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      <ActivityOrMissionDesc>NACH SUPPORTS CHILDREN'S HOSPITALS IN ADDRESSING PUBLIC POLICY ISSUES THAT AFFECT THEIR ABILITY TO FULFILL THEIR MISSIONS TO SERVE CHILDREN AND THEIR FAMILIES. NACH FULFILLS ITS MISSION AND VISION THROUGH FEDERAL ADVOCACY, COLLABORATION AND COMMUNICATION DESIGNED TO STRENGTHEN THE ABILITY OF CHILDREN'S HOSPITALS AND HEALTH SYSTEMS TO INFLUENCE PUBLIC POLICY MAKERS, UNDERSTAND FEDERAL AND STATE POLICY ISSUES, ADVANCE ACCESS AND QUALITY OF HEALTH CARE FOR ALL CHILDREN, AND SUSTAIN FINANCIALLY THEIR MISSIONS OF CLINICAL CARE, EDUCATION, RESEARCH AND ADVOCACY.</ActivityOrMissionDesc>
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      <MissionDesc>NACH SUPPORTS CHILDREN'S HOSPITALS IN ADDRESSING PUBLIC POLICY ISSUES THAT AFFECT THEIR ABILITY TO FULFILL THEIR MISSIONS TO SERVE CHILDREN AND THEIR FAMILIES. NACH FULFILLS ITS MISSION AND VISION THROUGH FEDERAL ADVOCACY, COLLABORATION AND COMMUNICATION DESIGNED TO STRENGTHEN THE ABILITY OF CHILDREN'S HOSPITALS AND HEALTH SYSTEMS TO INFLUENCE PUBLIC POLICY MAKERS, UNDERSTAND FEDERAL AND STATE POLICY ISSUES, ADVANCE ACCESS AND QUALITY OF HEALTH CARE FOR ALL CHILDREN, AND SUSTAIN FINANCIALLY THEIR MISSIONS OF CLINICAL CARE, EDUCATION, RESEARCH AND ADVOCACY.</MissionDesc>
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      <Desc>INFORMATION SERVICES: BECAUSE OF THE EXTRAORDINARY ROLE THAT PUBLIC POLICY PLAYS IN THE FINANCING AND DELIVERY OF CARE BY CHILDREN'S HOSPITALS, NACH PUBLISHES A BROAD ARRAY OF PUBLICATIONS AND INFORMATION SERVICES THAT ENABLE CHILDREN'S HOSPITALS TO UNDERSTAND THE CHANGING PUBLIC POLICY ENVIRONMENT, ITS IMPLICATIONS FOR THE MISSIONS OF CHILDREN'S HOSPITALS, AND THE OPPORTUNITY IT PRESENTS FOR CHILDREN'S HOSPITALS TO PROTECT AND ADVANCE THEIR COMMON BUSINESS INTERESTS.</Desc>
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        <Desc>ADVOCACY: NACH DIRECTLY ADVOCATES PUBLIC POLICY POSITIONS ON BEHALF OF THE COMMON INTERESTS OF CHILDREN'S HOSPITALS IN MEETING WITH FEDERAL POLICY MAKERS AND THEIR STAFF, IN TESTIMONY TO CONGRESSIONAL AND EXECUTIVE BRANCH AGENCIES, IN LETTERS AND OTHER WRITTEN COMMUNICATIONS, AND IN COMMUNICATIONS BY COALITIONS INVOLVING OTHER ORGANIZATIONS WITH COMMON INTERESTS, AS WELL AS IN MEDIA RELATED ADVOCACY, SUCH AS PRESS RELEASES AND BRIEFINGS, AND PAID ADVERTISEMENTS. NACH'S PRIMARY AREAS OF PUBLIC POLICY ADVOCACY FOCUSED ON LEGISLATION THAT DIRECTLY AFFECTS THE ABILITY OF CHILDREN'S HOSPITALS TO FULFILL THEIR MISSION OF PROVIDING CLINICAL CARE FOR CHILDREN REGARDLESS OF ECONOMIC OR MEDICAL CONDITION, TRAINING THE NEXT GENERATION OF PHYSICIANS FOR CHILDREN, SPONSORING RESEARCH TO IMPROVE CHILDREN'S HEALTH CARE, AND EDUCATING THE PUBLIC ABOUT BROADER ISSUES THAT AFFECT CHILDREN'S HEALTH CARE.NACH SEEKS TO ASSIST INDIVIDUAL CHILDREN'S HOSPITALS TO ADVOCATE - THROUGH THE HOSPITAL STAFF, HOSPITAL SUPPORTERS, AND MEMBERS OF THEIR COMMUNITIES - ON BEHALF OF THE NATIONAL ASSOCIATION'S PUBLIC POLICY AGENDA, WHICH ADVANCES THE COMMON INTERESTS OF ALL CHILDREN'S HOSPITALS. SUCH ASSISTANCE INCLUDES WASHINGTON DC ADVOCACY DAYS, ACTION ALERTS, SAMPLE ADVOCACY LETTERS, SAMPLE PRESS RELEASES, AND SAMPLE ORGANIZING ACTIVITIES.</Desc>
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        <Desc>EDUCATION SERVICES: NACH ORGANIZES EDUCATIONAL PROGRAMING AND OPPORTUNITIES FOR MEMBER HOSPITALS TO ENGAGE WITH THE FEDERAL LEGISLATIVE AND REGULATORY PROCESS, FOCUSED ON ADVOCACY FOR CHILDREN AND CHILDREN'S HOSPITALS. NACH ENGAGES WITH MEMBER HOSPITALS TO EDUCATE LAWMAKERS THROUGH ADVOCACY MATERIALS, MEETINGS AND EDUCATION EVENTS TO HIGHLIGHT THE UNIQUE CHALLENGES, PATIENT POPULATIONS, AND COMMUNITIES CHILDREN'S HOSPITALS SERVE.</Desc>
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        <BonusFilingOrganizationAmount>25438</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>178064</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>155</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>1086</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>25888</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>181217</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>3195</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>22367</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>128359</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>898513</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LEAH EVANGELISTA</PersonNm>
        <TitleTxt>CHIEF PUBLIC AFFAIRS OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>255915</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>85306</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>19725</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>6575</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>247</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>82</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>0</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>0</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>18835</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>6278</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>294722</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>98241</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>TOREY MACK</PersonNm>
        <TitleTxt>CHIEF QUALITY &amp; SOLUTIONS OFFICER</TitleTxt>
        <BaseCompensationFilingOrgAmt>8418</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>328311</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>413</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>16088</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>9</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>338</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>56</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>2199</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>44</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1731</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>8940</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>348667</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>MICHELLE HOGERTY</PersonNm>
        <TitleTxt>CFO</TitleTxt>
        <BaseCompensationFilingOrgAmt>7309</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>285038</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>478</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>18623</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>33</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>1276</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>171</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>6665</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>351</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>13679</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>8342</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>325281</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KASSANDRA K JENSEN</PersonNm>
        <TitleTxt>VP, EDUCATION &amp; EXECUTIVE LEARNING</TitleTxt>
        <BaseCompensationFilingOrgAmt>5805</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>226399</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>1140</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>44460</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>13</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>503</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>628</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>24481</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>422</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>16459</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>8008</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>312302</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>LORI HOTZEL</PersonNm>
        <TitleTxt>CTO</TitleTxt>
        <BaseCompensationFilingOrgAmt>28507</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>199552</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>5250</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>36750</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>112</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>786</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>2732</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>19123</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>2110</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>14771</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>38711</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>270982</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>AIMEE OSSMAN</PersonNm>
        <TitleTxt>VP, POLICY</TitleTxt>
        <BaseCompensationFilingOrgAmt>187451</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>15198</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>31080</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>2520</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>392</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>33</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>18100</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>1467</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>14587</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>1182</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>251610</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>20400</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>KORY K KITTLE</PersonNm>
        <TitleTxt>VP, ANALYTICS</TitleTxt>
        <BaseCompensationFilingOrgAmt>13868</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>171033</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>2775</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>34225</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>56</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>692</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>1551</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>19124</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>1266</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>15615</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>19516</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>240689</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <RltdOrgOfficerTrstKeyEmplGrp>
        <PersonNm>DAVID E BERTOCH</PersonNm>
        <TitleTxt>VP, INFO &amp; COMP DATA (THRU 2/11/22)</TitleTxt>
        <BaseCompensationFilingOrgAmt>1154</BaseCompensationFilingOrgAmt>
        <CompensationBasedOnRltdOrgsAmt>44997</CompensationBasedOnRltdOrgsAmt>
        <BonusFilingOrganizationAmount>745</BonusFilingOrganizationAmount>
        <BonusRelatedOrganizationsAmt>29055</BonusRelatedOrganizationsAmt>
        <OtherCompensationFilingOrgAmt>4132</OtherCompensationFilingOrgAmt>
        <OtherCompensationRltdOrgsAmt>161130</OtherCompensationRltdOrgsAmt>
        <DeferredCompensationFlngOrgAmt>95</DeferredCompensationFlngOrgAmt>
        <DeferredCompRltdOrgsAmt>3714</DeferredCompRltdOrgsAmt>
        <NontaxableBenefitsFilingOrgAmt>74</NontaxableBenefitsFilingOrgAmt>
        <NontaxableBenefitsRltdOrgsAmt>2895</NontaxableBenefitsRltdOrgsAmt>
        <TotalCompensationFilingOrgAmt>6200</TotalCompensationFilingOrgAmt>
        <TotalCompensationRltdOrgsAmt>241791</TotalCompensationRltdOrgsAmt>
        <CompReportPrior990FilingOrgAmt>0</CompReportPrior990FilingOrgAmt>
        <CompReportPrior990RltdOrgsAmt>0</CompReportPrior990RltdOrgsAmt>
      </RltdOrgOfficerTrstKeyEmplGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINE 3</FormAndLineReferenceDesc>
        <ExplanationTxt>THE NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS, INC. (NACHRI) ACTS AS THE "COMMON PAYMASTER" FOR NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS (NACH). NACHRI ISSUES ALL W-2S FOR ALL EMPLOYEES OF THIS GROUP. THE W-2S ARE REPORTED ONLY ON THE NACHRI RETURN, WHILE COMPENSATION ALLOCATED BY TIME-SPENT IS REPORTED ON THE NACHRI AND NACH RETURNS. THE PROCESS FOR DETERMINING COMPENSATION FOR OFFICERS AND STAFF IS DONE THROUGH THE NACHRI BOARD. THEREFORE, ALL QUESTIONS REGARDING COMPENSATION POLICY ARE ANSWERED ON THE NACHRI RETURN. METHODS USED BY NACHRI INCLUDE COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, AND APPROVAL BY BOARD OR COMPENSATION COMMITTEE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>PART I, LINES 4A-B</FormAndLineReferenceDesc>
        <ExplanationTxt>DAVID BERTOCH RECEIVED SEVERANCE PAYMENTS TOTALING $165,133 DURING THE CALENDAR YEAR. THE PAYMENT IS INCLUDED IN PART VII, COLUMN D AND SCHEDULE J, PART II, COLUMN BIII. THE TERMS AND CONDITIONS OF THE CONFIDENTIAL SEVERANCE AGREEMENT ARE AVAILABLE TO THE INTERNAL REVENUE SERVICE UPON REQUEST. THE FOLLOWING LISTED EMPLOYEES PARTICIPATED IN A 457(F) PLAN DURING THE YEAR: - MARK WIETECHA (NO DISTRIBUTION IN 2022, $269,100 WAS CONTRIBUTED TO THE PLAN) - AMY KNIGHT (NO DISTRIBUTION IN 2022, $181,410 WAS CONTRIBUTED TO THE PLAN)</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleJ>
    <IRS990ScheduleO documentId="RetDoc1044400001">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 6</FormAndLineReferenceDesc>
        <ExplanationTxt>MEMBERSHIP IS COMPOSED OF TWO CATEGORIES OF MEMBERS, VOTING AND NONVOTING. VOTING MEMBERS ARE HOSPITALS AND THOSE RELATED INSTITUTIONS EMPHASIZING THE CLINICAL CARE OF CHILDREN. NONVOTING MEMBERS ARE INSTITUTIONS AND INDIVIDUALS. MEMBERSHIP MAY BE GRANTED UPON APPLICATION TO THE BOARD OF TRUSTEES, WHICH SHALL ESTABLISH MEMBERSHIP CRITERIA, GRANT OR DENY MEMBERSHIP AND ASSIGN APPLICANTS TO MEMBERSHIP CATEGORIES AT ITS PLEASURE.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7A</FormAndLineReferenceDesc>
        <ExplanationTxt>THE VOTING MEMBERS ELECT THE TRUSTEES.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION A, LINE 7B</FormAndLineReferenceDesc>
        <ExplanationTxt>THE MEMBERSHIP MAY APPROVE VARIOUS DECISIONS OF THE GOVERNING BOARD.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 11B</FormAndLineReferenceDesc>
        <ExplanationTxt>INITIAL COMPILATION OF INFORMATION IS COMPLETED BY FINANCE STAFF FOR TRANSMISSION TO AN OUTSIDE FIRM FOR TAX RETURN PREPARATION. THE DRAFT RETURN IS REVIEWED BY FINANCE STAFF AND THE CFAO. THE DRAFT RETURN IS PROVIDED TO THE BOARD OF TRUSTEES; ANY BOARD COMMENTS OR QUESTIONS ARE CLEARED PRIOR TO FILING THE FINAL RETURN.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 12C</FormAndLineReferenceDesc>
        <ExplanationTxt>PERIODICALLY, THE BOARD OF TRUSTEES MUST FILL OUT A CONFLICT OF INTEREST QUESTIONNAIRE AND ALSO SUBMIT TO BACKGROUND CHECKS OF VARYING DEGREES. THE RESULTS ARE REVIEWED BY THE CEO. AT THE START OF ALL BOARD AND COMMITTEE MEETINGS, THE PARTICIPATING MEMBERS ARE ASKED TO DECLARE ANY CONFLICT OF INTEREST ACCORDINGLY. PERIODICALLY, ALL STAFF MUST FILL OUT A CONFLICT OF INTEREST FORM AND MUST ADHERE TO THE ASSOCIATION'S CONFLICT OF INTEREST POLICY. ANY CONFLICTS OF INTEREST ARE RESOLVED AS APPROPRIATE. THE HUMAN RESOURCE DEPARTMENT ENCOURAGES STAFF TO BRING ANY SITUATIONS TO THEIR ATTENTION AND MAKE PROMPT AND FULL DISCLOSURE OF ANY POTENTIAL SITUATIONS THAT MAY INVOLVE A CONFLICT OF INTEREST. THE POLICY IS INCLUDED IN OUR EMPLOYEE MANUAL AND WHISTLEBLOWER POLICY.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION B, LINE 15</FormAndLineReferenceDesc>
        <ExplanationTxt>THE CURRENT CEO WAS HIRED IN SEPTEMBER 2011 AND THE CURRENT PRESIDENT WAS HIRED IN DECEMBER 2011. THIS PROCESS INVOLVED A NATIONAL SEARCH FIRM THAT WAS CLOSELY MONITORED BY A TASK FORCE AND THE BOARD OF TRUSTEES. IN ADDITION, THE GOVERNANCE COMMITTEE ALSO ACTS AS THE COMPENSATION COMMITTEE AND REVIEWS ALL COMPENSATION RELATED MATTERS. THE CEO AND PRESIDENT'S COMPENSATION WAS BASED ON MARKET COMPARABLES OF SIMILAR SIZED ORGANIZATIONS AND RESPONSIBILITIES. THE COMPENSATION IS ALSO INCLUDED IN A WRITTEN EMPLOYMENT AGREEMENT. A COMPLETE REVIEW OF EXECUTIVE (CEO AND PRESIDENT) SALARIES OCCURRED DURING 2022. SALARY INCREASES FOR THE CEO ARE RECOMMENDED BY THE GOVERNANCE COMMITTEE TO THE FULL BOARD FOR APPROVAL IN EXECUTIVE SESSION WITHOUT THE CEO PRESENT. THE CEO UTILIZES THE MARKET STUDY TO DETERMINE AND APPROVE COMPENSATION FOR THE PRESIDENT. FOR ALL OTHER STAFF, THE ASSOCIATION PERIODICALLY ENGAGES AN OUTSIDE CONSULTANT FOR COMPENSATION STUDIES TO REVIEW ALL JOB DESCRIPTIONS AND SALARIES. THIS CONSULTANT HAS EXPERTISE IN THE NON-PROFIT AND HEALTH FIELDS AND IS VERY FAMILIAR WITH THE COMPENSATION PRACTICES. THE CONSULTANT REVIEWS THE COMPENSATION OF OTHER NATIONAL ASSOCIATIONS AND PEER GROUPS. A FORMAL EVALUATION OF ALL CURRENT SALARIES OCCURRED DURING 2022.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>FORM 990, PART VI, SECTION C, LINE 19</FormAndLineReferenceDesc>
        <ExplanationTxt>THE GOVERNING DOCUMENTS AND CONFLICT OF INTREST POLICY ARE NOT GENERALLY MADE AVAILABLE TO THE PUBLIC. AUDITED FINANCIAL STATEMENTS AND FORM 990 ARE AVAILABLE UPON REQUEST.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="RetDoc1043400001">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>600 13TH STREET NW</AddressLine1Txt>
          <CityNm>WASHINGTON</CityNm>
          <StateAbbreviationCd>DC</StateAbbreviationCd>
          <ZIPCd>20005</ZIPCd>
        </USAddress>
        <EIN>510120256</EIN>
        <PrimaryActivitiesTxt>TO PROMOTE SUPPORT OF CHILDREN'S HOSPITALS</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>GA</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(2)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
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      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>CHILD HEALTH PATIENT SAFETY ORGANIZATION INC</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>16011 COLLEGE BLVD</AddressLine1Txt>
          <CityNm>LENEXA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66219</ZIPCd>
        </USAddress>
        <EIN>270386722</EIN>
        <PrimaryActivitiesTxt>TO IMPROVE THE SAFETY OF CHILDREN'S HOSPITALS BY SHARING DATA &amp; EXPERIENCES</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>KS</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(C)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>509(A)(2)</PublicCharityStatusTxt>
        <DirectControllingEntityName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS</BusinessNameLine1Txt>
        </DirectControllingEntityName>
        <ControlledOrganizationInd>1</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <IdRelatedOrgTxblCorpTrGrp>
        <RelatedOrganizationName>
          <BusinessNameLine1Txt>CHILD HEALTH CORPORATION OF AMERICA</BusinessNameLine1Txt>
        </RelatedOrganizationName>
        <USAddress>
          <AddressLine1Txt>16011 COLLEGE BLVD</AddressLine1Txt>
          <CityNm>LENEXA</CityNm>
          <StateAbbreviationCd>KS</StateAbbreviationCd>
          <ZIPCd>66219</ZIPCd>
        </USAddress>
        <EIN>521421302</EIN>
        <PrimaryActivitiesTxt>HOSPITAL BUSINESS ALLIANCE TO BETTER SERVE CHILDREN</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>DE</LegalDomicileStateCd>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <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>1</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>1</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>1</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>0</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>M</TransactionTypeTxt>
        <InvolvedAmt>1688342</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>O</TransactionTypeTxt>
        <InvolvedAmt>1676291</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>NATIONAL ASSOCIATION OF CHILDREN'S HOSPITALS AND RELATED INSTITUTIONS</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>N</TransactionTypeTxt>
        <InvolvedAmt>562781</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>ACTUAL COST</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
  </ReturnData>
</Return>
