Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(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.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
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.) | ||||||
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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 | ||||
| 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. |
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| 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) |
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| 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. |
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|
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. |
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7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
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| 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..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: | THE HOSPITAL FOR SICK CHILDREN, COMMONLY KNOWN AS THE HSC PEDIATRIC CENTER (AND SOMETIMES REFERRED TO IN THIS 990 AS "HSCPC"), PROVIDES QUALITY CARE FOR YOUTH WITH SPECIAL HEALTH CARE NEEDS IN THE WASHINGTON, D.C. AND BALTIMORE AREAS. |
| FORM 990, PART V: | THE FILING ORGANIZATION HAS ENTERED "0" IN PART V, LINE 1A AND LINE 2A BECAUSE THE ORGANIZATION'S 1099 AND W-2 RETURNS ARE FILED BY AND UNDER THE NAME AND EIN OF CHILDREN'S HOSPITAL, INC., A RELATED ENTITY, UNDER A SHARED SERVICES AGREEMENT. |
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERS OR STOCKHOLDERS THE HSC FOUNDATION IS THE SOLE MEMBER OF THE HOSPITAL FOR SICK CHILDREN. |
| FORM 990, PART VI, SECTION A, LINE 7A | ELECTION OF MEMBERS THE HSC FOUNDATION IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL FOR SICK CHILDREN. CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL) IS THE SOLE CORPORATE MEMBER OF THE HSC FOUNDATION. ON SEPTEMBER 1, 2019, THE HSC FOUNDATION AFFILIATED WITH CHILDREN'S NATIONAL AND FOR A PERIOD OF FIVE YEARS THEREAFTER, THE MEMBERS OF THE HSC FOUNDATION'S GOVERNING BODY TOGETHER WITH THE BOARD OF CHILDREN'S NATIONAL APPOINT THE MEMBERS OF THE HOSPITAL FOR SICK CHILDREN'S GOVERNING BODY. AFTER SEPTEMBER 1, 2024, CHILDREN'S NATIONAL WILL APPOINT MEMBERS OF THE HOSPITAL FOR SICK CHILDREN'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | RIGHTS OF MEMBERS THE SOLE MEMBER (THE HSC FOUNDATION) TOGETHER WITH ITS SOLE MEMBER (CHILDREN'S NATIONAL MEDICAL CENTER) HAVE ALL OF THE POWERS SPECIFIED IN THE ARTICLES OF INCORPORATION AND BYLAWS, INCLUDING THE POWER TO: (A) ESTABLISH THE HOSPITAL FOR SICK CHILDREN'S (HSC'S) POLICIES AND GOALS, AND APPROVE THE BYLAWS INCLUDING ANY AMENDMENTS THERETO; (B) APPOINT AND REMOVE HSC'S BOARD OF DIRECTORS; (C) MONITOR THE DECISIONS OF THE HSC'S BOARDS OF DIRECTORS; AND (D) APPROVE HSC'S BUDGET. ON SEPTEMBER 1, 2019, AND BY MEANS OF AN AFFILIATION AGREEMENT, THE HSC FOUNDATION AFFILIATED WITH CHILDREN'S NATIONAL MEDICAL CENTER. EFFECTIVE AS OF THAT DATE, THE HSC FOUNDATION AND THE HOSPITAL FOR SICK CHILDREN AMENDED AND RESTATED THE HOSPITAL FOR SICK CHILDREN'S BYLAWS TO COMPLY WITH CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE. UNDER CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE, CHILDREN'S NATIONAL RETAINS CERTAIN AUTHORITY OVER SUBSIDIARY (AND A SUBSIDIARY OF A SUBSIDIARY) ENTITIES. THE RETENTION OF AUTHORITY INCLUDES ITEMS SUCH AS: THE AUTHORITY TO AMEND A SUBSIDIARY'S GOVERNING DOCUMENTS, AUTHORIZATION OF THE SALE OF SUBSTANTIALLY ALL ASSETS, APPOINT/REMOVE OFFICERS AND DIRECTORS, APPROVE BUDGETS, SET SIGNATURE AUTHORITY, AND ADOPT AN ENTERPRISE-WIDE COMPLIANCE PLAN. THE AFFILIATION AGREEMENT ANTICIPATES A FIVE-YEAR INTEGRATION PERIOD, DURING SUCH PERIOD THE HSC FOUNDATION AND CHILDREN'S NATIONAL WILL SHARE RESPONSIBILITY FOR CERTAIN AUTHORITIES THAT ARE OTHERWISE SET UNDER THE SYSTEM OF GOVERNANCE. AFTER SEPTEMBER 1, 2024, CHILDREN'S NATIONAL WILL HAVE SOLE RESPONSIBILITY FOR AUTHORITY THAT IS RESERVED UNDER THE SYSTEM OF GOVERNANCE. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990 BY GOVERNING BODY 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 EACH OF THE HOSPITAL FOR SICK CHILDREN AND ITS CORPORATE MEMBER, THE HSC FOUNDATION, HAVE ADOPTED THE CONFLICT OF INTEREST POLICY OF THE PARENT ORGANIZATION, CHILDREN'S NATIONAL MEDICAL CENTER. CHILDREN'S NATIONAL AND ITS SUBSIDIARIES ASK EACH OFFICER, DIRECTOR, AND KEY EMPLOYEE TO 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 INTEREST ARE NOTED. THE CHILDREN'S NATIONAL 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. FORM 990, PART VI, SECTION B, LINES 13 & 14: GOVERNING POLICIES THE HOSPITAL FOR SICK CHILDREN ("HSCPC") IS GOVERNED BY THE COMPLIANCE POLICIES OF CHILDREN'S NATIONAL, THE SOLE MEMBER OF HSCPC'S PARENT ORGANIZATION. 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 HOSPITAL FOR SICK CHILDREN RELIES ON CHILDREN'S NATIONAL, THE PARENT OF ITS SOLE MEMBER, TO DETERMINE COMPENSATION FOR THE ORGANIZATION'S PRESIDENT. CHILDREN'S NATIONAL USED AN EXECUTIVE COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE PEOPLE, CULTURE AND COMPENSATION COMMITTEE OF THE BOARD TO ESTABLISH COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND ORGANIZATIONAL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, SECTION A: | FORMER OFFICER, KIMBERLY BROWN, AND FORMER KEY EMPLOYEE, DONNA ANTHONY, ARE LISTED AS "FORMER" ON PART VII, BUT CONTINUE TO BE EMPLOYED BY CHILDREN'S NATIONAL IN A LESSER CAPACITY. THEY NO LONGER SERVE THE HOSPITAL FOR SICK CHILDREN IN THEIR PRIOR ROLE AS OFFICER OR KEY EMPLOYEE. |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 2,146,738. MANAGEMENT AND GENERAL EXPENSES 342,000. TOTAL EXPENSES 2,488,738. CONSULTANTS: PROGRAM SERVICE EXPENSES 8,545. MANAGEMENT AND GENERAL EXPENSES 50,201. TOTAL EXPENSES 58,746. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,037,138. TOTAL EXPENSES 2,037,138. |
| Software ID: | |
| Software Version: |