TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) MICHELLE RILEY-BROWN...................................................................... PRESIDENT/CEO FROM 07/23	43.00 ................. 12.00	X	X		843,121	15,887
(2) AMY FREEMAN...................................................................... BOARD CHAIRMAN	2.00 ................. 1.00	X	X		0	0
(3) PAUL KALB MD...................................................................... BOARD VICE CHAIRMAN	1.00 ................. 0.00	X	X		0	0
(4) ELLIE HAMBURGER MD...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(5) ARTENCIA HAWKINS-BELL...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(6) MARY GEN LEDECKY...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(7) AMANDA LELAND...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(8) MARSHA REGENSTEIN...................................................................... BOARD MEMBER	1.00 ................. 4.00	X			0	0
(9) HORACIO ROZANSKI...................................................................... BOARD MEMBER	1.00 ................. 4.00	X			0	0
(10) JERRY STOUCK...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(11) IVY WAFFORD DUKE...................................................................... BOARD MEMBER	1.00 ................. 0.00	X			0	0
(12) ALDWIN LINDSAY...................................................................... EVP/CFO	37.00 ................. 18.00		X		1,138,312	135,445
(13) MARY ANNE HILLIARD...................................................................... EVP/CHIEF LEGAL OFFICER	38.00 ................. 17.00		X		932,977	126,033
(14) ANTHONY SANDLER MD...................................................................... SVP CENTER OF EXCELLENCE	45.00 ................. 10.00			X	1,577,071	212,681
(15) DAVID WESSEL MD...................................................................... CHIEF MEDICAL OFFICER	53.00 ................. 2.00			X	1,250,087	54,492
(16) DEANN MARSHALL...................................................................... PRESIDENT OF FOUNDATION	1.00 ................. 54.00			X	1,019,162	104,508
(17) ELIZABETH WELLS...................................................................... SVP CENTER OF EXCELLENCE	54.00 ................. 1.00			X	656,503	48,270

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(F) Estimated amount of other compensation from the organization and related organizations
(18) NATHANIEL BEERS MD........................................................................ PRESIDENT OF HSC	1.00 .......................54.00	X			843,320	134,498
(19) MICHELLE M MCGUIRE........................................................................ CHIEF STRATEGY OFFICER TO 12/23	54.00 .......................1.00	X			864,599	139,462
(20) CHARLES WEINSTEIN........................................................................ CHIEF REAL ESTATE OFFICER TO 12/23	54.00 .......................1.00	X			955,553	49,442
(21) MATTHEW MACVEY........................................................................ CHIEF INFO OFFICER	54.00 .......................1.00	X			763,612	136,889
(22) LINDA TALLEY........................................................................ CHIEF NURSING OFFICER	54.00 .......................1.00	X			762,525	106,486
(23) VITTORIO GALLO PHD........................................................................ CHIEF RESEARCH OFFICER TO 09/23	15.00 .......................40.00	X			818,162	26,801
(24) CATHERINE CODISPOTI MD........................................................................ CHIEF PEOPLE OFFICER TO 10/23	54.00 .......................1.00	X			652,532	42,580
(25) YVES D'UDEKEM D'ACOZ MD........................................................................ CHIEF OF CARDIO SURGERY	55.00 .......................1.00		X		2,329,784	47,484
(26) ROBERT KEATING MD........................................................................ CHIEF OF NEUROSURGERY	54.00 .......................1.00		X		1,191,135	43,839
(27) JOHN S MYSEROS........................................................................ ASSOC. CHIEF OF NEUROSURGERY	55.00 .......................0.00		X		989,680	37,863
(28) TIMOTHY KANE MD........................................................................ CHIEF OF PEDIATRIC SURGERY	55.00 .......................0.00		X		1,139,684	49,184
(29) MARK L BATSHAW MD........................................................................ SENIOR INVESTIGATOR	53.00 .......................2.00		X		1,035,577	38,308
(30) KURT D NEWMAN MD........................................................................ FORMER PRESIDENT / CEO (CNMC)	54.00 .......................1.00			X	3,000,204	46,404
(31) DENICE CORA-BRAMBLE MD........................................................................ FMR CHIEF MEDICAL OFFICER	54.00 .......................1.00			X	319,655	37,324
(32) KATHLEEN CHAVANU GORMAN........................................................................ FORMER CHIEF OPERATING OFFICER	52.00 .......................3.00			X	1,259,773	143,036
(33) ROGER PACKER MD........................................................................ FORMER SVP CENTER OF EXCELLENCE	53.00 .......................0.00			X	921,243	47,984

(A) Name and business address	(B) Description of services	(C) Compensation
CERNER CORPORATION 2800 ROCKCREEK PARKWAY KANSAS CITY,MO64117	INFORMATION TECHNOLOGY	20,028,219
ORACLE AMERICA INC PO BOX 203448 DALLAS,TX753203448	INFORMATION TECHNOLOGY	6,313,007
ARAMARK SERVICES INC 2400 KARKET STREET PHILADELPHIA,PA19103	PURCHASED FOOD SERVICES	4,111,157
TAG B VALET PARKING LLC 610 10TH STREET NW SUITE 100 WASHINGTON,DC20001	PARKING	3,282,883
QUEST DIAGNOSTIC CLINICAL LAB INC PO BOX 829864 PHILADELPHIA,PA191828298	PURCHASED LAB SERVICES	2,501,354
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 184

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	85,105,614	58,540,048	66,496,859	53,753,566	68,530,658	332,426,745
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	85,105,614	58,540,048	66,496,859	53,753,566	68,530,658	332,426,745
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.						332,426,745

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..	85,105,614	58,540,048	66,496,859	53,753,566	68,530,658	332,426,745
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	7,995,875	11,995,360	13,818,827	12,071,637	14,093,792	59,975,491
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..	4,528,932	3,800,400	4,254,430	4,952,676	6,148,457	23,684,895
11	Total support. Add lines 7 through 10						416,087,131

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

6,902,658,987

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 2023 (line 6, column (f) divided by line 11, column (f)) .........

79.890 %

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

79.740 %

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

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) 2023

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) 2023

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) 2023

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

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

Facts And Circumstances Test

Return Reference	Explanation
SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:	PARKING - 2019 AMOUNT: $ 4,528,932. 2020 AMOUNT: $ 3,800,400. 2021 AMOUNT: $ 4,254,430. 2022 AMOUNT: $ 4,952,676. 2023 AMOUNT: $ 6,148,457.

Schedule A (Form 990) 2023

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

2023

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

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

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

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

501(c)(3) taxable private foundation

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

General Rule

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

Special Rules

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

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

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

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

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

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization CHILDREN'S HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

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

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization CHILDREN'S HOSPITAL			Employer identification number 53-0196580
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

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

Schedule B (Form 990) (2023)

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

right arrow

Complete if the organization is described below. 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

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I-A

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

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

Political campaign activity expenditures. See instructions .................................................................... right arrow

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

Page 3

Part II-B

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

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

(a)

Yes|No

(b)

Amount

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

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

Yes

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

Yes

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

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

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

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

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

Yes

382,825

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

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

Yes

59,415

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

442,240

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

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

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

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

Part III-A

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

Yes

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

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

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

Part III-B

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

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

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

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

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

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

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

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

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

Part IV

Supplemental Information

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

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

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
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

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

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

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

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

Yes No

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

Yes No

Part II

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

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

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

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

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

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

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

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

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

Yes No

Part IV

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

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

Yes No


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

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

Yes No

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

Part V

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

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

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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

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

Yes

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

3a(i)

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

3a(ii)

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

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

Part VI

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

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

1a	Land .....	22,186,326		22,186,326
b	Buildings ....	370,952,992	104,162,961	266,790,031
c	Leasehold improvements	948,017,060	726,462,148	221,554,912
d	Equipment ....	409,153,999	273,751,752	135,402,247
e	Other .....	110,559,754	4,954,132	105,605,622
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				751,539,138

Schedule D (Form 990) 2022

Page 3

Part VII

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

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

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)DUE FROM AFFILIATES				644,896,695
(2)OPERATING ROU ASSETS				60,167,379
(3)DEFERRED COMPENSATION PLAN				53,913,326
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				758,977,400

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
FINANCE LEASE OBLIGATIONS	147,853,348
RESERVE FOR CLAIMS	131,476,799
OTHER LIABILITIES	72,154,412
OPERATING LEASE OBLIGATIONS	65,011,276
SETTLEMENTS TO THIRD PARTY PAY	12,163,718
DUE TO AFFILIATES	2,192,750



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	430,852,303
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) 2022

Page 4

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

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

Part XIII

Supplemental Information

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

Return Reference

Explanation

PART X, LINE 2:

LIABILITY FOR UNCERTAIN TAX POSITIONS (ASC 740) FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL), OF WHICH CHILDREN'S NATIONAL HOSPITAL IS A SUBSIDIARY, IS AS FOLLOWS: CHILDREN'S NATIONAL EVALUATES UNCERTAIN TAX POSITIONS USING A TWO-STEP APPROACH FOR RECOGNIZING AND MEASURING TAX BENEFITS TAKEN OR EXPECTED TO BE TAKEN IN AN UNRELATED BUSINESS ACTIVITY TAX RETURN AND DISCLOSURES REGARDING UNCERTAINTIES IN TAX POSITIONS. THERE WAS NO IMPACT ON CHILDREN'S NATIONAL'S FINANCIAL STATEMENTS DURING THE YEARS ENDED JUNE 30, 2024 AND 2023 AS CHILDREN'S NATIONAL HAS NO UNCERTAIN TAX POSITIONS.

Schedule D (Form 990) 2022

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 arrow

Attach to Form 990. Right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

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

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

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

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

Yes

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

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

(a) Region		(b) Number of offices in the region	(c) Number of employees, agents, and independent contractors in the region	(d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in the region	(f) Total expenditures for and investments in the region
	MIDDLE EAST AND NORTH AFRICA	0	1	PROGRAM SERVICES	PATIENT REFERRALS	581,019
	CENTRAL AMERICA AND THE CARIBBEAN	0	0	PROGRAM SERVICES	INSURANCE PREMIUMS	16,411,045















3a	Sub-total ....	0	1			16,992,064
b	Total from continuation sheets to Part I ...	0	0			0
c	Totals (add lines 3a and 3b)	0	1			16,992,064

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2023

Schedule F (Form 990) 2023

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) 2023

Schedule F (Form 990) 2023Page 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) 2023

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2023

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

Schedule F (Form 990) 2023

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.
Medium right arrow

Attach to Form 990.
Medium right arrow

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

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

Yes

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

Yes

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

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

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

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

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

Yes

100% 150% 200% Other 40000.0000000000 %

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

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

Yes

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

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

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

Yes

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

Yes

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

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

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

Yes

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

Yes

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

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .		5,837,321		5,837,321	0.360 %
b	Medicaid (from Worksheet 3, column a) . . . . .		798,671,629	644,894,052	153,777,577	9.560 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .		804,508,950	644,894,052	159,614,898	9.920 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	140,491	6,518,098	2,902,879	3,615,219	0.220 %
f	Health professions education (from Worksheet 5) . . .	1,593	59,620,024	8,699,581	50,920,443	3.160 %
g	Subsidized health services (from Worksheet 6) . . . .		23,777,071	20,403,767	3,373,304	0.210 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	433	760,112		760,112	0.050 %
j	Total. Other Benefits . .	142,517	90,675,305	32,006,227	58,669,078	3.640 %
k	Total. Add lines 7d and 7j .	142,517	895,184,255	676,900,279	218,283,976	13.560 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development			49,661		49,661	0 %
3	Community support		5	57,332		57,332	0 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy			6,027		6,027	0 %
8	Workforce development		162	1,480,661		1,480,661	0.090 %
9	Other
10	Total		167	1,593,681		1,593,681	0.090 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Yes

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

33,790,028

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. ......

1,315,000

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

Section B. Medicare

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

2,011,919

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

2,139,069

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

-127,150

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) 2023

Page

Part VFacility Information

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

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

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

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

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

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

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

Yes

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

A definition of the community served by the hospital facility

Demographics of the community

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

How data was obtained

The significant health needs of the community

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

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

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

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

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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

Yes

6 a

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

Yes

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

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

Yes

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

Hospital facility’s website (list url): WWW.CHILDRENSNATIONAL.ORG

Other website (list url):

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

Other (describe in Section C)

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

Yes

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

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

Yes

If "Yes" (list url): WWW.CHILDRENSNATIONAL.ORG

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

10b

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

12a

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

12a

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

12b

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

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

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

Yes

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

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

Yes

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

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 400.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

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

Yes

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

Yes

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

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

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

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

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

Other (describe in Section C)

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

Yes

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

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

SEE PART V, PAGE 8

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

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

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) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

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

Yes

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

Yes

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

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

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

Reporting to credit agency(ies)

Selling an individual’s debt to another party

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

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

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

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

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

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

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

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

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

Yes

If "No," indicate why:

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

The hospital facility’s policy was not in writing

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

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

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

Yes

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

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

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

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

The hospital facility used a prospective Medicare or Medicaid method

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

If "Yes," explain in Section C.

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

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B, LINE 3J:	CHILDREN'S NATIONAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN PARTNERSHIP WITH CHILDREN'S NATIONAL REHABILITATION & SPECIALIZED CARE (RSC) IN 2022. THIS 2022 CHNA, DIFFERENT FROM OUR PRIOR ASSESSMENTS AS IT FOCUSES SPECIFICALLY ON CHILDREN, IS AN ASSESSMENT OF CHILDREN'S NATIONAL AND RSC'S PRIMARY SERVICE AREA (PSA) WHICH INCLUDES WASHINGTON, D.C., AND PARTS OF MARYLAND, AND APPLIES A STRONGER PEDIATRIC HEALTH EQUITY LENS BY UTILIZING THE CHILD OPPORTUNITY INDEX (COI). THE COI DEFINES OPPORTUNITY AS THE NEIGHBORHOOD RESOURCES THAT MATTER FOR A CHILD'S HEALTHY DEVELOPMENT. THE 29 INDICATORS FOCUS ON NEIGHBORHOOD FEATURES SUCH AS ACCESS TO HEALTHY FOOD, HIGH-QUALITY EDUCATION, PARKS, AND PLAYGROUNDS. EACH NEIGHBORHOOD IS ASSIGNED A SCORE RANGING FROM 1 TO 100 TO INDICATE THE OPPORTUNITY IN THAT SPECIFIC NEIGHBORHOOD FOR CHILDREN TO REACH THEIR POTENTIAL. THE HIGHER THE SCORE, THE BETTER THE OPPORTUNITY FOR CHILD DEVELOPMENT AND WELL-BEING. THE COI HIGHLIGHTS THE INTERPLAY BETWEEN LOW OPPORTUNITY NEIGHBORHOODS AND THE AVAILABILITY OF SOCIAL RESOURCES THAT ARE CRITICAL TO CHILD WELL-BEING. OUR CHNA FINDINGS REVEAL THAT CHILD OPPORTUNITY VARIES CONSIDERABLY WITHIN OUR SERVICE AREA. CHILD OPPORTUNITY IS LOWEST AND CRITICALLY LACKING IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS CERTAIN PRINCE GEORGE'S COUNTY NEIGHBORHOODS IN MARYLAND. IN ADDITION TO THE QUANTITATIVE DATA, WE IMPLEMENTED MANY COMMUNITY ENGAGEMENT EFFORTS TO GATHER QUALITATIVE DATA. WE INVITED RESIDENTS FROM OUR COMMUNITY, SPECIFICALLY THE NEIGHBORHOODS WE IDENTIFIED WITH THE LOWEST OPPORTUNITY SCORES, TO SHARE THEIR EXPERIENCES ON OPPORTUNITY IN THEIR COMMUNITIES. WE ENGAGED WITH YOUTH, PARENTS AND OLDER ADULTS THROUGH VIRTUAL CONVERSATIONS, INPUT FORMS AND INTERVIEWS TO FURTHER INFORM OUR FINDINGS AND RECOMMENDATIONS SPECIFICALLY RELATED TO EDUCATION, HEALTH, AND ECONOMIC CONDITIONS. TO ELEVATE THE VOICE OF OUR YOUTH IN THIS ASSESSMENT, WE CREATED AN EIGHT-WEEK PHOTOVOICE PROGRAM TAILORED TO ADOLESCENTS. THE STUDENTS WERE ASKED TO USE THEIR CELL PHONES TO CAPTURE IMAGES THAT SHOWED THE ASSETS AND CHALLENGES THAT IMPACT HEALTH IN THEIR COMMUNITIES. THEY WORKED WITH THE FACILITATORS TO LEARN HOW TO USE THEIR VOICES TO PROMOTE POSITIVE CHANGE IN THEIR NEIGHBORHOODS. THE FOUR INDICATORS THAT SCORED AS THE HIGHEST PRIORITY INDICATORS ARE (1) EARLY CHILDHOOD EDUCATION, (2) HEALTH INSURANCE COVERAGE, (3) HEALTHY FOOD AND (4) EMPLOYMENT RATE.
PART V, SECTION B, LINE 5:	IN CONDUCTING THE MOST RECENT CHNA, CHILDREN'S NATIONAL CONSIDERED INPUT FROM COMMUNITY RESIDENTS, STAKEHOLDERS INCLUDING LEADERS IN HEALTHCARE AND COMMUNITY-BASED ORGANIZATIONS, AS WELL AS BUSINESS AND GOVERNMENT OFFICIALS INCLUDING THE DC HOSPITAL ASSOCIATION, PRINCE GEORGE'S COUNTY CHAMBER OF COMMERCE, DC PRIMARY CARE ASSOCIATION, CHILDREN'S LAW CENTER AND THE DC HEALTH MATTERS COLLABORATIVE. THROUGH OUR QUALITATIVE WORK, WE HEARD FROM OVER 300 STAKEHOLDERS. WE CONDUCTED ELEVEN 60-MINUTE, VIRTUAL COMMUNITY CONVERSATIONS WITH 67 PARENTS AND CAREGIVERS LIVING IN THE NEIGHBORHOODS WITH THE LOWEST OPPORTUNITY FOR CHILDREN IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS PRINCE GEORGE'S COUNTY, MD. THREE OF THE 11 COMMUNITY CONVERSATIONS WERE HELD IN SPANISH. THESE CONVERSATIONS PROVIDED PERSPECTIVES FROM NEIGHBORHOOD RESIDENTS ON HOW THEY VIEW THE IMPACT OF NEIGHBORHOOD CONDITIONS - SPECIFICALLY RELATED TO EDUCATION, HEALTH, AND ECONOMIC CONDITIONS - ON A CHILD'S OPPORTUNITY TO LIVE A HEALTHY AND PRODUCTIVE LIFE. WE CONDUCTED 33 KEY INFORMANT INTERVIEWS WITH A WIDE RANGE OF PEOPLE - INCLUDING RESIDENTS, PUBLIC HEALTH, COMMUNITY, AND GOVERNMENT LEADERS - WHO HAD FIRSTHAND KNOWLEDGE ABOUT THE COMMUNITY. WE ALSO ISSUED A COMMUNITY INPUT FORM AS A WAY FOR RESIDENTS WHO MAY NOT HAVE BEEN ABLE TO PARTICIPATE IN PREVIOUS CONVERSATIONS AND INTERVIEWS TO PROVIDE THEIR INPUT. WE RECEIVED FEEDBACK FROM 88 NEIGHBORHOOD RESIDENTS ON WHICH INDICATORS SHOULD BE A PRIORITY, WHAT FACTORS IMPACT OPPORTUNITIES IN THEIR NEIGHBORHOOD, AND HOW HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS CAN WORK TOGETHER TO MAKE IMPROVEMENTS IN THESE AREAS. IN ADDITION TO THE COMMUNITY INPUT FORM, WE RECEIVED FEEDBACK FROM 156 HOSPITAL STAFF VIA A HOSPITAL INPUT FORM TO GAIN THEIR PERSPECTIVE ON WHICH OF THE 29 COI INDICATORS WE SHOULD SELECT AS "PRIORITY INDICATORS" FOR THE 2022 CHNA. ONCE THE PRIORITIES WERE SELECTED, WE HOSTED FOUR ADDITIONAL COMMUNITY CONVERSATIONS WITH 26 PARENTS AND CAREGIVERS LIVING IN PRIORITY NEIGHBORHOODS TO IDENTIFY SPECIFIC STRATEGIES TO IMPROVE ACCESS TO EARLY CHILDHOOD EDUCATION, HEALTHY FOOD, HEALTH INSURANCE AND HEALTH SERVICES AND EMPLOYMENT.
PART V, SECTION B, LINE 6A:	THE CHNA WAS CONDUCTED WITH CHILDREN'S NATIONAL REHABILITATION & SPECIALIZED CARE (RSC). BASED IN WASHINGTON, D.C., CHILDREN'S NATIONAL AND RSC ARE COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE FOR CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WITH COMPLEX MEDICAL CONDITIONS. OUR GOAL IS TO PROVIDE COMPREHENSIVE, FAMILY-CENTERED CARE THAT MEETS OUR PATIENTS' PHYSICAL, EMOTIONAL, AND PSYCHOLOGICAL NEEDS. WE STRIVE TO CREATE AN ENVIRONMENT WHERE EVERY FAMILY FEELS INCLUDED, RESPECTED, AND SUPPORTED. OUR TEAM OF PHYSICIANS, NURSES, AND OTHER HEALTHCARE PROVIDERS WORK TOGETHER TO ENSURE THE BEST OUTCOMES FOR OUR PATIENTS.
PART V, SECTION B, LINE 7D:	THE CHNA IS LOCATED ON THE HOSPITAL WEBSITE. CHILDREN'S NATIONAL ALSO SHARED FINDINGS AND ANNOUNCEMENTS ABOUT THE CHNA WITH CHILDREN'S NATIONAL LEADERSHIP AND BOARD MEMBERS. WE ALSO SHARED OUR CHNA AND IMPLEMENTATION STRATEGY (COMMUNITY HEALTH IMPROVEMENT PLAN) DURING COMMUNITY EVENTS SUCH AS OUR CELEBRATING OUR PARTNERS EVENT HELD IN JUNE 2023. DURING THIS EVENT, WE GATHERED WITH OUR COMMUNITY PARTNERS AND PROVIDED AN OVERVIEW OF OUR CHNA AND CHIP AND HELD A DISCUSSION ON THE IMPORTANCE OF PARTNERSHIPS TO ADVANCE COMMUNITY HEALTH IMPROVEMENT EFFORTS.PART V, SECTION B, LINE 8:CHILDREN'S HOSPITAL ADOPTED AN IMPLEMENTATION STRATEGY IN NOVEMBER 2022, REFERRED TO AS THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP). THE CHIP IS AVAILABLE AT: HTTPS://CHILDRENSNATIONAL. ORG/ADVOCACY-AND-OUTREACH/CHILD-HEALTH-ADVOCACY-INSTITUTE/COMMUNITY-AFFAIRS/IMPROVING-COMMUNITY-HEALTH.
PART V, SECTION B, LINE 11:	FROM THE INSIGHT GAINED FROM THE COI AND OUR UNDERSTANDING OF OUR COMMUNITY PERSPECTIVES, WE PARED DOWN THE 29 COI INDICATORS TO FOUR INDICATORS THAT WILL BE OUR HOSPITAL'S FOCUS FROM 2022-2025. TO GET TO THESE FOUR INDICATORS, WE USED A PROCESS MODELED OFF A WIDELY USED PRIORITIZATION METHOD, CALLED THE HANLON METHOD. THE PRIORITIZATION EXERCISE SCORED EACH INDICATOR BASED ON THE IMPORTANCE TO OUR COMMUNITY, IMPORTANCE TO OUR HOSPITALS, HOSPITAL'S CAPACITY TO ADDRESS THE INDICATOR, ALIGNMENT WITH THE HOSPITAL'S MISSION, AND HOSPITAL'S EXISTING WORK IN THE AREA. THE FOUR INDICATORS THAT SCORED AS THE HIGHEST PRIORITY INDICATORS ARE EARLY CHILDHOOD EDUCATION, HEALTH INSURANCE COVERAGE, HEALTHY FOOD AND EMPLOYMENT RATE. THE CHNA UNCOVERED NUMEROUS NEEDS WITHIN OUR COMMUNITY. HOWEVER, DUE TO PRACTICAL AND RESOURCE CONSTRAINTS, THE ORGANIZATION PRIORITIZED ITS EFFORTS ON THE MOST IMPACTFUL NEEDS.WITH A FOCUS ON THE HIGHEST PRIORITY INDICATORS, WE DEVELOPED AN IMPLEMENTATION STRATEGY THAT WE CALL A COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) IN WHICH WE OUTLINE ACTIONS AND IDENTIFY RESOURCES TO RESPOND TO THE ASSESSMENT FINDINGS OVER THE NEXT THREE YEARS. TO CREATE THE CHIP, WE ENGAGED WITH OUR HOSPITAL EMPLOYEES, LOCAL COMMUNITIES, AND AREA ORGANIZATIONS TO SHARE THESE FINDINGS AND IDENTIFY POLICY AND SYSTEMS CHANGES THAT WILL IMPROVE OPPORTUNITY LEVELS FOR CHILDREN LIVING IN LOW OPPORTUNITY NEIGHBORHOODS. IN THE 2022 CHIP, ADOPTED BY OUR HOSPITAL BOARD IN NOVEMBER 2022, WE OUTLINE NINE STRATEGIES THAT USE ADVOCACY EFFORTS AND PROGRAMS AND PRACTICE TO IMPROVE OPPORTUNITY FOR CHILDREN LIVING IN WARDS 7 AND 8 IN WASHINGTON, DC AND PRINCE GEORGE'S COUNTY, MARYLAND. AN INTERNAL CHIP STRUCTURE HAS BEEN PUT IN PLACE TO ENSURE THE SUCCESS OF OUR INVESTMENTS IN CHANGING POLICY, IMPROVING PROGRAMS AND ALLOCATING RESOURCES MORE EQUITABLY: WORKGROUPS AND A STEERING COMMITTEE. IN MARCH 2023, WE LAUNCHED WORKGROUPS FOR EACH PRIORITY AREA, COMPRISED OF REPRESENTATIVES FROM ACROSS CHILDREN'S NATIONAL AND RSC THAT PROVIDE SUBJECT MATTER EXPERTISE FOR THE CHIP AND LEAD THE ACTIVITIES ACROSS THE FOUR PRIORITY AREAS. WORKGROUPS ARE LED BY TWO CO-LEADS THAT DRIVE THE AGENDA, MONITOR PROGRESS, AND REPORT TO THE STEERING COMMITTEE. AS PART OF THIS STRUCTURE, THE WORKGROUPS PROVIDE FREQUENT UPDATES TO THE CHIP STEERING COMMITTEE WHICH IS COMPRISED OF REPRESENTATIVES FROM ACROSS CHILDREN'S NATIONAL AND RSC THAT PROVIDE STRATEGIC DIRECTION FOR THE CHIP AND CHAMPIONS ITS WORK. BELOW ARE THE CHIP STRATEGIES ALONG WITH PROGRESS FOR FY 2024. 1. EARLY CHILDHOOD EDUCATION GOAL: BUILD A STRONGER EARLY CHILDHOOD EDUCATION COMMUNITYADVOCACY: ADVOCATE FOR HIGH QUALITY, AFFORDABLE ECE CENTERS WITH WELL COMPENSATED STAFFPROGRAMS AND PRACTICE: STRENGTHEN CONNECTIONS BETWEEN ECE AND HOSPITALS ABOUT THE REFERRAL PROCESS (E.G., WHAT'S AVAILABLE, HOW TO ENROLL, REQUIREMENTS FOR VOUCHERS, HELPING FAMILIES WHO HAVE CHILDREN WITH DISABILITIES, MATERIALS IN MULTIPLE LANGUAGES, ETC.)2. HEALTHY FOOD GOAL: INCREASE ACCESS TO HEALTHY FOOD OPTIONSADVOCACY: ADVOCATE FOR FUNDING AND IMPROVED ACCESS TO HEALTHY FOOD OPTIONS IN THE COMMUNITYPROGRAMS AND PRACTICE: INCREASE ACCESS TO HEALTHY FOOD OPTIONS WITHIN THE HOSPITAL AND COMMUNITY THROUGH THE HOSPITAL CAFETERIA, FOOD PHARMACIES, FARMERS MARKETS AND OTHER INITIATIVES EXPAND FOOD INSECURITY SCREENINGS TO DETERMINE ELIGIBILITY FOR ENROLLMENT IN FOOD ACCESS PROGRAMS 3. HEALTH INSURANCE COVERAGE GOAL: IMPROVE ACCESS TO HEALTH CARE AND HEALTH INSURANCE COVERAGEADVOCACY: ADVOCATE FOR HIGH QUALITY AND EASILY ACCESSIBLE MENTAL HEALTH SERVICE CONTINUUM INCLUSIVE OF SUSTAINABLE PROMOTION, PREVENTION, EARLY INTERVENTION, TREATMENT, CRISIS AND RECOVERY SERVICES COVERED BY INSURANCEPROGRAMS AND PRACTICE: IMPROVE CARE COORDINATION WITHIN THE HOSPITAL AND WITH INSURANCE PROVIDERS AND COMMUNITY ORGANIZATIONS.4. EMPLOYMENT RATEGOAL: STRENGTHEN EMPLOYMENT OPPORTUNITIESPROGRAMS AND PRACTICE: SUSTAIN AND EXPAND HOSPITAL RESEARCH YOUTH ENGAGEMENT PROGRAMS AND JOB OPPORTUNITIES (INTERNSHIPS, TRAININGS, AND RESEARCH OPPORTUNITIES)CREATE JOB OPPORTUNITIES FOR PEOPLE WITH DISABILITIES, INCLUDING PARTNERING WITH ORGANIZATIONS TO PROVIDE SKILL-BASED TRAINING. FY 2024 PROGRESS: - CONDUCTED LANDSCAPE ANALYSES AND STAKEHOLDER MAPPING TO LEARN ABOUT PROGRAMS AND ACTIVITIES RELATED TO THEIR SPECIFIC PRIORITY AREAS, WHERE WE HAVE PARTNERSHIPS, AND POTENTIAL PARTNERS. - TESTIFIED OR SUBMITTED WRITTEN COMMENTS ON BILLS IN MARYLAND AND D.C., INCLUDING BUT NOT LIMITED TO, REQUIRING ECE PROGRAMS IN CERTAIN HIGH SCHOOLS AND THE UNIVERSAL FREE SCHOOL MEALS AMENDMENT.- HOSTED A VIRTUAL COMMUNITY CONVERSATION EVENT FOCUSED ON OPEN DIALOGUE AND DISCUSSION AROUND BARRIERS TO, AND RESOURCES FOR, THE INCLUSION OF CHILDREN WITH DEVELOPMENTAL DISABILITIES IN ECE PROGRAMS. THE PROGRAM WAS OPEN TO THE COMMUNITY WITH 50 PARENTS & ECE PROVIDERS ATTENDING THE EVENT. - PARTICIPATED IN CAREER DAYS AND COMMUNITY EVENTS AT ECE CENTERS AND SCHOOLS TO PROVIDE RESOURCES RELATED TO THE CHIP PRIORITIES.- DISTRIBUTED 1,500 HEALTH INSURANCE POSTCARDS TO WIC OFFICES, WITHIN FOOD PHARMACY BAGS AND COMMUNITY EVENTS TO SHARE INFORMATION ON MEDICAID RE-ENROLLMENT. - SHARED HEALTHY FOOD RESOURCES AT COMMUNITY EVENTS. COLLABORATED WITH D.C. HUNGER SOLUTIONS TO HOST A SUMMER FOOD PROGRAM KICKOFF EVENT AT ELEMENTARY SCHOOL LOCATED IN WARD 7 IN THE DISTRICT OF COLUMBIA WITH OVER 100 ATTENDEES.
CHILDREN'S HOSPITAL	PART V, LINE 16A, FAP WEBSITE:WWW.CHILDRENSNATIONAL.ORG/PLAN-YOUR-VISIT/INSURANCE-AND-BILLING/FINANCIAL-ASSISTANCECHILDREN'S HOSPITALPART V, LINE 16B, FAP APPLICATION WEBSITE:WWW.CHILDRENSNATIONAL.ORG/PLAN-YOUR-VISIT/INSURANCE-AND-BILLING/FINANCIAL-ASSISTANCECHILDREN'S HOSPITALPART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:WWW.CHILDRENSNATIONAL.ORG/PLAN-YOUR-VISIT/INSURANCE-AND-BILLING/FINANCIAL-ASSISTANCE

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?22
Name and address		Type of Facility (describe)
1	1 - CHILDREN'S NAT'L AMBU SURGERY CTR 9850 KEY WEST AVENUE ROCKVILLE,MD20850	REGIONAL OUTPATIENT CENTER
2	2 - CHILDREN'S OUTPATIENT CTR FREDERICK 5285 WESTVIEW DRIVE SUITE 103 FREDERICK,MD21703	REGIONAL OUTPATIENT CENTER
3	3 - MOBILE VAN - DENTAL N/A NA,DC20010	MOBILE HEALTH CARE
4	4 - CHILDREN'S HEALTH CENTER AT THEARC 1801 MISSISSIPPI AVE SE WASHINGTON,DC20020	HEALTH CENTERS
5	5 - CHILDREN'S OUTPATIENT CTR MONTGOMERY 15245 SHADY GROVE ROAD SUITE 350 ROCKVILLE,MD20850	REGIONAL OUTPATIENT CENTER
6	6 - CHILDREN'S OUTPATIENT FREDRICKSBURG 1300 HOSPITAL DRIVE SUITE 201 FREDRICKSBURG,VA22401	REGIONAL OUTPATIENT CENTER
7	7 - CHILDREN'S NATIONAL IMAGING CENTER 9850 KEY WEST AVENUE SUITE 110 ROCKVILLE,MD20850	REGOINAL OUTPATIENT CENTER
8	8 - CHILDREN'S NATIONAL PULMONARY MED - R 9711 MEDICAL CENTER DRIVE SUITE 212 ROCKVILLE,MD20850	HEALTH CENTERS
9	9 - CHILDREN'S OUTPATIENT CTR HOWARD CITY 7625 MAPLE LAWN BLVD SUITE 230 FULTON,MD20759	REGIONAL OUTPATIENT CENTER
10	10 - FIGHT FOR CHILDREN SPORTS MED CTR 1 INVENTA PLACE SUITE 150 SILVER SPRING,MD20910	HEALTH CENTERS
11	11 - CHILDREN'S HEALTH CTR AT SHAW METRO 641 S STREET NW WASHINGTON,DC20001	HEALTH CENTERS
12	12 - CHILDREN'S HEALTH CTR AT WALTER REED 7125 13TH PLACE NW WASHINGTON,DC20012	HEALTH CENTERS
13	13 - CHILDREN'S OUTPATIENT CTR OF MONTGOMERY SHADY GROVE MEDICAL PARK ROCKVILLE,MD20850	REGIONAL OUTPATIENT CENTER
14	14 - CHILDREN'S OUTPATIENT CTR OF NORTHERN VA 3023 HAMACKER COURT SUITE 300 FAIRFAX,VA22031	REGIONAL OUTPATIENT CENTER
15	15 - CHILDREN'S HEALTH CTR AT TAKOMA THEATRE 6833 4TH STREET NW WASHINGTON,DC20012	HEALTH CENTERS
16	16 - CHILDREN'S HEALTH CTR AT COLUMBIA HEI 3336 14TH STREET NW WASHINGTON,DC20010	HEALTH CENTERS
17	17 - CHILDREN'S HEALTH CENTER AT ANACOSTIA 2101 MARTIN LUTHER KING JR AVENUE SE WASHINGTON,DC20020	HEALTH CENTERS
18	18 - CHILDREN'S OUTPATIENT CTR PRINCE GEOR 2900 CAMPUS WAY NORTH LANHAM,MD20706	REGIONAL OUTPATIENT CENTER
19	19 - MOBILE VAN - HEALTH CARE N/A NA,DC20010	MOBILE HEALTH CARE
20	20 - CHILDREN'S OUTPATIENT CTR OF ANNAPOLIS 1730 WEST STREET SUITE 100 ANNAPOLIS,MD21401	REGIONAL OUTPATIENT CENTER
21	21 - CHILDREN'S NATIONAL EMERG DEPT UNIT 1310 SOUTHERN AVENUE SE WASHINGTON,DC20032	ED FACILITY
22	22 - CHILDREN'S OUTPATIENT CTR OF FRIENDSHIP 5028 WISCONSIN AVE SUITES 250 310 WASHINGTON,DC20016	REGIONAL OUTPATIENT CENTER

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

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

Form and Line Reference	Explanation
PART I, LINE 3C:	ELIGIBILITY FOR CHARITY CARE PROGRAMCHILDREN'S NATIONAL USED THE FEDERAL POVERTY GUIDELINES, MEDICAL INDIGENCE, INSURANCE STATUS, AND RESIDENCY TO DETERMINE ELIGIBILITY FOR ITS CHARITY CARE PROGRAM. ELIGIBILITY WAS INCOME BASED AND NOT ASSET BASED.
PART I, LINE 6A:	CHILDREN'S NATIONAL MEDICAL CENTER ANNUAL REPORTCHILDREN'S NATIONAL HOSPITAL PREPARES AN ANNUAL COMMUNITY BENEFIT REPORT. THE REPORT IS POSTED ON THE HOSPITAL WEBSITE, AND HARD COPIES ARE MADE AVAILABLE AND DISTRIBUTED TO THE HOSPITAL'S KEY INTERNAL AND EXTERNAL STAKEHOLDERS. AS PART OF OUR COMMITMENT TO THE COMMUNITY, BELOW ARE SOME OF THE PROGRAMS AND ACTIVITIES THAT WERE CONDUCTED IN FY 2024. SAFE CONCUSSION OUTCOME RECOVERY & EDUCATION (SCORE) PROGRAMTHE SAFE CONCUSSION OUTCOME RECOVERY & EDUCATION (SCORE) PROGRAM IS A COMPREHENSIVE CLINICAL, RESEARCH AND EDUCATIONAL PROGRAM TO EVALUATE AND MANAGE THE CARE OF CHILDREN AND ADOLESCENTS WITH CONCUSSIONS (ALSO KNOWN AS MILD TRAUMATIC BRAIN INJURY OR MTBI). THE PROGRAM CONSULTS WITH HEALTHCARE PROVIDERS REGIONALLY AND NATIONALLY, AS WELL AS SCHOLASTIC AND YOUTH RECREATIONAL SPORTS PROGRAMS IN WHICH CHILDREN ARE VULNERABLE TO INJURY. CLINICIANS IN THE SCORE PROGRAM HAVE SPECIFIC EXPERTISE IN MANAGING ACADEMIC NEEDS AND WORK WITH SCHOOLS TO ASSURE A SAFE AND EFFECTIVE RETURN TO SCHOOL.THE SCORE PROGRAM HAS FOUR GOALS: - PROVIDE THE HIGHEST LEVEL OF SERVICE TO CHILDREN, ADOLESCENTS AND YOUNG ADULTS WITH CONCUSSIONS/MILD TBI - INCREASE RESEARCH-BASED KNOWLEDGE, SKILLS AND INSTRUMENTATION USED IN EVALUATION AND TREATMENT OF CONCUSSIONS/MILD TBI - DEVELOP THE NEXT GENERATION OF HIGHLY QUALIFIED PROFESSIONALS TO TREAT CHILDREN AND ADOLESCENTS WITH CONCUSSIONS/MILD TBI - IMPROVE THE GENERAL KNOWLEDGE AND SKILL OF PEOPLE IN THE MEDICAL, EDUCATIONAL AND ATHLETIC COMMUNITY REGARDING THE SPECIFIC TREATMENT/NEEDS OF INDIVIDUALS WITH CONCUSSIONS/MILD TBIIN FY 2024, SCORE PROGRAM STAFF EDUCATED LOCAL PEDIATRICIANS AND SCHOOL PERSONNEL INCLUDING SCHOOL NURSES AND TEACHERS ON CURRENT CONCUSSION MANAGEMENT STRATEGIES AND RECREATIONAL BASKETBALL COACHES IN MONTGOMERY COUNTY, MD ON CONCUSSION RECOGNITION AND RESPONSE. OVER 1300 PEOPLE PARTICIPATED IN THE EDUCATIONAL OFFERINGS. THE SCORE PROGRAM STAFF PROVIDES EDUCATIONAL EVENTS NOT ONLY FOR THE LOCAL COMMUNITY, BUT ALSO NATIONALLY AND INTERNATIONALLY. ADDITIONALLY, THE SCORE PROGRAM CREATED THE SCORE4 BRAIN HEALTH APP, TO PROVIDE IMMEDIATE AND FREE ACCESS TO A CONCUSSION RECOGNITION AND RESPONSE TOOL, WITH SYMPTOM ASSESSMENT AND TRACKING FEATURES, INITIAL RESPONSE AND SCREENING FOR URGENT MEDICAL NEEDS, AND EDUCATIONALLY BASED VIDEOS AND TIP SHEETS FOR MANAGING SYMPTOMS AND FACILITATING RECOVERY. NURSING STUDENTS CHILDREN'S NATIONAL IS COMMITTED TO EDUCATING THE NEXT GENERATION OF HEALTH CARE PROFESSIONALS INCLUDING NURSES. NURSING IS THE LARGEST HEALTHCARE PROFESSION IN THE COUNTRY, WITH MORE THAN 4 MILLION REGISTERED NURSES, LICENSED PRACTICAL/VOCATIONAL NURSES AND ADVANCED PRACTICE REGISTERED NURSES IN 2023 (PER AN ANALYSIS RELEASED IN NOVEMBER 2024 BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION). EVEN WITH THESE NUMBERS, CONCERNS ABOUT SHORTAGES CONTINUE. THROUGH SEVERAL PROGRAMS, OUR DIVISION OF NURSING PROVIDES OPPORTUNITIES FOR STUDENTS FROM ACROSS THE UNITED STATES. STUDENTS EXPERIENCE THE DISTINCTIVE ASPECTS OF PEDIATRIC NURSING AND IMMERSE THEMSELVES IN A CULTURE OF EXCELLENCE AND SAFETY, ALL WHILE BENEFITING FROM MENTORSHIP. IN FY 2024, MORE THAN 700 NURSING STUDENTS ROTATED WITHIN OUR SYSTEM. ADDITIONALLY, WE OFFER THE LAUNCH AND CONWAY NURSING PATHWAY PROGRAM. LAUNCH PROVIDES SUMMER AND WINTER INTERNSHIPS FOR NURSING STUDENTS FROM ACROSS THE COUNTRY INTERESTED IN PEDIATRIC NURSING. NOT ONLY ARE THEY EXPOSED TO THE CLINICAL SETTING BUT ALSO EDUCATED THROUGH A LECTURE SERIES ON SOCIAL DRIVERS OF HEALTH AND HEALTH EQUITY. LAUNCH STUDENTS PRESENT AT THE END OF THEIR SESSIONS TO HIGHLIGHT WHAT THEY'VE LEARNED. THE CONWAY NURSING PATHWAY PROGRAM IDENTIFIES STUDENTS FACING FINANCIAL HARDSHIPS AND OTHER CHALLENGES THAT WOULD PREVENT THEM FROM STARTING A CAREER IN PEDIATRIC NURSING AND PROVIDES THEM WITH SUPPORTS. IN ADDITION TO SCHOLARSHIPS AND FINANCIAL SUPPORT, THE NURSES CULTIVATE MENTORSHIP RELATIONSHIPS WITH PRACTICING PEDIATRIC NURSES. THE MENTORSHIP BEGINS AS THEY ENTER THE PROGRAM AND THROUGHOUT THEIR FIRST YEAR AS A PRACTICING NURSE. A LITTLE OVER 100 STUDENTS PARTICIPATED IN THESE PROGRAMS IN FY 2024. FOOD INSECURITYCHILDREN'S NATIONAL HOSPITAL IS COMMITTED TO HELPING ADDRESS THE SOCIAL DRIVERS OF HEALTH THAT AFFECT CHILDREN AND FAMILIES IN OUR COMMUNITY. SOCIAL DRIVERS OF HEALTH (SDOH) ARE NONMEDICAL FACTORS THAT INFLUENCE HEALTH OUTCOMES. ACCESS TO NUTRITIOUS FOOD IS A CRITICAL SOCIAL DRIVER OF HEALTH. ONE IN TEN CHILDREN ACROSS OUR REGION EXPERIENCE FOOD INSECURITY. THROUGH A PARTNERSHIP WITH OUR LOCAL FOOD BANK, WE LEAD A FOOD PHARMACY PROGRAM WITHIN OUR DIABETES AND ENDOCRINOLOGY CLINIC. PATIENTS WITH PREDIABETES AND DIABETES THAT SCREEN POSITIVE FOR FOOD INSECURITY ARE PROVIDED WITH PRODUCE AND SHELF-STABLE FOOD FOR THEIR FAMILY. FAMILIES ARE ALSO PROVIDED WITH INFORMATION ON WHERE TO FIND ADDITIONAL SUPPORT AS WELL AS RECIPE CARDS AND NUTRITION EDUCATION MATERIALS. THE PROGRAM SERVICES OVER 200 UNIQUE FAMILIES EACH MONTH AND HAS RECEIVED OVERWHELMINGLY POSITIVE FEEDBACK FROM PARTICIPANTS. PATIENTS AND FAMILIES HAVE GIVEN INCREASINGLY POSITIVE FEEDBACK WHILE RECEIVING MEDICALLY TAILORED GROCERIES, ESPECIALLY WITH THE GROWING VARIETY OF FOODS PROVIDED INCLUDING FRESH EGGS. THE FOOD PHARMACY PROGRAM HAS INSPIRED A SECOND LOCATION IN A PRIMARY CARE CLINIC IN COLUMBIA HEIGHTS, DC, ALSO IN COLLABORATION WITH OUR LOCAL FOOD BANK, PROVIDING SHELF STABLE FOODS TO ANY WHO SCREEN POSITIVE FOR FOOD INSECURITY. PEDIATRIC MENTAL HEALTH RECENT NATIONAL SURVEYS OF CHILDREN HAVE SHOWN INCREASES IN THE PREVALENCE OF MENTAL HEALTH CHALLENGES. IN 2021, U.S. SURGEON GENERAL DR. VIVEK MURTHY ISSUED AN ADVISORY DETAILING AN URGENT YOUTH MENTAL HEALTH CRISIS. THE LEADING CHILD HEALTH ASSOCIATIONS ALSO DECLARED A YOUTH MENTAL HEALTH CRISIS IN OCTOBER 2021. MENTAL HEALTH IS SHAPED BY MANY FACTORS INCLUDING BIOLOGICAL AND ENVIRONMENTAL FACTORS SUCH AS LIFE EXPERIENCES. AS YOUNG PEOPLE DEAL WITH MENTAL HEALTH CHALLENGES, ACCESS TO PEDIATRIC MENTAL HEALTH CARE IS A CHALLENGE OF NATIONAL SCALE. MENTAL HEALTH REMAINS A PRIORITY FOR CHILDREN'S NATIONAL WITH STAFF WORKING TO EMPOWER PRIMARY CARE PROVIDERS WITH TRAINING, ADVOCATE FOR EQUITABLE MENTAL HEALTH SERVICES THROUGH POLICY AND ADVOCACY EFFORTS AT LOCAL, NATIONAL AND FEDERAL LEVELS, AND EDUCATION OF COMMUNITY RESIDENTS THROUGH PARENT CAFS WHICH ARE DESIGNED TO ADDRESS STIGMAS AROUND MENTAL HEALTH AND BEHAVIORAL HEALTH CHALLENGES WITHIN FAMILIES. IN COLLABORATION WITH CAREFIRST BLUECROSS BLUESHIELD (CAREFIRST), WE CONVENED A 1-DAY PEDIATRIC MENTAL HEALTH SUMMIT OF COMMUNITY LEADERS, PROVIDERS, ELECTED OFFICIALS, AND OTHER STAKEHOLDERS TO DISCUSS CHILDREN'S MENTAL HEALTH IN THE CAPITOL REGION. THE GOAL OF THE SUMMIT WAS TO INCREASE AWARENESS AND UNDERSTANDING OF THE YOUTH MENTAL HEALTH CRISIS, OPPORTUNITIES AND CHALLENGES TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES AND IDENTIFY POTENTIAL CHANGES IN POLICY AND PROGRAMMATIC EFFORTS RELATED TO YOUTH MENTAL HEALTH. THE SUMMIT INCLUDED PANEL DISCUSSIONS WITH FEDERAL OFFICIALS REGARDING POLICIES AND OPPORTUNITIES, LEADERS OF NATIONAL ORGANIZATIONS WHO ORIGINALLY DECLARED THE CHILDREN'S MENTAL HEALTH CRISIS, AND LOCAL AND REGIONAL PROGRAMS WORKING TO IMPROVE ACCESS TO MENTAL HEALTH SERVICES. OVER TWO HUNDRED ATTENDEES PARTICIPATED IN THE SUMMIT. BUILDING ON THE SUCCESS OF THE SUMMIT, STAFF ARE NOW CURRENTLY PRODUCING WEBINARS IN COLLABORATION WITH CAREFIRST, FOR COMMUNITY RESIDENTS TO EDUCATE AND BRING AWARENESS OF MENTAL HEALTH CHALLENGES FACED BY YOUTH.
PART I, LINE 7A:	CHARITY AT COSTHOSPITAL AND PHYSICIAN CHARITY AMOUNTS REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS.PART I, LINE 7B:MEDICAIDHOSPITAL AND PHYSICIAN GROSS PATIENT REVENUE AND PAYMENT FROM FINANCIAL DECISION SUPPORT SYSTEMS WERE ADJUSTED TO COST USING THE COST TO CHARGES RATIO PER THE IRS INSTRUCTIONS. MEDICAID GRADUATE MEDICAL EDUCATION (GME) ADD-ON PAYMENTS WERE EXCLUDED AS THEY ARE REPORTED ON THE HEALTH EDUCATION LINE. CHILDREN'S NATIONAL GME INDIRECT MEDICAL EDUCATION (IME) PAYMENTS WERE INCLUDED AS PER 990 INSTRUCTIONS.PART I, LINE 7F:HEALTH EDUCATIONTHE HEALTH EDUCATION COST INCLUDES THE TOTAL COST OF INTERNS AND RESIDENTS FROM THE FY24 SUBMITTED MEDICARE COST REPORT. EDUCATION PAYMENTS AND RESIDENT FUNDING AMOUNTS OFFSET THE REPORTED EXPENSE. DC MEDICAID GME PAYMENTS WERE CALCULATED AND DEDUCTED FROM TOTAL MEDICAID PAYMENTS TO BE REPORTED ON THE LINE FOR HEALTH EDUCATION (PART I, LINE 7B).PART I, LINE 7G:SUBSIDIZED HEALTH SERVICESTHE HOSPITAL AND PHYSICIAN COMBINED SERVICE LINES FOR PROGRAMS IN UNDERSERVED AREAS WITH LOSSES WERE REPORTED AS SUBSIDIZED HEALTH SERVICES. TOTAL CHARGES WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO BASED ON THE IRS INSTRUCTIONS. THE CLAIMS PAYMENTS WERE NETTED AGAINST THE COST.COSTS ATTRIBUTABLE TO A PHYSICAL CLINIC:SUBSIDIZED HEALTH SERVICES ARE CLINICAL PROGRAMS THAT ARE PROVIDED DESPITE A LOSS SO SIGNIFICANT THAT NEGATIVE MARGINS REMAIN AFTER REMOVING THE EFFECTS OF CHARITY CARE, BAD DEBT AND MEDICAID SHORTFALLS. THE SERVICES ARE PROVIDED DESPITE THE FINANCIAL LOSS TO MEET THE IDENTIFIED AND UNMET NEEDS OF THE COMMUNITY. IF THE SERVICES WERE NOT PROVIDED, THEY WOULD NOT BE AVAILABLE TO THE AREA OR WOULD RESULT IN THE GOVERNMENT OR ANOTHER NOT-FOR-PROFIT ORGANIZATION PROVIDING THE SERVICES. THE SUBSIDIZED HEALTH SERVICES AMOUNT IN PART I, LINE 7G INCLUDES $3,373,304 WHICH IS ATTRIBUTED TO THE PRIMARY CLINICAL SERVICES PROVIDED VIA CHILDREN'S NATIONAL HOSPITAL. CHILDREN'S HEALTH CENTERS PROVIDE PROGRAMS AND INITIATIVES INCLUDING COMPREHENSIVE AND HIGH-QUALITY PREVENTIVE SERVICES, IMPROVEMENT OF IMMUNIZATION RATES, AND COORDINATION OF CARE FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS. THE AMOUNT INCLUDES SALARY, FRINGE, DIRECT, AND INDIRECT COSTS EXPENDED TO PROVIDE THE CLINICAL SERVICES. OUR CHILDREN'S HEALTH CENTERS ARE ESTABLISHING BEST PRACTICES IN COMMUNITY HEALTH.PART I, LINES 7 E - F:OTHER BENEFITSIN CALCULATING THE AMOUNTS REPORTED IN THE TABLE IN PART I RELATING TO OTHER BENEFITS (E - I), WE USE AN ACCOUNTABILITY AND ELIGIBILITY SYSTEM BASED ON THE COMMUNITY BENEFIT DEFINITION AND GUIDELINES FOR DETERMINING WHERE PROGRAMS FIT INTO EACH COMMUNITY BENEFIT CATEGORY. TIME SPENT ON PROGRAMS/ACTIVITIES AND PROGRAM FUNDING IS PROVIDED BY PROGRAM STAFF. AVERAGE SALARY RATES ARE USED TO CALCULATE SALARY EXPENSES AND A FRINGE RATE IS ATTACHED AS NECESSARY. THE COMMUNITY BENEFIT STAFF ANALYZES THE FINANCIALS SUBMITTED TO ENSURE CONSISTENCY IN REPORTING AND CONFIRM WITH PROGRAM STAFF THE ACCURACY OF THE FINANCIALS. THE COMMUNITY BENEFIT STAFF ALSO WORKS WITH THE ACCOUNTING & FINANCE DEPARTMENT TO VERIFY THE ACCURACY OF SUBMITTED FINANCIALS. PART I, LINE 7, COL (F):BAD DEBT EXPENSESCHILDREN'S NATIONAL MEDICAL CENTER DOES NOT INCLUDE ITS BAD DEBT EXPENSE ($33,790,028) REPORTED ON FORM 990, PART IX, LINE 25 FOR PURPOSES OF ITS COMMUNITY BENEFIT CALCULATION HERE.
SCHEDULE H, PART II:	COMMUNITY BUILDING ACTIVITIESPART II INCLUDES THE COST INCURRED FOR ACTIVITIES AND PROGRAMS TO PROTECT OR IMPROVE THE COMMUNITY'S HEALTH OR SAFETY. PROGRAMS ACCOUNTED FOR AS COMMUNITY BUILDING ACTIVITIES FALL INTO THE SUBCATEGORIES OF COMMUNITY HEALTH IMPROVEMENT ADVOCACY, COMMUNITY SUPPORT AND WORKFORCE DEVELOPMENT. COMMUNITY HEALTH IMPROVEMENT ADVOCACY: IN FY 2024, HOSPITAL STAFF SERVED AS A VOICE FOR CHILDREN AT THE LOCAL, STATE AND FEDERAL LEVELS BY BRINGING ATTENTION TO AND RALLYING SUPPORT FOR PUBLIC POLICIES AND SYSTEM CHANGES THAT PROTECT THE INTEREST OF CHILDREN'S HEALTH, AIM TO ELIMINATE HEALTH DISPARITIES, AND SUPPORT MEDICAL AND RESEARCH INNOVATION. ECONOMIC DEVELOPMENT: CHILDREN'S NATIONAL LEADERSHIP PARTICIPATES IN BOARDS AND ORGANIZATIONS THAT FOCUS ON THE ECONOMIC DEVELOPMENT OF OUR LOCAL COMMUNITY. STAFF PARTICIPATE IN DISCUSSIONS AROUND WAYS TO STRENGTHEN TIES AMONG THE DIVERSE AND GROWING BUSINESS COMMUNITY, IMPROVE THE BUSINESS CLIMATE AND ENHANCE THE REGION'S ECONOMIC COMPETITIVENESS.COMMUNITY SUPPORT: CHILDREN'S NATIONAL STAFF WORK WITH LOCAL GOVERNMENT AND HEALTHCARE PARTNERS FOCUSED ON EMERGENCY PREPAREDNESS AND RESPONSE AND BRINGS THE PEDIATRIC HOSPITAL PERSPECTIVE. STAFF PARTICIPATE IN MEETINGS WITH CITY-WIDE PUBLIC HEALTH LEADERS, WHERE UPDATES ON CURRENT ISSUES IMPACTING THE HEALTH AND SAFETY OF DC RESIDENTS ARE DISCUSSED AND PARTICIPATE IN CITYWIDE AND REGIONAL DRILLS. WORKFORCE DEVELOPMENT: CHILDREN'S NATIONAL IS DEDICATED TO ENGAGING IN AND PROVIDING OPPORTUNITIES FOR LEARNING AND DEVELOPMENT FOR SCHOOL-AGED CHILDREN AND ADULTS. WE WORK WITH LOCAL ORGANIZATIONS, COLLEGES AND UNIVERSITIES TO PROVIDE LEARNING OPPORTUNITIES FOR STUDENTS INTERESTED IN HEALTH PROFESSIONS. CHILDREN'S NATIONAL OFFERED WORK READINESS WORKSHOPS INCLUDING TIPS ON RESUME WRITING FOR UNIVERSITY STUDENTS. WE ALSO EXPOSE LOCAL STUDENTS FROM A LOCAL NON-PROFIT HORTONS KIDS TO HEALTH PROFESSIONS THROUGH CAREER FAIRS AND OTHER EXPERIENCES. OUR LEADERSHIP ALSO PARTICIPATES IN ASSOCIATIONS AND PROJECTS THAT FOCUS ON MENTORSHIP OPPORTUNITIES FOR RESEARCH AND HEALTHCARE PROFESSIONALS. CHILDREN'S NATIONAL ALSO SUPPORTS THE LEADING THE ADVANCEMENT OF UNDERGRADUATE NURSES AT CHILDREN'S NATIONAL (LAUNCH) AND CONWAY NURSING PATHWAY PROGRAMS WHICH ALLOW UNIVERSITY STUDENTS INTERESTED IN NURSING TO SHADOW PEDIATRIC NURSES DURING A SUMMER INTERNSHIP. THESE STUDENTS WORK CLOSELY WITH A PRECEPTOR AND SUPERVISOR LEARNING THE SKILLS AND TECHNIQUES OF A PEDIATRIC NURSE.
PART III, LINES 2, 3 AND 4:	BAD DEBT EXPENSETHE HOSPITAL AND PHYSICIAN BAD DEBT WRITE-OFF REPORTED IN THE AUDITED FINANCIAL STATEMENTS WERE ADJUSTED TO COST USING THE COST TO CHARGE RATIO CALCULATION PER THE IRS INSTRUCTIONS. DISCOUNTS AND PAYMENTS REDUCE THE PATIENT'S ACCOUNT BALANCE PRIOR TO SENDING THE PATIENT A STATEMENT FOR ANY REMAINING BALANCES DUE TO CHILDREN'S HOSPITAL. FINANCIAL ASSISTANCE ELIGIBLE PATIENTS RECEIVE A 100% DISCOUNT ON THE BALANCE DUE. PAYMENT PLANS ARE ALSO AVAILABLE FOR PATIENT BALANCES DUE. ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER COLLECTION EFFORTS (BILLING STATEMENTS AND PHONE CALLS) ARE UNSUCCESSFUL.BAD DEBT IS NOT INCLUDED IN CHILDREN'S NATIONAL'S COMMUNITY BENEFIT. A DEMOGRAPHIC ANALYSIS BASED ON ZIP CODES WAS COMPLETED TO ESTIMATE THE AMOUNT OF BAD DEBT THAT COULD HAVE BEEN ATTRIBUTED TO PATIENTS WITH A LIKELIHOOD OF QUALIFYING FOR FINANCIAL ASSISTANCE HAD SUFFICIENT INFORMATION BEEN OBTAINED TO DETERMINE THEIR ELIGIBILITY. BASED ON THE ANALYSIS, APPROXIMATELY $1.3M OF BAD DEBT COULD HAVE BEEN ATTRIBUTED TO FINANCIAL ASSISTANCE ELIGIBLE PATIENTS. CHILDREN'S HOSPITAL REPORTS ITS APPLICABLE BAD DEBT ($33.8M) AMOUNT WITHIN THE AUDITED FINANCIAL STATEMENTS. THERE IS NO SPECIFIC FOOTNOTE FOR BAD DEBT IN THE STATEMENTS.
PART III, LINE 8:	COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT ON LINE 6MEDICARE SHORTFALLS ARE NOT INCLUDED AS A COMMUNITY BENEFIT AS ANY SHORTFALL DETERMINATION FROM THE MEDICARE COST REPORT IS EVENTUALLY PAID AS A SETTLEMENT.SCHEDULE H, PART III, LINES 9A AND 9B:COLLECTION PRACTICESCHILDREN'S HOSPITAL HAS A WRITTEN COLLECTION POLICY. THE POLICY IS APPLIED UNIFORMLY TO ALL PATIENTS. CHILDREN'S HOSPITAL IS COMMITTED TO PROVIDING QUALITY HEALTHCARE TO ALL PATIENTS WHILE MAINTAINING RESPONSIBLE AND EFFECTIVE FINANCIAL PROGRAMS WHICH ENSURE THAT THIS COMMITMENT CAN CONTINUE. CHILDREN'S HOSPITAL SUPPORTS FAMILIES IN CARRYING OUT THEIR RESPONSIBILITY FOR OBTAINING MEDICAL CARE FOR THEIR CHILDREN. CHILDREN'S HOSPITAL THEREFORE WILL ASSIST FAMILIES IN VERIFYING THEIR ABILITY TO MEET THEIR FINANCIAL OBLIGATION TO THE HOSPITAL OR IN SECURING THE RESOURCES NECESSARY TO DO SO. THE PURPOSE OF THIS POLICY IS TO ESTABLISH GUIDELINES FOR THE EFFECTIVE AND RESPONSIBLE FISCAL PROGRAMMING, WHICH ASSURES THE FINANCIAL VIABILITY OF THE INSTITUTION AND MAINTAINS THE DIGNITY OF THE FAMILY.COLLECTION EFFORTS ARE THEREFORE THE SAME FOR ALL PATIENTS. ONCE THE APPROVED CHARITY ADJUSTMENT HAS BEEN DETERMINED, THE ACCOUNT BALANCE IS WRITTEN OFF TO CHARITY AND COLLECTION EFFORTS CEASE. FOR PATIENT BALANCES THAT ARE NOT FINANCIAL ASSISTANCE ELIGIBLE, CHILDREN'S OFFERS PAYMENT PLANS. BILLING STATEMENTS WILL BE SENT TO GUARANTORS FOR OUTSTANDING BALANCES. ATTEMPTS TO CONTACT THE GUARANTORS VIA PHONE WILL ALSO OCCUR. ACCOUNTS WITH BALANCES AND NO RESPONSE FROM GUARANTORS AFTER REPEATED STATEMENTS AND PHONE CALLS WILL BE WRITTEN OFF TO BAD DEBT. AN EXTERNAL AGENCY WILL THEN ATTEMPT TO REACH THE PATIENT FOR PAYMENT. IF THE PATIENT SUBSEQUENTLY PAYS, THE BAD DEBT ADJUSTMENT WILL BE REVERSED, AND PAYMENT POSTED TO THE PATIENT'S ACCOUNT. IF THE EXTERNAL AGENCY'S EFFORTS, PROVE TO BE INEFFECTIVE THE ACCOUNT WILL BE CLOSED WITH THE AGENCY AND THEIR EFFORTS WILL CEASE. CHILDREN'S HOSPITAL DOES NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIVITIES, E.G. CREDIT REPORTING, WAGE GARNISHMENTS, LIENS, ETC.
PART VI, LINE 2:	COMMUNITY HEALTH CARE NEEDS ASSESSMENTIN ADDITION TO THE JOINT PEDIATRIC COMMUNITY HEALTH NEEDS ASSESSMENT WITH CHILDREN'S NATIONAL REHABILITATION & SPECIALIZED CARE, CHILDREN'S NATIONAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH OTHER EFFORTS. THE CHILDREN'S NATIONAL ASTHMA PROGRAM, IMPACT DC, ANALYZES ON AN ANNUAL BASIS EMERGENCY DEPARTMENT VISITS AND HOSPITAL ADMISSIONS FOR ASTHMA TO ALL NON-MILITARY HOSPITAL EMERGENCY DEPARTMENTS IN DC. THIS ALLOWS THE HOSPITAL TO TRACK TRENDS OVER TIME AND ACROSS ZIP CODES IN DC. THE HOSPITAL ALSO CONDUCTS STUDIES TO IDENTIFY BARRIERS TO CARE, INTERVENTION PREFERENCES, AND PARENT CONCERNS ABOUT ASTHMA. IN 2018-2019, THE HOSPITAL USED FUNDING FROM NIH TO SPECIFICALLY CONDUCT A COMMUNITY NEEDS ASSESSMENT FOCUSED ON ASTHMA. IMPACT DC PRODUCED REPORTS USING BOTH QUANTITATIVE AND QUALITATIVE METHODS. THE HOSPITAL SUBSEQUENTLY SUBMITTED ANOTHER NIH GRANT TO REFINE AND STUDY AN ASTHMA INTERVENTION THAT IS HIGHLY RESPONSIVE TO THE FINDINGS. MOST RECENTLY, THE ASTHMA PROGRAM LED FOCUS GROUPS WITH FAMILIES TO LEARN HOW HOUSING CONDITIONS IMPACT ASTHMA CARE AND IS WORKING TOGETHER WITH COMMUNITY-BASED ORGANIZATIONS TO ADDRESS SOME OF THE BARRIERS IDENTIFIED THROUGH THE ASSESSMENT. AS PART OF THIS WORK, THE TEAM GATHERED DATA AND MAPPED PROPERTIES MOST FREQUENTLY REPORTED WITH UNHEALTHY HOUSING CONDITIONS AND ASTHMA EXACERBATIONS. USING THE DATA, INTERACTIVE MAPS WERE DEVELOPED. THE MAPS HELP IDENTIFY LARGE-SCALE PROBLEMATIC REGIONS WHERE THERE IS AN INTERSECTION BETWEEN HEALTH AND HOUSING CONDITIONS THAT REQUIRES LARGER-SCALE INTERVENTIONS. SIMILARLY, IN SUMMER 2023, THE EARLY CHILDHOOD INNOVATION NETWORK (ECIN) COLLECTED DATA TO UNDERSTAND THE NEEDS AND WANTS OF DC PARENTS AND CAREGIVERS OF YOUNG CHILDREN, ESPECIALLY IN ECONOMICALLY DISADVANTAGED AREAS. USING THE THOUGHTEXCHANGE PLATFORM, THEY GATHERED INPUT FROM 113 PARTICIPANTS, INCLUDING FAMILY CAREGIVERS AND SERVICE PROVIDERS, FOCUSING ON WARDS 4, 5, 7, AND 8. THE KEY THEMES IDENTIFIED WERE THE NEED FOR SAFE HOUSING, QUALITY EARLY EDUCATION AND CHILDCARE, ACCESSIBLE HEALTHCARE, EMPLOYMENT OPPORTUNITIES, FINANCIAL RESOURCES, SOCIAL SUPPORT, HEALTHY FOOD, RESOURCE NAVIGATION, AND FAIRNESS AND RESPECT. THESE FINDINGS AIM TO GUIDE COMMUNITY ORGANIZATIONS, ADVOCATES, POLICYMAKERS, RESEARCHERS, AND SERVICE PROVIDERS IN IMPROVING EARLY CHILDHOOD SYSTEMS AND FAMILY WELL-BEING.FINALLY, TO SUPPORT CONTINUOUS ASSESSMENT OF THE NEEDS OF OUR COMMUNITY, THE HOSPITAL ESTABLISHED THE CHILD HEALTH DATA LAB OVER TEN YEARS AGO WHERE DATA SCIENTISTS USE EVIDENCE-BASED APPROACHES TO IDENTIFY AND TRACK TRENDS IN POPULATION HEALTH USING BIG DATA ANALYSIS, DEVELOPING INTERACTIVE MAPS, AND COLLECTING COMMUNITY INPUT. THE CHILD HEALTH DATA LAB OVERSEES THE DC HEALTH MATTERS WEB PORTAL THAT PROVIDES A ONE-STOP RESOURCE FOR ONLINE ACCESS TO COMMUNITY HEALTH INDICATORS THAT IMPACT THE HEALTH OF DC COMMUNITIES.
PART VI, LINE 3:	ELIGIBILITY EDUCATIONCHILDREN'S HOSPITAL HAS A FINANCIAL ASSISTANCE POLICY (FAP) THAT PROVIDES ELIGIBLE PATIENTS WITH DISCOUNTED EMERGENCY OR OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES PROVIDED BY CHILDREN'S HOSPITAL. CHILDREN'S WILL PROVIDE, WITHOUT DISCRIMINATION, CARE FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE ELIGIBLE FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL PROHIBITS ANY ACTIONS THAT WOULD DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE. FINANCIAL ASSISTANCE INFORMATION, INCLUDING THE POLICY AND PLAIN LANGUAGE GUIDES, AND APPLICATION FORM, IS AVAILABLE ON CHILDREN'S PUBLIC WEBSITE. FINANCIAL ASSISTANCE COUNSELORS ARE AVAILABLE IN PERSON AND VIA PHONE. THE COUNSELORS CONTACT INFORMATION IS PUBLICIZED ON THE WEBSITE. CUSTOMER SERVICE CONTACT INFORMATION IS ALSO PROVIDED ON THE WEBSITE AS WELL AS BILLING STATEMENTS. SIGNAGE ALERTING PATIENTS TO THE AVAILABILITY OF FINANCIAL AID IS POSTED AT REGISTRATION AREAS AND APPLICATIONS ARE READILY AVAILABLE. CHILDREN'S ALSO WORKS WITH EXTERNAL VENDORS WHO ASSIST PATIENTS WITH THE FINANCIAL ASSISTANCE APPLICATION AS WELL AS APPLYING FOR STATE MEDICAID AND OTHER FEDERAL AND LOCAL PROGRAMS.THE FOLLOWING PROCESSES TAKE PLACE FOR FAMILIES WHO DO NOT HAVE INSURANCE OR WHO CANNOT PAY:1. THROUGH OUR CONTRACTED COMPANIES (MEDLAW AND ELEVATE) WHO RESIDE IN OUR FINANCIAL INFORMATION CENTER (FIC), AN APPLICATION IS MADE FOR MEDICAL ASSISTANCE AND OUR FINANCIAL ASSISTANCE PROGRAM (FAP). ELIGIBILITY IS CONSIDERED FOR ALL APPROPRIATE PUBLIC PROGRAMS. IN AN EFFORT TO HAVE THIS PROCESS TAKE PLACE PRIOR TO THE MEDICAL VISIT, FAP APPLICATIONS ARE MAILED TO SELF-PAY PATIENTS WHEN THEY MAKE AN APPOINTMENT.2. WHILE THE APPLICATION IS IN PROCESS, THE PATIENT IS REGISTERED AS MEDICAID PENDING AND THE MEDICAL VISIT TAKES PLACE (CITIZENS ONLY). NON-CITIZENS ARE REGISTERED AS SELF-PAY.3. IF THE PATIENT IS DETERMINED TO BE MEDICAID ELIGIBLE, THE PATIENT REGISTRATION IS CONVERTED TO THE MEDICAID PLAN.4. IF NOT ELIGIBLE, THE PATIENT'S CHARITY CARE APPLICATION IS FURTHER EVALUATED FOR CHARITY CARE BY CHILDREN'S CUSTOMER SERVICE STAFF IN THE FIC.5. IF FAP IS APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. THE ACCOUNTS ARE MANAGED BY CUSTOMER SERVICE STAFF. ONLY EXPECTED BALANCES REMAIN ON THE ACCOUNT AND FAMILIES RECEIVE STATEMENTS SHOWING THEIR RESPONSIBILITY.6. IF FAP IS NOT APPROVED, THE FAMILY IS NOTIFIED OF THEIR STATUS AND RESPONSIBILITY. FAMILIES CAN SET UP PAYMENT PLANS TO RESOLVE THEIR ACCOUNT BALANCES.7. MEDICALLY INDIGENT STATUS CAN APPLY FOR INSURED FAMILIES. THIS STATUS CAN BE EVALUATED AT ANY TIME IF A FAMILY'S REMAINING BALANCE (EXCLUDING ANY DEDUCTIBLES) AFTER THIRD PARTY PAYER PAYMENT IS GREATER THAN 30% OF ANNUAL INCOME LESS HOUSING EXPENSES.- WHENEVER APPLICABLE, IT IS ENCOURAGED THAT FAMILIES REVIEW THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE THE APPOINTMENT DATE. APPOINTMENTS ARE TYPICALLY MADE WITH THE FIC OFFICE WHEN FAMILIES MAKE THEIR MEDICAL APPOINTMENTS. THEY CAN GO DIRECTLY TO THE FIC OFFICE AT CHILDREN'S HOSPITAL AT ANY OTHER TIME. FAMILIES ARE ENCOURAGED TO COOPERATE WITH OUR STAFF BY SUPPLYING ALL NECESSARY INFORMATION FOR THE MEDICAID AND FAP APPLICATIONS.
PART VI, LINE 4:	DESCRIPTION OF COMMUNITY SERVEDAS THE ONLY EXCLUSIVE PROVIDER OF PEDIATRIC CARE IN THE NATION'S CAPITAL, CHILDREN'S NATIONAL SERVES A DIVERSE AND BROAD COMMUNITY, SPANNING FROM THE DISTRICT OF COLUMBIA TO MARYLAND AND VIRGINIA AND BEYOND. THE U.S. CENSUS ESTIMATES THE 2024 POPULATION OF THE DISTRICT OF COLUMBIA TO BE 702,250 RESIDENTS. THE POPULATION GREW BY 23,278 PEOPLE FROM JULY 1, 2023, TO JULY 1, 2024, WHICH IS ATTRIBUTED TO THE DISTRICT HAVING 2,761 MORE BIRTHS THAN DEATHS AND POSITIVE NET MIGRATION OF 12,165 MORE PEOPLE MOVING INTO THE DISTRICT THAN MOVING OUT DURING THIS PERIOD. MARYLAND AND VIRGINIA ARE HOME TO 6.3 MILLION AND 8.8 MILLION RESIDENTS, RESPECTIVELY. THE SOCIAL DEMOGRAPHICS FOR THE DISTRICT OF COLUMBIA, MARYLAND, AND VIRGINIA, ACCORDING TO THE U.S. CENSUS, ARE AS FOLLOWS: DISTRICT OF COLUMBIA: ABOUT 44.4% BLACK OR AFRICAN AMERICAN; 46.6% WHITE; 4.9% ASIAN; 12.0% HISPANIC OR LATINO; 0.7% AMERICAN INDIAN OR ALASKA NATIVE; 3.3% TWO OR MORE RACES; MARYLAND: APPROXIMATELY 31.6% BLACK OR AFRICAN AMERICAN; 57.2% WHITE; 7.1% ASIAN; 12.6% HISPANIC OR LATINO; VIRGINIA: 20.0% BLACK OR AFRICAN AMERICAN; 68.3% WHITE; 7.4% ASIAN; 11.2% HISPANIC OR LATINO; 0.6% AMERICAN INDIAN OR ALASKA NATIVE. IN THE DISTRICT OF COLUMBIA, CHILDREN 18 YEARS OLD AND YOUNGER MAKE UP 18.6% OF THE POPULATION WITH THE HIGHEST PERCENTAGE RESIDING IN WARDS 7 AND 8. IN BOTH MARYLAND AND VIRGINIA, ABOUT 22% OF THE POPULATION IS CHILDREN 18 YEARS OLD AND YOUNGER. CHILDREN AGED FIVE AND YOUNGER MAKE UP APPROXIMATELY 6% OF THE POPULATION IN THE DISTRICT OF COLUMBIA, MARYLAND AND VIRGINIA.SOCIOECONOMIC STATUS IS THE SOCIAL STANDING OF AN INDIVIDUAL OR GROUP. IT IS OFTEN MEASURED AS A COMBINATION OF EDUCATION, INCOME, AND OCCUPATION. LOW SOCIOECONOMIC STATUS IS STRONGLY CORRELATED WITH INEQUITIES IN ACCESS TO RESOURCES, AS WELL AS ISSUES RELATED TO PRIVILEGE, POWER, AND CONTROL. PEOPLE WITH LOWER SOCIOECONOMIC STATUS TYPICALLY EXPERIENCE POORER HEALTH AND DIE YOUNGER THAN THOSE WITH MORE ECONOMIC ADVANTAGE. CITYWIDE AVERAGES OFTEN PAINT DC AS A SOCIALLY AND ECONOMICALLY RICH CITY; HOWEVER, A MORE DETAILED LOOK REVEALS A STORY OF PROFOUND INEQUITIES. SOCIOECONOMIC CHARACTERISTICS OF DC RESIDENTS VARY IMMENSELY ACROSS THE CITY. HEALTH INEQUITIES FOLLOW THE SAME PATTERN. FOR EXAMPLE, THERE ARE DIRECT CORRELATIONS BETWEEN THE CONCENTRATION OF POVERTY IN SEGMENTS OF THE CITY, PARTICULARLY IN WARDS 7 AND 8, AND PATTERNS OF POOR HEALTH OUTCOMES CONCENTRATED IN THE SAME AREAS. 35% OF CHILDREN IN WARD 8, THE WARD WITH THE LOWEST HOUSEHOLD INCOME IN THE DISTRICT OF COLUMBIA, LIVE IN POVERTY, AS COMPARED TO 2% OF CHILDREN IN WARD 3, THE WEALTHIEST WARD. ADDITIONALLY, DC HAS A 15+ YEAR DIFFERENCE IN LIFE EXPECTANCY BY WARD: 86 YEARS IN WARD 3 COMPARED TO 71 YEARS IN WARD 8. RACIAL DIFFERENCES IN LIFE EXPECTANCY ARE ALSO STRIKING. WHEN COMPARED TO OTHER RACIAL GROUPS, THE LIFE EXPECTANCY FOR BLACK RESIDENTS IS THE LOWEST. WHITE MALES IN THE DISTRICT ARE EXPECTED TO LIVE ALMOST 15 YEARS LONGER THAN BLACK MALES (83.2 AND 68.8 YEARS, RESPECTIVELY). WHITE FEMALES IN THE DISTRICT ARE EXPECTED TO LIVE APPROXIMATELY 9 YEARS LONGER THAN BLACK FEMALES (85.2 AND 76.2 YEARS, RESPECTIVELY).CHILDREN'S NATIONAL IS IN AN URBAN COMMUNITY WHERE THERE ARE SEVERAL LARGE ACADEMIC AND COMMUNITY HOSPITALS. HOWEVER, WE SERVE MOST OF THE CHILDREN IN DC. WE CARED FOR MORE THAN 258,530 UNIQUE PATIENTS THROUGH OUR HEALTH CENTERS IN 2024, AS THE LARGEST NON-GOVERNMENT PROVIDER OF PRIMARY CARE IN THE DISTRICT OF COLUMBIA. MARYLAND RESIDENTS ACCOUNTED FOR 56% CHILDREN'S NATIONAL PATIENTS, AND CHILDREN'S NATIONAL IS THE LARGEST PROVIDER OF PEDIATRIC CARE FOR RESIDENTS OF NORTHERN VIRGINIA AS WELL. THE NEEDS OF THE POPULATION SERVED IN MARYLAND AND NORTHERN VIRGINIA ARE SIMILAR TO THE DISTRICT OF COLUMBIA. AS PREVIOUSLY MENTIONED, THE CHILDHOOD OPPORTUNITY INDEX (COI) DEFINES OPPORTUNITY AS THE NEIGHBORHOOD RESOURCES THAT MATTER FOR A CHILD'S HEALTHY DEVELOPMENT. THE 29 INDICATORS FOCUS ON NEIGHBORHOOD FEATURES SUCH AS ACCESS TO HEALTHY FOOD, HIGH-QUALITY EDUCATION, PARKS AND PLAYGROUNDS. IN THE 2022 CHNA, OUR FINDINGS REVEAL THAT CHILD OPPORTUNITY VARIES CONSIDERABLY WITHIN OUR SERVICE AREA. CHILD OPPORTUNITY IS LOWEST AND CRITICALLY LACKING IN WARDS 7 AND 8 IN WASHINGTON, D.C., AS WELL AS CERTAIN PRINCE GEORGE'S COUNTY NEIGHBORHOODS IN MARYLAND.WE ALSO OFFER FAMILIES A LINK TO QUALITY PEDIATRIC CARE THROUGH OUR MOBILE MEDICAL PROGRAM AND AT COMMUNITY HEALTH CENTERS. OUR TEAM AVERAGES MORE THAN 551,000 OUTPATIENT VISITS EACH YEAR AT HEALTH CLINICS IN THE DISTRICT OF COLUMBIA, AFFILIATED CENTERS IN MARYLAND AND VIRGINIA, AND AT THE SHEIKH ZAYED CAMPUS IN WASHINGTON, DC. ON AVERAGE, THAT EQUALS OVER 1,506 PATIENT VISITS IN ONE DAY TO ONE OF CHILDREN'S NATIONAL'S 30 LOCATIONS IN THE DISTRICT OF COLUMBIA AND THROUGHOUT THE METROPOLITAN AREA. IN FISCAL YEAR 2024, WE PERFORMED 19,564 SURGICAL PROCEDURES, 135,368 DIAGNOSTIC IMAGING PROCEDURES, AND MORE THAN 1.3 MILLION LABORATORY TESTS.
PART VI, LINE 5:	PROMOTING THE HEALTH OF THE COMMUNITYCHILDREN'S NATIONAL HAS EVOLVED FROM A MODEST 12-BED FACILITY FOUNDED OVER 150 YEARS AGO INTO A LEADER IN PEDIATRIC HEALTHCARE, YET ITS CORE MISSION REMAINS TO EXCEL IN CARE, ADVOCACY, RESEARCH, AND EDUCATION. OUR COMMITMENT IS TO DELIVER HIGH-QUALITY HEALTHCARE, IMPROVE HEALTH OUTCOMES FOR CHILDREN, AND LEAD INNOVATIVE SOLUTIONS TO PEDIATRIC HEALTH CHALLENGES. THIS MISSION EXTENDS BEYOND CLINICAL CARE, ADVOCATING FOR POLICIES THAT IMPROVE CHILD HEALTH.IN 2007, WITH FUNDING FROM THE CHILDREN'S HEALTH BOARD, THE CHILD HEALTH ADVOCACY INSTITUTE (CHAI) WAS ESTABLISHED, MAKING CHILDREN'S NATIONAL THE FIRST PEDIATRIC HOSPITAL TO CREATE AN IN-HOUSE ADVOCACY INSTITUTE. CHAI'S FOUNDERS ENVISIONED A FUTURE WHERE CHILDREN'S NEEDS ARE PARAMOUNT IN POLICY AND SYSTEMS. TODAY, THAT VISION IS EVEN MORE VITAL.CHAI'S TEAM, INCLUDING CLINICIANS, PUBLIC HEALTH EXPERTS, DATA ANALYSTS, AND GOVERNMENT AFFAIRS PROFESSIONALS, IS DEDICATED TO ADVANCING COMMUNITY HEALTH, FOCUSING ON UNDER-RESOURCED FAMILIES. CHAI'S EFFORTS RANGE FROM LEADING THE COMMUNITY BENEFIT PROGRAM TO MOBILIZING STAFF FOR COMMUNITY HEALTH IMPROVEMENT AND ADVOCACY, ALL AIMED AT ACHIEVING HEALTH EQUITY FOR CHILDREN. THE INSTITUTE LEVERAGES THE EXPERTISE OF OVER 8,000 CHILDREN'S NATIONAL EMPLOYEES AND NUMEROUS COMMUNITY STAKEHOLDERS.IN FY 2023, WE FORMED THE COMMUNITY HEALTH ADVISORY COUNCIL, COMPOSED OF PARENTS AND CAREGIVERS FROM WASHINGTON, D.C.'S WARDS 7 AND 8 AND PRINCE GEORGE'S COUNTY, MARYLAND. THE COUNCIL OFFERS INSIGHTS INTO HEALTHCARE QUALITY AND SAFETY, ADDRESSING HOW COMMUNITY CHALLENGES AND CULTURAL TRADITIONS IMPACT CARE. THEIR GUIDANCE HAS SHAPED CHIP PRIORITIES AND COMMUNITY HEALTH STRATEGIES.CHILDREN'S NATIONAL IS COMMITTED TO ITS MISSION TO ADVANCE CHILD HEALTH, ENSURING THAT EVERY CHILD HAS THE OPPORTUNITY TO THRIVE. THROUGH ADVOCACY, COMMUNITY ENGAGEMENT, AND INNOVATIVE HEALTH SOLUTIONS, WE CONTINUE TO DRIVE IMPACTFUL CHANGE TO IMPROVE COMMUNITY HEALTH.
PART VI, LINE 6:	AFFILIATED HEALTH CARE SYSTEM ROLESCHILDREN'S HOSPITAL IS PART OF AN AFFILIATED HEALTH CARE SYSTEM COMPRISED OF THE FOLLOWING TAX-EXEMPT ENTITIES:- CHILDREN'S NATIONAL MEDICAL CENTER - 501(C)(3), OVERSIGHT AND FINANCIAL RESPONSIBLE FOR HEALTH CARE SYSTEM- CHILDREN'S HOSPITAL FOUNDATION - 501(C)(3), FUNDRAISING- CHILDREN'S RESEARCH INSTITUTE - 501(C)(3), CONDUCTING CLINICAL MEDICAL RESEARCH AND EDUCATION PROGRAMS- SAFE KIDS WORLDWIDE - 501(C)(3), INJURY PREVENTION FOR CHILDREN- BRAINY CAMPS ASSOCIATION - 501(C)(3), PROVISION OF CAMPS FOR CHILDREN- CHILDREN'S SCHOOL SERVICES - 501(C)(3), OPERATION OF A SCHOOL NURSE PROGRAM- HSC FOUNDATION - 501 (C)(3), SUPPORT FOR THE HSC ENTITIES- HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS - 501(C)(3), HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES FOR YOUNG INDIVIDUALS WITH SPECIAL NEEDS- THE HOSPITAL FOR SICK CHILDREN DBA CHILDREN'S NATIONAL REHABILITATION & SPECIALIZED CARE - 501(C)(3), ACUTE CARE HOSPITAL FACILITY THAT PROVIDES REHABILITATION AND TRANSITIONAL CARE FOR CHILDREN AND ADOLESCENTS WITH DISABILITIES AND CHRONIC ILLNESSES- HSC HOME CARE - 501(C)(3), HOME AND COMMUNITY - PROVIDES ACCESS TO QUALITY REHABILITATIVE AND SPECIALTY SERVICES FOR INFANTS, CHILDREN AND ADOLESCENTS WITH SPECIAL NEEDSTHE FOR-PROFIT ENTITIES (PHN, CNHN AND CP&A) AFFILIATED WITH THE CHILDREN'S NATIONAL HOSPITAL HEALTH SYSTEM PROVIDE SIGNIFICANT CONTRIBUTIONS TO THE OVERALL OPERATIONS, FINANCIAL PERFORMANCE, AND GROWTH OF THE SYSTEM. THESE CONTRIBUTIONS INCLUDE, BUT ARE NOT LIMITED TO, FINANCIAL SUPPORT, SHARED RESOURCES, COLLABORATIVE HEALTHCARE INITIATIVES, AND INVESTMENT IN INNOVATIVE CARE MODELS. THE AFFILIATED FOR-PROFIT ENTITIES ENGAGE IN VARIOUS STRATEGIC PARTNERSHIPS, SERVICE EXPANSIONS, AND SPECIALIZED HEALTHCARE PROGRAMS, WHICH ENHANCE THE DELIVERY OF CARE AND FURTHER THE MISSION OF THE CHILDREN'S NATIONAL HOSPITAL HEALTH SYSTEM. THESE ENTITIES OPERATE IN ACCORDANCE WITH THEIR RESPECTIVE BUSINESS OBJECTIVES, WHILE ALSO SUPPORTING THE BROADER GOALS OF THE AFFILIATED HEALTH SYSTEM THROUGH MEANINGFUL COLLABORATIONS.EACH ENTITY PARTICIPATES IN THE CHILDREN'S NATIONAL'S ABILITY TO DELIVER PEDIATRIC HEALTH CARE SERVICES ON AN INTEGRATED BASIS.
PART VI, LINE 7, REPORTS FILED WITH STATES	DC

Schedule H (Form 990) 2023

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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
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
medium right arrow graphic

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

Questions Regarding Compensation

Yes

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

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

Travel for companions Payments for business use of personal residence

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

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

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

Yes

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

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

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

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

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

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KURT D NEWMAN MD FORMER PRESIDENT / CEO (CNMC)	(i) (ii)	1,006,360 ------------- 0	1,635,633 ------------- 0	358,211 ------------- 0	16,500 ------------- 0	29,904 ------------- 0	3,046,608 ------------- 0	0 ------------- 0
2YVES D'UDEKEM D'ACOZ MD CHIEF OF CARDIO SURGERY	(i) (ii)	1,875,059 ------------- 0	325,450 ------------- 0	129,275 ------------- 0	16,500 ------------- 0	30,984 ------------- 0	2,377,268 ------------- 0	0 ------------- 0
3ANTHONY SANDLER MD SVP CENTER OF EXCELLENCE	(i) (ii)	972,616 ------------- 0	454,064 ------------- 0	150,391 ------------- 0	167,855 ------------- 0	44,826 ------------- 0	1,789,752 ------------- 0	116,113 ------------- 0
4KATHLEEN CHAVANU GORMAN FORMER CHIEF OPERATING OFFICER	(i) (ii)	767,391 ------------- 0	349,944 ------------- 0	142,438 ------------- 0	133,148 ------------- 0	9,888 ------------- 0	1,402,809 ------------- 0	99,060 ------------- 0
5DAVID WESSEL MD CHIEF MEDICAL OFFICER	(i) (ii)	742,703 ------------- 0	349,664 ------------- 0	157,720 ------------- 0	16,500 ------------- 0	37,992 ------------- 0	1,304,579 ------------- 0	0 ------------- 0
6ALDWIN LINDSAY EVP/CFO	(i) (ii)	680,428 ------------- 0	318,096 ------------- 0	139,788 ------------- 0	122,532 ------------- 0	12,913 ------------- 0	1,273,757 ------------- 0	82,363 ------------- 0
7ROBERT KEATING MD CHIEF OF NEUROSURGERY	(i) (ii)	916,576 ------------- 0	176,288 ------------- 0	98,271 ------------- 0	16,500 ------------- 0	27,339 ------------- 0	1,234,974 ------------- 0	0 ------------- 0
8TIMOTHY KANE MD CHIEF OF PEDIATRIC SURGERY	(i) (ii)	812,581 ------------- 0	322,747 ------------- 0	4,356 ------------- 0	16,500 ------------- 0	32,684 ------------- 0	1,188,868 ------------- 0	0 ------------- 0
9DEANN MARSHALL PRESIDENT OF FOUNDATION	(i) (ii)	592,908 ------------- 0	398,459 ------------- 0	27,795 ------------- 0	63,168 ------------- 0	41,340 ------------- 0	1,123,670 ------------- 0	0 ------------- 0
10MARK L BATSHAW MD SENIOR INVESTIGATOR	(i) (ii)	523,403 ------------- 0	131,659 ------------- 0	380,515 ------------- 0	16,500 ------------- 0	21,808 ------------- 0	1,073,885 ------------- 0	254,540 ------------- 0
11MARY ANNE HILLIARD EVP/CHIEF LEGAL OFFICER	(i) (ii)	583,992 ------------- 0	260,644 ------------- 0	88,341 ------------- 0	89,381 ------------- 0	36,652 ------------- 0	1,059,010 ------------- 0	61,769 ------------- 0
12JOHN S MYSEROS ASSOC. CHIEF OF NEUROSURGERY	(i) (ii)	839,166 ------------- 0	147,676 ------------- 0	2,838 ------------- 0	16,500 ------------- 0	21,363 ------------- 0	1,027,543 ------------- 0	0 ------------- 0
13CHARLES WEINSTEIN CHIEF REAL ESTATE OFFICER TO 12/23	(i) (ii)	504,438 ------------- 0	243,477 ------------- 0	207,638 ------------- 0	16,500 ------------- 0	32,942 ------------- 0	1,004,995 ------------- 0	0 ------------- 0
14MICHELLE M MCGUIRE CHIEF STRATEGY OFFICER TO 12/23	(i) (ii)	508,935 ------------- 0	246,583 ------------- 0	109,081 ------------- 0	98,694 ------------- 0	40,768 ------------- 0	1,004,061 ------------- 0	24,454 ------------- 0
15NATHANIEL BEERS MD PRESIDENT OF HSC	(i) (ii)	511,166 ------------- 0	241,822 ------------- 0	90,332 ------------- 0	97,107 ------------- 0	37,391 ------------- 0	977,818 ------------- 0	65,118 ------------- 0
16ROGER PACKER MD FORMER SVP CENTER OF EXCELLENCE	(i) (ii)	551,414 ------------- 0	228,274 ------------- 0	141,555 ------------- 0	16,500 ------------- 0	31,484 ------------- 0	969,227 ------------- 0	0 ------------- 0
17MATTHEW MACVEY CHIEF INFO OFFICER	(i) (ii)	499,604 ------------- 0	231,750 ------------- 0	32,258 ------------- 0	93,750 ------------- 0	43,139 ------------- 0	900,501 ------------- 0	30,726 ------------- 0
18LINDA TALLEY CHIEF NURSING OFFICER	(i) (ii)	475,409 ------------- 0	229,500 ------------- 0	57,616 ------------- 0	83,700 ------------- 0	22,786 ------------- 0	869,011 ------------- 0	29,589 ------------- 0
19MICHELLE RILEY-BROWN PRESIDENT/CEO FROM 07/23	(i) (ii)	643,121 ------------- 0	200,000 ------------- 0	0 ------------- 0	0 ------------- 0	15,887 ------------- 0	859,008 ------------- 0	0 ------------- 0
20VITTORIO GALLO PHD CHIEF RESEARCH OFFICER TO 09/23	(i) (ii)	425,491 ------------- 0	247,497 ------------- 0	145,174 ------------- 0	15,050 ------------- 0	11,751 ------------- 0	844,963 ------------- 0	0 ------------- 0
21ELIZABETH WELLS SVP CENTER OF EXCELLENCE	(i) (ii)	512,545 ------------- 0	131,667 ------------- 0	12,291 ------------- 0	16,500 ------------- 0	31,770 ------------- 0	704,773 ------------- 0	0 ------------- 0
22CATHERINE CODISPOTI MD CHIEF PEOPLE OFFICER TO 10/23	(i) (ii)	402,331 ------------- 0	231,346 ------------- 0	18,855 ------------- 0	16,500 ------------- 0	26,080 ------------- 0	695,112 ------------- 0	0 ------------- 0
23DENICE CORA-BRAMBLE MD FMR CHIEF MEDICAL OFFICER	(i) (ii)	207,447 ------------- 0	49,985 ------------- 0	62,223 ------------- 0	11,847 ------------- 0	25,477 ------------- 0	356,979 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

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

Return Reference	Explanation
SCHEDULE J, PART I, LINE 1A:	FIRST CLASS OR CHARTER TRAVEL THE CEO PER HER EMPLOYMENT CONTRACT IS ENTITLED TO USE FIRST CLASS TRAVEL (WHERE BUSINESS CLASS IS NOT AVAILABLE) FOR TRIPS OF MORE THAN 4 HOURS. HOSPITAL POLICY PERMITS BUSINESS CLASS FOR INTERNATIONAL TRAVEL. THERE IS NO CHARTER TRAVEL. SCHEDULE J, PART I, LINE 1A: PERSONAL SERVICES CERTAIN EXECUTIVES, THROUGH THEIR EMPLOYMENT AGREEMENTS, ARE REIMBURSED FOR TAX, FINANCIAL AND ESTATE PLANNING, AND HEALTH COSTS. THIS IS TREATED AS TAXABLE COMPENSATION TO THE RECIPIENT.
SCHEDULE J, PART I, LINE 4A:	SEVERANCE THE FOLLOWING KEY EMPLOYEES RECEIVED A SEVERANCE PAYMENT. THE SEVERANCE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF OTHER REPORTABLE COMPENSATION: CHARLES WEINSTEIN $6,243 MICHELLE M. MCGUIRE $6,323
SCHEDULE J, PART I, LINE 4B:	SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING OFFICERS AND KEY EMPLOYEES PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE CONTRIBUTIONS TO THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ARE INCLUDED IN SCHEDULE J, PART II COLUMN (C ) AS PART OF DEFERRED COMPENSATION OR SCHEDULE J, PART II, COLUMN (B)(III) WHEN AMOUNTS ARE DEFERRED AND DISTRIBUTED IN THE SAME CALENDAR YEAR: KATHLEEN CHAVANU GORMAN $116,648 ALDWIN LINDSAY $106,032 MARY ANNE HILLIARD $72,881 ANTHONY SANDLER, MD $151,355 ROBERT KEATING, MD $93,090 DAVID WESSEL, MD $116,555 DEANN MARSHALL $46,668 CHARLES WEINSTEIN $81,159 MICHELLE M. MCGUIRE $82,194 NATHANIEL BEERS, MD $80,607 VITTORIO GALLO, PHD $82,499 MATTHEW MACVEY $77,250 LINDA TALLEY $69,355 DENICE CORA-BRAMBLE, MD $35,542 MARK L. BATSHAW, MD $81,439 ROGER PACKER, MD $78,993 KURT D. NEWMAN, MD $251,063 ADDITIONALLY, THE FOLLOWING INDIVIDUALS RECEIVED DISTRIBUTIONS FROM THE PLAN THAT WERE DEFERRED ON A PREVIOUSLY FILED FORM 990 AND ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (B)(III) AS TAXABLE WAGES IN THE CURRENT YEAR. KATHLEEN CHAVANU GORMAN $99,060 ALDWIN LINDSAY $82,363 MARY ANNE HILLIARD $61,769 ANTHONY SANDLER, MD $116,113 MICHELLE M. MCGUIRE $24,454 NATHANIEL BEERS, MD $65,118 MATTHEW MACVEY $30,726 LINDA TALLEY $29,589 MARK L. BATSHAW, MD $254,540
SCHEDULE J, PART I, LINE 7:	NON-FIXED PAYMENTS THE ORGANIZATION ESTABLISHES QUANTITATIVE TARGETS FOR ITS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES TO MEET. IF THE METRICS ARE MET, THEN A BONUS IS PAID TO THE INDIVIDUAL. BOTH THE DETERMINATION TO PAY A BONUS AND THE AMOUNT OF THE BONUS IS DETERMINED BY ESTABLISHED FORMULAS AND THE PAYMENT IS NOT CONTINGENT ON THE EXERCISE OF ANY PERSON'S DISCRETION. DUE TO EXTENUATING CIRCUMSTANCES, BONUSES WILL SOMETIMES BE AWARDED EVEN IF METRICS ARE NOT MET. HOWEVER, FOR THIS TO OCCUR, THERE IS A MULTI-LEVEL REVIEW PROCESS AND CONCURRENCE REGARDING THE APPROPRIATENESS OF THE PAYMENT.
SCHEDULE J, PART I, LINE 8:	INITIAL CONTRACT EXCEPTION CERTAIN INDIVIDUALS HIRED DURING THE YEAR HAVE EMPLOYMENT CONTRACTS WHICH MEET THE INITIAL CONTRACT EXCEPTIONS DESCRIBED IN THE TREASURY REGULATIONS.
SCHEDULE J, PART II, COLUMN (F):	COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990 THE AMOUNTS REPORTED IN COLUMN F REPRESENT THE ACCUMULATION OVER MANY YEARS OF DEFERRED COMPENSATION BENEFITS WHICH ARE NOW TAXABLE TO THE RECIPIENT. THE ORGANIZATION HAS ALSO REPORTED THESE SAME AMOUNTS AS ACCRUED DEFERRED COMPENSATION IN PRIOR YEARS' COLUMN C.

Schedule J (Form 990) 2023

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
CHILDREN'S HOSPITAL

Employer identification number
53-0196580

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	DISTRICT OF COLUMBIA	53-6001131	254764KB8	09-17-2015	413,728,662	SEE PART VI		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	48,640,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	413,728,662
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............	410,562,146
7 Issuance costs from proceeds ...............	3,166,515
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............
12 Other unspent proceeds .............
13 Year of substantial completion .............	2012
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........	X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............	X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?	X
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0.100 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0.100 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

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

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

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

Part Ⅴ

Procedures To Undertake Corrective Action

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

Part Ⅵ

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

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

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

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

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

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

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

Part II

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

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No
(1) M RILEY-BROWN	OFFICER	HOUSING		X	750,000	600,000		No	Yes		Yes



Total ............... $						600,000

Part III

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

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

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

Cat. No. 50056A

Schedule L (Form 990) 2023

Page 2

Part IV

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

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

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2023

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

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

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

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

Cat. No. 51056K

Schedule O (Form 990) 2023

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

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

CHILDREN'S HOSPITAL

Employer identification number

53-0196580

Part I

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

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CHILDREN'S NATIONAL AT WALTER REED LLC 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 38-3987350	HEALTH CARE	DC	1,157,135	93,140,848	CH

Part II

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CHILDREN'S HOSPITAL FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1640402	FUNDRAISING	DC	501(C)(3)	LINE 7	CNMC		No
(2)CHILDREN'S NATIONAL MEDICAL CENTER 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1640403	HEALTH CARE	DC	501(C)(3)	LINE 12C, III-FI	N/A		No
(3)CHILDREN'S RESEARCH INSTITUTE 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1654453	RESEARCH	DC	501(C)(3)	LINE 7	CNMC		No
(4)SAFE KIDS WORLDWIDE 1 INVENTA PL 6TH FL W SILVER SPRING,MD20910 52-1627574	INJURY PREVENTION	DC	501(C)(3)	LINE 7	CNMC		No
(5)BRAINY CAMPS ASSOCIATION 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 27-1547370	CHILD CAMPS	DC	501(C)(3)	LINE 12A, I	CH	Yes
(6)CHILDREN'S SCHOOL SERVICES 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 81-4291601	NURSING SERVICES	DC	501(C)(3)	LINE 12A, I	CNMC		No
(7)THE HSC FOUNDATION 111 MICHIGAN AVENUE NW WASHINGTON,DC20010 52-1346603	HEALTH CARE	DC	501(C)(3)	LINE 12C, III-FI	CNMC		No
(8)THE HOSPITAL FOR SICK CHILDREN 111 MICHIGAN AVE NW WASHINGTON,DC20010 53-0204670	HOSPITAL	DC	501(C)(3)	LINE 3	HSC FNDN		No
(9)HEALTH SVCS FOR CHILDREN W SPEC NEEDS 111 MICHIGAN AVE NW WASHINGTON,DC20010 52-1862406	HEALTH CARE	DC	501(C)(3)	LINE 10	HSC FNDN		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) CHILDREN'S PEDIATRICIANS AND ASSOCIATES LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 52-2072589	HEALTH CARE	DC	N/A	RELATED	1,892,260	13,012,251		No			No	50.000 %
(2) 5253 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-2873855	PROPERTY MANAGEMENT	DC	N/A					No			No
(3) 5253 HTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-3044006	PROPERTY MANAGEMENT	DC	N/A					No			No
(4) 54 NMTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-3358685	PROPERTY MANAGEMENT	DC	N/A					No			No
(5) 54 HTC LLC 111 MICHIGAN AVE NW WASHINGTON,DC20010 83-3385522	PROPERTY MANAGEMENT	DC	N/A					No			No

Part IV

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

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

Schedule R (Form 990) 2023

Page 3

Part V

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

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

Yes

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

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

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

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

Yes

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

Yes

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

Yes

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

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

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

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

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

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

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

Yes

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

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) BRAINY CAMPS ASSOCIATION	Q	281,470	COST
(2) BRAINY CAMPS ASSOCIATION	S	4,301	COST

Schedule R (Form 990) 2023

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) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	10
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	9,664
6	Total number of volunteers (estimate if necessary) .............	6	1,232
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,685,807
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	54,165,516	68,530,658
9	Program service revenue (Part VIII, line 2g) .........	1,502,472,344	1,629,536,880
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	7,449,655	11,184,261
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	-1,855,584	9,560,079
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,562,231,931	1,718,811,878
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	175,065	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	874,349,566	946,377,644
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	643,413,803	697,299,673
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,517,938,434	1,643,677,317
19	Revenue less expenses. Subtract line 18 from line 12.......	44,293,497	75,134,561
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,228,485,013	2,333,479,544
21	Total liabilities (Part X, line 26).............	1,366,024,806	1,368,174,724
22	Net assets or fund balances. Subtract line 21 from line 20.....	862,460,207	965,304,820

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,244,076,520 including grants of $ ) (Revenue $ 1,627,733,713 )
	CHILDREN'S HOSPITAL DBA CHILDREN'S NATIONAL HOSPITAL OPERATES AN ACUTE CARE PEDIATRIC AND TEACHING FACILITY IN WASHINGTON, DC. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. CHILDREN'S NATIONAL MEDICAL CENTER DBA CHILDREN'S NATIONAL IS THE PARENT COMPANY OF THE HOSPITAL. CHILDREN'S NATIONAL AND ITS AFFILIATES PROVIDE HEALTHCARE SERVICES TO INFANTS, CHILDREN, AND YOUTH IN WASHINGTON, DC AND THE SURROUNDING METROPOLITAN AREA. SEE SCHEDULE H, PART VI FOR COMPLETE FY24 COMMUNITY BENEFIT REPORT.

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












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












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,244,076,520

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	25,264,271	0	1,824,900

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	31,683,137
e	Government grants (contributions)		1e	8,934,509

f	All other contributions, gifts, grants, and similar amounts not included above		1f	27,913,012

g	Noncash contributions included in lines 1a - 1f:$		1g	14,982

h Total. Add lines 1a-1f.......		68,530,658

		Business Code
2a	PATIENT REVENUE	621400	1,469,468,747	1,469,468,747
b	ALL OTHER PROGRAM SERV	900099	160,068,133	160,068,133
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		1,629,536,880

3 Investment income (including dividends, interest, and othersimilar amounts) ......			10,564,810			10,564,810
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	3,528,982
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	3,528,982
d	Net rental income or (loss).......			3,528,982			3,528,982
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	54,842,813	1,835,300
b	Less: cost or other basis and sales expenses	7b	54,589,876	1,468,786
c	Gain or (loss)	7c	252,937	366,514
d	Net gain or (loss).........			619,451			619,451
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	PARKING		812390	6,148,457			6,148,457
b	LAB FEES		621500	1,685,807		1,685,807
c	EQUITY AND PARTNERSHIP		621110	-1,803,167	-1,803,167
d	All other revenue ....
e	Total. Add lines 11a–11d ......			6,031,097
12	Total revenue. See instructions.....			1,718,811,878	1,627,733,713	1,685,807	20,861,700

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	11,522,413	349,081	11,173,332
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	4,014,433		4,014,433
7	Other salaries and wages........	787,961,070	574,746,029	213,215,041
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	27,220,914	19,482,008	7,738,906
9	Other employee benefits .......	64,973,387	46,501,453	18,471,934
10	Payroll taxes ...........	50,685,427	36,275,560	14,409,867
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	3,779,360	2,704,888	1,074,472
c	Accounting ...........	2,206,013		2,206,013
d	Lobbying ...........	442,240		442,240
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	407,953	291,972	115,981
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	120,693,283	86,665,042	34,028,241
12	Advertising and promotion ....	4,564,864	3,267,073	1,297,791
13	Office expenses .......	14,622,405	10,465,255	4,157,150
14	Information technology ......	70,978,478	50,799,297	20,179,181
15	Royalties ..
16	Occupancy ...........	33,890,003	24,255,075	9,634,928
17	Travel ............	4,307,749	3,083,056	1,224,693
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	832,645	595,924	236,721
20	Interest ...........	27,832,889	19,919,999	7,912,890
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	100,635,762	72,025,015	28,610,747
23	Insurance ...	28,846,810	20,645,662	8,201,148
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	209,880,419	209,880,419
b	BAD DEBT EXPENSE	33,790,028	33,790,028
c	REPAIRS & MAINTENANCE	30,790,123	22,036,491	8,753,632
d	DUES & MEMBERSHIPS	3,946,032	2,824,175	1,121,857
e	All other expenses	4,852,617	3,473,018	1,379,599
25	Total functional expenses. Add lines 1 through 24e	1,643,677,317	1,244,076,520	399,600,797	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			69,359,836	2	20,725,121
3	Pledges and grants receivable, net ......			3,728,298	3	24,055,734
4	Accounts receivable, net .............			337,220,959	4	374,893,852
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 .......
				50,000	5	600,000
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			15,045,348	8	20,716,334
9	Prepaid expenses and deferred charges ......			74,611,724	9	81,228,092
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,860,870,131
b	Less: accumulated depreciation	10b	1,109,330,993	776,377,053	10c	751,539,138
11	Investments—publicly traded securities .			270,094,021	11	285,569,960
12	Investments—other securities. See Part IV, line 11 .....			11,637,332	12	15,173,913
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			670,360,442	15	758,977,400
16	Total assets. Add lines 1 through 15 (must equal line 33)...			2,228,485,013	16	2,333,479,544

17	Accounts payable and accrued expenses .....	231,904,646	17	240,094,295
18	Grants payable ...		18
19	Deferred revenue .........	6,394,536	19	6,055,964
20	Tax-exempt bond liabilities .........	350,214,726	20	339,658,642
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	352,030,242	23	351,513,520
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	425,480,656	25	430,852,303
26	Total liabilities. Add lines 17 through 25..	1,366,024,806	26	1,368,174,724

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	862,460,207	27	965,304,820
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 ...........	862,460,207	32	965,304,820
33	Total liabilities and net assets/fund balances ........	2,228,485,013	33	2,333,479,544

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