PACKARD CHILDRENS HEALTH ALLIANCE: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PACKARD CHILDRENS HEALTH ALLIANCE (EIN 32-0359189)
- Tax period
- 2012-09-01 to 2013-08-31
- Filed
- 2014-07-15
- IRS object ID
- 201401969349301565
- Schema version
- 2012v2.3
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-07-15T15:51:50-05:00 | Timestamp |
| Tax Period End Date | 2013-08-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 High Street | AddressLine1 |
| City | Boston | City |
| State | MA | State |
| ZIP Code | 02110 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-09-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320359189 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Packard Children's Health Alliance | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % KIM ROBERTS FINANCE DEPT | InCareOfName |
| Name Control | PACK | NameControl |
| Phone | 4159831135 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 WELCH ROAD MC 5551 | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | PALO ALTO | City |
| State | CA | State |
| ZIP Code | 94304 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DANA HAERING | Name |
| Title | INT. CFO/VP/CONTROL. | Title |
| Phone | 6507212222 | Phone |
| Date Signed | 2014-07-11 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6175305000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KIM ROBERTS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 WELCH ROAD MC 5551 | AddressLine1 |
| City | PALO ALTO | City |
| State | CA | State |
| ZIP Code | 94304 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 34158708 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PCHA.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2011 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 5 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 2 | NbrIndependentVotingMembers |
| Total Nbr Employees | 201 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 938997 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 34158708 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 13 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 939015 | TotalRevenuePriorYear |
| Total Revenue Current Year | 34158708 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 622785 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8067950 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2892642 | OtherExpensePriorYear |
| Other Expenses Current Year | 35562883 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3515427 | TotalExpensesPriorYear |
| Total Expenses Current Year | 43630833 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -2576412 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -9472125 | RevenuesLessExpensesCY |
| Total Assets BOY | 617014 | TotalAssetsBOY |
| Total Assets EOY | 24908647 | TotalAssetsEOY |
| Total Liabilities BOY | 2406215 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 11872126 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -1789201 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 13036521 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SEE SCHEDULE O | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 33162506 | Expense |
| Revenue | 34158708 | Revenue |
| Description | SEE SCHEDULE O | Description |
| Total Program Service Expense | 33162506 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 201 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 5 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 2 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicy |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | KIM ROBERTS FINANCE DEPT | NamePerson |
| Telephone Number | 6507212222 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 725 WELCH ROAD MC 5551 | AddressLine1 |
| City | PALO ALTO | City |
| State | CA | State |
| ZIP Code | 94304 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|---|
| MARCIA COHEN | ||||||||
| Director/Treasurer | 1.0 | 1.0 | X | 0 | 432980 | 91692 | ||
| KENNETH L COX MD | ||||||||
| SECRETARY, DIRECTOR, AND CMO | 2.0 | 52.0 | X | 0 | 478565 | 28637 | X | |
| WILLIAM KENNEDY MD | ||||||||
| DIRECTOR/CHAIRMAN | 1.0 | 50.0 | X | 0 | 372332 | 31107 | ||
| JACOB CHACKO | ||||||||
| Director | 1.0 | 0.0 | X | 0 | 0 | 0 | ||
| BERNADINE CHUCK FONG | ||||||||
| DIRECTOR | 1.0 | 0.0 | X | 0 | 0 | 0 | ||
| TIMOTHY W CARMACK | ||||||||
| VP & CFO | 2.0 | 50.0 | 0 | 606698 | 90746 | X | ||
| KIM ROBERTS | ||||||||
| PRESIDENT & CEO | 25.0 | 25.0 | 0 | 358487 | 87491 | X | ||
| RICK VANCE | ||||||||
| COO (AS OF 4/2013) | 50.0 | 0.0 | 0 | 0 | 0 | X | ||
| MARGARET JOHNSON | ||||||||
| SR DIR FINANCE (AS OF 10/2012) | 50.0 | 0.0 | 0 | 208450 | 44384 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2457512 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 374057 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| PACKARD MEDICAL GROUP INC | |||||
| 725 WELCH ROAD MC 5551 | PALO ALTO | CA | 94304 | PHYSICIAN SERVICES | 14738347 |
| PER-SE TECHNOLOGIES | |||||
| 1145 SANCTUARY PKWY STE 200 | ALPHARETTA | CA | 30004 | FIN & MGMT SOFTWARE | 449687 |
| THE CAMDEN GROUP | |||||
| 100 N SEPULVEDA BLVD SUITE 600 | EL SEGUNDO | CA | 90245 | CONSULTING/VALUATION | 254790 |
| HEALTHCARE INVESTMENT VISIONS | |||||
| 1901 HARRISON ST | OAKLAND | CA | 94612 | PROFESSIONAL SERVICE | 160200 |
| STANFORD UNIVERSITY | |||||
| 300 PASTEUR DRIVE | STANFORD | CA | 94305 | LEGAL & OTHER SERV. | 139760 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICES | 900099 | 29553879 | 29553879 |
| PROGRAM SUPPORT | 900099 | 4604829 | 4604829 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 34158708 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34158708 | TotalRevenueColumn |
| Related Or Exempt Function Income | 34158708 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92696 | Total |
| Program Services | 41713 | ProgramServices |
| Management And General | 50983 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6137171 | Total |
| Program Services | 5413886 | ProgramServices |
| Management And General | 723285 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10926 | Total |
| Program Services | 2156 | ProgramServices |
| Management And General | 8770 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1281661 | Total |
| Program Services | 391527 | ProgramServices |
| Management And General | 890134 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 545496 | Total |
| Program Services | 482369 | ProgramServices |
| Management And General | 63127 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1551836 | Total |
| Program Services | 218375 | ProgramServices |
| Management And General | 1333461 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1355903 | Total |
| Management And General | 1355903 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21195 | Total |
| Management And General | 21195 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19807778 | Total |
| Program Services | 15559031 | ProgramServices |
| Management And General | 4248747 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17436 | Total |
| Program Services | 14593 | ProgramServices |
| Management And General | 2843 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5616335 | Total |
| Program Services | 5466558 | ProgramServices |
| Management And General | 149777 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1715860 | Total |
| Program Services | 993190 | ProgramServices |
| Management And General | 722670 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2108192 | Total |
| Program Services | 2108192 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25798 | Total |
| Program Services | 14414 | ProgramServices |
| Management And General | 11384 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 589663 | Total |
| Program Services | 358377 | ProgramServices |
| Management And General | 231286 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 521657 | Total |
| Program Services | 58606 | ProgramServices |
| Management And General | 463051 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| UNCOLLECTIBLES | 1633069 | 1633069 | |
| RECRUITMENT | 167213 | 167213 | |
| LICENSES & TAXES | 97045 | 95928 | 1117 |
| DUES & SUBSCRIPTIONS | 70506 | 59739 | 10767 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 263397 | Total |
| Program Services | 250783 | ProgramServices |
| Management And General | 12614 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43630833 | Total |
| Program Services | 33162506 | ProgramServices |
| Management And General | 10468327 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 255659 | BOY |
| EOY | 3618755 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 165848 | BOY |
| EOY | 7189306 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88541 | BOY |
| EOY | 353844 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3631777 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 591979 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85966 | BOY |
| EOY | 3039798 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21000 | BOY |
| EOY | 10647486 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 59458 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 617014 | BOY |
| EOY | 24908647 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 638994 | BOY |
| EOY | 3818202 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1767221 | BOY |
| EOY | 8053924 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2406215 | BOY |
| EOY | 11872126 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1789201 | BOY |
| EOY | 13036521 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1789201 | BOY |
| EOY | 13036521 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 617014 | BOY |
| EOY | 24908647 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -9472125 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 24297847 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| General Explanation | PCHA HAS APPLIED TO THE IRS FOR RECOGNITION 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. | GeneralExplanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years | |
| Current Year Minus4 Years | CurrentYearMinus4Years | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 279502 | OtherCostOrOtherBasis |
| Depreciation | 64765 | Depreciation |
| Book Value | 214737 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1013472 | OtherCostOrOtherBasis |
| Depreciation | 527214 | Depreciation |
| Book Value | 486258 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2338803 | OtherCostOrOtherBasis |
| Book Value | 2338803 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3039798 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO RELATED PARTIES, NET | Description |
| Amount | $8,053,924 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8053924 | TotalOfAmounts |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE D, PART X, LINE 2 | Identifier |
| Return Reference | THE ORGANIZATION'S FINANCIAL STATEMENTS DID NOT REPORT A LIABILITY FOR | ReturnReference |
| Explanation | UNCERTAIN TAX POSITIONS UNDER FIN48. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY W CARMACK | ||||||||||||||
| VP & CFO | 0 | 450248 | 0 | 59930 | 0 | 96520 | 0 | 80229 | 0 | 10517 | 0 | 697444 | 0 | 0 |
| MARCIA COHEN | ||||||||||||||
| Director/Treasurer | 0 | 376445 | 0 | 56048 | 0 | 487 | 0 | 25000 | 0 | 66692 | 0 | 524672 | 0 | 0 |
| KENNETH L COX MD | ||||||||||||||
| SECRETARY, DIRECTOR, AND CMO | 0 | 261143 | 0 | 216322 | 0 | 1100 | 0 | 25000 | 0 | 3637 | 0 | 507202 | 0 | 0 |
| MARGARET JOHNSON | ||||||||||||||
| SR DIR FINANCE (AS OF 10/2012) | 0 | 182485 | 0 | 17460 | 0 | 8505 | 0 | 21504 | 0 | 22880 | 0 | 252834 | 0 | 0 |
| WILLIAM KENNEDY MD | ||||||||||||||
| DIRECTOR/CHAIRMAN | 0 | 265113 | 0 | 88726 | 0 | 18493 | 0 | 21298 | 0 | 9809 | 0 | 403439 | 0 | 0 |
| KIM ROBERTS | ||||||||||||||
| PRESIDENT & CEO | 0 | 318413 | 0 | 34538 | 0 | 5536 | 0 | 56600 | 0 | 30891 | 0 | 445978 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR DETERMINING COMPENSATION | Identifier |
| Explanation | 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 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. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B CERTAIN OFFICERS OF PACKARD CHILDREN'S HEALTH ALLIANCE ARE PROVIDED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS BY STANFORD HOSPITAL AND CLINICS, A RELATED ORGANIZATION. AT THE LAST DATE 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 amount became vested and wAS paid to the following individual in calendar year 2012: TIMOTHY W CARMACK $55,125 KIM ROBERTS $2,098 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (C). KENNETH L COX, M.D. PARTICIPATES IN A DEFERRED COMPENSATION PLAN AT STANFORD UNIVERSITY, A RELATED ORGANIZATION. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. THESE AMOUNTS APPEAR IN SCHEDULE J, PART II, COLUMN (C). PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. SCHEDULE J, PART I, LINE 7 OFFICERS AND OTHERS AS ENUMERATED IN SCHEDULE J, PART II PARTICIPATE IN A DEFERRED COMPENSATION PLAN SPONSORED BY SHC. 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(II) OFFICERS AND OTHERS WITH AMOUNTS IN THIS COLUMN RECEIVE BONUSES, AWARDS AND INCENTIVE COMPENSATION. SCHEDULE J, PART II, DESCRIPTION FOR COLUMN C & D THESE EMPLOYEES ACCRUE FUTURE BENEFITS THAT ARE AVAILABLE TO ALL STANFORD EMPLOYEES, SUCH AS EMPLOYER'S CONTRIBUTION TO QUALIFIED RETIRMENT PLAN. COMPENSATION OF LEASED EMPLOYEES SCHEDULE J, PART II LISA HOLBROOK DEVOTED FULL TIME AND EFFORT TO PCHA FOR THE PERIOD 10/7/11 THROUGH 3/31/12. LISA HOLBROOK WAS PAID BY SHC, A RELATED ENTITY, AND THIS AMOUNT WAS REIMBURSED BY LPCH, A RELATED ENTITY. THIS AMOUNT IS REFLECTED AS A PAYABLE TO LPCH IN FORM 990, PART X. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | PACKARD MEDICAL GROUP | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | SEE PART V | Relationship |
| Amount Of Transaction | 14738347 | AmountOfTransaction |
| Description Of Transaction | PHYSICIAN SERVICES & EXPENSES | DescriptionOfTransaction |
| Sharing Of Revenues | false | SharingOfRevenues |
Form990 Schedule L Part V Form990ScheduleLPartV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE L, PART IV, COLUMN B | Identifier |
| Return Reference | KENNETH COX, A DIRECTOR AND OFFICER OF PCHA, IS A DIRECTOR OF PACKARD | ReturnReference |
| Explanation | MEDICAL GROUP. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | ORGANIZATION'S PRIMARY EXEMPT PURPOSE | Identifier |
| Return Reference | FORM 990, PART I, LINE 1 & PART III, LINE 1 | ReturnReference |
| Explanation | At Packard Children's Health Alliance (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; 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 outside the practice setting serving the PCHA community. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION During the period of September 2012 and August 2013 (FY 2013), PCHA grew rapidly adding the following practices to its network: -Orthopedics (Sept 12) - Pediatric orthopedics, 4 medical providers, 4 locations -Peninsula Pediatrics (Nov 12) - General pediatrics, 11 medical providers, 2 locations -LPSR (Mid Nov 12) - General pediatrics, 7 medical providers, 3 locations -Bayside (Jan 13) - General pediatrics, 34 medical providers, 10 locations -GI (Jan 13) - General gastroenterology, 6 medical providers, 3 locations -PCMG (Jan 13) - Pediatric cardiology, 10 physicians, 10 locations -PCA (Mar 13) - Pediatric cardiology, 3 physicians, 3 locations -DVCN (Mar 13) - Pediatric neurology, 2 medical providers, 1 location The three largest services PCHA operated in fiscal year 2013 were all primary care pediatrics: Bayside, Peninsula Pediatrics and LPSR as determined by expense. General pediatrics is focused on healing sick child illness as well as a large focus on preventative medicine consisting largely of immunizations. Bayside Medical Group 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. Livermore Pleasanton San Ramon Pediatrics Group Livermore Pleasanton San Ramon Pediatrics Group was established in 1974, and has grown to serve our expanding community. We are proud to build rewarding and lasting relationships with the children and families we serve, and honored that second and even third generation patients continue to choose us. With a compassionate focus on your child's individual needs, we offer comprehensive and routine medical services for children from birth through college age. 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. Patients visits provided in fiscal year 2013 for each of the largest services are: Peninsula Pediatrics 29,483 LPSR 15,438 Bayside 71,371 During FY 2013, PCHA generated 141,154 office visits. Network growth for the next two fiscal years is projected to be 20 physicians per year. 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. POLICIES FORM 990, PART VI, LINES 12, 13, & 14 PCHA CURRENTLY DOES NOT HAVE A WRITTEN CONFLICT OF INTEREST POLICY, A WRITTEN WHISTLEBLOWER POLICY, OR A WRITTEN DOCUMENT RETENTION POLICY; HOWEVER, OFFICERS, DIRECTORS AND EMPLOYEES OF PCHA WHO ARE OFFICERS, DIRECTORS OR EMPLOYEES OF LPCH ARE SUBJECT TO LPCH'S POLICIES. PCHA IS IN THE PROCESS OF DEVELOPING ITS OWN POLICIES FOR ADOPTION BY THE BOARD OF DIRECTORS. PROCEDURES FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15 FOR THE CHIEF EXECUTIVE DIRECTOR 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. 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. FORM 990, PART IX, LINE 11G Contracted Physician Services $12,444,483 Other Purchased services $6,674,382 Temporary Labor $563,744 Other Professional services $125,169 Total $19,807,778 RECONCILIATION FORM 990, PART XI, LINE 9 EQUITY TRANSFERS TO PCHA FROM LPCH $24,297,847 | Explanation |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (16 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STANFORD HOSPITAL AND CLINICS | |||||||||||||||
| 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 | |||||
| THE FREIDENRICH SUPPORT FOUNDATION | |||||||||||||||
| 3145 PORTER DRIVE | PALO ALTO | CA | 94304 | 300519583 | SUPPORT | CA | 501(C)(3) | 11, TYPE 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 | |||||||||||||||
| 855 OAK GROVE AVE SUITE 100 | MENLO PARK | CA | 94205 | 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) | 11,TYPE III | STANFORD | true | |||||
| STANFORD UNIVERSITY BOOK STORE | |||||||||||||||
| BLDG 60 MAIN QUAD NO 105 | STANFORD | CA | 94305 | 940894150 | SUPPORT | CA | 501(C)(3) | 11, TYPE I | STANFORD | true | |||||
| STANFORD SCHOOLS CORPORATION | |||||||||||||||
| 475 POPE STREET | MENLO PARK | CA | 94025 | 202699147 | EDUCATIONAL | CA | 501(C)(3) | 2 | STANFORD | true | |||||
| LELAND STANFORD JUNIOR UNIVERSITY | |||||||||||||||
| 3145 PORTER DRIVE | PALO ALTO | CA | 94304 | 941156365 | ACADEMIA | CA | 501(C)(3) | 2 | NA | false | |||||
| 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 | |||||||||||||||
| SUPPORT | 501(C)(3) | STANFORD | true | 1401 CAROLINE CENTER | 28 PING ROAD | CAUSEWAY | HK | HK | |||||||
| THE STANFORD TRUST | |||||||||||||||
| SUPPORT | 501(C)(3) | STANFORD | true | 65 HIGH STREET | OXFORD | OX1 46L | UK | UK | |||||||
| STANFORD PROGRAMME (CAPE TOWN) NPC | |||||||||||||||
| EDUCATION | 501(C)(3) | STANFORD | true | WAVERLY BUSINESS PARK BUILDING 11 | CAPE TOWN | SF | SF | ||||||||
| STANFORD FEDERAL CREDIT UNION | |||||||||||||||
| 1860 EMBARCADERO RD | PALO ALTO | CA | 943033335 | 941492212 | CREDIT UNION | CA | 501(C)(1) | N/A | STANFORD | true | |||||
Form990 Schedule R Part III Form990ScheduleRPartIII (30 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Postal CodeAddressForeign/PostalCode | Province Or StateAddressForeign/ProvinceOrState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ARCOLA LP | |||||||||||||
| C/O ARCOLOA GP LLC 1 EMBARCADERO C | SAN FRANCISCO | CA | 94111 | 204222260 | RE DEVELOPMENT | DE | NA | ||||||
| ATWATER 12 LP | |||||||||||||
| 2001 ROSS AVE STE 1600 | DALLAS | TX | 75201 | 752944481 | INVESTMENTS | DE | NA | ||||||
| AVENUE ASIA CAPITAL PARTNERS LP | |||||||||||||
| 399 Park Ave 6th Fl | NEW YORK | NY | 10022 | 010553224 | FOREIGN INV. | DE | NA | ||||||
| JER R E QUALIFIED PARTNERS EUROPE LP | |||||||||||||
| C/O JE ROBERT COS 1650 TYSON BL | STE MCLEAN | VA | 22102 | 542029560 | INVESTMENTS | DE | NA | ||||||
| LINCOLN COMMERCE PARK II LTD | |||||||||||||
| PO BOX 1920 | DALLAS | TX | 75221 | 204681486 | RE DEVELOPMENT | DE | NA | ||||||
| PARMENTER REALTY FUND II LP | |||||||||||||
| 1111 BRICKELL AVE STE 2910 | MIAMI | FL | 33131 | 200973616 | INVESTMENTS | DE | NA | ||||||
| REGENT OFFICE CENTER LP | |||||||||||||
| c/o Bentall Kennedy US LP 1215 4 | SEATTLE | WA | 33131 | 912116424 | INVESTMENTS | TX | NA | ||||||
| SANDPIPER FUND LP | |||||||||||||
| 2100 MCKINNEY AVE STE 1770 | DALLAS | TX | 98161 | 260341626 | INVESTMENTS | TX | NA | ||||||
| SAROFIM MULTIFAMILY PARTNERS LP | |||||||||||||
| 8115 PRESTON RD STE 400 | DALLAS | TX | 75201 | 201929002 | RE DEVELOPMENT | DE | NA | ||||||
| SKY HARBOR ASSOCIATES LP | |||||||||||||
| PO BOX 1920 | DALLAS | TX | 75225 | 205803431 | INVESTMENTS | DE | NA | ||||||
| SNOWCREEK VI PARTNERS LLC | |||||||||||||
| C/O SMC 2770 SAND HILL RD | MENLO PARK | CA | 75221 | 861089966 | RE DEVELOPMENT | CA | NA | ||||||
| STERLING STAMOS REAL ASSETS FUND (A) LP | |||||||||||||
| 250 PARK AVE 29TH FL | NEW YORK | NY | 94025 | 203949682 | INVESTMENTS | DE | NA | ||||||
| DEK PORTFOLIO LLC | |||||||||||||
| C/O SPAULDING SLYE INV 1 PO S | BOSTON | MA | 10022 | 043446765 | INVESTMENTS | DE | NA | ||||||
| BROWN BARK I LP | |||||||||||||
| PO BOX 1068 | STAFFORD | TX | 77497 | 721604614 | INVESTMENTS | DE | NA | ||||||
| BROWN BARK II LP | |||||||||||||
| PO BOX 1068 | STAFFORD | TX | 77497 | 208727391 | INVESTMENTS | DE | NA | ||||||
| BROWN BARK III LP | |||||||||||||
| PO BOX 1068 | STAFFORD | TX | 77497 | 261780743 | INVESTMENTS | DE | NA | ||||||
| STANFORD PET-CT LLC | |||||||||||||
| 300 PASTEUR DRIVE M/C 5555 | STANFORD | CA | 94305 | 611423414 | MED. DIAGNOSICS | CA | NA | ||||||
| LSF V DHB HOLDINGS LP | |||||||||||||
| 2711 N Haskell Ave Ste 1700 | DALLAS | TX | 75204 | 272858604 | INVESTMENTS | DE | NA | ||||||
| SIC SNOWCREEK VIII LLC | |||||||||||||
| 635 KNIGHT WAY | STANFORD | CA | 94305 | 275431605 | RE DEVELOPMENT | CA | NA | ||||||
| SUMIT HOLDING INTERNATIONAL LLC | |||||||||||||
| 1400 PAGE MILL ROAD MC5713 | PALO ALTO | CA | 94305 | 263934706 | HOLDING COMPANY | DE | NA | ||||||
| ARCOLA VENTURE LLC | |||||||||||||
| C/O STANFORD MGMT CO 635 KNIGHT W | STANFORD | CA | 94304 | 371689632 | RE DEVELOPMENT | DE | NA | ||||||
| BLACKSTONE REP VII TE 7-NQ LP | |||||||||||||
| C/O THE BLACKSTONE GROUP 345 PARK | NEW YORK | NY | 943057297 | 900878802 | INVESTMENTS | DE | NA | ||||||
| OUTLAWS CASINO LTD | |||||||||||||
| 3160 PORTER DR | PALO ALTO | CA | 94304 | 841457498 | HOLDING COMPANY | CO | NA | ||||||
| STANFORD EMANUEL RAD ONCOLOGY | |||||||||||||
| RADIOLOGY | CA | NA | |||||||||||
| SAND HILL INVESTMENTS LP | |||||||||||||
| C/O SMC 635 KNIGHT WAY | STANFORD | CA | 943057297 | 371557441 | INVESTMENT | DE | NA | ||||||
| KEB INVESTORS II LP | |||||||||||||
| FOREIGN INV. | NA | WASHINGTON MALL STE 304 7 REID ST | HAMILTON | BD | BD | ||||||||
| PALO ALTO LP | |||||||||||||
| FOREIGN INV. | NA | OGIER HOUSE THE ESPLANADE | ST. HELIER | JE | JE | XC JE4 9WG | |||||||
| FORTRESS IW COINVESTMENT (FUND B) LP | |||||||||||||
| 1345 AVE OF THE AMERICAS 23RD FL | NEW YORK | NY | 10105 | 980509639 | INVESTMENTS | NA | CJ | ||||||
| JER REAL ESTATE PARTNERS EUROPE II LP | |||||||||||||
| INVESTMENTS | NA | CLARGES HOUSE 6-12 CLARGES ST | LONDON | UK | UK | W1J 8AD | EN | ||||||
| CEE EQUITY HOLDINGS LP | |||||||||||||
| INVESTMENTS | NA | Elizabeth House 9 Castle St | St. Helier, | JE | JE | JE4 2QP | Je | ||||||
Form990 Schedule R Part IV Form990ScheduleRPartIV (24 entries)
| Address Line1AddressForeign/AddressLine1 | CityAddressForeign/City | CountryAddressForeign/Country | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | EINEIN | Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Legal Domicile StateLegalDomicileState | Province Or StateAddressForeign/ProvinceOrState | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARINER VOYAGER INTERNATIONAL LTD | |||||||||||||||||
| C/O STUARTS CORP SVCS PO BOX 2510 | GEORGE TOWN | CJ | INVESTMENTS | CJ | NA | C CORP | |||||||||||
| STANFORD SGGS EUROPE INC | |||||||||||||||||
| UGLAND HOUSE S CHURCH ST | PO BOX 309GT, GEORGE TOWN | CJ | INVESTMENTS | CJ | NA | C CORP | 131684331 | ||||||||||
| BLACK RIVER EMEA INVESTORS FUND LTD | |||||||||||||||||
| UGLAND HOUSE S CHURCH ST | GEORGE TOWN | CJ | INVESTMENTS | CJ | NA | C CORP | 980428006 | ||||||||||
| EAST SAIL | |||||||||||||||||
| C/O INTL FS INC IFS COURT | TWENTYEIGHT, CYBERCITY, EBENE | MP | INVESTMENTS | MP | NA | C CORP | |||||||||||
| GAVEA INVESTMENT FUND II-C LP | |||||||||||||||||
| PO BOX 896GT HARBOUR CENTRE | GEORGE TOWN | CJ | INVESTMENTS | CJ | NA | C CORP | 980537952 | ||||||||||
| JER ALBERTA LP | |||||||||||||||||
| INVESTMENTS | CA | NA | C CORP | 980537952 | C/O JE ROBERT COS 1650 TYSON BLVD | MCLEAN | VA | 22102 | |||||||||
| JER ALBERTA III LP | |||||||||||||||||
| INVESTMENTS | CA | NA | C CORP | 980423557 | C/O JE ROBERT COS 1650 TYSON BLVD | MCLEAN | VA | 22102 | |||||||||
| MARBLETON PROPERTY FUND (ALBERTA) LP | |||||||||||||||||
| INVESTMENTS | CA | NA | C CORP | 980493425 | C/O JE ROBERT COMPANIES 1650 TYS | MCLEAN | VA | 22102 | |||||||||
| CLAT (16) | |||||||||||||||||
| CHARITABLE TR | STANFORD | TRUST | CA | ||||||||||||||
| CRT (513) | |||||||||||||||||
| CHARITABLE TR | NA | TRUST | CA | ||||||||||||||
| OTHER (10) | |||||||||||||||||
| CHARITABLE TR | NA | TRUST | CA | ||||||||||||||
| PIF (82) | |||||||||||||||||
| CHARITABLE TR | NA | TRUST | CA | ||||||||||||||
| MIDPOINT TECHNOLOGY PARK OWNERS ASSOC | |||||||||||||||||
| REAL ESTATE | NA | C CORP | 943287254 | 3145 PORTER DR | PALO ALTO | CA | 94304 | CA | |||||||||
| ALPINE CHALET INC | |||||||||||||||||
| SKI LODGE | CA | NA | C CORP | PO BOX 9988 | SOUTH LAKE TAHOE | CA | 96158 | ||||||||||
| NW CAMPUS MIDPOINT TECH PARK OWNRS ASSOC | |||||||||||||||||
| REAL ESTATE | CA | NA | C CORP | 943287254 | 3145 PORTER DR | PALO ALTO | CA | 94304 | |||||||||
| STANFORD CAMPUS RECREATION ASSOCIATION | |||||||||||||||||
| SOCIAL CLUB | CA | NA | C CORP | 941539127 | 3145 PORTER DR | PALO ALTO | CA | 94304 | |||||||||
| STANFORD (BEIJING) CNSLTNG CO LTD (WFOE) | |||||||||||||||||
| 5275TH FLBLDG CACADEMY SOUTH RD | HAIDAN DISTRICT | CH | EDUCATION | CH | NA | C CORP | BEIJING | ||||||||||
| STANFORD UNIV MED NETWORK RISK AUTHORITY | |||||||||||||||||
| RISK MGMT CONSULT | NA | C CORP | 461132002 | 1400 PAGE MILL RD MSC 5713 | PALO ALTO | CA | 94304 | CA | |||||||||
| PROFESSIONAL EXCHANGE ASSURANCE COMPANY | |||||||||||||||||
| INSURANCE | UHA | C CORP | 900897686 | 201 merchant street suite 2400 | honolulu | HI | 96813 | HI | 29633 | 800449 | 0.20400 | true | |||||
| ARCOLA RES DEVELOPMENT CORP | |||||||||||||||||
| INVESTMENT | NA | C CORP | 800804754 | C/O SMC 635 KNIGHT WAY | STANFORD | CA | 943057297 | CA | |||||||||
| BREP VII ALBERTA FEEDER (OFFSHORE) TE7LP | |||||||||||||||||
| INVESTMENTS | NA | C CORP | 981066351 | C/O THE BLACKSTONE GROUP 345 PARK | NEW YORK | NY | 10154 | CA | |||||||||
| BREP VII ALBERTA FEEDER(OFFSHORE)TE7NQLP | |||||||||||||||||
| INVESTMENTS | NA | C CORP | 981066355 | C/O THE BLACKSTONE GROUP 345 PARK | NEW YORK | NY | 10154 | CA | |||||||||
| SPM DIRECT MORTGAGE PREPAY OFFSHORE FUND | |||||||||||||||||
| INVESTMENTS | CJ | NA | C CORP | ||||||||||||||
| WOODBOURNE CANADA PARTNERS II -CAYMAN LP | |||||||||||||||||
| INVESTMENTS | CJ | NA | C CORP | 980705321 | |||||||||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE R, PART IV, LINE 2 | Identifier |
| Return Reference | CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. | ReturnReference |
| Explanation | SCHEDULE R, PART IV, LINE 3 CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 4 OTHER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 5 POOLED INVESTMENT FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. | Explanation |