIDE THE CLINICAL SERVICES. OUR CHILDREN'S HEALTH CENTERS ARE ESTABLISHING BEST PRACTICES IN COMMUNITY HEALTH.PART I, LINES 7E - F:OTHER BENEFITSIN CALCULATING THE AMOUNTS REPORTED IN THE TABLE IN PART I RELATING TO OTHER BENEFITS (E - I), WE USE AN ACCOUNTABILITY AND ELIGIBILITY SYSTEM BASED ON THE COMMUNITY BENEFIT DEFINITION AND GUIDELINES FOR DETERMINING WHERE PROGRAMS FIT INTO EACH COMMUNITY BENEFIT CATEGORY. TIME SPENT ON PROGRAMS/ACTIVITIES AND PROGRAM FUNDING IS PROVIDED BY PROGRAM STAFF. AVERAGE SALARY RATES ARE USED TO CALCULATE SALARY EXPENSES AND A FRINGE RATE IS ATTACHED AS NECESSARY. THE COMMUNITY BENEFIT STAFF ANALYZES THE FINANCIALS SUBMITTED TO ENSURE CONSISTENCY IN REPORTING AND CONFIRM WITH PROGRAM STAFF THE ACCURACY OF THE FINANCIALS. THE COMMUNITY BENEFIT STAFF ALSO WORKS WITH THE ACCOUNTING & FINANCE DEPARTMENT TO VERIFY THE ACCURACY OF SUBMITTED FINANCIALS.PART I, LINE 7, COLUMN (F):BAD DEBT EXPENSESCHILDREN'S NATIONAL MEDICAL CENTER DOES NOT INCLUDE ITS BAD DEBT EXPENSE ($26,932,186) REPORTED ON FORM 990, PART IX, LINE 25 FOR PURPOSES OF ITS COMMUNITY BENEFIT CALCULATION HERE.
SCHEDULE H, PART II:	COMMUNITY BUILDING ACTIVITIES PART II INCLUDES THE COST INCURRED FOR ACTIVITIES AND PROGRAMS TO PROTECT OR IMPROVE THE COMMUNITY'S HEALTH OR SAFETY. PROGRAMS ACCOUNTED FOR AS COMMUNITY BUILDING ACTIVITIES FALL INTO THE SUBCATEGORIES OF ECONOMIC DEVELOPMENT, COMMUNITY HEALTH IMPROVEMENT ADVOCACY, COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: IN FY 2023, HOSPITAL STAFF SERVED AS A VOICE FOR CHILDREN AT THE LOCAL, STATE AND FEDERAL LEVELS BY BRINGING ATTENTION TO AND RALLYING SUPPORT FOR PUBLIC POLICIES THAT PROTECT THE INTEREST OF CHILDREN'S HEALTH, AIM TO ELIMINATE HEALTH DISPARITIES, AND SUPPORT MEDICAL AND RESEARCH INNOVATION. STAFF HELPED DRAFT AND SUPPORTED LEGISLATION THAT WILL AUTHORIZE ACCESS TO EMERGENCY MEDICATIONS IN SCHOOLS AND PROVIDE ADDITIONAL FUNDING FOR SCHOOL NURSES IN DISTRICT OF COLUMBIA PUBLIC SCHOOLS.ECONOMIC DEVELOPMENT: CHILDREN'S NATIONAL LEADERSHIP PARTICIPATES IN BOARDS AND COUNCILS THAT FOCUS ON THE ECONOMIC DEVELOPMENT OF OUR LOCAL COMMUNITY. STAFF PARTICIPATED IN DISCUSSIONS TO STRENGTHEN TIES AMONG THE BUSINESS COMMUNITY AND EMPLOYMENT OPPORTUNITIES IN WASHINGTON, DC AND TOPICS RELATED TO THE HEALTH OF OUR LOCAL COMMUNITY. THE FOCUS ON HELPING TO EXPAND EMPLOYMENT IN PATHWAY TO THE MIDDLE CLASS OPPORTUNITIES ARE ESSENTIAL TO ADDRESSING POVERTY - A KEY DRIVER OF HEALTH INEQUITIES.COMMUNITY SUPPORT: CHILDREN'S NATIONAL STAFF WORKS WITH LOCAL GOVERNMENT AND HEALTHCARE PARTNERS FOCUSED ON EMERGENCY PREPAREDNESS AND RESPONSE AND BRINGS THE PEDIATRIC HOSPITAL PERSPECTIVE. MEETINGS INCLUDE PLANNING FOR LARGE-SCALE EVENTS, EVACUATION PLANS, EMERGENCY PREPAREDNESS AND DECONTAMINATION EXERCISES, AND FAMILY REUNIFICATION.WORKFORCE DEVELOPMENT: CHILDREN'S NATIONAL IS DEDICATED TO ENGAGING IN AND PROVIDING OPPORTUNITIES FOR LEARNING AND DEVELOPMENT FOR SCHOOL-AGED CHILDREN AND ADULTS. WE WORK WITH MANY LOCAL SCHOOLS, COLLEGES AND UNIVERSITIES TO PROVIDE LEARNING OPPORTUNITIES FOR STUDENTS INTERESTED IN HEALTH PROFESSIONS. CHILDREN'S NATIONAL OFFERED IN-PERSON AND VIRTUAL RESUME BUILDING AND EDITING WORKSHOPS FOR UNIVERSITY STUDENTS AND COMMUNITY MEMBERS. IN ADDITION, CHILDREN'S NATIONAL OFFERS INTERNSHIP PROGRAMS FOR LOCAL HIGH SCHOOL STUDENTS INTERESTED IN HEALTH-RELATED CAREERS. DURING THE INTERNSHIP PROGRAM LED BY THE COMMUNITY AFFAIRS DEPARTMENT, STUDENTS PARTICIPATED IN RESEARCH, ACADEMIC ACTIVITIES, PROFESSIONAL DEVELOPMENT AND SKILL-BUILDING. AT THE END OF THE INTERNSHIP, STUDENTS PRODUCED AN ADVOCACY PLAN AND DELIVERED ORAL PRESENTATIONS SUMMARIZING THEIR EXPERIENCE. THROUGH A PRE- AND POST-EVALUATION, INTERNS SHOWED AN INCREASE IN KNOWLEDGE IN AREAS SUCH AS UNDERSTANDING OF THE HEALTH INEQUITIES IN THEIR COMMUNITIES AND HOW YOUTH CIVIC ENGAGEMENT CAN HELP TO IMPROVE COMMUNITY HEALTH. CHILDREN'S NATIONAL ALSO SUPPORTS THE LEADING THE ADVANCEMENT OF UNDERGRADUATE NURSES AT CHILDREN'S NATIONAL (LAUNCH) AND CONWAY NURSING PATHWAY PROGRAMS WHICH ALLOW UNIVERSITY STUDENTS INTERESTED IN NURSING TO SHADOW PEDIATRIC NURSES DURING A SUMMER INTERNSHIP. THESE STUDENTS WORK CLOSELY WITH A PRECEPTOR AND SUPERVISOR LEARNING THE SKILLS AND TECHNIQUES OF A PEDIATRIC NURSE.
PART III, LINES 2, 3 AND 4:	BAD DEBT EXPENSETHE HOSPITAL AND PHYSICIAN BAD DEBT WRITE-OFF REPORTED IN THE AUDITED FINANCIAL STATEMENTS IS REFLECTED ON SCHEDULE H, PART III, LN 2. DISCOUNTS AND PAYMENTS REDUCE THE PATIENT'S ACCOUNT BALANCE PRIOR TO SENDING THE PATIENT A STATEMENT FOR ANY REMAINING BALANCES DUE TO CHILDREN'S HOSPITAL. FINANCIAL ASSISTANCE ELIGIBLE PATIENTS RECEIVE A 100% DISCOUNT ON THE BALANCE DUE. PAYMENT PLANS ARE ALSO AVAILABLE FOR PATIENT BALANCES DUE. ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER COLLECTION EFFORTS (BILLING STATEMENTS AND PHONE CALLS) ARE UNSUCCESSFUL.BAD DEBT IS NOT INCLUDED IN CHILDREN'S NATIONAL'S COMMUNITY BENEFIT. A DEMOGRAPHIC ANALYSIS BASED ON ZIP CODES WAS COMPLETED TO ESTIMATE THE AMOUNT OF BAD DEBT THAT COULD HAVE BEEN ATTRIBUTED TO PATIENTS WITH A LIKELIHOOD OF QUALIFYING FOR FINANCIAL ASSISTANCE HAD SUFFICIENT INFORMATION BEEN OBTAINED TO DETERMINE THEIR ELIGIBILITY. BASED ON THE ANALYSIS, APPROXIMATELY $310K OF BAD DEBT COULD HAVE BEEN ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. CHILDREN'S HOSPITAL REPORTS ITS APPLICABLE BAD DEBT ($26.9M) AMOUNT WITHIN THE AUDITED FINANCIAL STATEMENTS. THERE IS NO SPECIFIC FOOTNOTE FOR BAD DEBT IN THE STATEMENTS.
PART III, LINE 8:	COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT ON LINE 6MEDICARE SHORTFALLS ARE NOT INCLUDED AS A COMMUNITY BENEFIT AS ANY SHORTFALL DETERMINATION FROM THE MEDICARE COST REPORT IS EVENTUALLY PAID AS A SETTLEMENT.PART III, LINE 9B:COLLECTION PRACTICESCHILDREN'S HOSPITAL HAS A WRITTEN COLLECTION POLICY. POLICY IS APPLIED UNIFORMLY TO ALL PATIENTS. CHILDREN'S HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS WHILE MAINTAINING RESPONSIBLE AND EFFECTIVE FINANCIAL PROGRAMS WHICH ENSURE THAT THIS COMMITMENT CAN CONTINUE. CHILDREN'S HOSPITAL SUPPORTS FAMILIES IN CARRYING OUT THEIR RESPONSIBILITY FOR OBTAINING MEDICAL CARE FOR THEIR CHILDREN. CHILDREN'S HOSPITAL THEREFORE WILL ASSIST FAMILIES IN VERIFYING THEIR ABILITY TO MEET THEIR FINANCIAL OBLIGATION TO THE HOSPITAL OR IN SECURING THE RESOURCES NECESSARY TO DO SO. THE PURPOSE OF THIS POLICY IS TO ESTABLISH GUIDELINES FOR EFFECTIVE AND RESPONSIBLE FISCAL PROGRAMMING, WHICH ASSURES THE FINANCIAL VIABILITY OF THE INSTITUTION AND MAINTAINS THE DIGNITY OF THE FAMILY.COLLECTION EFFORTS ARE THEREFORE THE SAME FOR ALL PATIENTS. ONCE THE APPROVED CHARITY ADJUSTMENT HAS BEEN DETERMINED, THE ACCOUNT BALANCE IS WRITTEN OFF TO CHARITY AND COLLECTION EFFORTS CEASE. FOR PATIENT BALANCES THAT ARE NOT FINANCIAL ASSISTANCE ELIGIBLE, CHILDREN'S OFFERS PAYMENT PLANS. BILLING STATEMENTS WILL BE SENT TO GUARANTORS FOR OUTSTANDING BALANCES. ATTEMPTS TO CONTACT THE GUARANTORS VIA PHONE WILL ALSO OCCUR. ACCOUNTS WITH BALANCES AND NO RESPONSE FROM GUARANTORS AFTER REPEATED STATEMENTS AND PHONE CALLS WILL BE WRITTEN OFF TO BAD DEBT. AN EXTERNAL AGENCY WILL THEN ATTEMPT TO REACH THE PATIENT FOR PAYMENT. IF THE PATIENT SUBSEQUENTLY PAYS, THE BAD DEBT ADJUSTMENT WILL BE REVERSED, AND PAYMENT POSTED TO THE PATIENT'S ACCOUNT. IF THE EXTERNAL AGENCY'S EFFORTS, PROVE TO BE INEFFECTIVE, THE ACCOUNT WILL BE CLOSED WITH THE AGENCY AND THEIR EFFORTS WILL CEASE. CHILDREN'S HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES, E.G. CREDIT REPORTING, WAGE GARNISHMENTS, LIENS, ETC.
PART VI, LINE 2:	COMMUNITY HEALTH CARE NEEDS ASSESSMENTIN ADDITION TO THE JOINT PEDIATRIC COMMUNITY HEALTH NEEDS ASSESSMENT WITH THE HSC HEALTH CARE SYSTEM, CHILDREN'S NATIONAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH OTHER EFFORTS.THE CHILDREN'S NATIONAL ASTHMA PROGRAM, IMPACT DC, ANALYZES ON AN ANNUAL BASIS EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS FOR ASTHMA TO ALL NON-MILITARY HOSPITAL EMERGENCY DEPARTMENTS IN DC. THIS ALLOWS THE HOSPITAL TO TRACK TRENDS OVER TIME AND ACROSS ZIP CODES IN DC. THE HOSPITAL ALSO CONDUCTS STUDIES TO IDENTIFY BARRIERS TO CARE, INTERVENTION PREFERENCES, AND PARENT CONCERNS ABOUT ASTHMA. IN 2018-2019, THE HOSPITAL USED FUNDING FROM NIH TO SPECIFICALLY CONDUCT A COMMUNITY NEEDS ASSESSMENT FOCUSED ON ASTHMA. IMPACT DC PRODUCED REPORTS USING BOTH QUANTITATIVE AND QUALITATIVE METHODS. THE HOSPITAL SUBSEQUENTLY SUBMITTED ANOTHER NIH GRANT TO REFINE AND STUDY AN ASTHMA INTERVENTION THAT IS HIGHLY RESPONSIVE TO THE FINDINGS. MOST RECENTLY, THE ASTHMA PROGRAM LED FOCUS GROUPS WITH FAMILIES TO LEARN HOW HOUSING CONDITIONS IMPACT ASTHMA CARE AND IS WORKING TOGETHER WITH COMMUNITY-BASED ORGANIZATIONS TO ADDRESS SOME OF THE BARRIERS IDENTIFIED THROUGH THE ASSESSMENT. AS PART OF THIS WORK, THE TEAM GATHERED DATA AND MAPPED PROPERTIES MOST FREQUENTLY REPORTED WITH UNHEALTHY HOUSING CONDITIONS AND ASTHMA EXACERBATIONS. USING THE DATA, INTERACTIVE MAPS WERE DEVELOPED. THE MAPS HELP IDENTIFY LARGE-SCALE PROBLEMATIC REGIONS WHERE THERE IS AN INTERSECTION BETWEEN HEALTH AND HOUSING CONDITIONS THAT REQUIRES LARGER-SCALE INTERVENTIONS.SIMILARLY, THE HOSPITAL PUBLISHED THREE REPORTS IN FY 2021 ON BEHAVIORAL HEALTH SERVICES IN WASHINGTON, D.C. ONE REPORT DESCRIBED THE CURRENT LANDSCAPE OF BEHAVIORAL HEALTH SERVICES FOR CHILDREN WITH AUTISM SPECTRUM DISORDER INSURED BY MEDICAID IN WASHINGTON, D.C. AND ANOTHER REPORT ON HOW TO TRANSFORM BEHAVIORAL HEALTH IN THE DISTRICT OF COLUMBIA WITH PERSPECTIVES AND RECOMMENDATIONS FROM CHILDREN'S NATIONAL HOSPITAL AND THE EARLY CHILDHOOD INNOVATION NETWORK. THE THIRD REPORT ILLUSTRATED HOW COVID-19 HAD AN IMPACT ON CHILD BEHAVIORAL HEALTH OUTCOMES AND THE BEHAVIORAL HEALTH CARE SYSTEM. ALL THREE REPORTS ARE AVAILABLE ON THE HOSPITAL WEBSITE: HTTPS://CHILDRENSNATIONAL.ORG/ADVOCACY-AND-OUTREACH/CHILD-HEALTH-ADVOCACY-INSTITUTE/COMMUNITY-MENTAL-HEALTH/PUBLICATIONS.FINALLY, TO SUPPORT CONTINUOUS ASSESSMENT OF THE NEEDS OF OUR COMMUNITY, THE HOSPITAL ESTABLISHED THE CHILD HEALTH DATA LAB OVER TEN YEARS AGO WHERE DATA SCIENTIST USE EVIDENCE-BASED APPROACHES TO IDENTIFY AND TRACK TRENDS IN POPULATION HEALTH USING BIG DATA ANALYSIS, DEVELOPING INTERACTIVE MAPS, AND COLLECTING COMMUNITY INPUT. THE CHILD HEALTH DATA LAB OVERSEES THE DC HEALTH MATTERS WEB PORTAL THAT PROVIDES A ONE-STOP RESOURCE FOR ONLINE ACCESS TO COMMUNITY HEALTH INDICATORS THAT IMPACT THE HEALTH OF DC COMMUNITIES.
PART VI, LINE 3:	ELIGIBILITY EDUCATION CHILDREN'S HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY (FAP) THAT PROVIDES ELIGIBLE PATIENTS WITH DISCOUNTED EMERGENCY OR OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES PROVIDED BY CHILDREN'S HOSPITAL. CHILDREN'S WILL PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL PROHIBITS ANY ACTIONS THAT WOULD DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE. FINANCIAL ASSISTANCE INFORMATION, INCLUDING THE POLICY AND PLAIN LANGUAGE GUIDES, AND APPLICATION FORM, IS AVAILABLE ON CHILDREN'S PUBLIC WEBSITE. FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND VIA PHONE. THE COUNSELORS CONTACT INFORMATION IS PUBLICIZED ON THE WEBSITE. CUSTOMER SERVICE CONTACT INFORMATION IS ALSO PROVIDED ON THE WEBSITE AS WELL AS BILLING STATEMENTS. SIGNAGE ALERTING PATIENTS TO THE AVAILABILITY OF FINANCIAL AID IS POSTED AT REGISTRATION AREAS AND APPLICATIONS ARE READILY AVAILABLE. CHILDREN'S ALSO WORKS WITH EXTERNAL VENDORS WHO ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE APPLICATION AS WELL AS APPLYING FOR STATE MEDICAID AND OTHER FEDERAL AND LOCAL PROGRAMS.THE FOLLOWING PROCESSES TAKE PLACE FOR FAMILIES WHO DO NOT HAVE INSURANCE OR WHO CANNOT PAY:1. THROUGH OUR CONTRACTED COMPANIES (MEDLAW AND DECO) WHO RESIDE IN OUR FINANCIAL INFORMATION CENTER (FIC), AN APPLICATION IS MADE FOR MEDICAL ASSISTANCE AND OUR FINANCIAL ASSISTANCE PROGRAM (FAP). ELIGIBILITY IS CONSIDERED FOR ALL APPROPRIATE PUBLIC PROGRAMS. IN AN EFFORT TO HAVE THIS PROCESS TAKE PLACE PRIOR TO THE MEDICAL VISIT, FAP APPLICATIONS ARE MAILED TO SELF-PAY PATIENTS WHEN THEY MAKE AN APPOINTMENT.2. WHILE THE APPLICATION IS IN PROCESS, THE PATIENT IS REGISTERED AS MEDICAID PENDING AND THE MEDICAL VISIT TAKES PLACE (CITIZENS ONLY). NON-CITIZENS ARE REGISTERED AS SELF-PAY.3. IF THE PATIENT IS DETERMINED TO BE MEDICAID ELIGIBLE, THE PATIENT REGISTRATION IS CONVERTED TO THE MEDICAID PLAN.4. IF NOT ELIGIBLE, THE PATIENT'S CHARITY CARE APPLICATION IS FURTHER EVALUATED FOR CHARITY CARE BY CHILDREN'S CUSTOMER SERVICE STAFF IN THE FIC.5. IF FAP IS APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. THE ACCOUNTS ARE MANAGED BY CUSTOMER SERVICE STAFF. ONLY EXPECTED BALANCES REMAIN ON THE ACCOUNT AND FAMILIES RECEIVE STATEMENTS SHOWING THEIR RESPONSIBILITY.6. IF FAP IS NOT APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. FAMILIES CAN SET UP PAYMENT PLANS TO RESOLVE THEIR ACCOUNT BALANCES.7. MEDICALLY INDIGENT STATUS CAN APPLY FOR INSURED FAMILIES. THIS STATUS CAN BE EVALUATED AT ANY TIME IF A FAMILY'S REMAINING BALANCE (EXCLUDING ANY DEDUCTIBLES) AFTER THIRD PARTY PAYER PAYMENT IS GREATER THAN 30% OF ANNUAL INCOME LESS HOUSING EXPENSES.- WHENEVER APPLICABLE, IT IS ENCOURAGED THAT FAMILIES REVIEW THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE THE APPOINTMENT DATE. APPOINTMENTS ARE TYPICALLY MADE WITH THE FIC OFFICE WHEN FAMILIES MAKE THEIR MEDICAL APPOINTMENTS. THEY CAN GO DIRECTLY TO THE FIC OFFICE AT CHILDREN'S HOSPITAL AT ANY OTHER TIME.- FAMILIES ARE ENCOURAGED TO COOPERATE WITH OUR STAFF BY SUPPLYING ALL NECESSARY INFORMATION FOR THE MEDICAID AND FAP APPLICATIONS.
PART VI, LINE 4:	DESCRIPTION OF COMMUNITY SERVEDAS THE ONLY EXCLUSIVE PROVIDER OF PEDIATRIC CARE IN THE NATION'S CAPITAL, CHILDREN'S NATIONAL SERVES A DIVERSE AND BROAD COMMUNITY, SPANNING FROM THE DISTRICT OF COLUMBIA TO MARYLAND AND VIRGINIA AND BEYOND. THE U.S. CENSUS ESTIMATES THE 2023 POPULATION OF THE DISTRICT OF COLUMBIA TO BE 678,972 RESIDENTS. THE POPULATION GREW BY 8,023 PEOPLE FROM JULY 1, 2022 TO JULY 1, 2023, WHICH IS ATTRIBUTED TO THE DISTRICT HAVING 2,607 MORE BIRTHS THAN DEATHS IN THE YEAR. MARYLAND AND VIRGINIA ARE HOME TO 6 MILLION AND 8 MILLION RESIDENTS, RESPECTIVELY. THE SOCIAL DEMOGRAPHICS FOR THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA, ACCORDING TO THE U.S. CENSUS, ARE AS FOLLOWS: DISTRICT OF COLUMBIA: ABOUT 45.0% BLACK; 46.2% WHITE; 11.7% LATINO; 4.7% ASIAN AND 0.7% AMERICAN INDIAN/ALASKA NATIVE; MARYLAND: APPROXIMATELY 57.3% WHITE; 31.7% BLACK; 11.5% HISPANIC; 7.1% ASIAN AND VIRGINIA 68.5% WHITE, 20.0% BLACK, 10.5% HISPANIC, 7.3% ASIAN, AND 0.6% AMERICAN INDIAN/ALASKA NATIVE. IN THE DISTRICT OF COLUMBIA, CHILDREN 18 YEARS OLD AND YOUNGER MAKE UP 18.5 PERCENT OF THE POPULATION WITH THE HIGHEST PERCENTAGE RESIDING IN WARDS 7 AND 8, 3.14% AND 3.30% RESPECTIVELY. IN BOTH MARYLAND AND VIRGINIA ABOUT 21 PERCENT OF THE POPULATION IS CHILDREN 18 YEARS OLD AND YOUNGER. CHILDREN AGED FIVE AND YOUNGER MAKE UP APPROXIMATELY 5.7% PERCENT OF THE POPULATION IN THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA.SOCIOECONOMIC STATUS IS THE SOCIAL STANDING OF AN INDIVIDUAL OR GROUP. IT IS OFTEN MEASURED AS A COMBINATION OF EDUCATION, INCOME, AND OCCUPATION. LOW SOCIOECONOMIC STATUS IS STRONGLY CORRELATED WITH INEQUITIES IN ACCESS TO RESOURCES, AS WELL AS ISSUES RELATED TO PRIVILEGE, POWER, AND CONTROL. PEOPLE WITH LOWER SOCIOECONOMIC STATUS TYPICALLY EXPERIENCE POORER HEALTH AND DIE YOUNGER THAN THOSE WITH MORE ECONOMIC ADVANTAGE. CITYWIDE AVERAGES OFTEN PAINT DC AS A SOCIALLY AND ECONOMICALLY RICH CITY; HOWEVER, A MORE DETAILED LOOK REVEALS A STORY OF PROFOUND INEQUITIES. SOCIOECONOMIC CHARACTERISTICS OF DC RESIDENTS VARY IMMENSELY ACROSS THE CITY. HEALTH INEQUITIES FOLLOW THE SAME PATTERN. FOR EXAMPLE, THERE ARE DIRECT CORRELATIONS BETWEEN THE CONCENTRATION OF POVERTY IN SEGMENTS OF THE CITY, PARTICULARLY IN WARDS 7 AND 8, AND PATTERNS OF POOR HEALTH OUTCOMES CONCENTRATED IN THE SAME AREAS. 36% OF CHILDREN IN WARD 8, THE WARD WITH THE LOWEST HOUSEHOLD INCOME IN THE DISTRICT OF COLUMBIA, LIVE IN POVERTY, AS COMPARED TO 1% OF CHILDREN IN WARD 3, THE WEALTHIEST WARD. ADDITIONALLY, DC HAS A 15+ YEAR DIFFERENCE IN LIFE EXPECTANCY BY WARD: 86 YEARS IN WARD 3 COMPARED TO 71 YEARS IN WARD 8. RACIAL DIFFERENCES IN LIFE EXPECTANCY ARE ALSO STRIKING. WHEN COMPARED TO OTHER RACIAL GROUPS, THE LIFE EXPECTANCY FOR BLACK RESIDENTS IS THE LOWEST. WHITE MALES IN THE DISTRICT ARE EXPECTED TO LIVE ALMOST 15 YEARS LONGER THAN BLACK MALES (83.2 AND 68.8 YEARS, RESPECTIVELY). WHITE FEMALES IN THE DISTRICT ARE EXPECTED TO LIVE APPROXIMATELY 9 YEARS LONGER THAN BLACK FEMALES (85.2 AND 76.2 YEARS, RESPECTIVELY).CHILDREN'S NATIONAL IS IN AN URBAN COMMUNITY WHERE THERE ARE SEVERAL LARGE ACADEMIC AND COMMUNITY HOSPITALS. HOWEVER, WE SERVE MOST OF THE CHILDREN IN DC. WE CARED FOR MORE THAN 253,167 UNIQUE PATIENTS THROUGH OUR HEALTH CENTERS IN 2023, AS THE LARGEST NON-GOVERNMENT PROVIDER OF PRIMARY CARE IN THE DISTRICT OF COLUMBIA. MARYLAND RESIDENTS ACCOUNTED FOR 50% CHILDREN'S NATIONAL PATIENTS, AND CHILDREN'S NATIONAL IS THE LARGEST PROVIDER OF PEDIATRIC CARE FOR RESIDENTS OF NORTHERN VIRGINIA AS WELL. THE NEEDS OF THE POPULATION SERVED IN MARYLAND AND NORTHERN VIRGINIA ARE SIMILAR TO THE DISTRICT OF COLUMBIA.AS PREVIOUSLY MENTIONED, THE CHILDHOOD OPPORTUNITY INDEX (COI) DEFINES OPPORTUNITY AS THE NEIGHBORHOOD RESOURCES THAT MATTER FOR A CHILD'S HEALTHY DEVELOPMENT. THE 29 INDICATORS FOCUS ON NEIGHBORHOOD FEATURES SUCH AS ACCESS TO HEALTHY FOOD, HIGH-QUALITY EDUCATION, PARKS AND PLAYGROUNDS. IN THE 2022 CHNA, OUR FINDINGS REVEAL THAT CHILD OPPORTUNITY VARIES CONSIDERABLY WITHIN OUR SERVICE AREA. CHILD OPPORTUNITY IS LOWEST AND CRITICALLY LACKING IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS CERTAIN PRINCE GEORGE'S COUNTY NEIGHBORHOODS IN MARYLAND.WE ALSO OFFER FAMILIES A LINK TO QUALITY PEDIATRIC CARE THROUGH OUR MOBILE MEDICAL PROGRAM AND AT COMMUNITY HEALTH CENTERS. OUR TEAM AVERAGES MORE THAN 552,000 OUTPATIENT VISITS EACH YEAR AT HEALTH CLINICS IN THE DISTRICT OF COLUMBIA, AFFILIATED CENTERS IN MARYLAND AND VIRGINIA, AND AT THE SHEIKH ZAYED CAMPUS IN WASHINGTON, DC. ON AVERAGE, THAT EQUALS OVER 1,000 PATIENT VISITS IN ONE DAY TO ONE OF CHILDREN'S NATIONAL'S 30 LOCATIONS IN THE DISTRICT OF COLUMBIA AND THROUGHOUT THE METROPOLITAN AREA. IN FISCAL YEAR 2023, WE PERFORMED 19,601 SURGICAL PROCEDURES, 135,498 DIAGNOSTIC IMAGING PROCEDURES, AND MORE THAN 1.3 MILLION LABORATORY TESTS.
PART VI, LINE 5:	PROMOTING THE HEALTH OF THE COMMUNITYCHILDREN'S NATIONAL WAS FOUNDED 150 YEARS AGO AS A MODEST 12-BED FACILITY DEDICATED TO SERVING THE CHILDREN OF THE NATION'S CAPITAL. WHILE THE HEALTH CARE LANDSCAPE LOOKS VERY DIFFERENT TODAY THAN IT DID IN THE 19TH CENTURY, OUR CORE MISSION REMAINS THE SAME. THE MISSION OF CHILDREN'S NATIONAL IS TO EXCEL IN CARE, ADVOCACY, RESEARCH, AND EDUCATION. WE ACCOMPLISH THIS THROUGH PROVIDING A QUALITY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND FAMILIES, IMPROVING HEALTH OUTCOMES FOR CHILDREN, AND LEADING THE CREATION OF INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES. RECOGNIZING THAT A CHILD'S HEALTH IS THE RESULT OF COUNTLESS FACTORS, CHILDREN'S NATIONAL ALSO ADVOCATES FOR POLICIES THAT PROMOTE HEALTH AND WELL-BEING FOR CHILDREN, MANY OF WHICH EXIST OUTSIDE THE CLINICAL SETTING. WHILE THE HOSPITAL HAS SUPPORTED ADVOCACY AND COMMUNITY HEALTH EFFORTS FOR DECADES, IN 2007, THE CHILDREN'S HEALTH BOARD PROVIDED FUNDING TO FORMALLY ESTABLISH THE CHILD HEALTH ADVOCACY INSTITUTE (CHAI). CHILDREN'S NATIONAL BECAME THE FIRST PEDIATRIC HOSPITAL IN THE NATION TO FORM AN IN-HOUSE ADVOCACY INSTITUTE. CHAI FOUNDERS BELIEVED THAT TO CREATE AN ENVIRONMENT WHERE CHILDREN COULD GROW UP TO FULFILL THEIR POTENTIAL, THERE SHOULD BE A COHORT OF ADVOCATES AND COMMUNITY HEALTH EXPERTS TO ENSURE SYSTEMS AND POLICY DID NOT IGNORE THE NEEDS OF THE REGION'S SMALLEST RESIDENTS. THAT MISSION IS EVEN MORE IMPORTANT TODAY.COMPRISED OF CLINICIANS, PUBLIC HEALTH EXPERTS, DATA ANALYSTS, AND GOVERNMENT AFFAIRS PROFESSIONALS, THE CHAI IS DEDICATED TO ADVANCING COMMUNITY HEALTH AND WELL-BEING, WITH A FOCUS ON CHILDREN AND FAMILIES IN UNDER-RESOURCED COMMUNITIES.CHAI'S PORTFOLIO INCLUDES A WIDE RANGE OF INITIATIVES THAT PROMOTE COMMUNITY HEALTH. FROM LEADING THE CHILDREN'S NATIONAL COMMUNITY BENEFIT PROGRAM TO EDUCATING AND MOBILIZING STAFF TO ENGAGE IN COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY - THE CHAI IS DEVOTED TO ADVANCING POLICY AND SYSTEMS CHANGES WITH THE GOAL OF ACHIEVING HEALTH EQUITY FOR ALL CHILDREN. IT IS THROUGH THIS LENS THAT CHILDREN'S NATIONAL ADDS A UNIQUE APPROACH TO ADDRESSING COMMUNITY HEALTH PRIORITIES AND PROMOTING HEALTH EQUITY. THIS WORK CANNOT BE DONE ALONE; THUS, THE CHAI SERVES AS A CONDUIT THROUGH WHICH THE COMBINED EXPERTISE OF MORE THAN 7,300 CHILDREN'S NATIONAL EMPLOYEES AND COUNTLESS COMMUNITY STAKEHOLDERS INTERACT WITH, REACT TO, AND SPEAK ON BEHALF OF CHILDREN AND FAMILIES. IN ADDITION, CHILDREN'S NATIONAL IS ENSURING THAT WE ARE ON THE PATH TOWARD BECOMING A MORE DIVERSE, EQUITABLE AND INCLUSIVE ORGANIZATION TO IMPROVE HEALTH AND RACIAL EQUITY. OUR HOSPITAL HAS BEEN ON A JOURNEY TOWARD GREATER DIVERSITY, EQUITY AND INCLUSION SINCE THE EARLY 2000S. LEADING UP TO THE YEAR 2020, WE FOCUSED ON RECRUITMENT, ACADEMIC ADVANCEMENT AND LEADERSHIP DEVELOPMENT OF FACULTY MEMBERS AND TRAINEES UNDERREPRESENTED IN MEDICINE. THIS WORK HAS CONTRIBUTED TO IMPORTANT MILESTONES, INCLUDING WELCOMING A 2021 RESIDENCY CLASS THAT IS OUR MOST DIVERSE CLASS EVER AND MORE THAN THREE TIMES THE NATIONAL AVERAGE FOR DIVERSITY, BETTER REFLECTING OUR PATIENTS AND FAMILIES IN OUR COMMUNITY. OUR HISTORY OF LEADING THESE EFFORTS MEANT WE WERE POISED TO EXPAND OUR SCOPE OF WORK ON DIVERSITY, EQUITY AND INCLUSION. IN FISCAL YEAR 2021, WE BEGAN DESIGNING EFFECTIVE, DATA-DRIVEN AND RESPONSIVE HOSPITAL AND COMMUNITY PROGRAMS THAT LED TO A MORE DIVERSE, EQUITABLE AND INCLUSIVE WORKPLACE AND MORE IMPORTANTLY, WILL ENSURE THE CONTINUED DELIVERY OF HIGH-QUALITY HEALTH CARE SERVICES AND EDUCATION TO ALL PATIENTS AND FAMILIES. THIS IS NOT AN EASY PATH - DEVELOPING INITIATIVES AND PROGRAMS TO REACH THE GOAL OF EQUITY AND INCLUSION FOR ALL REQUIRES US TO OVERCOME CENTURIES OF PERVASIVE RACISM, SEXISM AND CULTURAL AND RELIGIOUS BIAS THAT HAVE CREATED FUNCTIONAL, ECONOMIC AND STRUCTURAL BARRIERS IN SOCIETY. BUT THE DEDICATION AND PASSION THAT OUR TEAMS CONTINUE TO SHOW IN THE FACE OF THESE CHALLENGES GIVE US CONFIDENCE THAT WE HAVE THE VISION, RESOLVE, KNOWLEDGE AND SKILLS TO ADVANCE THIS IMPORTANT BODY OF WORK ON BEHALF OF OUR PATIENTS, FAMILIES AND COMMUNITY. IN FY 2023, WE ESTABLISHED THE COMMUNITY HEALTH ADVISORY COUNCIL. THE COUNCIL IS COMPRISED OF PARENTS/CAREGIVERS THAT RESIDE IN WARDS 7 AND 8 IN WASHINGTON, D.C. AND PRINCE GEORGE'S COUNTY, MARYLAND. THE COUNCIL'S MEMBERS HAVE PROVIDED VALUABLE INPUT REGARDING THEIR EXPERIENCES WITH THE QUALITY AND SAFETY OF CARE, INCLUDING HOW COMMUNITY CHALLENGES, FAMILY BARRIERS AND CULTURAL TRADITIONS IMPACT THE CARE RECEIVED. THEY HAVE ADVISED ON CHIP PRIORITIES AND PROVIDED STRATEGIC DIRECTION FOR COMMUNITY HEALTH PLANNING. ALSO, WE CREATED AN EXPANDED COMMUNITY-BASED SERVICE-LEARNING CURRICULUM THAT ESTABLISHED A NATIONAL MODEL FOR SERVICE-LEARNING IN GRADUATE MEDICAL EDUCATION. THROUGH A PARTNERSHIP WITH A LOCAL, NONCLINICAL, COMMUNITY-BASED ORGANIZATION (CBO) THAT SERVES UNDER-RESOURCED CHILDREN AND FAMILIES LIVING WITH MENTAL HEALTH ISSUES, SECOND-YEAR RESIDENTS SERVE AS MEDICAL EXPERTS FOR FAMILY SUPPORT GROUPS, ADVOCATE FOR SUPPORT SERVICES DURING HEARINGS FOR JUSTICE-INVOLVED YOUTH AND PARTICIPATE IN SCHOOL ADVOCACY WORK. THESE ACTIVITIES GIVE STAFF THE OPPORTUNITY TO HELP IMPROVE ACCESS TO HEALTH CARE, LEARN FROM OUR COMMUNITY AND BUILD TRUST WITH COMMUNITY MEMBERS.
PART VI, LINE 6:	AFFILIATED HEALTH CARE SYSTEM ROLESCHILDREN'S HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING TAX-EXEMPT ENTITIES:- CHILDREN'S NATIONAL MEDICAL CENTER - 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBLE FOR HEALTH CARE SYSTEM- CHILDREN'S HOSPITAL FOUNDATION - 501(C)(3), FUNDRAISING- CHILDREN'S RESEARCH INSTITUTE - 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS- SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN- BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN- CHILDREN'S SCHOOL SERVICES - 501(C)(3), OPERATION OF A SCHOOL NURSE PROGRAM- HSC FOUNDATION - 501(C)(3), SUPPORT FOR THE HSC ENTITIES - HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS - 501(C)(3), HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES FOR YOUNG INDIVIDUALS WITH SPECIAL NEEDS- THE HOSPITAL FOR SICK CHILDREN DBA THE HSC PEDIATRIC CENTER - 501(C)(3), ACUTE CARE HOSPITAL FACILITY THAT PROVIDES REHABILITATION AND TRANSITIONAL CARE FOR CHILDREN AND ADOLESCENTS WITH DISABILITIESAND CHRONIC ILLNESSES- HSC HOME CARE, LLC - 501(C)(3), HOME AND COMMUNITY PROVIDES ACCESS TO QUALITY REHABILITATIVE AND SPECIALTY SERVICES FOR INFANTS, CHILDREN AND ADOLESCENTS WITH SPECIAL NEEDSEACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS.
PART VI, LINE 7, REPORTS FILED WITH STATES	DC

Schedule H (Form 990) 2022

Additional Data

Software ID:
Software Version:

- 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

2022

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Cat. No. 50053T

Schedule J (Form 990) 2022

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)
1KURT D NEWMAN MD PRESIDENT / CEO (CNMC) TO 06/23	(i) (ii)	1,615,608 ------------- 0	1,076,563 ------------- 0	281,583 ------------- 0	15,250 ------------- 0	37,699 ------------- 0	3,026,703 ------------- 0	0 ------------- 0
2YVES D'UDEKEM D'ACOZ MD CHIEF OF CARDIO SURGERY	(i) (ii)	1,702,141 ------------- 0	318,623 ------------- 0	126,220 ------------- 0	15,250 ------------- 0	30,425 ------------- 0	2,192,659 ------------- 0	0 ------------- 0
3ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE	(i) (ii)	945,874 ------------- 0	519,210 ------------- 0	263,141 ------------- 0	162,196 ------------- 0	41,037 ------------- 0	1,931,458 ------------- 0	232,321 ------------- 0
4KATHLEEN CHAVANU GORMAN CHIEF OPERATING OFFICER	(i) (ii)	760,222 ------------- 0	400,152 ------------- 0	177,199 ------------- 0	128,500 ------------- 0	34,770 ------------- 0	1,500,843 ------------- 0	150,880 ------------- 0
5ROBERT KEATING MD CHIEF OF NEUROSURGERY	(i) (ii)	890,779 ------------- 0	172,848 ------------- 0	274,045 ------------- 0	105,628 ------------- 0	24,652 ------------- 0	1,467,952 ------------- 0	268,002 ------------- 0
6DAVID WESSEL MD CHIEF MEDICAL OFFICER	(i) (ii)	722,447 ------------- 0	399,831 ------------- 0	149,454 ------------- 0	15,250 ------------- 0	68,349 ------------- 0	1,355,331 ------------- 0	0 ------------- 0
7RICARDO MUNOZ MD CHIEF OF CARDIAC CRITICAL CARE	(i) (ii)	738,881 ------------- 0	137,229 ------------- 0	244,067 ------------- 0	68,282 ------------- 0	19,977 ------------- 0	1,208,436 ------------- 0	179,211 ------------- 0
8ALDWIN LINDSAY EVP/CFO	(i) (ii)	671,077 ------------- 0	340,588 ------------- 0	56,613 ------------- 0	111,643 ------------- 0	12,797 ------------- 0	1,192,718 ------------- 0	30,753 ------------- 0
9TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY	(i) (ii)	841,932 ------------- 0	298,616 ------------- 0	4,356 ------------- 0	15,250 ------------- 0	28,878 ------------- 0	1,189,032 ------------- 0	0 ------------- 0
10RAHUL SHAH MD SVP, HOSPITAL-BASED SPECIALTIES	(i) (ii)	564,976 ------------- 0	276,649 ------------- 0	207,207 ------------- 0	99,253 ------------- 0	10,475 ------------- 0	1,158,560 ------------- 0	184,589 ------------- 0
11DEANN MARSHALL PRESIDENT OF FOUNDATION	(i) (ii)	572,442 ------------- 0	311,118 ------------- 0	125,156 ------------- 0	15,250 ------------- 0	37,569 ------------- 0	1,061,535 ------------- 0	0 ------------- 0
12MARY ANNE HILLIARD EVP/CHIEF LEGAL OFFICER	(i) (ii)	521,914 ------------- 0	269,596 ------------- 0	153,026 ------------- 0	80,233 ------------- 0	29,275 ------------- 0	1,054,044 ------------- 0	100,169 ------------- 0
13ROGER PACKER MD SVP CENTER OF EXCELLENCE TO 3/23	(i) (ii)	549,112 ------------- 0	315,230 ------------- 0	138,247 ------------- 0	15,250 ------------- 0	31,548 ------------- 0	1,049,387 ------------- 0	0 ------------- 0
14CHARLES WEINSTEIN CHIEF REAL ESTATE OFFICER	(i) (ii)	496,567 ------------- 0	272,105 ------------- 0	138,582 ------------- 0	15,250 ------------- 0	29,116 ------------- 0	951,620 ------------- 0	0 ------------- 0
15MICHELLE M MCGUIRE CHIEF STRATEGY OFFICER	(i) (ii)	503,410 ------------- 0	262,656 ------------- 0	52,868 ------------- 0	91,752 ------------- 0	37,996 ------------- 0	948,682 ------------- 0	28,749 ------------- 0
16NATHANIEL BEERS MD PRESIDENT OF HSC	(i) (ii)	469,321 ------------- 0	232,918 ------------- 0	119,460 ------------- 0	86,395 ------------- 0	34,017 ------------- 0	942,111 ------------- 0	96,313 ------------- 0
17MARK L BATSHAW MD FMR EVP & CHIEF ACADEMIC OFFICER	(i) (ii)	508,148 ------------- 0	134,413 ------------- 0	118,511 ------------- 0	140,250 ------------- 0	22,510 ------------- 0	923,832 ------------- 0	0 ------------- 0
18CATHERINE CODISPOTI MD CHIEF PEOPLE OFFICER	(i) (ii)	454,624 ------------- 0	295,973 ------------- 0	70,520 ------------- 0	15,250 ------------- 0	31,043 ------------- 0	867,410 ------------- 0	0 ------------- 0
19MATTHEW MACVEY CHIEF INFO OFFICER	(i) (ii)	484,976 ------------- 0	189,907 ------------- 0	37,275 ------------- 0	90,250 ------------- 0	39,640 ------------- 0	842,048 ------------- 0	35,781 ------------- 0
20VITTORIO GALLO PHD CHIEF RESEARCH OFFICER	(i) (ii)	473,627 ------------- 0	214,200 ------------- 0	97,948 ------------- 0	13,923 ------------- 0	11,990 ------------- 0	811,688 ------------- 0	0 ------------- 0
21LINDA TALLEY CHIEF NURSING OFFICER	(i) (ii)	419,046 ------------- 0	228,404 ------------- 0	55,086 ------------- 0	77,208 ------------- 0	24,065 ------------- 0	803,809 ------------- 0	29,249 ------------- 0
22ELIZABETH WELLS SVP CENTER OF EXCELLENCE FROM 3/23	(i) (ii)	423,209 ------------- 0	132,841 ------------- 0	1,220 ------------- 0	15,250 ------------- 0	35,125 ------------- 0	607,645 ------------- 0	0 ------------- 0
23DENICE CORA-BRAMBLE MD FMR CHIEF MEDICAL OFFICER	(i) (ii)	200,219 ------------- 0	47,447 ------------- 0	57,890 ------------- 0	11,502 ------------- 0	44,879 ------------- 0	361,937 ------------- 0	0 ------------- 0
24DARRYL VARNADO PHD FMR CHIEF PEOPLE OFFICER	(i) (ii)	0 ------------- 0	0 ------------- 0	226,437 ------------- 0	0 ------------- 0	23,876 ------------- 0	250,313 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2022

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 1A:	FIRST CLASS OR CHARTER TRAVEL THE CEO PER HIS EMPLOYMENT CONTRACT IS ENTITLED TO USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS. HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL. SCHEDULE J, PART I, LINE 1A: PERSONAL SERVICES CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT.
SCHEDULE J, PART I, LINE 4A:	SEVERANCE THE FOLLOWING FORMER KEY EMPLOYEE RECEIVED A SEVERANCE PAYMENT. THE SEVERANCE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF OTHER REPORTABLE COMPENSATION: DARYL VARNADO $226,437
SCHEDULE J, PART I, LINE 4B:	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II COLUMN (C ) AS PART OF DEFERRED COMPENSATION OR SCHEDULE J, PART II, COLUMN (B)(III) WHEN AMOUNTS ARE DEFERRED AND DISTRIBUTED IN THE SAME CALENDAR YEAR: KURT NEWMAN, MD $243,750 ANTHONY SANDLER, MD $146,946 MARK BATSHAW, MD $204,067 DAVID WESSEL, MD $113,160 KATHLEEN CHAVANU GORMAN $113,250 ROGER PACKER, MD $76,316 VITTORIO GALLO, PHD $64,260 DENISE CORA-BRAMBLE, MD $35,197 ALDWIN LINDSAY $96,393 MICHELLE MCGUIRE $76,502 LINDA TALLEY $64,643 MARY ANNE HILLIARD $64,983 ROBERT KEATING $90,378 NATHANIEL BEERS, MD $71,145 MATTHEW MACVEY $75,000 CHARLES WEINSTEIN $78,795 RICARDO MUNOZ, MD $53,293 RAHUL SHAH, MD $84,003 ADDITIONALLY, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE PLAN THAT WERE DEFERRED ON A PREVIOUSLY FILED FORM 990 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AS TAXABLE WAGES IN THE CURRENT YEAR. ANTHONY SANDLER, MD $232,321 KATHLEEN CHAVANU GORMAN $150,880 ROBERT KEATING, MD $268,002 RICARDO MUNOZ, MD $179,211 ALDWIN LINDSAY $30,753 RAHUL SHAH, MD $184,589 MARY ANNE HILLIARD $100,169 MICHELLE M. MCGUIRE $28,749 NATHANIEL BEERS, MD $96,313 MATTHEW MACVEY $35,781 LINDA TALLEY $29,249
SCHEDULE J, PART I, LINE 7:	NON-FIXED PAYMENTS THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT.
SCHEDULE J, PART I, LINE 8:	INITIAL CONTRACT EXCEPTION CERTAIN INDIVIDUALS HIRED DURING THE YEAR HAVE EMPLOYMENT CONTRACTS WHICH MEET THE INITIAL CONTRACT EXCEPTIONS DESCRIBED IN THE TREASURY REGULATIONS.
SCHEDULE J, PART II, COLUMN (F):	COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990 THE AMOUNTS REPORTED IN COLUMN F REPRESENT THE ACCUMULATION OVER MANY YEARS OF DEFERRED COMPENSATION BENEFITS WHICH ARE NOW TAXABLE TO THE RECIPIENT. THE ORGANIZATION HAS ALSO REPORTED THESE SAME AMOUNTS AS ACCRUED DEFERRED COMPENSATION IN PRIOR YEARS' COLUMN C.

Schedule J (Form 990) 2022

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

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

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
CHILDREN'S HOSPITAL

Employer identification number
53-0196580

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	DISTRICT OF COLUMBIA	53-6001131	254764KB8	09-17-2015	413,728,662	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	39,885,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	413,728,662
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............	410,562,146
7 Issuance costs from proceeds ...............	3,166,515
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		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
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.100 %
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 %
6 Total of lines 4 and 5 .............	0.100 %
7 Does the bond issue meet the private security or payment test? ...		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
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

Part Ⅳ

Arbitrage

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

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
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
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
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

Return Reference	Explanation
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: DISTRICT OF COLUMBIA DATE THE REBATE COMPUTATION WAS PERFORMED: 09/17/2020
SCHEDULE K, PART I, LINE A, COLUMN (F):	ADV REFUND BOND ISSUES 10/26/2005 AND 4/10/2008

Schedule K (Form 990) 2021

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Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

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

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

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

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

Part II

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

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No
(1) CATHERINE CODISPOTI	KEY EMPLOYEE	HOUSING		X	200,000	50,000		No	Yes		Yes





Total ............... $						50,000

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

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

(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person	(c) Amount of transaction	(d) Description of transaction	Yes	No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2021

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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

2022

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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 .
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 ( MEDICAL EQUIPMENT )	X	1	495,933	FMV
26 Other ( )
27 Other ( )
28 Other ( )

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

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which 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) (2022)

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, COLUMN (B):	THE AMOUNT IN COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.

Schedule M (Form 990) (2022)

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SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Return Reference	Explanation
FORM 990, PART I, LINE 1 AND PART III, LINE 1:	ORGANIZATION'S MISSION TO IMPROVE HEALTH OUTCOMES FOR CHILDREN; BE A LEADER IN CREATING INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTHCARE PROBLEMS; AND EXCEL IN CARE, ADVOCACY, RESEARCH. AS THE NATION'S CHILDREN'S HOSPITAL, THE MISSION OF CHILDREN'S NATIONAL IS TO EXCEL IN CARE, ADVOCACY, RESEARCH AND EDUCATION. WE ACCOMPLISH THIS THROUGH: - PROVIDING A QUALITY HEALTH CARE EXPERIENCE FOR OUR PATIENTS AND FAMILIES. - IMPROVING HEALTH OUTCOMES FOR CHILDREN REGIONALLY, NATIONALLY, AND INTERNATIONALLY. - LEADING THE CREATION OF INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES.
FORM 990, PART VI, SECTION A, LINE 6	MEMBERS OR STOCKHOLDERS CHILDREN'S NATIONAL IS THE SOLE MEMBER OF CHILDREN'S NATIONAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	MEMBERS OR STOCKHOLDERS THE SOLE MEMBER OF CHILDREN'S NATIONAL HOSPITAL HAS THE RIGHT TO ELECT DIRECTORS OF CHILDREN'S NATIONAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	MEMBERS OR STOCKHOLDERS THE ARTICLES AND BY-LAWS OF CHILDREN'S NATIONAL HOSPITAL DESCRIBE CERTAIN RIGHTS RESERVED TO THE SOLE MEMBER.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW PROCESS ONCE THE FORM 990 AND ALL SCHEDULES HAVE BEEN PREPARED BY THE ORGANIZATION'S PROFESSIONAL TAX SERVICES PROVIDER, THE RELEVANT COMMITTEES OF THE ORGANIZATION, ENTITY OPERATIONAL LEADERSHIP, AND FINANCE MANAGEMENT REVIEW APPLICABLE PORTIONS OF THE FORM 990. THE COMPLETED FORM 990 IS ALSO MADE AVAILABLE TO THE BOARD OF CHILDREN'S NATIONAL PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICT OF INTEREST POLICY MONITORING & ENFORCEMENT CHILDREN'S NATIONAL HOSPITAL ASKS THAT EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE COMPLETE A CONFLICT OF INTEREST FORM AT LEAST EVERY YEAR. IN ADDITION, EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE IS INSTRUCTED TO AMEND THE CONFLICT OF INTEREST FORM IMMEDIATELY UPON A CHANGE IN STATUS OF ANY OF THE QUESTIONS ON THE FORM. THESE FORMS ARE REVIEWED ANNUALLY BY THE CHIEF LEGAL OFFICER AND CONFLICTS OF INTERESTS ARE NOTED. THE CHILDREN'S NATIONAL HOSPITAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY. IF ANYONE IS FOUND TO BE CONFLICTED OR A SIGNIFICANT PERCEIVED CONFLICT EXISTS, THAT BOARD MEMBER WOULD RECUSE HIMSELF OR HERSELF FROM ALL DISCUSSIONS RELATED TO THE TRANSACTION. FORM 990, PART VI, LINES 13 & 14: GOVERNING POLICIES CHILDREN'S NATIONAL HOSPITAL IS GOVERNED BY THE POLICIES OF ITS PARENT, CHILDREN'S NATIONAL. THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY.
FORM 990, PART VI, SECTION B, LINE 15	PROCESS FOR DETERMINING COMPENSATION THE PEOPLE, CULTURE AND COMPENSATION COMMITTEE OF THE CHILDREN'S NATIONAL BOARD OF DIRECTORS IS COMPRISED WHOLLY OF DISINTERESTED, INDEPENDENT BOARD MEMBERS. THE COMMITTEE HAS RETAINED INDEPENDENT OUTSIDE CONSULTANTS EXPERT ON COMPENSATION MATTERS. THE COMMITTEE DETERMINES ADJUSTMENTS IN COMPENSATION, INCLUDING BASE PAY, INCENTIVES, AND OTHER FORMS OF COMPENSATION FOR EACH PERSON DEEMED BY THE COMPENSATION COMMITTEE TO BE A "DISQUALIFIED PERSON" AS THAT TERM IS USED IN THE INTERMEDIATE SANCTIONS REGULATIONS OF THE IRS. THE COMMITTEE IS INFORMED IN ITS DECISION-MAKING BY COMPENSATION STUDIES AND COMPARISONS DONE BY THE INDEPENDENT CONSULTANT AND RELIES UPON "REASONABLENESS" OPINIONS FOR SUCH CONSULTANTS, PRIOR TO OR CONTEMPORANEOUS WITH MAKING COMPENSATION DECISIONS. THE COMMITTEE MEETS 4-6 TIMES PER YEAR TO CONSIDER SUCH MATTERS AND DOCUMENTS THESE MEETINGS IN MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	HOW DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC CHILDREN'S NATIONAL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FORM 990 ARE PROVIDED ON REQUEST.
FORM 990, PART XI, LINE 9:	UNRESTRICTED EQUITY TRANSFER -16,872,385.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

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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

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CHILDREN'S NATIONAL AT WALTER REED LLC 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 38-3987350	HEALTH CARE	DC	993,822	100,652,527	CH

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CHILDREN'S HOSPITAL FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1640402	FUNDRAISING	DC	501(C)(3)	LINE 7	CNMC		No
(2)CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1640403	HEALTH CARE	DC	501(C)(3)	LINE 12C, III-FI	N/A		No
(3)CHILDREN'S RESEARCH INSTITUTE 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1654453	RESEARCH	DC	501(C)(3)	LINE 7	CNMC		No
(4)SAFE KIDS WORLDWIDE 1255 23RD STREET NW WASHINGTON,DC20037 52-1627574	INJURY PREVENTION	DC	501(C)(3)	LINE 7	CNMC		No
(5)BRAINY CAMPS ASSOCIATION 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 27-1547370	CHILD CAMPS	DC	501(C)(3)	LINE 12A, I	CH	Yes
(6)CHILDREN'S SCHOOL SERVICES 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 81-4291601	NURSING SERVICES	DC	501(C)(3)	LINE 12A, I	CNMC		No
(7)THE HSC FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1346603	HEALTH CARE	DC	501(C)(3)	LINE 12C, III-FI	CNMC		No
(8)THE HOSPITAL FOR SICK CHILDREN 111 MICHIGAN AVE NW WASHINGTON,DC20010 53-0204670	HOSPITAL	DC	501(C)(3)	LINE 3	HSC FNDN		No
(9)HEALTH SVCS FOR CHILDREN W SPEC NEEDS 111 MICHIGAN AVE NW WASHINGTON,DC20010 52-1862406	HEALTH CARE	DC	501(C)(3)	LINE 10	HSC FNDN		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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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
(1) CHILDREN'S PEDIATRICIANS AND ASSOCIATES LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 52-2072589	HEALTH CARE	DC	N/A	RELATED	-962,502	8,762,420		No			No	50.000 %
(2) 5253 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-2873855	PROPERTY MANAGEMENT	DC	N/A					No			No
(3) 5253 HTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-3044006	PROPERTY MANAGEMENT	DC	N/A					No			No
(4) 54 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-3358685	PROPERTY MANAGEMENT	DC	N/A					No			No
(5) 54 HTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-3385522	PROPERTY MANAGEMENT	DC	N/A					No			No

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(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) CHILDREN'S NATIONAL HEALTH NETWORK 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1996521	HEALTH CARE	DC	N/A	C					No
(2) BEARACUDA RE PO BOX 69 GRANDCAYMAN KY1-1102 CJ	REINSURANCE	CJ	N/A	C					No
(3) PEDIATRIC HEALTH NETWORK INC 12211 PLUM ORCHARD DR STE 102 SILVER SPRING,MD20904 83-3415276	HEALTH CARE	DC	N/A	C					No
(4) BUILDING 5253 MANAGING MEMBER LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-2801690	PROPERTY MGMT	DC	N/A	C					No
(5) BUILDING 54 MANAGING MEMBER LLC 111 MICHIGAN AVE WASHINGTON,DC20010 83-3272918	PROPERTY MGMT	DC	N/A	C					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) ............................

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) BRAINY CAMPS ASSOCIATION	Q	396,483	COST
(2) BRAINY CAMPS ASSOCIATION	S	234,493	COST

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:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	9,441
6	Total number of volunteers (estimate if necessary) .............	6	1,114
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,604,416
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) .........	66,496,859	53,753,566
9	Program service revenue (Part VIII, line 2g) .........	1,373,049,864	1,502,472,344
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,791,262	7,449,655
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-1,631,298	-1,443,634
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,445,706,687	1,562,231,931
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	834,429,360	874,349,566
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	581,978,911	643,588,868
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,416,408,271	1,517,938,434
19	Revenue less expenses. Subtract line 18 from line 12.......	29,298,416	44,293,497
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,196,591,270	2,228,485,013
21	Total liabilities (Part X, line 26).............	1,380,604,530	1,366,024,806
22	Net assets or fund balances. Subtract line 21 from line 20.....	815,986,740	862,460,207

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,144,806,009 including grants of $ ) (Revenue $ 1,490,316,318 )
	CHILDREN'S HOSPITAL DBA CHILDREN'S NATIONAL HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER DBA CHILDREN'S NATIONAL IS THE PARENT COMPANY OF THE HOSPITAL. CHILDREN'S NATIONAL AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE H, PART VI FOR COMPLETE FY23 COMMUNITY BENEFIT REPORT.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,144,806,009

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	25,553,780	0	2,145,973

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	32,206,442
e	Government grants (contributions)		1e	12,012,446

f	All other contributions, gifts, grants, and similar amounts not included above		1f	9,534,678

g	Noncash contributions included in lines 1a - 1f:$		1g	495,933

h Total. Add lines 1a-1f.......		53,753,566

		Business Code
2a	PATIENT REVENUE	621400	1,389,308,992	1,389,308,992
b	ALL OTHER PROGRAM SERV	900099	113,163,352	113,163,352
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,502,472,344

3 Investment income (including dividends, interest, and othersimilar amounts) ......			7,916,337			7,916,337
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........			411,950			411,950
		(ii) Personal	(i) Real
6a	Gross rents		3,743,350	6a
b	Less: rental expenses		0	6b
c	Rental income or (loss)		3,743,350	6c
d	Net rental income or (loss).......			3,743,350			3,743,350
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	2,407,265	63,949,995	7a
b	Less: cost or other basis and sales expenses	2,168,655	64,655,287	7b
c	Gain or (loss)	238,610	-705,292	7c
d	Net gain or (loss).........			-466,682			-466,682
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	PARKING		812390	4,952,676			4,952,676
b	LAB FEES		621500	1,604,416		1,604,416
c	PARTNERSHIP LOSS		621110	-12,156,026	-12,156,026
d	All other revenue ....
e	Total. Add lines 11a–11d ......			-5,598,934
12	Total revenue. See instructions.....			1,562,231,931	1,490,316,318	1,604,416	16,557,631

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	14,818,486	635,689	14,182,797
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	849,244	113,365	735,879
7	Other salaries and wages........	715,694,258	525,943,308	189,750,950
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	27,035,944	19,468,583	7,567,361
9	Other employee benefits .......	68,783,257	49,530,823	19,252,434
10	Payroll taxes ...........	47,168,377	33,965,948	13,202,429
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	3,641,548	2,622,279	1,019,269
c	Accounting ...........	2,032,395		2,032,395
d	Lobbying ...........	535,954		535,954
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	431,686	310,857	120,829
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	118,209,689	85,470,143	32,739,546
12	Advertising and promotion ....	6,375,755	4,591,181	1,784,574
13	Office expenses .......	14,727,548	10,605,641	4,121,907
14	Information technology ......	84,073,526	60,541,346	23,532,180
15	Royalties ..
16	Occupancy ...........	31,151,186	22,431,969	8,719,217
17	Travel ............	2,813,149	2,025,749	787,400
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	1,114,226	802,354	311,872
20	Interest ...........	28,687,803	20,658,087	8,029,716
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	100,970,142	72,708,599	28,261,543
23	Insurance ...	23,278,790	16,763,057	6,515,733
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	163,141,903	163,141,903
b	BAD DEBT EXPENSE	26,932,186	26,932,186
c	REPAIRS & MAINTENANCE	25,064,497	18,048,944	7,015,553
d	DUES & MEMBERSHIPS	3,511,703	2,528,777	982,926
e	All other expenses	6,895,182	4,965,221	1,929,961
25	Total functional expenses. Add lines 1 through 24e	1,517,938,434	1,144,806,009	373,132,425	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			101,393,747	2	69,359,836
3	Pledges and grants receivable, net ......			1,727,000	3	3,728,298
4	Accounts receivable, net .............			339,101,037	4	337,220,959
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5	50,000
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			13,488,520	8	15,045,348
9	Prepaid expenses and deferred charges ......			79,811,336	9	74,611,724
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,805,285,510
b	Less: accumulated depreciation	10b	1,028,908,457	799,055,245	10c	776,377,053
11	Investments—publicly traded securities .			217,649,301	11	270,094,021
12	Investments—other securities. See Part IV, line 11 .....			12,050,193	12	11,637,332
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			632,314,891	15	670,360,442
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,196,591,270	16	2,228,485,013

17	Accounts payable and accrued expenses .....	242,323,782	17	231,904,646
18	Grants payable ...		18
19	Deferred revenue .........	5,036,712	19	6,394,536
20	Tax-exempt bond liabilities .........	360,432,528	20	350,214,726
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	352,480,046	23	352,030,242
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	420,331,462	25	425,480,656
26	Total liabilities. Add lines 17 through 25..	1,380,604,530	26	1,366,024,806

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	815,986,740	27	862,460,207
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	815,986,740	32	862,460,207
33	Total liabilities and net assets/fund balances ........	2,196,591,270	33	2,228,485,013

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