Instrumentl eFile Render
Object ID: 202342169349301564 - Rendered 2024-09-08
TIN: 91-0564748
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
21
Open to Public Inspection
Name of the organization
SEATTLE CHILDREN'S HOSPITAL
Employer identification number
91-0564748
Part I
Identification of Disregarded Entities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Total income
(e)
End-of-year assets
(f)
Direct controlling
entity
(1)
CHILDREN'S CLINICALLY INTEGRATED NETWORK LLC
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
91-0564748
ADMINISTRATION OF PEDIATRIC PHYSICIANS NETWORK
WA
3,315,002
2,920,900
SEATTLE CHILDREN'S HOSPITAL
Part II
Identification of Related Tax-Exempt Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization
(b)
Primary activity
(c)
Legal domicile (state
or foreign country)
(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))
(f)
Direct controlling
entity
(g)
Section 512(b)(13) controlled entity?
Yes
No
(1)
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
91-1250116
HEALTHCARE
WA
501(C)(3)
LINE 7
SEATTLE CHILDREN'S HOSPITAL
Yes
(2)
SEATTLE CHILDREN'S HOSPITAL FOUNDATION
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
91-1156519
FUNDRAISING
WA
501(C)(3)
LINE 7
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
No
(3)
SEATTLE CHILDREN'S HOSPITAL GUILD ASSN
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
91-1394056
FUNDRAISING, CHILD ADVOCACY, AND PEDIATRIC HEALTH AWARENESS
WA
501(C)(3)
LINE 7
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
No
(4)
CHILDREN'S RETAIL
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
91-1998909
THRIFT STORES
WA
501(C)(3)
LINE 12A, I
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
No
(5)
CHILDREN'S UNIVERSITY MEDICAL GROUP
4500 SANDPOINT WAY NE STE 100
SEATTLE
,
WA
98105
91-1336707
MEDICAL PRACTICE
WA
501(C)(3)
LINE 12A, I
N/A
No
(6)
CHILDREN'S HEALTH NETWORK
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
91-1226716
PEDIATRIC HEALTHCARE SERVICES
WA
501(C)(3)
LINE 12A, I
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
No
(7)
OBCC OTHELLO QALICB
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
85-2793713
CONSTRUCTION OF A HEALTHCARE CLINIC
WA
501(C)(3)
LINE 12C, III-FI
N/A
No
(8)
UMBRELLA PEDIATRICS PC
PO BOX 5371 MS 818-FI
SEATTLE
,
WA
981455005
86-1448700
PEDIATRIC HEALTHCARE SERVICES
WA
501(C)(3)
LINE 10
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page
2
Part III
Identification of Related Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Part IV
Identification of Related Organizations Taxable as a Corporation or Trust.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
(b)
Primary activity
(c)
Legal
domicile
(state or foreign
country)
(d)
Direct controlling
entity
(e)
Type of entity
(C corp, S corp,
or trust)
(f)
Share of total income
(g)
Share of end-of-year
assets
(h)
Percentage
ownership
(i)
Section 512(b)(13) controlled entity?
Yes
No
(1)
CHARITABLE REMAINDER UNITRUSTS (3)
INVESTMENTS
WA
SEATTLE CHILDREN'S HOSPITAL
Yes
(2)
CHARITABLE REMAINDER UNITRUSTS (7)
INVESTMENTS
WA
N/A
No
(3)
CHARITABLE REMAINDER UNITRUST (1)
INVESTMENTS
AK
SEATTLE CHILDREN'S HOSPITAL
Yes
(4)
CHARITABLE REMAINDER UNITRUSTS (3)
INVESTMENTS
CA
SEATTLE CHILDREN'S HOSPITAL
Yes
(5)
CHARITABLE REMAINDER UNITRUST (1)
INVESTMENTS
FL
N/A
No
(6)
CHARITABLE REMAINDER ANNUITY TRUSTS (2)
INVESTMENTS
WA
N/A
No
(7)
CHARITABLE LEAD ANNUITY TRUST (1)
INVESTMENTS
WA
N/A
No
(8)
PERPETUAL TRUSTS (5)
INVESTMENTS
WA
SEATTLE CHILDREN'S HOSPITAL
Yes
(9)
PERPETUAL TRUSTS (2)
INVESTMENTS
WA
N/A
No
(10)
POOLED INCOME FUND (1)
INVESTMENTS
WA
N/A
No
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page
3
Part V
Transactions With Related Organizations.
Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note.
Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1
During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a
Receipt of
(i)
interest,
(ii)
annuities,
(iii)
royalties, or
(iv)
rent from a controlled entity
.....................
1a
No
b
Gift, grant, or capital contribution to related organization(s)
............................
1b
Yes
c
Gift, grant, or capital contribution from related organization(s)
............................
1c
Yes
d
Loans or loan guarantees to or for related organization(s)
............................
1d
Yes
e
Loans or loan guarantees by related organization(s)
............................
1e
Yes
f
Dividends from related organization(s)
............................
1f
No
g
Sale of assets to related organization(s)
............................
1g
No
h
Purchase of assets from related organization(s)
............................
1h
No
i
Exchange of assets with related organization(s)
............................
1i
No
j
Lease of facilities, equipment, or other assets to related organization(s)
.......................
1j
No
k
Lease of facilities, equipment, or other assets from related organization(s)
......................
1k
Yes
l
Performance of services or membership or fundraising solicitations for related organization(s)
.....................
1l
Yes
m
Performance of services or membership or fundraising solicitations by related organization(s)
.................
1m
Yes
n
Sharing of facilities, equipment, mailing lists, or other assets with related organization(s)
...................
1n
No
o
Sharing of paid employees with related organization(s)
............................
1o
Yes
p
Reimbursement paid to related organization(s) for expenses
............................
1p
No
q
Reimbursement paid by related organization(s) for expenses
............................
1q
Yes
r
Other transfer of cash or property to related organization(s)
............................
1r
No
s
Other transfer of cash or property from related organization(s)
............................
1s
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization
(b)
Transaction
type (a-s)
(c)
Amount involved
(d)
Method of determining amount involved
(1)
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
E
293,255,315
ACTUAL PAYABLE
(2)
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
K
868,237
ACTUAL RENT
(3)
SEATTLE CHILDREN'S HEALTHCARE SYSTEM
Q
1,165,886
ACTUAL REIMBURSEMENTS
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page
4
Part VI
Unrelated Organizations Taxable as a Partnership.
Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity
(b)
Primary activity
(c)
Legal domicile
(state or foreign
country)
(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)
(e)
Are all partners
section
501(c)(3)
organizations?
(f)
Share of total income
(g)
Share of
end-of-year
assets
(h)
Disproprtionate allocations?
(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065)
(j)
General or
managing
partner?
(k)
Percentage
ownership
Yes
No
Yes
No
Yes
No
Schedule R (Form 990) 2021
Schedule R (Form 990) 2021
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference
Explanation
Schedule R (Form 990) 2021
Additional Data
Software ID:
Software Version: