Children's Hospitals Alliance of Tn

What it reported doing in 2025

$98,000 children's hospital advocacy and annual meetings the most significant program expense is related to member advocacy which includes staff salary and annual meeting costs. The most significant accomplishment was securing $10million in direct funding for mental health infrastructure support for the state's 5 nonprofit children's hospitals improve facilities and augment staff to address the pediatric behavioral health crisis.2025 represented a year of significant operational stabilization and expanded influence for the children's hospital alliance of Tennessee (chat). Operational leadership and staffing the organization successfully transitioned its internal leadership following the retirement of the founding president. In march 2025, chat welcomed a new project manager, callie rowland, mph, whose background in perinatal quality collaboratives has energized the organization's data-driven advocacy efforts. The organization currently operates with 1.75 ftes and has moved to a more efficient combined model for quality-safety collaborative management and administration. Quality and safety collaborative (qsc)chat continues to lead the Tennessee state-level collaborative within the national solutions for patient safety (sps), where it is recognized as a model for the nation. In august 2025, chat hosted an annual convening featuring the ceo of sps to share best practices among quality and safety leaders. The organization successfully integrated these quality efforts into legislative advocacy, using data to demonstrate how hospital investments in safety reduce both patient harm and overall healthcare costs. In addition, the qsc work now includes coordinating behavioral health work group convenings to improve quality outcomes for children presenting with a behavioral or mental health challenge in the hospitals. State legislative advocacy and rulemaking the organization maintained a robust presence at the Tennessee general assembly, conducting more than a dozen meetings with the governor's office and legislative leaders during the annual "day on the hill". Key accomplishments include: neonatal intensive care units (nicu): chat served as a vital pediatric voice for the health facilities commission (hfc), advising on the creation of new nicu licensure standards and ensuring rulemaking recognized the unique nature of stand-alone nicus. Mental and behavioral health: chat successfully advocated for the continued funding of youth mental health initiatives in the final state budget. Additionally, chat led a panel on youth mental health for "heartland health forward and participated in the southeastern infant and early childhood mental health summit. Idd gaps in care: the organization identified and documented critical gaps in care for children with intellectual and developmental disabilities (idd), specifically addressing the 1,500 days children in state custody spent in hospitals after being medically cleared. Legislative champions were identified and convened multiple multi-agency meetings. Legislation was drafted at the end of 2025 to run in the 2026 general assembly. Safety for children: following the anxious generation the organization provided strategic guidance to groups such as 'say yes to recess' - successfully advocating for additional recess for elementary students and a bill to ban cell phones during instructional time. It is expected in 2026 there will be greater emphasis on harms caused to children due to online activities at school and through various social media and apps marketed as safe for children but which are showing demonstrable harm. Federal advocacy at the federal level, chat remained deeply engaged with the children's hospital association (cha). In december 2024, chat leaders conducted delegation visits to Washington d.c. To advocate for the accelerating kids' access to care act (s.752), the kosa act, and stable medicaid funding. The organization also authored a joint letter to the Tennessee congressional delegati

Financial Efficiency

• Mission deployment rate: 83.9%; rating input score 84
• Program expense ratio: 95.7%; rating input score 96
• Fundraising efficiency: Limited

Transparency & Controls

• Consistency checks: 100%; rating input score 100; 64th percentile among comparable filings
• Pay-setting controls: 4 of 6 controls in place; rating input score 67
  • Compensation committee: Pass
  • Independent consultant: Pass
  • Other Form 990s reviewed: Pass
  • Written employment contract: Missing
  • Compensation survey or study: Missing
  • Board or committee approval: Pass
• Foreign activity oversight: Limited
• Grant itemization coverage: Limited
• Major donor itemization: Limited
• Related-party transparency: Limited

Accountability

• Independent voting board: 83.3%; rating input score 83; 24th percentile among comparable filings
• Governance controls: 5 of 9 controls in place; rating input score 56
  • Conflict-of-interest policy: Pass
  • Whistleblower policy: Pass
  • Document-retention policy: Fail
  • CEO compensation review process: Pass
  • Other executive compensation review process: Fail
  • Form 990 shared with the board: Pass
  • Board meeting minutes documented: Pass
  • Audit committee oversight: Missing
  • Independent financial-statement audit: Fail

Sustainability

• Operating margin: 10.5%; rating input score 57; 57th percentile among comparable filings
• Total-asset coverage ratio: 1.21; rating input score 46; 46th percentile among comparable filings
• Liabilities to assets ratio: 0.2; rating input score 17; 17th percentile among comparable filings
• Officer compensation ratio: 72.1%; rating input score 1; 1st percentile among comparable filings

Growth

• Program expense growth: 4.6% per year; rating input score 100; 49th percentile among comparable filings
• Revenue growth: 3.9% per year; rating input score 100; 41st percentile among comparable filings
• Asset growth: 7.1% per year; rating input score 100; 53rd percentile among comparable filings