Boston Children's Hospital

What it reported doing in 2023

COMMUNITY: Boston Children's Hospital was among the first academic medical centers in the country to expand the traditional missions of patient care, teaching, and research to embrace a fourth part of its mission - community. Through the years, Boston Children's has strived to ensure that community health is more than just words in its mission statement. The efforts have evolved from targeted services for individual families to innovative models that have proven to reduce health disparities, improve child health outcomes, and promote health equity.Boston Children's community mission is based on the needs of the community. It revolves around keeping children healthy through wellness and prevention efforts, ensuring that children have access to needed health care services, and partnering with others in the community to address the social determinants of health. These are issues that can have a significant impact on an individual's health such as exposure to violence, experiencing food insecurity, living in poverty or having unstable housing. In all its endeavors, Boston Children's focuses on meeting community needs and implementing programs that are aligned with the priorities of the City of Boston, the Boston Public Health Commission, the Boston Public Schools, as well as other key partners and city agencies.Understanding Community Needs: Boston Children's conducts a comprehensive community health needs assessment every three years as required by the Internal Revenue Service. The full report from the 2022 assessment can be found here. The findings inform the direction of Boston Children's Community Health Improvement Plan, which outlines how the hospital will use its resources and partner with others to address those themes and improve community health. This process also ensures that the hospital utilizes its resources and leverages community partnerships in the most effective way. The assessment was approved by the Boston Children's Board of Trustees in the fall of 2022. The 2022 assessment identified the health-related needs, strengths, and resources available to children, youth, families, and residents in Boston - specifically the neighborhoods of Dorchester, Jamaica Plain, Mattapan, Mission Hill, and Roxbury. The assessment also looked at those living in the communities served by Boston Children's locations outside of Boston, which includes Brookline, Lexington, North Dartmouth, Peabody, Waltham, and Weymouth.Boston Children's 2022 assessment also included data from the Boston Community Health Collaborative. This assessment included a wide range of Boston stakeholders - community organizations, community development corporations, health centers, hospitals, and the Boston Public Health Commission. While community health assessment and planning work are often conducted by individual organizations, the Boston Collaborative aligns and coordinates resources between multi-sector stakeholders across the city. Boston Children's is a founding member, and staff participate in the steering committee and work groups.Key themes from the assessment include how poverty impacts child and community health, access to stable and affordable housing, concerns about food access and insecurity, and the importance of prevention and focus on early childhood and youth development. Health issues of concern for families continue to be around mental/behavioral health, asthma, and obesity. A formal and comprehensive needs assessment is only one part of Boston Children's approach to understanding the health needs and vital resources within the community. Boston Children's is continually listening and learning from patient families, community leaders, and staff. The staff rely on ongoing conversations with Boston Children's key partners - community health centers and community-based organizations, as well as the Boston Public Health Commission, and the Boston Public Schools.Through the Community Advisory Board, which meets on a quarterly basis, Boston Chi

Financial Efficiency

• Mission deployment rate: 86.8%; rating input score 87
• Program expense ratio: 84.8%; rating input score 85
• Fundraising efficiency: $14.69 raised per $1 spent on fundraising; rating input score 52; 52nd percentile among comparable filings

Transparency & Controls

• Consistency checks: 94.7%; rating input score 95; 40th percentile among comparable filings
• Pay-setting controls: 6 of 6 controls in place; rating input score 100
• Foreign activity oversight: Scored; rating input score 0
• Grant itemization coverage: 99.1%; rating input score 99; 39th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Limited
• Public monitoring controls: 0 of 8 controls in place; rating input score 0
• Public policy transparency: 1 of 7 controls in place; rating input score 14
• Public financial transparency: 0 of 5 controls in place; rating input score 0
• Impact reporting controls: 0 of 7 controls in place; rating input score 0
• Public relationship transparency: Yes; rating input score 100

Accountability

• Independent voting board: 94.7%; rating input score 95; 48th percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
• Public governance controls: 0 of 4 controls in place; rating input score 0
• Zakat policy transparency: Limited

Sustainability

• Operating margin: 0.5%; rating input score 38; 38th percentile among comparable filings
• Operating reserve ratio: 2.82; rating input score 76; 76th percentile among comparable filings
• Liabilities to assets ratio: 0.4; rating input score 47; 47th percentile among comparable filings
• Officer compensation ratio: 0.8%; rating input score 77; 77th percentile among comparable filings

Growth

• Program expense growth: 7.6% per year; rating input score 100; 62nd percentile among comparable filings
• Revenue growth: 5.8% per year; rating input score 100; 52nd percentile among comparable filings
• Asset growth: 7.4% per year; rating input score 100; 55th percentile among comparable filings