2017-07-17T16:21:56-05:00 2016-08-31 PricewaterhouseCoopers LLP 101 SEAPORT BOULEVARD BOSTON MA 02210 990 2015-09-01 320359189 PACKARD CHILDREN'S HEALTH ALLIANCE % KIM ROBERTS FINANCE DEPT PACK 6504978000 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 GREG HOGUE CONTROLLER 6507212222 2017-07-21 true GWEN SPENCER P00641463 6175305000 2015 2021-01-29 14:40:06Z KIM ROBERTS 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 81855201 false X WWW.PCHA.ORG X 2011 CA SEE SCHEDULE O 7 2 341 0 0 0 0 71682237 81855201 0 0 0 0 71682237 81855201 0 0 0 0 18991883 23102959 0 0 0 64114095 68168725 83105978 91271684 -11423741 -9416483 27470485 30517724 19605453 22917480 7865032 7600244 X SEE SCHEDULE O false false 83571354 81855201 SEE SCHEDULE O 83571354 true false false false false false false false false false true false false false true false 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 75 0 true 341 true false false false false false false false false false false X 7 2 false false false false true true true true true false false true true true true true false false false false CA X KIM ROBERTS FINANCE DEPT 6507212222 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 X MARCIA COHEN DIRECTOR/CHAIR 1.0 50.0 X X 0 546604 75066 WILLIAM KENNEDY MD DIRECTOR 1.0 50.0 X 0 421908 39034 KIM ROBERTS CEO 25.0 25.0 X X 0 669258 133667 JACOB CHACKO DIRECTOR 1.0 0.0 X 0 0 0 JOHN WALKER DIRECTOR/VICE CHAIR 1.0 3.0 X X 0 0 0 DENNIS P LUND MD DIRECTOR 1.0 50.0 X 0 793402 51138 ANDREW SMITH MEDICAL DIRECTOR 50.0 0.0 X X 359843 0 33018 DANA HAERING CFO 2.0 50.0 X 0 532041 80411 MALAVIKA NARAYAN SR DIR FINANCE 50.0 0.0 X 0 185012 28415 RICK VANCE COO 50.0 0.0 X 297442 0 28714 EDWARD KOPETSKY VP & CIO 1.0 50.0 X 0 853966 67389 MARGARET JOHNSON SR DIR FINANCE (UNTIL 8/16/15) 12.0 38.0 X 0 204723 40603 CARLOTTA GABARD PRACTICE ADMINISTRATOR 50.0 0.0 X 224274 0 25968 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 50.0 0.0 X 222758 0 25875 MICHAEL LIPMAN PROVIDER RECRUIT. AND DEV. DIR 50.0 0.0 X 212848 0 25329 DOROTHY NAIDU DIRECTOR, CLINICAL QUALITY 50.0 0.0 X 169130 0 17893 AUBYN REDMOND DIRECTOR, PRACTICE OPERATIONS 50.0 0.0 X 159424 0 9084 1645719 4206914 681604 23 false true false PACKARD MEDICAL GROUP INC 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 PHYSICIAN SERVICES 39268596 ADP INC PO Box 31001-1874 PASADENA CA 91110 Payroll & Benefits 3230002 G AND G ORGANIZATION LTD DBA PFS GR 2600 NORTH LOOP WEST STE 150 HOUSTON TX 77092 PAYROLL SERVICES 1309209 ADECCO EMPLOYMENT SERVICES Department LA 21403 PASADENA CA 91185 Payroll & Benefits 1264410 DOME CONSTRUCTION 393 E GRAND AVE S SAN FRANCISCO CA 94080 CONSTRUCTION 872610 44 0 PATIENT SERVICES 900099 71689557 71689557 PROGRAM SUPPORT 900099 10243190 10243190 OTHER INCOME - RISK POOL 900099 -77546 -77546 81855201 0 0 0 0 0 0 0 0 0 0 0 81855201 81855201 X 0 0 0 0 689753 516733 173020 0 14252429 12594152 1658277 682381 628868 53513 6141202 5174861 966341 1337194 1204960 132234 1225076 627522 597554 0 39115 39115 0 0 0 48877904 45478859 3399045 46751 8712 38039 10843159 10317518 525641 875 875 0 5024852 5020682 4170 88932 76340 12592 0 0 0 0 1829692 1201534 628158 396414 396414 UNCOLLECTIBLES 1188890 1188890 RECRUITMENT 45471 35826 9645 LICENSES & TAXES 55418 55333 85 DUES & SUBSCRIPTIONS 165805 107180 58625 -1659629 -667491 -992138 91271684 83571354 7700330 0 0 0 823805 571439 0 0 8306776 7047466 0 0 0 0 0 0 0 0 399940 535710 15926180 5814827 6142061 10111353 0 0 0 0 0 0 11064286 11336186 733617 915570 27470485 30517724 6639828 6087013 0 0 0 0 0 0 0 0 0 0 0 0 0 0 12965625 16830467 19605453 22917480 X 7865032 7600244 0 0 0 0 7865032 7600244 27470485 30517724 X -9416483 9151695 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. 431877 431877 3463519 499872 2963647 7199959 4180761 3019198 4830825 1134194 3696631 10111353 0 DUE TO RELATED PARTIES, NET 16830467 16830467 false true false false false false false false false MARCIA COHEN DIRECTOR/CHAIR 0 457688 0 88916 0 0 26500 0 48566 0 621670 0 0 WILLIAM KENNEDY MD DIRECTOR 0 301037 0 108798 0 12073 0 26500 0 12534 0 460942 0 0 KIM ROBERTS CEO 0 496757 0 106501 0 66000 0 94813 0 38854 0 802925 0 36085 DENNIS P LUND MD DIRECTOR 0 288544 0 480310 0 24548 0 0 0 51138 0 844540 0 0 ANDREW SMITH MEDICAL DIRECTOR 311970 0 37517 0 10356 0 24000 0 9018 0 392861 0 0 0 DANA HAERING CFO 0 405162 0 117573 0 9306 0 68671 0 11740 0 612452 0 0 CARLOTTA GABARD PRACTICE ADMINISTRATOR 213022 0 11252 0 0 0 24000 0 1968 0 250242 0 0 0 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 205441 0 17317 0 0 0 18000 0 7875 0 248633 0 0 0 MICHAEL LIPMAN PROVIDER RECRUIT. AND DEV. DIR 197057 0 15791 0 0 0 24000 0 1329 0 238177 0 0 0 DOROTHY NAIDU DIRECTOR, CLINICAL QUALITY 156286 0 12844 0 0 0 11317 0 6576 0 187023 0 0 0 AUBYN REDMOND DIRECTOR, PRACTICE OPERATIONS 146167 0 13257 0 0 0 4903 0 4181 0 168508 0 0 0 MALAVIKA NARAYAN SR DIR FINANCE 0 172647 0 12365 0 0 17778 0 10637 0 213427 0 0 RICK VANCE COO 260248 0 25194 0 12000 0 18000 0 10714 0 326156 0 0 0 EDWARD KOPETSKY VP & CIO 0 461170 0 205675 0 187121 0 36550 0 30839 0 921355 0 115355 MARGARET JOHNSON SR DIR FINANCE (UNTIL 8/16/15) 174775 0 29948 0 0 0 11037 0 29566 0 245326 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 2015: DANA HAERING 7,289 KIM ROBERTS 36,561 EDWARD KOPETSKY 172,019 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (C). CERTAIN OFFICERS AND OTHER 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. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION DURING THE PERIOD OF SEPTEMBER 2015 THROUGH AUGUST 2016 (FY 2016), PCHA CONTINUED ITS DRAMATIC GROWTH BY ADDING THE FOLLOWING PRACTICES AND SERVICES TO ITS NETWORK: JUVVADI PEDIATRICS - MOUNTAIN VIEW ALTOS OAKS MEDICAL GROUP - MOUNTAIN VIEW WOMEN'S CARE MEDICAL GROUP - REDWOOD CITY IN ADDITION, WE CONTINUE TO INCREASE OUR AVAILABILITY AT MANY OF OUR SITES BY INCREASING THE NUMBER OF PROVIDERS. THIS YEAR WE CONTINUE 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 2016 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 10 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, AND OUR FAMILY PRACTITIONERS PROVIDE ADULT CARE AT TWO OF OUR OFFICES (BERKELEY AND ALAMEDA). 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 AND SAN MATEO. 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 2016 FOR EACH OF THE LARGEST SERVICES ARE: BAYSIDE: 93,371 PENINSULA PEDIATRICS: 38,408 PEDIATRIC ASSOCIATES: 24,215 DURING FISCAL YEAR 2016 PCHA PROVIDED 258,990 OFFICE VISITS. NETWORK GROWTH FOR FISCAL YEAR 2017 IS PROJECTED TO BE 5 ADDITIONAL PHYSICIAN PRACTICES. 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 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. DOCUMENT RETENTION POLICY. FORM 990, PART VI, LINE 14 PCHA IS IN THE PROCESS OF DEVELOPING ITS OWN DOCUMENT RETENTION POLICY FOR ADOPTION BY THE BOARD OF DIRECTORS. 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 $9,151,695 FORM 990 PART IX LINE 11G DESCRIPTION:TEMP LABOR - MEDICAL PHYSICIAN TOTAL FEES:1598838 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL SERVICE TOTAL FEES:19686 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:6962615 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER MEDICAL SERVICES TOTAL FEES:40296765 THE BRD OF TRUST LELAND STANF JR UNIV 3145 PORTER DRIVE PALO ALTO CA 94304 941156365 EDUCATION CA 501(C)(3) 2 NA false STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD CA 94305 946174066 HEALTHCARE CA 501(C)(3) 3 STANFORD true LUCILE SALTER PACKARD CHILDRENS HOSPITAL 725 WELCH ROAD MC 5553 PALO ALTO CA 94304 770003859 HEALTHCARE CA 501(C)(3) 3 STANFORD true HOSPITAL COMMITTEE FOR THE L-P AREAS 1111 E STANLEY BLVD LIVERMORE CA 94550 941429628 HOSPITAL 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) 9 HOSP CMTE LP true VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE CA 94550 943382224 SR. FACILITY CA 501(C)(3) 11C, III-FI HOSP CMTE LP true THE FREIDENRICH SUPPORT FOUNDATION 3145 PORTER DRIVE PALO ALTO CA 94304 300519583 SUPPORT CA 501(C)(3) 11A, I STANFORD true SHR HOLDINGS INC 3145 PORTER DRIVE PALO ALTO CA 94304 943187167 REAL ESTATE CA 501(C)(25) N/A STANFORD true SU EMP BEN TRUST POST RETEMPYNT BEN 3145 PORTER DRIVE PALO ALTO CA 94304 943246199 BENEFITS CA 501(C)(9) N/A STANFORD true UNIVERSITY HEALTHCARE ALLIANCE 7999 GATEWAY BLVD STE 300 NEWARK CA 94560 943192446 HEALTHCARE CA 501(C)(3) 3 SHC true THE DUDLEY E CHAMBERS FOUNDATION JP MORGAN CHASE PO BOX 3038 MILWAUKEE WI 53201 386841793 SUPPORT NY 501(C)(3) 11D, III-O STANFORD true STANFORD UNIVERSITY BOOKSTORE BLDG 60 MAIN QUAD NO 105 STANFORD CA 94305 940894150 SUPPORT CA 501(C)(3) 11A, I STANFORD true STANFORD HABITAT CONSERVATION BOARD 3160 PORTER DR STE 200 PALO ALTO CA 94304 461882243 CONSERVATION CA 501(C)(3) 7 STANFORD true STANFORD FACULTY CLUB PO BOX 7229 STANFORD CA 94309 941187089 FAC INTERACT. CA 501(C)(7) N/A STANFORD true THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD CAUSEWAY HK 986078093 SUPPORT HK 501(C)(3) STANFORD true THE STANFORD TRUST 65 HIGH STREET OXFORD UK OX1 46L SUPPORT UK 501(C)(3) STANFORD true STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BUILDING 11 CAPE TOWN SF EDUCATION SF 501(C)(3) 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 HEALTH CARE ADVANTAGE 1221 BROADWAY 3RD FLOOR OAKLAND CA 94612 464071746 HEALTHCARE CA 501(c)(3) 11A, I SHC true STANFORD SCHOOLS CORPORATION 475 POPE STREET MENLO PARK CA 94025 202699147 EDUCATIONAL CA 501(C)(3) 2 STANFORD true ADOM PARTNERS LP 500 MADISON AVENUE NEW YORK NY 10022 INVESTMENTS DE NA ALBUS SELECT FUND LP 750 MENLO AVENUE MENLO PARK CA 94025 INVESTMENTS DE NA ARCOLA RESIDENTIAL VENTURE LLC 635 KNIGHT WAY STANFORD CA 943057297 900818278 REAL ESTATE DE NA ARCOLA VENTURE LLC 635 KNIGHT WAY STANFORD CA 943057297 371689632 RE DEVELOPMENT DE NA ATWATER 12 LP 2100 ROSS AVE STE 1600 DALLAS TX 75201 752944481 INVESTMENTS DE NA AVALANCHE ROYALTY PARTNERS LLC 410 17TH ST STE 1150 DENVER CO 80202 841539807 INVESTMENTS DE NA CEE EQUITY HOLDINGS LP ELIZABETH HOUSE 9 CASTLE ST ST. HELIER, JERSEY JE JE4 2QP INVESTMENTS JE NA CLAIRVUE CAPITAL PARTNERS II-TE 1 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO CA 94111 800909516 INVESTMENTS DE NA CLAIRVUE CAPITAL PARTNERS II-TE 2 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO CA 94111 800909556 INVESTMENTS DE NA CANARY SC FUND LP 399 PARK AVENUE NEW YORK NY 10022 INVESTMENTS DE NA ENERGY CAPITAL PARTNERS III (SENDERO CO- 51 JOHN F KENNEDY PARKWAY SUITE 2 SHORT HILLS NJ 07078 471702425 INVESTMENTS DE NA FORTRESS IW COINVESTMENT (FUND B) LP 1345 AVE OF THE AMERICAS 45TH FL NEW YORK NY 10105 980509639 INVESTMENTS CJ NA KEB INVESTORS II LP WASHINGTON MALL STE 304 7 REID ST HAMILTON, HM 11 BD INVESTMENTS BD NA LSF V DHB HOLDINGS LP 2711 N HASKELL AVE STE 1700 DALLAS TX 75204 272858604 INVESTMENTS DE NA OUTLAWS CASINO LTD 3160 PORTER DR PALO ALTO CA 94304 841457498 HOLDING COMPANY CO NA PALO ALTO LP 13 CASTLE STREET ST. 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