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CHILDRENS HOSPITAL LOS ANGELES: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CHILDRENS HOSPITAL LOS ANGELES (EIN 95-1690977)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201411349349304306
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-05-14T12:56:30-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1655 WEST BROADWAY SUITE 700AddressLine1
CitySAN DIEGOCity
StateCAState
ZIP Code921018590ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN951690977EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL LOS ANGELESBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone3236602450Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line14650 SUNSET BOULEVARDAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900270982ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDIEMLAN LANNIE TONNUName
TitleSVP AND CFOTitle
Phone3233612235Phone
Date Signed2014-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDIANA J MCCUTCHENName
PTINP00545657PTIN
Phone6192326500Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDIEMLAN LANNIE TONNUNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line14650 SUNSET BOULEVARDAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900270982ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1362149747GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CHLA.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1901YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionPROMOTION AND ADVANCEMENT OF CHILDREN'S HEALTH THROUGH PATIENT CARE, RESEARCH, AND EDUCATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body69NbrVotingMembersGoverningBody
Nbr Independent Voting Members52NbrIndependentVotingMembers
Total Nbr Employees5559TotalNbrEmployees
Total Nbr Volunteers500TotalNbrVolunteers
Total Gross UBI31608TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year104447599ContributionsGrantsPriorYear
Contributions Grants Current Year115036083ContributionsGrantsCurrentYear
Program Service Revenue Prior Year696881291ProgramServiceRevenuePriorYear
Program Service Revenue CY735921091ProgramServiceRevenueCY
Investment Income Prior Year16242271InvestmentIncomePriorYear
Investment Income Current Year14622702InvestmentIncomeCurrentYear
Other Revenue Prior Year4915931OtherRevenuePriorYear
Other Revenue Current Year4093891OtherRevenueCurrentYear
Total Revenue Prior Year822487092TotalRevenuePriorYear
Total Revenue Current Year869673767TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year10575398GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY7223810GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year373063346SalariesEtcPriorYear
Salaries Etc Current Year400984720SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year321775TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY348364TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year14595147TotalFundrsngExpCurrentYear
Other Expense Prior Year402043040OtherExpensePriorYear
Other Expenses Current Year424900286OtherExpensesCurrentYear
Total Expenses Prior Year786003559TotalExpensesPriorYear
Total Expenses Current Year833457180TotalExpensesCurrentYear
Revenues Less Expenses Prior Year36483533RevenuesLessExpensesPriorYear
Revenues Less Expenses CY36216587RevenuesLessExpensesCY
Total Assets BOY1701215324TotalAssetsBOY
Total Assets EOY1745766595TotalAssetsEOY
Total Liabilities BOY651900312TotalLiabilitiesBOY
Total Liabilities EOY621479251TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1049315012NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1124287344NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE HOSPITAL'S PRINCIPAL MISSION IS TO PROMOTE AND ADVANCE THE STATE OF CHILDREN'S HEALTH, FOCUSING ON TERTIARY AND QUATERNARY SPECIALTIES IN PATIENT CARE, RESEARCH, AND EDUCATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense576434222Expense
Grants7223810Grants
Revenue699846024Revenue
DescriptionMEDICAL CARE PROVIDED TO CHILDRENIT IS THE POLICY OF THE HOSPITAL TO STRIVE TO MAINTAIN QUALITY HEALTH CARE DELIVERY IN A MANNER THAT RESPECTS THE DIGNITY OF THE INDIVIDUAL AND FAMILY, REGARDLESS OF THE ABILITY TO PAY. UNDER THE HOSPITAL'S POLICY, MEDICAL CARE MAY BE PROVIDED WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PEOPLE WHO ARE UNINSURED OR UNDERINSURED AND CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE. THE HOSPITAL PROVIDES ADDITIONAL COMMUNITY SUPPORT BY PROVIDING CARE TO PATIENTS WHO PARTICIPATE IN PROGRAMS, LIKE MEDI-CAL, THAT DO NOT PAY FULL CHARGES. APPROXIMATELY THREE-FOURTHS OF THE HOSPITAL'S PATIENTS ARE COVERED BY MEDI-CAL PROGRAMS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense46512826Expense
Revenue27911930Revenue
DescriptionGRADUATE MEDICAL EDUCATION PROVIDES TRAINING AND EDUCATION TO MEDICAL STUDENTS IN LOS ANGELES COUNTY WHO, IN TURN, PROVIDE SERVICES TO PATIENTS AT THE HOSPITAL. ALSO, INCLUDES EDUCATION REVENUE FROM THE RESIDENCY AND FELLOWSHIP PROGRAMS AT CHLA. THE HOSPITAL SUBSIDIZES A LARGE PART OF THE COST OF TRAINING PHYSICIANS, ALLIED HEALTH PROFESSIONALS, AND OTHER HEALTH CARE WORKERS IN ITS EMERGENCY ROOM, CLINICS, INPATIENT AREAS, AND OTHER PARTS OF ITS FACILITIES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense66750105Expense
Revenue8163137Revenue
DescriptionRESEARCH REVENUES FURTHER THE EXEMPT PURPOSE OF CHLA BY PROVIDING THE PATIENTS OF CHLA ACCESS TO NEW TECHNOLOGIES, DISCOVERIES AND MEDICATIONS FOR TREATMENT. RESULTS OF THIS RESEARCH IS DISSEMINATED THROUGH PUBLICATIONS IN SCIENTIFIC JOURNALS AND PRESENTATIONS BY THE PRINCIPAL INVESTIGATORS. THE HOSPITAL SUBSIDIZES A LARGE PART OF THE COST OF MEDICAL RESEARCH TAKING PLACE IN ITS FACILITIES.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense594741Expense
Revenue679115Revenue
DescriptionOTHER PROGRAM SERVICE REVENUES ALSO INCLUDE RESIDENTS HOUSING AND MISCELLANEOUS TUITION AND EDUCATION INCOME.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp594741TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev679115TotalOfOtherProgramServiceRev
Total Program Service Expense690291894TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096431NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees5559NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members69NbrVotingGoverningBodyMembers
Number Independent Voting Members52NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LAWRENCE FOUSTBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3233612425TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14650 SUNSET BLVDAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900270980ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (82 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
RICHARD CORDOVA
PRESIDENT & CEO/TRUSTEE40.00XX773055053534
MARY DEE HACKER
TRUSTEE/VP PATIENT CARE40.00XX386129070792
HENRI FORD MD
TRUSTEE/FAC PHYSICIAN/VP40.00XX72328100
STUART SIEGEL MD
TRUSTEE/FACULTY PHYSICIAN40.00X41725600
BRENT POLK MD
TRUSTEE/FACULTY PHYSICIAN40.00XX58428300
BONNIE MCCLURE
TRUSTEE/FUNDRAISER COORD30.00X6400000
ARNOLD KLEINER
TRUSTEE1.00X000
ELIZABETH LOWE
TRUSTEE1.00X000
CATHY WEISS
TRUSTEE1.00X000
MARION ANDERSON
TRUSTEE1.00X000
JOHN JACK PETTKER
TRUSTEE1.00X000
THEODORE SAMUELS
TRUSTEE1.00X000
BROOKE ANDERSON
TRUSTEE1.00X000
ASHWIN ADARKAR
TRUSTEE1.00X000
JUNE BANTA
TRUSTEE1.00X000
LYNDA BOONE FETTER
TRUSTEE1.00X000
ALEX CHAVES SR
TRUSTEE1.00X000
MARTHA CORBETT
TRUSTEE1.00X000
MARGARET EBERHARDT
TRUSTEE1.00X000
RICHARD FARMAN
TRUSTEE1.00X000
GREGORY T FORGATCH
TRUSTEE1.00X000
PEGGY GALBRAITH
TRUSTEE1.00X000
CARL GRUSHKIN MD
TRUSTEE1.00X000
MARY HART
TRUSTEE1.00X000
MEGAN M HERNANDEZ
TRUSTEE1.00X000
MARCIA WILSON HOBBS
TRUSTEE1.00X000
GLORIA HOLDEN
TRUSTEE1.00X000
MARK D KRIEGER MD
FACULTY PHYSICIAN40.00X16162300
JAMES HUNT
TRUSTEE1.00X000
WILLIAM HURT
TRUSTEE1.00X000
TODD E MOLZ
TRUSTEE1.00X000
SUSAN MALLORY
TRUSTEE1.00X000
CAROL MANCINO
TRUSTEE1.00X000
ELIZABETH HUNT PRICE
TRUSTEE1.00X000
ALEX MENESES
TRUSTEE1.00X000
CARYLL SPRAGUE MINGST
TRUSTEE1.00X000
MARY ADAMS O'CONNELL
TRUSTEE1.00X000
CHESTER CHET PIPKIN
TRUSTEE1.00X000
RONALD PREISSMAN
TRUSTEE1.00X000
DR CARMEN PULIAFITO
TRUSTEE1.00X000
ALAN PURWIN
TRUSTEE1.00X000
DAYLE ROATH
TRUSTEE1.00X000
KATHY LUPPEN ROSE
TRUSTEE1.00X000
W SCOTT SANFORD
TRUSTEE1.00X000
PAUL SCHAEFFER
TRUSTEE1.00X000
THOMAS SIMMS
TRUSTEE1.00X000
VICTORIA SIMMS PHD
TRUSTEE1.00X000
LISA STEVENS
TRUSTEE1.00X000
JAMES TERRILE
TRUSTEE1.00X000
HON DICKRAM M TEVRIZIAN
TRUSTEE1.00X000
JOYCE BOGART TRABULUS
TRUSTEE1.00X000
PEGGY TSIANG CHERNG PHD
TRUSTEE1.00X000
ALYCE WILLIAMSON
TRUSTEE1.00X000
ALAN WILSON
TRUSTEE1.00X000
JEFFREY WORTHE
TRUSTEE1.00X000
DICK ZIEGLER
TRUSTEE1.00X000
KEVIN BROGAN
TRUSTEE1.00X000
GARY COHEN
TRUSTEE1.00X000
DEBBIE FREUND
TRUSTEE1.00X000
KATHLEEN MCCARTHY KOSTLAN
TRUSTEE1.00X000
EUGENE MITCHELL
TRUSTEE1.00X000
ELIZABETH RAHN
TRUSTEE1.00X000
STEVEN ROUNDTREE
TRUSTEE1.00X000
ALAN RUDNICK
TRUSTEE1.00X000
RICHARD ZAPANTA MD
TRUSTEE1.00X000
KIMBERLY SHEPHARD
TRUSTEE1.00X000
JAIME LEE CURTIS
TRUSTEE1.00X000
JIHEE HUH
TRUSTEE1.00X000
WILLIAM WARDLAW
TRUSTEE1.00X000
DIEMLAN LANNIE TONNU
SVP/CFO/TREASURER40.00X5602100101149
LAWRENCE FOUST
SVP-GEN COUNSEL/SEC40.00X476754081858
MICHELLE CRONKHITE
ASSISTANT SECRETARY40.00X6443502212
RODNEY HANNERS
SVP OPERATIONS/COO40.00501824097345X
CLAUDIA LOONEY
SVP-DEVELOPMENT40.00752153080584X
GAIL MARGOLIS
VP, GOVERNMENT & PUBLIC POLICY40.00311657057315X
KEITH HOBBS
VP, ANCILLARY & SUPPORT SERVICES40.00289582056830X
DEANN MARSHALL
SVP, CHIEF DEV & MKTG OFFICER40.00446720072090X
TIM MALSEED
AVP, CHIEF APPLICATIONS OFFICER40.00322141043926X
MARTY MILLER
VP, CHIEF INFORMATION OFFICER40.00349392043655X
ROBERT ADLER MD
FORMER TRUSTEE/FACULTY PHYSICIAN40.0030615700X
ROBERT KAY MD
FORMER TRUSTEE/FACULTY PHYSICIAN40.0015381200X
ROBERTA WILLIAMS MD
FORMER TRUSTEE/FACULTY PHYSICIAN40.0028087000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org7925334TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation761290TotalOtherCompensation
Number Individuals GT100 K760NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources1CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
IDEAOLOGY ADVERTISING
4223 GLENCOE AVE STE A-127MARINA DEL REYCA90292ADVERTISING SERVICES3296512
CLEO ENTERPRISES LLC
34 CALLE CASTILLOSAN CLEMENTECA92673CONSTRUCTION MGMT1089318
ERNST & YOUNG US LLP
PO BOX 846793LOS ANGELESCA90084INTERNAL AUDIT SERVICES756812
DELOITTE & TOUCHE LLP
PO BOX 7247-6446PHILADELPHIAPA19170AUDIT SERVICES553106
THINKBOX TECHNOLOGY GROUP LLC
49 DISCOVERY STE 140IRVINECA92618VIDEO CONFERENCING SYSTEMS444685
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K
Fundraising Events2576885FundraisingEvents
Government Grants41542241GovernmentGrants
All Other Contributions70916957AllOtherContributions
Noncash Contributions782771NoncashContributions
Total Contributions115036083TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT REVENUE621110699846024699846024
EDUCATION REVENUE9000991941193019411930
GRADUATE MEDICAL EDUCATION90009985000008500000
RESEARCH REVENUE90009981631378163137
FieldValueIRS element (for citing)
Total Program Service Revenue735921091TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1364455TotalRevenueColumn
Unrelated Business Revenue19573UnrelatedBusinessRevenue
Exclusion$1,344,882ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column223300TotalRevenueColumn
Exclusion$223,300ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities504608514Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities491275665Securities
Other74602Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities13332849Securities
Other-74602Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column13258247TotalRevenueColumn
Exclusion$13,258,247ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events215500GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events2576885CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses1125713FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-910213TotalRevenueColumn
Exclusion-$910,213ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PARKING GARAGE8129302365898$2,365,898
CHILD DEVELOPMENT CENTER6244101237973$1,237,973
RESIDENT'S HOUSING900099453649453649

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column723284TotalRevenueColumn
Related Or Exempt Function Income225466RelatedOrExemptFunctionIncome
Unrelated Business Revenue12035UnrelatedBusinessRevenue
Exclusion$485,783ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4780804TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column869673767TotalRevenueColumn
Related Or Exempt Function Income736600206RelatedOrExemptFunctionIncome
Unrelated Business Revenue31608UnrelatedBusinessRevenue
Exclusion$18,005,870ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total7223810Total
Program Services7223810ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3924123Total
Program Services475352ProgramServices
Management And General2688880ManagementAndGeneral
Fundraising759891Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total334147572Total
Program Services270345594ProgramServices
Management And General56732629ManagementAndGeneral
Fundraising7069349Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6327976Total
Program Services5310361ProgramServices
Management And General881216ManagementAndGeneral
Fundraising136399Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total33248231Total
Program Services28190318ProgramServices
Management And General4294239ManagementAndGeneral
Fundraising763674Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total23336818Total
Program Services19324188ProgramServices
Management And General3503186ManagementAndGeneral
Fundraising509444Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total200869Total
Program Services197658ProgramServices
Management And General3211ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1994820Total
Program Services339556ProgramServices
Management And General1519530ManagementAndGeneral
Fundraising135734Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total406742Total
Program Services600ProgramServices
Management And General406142ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total46582Total
Management And General46582ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total348364Total
Fundraising348364Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total1107512Total
Management And General1107512ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total130582215Total
Program Services91490324ProgramServices
Management And General37116505ManagementAndGeneral
Fundraising1975386Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total3805480Total
Program Services3805480ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total115329494Total
Program Services111974078ProgramServices
Management And General2885447ManagementAndGeneral
Fundraising469969Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total28708730Total
Program Services21836804ProgramServices
Management And General6527598ManagementAndGeneral
Fundraising344328Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total197982Total
Program Services197982ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5935686Total
Program Services3183567ProgramServices
Management And General1905362ManagementAndGeneral
Fundraising846757Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total2706324Total
Program Services1904640ProgramServices
Management And General672650ManagementAndGeneral
Fundraising129034Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total2267223Total
Program Services1198524ProgramServices
Management And General678914ManagementAndGeneral
Fundraising389785Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total24117449Total
Program Services22860930ProgramServices
Management And General1256519ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total46830318Total
Program Services44684755ProgramServices
Management And General2145563ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2621174Total
Program Services2484611ProgramServices
Management And General136563ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
HOSPITAL FEE PROGRAM277589402775894000
UTILITIES1086366910317622545708339
PROVISION FOR BAD DEBTS6219754621975400
MINOR EQUIPMENT37584073612101146599-293

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total9440916Total
Program Services5354345ProgramServices
Management And General3369584ManagementAndGeneral
Fundraising716987Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total833457180Total
Program Services690291894ProgramServices
Management And General128570139ManagementAndGeneral
Fundraising14595147Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY236447BOY
EOY393731EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9363016BOY
EOY26671972EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY87959417BOY
EOY86184393EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY95413027BOY
EOY120085788EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY67723BOY
EOY45149EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY790431BOY
EOY1078627EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6784287BOY
EOY6802184EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6772050BOY
EOY4554792EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1427878882LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec516791376LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY906924725BOY
EOY911087506EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY459213083BOY
EOY507618625EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY5180564BOY
EOY5121549EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY122510554BOY
EOY76122279EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1701215324BOY
EOY1745766595EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY86453167BOY
EOY83872499EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY34982750BOY
EOY10468538EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY487476851BOY
EOY487314409EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY42987544BOY
EOY39823805EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY651900312BOY
EOY621479251EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY774155934BOY
EOY834693032EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY127370121BOY
EOY139982752EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY147788957BOY
EOY149611560EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1049315012BOY
EOY1124287344EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1701215324BOY
EOY1745766595EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses36216587ReconcilationRevenueExpenses
Reconciliation Unrealized Invest35374107ReconciliationUnrealizedInvest
Reconcilation Other Changes3381638ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals46582FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals46582FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals690245312FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals690291894FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus31000000CurrentYearMinus3
Current Year Minus21000000CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total4000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$6,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus346205CurrentYearMinus3
Current Year Minus261012CurrentYearMinus2
Current Year Minus149816CurrentYearMinus1
Current Year46582CurrentYear
Total203615Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus3250000CurrentYearMinus3
Current Year Minus2250000CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total1000000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$1,500,000GrassrootsCeilingAmount

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance528012698BeginningOfYearBalance
Contributions49282881Contributions
Investment Earnings Or Losses46289884InvestmentEarningsOrLosses
Other Expenditures53191399OtherExpenditures
End Of Year Balance570394064EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance542188938BeginningOfYearBalance
Contributions39523985Contributions
Investment Earnings Or Losses-69784InvestmentEarningsOrLosses
Other Expenditures53630441OtherExpenditures
End Of Year Balance528012698EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance495093405BeginningOfYearBalance
Contributions32136775Contributions
Investment Earnings Or Losses63246838InvestmentEarningsOrLosses
Other Expenditures48288079OtherExpenditures
End Of Year Balance542188939EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance471903453BeginningOfYearBalance
Contributions30649271Contributions
Investment Earnings Or Losses45036808InvestmentEarningsOrLosses
Other Expenditures52496127OtherExpenditures
End Of Year Balance495093405EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance592416535BeginningOfYearBalance
Contributions32922898Contributions
Investment Earnings Or Losses-81655753InvestmentEarningsOrLosses
Other Expenditures71780227OtherExpenditures
End Of Year Balance471903453EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.71080BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.26230PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.02690TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis25551282OtherCostOrOtherBasis
Book Value25551282BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1035909360OtherCostOrOtherBasis
Depreciation259165106Depreciation
Book Value776744254BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis321540907OtherCostOrOtherBasis
Depreciation252399495Depreciation
Book Value69141412BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis44877333OtherCostOrOtherBasis
Depreciation5226775Depreciation
Book Value39650558BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings911087506TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
INTEREST RATE SWAP$9,761,927
WORKERS COMPENSATION INSURANCE RESERVE$15,153,725
DEFERRED BENEFITS$5,712,243
MALPRACTICE TAIL RESERVE$3,700,000
LIABILITY UNDER UNITRUST AGREEMENTS$3,032,214
DEFERRED REVENUE/DEPOSITS LT$2,453,147
OTHER$10,549
FieldValueIRS element (for citing)
Total Of Amounts39823805TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:ENDOWMENT FUNDS ARE INTENDED TO BE USED ACCORDING TO THE DONOR'S WISHES WHICH VARY FROM ONGOING PROGRAM SUPPORT, TO SPECIFIC RESEARCH, TO BUILDING OR ASSET ACQUISITION, OR SUPPORT OF ACADEMIC CHAIRS WITHIN THE ORGANIZATION.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE HOSPITAL ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES. FASB ASC 740 PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT, AND DISCLOSE IN ITS CONSOLIDATED FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT THE COMPANY HAS TAKEN, OR EXPECTS TO TAKE, ON A TAX RETURN. DURING THE YEARS ENDED JUNE 30, 2013 AND 2012, THE HOSPITAL DID NOT RECORD ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

Name Of Organization NameOfOrganization

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S MIRACLE NETWORKBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1205 WEST 700 SOUTHAddressLine1
CitySALT LAKECity
StateUTState
ZIP Code84101ZIPCode
FieldValueIRS element (for citing)
ActivityGENERAL FUNDRAISINGActivity
Fundraiser Control Of Funds0FundraiserControlOfFunds
Gross Receipts3581002GrossReceipts
Amount Retained By Contractor348364AmountRetainedByContractor
Net To Organization3232638NetToOrganization
FieldValueIRS element (for citing)
Total Gross Receipts3581002TotalGrossReceipts
Total Retained By Contractors348364TotalRetainedByContractors
Total Net To Organization3232638TotalNetToOrganization
Licensed StatesCALicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1NOCHE DE NINOSNameOfEvent1
Gross Receipts Event12792385GrossReceiptsEvent1
Charitable Contributions Event12576885CharitableContributionsEvent1
Gross Revenue Event1215500GrossRevenueEvent1
Rent Facility Costs Event1151226RentFacilityCostsEvent1
Food And Beverage Event1243772FoodAndBeverageEvent1
Entertainment Event1342650EntertainmentEvent1
Other Direct Expenses Event1388065OtherDirectExpensesEvent1
Gross Receipts Total2792385GrossReceiptsTotal
Charitable Contributions Total2576885CharitableContributionsTotal
Gross Revenue Total Events215500GrossRevenueTotalEvents
Rent Facility Costs Total Events151226RentFacilityCostsTotalEvents
Food And Beverage Total Events243772FoodAndBeverageTotalEvents
Entertainment Total Events342650EntertainmentTotalEvents
Other Direct Expenses Total Events388065OtherDirectExpensesTotalEvents
Direct Expense Summary Events1125713DirectExpenseSummaryEvents
Net Income Summary-910213NetIncomeSummary

Form990 Schedule G Part IV Form990ScheduleGPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF FUNDRAISING PAYMENTSIdentifier
Return ReferenceSCHEDULE G, PART I, LINE 2B, COLUMN (V)ReturnReference
ExplanationFUNDS SUBMITTED DIRECTLY TO CHILDREN'S MIRACLE NETWORK BY SPONSOR PARTNERS ARE REMITTED TO MEMBER HOSPITALS ON A QUARTERLY BASIS BY CHILDREN'S MIRACLE NETWORK. FUNDS REMITTED DIRECTLY TO MEMBER HOSPITALS AS A RESULT OF A CHILDREN'S MIRACLE NETWORK FUNDRAISING PROGRAM ARE REPORTED BACK TO CHILDREN'S MIRACLE NETWORK FOR THE PURPOSES TRACKING FUNDRAISING RESULTS BUT THOSE ARE DEPOSITED BY THE MEMBER HOSPITAL. MEMBER HOSPITALS PAY AN ANNUAL MEMBERSHIP FEE, WHICH DIFFERS FOR EACH MEMBER HOSPITAL AND DEPENDS LARGELY ON ITS MARKET TERRITORY POPULATION. THESE FEES ARE ANALOGOUS TO FRANCHISE FEES, WHERE HOSPITALS "OWN" MARKET TERRITORY IN WHICH THEY FUNDRAISE USING THE CHILDREN'S MIRACLE NETWORK BRAND. CHILDREN'S MIRACLE NETWORK FURNISHES FUNDRAISING MATERIALS THAT ARE ESSENTIAL TO THE CAMPAIGNS. SUCH MATERIALS INCLUDE THE PAPER ICONS, COLLATERAL MATERIALS, AND COIN CANNISTERS. MATERIALS ARE SENT DIRECTLY TO LOCATIONS OF SPONSOR PARTNERS (SUCH AS AN INDIVIDUAL COSTCO WAREHOUSE). IT IS THE RESPONSIBILITY OF EACH HOSPITAL TO PAY FOR THE COST OF THESE MATERIALS. MATERIALS COSTS ARE BILLED SEPARATE FROM THE ANNUAL MEMBERSHIP FEE AND ARE SENT INTERMITTENTLY DEPENDING ON THE FREQUENCY OF THE CAMPAIGNS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent350XPcent350
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1100PersonsServed
Total Community Benefit Expense2700000TotalCommunityBenefitExpense
Net Community Benefit Expense2700000NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served1100PersonsServed
Total Community Benefit Expense2700000TotalCommunityBenefitExpense
Net Community Benefit Expense2700000NetCommunityBenefitExpense
Percent Of Total Expense0.00330PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs68NumberOfActivitiesOrPrograms
Persons Served683109PersonsServed
Total Community Benefit Expense6776847TotalCommunityBenefitExpense
Net Community Benefit Expense6776847NetCommunityBenefitExpense
Percent Of Total Expense0.00820PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs21NumberOfActivitiesOrPrograms
Persons Served25707PersonsServed
Total Community Benefit Expense66681301TotalCommunityBenefitExpense
Direct Offsetting Revenue45945427DirectOffsettingRevenue
Net Community Benefit Expense20735874NetCommunityBenefitExpense
Percent Of Total Expense0.02510PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served80PersonsServed
Total Community Benefit Expense4254500TotalCommunityBenefitExpense
Net Community Benefit Expense4254500NetCommunityBenefitExpense
Percent Of Total Expense0.00510PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense96736276TotalCommunityBenefitExpense
Direct Offsetting Revenue65436276DirectOffsettingRevenue
Net Community Benefit Expense31300000NetCommunityBenefitExpense
Percent Of Total Expense0.03780PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs7NumberOfActivitiesOrPrograms
Persons Served41481PersonsServed
Total Community Benefit Expense557612TotalCommunityBenefitExpense
Net Community Benefit Expense557612NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs99NumberOfActivitiesOrPrograms
Persons Served750377PersonsServed
Total Community Benefit Expense175006536TotalCommunityBenefitExpense
Direct Offsetting Revenue111381703DirectOffsettingRevenue
Net Community Benefit Expense63624833NetCommunityBenefitExpense
Percent Of Total Expense0.07690PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs100NumberOfActivitiesOrPrograms
Persons Served751477PersonsServed
Total Community Benefit Expense177706536TotalCommunityBenefitExpense
Direct Offsetting Revenue111381703DirectOffsettingRevenue
Net Community Benefit Expense66324833NetCommunityBenefitExpense
Percent Of Total Expense0.08020PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served7500PersonsServed
Total Community Building Expense40000TotalCommunityBuildingExpense
Net Community Building Expense40000NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served550050PersonsServed
Total Community Building Expense1220000TotalCommunityBuildingExpense
Net Community Building Expense1220000NetCommunityBuildingExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served225PersonsServed
Total Community Building Expense322000TotalCommunityBuildingExpense
Net Community Building Expense322000NetCommunityBuildingExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served557775PersonsServed
Total Community Building Expense1582000TotalCommunityBuildingExpense
Net Community Building Expense1582000NetCommunityBuildingExpense
Percent Of Total Expense0.00190PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$6,219,754BadDebtExpenseAmount
Amount Reimbursed By Medicare2282110AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare2282110CostOfCareReimbursedByMedicare

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL LOS ANGELESBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line14650 SUNSET BLVDAddressLine1
CityLOS ANGELESCity
StateCAState
ZIP Code900270982ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Childrens HospitalXChildrensHospital
Teaching HospitalXTeachingHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL LOS ANGELESBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA Conducted1CHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into Account1TakeIntoAccount
Other Facilities0OtherFacilities
CHNA Widely Available1CHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs Addressed0AllNeedsAddressed
Organization Incur Excise Tax0OrganizationIncurExciseTax
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent350.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Average Negotiated RatesXAverageNegotiatedRates
Medicare RateXMedicareRate
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6219754.
PART II: THE HOSPITAL SPONSORS VARIOUS COMMUNITY SERVICES TO BENEFIT THE PHYSICALLY, MENTALLY AND GENETICALLY DISABLED AS PART OF ITS CHARITABLE MISSION. THESE SERVICES INCLUDE PARENTAL COUNSELING, EDUCATIONAL SEMINARS, FAMILY SUPPORT GROUPS, AND AN OUTREACH ORGANIZATION FOR FAMILIES ADMINISTERED BY THE HOSPITAL IN AN AGENCY RELATIONSHIP AND FUNDED BY THE STATE OF CALIFORNIA. ADDITIONALLY, A LARGE NUMBER OF HEALTH-RELATED EDUCATIONAL PROGRAMS ARE PROVIDED FOR THE BENEFIT OF THE COMMUNITY, INCLUDING HEALTH ENHANCEMENTS AND WELLNESS, TELEPHONE INFORMATION SERVICES, AND PROGRAMS DESIGNED TO IMPROVE THE GENERAL STANDARDS OF THE HEALTH OF THE COMMUNITY.
PART III, LINE 4: THE HOSPITAL RECOGNIZES PATIENT SERVICE REVENUE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED FOR THOSE PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE. FOR UNINSURED PATIENTS WHO DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). PATIENTS COVERED BY INSURANCE, BUT REQUIRED TO PAY DEDUCTIBLES OR COPAYMENTS, ARE CONSIDERED TO BE UNINSURED FOR THOSE PORTIONS. BASED ON HISTORICAL EXPERIENCE, THE HOSPITAL BELIEVES THAT A SIGNIFICANT PORTION OF ITS PATIENT ACCOUNTS WILL BE UNCOLLECTIBLE. THUS, IT RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO PATIENT ACCOUNTS IN THE PERIOD THE SERVICES ARE PROVIDED. BAD DEBTS ARE NOT INCLUDED AS COMMUNITY BENEFITS AND CONTAIN -0- CHARITY COST. BAD DEBTS ARE CALCULATED BASED ON UNCOLLECTIBLE ACCOUNTS NET OF CONTRACTUALS.
PART III, LINE 8: CHLA IS NOT INCLUDING ANY MEDICARE SHORTFALL AS PART OF ITS COMMUNITY BENEFIT. FURTHER, CHLA USES FEDERAL MEDICARE COST ALLOCATION METHODOLOGY, AS REPORTED IN ITS MEDICARE COST REPORT, TO DETERMINE THE ALLOWABLE COSTS OF CARE RELATING TO MEDICARE PAYMENTS RECEIVED.
PART III, LINE 9B: THE HOSPITAL'S POLICY STATES THAT IF THE PATIENT/GUARANTOR IS UNABLE TO PAY FOR SERVICES DUE TO THEIR CURRENT FINANCIAL SITUATION, THEY COULD BE ELIGIBLE FOR UNCOMPENSATED CARE, IN WHICH CASE THE HOSPITAL'S APPLICABLE POLICY AND PROCEDURE IS FURTHER REFERENCED. IF THE PATIENT/GUARANTOR DOES NOT QUALIFY, THE HOSPITAL FOLLOWS ALL APPLICABLE FEDERAL AND STATE GUIDELINES FOR DEBT COLLECTION, INCLUDING THE REQUIREMENT OF FAIR TREATMENT, THE PROHIBITION OF MAKING FALSE STATEMENTS AND RESTRICTIONS ON THE TIME OF DAY THAT DEBT COLLECTORS MAY CONTACT THE DEBTOR.
PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY THE ADVANCEMENT PROJECT HEALTHY CITY, BIEL CONSULTING AND THE OFFICE OF COMMUNITY AFFAIRS AT CHILDREN'S HOSPITAL LOS ANGELES. OTHER INSTITUTIONS, ORGANIZATIONS AND AGENCIES-AS WELL AS MEMBERS OF THE CHILDREN'S HOSPITAL COMMUNITY BENEFIT ADVISORY COMMITTEE-ALSO CONTRIBUTED TIME AND RESOURCES TO ASSIST WITH THIS ASSESSMENT.THE ADVANCEMENT PROJECT HEALTHY CITY IS AN INFORMATION AND ACTION RESOURCE ORGANIZATION THAT CREATED THE FOCUSED DATA MAPS USED IN THE ASSESSMENT. MELISSA BIEL OF BIEL CONSULTING CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT. BIEL CONSULTING IS AN INDEPENDENT CONSULTING FIRM THAT WORKS WITH HOSPITALS, CLINICS AND COMMUNITY-BASED NONPROFIT ORGANIZATIONS. DR. BIEL HAS OVER 10 YEARS OF EXPERIENCE CONDUCTING HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENTS.SOURCES OF DATA INCLUDE THE U.S. CENSUS 2010 DECENNIAL CENSUS AND AMERICAN COMMUNITY SURVEY, CALIFORNIA HEALTH INTERVIEW SURVEY, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, CALIFORNIA EMPLOYMENT DEVELOPMENT DEPARTMENT, LOS ANGELES COUNTY HEALTH SURVEY, LOS ANGELES HOMELESS SERVICES AUTHORITY, UNIFORM DATA SET, CDC NATIONAL HEALTH STATISTICS, NATIONAL CANCER INSTITUTE, U.S. DEPARTMENT OF EDUCATION, AND OTHERS. WHEN PERTINENT, THESE DATA SETS ARE PRESENTED IN THE CONTEXT OF CALIFORNIA STATE.TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. TWENTY INTERVIEWS WERE COMPLETED DURING MARCH AND APRIL 2013. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS. ADDITIONALLY, INPUT WAS OBTAINED FROM LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH OFFICIALS. FOR THE INTERVIEWS, COMMUNITY STAKEHOLDERS IDENTIFIED BY KEY DEPARTMENTS AT CHILDREN'S HOSPITAL LOS ANGELES WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS, OR REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE "CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY."CHILDREN'S HOSPITAL LOS ANGELES
PART V, SECTION B, LINE 7: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), HEALTH AND SOCIAL NEEDS WERE IDENTIFIED THROUGH AN EXAMINATION OF PRIMARY AND SECONDARY DATA AND THEN PRIORITIZED THROUGH A STRUCTURED PROCESS USING THE RELATIVE WORTH METHOD. THIS METHOD IS A RANKING STRATEGY WHERE EACH PARTICIPANT IN THE PROCESS RECEIVED A FIXED NUMBER OF POINTS TO RANK EACH IDENTIFIED NEED. THE PRIORITY AREAS THAT ARE BEING ADDRESSED ARE: ACCESS TO CARE, HEALTH PROMOTION AND PREVENTION, OBESITY AND WORKFORCE DEVELOPMENT. OTHER HEALTH AND SOCIAL NEEDS THAT WERE IDENTIFIED, SUCH AS MENTAL HEALTH, CHRONIC DISEASE CONDITIONS, COMMUNITY SAFETY, AND EARLY CHILDHOOD DEVELOPMENT, ARE ALREADY BEING ADDRESSED BY OTHER LOCAL AND REGIONAL COMMUNITY ORGANIZATIONS.CHILDREN'S HOSPITAL LOS ANGELES
PART V, SECTION B, LINE 19D: THE HOSPITAL WILL CHARGE THE GREATER OF THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS DETERMINED BY THE FOLLOWING METHODS: - LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE - AVERAGE OF ITS THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES - MEDICARE RATESCHILDREN'S HOSPITAL LOS ANGELES
PART I, LINE 7B:IN OCTOBER 2010, CMS APPROVED LEGISLATION ENACTED BY THE STATE OF CALIFORNIA THAT PROVIDED FOR SUPPLEMENTAL MEDI-CAL PAYMENTS TO BE PAID TO CERTAIN HOSPITALS FROM FUNDS COLLECTED FROM PARTICIPATING HOSPITALS UNDER THE STATE'S QUALITY ASSURANCE FEE PROGRAM. SUCH AMOUNTS WERE ALLOCATED AND PAID TO CHLA BASED ON PRIOR YEAR PATIENT DATA, WHICH INCLUDES MEDI-CAL PATIENTS. IF THESE AMOUNTS HAD NOT BEEN INCLUDED, THE HOSPITAL WOULD HAVE REPORTED A TOTAL COMMUNITY BENEFIT PERCENTAGE IN EXCESS OF 21%.
PART VI, LINE 2: CHILDREN'S HOSPITAL LOS ANGELES RECOGNIZES THE IMPORTANCE OF KNOWING AND UNDERSTANDING THE KEY INDICATORS OF ITS COMMUNITY'S HEALTH AND THE ISSUES THAT AFFECT PATIENTS, PARENTS, AND COMMUNITY ORGANIZATIONS. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY THE ADVANCEMENT PROJECT HEALTHY CITY, BIEL CONSULTING AND THE OFFICE OF COMMUNITY AFFAIRS AT CHILDREN'S HOSPITAL LOS ANGELES. OTHER INSTITUTIONS, ORGANIZATIONS AND AGENCIES-AS WELL AS MEMBERS OF THE CHILDREN'S HOSPITAL COMMUNITY BENEFIT ADVISORY COMMITTEE-ALSO CONTRIBUTED TIME AND RESOURCES TO ASSIST WITH THIS ASSESSMENT. CONDUCTING THE COMMUNITY HEALTH NEEDS ASSESSMENT IS ONE OF THE MANY WAYS THAT CHILDREN'S HOSPITAL LOS ANGELES STRENGTHENS ITS COMMITMENT TO UNDERSTANDING THE HEALTH NEEDS OF THE COMMUNITIES IT SERVES. NEEDS ASSESSMENTS ARE THE PRIMARY TOOLS USED TO DETERMINE A HOSPITAL'S "COMMUNITY BENEFIT" PLANS, THAT IS, HOW THE HOSPITAL WILL ADDRESS UNMET COMMUNITY NEEDS THROUGH THE PROVISION OF COMMUNITY HEALTH SERVICES.
PART VI, LINE 3: THE OFFICE OF COMMUNITY AFFAIRS AT CHILDREN'S HOSPITAL LOS ANGELES HELPS FAMILIES ACCESS AVAILABLE COMMUNITY RESOURCES, INCLUDING LOW-COST HEALTH INSURANCE COVERAGE AND HEALTH PROGRAMS. IN FY 2013, THE OFFICE OF COMMUNITY AFFAIRS ASSISTED MORE THAN 350 CHILDREN AND FAMILIES IN ACCESSING NEW HEALTH INSURANCE COVERAGE AND REACHED MORE THAN 47,000 CHILDREN AND FAMILIES THROUGH OUTREACH CAMPAIGNS PROMOTING AWARENESS OF AVAILABLE ACCESS TO HEALTH PROGRAMS.
PART VI, LINE 4: OUR HOSPITAL SERVICES REACH THOUSANDS ACROSS LOS ANGELES COUNTY--A REGION THAT SPANS 4,000 SQUARE MILES AND INCLUDES VAST URBAN COMMUNITIES, SUBURBAN AREAS AND RURAL NEIGHBORHOODS. LOS ANGELES COUNTY IS HOME TO MORE THAN 10 MILLION RESIDENTS, WHO COME FROM AROUND THE WORLD AND SPEAK MORE THAN 140 LANGUAGES. IT IS THE MOST POPULOUS COUNTY IN THE NATION--AND ONE OF THE MOST ETHNICALLY AND RACIALLY DIVERSE. THE HOSPITAL IS PHYSICALLY LOCATED IN THE METRO AREA OF THE CITY OF LOS ANGELES. IT IS A REGIONAL, TERTIARY HEALTHCARE FACILITY THAT SERVES PATIENTS THROUGHOUT L.A. COUNTY AND BEYOND AND IS THE ONLY LEVEL 1 PEDIATRIC TRAUMA CENTER BETWEEN SAN FRANCISCO AND SAN DIEGO.
PART VI, LINE 5: AT CHILDREN'S HOSPITAL LOS ANGELES, PROVIDING HEALTH CARE TO PATIENTS AND THEIR FAMILIES DOESN'T STOP AT THE HOSPITAL WALLS. THE STAFF IS ACTIVELY ENGAGED WITHIN THE COMMUNITY, PROVIDING PREVENTATIVE SERVICES AND ACCESS TO HEALTH CARE.--TRANSITIONING FROM PEDIATRIC TO ADULT CARE - IN 2002, A CONSENSUS DOCUMENT BETWEEN THE AMERICAN ACADEMY OF PEDIATRICS, THE AMERICAN ACADEMY OF FAMILY PHYSICIANS AND THE AMERICAN COLLEGE OF PHYSICIANS-AMERICAN SOCIETY OF INTERNAL MEDICINE STATED THAT, "THE GOAL OF TRANSITION IN HEALTH CARE FOR YOUNG ADULTS WITH SPECIAL HEALTH CARE NEEDS IS TO MAXIMIZE LIFELONG FUNCTIONING AND POTENTIAL THROUGH THE PROVISION OF HIGH-QUALITY, DEVELOPMENTALLY APPROPRIATE HEALTH CARE SERVICES THAT CONTINUE UNINTERRUPTED AS THE INDIVIDUAL MOVES FROM ADOLESCENCE TO ADULTHOOD." IN JULY 2012, THE WHH FOUNDATION SUPPORTED THE LAUNCH OF AN EFFORT TO ESTABLISH A CHILDREN'S HOSPITAL LOS ANGELES ADOLESCENT AND YOUNG ADULT (AYA) TRANSITION CORE INFRASTRUCTURE. THE INFRASTRUCTURE IS DESIGNED TO SUPPORT THE HOSPITAL'S EXISTING AND EMERGING EFFORTS TO PROVIDE HIGH-QUALITY, COORDINATED AND COMPREHENSIVE TRANSITION SERVICES TO ALL PATIENTS LIVING WITH CHRONIC ILLNESS AND DISABILITY.-- AUTISM WARM PHONE LINE - THE BOONE FETTER CLINIC AT CHILDREN'S HOSPITAL LOS ANGELES PROVIDES COMPREHENSIVE DIAGNOSTIC SERVICES FOR CHILDREN WITH AUTISM AND OTHER NEURODEVELOPMENTAL AND BEHAVIORAL DISORDERS. IT ALSO PROVIDES EARLY SCREENING AND IDENTIFICATION, AS WELL AS ONGOING MEDICAL FOLLOW-UP AND CARE COORDINATION. IN ADDITION, THE CLINIC SERVES AS A VALUABLE RESOURCE TO OUR COMMUNITY THROUGH ITS AUTISM WARM PHONE LINE. THE PHONE LINE HELPS FAMILIES FIND ANSWERS TO QUESTIONS ABOUT THEIR CHILDREN'S HEALTH NEEDS AND SERVICES AVAILABLE, AND ALSO TO NAVIGATE VARIOUS HEALTH SYSTEMS IN LOS ANGELES COUNTY. --FAITH-BASED PARTNERSHIPS FOR INJURY PREVENTION BUCKLE UP FOR LIFE - THE INJURY PREVENTION PROGRAM HAS CONDUCTED THE BUCKLE UP FOR LIFE PROGRAM AT 14 CHURCHES SINCE 2010. THROUGH 136 EVENTS, WORKSHOPS AND PROGRAMS CONDUCTED AT VARIOUS FAITH-BASED SITES AND COMMUNITY VENUES, THE PROGRAM HAS PROVIDED VALUABLE EDUCATION ON CHILD PASSENGER SAFETY, PEDESTRIAN SAFETY, SAFE DRIVING, HOME SAFETY AND DISASTER PREPAREDNESS. THIS PAST YEAR, MORE THAN 2,000 FAITH-BASED COMMUNITY MEMBERS AND 3,000 FAMILIES RECEIVED INJURY PREVENTION EDUCATION FROM CHILDREN'S HOSPITAL STAFF MEMBERS. IN THIS SAME PERIOD, MORE THAN 700 CHILD RESTRAINTS WERE INSPECTED, 344 CHILD RESTRAINTS WERE DISTRIBUTED AND 141 WERE REPLACED - DEMONSTRATING THE IMPACT OF THESE CHILD PASSENGER SAFETY EFFORTS IN LOS ANGELES COUNTY.--NICCU FAMILY SUPPORT PROGRAM - THE NEWBORN AND INFANT CRITICAL CARE UNIT (NICCU) AT CHILDREN'S HOSPITAL LOS ANGELES IS A DESIGNATED CALIFORNIA CHILDREN'S SERVICES REGIONAL CENTER. IN COLLABORATION WITH THE MARCH OF DIMES, CHILDREN'S HOSPITAL LOS ANGELES PROVIDES A PERSONALIZED FAMILY SUPPORT PROGRAM FOR FAMILIES IN OUR NICCU. --TEEN IMPACT AND FAMILY SUPPORT PROGRAM - SINCE 1988, THE TEEN IMPACT AND FAMILY SUPPORT PROGRAM AT CHILDREN'S HOSPITAL LOS ANGELES HAS OFFERED GROUP-BASED PSYCHOLOGICAL, EMOTIONAL AND SOCIAL SUPPORT SERVICES FOR YOUNG PEOPLE DIAGNOSED WITH CANCER OR A BLOOD DISEASE, AS WELL AS THEIR PARENTS AND SIBLINGS. IN THE PAST YEAR, THE PROGRAM REACHED 100 UNIQUE FAMILIES, INCLUDING 30 FIRST-TIME PARTICIPANTS. FIFTEEN UNIQUE INPATIENTS PARTICIPATED IN THE WEEKLY INPATIENT GROUP, AND 45 TEENS TOOK PART IN THE THREE-DAY RETREAT. HALF OF THESE RETREAT PARTICIPANTS WERE NEW TO TEEN IMPACT. THE PROGRAM ALSO TRAINED 15 YOUNG-ADULT SURVIVOR COUNSELORS. -- LANGUAGE INTERPRETATION SERVICES - CHILDREN'S HOSPITAL LOS ANGELES WAS ONE OF THE FIRST HOSPITALS IN THE NATION TO INSTITUTE A FORMAL DIVERSITY SERVICES DEPARTMENT WITH SERVICES THAT MEET THE CULTURALLY AND LINGUISTICALLY APPROPRIATE STANDARDS (CLAS) OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, OFFICE OF MINORITY HEALTH. THIS PAST YEAR, THE TEAM OVERALL PROVIDED NEARLY 37,000 IN-PERSON VISITS FOR LANGUAGE SERVICES ACROSS OUR CLINICS, THE HOSPITAL AND THE EMERGENCY DEPARTMENT. THE TEAM PROVIDED MORE THAN 67,400 MINUTES OF LANGUAGE SERVICES VIA VIDEO REMOTE, AND MORE THAN 267,000 MINUTES BY TELEPHONE. -- PROJECT NATEEN: L.A. FATHERS PROGRAM - PROJECT NATEEN'S L.A. FATHERS PROGRAM IS PART OF THE DIVISION OF ADOLESCENT AND YOUNG ADULT MEDICINE AT CHILDREN'S HOSPITAL LOS ANGELES. THE PROGRAM WAS DEVELOPED TO ADDRESS THE ENVIRONMENTAL AND SOCIO-ECONOMIC FACTORS THAT CONTRIBUTE TO THE VARIOUS DIFFICULTIES FACED BY YOUNG FATHERS IN LOS ANGELES-SPECIFICALLY YOUNG FATHERS AGES 15 THROUGH 25 IN THE METROPOLITAN AREA OF THE CITY. AVERAGE INCOME LEVELS IN THIS COMMUNITY ARE THE SECOND-LOWEST IN ALL OF LOS ANGELES COUNTY. THE COMMUNITY ALSO HAS A HIGH RATE OF CRIME AND GANG ACTIVITY. THROUGH PROJECT NATEEN, PREGNANT AND PARENTING TEENS RECEIVE A FULL SPECTRUM OF SUPPORTIVE SERVICES, INCLUDING HEALTH EDUCATION, PARENT EDUCATION AND COMPREHENSIVE CASE MANAGEMENT AND COUNSELING.--RISK REDUCTION PROGRAM - HOUSED IN THE DIVISION OF ADOLESCENT AND YOUNG ADULT MEDICINE AT CHILDREN'S HOSPITAL LOS ANGELES, THE RISK REDUCTION PROGRAM (RRP) IS ONE OF THE LARGEST YOUTH-SPECIFIC HIV PROGRAMS IN THE COUNTRY. THE PROGRAM PROVIDES STATE-OF THE-ART COMPREHENSIVE HEALTH AND PSYCHOSOCIAL TREATMENT FOR YOUTHS THROUGH AGE 24 WHO ARE LIVING WITH HIV, AS WELL AS SPECIALIZED HIV PREVENTION SERVICES FOR YOUTH. RRP ALSO PROVIDES RESEARCH AND CAPACITY-BUILDING SERVICES FOR YOUNG GAY AND BISEXUAL MEN, TRANSGENDER YOUTH AND YOUNG TRANSGENDER PERSONS OF COLOR.-- DETECTING EARLY CHILDHOOD HEARING LOSS - A COLLABORATIVE STUDY BETWEEN THE SABAN RESEARCH INSTITUTE OF CHILDREN'S HOSPITAL LOS ANGELES, THE JOHN TRACY CLINIC AND THE UNIVERSITY OF CALIFORNIA, LOS ANGELES (UCLA) DAVID GEFFEN SCHOOL OF MEDICINE FOUND THAT HEARING SCREENINGS CONDUCTED DURING ROUTINE DOCTOR VISITS ARE FEASIBLE AND EFFECTIVE IN DETECTING POSTNATAL HEARING LOSS. DATA FOR THE STUDY WAS GATHERED THROUGH THE BABY SOUND CHECK PROJECT, A THREE-YEAR PILOT PROGRAM LAUNCHED IN 2007 BY THE JOHN TRACY CLINIC TO FILL CRITICAL GAPS IN THE EARLY DETECTION AND TREATMENT OF HEARING LOSS. THE STUDY ESTABLISHED PROTOCOLS FOR DOCTORS AND MEDICAL ASSISTANTS IN FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) IN LOS ANGELES TO CONDUCT HEARING SCREENINGS ON CHILDREN 0-3 YEARS OLD DURING ROUTINE WELL-CHILD CHECKS.
PART VI, LINE 6: CHILDREN'S HOSPITAL LOS ANGELES IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
CAREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1CALIFORNIA HEALTH FOUNDATION AND TRUSTBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11215 K STREET SUITE 800AddressLine1
CitySACRAMENTOCity
StateCAState
ZIP Code95814ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient941498687EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant7223810AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Purpose Of GrantSUPPORT CHARITABLE ACTIVITES AT HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIAPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: GRANTS WILL ONLY BE MADE TO 501(C)(3) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Discretionary Spending AccountXDiscretionarySpendingAccount
Housing Allowance Or ResidenceXHousingAllowanceOrResidence
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (18 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
RICHARD CORDOVA
PRESIDENT & CEO/TRUSTEE6378360100000035219075000460340826589000
MARY DEE HACKER
TRUSTEE/VP PATIENT CARE24386605934008292304822602256604569210546540
HENRI FORD MD
TRUSTEE/FAC PHYSICIAN/VP60187500012140600000723281000
STUART SIEGEL MD
TRUSTEE/FACULTY PHYSICIAN417256000000000417256000
BRENT POLK MD
TRUSTEE/FACULTY PHYSICIAN584283000000000584283000
MARK D KRIEGER MD
FACULTY PHYSICIAN161623000000000161623000
DIEMLAN LANNIE TONNU
SVP/CFO/TREASURER38269009157508594507535302579606613590519100
LAWRENCE FOUST
SVP-GEN COUNSEL/SEC32375507879307420606705501480305586120572060
RODNEY HANNERS
SVP OPERATIONS/COO3770250890010357980592570380880599169000
CLAUDIA LOONEY
SVP-DEVELOPMENT3060410794400366672057191023393083273703496720
GAIL MARGOLIS
VP, GOVERNMENT & PUBLIC POLICY2359000534640222930468440104710368972000
KEITH HOBBS
VP, ANCILLARY & SUPPORT SERVICES228168051613098010372960195340346412000
DEANN MARSHALL
SVP, CHIEF DEV & MKTG OFFICER29446506187409038105844301364705188100396450
TIM MALSEED
AVP, CHIEF APPLICATIONS OFFICER254565035100032476043097082903660670217590
MARTY MILLER
VP, CHIEF INFORMATION OFFICER26951304903803084101290703074803930470189510
ROBERT ADLER MD
FORMER TRUSTEE/FACULTY PHYSICIAN306157000000000306157000
ROBERT KAY MD
FORMER TRUSTEE/FACULTY PHYSICIAN153812000000000153812000
ROBERTA WILLIAMS MD
FORMER TRUSTEE/FACULTY PHYSICIAN280870000000000280870000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AHENRI FORD RECEIVED A HOUSING ALLOWANCE OF $121,406 IN CALENDAR YEAR 2012, WHICH WAS TREATED AS TAXABLE COMPENSATION. RICHARD CORDOVA HAS A DISCRETIONARY SPENDING ACCOUNT OF $36,000 FOR CALENDAR YEAR 2012. THIS ACCOUNT IS TO BE USED FOR CHLA BUSINESS ACTIVITIES IN HIS ROLE AS CEO. THIS AMOUNT WAS REPORTED AS TAXABLE INCOME ON HIS FORM W-2.
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATED IN CHLA'S 457(F) PLAN, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. AMOUNTS DEFERRED UNDER SECTION 457(F) PLAN ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WILL BE REPORTED AS COMPENSATION FOR THE YEAR PAID. AMOUNTS RECOGNIZED AS TAXABLE COMPENSATION ON THE EMPLOYEE'S 2012 FORM W-2 REFLECT PAYMENTS RECEIVED BY THE EMPLOYEE DURING CALENDAR YEAR 2012 THAT WERE PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEAR FORM 990S: DIEMLAN (LANNIE) TONNU - $51,910 CLAUDIA LOONEY - $349,672 LAWRENCE FOUST - $57,206 MARY DEE HACKER - $54,654 DEANN MARSHALL - $39,645 TIM MALSEED - $21,759 MARTY MILLER - $18,951
PART I, LINE 7CHLA MAINTAINS AN EXECUTIVE BONUS PROGRAM THAT AWARDS INCENTIVE COMPENSATION BASED UPON ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES INCLUDING HEALTH OUTCOMES, QUALITY IMPROVEMENT, LEVEL OF COMMUNITY BENEFIT PROVIDED AND OTHER MEASURES AS DETERMINED ANNUALLY BY THE COMPENSATION COMMITTEE. ALTHOUGH THE AMOUNT OF BONUS INCENTIVES THAT EACH EMPLOYEE MAY BE GRANTED IS BASED ON A FIXED FORMULA, THE COMPENSATION COMMITTEE HAS THE DISCRETION TO DETERMINE THE EXTENT OF THE GOALS THAT HAVE BEEN MET BY EACH EMPLOYEE. PART VII, LINE 5: PURSUANT TO THE AFFILIATE AGREEMENT WITH THE UNIVERSITY OF SOUTHERN CALIFORNIA ("USC"), AN UNRELATED ORGANIZATION, THE FOLLOWING COMPENSATION AMOUNTS WERE PAID TO THE FOLLOWING INDIVIDUALS. USC WAS SUBSEQUENTLY REIMBURSED BY CHLA FOR THE AMOUNTS: ROBERT ADLER, M.D. (FORMER) - $306,157 HENRI FORD, M.D. - $601,875 ROBERT KAY, M.D. (FORMER) - $153,812 STUART E. SIEGEL, M.D. - $417,256 ROBERTA G. WILLIAMS, M.D. (FORMER) - $280,870 BRENT POLK, M.D. - $584,283 MARK D. KRIEGER, M.D. - $161,623 IN ADDITION TO HER FUNDRAISING ACTIVITIES, BONNIE MCCLURE ALSO ADMINISTERS THE HOSPITAL'S PHOTOGRAPHIC AND MEMORABILIA ARCHIVES AND ADMINISTERS THE TOUR DOCENT PROGRAM. SHE WAS COMPENSATED $64,000 FOR HER SERVICES.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY INSURED REVENUE BOND
A680164610130795CQ82007-04-24170792342FINANCED THE COSTS OF MAJOR EXPANSION AND MODERNIZATION OF THE HOSPITAL000
CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY INSURED REVENUE BOND
B680164610NONEAVAIL2009-12-1829865000REFUNDED SERIES 2008 BONDS100
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY INSURED REVENUE BONDS
C52164382813033LHC42010-05-20186024080REFUNDED SERIES 2004 & 2008 BONDS AND A PORTION OF SERIES 1999 CERTIFICATE100
CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY INSURED REVENUE BONDS
D52164382813033LB222012-08-15182930717REFUNDED SERIES 2009 AND 2010B AND 1999000

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount Bond DefeasedAmountBondDefeasedCredit EnhancementCreditEnhancement
A1707923421500000930122515999111720090011
B298650002010101130000000
C186024080264479820111011510000005213423
D182930717231072220131011

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUseBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A001000.008000.00800000
B0000000
C0000000
D0000000

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Term Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
GOLDMAN SACHS & CO
A0001010.100000000000011AIG MATCHED FUNDING1.400000000000100
(no name)
B000110000
(no name)
C000110000
(no name)
D000110000

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
A1
B1
C1
D1

Form990 Schedule K Part VI Form990ScheduleKPartVI (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE K PART IV, ARBITRAGE, LINE 2CDATE REBATE COMPUTATION PERFORMEDISSUER NAME: CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY INSURED DATE THE REBATE COMPUTATION WAS PERFORMED: 04/23/2013
SCHEDULE K SUPPLENTAL INFORMATIONPART III, LINE 3B AND 3D: WHILE CHLA DOES NOT ROUTINELY ENGAGE BOND COUNSEL OR OTHER OUTSIDE COUNSEL TO REVIEW ANY CONTRACTS OR AGREEMENTS RELATING TO TAX-EXEMPT BOND-FINANCED PROPERTY, CHLA UTILIZES ITS FULL-TIME IN-HOUSE LEGAL DEPARTMENT TO REVIEW ANY SUCH CONTRACTS. CHLA'S GENERAL COUNSEL'S OFFICE HAS DEVELOPED INTERNAL PROCEDURES FOR REVIEWING CONTRACTS RELATING TO TAX-EXEMPT BOND-FINANCED PROPERTIES TO ENSURE COMPLIANCE WITH PROPER SAFE HARBORS. PART IV, LINE 4C, COLUMN A: THERE WERE TWO CONTRACTS WITH THE PROVIDER, ONE WITH A TERM OF 1.3 YEARS, THE OTHER WITH A TERM OF 2.3 YEARS.
PART III, LINE 9:CHLA DOES NOT HAVE ANY NONQUALIFIED BONDS.
PART IV, LINE 2C:BOND A: CALCULATION PERFORMED ON 04/23/2013. BOND B: BOND WAS DEFEASED ON 08/15/2012. BOND C: CALCULATION PERFORMED ON 10/01/2012. BOND D: CALCULATION IS NOT YET DUE ON THIS BOND.

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonHENRI R FORD MDNamePerson
Relationship With OrganizationDIRECTOR OF CHLAMG, VICE PRESIDENT AND CHIEF OF SURGERYRelationshipWithOrganization
Purpose Of LoanHOUSING ASSISTANCEPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$237,495OriginalPrincipalAmount
Balance Due45149BalanceDue
Default0Default
Approved By Board1ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due45149TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (14 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MR WILLIAM H HURT TRUSTEE
CHAIRMAN OF CAPITAL STRATEGY RESEARCH, INC. (AN AFFILIATE OF CGT)133110THE HOSPITAL HAS INVESTMENT ACCOUNTS WITH CAPITAL GUARDIAN TRUST (CGT).0
MR ALAN PURWIN TRUSTEE
PRESIDENT OF HELINET AVIATION194822PROVIDES HELICOPTER TRANSPORTATION SERVICES FOR THE HOSPITAL.0
MR ALEX CHAVES SR TRUSTEE
OWNER OF PARKING COMPANY OF AMERICA3172494PROVIDES PARKING SERVICES FOR THE HOSPITAL.0
THEODORE R SAMUELS TRUSTEE
SR. VP AND DIRECTOR OF CAPITAL GUARDIAN TRUST COMPANY133110PAYMENT FOR INVESTMENT SERVICES TO THE HOSPITAL.0
CARL GRUSHKIN MD TRUSTEE
PRESIDENT FOR CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP ("CHLAMG")10750029CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.0
HENRI R FORD MD TRUSTEE
DIRECTOR FOR CHLAMG, CHIEF OF SURGERY10750029CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.0
LISA STEVENS TRUSTEE
EXECUTIVE VP AND REGIONAL PRESIDENT OF WELLS FARGO & CO.300490PAYMENT FOR BANKING SERVICES AS WELL AS REPAYMENT OF HOUSING MORTGAGE.0
KIMBERLY SHEPHERD TRUSTEE
HER MOTHER IS A TRUSTEE OF UNIVERSITY OF SOUTHERN CALIFORNIA0REIMBURSEMENT OF FACULTY SALARIES TO USC BY CHLA. ZERO AMOUNT REFLECTS REIMBURSEMENT NATURE OF TRANSACTION.0
MEGAN HERNANDEZ TRUSTEE
HUSBAND IS ENRIQUE HERNANDEZ, FOUNDER AND HEAD OF INTER-CON SECURITY SYSTEM2573151PROVIDES PRIVATE SECURITY SERVICES FOR THE HOSPITAL.0
BRENT POLK TRUSTEE
DIRECTOR FOR CHLAMG10750029CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.0
ROBERT ADLER FORMER TRUSTEE
DIRECTOR FOR CHLAMG10750029CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.0
CARMEN PULIAFITO TRUSTEE
DEAN OF USC AND DIRECTOR FOR CHLAMG10750029CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS. ALSO, INCLUDES THE REIMBURSEMENT OF FACULTY SALARIES TO USC BY CHLA.0
MARTHA N CORBETT TRUSTEE
PARTNER, PRICEWATERHOUSECOOPERS LLP248873PAYMENT FOR CONSULTING SERVICES RELATED TO REVENUE ENHANCEMENTS.0
ALAN WILSON
SR. VP AND DIRECTOR OF CAPITAL GUARDIAN TRUST COMPANY133110PAYMENT FOR INVESTMENT SERVICES TO THE HOSPITAL.0

Schedule M IRS990ScheduleM

Works Of Art WorksOfArt

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F99052050NoncashContribsRptdF990
Method Of Determining RevenuesFMV APPRAISALMethodOfDeterminingRevenues

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions37NumberOfContributions
Noncash Contribs Rptd F990726743NoncashContribsRptdF990
Method Of Determining RevenuesCOST OR SELLING PRICEMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionIKEA TOYSDescription
Number Of Contributions3NumberOfContributions
Noncash Contribs Rptd F9903978NoncashContribsRptdF990
Method Of Determining RevenuesCOST OR SELLING PRICEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received4NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used1ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierTHIRD PARTY USE:Identifier
Return ReferencePART I, LINE 32B:ReturnReference
ExplanationTHE HOSPITAL USES BROKERAGE HOUSES TO SELL NON-CASH CONTRIBUTIONS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE CONSISTS OF ONLY ACTIVE, VOTING MEMBERS OF THE BOARD OF TRUSTEES AND IS COMPOSED OF THE CO-CHAIRPERSONS OF THE BOARD; THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE HOSPITAL; THE CHAIRPERSONS OF THE BOARD'S FINANCE; AUDIT; SAFETY, QUALITY AND SERVICE; COMPENSATION; GOVERNMENT RELATIONS; INVESTMENT; GOVERNANCE; NOMINATING; AND RESEARCH INSTITUTE COMMITTEES AND SEVERAL OTHER TRUSTEES ELECTED BY THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE MAY ACT WITH THE FULL AUTHORITY OF THE BOARD OF TRUSTEES EXCEPT ON THOSE MATTERS THAT ARE REQUIRED BY LAW OR THE BYLAWS TO BE DECIDED BY THE FULL BOARD OF TRUSTEES. ALL ACTIONS OF THE EXECUTIVE COMMITTEE ARE REFLECTED IN MINUTES OF THE COMMITTEE, CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO BOTH THE EXECUTIVE COMMITTEE AND THE FULL BOARD OF TRUSTEES AT THEIR NEXT MEETINGS.
FORM 990, PART VI, SECTION A, LINE 21. ALAN WILSON (TRUSTEE) - BUSINESS RELATIONSHIPS AMONG THEODORE SAMUELS (TRUSTEE), BILL HURT (TRUSTEE) AND JAMES TERRILE (TRUSTEE) 2. SUSAN MALLORY (TRUSTEE) - BUSINESS RELATIONSHIPS AMONG MARION ANDERSON (TRUSTEE) AND MARCIA HOBBS (TRUSTEE) 3. ELIZABETH LOWE (TRUSTEE) - BUSINESS RELATIONSHIPS AMONG THEODORE SAMUELS (TRUSTEE), JAMES TERRILE (TRUSTEE), ALAN WILSON (TRUSTEE) AND BILL HURT (TRUSTEE)
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED BY DELOITTE TAX LLP, WORKING IN CONJUNCTION WITH CHLA'S FINANCE DEPARTMENT. CHLA'S DIRECTOR OF ACCOUNTING HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE CHIEF FINANCIAL OFFICER. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY AND/OR KNOWLEDGE ABOUT THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE CHIEF FINANCIAL OFFICER AND GENERAL COUNSEL, IN PARTICULAR, REVIEW THE FORM 990 AND ENSURE ACCURACY OF DESCRIPTIONS AND THAT DISCLOSURE IS COMPLETE. THE DRAFT FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF CHLA, ACTING ON BEHALF OF THE BOARD OF TRUSTEES OF CHLA. ONCE THE DRAFT FORM 990 HAS BEEN REVIEWED AND DISCUSSED BY THE AUDIT COMMITTEE, ANY CHANGES RESULTING FROM THEIR REVIEW IS INCORPORATED INTO THE FINAL DRAFT OF THE FORM 990. THE FINAL DRAFT OF THE FORM 990 IS THEN DISTRIBUTED TO THE BOARD OF TRUSTEES VIA A SECURE WEB SITE FOR THEIR REVIEW AND COMMENTS PRIOR TO THE FILING OF THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CCHLA REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REQUIRED TO BE ANSWERED BY ALL OFFICERS AND MEMBERS OF THE BOARD OF TRUSTEES, AS WELL AS CERTAIN KEY EMPLOYEES THAT ARE DESIGNATED ANNUALLY BY THE GOVERNANCE COMMITTEE. THESE ANNUAL DISCLOSURES ARE REVIEWED BY A COMBINATION OF CHLA'S GENERAL COUNSEL, COMPLIANCE OFFICER, CHIEF EXECUTIVE OFFICER, GOVERNANCE COMMITTEE OF THE BOARD AND THE FULL BOARD OF TRUSTEES, DEPENDING ON THE INDIVIDUAL MAKING THE DISCLOSURE. ADDITIONALLY, THE LEGAL DEPARTMENT OF CHLA REVIEWS CONTRACTUAL RELATIONSHIPS ENTERED INTO BY CHLA. FURTHERMORE, BOARD MEMBERS AND OFFICERS ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ON A CONTINUOUS BASIS THROUGHOUT THE YEAR. IF A POTENTIAL CONFLICT EXISTS, THE BOARD OR COMMITTEE DETERMINES WHETHER THE BOARD MEMBER OR OFFICER SHOULD BE EXCLUDED FROM VOTING ON THAT PARTICULAR MATTER.
FORM 990, PART VI, SECTION B, LINE 1515. A. THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF CHLA IS CONDUCTED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF CHLA, ACTING ON BEHALF OF THE BOARD OF TRUSTEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE REPORTED ITS DELIBERATIONS AND DECISIONS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. IN DETERMINING THE CHIEF EXECUTIVE OFFICER'S COMPENSATION DURING THE TAX PERIOD OF THIS INFORMATION RETURN THE COMPENSATION COMMITTEE WORKED WITH AND RELIED UPON THE COUNSEL AND EXPERTISE OF MERCER CONSULTING, A FIRM WITH EXPERIENCE AND EXPERTISE IN THE AREA OF NON-PROFIT ORGANIZATION EXECUTIVE COMPENSATION. MERCER CONSULTING PROVIDED REPORTS TO THE COMPENSATION COMMITTEE, WHICH FURNISHED THE BASIS FOR THE ESTABLISHMENT OF THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE. THEIR REPORTS WERE BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO CHLA BASED ON VARIOUS METRICS SUCH AS HOSPITAL TYPE AND REVENUE. THE COMPENSATION COMMITTEE DELIBERATED ON THE ISSUE OF THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE IN LIGHT OF THESE REPORTS AND QUESTIONS WERE ASKED OF, AND ANSWERED BY, MERCER REGARDING SUCH REPORTS AND OTHER RELEVANT MATTERS. BASED ON SUCH DELIBERATIONS, THE COMPENSATION COMMITTEE NEGOTIATED A WRITTEN CONTRACT WITH THE CEO. 15. B. THE PROCESS FOR DETERMINING THE COMPENSATION OF OFFICERS AND OTHER KEY EMPLOYEES OF CHLA IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT OF CHLA, AND THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF CHLA, ACTING ON BEHALF OF THE BOARD OF TRUSTEES OF THE ORGANIZATION. IN DETERMINING SUCH EMPLOYEE'S COMPENSATION, DURING THE 2012 COMPENSATION SEASON THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WORKED WITH AND RELIED UPON THE COUNSEL AND EXPERTISE OF MERCER CONSULTING, A FIRM WITH EXPERIENCE AND EXPERTISE IN THE AREA OF NON-PROFIT ORGANIZATION EXECUTIVE COMPENSATION. MERCER PROVIDED AN EXECUTIVE COMPENSATION REPORT TO THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WHICH FURNISHED THE BASIS FOR THE ESTABLISHMENT OF SUCH EMPLOYEES' COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. MERCER'S REPORT WAS BASED ON A REVIEW OF EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO CHLA BASED ON VARIOUS METRICS SUCH AS HOSPITAL TYPE AND REVENUE. IN ADDITION, THE CHIEF EXECUTIVE OFFICER MADE A RECOMMENDATION TO THE COMPENSATION COMMITTEE WITH RESPECT TO EACH OF SUCH EMPLOYEES' COMPENSATION PACKAGE IN LIGHT OF THE MERCER REPORT AND IN LIGHT OF THE EXECUTIVE'S PERFORMANCE. AT THE COMPENSATION COMMITTEE MEETING ADDRESSING SUCH MATTERS, QUESTIONS WERE ASKED OF, AND ANSWERED BY, MERCER REGARDING SUCH REPORT AND OTHER RELEVANT MATTERS. BASED ON SUCH DELIBERATIONS, THE COMPENSATION COMMITTEE MADE A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR.
FORM 990, PART VI, SECTION C, LINE 19CHLA DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. CHLA'S FINANCIAL STATEMENTS ARE CONTAINED IN ITS FORM 990, WHICH IS AVAILABLE FOR PUBLIC INSPECTION DURING BUSINESS HOURS.
FORM 990, PART VII, COLUMN B:THE HOURS REPORTED FOR EACH OF THE FACULTY PHYSICIANS RELATES TO THEIR TOTAL COMPENSATION FROM ALL SOURCES AS REPORTED IN COLUMN D OF PART VII.
FORM 990, PART IX, LINE 11GPROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 71,419,391. MANAGEMENT AND GENERAL EXPENSES 11,850,949. FUNDRAISING EXPENSES 623,723. TOTAL EXPENSES 83,894,063. MEDICAL-RELATED SERVICES: PROGRAM SERVICE EXPENSES 11,402,664. MANAGEMENT AND GENERAL EXPENSES 4,055,468. FUNDRAISING EXPENSES 765. TOTAL EXPENSES 15,458,897. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,668,269. MANAGEMENT AND GENERAL EXPENSES 21,210,088. FUNDRAISING EXPENSES 1,350,898. TOTAL EXPENSES 31,229,255.OTHER FEES
FORM 990, PART XI, LINE 9:CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS -193,496. TRANSFERS AND OTHER -2,526,961. CHANGE IN SWAP MARK TO MARKET 5,926,027. INVESTMENT IN DISREGARDED ENTITY 176,068.CHANGES IN NET ASSETS OR FUND BALANCES:
SCHEDULE H, PART VI:LETTER FROM RICHARD CORDOVA, CEO, ON COMMUNITY BENEFIT AT CHILDREN'S HOSPITAL LOS ANGELES: ALL OF OUR ORGANIZATIONAL VALUES ARE IMPORTANT, BUT ONE IN PARTICULAR STANDS OUT TO ME AT THIS MOMENT IN TIME: WE ARE STEWARDS OF THE LIVES AND RESOURCES ENTRUSTED TO US. AS WE TRANSITION OURSELVES DURING A TIME OF GREAT CHANGE IN THE HEALTH CARE INDUSTRY, WE ARE CONSTANTLY LOOKING FOR WAYS TO IMPROVE THE LIVES OF CHILDREN, INCLUDING MORE THAN 100,000 WHO COME THROUGH OUR DOORS EVERY YEAR, AS WELL AS THOSE WHO MAY NEED US AT SOME POINT IN THE FUTURE, AND THOSE WHO WILL NEVER EVEN SET FOOT IN OUR FACILITIES. THOUGH THEY MAY NOT COME TO OUR MAIN FACILITY IN HOLLYWOOD, THEY NOW HAVE MORE OPPORTUNITIES TO VISIT US IN THEIR OWN NEIGHBORHOODS. OUR NEW LOCATIONS IN THE SOUTH BAY AND SANTA MONICA OPENED IN 2013, ADDING TO OUR PRESENCES IN ARCADIA AND VALENCIA. WITH THESE OPENINGS, WE ARE FULFILLING A VISION OF ESTABLISHING CENTERS THAT BRING OUR SPECIAL BRAND OF CARE CLOSER TO FAMILIES WHO NEED IT MOST. THIS IS JUST ONE WAY THAT WE ARE WORKING TO IMPROVE THE COMMUNITIES OF SOUTHERN CALIFORNIA; MANY MORE ARE DETAILED IN THE FOLLOWING PAGES. BUILDING STRONGER COMMUNITIES BUILDS STRONGER CHILDREN, AND VICE VERSA. OUR COMMUNITY BENEFIT EFFORTS ARE ALL WORKING TOWARD THAT GOAL-HELPING CHILDREN BE SAFER, HEALTHIER AND ULTIMATELY STRONGER. THANK YOU FOR TAKING THE TIME TO LEARN A LITTLE BIT MORE ABOUT OUR EFFORTS TO CREATE HOPE AND BUILD HEALTHIER FUTURES FOR ALL CHILDREN. SINCERELY, RICHARD D. CORDOVA, FACHE PRESIDENT AND CHIEF EXECUTIVE OFFICER CHILDREN'S HOSPITAL LOS ANGELES OUR HISTORY FOUNDED IN 1901, CHILDREN'S HOSPITAL LOS ANGELES IS THE OLDEST FREESTANDING PEDIATRIC HOSPITAL IN CALIFORNIA. WITH MORE THAN 110 YEARS OF EXPERIENCE, WE LOOK FORWARD TO PROVIDING OUR PATIENTS WITH ANOTHER CENTURY OF CARE. CHILDREN'S HOSPITAL LOS ANGELES IS ONE OF THE NATION'S LEADING CHILDREN'S HOSPITALS AND IS ACKNOWLEDGED WORLDWIDE FOR ITS LEADERSHIP IN PEDIATRIC AND ADOLESCENT HEALTH. CHILDREN'S HOSPITAL LOS ANGELES IS ONE OF ONLY 10 CHILDREN'S HOSPITALS IN THE NATION, AND THE ONLY ONE IN CALIFORNIA, RANKED IN ALL 10 PEDIATRIC SPECIALTIES BY U.S. NEWS & WORLD REPORT AND NAMED TO THE MAGAZINE'S HONOR ROLL OF CHILDREN'S HOSPITALS. THE MARION AND JOHN E. ANDERSON PAVILION CHILDREN'S HOSPITAL LOS ANGELES PROVIDES INPATIENT CARE FOR CHILDREN IN THE MARION AND JOHN E. ANDERSON PAVILION. NAMED FOR GENEROUS BENEFACTOR AND HOSPITAL BOARD CO-CHAIR, MARION ANDERSON, AND HER HUSBAND, JOHN, THIS NEW BUILDING IS A PREMIERE HEALTH CARE SETTING FOR THE CARE OF CHILDREN. OPENED IN JULY 2011, THIS HOSPITAL BUILDING IS ALLOWING US TO TRANSFORM THE PRACTICE OF PEDIATRIC MEDICINE, BENEFITING OUR PATIENTS, FAMILIES AND HOSPITAL CAREGIVERS FOR GENERATIONS TO COME. CHILDREN'S HOSPITAL EXPANDS OUTPATIENT SERVICES IN THE COMMUNITY - VALENCIA, SOUTH BAY, ARCADIA AND SANTA MONICA VALENCIA CHILDREN'S HOSPITAL LOS ANGELES - VALENCIA OPENED IN THE SANTA CLARITA VALLEY IN JULY 2012. THE CENTER OFFERS BOARD-CERTIFIED AND BOARD-ELIGIBLE PEDIATRIC SPECIALISTS FOR INITIAL EVALUATION AND FOLLOW-UP CARE IN ENDOCRINOLOGY, GASTROENTEROLOGY, HEMATOLOGY-ONCOLOGY, IMAGING AND LABORATORY SERVICES, NEUROLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, PEDIATRIC SURGERY, PLASTIC AND MAXILLOFACIAL SURGERY, PULMONOLOGY AND UROLOGY. SOUTH BAY CHILDREN'S HOSPITAL LOS ANGELES - SOUTH BAY IS SCHEDULED TO OPEN IN FEBRUARY 2013. THE SAME BOARD-CERTIFIED AND BOARD-ELIGIBLE SPECIALISTS PROVIDING CARE AT CHILDREN'S HOSPITAL WILL BE OFFERING CONSULTATIONS AND FOLLOW-UP CARE IN CARDIOLOGY, ENDOCRINOLOGY, GASTROENTEROLOGY, NEUROLOGY, OPHTHALMOLOGY, ORTHOPEDICS, OTOLARYNGOLOGY, PULMONOLOGY, PLASTIC AND MAXILLOFACIAL SURGERY AND UROLOGY. ARCADIA AT CHILDREN'S HOSPITAL LOS ANGELES OUTPATIENT LOCATION IN ARCADIA, FAMILIES HAVE ACCESS TO SPECIALISTS FROM THE FOLLOWING AREAS: ALLERGY AND IMMUNOLOGY, ENDOCRINOLOGY, GASTROENTEROLOGY, HEMATOLOGY-ONCOLOGY, LABORATORY SERVICES, OPHTHALMOLOGY, OTOLARYNGOLOGY - HEAD AND NECK SURGERY, PEDIATRIC SURGERY, PULMONOLOGY, RADIOLOGY SERVICES AND UROLOGY. LOCATED IN MONROVIA, CLOSE TO THE CHILDREN'S HOSPITAL LOS ANGELES - ARCADIA, CHILDREN'S OPTICAL OFFERS ONE-STOP SHOPPING FOR PATIENTS NEEDING PRESCRIPTION EYE GLASSES, CONTACT LENSES, FRAME REPAIRS, ACCESSORIES AND PROTECTIVE EYEWEAR. SANTA MONICA CHILDREN'S HOSPITAL LOS ANGELES - SANTA MONICA OPENED NOVEMBER 2013. THE LOCATION OFFERS FAMILIES CONVENIENT ACCESS TO A WIDE VARIETY OF PEDIATRIC SPECIALISTS FOR INITIAL EVALUATION AND FOLLOW-UP CARE IN THE AREAS OF MEDICAL GENETICS, NEUROLOGY, ONCOLOGY, PLASTIC AND MAXILLOFACIAL SURGERY AND UROLOGY. ALTAMED COMMUNITY HEALTH CLINIC THE ALTAMED COMMUNITY HEALTH CLINIC OF THE DIVISION OF GENERAL PEDIATRICS AT CHILDREN'S HOSPITAL LOS ANGELES SERVES AS A PREVENTIVE AND PRIMARY MEDICAL CARE CENTER FOR CHILDREN AND ADOLESCENTS IN OUR COMMUNITY. ALTAMED IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), WITH EMPHASIS ON DELIVERING HIGH-LEVEL PREVENTIVE AND PRIMARY MEDICAL CARE, MAKES THIS CLINIC AN ESSENTIAL COMMUNITY PARTNER IN PROVIDING FIRST-CLASS MEDICAL CARE FOR FAMILIES IN UNDERSERVED AREAS OF OUR COMMUNITY. THE SABAN RESEARCH INSTITUTE THE SABAN RESEARCH INSTITUTE OF CHILDREN'S HOSPITAL LOS ANGELES IS ONE OF THE FEW FREESTANDING RESEARCH CENTERS IN THE U.S. WHERE SCIENTIFIC INQUIRY AND CLINICAL CARE ARE COMBINED AND DEVOTED EXCLUSIVELY TO CHILDREN. OUR GOAL IS TO IMPROVE THE HEALTH AND WELLNESS OF CHILDREN THROUGH A COMBINATION OF BASIC, CLINICAL AND TRANSLATIONAL STUDIES. RESEARCH IS PERFORMED AT THE LAB BENCH, IN THE CLINIC AND IN THE COMMUNITY. AS A PREMIER TEACHING HOSPITAL, CHILDREN'S HOSPITAL HAS BEEN AFFILIATED WITH THIS TOP MEDICAL SCHOOL SINCE 1932. THE INSTITUTE'S RESEARCHERS ALSO ARE INVOLVED IN COLLABORATIVE PROJECTS WITH ACADEMIC INSTITUTIONS THROUGHOUT THE U.S. AND ABROAD. TOMORROW'S CAREGIVERS AT CHILDREN'S HOSPITAL LOS ANGELES, WE BELIEVE THAT EDUCATION IS AMONG THE GREATEST LEGACIES WE CAN LEAVE FOR FUTURE GENERATIONS, AND THIS COMMITMENT IS EVIDENT IN OUR TEACHING AND TRAINING OF MEDICAL STUDENTS, RESIDENTS AND FELLOWS. THE PEDIATRIC RESIDENCY PROGRAM AT CHILDREN'S HOSPITAL LOS ANGELES IS ONE OF THE LARGEST IN THE COUNTRY. CHILDREN'S HOSPITAL ANNUALLY TRAINS 500 MEDICAL STUDENTS, 87 FULL-TIME RESIDENTS, THREE CHIEF RESIDENTS AND 107 FELLOWS, WHO COLLECTIVELY REFLECT THE DIVERSITY NOT ONLY OF OUR PATIENT POPULATION, BUT ALSO OF THE LOS ANGELES REGION. THE DEPARTMENT OF PEDIATRICS' CONTINUING MEDICAL EDUCATION (CME) ALSO EDUCATES PRACTICING PEDIATRICIANS IN OUR COMMUNITIES ABOUT THE LATEST DEVELOPMENTS AND STANDARDS OF PEDIATRIC MEDICINE. OVER THE PAST YEAR, CHILDREN'S HOSPITAL HAS OFFERED 2,107 CME ACTIVITIES FOR PROFESSIONALS THROUGHOUT THE LOS ANGELES AREA, WITH A TOTAL ATTENDANCE OF 23,410. CHILDREN'S HOSPITAL LOS ANGELES IS COMMITTED TO SUPPORTING AND ENCOURAGING OUR NURSES TO PURSUE THEIR PROFESSIONAL DEVELOPMENT. AS A MAGNET HOSPITAL OUR ORGANIZATION HAS BEEN RECOGNIZED FOR QUALITY INPATIENT CARE AS WELL AS EXCELLENCE IN NURSING. FOUNDED AT CHILDREN'S HOSPITAL LOS ANGELES IN 1999 AND NOW REPLICATED AT MORE THAN 90 HOSPITALS NATIONWIDE, THE VERSANT RN RESIDENCY IN PEDIATRICS COMBINES CLASSROOM INSTRUCTION WITH HANDS-ON OPPORTUNITIES TO HELP NEW NURSES MASTER THE CLINICAL SKILLS THEY RECENTLY DEVELOPED IN NURSING SCHOOL. THE RN RESIDENCY IS UNIQUE IN ITS LENGTH, COMPREHENSIVENESS AND FOCUS ON EVIDENCE-BASED NURSING PRACTICE. DURING THE 22-WEEK PROGRAM, NOVICE NURSES SPEND APPROXIMATELY 650 HOURS PROVIDING PATIENT CARE UNDER THE ONE-ON-ONE SUPERVISION OF PRECEPTORS (EXPERIENCED, UNIT-BASED RNS). PRIOR TO THE PROGRAM, THE HOSPITAL'S TURNOVER RATE FOR NEW GRADUATES DURING THE FIRST YEAR OF EMPLOYMENT WAS 36 PERCENT; IT IS NOW LESS THAN FIVE PERCENT. CAREERS IN HEALTH AND MENTORSHIP PROGRAM (CHAMP) FOR MORE THAN 10 YEARS, THE OFFICE OF COMMUNITY AFFAIRS AT CHILDREN'S HOSPITAL HAS COLLABORATED WITH LOCAL HIGH SCHOOLS, COLLEGES AND UNIVERSITIES, WORKFORCE INVESTMENT BOARDS (WIBS), YOUTH DEVELOPMENT ORGANIZATIONS AND CITYWIDE INITIATIVES SUCH AS THE MAYOR'S HIRE LA'S YOUTH PROGRAM. THESE EFFORTS HAVE PROVIDED THOUSANDS OF YOUNG AND UNEMPLOYED INDIVIDUALS IN THE COMMUNITY AN OPPORTUNITY TO PARTICIPATE IN INTERNSHIP, MENTORSHIP AND WORK EXPERIENCE PROGRAMS. THIS DECADE OF PARTNERSHIPS SET THE GROUNDWORK FOR THE DEVELOPMENT OF THE CHILDREN'S HOSPITAL LOS ANGELES CAREERS IN HEALTH AND MENTORSHIP PROGRAM (CHAMP), A PARTNERSHIP WITH BANK OF AMERICA. INTERNS ARE CHOSEN BASED ON SPECIFIC MEASURABLE CRITERIA, AS WELL AS THOUGHTFUL CONSIDERATION OF THEIR LIFE EXPERIENCES. AFTER COMPLETING THE INTERNSHIP, CHAMP INTERNS RECEIVED JOB TRANSITIONING AND PLACEMENT SERVICES, COORDINATED BY RIGHTSOURCING INC. AT CHILDREN'S HOSPITAL. ADDITIONAL INFORMATION ON THE ORGANIZATION'S PROGRAMS IS PROVIDED IN THE COMMUNITY BENEFITS REPORT (WHICH IS AVAILABLE UPON REQUEST).

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CHLA HOLDINGS LLC
4650 SUNSET BLVDLOS ANGELESCA900270980273653228INVESTMENT VEHICLECA44263649613CHILDREN'S HOSPITAL OF LOS ANGELES
CHILDREN'S HEALTH SYSTEM OF LOS ANGELES LLC
4650 SUNSET BLVDLOS ANGELESCA90027951690977HEALTHCARE SERVICESCA00CHILDREN'S HOSPITAL OF LOS ANGELES
CHILDREN'S HOSPITAL LOS ANGELES HEALTH NETWORK LLC
4650 SUNSET BLVDLOS ANGELESCA90027951690977HEALTHCARE SERVICESCA00CHILDREN'S HOSPITAL OF LOS ANGELES

Form990 Schedule R Part II Form990ScheduleRPartII (38 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
ANCHORS GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118986FUNDRAISINGCA501(C)(3)11DN/A0
ANTELOPE VALLEY GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118987FUNDRAISINGCA501(C)(3)11DN/A0
BEL AIR GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118835FUNDRAISINGCA501(C)(3)11DN/A0
CENTENNIAL GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027141878642FUNDRAISINGCA501(C)(3)11DN/A0
CHILDREN'S CHAIN GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027954559789FUNDRAISINGCA501(C)(3)11DN/A0
DELLA ROBBIA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118990FUNDRAISINGCA501(C)(3)11DN/A0
DELTA DELTA DELTA FOR CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027237294093FUNDRAISINGCA501(C)(3)11DN/A0
EL SEGUNDO AUXILIARY GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118991FUNDRAISINGCA501(C)(3)11DN/A0
FLINTRIDGE GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118993FUNDRAISINGCA501(C)(3)11DN/A0
FOCUS
4650 SUNSET BLVD MS 4LOS ANGELESCA90027800290181FUNDRAISINGCA501(C)(3)11DN/A0
FRIENDS OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027141878647FUNDRAISINGCA501(C)(3)11DN/A0
GLENDALE AUXILIARY OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118994FUNDRAISINGCA501(C)(3)11DN/A0
GREEN HOUSE
4650 SUNSET BLVD MS 4LOS ANGELESCA90027237215226FUNDRAISINGCA501(C)(3)11DN/A0
HEALING ARTS REACHING KIDS (HARK)
4650 SUNSET BLVD MS 4LOS ANGELESCA90027204459362FUNDRAISINGCA501(C)(3)11DN/A0
LA PROVIDENCIA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956128178FUNDRAISINGCA501(C)(3)11DN/A0
LAS HERMANAS GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956128176FUNDRAISINGCA501(C)(3)11DN/A0
LAS MADRINAS INC
4650 SUNSET BLVD MS 4LOS ANGELESCA90027951959907FUNDRAISINGCA501(C)(3)11DN/A0
LAS PRIMERAS GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121928FUNDRAISINGCA501(C)(3)11DN/A0
MARY DUQUE OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121921FUNDRAISINGCA501(C)(3)11DN/A0
MARY DUQUE JUNIORS OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027953786303FUNDRAISINGCA501(C)(3)11DN/A0
MEN'S GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027260109744FUNDRAISINGCA501(C)(3)11DN/A0
MONROVIA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121929FUNDRAISINGCA501(C)(3)11DN/A0
NORTHRIDGE GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121930FUNDRAISINGCA501(C)(3)11DN/A0
PASADENA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121932FUNDRAISINGCA501(C)(3)11DN/A0
PENINSULA COMMITTEE
4650 SUNSET BLVD MS 4LOS ANGELESCA90027237091175FUNDRAISINGCA501(C)(3)11DN/A0
PROJECT CHLA
4650 SUNSET BLVD MS 4LOS ANGELESCA90027954524737FUNDRAISINGCA501(C)(3)11DN/A0
SAN ANTONIO GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121934FUNDRAISINGCA501(C)(3)11DN/A0
SANTA MONICA BAY AUXILIARY OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027237293607FUNDRAISINGCA501(C)(3)11DN/A0
SIERRA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121935FUNDRAISINGCA501(C)(3)11DN/A0
SOUTH BAY AUXILIARY OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956118996FUNDRAISINGCA501(C)(3)11DN/A0
SPIRITUAL CARE OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027200872821FUNDRAISINGCA501(C)(3)11DN/A0
THIS LITTLE LIGHT OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027954445549FUNDRAISINGCA501(C)(3)11DN/A0
TOLUCA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956098666FUNDRAISINGCA501(C)(3)11DN/A0
WESTSIDE GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956059321FUNDRAISINGCA501(C)(3)11DN/A0
WHITTIER GUILD OF CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027956121939FUNDRAISINGCA501(C)(3)11DN/A0
BRIGHTEYES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027461214808FUNDRAISINGCA501(C)(3)11DN/A0
TEEN IMPACT AFFILIATES
4650 SUNSET BLVD MS 4LOS ANGELESCA90027454799602FUNDRAISINGCA501(C)(3)11DN/A0
YOUNG PROFESSIONALS COUNCIL
4650 SUNSET BLVD MS 4LOS ANGELESCA90027461301196FUNDRAISINGCA501(C)(3)11DN/A0

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomePercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
CHLA ESBT
4650 SUNSET BOULEVARDLOS ANGELESCA90027203115169INVESTMENTCAT735441.000001
CRUT-11
4650 SUNSET BOULEVARDLOS ANGELESCA90027CHARITABLE TRUSTCAT0
CRAT-3
4650 SUNSET BOULEVARDLOS ANGELESCA90027CHARITABLE TRUSTCAT0
MMR LIT-1
4650 SUNSET BOULEVARDLOS ANGELESCA90027CHARITABLE TRUSTCAT0
GROVER COLLINS INC
4650 SUNSET BOULEVARDLOS ANGELESCA90027951911481PASSIVE INVESTMENTCAC-104961.000001
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization1DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1GROVER COLLINS INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeFTransactionType
Amount Involved79373AmountInvolved
Method Of Amt DeterminationCASHMethodOfAmtDetermination