<?xml version="1.0" encoding="utf-8"?>
<Return xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.irs.gov/efile" returnVersion="2020v4.2">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2022-05-13T15:25:54-05:00</ReturnTs>
    <TaxPeriodEndDt>2021-06-30</TaxPeriodEndDt>
    <PreparerFirmGrp>
      <PreparerFirmEIN>366055558</PreparerFirmEIN>
      <PreparerFirmName>
        <BusinessNameLine1Txt>GRANT THORNTON LLP</BusinessNameLine1Txt>
      </PreparerFirmName>
      <PreparerUSAddress>
        <AddressLine1Txt>1000 WILSON BLVD SUITE 1400</AddressLine1Txt>
        <CityNm>ARLINGTON</CityNm>
        <StateAbbreviationCd>VA</StateAbbreviationCd>
        <ZIPCd>22209</ZIPCd>
      </PreparerUSAddress>
    </PreparerFirmGrp>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2020-07-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>521862406</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>HEALTH SERVICES FOR CHILDREN WITH</BusinessNameLine1Txt>
        <BusinessNameLine2Txt>SPECIAL NEEDS INC</BusinessNameLine2Txt>
      </BusinessName>
      <BusinessNameControlTxt>HEAL</BusinessNameControlTxt>
      <PhoneNum>2024765000</PhoneNum>
      <USAddress>
        <AddressLine1Txt>111 MICHIGAN AVE NW</AddressLine1Txt>
        <CityNm>WASHINGTON</CityNm>
        <StateAbbreviationCd>DC</StateAbbreviationCd>
        <ZIPCd>20010</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>ALDWIN LINDSAY</PersonNm>
      <PersonTitleTxt>CFO</PersonTitleTxt>
      <PhoneNum>2024765000</PhoneNum>
      <SignatureDt>2022-05-13</SignatureDt>
      <DiscussWithPaidPreparerInd>1</DiscussWithPaidPreparerInd>
    </BusinessOfficerGrp>
    <SigningOfficerGrp>
      <PersonFullName>
        <PersonFirstNm>ALDWIN</PersonFirstNm>
        <PersonLastNm>LINDSAY</PersonLastNm>
      </PersonFullName>
      <SSN>999009999</SSN>
    </SigningOfficerGrp>
    <PreparerPersonGrp>
      <PreparerPersonNm>MARY TORRETTA</PreparerPersonNm>
      <PTIN>P00847851</PTIN>
      <PhoneNum>7038477500</PhoneNum>
    </PreparerPersonGrp>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>3</TrustedCustomerCd>
        <AuthenticationAssuranceLevelCd>AAL1</AuthenticationAssuranceLevelCd>
        <IdentityAssuranceLevelCd>IAL1</IdentityAssuranceLevelCd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2020</TaxYr>
    <BuildTS>2022-09-23 18:48:47Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="6">
    <IRS990 documentId="RetDoc1038000001" referenceDocumentId="RetDoc1044400001">
      <PrincipalOfficerNm>NATHANIEL BEERS MD</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>111 MICHIGAN AVE NW</AddressLine1Txt>
        <CityNm>WASHINGTON</CityNm>
        <StateAbbreviationCd>DC</StateAbbreviationCd>
        <ZIPCd>20010</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>176897085</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <WebsiteAddressTxt>HTTPS://WWW.CHILDRENSNATIONAL.ORG/HSC</WebsiteAddressTxt>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1994</FormationYr>
      <LegalDomicileStateCd>DC</LegalDomicileStateCd>
      <ActivityOrMissionDesc>SEE SCHEDULE O.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>6</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>5</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>214</TotalEmployeeCnt>
      <TotalVolunteersCnt>5</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>0</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>0</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>88246359</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>176260303</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>299735</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>551324</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>76018</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>88546094</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>176887645</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>0</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>0</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>9778019</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>20612514</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>0</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>0</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>0</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>78252668</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>151214671</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>88030687</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>171827185</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>515407</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>5060460</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>65554023</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>113351852</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>43291621</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>81197860</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>22262402</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>32153992</NetAssetsOrFundBalancesEOYAmt>
      <InfoInScheduleOPartIIIInd>X</InfoInScheduleOPartIIIInd>
      <MissionDesc>TO PROVIDE COORDINATION OF HEALTHCARE, SOCIAL, AND EDUCATIONAL, SERVICES FOR INFANTS, CHILDREN, ADOLESCENTS, AND YOUNG ADULTS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOLOGICAL NEEDS.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>143509283</ExpenseAmt>
      <RevenueAmt>176260303</RevenueAmt>
      <Desc>SEE SCHEDULE O</Desc>
      <TotalProgramServiceExpensesAmt>143509283</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="RetDoc1039100001">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd>0</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd referenceDocumentId="RetDoc1040000001">0</DonorAdvisedFundInd>
      <ConservationEasementsInd referenceDocumentId="RetDoc1040000001">0</ConservationEasementsInd>
      <CollectionsOfArtInd referenceDocumentId="RetDoc1040000001">0</CollectionsOfArtInd>
      <CreditCounselingInd referenceDocumentId="RetDoc1040000001">0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd>0</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd referenceDocumentId="RetDoc1040000001">1</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="RetDoc1040000001">0</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd referenceDocumentId="RetDoc1040000001">0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="RetDoc1040000001">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="RetDoc1040000001">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd referenceDocumentId="RetDoc1040000001">1</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="RetDoc1040000001">1</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd>0</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd>0</GrantsToIndividualsInd>
      <ScheduleJRequiredInd referenceDocumentId="RetDoc1042400001">1</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd referenceDocumentId="RetDoc1043400001">0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="RetDoc1043400001">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd referenceDocumentId="RetDoc1043400001">0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd referenceDocumentId="RetDoc1043400001">0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>462</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>1</BackupWthldComplianceInd>
      <EmployeeCnt>214</EmployeeCnt>
      <EmploymentTaxReturnsFiledInd>1</EmploymentTaxReturnsFiledInd>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <QuidProQuoContributionsInd>0</QuidProQuoContributionsInd>
      <Form8282PropertyDisposedOfInd>0</Form8282PropertyDisposedOfInd>
      <RcvFndsToPayPrsnlBnftCntrctInd>0</RcvFndsToPayPrsnlBnftCntrctInd>
      <PayPremiumsPrsnlBnftCntrctInd>0</PayPremiumsPrsnlBnftCntrctInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>6</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>5</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>1</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>1</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>1</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <BusinessName>
          <BusinessNameLine1Txt>CORPORATE OFFICERS</BusinessNameLine1Txt>
        </BusinessName>
        <PhoneNum>2024765000</PhoneNum>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVE</AddressLine1Txt>
          <CityNm>NW WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <InfoInScheduleOPartVIIInd>X</InfoInScheduleOPartVIIInd>
      <Form990PartVIISectionAGrp>
        <PersonNm>ANNA PILSKAYA DUNN</PersonNm>
        <TitleTxt>CHAIR TO 07/20/PRESIDENT OF HSCSN</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>173658</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>18</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NEIL GRAMMER</PersonNm>
        <TitleTxt>BOARD CHAIR</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NATHANIEL BEERS</PersonNm>
        <TitleTxt>PRESIDENT OF HSC, BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>22.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>33.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>613870</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>111377</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>WENDY GOLDBERG</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>2.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>SHARON BRICKHOUSE MARTIN</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MICHAEL JONES</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>2.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KATHRYN KUHMERKER</PersonNm>
        <TitleTxt>BOARD MEMBER</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALEC KING</PersonNm>
        <TitleTxt>TREASURER &amp; EVP/CFO TO 10/20</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>54.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>702850</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>35922</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>MARY ANNE HILLIARD</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>54.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>822880</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>126992</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ALDWIN LINSDAY</PersonNm>
        <TitleTxt>TREASURER &amp; EVP/CFO FROM 12/20</TitleTxt>
        <AverageHoursPerWeekRt>1.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>54.00</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>440893</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>38519</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>ERIC LEVEY MD</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>330285</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>42098</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>STEPHANIE TAYLOR</PersonNm>
        <TitleTxt>VP QUALITY &amp; RISK MANAGEMENT</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>218586</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>23832</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>LISA PROCTOR</PersonNm>
        <TitleTxt>VP MARKETING &amp; OUTREACH</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>210597</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>28568</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>RICHARD BOLDUC</PersonNm>
        <TitleTxt>VP APP &amp; DATA ANALYTICS TO 4/21</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>222572</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>26564</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>NADINE COY</PersonNm>
        <TitleTxt>CHIEF OPERATING OFFICER</TitleTxt>
        <AverageHoursPerWeekRt>55.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <HighestCompensatedEmployeeInd>X</HighestCompensatedEmployeeInd>
        <ReportableCompFromOrgAmt>263710</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>32626</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>KIMBERLY BROWN</PersonNm>
        <TitleTxt>FMR VP FINANCE/INT CFO TO 11/19</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>55.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>257224</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>31870</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>VICTOR FIELDS</PersonNm>
        <TitleTxt>FORMER EVP MGD CARE TO 3/20</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>453772</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>41563</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>THOMAS W CHAPMAN</PersonNm>
        <TitleTxt>FMR PRESIDENT &amp; CEO TO 4/17</TitleTxt>
        <AverageHoursPerWeekRt>0.00</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.00</AverageHoursPerWeekRltdOrgRt>
        <FormerOfcrDirectorTrusteeInd>X</FormerOfcrDirectorTrusteeInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>137429</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>1245750</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>3602576</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>539949</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>129</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>1</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>1</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <ProgramServiceRevenueGrp>
        <Desc>MANAGED CARE REVENUE</Desc>
        <BusinessCd>621400</BusinessCd>
        <TotalRevenueColumnAmt>176260303</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>176260303</RelatedOrExemptFuncIncomeAmt>
      </ProgramServiceRevenueGrp>
      <TotalProgramServiceRevenueAmt>176260303</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>550309</TotalRevenueColumnAmt>
        <ExclusionAmt>550309</ExclusionAmt>
      </InvestmentIncomeGrp>
      <GrossAmountSalesAssetsGrp>
        <OtherAmt>10455</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <OtherAmt>9440</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <OtherAmt>1015</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>1015</TotalRevenueColumnAmt>
        <ExclusionAmt>1015</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <OtherRevenueMiscGrp>
        <Desc>CONSTRUCTION REFUND</Desc>
        <BusinessCd>900099</BusinessCd>
        <TotalRevenueColumnAmt>76018</TotalRevenueColumnAmt>
        <ExclusionAmt>76018</ExclusionAmt>
      </OtherRevenueMiscGrp>
      <OtherRevenueTotalAmt>76018</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>176887645</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>176260303</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>627342</ExclusionAmt>
      </TotalRevenueGrp>
      <CompCurrentOfcrDirectorsGrp>
        <TotalAmt>338435</TotalAmt>
        <ManagementAndGeneralAmt>338435</ManagementAndGeneralAmt>
      </CompCurrentOfcrDirectorsGrp>
      <OtherSalariesAndWagesGrp>
        <TotalAmt>17026605</TotalAmt>
        <ProgramServicesAmt>10411946</ProgramServicesAmt>
        <ManagementAndGeneralAmt>6614659</ManagementAndGeneralAmt>
      </OtherSalariesAndWagesGrp>
      <PensionPlanContributionsGrp>
        <TotalAmt>545866</TotalAmt>
        <ProgramServicesAmt>13128</ProgramServicesAmt>
        <ManagementAndGeneralAmt>532738</ManagementAndGeneralAmt>
      </PensionPlanContributionsGrp>
      <OtherEmployeeBenefitsGrp>
        <TotalAmt>1325010</TotalAmt>
        <ProgramServicesAmt>2398</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1322612</ManagementAndGeneralAmt>
      </OtherEmployeeBenefitsGrp>
      <PayrollTaxesGrp>
        <TotalAmt>1376598</TotalAmt>
        <ProgramServicesAmt>35075</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1341523</ManagementAndGeneralAmt>
      </PayrollTaxesGrp>
      <FeesForSrvcInvstMgmntFeesGrp>
        <TotalAmt>14602</TotalAmt>
        <ManagementAndGeneralAmt>14602</ManagementAndGeneralAmt>
      </FeesForSrvcInvstMgmntFeesGrp>
      <FeesForServicesOtherGrp>
        <TotalAmt>4102437</TotalAmt>
        <ProgramServicesAmt>1275271</ProgramServicesAmt>
        <ManagementAndGeneralAmt>2827166</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <AdvertisingGrp>
        <TotalAmt>649</TotalAmt>
        <ManagementAndGeneralAmt>649</ManagementAndGeneralAmt>
      </AdvertisingGrp>
      <OfficeExpensesGrp>
        <TotalAmt>1310774</TotalAmt>
        <ProgramServicesAmt>160966</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1149808</ManagementAndGeneralAmt>
      </OfficeExpensesGrp>
      <InformationTechnologyGrp>
        <TotalAmt>1595421</TotalAmt>
        <ProgramServicesAmt>32906</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1562515</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <OccupancyGrp>
        <TotalAmt>1033261</TotalAmt>
        <ManagementAndGeneralAmt>1033261</ManagementAndGeneralAmt>
      </OccupancyGrp>
      <TravelGrp>
        <TotalAmt>30887</TotalAmt>
        <ProgramServicesAmt>10794</ProgramServicesAmt>
        <ManagementAndGeneralAmt>20093</ManagementAndGeneralAmt>
      </TravelGrp>
      <ConferencesMeetingsGrp>
        <TotalAmt>1495</TotalAmt>
        <ManagementAndGeneralAmt>1495</ManagementAndGeneralAmt>
      </ConferencesMeetingsGrp>
      <InterestGrp>
        <TotalAmt>3322</TotalAmt>
        <ManagementAndGeneralAmt>3322</ManagementAndGeneralAmt>
      </InterestGrp>
      <DepreciationDepletionGrp>
        <TotalAmt>1531383</TotalAmt>
        <ManagementAndGeneralAmt>1531383</ManagementAndGeneralAmt>
      </DepreciationDepletionGrp>
      <InsuranceGrp>
        <TotalAmt>39108</TotalAmt>
        <ManagementAndGeneralAmt>39108</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <OtherExpensesGrp>
        <Desc>HEALTHCARE SERVICE COST</Desc>
        <TotalAmt>132630188</TotalAmt>
        <ProgramServicesAmt>131561870</ProgramServicesAmt>
        <ManagementAndGeneralAmt>1068318</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>SHARED SERVICE ALLOC</Desc>
        <TotalAmt>5328000</TotalAmt>
        <ManagementAndGeneralAmt>5328000</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>PREMIUM TAXES</Desc>
        <TotalAmt>3510514</TotalAmt>
        <ManagementAndGeneralAmt>3510514</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <OtherExpensesGrp>
        <Desc>BOOKS &amp; SUBSCRIPTIONS</Desc>
        <TotalAmt>63245</TotalAmt>
        <ProgramServicesAmt>4929</ProgramServicesAmt>
        <ManagementAndGeneralAmt>58316</ManagementAndGeneralAmt>
      </OtherExpensesGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>19385</TotalAmt>
        <ManagementAndGeneralAmt>19385</ManagementAndGeneralAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>171827185</TotalAmt>
        <ProgramServicesAmt>143509283</ProgramServicesAmt>
        <ManagementAndGeneralAmt>28317902</ManagementAndGeneralAmt>
        <FundraisingAmt>0</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>23922476</BOYAmt>
        <EOYAmt>52673991</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>155647</BOYAmt>
        <EOYAmt>23553236</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>6816532</BOYAmt>
        <EOYAmt>6152937</EOYAmt>
      </AccountsReceivableGrp>
      <ReceivablesFromOfficersEtcGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </ReceivablesFromOfficersEtcGrp>
      <RcvblFromDisqualifiedPrsnGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </RcvblFromDisqualifiedPrsnGrp>
      <OthNotesLoansReceivableNetGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </OthNotesLoansReceivableNetGrp>
      <InventoriesForSaleOrUseGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InventoriesForSaleOrUseGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>18066</BOYAmt>
        <EOYAmt>131740</EOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <LandBldgEquipCostOrOtherBssAmt>6360511</LandBldgEquipCostOrOtherBssAmt>
      <LandBldgEquipAccumDeprecAmt>2618146</LandBldgEquipAccumDeprecAmt>
      <LandBldgEquipBasisNetGrp>
        <BOYAmt>4236099</BOYAmt>
        <EOYAmt>3742365</EOYAmt>
      </LandBldgEquipBasisNetGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>19091225</BOYAmt>
        <EOYAmt>23383002</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <InvestmentsProgramRelatedGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </InvestmentsProgramRelatedGrp>
      <IntangibleAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </IntangibleAssetsGrp>
      <OtherAssetsTotalGrp>
        <BOYAmt>11313978</BOYAmt>
        <EOYAmt>3714581</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>65554023</BOYAmt>
        <EOYAmt>113351852</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>38599022</BOYAmt>
        <EOYAmt>32575956</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <GrantsPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </GrantsPayableGrp>
      <DeferredRevenueGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DeferredRevenueGrp>
      <TaxExemptBondLiabilitiesGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </TaxExemptBondLiabilitiesGrp>
      <EscrowAccountLiabilityGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </EscrowAccountLiabilityGrp>
      <LoansFromOfficersDirectorsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </LoansFromOfficersDirectorsGrp>
      <MortgNotesPyblScrdInvstPropGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </MortgNotesPyblScrdInvstPropGrp>
      <UnsecuredNotesLoansPayableGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </UnsecuredNotesLoansPayableGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>4692599</BOYAmt>
        <EOYAmt>48621904</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>43291621</BOYAmt>
        <EOYAmt>81197860</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>22262402</BOYAmt>
        <EOYAmt>32153992</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>0</BOYAmt>
        <EOYAmt>0</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>22262402</BOYAmt>
        <EOYAmt>32153992</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>65554023</BOYAmt>
        <EOYAmt>113351852</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <InfoInScheduleOPartXIInd>X</InfoInScheduleOPartXIInd>
      <ReconcilationRevenueExpnssAmt>5060460</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>4431184</NetUnrlzdGainsLossesInvstAmt>
      <OtherChangesInNetAssetsAmt>399946</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>0</AccountantCompileOrReviewInd>
      <FSAuditedInd>1</FSAuditedInd>
      <FSAuditedBasisGrp>
        <ConsolidatedBasisFinclStmtInd>X</ConsolidatedBasisFinclStmtInd>
      </FSAuditedBasisGrp>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="RetDoc1039100001">
      <PubliclySupportedOrg509a2Ind>X</PubliclySupportedOrg509a2Ind>
      <GiftsGrantsContrisRcvd509Grp>
        <CurrentTaxYearMinus4YearsAmt>5000</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>105</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>85</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>0</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>0</CurrentTaxYearAmt>
        <TotalAmt>5190</TotalAmt>
      </GiftsGrantsContrisRcvd509Grp>
      <GrossReceiptsAdmissionsGrp>
        <CurrentTaxYearMinus4YearsAmt>183616892</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>182035004</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>180417655</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>88246359</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>176260303</CurrentTaxYearAmt>
        <TotalAmt>810576213</TotalAmt>
      </GrossReceiptsAdmissionsGrp>
      <Total509Grp>
        <CurrentTaxYearMinus4YearsAmt>183621892</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>182035109</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>180417740</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>88246359</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>176260303</CurrentTaxYearAmt>
        <TotalAmt>810581403</TotalAmt>
      </Total509Grp>
      <AmountsRcvdDsqlfyPersonGrp>
        <TotalAmt>0</TotalAmt>
      </AmountsRcvdDsqlfyPersonGrp>
      <SubstantialContributorsAmtGrp>
        <TotalAmt>0</TotalAmt>
      </SubstantialContributorsAmtGrp>
      <SubstAndDsqlfyPrsnsTotGrp>
        <TotalAmt>0</TotalAmt>
      </SubstAndDsqlfyPrsnsTotGrp>
      <PublicSupportTotal509Amt>810581403</PublicSupportTotal509Amt>
      <GrossInvestmentIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>1223</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>282261</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>745896</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>299735</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>550309</CurrentTaxYearAmt>
        <TotalAmt>1879424</TotalAmt>
      </GrossInvestmentIncome509Grp>
      <InvestmentIncomeAndUBTIGrp>
        <CurrentTaxYearMinus4YearsAmt>1223</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>282261</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>745896</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>299735</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>550309</CurrentTaxYearAmt>
        <TotalAmt>1879424</TotalAmt>
      </InvestmentIncomeAndUBTIGrp>
      <OtherIncome509Grp>
        <CurrentTaxYearMinus4YearsAmt>2683</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>1681</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>23</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearAmt>76018</CurrentTaxYearAmt>
        <TotalAmt>80405</TotalAmt>
      </OtherIncome509Grp>
      <TotalSupportCalendarYearGrp>
        <CurrentTaxYearMinus4YearsAmt>183625798</CurrentTaxYearMinus4YearsAmt>
        <CurrentTaxYearMinus3YearsAmt>182319051</CurrentTaxYearMinus3YearsAmt>
        <CurrentTaxYearMinus2YearsAmt>181163659</CurrentTaxYearMinus2YearsAmt>
        <CurrentTaxYearMinus1YearAmt>88546094</CurrentTaxYearMinus1YearAmt>
        <CurrentTaxYearAmt>176886630</CurrentTaxYearAmt>
        <TotalAmt>812541232</TotalAmt>
      </TotalSupportCalendarYearGrp>
      <PublicSupportCY509Pct>0.99760</PublicSupportCY509Pct>
      <PublicSupportPY509Pct>0.99840</PublicSupportPY509Pct>
      <InvestmentIncomeCYPct>0.00230</InvestmentIncomeCYPct>
      <InvestmentIncomePYPct>0.00160</InvestmentIncomePYPct>
      <ThirtyThrPctSuprtTestsCY509Ind>X</ThirtyThrPctSuprtTestsCY509Ind>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:</FormAndLineReferenceDesc>
        <ExplanationTxt>OTHER INCOME - 2016 AMOUNT: $ 2,683. 2017 AMOUNT: $ 1,681. 2018 AMOUNT: $ 23. 2019 AMOUNT: $ 0. 2020 AMOUNT: $ 76,018.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>PART III, SHORT YEAR EXPLANATION:</FormAndLineReferenceDesc>
        <ExplanationTxt>THE BOARD OF THE ORGANIZATION APPROVED A FISCAL YEAR CHANGE TO 6/30, WHICH REQUIRED THAT THE ORGANIZATION FILE A SHORT-PERIOD RETURN FOR THE YEAR ENDING 6/30/2020. THE AMOUNTS LISTED FOR 2019 REPRESENT THE SHORT PERIOD FROM 1/1/2020 TO 6/30/2020.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleD documentId="RetDoc1040000001">
      <LeaseholdImprovementsGrp>
        <OtherCostOrOtherBasisAmt>2787995</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>615620</DepreciationAmt>
        <BookValueAmt>2172375</BookValueAmt>
      </LeaseholdImprovementsGrp>
      <EquipmentGrp>
        <OtherCostOrOtherBasisAmt>3533316</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>1963326</DepreciationAmt>
        <BookValueAmt>1569990</BookValueAmt>
      </EquipmentGrp>
      <OtherLandBuildingsGrp>
        <OtherCostOrOtherBasisAmt>39200</OtherCostOrOtherBasisAmt>
        <DepreciationAmt>39200</DepreciationAmt>
        <BookValueAmt>0</BookValueAmt>
      </OtherLandBuildingsGrp>
      <TotalBookValueLandBuildingsAmt>3742365</TotalBookValueLandBuildingsAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>DUE TO AFFILIATES</Desc>
        <Amt>44457947</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>OPERATING LEASE LIABILITY</Desc>
        <Amt>3965316</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>FINANCING LEASE LIABILITY</Desc>
        <Amt>107241</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>SELF INSURANCE LIABILITY</Desc>
        <Amt>91400</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>48621904</TotalLiabilityAmt>
      <FootnoteTextInd>X</FootnoteTextInd>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART X, LINE 2:</FormAndLineReferenceDesc>
        <ExplanationTxt>LIABILITY FOR UNCERTAIN TAX POSITION (ASC 740) FIN 48 FINANCIAL STATEMENT FOOTNOTE FROM CHILDREN'S NATIONAL MEDICAL CENTER (CHILDREN'S NATIONAL), THE PARENT OF HSCSN'S SOLE MEMBER, 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, 2021 AND 2020 AS CHILDREN'S NATIONAL HAS NO UNCERTAIN TAX POSITIONS.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleJ documentId="RetDoc1042400001">
      <SeverancePaymentInd>1</SeverancePaymentInd>
      <SupplementalNonqualRtrPlanInd>1</SupplementalNonqualRtrPlanInd>
      <EquityBasedCompArrngmInd>0</EquityBasedCompArrngmInd>
      <CompBasedOnRevenueOfFlngOrgInd>0</CompBasedOnRevenueOfFlngOrgInd>
      <CompBsdOnRevRelatedOrgsInd>0</CompBsdOnRevRelatedOrgsInd>
      <CompBsdNetEarnsFlngOrgInd>0</CompBsdNetEarnsFlngOrgInd>
      <CompBsdNetEarnsRltdOrgsInd>0</CompBsdNetEarnsRltdOrgsInd>
      <AnyNonFixedPaymentsInd>0</AnyNonFixedPaymentsInd>
      <InitialContractExceptionInd>0</InitialContractExceptionInd>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MARY ANNE HILLIARD</PersonNm>
        <TitleTxt>SECRETARY</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>526285</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>207524</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>89071</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>91684</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>35308</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>949872</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>65414</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALEC KING</PersonNm>
        <TitleTxt>TREASURER &amp; EVP/CFO TO 10/20</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>540791</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>-20853</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>182912</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>14250</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>21672</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>738772</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>100312</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NATHANIEL BEERS</PersonNm>
        <TitleTxt>PRESIDENT OF HSC, BOARD MEMBER</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>454172</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>140198</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>19500</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>84000</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>27377</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>725247</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>VICTOR FIELDS</PersonNm>
        <TitleTxt>FORMER EVP MGD CARE TO 3/20</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>130295</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>62156</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>261321</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>22208</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19355</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>495335</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ALDWIN LINSDAY</PersonNm>
        <TitleTxt>TREASURER &amp; EVP/CFO FROM 12/20</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>323772</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>72276</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>44845</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>36741</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1778</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>479412</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>24355</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ERIC LEVEY MD</PersonNm>
        <TitleTxt>CHIEF MEDICAL OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>294656</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>35024</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>605</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>14616</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>27482</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>372383</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>NADINE COY</PersonNm>
        <TitleTxt>CHIEF OPERATING OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>231313</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>31898</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>499</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>13149</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>19477</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>296336</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KIMBERLY BROWN</PersonNm>
        <TitleTxt>FMR VP FINANCE/INT CFO TO 11/19</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>254719</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>300</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>2205</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>12393</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>19477</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>289094</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>RICHARD BOLDUC</PersonNm>
        <TitleTxt>VP APP &amp; DATA ANALYTICS TO 4/21</TitleTxt>
        <BaseCompensationFilingOrgAmt>198445</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>23821</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>306</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>5892</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>20672</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>249136</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>STEPHANIE TAYLOR</PersonNm>
        <TitleTxt>VP QUALITY &amp; RISK MANAGEMENT</TitleTxt>
        <BaseCompensationFilingOrgAmt>203354</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>14339</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>893</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>11072</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>12760</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>242418</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LISA PROCTOR</PersonNm>
        <TitleTxt>VP MARKETING &amp; OUTREACH</TitleTxt>
        <BaseCompensationFilingOrgAmt>185908</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>24272</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>417</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>0</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>10503</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18065</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>239165</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>0</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>ANNA PILSKAYA DUNN</PersonNm>
        <TitleTxt>CHAIR TO 07/20/PRESIDENT OF HSCSN</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>143429</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>30000</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>229</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>18</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>173676</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>THOMAS W CHAPMAN</PersonNm>
        <TitleTxt>FMR PRESIDENT &amp; CEO TO 4/17</TitleTxt>
        <BaseCompensationFilingOrgAmt>0</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>0</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>0</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>0</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>0</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>137429</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>0</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>0</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>0</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>137429</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 3:</FormAndLineReferenceDesc>
        <ExplanationTxt>RELATED ORGANIZATION HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. (HSCSN) RELIES ON ITS SOLE MEMBER'S PARENT, CHILDREN'S NATIONAL MEDICAL CENTER (DBA CHILDREN'S NATIONAL), TO DETERMINE COMPENSATION FOR HSCSN'S PRESIDENT. CHILDREN'S NATIONAL USES AN EXECUTIVE COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE PEOPLE, CULTURE AND COMPENSATION COMMITTEE OF THE BOARD TO ESTABLISH COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4A:</FormAndLineReferenceDesc>
        <ExplanationTxt>SEVERANCE THE FOLLOWING FORMER OFFICERS RECEIVED A SEVERANCE PAYMENT. THE SEVERANCE PAYMENTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(III) AS PART OF OTHER REPORTABLE COMPENSATION: VICTOR FIELDS $260,100 THOMAS W. CHAPMAN $137,429</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>SCHEDULE J, PART I, LINE 4B:</FormAndLineReferenceDesc>
        <ExplanationTxt>SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED SUPPLEMENTAL 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: ALDWIN LINDSAY $22,491 MARY ANN HILLIARD $77,434 NATHANIEL BEERS $69,750 VICTOR FIELDS $16,500</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART I, LINE 1</FormAndLineReferenceDesc>
        <ExplanationTxt>TO PROVIDE COORDINATION OF HEALTHCARE, SOCIAL, AND EDUCATIONAL SERVICES TO PERSONS WHO HAVE DISABILITIES AND/OR COMPLEX MEDICAL AND/OR PSYCHOLOGICAL NEEDS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART III, LINE 4A</FormAndLineReferenceDesc>
        <ExplanationTxt>PROGRAM SERVICE ACTIVITY 1 HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. (HSCSN) SERVED OVER 5,000 ENROLLEES DURING THE TWELVE MONTHS ENDED JUNE 30, 2021 THROUGH INTENSE ONE ON ONE CARE MANAGEMENT SERVICES. HSCSN COLLABORATED WITH 1,400 PROVIDERS (SYSTEM AND GROUP LEVEL) TO PROVIDE ITS ENROLLEES WITH QUALITY MEDICAL CARE. HSCSN FACILITATED $42 MILLION DOLLARS OF INPATIENT CARE, OVER $28 MILLION DOLLARS OF PRIMARY/SPECIALTY CARE, $16 MILLION DOLLARS OF OUTPATIENT CARE (INCLUDING EMERGENCY ROOM), AND $27 MILLION DOLLARS OF HOME HEALTH CARE. HSCSN ENROLLEES UTILIZED 2,924 EMERGENCY DEPARTMENT VISITS AND A TOTAL OF 674 HOSPITAL ADMISSIONS. HSCSN COVERED APPROXIMATELY 62,000 PRESCRIPTIONS, WHICH TOTALED OVER $14.7 MILLION DOLLARS. OF THE 62,000 PRESCRIPTIONS FILLED IN THE TWELVE MONTHS ENDED JUNE 30, 2021, 705 OR 1.1% WERE FOR SPECIALTY MEDICATIONS WHICH ARE REQUIRED FOR COMPLEX MEDICAL CONDITIONS - TOTALING OVER $8.9 MILLION DOLLARS. OTHER SERVICES COORDINATED INCLUDE: TRANSPORTATION TO MEDICAL APPOINTMENTS, DENTAL CARE, LAB/RADIOLOGY SERVICES, DAY TREATMENT, MEDICAL DRUGS AND MEDICAL EQUIPMENT AND SUPPLIES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERS OR STOCKHOLDERS THE HSC FOUNDATION IS THE SOLE MEMBER OF HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>ELECTION OF MEMBERS THE SOLE MEMBER (THE HSC FOUNDATION) HAS THE RIGHT TO ELECT DIRECTORS OF HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS, INC. THE HSC FOUNDATION IS THE SOLE CORPORATE MEMBER OF HSCSN. ON SEPTEMBER 1, 2019, THE FOUNDATION AFFILIATED WITH CHILDREN'S NATIONAL MEDICAL CENTER DBA CHILDREN'S NATIONAL. EFFECTIVE SEPTEMBER 1, 2019 AND FOR A PERIOD OF FIVE YEARS THEREAFTER, THE MEMBERS OF THE FOUNDATION'S GOVERNING BODY TOGETHER WITH THE BOARD OF CHILDREN'S NATIONAL APPOINT THE MEMBERS OF HSCSN'S GOVERNING BODY. AFTER SEPTEMBER 1, 2024, CHILDREN'S NATIONAL WILL APPOINT MEMBERS OF THE HSCSN'S GOVERNING BODY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE SOLE MEMBER (THE HSC FOUNDATION) SHALL HAVE ALL OF THE POWERS SPECIFIED IN THE ARTICLES OF INCORPORATION AND BYLAWS, INCLUDING THE POWER TO: (A) ESTABLISH THE CORPORATION'S POLICIES AND GOALS; (B) APPOINT AND REMOVE THE CORPORATION'S BOARD OF DIRECTORS; (C) MONITOR THE DECISIONS OF THE CORPORATION'S BOARDS OF DIRECTORS; AND (D) APPROVE THE CORPORATION'S BUDGET. ON SEPTEMBER 1, 2019, AND BY MEANS OF AN AFFILIATION AGREEMENT, THE FOUNDATION AFFILIATED WITH CHILDREN'S NATIONAL. EFFECTIVE AS OF THAT DATE, THE FOUNDATION AND HSCSN AMENDED AND RESTATED THEIR BYLAWS TO COMPLY WITH CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE. UNDER CHILDREN'S NATIONAL'S SYSTEM OF GOVERNANCE, CHILDREN'S NATIONAL RETAINS CERTAIN AUTHORITY OVER SUBSIDIARY (AND A SUBSIDIARY OF A SUBSIDIARY) ENTITIES. THE RETENTION OF AUTHORITY INCLUDES ITEMS SUCH AS: THE AUTHORITY TO AMEND A SUBSIDIARY'S GOVERNING DOCUMENTS, AUTHORIZATION OF THE SALE OF SUBSTANTIALLY ALL ASSETS, APPOINT/REMOVE OFFICERS AND DIRECTORS, APPROVE BUDGETS, SET SIGNATURE AUTHORITY, AND ADOPT AN ENTERPRISE-WIDE COMPLIANCE PLAN. THE AFFILIATION AGREEMENT AND THE FOUNDATION AND HSCSN'S AMENDED AND RESTATED BYLAWS ANTICIPATE A FIVE-YEAR INTEGRATION PERIOD, DURING SUCH PERIOD THE ORGANIZATION AND CHILDREN'S NATIONAL WILL SHARE RESPONSIBILITY FOR CERTAIN AUTHORITIES THAT ARE OTHERWISE SET UNDER THE SYSTEM OF GOVERNANCE. AFTER SEPTEMBER 1, 2024, CHILDREN'S NATIONAL WILL HAVE SOLE RESPONSIBILITY FOR AUTHORITY THAT IS RESERVED UNDER THE SYSTEM OF GOVERNANCE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>REVIEW OF FORM 990 BY GOVERNING BODY THE RELEVANT COMMITTEES OF THE ORGANIZATION REVIEW APPLICABLE PORTIONS OF THE 990. THE FORM 990 IS REVIEWED AND APPROVED BY THE CHAIRPERSON OF THE AUDIT COMMITTEE OF CHILDREN'S NATIONAL PRIOR TO FILING WITH IRS. HSCSN PROVIDES A COPY OF THE FORM 990 TO THE FULL HSCSN BOARD PRIOR TO FILING WITH THE IRS. THE COMPLETED FORM 990 IS ALSO MADE AVAILABLE TO THE BOARD OF CHILDREN'S NATIONAL BEFORE FILING.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>CONFLICT OF INTEREST POLICY HSCSN ADOPTED THE CONFLICT OF INTEREST POLICY OF CHILDREN'S NATIONAL, THE PARENT OF ITS SOLE MEMBER. CHILDREN'S NATIONAL AND SUBSIDIARIES 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 INTEREST ARE NOTED. THE CHILDREN'S NATIONAL BOARD MAKES A DETERMINATION, BASED ON THE RECOMMENDATION OF THE CHIEF LEGAL OFFICER AS TO WHICH PERSONS SHOULD BE CONSIDERED "INTERESTED PARTIES" BASED ON THE CRITERIA SET FORTH IN THE BOARD'S GOVERNANCE POLICY. FORM 990, PART VI, LINES 13 &amp; 14: GOVERNING POLICIES HSCSN IS GOVERNED BY THE POLICIES OF CHILDREN'S NATIONAL, THE PARENT OF ITS SOLE MEMBER. THESE POLICIES INCLUDE A WRITTEN WHISTLEBLOWER POLICY AND A WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>PROCESS FOR DETERMINING COMPENSATION HSCSN RELIES ON CHILDREN'S NATIONAL, THE PARENT OF ITS SOLE MEMBER, TO DETERMINE COMPENSATION FOR ITS PRESIDENT. CHILDREN'S NATIONAL USED AN EXECUTIVE COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE PEOPLE, CULTURE AND COMPENSATION COMMITTEE OF THE BOARD TO ESTABLISH COMPENSATION.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>REQUIRED DOCUMENTS MADE AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS AND ORGANIZATIONAL DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VII, SECTION A:</FormAndLineReferenceDesc>
        <ExplanationTxt>FORMER OFFICER, KIMBERLY BROWN, IS LISTED AS "FORMER" ON PART VII, BUT CONTINUES TO BE EMPLOYED BY CHILDREN'S NATIONAL IN A LESSER CAPACITY. SHE NO LONGER SERVES HEALTH SERVICES FOR CHILDREN WITH SPECIAL NEEDS IN HER PRIOR ROLE AS OFFICER.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART XI, LINE 9:</FormAndLineReferenceDesc>
        <ExplanationTxt>RESTRUCTURING ADJUSTMENT 399,946.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE HOSPITAL FOR SICK CHILDREN</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>530204670</EIN>
        <PrimaryActivitiesTxt>HOSPITAL</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>HSC FOUNDATION</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>THE HSC FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>521346603</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12C, III-FI</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CNMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S HOSPITAL FOUNDATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>521640402</EIN>
        <PrimaryActivitiesTxt>FUNDRAISING</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CNMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S NATIONAL MEDICAL CENTER</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>521640403</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12C, III-FI</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>SAFE KIDS WORLDWIDE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>1255 23RD STREET NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20037</ZIPCd>
        </USAddress>
        <EIN>521627574</EIN>
        <PrimaryActivitiesTxt>INJURY PREVENTION</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CNMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S HOSPITAL SELF-INSURANCE TRUST</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>521640399</EIN>
        <PrimaryActivitiesTxt>INSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12C, III-FI</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S HOSPITAL</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>530196580</EIN>
        <PrimaryActivitiesTxt>HEALTHCARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 3</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CNMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>BRAINY CAMPS ASSOCIATION</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>271547370</EIN>
        <PrimaryActivitiesTxt>CHILD CAMPS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CH</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S SCHOOL SERVICES</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>814291601</EIN>
        <PrimaryActivitiesTxt>NURSING SERVICES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 12A, I</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CNMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILDREN'S RESEARCH INSTITUTE</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>521654453</EIN>
        <PrimaryActivitiesTxt>RESEARCH</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>LINE 7</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>CNMC</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>CHILDREN'S PEDIATRICIANS AND ASSOCIATES LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>522072589</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>5253 NMTC LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>832873855</EIN>
        <PrimaryActivitiesTxt>PROPERTY MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>5253 HTC LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>833044006</EIN>
        <PrimaryActivitiesTxt>PROPERTY MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>54 NMTC LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>833358685</EIN>
        <PrimaryActivitiesTxt>PROPERTY MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblPartnershipGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>54 HTC LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>833385522</EIN>
        <PrimaryActivitiesTxt>PROPERTY MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <DisproportionateAllocationsInd>0</DisproportionateAllocationsInd>
        <GeneralOrManagingPartnerInd>0</GeneralOrManagingPartnerInd>
      </IdRelatedOrgTxblPartnershipGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>CHILDREN'S NATIONAL HEALTH NETWORK</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>521996521</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BEARACUDA RE</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <ForeignAddress>
          <AddressLine1Txt>PO BOX 69 KY1-1102</AddressLine1Txt>
          <CityNm>GRAND CAYMAN</CityNm>
          <CountryCd>CJ</CountryCd>
        </ForeignAddress>
        <PrimaryActivitiesTxt>REINSURANCE</PrimaryActivitiesTxt>
        <LegalDomicileForeignCountryCd>CJ</LegalDomicileForeignCountryCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>PEDIATRIC HEALTH NETWORK INC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>833415276</EIN>
        <PrimaryActivitiesTxt>HEALTH CARE</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BUILDING 5253 MANAGING MEMBER LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>832801690</EIN>
        <PrimaryActivitiesTxt>PROPERTY MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>BUILDING 54 MANAGING MEMBER LLC</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>111 MICHIGAN AVENUE NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20010</ZIPCd>
        </USAddress>
        <EIN>833272918</EIN>
        <PrimaryActivitiesTxt>PROPERTY MANAGEMENT</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DC</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <EntityTypeTxt>C</EntityTypeTxt>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedOrgTxblCorpTrGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>0</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>1</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
