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)
(1) ADAM MEZOFF MD...................................................................... CMO	40.00 ................. 0.00	X		2,497,926	0	332,311
(2) DEBORAH FELDMAN...................................................................... CEO	40.00 ................. 1.00	X	X	1,022,758	0	1,045,972
(3) VIPUL PATEL MD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	441,307	134,542
(4) JAMES WHALEN...................................................................... CHAIR	1.00 ................. 0.00	X	X	0	0	0
(5) MICHAEL MCQUISTON...................................................................... VICE CHAIR	1.00 ................. 0.00	X	X	0	0	0
(6) JACQUELINE GAMBLIN...................................................................... SECRETARY/TREASURER	1.00 ................. 0.00	X	X	0	0	0
(7) TODD PLEIMAN...................................................................... ASSISTANT SECRETARY/TREASURER	1.00 ................. 0.00	X	X	0	0	0
(8) MAMLE ANIM MD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(9) LINDA BLACK-KUREK...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(10) MARK CHILSON...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(11) ROB CONNELLY...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(12) MERRILEE COX...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(13) JOHN DUBY MD...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(14) MATTHEW HARDWICK MD...................................................................... TRUSTEE (UNTIL 11/01/2022)	1.00 ................. 0.00	X		0	0	0
(15) HELEN JONES-KELLEY...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(16) ANTHONY R KENNEY...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0
(17) MANOJ KUMAR...................................................................... TRUSTEE	1.00 ................. 0.00	X		0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
WRIGHT STATE PHYSICIANS 725 UNIVERSITY BLVD FAIRBORN,OH45324	PHYSICIAN SERVICES	848,630
CHANGE HEALTHCARE TECHNOLOGIES LLC PO BOX 98347 CHICAGO,IL60693	CLAIMS CLEARINGHOUSE SERVICES	650,778
COMPUNET CLINICAL LAB 2308 SANDRIDGE DRIVE MORAINE,OH45439	LABORATORY SERVICES	504,604
OSAMA SHETH 36663 HOWARD ROAD FARMINGTON HILLS,MI48331	PHYSICIAN STAFFING	467,240
ENCORE TECHNOLOGIES 4620 WESLEY AVE CINCINNATI,OH45212	IT SOLUTIONS	438,098
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 29

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

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

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

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

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.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 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

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

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

Section C. Computation of Public Support Percentage

Public support percentage for 2022 (line 6, column (f) divided by line 11, column (f)) .........

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

16a

33 1/3% support test—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 (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

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

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 DAYTON 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 DAYTON CHILDREN'S HOSPITAL		Employer identification number 31-0672132

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 DAYTON CHILDREN'S HOSPITAL			Employer identification number 31-0672132
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

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

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

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

Yes

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

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

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

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

Yes

87,057

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

Yes

44,221

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

Yes

4,099

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

Yes

30,000

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

165,377

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
PART II-B, LINE 1:	LINE 1F: OHIO HOSPITAL ASSOCIATION $5,542 OHIO CHILDREN'S HOSPITAL ASSOCIATION $49,910 CHILDREN'S HOSPITAL ASSOCIATION $29,016 DAYTON DEVELOPMENT COALITION $2,250 DAYTON AREA CHAMBER OF COMMERCE $339 TOTAL $87,057 LINE 1G: MANAGEMENT TIME $44,221 DAYTON CHILDREN'S HOSPITAL SPENDS TIME TRACKING SPECIFIC LEGISLATION THAT IS OF INTEREST TO PEDIATRIC HEALTH ISSUES. IT PROVIDES SUGGESTIONS AND FEEDBACK TO LOCAL, STATE AND FEDERAL LEGISLATURES. THE MAIN FOCUS CONCERNS MEDICAID, CHILDREN'S SPECIFIC HEALTH ISSUES AND MEDICAL EDUCATION FUNDING. LINE 1H: TRAVEL EXPENSES FOR FAMILY ADVOCACY DAY $4,099 LINE 1I: CONSULTING EXPENSE FOR GOVERNMENT ADVOCACY TO STATE AND FEDERAL AGENCIES TO BENEFIT CHILDREN'S HOSPITALS: $30,000 TOTAL LINE 1J : $165,377

Return Reference

Explanation

PART II-B, LINE 1:

LINE 1F: OHIO HOSPITAL ASSOCIATION $5,542 OHIO CHILDREN'S HOSPITAL ASSOCIATION $49,910 CHILDREN'S HOSPITAL ASSOCIATION $29,016 DAYTON DEVELOPMENT COALITION $2,250 DAYTON AREA CHAMBER OF COMMERCE $339 TOTAL $87,057 LINE 1G: MANAGEMENT TIME $44,221 DAYTON CHILDREN'S HOSPITAL SPENDS TIME TRACKING SPECIFIC LEGISLATION THAT IS OF INTEREST TO PEDIATRIC HEALTH ISSUES. IT PROVIDES SUGGESTIONS AND FEEDBACK TO LOCAL, STATE AND FEDERAL LEGISLATURES. THE MAIN FOCUS CONCERNS MEDICAID, CHILDREN'S SPECIFIC HEALTH ISSUES AND MEDICAL EDUCATION FUNDING. LINE 1H: TRAVEL EXPENSES FOR FAMILY ADVOCACY DAY $4,099 LINE 1I: CONSULTING EXPENSE FOR GOVERNMENT ADVOCACY TO STATE AND FEDERAL AGENCIES TO BENEFIT CHILDREN'S HOSPITALS: $30,000 TOTAL LINE 1J : $165,377

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

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

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 ....	1,303,754	1,372,372	1,444,603	1,520,634	1,601,373
b	Contributions ...
c	Net investment earnings, gains, and losses					21
d	Grants or scholarships ...	65,188	68,618	72,231	76,031	80,760
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	1,238,566	1,303,754	1,372,372	1,444,603	1,520,634

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

Board designated or quasi-endowment SchDMd Bullet

100.000 %

Permanent endowment SchDMd Bullet

0 %

Term endowment SchDMd Bullet

0 %

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

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

Yes

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

3a(i)

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

3a(ii)

Yes

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

Yes

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

Part VI

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

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

1a	Land .....	27,459,330		27,459,330
b	Buildings ....	174,071,892	69,693,498	104,378,394
c	Leasehold improvements
d	Equipment ....	511,062,599	198,935,352	312,127,247
e	Other .....	64,746,966	37,242,441	27,504,525
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				471,469,496

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) HEDGE FUNDS	9,720,316	F
(B) LIMITED PARTNERSHIPS	113,734,451	F
(C) PRIVATE EQUITY	65,217,377	F
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	188,672,144

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)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

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
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	72,331,533
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 V, LINE 4:

THE ENDOWMENTS ARE HELD BY DAYTON CHILDREN'S HOSPITAL FOUNDATION, A SUPPORTING ORGANIZATION OF DAYTON CHILDREN'S HOSPITAL. THE FUNDS ARE USED EXCLUSIVELY TO SUPPORT DAYTON CHILDREN'S HOSPITAL AND ITS SUBSIDIARIES. THE INTENDED USE OF THE FUNDS IS TO COVER EXPENSES FOR THE CARE AND COMFORT PROGRAM.

PART X, LINE 2:

ALL SUBSIDIARIES OF THE HOSPITAL, EXCEPT DAYTON CHILDREN'S SPECIALTY PHYSICIANS, AND SELECTED JOINT VENTURE ENTITIES, ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE WHOLLY OWNED FOR-PROFIT SUBSIDIARIES DAYTON CHILDREN'S SPECIALTY PEDIATRICS HAD NO TAXABLE INCOME IN 2023 OR 2022. THE PROVISION FOR INCOME TAXES FOR THE JOINT VENTURE ENTITIES IS NOT SIGNIFICANT TO THE HOSPITAL. THE HOSPITAL COMPLETED AN ANALYSIS OF ITS UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH APPLICABLE ACCOUNTING GUIDANCE, AND DETERMINED THAT NO AMOUNTS WERE REQUIRED TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS AT JUNE 30, 2023 OR 2022.

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
DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

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
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	INVESTMENTS		85,259,350
	CENTRAL AMERICA AND THE CARIBBEAN	1	2	PROGRAM SERVICE	SELF INSURANCE	3,429,395
	EAST ASIA AND THE PACIFIC	0	0	INVESTMENTS		440,161
	NORTH AMERICA	0	0	INVESTMENTS		2,508,165
	SOUTH AMERICA	0	0	INVESTMENTS		4,803
	EUROPE (INCLUDING ICELAND & GREENLAND)	0	0	INVESTMENTS		1,805,355











3a	Sub-total ....	1	2			93,447,229
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	1	2			93,447,229

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:

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

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other %

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

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

Yes

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	3,947,748		3,947,748	0.750 %
b	Medicaid (from Worksheet 3, column a) . . . . .	255,493,478	226,670,159	28,823,319	5.500 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	259,441,226	226,670,159	32,771,067	6.250 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	12,208,699	8,793,733	3,414,966	0.650 %
f	Health professions education (from Worksheet 5) . . .	3,293,736	1,588,699	1,705,037	0.330 %
g	Subsidized health services (from Worksheet 6) . . . .	31,227,766	6,353,518	24,874,248	4.740 %
h	Research (from Worksheet 7) .	602,708	473,648	129,060	0.020 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	292,575		292,575	0.060 %
j	Total. Other Benefits . .	47,625,484	17,209,598	30,415,886	5.800 %
k	Total. Add lines 7d and 7j .	307,066,710	243,879,757	63,186,953	12.050 %

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.

		(a) Number of activities or programs (optional)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	18	247,417	247,417	0.040 %
3	Community support	3	13,000	13,000	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development	10	16,666	16,666	0 %
9	Other
10	Total	31	277,083	277,083	0.040 %

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

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

9,156,122

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

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

Section B. Medicare

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

319,595

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

319,595

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

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	DAYTON CHILDREN'S HOSPITAL 1 CHILDRENS PLAZA DAYTON,OH454041815 WWW.CHILDRENSDAYTON.ORG 020035650	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)

	DAYTON 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 23

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

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): SEE PART V, SECTION C

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 23

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

Yes

If "Yes" (list url): SEE PART V, SECTION C

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)

	DAYTON 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 100.000000000000%
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):

SEE PART V, SECTION C

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

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

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

	DAYTON 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)

	DAYTON 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
DAYTON CHILDREN'S HOSPITAL	PART V, SECTION B, LINE 5: PURSUING THE OPTIMAL HEALTH OF ALL CHILDREN IS THE MISSION OF DAYTON CHILDREN'S HOSPITAL. TO HELP DEVELOP MEANINGFUL AND IMPACTFUL COMMUNITY ENGAGEMENT AND CHILD HEALTH PROGRAMS, DAYTON CHILDREN'S EVALUATES THE STATUS OF OUR REGION'S PEDIATRIC HEALTH EVERY THREE YEARS THROUGH OUR COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). THE MOST RECENT CHNA WAS COMPLETED AND APPROVED BY THE BOARD IN JUNE 2023.DAYTON CHILDREN'S SERVES 20 OHIO COUNTIES AND EASTERN INDIANA, HOWEVER FOR THE PURPOSES OF DETERMINING THE COMMUNITY COVERED BY THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL CHOSE TO INCLUDE OUR PRIMARY SERVICE AREA WHERE 75 PERCENT OF OUR PATIENT POPULATION COMES FROM. THIS PRIMARY SERVICE AREA COVERS ZIP CODES IN MONTGOMERY, MIAMI, GREENE, CLARK AND WARREN COUNTIES. THESE COUNTIES REPRESENT URBAN, RURAL AND SUBURBAN COMMUNITIES. OUR HEALTH ASSESSMENT FOCUSES ON THE PEDIATRIC POPULATION LIVING IN THESE COUNTIES. SPECIAL ATTENTION HAS BEEN GIVEN TO THE CITY OF DAYTON IN MONTGOMERY COUNTY WHERE DAYTON CHILDREN'S PHYSICALLY IS LOCATED AND HEALTH DISPARITIES FOR CHILDREN ARE MOST CHALLENGING. WE FOCUSED ON THE INCLUSION OF VULNERABLE POPULATIONS. APPROXIMATELY 28.6% OF DAYTON CITY RESIDENTS WERE BELOW THE POVERTY LINE, ACCORDING TO THE 2021 AMERICAN COMMUNITY SURVEY 5-YEAR ESTIMATES. FOR THIS REASON, SPECIFIC ZIP CODES WHERE THERE IS GREAT POVERTY, LESS ACCESS TO RESOURCES AND POORER HEALTH OUTCOMES WERE A FOCUS OF DATA COLLECTION EFFORTS. THESE ZIP CODES INCLUDE 45403, 45404, 45405, 45406, 45410, AND 45417. SPECIAL ATTENTION WAS ALSO PAID TO INCLUDE COMMUNITY MEMBERS WHOSE FIRST LANGUAGE WAS SOMETHING OTHER THAN ENGLISH, WHICH REPRESENT A GROWING SEGMENT OF THE POPULATION. WHEREVER POSSIBLE, TRANSLATION SERVICES AND MULTIPLE LANGUAGE OPTIONS WERE SOUGHT OUT FOR DATA COLLECTION. COMMUNITY ENGAGEMENT WAS PARAMOUNT THROUGHOUT THE DATA COLLECTION PROCESS. MULTIPLE SECTORS, INCLUDING THE PUBLIC, WERE ASKED TO PARTICIPATE IN THE VARIOUS PHASES OF THE PROJECT. AT A REGIONAL LEVEL, PUBLIC HEALTH PROFESSIONALS WERE INTERVIEWED FROM MONTGOMERY, MIAMI, GREENE, CLARK, AND WARREN COUNTIES. THROUGH THESE INTERVIEWS, DAYTON CHILDREN'S EXPLORED EACH HEALTH DEPARTMENT'S COMMUNITY HEALTH ASSESSMENTS AND ADDITIONAL QUESTIONS RELATED TO PEDIATRIC HEALTH. COUNTY PROFILES WERE THEN ASSEMBLED TO SUMMARIZE THESE FINDINGS.TO ENGAGE CAREGIVERS AND COMMUNITY MEMBERS AT THE REGIONAL LEVEL, A 10-QUESTION LONG FORM (OPEN TO ALL) AND 5 QUESTION SHORT FORM (FOR USE AT HIGH VOLUME ATTENDEE IN-PERSON EVENTS) ONLINE SURVEYS WERE CREATED TO IDENTIFY HEALTH PRIORITIES AND CAPTURE BARRIERS TO OPTIMAL HEALTH ALONG WITH EXISTING COMMUNITY RESOURCES. OVER 2,000 COMMUNITY MEMBERS TOOK THIS SURVEY. TO THOROUGHLY ENGAGE COMMUNITY MEMBERS IN THE IDENTIFIED ZIP CODES, STAFF FROM THE DAYTON CHILDREN'S CENTER FOR HEALTH EQUITY WORKED WITH KEY COMMUNITY PARTNERS TO ATTEND COMMUNITY FORUMS, FOOD DISTRIBUTION EVENTS, OPEN HOUSES, AND OTHER EVENTS FOR IN-PERSON DATA COLLECTION. THE ASSESSMENT AND PLAN WERE WIDELY DISTRIBUTED TO THE PUBLIC THROUGH THE HOSPITAL WEBSITE, THROUGH KEY CONSTITUENT MEETINGS AND A PUBLIC MEDIA LAUNCH. THE 2023 CHNA AND SUBSEQUENT COMMUNITY HEALTH IMPLEMENTATION STRATEGY PLAN (CHIP), BUILT UPON PREVIOUS CHNA/CHIP PRIORITIES BUT ENGAGED COMMUNITY MEMBERS THROUGH THE ONLINE SURVEY AND IN-PERSON DATA COLLECTION TO PRIORITIZE ISSUES WHILE FURTHER INVESTIGATING BARRIERS TO OPTIMAL HEALTH FOR CHILDREN. THIS PROCESS LED TO A COMPREHENSIVE LIST OF EXISTING RESOURCES. THESE PRIORITIZATIONS WERE THEN BROKEN DOWN BY ZIP CODE AND SUMMARIZED TO IDENTIFY PLACE-BASED STRATEGIES FOR CONSIDERATION IN THE CHIP. THEN AN INTERNAL TEAM OF DAYTON CHILDREN'S LEADERS FURTHER REFINED THE PRIORITIES TO ENSURE ALIGNMENT WITH HOSPITAL STRATEGY AND INVESTMENT. DAYTON CHILDREN'S IS FOCUSED ON THE FOLLOWING PRIORITY HEALTH OUTCOMES: MENTAL HEALTH AND ADDICTION, CHRONIC DISEASE, AND MATERNAL AND INFANT HEALTH. DAYTON CHILDREN'S HOSPITAL WILL ALSO FOCUS ON THE FOLLOWING PRIORITY FACTORS TO ADDRESS MOST, IF NOT ALL, PRIORITY AREAS: COMMUNITY CONDITIONS AND ACCESS TO CARE. ADDITIONAL DETAILS OF THIS PROCESS AND ITS RESULTS CAN BE FOUND ON THE DAYTON CHILDREN'S HOSPITAL WEBSITE. DAYTON CHILDREN'S POSTS THE ENTIRE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT STRATEGY PLAN WITH YEARLY PROGRESS UPDATES TO OUR WEBSITE. DAYTON CHILDREN'S ALSO PRINTS HARD COPIES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT STRATEGY PLAN TO SHARE WITH COMMUNITY MEMBERS, DECISION MAKERS AND HOSPITAL LEADERS. IT IS WIDELY AVAILABLE UPON REQUEST. INFORMATION ABOUT THE COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT STRATEGY PLAN IS PRESENTED THROUGHOUT THE YEAR AT LOCAL AND REGIONAL MEETINGS.
DAYTON CHILDREN'S HOSPITAL	PART V, SECTION B, LINE 11: THE HOSPITAL'S 2023-2026 CHNA AND CORRESPONDING IMPLEMENTATION STRATEGY WAS ADOPTED BY DAYTON CHILDREN'S HOSPITAL BOARD OF TRUSTEES IN JUNE 2023.IN RESPONSE TO THE 2023 COMMUNITY HEALTH NEEDS ASSESSMENT, THE HOSPITAL'S IMPLEMENTATION STRATEGY PLAN OUTLINES HOW THE HOSPITAL WILL WORK TO ADDRESS THE PRIORITIES IDENTIFIED. THE STRATEGIES WERE CHOSEN BASED ON EVIDENCE-BASED GUIDELINES, THE ABILITY TO ADDRESS HEALTH DISPARITIES AND ALIGNMENT WITH REGIONAL AND STATEWIDE AREAS OF FOCUS. TO WORK TOWARD IMPROVING MENTAL HEALTH AND ADDICTION OUTCOMES, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. CONTINUE TO SPREAD THE ON OUR SLEEVE MOVEMENT THROUGHOUT THE DAYTON REGION 2. INTEGRATE BEHAVIORAL HEALTH THROUGHOUT PRIMARY CARE 3. SPREAD A COMPREHENSIVE SCHOOL-BASED "STUDENT-RESILIENCY COORDINATOR" PROGRAM4. SPREAD A COMPREHENSIVE APPROACH TO SUICIDE CARE (ZERO-SUICIDE) TO WORK TOWARD IMPROVING CHRONIC DISEASE OUTCOMES, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. IMPLEMENT HEALTHY FOOD INITIATIVES TO REDUCE THE IMPACT OF CHRONIC DISEASE2. IMPROVE HEALTH DISPARITIES FOR CHILDREN WITH ASTHMA TO WORK TOWARD IMPROVING MATERNAL AND INFANT HEALTH OUTCOMES, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. INCREASE THE USE OF SAFE SLEEP PRACTICES 2. INCREASE HUMAN MILK FEEDING AND PROVIDE LACTATION SUPPORT3. IMPLEMENT THE OHIO BETTER BIRTH OUTCOMES PROJECTTO WORK TOWARD IMPROVING COMMUNITY CONDITIONS, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. OUTREACH AND ADVOCACY TO MAINTAIN OR INCREASE ENROLLMENT IN FEDERAL FOOD ASSISTANCE, HOUSING AND POVERTY REDUCTION PROGRAMS2. LAUNCH COLLECTIVE IMPACT INITIATIVE TO ADDRESS HEALTH AND EDUCATIONAL NEEDS OF CHILDREN BIRTH TO FIVE3. CONTINUE THE DEVELOPMENT AND EXECUTION OF PROGRAMS TO ADDRESS FOOD INSECURITY TO WORK TOWARD IMPROVING ACCESS TO CARE, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED.1. PROMOTE CONNECTIONS TO PRIMARY/PREVENTIVE CARE2. FURTHER INTEGRATE COMMUNITY HEALTH WORKERS INTO CLINICAL SERVICES IN ADDITION TO THE STRATEGIES IDENTIFIED ABOVE THAT ADDRESS PRIORITY INDICATOR AND FACTORS, THE HOSPITAL IDENTIFIED SEVERAL PLACE-BASED STRATEGIES WITHIN SPECIFIC GEOGRAPHIC REGIONS WHERE HEALTH OUTCOMES ARE POORER COMPARED TO THE OVERALL REGION. THE PLAN INCLUDES SEVERAL STRATEGIES TO DIRECTLY ADDRESS IDENTIFIED POPULATIONS AT A DISPROPORTIONATE RISK FOR NEGATIVE IMPACTS TO THEIR HEALTH PARTICULARLY BASED ON RACE, ECONOMIC STATUS AND GEOGRAPHIC REGION. TO WORK TOWARD IMPROVING HEALTH OUTCOMES IN NORTHWEST AND WEST DAYTON, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED:1. INTEGRATE HOPE CENTER PRIMARY CARE PRACTICE/DAYTON CHILDREN'S PEDIATRICS NORTHWEST INTO PROMISE ZONE INITIATIVE.2. DEFINE AND IMPLEMENT TARGETED INTERVENTIONS IN 45417 TO REDUCE HEALTH DISPARITIES AND IMPROVE ACCESS TO PEDIATRIC PRIMARY CARE.3. IMPROVE ACCESS TO BUILT-ENVIRONMENT AMENITIES FOR CHILDREN.TO WORK TOWARDS IMPROVING HEALTH OUTCOMES IN OLD NORTH DAYTON, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED:1. IMPLEMENT KINSHIP HOUSING PROJECT IN GREATER OLD NORTH DAYTON2. BUILD COMMUNITY NETWORK TO SUPPORT FAMILIES IN OLD NORTH DAYTONTO WORK TOWARDS IMPROVING HEALTH OUTCOMES IN EAST DAYTON, THE FOLLOWING STRATEGIES ARE BEING EMPLOYED:1. BUILD COMMUNITY NETWORK TO SUPPORT FAMILIES IN EAST DAYTON2. COMPLETE OHIO HEALTH IMPROVEMENT ZONE (OHIZ) COMMUNITY ASSESSMENT AND ASSET MAP TO IDENTIFY COMMUNITY-DRIVEN HEALTH IMPROVEMENT INITIATIVES3. IMPROVE ACCESS TO BUILT-ENVIRONMENT AMENITIES FOR CHILDREN AND FAMILIESTO FINALIZE THE 2020-2023 COMMUNITY HEALTH IMPROVEMENT STRATEGY PLAN, AN EVALUATION OF IMPACT WAS CONDUCTED. HERE ARE THE OUTCOMES THAT WERE REALIZED DURING THE LAST THREE-YEAR CYCLE.TO WORK TOWARD IMPROVING MENTAL HEALTH AND ADDICTION OUTCOMES:1. LAUNCH AND SPREAD THE ON OUR SLEEVES MOVEMENT THROUGHOUT THE REGIONDAYTON CHILDREN'S SUCCESSFULLY LAUNCHED THE ON OUR SLEEVES MOVEMENT IN MAY 2021. OVER THE LAST TWO YEARS, THE ON OUR SLEEVES CAMPAIGN GAINED MOMENTUM WITH MANY COMMUNITY PARTNERS INCLUDING SCHOOLS, NEIGHBORHOOD ORGANIZATIONS, LIBRARIES, AND MANY OTHER CHILD-SERVING ORGANIZATIONS. A POPULAR FEATURE OF THE PROGRAM IS CONVERSATION STARTER CARDS THAT ENCOURAGE DISCUSSIONS ABOUT THOUGHTS AND FEELINGS. MOST RECENTLY, THE CAMPAIGN LAUNCHED THE CLASSROOM CHAMPIONS DISTRIBUTION LIST FOR EDUCATORS AND DISTRIBUTED KINDNESS CLASSROOM KITS. THE PROGRAM CONTINUES TO MAKE THE DISCUSSION OF MENTAL HEALTH COMMONPLACE, REDUCING STIGMA FOR CHILDREN IN OUR COMMUNITY. 2. INTEGRATE BEHAVIORAL HEALTH THROUGHOUT PRIMARY CAREOVER THE LAST THREE YEARS, THE HOSPITAL RECRUITED AND SECURED SEVERAL LICENSED CLINICAL COUNSELORS AND PSYCHOLOGISTS WHO ARE NOW PROVIDING SERVICES IN OUR PRIMARY PEDIATRIC CLINICS ON THE MAIN CAMPUS AND AT THE HOPE CENTER. THIS HAS IMPROVED ACCESS TO BEHAVIORAL HEALTH SERVICES FOR PATIENTS AND THE COMMUNITY. 3. DEVELOP A COMPREHENSIVE SCHOOL-BASED PROGRAMSTUDENT RESILIENCY COORDINATORS STARTED IN DAYTON PUBLIC SCHOOLS IN AUGUST OF 2020 AND ADDED IN ADDITIONAL DISTRICTS WITHIN MONTHS. THE PROGRAM SERVED 417 STUDENTS IN ITS FIRST YEAR. THE PROGRAM CONTINUES TO GROW MOMENTUM AS IT NOW HAS 61 STUDENT RESILIENCY COORDINATORS AND 12 SCHOOL-BASED THERAPISTS. 4. ADOPT AND EMBED A COMPREHENSIVE APPROACH TO SUICIDE CARE (ZERO SUICIDE)THROUGH A TWO-YEAR GRANT FROM CARDINAL HEALTH, THE ZERO SUICIDE INITIATIVE WAS SUCCESSFUL IN ACHIEVING THE PROGRAM GOALS OF IMPLEMENTING THE SEVEN ELEMENTS (LEAD, TRAIN, IDENTIFY, ENGAGE, TREAT, TRANSITION, IMPROVE) OF SAFER SUICIDE CARE WITH THE HOSPITAL'S BEHAVIORAL HEALTH DIVISION. IN THE THIRD YEAR OF THE CHNA CYCLE, THE ZERO SUICIDE INITIATIVE SPREAD INTO ADDITIONAL AMBULATORY CLINICS. 5. DEVELOP AND LAUNCH PARTIAL HOSPITALIZATION AND INTENSIVE OUTPATIENT THERAPY SERVICESTO BEST MEET THE NEEDS OF CHILDREN ACROSS THE BEHAVIORAL HEALTH CONTINUUM, DAYTON CHILDREN'S FOCUSED ON CREATING ACCESS TO INTERMEDIATE LEVELS OF CARE. IN DECEMBER 2020, THE PARTIAL HOSPITALIZATION PROGRAM (PHP) LAUNCHED, FOCUSING ON GROUP THERAPY FIVE DAYS A WEEK. IN FEBRUARY 2021, DAYTON CHILDREN'S OPENED OUR INTENSIVE OUTPATIENT PROGRAM (IOP). THESE PROGRAMS HAVE SHOWN A SIGNIFICANT INCREASE IN ACCESS TO INTERMEDIATE BEHAVIORAL HEALTH CARE. 6. IMPLEMENT THE OAAP STORE IT SAFE PROGRAMTHE OHIO AMERICAN ACADEMY OF PEDIATRICS (OAAP) STORE IT SAFE PROGRAM OFFICIALLY BEGAN IN FEBRUARY 2021. THE PROGRAM CONTINUES TO SCREEN FAMILIES TO DETERMINE IF THEY HAVE A FIREARM IN THE HOME AND IF IT IS BEING STORED SAFELY. IF THE FAMILY NEEDS A SAFE STORAGE OPTION, A LOCKBOX IS PROVIDED. 7. IMPLEMENT THE ROADMAP PROJECTDAYTON CHILDREN'S PARTICIPATED IN A NINE-SITE NATIONAL LEARNING COLLABORATIVE TO IMPROVE RESILIENCY FOR CHILDREN WITH CHRONIC DISEASES. THE LEARNING COLLABORATIVE FOCUSED ON EXPANDING THE FAMILY RESOURCE DIRECTORY ON THE HOSPITAL WEBSITE, PILOTING A DIGITAL MENTORING PROGRAM FOR FAMILIES WITH EPILEPSY, AND CONTINUING TO SPREAD THE IMPORTANCE OF INQUIRING ABOUT AND SUPPORTING THE EMOTIONAL NEEDS OF PATIENTS AND CAREGIVERS AMONG THE NEUROLOGY STAFF. THE PILOT WRAPPED UP IN APRIL 2021. TO WORK TOWARD IMPROVING CHRONIC DISEASE OUTCOMES, THESE WERE THE RECOMMENDED STRATEGIES AND OUTCOMES: 1. IMPLEMENT HEALTHY FOOD INITIATIVESDUE TO COVID-19, INITIAL PLANS TO GROW THE NUMBER OF COOKING CLASSES IN THE FOOD DEMONSTRATION KITCHEN WAS PUT ON HOLD. HOWEVER, THE DAYTON CHILDREN'S TEAM PIVOTED TO FOCUS ON FOOD ACCESS DURING THE PANDEMIC. IN YEAR ONE OF THE CHNA CYCLE, DAYTON CHILDREN'S PARTNERED WITH MIAMI VALLEY MEALS TO SERVE 1,300 MEALS TO 394 NEIGHBORHOOD FAMILIES. EVENTUALLY THE COMMUNITY TEACHING KITCHEN WAS REOPENED AND PARTICIPATION IN FOOD DEMONSTRATION CLASSES CONTINUED TO GROW. IN EARLY 2023, DAYTON CHILDREN'S OPENED AN ON-SITE FOOD PANTRY SERVING FAMILIES AT KISER SCHOOL AND THROUGHOUT THE GREATER OLD NORTH DAYTON NEIGHBORHOOD. THIS PROGRAM AVERAGES 50-60 CUSTOMERS A MONTH.2. IMPLEMENT SAFE ROUTES TO SCHOOLIN PARTNERSHIP WITH THE OHIO DEPARTMENT OF TRANSPORTATION, THE SAFE ROUTES TO SCHOOL PROGRAM WAS LEVERAGED TO GET MORE BIKES TO STUDENTS WITHOUT ACCESS TO RESOURCES TO PURCHASE A BIKE. THIS ALLOWED UNDERSERVED STUDENTS TO HAVE ANOTHER, AFFORDABLE MEANS OF TRANSPORTATION. THE PROGRAM ALSO HELD GIRLS IN GEAR PROGRAMMING TO TEACH GIRLS EMPOWERMENT AND HOW TO CARE FOR A BICYCLE. THE PROGRAM ALSO LAUNCHED A PEDESTRIAN SAFETY CAMPAIGN WITH OVER 111,369 FACEBOOK IMPRESSIONS AND 304,536 IMPRESSIONS THROUGH BILLBOARDS. CONTINUED AT THE END.
PART V, SECTION B, LINE 7A:	THE CHNA REPORT IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINES 16A-16C:	THE FAP, FAP APPLICATION, AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/PATIENTS-VISITORS/AFTER-YOUR-VISIT/ BILLING/FINANCIAL-ASSISTANCE
PART V, SECTION B LINE 10A:	THE IMPLEMENTATION STRATEGY IS MADE WIDELY AVAILABLE TO THE PUBLIC AT THE FOLLOWING URL: HTTPS://WWW.CHILDRENSDAYTON.ORG/COMMUNITY/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT
PART V, SECTION B, LINE 11 CONTINUED:	3. ENHANCE THE DAYTON ASTHMA ALLIANCETHE DAYTON ASTHMA ALLIANCE CONTINUED TO IMPROVE OUTCOMES FOR CHILDREN IN VARIOUS SETTINGS. THE ALLIANCE SUPPORTED THE CO-MANAGEMENT PROGRAM BY WORKING WITH PRIMARY CARE PRACTICES IN THE HOSPITAL'S CLINICALLY INTEGRATED NETWORK. MEMBERS OF THE ALLIANCE WORKED ON THE STANDARDIZATION OF THE "ASTHMA PATHWAY" FOR COMMUNITY HEALTH WORKERS. THE ALLIANCE ALSO EXPLORED MULTIPLE PROGRAMS TO IMPROVE HOUSING FOR CHILDREN WITH ASTHMA AND PILOTED A TRAINING PROGRAM FOR CONTRACTORS IN MAY 2023. 4. EXPAND THE FOOD INSECURITY SCREENING AND REFERRAL PROGRAMTHE PROGRAM PILOTED FOOD BOXES IN OTHER DAYTON CHILDREN'S LOCATIONS WHICH WAS NOT SUCCESSFUL. THERE WAS A TRANSITION TO GIFT CARDS, AND THEY ARE AVAILABLE AT VARIOUS CLINICS. THIS SPECIFIC STRATEGY WAS SUNSET AND INCLUDED IN STRATEGY 1: SOCIAL NEEDS SCREENING (COMMUNITY CONDITIONS) AS FOOD SCREENING IS PART OF THE OVERALL SOCIAL NEEDS SCREENING INITIATIVE. 5. CONTINUE TO ENHANCE THE "FOOD PHARM" PROGRAMTHE FOOD PHARM WAS A CRITICAL PROGRAM WHEN THE COVID-19 PANDEMIC HIT. DAYTON CHILDREN'S PARTNERED WITH SEVERAL AGENCIES TO DO FOOD DISTRIBUTION IN SUMMER 2020. DURING THE FIRST YEAR OF THIS CHNA CYCLE, OVER 400 FOOD BOXES WERE DISTRIBUTED FROM THE FOOD PHARM AND 1466 PEOPLE WERE SERVED BY DAYTON CHILDREN'S CO-SPONSORED MASS FOOD DISTRIBUTIONS. THE FOOD PHARM CONTINUES TO SERVE FAMILIES MONTHLY THROUGH THE ON-SITE FOOD BOX PROGRAM. FOCUSING ON CONTINUOUS IMPROVEMENT, THE PROGRAM ALSO COMPLETED A CULTURAL COMPETENCE STUDY TO BETTER UNDERSTAND THE FOOD OPTIONS OFFERED THROUGH THE FOOD BOXES AND HOW THEY COULD BE MORE CULTURALLY APPROPRIATE FOR THE FAMILIES SERVED. 6. INCREASE PHYSICAL ACTIVITY OPPORTUNITIES AMONG FAMILIESCOVID RESTRICTIONS LIMITED PARTICIPATION IN THE WALK WITH A DOC SERIES AND OTHER INITIATIVES RELATED TO THIS STRATEGY. AS THE PANDEMIC SLOWED DOWN AND PROGRAMMING COULD BEGIN AGAIN, THE HEALTHY ME CLINIC AT DAYTON CHILDREN'S FOCUSED ON RX TO PARKS PRESCRIPTIONS AND CONTINUED WRITING EXERCISE GOALS WITH PATIENTS AS PART OF TREATMENT PLANS. 7. IMPLEMENT LEAD PREVENTION QUALITY IMPROVEMENT PROJECTDAYTON CHILDREN'S PEDIATRICS COMPLETED A SIX-MONTH PILOT WITH OHIO AMERICAN ACADEMY OF PEDIATRICS TO INCREASE LEAD SCREENING. AS A RESULT, THE SCREENING RATES INCREASED WHICH LED TO MORE LAB TESTS AND AN INCREASE IN ANTICIPATORY GUIDANCE. LEAD SCREENING WILL CONTINUE IN CLINICS AND WILL CONTINUE TO BE MONITORED. TO WORK TOWARD IMPROVING MATERNAL AND INFANT HEALTH, THESE WERE THE RECOMMENDED STRATEGIES AND OUTCOMES:1. INCREASE THE USE OF SAFE SLEEP PRACTICESDAYTON CHILDREN'S DEVELOPED AND IMPLEMENTED A CONVERSATION-BASED SAFE SLEEP TRAINING FOR CLINICAL STAFF. THIS TRAINING WAS COMPLETED BY ALL CLINICAL STAFF BY MAY 2022. THE TRAINING WAS ALSO SHARED WITH LOCAL, STATE, AND NATIONAL PARTNERS. IN ADDITION, DAYTON CHILDREN'S PROVIDED 306 FAMILIES WITH A SAFE PLACE FOR THEIR BABY TO SLEEP THROUGH THE EARLY CHILDHOOD EDUCATION PROGRAM FUNDED BY THE OHIO CHILDREN'S TRUST FUND AND OTHER PACK 'N PLAY ASSISTANCE PROGRAMS. 2. INCREASE HUMAN MILK FEEDING AND PROVIDE LACTATION SUPPORTDAYTON CHILDREN'S INCREASED SUPPORT FOR FAMILIES BY HIRING FULL-TIME INTERNATIONAL BOARD-CERTIFIED LACTATION CONSULTANT'S (IBCLC'S). THE CERTIFIED LACTATION CONSULTANTS EXPANDED SERVICES THROUGHOUT THE HOSPITAL. IN YEAR THREE, THE HOSPITAL PLACED MORE FOCUS ON UNDERSTANDING BARRIERS TO BREASTFEEDING CONTINUATION AND TRANSITIONED TO FOCUSING EFFORTS TO REDUCE INEQUITIES IN CONTINUATION RATES BY RACE. 3. INCREASE PARENTING RESOURCES AND SUPPORTTHE UBICARE MESSAGING PLATFORM WAS LEVERAGED TO REGULARLY REACH 20,000 FAMILIES WITH CHILDREN THREE AND YOUNGER EACH WEEK WITH IMPORTANT HEALTH AND SAFETY INFORMATION. ALIGNING MESSAGING ON UBICARE WITH SOME OF THE OTHER HEALTH PRIORITIES INCLUDING SAFE SLEEP AND BREASTFEEDING WERE A FOCUS. FOR THE TRIPLE P PROGRAM, STAFF TRAINING WAS HELD, AND SEVERAL STAFF CAN NOW DELIVER THIS PROGRAM. HOWEVER, ENGAGEMENT WITH FAMILIES HAS BEEN LIMITED. THE HOSPITAL CONTINUES TO LOOK FOR WAYS TO BEST ENGAGE FAMILIES IN THIS PROGRAM. TO WORK TOWARD COMMUNITY CONDITIONS, THESE WERE THE RECOMMENDED STRATEGIES AND OUTCOMES:1. EXPAND SCREENINGS TO ADDRESS SOCIAL NEEDSA SOCIAL NEEDS DIGITAL SCREENING PILOT WAS LAUNCHED IN DAYTON CHILDREN'S PEDIATRICS WITH PHYSICIANS TO SCREEN FOR SOCIAL NEEDS ON A DIGITAL PLATFORM. RESPONSES POPULATE INTO THE MEDICAL RECORD IN EPIC, ARE REVIEWED BY PHYSICIANS AND THE PATIENT'S FAMILY IS CONTACTED TO DISCUSS NEEDS. A DASHBOARD THAT PULLS DATA FROM EPIC HAS BEEN CREATED TO TRACK COMPLIANCE AND POSITIVITY RATE OF SCREENS. THE FINDHELP PLATFORM LAUNCHED AND IS BEING UTILIZED TO PROVIDE RESOURCES TO FAMILIES THAT INDICATED NEEDS. SOCIAL NEEDS SCREENING IS CURRENTLY HAPPENING IN TWO PRIMARY CARE CLINIC LOCATIONS AND FOUR AMBULATORY CLINICS WITH PLANS FOR CONTINUED GROWTH. 2. SUPPORT AND EXPAND STRATEGIES TO IMPROVE KINDERGARTEN READINESSCURRENTLY, 50% OF CHILDREN AGES 0 TO 5 IN MONTGOMERY COUNTY ARE ENROLLED IN THE IMAGINATION LIBRARY. IN ADDITION, THE PROGRAM IDENTIFIED HIGH-NEED ZIP CODES TO FOCUS OUTREACH EFFORTS AND THE HIGH-RISK ZIP CODES WITHIN THE COUNTY AT TRACKING WITH THE OVERALL MONTGOMERY COUNTY IMAGINATION LIBRARY NUMBERS WITH 50% OR MORE SATURATION.TO WORK TOWARD ACCESS TO CARE, THESE WERE THE RECOMMENDED STRATEGIES AND OUTCOMES:1. PROMOTE PREVENTIVE HEALTH CAREDAYTON CHILDREN'S PEDIATRICS EXTENDED ITS HOURS, EXPANDED TELEHEALTH OPTIONS, AND UTILIZED PROACTIVE OUTREACH TO CLOSE WELL-CHILD AND IMMUNIZATION CARE GAPS. DAYTON CHILDREN'S PEDIATRICS EXPANDED ITS SERVICES TO THE COMMUNITY SURROUNDING THE NEW COMMUNITY CENTER, THE HOPE CENTER IN WEST DAYTON. THE PEDIATRICS IS WORKING AT FULL CAPACITY WITH TWO PROVIDERS. THE PEDIATRICS ADDED WALK-IN CLINIC SERVICES ON MONDAY MORNINGS AND ONLINE SCHEDULING FOR FAMILIES. IN CONNECTION WITH PEDIATRICS, DAYTON CHILDREN'S HAS ADDED SOCIAL WORKERS AND COMMUNITY HEALTH WORKERS, AND BEHAVIORAL HEALTH SPECIALIST WORKING AT THE CENTER.2. FURTHER INTEGRATE COMMUNITY HEALTH WORKERS INTO CLINICAL SERVICESTHE COMMUNITY HEALTH WORKER EVOLVED OVER THE LAST THREE YEARS TO IMPROVE OUTCOMES AROUND SICKLE CELL, NEWBORN/WELL-CHILD VISITS, ASTHMA AND MEDICAL COMPLEXITIES. WITH A STRONG GROUP OF COMMUNITY HEALTH WORKERS HIRED, THE FOCUS TURNED TO FURTHER INTEGRATE THEIR ROLE IN THE CLINICAL SETTING THROUGH STANDARDIZED REFERRAL PROCESSES AND IMPROVED DATA COLLECTION. 3. PROVIDE CULTURAL COMPETENCY TRAINING FOR HEALTH CARE PROFESSIONALSDAYTON CHILDREN'S IMPLEMENTED MANDATORY DIVERSITY, EQUITY, AND INCLUSION (DEI) EDUCATION FOR ALL STAFF, BRINGING IN CONSULTANTS TO EXPAND TRAINING, AND OFFERED OPPORTUNITIES THROUGH EMPLOYEE RESOURCE GROUPS. BECAUSE DAYTON CHILDREN'S SERVES A VERY DIVERSE POPULATION IT IS IMPERATIVE OUR STAFF RECEIVE TRAINING TO DELIVER OPTIMAL CARE.

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?18
Name and address		Type of Facility (describe)
1	1 - SPRINGBORO SOUTH URGENT CARE & OP CARE C 3333 WEST TECH ROAD MIAMISBURG,OH45342	URGENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER
2	2 - CHILD HEALTH PAVILION 1010 VALLEY STREET DAYTON,OH45404	PEDIATRIC CARE CLINICS AND COMMUNITY CONNECTIONS
3	3 - BEAVERCREEK OUTPATIENT CARE CENTER 1425 NORTH FAIRFIELD ROAD BEAVERCREEK,OH45432	OUTPATIENT DIAGNOSTIC CENTER
4	4 - HUBER HEIGHTS OUTPATIENT TESTING CENTER 8501 OLD TROY PIKE HUBER HEIGHTS,OH45424	OUTPATIENT DIAGNOSTIC CENTER
5	5 - BEHAVIORAL HEALTH CENTER DAYTON 700 E 1ST STREET DAYTON,OH45402	BEHAVIORAL HEALTH CARE
6	6 - SPRINGFIELD SPECIALTY CARE CENTER 1644 NORTH LIMESTONE STREET SPRINGFIELD,OH45503	OUTPATIENT DIAGNOSTIC CENTER
7	7 - TROY OUTPATIENT TESTING CENTER 865 W MARKET STREET TROY,OH45373	OUTPATIENT DIAGNOSTIC CENTER
8	8 - MICHAELS HOUSE 1016 RAINBOW COURT FAIRBORN,OH45324	CHILD ADVOCACY CENTER
9	9 - BEHAVIORAL HEALTH CENTER SOUTH 76 REMICK BOULEVARD SPRINGBORO,OH45066	BEHAVIORAL HEALTH CARE
10	10 - HOPE CENTER 1816 HARVARD BOULEVARD DAYTON,OH45406	PEDIATRIC CARE CLINIC
11	11 - KIDS EXPRESS WEST CHESTER 7787 COX LANE WEST CHESTER,OH45069	EXPRESS CARE
12	12 - KETTERING OUTPATIENT TESTING CENTER 4475 FAR HILLS AVENUE KETTERING,OH45429	OUTPATIENT DIAGNOSTIC CENTER
13	13 - LIMA CLINIC 967 BELLEFONTAINE LIMA,OH45801	OUTPATIENT DIAGNOSTIC CENTER
14	14 - KIDS EXPRESS MASON 8809 WILKENS BOULEVARD MASON,OH45040	EXPRESS CARE
15	15 - KIDS EXPRESS SPRINGBORO 662 N MAIN STREET SPRINGBORO,OH45066	EXPRESS CARE
16	16 - KIDS EXPRESS BEAVERCREEK 3301 DAYTON-XENIA ROAD SUITE 200 BEAVERCREEK,OH45432	EXPRESS CARE
17	17 - WARREN COUNTY SPECIALTY CARE CENTER 100 CAMPUS LOOP ROAD SUITE A FRANKLIN,OH45005	OUTPATIENT CARE CENTER AND OUTPATIENT DIAGNOSTIC CENTER
18	18 - COVID TETING LAB - SOUTH CAMPUS 3300 WEST TECH MIAMISBURG,OH45432	OUTPATIENT DIAGNOSTIC 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:	IN ADDITION TO THE FEDERAL POVERTY GUIDELINES, THE HOSPITAL FACILITY USES INSURANCE STATUS AND RESIDENCY TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE.
PART I, LINE 7:	THE FOLLOWING COSTING METHODOLOGIES WERE USED IN PREPARATION OF SCHEDULE H, PART I, LINE 7:- CHARITY CARE AT COST WAS CALCULATED USING THE COST TO CHARGE RATIO.- UNREIMBURSED MEDICAID WAS CALCULATED USING THE COST TO CHARGE RATIO.- COMMUNITY HEALTH IMPROVEMENT SERVICES WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION.- HEALTH PROFESSIONS EDUCATION COSTS WERE DETERMINED USING THE FACILITY'S MEDICARE COST REPORTED, SUPPLEMENTED BY THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES.- SUBSIDIZED HEALTH SERVICES COSTS WERE DETERMINED USING THE FACILITY'S INTERNAL COST ACCOUNTING SYSTEM. THE COST OF THESE SERVICES INCLUDES DIRECT COSTS ATTRIBUTABLE TO HEALTH SERVICES OPERATIONS, TOGETHER WITH AN ALLOCATION OF FACILITY DIRECT AND INDIRECT OVERHEAD USING A COST FINDING METHODOLOGY PATTERNED AFTER THE MEDICARE COST REPORT.- RESEARCH COSTS WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION.- CASH AND IN KIND CONTRIBUTIONS WERE VALUED AT THE ACTUAL CASH COSTS, INCLUDING DIRECTLY ASSIGNABLE PAYROLL COSTS, RELATED TO THESE ACTIVITIES. NO OVERHEAD ALLOCATION WAS CHARGED TO ANY AMOUNT INCLUDED IN THIS COMPUTATION.
PART I, LINE 7G:	DAYTON CHILDREN'S INCLUDED $16,819,917 OF PHYSICIAN CLINIC COSTS IN THE SUBSIDIZED HEALTH SERVICES CATEGORY.
PART II, COMMUNITY BUILDING ACTIVITIES:	AS THE ONLY CHILDREN'S HOSPITAL IN THE REGION, WE TAKE OUR PEDIATRIC EXPERTISE INTO THE COMMUNITY TO SOLVE PROBLEMS AND CREATE A HEALTHY COMMUNITY FOR OUR CHILDREN. OUR COMMUNITY RELATIONSHIPS DEMONSTRATE OUR COMMITMENT TO DAYTON AND THE SURROUNDING COMMUNITY - A COMMUNITY WE HAVE CALLED HOME FOR OVER 50 YEARS. DAYTON CHILDREN'S IS COMMITTED TO WORKING WITH OUR MANY VALUED PARTNERS TO HELP ENSURE DAYTON REMAINS A GREAT CITY FOR CHILDREN TO LIVE, LEARN, GROW AND PLAY.THE DAVINCI PROJECTTHE DAVINCI PROJECT IS A COMPREHENSIVE STRATEGY FOR NEIGHBORHOOD REVITALIZATION SUPPORTED IN THE OLD NORTH DAYTON AND MCCOOK FIELD NEIGHBORHOODS AND THE BUSINESS COMMUNITY AROUND IT INCLUDING DAYTON CHILDREN'S. DAYTON CHILDREN'S LEADS THIS EFFORT AND IS JOINED BY PARTNERS INCLUDING THE CITY OF DAYTON, GREATER OLD NORTH DAYTON BUSINESS ASSOCIATION, THE SALVATION ARMY KROC CENTER, ST. MARY'S COMMUNITY DEVELOPMENT CORP. AND CITYWIDE DEVELOPMENT. THE DAVINCI PROJECT IS WORKING ON EFFORTS TO DEMOLISH NUISANCE BUILDINGS, REALIGN STREETS, BUILD RECREATIONAL SPACES, REVITALIZE BUS STOPS, IMPROVE WAYFINDING, AND BEAUTIFY THE NEIGHBORHOOD SO IT CONTINUES TO BE ATTRACTIVE TO FAMILIES AND BUSINESSES. THIS PROJECT IS IMPORTANT TO DAYTON CHILDREN'S, NOT ONLY BECAUSE WE WANT TO BE AN ACTIVE PARTICIPANT IN OUR COMMUNITY, WE WANT PATIENTS, STAFF, VOLUNTEERS AND VISITORS TO FEEL WELCOME WHEN THEY ENTER THE OLD NORTH DAYTON - A NEIGHBORHOOD THAT WE ARE PROUD TO CALL HOME.COMMUNITY LEADERSHIPBEYOND PARTICIPATION IN ORGANIZATIONS THAT DIRECTLY IMPACT CHILDREN AND CHILDREN'S HEALTH, DAYTON CHILDREN'S STAFF AND LEADERSHIP SERVE ON VARIOUS COALITIONS TO IMPROVE THE ECONOMIC AND SOCIAL HEALTH OF OUR COMMUNITY INCLUDING THE PRESCHOOL PROMISE, THE FAMILY AND CHILDREN FIRST COUNCIL, A SPECIAL WISH, DAYTON DEVELOPMENT CORPORATION, HOPE CENTER, AND CITYWIDE DEVELOPMENT. THROUGH THESE ACTIVITIES, DAYTON CHILDREN'S STRIVES TO CREATE A COMMUNITY THAT IS A PLACE WHERE ALL CHILDREN AND FAMILIES GROW AND THRIVE. DAYTON CHILDREN'S IS AN INDISPENSABLE RESOURCE TO OUR COMMUNITY BECAUSE WE: -SERVE AS THE COMMUNITY'S SAFETY NET HOSPITAL BY CARING FOR ALL CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, WHILE PROVIDING AND SUBSIDIZING HOSPITAL AND COMMUNITY-BASED SERVICES THAT ARE EITHER LIMITED OR UNAVAILABLE ELSEWHERE IN OUR COMMUNITY.-SERVE AS A VOICE FOR CHILDREN THROUGH PUBLIC POLICY ADVOCACY TO CHANGE LAWS, POLICIES, OR SYSTEMS LEADING TO THE IMPROVEMENT OF HEALTH AND SAFETY FOR CHILDREN AND FAMILIES.-JOIN WITH COMMUNITY PARTNERS AND LEND SUPPORT THROUGHOUT OUR REGION TO IMPROVE THE LIVES OF CHILDREN AND THEIR FAMILIES.-TRAIN FUTURE DOCTORS AND HEALTH CARE PROVIDERS TO BECOME THE NEXT GENERATION OF HIGH QUALITY, PROFESSIONAL PEDIATRIC EXPERTS, OFTEN AT A FINANCIAL LOSS TO THE HOSPITAL.AS A TEACHING HOSPITAL, DAYTON CHILDREN'S IS DEDICATED TO TRAINING THE NEXT GENERATION OF PEDIATRICIANS AND PEDIATRIC SPECIALISTS. EACH YEAR, DAYTON CHILDREN'S HOSTS MEDICAL RESIDENTS FROM THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE. IN ADDITION, DAYTON CHILDREN'S HOUSES THIS COUNTRY'S ONLY CIVILIAN/MILITARY INTEGRATED PEDIATRIC RESIDENCY PROGRAM WITH WRIGHT-PATTERSON AIR FORCE BASE. PHYSICIANS TRAINED AT DAYTON CHILDREN'S ARE CARING FOR CHILDREN IN OUR REGION AND THROUGHOUT THE WORLD. IN ADDITION, WE WORK WITH NUMEROUS COLLEGES AND UNIVERSITIES TO HELP TRAIN STUDENTS IN MULTIPLE DISCIPLINES INCLUDING NURSING, PUBLIC HEALTH, SOCIAL WORK, AND MANY MORE AREAS REQUIRED BY MODERN HEALTHCARE. TRAINING INVOLVES SIGNIFICANT COSTS FAR BEYOND THOSE USUALLY ASSOCIATED WITH PATIENT CARE. HOWEVER, WE RECOGNIZE TRAINING THE NEXT GENERATION OF HEALTH CARE WORKERS IS ESSENTIAL TO THE OVERALL HEALTH OF OUR COMMUNITY. DAYTON CHILDREN'S JOINS WITH OTHER CHILDREN'S HOSPITALS ACROSS THE COUNTRY TO ADDRESS ISSUES UNIQUE TO THE POPULATION WE SERVE. WE WORK WITH THE CHILDREN'S HOSPITAL ASSOCIATION, THE OHIO CHILDREN'S HOSPITAL ASSOCIATION AND THE OHIO HOSPITAL ASSOCIATION TO ENSURE CHILDREN HAVE A VOICE IN POLICY MATTERS. DAYTON CHILDREN'S FURTHER SUPPORTS COMMUNITY EFFORTS TO IMPROVE THE HEALTH AND SAFETY OF CHILDREN THROUGHOUT THE REGION THROUGH DONATIONS AND SPONSORSHIPS MADE TO PROGRAMS THAT SUPPORT, HELP AND IMPROVE THE HEALTH STATUS OF CHILDREN AND IMPROVE THE QUALITY OF LIFE FOR CHILDREN AND THEIR FAMILIES.
PART III, LINE 2:	THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. PERIODICALLY THROUGHOUT THE YEAR, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR BAD DEBTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE OF SELF-PAY ACCOUNTS RECEIVABLE INCLUDING THOSE BALANCES AFTER INSURANCE PAYMENTS AND NOT COVERED BY INSURANCE. THE RESULTS OF THIS REVIEW ARE THEN USED TO MAKE ANY MODIFICATIONS TO THE PROVISION FOR BAD DEBTS TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR BAD DEBTS. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE AND REASONABLE EFFORTS TO COLLECT FROM THE PATIENTS THEMSELVES HAVE BEEN EXHAUSTED, THE HOSPITAL MAY PLACE CERTAIN PAST-DUE PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO THE TERMS OF CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY THE HOSPITAL. PATIENT ACCOUNTS RECEIVABLE ARE WRITTEN OFF AFTER COLLECTION EFFORTS HAVE BEEN FOLLOWED IN ACCORDANCE WITH THE HOSPITAL'S POLICIES.
PART III, LINE 4:	THE COSTING METHODOLOGY USED IN PREPARATION OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS IS THE COST TO CHARGE RATIO, RATIO OF PATIENT COST-TO-CHARGE. THE DAYTON CHILDREN'S AUDITED FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE DISCUSSING BAD DEBT EXPENSE. A PROVISION FOR BAD DEBT EXPENSE IS SHOWN ON THE PROFIT AND LOSS STATEMENT. THE CALCULATION FOR BAD DEBT EXPENSE IS IN CONFORMITY WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES REQUIRING MANAGEMENT TO MAKE ESTIMATES AND ASSUMPTIONS BASED ON HISTORICAL DATA THAT AFFECT THE REPORTED AMOUNTS OF REVENUE AND EXPENSES DURING THE REPORTED PERIOD. LIKEWISE, AN ALLOWANCE FOR BAD DEBT IS SHOWN ON THE BALANCE SHEET UNDER THE SAME PRINCIPLE AFFECTING THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES DURING THE REPORTED PERIOD.
PART III, LINE 8:	THE COSTS REPORTED FOR SERVICES PROVIDED TO MEDICARE PATIENTS COME FROM SCHEDULE E OF THE FACILITY'S COST REPORT AS FILED. SINCE DAYTON CHILDREN'S IS REIMBURSED FOR MEDICARE SERVICES UNDER A TEFRA METHODOLOGY, THERE IS NORMALLY NO SHORTFALL, AS ALLOWED COSTS AND PAYMENTS DUE ARE EQUAL.
PART III, LINE 9B:	THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE UNDER THE "FINANCIAL MATTERS" TAB. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT AND OTHER FINANCIAL ASSISTANCE PROGRAMS UP FRONT BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS. EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE-TO-FACE INTERVIEWS. THESE FINANCIAL ASSISTANCE COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE PROGRAMS IF DESIRED.
PART VI, LINE 2:	IN ADDITION TO OUR CHNA, DAYTON CHILDREN'S ASSESSES THE NEEDS OF OUR COMMUNITY IN A VARIETY OF WAYS. WE SERVE AS A KEY COMMUNITY PARTNER ON MANY LOCAL INITIATIVES WHICH ALLOWS US TO BETTER UNDERSTAND COMMUNITY NEEDS AND TRENDS. SPECIFICALLY, WE PARTNER WITH PUBLIC HEALTH DAYTON AND MONTGOMERY COUNTY AND THE GREATER DAYTON AREA HOSPITAL ASSOCIATION ON THEIR COMMUNITY HEALTH NEEDS ASSESSMENTS AND COMMUNITY HEALTH IMPROVEMENT PLANS WHERE APPROPRIATE. KEY AREAS WE WORK ON TOGETHER INCLUDE HEALTHY LIFESTYLES AND INFANT MORTALITY. WE ALSO HAVE SEVERAL OTHER COMMUNITY BASED PROGRAMS WHICH ALLOW FOR FEEDBACK ABOUT THE COMMUNITY. CENTER FOR HEALTH EQUITYIN FALL 2021, AMID THE TURMOIL OF COVID-19 AND UNREST IN OUR COMMUNITY THERE WAS THE STRONG NEED TO FOCUS ON HEALTH EQUITY TO ENSURE ALL CHILDREN CAN OBTAIN OPTIMAL HEALTH. DAYTON CHILDREN'S HAS BEEN WORKING IN THE COMMUNITY FOR MANY YEARS THROUGH HOSPITAL-BASED PROGRAMS AND PARTNERSHIPS TO ADDRESS COMMUNITY CONDITIONS THAT IMPACT HEALTH. HOWEVER, THE HOSPITAL HAS DECIDED TO TAKE HEALTH EQUITY TO THE NEXT LEVEL THROUGH THE CREATION OF THE CENTER FOR HEALTH EQUITY. THE REASONS FOR THE PROBLEM ARE COMPLEX AND NO ONE ORGANIZATION CAN PROVIDE A SINGLE SOLUTION. BUT AS ONE OF THE CITY'S LARGEST EMPLOYERS AND THE ONLY INSTITUTION IN THE REGION ENTIRELY DEDICATED TO PEDIATRIC HEALTH CARE, DAYTON CHILDREN'S HAS A UNIQUE RESPONSIBILITY TO LEAD THE WAY. THROUGH SIGNIFICANT INVESTMENT FROM THE HOSPITAL, THE CENTER IS STAFFED AND WORKING TOWARD ITS MISSION OF ADVANCING HEALTH EQUITY SOLUTIONS IN OUR REGION SO THAT ALL CHILDREN CAN THRIVE. THE CENTER USES MANY NEW, INNOVATIVE PROGRAMS, STRATEGIES, AND PARTNERSHIPS TO REDUCE HEALTH DISPARITIES AND IMPROVE COMMUNITY HEALTH. A SIGNIFICANT FOCUS IS ON QUALITY IMPROVEMENT AND ENGAGING WITH THE COMMUNITY TO IDENTIFY INNOVATIVE APPROACHES TO CLOSING THE GAP IN HEALTH DISPARITIES. THERE IS ALSO A FOCUS ON COMMUNITY HEALTH RESEARCH TO IMPROVE HEALTH OUTCOMES FOR CHILDREN IN LOW INCOME COMMUNITIES IN THE CENTER.DAYTON ASTHMA ALLIANCETHE DAYTON ASTHMA ALLIANCE AIMS TO POSITIVELY IMPACT THE HEALTH AND WELLNESS OF CHILDREN WITH ASTHMA IN THE DAYTON AREA, FOCUSING ON THE MOST AT-RISK POPULATIONS. USING THE COLLECTIVE IMPACT FRAMEWORK, THE ALLIANCE ENGAGES LOCAL PARTNER ORGANIZATIONS TO COLLABORATIVELY IMPLEMENT A VARIETY OF STRATEGIC ACTIONS TO IMPROVE OUTCOMES FOR CHILDREN WITH ASTHMA. TO HAVE THE GREATEST IMPACT AND TO ENSURE ALL CHILDREN WITH ASTHMA HAVE OPTIMAL HEALTH OUTCOMES, THE ALLIANCE IDENTIFIED THREE STRATEGIC FOCUS AREAS FOR THEIR WORK 1) ENSURE ASTHMA-FRIENDLY ENVIRONMENTS; 2) ENHANCE ACCESS TO HIGH QUALITY HEALTHCARE AND SUPPORTIVE SOCIAL SERVICES THROUGH CLINICAL-COMMUNITY LINKAGES; AND 3) EDUCATE AND EQUIP CHILDREN, FAMILIES AND THE COMMUNITY FOR ASTHMA WELLNESS. TO SUPPORT WORK IN THESE AREAS, DAYTON CHILDREN'S SERVES AS THE BACKBONE ORGANIZATION CONVENING THE GROUP OF COMMITTED STAKEHOLDERS AND SUPPORTING THE ALLIANCE WITH STAFF AND RESOURCES. THE ALLIANCE IS GOVERNED BY ENTITIES WITH A COMMON PURPOSE TO IMPROVE HEALTH OUTCOMES FOR CHILDREN WITH ASTHMA IN THE DAYTON REGION. THE ALLIANCE CONSULTS WITH ADDITIONAL ORGANIZATIONS TO GATHER DATA AND RESEARCH, ASCERTAIN BEST PRACTICES, AND TO IDENTIFY COMMUNITY RESOURCES TO SUPPORT CHILDREN WITH ASTHMA AND TO INFORM THE STRATEGIC FOCUS AREAS. THIS WORK COULD NOT BE DONE WITHOUT ALIGNMENT WITH A VARIETY OF COMMUNITY STAKEHOLDERS. IN ADDITION TO STAFF AND PERSONNEL FROM DAYTON CHILDREN'S CENTER FOR CHILD HEALTH AND WELLNESS AND DAYTON CHILDREN'S PULMONARY CLINIC, PARTNERS IN THE DAYTON ASTHMA ALLIANCE INCLUDE COMMUNITY PRIMARY CARE PHYSICIANS, COMMUNITY ALLERGISTS, CARESOURCE, COMMUNITY HEALTH CENTERS OF GREATER DAYTON, DAYTON PUBLIC SCHOOLS, GREATER DAYTON PREMIER MANAGEMENT, LEGAL AID OF WESTERN OHIO (MEDICAL-LEGAL PARTNERSHIP), PUBLIC HEALTH - DAYTON & MONTGOMERY COUNTY, AND THE MIAMI VALLEY CHILD DEVELOPMENT CENTERS. ADDITIONAL PARTNERS AND COLLABORATORS ARE CONTINUALLY INVITED TO JOIN THE ALLIANCE AS THE NEEDS OR INTEREST ARISE.FAMILY RESOURCE CONNECTIONWHEN PATIENTS AND THEIR FAMILIES SEEK MEDICAL CARE, THEY ARE OFTEN FACING ADDITIONAL CRITICAL CHALLENGES IN THEIR LIVES - THEY MAY HAVE LITTLE FOOD, THEY MAY NOT HAVE A JOB, OR THEY MAY STRUGGLE TO KEEP UP WITH BILLS FOR UTILITIES. UNFORTUNATELY, THESE CHALLENGES OFTEN AFFECT THEIR HEALTH. THE FAMILY RESOURCE CONNECTION USES A PATIENT'S VISIT TO THE DOCTOR AS AN OPPORTUNITY TO ADDRESS THE NON-MEDICAL ISSUES THAT HAVE AN IMPACT ON HEALTH. THIS PROGRAM SCREENS PATIENT FAMILIES FOR SOCIAL NEEDS. IDENTIFIED FAMILIES THEN ARE REFERRED TO AN ADVOCATE WORKING IN THE DAYTON CHILDREN'S HOSPITAL FAMILY RESOURCE CONNECTION FOR RESOURCE CONNECTION AND FOLLOW-UP. THE FAMILY RESOURCE CONNECTION IS MODELED AFTER THE WELL-KNOWN AND RESPECTED HEALTH LEADS PROGRAM.IN FY 2022-2023, THE FAMILY RESOURCE CONNECTION HAS WORKED WITH PATIENT FAMILIES TO CONNECT THEM TO COMMUNITY RESOURCES TO MEET NEEDS. IN THE PAST YEAR, 6,977 SOCIAL NEEDS SCREENS WERE ADMINISTERED WITH 2,357 INDICATING A NEED. THE GREATEST NEEDS IDENTIFIED IN THE FAMILY RESOURCE CONNECTION CONTINUE TO BE FOOD, HOUSING AND COMMODITIES INCLUDING DIAPERS, CRIBS AND BEDS, SCHOOL SUPPLIES AND CLOTHING.STARTING IN THE SPRING OF 2020, DAYTON CHILDREN'S HOSPITAL PARTNERED WITH THE CITY OF DAYTON TO PARTICIPATE IN THE VOLUNTEER INCOME TAX ASSISTANCE PROGRAM. (VITA) THIS IS AN IRS INITIATIVE DESIGNED TO SUPPORT FREE TAX PREPARATION SERVICES TO THE UNDERSERVED. FAMILY RESOURCE CONNECTION STAFF AND STUDENTS ARE IRS TRAINED TO PREPARE AND FILE TAX RETURNS. THE GOAL OF THIS PROGRAM IS TO PREPARE AND FILE TAXES AT NO COST AND ASSURE FAMILIES ARE COLLECTING ANY TAX CREDITS THEY ARE ELIGIBLE FOR PARTICULARLY THE EARNED INCOME TAX CREDIT (EITC). IN SPRING 2023, STAFF PREPARED 82 TAX RETURNS WITH FAMILIES RECEIVING OVER $37,000 IN EARNED INCOME TAX CREDIT (EITC).KISER NEIGHBORHOOD SCHOOLS CENTERDAYTON CHILDREN'S IS THE NONPROFIT COMMUNITY PARTNER TO THE KISER NEIGHBORHOOD SCHOOLS CENTER, AS PART OF THE DAYTON PUBLIC SCHOOL'S NEIGHBORHOOD SCHOOL CENTER PROGRAM. NEIGHBORHOOD SCHOOL CENTERS ARE DAYTON PUBLIC SCHOOLS THAT ARE CENTERED ON THEIR NEIGHBORHOODS, SERVING AS HEALTHY PLACES OF LEARNING FOR CHILDREN AND FAMILIES. THEY SEEK TO IMPROVE STUDENT PERFORMANCE, REALIGN COMMUNITY RESOURCES TO SUPPORT YOUTH ACHIEVEMENT AND IMPROVE QUALITY OF LIFE IN THE NEIGHBORHOOD. FOCUSED ON COMMUNITY LEADERSHIP, NEIGHBORHOOD SCHOOL CENTERS BRING TOGETHER PARTNERS TO OFFER A RANGE OF OPPORTUNITIES TO CHILDREN, FAMILIES, AND COMMUNITIES. TO AID IN THIS PARTNERSHIP, TWO GRANT-FUNDED DAYTON CHILDREN'S STAFF MEMBERS SERVE AT THE SCHOOL. WE HAVE A FAMILY RESOURCE COORDINATOR (FRC) WHO FACILITATES STUDENT CLUBS, FAMILY ENGAGEMENT EVENTS, PROVIDES SUPPLIES TO MEET BASIC NEEDS OF FAMILIES AND REFERRALS TO COMMUNITY RESOURCES FOR LONG TERM NEEDS. IN FISCAL YEAR 2023, THE FRC COLLABORATED WITH INTERNAL AND EXTERNAL SCHOOL PARTNERS TO PROVIDE 28 HOURS OF UNIQUE PROGRAMMING SUPPORTED BY 51 VOLUNTEERS, SERVING A TOTAL OF 727 STUDENTS AND 214 FAMILIES. ALSO, WE HAVE AN AFTERSCHOOL AND SUMMER PROGRAM MANAGER, WHO LEADS A TEAM OF TEACHERS AND ENRICHMENT SPECIALISTS TO PROVIDE DAILY ACADEMIC FOCUSED PROGRAMMING THAT IS INCENTIVIZED THROUGH FIELD TRIPS AND FAMILY EVENTS. FOR THE 2022-2023 SCHOOL YEAR, 38 STUDENTS WERE SERVED IN THIS PROGRAM. IN ADDITION TO MANAGING THE DUTIES OF THE FAMILY RESOURCE COORDINATOR AND PROGRAM MANAGER, DAYTON CHILDREN'S OFFERS VARIOUS SERVICES AND RESOURCES TO CHILDREN AT KISER INCLUDING TUTORS. THIS IS A KEY PARTNERSHIP AS KISER NEIGHBORHOOD SCHOOLS CENTER IS IN OUR BACKYARD, GREATER OLD NORTH DAYTON.MONTGOMERY COUNTY IMAGINATION LIBRARY IN DECEMBER 2019, DAYTON CHILDREN'S HOSPITAL PARTNERED WITH MONTGOMERY COUNTY AND OTHER LOCAL ORGANIZATIONS TO LAUNCH THE OHIO GOVERNOR'S IMAGINATION LIBRARY INITIATIVE TO PROVIDE FREE BOOKS TO LOCAL CHILDREN FOUR YEARS OLD AND YOUNGER, THROUGH A PARTNERSHIP WITH DOLLY PARTON'S IMAGINATION LIBRARY. THE PROGRAM IS AIMED AT INCREASING LITERACY AND EARLY LEARNING OPPORTUNITIES FOR CHILDREN THROUGHOUT MONTGOMERY COUNTY, AND WILL BE PROVIDED FREE OF CHARGE TO LOCAL FAMILIES. THIS PROGRAM ADDRESSES A KEY NEED IN OUR COMMUNITY AROUND KINDERGARTEN READINESS - A BUILDING BLOCK FOR A HEALTHY COMMUNITY AND STRONG WORKFORCE. CURRENTLY, OVER 50% OF CHILDREN IN MONTGOMERY COUNTY AGES ZERO TO FIVE ARE ENROLLED IN THE PROGRAM AND RECEIVING BOOKS MONTHLY. CONTINUED AT THE END.
PART VI, LINE 3:	THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS ARE POSTED ON OUR WEBSITE UNDER THE "FINANCIAL MATTERS" TAB. IT IS THE HOSPITAL'S POLICY TO PUBLICIZE THE AVAILABILITY OF FREE CARE, GOVERNMENT, AND OTHER FINANCIAL ASSISTANCE PROGRAMS BEFORE SERVICES ARE PROVIDED THROUGH MEANS SUCH AS ONSITE FINANCIAL COUNSELORS AND BROCHURES PROVIDED IN THE REGISTRATION AREAS EACH OF THESE AVENUES OF COMMUNICATION INCLUDES DETAILED INSTRUCTIONS ON HOW PATIENTS AND FAMILIES MAY APPLY FOR ASSISTANCE. THE HOSPITAL'S POLICIES ON BILLING AND COLLECTIONS SPECIFY WHEN COLLECTION ACTION MAY BE TAKEN AND MAKES IT CLEAR THAT THESE MEASURES WILL ONLY OCCUR AFTER DAYTON CHILDREN'S HAS MADE REASONABLE EFFORTS TO CONTACT A FAMILY ABOUT ITS BILL AND THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS. THESE PRACTICES APPLY TO ALL PATIENTS IN GENERAL, NOT ONLY PATIENTS WHO MIGHT BE ELIGIBLE FOR FINANCIAL ASSISTANCE. IN ADDITION, PATIENTS ARE INFORMED OF THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAMS THROUGH SIGNS DISPLAYED IN REGISTRATION AREAS AND THROUGH MESSAGES APPEARING ON BILLING STATEMENTS MAILED BY THE HOSPITAL. FINALLY, THE HOSPITAL EMPLOYS ON-SITE FINANCIAL COUNSELORS WHO CONTACT PATIENTS WITHOUT COVERAGE IN ORDER TO DISCUSS THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE PROGRAMS VIA PHONE OR THROUGH FACE-TO-FACE INTERVIEWS. THESE FINANCIAL COUNSELORS WILL ASSIST FAMILIES IN APPLYING FOR FINANCIAL ASSISTANCE.
PART VI, LINE 4:	DAYTON CHILDREN'S HOSPITAL IS LOCATED IN OLD NORTH DAYTON, NORTHEAST OF DOWNTOWN DAYTON AND THE URBAN CORE, IN MONTGOMERY COUNTY IN SOUTHWESTERN OHIO. THE HOSPITAL'S ROOTS CAN BE TRACED BACK TO 1919, WHEN PHILANTHROPIST AND ACTIVIST ANNA BARNEY GORMAN PLANNED A NORTH DAYTON COMMUNITY CENTER TO OFFER HEALTH SERVICES, EDUCATION AND RECREATION. THE BARNEY COMMUNITY CENTER LATER DEVELOPED INTO THE BARNEY CONVALESCENT HOSPITAL, WHICH CARED FOR POLIO VICTIMS. IN 1967 A FULL-SERVICE CHILDREN'S HOSPITAL, THE BARNEY CHILDREN'S MEDICAL CENTER, OPENED. THE NAME WAS CHANGED IN 1970 TO THE CHILDREN'S MEDICAL CENTER OF DAYTON. IN SPRING 2013, THE HOSPITAL CHANGED ITS NAME ONCE AGAIN TO DAYTON CHILDREN'S HOSPITAL. THE HOSPITAL CELEBRATED ITS 50-YEAR ANNIVERSARY IN 2017. DAYTON CHILDREN'S NOW SERVES INFANTS, CHILDREN AND TEENS FROM 20 OHIO COUNTIES, WITH 75 PERCENT OF PATIENTS COMING FROM MONTGOMERY, GREENE, CLARK, MIAMI AND NORTHERN WARREN COUNTIES. THE SERVICE AREA SPANS 9,000 SQUARE MILES WITH A 2.1 MILLION PEDIATRIC POPULATION THAT INCLUDES POOR URBAN AND RURAL AREAS. DAYTON CHILDREN'S IS THE ONLY PEDIATRIC HEALTH CARE PROVIDER AND THE LARGEST PROVIDER OF MEDICAL CARE TO LOW-INCOME CHILDREN IN THE REGION. CURRENTLY, THE HOSPITAL SERVES A DISPROPORTIONATE SHARE OF CHILDREN FROM LOW-INCOME FAMILIES. OVER 54 PERCENT OF THE PATIENTS AT DAYTON CHILDREN'S ARE COVERED BY MEDICAID. ONE OF ONLY 31 INDEPENDENT FREESTANDING CHILDREN'S HOSPITALS IN THE COUNTRY, DAYTON CHILDREN'S IS THE REGION'S ONLY MEDICAL FACILITY DEDICATED TO CHILDREN. ACCREDITED BY THE JOINT COMMISSION, THE EXPERTS AT DAYTON CHILDREN'S CARE FOR MORE THAN 320,000 CHILDREN EACH YEAR. CONSISTENTLY RECOGNIZED AS ONE OF THE COUNTRY'S BEST AND MOST COST-EFFECTIVE PEDIATRIC HOSPITALS, DAYTON CHILDREN'S IS HOME TO THE WRIGHT STATE UNIVERSITY BOONSHOFT SCHOOL OF MEDICINE, DEPARTMENT OF PEDIATRICS AND TOGETHER WITH THE UNITED STATES AIR FORCE SHARES THE NATION'S ONLY CIVILIAN-MILITARY INTEGRATED PEDIATRIC TRAINING PROGRAM.
PART VI, LINE 5:	INJURY PREVENTIONDAYTON CHILDREN'S CONTINUES OUR WORK TO PREVENT CHILDHOOD INJURIES AS UNINTENTIONAL INJURY IS A LEADING CAUSE OF DEATH AND DISABILITY FOR CHILDREN ACROSS THE COUNTY AND REGIONALLY. DAYTON CHILDREN'S WORKS WITH PARTNERS SUCH AS THE OHIO INJURY PREVENTION PARTNERSHIP, OHIO OCCUPANT PROTECTION REGIONAL COORDINATOR PROGRAM, AND THE MONTGOMERY COUNTY CHILD FATALITY REVIEW BOARD TO ADDRESS SOME OF THE KEY UNINTENTIONAL INJURIES TO CHILDREN IN OUR COMMUNITY, SUCH AS MOTOR VEHICLE ACCIDENTS, PEDESTRIAN ACCIDENTS, AND UNSAFE SLEEP PRACTICES. DAYTON CHILDREN'S IS THE LEAD AGENCY OF SAFE KIDS GREATER DAYTON, WHICH IS OUR REGION'S LEADER IN CHILDHOOD INJURY PREVENTION PROGRAMMING. THE SAFE KIDS GREATER DAYTON COALITION ADDRESSES KEY PEDIATRIC SAFETY ISSUES WITH COMMUNITY PROGRAMMING INCLUDING CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, HOME/FIRE SAFETY, MEDICATION POISONING PREVENTION, WATER SAFETY AND BICYCLE HELMET EDUCATION. PROGRAMMING INCLUDED BIKE AND PEDESTRIAN SAFETY EDUCATION AND HOME SAFETY EDUCATION TO TWELVE AREA SCHOOLS.DAYTON CHILDREN'S RECEIVED FUNDING FROM THE OHIO DEPARTMENT OF TRANSPORTATION TO IMPLEMENT SAFE ROUTES TO SCHOOLS PROGRAMING FOR THE DAYTON PUBLIC SCHOOLS IN JULY 2022. SUCCESSES INCLUDED CREATING BLOGS, SOCIAL MEDIA POSTS AND BILLBOARDS TO PROMOTE A BIKE AND PEDESTRIAN SAFETY CAMPAIGN. ADDITIONALLY, THE SAFE ROUTES TO SCHOOL PROGRAM PROVIDED A BIKE SAFETY COURSE CALLED GIRLS IN GEAR WITH 15 GIRLS COMPLETING THE PROGRAM. THE SAFE ROUTES TO SCHOOL PROGRAM ALSO IMPLEMENTED A LEARN TO BIKE PROGRAM AT STEPPING STONES CHILDCARE CENTER. TWENTY-FOUR STUDENTS RECEIVED BIKE SAFETY EDUCATION, A BIKE AND SAFETY EQUIPMENT DURING THIS FOUR WEEK PROGRAM.DAYTON CHILDREN'S RECEIVED FUNDING FROM THE OHIO CHILDREN'S TRUST FUND TO IMPLEMENT AN EARLY CHILDHOOD SAFETY INITIATIVE. THIS FUNDING ALLOWED DAYTON CHILDREN'S TO EDUCATE AND PROVIDE NEEDED SAFETY EQUIPMENT TO 84 ELIGIBLE FAMILIES. EDUCATION COVERED HOME SAFETY FOR CHILDREN AGES ZERO TO THREE AND EQUIPMENT RECEIVED BY FAMILIES INCLUDED CRIBS, TODDLER BEDS, STOLLERS, HIGHCHAIRS, SAFETY GATES AND CHILDPROOFING EQUIPMENT. DAYTON CHILDREN'S HOSPITAL HAS ADDITIONAL OUTREACH PROGRAMS TO PREVENT INJURY THAT EDUCATE PROFESSIONALS TO UNDERSTAND THE UNIQUE PHYSIOLOGY OF CHILDREN. THESE PROGRAMS INCLUDE EMS OUTREACH AND EDUCATION, THE NURSING LIAISON PROGRAM AND SPORTS MEDICINE. DAYTON CHILDREN'S EMS OUTREACH COORDINATORS TRAINED THE STAFF AT FIRE DEPARTMENTS THROUGHOUT THE REGION SPECIFIC PEDIATRIC TRAUMA CASES AS WELL AS CHILDREN WITH SPECIFIC HEALTH CARE NEEDS. BY COVERING TOPICS RANGING FROM SEIZURES TO RESPIRATORY, TO HIDDEN HAZARDS (POISON), THE EMS OUTREACH COORDINATORS ENSURE EMTS ARE EDUCATED IN VARIOUS PEDIATRIC HEALTH ISSUES. THE EMS OUTREACH COORDINATORS ENSURE ALL FIRE DEPARTMENTS HAD ACCESS TO TRAINING AS NEEDED IN THE GREATER DAYTON AREA. DAYTON CHILDREN'S NURSE LIAISONS PROVIDE CONTINUING EDUCATION TO COMMUNITY AND SCHOOL NURSES. DAYTON CHILDREN'S SPORTS MEDICINE PROGRAM PROVIDED SERVICES AT SPORTING TOURNAMENTS AND PROVIDED FREE BASELINE CONCUSSION SCREENINGS TO CHILDREN AGES 12 AND OVER.
PART VI, LINE 7, REPORTS FILED WITH STATES	OH
PART VI, LINE 2 CONTINUED:	COMMUNITY CONTRIBUTION PROGRAMIN FY20, DAYTON CHILDREN'S CREATED A COMMUNITY CONTRIBUTION PROGRAM TO PROVIDE SUPPORT COMMUNITY PROGRAMS THAT FOCUS ON IMPROVING HEALTH OUTCOME FOR CHILDREN. ORGANIZATIONS ARE ASKED TO SUBMIT AN APPLICATION TO ENSURE FUNDING ALIGNS WITH COMMUNITY BENEFIT REQUIREMENTS AND STRATEGIES. THE HOSPITAL LOOKS AT THE FOLLOWING ITEMS WHEN FUNDING PROPOSALS. - SOCIAL CORRELATES OF HEALTH THROUGH UPSTREAM APPROACHES: WE KNOW A CHILD'S HEALTH IS GREATLY RELATED TO THE ENVIRONMENT IN WHICH HE OR SHE LIVES. THE SOCIAL CORRELATES OF HEALTH ARE ALL THE ENVIRONMENTAL FACTORS THAT INFLUENCE HEALTH, INCLUDING EARLY CHILDHOOD DEVELOPMENT, EMPLOYMENT OPPORTUNITIES, FOOD INSECURITY, AIR AND WATER QUALITY, TRANSPORTATION, EDUCATIONAL ATTAINMENT, PUBLIC SAFETY, AND HOUSING. - HEALTH EQUITY & DISPARITIES: HEALTH DISPARITIES ARE THE DIFFERENCES IN HEALTH OUTCOMES BASED ON RACE, ETHNICITY, SEXUAL ORIENTATION, AND/OR SOCIO-ECONOMIC STATUS. HEALTH EQUITY IS ACHIEVED WHEN CHARACTERISTICS SUCH AS RACE, GENDER, SEXUAL IDENTITY, AND MORE ARE NOT CORRELATED TO HIGHER RATES OF ADVERSE HEALTH OUTCOMES. - COLLABORATION AND PARTNERSHIP: PROGRAMS THAT VALUE PARTNERSHIPS AND ALIGN THE PRACTICES AND PERSPECTIVES OF COMMUNITIES, HEALTH SYSTEMS AND PUBLIC HEALTH UNDER A SHARED VISION HELP FACILITATE STRONG COLLABORATION AND PARTNERSHIPS. PROGRAMS THAT DRAW UPON THE STRENGTHS OF EACH PARTNER TO HAVE A GREATER COLLECTIVE IMPACT. - COMMUNITY-INFORMED DECISION MAKING: PROGRAMS THAT ENGAGE NEIGHBORHOOD RESIDENTS AND COMMUNITY LEADERS AS KEY VOICES THROUGHOUT ALL STAGES OF PLANNING AND IMPLEMENTATION HONOR THE UNIQUE EXPERIENCE OF THOSE IMPACTED BY THE INTERVENTION. - DATA-DRIVEN AND EVIDENCE-BASED INTERVENTIONS: PROGRAMS THAT USE DATA FROM BOTH CLINICAL AND COMMUNITY SOURCES AS A TOOL TO IDENTIFY KEY NEEDS, MEASURE MEANINGFUL CHANGE, AND CREATE TRANSPARENCY AMONGST STAKEHOLDERS. IDENTIFYING PROVEN STRATEGIES THAT HAVE TANGIBLE RESULTS.- ALIGNED WITH REGIONAL, STATEWIDE AND NATIONAL STRATEGIES: PROGRAMS THAT ARE ALIGNED WITH THE AMERICAN ACADEMY OF PEDIATRICS, HEALTHY PEOPLE 2020, THE STATE HEALTH IMPROVEMENT PLAN AND OTHER REGIONAL HEALTH IMPROVEMENT PLANS TO CONTRIBUTE TO A GREATER IMPACT ON CHILDREN'S HEALTH.THE FOLLOWING ORGANIZATIONS RECEIVED FUNDING IN FY23: AMERICAN RED CROSS, BIG BROTHER BIG SISTERS, DAYBREAK, DAYTON METRO LIBRARY, GOODWILL EASTERSEALS, LESSONS FROM THE GARDEN, OHIO TRI COUNTY FOOD ALLIANCE, CATHOLIC SOCIAL SERVICES, MIAMI VALLEY MEALS, AND MILK MAMAS. IN ADDITION, THE HOSPITAL FINANCIALLY SUPPORTED VARIOUS COMMUNITY AGENCIES INCLUDING OMEGA COMMUNITY DEVELOPMENT CORPORATION, GIRLS ON THE RUN, CITIZENS FOR SINCLAIR, CHILDREN'S BRAIN TUMOR FOUNDATION, YWCA, DAYTON LIVE, SPECIAL WISH, DIABETES DAYTON, AMERICAN LUNG ASSOCIATION, UNITED WAY HEART ASSOCIATION, AND COMMUNITY YOUTH SPORTS TEAMS TO ENSURE LOCAL CHILDREN HAVE ACCESS TO HEALTHY ACTIVITIES. AT DAYTON CHILDREN'S, WE BELIEVE THAT ALL CHILDREN IN OUR REGION DESERVE A GREAT CHILDREN'S HOSPITAL CLOSE TO HOME. WE ARE DEDICATED TO ADDRESSING THE HEALTH AND WELLNESS NEEDS OF CHILDREN BOTH THROUGH CLINICAL PRACTICE AS WELL AS OUR COMMUNITY BENEFIT ACTIVITIES.

Schedule H (Form 990) 2022

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Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2022

Open to Public
Inspection

Name of the organization
DAYTON CHILDREN'S HOSPITAL

Employer identification number
31-0672132

Part I

General Information on Grants and Assistance

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

Yes No

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

Part II

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

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

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) A SPECIAL WISH FOUNDATION - DAYTON CHAPTER 741 VALLEY STREET DAYTON,OH45404	31-1234314	501 (C) (3)	6,250	PROGRAM DONATION
(2) ADVOCATES FOR BASIC LEGAL EQUALITY INC 525 JEFFERSON AVE SUITE 300 TOLEDO,OH43604	23-7376131	501 (C) (3)	10,000	PROGRAM DONATION
(3) AMERICAN RED CROSS 370 WEST FIRST STREET DAYTON,OH45402	53-0196605	501 (C) (3)	17,000	PROGRAM DONATION
(4) BIG BROTHERS BIG SISTERS MIAMI VALLEY 22 SOUTH JEFFERSON STREET DAYTON,OH45402	31-0641306	501 (C) (3)	10,000	PROGRAM DONATION
(5) CATHOLIC SOCIAL SERVICES OF MIAMI VALLEY 922 W RIVERSIDE AVE DAYTON,OH45402	31-0536645	501 (C) (3)	10,000	PROGRAM DONATION
(6) DAYTON METRO LIBRARY FOUNDATION 215 E THIRD STREET DAYTON,OH45402	35-2511884	501 (C) (3)	12,000	PROGRAM DONATION
(7) DAYBREAK INC 605 S PATTERSON BOULEVARD DAYTON,OH45402	31-0864474	501 (C) (3)	15,000	PROGRAM DONATION
(8) FIRST LADY'S CHARITABLE FOUNDATION PO BOX 340734 COLUMBUS,OH43234	87-1678867	501 (C) (3)	10,000	PROGRAM DONATION
(9) FIVE RIVERS METROPARKS 409 E MONUMENT AVE THIRD FLOOR DAYTON,OH45402	31-0937070	115	25,000	PROGRAM DONATION
(10) GOODWILL EASTER SEALS MIAMI VALLEY 660 SOUTH MAIN STREET DAYTON,OH45402	31-0537112	501 (C) (3)	10,000	PROGRAM DONATION
(11) HANNAH'S TREASURE CHEST 124 WESTPARK RD CENTERVILLE,OH45459	31-1772684	501 (C) (3)	20,000	PROGRAM DONATION
(12) LEUKEMIA & LYMPHOMA SOCIETY 4370 GLENDALE MILFORD RD CINCINNATI,OH45242	13-5644916	501 (C) (3)	10,000	PROGRAM DONATION
(13) MIAMI VALLEY MEALS INC 428 S EDWIN C MOSES BLVD DAYTON,OH45402	47-5233212	501 (C) (3)	15,000	PROGRAM DONATION
(14) SECOND HARVEST FOOD BANK 20 N MURRAY STREET SPRINGFIELD,OH45503	83-2134113	501 (C) (3)	12,000	PROGRAM DONATION
(15) SOUTHWESTERN OHIO COUNCIL FOR HIGHER EDUCATION 3155 RESEARCH BOULEVARD DAYTON,OH45420	23-7109141	501 (C) (3)	7,500	PROGRAM DONATION
(16) THE DAYTON FOUNDATION 1401 S MAIN STREET SUITE 100 DAYTON,OH45409	31-6027287	501 (C) (3)	30,000	PROGRAM DONATION
(17) YWCA DAYTON 141 WEST THIRD STREET DAYTON,OH45402	31-0537168	501 (C) (3)	12,500	PROGRAM DONATION

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

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

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

Cat. No. 50055P

Schedule I (Form 990) 2022

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

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

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

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

Return Reference	Explanation
PART I, LINE 2:	THE FINANCE COMMITTEE AND COMMUNITY RELATIONS MANAGER APPROVE ALL GRANTS AND CHARITABLE DONATIONS.

Schedule I (Form 990) 2022

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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

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

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

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 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)
1ADAM MEZOFF MD CMO	(i) (ii)	703,338 ------------- 0	0 ------------- 0	1,794,588 ------------- 0	314,494 ------------- 0	17,817 ------------- 0	2,830,237 ------------- 0	0 ------------- 0
2DEBORAH FELDMAN CEO	(i) (ii)	978,584 ------------- 0	0 ------------- 0	44,174 ------------- 0	1,037,900 ------------- 0	8,072 ------------- 0	2,068,730 ------------- 0	0 ------------- 0
3CHRIS BERGMAN CFO	(i) (ii)	577,530 ------------- 0	0 ------------- 0	583,201 ------------- 0	287,493 ------------- 0	25,110 ------------- 0	1,473,334 ------------- 0	0 ------------- 0
4CINDY BURGER VP & CHIEF EXPERIENCE OFFICER	(i) (ii)	347,486 ------------- 0	0 ------------- 0	941,074 ------------- 0	105,432 ------------- 0	20,042 ------------- 0	1,414,034 ------------- 0	0 ------------- 0
5VIPUL PATEL MD TRUSTEE	(i) (ii)	0 ------------- 415,917	0 ------------- 21,000	0 ------------- 4,390	0 ------------- 117,500	0 ------------- 17,042	0 ------------- 575,849	0 ------------- 0
6CHARLES KIDWELL CHIEF LEGAL OFFICER	(i) (ii)	467,353 ------------- 0	0 ------------- 0	8,064 ------------- 0	18,323 ------------- 0	28,210 ------------- 0	521,950 ------------- 0	0 ------------- 0
7BENJAMIN GOODSTEIN VP & CHIEF AMBULATORY OFFICER	(i) (ii)	408,450 ------------- 0	0 ------------- 0	5,869 ------------- 0	17,120 ------------- 0	27,610 ------------- 0	459,049 ------------- 0	0 ------------- 0
8KELLY KAVANAUGH VP & CHIEF STRATEGY OFFICER	(i) (ii)	352,565 ------------- 0	0 ------------- 0	9,523 ------------- 0	59,114 ------------- 0	26,333 ------------- 0	447,535 ------------- 0	0 ------------- 0
9JAYNE GMEINER VP & CHIEF NURSING OFFICER	(i) (ii)	356,569 ------------- 0	0 ------------- 0	9,245 ------------- 0	17,577 ------------- 0	8,619 ------------- 0	392,010 ------------- 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

PART I, LINE 4B

THE FOLLOWING INDIVIDUALS PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND THE FOLLOWING ARE THE INCREASES IN THE ACTUARIAL VALUE DURING THE YEAR: DEBORAH FELDMAN - $1,019,975 CINDY BURGER - $52,712 KELLY KAVANAUGH - $5,553 ADAM MEZOFF - $296,494 CHRIS BERGMAN - $269,453 THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: DEBORAH FELDMAN - $27,110 CHRIS BERGMAN - $568,183 CINDY BURGER - $926,056 KELLY KAVANAUGH - $1,808 BENJAMIN GOODSTEIN - $3,369 ADAM MEZOFF - $1,779,570

PART I, LINE 7

BONUSES ARE DISCRETIONARY AND ARE BASED ON AN INCENTIVE PROGRAM APPROVED BY SENIOR MANAGEMENT.

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
DAYTON CHILDREN'S HOSPITAL

Employer identification number
31-0672132

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	COUNTY OF MONTGOMERY	31-6000172	613520PD1	11-01-2021	278,059,458	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	278,059,458
4 Gross proceeds in reserve funds .............	13,150,717
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	3,237,775
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	109,188,162
11 Other spent proceeds .............	152,482,804
12 Other unspent proceeds .............
13 Year of substantial completion .............	2023
	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?
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?
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 ....
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 .........
6 Total of lines 4 and 5 .............
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
SCHEDULE K, PART I, BOND ISSUES:	(F) DESCRIPTION OF PURPOSE: CONSTRUCT & EQUIP FACILITY; REFUND PRIOR BOND ISSUES: 10/13/16, 11/20/15, AND 8/19/14.

Schedule K (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

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

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

Return Reference	Explanation
FORM 990, PART VI, SECTION B, LINE 11B	THE CFO REVIEWS KEY DISCLOSURES WITH APPROPRIATE COMMITTEES OF THE BOARD OF TRUSTEES. THEN PRIOR TO FILING, THE FORM 990 IS ELECTRONICALLY LOADED TO A SECURE WEBSITE FOR THE ENTIRE BOARD OF TRUSTEES TO REVIEW. AN EMAIL IS SENT TO ALL MEMBERS NOTIFYING THEM THAT THE FORM IS AVAILABLE FOR THEIR REVIEW AND THAT IT WILL BE FILED ON OR BEFORE THE EXTENDED DUE DATE.
FORM 990, PART VI, SECTION B, LINE 12C	AT THE BEGINNING OF EACH MEETING, THE CHAIRMAN OF THE BOARD ASKS EACH MEMBER TO IDENTIFY AND DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST BASED ON THE AGENDA OR ANY CHANGES IN THEIR BUSINESS PRACTICE THAT MIGHT BE RELEVANT. IF THERE ARE ANY CONFLICTS, THE MEMBER(S) RECUSE THEMSELVES AND DO NOT PARTICIPATE IN THE DISCUSSION AND DO NOT VOTE ON THE ITEM. THIS THEN IS NOTED IN THE MINUTES OF THAT MEETING. BOARD MEMBERS ANNUALLY AGREE TO ABIDE BY WRITTEN CONFLICT OF INTEREST AND CONFIDENTIALITY POLICIES. BOARD MEMBERS ALSO WORK TO REPRESENT AND BALANCE THE INTERESTS OF DAYTON CHILDREN'S HOSPITAL'S MANY CONSTITUENTS. THE BOARD ANNUALLY EVALUATES ITS OWN PERFORMANCE.
FORM 990, PART VI, SECTION B, LINE 15	THE COMMITTEE USED A TOTAL COMPENSATION PHILOSOPHY TO GUIDE ALL DECISIONS RELATED TO EXECUTIVE COMPENSATION AT DAYTON CHILDREN'S HOSPITAL (DCH), AND AS SUCH DETERMINES AND APPROVES ALL ASPECTS OF THE CEO'S TOTAL COMPENSATION PACKAGE, INCLUDING BENEFITS AND EXPENSE ALLOWANCES. THESE ARE DETAILED IN A WRITTEN EMPLOYMENT AGREEMENT FOR THE CEO. THE COMMITTEE USES AN OUTSIDE CONSULTANT TO CONDUCT PERIODIC REVIEWS OF THE EXECUTIVE COMPENSATION LEVELS OF THE ORGANIZATION VERSUS THOSE OF SIMILARLY SIZED AND SITUATED ORGANIZATIONS USING PUBLISHED SURVEYS. THESE SURVEY RESULTS ARE USED BY THE COMMITTEE IN SETTING EXECUTIVE LEVELS AND THE CEO'S COMPENSATION IN PARTICULAR. THE COMMITTEE FOLLOWS A FORMAL CALENDAR OF MEETINGS AND THE CHAIRMAN OF THE COMMITTEE REPORTS TO THE BOARD OF TRUSTEES AT LEAST ANNUALLY ON THE COMMITTEE'S ACTIVITIES AND ON DETAILS OF THE CEO'S COMPENSATION AND BENEFITS PACKAGE. THE COMMITTEE ALSO REVIEWS AND APPROVES DISCLOSURES RELATED TO EXECUTIVE COMPENSATION MADE AS PART OF IRS FORM 990. CONTEMPORANEOUS MINUTES WERE KEPT OF THE COMMITTEE PROCEEDINGS.
FORM 990, PART VI, SECTION C, LINE 19	THE FINANCIAL STATEMENTS, ORGANIZING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE GENERAL PUBLIC UPON WRITTEN OR VERBAL REQUEST TO DAYTON CHILDREN'S HOSPITAL, FOR THE SAME PERIOD OF TIME AS SET FORTH IN THE INTERNAL REVENUE CODE SECTION 6104(D).
FORM 990, PART XI, LINE 9:	CHANGE IN PENSION BENEFIT OBLIGATION -4,870,037. TRANSFER FROM DAYTON CHILDREN'S HOSPITAL FOUNDATION 286,023.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

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

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

DAYTON CHILDREN'S HOSPITAL

Employer identification number

31-0672132

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) CENTER FOR COMMUNITY HEALTH AND ADVOCACY ONE CHILDRENS PLAZA DAYTON,OH45404 82-4391789	NEW MARKETS TAX CREDIT	OH	105,128	9,590,947	DAYTON CHILDREN'S HOSPITAL

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 HOME CARE OF DAYTON 18 CHILDRENS PLAZA DAYTON,OH45404 31-1356037	HOME CARE	OH	501(C)(3)	LINE 10	DAYTON CHILDREN'S HOSPITAL	Yes
(2)DAYTON CHILDREN'S HOSPITAL FOUNDATION ONE CHILDRENS PLAZA DAYTON,OH45404 31-1045247	SUPPORT	OH	501(C)(3)	LINE 12A, I	DAYTON CHILDREN'S HOSPITAL	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

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

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

Part IV

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) PEDIATRIC ASSURANCE COMPANY LTD BUTTERFIELD BANK BLDG 6TH FL 65 FRO HAMILTON HM BD 98-0478183	SELF-INSURANCE	BD	DAYTON CHILDREN'S HOSPITAL		4,031,003	13,298,090	100.000 %	Yes
(2) DAYTON CHILDREN'S SPECIALTY PHYSICIANS ONE CHILDRENS PLAZA DAYTON,OH45404 31-1411364	SPECIALTY PHYSICIANS GROUP	OH	DAYTON CHILDREN'S HOSPITAL	C	31,497,478	39,462,608	100.000 %	Yes

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

Yes

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

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

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

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) CHILDREN'S HOME CARE OF DAYTON	O	57,834	CASH
(2) CHILDREN'S HOME CARE OF DAYTON	P	9,911,320	CASH
(3) CHILDREN'S HOME CARE OF DAYTON	S	4,980,000	CASH
(4) DAYTON CHILDREN'S HOSPITAL FOUNDATION	O	160,160	CASH
(5) DAYTON CHILDREN'S HOSPITAL FOUNDATION	C	12,018,954	CASH
(6) DAYTON CHILDREN'S HOSPITAL FOUNDATION	R	9,263,378	CASH
(7) DAYTON CHILDREN'S SPECIALTY PHYSICIANS	O	1,446,201	CASH
(8) DAYTON CHILDREN'S SPECIALTY PHYSICIANS	R	93,400,000	CASH
(9) DAYTON CHILDREN'S SPECIALTY PHYSICIANS	P	880,991	CASH

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: THE RELENTLESS PURSUIT OF OPTIMAL HEALTH FOR EVERY CHILD WITHIN OUR REACH.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	21
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	18
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	4,415
6	Total number of volunteers (estimate if necessary) .............	6	533
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	101,990
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	84,937

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	12,725,312	15,161,768
9	Program service revenue (Part VIII, line 2g) .........	544,031,281	572,271,047
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	52,501,212	15,889,093
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	29,989,917	48,001,716
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	639,247,722	651,323,624
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	2,647,500	232,250
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)	267,325,617	299,793,391
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 4,739,367
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	224,008,459	255,176,055
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	493,981,576	555,201,696
19	Revenue less expenses. Subtract line 18 from line 12.......	145,266,146	96,121,928
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,421,282,637	1,565,773,605
21	Total liabilities (Part X, line 26).............	382,979,649	409,957,169
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,038,302,988	1,155,816,436

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 442,018,337 including grants of $ 232,250 ) (Revenue $ 616,644,030 )
	DAYTON CHILDREN'S HOSPITAL IS A PEDIATRIC HOSPITAL LOCATED IN DOWNTOWN DAYTON, OHIO. THE HOSPITAL AND ITS STAFF ARE COMMITTED TO SERVING AS AN ADVOCATE FOR THE CHILDREN AND THEIR FAMILIES IN THE MIAMI VALLEY THROUGH A VARIETY OF DIFFERENT PROGRAMS. IT OFFERS INPATIENT, OUTPATIENT AND ANCILLARY SERVICES TO THE CHILDREN IN THE SURROUNDING 20 COUNTIES. SERVICES ARE PROVIDED TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY. FOR THE FISCAL YEAR ENDING JUNE 30, 2023, THE HOSPITAL'S MIX OF PATIENTS WAS 54.5% MEDICAID, 36.5% COMMERCIAL, 3.5% OTHER GOVERNMENT PROGRAMS AND 5.5% SELF PAY. THE HOSPITAL PROVIDES A LEVEL III NEONATAL NURSERY FOR PREMATURE NEWBORNS AS WELL AS CRITICAL CARE AND GENERAL PEDIATRIC INPATIENT BEDS. A 24 HOUR EMERGENCY DEPARTMENT IS AVAILABLE TO ALL CHILDREN IN THE AREA. SOME OF THE SPECIALTIES OFFERED AT THE HOSPITAL ARE NEUROSURGERY, HEMATOLOGY/ONCOLOGY, PULMONARY, GASTROENTEROLOGY,NEUROLOGY, UROLOGY, DEVELOPMENTAL DISORDERS, PSYCHOLOGY, PSYCHIATRY, ENDOCRINOLOGY, GENETICS, CARDIOLOGY, ORTHOPEDICS AND GENERAL SURGERY. WITHOUT DAYTON CHILDREN'S HOSPITAL, MANY CHILDREN IN THE AREA WOULD HAVE TO TRAVEL A GOOD DISTANCE TO RECEIVE THESE SERVICES. THE HOSPITAL ALSO OFFERS A PEDIATRIC RESIDENCY PROGRAM THAT TRAINS NEW PEDIATRICIANS WHO WILL CARE FOR THE NEXT GENERATION OF CHILDREN. DAYTON CHILDREN'S ALSO SPONSORS MANY COMMUNITY EVENTS WHERE CHILDREN'S HEALTH AND SAFETY ARE PROMOTED. SOME STATISTICS FOR THE FISCAL YEAR ENDING JUNE 30, 2023 ARE AS FOLLOWS # OF BEDS 181, INPATIENT DAYS 37,171, ADMISSIONS 7,978. AVERAGE LENGTH OF STAY 4.66 DAYS. AVERAGE DAILY CENSUS 120.2, OCCUPANCY RATE 66%, SURGERIES PERFORMED 13,224, X-RAY STUDIES 48,655, LAB TEST 606,132, RESPIRATORY THERAPY PROCEDURES 93,530, PHARMACY DOSES DISPENSED 836,286 CARDIOLOGY PROCEDURES 21,138, NEUROLOGY PROCEDURES 4,822, URGENT CARE VISITS 48,011, EMERGENCY DEPARTMENT VISITS 99,052, OUTPATIENT CLINIC VISITS 215,530.

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 expenses442,018,337

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) JAMIE MCGREGOR........................................................................ TRUSTEE	1.00 .......................0.00	X			0	0	0
(19) DAVID C MELIN........................................................................ TRUSTEE	1.00 .......................0.00	X			0	0	0
(20) LESLIE C MILLER........................................................................ TRUSTEE	1.00 .......................0.00	X			0	0	0
(21) GREGORY TOUSSAINT MD........................................................................ TRUSTEE	1.00 .......................0.00	X			0	0	0
(22) DAVID TAYLOR........................................................................ TRUSTEE	1.00 .......................0.00	X			0	0	0
(23) CHRIS BERGMAN........................................................................ CFO	40.00 .......................2.00		X		1,160,731	0	312,603
(24) CINDY BURGER........................................................................ VP & CHIEF EXPERIENCE OFFICER	40.00 .......................0.00			X	1,288,560	0	125,474
(25) CHARLES KIDWELL........................................................................ CHIEF LEGAL OFFICER	40.00 .......................0.00			X	475,417	0	46,533
(26) BENJAMIN GOODSTEIN........................................................................ VP & CHIEF AMBULATORY OFFICER	39.00 .......................1.00			X	414,319	0	44,730
(27) KELLY KAVANAUGH........................................................................ VP & CHIEF STRATEGY OFFICER	40.00 .......................0.00			X	362,088	0	85,447
(28) JAYNE GMEINER........................................................................ VP & CHIEF NURSING OFFICER	39.00 .......................1.00			X	365,814	0	26,196

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	7,587,613	441,307	2,153,808

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	12,018,954
e	Government grants (contributions)		1e	3,142,814

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

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

h Total. Add lines 1a-1f.......		15,161,768

		Business Code
2a	PATIENT SERVICE REVENUE	624100	348,997,103	348,997,103
b	MEDICARE/MEDICAID	624100	223,129,296	223,129,296
c	RELATED ORG RENT	532000	144,648	144,648
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		572,271,047

3 Investment income (including dividends, interest, and othersimilar amounts) ......			13,942,271		101,990	13,840,281
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		1,530,868	6a
b	Less: rental expenses		579,563	6b
c	Rental income or (loss)		951,305	6c
d	Net rental income or (loss).......			951,305			951,305
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	124,515	141,583,222	7a
b	Less: cost or other basis and sales expenses	176,973	139,583,942	7b
c	Gain or (loss)	-52,458	1,999,280	7c
d	Net gain or (loss).........			1,946,822			1,946,822
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	579,495
b	Less: cost of goods sold ..		10b	537,446
c	Net income or (loss) from sales of inventory..			42,049			42,049
Business Code			Miscellaneous Revenue
11a	CONTRACT SPECIALTY PHARMACY		900099	12,448,090	12,448,090
b	PARTNERS FOR KIDS		900099	11,709,317	11,709,317
c	CAFETERIA		900099	2,635,379			2,635,379
d	All other revenue ....			20,215,576	20,215,576
e	Total. Add lines 11a–11d ......			47,008,362
12	Total revenue. See instructions.....			651,323,624	616,644,030	101,990	19,415,836

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	232,250	232,250
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	6,372,301		6,372,301
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	224,758,740	194,346,538	28,070,275	2,341,927
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	14,703,013	12,363,028	2,191,007	148,978
9	Other employee benefits .......	37,195,566	31,275,892	5,542,791	376,883
10	Payroll taxes ...........	16,763,771	14,095,817	2,498,096	169,858
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	522,497		522,497
c	Accounting ...........	514,531		514,531
d	Lobbying ...........	121,156	121,156
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	1,152,307		1,152,307
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	24,835,420	12,746,197	11,255,576	833,647
12	Advertising and promotion ....	1,270,911		1,270,911
13	Office expenses .......	15,858,204	8,523,921	6,994,543	339,740
14	Information technology ......	16,727,987	12,162,839	4,337,174	227,974
15	Royalties ..
16	Occupancy ...........	9,990,455	5,691,563	4,271,758	27,134
17	Travel ............	1,413,999	749,002	587,014	77,983
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	8,801,772		8,801,772
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	37,022,917	34,142,015	2,754,611	126,291
23	Insurance ...	2,890,063		2,890,063
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 AND DR	86,041,417	83,654,477	2,320,043	66,897
b	BAD DEBT EXPENSE	30,774,688	30,774,688
c	STATE HOSPITAL ASSESSME	15,908,387		15,908,387
d	REPAIRS AND MAINTENANCE	1,329,344	1,138,954	188,335	2,055
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	555,201,696	442,018,337	108,443,992	4,739,367
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 ........			31,715,027	1	30,895,340
2	Savings and temporary cash investments .........			149,384	2
3	Pledges and grants receivable, net ......			269,004	3	222,792
4	Accounts receivable, net .............			307,232,589	4	406,386,736
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			8,894,870	8	9,350,288
9	Prepaid expenses and deferred charges ......			6,744,509	9	15,405,126
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	777,340,787
b	Less: accumulated depreciation	10b	305,871,291	443,491,994	10c	471,469,496
11	Investments—publicly traded securities .			389,062,674	11	398,617,001
12	Investments—other securities. See Part IV, line 11 .....			184,046,082	12	188,672,144
13	Investments—program-related. See Part IV, line 11 ..			13,987,935	13	13,920,405
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			35,688,569	15	30,834,277
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,421,282,637	16	1,565,773,605

17	Accounts payable and accrued expenses .....	32,256,832	17	34,779,169
18	Grants payable ...		18
19	Deferred revenue .........	989,451	19	730,489
20	Tax-exempt bond liabilities .........	273,701,189	20	271,985,978
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 ..	10,415,000	23	30,130,000
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	65,617,177	25	72,331,533
26	Total liabilities. Add lines 17 through 25..	382,979,649	26	409,957,169

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	1,038,302,988	27	1,155,816,436
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 ...........	1,038,302,988	32	1,155,816,436
33	Total liabilities and net assets/fund balances ........	1,421,282,637	33	1,565,773,605

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