2020-07-15T11:07:26-05:00 2019-08-31 PricewaterhouseCoopers LLP 101 SEAPORT BLVD SUITE 500 BOSTON MA 02210 990 2018-09-01 320359189 PACKARD CHILDREN'S HEALTH ALLIANCE % CAMERON D'ALPE FINANCE DEPT PACK 6504978000 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 DANA HAERING CFO 6507212222 2020-07-08 true GWEN SPENCER P00641463 6175305000 2020-07-08 155.201.42.76 04363820201975000061 2020-07-15 P 0EBABC6EBE59E07D7A0B0201016F629EF3516635 D9F86E75EFDAFE7C85A38040228A3F35A3BFA220 2018 2021-01-29 14:40:06Z CAMERON D'ALPE 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 108444792 false X WWW.STANFORDCHILDRENS.ORG X 2011 CA SEE SCHEDULE O 7 2 391 0 0 0 0 0 98604230 108444792 0 0 0 0 98604230 108444792 0 0 0 0 27551117 32053884 0 0 0 78966722 90778836 106517839 122832720 -7913609 -14387928 29253236 27033337 21576315 18750444 7676921 8282893 X SEE SCHEDULE O false false 108123072 108444792 SEE SCHEDULE O 108123072 true false false false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 63 0 true 391 true false false false false false false false false false false false false X 7 2 true false false false true true true true true false false true true true true true false false false false CA X CAMERON D'ALPE FINANCE DEPT 6507235636 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 John Walker DIRECTOR/CHAIR 1.0 3.0 X X 0 0 0 William Kennedy MD DIRECTOR 1.0 50.0 X 0 476766 43213 Dennis P Lund MD DIRECTOR, VICE CHAIR 1.0 52.0 X X 0 1242885 61256 Andrew Smith MEDICAL DIRECTOR 50.0 0.0 X X 394435 0 19216 Cameron D'Alpe CEO 17.0 33.0 X X 0 464073 95412 Malinda Mitchell DIRECTOR 1.0 0.0 X 0 0 0 MARCIA COHEN DIRECTOR 1.0 1.0 X 0 648145 53670 Dana Haering VP & CFO 3.0 47.0 X 0 701413 117163 Malavika Narayan DIR OF PHYSICIAN NETWORK FIN. 50.0 0.0 X 0 234623 37005 Rick Vance COO 50.0 0.0 X 339278 0 13144 Michael Lipman PROVIDER RECRUIT. AND DEV. DIR 50.0 0.0 X 236727 0 9993 Dorothy Naidu DIRECTOR, CLINICAL QUALITY 50.0 0.0 X 181467 0 8557 Susan Ault PRACTICE ADMINISTRATOR 50.0 0.0 X 162928 0 6445 Gaguik Khachatourian OPERATIONS EXEC (AS OF 4/18) 50.0 0.0 X 187727 0 5599 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 50.0 0.0 X 242076 0 18080 Kim Roberts CHIEF STRAt. off. (until 6/18) 17.0 33.0 X 0 721968 71880 Kenneth Cox PROFESSOR MED CTR LINE 50.0 0.0 X 0 181691 2170 Edward Kopetsky VP & CIO 1.0 50.0 X 0 665747 80914 1744638 5337311 643717 29 true true false PACKARD MEDICAL GROUP INC 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 PHYSICIAN SERVICES 43449478 G AND G ORGANIZATION LTD DBA PFS GR 2600 NORTH LOOP WEST STE 150 HOUSTON TX 77092 SERVICE 1956008 CAREMARK LLC PO BOX 848001 DALLAS TX 75284 SERVICE 898374 Adecco Employment Services DEPARTMENT LA 21403 PASADENA CA 911851403 EMPLOYMENT SERVICE 677840 THE CORE GROUP 890 N MCCARTHY BLVD SUITE 100 MILPITAS CA 95035 PURCHASE SERVICES 233845 36 0 PATIENT SERVICES 900099 96966640 96966640 PROGRAM SUPPORT 900099 11048236 11048236 OTHER INCOME - RISK POOL 900099 429916 429916 108444792 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 108444792 108444792 X 0 0 0 0 1010255 743906 266349 0 17577744 14291248 3286496 736323 344374 391949 11113001 9152323 1960678 1616561 1363399 253162 333052 238634 94418 284381 284381 45176 45176 0 0 0 61250633 57816090 3434543 109907 49194 60713 13183874 12124153 1059721 3742106 3742106 0 5974593 5887480 87113 59910 24353 35557 0 0 0 0 5069656 1816030 3253626 311898 311898 UNCOLLECTIBLES 1096688 1096688 0 0 DUES & SUBSCRIPTIONS 349511 227598 121913 0 UTILITIES 114223 110174 4049 0 LICENSES & TAXES 63022 20110 42912 0 -1209794 -924788 -285006 122832720 108123072 14709648 0 0 0 -713981 101918 0 0 9094558 9740723 0 0 0 0 0 0 0 0 770946 689779 19559060 14421612 6664599 5137448 0 0 0 0 0 0 11474686 8962302 1962428 2401167 29253236 27033337 4086839 4895876 0 0 0 0 0 0 0 0 0 0 0 0 0 0 17489476 13854568 21576315 18750444 X 7676921 8282893 0 0 0 0 7676921 8282893 29253236 27033337 X -14387928 14993900 X false true X true false X SCHEDULE A, PART I PACKARD CHILDREN'S HEALTH ALLIANCE WAS RECOGNIZED AS A HEALTHCARE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) OF THE INTERNAL REVENUE CODE. PCHA DOES NOT OPERATE A FACILITY THAT IS OR IS REQUIRED TO BE LICENSED AS A HOSPITAL. THEREFORE, PCHA IS NOT REQUIRED TO FILE FORM 990, SCHEDULE H. 5721766 4307837 1413929 11620718 10113775 1506943 2216576 0 2216576 5137448 OTHER ASSETS 2340598 SECURITY DEPOSITS 60569 2401167 0 DUE TO RELATED PARTIES, NET 13854568 13854568 X SCHEDULE D, PART X, LINE 2 FIN 48 PCHA IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF STANFORD UNIVERSITY, WHICH INCLUDE THE FOLLOWING NOTE: IN ACCORDANCE WITH THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, MANAGEMENT REGULARLY EVALUATES ITS TAX POSITIONS AND DOES NOT BELIEVE PCHA HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE FINANCIAL STATEMENTS. false true false false false false false true false William Kennedy MD DIRECTOR 0 375387 0 87810 0 13569 0 27165 0 16048 0 519979 0 0 Dennis P Lund MD DIRECTOR, VICE CHAIR 0 394948 0 820769 0 27168 0 19967 0 41289 0 1304141 0 0 Andrew Smith MEDICAL DIRECTOR 346184 0 48251 0 0 0 10600 0 8616 0 413651 0 0 0 Dana Haering VP & CFO 0 553586 0 30000 0 117827 0 102566 0 14597 0 818576 0 54671 Cameron D'Alpe CEO 0 360355 0 30000 0 73718 0 76798 0 18614 0 559485 0 24669 Michael Lipman PROVIDER RECRUIT. AND DEV. DIR 220868 0 15859 0 0 0 9429 0 564 0 246720 0 0 0 Dorothy Naidu DIRECTOR, CLINICAL QUALITY 175352 0 6115 0 0 0 7309 0 1248 0 190024 0 0 0 Susan Ault PRACTICE ADMINISTRATOR 156791 0 6137 0 0 0 4933 0 1512 0 169373 0 0 0 Gaguik Khachatourian OPERATIONS EXEC (AS OF 4/18) 187727 0 0 0 0 0 4791 0 808 0 193326 0 0 0 Malavika Narayan DIR OF PHYSICIAN NETWORK FIN. 0 219623 0 15000 0 0 0 24525 0 12480 0 271628 0 0 Rick Vance COO 304659 0 34619 0 0 0 10600 0 2544 0 352422 0 0 0 Kim Roberts CHIEF STRAt. off. (until 6/18) 0 564739 0 80000 0 77229 0 56419 0 15461 0 793848 0 0 Kenneth Cox PROFESSOR MED CTR LINE 0 12782 0 166396 0 2513 0 1280 0 890 0 183861 0 0 Edward Kopetsky VP & CIO 0 525566 0 77000 0 63181 0 45643 0 35271 0 746661 0 0 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 227789 0 14287 0 0 0 6324 0 11756 0 260156 0 0 0 MARCIA COHEN DIRECTOR 0 544807 0 102858 0 480 0 27500 0 26170 0 701815 0 0 PROCEDURES FOR DETERMINING COMPENSATION SCHEDULE J, PART I, LINE 3 PCHA RELIED ON LPCH, A RELATED ORGANIZATION, TO DETERMINE OFFICER COMPENSATION. LPCH'S PROCESS FOR DETERMINING COMPENSATION REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED ON INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF LPCH. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS, AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B CERTAIN OFFICERS OF PCHA ARE PROVIDED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS BY LPCH, A RELATED ORGANIZATION. AT THE LAST DAY OF EACH QUARTER, EACH PARTICIPANT'S ACCOUNT IS CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION). THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN THE ACCOUNT AS FOLLOWS: (A) THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED AND THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION; (B)DISCHARGE FROM EMPLOYMENT; (C) ENTITLEMENT TO LONG-TERM DISABILITY; OR (D) THE PARTICIPANT ATTAINS THE AGE OF 60 WHILE EMPLOYED. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING INDIVIDUALS IN CALENDAR YEAR 2018: DANA HAERING $ 55,413 KIM ROBERTS $ 55,485 EDWARD KOPETSKY $ 63,181 CAMERON D'ALPE $ 25,007 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (C). SCHEDULE J, PART I, LINE 7 CERTAIN OFFICERS AND OTHERS AS ENUMERATED IN SCHEDULE J, PART II PARTICIPATE IN A DEFERRED COMPENSATION PLAN SPONSORED BY LPCH. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. SCHEDULE J, PART II, DESCRIPTION FOR COLUMN B (III) OTHER REPORTABLE COMPENSATION IN SCHEDULE J, COLUMN B-III INCLUDES SERP CASH DISTRIBUTION, ACCRUED VACATION PAY OUT, AND GROUP TERM LIFE. IN ADDITION, PCHA HAS PROVIDED VARIOUS ITEMS OF LISTED PROPERTY (I.E. COMPUTERS AND PERIPHERALS) TO THE ABOVE LISTED EMPLOYEES PRINCIPALLY FOR THEIR BUSINESS USE. ORGANIZATION'S PRIMARY EXEMPT PURPOSE FORM 990, PART I, LINE 1 & PART III, LINE 1 AT PCHA, THE FOCUS IS ON PATIENT CARE AND COMMUNITY OUTREACH TO ENSURE PATIENT ACCESS TO PCHA'S SERVICES. PCHA PHYSICIANS, NON MD CLINICIANS, AND STAFF ASSUME THE ROLE OF EDUCATORS TO IMPROVE THE PHYSICAL AND BEHAVIORAL WELL-BEING OF CHILDREN IN THE COMMUNITIES IT SERVES. THE OVERALL STRATEGY TO ACCOMPLISH THE OBJECTIVE IS TWOFOLD: BECOME A RELIED UPON RESOURCE FOR CAREGIVERS/PARENTS AND PROVIDE PREVENTATIVE CARE FOR CHILDREN. EDUCATION IS THE KEY FOR BOTH STRATEGIES. WHILE MULTIPLE COMMUNITY SERVICES WILL BE OFFERED AT THE MEDICAL SITES, A SIGNIFICANT PART OF THE OUTREACH EFFORTS WILL BE SPENT SERVING THE PCHA COMMUNITY. PROGRAM SERVICE DESCRIPTION FORM 990, PART III, LINE 4A DURING THE PERIOD OF SEPTEMBER 2018 THROUGH AUGUST 2019 (FY 2019), PCHA PRIMARILY FOCUSED ON OPERATIONS AND EXISTING PROVIDER VISIT GROWTH, AND ACQUIRED JUST ONE NEW PRACTICE IN JULY 2019, TOWN & COUNTRY. IN ADDITION, WE CONTINUE TO INCREASE OUR AVAILABILITY AT MANY OF OUR SITES BY INCREASING THE NUMBER OF PROVIDERS. THIS YEAR WE CONTINUED TO IMPROVE SERVICES OFFERED VIA OUR PATIENT PORTAL INCLUDING DIRECTLY SCHEDULING APPOINTMENTS, REQUESTING PRESCRIPTIONS, VIEWING BILLING STATEMENTS AND COMMUNICATING WITH MEDICAL PROVIDERS. THE THREE LARGEST SERVICES PCHA OPERATED IN FISCAL YEAR 2019 WERE: GENERAL PEDIATRICS - BAYSIDE GENERAL PEDIATRICS - PENINSULA PEDIATRICS GENERAL PEDIATRICS - PEDIATRIC ASSOCIATES BAYSIDE BAYSIDE PEDIATRICS WAS ESTABLISHED IN OAKLAND IN 1979, AND HAS GROWN THROUGHOUT THE EAST BAY INTO A NETWORK OF 11 PEDIATRIC AND FAMILY PRACTICE OFFICES, WITH A DEDICATED TEAM OF PEDIATRICIANS AND FAMILY PRACTITIONERS WHO HAVE OUTSTANDING CREDENTIALS AND EXPERIENCE. WE PROVIDE PERSONALIZED, HIGH-QUALITY AND PATIENT-CENTERED CARE. OUR PEDIATRICIANS SPECIALIZE IN THE CARE OF NEWBORNS, CHILDREN AND ADOLESCENTS AT ALL 10 OF OUR OFFICES. IN ADDITION, WE HAVE A PEDIATRICIAN WITH PULMONOLOGY EXPERIENCE WHO BRINGS EXPERTISE IN ASTHMA CARE TO OUR PATIENTS. WE ALSO PROVIDE TRAVEL MEDICINE SERVICES. WE ARE COMMITTED TO PROVIDING EXCELLENT CARE TO ALL CHILDREN AND THEIR FAMILIES. PENINSULA PEDIATRICS AT PENINSULA PEDIATRIC MEDICAL GROUP, OUR FAMILY OF EXPERIENCED AND CARING PEDIATRICIANS HAS BEEN SERVING CHILDREN IN THE BAY AREA FOR GENERATIONS. WE SPECIALIZE IN CARING FOR NEWBORNS THROUGH ADOLESCENTS IN THEIR LATE TEENS. WE WORK WITH PARENTS TO HELP CHILDREN REACH THEIR HIGHEST POTENTIAL BY GIVING THEM THE TOOLS THEY NEED TO LIVE A HEALTHY LIFE. WE STRIVE TO BE UNDERSTANDING AND AVAILABLE TO THE FAMILIES WE ARE PRIVILEGED TO SERVE, AND OFFER OUR SERVICES IN BURLINGAME, SAN MATEO AND MENLO PARK. PEDIATRIC ASSOCIATES MEDICAL GROUP THE PEDIATRIC ASSOCIATES MEDICAL GROUP HAS SEVEN PHYSICIANS IN TWO SAN JOSE LOCATIONS, SAMARITAN AND CAMDEN. THE GROUP HAS BEEN PROVIDING THE FULL CONTINUUM OF GENERAL PEDIATRIC SERVICES TO CHILDREN AND YOUNG ADULTS FOR OVER 30 YEARS. PATIENT VISITS PROVIDED IN THE FISCAL YEAR 2019 FOR EACH OF THE LARGEST SERVICES ARE: BAYSIDE: $80,212 PENINSULA PEDIATRICS: $38,266 PEDIATRIC ASSOCIATES: $27,000 DURING FISCAL YEAR 2019 PCHA PROVIDED 281,728 OFFICE VISITS. FAMILY/BUSINESS RELATIONSHIP FORM 990, PART VI, LINE 2 ANDREW SMITH, MARCIA COHEN, WILLIAM KENNEDY, AND DENNIS LUND ARE EMPLOYEES OF STANFORD SCHOOL OF MEDICINE. MEMBERS FORM 990, PART VI, LINE 6 STANFORD UNIVERSITY AND LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD ARE THE MEMBERS OF PCHA. FORM 990, PART VI, LINE 7A STANFORD UNIVERSITY AND LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD, AS THE MEMBERS OF PCHA, APPOINT THE PCHA BOARD OF DIRECTORS. TWO OF THE DIRECTORS MUST BE PERSONS WHO RESIDE IN THE COMMUNITIES SERVED BY PCHA AND WHO ARE NOT COMPENSATED BY PCHA, THE MEMBERS, OR ANY MEDICAL GROUP AFFILIATED WITH PCHA. FORM 990, PART VI, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY ONE OR MORE MEMBERS: - ENTERING INTO PROFESSIONAL SERVICE AGREEMENTS WITH NEW MEDICAL GROUPS - ACQUISITION, MERGER, OR CONSOLIDATION OF ANY OTHER ENTITY PROCEDURES FOR REVIEWING FORM 990 FROM GOVERNING BODY FORM 990, PART VI, LINE 11 WORKING WITH PRICEWATERHOUSECOOPERS, THE FORM 990 IS PREPARED FOR MANAGEMENT'S REVIEW. A DRAFT OF THE FORM 990 IS MAILED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW, ALONG WITH AN EXECUTIVE SUMMARY OF RECENT CHANGES AND NEW REQUIREMENTS. THE DRAFT FORM 990 IS REVIEWED AT THE AUDIT AND COMPLIANCE COMMITTEE MEETING. A FINAL FORM 990 IS THEN DISTRIBUTED TO THE FULL BOARD BEFORE FILING WITH THE IRS. PRICEWATERHOUSECOOPERS SIGNS THE FINAL RETURN AS PAID PREPARER. PROCEDURES FOR MONITORING AND ENFORCING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C OFFICERS, DIRECTORS AND EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") AT THE TIME OF APPOINTMENT AT PCHA. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS. A DISCLOSURE THAT APPEARS TO BE A CONFLICT WILL BE RESOLVED BY A MUTUAL AGREEABLE PLAN WITH THE PCHA CHIEF EXECUTIVE OFFICER THAT OUTLINES THE STEPS THE OFFICER, DIRECTOR OR EMPLOYEE MUST TAKE TO RECTIFY THE CONFLICT. PROCEDURES FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15 FOR THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER, PCHA RELIED ON LPCH, A RELATED ORGANIZATION, TO DETERMINE OFFICER COMPENSATION. LPCH'S PROCESS FOR DETERMINING COMPENSATION REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF LPCH. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS, AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES WHO ARE EMPLOYEES OF PCHA IS DETERMINED BY A PROCESS THAT INCLUDES A REVIEW OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DECISION. COMPENSATION DECISIONS WITH RESPECT TO OFFICERS AND KEY EMPLOYEES WHOSE COMPENSATION EXCEEDS A SPECIFIED THRESHOLD ARE MADE BY THE PCHA COMPENSATION COMMITTEE. FORM 990, PART VI, LINE 19 THE STATEMENTS OF OPERATIONS AND BALANCE SHEET ARE INCLUDED IN THE ANNUAL REPORT POSTED ON THE ORGANIZATION'S PUBLIC WEBSITE. COPIES OF THE FINANCIAL STATEMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. COPIES OF THE GOVERNING DOCUMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. THE CONFLICT OF INTEREST POLICY IS NOT CURRENTLY AVAILABLE FOR PUBLIC INSPECTION. RECONCILIATION FORM 990, PART XI, LINE 9 EQUITY TRANSFERS TO PCHA FROM LPCH IN FY19 $ 14,993,900 FORM 990 PART IX LINE 11G DESCRIPTION:TEMP LABOR - MEDICAL PHYSICIAN TOTAL FEES:1754269 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL SERVICE TOTAL FEES:91310 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:5804487 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER MEDICAL SERVICES TOTAL FEES:53600567 THE BRD OF TRUST LELAND STANF JR UNIV 485 BROADWAY MAIL CODE 8838 REDWOOD CITY CA 94063 941156365 EDUCATION CA 501(C)(3) 2 NA false HOSPITAL COMMITTEE FOR THE L-P AREAS 1111 E STANLEY BLVD LIVERMORE CA 94550 941429628 HOSPITAL CA 501(C)(3) 3 SHC true LUCILE PACKARD FOUNDATION FOR CHILDREN'S 400 HAMILTON AVENUE SUITE 340 PALO ALTO CA 94301 770440090 HEALTHCARE CA 501(C)(3) 7 LPCH true LUCILE SALTER PACKARD CHILDRENS HOSPITAL 725 WELCH ROAD MC 5553 PALO ALTO CA 94304 770003859 HEALTHCARE CA 501(C)(3) 3 STANFORD true SHR HOLDINGS INC 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 943187167 REAL ESTATE CA 501(C)(25) N/A STANFORD true STANFORD FACULTY CLUB PO BOX 7229 STANFORD CA 94309 941187089 FAC INTERACT. CA 501(C)(7) N/A STANFORD true STANFORD FEDERAL CREDIT UNION 1860 EMBARCADERO RD PALO ALTO CA 94303 941492212 CREDIT UNION CA 501(C)(1) N/A STANFORD true STANFORD HABITAT CONSERVATION BOARD 415 BROADWAY REDWOOD CITY CA 94063 461882243 CONSERVATION CA 501(C)(3) 7 STANFORD true STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD CA 94305 946174066 HEALTHCARE CA 501(C)(3) 3 STANFORD true STANFORD HEALTH CARE ADVANTAGE 1221 BROADWAY 3RD FLOOR OAKLAND CA 94612 464071746 HEALTHCARE CA 501(c)(3) 12A, I SHC true STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BLDG 11 CAPE TOWN SF EDUCATION SF 501(C)(3) N/A STANFORD true STANFORD UNIVERSITY BOOKSTORE BLDG 60 MAIN QUAD NO 105 STANFORD CA 94305 940894150 SUPPORT CA 501(C)(3) 12A, I STANFORD true SU EMP BEN TRUST POST RETEMPYNT BEN 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 943246199 BENEFITS CA 501(C)(9) N/A STANFORD true THE DUDLEY E CHAMBERS FOUNDATION JP MORGAN CHASE PO BOX 3038 MILWAUKEE WI 53201 386841793 SUPPORT NY 501(C)(3) 12D, III-O STANFORD true THE FREIDENRICH SUPPORT FOUNDATION 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 300519583 SUPPORT CA 501(C)(3) 12A, I STANFORD true THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD CAUSEWAY HK 986078093 SUPPORT HK 501(C)(3) N/A STANFORD true THE STANFORD TRUST 65 HIGH STREET OXFORD UK OX1 46L SUPPORT UK 501(C)(3) N/A STANFORD true UNIVERSITY HEALTHCARE ALLIANCE 7999 GATEWAY BLVD STE 300 NEWARK CA 94560 943192446 HEALTHCARE CA 501(C)(3) 3 SHC true VALLEYCARE MEDICAL FOUNDATION INC 5655 W LAS POSITAS BLVD 220 PLEASANTON CA 94588 262593526 SUPPRT SHC-VC CA 501(C)(3) 10 HOSP CMTE LP true VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE CA 94550 943382224 SR. 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SCHEDULE R, PART IV, LINE 6 CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 7 OTHER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 1 POOLED INVESTMENT FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.