2024-05-13T09:14:05-05:00 2023-06-30 135565207 KPMG LLP 550 SOUTH HOPE STREET SUITE 1500 LOS ANGELES CA 90071 990 2022-07-01 956154473 PROVIDENCE SPEECH AND HEARING CENTER PROV 7146394990 1201 W LA VETA AVENUE ORANGE CA 92868 KERRI RUPPERT SCHILLER DIRECTOR/TREASURER 7146394990 2024-05-07 1 KERRI RUPPERT SCHILLER 999009999 0 HOLLY MOEN P01800653 2139724000 2024-05-07 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z PAUL VAN DOLAH 1201 W LA VETA AVENUE ORANGE CA 92868 12335868 0 X WWW.PSHC.ORG X 1996 CA ENRICHING LIFE THROUGH THE GIFTS OF SPEECH AND HEARING. 4 0 175 13 0 0 259888 253804 8408596 11930526 82092 16522 56141 38020 8806717 12238872 0 0 0 0 10958664 13014912 0 0 0 2810997 3271183 13769661 16286095 -4962944 -4047223 14859501 13888798 15764314 18878922 -904813 -4990124 TO CONTINUALLY PROVIDE THE HIGHEST STANDARDS OF SERVICES IN THE IDENTIFICATION, DIAGNOSIS, TREATMENT AND PREVENTION OF SPEECH, LANGUAGE AND HEARING DISORDERS FOR PERSONS OF ALL AGES, RACES AND SOCIO-ECONOMIC BACKGROUNDS. 0 0 14657420 11968546 PROVIDENCE PROVIDES AUDIOLOGY AND HEARING CARE AND SPEECH-LANGUAGE PATHOLOGY TO ALL THOSE IN NEED, REGARDLESS OF THEIR ABILITY TO PAY. PROVIDENCE STRIVES TO ACHIEVE ITS MISSION BY CONTINUALLY PROVIDING THE HIGHEST QUALITY SERVICES IN THE IDENTIFICATION, DIAGNOSIS, TREATMENT AND PREVENTION OF SPEECH, LANGUAGE AND HEARING DISORDERS FOR PERSONS OF ALL AGES, RACES AND SOCIO-ECONOMIC BACKGROUNDS. PROVIDENCE IS A LEADING SERVICE PROVIDER TO THE SPEECH AND HEARING IMPAIRED OF ORANGE COUNTY, PROVIDING MORE THAN 114,431 PATIENT VISITS EACH YEAR. MORE THAN HALF OF THE WORK IS DEDICATED TO LOW-INCOME PATIENTS, ALL OF WHOM ARE UNINSURED OR UNDERINSURED. 14657420 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 7 0 175 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MARY NGUYEN 7145094124 1201 WEST LA VETA AVENUE ORANGE CA 92868 JAY GABRIEL DIRECTOR/SECRETARY 0.50 39.50 X X 0 771599 79346 KERRI RUPPERT SCHILLER DIRECTOR/TREASURER 0.50 39.50 X X 0 924633 75580 MARY ZIMMER DIRECTOR 2.00 38.00 X 0 488057 61951 PAUL VAN DOLAH PRESIDENT/CHAIR 0.50 39.50 X X 0 896478 30198 LUCIA MORIZIO EXECUTIVE DIR, SPEECH & HEARING 40.00 0.00 X 270370 0 17165 SAMANTHA MCCOMB MANAGER, SPEECH & LANGUAGE 40.00 0.00 X 146484 0 16488 ROBYN BELZ SPEECH LANGUAGE PATHOLOGIST 40.00 0.00 X 146500 0 8499 AMY MARSHALL MANAGER, SPEECH & LANGUAGE 40.00 0.00 X 142385 0 7205 KYM ASAHARA SPEECH LANGUAGE PATHOLOGIST 40.00 0.00 X 129080 0 0 HAGAR MADNICK SPEECH LANGUAGE PATHOLOGIST 40.00 0.00 X 123666 0 20083 SHAHAB DADJOU SVP, STRATEGY & INTEGRATION/CSO 0.00 0.00 X 0 392881 0 958485 3473648 316515 18 1 1 0 OTICON INC PO BOX 347996 PITTSBURGH PA 152514996 HEARING AID DEVICES 357557 WIDEX USA INC PO BOX 200138 DALLAS TX 753200138 HEARING AID DEVICES 318956 OTICON MEDICAL LLC 580 HOWARD SOMERSET NJ 08873 BONE CONDUCTION MANUFACTURE 267604 COCHLEAR AMERICAS PO BOX 910811 DENVER CO 802910811 BONE CONDUCTION MANUFACTURE 140551 EPLUS TECHNOLOGY INC 13595 DULLES TECHNOLOGY DR HERNDON VA 20171 TECHNOLOGY SOLUTIONS 108838 5 253804 253804 PATIENT REVENUE 621400 11930526 11930526 11930526 15028 15028 98490 96996 1494 1494 1494 OTHER REVENUE 621990 38020 38020 38020 12238872 11968546 0 16522 10790409 9711368 1079041 145858 131272 14586 1279188 1151269 127919 799457 719511 79946 71 71 1386 1247 139 205471 184924 20547 5130 4617 513 975028 877525 97503 79 71 8 10493 9444 1049 583013 524712 58301 11357 10221 1136 MEDICAL SUPPLIES 1464687 1318218 146469 LICENSES & TAXES 13772 12395 1377 CONSULTANT 696 626 70 16286095 14657420 1628675 0 1331180 170687 871860 2075262 1772531 27404 44640 73619 91498 11713927 1537402 10031536 10176525 41104 1320500 719953 14859501 13888798 1983885 695074 115697 -3673 13664732 18187521 15764314 18878922 X -2125640 -6254466 1220827 1264342 -904813 -4990124 14859501 13888798 -4047223 33327 -71415 0 X 0 1 X 1 0 X 3709973 1567254 596177 4432319 253804 10559527 3709973 1567254 596177 4432319 253804 10559527 4574886 5984641 1194 2080 0 87719 15028 106021 270071 24069 106616 56141 4783 461680 11127228 0.53780 0.57340 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 901366 497 11100 212006 700957 815612 3662 82092 901366 723981 91631 815612 761967 -37986 723981 582667 137000 42300 761967 0.05558 0.94442 1 0 9850254 1162764 8687490 1498836 374638 1124198 364837 364837 10176525 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 194 LEASED FACILITY AND EQUIPMENT 719759 719953 PAYABLE TO RELATED ORGANIZATIONS 17449976 LEASE PAYABLE 737545 18187521 X PART V, LINE 4: THE ENDOWMENT FUND IS USED TO SUPPORT PSHC PROGRAMS ADDRESSING THE NEEDS OF THE UNDERSERVED, AND SOCIAL SERVICES TO PATIENTS AND FAMILIES IN NEED. PART X, LINE 2: U.S. GAAP REQUIRES THE ORGANIZATION'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2023, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. X X X X 1 1 0 0 0 0 0 0 0 KERRI RUPPERT SCHILLER DIRECTOR/TREASURER 0 626529 0 146330 0 151774 0 46201 0 29379 0 1000213 0 29032 PAUL VAN DOLAH PRESIDENT/CHAIR 0 642870 0 147277 0 106331 0 30198 0 0 0 926676 0 29238 JAY GABRIEL DIRECTOR/SECRETARY 0 534229 0 114164 0 123206 0 36995 0 42351 0 850945 0 21195 MARY ZIMMER DIRECTOR 0 358081 0 67948 0 62028 0 19600 0 42351 0 550008 0 14140 SHAHAB DADJOU SVP, STRATEGY & INTEGRATION/CSO 0 0 0 0 0 392881 0 0 0 0 0 392881 0 0 LUCIA MORIZIO EXECUTIVE DIR, SPEECH & HEARING 204515 0 57855 0 8000 0 2400 0 14765 0 287535 0 0 0 SAMANTHA MCCOMB MANAGER, SPEECH & LANGUAGE 139626 0 6858 0 0 0 8499 0 7989 0 162972 0 0 0 ROBYN BELZ SPEECH LANGUAGE PATHOLOGIST 141644 0 4856 0 0 0 8499 0 0 0 154999 0 0 0 PART I, LINES 4A-B SEVERANCE ARRANGEMENTS: PART I, LINE 4A SOME OF THE ORGANIZATION'S PERSONNEL LISTED ON FORM 990 PART VII AND SCHEDULE J PARTICIPATE IN A SEPARATION ARRANGEMENT THAT PROVIDES FOR A PORTION OF THE EMPLOYEE'S ANNUAL SALARY BASED ON THEIR POSITION IN THE ORGANIZATION. FOR THE SENIOR EXECUTIVE LEVEL, THE AMOUNT IS BASED ON YEARS OF SERVICE UP TO A MAXIMUM NUMBER OF MONTHS. UNPAID SEVERANCE UNDER THE SEPARATION AGREEMENTS FOR CURRENT KEY EMPLOYEES WERE REPORTED AT THEIR FULL VALUE IN A PREVIOUS TAX YEAR. IN 2022 SHAHAB DADJOU RECEIVED A SEVERANCE PAYMENT OF $392,881. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: PART I, LINE 4B CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC OR THE COMPANY) ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN EFFECTIVE JANUARY 1, 2010 IN WHICH CERTAIN INDIVIDUALS LISTED ON THE FORM 990, PART VII AND SCHEDULE J ARE PARTICIPANTS. UNDER THE ESTABLISHED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE PLAN), OR SERP, FOR EACH PLAN YEAR THAT BEGINS PRIOR TO THE PARTICIPANT'S CASH DATE, CHOC SHALL CREATE A NEW SERP ACCOUNT ON ITS BOOKS FOR THE PARTICIPANT AND SHALL CREDIT TO SUCH ACCOUNT AT TIMES SPECIFIED. THE PARTICIPANTS OF THE PLAN ARE GENERAL CREDITORS OF THE COMPANY. THE PARTICIPANT'S SERP ACCOUNT SHALL BE UTILIZED SOLELY AS A DEVICE FOR THE MEASUREMENT AND DETERMINATION OF THE AMOUNTS TO BE PAID TO THE PARTICIPANT UNDER THIS PLAN. THE PARTICIPANT IS ENTITLED TO HIS/HER SERP BENEFIT AMOUNT UPON THE EARLIEST OF (1) REMAINING EMPLOYED WITH THE COMPANY TO THE THIRD ANNIVERSARY OF THE FIRST DAY OF THE PLAN YEAR FOR WHICH THE SERP ACCOUNT WAS CREATED; (2) REMAINING EMPLOYED WITH THE COMPANY TO THE PARTICIPANT'S 60TH BIRTHDAY; (3) REMAINING EMPLOYED WITH THE COMPANY TO THE DATE THE PARTICIPANT HAS BOTH ATTAINED AT LEAST AGE 55 AND HAS COMPLETED AT LEAST 10 YEARS OF SERVICE; (4) DISABILITY; (5) INVOLUNTARY SEPARATION FROM SERVICE WITHOUT REASONABLE CAUSE; (6) VOLUNTARY SEPARATION FROM SERVICE FOR GOOD REASON OR (7) DEATH. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN DURING CALENDAR YEAR 2022: MS. SCHILLER ($101,580), MR. GABRIEL ($76,697), MS. ZIMMER ($44,669), AND MR. VAN DOLAH ($102,255). THE COMPANY PROVIDES AN INCENTIVE PLAN TO ALL ELIGIBLE MEMBERS OF MANAGEMENT, INCLUDING CERTAIN INDIVIDUALS LISTED IN PART II OF SCHEDULE J. INCENTIVES ARE EARNED BASED ON ACHIEVEMENT OF ORGANIZATION AND INDIVIDUAL GOALS TYPICALLY RELATED TO QUALITY, PATIENT SAFETY, OPERATING, AND FINANCIAL PERFORMANCE AS WELL AS OTHER SIGNIFICANT CLINICAL, QUALITY, AND STRATEGIC ACHIEVEMENTS. THE COMPANY MAINTAINS A CORPORATE MEMBERSHIP IN A SOCIAL CLUB THAT IS UTILIZED FOR BUSINESS PURPOSES BY ITS EXECUTIVES, INCLUDING CERTAIN INDIVIDUALS LISTED IN PART II OF SCHEDULE J. USE OF THE CLUB AND PAYMENTS TO THE CLUB FOR BUSINESS-RELATED EXPENSES ARE SUBJECT TO THE COMPANY'S WRITTEN POLICIES AND PROCEDURES THAT INCLUDE A REQUIREMENT TO DOCUMENT THE PURPOSE AND ATTENDEES OF THE BUSINESS MEETING PRIOR TO PAYMENT. COMPENSATION FROM AN AFFILIATED ORGANIZATION KERRI RUPPERT SCHILLER IS COMPENSATED THROUGH CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), HOWEVER, IN ADDITION TO HER RESPONSIBILITIES FOR CHC, SHE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHOC FOUNDATION, CRC REAL ESTATE CORPORATION AND CHILDREN'S HOSPITAL AT MISSION (ALL IRC SECTION 501(C)(3) AFFILIATES). MS. SCHILLER DEVOTES APPROXIMATELY 50% OF HER TIME EACH WEEK TO CHILDREN'S HOSPITAL OF ORANGE COUNTY RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS AFFAIRS. JAY GABRIEL IS COMPENSATED THROUGH CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC), HOWEVER, IN ADDITION TO HIS RESPONSIBILITIES FOR CHOC, HE ALSO SERVES AS AN OFFICER OF CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), CRC REAL ESTATE CORPORATION, CHILDREN'S HOSPITAL AT MISSION (CCMH) AND PROVIDENCE ESTATE CORPORATION, CHILDREN'S HOSPITAL AT MISSION (CCMH) AND PROVIDENCE SPEECH AND HEARING CENTER (PSHC) (ALL IRC SECTION 501(C)(3) AFFILIATES). MR. GABRIEL DEVOTES APPROXIMATELY 44% OF HIS TIME EACH WEEK TO CHOC RESPONSIBILITIES WITH THE BALANCE OF HIS TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS AFFAIRS. PAUL VAN DOLAH IS COMPENSATED THROUGH CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), HOWEVER, IN ADDITION TO HIS RESPONSIBILITIES FOR CHC, HE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CRC REAL ESTATE CORPORATION, CHILDREN'S HOSPITAL AT MISSION AND PROVIDENCE SPEECH AND HEARING CENTER (PSHC) (ALL IRC SECTION 501(C)(3) AFFILIATES). MR. VAN DOLAH DEVOTES APPROXIMATELY 84% OF HIS TIME EACH WEEK TO CHOC RESPONSIBILITIES WITH THE BALANCE OF HIS TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS AFFAIRS. MARY ZIMMER IS COMPENSATED THROUGH CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC), HOWEVER, IN ADDITION TO HER RESPONSIBILITIES FOR CHOC, SHE ALSO SERVES AS DIRECTOR OF PROVIDENCE SPEECH AND HEARING CENTER (PSHC). MS. ZIMMER DEVOTES APPROXIMATELY 95% OF HER TIME EACH WEEK TO CHOC RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON PSHC BUSINESS AFFAIRS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF PROVIDENCE SPEECH AND HEARING CENTER (PSHC) IS CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC.) THE OFFICERS AND DIRECTORS OF PSHC ARE EMPLOYEES OF CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC) WITH THE EXCEPTION OF 1 DIRECTOR WHO IS EMPLOYED AT CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC). FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER, CHOC, HAS THE POWERS DETAILED IN LINE 7B. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL OF THE MEMBER SHALL BE REQUIRED WITH RESPECT TO ANY OF THE FOLLOWING ACTIONS: (1) CHANGING THE PURPOSES AND POWERS OF PSHC; (2) OBLIGATING PSHC TO UNDERTAKE ANY CAPITAL EXPENDITURE IN EXCESS OF $5,000,000; (3) ADOPTING PSHC'S ANNUAL OPERATING AND CAPITAL BUDGETS; (4) ADOPTING A LONG-TERM CAPITAL BUDGET; (5) BUYING, SELLING, LEASING, MORTGAGING, PLEDGING, OR OTHERWISE HYPOTHECATING ANY REAL PROPERTY; (6) INCURRING ANY INDEBTEDNESS IN EXCESS OF $5,000,000; (7) OBLIGATING PSHC TO ACT AS GUARANTOR WITH RESPECT TO ANY DEBT OF ANY PERSON OR OTHER ENTITY; (8) ACCEPTING ANY DONATION WHICH IS CONDITIONED UPON PSHC'S UNDERTAKING ANY UNBUDGETED CAPITAL EXPENDITURE IN EXCESS OF $5,000,000 OR ANY UNBUDGETED EXPENDITURE IN EXCESS OF $5,000,000; (9) ENTERING INTO ANY CONTRACT WHICH INVOLVES THE FOLLOWING: (A) ANY FINANCIAL OBLIGATION ON THE PART OF PSHC IN AN AMOUNT IN EXCESS OF $5,000,000 OR (B) ANY PURPOSE OR ACTIVITY WHICH IS OUTSIDE THE SCOPE OF PSHC'S ORDINARY COURSE OF BUSINESS. (10) INVOLVING PSHC IN ANY MERGER, ACQUISITION, CORPORATE RESTRUCTURING, OR FORMAL AFFILIATION; (11) INVOLVING PSHC AS A MEMBER, SHAREHOLDER, OR PARTNER IN ANY NEW CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITY; (12) DISSOLVING PSHC; (13) ENTERING INTO ANY TRANSACTION INVOLVING THE SALE, CONVEYANCE, EXCHANGE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF PSHC'S ASSETS; (14) AMENDING PSHC'S ARTICLES OF INCORPORATION; (15) ADOPTING NEW BYLAWS OR AMENDING EXISTING BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE DIRECTORS OF PSHC WILL HAVE REVIEWED THE COMPLETED FORM 990 FOR COMPLETENESS AND ACCURACY PRIOR TO ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE. IN ADDITION, A COPY OF THE COMPLETED AND REVIEWED FORM 990 WILL BE SUBMITTED TO EACH BOARD MEMBER PRIOR TO THE SCHEDULED BOARD MEETING FOR REVIEW AND APPROVAL PRIOR TO ITS SUBMISSION TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING AND ENFORCING COMPLIANCE OF CONFLICT OF INTEREST POLICY THE CHOC COMPLIANCE OFFICER IS CHARGED WITH MONITORING PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. PURSUANT TO THE CONFLICTS OF INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, AIMED AT DETERMINING ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT, IS DISTRIBUTED TO ALL COVERED PERSONS (I.E., BOARD MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP). COVERED PERSONS ARE REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME WHEN SUCH CONFLICTS ARISE. WHEN AN INDIVIDUAL BECOMES A COVERED PERSON AND ANNUALLY THEREAFTER, EACH COVERED PERSON IS REQUIRED TO SIGN A STATEMENT AFFIRMING THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE CONFLICTS OF INTEREST POLICY AND UNDERSTANDS SAID POLICY; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICTS OF INTEREST QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE OFFICER AND ANY PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS ARE CONTACTED VIA WRITTEN COMMUNICATION. THE PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST MAY INCLUDE BUT ARE NOT LIMITED TO THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD OF DIRECTORS; (2)THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE CONFLICT, THE SUBSTANCE OF THE TRANSACTION OR THE ARRANGEMENT BEING CONSIDERED; (3) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM ANY DISCUSSION OR APPROVAL OF SUCH TRANSACTION; (4) IF APPLICABLE ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; AND (5) THE TRANSACTION OR ACTION MUST BE APPROVED BY A MAJORITY OF DISINTERESTED PERSONS. FORM 990, PART VI, SECTION B, LINE 15 PROCESS OF DETERMINING COMPENSATION OF THE CEO AND OTHER OFFICERS AN INDEPENDENT BOARD COMMITTEE OF CHC CHARGED WITH THE DUTIES OF THE COMPENSATION COMMITTEE, WHOSE MEMBERS ARE DISINTERESTED AND INDEPENDENT, IS IN PLACE WITH A WRITTEN COMPENSATION COMMITTEE CHARTER. THIS COMMITTEE ANNUALLY RETAINS AN INDEPENDENT HEALTHCARE COMPENSATION CONSULTING FIRM TO PROVIDE RELEVANT COMPARABILITY DATA AND OTHER COMPENSATION STUDIES. THE CEO, OFFICERS AND EXECUTIVE MANAGEMENT SALARIES, INCENTIVES AND BENEFITS, AS WELL AS OVERALL COMPENSATION PHILOSOPHY AND POLICIES, ARE DISCUSSED WITH THE INDEPENDENT CONSULTANT REPRESENTATIVES AND THE COMPENSATION COMMITTEE MEMBERS, IN PERSON, IN CLOSED SESSIONS WITH NO STAFF MEMBERS PRESENT. THIS ANNUAL REVIEW WAS LAST PERFORMED IN OCTOBER 2023. ALL COMPARATIVE MARKET DATA, SUCH AS ANNUAL COMPENSATION SURVEY COMPRISED OF A PEER GROUP OF COMPARABLY SIZED PEDIATRIC HOSPITALS, IS WELL DOCUMENTED AND THERE ARE MINUTES FROM THESE MEETINGS THAT DOCUMENT THE MEMBERS PRESENT AND VOTING, THE COMPARATIVE DATA USED AND HOW IT WAS OBTAINED AND THE DELIBERATIONS AND DECISIONS OF THE COMMITTEE. THE RESULTS AND RECOMMENDATIONS FROM THE COMMITTEE ARE SHARED IN AN EXECUTIVE SESSION WITH THE CHC BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 DISCLOSURE COPY WHILE FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE FOR PUBLIC INSPECTION, THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. PART XII, LINE 2 OVERSIGHT OR SELECTION PROCESS CHC HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE OVERSIGHT PROCESS OR SELECTION PROCESS HAS NOT CHANGED DURING THE YEAR. BELOW ARE THE DUTIES AND MEMBERSHIP CRITERIA OF THE AUDIT COMMITTEE: DUTIES: - RECOMMENDS ACCOUNTING FIRM RETENTION AND TERMINATION - NEGOTIATES THE ACCOUNTING FIRM'S COMPENSATION - CONFERS WITH THE ACCOUNTING FIRM TO ASSURE FINANCIAL AFFAIRS ARE IN ORDER - DETERMINES WHETHER TO ACCEPT THE AUDIT - APPROVES PERFORMANCE NON-AUDIT SERVICES TO BE PROVIDED BY ACCOUNTING FIRM - REPORTS AUDIT FINDINGS TO BOARD OF DIRECTORS - ENSURES THAT AUDIT RECOMMENDATIONS ARE ADEQUATELY AND TIMELY IMPLEMENTED BY STAFF MEMBERSHIP: - CHAIRPERSON MAY NOT BE A FINANCE COMMITTEE MEMBER - FINANCE COMMITTEE MEMBERS MUST COMPRISE LESS THAN 50% OF MEMBERSHIP - MAY INCLUDE NON BOARD OF DIRECTOR MEMBERS - NO MEMBER OF STAFF, INCLUDING MANAGEMENT - NO PERSON WITH A MATERIAL FINANCIAL INTEREST IN AN ENTITY DOING BUSINESS WITH PROVIDENCE SPEECH AND HEARING CENTER NEWPORT LANGUAGE SPEECH & AUD 26137 LA PAZ RD SUITE 104 MISSION VIEJO CA 92691 956154473 HEARING ASSISTANCE CA 0 0 PSHC CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 WEST LA VETA AVENUE ORANGE CA 92868 952321786 HEALTHCARE CA 501(C)(3) LINE 3 CHC 0 CHILDREN'S HOSPITAL AT MISSION 1201 WEST LA VETA AVENUE ORANGE CA 92868 330528802 HEALTHCARE CA 501(C)(3) LINE 3 CHC 0 CHOC FOUNDATION 1201 WEST LA VETA AVENUE ORANGE CA 92868 956097416 FUNDRAISING CA 501(C)(3) LINE 7 CHC 0 CRC REAL ESTATE 1201 WEST LA VETA AVENUE ORANGE CA 92868 330612565 REAL ESTATE CA 501(C)(3) LINE 12B, II CHC 0 CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC) 1201 WEST LA VETA AVENUE ORANGE CA 92868 330265266 HEALTHCARE CA 501(C)(3) LINE 12A, I N/A 0 ORANGE COUNTY MEDICAL RECIPROCAL INSURANCE 7400 E GAINEY CLUB DR 111 SCOTTSDALE AZ 85258 201620666 INSURANCE AZ C 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0