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        <TitleTxt>VP, EDUCATION &amp; EXECUTIVE LEARNING</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>20964</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LORI HOTZEL</PersonNm>
        <TitleTxt>CTO</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>3.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>19014</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>37697</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHERINE A CONRAD</PersonNm>
        <TitleTxt>VP, DELIVERY SYS TRAN (THRU 9/30/21)</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <ReportableCompFromRltdOrgAmt>225270</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28426</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>AIMEE OSSMAN</PersonNm>
        <TitleTxt>VP, POLICY</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>39.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
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        <ReportableCompFromRltdOrgAmt>214347</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KORY K KITTLE</PersonNm>
        <TitleTxt>VP, ANALYTICS</TitleTxt>
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        <ReportableCompFromRltdOrgAmt>26809</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>GILLIAN RAY</PersonNm>
        <TitleTxt>VP, EXTERNAL RELATIONS</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>21.00</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW A HALL</PersonNm>
        <TitleTxt>PRINCIPAL, BIOSTATISTICIAN</TitleTxt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MATTHEW COOK</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY CRIPE</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL FARRELL</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>DEBORAH FELDMAN</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JENA HAUSMANN</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>JOHN D NASH</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
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        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KURT NEWMAN</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>TIMOTHY ROBINSON</PersonNm>
        <TitleTxt>MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
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        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
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      <TotReportableCompRltdOrgAmt>2769349</TotReportableCompRltdOrgAmt>
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      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RIGHTPOINT CONSULTING LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>29 N WACKER DRIVE 4TH FLOOR</AddressLine1Txt>
            <CityNm>CHICAGO</CityNm>
            <StateAbbreviationCd>IL</StateAbbreviationCd>
            <ZIPCd>60606</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>WEB DESIGN</ServicesDesc>
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      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>DELOITTE &amp; TOUCHE LLP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>200 RENAISSANCE CENTER STE 3900</AddressLine1Txt>
            <CityNm>DETROIT</CityNm>
            <StateAbbreviationCd>MI</StateAbbreviationCd>
            <ZIPCd>48243</ZIPCd>
          </USAddress>
        </ContractorAddress>
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        <CompensationAmt>142790</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>BEEKEEPER GROUP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>1101 14TH STREET NW STE 200</AddressLine1Txt>
            <CityNm>WASHINGTON</CityNm>
            <StateAbbreviationCd>DC</StateAbbreviationCd>
            <ZIPCd>20005</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>LOBBYING</ServicesDesc>
        <CompensationAmt>139647</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>HEALTHDATAVIZ LLC</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>177 HUNTINGTON AVE STE XXX-XX-XXXX</AddressLine1Txt>
            <CityNm>BOSTON</CityNm>
            <StateAbbreviationCd>MA</StateAbbreviationCd>
            <ZIPCd>02115</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>PROGRAM DEVELOPMENT</ServicesDesc>
        <CompensationAmt>114325</CompensationAmt>
      </ContractorCompensationGrp>
      <ContractorCompensationGrp>
        <ContractorName>
          <BusinessName>
            <BusinessNameLine1Txt>RSM US LLP</BusinessNameLine1Txt>
          </BusinessName>
        </ContractorName>
        <ContractorAddress>
          <USAddress>
            <AddressLine1Txt>2021 L STREET NW STE 400</AddressLine1Txt>
            <CityNm>WASHINGTON</CityNm>
            <StateAbbreviationCd>DC</StateAbbreviationCd>
            <ZIPCd>20036</ZIPCd>
          </USAddress>
        </ContractorAddress>
        <ServicesDesc>AUDIT &amp; TAX SERVICES</ServicesDesc>
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      </ContractorCompensationGrp>
      <CntrctRcvdGreaterThan100KCnt>6</CntrctRcvdGreaterThan100KCnt>
      <GovernmentGrantsAmt>3112</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>394879</AllOtherContributionsAmt>
      <NoncashContributionsAmt>16560</NoncashContributionsAmt>
      <TotalContributionsAmt>397991</TotalContributionsAmt>
      <ProgramServiceRevenueGrp>
        <Desc>PROJECT PARTICIPATION</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>29100353</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>29100353</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>MEMBERSHIP DUES</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>10424280</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>10424280</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <ProgramServiceRevenueGrp>
        <Desc>MEETINGS AND CONFERENC</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>208885</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>208885</RelatedOrExemptFuncIncomeAmt>
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      <ProgramServiceRevenueGrp>
        <Desc>PUBLICATIONS</Desc>
        <BusinessCd>541800</BusinessCd>
        <TotalRevenueColumnAmt>115238</TotalRevenueColumnAmt>
        <UnrelatedBusinessRevenueAmt>115238</UnrelatedBusinessRevenueAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>39848756</TotalProgramServiceRevenueAmt>
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        <ExclusionAmt>1152667</ExclusionAmt>
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      <RoyaltiesRevenueGrp>
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        <ExclusionAmt>23514</ExclusionAmt>
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      <GrossRentsGrp>
        <RealAmt>36867</RealAmt>
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      <LessRentalExpensesGrp>
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      <RentalIncomeOrLossGrp>
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      </RentalIncomeOrLossGrp>
      <NetRentalIncomeOrLossGrp>
        <TotalRevenueColumnAmt>36867</TotalRevenueColumnAmt>
        <ExclusionAmt>36867</ExclusionAmt>
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      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>3310088</SecuritiesAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
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      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>1924074</SecuritiesAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1924074</TotalRevenueColumnAmt>
        <ExclusionAmt>1924074</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>MISCELLANEOUS</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>8708</TotalRevenueColumnAmt>
        <ExclusionAmt>8708</ExclusionAmt>
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      <OtherRevenueTotalAmt>8708</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>43392577</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>39733518</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>115238</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>3145830</ExclusionAmt>
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      <InfoInScheduleOPartIXInd>X</InfoInScheduleOPartIXInd>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>404789</TotalAmt>
        <ProgramServicesAmt>404789</ProgramServicesAmt>
      </GrantsToDomesticOrgsGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>1767849</TotalAmt>
        <ProgramServicesAmt>887629</ProgramServicesAmt>
        <ManagementAndGeneralAmt>844863</ManagementAndGeneralAmt>
        <FundraisingAmt>35357</FundraisingAmt>
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        <ProgramServicesAmt>7274035</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6923568</ManagementAndGeneralAmt>
        <FundraisingAmt>289747</FundraisingAmt>
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      <PensionPlanContributionsGrp>
        <TotalAmt>1083789</TotalAmt>
        <ProgramServicesAmt>580370</ProgramServicesAmt>
        <ManagementAndGeneralAmt>481743</ManagementAndGeneralAmt>
        <FundraisingAmt>21676</FundraisingAmt>
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        <ProgramServicesAmt>1052940</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1121536</ManagementAndGeneralAmt>
        <FundraisingAmt>44377</FundraisingAmt>
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        <ProgramServicesAmt>561065</ProgramServicesAmt>
        <ManagementAndGeneralAmt>481594</ManagementAndGeneralAmt>
        <FundraisingAmt>21279</FundraisingAmt>
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        <ProgramServicesAmt>9579</ProgramServicesAmt>
        <ManagementAndGeneralAmt>112260</ManagementAndGeneralAmt>
        <FundraisingAmt>2487</FundraisingAmt>
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      <FeesForServicesAccountingGrp>
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        <ManagementAndGeneralAmt>62852</ManagementAndGeneralAmt>
        <FundraisingAmt>1283</FundraisingAmt>
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      <FeesForSrvcInvstMgmntFeesGrp>
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        <ManagementAndGeneralAmt>93417</ManagementAndGeneralAmt>
        <FundraisingAmt>1907</FundraisingAmt>
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        <ProgramServicesAmt>2252008</ProgramServicesAmt>
        <ManagementAndGeneralAmt>770626</ManagementAndGeneralAmt>
        <FundraisingAmt>61686</FundraisingAmt>
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        <ProgramServicesAmt>39930</ProgramServicesAmt>
        <ManagementAndGeneralAmt>19653</ManagementAndGeneralAmt>
        <FundraisingAmt>1216</FundraisingAmt>
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      <OfficeExpensesGrp>
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        <ProgramServicesAmt>10189</ProgramServicesAmt>
        <ManagementAndGeneralAmt>357970</ManagementAndGeneralAmt>
        <FundraisingAmt>7513</FundraisingAmt>
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      <InformationTechnologyGrp>
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        <ProgramServicesAmt>695302</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2163290</ManagementAndGeneralAmt>
        <FundraisingAmt>58339</FundraisingAmt>
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        <ProgramServicesAmt>977337</ProgramServicesAmt>
        <ManagementAndGeneralAmt>536871</ManagementAndGeneralAmt>
        <FundraisingAmt>30902</FundraisingAmt>
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      <TravelGrp>
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        <ProgramServicesAmt>11074</ProgramServicesAmt>
        <ManagementAndGeneralAmt>25591</ManagementAndGeneralAmt>
        <FundraisingAmt>748</FundraisingAmt>
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      <ConferencesMeetingsGrp>
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        <ProgramServicesAmt>681269</ProgramServicesAmt>
        <ManagementAndGeneralAmt>147806</ManagementAndGeneralAmt>
        <FundraisingAmt>16920</FundraisingAmt>
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        <ManagementAndGeneralAmt>3901</ManagementAndGeneralAmt>
        <FundraisingAmt>80</FundraisingAmt>
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      <DepreciationDepletionGrp>
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        <ProgramServicesAmt>825576</ProgramServicesAmt>
        <ManagementAndGeneralAmt>361197</ManagementAndGeneralAmt>
        <FundraisingAmt>24220</FundraisingAmt>
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        <ManagementAndGeneralAmt>206918</ManagementAndGeneralAmt>
        <FundraisingAmt>4223</FundraisingAmt>
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        <Desc>DUES &amp; SUBSCRIPTIONS</Desc>
        <TotalAmt>1080211</TotalAmt>
        <ProgramServicesAmt>924145</ProgramServicesAmt>
        <ManagementAndGeneralAmt>134462</ManagementAndGeneralAmt>
        <FundraisingAmt>21604</FundraisingAmt>
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      <OtherExpensesGrp>
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        <TotalAmt>327059</TotalAmt>
        <ProgramServicesAmt>208491</ProgramServicesAmt>
        <ManagementAndGeneralAmt>112027</ManagementAndGeneralAmt>
        <FundraisingAmt>6541</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>RECRUITING</Desc>
        <TotalAmt>287399</TotalAmt>
        <ProgramServicesAmt>128284</ProgramServicesAmt>
        <ManagementAndGeneralAmt>153367</ManagementAndGeneralAmt>
        <FundraisingAmt>5748</FundraisingAmt>
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      <OtherExpensesGrp>
        <Desc>TAXES</Desc>
        <TotalAmt>123787</TotalAmt>
        <ManagementAndGeneralAmt>121311</ManagementAndGeneralAmt>
        <FundraisingAmt>2476</FundraisingAmt>
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      <AllOtherExpensesGrp>
        <TotalAmt>-3938398</TotalAmt>
        <ProgramServicesAmt>7849208</ProgramServicesAmt>
        <ManagementAndGeneralAmt>-11701039</ManagementAndGeneralAmt>
        <FundraisingAmt>-86567</FundraisingAmt>
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      <TotalFunctionalExpensesGrp>
        <TotalAmt>29482766</TotalAmt>
        <ProgramServicesAmt>25373220</ProgramServicesAmt>
        <ManagementAndGeneralAmt>3535784</ManagementAndGeneralAmt>
        <FundraisingAmt>573762</FundraisingAmt>
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      <CashNonInterestBearingGrp>
        <BOYAmt>700</BOYAmt>
        <EOYAmt>19340992</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>52621493</BOYAmt>
        <EOYAmt>49230061</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <AccountsReceivableGrp>
        <BOYAmt>463636</BOYAmt>
        <EOYAmt>732175</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>1583536</BOYAmt>
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          <CityNm>TACOMA</CityNm>
          <StateAbbreviationCd>WA</StateAbbreviationCd>
          <ZIPCd>98415</ZIPCd>
        </USAddress>
        <RecipientEIN>911352172</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>15000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>MUSC SHAWN JENKINS CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>10 MCCLENNAN BANKS DR</AddressLine1Txt>
          <CityNm>CHARLESTON</CityNm>
          <StateAbbreviationCd>SC</StateAbbreviationCd>
          <ZIPCd>29425</ZIPCd>
        </USAddress>
        <RecipientEIN>576000722</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>23000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>NEMOURS CHILDREN'S HEALTH</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>10140 CENTURION PARKWAY</AddressLine1Txt>
          <CityNm>JACKSONVILLE</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>62256</ZIPCd>
        </USAddress>
        <RecipientEIN>590634433</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>NICKLAUS CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3100 SW 62ND AVE</AddressLine1Txt>
          <CityNm>MIAMI</CityNm>
          <StateAbbreviationCd>FL</StateAbbreviationCd>
          <ZIPCd>33155</ZIPCd>
        </USAddress>
        <RecipientEIN>453481327</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>OSF HEALTHCARE CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>800 NE GLEN OAK</AddressLine1Txt>
          <CityNm>PEORIA</CityNm>
          <StateAbbreviationCd>IL</StateAbbreviationCd>
          <ZIPCd>61603</ZIPCd>
        </USAddress>
        <RecipientEIN>370813229</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>ST LOUIS CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>1 CHILDRENS PLACE</AddressLine1Txt>
          <CityNm>ST LOUIS</CityNm>
          <StateAbbreviationCd>MO</StateAbbreviationCd>
          <ZIPCd>63110</ZIPCd>
        </USAddress>
        <RecipientEIN>430654870</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>10350</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>THE CHILDREN'S HOSPITAL AT MONTEFIORE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>3415 BAINBRIDGE AVE</AddressLine1Txt>
          <CityNm>BRONX</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>10467</ZIPCd>
        </USAddress>
        <RecipientEIN>131740114</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <RecipientTable>
        <RecipientBusinessName>
          <BusinessNameLine1Txt>VALLEY CHILDREN'S HEALTHCARE</BusinessNameLine1Txt>
        </RecipientBusinessName>
        <USAddress>
          <AddressLine1Txt>9300 VALLEY CHILDRENS PLACE</AddressLine1Txt>
          <CityNm>MADERA</CityNm>
          <StateAbbreviationCd>CA</StateAbbreviationCd>
          <ZIPCd>93636</ZIPCd>
        </USAddress>
        <RecipientEIN>464158433</RecipientEIN>
        <IRCSectionDesc>501(C)(3)</IRCSectionDesc>
        <CashGrantAmt>25000</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <PurposeOfGrantTxt>CHILD'S PLAY GRANT</PurposeOfGrantTxt>
      </RecipientTable>
      <Total501c3OrgCnt>20</Total501c3OrgCnt>
      <TotalOtherOrgCnt>0</TotalOtherOrgCnt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>NACHRI REQUIRES GRANT RECIPIENTS TO MEET STRINGENT CRITERIA AS PART OF THE SELECTION AND FUNDS DISBURSAL PROCESS. ONCE FUNDS HAVE BEEN DISTRIBUTED, EACH RECIPIENT IS RESPONSIBLE FOR ENSURING THE FUNDS ARE USED FOR THEIR INTENDED PURPOSE.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <CompensationCommitteeInd>X</CompensationCommitteeInd>
      <IndependentConsultantInd>X</IndependentConsultantInd>
      <WrittenEmploymentContractInd>X</WrittenEmploymentContractInd>
      <BoardOrCommitteeApprovalInd>X</BoardOrCommitteeApprovalInd>
      <SeverancePaymentInd>0</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>1</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARK WIETECHA</PersonNm>
        <TitleTxt>CEO</TitleTxt>
        <BaseCompensationFilingOrgAmt>212450</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>637349</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>84500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>253500</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>278404</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>835213</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>75713</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>227137</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3935</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>11803</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>655002</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>1965002</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AMY W KNIGHT</PersonNm>
        <TitleTxt>PRESIDENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>354173</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>212505</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>125000</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>75000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>776</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>465</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>124388</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>74634</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15944</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>9567</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>620281</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>372171</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NANCY O STAHL</PersonNm>
        <TitleTxt>CFO (THRU 3/1/21)</TitleTxt>
        <BaseCompensationFilingOrgAmt>104992</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>34998</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>67500</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>22500</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>68647</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>22882</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>20946</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>6982</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1038</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>347</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>263123</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>87709</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID E BERTOCH</PersonNm>
        <TitleTxt>VP, INFORMATICS &amp; COMPARATIVE DATA</TitleTxt>
        <BaseCompensationFilingOrgAmt>218648</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>17727</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>39775</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>3225</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>505</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>42</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>22212</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>1800</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21917</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1776</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>303057</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>24570</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KASSANDRA K JENSEN</PersonNm>
        <TitleTxt>VP, EDUCATION &amp; EXECUTIVE LEARNING</TitleTxt>
        <BaseCompensationFilingOrgAmt>207297</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>16809</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>50783</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>4119</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>456</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>36</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>22703</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>1842</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>7545</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>612</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>288784</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>23418</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LORI HOTZEL</PersonNm>
        <TitleTxt>CTO</TitleTxt>
        <BaseCompensationFilingOrgAmt>186371</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>15111</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>47360</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>3840</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>775</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>63</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>19290</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>1563</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>15581</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1263</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>269377</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>21840</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KATHERINE A CONRAD</PersonNm>
        <TitleTxt>VP, DELIVERY SYS TRAN (THRU 9/30/21)</TitleTxt>
        <BaseCompensationFilingOrgAmt>4695</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>183097</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1073</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>41829</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>9</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>344</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>449</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>17502</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>262</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>10213</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>6488</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>252985</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AIMEE OSSMAN</PersonNm>
        <TitleTxt>VP, POLICY</TitleTxt>
        <BaseCompensationFilingOrgAmt>4489</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>175076</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>998</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>38904</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>9</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>367</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>459</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>17895</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>393</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15344</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>6348</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>247586</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KORY K KITTLE</PersonNm>
        <TitleTxt>VP, ANALYTICS</TitleTxt>
        <BaseCompensationFilingOrgAmt>154841</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>22120</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>32200</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>4600</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>614</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>89</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>17570</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>2510</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14738</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>2105</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>219963</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>31424</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>GILLIAN RAY</PersonNm>
        <TitleTxt>VP, EXTERNAL RELATIONS</TitleTxt>
        <BaseCompensationFilingOrgAmt>82767</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>91479</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>15533</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>17169</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>342</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>378</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>7760</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>8576</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12118</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>13394</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>118520</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>130996</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MATTHEW A HALL</PersonNm>
        <TitleTxt>PRINCIPAL, BIOSTATISTICIAN</TitleTxt>
        <BaseCompensationFilingOrgAmt>161901</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>13128</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>27750</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>2250</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>334</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>27</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>16162</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>1311</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>21917</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1776</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>228064</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>18492</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CURRENT CEO WAS HIRED IN SEPTEMBER 2011 AND THE CURRENT PRESIDENT WAS HIRED IN DECEMBER 2011. THIS PROCESS INVOLVED A NATIONAL SEARCH FIRM THAT WAS CLOSELY MONITORED BY A TASK FORCE AND THE BOARD OF TRUSTEES. IN ADDITION, THE GOVERNANCE COMMITTEE ALSO ACTS AS THE COMPENSATION COMMITTEE AND REVIEWS, AND APPROVES, ALL COMPENSATION RELATED MATTERS. THE CEO AND PRESIDENT'S COMPENSATION WAS BASED ON MARKET COMPARABLES OF SIMILAR SIZED ORGANIZATIONS AND RESPONSIBILITIES. THE COMPENSATION IS ALSO INCLUDED IN A WRITTEN EMPLOYMENT AGREEMENT. A COMPLETE REVIEW OF ALL SALARIES OCCURRED DURING 2018. SALARY INCREASES ARE RECOMMENDED BY THE GOVERNANCE COMMITTEE TO THE FULL BOARD FOR APPROVAL IN EXECUTIVE SESSION WITHOUT THE CEO PRESENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 4B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE FOLLOWING LISTED EMPLOYEES PARTICIPATED IN A 457(F) PLAN DURING THE YEAR: - MARK WIETECHA ($1,110,053 DISTRIBUTION IN 2021, $258,750 WAS CONTRIBUTED TO THE PLAN) - AMY KNIGHT (NO DISTRIBUTION IN 2021, $174,4240 WAS CONTRIBUTED TO THE PLAN) - NANCY STAHL ($91,263 DISTRIBUTION IN 2021, $11,918 WAS CONTRIBUTED TO THE PLAN)</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 7</FormAndLineReferenceDesc>
        <ExplanationTxt>MARK WIETECHA'S COMPENSATION AGREEMENT ALLOWS FOR AN ANNUAL BONUS, WITH THE ACTUAL AMOUNT APPROVED BY THE BOARD. AMY KNIGHT'S COMPENSATION AGREEMENT ALLOWS FOR AN ANNUAL BONUS, WITH THE ACTUAL AMOUNT REVIEWED BY THE COMPENSATION COMMITTEE FOR REASONABLENESS AND APPROVED BY MARK WIETECHA. ALL REMAINING EMPLOYEES ARE ELIGIBLE TO RECEIVE AN ANNUAL BONUS, OF WHICH THE POOL AMOUNT IS APPROVED BY THE BOARD, AND INDIVIDUAL ACTUAL AMOUNTS ARE APPROVED BY THE CEO AND PRESIDENT.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS, INC. (NACHRI) ACTS AS THE "COMMON PAYMASTER" FOR ITS RELATED ENTITIES. NACHRI ISSUES ALL W-2S FOR ALL EMPLOYEES OF THIS GROUP. THE W-2S ARE REPORTED ONLY ON THE NACHRI RETURN, WHILE COMPENSATION ALLOCATED BY TIME-SPENT IS REPORTED ON THE RETURNS OF THESE ENTITIES.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERSHIP IS COMPOSED OF TWO CATEGORIES, VOTING AND NONVOTING, AND MAY BE GRANTED UPON APPLICATION TO THE BOARD OF TRUSTEES, WHICH SHALL ESTABLISH MEMBERSHIP CRITERIA, GRANT OR DENY MEMBERSHIP AND ASSIGN APPLICANTS TO MEMBERSHIP CATEGORIES AT ITS PLEASURE. THE SOLE VOTING MEMBER IS THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS, INC., A RELATED, NON-PROFIT ENTITY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>NACHRI'S BOARD OF TRUSTEES CONSISTS OF THOSE PERSONS WHO SERVE AS TRUSTEES OF NACHRI'S SOLE MEMBER, THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH), A RELATED 501(C)(6) ORGANIZATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEMBERSHIP MAY APPROVE VARIOUS DECISIONS OF THE GOVERNING BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>INITIAL COMPILATION OF INFORMATION IS COMPLETED BY FINANCE STAFF FOR TRANSMISSION TO AN OUTSIDE FIRM FOR TAX RETURN PREPRATION. THE DRAFT RETURN IS REVIEWED BY FINANCE STAFF AND THE CFAO. THE DRAFT RETURN IS PROVIDED TO THE BOARD OF TRUSTEES; ANY BOARD COMMENTS OR QUESTIONS ARE CLEARED PRIOR TO FILING THE FINAL RETURN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>PERIODICALLY, THE BOARD OF TRUSTEES MUST FILL OUT A CONFLICT OF INTEREST QUESTIONNAIRE AND ALSO SUBMIT TO BACKGROUND CHECKS OF VARYING DEGREES. THE RESULTS ARE REVIEWED BY THE CEO AND ALSO THE EXTERNAL AUDITORS. AT THE START OF ALL BOARD AND COMMITTEE MEETINGS, THE PARTICIPATING MEMBERS ARE ASKED TO DECLARE ANY CONFLICT OF INTEREST ACCORDINGLY. PERIODICALLY, ALL STAFF MUST FILL OUT A CONFLICT OF INTEREST FORM AND MUST ADHERE TO THE ASSOCIATION'S CONFLICT OF INTEREST POLICY. ANY CONFLICTS OF INTEREST ARE RESOLVED AS APPROPRIATE. THE HUMAN RESOURCE DEPARTMENT ENCOURAGES STAFF TO BRING ANY SITUATIONS TO THEIR ATTENTION AND MAKE PROMPT AND FULL DISCLOSURE OF ANY POTENTIAL SITUATIONS THAT MAY INVOLVE A CONFLICT OF INTEREST. THE POLICY IS INCLUDED IN OUR EMPLOYEE MANUAL AND WHISTLEBLOWER POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CURRENT CEO WAS HIRED IN SEPTEMBER 2011 AND THE CURRENT PRESIDENT WAS HIRED IN DECEMBER 2011. THIS PROCESS INVOLVED A NATIONAL SEARCH FIRM THAT WAS CLOSELY MONITORED BY A TASK FORCE AND THE BOARD OF TRUSTEES. IN ADDITION, THE GOVERNANCE COMMITTEE ALSO ACTS AS THE COMPENSATION COMMITTEE AND REVIEWS ALL COMPENSATION RELATED MATTERS. THE CEO AND PRESIDENT'S COMPENSATION WAS BASED ON MARKET COMPARABLES OF SIMILAR SIZED ORGANIZATIONS AND RESPONSIBILITIES. THE COMPENSATION IS ALSO INCLUDED IN A WRITTEN EMPLOYMENT AGREEMENT. A COMPLETE REVIEW OF ALL SALARIES OCCURRED DURING 2018. SALARY INCREASES ARE RECOMMENDED BY THE GOVERNANCE COMMITTEE TO THE FULL BOARD FOR APPROVAL IN EXECUTIVE SESSION WITHOUT THE CEO PRESENT. FOR ALL OTHER STAFF, THE ASSOCIATION PERIODICALLY ENGAGES AN OUTSIDE CONSULTANT FOR COMPENSATION STUDIES TO REVIEW ALL JOB DESCRIPTIONS AND SALARIES. THIS CONSULTANT HAS EXPERTISE IN THE NON-PROFIT AND HEALTH FIELDS AND IS VERY FAMILIAR WITH THE COMPENSATION PRACTICES. THE CONSULTANT REVIEWS THE COMPENSATION OF OTHER NATIONAL ASSOCIATIONS AND PEER GROUPS. SELECTED SENIOR STAFF WERE GIVEN RAISES AS A RESULT OF A CONSOLIDATION OF POSITIONS AND THESE WERE REVIEWED BY THE GOVERNANCE COMMITTEE. A FORMAL EVALUATION OF ALL CURRENT SALARIES OCCURRED DURING 2018. ALL OTHER STAFF RECEIVED MINIMAL INCREASES IN LINE WITH THE MOST RECENT COMPENSATION STUDIES COMPLETED.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS AND CONFLICT OF INTREST POLICY ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC. AUDITED FINANCIAL STATEMENTS AND FORM 990 ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART IX, LINE 11G</FormAndLineReferenceDesc>
        <ExplanationTxt>MISCELLANEOUS: PROGRAM SERVICE EXPENSES 2,252,008. MANAGEMENT AND GENERAL EXPENSES 770,626. FUNDRAISING EXPENSES 61,686. TOTAL EXPENSES 3,084,320.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
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          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
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          <AddressLine1Txt>600 13TH STREET NW SUITE 500</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20090</ZIPCd>
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        <EIN>582176067</EIN>
        <PrimaryActivitiesTxt>ASSIST CHILDREN'S HOSPITALS IN COMMON BUSINESS INTEREST AND ECONOMIC WELFARE</PrimaryActivitiesTxt>
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      <IdRelatedTaxExemptOrgGrp>
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          <AddressLine1Txt>16011 COLLEGE BLVD SUITE 250</AddressLine1Txt>
          <CityNm>LENEXA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66219</ZIPCd>
        </USAddress>
        <EIN>270386722</EIN>
        <PrimaryActivitiesTxt>IMPROVE SAFETY OF CHILDREN'S HOSPITALS BY SHARING DATA &amp; EXPERIENCES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KS</LegalDomicileStateCd>
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          <BusinessNameLine1Txt>CHILD HEALTH CORPORATION OF AMERICA</BusinessNameLine1Txt>
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          <AddressLine1Txt>16011 COLLEGE BLVD</AddressLine1Txt>
          <CityNm>LENEXA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66219</ZIPCd>
        </USAddress>
        <EIN>521421302</EIN>
        <PrimaryActivitiesTxt>HOSPITAL BUSINESS ALLIANCE TO BETTER SERVE CHILDREN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
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      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
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      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
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      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
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          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>L</TransactionTypeTxt>
        <InvolvedAmt>1648132</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
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      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC</BusinessNameLine1Txt>
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        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>1545840</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS INC</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
        <InvolvedAmt>549377</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CHILD HEALTH PATIENT SAFETY ORGANIZATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
        <InvolvedAmt>341314</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>CHILD HEALTH PATIENT SAFETY ORGANIZATION</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>475156</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
