Boston Children's Hospital

What it reported doing in 2024

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 drivers 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 needsBoston Children's conducts a comprehensive community health needs assessment every three years as required by the Internal Revenue Service. 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 is utilizing its resources and leveraging community partnerships in the most effective way. The latest assessment was approved by the Boston Children's Board of Trustees in the fall of 2025. The 2025 needs assessment was focused on identifying the health-related needs, strengths, and resources available to children, youth, families and residents in Boston with special emphasis on the neighborhoods of Dorchester, Jamaica Plain, Mattapan, Mission Hill, and Roxbury. The assessment also looked at children living in the communities served by Boston Children's locations outside of Boston, which include Brockton, Brookline, Framingham, Lexington, North Dartmouth, Peabody, Quincy, Randolph, Waltham, and Weymouth.The assessment showed that many families are struggling with rising housing costs, food insecurity, and limited access to health care, especially mental health services. Youth mental health concerns are widespread, with high rates of anxiety and depression, particularly among LGBTQ+ and immigrant youth. Chronic conditions like asthma and obesity remain prevalent, disproportionately affecting communities of color. Environmental health issues, including air pollution and climate change, are emerging threats to child development and well-being. Safety concerns in schools and neighborhoods also impact youth, contributing to stress and missed school days. Despite these challenges, the assessment underscores the resilience of Boston's communities and their commitment to creating healthier, more equitable environments for children to grow and thrive. Boston Children's 2025 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.A formal and comprehensive needs assessment is only one part of Boston Chil

Financial Efficiency

• Mission deployment rate: 85.6%; rating input score 86
• Program expense ratio: 85.5%; rating input score 86
• Fundraising efficiency: $12.33 raised per $1 spent on fundraising; rating input score 47; 47th percentile among comparable filings

Transparency & Controls

• Consistency checks: 94.7%; rating input score 95; 33rd percentile among comparable filings
• Pay-setting controls: 6 of 6 controls in place; rating input score 100
  • Compensation committee: Pass
  • Independent consultant: Pass
  • Other Form 990s reviewed: Pass
  • Written employment contract: Pass
  • Compensation survey or study: Pass
  • Board or committee approval: Pass
• Foreign activity oversight: Scored; rating input score 0
• Grant itemization coverage: 99.4%; rating input score 99; 40th percentile among comparable filings
• Major donor itemization: Yes; rating input score 100
• Related-party transparency: Yes; rating input score 100

Accountability

• Independent voting board: 95.7%; rating input score 96; 49th percentile among comparable filings
• Governance controls: 9 of 9 controls in place; rating input score 100
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Pass
  • CEO compensation review process: Pass
  • Other executive compensation review process: Pass
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Pass
  • Independent financial-statement audit: Pass

Sustainability

• Operating margin: 1.7%; rating input score 41; 41st percentile among comparable filings
• Total-asset coverage ratio: 2.59; rating input score 71; 71st percentile among comparable filings
• Liabilities to assets ratio: 0.38; rating input score 47; 47th percentile among comparable filings
• Officer compensation ratio: 0.8%; rating input score 78; 78th percentile among comparable filings

Growth

• Program expense growth: 8.1% per year; rating input score 100; 64th percentile among comparable filings
• Revenue growth: 6.3% per year; rating input score 100; 55th percentile among comparable filings
• Asset growth: 7.1% per year; rating input score 100; 52nd percentile among comparable filings