CHILDRENS HOSPITAL AT MISSION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: CHILDRENS HOSPITAL AT MISSION (EIN 33-0528802)
Tax period: 2015-07-01 to 2016-06-30
Filed: 2017-05-15
IRS object ID: 201731359349306183
Schema version: 2015v3.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-05-15T12:26:09-05:00	ReturnTs
Tax Period End	2016-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	550 S Hope St Suite 1500	AddressLine1Txt
City	Los Angeles	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	90071	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	330528802	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL AT MISSION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DONALD NOBLE	InCareOfNm
Business Name Control	CHIL	BusinessNameControlTxt
Phone	7149973000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1201 West La Veta Avenue	AddressLine1Txt
City	ORANGE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92868	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	KERRI RUPPERT SCHILLER	PersonNm
Person Title	CFO/Assistant Secret	PersonTitleTxt
Signature	2017-05-12	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Valerie J Ball	PreparerPersonNm
PTIN	P00178114	PTIN
Phone	2139724000	PhoneNum
Preparation	2017-05-03	PreparationDt

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	KIMBERLY C CRIPE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1201 West La Veta Avenue	AddressLine1Txt
City	ORANGE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92868	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$62,001,728	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.CHOC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1991	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	144	TotalEmployeeCnt
Total Volunteers	84	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$157,138	PYContributionsGrantsAmt
CY Contributions Grants	$207,528	CYContributionsGrantsAmt
PY Program Service Revenue	$56,615,887	PYProgramServiceRevenueAmt
CY Program Service Revenue	$61,604,433	CYProgramServiceRevenueAmt
PY Investment Income	$100,271	PYInvestmentIncomeAmt
CY Investment Income	$182,200	CYInvestmentIncomeAmt
PY Other Revenue	$285,841	PYOtherRevenueAmt
CY Other Revenue	$7,567	CYOtherRevenueAmt
PY Total Revenue	$57,159,137	PYTotalRevenueAmt
CY Total Revenue	$62,001,728	CYTotalRevenueAmt
PY Grants And Similar Paid	$4,000,000	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$2,500,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$11,667,535	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$13,499,591	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$39,600,700	PYOtherExpensesAmt
CY Other Expenses	$39,916,028	CYOtherExpensesAmt
PY Total Expenses	$55,268,235	PYTotalExpensesAmt
CY Total Expenses	$55,915,619	CYTotalExpensesAmt
PY Revenues Less Expenses	$1,890,902	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$6,086,109	CYRevenuesLessExpensesAmt
Total Assets BOY	$40,051,779	TotalAssetsBOYAmt
Total Assets EOY	$44,478,870	TotalAssetsEOYAmt
Total Liabilities BOY	$8,071,374	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$6,379,645	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$31,980,405	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$38,099,225	NetAssetsOrFundBalancesEOYAmt
Mission	TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$52,606,032	ExpenseAmt
Grant	$2,500,000	GrantAmt
Revenue	$61,604,433	RevenueAmt
Desc	Facility provides specialized pediatric services for the medical/surgical care of children from birth to age 18. There were 8,049 inpatient care days; 15,160 emergency room visits(including pediatric trauma visits); 615 surgeries and 23,172 outpatient visits. See our complete community benefit report on our website at www.choc.org.	Desc
Total Program Service Expenses	$52,606,032	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
Info In Schedule O Part V	Yes (X)	InfoInScheduleOPartVInd
IRP Document	24	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	144	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DONALD NOBLE	PersonNm
Phone	7145094038	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1201 WEST LA VETA AVENUE	AddressLine1Txt
City	ORANGE	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	928683874	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Kimberly Cripe
Director/President	2.0	38.0	Yes (X)	Yes (X)	$0	$1,413,813	$83,775
david dukes
Director/Chair	1.0	5.5	Yes (X)	Yes (X)	$0	$0	$0
Sam Auriemma
Director/Vice Chair	1.0	3.0	Yes (X)	Yes (X)	$0	$0	$0
Dick Ackerman
Director	1.0	2.5	Yes (X)		$0	$0	$0
Michael Coglazier
Director	1.0	2.0	Yes (X)		$0	$0	$0
Vijay Dhar MD
Director	1.0	1.0	Yes (X)		$0	$0	$0
Howard Federoff MD
Director	1.0	2.0	Yes (X)		$0	$0	$0
Chancellor Howard Gillman
Director	1.0	2.0	Yes (X)		$0	$0	$0
Joe Kiani
Director	1.0	2.0	Yes (X)		$0	$0	$0
Douglas McCombs
Director	1.0	3.0	Yes (X)		$0	$0	$0
Marshall Rowen MD
Director	1.0	6.0	Yes (X)		$0	$0	$0
Kim Sentovich
Director	1.0	2.5	Yes (X)		$0	$0	$0
Thomas Tierney
Director	1.0	1.5	Yes (X)		$0	$0	$0
Kerri Ruppert Schiller
CFO/Assistant Secretary	3.0	37.0		Yes (X)	$0	$776,744	$75,322
Jay Gabriel
Secretary	4.0	36.0		Yes (X)	$0	$588,875	$49,026
Matthew Gerlach
Exec. Vice President/COO	5.0	35.0			$0	$665,662	$106,464	Yes (X)
Marcia Folli
Vice President/CNO	20.0	20.0			$256,612	$256,614	$28,534	Yes (X)
Bonni Gravett
Clinical Nurse III	40.0	0.0			$175,018	$0	$25,706		Yes (X)
Eva Esmaeli
nurse manager	40.0	0.0			$156,487	$0	$24,740		Yes (X)
Karen McGurk-Mish
Nurse MAnager	40.0	0.0			$166,804	$0	$25,389		Yes (X)
Michelle Spensiero
clinical nurse ii	40.0	0.0			$149,110	$0	$14,500		Yes (X)
Emma Sandhu
director clinical services	40.0	0.0			$160,133	$0	$9,155		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,064,164	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,701,708	TotReportableCompRltdOrgAmt
Total Other Compensation	$442,611	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	27	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
MILES AND KELLEY CONSTRUCTION
1102 East Valencia Drive	FULLERTON	CA	92831	Construction	$358,376
RightSourcing Inc
PO Box 9695	UNIONDALE	NY	115559695	Temporary staffing	$264,393
PDC INTERIORS
3811 East La Palma Ave	ANAHEIM	CA	92807	CONSTRUCTION	$173,656
DIVERSIFIED HEALTHCARE
PO Box 4950	THE WOODLANDS	TX	77387	COLLECTION	$162,840
NAVIGANT CONSULTING INC
4511 Paysphere Cir	CHICAGO	IL	60674	Collection Services	$111,650

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	6	CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIII	Yes (X)	InfoInScheduleOPartVIIIInd
Related Organizations	$0	RelatedOrganizationsAmt
All Other Contributions	$207,528	AllOtherContributionsAmt
Total Contributions	$207,528	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICES	621400	$61,199,457	$61,199,457
MEANINGFUL USE REVENUE	923120	$404,976	$404,976

Field	Value	IRS element (for citing)
Total Program Service Revenue	$61,604,433	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$182,200	TotalRevenueColumnAmt
Exclusion	$182,200	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	OTHER MISCELLANEOUS REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$7,567	TotalRevenueColumnAmt
Exclusion	$7,567	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$7,567	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$62,001,728	TotalRevenueColumnAmt
Related Or Exempt Func Income	$61,604,433	RelatedOrExemptFuncIncomeAmt
Exclusion	$189,767	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$2,500,000	TotalAmt
Program Services	$2,500,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$211,827	TotalAmt
Management And General	$211,827	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$10,791,212	TotalAmt
Program Services	$9,712,091	ProgramServicesAmt
Management And General	$1,079,121	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$358,174	TotalAmt
Program Services	$322,357	ProgramServicesAmt
Management And General	$35,817	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,354,951	TotalAmt
Program Services	$1,219,456	ProgramServicesAmt
Management And General	$135,495	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$783,427	TotalAmt
Program Services	$705,084	ProgramServicesAmt
Management And General	$78,343	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$11,024,616	TotalAmt
Program Services	$9,922,154	ProgramServicesAmt
Management And General	$1,102,462	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$106,780	TotalAmt
Management And General	$106,780	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$28,403	TotalAmt
Program Services	$25,563	ProgramServicesAmt
Management And General	$2,840	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$5,660	TotalAmt
Program Services	$5,660	ProgramServicesAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,803,014	TotalAmt
Program Services	$1,622,147	ProgramServicesAmt
Management And General	$180,867	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$228,704	TotalAmt
Program Services	$205,834	ProgramServicesAmt
Management And General	$22,870	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$605,270	TotalAmt
Program Services	$544,743	ProgramServicesAmt
Management And General	$60,527	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,487,997	TotalAmt
Program Services	$1,339,197	ProgramServicesAmt
Management And General	$148,800	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$12,049	TotalAmt
Program Services	$10,844	ProgramServicesAmt
Management And General	$1,205	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$6,237	TotalAmt
Program Services	$5,613	ProgramServicesAmt
Management And General	$624	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,105,170	TotalAmt
Program Services	$994,653	ProgramServicesAmt
Management And General	$110,517	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$224,741	TotalAmt
Program Services	$202,267	ProgramServicesAmt
Management And General	$22,474	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
PURCHASED SRVS OTHR HOSP.	$21,981,895	$21,981,895
PROVIDER PROGRAM FEE	$1,238,893	$1,238,893
OSHPD FEE	$21,350	$19,215	$2,135
LICENSE AND TAXES	$16,970	$15,273	$1,697

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$18,279	TotalAmt
Program Services	$13,093	ProgramServicesAmt
Management And General	$5,186	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$55,915,619	TotalAmt
Program Services	$52,606,032	ProgramServicesAmt
Management And General	$3,309,587	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$203,447	BOYAmt
EOY	$128,998	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$10,227,308	BOYAmt
EOY	$10,745,477	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$13,074,446	BOYAmt
EOY	$16,546,388	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$829,497	BOYAmt
EOY	$1,968,365	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$20,752,093	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$12,040,637	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$9,164,938	BOYAmt
EOY	$8,711,456	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$5,800,679	BOYAmt
EOY	$5,800,679	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$751,464	BOYAmt
EOY	$577,507	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$40,051,779	BOYAmt
EOY	$44,478,870	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,960,321	BOYAmt
EOY	$2,297,338	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,033,985	BOYAmt
EOY	$792,537	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$2,077,068	BOYAmt
EOY	$3,289,770	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$8,071,374	BOYAmt
EOY	$6,379,645	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$31,049,417	BOYAmt
EOY	$37,115,987	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$930,988	BOYAmt
EOY	$983,238	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$31,980,405	BOYAmt
EOY	$38,099,225	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$40,051,779	BOYAmt
EOY	$44,478,870	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$6,086,109	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$32,711	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$5,660	OtherActivitiesAmt
Total Lobbying Expenditures	$5,660	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Grants to Other Organizations for Lobbying Purposes	FormAndLineReferenceDesc
Explanation	form 990, schedule c, part II-B, line 1i during fye 06/30/2016, children's hospital at mission paid dues to Hospital Association of Southern California, $5,660 of which supported lobbying purposes.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp
Land		LandGrp
Buildings		BuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$13,620,972	OtherCostOrOtherBasisAmt
Depreciation	$6,739,611	DepreciationAmt
Book Value	$6,881,361	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$6,806,816	OtherCostOrOtherBasisAmt
Depreciation	$5,301,026	DepreciationAmt
Book Value	$1,505,790	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$324,305	OtherCostOrOtherBasisAmt
Book Value	$324,305	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$8,711,456	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
DUE TO RELATED PARTIES	$1,653,434
LONG TERM ACC TAIL COVERAGE	$121,000
DUE TO CONTRACTING HOSPITALS	$881,215
DUE TO THIRD PARTIES	$634,121

Field	Value	IRS element (for citing)
Total Liability	$3,289,770	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$62,030,708	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$32,711	NetUnrealizedGainsInvstAmt
Other Revenue	-$3,731	OtherRevenueAmt
Revenue Not Reported	$28,980	RevenueNotReportedAmt
Revenue Subtotal	$62,001,728	RevenueSubtotalAmt
Total Revenue Per Form990	$62,001,728	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$55,911,888	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$55,911,888	ExpensesSubtotalAmt
Other Expenses Not Included	$3,731	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$3,731	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$55,915,619	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

ASC 740

Form 990, Schedule D, Part X U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES 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, 2016, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS.

Reconciliation of Net Asstes

Form 990, Part XI, Line 2d Loss on Abandoned Assets Reclassed to Expenses $(3,731) Form 990, Part XII, Line 4b Loss on Abandoned Assets Reclassed to Expenses $(3,731)

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$113,639	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$113,639	NetCommunityBenefitExpnsAmt
Total Expense	0.00200	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,885,804	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,089,070	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,796,734	NetCommunityBenefitExpnsAmt
Total Expense	0.10370	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,999,443	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,089,070	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,910,373	NetCommunityBenefitExpnsAmt
Total Expense	0.10570	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$22,999,443	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$17,089,070	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,910,373	NetCommunityBenefitExpnsAmt
Total Expense	0.10570	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$20,619	TotalCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Total Community Benefit Expns	$20,619	TotalCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$6,290,099	BadDebtExpenseAmt
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL AT MISSION	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	27700 MEDICAL CENTER ROAD	AddressLine1Txt
City	MISSION VIEJO	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92691	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.choc.org	WebsiteAddressTxt
State License	060000348	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
Childrens Hospital	Yes (X)	ChildrensHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL AT MISSION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Information Gaps	Yes (X)	InformationGapsInd
CHNA Conducted	14	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	http://www.choc.org/about	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	14	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	http://www.choc.org/about	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Income Level Criteria	Yes (X)	IncomeLevelCriteriaInd
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	www.choc.org	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	www.choc.org	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	www.choc.org	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified Before Discharge	Yes (X)	FAPNotifiedBeforeDischargeInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Reason	Yes (X)	OtherReasonInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule H, Part V Additional Information	FormAndLineReferenceDesc
Explanation	Schedule H, Part V, Line 5 SURVEYS and interviews were used to gather opinions and impressions from people who represent the broad interests of the community. IN ADDITION, LEADERS OF community based organizations participated in SURVEYS and interviews in october 2013. Included were people from health providers community benefit organizations, county and city governments, hospitals, community clinics/fhqc's and health advocacy education organizations. SCHEDULE H, PART V, LINE 6a Children's Hospital of orange county and choc children's at mission together conducted the health needs assessments. Schedule H, Part V, Line 10a The Hospital's Implementation Strategy is included at the end of the Community Health Needs Assessment (CHNA) located at HTTP://WWW.CHOC.ORG/ABOUT. Schedule H, Part V, Line 11 Addressing High Priority Community Health Needs Children's Hospital at Mission coordinates its response to its most recent CHNA with its larger affiliate, Children's Hospital of Orange County (CHOC). CHOC's and CCMH's most recent CHNA identified three high-priority needs: Mental Health, Obesity and Autism. In 2013, CHOC developed its new seven-year strategic plan - CHOC 2020. This long-range plan has five goals, one of which is CHOC's Pediatric System of Care". The Pediatric System of Care includes assuring access to the full continuum of healthcare services addressing both the physical and behavioral health of children we serve; creating and implementing processes for the seamless transitioning of patients from one care provider to the next; and, actively engaging patients and families in taking responsibility for their healthcare. The three high-priority needs are recognized in CHOC 2020 as critical elements of the CHOC Pediatric System of Care. Specific initiatives for the high-priority needs are as follows: Pediatric Mental Health CHOC Children's, in partnership with committed organizations and community groups, aspires to create an outstanding mental health system of care for all children, teens and young adults in Orange County. Our goal is to provide a comprehensive approach to pediatric mental illness. Among the initiatives will be the creation of CHOC Children's Mental Health Inpatient Center. Orange County currently has only 32 inpatient adolescent psychiatric beds for a population of roughly 3 million, and not a single bed for children under 12. The Center will have 18 beds in a secured and healing environment, in addition to an outdoor area for recreation. The Center will provide a safe, nurturing place for children ages 3 to 18, and specialty programming for children younger than 12. Construction is expected to begin in 2016 and be completed in MID 2018. In addition to opening the new mental health inpatient center, CHOC has initiated and will be pursuing the following action in support of the pediatric mental health system of care: - Expanded in 2015 mental health services for CHOC patients being treated for serious/chronic illnesses (these children are more likely to have mental health problems, such as depression and severe anxiety, than their healthier peers). - OpenED an intensive outpatient program in 2016 to keep struggling children out of the hospital and assist those who have been released. - ExpandED CHOC's outpatient eating disorders program IN 2016. - Continue to facilitate and work on multiple county-wide projects with a community task force formed by CHOC Children's and Pastor Rick and Kay Warren, founders of Saddleback Church. Obesity CHOC has convened a multi-disciplinary coalition of community members to work on the issue of obesity. This task force includes representatives from the health care community (physicians, dieticians, and psychologists), the University of California - Irvine, Orange County Social Services and the school districts throughout the community. Efforts to date include offering 9 classes and educational materials, starting a Kids Fit Club, and offering a symposium for the community in June 2014. Adequate and proper nutrition is important for a child's normal growth and development. CHOC Children's Clinical Nutrition and Lactation Services aim to be a reliable source of nutrition and lactation information for our patients, families and community. We are here to help patients with growth and development, while giving them a foundation for lifelong health and wellness. We provide family-centered, culturally sensitive care that is custom for every individual, using evidence-based techniques and best practices with a multidisciplinary approach. Developmental Disabilities, specifically Autism Recognizing the pervasiveness of autism in the Orange County pediatric population, CHOC has actively supported For OC Kids, an organization that diagnoses and treats children up to 6 years of age. More recently, CHOC has engaged in a partnership with the Children and Families Commission of Orange County, the University of California - Irvine, Chapman University and the Thompson Center for Autism (Columbia, MO) to establish the Center for Autism and Neurodevelopment Disorders in Santa Ana. CHOC is providing financial support for an additional neuro-developmental pediatrician, psychology and physical therapy services in order to expand access to the services for a greater number of Orange County children including those over eight years old. There were no significant needs identified but not addressed from the most recently conducted CHNA. Schedule H, Part V, Line 22D, Other The maximum amounts that may be charged to FAP-eligible individuals for emergency or other medically necessary services are determined by the Fee-for-service medi-cal rate. the rate is determined annually by the allowable cost-to-charge ration as determined by the annual medi-cal cost report. report.	ExplanationTxt

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART I, LINE 6A	THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) AND CHOC CHILDREN'S AT MISSION HOSPITAL (CCMH) ANNUALLY AND IS FILED IN ACCORDANCE WITH CALIFORNIA SB697.
SCHEDULE H, PART I, LINE 7	THE ORGANIZATION USES THE COST-TO-CHARGE RATIO METHODOLOGY TO DETERMINE THE COST OF CHARITY CARE AND UNREIMBURSED COST OF CARE PROVIDED TO MEDI-CAL PATIENTS. COSTS ARE ACCOUNTED FOR USING AN INTERNAL DECISION SUPPORT SYSTEM. THE COST-TO-CHARGE RATIO FOLLOWS THE METHOD DEFINED BY THE MEDICARE COST REPORT AND IS UPDATED MONTHLY USING THE MOST RECENT ORGANIZATIONAL INFORMATION. Provider Fee Program In 2015, CMS issued final required federal approval for the fee for service portion of the 36 month California Provider Fee Program. This approval covered the 12 month period from JULY 1, 2015-June 30, 2016. In fiscal year 2016, CCMH recognized revenues under THIS 12 months of the fee for service portion of the program of $2,057,000 and Provider Fees and other expenses of $827,000. In addition, CMS issued final approval in 2015 of 60%, AND IN 2016, 40% of the Managed Care portion of the 36 month program for the 6 months ended June 30, 2014. Under this portion of the program, CCMH recognized revenues of $1,008,000 and Provider Fee and other expenses of $412,000. The amounts were recognized as net patient revenue and operating expenses, respectively, in the year ended June 30, 2016.
SCHEDULE H, PART II	Community building activities Community support is best exemplified by the organization's increased emphasis on community outreach and community education, which includes injury prevention safety and wellness. The organization has 86 different community benefit programs categorized according to the California community benefits law, SB697. Within these categories, the category which most closely correlates to line 3, community support, is Healthcare Access. Through Healthcare Access, the organization increases access to quality pediatric healthcare resources and information to families, especially low-income and medically underserved, throughout Orange County. This is accomplished through community outreach clinics and education.
SCHEDULE H, PART III, LINE 2	THE ORGANIZATION CHARGES BAD DEBT FOR (A) THE WRITE-OFF OF PATIENT ACCOUNTS WHERE FAMILIES DID NOT COOPERATE IN THE COMPLETION OF MEDI-CAL OR CHARITY CARE APPLICATIONS AND WHERE INSUFFICIENT INFORMATION COULD BE OBTAINED REGARDING THE FINANCIAL STATUS OF THE FAMILY, AND (B) A PROVISION FOR OUTSTANDING ACCOUNTS RECEIVABLE FROM SELF-PAY (INCLUDING PENDING MEDI-CAL AND PENDING CHARITY) ACCOUNTS. THE ORGANIZATION APPLIES ITS CHARITY CARE POLICY TO DETERMINE ELIGIBILITY BASED ON FAMILIES' SATISFYING THE APPLICATION REQUIREMENTS AND THE ORGANIZATION'S ELIGIBILITY CRITERIA. THE ORGANIZATION DOES, HOWEVER, HAVE FAMILIES WHO FAIL TO COMPLETE THE REQUIRED PAPERWORK DESPITE THE ORGANIZATION'S EFFORTS TO EDUCATE ALL FAMILIES OF THE CHARITY CARE OPTIONS. IN THESE CASES, AN ASSESSMENT OF CHARITY CARE ELIGIBILITY IS MADE BASED ON KNOWN INFORMATION. SCHEDULE H, PART III, LINE 3 The hospital follows HFMA statement 15 and therefore no part of bad debt, as defined by statement 15, represents amounts attributable to patients eligible to receive financial assistance. SCHEDULE H, PART III, LINE 4 AUDITED FINANCIAL STATEMENT FOOTNOTE: PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT THE INVOICED AMOUNT NET OF ANY EXPECTED CONTRACTUAL ADJUSTMENTS AND DO NOT BEAR INTEREST. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CCMH'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN CCMH'S EXISTING PATIENT ACCOUNTS RECEIVABLE. CCMH DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. CCMH REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS ON A MONTHLY BASIS. PAST-DUE BALANCES OVER 90 DAYS AND OVER A SPECIFIED AMOUNT ARE REVIEWED INDIVIDUALLY FOR COLLECTABILITY. THERE ARE OTHER FACTORS THAT CAN IMPACT COLLECTIONS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF CO-PAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS REMOTE, BUT IN NO CASES BEYOND ONE YEAR FROM DATE OF SERVICE.
SCHEDULE H, PART III, LINE 8	AS A CHILDREN'S HOSPITAL, CCMH MEDICARE ALLOWABLE COSTS ARE ZERO. THEREFORE THERE IS NO AMOUNT ENTERED ON PART III LINE 6 AND NO MEDICARE SHORTFALL REPORTED ON LINE 7. SCHEDULE H, PART III, LINE 9B THE HOSPITAL'S WRITTEN BAD-DEBT COLLECTION POLICY STATES THE FOLLOWING: 1. IF A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM (FAP) AND IS MAKING EVERY EFFORT TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, CCMH OR ITS AGENT WILL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID ACCOUNT TO AN OUTSIDE AGENCY IF DOING SO MAY NEGATIVELY IMPACT A PATIENT'S CREDIT. IF CCMH IS FORCED TO SEND THE ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY WILL REFLECT THE REDUCED PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE FAP. AT NO TIME WILL A PATIENT ACCOUNT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY IF THE ACCOUNT IS LESS THAN 150 DAYS FROM ORIGINAL BILLING. 2. IN DEALING WITH IDENTIFIED UNINSURED PATIENTS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL, CCMH WILL NOT USE WAGE GARNISHMENTS OR LIENS ON PATIENT'S OR PATIENT FAMILY'S PRIMARY RESIDENCE AS A MEANS OF COLLECTING UNPAID CCMH BILLS. THIS REQUIREMENT DOES NOT PRECLUDE CCMH FROM PURSUING REIMBURSEMENT FROM THIRD PARTY LIABILITY SETTLEMENTS.
SCHEDULE H, PART VI, LINE 2	Needs Assessment: IN ADDITION TO THE TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENT, CCMH REGULARLY TRACKS KEY DEMOGRAPHIC CHANGES IN THE PEDIATRIC POPULATION OF ITS COMMUNITY AND THE UTILIZATION OF KEY SERVICES DELIVERED, AND EVALUATES THE PROGRAMS IT PROVIDES TO MEET IDENTIFIED NEEDS. THROUGH CONSTANT CONTACT WITH A VARIETY OF COMMUNITY CONSTITUENTS, CCMH IS ABLE TO LEARN ABOUT EMERGING TRENDS AND NEEDS. IT THEN EVALUATES OPTIONS TO MEET THOSE NEEDS, EITHER ALONE OR IN COLLABORATION WITH OTHERS IN THE COMMUNITY. All of the programs associated with the community health needs assessment are available in the report on the hospital's website at www.choc.org as well as a paper copy that is available upon request for public inspection.
SCHEDULE H, PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PATIENTS ARE INFORMED OF THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE HOSPITAL'S CHARITY CARE POLICY IN OUR FINANCIAL ASSISTANCE AND DISCOUNT PROGRAM POLICY. THIS INFORMATION, EITHER IN FULL OR IN SUMMARY, IS POSTED IN ALL OF THE HIGH TRAFFIC PATIENT AREAS: ADMITTING, EMERGENCY ROOM, CLINIC AND THE BUSINESS OFFICE. THE PATIENTS ARE ALSO INFORMED IF THERE IS A FINANCIAL NEED IDENTIFIED BY THE HOSPITAL FINANCIAL COUNSELORS WHEN SPEAKING TO THE FAMILIES ABOUT THEIR INSURANCE OR LACK OF INSURANCE. PATIENTS ARE PROVIDED A COPY OF THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE AND DISCOUNT PAYMENT PROGRAM POLICY. FAMILIES ARE ALSO NOTIFIED ON EVERY PATIENT STATEMENT THAT IF THERE IS A FINANCIAL NEED THEY SHOULD CALL THE DESIGNATED PHONE NUMBER FOR MORE INFORMATION AND ASSISTANCE. FINANCIAL ASSISTANCE COMMUNICATION: AS PART OF THE HOSPITALS' ONGOING PUBLIC AWARENESS CAMPAIGNS, THE MISSION STATEMENTS(INCLUDING THE FINANCIAL ASSISTANCE POLICY) ARE INCLUDED WHEREVER POSSIBLE ON PROGRAM BROCHURES, FACILITY BROCHURES, MEDICAL EDUCATION INFORMATION, COMMUNITY EDUCATION MATERIALS, CONFERENCE INVITATIONS AND ADMISSION MATERIALS. ADDITIONALLY, THE HOSPITALS' FINANCIAL ASSISTANCE POLICY IS EMPHASIZED IN PUBLIC RELATIONS AND MEDIA RELATIONS EFFORTS, FOUNDATION CAMPAIGNS, AND SELECTED MARKETING CAMPAIGNS. THE FINANCIAL ASSISTANCE POLICY IS ALSO INCLUDED AS PART OF THE ANNUAL COMMUNITY BENEFIT REPORT. The financial assistance policy is available in english and spanish.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: THE HOSPITAL SERVES ALL OF ORANGE COUNTY AND A LIMITED NUMBER OF PATIENTS FROM THE WESTERN RIM OF RIVERSIDE COUNTY, THE NORTHERN PORTION OF SAN DIEGO COUNTY AND SOUTHEAST AREAS OF LOS ANGELES COUNTY. THE PRIMARY SERVICE AREA IS THE SOUTHERN PORTION OF ORANGE COUNTY, AND IS THE SOURCE OF APPROXIMATELY 84% OF ITS PATIENTS. SIGNIFICANT CITIES IN THIS AREA ARE: MISSION VIEJO, SAN CLEMENTE, SAN JUAN CAPISTRANO, LAGUNA NIGUEL, Rancho Santa Margarita, Laguna Hills, and Lake Forest. THE SECONDARY SERVICE AREA INCLUDES ALL THE OTHER ORANGE COUNTY CITIES AND UNINCORPORATED AREAS. the community served by the hospital includes federally-designated medically underserved areas and populations. COMMUNITY CHARACTERISTICS: POPULATION AND SOCIOECONOMIC DATA PROJECTIONS FOR 2016 ARE PROVIDED BY CLARITAS, A THIRD-PARTY VENDOR THAT MAKES PROJECTIONS BASED ON DEMOGRAPHIC ANALYSIS OF ORANGE COUNTY, INCLUDING THE COMBINED SERVICE AREAS OF BOTH HOSPITALS CHOC AND CCMH. TOTAL POPULATION OF THE COUNTY WAS 3.2 MILLION, ACCORDING TO 2016 ESTIMATES, MAKING IT THE THIRD LARGEST COUNTY IN CALIFORNIA. THE MEDIAN AGE IS 36.4, AND CHILDREN UP TO 18 YEARS OF AGE MAKE UP 25% OF THE TOTAL POPULATION. THE LARGEST RACE/ETHNICITY SUBGROUP IS WHITE, AT 43%. LATINOS/HISPANICS ARE 34% OF THE POPULATION. ASIANS/PACIFIC ISLANDERS ARE 19% OF THE TOTAL, AND THE AFRICAN AMERICAN POPULATION REPRESENTS APPROXIMATELY 2% OF THE TOTAL ORANGE COUNTY POPULATION. SOCIOECONOMIC PROFILE THE U.S. CENSUS AMERICAN COMMUNITY SURVEY FOR 2016 INDICATED THAT 17.6% OF CHILDREN UNDER THE AGE OF 18 IN ORANGE COUNTY, 23% IN CALIFORNIA, AND 22.0% IN THE U.S. WERE BELOW THE POVERTY LEVEL. THE COUNTY'S MEDIAN HOUSEHOLD INCOME iS $74,163. THE PERCENTAGE OF THE HOSPITAL'S PATIENTS WHO ARE UNINSURED OR MEDICAID RECIPIENTS WAS 41.9%. THERE ARE 29 OTHER HOSPITALS SERVING THE COMMUNITY.
SCHEDULE H, PART VI, LINE 5	PROMOTION OF COMMUNITY HEALTH: CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC) IS THE NOT-FOR-PROFIT, TAX-EXEMPT PARENT CORPORATION OF CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC CHILDREN'S) AND CHOC CHILDREN'S AT MISSION HOSPITAL (CCMH). THE HOSPITALS ARE THE PRINCIPAL TERTIARY AND QUATERNARY PEDIATRIC HOSPITALS SERVING ORANGE COUNTY AND ARE THE ONLY HOSPITALS EXCLUSIVELY SERVING INFANTS, CHILDREN AND ADOLESCENTS. CCMH ALSO OFFERS PEDIATRIC TRAUMA SERVICES TO THE COMMUNITY. THE ORGANIZATION IS COMPRISED OF TWO HOSPITALS; SEVERAL PRIMARY AND SPECIALTY CLINICS, PROGRAMS AND SERVICES; AND FOUR CENTERS OF EXCELLENCE, THE CHOC HEART, NEUROSCIENCE, ONCOLOGY AND ORTHOPAEDIC INSTITUTES. CHOC ALSO HAS A RESEARCH INSTITUTE PERFORMING BASIC SCIENCE AND CLINICAL RESEARCH. THROUGH ITS RESIDENCY PROGRAM, THE ORGANIZATION ALSO TRAINS TOMORROW'S PHYSICIANS. THE COMMUNITY BENEFIT PLAN FOR THE FISCAL YEAR ENDING JUNE 30, 2016, DESCRIBES THE BENEFIT PLANNING PROCESS, THE BENEFITS PROVIDED, AND THE ECONOMIC VALUE OF THE BENEFITS. COMMUNITY BENEFITS ARE FREE OR SUBSIDIZED PROGRAMS AND SERVICES PROVIDED TO MEET IDENTIFIED COMMUNITY NEEDS AND TO SERVE THE PUBLIC INTEREST. THE ORGANIZATION'S COMMUNITY BENEFIT PLAN IS AVAILABLE ONLINE AT: HTTP://WWW.CHOC.ORG/ABOUT. THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPOSED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CLINICAL PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS AS MEMBERS OF THE MEDICAL STAFF. MEDICAL STAFF MEMBERS PROVIDE PATIENT CARE AND HAVE ACCESS TO HOSPITAL RESOURCES(INCLUDING EQUIPMENT, FACILITIES AND PERSONNEL) WHICH ARE NECESSARY TO EFFECTIVELY EXERCISE THEIR PRIVILEGES. PHYSICIANS ARE QUALIFIED TO BE MEMBERS OF THE MEDICAL STAFF IF THEY MEET THE FOLLOWING CRITERIA: SECTION 1. NATURE OF MEDICAL STAFF MEMBERSHIP MEMBERSHIP ON THE MEDICAL STAFF OF CHOC CHILDREN'S AT MISSION HOSPITAL IS A PRIVILEGE THAT SHALL BE EXTENDED ONLY TO PROFESSIONALLY COMPETENT PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS SET FORTH IN THESE BYLAWS. A PRACTITIONER MAY ADMIT OR PROVIDE SERVICES TO PATIENTS IN THE HOSPITAL ONLY IF THE PRACTITIONER IS A MEMBER OF THE MEDICAL STAFF OR HAS BEEN GRANTED TEMPORARY PRIVILEGES IN ACCORDANCE WITH THE BYLAWS, RULES AND REGULATIONS. APPOINTMENT TO THE MEDICAL STAFF SHALL CONFER ONLY SUCH CLINICAL PRIVILEGES AND PREROGATIVES AS HAVE BEEN GRANTED IN ACCORDANCE WITH THESE BYLAWS. SECTION 2. QUALIFICATIONS FOR MEMBERSHIP A. ONLY PRACTITIONERS WHO HOLD AN UNRESTRICTED LICENSE TO PRACTICE MEDICINE, DENTISTRY, PODIATRY OR CLINICAL PSYCHOLOGY IN THE STATE OF CALIFORNIA, WHO CAN DOCUMENT THE FOLLOWING WITH SUFFICIENT ADEQUACY TO ASSURE THE MEDICAL STAFF AND THE GOVERNING BODY THAT ANY PATIENT TREATED BY THEM IN THE HOSPITAL WILL RECEIVE CARE OF THE GENERALLY RECOGNIZED PROFESSIONAL LEVEL AND EFFICIENCY ESTABLISHED BY THE MEDICAL STAFF AND HOSPITAL, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF THEIR BACKGROUND; EDUCATION; EXPERIENCE; JUDGMENT; TRAINING; DEMONSTRATED CURRENT COMPETENCE; ABILITY TO COMMUNICATE INCLUDING A DEMONSTRATED PROFICIENCY IN THE ENGLISH LANGUAGE SUCH THAT THERE IS REASONABLE ASSURANCE THAT THERE WILL BE NO RISK OF MISUNDERSTANDING IN COMMUNICATION WITH ENGLISH SPEAKING COLLEAGUES, PATIENTS AND HEALTH CARE WORKERS; PHYSICAL AND MENTAL HEALTH STATUS; ADHERENCE TO THE ETHICS OF THEIR PROFESSION; GOOD REPUTATION; AND ABILITY TO WORK WITH OTHERS. NO PRACTITIONER SHALL BE ENTITLED TO MEMBERSHIP ON THE MEDICAL STAFF OR TO THE EXERCISE OF PARTICULAR CLINICAL PRIVILEGES IN THE HOSPITAL MERELY BECAUSE HE IS DULY LICENSED TO PRACTICE MEDICINE, DENTISTRY, CLINICAL PSYCHOLOGY OR PODIATRY IN THIS OR IN ANY OTHER STATE, HOLDS A CERTAIN DEGREE, IS CERTIFIED BY ANY CLINICAL BOARD, OR THAT HE IS A MEMBER OF SOME PROFESSIONAL ORGANIZATION, OR THAT HE HAD IN THE PAST, OR PRESENTLY HAS SUCH PRIVILEGES AT ANOTHER HOSPITAL INCLUDING BUT NOT LIMITED TO MISSION HOSPITAL OR CHOC CHILDREN'S (CHOC). NO APPLICANT SHALL BE DENIED MEMBERSHIP ON THE BASIS OF SEX, SEXUAL ORIENTATION, RACE, RELIGION, ANCESTRY, AGE, CREED, COLOR, NATIONAL ORIGIN, MARITAL STATUS, HANDICAP OR DISABILITY (EXCEPT TO THE EXTENT THE HANDICAP OR DISABILITY PREVENTS THE PRACTITIONER FROM PERFORMING ESSENTIAL FUNCTIONS OR POSES A HEALTH OR SAFETY RISK TO THE PRACTITIONER OR OTHERS AND THE HANDICAP OR DISABILITY CANNOT BE REASONABLY ACCOMMODATED OR ON THE BASIS OF ANY OTHER CRITERION THAT IS NOT RELATED TO AN INDIVIDUAL'S PROFESSIONAL CAPABILITIES (CHOC CHILDREN'S AT MISSION HOSPITAL MEDICAL STAFF BYLAWS). B. ONLY PRACTITIONERS WHO MAINTAIN IN FORCE PROFESSIONAL LIABILITY INSURANCE IN NOT LESS THAN THE MINIMUM AMOUNTS JOINTLY DETERMINED BY THE GOVERNING BODY AND THE MEDICAL STAFF EXECUTIVE COMMITTEE, BUT IN NO EVENT LESS THAN $1.0 MILLION PER INCIDENT AND $3.0 MILLION IN THE AGGREGATE IN A POLICY YEAR, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF. THE INSURANCE MUST COVER ALL PRIVILEGES THE PRACTITIONER IS GRANTED BY THE GOVERNING BODY. A CARRIER ADMITTED TO DO BUSINESS IN CALIFORNIA OR A MUTUAL COOPERATIVE TRUST MUST PROVIDE THE INSURANCE. INFORMATION REGARDING EACH APPLICANT'S AND MEMBER'S INSURANCE COVERAGE MUST BE PROVIDED IN THE FORM OF A CURRENT CERTIFICATE OF INSURANCE WHICH SHALL BE MAINTAINED IN EACH PRACTITIONER'S CREDENTIALS FILE. INFORMATION REGARDING INSURANCE COVERAGE MUST BE PROVIDED AT THE TIME OF APPOINTMENT AND REAPPOINTMENT AND IMMEDIATELY UPON RECEIPT OF EACH ANNUAL RENEWAL CERTIFICATE. EACH MEMBER SHALL REPORT TO THE MEDICAL STAFF SERVICES OFFICE ANY REDUCTION, RESTRICTION, CLAIMS, CANCELLATION OR TERMINATION OF THE REQUIRED PROFESSIONAL LIABILITY INSURANCE OR CHANGE IN CARRIER IMMEDIATELY UPON THE NOTICE OF ACTION OR CHANGE. C. ACCEPTANCE OF MEMBERSHIP ON THE MEDICAL STAFF SHALL CONSTITUTE THE STAFF MEMBER'S CERTIFICATION THAT HE HAS IN THE PAST, AND HIS AGREEMENT THAT HE WILL IN THE FUTURE, BEHAVE ACCORDING TO ETHICAL PRINCIPLES APPLICABLE TO HIS PROFESSION, AND WILL ABIDE BY ALL STATE AND FEDERAL LAWS AND REGULATIONS GOVERNING THE PROFESSION, INCLUDING, BUT NOT LIMITED TO, MEDICARE/MEDICAID LAWS AND REGULATIONS. FURTHER, ALL MEMBERS OF THE MEDICAL STAFF SHALL PLEDGE THAT THEY WILL NOT RECEIVE FROM, OR PAY TO ANOTHER PHYSICIAN, DENTIST, CLINICAL PSYCHOLOGIST OR PODIATRIST, EITHER DIRECTLY OR INDIRECTLY, ANY PART OF A FEE RECEIVED FOR PROFESSIONAL SERVICES AND THEY WILL NOT DECEIVE A PATIENT AS TO THE IDENTITY OF AN OPERATING SURGEON, OR ANY OTHER MEDICAL PRACTITIONER PROVIDING TREATMENT.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: CCMH AND CHOC ARE MEMBERS OF A TWO-HOSPITAL SYSTEM. BOTH HOSPITALS HAVE A SOLE CORPORATE MEMBER, CHILDREN'S HEALTHCARE OF CALIFORNIA, THAT PROVIDES MANAGEMENT SERVICES TO BOTH HOSPITALS. THE HOSPITALS SHARE A COMMON MISSION AND ARE STRATEGICALLY ALIGNED IN THEIR EFFORT TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. SCHEDULE H, PART VI, LINE 7 A COMMUNITY BENEFIT REPORT IS FILED ANNUALLY IN THE STATE OF CALIFORNIA.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HEALTHCARE OF CALIFORNIA	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1201 West La Veta Avenue	AddressLine1Txt
City	orange	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	92868	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	330265266	RecipientEIN
IRC Section	501(c)(3)	IRCSectionDesc
Cash Grant	$2,500,000	CashGrantAmt
Purpose Of Grant	Support	PurposeOfGrantTxt

Field	Value	IRS element (for citing)
Total501c3 Org	1	Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Procedure for monitoring the use of grant funds - part i, line 2	FormAndLineReferenceDesc
Explanation	The grant from CCMH to CHC was in accordance with the bylaws of both organizations.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Kimberly Cripe
Director/President	$0	$838,732	$0	$317,258	$0	$257,823	$0	$63,390	$0	$20,385	$0	$1,497,588	$0	$44,445
Kerri Ruppert Schiller
CFO/Assistant Secretary	$0	$495,562	$0	$139,228	$0	$141,954	$0	$49,440	$0	$25,882	$0	$852,066	$0	$22,282
Jay Gabriel
Secretary	$0	$394,002	$0	$95,920	$0	$98,953	$0	$23,120	$0	$25,906	$0	$637,901	$0	$51,763
Matthew Gerlach
Exec. Vice President/COO	$0	$474,320	$0	$140,238	$0	$51,104	$0	$89,986	$0	$16,478	$0	$772,126	$0	$0
Marcia Folli
Vice President/CNO	$135,221	$135,221	$32,802	$32,803	$88,589	$88,590	$14,255	$14,255	$12	$12	$270,879	$270,881	$0	$106,600
Bonni Gravett
Clinical Nurse III	$162,898	$0		$0	$12,120	$0	$9,228	$0	$16,478	$0	$200,724	$0	$0	$0
Eva Esmaeli
nurse manager	$137,268	$0	$7,645	$0	$11,574	$0	$8,274	$0	$16,466	$0	$181,227	$0	$0	$0
Karen McGurk-Mish
Nurse MAnager	$148,441	$0	$6,510	$0	$11,853	$0	$8,911	$0	$16,478	$0	$192,193	$0	$0	$0
Michelle Spensiero
clinical nurse ii	$137,654	$0	$0	$0	$11,456	$0	$8,297	$0	$6,203	$0	$163,610	$0	$0	$0
Emma Sandhu
director clinical services	$139,261	$0	$9,141	$0	$11,731	$0	$8,359	$0	$796	$0	$169,288	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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. No payments were made in 2015.
Supplemental Nonqualified Retirement Plan	Part I, Line 4B Children's Hospital of Orange County (CHOC) 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 2015: Ms. Cripe ($165,908), Ms. Schiller ($83,035), and Ms. Folli ($137,022).
Compensation from an affiliated Organization	Kimberly C. 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 5% of her time each week to Children's Hospital at Mission 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 8% of her time each week to Children's Hospital at Mission responsibilities with the balance of her time being spent on the other related organizations' business affairs. Matthew Gerlach 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, Children's Hospital at Mission and CRC Real Estate Corportation (All IRC Secion 501(c)(3) affiliates). Mr. Gerlach devotes approximately 13% of his time each week to Children's Hospital at Mission responsibilities with the balance of his time being spent on Children's Hospital of Orange County business affairs. Marcia Folli is compensated through Children's Hospital at Mission; however, in addition to her responsibilities for Children's Hospital at Mission, she also serves as VP of Ancillary Services at Children's Hospital of Orange COunty, an IRC Section 501(c)(3) affiliate. Ms Folli devots approximately 50% of her time to Children's Hospital at Mission with the balance of her time being spent on Children's Hospital of Orange County Business affairs.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
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 Children's Hospital at Mission. Children's Hospital at Mission has 144 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 Children's Hospital at Mission. Part VI, Line 4 Changes to Bylaws included the following below: Reserved Powers: Removes the requirement of the member's approval to enter into a contract that involves a term in excess of 10 years. The Member's approval is required to make any change to the Bylaws, not just those that would affect the Member's rights. Powers: Clarified that the Member has the power to initiate an action as to a subsidiary as well as approve the subsidiarys action. Qualifications of Directors: Removed requirement that the Chief Legal Officer ("CLO") must be Secretary to attend meetings of the Board. Vacancies: Revised so that a vacancy on the Board may be filled by the vote of the remaining Directors, subject to ratification by the Member. Quorum: Revised so a quorum shall be a majority of the Directors then in office. Officers: Deleted the reference to the First Vice Chair and Second Vice Chair and replaced with one Vice Chair. Part VI, Lines 6 & 7a - Organization Member Information The sole member of Children's Hospital at Mission (CHM) is Children's HealthCare of California (CHC). Part VI, Line 7b - Organization Member Information The approval of the Member shall be required with respect to any of the following actions: (1) Changing the purposes and powers of CCMH; (2) Obligating CCMH to undertake any capital expenditure in excess of $5,000,000; (3) Adopting CCMH's annual operating and capital budgets; (4) Adopting a long-term capital budget; (5) Buying, selling, mortgaging, pledging, or otherwise hypothecating any real property; (6) Incurring any indebtedness in excess of $5,000,000; (7) Obligating CCMH to act as guarantor with respect to any debt of any person or other entity; (8) Accepting any donation which is conditioned upon CCMH'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 CCMH in an amount in excess of $5,000,000, or (b) any purpose or activity which is outside the scope of CCMH's ordinary course of business; (10) involving CCMH in any merger, acquisition, corporate restructuring, or formal affiliation; (11) Involving CCMH as a member, shareholder, or partner in any new corporation, partnership, or other legal entity; (12) Dissolving CCMH; (13) Entering into any transaction involving the sale, lease, conveyance, exchange, transfer or other disposition of all or substantially all of CCMH's assets; (14) Amending CCMH's articles of Incorporation; (15) Adopting new bylaws or amending existing bylaws.
Part VI, Line 11B - PROCESS OF REVIEW	Prior to filing, the tax return and related schedules are provided to the CHOC Executive compensation Committee, an empowered Board committee delegated with this authority. The Chief Financial Officer reviews the report with the committee prior to filing the final 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. Part VI, Line 12c - MONITORING/ENFORCING COMPLIANCE OF CONFLICT OF INTEREST POLICY 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 or key employees). 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 informed via written communication. The procedures for addressing any conflict of interest includes but is 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 substance of the transaction or arrangement being considered; (3) the person with the conflict of interest is excluded from any discussion or approval of such transaction; (4) alternatives to the proposed transaction are investigated, competitive bids or comparable valuations are obtained; (5) the transaction or action must be approved by a majority of disinterested persons. Line 15 - Compensation Determination: 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 2015. 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.
FORM 990, PART VI, SECTION C	Line 19 - DISCLOSURE POLICY Federal tax laws do not mandate that the organization's governing documents and conflict of interest policy be made available for public inspection. Form 990 and the copy of audited financial statements attached to it are made available upon request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
CHILDREN'S HOSPITAL OF ORANGE COUNTY
1201 West La Veta Avenue	ORANGE	CA	92868	952321786	HEALTH CARE	CA	501(c)(3)	3	CHC	false
CHOC FOUNDATION
1201 West La Veta Avenue	ORANGE	CA	92868	956097416	FUND RAISING	CA	501(c)(3)	7	CHC	false
CRC REAL ESTATE CORPORATION
1201 West La Veta Avenue	ORANGE	CA	92868	330612565	REAL ESTATE	CA	501(c)(3)	11	CHC	false
CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC)
1201 West La Veta Avenue	ORANGE	CA	92868	330265266	HEALTH CARE	CA	501(c)(3)	7	NA	false
choc thrift stores inc
455 S MAIN STREET	orange	CA	92868	330266422	Fund Raising	CA	501(c)(3)	9	CHC	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Orange County MEDICAL RECIPROCAL INS CO	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2999 North 4th Street Suite 250	AddressLine1Txt
City	phoenix	CityNm
State Abbreviation	AZ	StateAbbreviationCd
ZIP	85108	ZIPCd

Field	Value	IRS element (for citing)
EIN	201620666	EIN
Primary Activities	Insurance	PrimaryActivitiesTxt
Legal Domicile State	AZ	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CHOC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C Corp	EntityTypeTxt
Share Of Total Income	$74,201	ShareOfTotalIncomeAmt
Share Of EOY Assets	$2,813,273	ShareOfEOYAssetsAmt
Ownership	0.50000	OwnershipPct
Controlled Organization	false	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	Yes (true)	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd