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        <Identifier>SCHEDULE J, PART I, LINE 4B</Identifier>
        <Explanation>Some officers, directors, and key employees listed in Part VII participate in SERPs. Any SERP payments are reported in Column (B)(iii). SCHEDULE J, PART I, Line 7 Incentives are available for members of senior management and department chairs based on achievement of organization and individual goals typically related to quality, operating, and financial performance as well as other significant clinical, quality, and scientific achievements. Payment of incentives is dependent upon achieving sufficient operating margin to fund the incentives. SCHEDULE J, PART II, COLUMN (C) The amount reported here may include changes in actuarial values of SERPs as required to be reported by the IRS.</Explanation>
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      <GeneralExplanation>
        <Identifier>Form 990, PART IV, Line 12</Identifier>
        <Explanation>An audit is performed on an obligated group which comprises the Children's Hospital of Philadelphia, the Children's Hospital of Philadelphia Foundation and First Medical Insurance Company. An audit is also performed on a consolidated basis which includes the obligated group, PGH Development Corporation, Children's Anesthesiology Associates, Ltd, Children's Anesthesiology Associates of NJ, Inc., Children's Health Care Associates, Inc., Children's Health Care Associates of NJ, Children's Surgical Associates Ltd., Children's Surgical Associates of NJ, Inc., Surgical Research and Education Foundation and Radiology Associates of Children's Hospital, Inc. Part VI, Section B, Line 11A A copy of this return was reviewed by the Board Audit &amp; Compliance Committee before the return was filed. Before the return is filed, the Form 990 was also made available to the entire governing body of the organization through an accessible shared computer network drive maintained by The Children's Hospital of Philadelphia. FORM 990, PART VI, LINE 12 The organization has adopted the conflicts of interest policy of The Children's Hospital of Philadelphia. The Children's Hospital of Philadelphia maintains a written Conflicts of Interest Policy that applies to, inter alia, all of its Trustees, officers, employees, members of the Medical Staff and researchers of The Children's Hospital of Philadelphia and its affiliates. The Policy requires annual conflicts of interest statements from: Trustees and officers of the Hospital and its affiliates; the President and others in Senior Management; administrative personnel serving at the level of manager and above and certain other categories of employees defined in the conflicts of interest policy (such as persons known to place orders with vendors); Department Chairs, division chiefs and other members of the Medical Staff (except that members of the Medical Staff who are not based at the Hospital are only required to submit statements bi-annually); members of the Hospital Research Staff; designated employees of practice plans affiliated with the Hospital; and other persons designated by management. The statement tracks the conflicts of interest policy, requiring each person to disclose information for the reporting period regarding the existence and nature of gifts, outside interests, outside activities and other matters constituting a potential, perceived or actual conflict of interest, and to certify that they have read the policy and answered fully, accurately and to the best of their knowledge. After confirmation that all questions have been answered, the statements are reviewed by the relevant Vice President, Department Chair or other executive (or their designee), tracked by the Office of Compliance and Privacy (OC&amp;P), and all statements disclosing potential, perceived or actual conflicts are forwarded to the OC&amp;P as well as the Office of General Counsel (OGC) for further review and follow-up as needed. The conflicts statements submitted by Trustees of the Hospital and Foundation, and members of Senior Management, are reviewed by the OGC and OC&amp;P and the disclosures are summarized in memoranda distributed to and reviewed by the members of the Audit and Compliance Committee of the Hospital and Foundation Boards. The remaining conflicts statements containing affirmative disclosures are reviewed by staff in the OGC and OC&amp;P. In reviewing annual statements where an actual, perceived or potential conflict is disclosed, where problems are identified that need to be addressed, the goal is to eliminate or manage the conflict going forward and ensure that, as to employees or others on the Medical or Research Staff, the relevant supervisor is aware of the issue. Summary information about compliance with the policy's requirement to submit annual statements and disclosures contained therein is provided in memoranda to the Audit and Compliance Committee of the Boards. In addition, if any matter involving a potential violation of the conflict of interest policy is brought to the attention of management during the course of the year, a review is conducted by either the relevant department's management, OGC or OC&amp;P, as appropriate. FORM 990, PART VI, SECTION B, LINE 15 The compensation of executives and physicians/scientists is reviewed and approved by an independent Compensation Committee of the Boards of Trustees. The Committee reviews and approves in advance the compensation to be provided to the CEO, all Vice Presidents (including Executive and Senior VP levels), Clinical Department Chairs, and all faculty physicians and scientists. For each such person, this process was last performed in 2009. In making its determinations, the Committee considers the performance of the organization and that of the covered individuals as well as related business judgment factors. It also considers market comparison reports prepared by an external independent compensation consultant with significant experience in performing executive and physician compensation assessments for not-for-profit healthcare organizations. The Committee's process is designed to qualify for the rebuttable presumption of reasonableness for those individuals who are disqualified persons. The peer group for executives generally includes large and complex academic medical centers and health systems. For physicians and scientists, the peer group generally includes academic medical centers. Information from other organizations may also be considered where appropriate for the position. Form 990, Part VI, Line 19 Form 990 and financial statements are made available upon request. The conflicts of interest policy is available on The Children's Hospital of Philadelphia's website.</Explanation>
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      <GeneralExplanation>
        <Identifier>Form 990, Part VII</Identifier>
        <Explanation>Certain officers and key employees of The Children's Hospital Foundation of Philadelphia also devote significant time each week to other related organizations as follows: S. Altschuler - 40 hours to The Children's Hospital of Philadelphia - 1 hour to PGH Development Corporation - 1 hour to CHOP Clinical Associates Inc. - 1 hour to CHOP Practice Plan Association - 1 hour to The Children's Hospital of Philadelphia Foundation J. Perelman - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation N. Adzick - 1 hour to The Children's Hospital of Philadelphia - 1 hour to CHOP Practice Plan Association - 1 hour to The Children's Hospital of Philadelphia Foundation - 1 hour to Children's Surgical Associates of NJ, Inc. - 40 hours to Children's Surgical Associates Inc. - 1 hour to Surgical Associates Research and Education Foundation F. Biesecker - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation C. Baruch - 1 hour to The Children's Hospital of Philadelphia - 1 hour to CHOP Practice Plan Association - 1 hour to The Children's Hospital of Philadelphia Foundation A. Breaux - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation T. Brennan - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation M. Buckley - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation S. Burke - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation D. Caruso - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation A. Cohen - 1 hour to The Children's Hospital of Philadelphia - 1 hour to CHOP Clinical Associates Inc. - 1 hour to the Children's Hospital of Philadelphia Foundation - 1 hour to Children's Health Care Associates of New Jersey - 40 hours to Children's Health Care Associates Inc. - 1 hour to CHOP Practice Plan Association T. Colket - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation A. Dantchik - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation M. Fishman - 1 hour to The Children's Hospital of Philadelphia - 1 hour to CHOP Practice Plan Association - 1 hour to The Children's Hospital of Philadelphia Foundation L. Garbose - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation A. Latini - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation G. Lemmon Jr. - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation J. McCabe - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation J. Milligan - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation A. Nakahara - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation R. Pew - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation G. Quill - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation A. Kennedy Roberts - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation D. Rubenstein - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation S. Saunders Jr. - 1 hour to the Children's Hospital of Philadelphia - 1 hour to CHOP Practice Plan Association - 1 hour to the Children's Hospital of Philadelphia Foundation A. Faulkner Schoemaker - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation S. Shuchman - 1 hour to the Children's Hospital of Philadelphia - 1 hour to CHOP Practice Plan Association - 1 hour to the Children's Hospital of Philadelphia Foundation A. Talley - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation B. Wietlisbach - 1 hour to the Children's Hospital of Philadelphia - 1 hour to the Children's Hospital of Philadelphia Foundation N. Wolfson - 1 hour to the Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation D. Ziff - 1 hour to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation B. Brier - 1 hour to First Medical Insurance Company - 40 hours to The Children's Hospital of Philadelphia - 1 hour to PGH Development Corporation - 1 hour to CHOP Clinical Associates Inc. - 1 hour to The Children's Hospital of Philadelphia Foundation T. Todorow - 1 hour to First Medical Insurance Company - 40 hours to the Children's Hospital of Philadelphia - 1 hour to CHOP Clinical Associates Inc. - 1 hour to the Children's Hospital of Philadelphia Foundation M. Jones - 40 hours to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation R. Hairston - 40 hours to The Children's Hospital of Philadelphia - 1 hour to The Children's Hospital of Philadelphia Foundation - 1 hour to PGH Development Corporation E. Miles - 1 hour to The Children's Hospital of Philadelphia Foundation - 40 hours to The Children's Hospital of Philadelphia G. Kerr - 1 hour to The Children's Hospital of Philadelphia Foundation - 40 hours to The Children's Hospital of Philadelphia G. Hazlett - 1 hour to The Children's Hospital of Philadelphia Foundation - 40 hours to The Children's Hospital of Philadelphia L. Fontalvo-Herazo - 1 hour to The Children's Hospital of Philadelphia Foundation - 40 hours to The Children's Hospital of Philadelphia</Explanation>
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        <AmountInvolved>2421000</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>CHILDREN'S ANESTHESIOLOGY ASSOCIATES LTD</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>b</TransactionType>
        <AmountInvolved>492000</AmountInvolved>
      </TransactionsRelatedOrgsTable>
      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>RADIOLOGY ASSOCIATES OF CHILDREN'S HOSPITAL</BusinessNameLine1>
        </NameOfOtherOrganization>
        <TransactionType>b</TransactionType>
        <AmountInvolved>1293000</AmountInvolved>
      </TransactionsRelatedOrgsTable>
    </IRS990ScheduleR>
  </ReturnData>
</Return>