2018-05-15T11:13:26-05:00 2017-06-30 KPMG LLP 550 S Hope St Suite 1500 Los Angeles CA 90071 990 2016-07-01 956097416 CHOC Foundation % DONALD NOBLE CHOC 7149973000 1201 West La Veta Avenue Orange CA 92868 KERRI RUPPERT SCHILLER CFO/Assistant Secret 7149973000 2018-05-14 true VALERIE J BALL P00178114 4083675764 2018-05-01 2016 2022-09-23 18:48:47Z kimberly c cripe 1201 West La Veta Avenue orange CA 92868 49298782 false X www.choc.org X 1964 CA SUPPORTING CLINICAL & NONCLINICAL SVCS, MEDICAL EDuCaTioN, RESEARCH & ALLIED FIELDS OF PEDIATRICS AT CHILDRENS HOSPITAL OF OC, CHILDREN'S HOSPITAL AT MISSION AND ITS AFFILIATES. 23 22 41 0 0 23622305 28667067 0 0 761787 1721189 0 0 24384092 30388256 24000128 28041777 0 0 3548954 5481522 135210 0 6343881 3450373 4381383 31134665 37904682 -6750573 -7516426 68791124 63406293 1126699 1443699 67664425 61962594 CHOC FOUNDATION WAS FORMED TO HELP SUPPORT CLINICAL AND NONCLINICAL SERVICES, MEDICAL EDUCATION, RESEARCH AND ALLIED FIELDS OF PEDIATRICS AT CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHILDREN'S HOSPITAL AT MISSION AND TO SUPPORT ITS AFFILIATES. false false 27654407 27654407 0 Children's Hospital of Orange County - Provides specialized pediatric services for the care of children. During this year, there were 61,704 days of inpatient care; 89,791 emergency room visits; 12,004 surgeries; 1,958 day health visits and 538,702 primary and specialty care clinic visits. Funds raised helps to offset cost of services provided to indigent families. 387370 387370 0 Children Hospital at Mission - Funds support affiliated acute care pediatric hospital. Facility provides pediatric, neonatal, and care for emergency services. There were 7,929 inpatient care days; 15,365 emergency room visits; 671 surgeries and 22,921 outpatient visits. 1783057 0 0 CHOC Foundation generates community awareness and resources for CHOC Children's and CHOC Children's at Mission. The Foundation secures philanthropic support for health and well being of children. 29824834 true true false false false false false false false true true false false false true true true true false false false false false false true false false true false true false false false false false false false false true false false false false true false false false true X 61 0 true 41 true false false false false false true true false false false true false X 23 22 false false false false true true true true true false false true true true true true true true true false CA X DONALD NOBLE 7145094038 1201 WEST LA VETA AVENUE ORANGE CA 92868 X KIMBERLY CCRIPE DIRECTOR/PRESIDENT 5.0 35.0 X X 0 1529296 81880 STEPHANIE ARGYROS DIRECTOR 1.0 0.0 X 0 0 0 JOHN CARPINO DIRECTOR 1.0 0.0 X 0 0 0 JEFF ELGHANAYAN DIRECTOR 1.0 3.5 X 0 0 0 Jerry Flannery DIRECTOR 1.0 0.0 X 0 0 0 GREGORY GLUCHOWSKI DIRECTOR 1.0 0.0 X 0 0 0 STEVE HOLLEY DIRECTOR 1.5 0.0 X 0 0 0 Cary Hyden DIRECTOR 1.0 0.0 X 0 0 0 Daniel Hyman DIRECTOR/VICE CHAIR 1.5 0.0 X X 0 0 0 ALI KAVIANIAN MD Director 1.0 0.0 X 0 0 0 JASON KNIGHT MD Director 1.0 0.0 X 0 0 0 GIGI KROLL MD Director 1.0 0.0 X 0 0 0 Heather Madden Director/Secretary 1.5 0.0 X 0 0 0 CAROLINE MARCHANT DIRECTOR 1.0 0.0 X 0 0 0 SHRUTI MIYASHIRO DIRECTOR/CHAIR 3.0 0.0 X X 0 0 0 Chris Rommel Director/Vice Chair 1.5 0.0 X X 0 0 0 Doug Cavanaugh DIRECTOR 1.0 0.0 X 0 0 0 Michael Chao MD DIRECTOR 1.0 0.0 X 0 0 0 Steve Solomon Director 1.0 0.0 X 0 0 0 John Storbeck DIRECTOR 1.0 0.0 X 0 0 0 David Sugden DIRECTOR 1.5 0.0 X 0 0 0 David Willis DIRECTOR 1.5 0.0 X 0 0 0 GARY SMITH DIRECTOR 1.0 0.0 X 0 0 0 Kerri Ruppert-Schiller CFO/Assistant Secretary 3.5 36.5 X 0 832951 5747 Dennis McClellan Vice President 40.0 0.0 X 606839 0 0 Patrice Poidmore Executive Director 40.0 0.0 X 253873 0 13570 Zachariah Abrams Director Special Events 40.0 0.0 X 170291 0 16688 Lois Augustine Director Community Relations 40.0 0.0 X 153710 0 17564 Kara Kipp Director Major Gifts 40.0 0.0 X 183198 0 30807 Shaheen Husain Director of corporate relation 40.0 0.0 X 146723 0 32 1514634 2362247 166288 10 false true false CI PARTNERS DIRECT LLC 1601 EASTMAN AVE SUITE 202 VENTURA CA 930036471 Consulting 123121 Amusement Park 217 N Main Street Suite 200 SANTA ANA CA 92701 Advertising 122184 Blackbaud PO Box 930256 ATLANTA GA 311930256 Consulting 106823 3 5323638 23343429 1768927 28667067 0 685470 685470 0 0 0 0 0 17345175 16309456 1035719 1035719 1035719 2601070 5323638 2601070 0 0 0 0 0 0 0 0 0 0 0 30388256 1721189 28041777 28041777 0 0 0 403969 133310 133310 137349 0 3801788 950447 380179 2471162 73239 10152 12217 50870 908723 227181 90872 590670 293803 73451 29380 190972 702135 38834 538816 124485 1781 1781 1650 1650 0 0 63874 63874 523335 165435 214560 143340 516708 24141 34718 457849 22629 3638 3964 15027 182469 7845 82648 91976 0 283570 92041 92041 99488 106192 7675 7602 90915 0 75741 13208 12439 50094 0 0 89094 29401 29401 30292 7397 2233 2233 2931 DONOR EVENT EXPENSE 1061899 1061899 DUES 365916 3483 3700 358733 PROVISION FOR UNCOLLECTIBLES 335618 335618 TAXES & LICENSES 20832 582 582 19668 20543 20543 37904682 29824834 1735967 6343881 4039512 7754760 1684298 1060550 26783632 11156264 0 0 0 0 0 0 0 0 0 0 532638 254738 783302 608143 247823 175159 34971592 42487794 0 0 0 0 0 0 531629 517028 68791124 63406293 663206 817345 0 0 0 0 0 0 0 0 0 0 0 0 0 0 463493 626354 1126699 1443699 X 17909106 22056177 32392017 18660731 17363302 21245686 67664425 61962594 68791124 63406293 X -7516426 1829197 -14602 X false true X true false X 48376534 29891118 25814412 23622305 28646524 156350893 0 0 48376534 29891118 25814412 23622305 28646524 156350893 38497867 117853026 495115 629152 603492 646537 685470 3059766 0 1566510 1902114 1889252 2291610 2601070 10250556 169661215 0.69464 0.60700 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 32329250 4389756 3471548 652882 39537672 32289235 787732 -75491 0 672226 0 32329250 30854374 1095767 910970 0 571876 0 32289235 25687579 1865288 4042450 0 740943 0 30854374 22804894 1461132 1894713 0 473160 0 25687579 0.35840 0.53740 0.10420 false false 227280 153546 73734 556022 454597 101425 175159 0 PAYABLE TO AFFILIATES 626354 626354 X 31120410 1829197 386000 2215197 28905213 1483043 1483043 30388256 36822240 386000 386000 36436240 1468442 1468442 37904682 ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE 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, 2017, THERE ARE NO UNCERTIAN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. OTHER CHANGES IN NET ASSETS PART XI, LINE 4B CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS $ 14,601 DONOR EVENT EXPENSE $1,447,899 In-Kind donation $ 20,543 =============== TOTAL LINE 4B $1,483,043 PART XII, LINE 4B DONOR EVENT EXPENSE $1,447,899 In-Kind donation $ 20,543 =============== TOTAL LINE 4B $1,468,442 Schedule D, Part V, Line 4 The endowment fund is used to support hospital programs addressing the needs of the underserved, social services to patients and families in need, and research and treatment of children's diseases and disorders. X CHOC GALA 4159153 2455629 1703524 155113 1210 311678 1007582 227941 GUILDS 1427321 1020485 406836 26874 109317 24851 2734 243060 6 2338234 1847524 490710 33902 74328 85794 10121 286565 7924708 5323638 2601070 215889 184855 422323 1020437 757566 2601070 true CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 West La Veta Avenue ORANGE CA 92868 952321786 501(c)(3) 27654407 n/a n/a Hospital operations CHILDREN'S HOSPITAL AT MISSION 1201 West La Veta Avenue ORANGE CA 92868 330528802 501(c)(3) 387370 n/a n/a HOSPITAL OPERATIONS 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS - PART I, LINE 1 CHOC Foundation receives contributions on behalf of Children's Hospital of Orange County and Children's Hospital at Mission, both affiliated 501(c)(3) organizations. Donations are generally restricted or designated by donors for various purposes at inception. The funds are then distributed to the appropriate organization according to donor stipulations. X X X X false true false false false false false false false KIMBERLY CCRIPE DIRECTOR/PRESIDENT 0 883801 0 370786 0 274709 0 61495 0 20385 0 1611176 0 46284 Dennis McClellan Vice President 345897 0 148829 0 112113 0 940 0 4807 0 612586 0 0 0 Kerri Ruppert-Schiller CFO/Assistant Secretary 0 516920 0 167817 0 148214 0 47660 0 25882 0 906493 0 22838 Patrice Poidmore Executive Director 203141 0 36237 0 14495 0 7343 0 6227 0 267443 0 0 0 Zachariah Abrams Director Special Events 141640 0 16646 0 12005 0 5842 0 10846 0 186979 0 0 0 Lois Augustine Director Community Relations 126473 0 15695 0 11542 0 8373 0 9191 0 171274 0 0 0 Kara Kipp Director Major Gifts 154525 0 16372 0 12301 0 4974 0 25833 0 214005 0 0 0 SCHEDULE J, 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 THE CURRENT KEY EMPLOYEES WERE REPORTED AT THEIR FULL VALUE IN A PREVIOUS TAX YEAR. NO PAYMENTS WERE MADE DURING 2016. COMPENSATION FROM AN AFFILIATED ORGANIZATION KIMBERLY CRIPE 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. CRIPE DEVOTES APPROXIMATELY 13% OF HER TIME EACH WEEK TO CHOC FOUNDATION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS affairs. 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 9% OF HER TIME EACH WEEK TO CHOC FOUNDATION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS affairs. 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 individual received payments from the Plan during calendar year 2016: Ms. Cripe $(179,253) and Ms. Schiller $(87,664). X 2 82495 MSRP X 9 1215800 AVERAGE MARKET VALUE X airplane tickets 1 22000 retail price X gift certificates 2 190 retail price X disneyland tickets 1 406000 retail price X FOOD AND BEVERAGES 4 42442 retail price false true true SCHEDULE M, PART I, COLUMN B THE NUMBER LISTED IN PART I, LINE 9 COLUMN (B) WAS DETERMINED BASED ON THE NUMBER OF contributors. SCHEDULE M, QUESTION 32A CHOC FOUNDATION HAS AN AGREEMENT WITH RITEWAY CHARITY SERVCES (RITEWAY) TO RECEIVE THE NET PROCEEDS FROM RITEWAY FOR ANY CARS DONATED TO AND SOLD BY RITEWAY ON BEHALF OF CHOC FOUNDATION. Information Regarding Common Paymaster Form 990, Part I, Line 5 and Part V, Line 2 Children's Hospital of Orange County (CHOC) acts as a common paymaster, issuing forms W-2 and 1099 on behalf of CHOC Foundation. CHOC Foundation has 41 employees, however because of the common paymaster arrangement resulting in the Forms W-2 being issued under CHOC's employer identification number, there are no W-2s issued directly by CHOC Foundation. members or stockholders Form 990, Part VI, Section A, Line 6 The sole member of CHOC Foundation is Children's HealthCare of California (CHC). persons who may elect members of the governing body Form 990, Part VI, Section A, Line 7a Directors of CHOC Foundation shall be elected annually by the Member, based on the nomination(s) provided by CHOC Foundation'S Board of Directors. the governing body's decisions subject to approval 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 CHOC Foundation; (2) Obligating CHOC Foundation to undertake any capital expenditure in excess of $5,000,000; (3) Adopting CHOC Foundation'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 CHOC Foundation to act as guarantor with respect to any debt of any person or other entity; (8) Accepting any donation which is conditioned upon CHOC Foundation'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 any of the following: (a) any financial obligation on the part of CHOC Foundation in an amount in excess of $5,000,000, (b) any purpose or activity which is outside the scope of CHOC Foundation's ordinary course of business; (10) involving CHOC Foundation in any merger, acquisition, corporate restructuring, or formal affiliation; (11) Involving CHOC Foundation as a member, shareholder, or partner in any new corporation, partnership, or other legal entity; (12) Dissolving CHOC Foundation; (13) Entering into any transaction involving the sale, lease, conveyance, exchange, transfer or other disposition of all or substantially all of CHOC Foundation's assets; (14) Amending CHOC Foundation's articles of Incorporation; (15) Adopting new bylaws or amending existing bylaws. PROCESS OF REVIEW Form 990, Part VI, Section B, Line 11B Prior to the filing, the tax return and related schedules are presented to the CHOC Executive Compensation Committee, an empowered committees delegated with this authority. The tax return is also provided to the Foundation Executive Committee, an empowered board committee. The Chief Financial Officer reviews the report with the committee prior to filing the return. Prior to the filing of the form 990 with the Internal Revenue Service, a complete copy of the final form 990 is also sent electronically to all board members via Director's Desk, a secure web site that provides a confidential and secure access for all board materials to our board members. MONITORING AND ENFORCING COMPLIANCE OF CONFLICT INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C The Chief Compliance Officer is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to the conflict 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 Conflict 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 conflict 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. PROCESS OF DETERMINING COMPENSATION OF THE CEO AND OFFICERS FORM 990, PART VI, SECTION B, LINE 15 An independent Board Committee of THE ORGANIZATION 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 firm to provide relevant comparability data and other compensation studies. The CEO, officers and executive management salaries and incentives, 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 review was last performed in October 2016. All comparative salary data, such as annual compensation survey comprising 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 Board of Directors. disclosure copy - FORM 990, PART VI, SECTION C, LINE 19 While federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection, the organization makes its financial statements available upon request. Form 990, Part XI, Line 5 CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENT $ (14,602) CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC) 1201 West La Veta Avenue ORANGE CA 92868 330265266 HEALTH CARE CA 501(C)(3) 7 NA false CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 West La Veta Avenue ORANGE CA 92868 952321786 HEALTH CARE CA 501(C)(3) 3 CHC false CHILDREN'S HOSPITAL AT MISSION 1201 West La Veta Avenue ORANGE CA 92686 330528802 HEALTH CARE CA 501(C)(3) 3 CHC false CRC REAL ESTATE CORPORATION 455 S MAIN STREET ORANGE CA 92868 330612565 real estate CA 501(C)(3) 11a CHC false choc Thrift Stores Inc 455 S MAIN STREET orange CA 92868 330266422 fund raising CA 501(C)(3) 9 CHC false false false false false false false false false false false true true true false false false false false false PART V, LINE 2, COLUMN (C) THE METHODS USED BY CHOC FOUNDATION TO DETERMINE THE VALUE OF THE AMOUNTS LISTED IN SCHEDULE R, PART V, LINE 2, COLUMN (C) WERE BASED ON THE RECIPIENT CHARITABLE ORGANIZATION'S ANNUAL OPERATIONAL AND CAPITAL NEEDS AND WERE APPROVED BY CHC'S BOARD.