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CHILDRENS HOSPITAL OF ORANGE COUNTY: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CHILDRENS HOSPITAL OF ORANGE COUNTY (EIN 95-2321786)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201221369349305457
Schema version
2010v3.7
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)
Timestamp2012-05-15T14:05:00-04:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1355 S Grand Ave Suite 2000AddressLine1
CityLos AngelesCity
StateCAState
ZIP Code90071ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN952321786EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Children's Hospital of Orange CountyBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCHILNameControl
Phone7149973000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1455 S Main StreetAddressLine1
CityOrangeCity
StateCAState
ZIP Code928683874ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKERRI RUPPERT SCHILLERName
Titlesenior VP/CFOTitle
Date Signed2012-05-11DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone2139724000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CHOC CHILDREN'S ORANGEBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonKIMBERLY C CRIPENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1455 S MAIN STREETAddressLine1
CityORANGECity
StateCAState
ZIP Code928683874ZIPCode
FieldValueIRS element (for citing)
Gross Receipts599379069GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.choc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTO NURTURE, ADVANCE AND PROTECT THE HEALTH AND WELL-BEING OF CHILDREN.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees2529TotalNbrEmployees
Total Nbr Volunteers625TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year63114786ContributionsGrantsPriorYear
Contributions Grants Current Year115623838ContributionsGrantsCurrentYear
Program Service Revenue Prior Year399360759ProgramServiceRevenuePriorYear
Program Service Revenue CY471618897ProgramServiceRevenueCY
Investment Income Prior Year959578InvestmentIncomePriorYear
Investment Income Current Year1826663InvestmentIncomeCurrentYear
Other Revenue Prior Year5535802OtherRevenuePriorYear
Other Revenue Current Year975074OtherRevenueCurrentYear
Total Revenue Prior Year468970925TotalRevenuePriorYear
Total Revenue Current Year590044472TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY11250000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year164218628SalariesEtcPriorYear
Salaries Etc Current Year171593626SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year237721998OtherExpensePriorYear
Other Expenses Current Year273740241OtherExpensesCurrentYear
Total Expenses Prior Year401940626TotalExpensesPriorYear
Total Expenses Current Year456583867TotalExpensesCurrentYear
Revenues Less Expenses Prior Year67030299RevenuesLessExpensesPriorYear
Revenues Less Expenses CY133460605RevenuesLessExpensesCY
Total Assets BOY393024980TotalAssetsBOY
Total Assets EOY627851973TotalAssetsEOY
Total Liabilities BOY156996670TotalLiabilitiesBOY
Total Liabilities EOY255038207TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY236028310NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY372813766NetAssetsOrFundBalancesEOY
Mission DescriptionTO NURTURE, ADVANCE AND PROTECT THE HEALTH AND WELL-BEING OF CHILDREN.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense420826865Expense
Grants11250000Grants
Revenue471618897Revenue
DescriptionChildren's Hospital of Orange County - Provides specialized pediatric services for the care of children. During this year, there were 59,515 days of inpatient care; 54,553 Emergency room visits; 8,209 surgeries; 1,263 day health visits and 146,425 primary and specialty care clinic visits. see schedule o for additional information. See our complete community benefit report on our website at www.choc.org.Description
Total Program Service Expense420826865TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Info In Schedule O Part VXInfoInScheduleOPartV
Number Forms Transmitted With1096332NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2529NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDONALD NOBLENamePerson
Telephone Number7149973000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1455 S MAIN STREETAddressLine1
CityORANGECity
StateCAState
ZIP Code928683874ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (28 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
KIMBERLY C CRIPE
DIRECTOR / PRESIDENT30.0XX0104915973291
MEREDITH KHACHIGIAN
DIRECTOR1.0X000
JAY KEAR
DIRECTOR / FIRST VICE CHAIR1.0XX000
DOUGLAS MCCOMBS
DIRECTOR / SECRETARY1.0XX000
MARSHALL ROWEN MD
DIRECTOR1.0X000
MARK STEVENS
DIRECTOR / CHAIR4.0XX000
MAUREEN ZEHNTNER
DIRECTOR1.0X000
RALPH CLAYMAN MD
DIRECTOR2.0X000
JANET T DAVIDSON
DIRECTOR2.0X000
DAVID DUKES
DIRECTOR1.0X000
JOE DUNN
DIRECTOR1.0X000
JEFF ELGHANAYAN
DIRECTOR / 2ND VICE CHAIR2.0XX000
WILLIAM GURTNER
DIRECTOR2.0X000
MUSTAFA KABEER MD
DIRECTOR1.0X000
GEORGE KALOGRIDIS
DIRECTOR1.0X000
TIM RISTOFF
DIRECTOR1.0X000
KERRI RUPPERT SCHILLER
SR. VICE PRESIDENT & CFO25.0X056355899342
DEBRA MATHIAS
EXEC. VICE PRESIDENT / COO35.0X051713095474
MARIA E MINON MD
VP MEDICAL AFFAIRS / CMO40.0561800045239X
MARK L HEADLAND
VP / CHIEF INFORMATION OFFICER40.0362066053856X
MATTHEW NIEDZWIECKI
VP ANCILLARY / SUPPORT SERVICE40.0281441052689X
WALDO ROMERO
VP FACILITIES DESIGN / CONSTR.40.0333175054294X
dana bledsoe
vp / cno40.036084608679X
MARGARET T CONK
VP BUSINESS DEVELOPMENT40.027653002445X
JANET R LANSING
VP MARKETING / COMMUNICATIONS40.0298987032356X
JAMES P CAPPON MD
MEDICAL DIRECTOR40.0283131019966X
BETH ROWETT
vp quality / safety40.0278739025679X
JAY GABRIEL
GENERAL COUNSEL40.0384570068176X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3421285TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2129847TotalReportableCompFrmRltdOrgs
Total Other Compensation631486TotalOtherCompensation
Number Individuals GT100 K245NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
McCarthy Building Companies
20401 S W Birch St Suite 300NEWPORT BEACHCA92660General Construction90108579
Pediatric Subspecialty Faculty
455 S Main Street 5th FloorORANGECA92868Med. Dir. services6344214
Cerner Corporation
2800 Rockcreek ParkwayNORTH KANSAS CITYMO64117software services6027047
FKP Architects Inc
8 Greenway Plaza Suite 300HOUSTONTX77046Architect services5210444
Schaller Anderson of Arizona
1120 West La Veta AvenueORANGECA92868health insurance3401550
FieldValueIRS element (for citing)
Number Of Contractors GT100 K45NumberOfContractorsGT100K
Related Organizations41806136RelatedOrganizations
Government Grants72831839GovernmentGrants
All Other Contributions985863AllOtherContributions
Total Contributions115623838TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUE900099397338830397338830
PREMIUM REVENUE9000993361072733610727
MGMT/OCCUPANCY SERVICES5416101973756019737560
DRUGS/MEDICAL SUPPLIES44611088971868897186
RESEARCH REVENUE54170051335505133550

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column6901044TotalRevenueColumn
Related Or Exempt Function Income6901044RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue471618897TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1322202TotalRevenueColumn
Exclusion$1,322,202ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real9288Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real9288Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column9288TotalRevenueColumn
Exclusion$9,288ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities9818264Securities
Other20794Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9285100Securities
Other49497Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities533164Securities
Other-28703Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column504461TotalRevenueColumn
Exclusion$504,461ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA/CATERING SALES722320607007$607,007
GIFT SHOP PROCEEDS453220284679$284,679
VENDING MACHINES90009924617$24,617

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column49483TotalRevenueColumn
Exclusion$49,483ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue965786TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column590044472TotalRevenueColumn
Related Or Exempt Function Income471618897RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,801,737ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total11250000Total
Program Services11250000ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1653927Total
Program Services1653927ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total136173900Total
Program Services122556510ProgramServices
Management And General13617390ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3302729Total
Program Services2972456ProgramServices
Management And General330273ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total20176284Total
Program Services18158656ProgramServices
Management And General2017628ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total10286786Total
Program Services9258107ProgramServices
Management And General1028679ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2179691Total
Program Services1961722ProgramServices
Management And General217969ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total201837Total
Program Services181653ProgramServices
Management And General20184ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total41592Total
Program Services0ProgramServices
Management And General41592ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total70229905Total
Program Services63150962ProgramServices
Management And General7078943ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9618038Total
Program Services8656234ProgramServices
Management And General961804ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total19782623Total
Program Services17804361ProgramServices
Management And General1978262ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total420663Total
Program Services378597ProgramServices
Management And General42066ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total349249Total
Program Services314324ProgramServices
Management And General34925ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total909359Total
Program Services818423ProgramServices
Management And General90936ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13858372Total
Program Services12472535ProgramServices
Management And General1385837ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total3511341Total
Program Services3160207ProgramServices
Management And General351134ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PRCHSD SRVCS FRM OTR HOSP.727403437274034300
MEDICAL SUPPLIES45967307413705764596731
LEGAL SETTLEMENT COSTS160803081447227716080310
PROVISION FOR BAD DEBT143034381430343800
DUES & SUBSCRIPTIONS928728835855928730

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2617447Total
Program Services2355702ProgramServices
Management And General261745ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total456583867Total
Program Services420826865ProgramServices
Management And General35757002ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY20248476BOY
EOY3870592EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY56429948BOY
EOY155702262EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY11100757BOY
EOY8760720EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY73632451BOY
EOY71069049EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3049843BOY
EOY1901751EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6597778BOY
EOY10964357EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis477967633LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec116341237LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY209033818BOY
EOY361626396EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY35058BOY
EOY35058EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY12896851BOY
EOY13921788EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY393024980BOY
EOY627851973EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY57242822BOY
EOY79823192EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1170491BOY
EOY19128936EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY43283EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY98583357BOY
EOY156042796EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY156996670BOY
EOY255038207EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY189159012BOY
EOY336982336EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY46183146BOY
EOY35145278EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY686152BOY
EOY686152EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY236028310BOY
EOY372813766EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY393024980BOY
EOY627851973EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses133460605ReconcilationRevenueExpenses
Reconcilation Other Changes3324851ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

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

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$42,723OtherActivitiesAmount
Total Lobbying Expenditures IIB42723TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
Identifiergrants to other organizations for lobbying purposesIdentifier
Return Referenceform 990, schedule c, part II-B, line 1iReturnReference
Explanationduring fye 06/30/2011, children's hospital of orange county paid dues, a portion of which supports lobbying purposes to various healthcare associations including: Hospital association of southern california of $37,016 national association of children's hospitals of $5,707 Total dues paid for lobbying purposes: $42,723Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3691065BeginningOfYearBalance
Contributions643580Contributions
Investment Earnings Or Losses72135InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance4406780EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3339711BeginningOfYearBalance
Contributions351279Contributions
Investment Earnings Or Losses1363InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures1288OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance3691065EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3076071BeginningOfYearBalance
Contributions262998Contributions
Investment Earnings Or Losses11676InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures11034OtherExpenditures
Administrative Expenses0AdministrativeExpenses
End Of Year Balance3339711EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.82890BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.15570PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01540TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR
LandLand

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis406748OtherCostOrOtherBasis
Depreciation271627Depreciation
Book Value135121BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis52605082OtherCostOrOtherBasis
Depreciation21963022Depreciation
Book Value30642060BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis131609844OtherCostOrOtherBasis
Depreciation93849299Depreciation
Book Value37760545BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis293345959OtherCostOrOtherBasis
Depreciation257289Depreciation
Book Value293088670BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings361626396TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
DEFERRED LEASE OBLIGATION TO CHOCO REALTY$137,128,152
DUE TO ST. JOSEPH HOSPITAL$3,757,898
LT WORKERS COMPENSATION$7,756,773
POST-RETIREMENT BEN OBLIGATION$3,066,030
LT ACCRUED TAIL COVERAGE$2,786,674
DUE TO RELATED PARTIES$1,338,581
CAPITAL LEASE OBLIGATION$172,950
OTHER LIABILITIES$35,738
FieldValueIRS element (for citing)
Total Of Amounts156042796TotalOfAmounts
Total Revenue590044472TotalRevenue
Total Expenses456583867TotalExpenses
Excess Or Deficit For Year133460605ExcessOrDeficitForYear
Net Unrealized GL On Investments3393354NetUnrealizedGLOnInvestments
Prior Period Adjustments-2322620PriorPeriodAdjustments
Other$2,254,117OtherAmount
Total Adjustments3324851TotalAdjustments
Excess Or Deficit Per FS136785456ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt593217270TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments3393354NetUnrealizedGainsInvestments
Other Revenues2238109OtherRevenues
Revenue Not Rptd F9905631463RevenueNotRptdF990
Revenue Subtotal587585807RevenueSubtotal
Investment Expenses Not Included41592InvestmentExpensesNotIncluded
Other Revenues Not Included2417073OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt2458665RevenueNotRptdOnFinStmt
Total Revenue Per Form990590044472TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt456431814TotExpensesEtcAuditedFinclStmt
Expenses Subtotal456431814ExpensesSubtotal
Investment Expenses Not Included241592InvestmentExpensesNotIncluded2
Other Expenses Not Included110461OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt152053ExpensesNotRptdOnFinStmt
Total Expenses Per Form990456583867TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
fin 48 FootNoteform 990, schedule d, Part XU.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRES THE ORGANIZATION'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZES A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE COMBINED FINANCIAL STATEMENTS.
RECONCILIATION TO AUDITED FINANCIAL STATEMENTSSCHEDULE D, PART XI, LINE 8CHANGE IN BENEFICIAL INTEREST IN CHILDREN'S HOSPITAL OF ORANGE COUNTY FOUNDATION $ 2,238,109 ADJ. FOR INCOME FROM INVEST. PARTNERSHIP $ 16,008 --------------- TOTAL $ 2,254,117
RECONCILIATION OF REVENUEPART XII, LINE 2DCHANGE IN BENEFICIAL INTEREST IN CHILDREN'S HOSPITAL OF ORANGE COUNTY FOUNDATION $ 2,238,109 PART XII, LINE 4B RECLASS OF NON-OPERATING EXP. PRIOR PERIOD ADJ. $ 2,322,620 RECLASS FROM REVENUE $ 110,461 ADJ. FOR INCOME FROM INVEST. PARTNERSHIP $ (16,008) --------------- TOTAL $ 2,417,073
RECONCILIATION OF EXPENSESPART XIII, LINE 4BRECLASS OF NON-OPERATING EXPENSES $ 110,461
Use of endowment fundspart v, line 4the endowment fund is used for hospital programs and charity care including research and treatment of children's diseases and disorders.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent350XPcent350
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense416079TotalCommunityBenefitExpense
Net Community Benefit Expense416079NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense180716833TotalCommunityBenefitExpense
Direct Offsetting Revenue165537272DirectOffsettingRevenue
Net Community Benefit Expense15179561NetCommunityBenefitExpense
Percent Of Total Expense0.03430PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense181132912TotalCommunityBenefitExpense
Direct Offsetting Revenue165537272DirectOffsettingRevenue
Net Community Benefit Expense15595640NetCommunityBenefitExpense
Percent Of Total Expense0.03520PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2964378TotalCommunityBenefitExpense
Net Community Benefit Expense2964378NetCommunityBenefitExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense9762974TotalCommunityBenefitExpense
Direct Offsetting Revenue2432997DirectOffsettingRevenue
Net Community Benefit Expense7329977NetCommunityBenefitExpense
Percent Of Total Expense0.01660PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense2383816TotalCommunityBenefitExpense
Net Community Benefit Expense2383816NetCommunityBenefitExpense
Percent Of Total Expense0.00540PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense15111168TotalCommunityBenefitExpense
Direct Offsetting Revenue2432997DirectOffsettingRevenue
Net Community Benefit Expense12678171NetCommunityBenefitExpense
Percent Of Total Expense0.02870PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense196244080TotalCommunityBenefitExpense
Direct Offsetting Revenue167970269DirectOffsettingRevenue
Net Community Benefit Expense28273811NetCommunityBenefitExpense
Percent Of Total Expense0.06390PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense2964378TotalCommunityBuildingExpense
Net Community Building Expense2964378NetCommunityBuildingExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2964378TotalCommunityBuildingExpense
Net Community Building Expense2964378NetCommunityBuildingExpense
Percent Of Total Expense0.00670PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$4,535,020BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare287433AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare291879CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4446MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
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 OF ORANGE COUNTYBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1455 SOUTH MAIN STREETAddressLine1
CityORANGECity
StateCAState
ZIP Code92868ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Childrens HospitalXChildrensHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CHILDREN'S HOSPITAL OF ORANGE COUNTYBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities12NumberOfOtherFacilities

Other Facilities OtherFacilities (12 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
ORANGE PRIMARY CARE CLINIC
455 SOUTH MAIN STREETORANGECA92868clinic
CLINICA CHOC PARA NINOS-SANTA ANA
406 SOUTH MAIN STREETSANTA ANACA92701clinic
SANTA ANA BOYS AND GIRLS CLUB
1000 WEST HIGHLANDSANTA ANACA92703clinic
ASTHMA BREATHMOBILE
455 SOUTH MAIN STREETORANGECA92868clinic
COSTA MESA CLINIC
136 BROADWAYCOSTA MESACA92627clinic
GARDEN GROVE CLINIC
10602 CHAPMAN AVENUEGARDEN GROVECA92840clinic
CHOC CHILDREN'S ENDOCRINE & DIABETES CTR
520 SUPERIOR AVE SUITE 160NEWPORT BEACHCA92663clinic
CHOC CHILDREN'S HOSPITAL
SPECIALTY CLINICS 455 SOUTH MAIN SORANGECA92868clinics
CHOC UROLOGY CENTER SUITE 100
505 S MAIN STORANGECA92868clinic
PEDIATRIC PSYCHOLOGY
1120 W LA VETA AVENUE SUITE 470ORANGECA92868CLINIC
BLOOD&DONORAPHERESIS
505 SOUTH MAIN STREET SUITE 185ORANGECA92868CLINIC
CHOC NEUROLOGY CENTER
1120 W LA VETA AVENUE SUITE 125ORANGECA92868CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

IdentifierIdentifierExplanationExplanation
SCHEDULE H, PART I, LINE 6ATHE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC CHILDREN'S) AND CHOC CHILDREN'S AT MISSION HOSPITAL (CCMH) ANNUALLY AND IS FILED IN ACCORDANCE WITH CALIFORNIA SB697.
SCHEDULE H, PART I, LINE 7, COLUMN FTHE BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $14,303,438. SCHEDULE H, PART I, LINE 7 THE ORGANIZATION USES THE COST-TO-CHARGE RATIO METHODOLOGY TO DETERMINE THE COST OF CHARITY CARE AND UNREIMBURSED COST OF CARE PROVIDED TO MEDI-CAL PATIENTS. COSTS ARE ACCOUNTED FOR USING AN INTERNAL DECISION SUPPORT SYSTEM. THE COST-TO-CHARGE RATIO FOLLOWS THE METHOD DEFINED BY THE MEDICARE COST REPORT AND IS UPDATED MONTHLY USING THE MOST RECENT ORGANIZATIONAL INFORMATION. IN JANUARY 2011, THE CMS ISSUED THE FINAL REQUIRED FEDERAL APPROVAL OF CALIFORNIA'S PROGRAM TO IMPOSE A PROVIDER FEE ON HOSPITALS THAT, COMBINED WITH FEDERAL MATCHING FUNDS, HAS BEEN USED TO PROVIDE SUPPLEMENTAL MEDI-CAL PAYMENTS TO HOSPITALS IN THE STATE. THE PROGRAM WAS ENACTED TO PROVIDE SUPPLEMENTAL MEDI-CAL PAYMENTS FOR UP TO 21 MONTHS RETROACTIVE TO APRIL 2009 AND EXPIRING ON DECEMBER 31, 2010. REVENUES UNDER THE PROGRAM OF $61,060,483, AND PROVIDER FEES AND OTHER EXPENSES TOTALING $17,207,806 WERE RECOGNIZED AS NET PATIENT REVENUE AND OPERATING EXPENSES, RESPECTIVELY, IN THE YEAR ENDED June 30, 2011. THE RESULT IS THAT THE UNREIMBURSED MEDI-CAl ON PART 1 LINE 7B IS MUCH LOWER THAN IN THE PRIOR YEAR.
SCHEDULE H, PART IICOMMUNITY BUILDING ACTIVITIES: COMMUNITY SUPPORT IS DEFINED AS THOSE ACTIVITIES SUPPORTING COMMUNITY LEADERSHIP. THE ORGANIZATION HAS 96 DIFFERENT COMMUNITY BENEFIT PROGRAMS CATEGORIZED ACCORDING TO THE CALIFORNIA COMMUNITY BENEFITS LAW, SB697. WITHIN THESE CATEGORIES, THE CATEGORY WHICH MOST CLOSELY CORRELATES TO LINE 3, COMMUNITY SUPPORT, IS BEHAVIORAL HEALTH ACCESS. THROUGH BEHAVIORAL HEALTH ACCESS, THE ORGANIZATION ENHANCES THE COMMUNITY'S ACCESS TO BEHAVIORAL HEALTH INFORMATION AND SOCIAL AND EMOTIONAL SERVICES, TARGETING THE UNDERSERVED. THIS IS ACCOMPLISHED THROUGH MANY COMMUNITY BASED ACTIVITIES INTEGRATED WITH SOCIAL SERVICES PROGRAMS.
SCHEDULE H, PART III, LINE 1THE ORGANIZATION REPORTS BAD DEBT EXPENSE AS AN OPERATING EXPENSE IN ACCORDANCE WITH U.S. GAAP. HFMA Statement no. 115, which requires bad debt to be recognized as a reduction from net patient revenue has been adopted as an accounting standard in the U.S and will be effective with CHOC's 2011 Form 990. SCHEDULE H, PART III, LINE 4 THE ORGANIZATION CHARGES BAD DEBT FOR (A) THE WRITE-OFF OF PATIENT ACCOUNTS WHERE FAMILIES DID NOT COOPERATE WITH CHOC IN THE COMPLETION OF MEDI-CAL OR CHARITY CARE APPLICATIONS AND WHERE INSUFFICIENT INFORMATION COULD BE OBTAINED REGARDING THE FINANCIAL STATUS OF THE FAMILY, AND (B) A PROVISION FOR OUTSTANDING ACCOUNTS RECEIVABLE FROM SELF-PAY (INCLUDING PENDING MEDI-CAL AND PENDING CHARITY) ACCOUNTS. AS A CHILDREN'S HOSPITAL, CHOC IS IN THE UNUSUAL CIRCUMSTANCE OF TREATING PATIENTS WHERE A MAJORITY COULD QUALIFY FOR SOME TYPE OF GOVERNMENT ASSISTANCE OR CHARITY CARE. THE ORGANIZATION APPLIES ITS CHARITY CARE POLICY TO DETERMINE ELIGIBILITY BASED ON FAMILIES' SATISFYING THE APPLICATION REQUIREMENTS AND THE ORGANIZATION'S ELIGIBILITY CRITERIA. THE ORGANIZATION DOES, HOWEVER, HAVE FAMILIES WHO FAIL TO COMPLETE THE REQUIRED PAPERWORK DESPITE THE ORGANIZATION'S EFFORTS TO EDUCATE ALL FAMILIES OF THE CHARITY CARE OPTIONS. IN THESE CASES, AN ASSESSMENT OF CHARITY CARE ELIGIBILITY IS MADE BASED ON KNOWN INFORMATION. AUDITED FINANCIAL STATEMENT FOOTNOTE: PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT THE INVOICED AMOUNT NET OF ANY EXPECTED CONTRACTUAL ADJUSTMENTS AND DO NOT BEAR INTEREST. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CHOC'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN CHOC'S EXISTING PATIENT ACCOUNTS RECEIVABLE. CHOC DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. CHOC REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS ON A MONTHLY BASIS AS WELL AS AGE OF ACCOUNTS AND OTHER FACTORS. PAST-DUE BALANCES OVER 90 DAYS AND OVER A SPECIFIED AMOUNT ARE REVIEWED INDIVIDUALLY FOR COLLECTABILITY. THERE ARE OTHER FACTORS THAT CAN IMPACT COLLECTIONS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF CO-PAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS REMOTE, BUT IN NO CASE BEYOND ONE YEAR FROM DATE OF SERVICE.
SCHEDULE H, PART III, LINE 8THE ALLOWABLE COST IS BASED ON A COST TO CHARGE RATIO OF .2654. SHORTFALLS ARE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE DOLLAR VALUE OF BENEFITS PROVIDED BY LEGISLATIVE CATEGORY LINK TO THE DOLLARS IDENTIFIED BY COMMUNITY NEEDS. CHOC REPORTS UNPAID COSTS OF PUBLIC PROGRAMS AS GOVERNMENT PAYOR SHORTFALLS. THE PRINCIPAL MEASURE FOR MONITORING COMMUNITY BENEFIT SERVICES IS THE DOLLAR VALUE OF BENEFITS RETURNED TO THE COMMUNITY PER DOLLAR OF TAX EXEMPTION VALUE RECEIVED. SCHEDULE H, PART III, LINE 9B THE HOSPITAL'S WRITTEN BAD-DEBT COLLECTION POLICY STATES THE FOLLOWING: 1. IF A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM AND IS MAKING EVERY EFFORT TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, CHOC OR ITS AGENT WILL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID ACCOUNT TO AN OUTSIDE AGENCY IF DOING SO MAY NEGATIVELY IMPACT A PATIENT'S CREDIT. IF CHOC IS FORCED TO SEND THE ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY WILL REFLECT THE REDUCED PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE PROGRAM. AT NO TIME WILL A PATIENT ACCOUNT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY IF THE ACCOUNT IS LESS THAN 150 DAYS FROM ORIGINAL BILLING. 2. IN DEALING WITH IDENTIFIED UNINSURED PATIENTS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL, CHOC WILL NOT USE WAGE GARNISHMENTS OR LIENS ON PATIENT'S OR PATIENT FAMILY'S PRIMARY RESIDENCE AS A MEANS OF COLLECTING UNPAID CHOC BILLS. THIS REQUIREMENT DOES NOT PRECLUDE CHOC FROM PURSUING REIMBURSEMENT FROM THIRD PARTY LIABILITY SETTLEMENTS. SCHEDULE H PART VI LINE 2 NEEDS ASSESSMENT: THE HOSPITAL PLAYS A LEADERSHIP ROLE IN THE ORANGE COUNTY HEALTH NEEDS ASSESSMENT (OCHNA). OCHNA IS A COMMUNITY-BASED, NOT-FOR-PROFIT PROJECT CREATED AND DESIGNED TO MEET THE REQUIREMENTS OF SB697 FOR ALL HEALTHCARE ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) MEMBER HOSPITALS IN ORANGE COUNTY, TO PRODUCE A COMPREHENSIVE, COUNTYWIDE ANALYSIS OF HEALTH NEEDS AND SERVICES. THE OCHNA PROJECT IS A COLLABORATIVE EFFORT AND IS JOINTLY FUNDED BY THE COUNTY OF ORANGE HEALTHCARE AGENCY AND 27 FOR-PROFIT AND NOT-FOR-PROFIT HOSPITALS, AND OTHER ORGANIZATIONS AND PROVIDERS. ITS GOAL IS TO ACHIEVE MAXIMUM, VALID AND RELIABLE INFORMATION THAT CAN BE ANALYZED BY ZIP CODE, IN ORDER TO PROVIDE HOSPITALS WITH DATA SIGNIFICANT TO THEIR SERVICE AREAS. IN ADDITION, THIS PROCESS IS THE BASIS OF THE COUNTYWIDE REPORT THAT WAS MADE AVAILABLE TO THE LARGER COMMUNITY OF HEALTH AND HUMAN SERVICES PROVIDERS. OCHNA STARTED DATA COLLECTION FOR ITS HEALTH ASSESSMENT IN 1997. THE LATEST SURVEY RESULTS FOR ORANGE COUNTY WERE FOR 2010 AND PUBLISHED IN THE "Health Needs Assessment". OCHNA IS AN ONGOING PROCESS WITH PARTICIPATION AND SUPPORT FROM HEALTHCARE PROVIDERS AND GOVERNMENT AGENCIES. THE HOSPITAL'S EXECUTIVE MANAGEMENT UTILIZED THE OCHNA HEALTH NEEDS FINDINGS TO DEVELOP THE HOSPITALS' GOALS FOR MEETING THE NEEDS INDENTIFIED IN SIX BROAD AREAS: HEALTHCARE ACCESS - INCREASE ACCESS TO QUALITY PEDIATRIC HEALTHCARE RESOURCES AND INFORMATION TO FAMILIES, ESPECIALLY LOW-INCOME AND MEDICALLY UNDERSERVED, THROUGHOUT ORANGE COUNTY. BEHAVIORAL HEALTH ACCESS - ENHANCE THE COMMUNITY'S ACCESS TO BEHAVIORAL HEALTH INFORMATION AND SERVICES, TARGETING THE UNDERSERVED. DISEASE PREVENTION - INCREASE AWARENESS OF DISEASE PREVENTION AND PROMOTE EARLY INTERVENTION OF MAJOR DISEASES THAT AFFECT THE COMMUNITY. INFORMATION RESOURCE - PROVIDE THE COMMUNITY WITH RESOURCES FOR INFORMATION AND EDUCATION OF HEALTH RISK BEHAVIORS. INJURY PREVENTION - ACTIVELY CONTRIBUTE TO REDUCING THE NUMBER OF UNINTENTIONAL INJURIES TO YOUNG CHILDREN, ESPECIALLY TARGETING LOW-INCOME, DIVERSE AND MEDICALLY UNDERSERVED POPULATIONS. COMMUNITY ACTION - ACTIVELY RECRUITS, RECOGNIZE AND ADVOCATE FOR THE IMPORTANCE OF VOLUNTEER LEADERSHIP AND COMMUNITY ASSISTANCE IN PROVIDING CARE FOR CHILDREN. SCHEDULE H PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PATIENTS ARE INFORMED OF THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE HOSPITAL'S CHARITY CARE POLICY IN OUR FINANCIAL ASSISTANCE AND DISCOUNT PROGRAM POLICY. THIS INFORMATION, EITHER IN FULL OR IN SUMMARY, IS POSTED IN ALL OF THE HIGH TRAFFIC PATIENT AREAS: ADMITTING, EMERGENCY ROOM, CLINIC AND THE BUSINESS OFFICE. THE PATIENTS ARE ALSO INFORMED IF THERE IS A FINANCIAL NEED IDENTIFIED BY THE HOSPITAL FINANCIAL COUNSELORS WHEN SPEAKING TO THE FAMILIES ABOUT THEIR INSURANCE OR LACK OF INSURANCE. PATIENTS ARE PROVIDED A COPY OF THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE AND DISCOUNT PAYMENT PROGRAM POLICY. FAMILIES ARE ALSO NOTIFIED ON EVERY PATIENT STATEMENT THAT IF THERE IS A FINANCIAL NEED THEY SHOULD CALL THE DESIGNATED PHONE NUMBER FOR MORE INFORMATION AND ASSISTANCE. FINANCIAL ASSISTANCE COMMUNICATION - AS PART OF THE HOSPITALS' ONGOING PUBLIC AWARENESS CAMPAIGNS, THE MISSION STATEMENTS (INCLUDING THE FINANCIAL ASSISTANCE POLICY) ARE INCLUDED WHEREVER POSSIBLE ON PROGRAM BROCHURES, FACILITY BROCHURES, MEDICAL EDUCATION INFORMATION, COMMUNITY EDUCATION MATERIALS, CONFERENCE INVITATIONS AND ADMISSION MATERIALS. ADDITIONALLY, THE HOSPITALS' FINANCIAL ASSISTANCE POLICY IS EMPHASIZED IN PUBLIC RELATIONS AND MEDIA RELATIONS EFFORTS, FOUNDATION CAMPAIGNS, AND SELECTED MARKETING CAMPAIGNS. THE FINANCIAL ASSISTANCE POLICY IS ALSO INCLUDED AS PART OF THE ANNUAL COMMUNITY BENEFIT REPORT. COMMUNITY INFORMATION - THE HOSPITAL SERVES ALL OF ORANGE COUNTY AND A LIMITED, ALTHOUGH SIGNIFICANT, NUMBER OF PATIENTS FROM THE WESTERN RIM OF RIVERSIDE COUNTY, THE NORTHERN PORTION OF SAN DIEGO COUNTY AND SOUTHEAST AREAS OF LOS ANGELES COUNTY. THE PRIMARY SERVICE AREA IS THE CENTRAL-NORTHERN PORTION OF ORANGE COUNTY, AND IS THE SOURCE OF APPROXIMATELY 71% OF ITS PATIENTS. SIGNIFICANT CITIES IN THIS AREA ARE: SANTA ANA, ANAHEIM, FULLERTON, ORANGE, AND GARDEN GROVE. THE SECONDARY SERVICE AREA INCLUDES ALL THE OTHER ORANGE COUNTY CITIES AND UNINCORPORATED AREAS. COMMUNITY CHARACTERISTICS - POPULATION AND SOCIOECONOMIC DATA PROJECTIONS FOR 2010 ARE PROVIDED BY CLARITAS, A THIRD-PARTY VENDOR THAT MAKES PROJECTIONS BASED ON DEMOGRAPHIC ANALYSIS OF ORANGE COUNTY, INCLUDING THE COMBINED SERVICE AREAS OF BOTH HOSPITALS CHOC AND CHM. TOTAL POPULATION OF THE COUNTY WAS 3.01 MILLION, ACCORDING TO 2010 ESTIMATES, MAKING IT THE THIRD LARGEST COUNTY IN CALIFORNIA. THE MEDIAN AGE IS 36.1, AND CHILDREN UP TO 17 YEARS OF AGE MAKE UP 25% OF THE TOTAL POPULATION. THE LARGEST RACE/ETHNICITY SUBGROUP IS WHITE, AT 45%. LATINOS/HISPANICS ARE 34% OF THE POPULATION. ASIANS/PACIFIC ISLANDERS ARE 17% OF THE TOTAL, AND THE AFRICAN AMERICAN POPULATION REPRESENTS APPROXIMATELY 2% OF THE TOTAL ORANGE COUNTY POPULATION. SOCIOECONOMIC PROFILE THE U.S. CENSUS AMERICAN COMMUNITY SURVEY FOR 2005-07 INDICATED THAT 12.0% (92,520) OF CHILDREN UNDER THE AGE OF 18 IN ORANGE COUNTY, 17.7% IN CALIFORNIA, AND 18.0% IN THE U.S. WERE BELOW THE POVERTY LEVEL. THIS SURVEY ALSO INDICATED THAT 9.7% (288,346) OF THE ORANGE COUNTY POPULATION OF ALL AGES WERE LIVING BELOW THE POVERTY LEVEL. THE U.S. BUREAU OF THE CENSUS ESTIMATED THAT IN 2009, THE COUNTY'S MEDIAN HOUSEHOLD INCOME WAS $70,751. The percentage of the hospital's and the community's patients who are uninsured or Medicaid recipients was 45.8%. THERE ARE 32 OTHER HOSPITALS SERVING THE COMMUNITY: ANAHEIM GENERAL HOSPITAL - ANAHEIM, CALIFORNIA ANAHEIM REGIONAL MEDICAL CENTER - ANAHEIM, CALIFORNIA CHAPMAN MEDICAL CENTER - ORANGE, CALIFORNIA COASTAL COMMUNITIES HOSPITAL - SANTA ANA, CALIFORNIA COLLEGE HOSPITAL COSTA MESA - COSTA MESA, CALIFORNIA FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER - FOUNTAIN VALLEY, CALIFORNIA GARDEN GROVE HOSPITAL AND MEDICAL CENTER - GARDEN GROVE, CALIFORNIA HEALTHBRIDGE CHILDREN'S REHABILITATION HOSPITAL - ORANGE, CALIFORNIA HOAG MEMORIAL HOSPITAL PRESBYTERIAN - NEWPORT BEACH, CALIFORNIA HOAG HOSPITAL - IRVINE - IRVINE, CALIFORNIA HUNTINGTON BEACH HOSPITAL AND MEDICAL CENTER - HUNTINGTON BEACH, CALIFORNIA KAISER FOUNDATION HOSPITAL - ANAHEIM, CALIFORNIA KINDRED HOSPITAL - BREA - BREA, CALIFORNIA KINDRED HOSPITAL - WESTMINSTER - WESTMINSTER, CALIFORNIA LA PALMA INTERCOMMUNITY HOSPITAL - LA PALMA, CALIFORNIA LOS ALAMITOS MEDICAL CENTER - LOS ALAMITOS, CALIFORNIA MISSION HOSPITAL REGIONAL MEDICAL CENTER - MISSION VIEJO, CALIFORNIA MISSION HOSPITAL - LAGUNA BEACH - LAGUNA BEACH, CALIFORNIA NEWPORT BAY HOSPITAL - NEWPORT BEACH, CALIFORNIA NEWPORT SPECIALTY HOSPITAL - NEWPORT BEACH, CALIFORNIA ORANGE COAST MEMORIAL MEDICAL CENTER - FOUNTAIN VALLEY, CALIFORNIA PLACENTIA-LINDA COMMUNITY HOSPITAL - PLACENTIA, CALIFORNIA ROYALE MISSION VIEJO HEALTH - MISSION VIEJO, CALIFORNIA SADDLEBACK MEMORIAL MEDICAL CENTER - SAN CLEMENTE, CALIFORNIA SAN CLEMENTE HOSPITAL AND MEDICAL CENTER - SAN CLEMENTE, CALIFORNIA ST. JOSEPH HOSPITAL - ORANGE, CALIFORNIA ST. JUDE MEDICAL CENTER - FULLERTON, CALIFORNIA TUSTIN REHABILITATION HOSPITAL - TUSTIN, CALIFORNIA UNIVERSITY OF CALIFORNIA,
SCHEDULE H, PART VI, LINE 5PROMOTION OF COMMUNITY HEALTH: CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC) IS THE NOT-FOR-PROFIT, TAX-EXEMPT PARENT CORPORATION OF CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC CHILDREN'S) AND CHOC CHILDREN'S AT MISSION HOSPITAL (CCMH). THE HOSPITALS ARE THE PRINCIPAL TERTIARY AND QUATERNARY PEDIATRIC HOSPITALS SERVING ORANGE COUNTY AND ARE THE ONLY HOSPITALS EXCLUSIVELY SERVING INFANTS, CHILDREN AND ADOLESCENTS. THE ORGANIZATION IS COMPRISED OF TWO HOSPITALS; SEVERAL PRIMARY AND SPECIALTY CLINICS, PROGRAMS AND SERVICES; AND FOUR CENTERS OFEXCELLENCE, THE CHOC HEART, NEUROSCIENCE, hyundai cancer institute AND ORTHOPAEDIC INSTITUTES. CHOC ALSO HAS A RESEARCH INSTITUTE PERFORMING BASIC SCIENCE AND CLINICAL RESEARCH. THROUGH ITS RESIDENCY PROGRAM, THE ORGANIZATION ALSO TRAINS TOMORROW'S PHYSICIANS. THE COMMUNITY BENEFIT PLAN FOR THE FISCAL YEAR ENDING JUNE 30, 2011, DESCRIBES THE BENEFIT PLANNING PROCESS, THE BENEFITS PROVIDED, AND THE ECONOMIC VALUE OF THE BENEFITS. COMMUNITY BENEFITS ARE FREE OR SUBSIDIZED PROGRAMS AND SERVICES PROVIDED TO MEET IDENTIFIED COMMUNITY NEEDS AND TO SERVE THE PUBLIC INTEREST. THE ORGANIZATION'S COMMUNITY BENEFIT PLAN IS AVAILABLE ONLINE AT: HTTP://WWW.CHOC.ORG/ABOUT/COMMUNITYBENEFITPLAN.PDF. THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPOSED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CLINICAL PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS AS MEMBERS OF THE MEDICAL STAFF. MEDICAL STAFF MEMBERS PROVIDE PATIENT CARE AND HAVE ACCESS TO HOSPITAL RESOURCES (INCLUDING EQUIPMENT, FACILITIES AND PERSONNEL) WHICH ARE NECESSARY TO EFFECTIVELY EXERCISE THEIR PRIVILEGES. PHYSICIANS ARE QUALIFIED TO BE MEMBERS OF THE MEDICAL STAFF IF THEY MEET THE FOLLOWING CRITERIA: ONLY PRACTICING PHYSICIANS, DENTISTS, PSYCHOLOGISTS OR PODIATRISTS SHALL BE DEEMED TO POSSESS BASIC QUALIFICATIONS FOR MEMBERSHIP ON THE MEDICAL STAFF, EXCEPT FOR THE HONORARY AND RETIRED STAFF CATEGORIES IN WHICH CASE THESE CRITERIA SHALL ONLY APPLY AS DEEMED INDIVIDUALLY APPLICABLE BY THE MEDICAL STAFF, AND WHO: (A) DOCUMENT THEIR (1) CURRENT LICENSURE, (2) ADEQUATE EXPERIENCE, EDUCATION, AND TRAINING, (3) CURRENT PROFESSIONAL COMPETENCE, (4) GOOD JUDGMENT, AND (5) CURRENT ADEQUATE PHYSICAL AND MENTAL HEALTH STATUS, SO AS TO DEMONSTRATE TO THE SATISFACTION OF THE MEDICAL STAFF THAT THEY ARE PROFESSIONALLY AND ETHICALLY COMPETENT AND THAT PATIENTS TREATED BY THEM CAN REASONABLY EXPECT TO RECEIVE QUALITY MEDICAL CARE. (B) ARE DETERMINED (1) TO ADHERE TO THE ETHICS OF THEIR RESPECTIVE PROFESSIONS, (2) TO BE ABLE TO WORK COOPERATIVELY WITH OTHERS SO AS NOT TO ADVERSELY AFFECT PATIENT CARE, (3) TO KEEP AS CONFIDENTIAL, AS REQUIRED BY LAW, ALL INFORMATION OR RECORDS RECEIVED IN THE PHYSICIAN-PATIENT RELATIONSHIP, AND (4) TO BE WILLING TO PARTICIPATE IN AND PROPERLY DISCHARGE THOSE RESPONSIBILITIES DETERMINED BY THE MEDICAL STAFF AND BE BOUND BY THE MEDICAL STAFF BYLAWS, RULES AND REGULATIONS, AND POLICIES. (C) WHO MAINTAIN IN FORCE PROFESSIONAL LIABILITY INSURANCE IN NOT LESS THAN THE MINIMUM AMOUNTS JOINTLY DETERMINED BY THE BOARD OF DIRECTORS AND THE MEDICAL EXECUTIVE COMMITTEE, BUT IN NO EVENT LESS THAN $1.0 MILLION PER INCIDENT AND $3.0 MILLION IN THE AGGREGATE IN A POLICY YEAR; PROVIDED, HOWEVER, THAT IN THE EVENT THAT (AND FOR SO LONG AS) SUCH INSURANCE IS NOT AVAILABLE ON COMMERCIALLY REASONABLE TERMS TO PHYSICIANS PRACTICING IN A PARTICULAR SPECIALTY OR SUB-SPECIALTY AREA OF MEDICAL PRACTICE, THE FOREGOING REQUIREMENTS MAY BE MODIFIED OR WAIVED WITH RESPECT TO ALL PHYSICIANS PRACTICING IN SUCH SPECIALTY OR SUB-SPECIALTY AREA, SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS UPON REQUEST OF THE MEDICAL EXECUTIVE COMMITTEE. ADMINISTRATIVE STAFF AND MEMBERS ON A LEAVE OF ABSENCE DO NOT NEED TO SHOW EVIDENCE OF INSURANCE. (D) IF BOARD CERTIFICATION IS AVAILABLE IN THEIR RESPECTIVE SPECIALTIES, ARE BOARD CERTIFIED OR BOARD ADMISSIBLE, OR IN THE ALTERNATIVE, CAN DEMONSTRATE TO THE REASONABLE SATISFACTION OF THE MEDICAL EXECUTIVE COMMITTEE, A COMPARABLE LEVEL OF TRAINING, EXPERIENCE AND SKILL. LIMITED privileges ARE PROVIDED TO PHYSICIANS LICENSED BY THE STATE OF CALIFORNIA WHO ARE ENROLLED IN AN ACCREDITED PEDIATRIC RESIDENCY TRAINING PROGRAM AND WHO ARE PROVIDING MEDICAL HEALTH-RELATED SERVICES TO PATIENTS INDEPENDENT OF THE HOSPITAL RESIDENCY PROGRAM. THE ORGANIZATION APPLIES ITS SURPLUS FUNDS TO IMPLEMENT IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. THE ORGANIZATION IS CURRENTLY EMBARKING ON THE CONSTRUCTION OF A STATE-OF-THE-ART $552 MILLION HOSPITAL TOWER ON ITS MAIN CAMPUS IN THE CITY OF ORANGE. CONSTRUCTION OF THE 7 STORY BUILDING STARTED IN 2009 AND WILL OPEN ITS DOORS TO PATIENTS IN 2013. THE NEW TOWER SHALL INCLUDE INPATIENT AND OUTPATIENT CARE FOR CHILDREN, WITH EMERGENCY DEPARTMENT, OPERATING ROOMS, A MEDICAL LABORATORY, PATHOLOGY DEPARTMENT AND IMAGING AND RADIOLOGY SERVICES. THERE SHALL ALSO BE A LARGE CONFERENCE AREA TO ACCOMMODATE SOME OF THE ORGANIZATION'S TEACHING RESPONSIBILITIES. THE CHOC ENDOWMENT FUNDS ARE USED TO FUND MEDICAL RESEARCH, CLINICAL PROGRAMS AND SERVICES, AND TO RECRUIT AND RETAIN DOCTORS WHO ARE THE BEST IN THEIR FIELDS.
SCHEDULE H, PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEM: CHOC HAS EVOLVED FROM A COMMUNITY HOSPITAL TO A WORLD-CLASS, INTEGRATED PEDIATRIC HEALTH CARE SYSTEM AFFILIATED WITH THE UNIVERSITY OF CALIFORNIA, IRVINE (UC IRVINE). THE ORGANIZATION IS STEADFASTLY COMMITTED TO THE TENS OF THOUSANDS OF CHILDREN AND FAMILIES WHO DEPEND ON CHOC FOR CARE, AS WELL AS LEADING THE CHARGE IN ADVANCING PEDIATRIC MEDICINE ON A NATIONAL LEVEL. CHOC'S NEW BRAND IDENTITY - CHOC CHILDREN'S - ASSERTS THE INSTITUTION'S POSITION IN THE COMMUNITY AND NATIONALLY. CHOC'S LEGAL NAME (CHILDREN'S HOSPITAL OF ORANGE COUNTY) WILL REMAIN. THE ECONOMIC VALUE OF THE 96 BENEFIT SERVICES PROVIDED BY CHOC AND CCMH IN FISCAL YEAR 2011 IS $39 MILLION. OF THESE DOLLARS, 60.2% ($23 MILLION) SERVED THE ECONOMICALLY DISADVANTAGED. THE ECONOMIC VALUE OF SAVINGS FROM NOT-FOR-PROFIT STATUS IS $ 31.8 MILLION. THUS, THE HOSPITALS RETURN $1.23 IN COMMUNITY BENEFITS FOR EACH $1 SAVED FROM TAX-EXEMPT STATUS. IN ADDITION TO THE $39 MILLION IN BENEFITS PROVIDED FOR BY THE HOSPITALS REFERENCED ABOVE, BOARD MEMBERS, PHYSICIANS, EMPLOYEES AND VOLUNTEERS CONTRIBUTED 59058 HOURS OF VOLUNTEER SERVICE TO THE COMMUNITY. SCHEDULE H PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: A COMMUNITY BENEFIT REPORT IS FILED IN THE STATE OF CALIFORNIA.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1CHOCO REALTY CORPORATIONBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1455 S MAIN STREETAddressLine1
CityORANGECity
StateCAState
ZIP Code92868ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient330011853EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant11250000AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance
Purpose Of GrantSUPPORTPurposeOfGrant
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 THE USE OF GRANT FUNDS - PART I, LINE 2Identifier
ExplanationCHOC transfers funds to CHOCO Realty Corporation, pursuant to the bylaws of CHOC.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base 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
KIMBERLY C CRIPE
0710811016968801686600545790187120112245000
KERRI RUPPERT SCHILLER
0419474080404063680080630018712066290000
DEBRA MATHIAS
0396210071257049663076762018712061260400
MARIA E MINON MD
4156410560750900840327970124420607039000
MARGARET T CONK
79550001969800230501400278975000
MARK L HEADLAND
260877036733064456049042048140415922000
JANET R LANSING
1898080315750776040204760118800331343000
JAMES P CAPPON MD
255220013569014342012540187120303097000
MATTHEW NIEDZWIECKI
2214130289740310540395980130910334130000
BETH ROWETT
1955330278970553090121880134910304418000
WALDO ROMERO
251976042910038289044751095430387469000
JAY GABRIEL
2942040509680393980495020186740452746000
dana bledsoe
258717045133056996086040750369525000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SEVERANCE ARRANGEMENTSPart I, Line 4aSome of the organization's personnel listed on form 990 Part VII and Schedule J participate in a separation arrangement that provides for a portion of the employee's annual salary based on their position in the organization. For the senior executive level, the amount is based on years of service up to a maximum number of months. Unpaid severance under the separation agreements for current key employees were reported at their full value in a previous tax year. ONE EXECUTIVE LISTED ON SCHEDULE J, PART II RECEIVED SEVERANCE PAYMENTS IN FISCAL YEAR 2011. THE PAYMENT WAS RECEIVED BY MARGARET T. CONK ($180,665).
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANPart I, Line 4bChildren's Hospital of Orange County (CHOC or the Company) established a nonqualified deferred compensation plan effective January 1, 2010 in which certain individuals listed on the form 990, Part VII and Schedule J are participants. Under the established Supplemental Executive Retirement Plan (the Plan) for each Plan year that begins prior to the participant's cash date, CHOC shall create a new SERP account on its books for the Participant and shall credit to such account at times specified. The participants of the plan are general creditors of the company. The participant's SERP account shall be utilized solely as a device for the measurement and determination of the amounts to be paid to the participant under this plan. The participant is entitled to his/her SERP benefit amount upon the earliest of (1) remaining employed with the Company to the third anniversary of the first day of the Plan Year for which the SERP account was created; (2) remaining employed with the Company to the Participant's 60th birthday; (3) remaining employed with the Company to the date the Participant has both attained at least age 55 and has completed at least 10 years of service; (4) disability; (5) involuntary separation from service without reasonable cause; (6) voluntary separation from service for good reason or (7) death. The following individuals received payments from the Plan during calendar year 2010: Ms. Cripe ($100,765), Ms. Rowett ($20,355), Dr. Minon ($44,638) and Ms. Lansing ($20,639). As stated in previous filings, in December 2008, the CHOC Executive Compensation Committee dissolved the previous non-qualified retirement plan and all assets were disbursed involuntarily to the participants. The following individuals listed on Schedule J received payments from the dissolution of the plan in calendar 2010, which are included as a component of the amount reported on Schedule J, Part II, column B: Ms. Bledsoe ($19,079); Ms. Schiller ($11,923); Mr. Headland ($25,413) and Ms. Lansing ($22,640).
Compensation from an affiliated organizationKimberly C. Cripe is compensated through Children's HealthCare of California (CHC), however, in addition to her responsibilities for CHC, she also serves as an officer of Children's Hospital of Orange County, CHOC Foundation, CHOCO Realty Corporation, CRC Real Estate Corporation and Children's Hospital at Mission (all 501(c)(3) affiliates). Ms. Cripe devotes approximately 75% of her time each week to Children's Hospital of Orange County responsibilities with the balance of her time being spent on the other related organizations' business affairs. Kerri Ruppert Schiller is compensated through Children's HealthCare of California (CHC), however, in addition to her responsibilities for CHC, she also serves as an officer of Children's Hospital of Orange County, CHOC Foundation, CHOCO Realty Corporation, CRC Real Estate Corporation and Children's Hospital at Mission (all 501(c)(3) affiliates). Ms. Schiller devotes approximately 63% of her time each week to Children's Hospital of Orange County responsibilities with the balance of her time being spent on the other related organizations' business affairs. Debra Mathias is compensated through Children's HealthCare of California (CHC), however, in addition to her responsibilities for CHC, she also serves as an officer of Children's Hospital of Orange County and Children's Hospital at Mission (both 501(c)(3) affiliates). Ms. Mathias devotes approximately 88% of her time each week to Children's Hospital of Orange County responsibilities with the balance of her time being spent on Children's Hospital at Mission's business affairs.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
MORAN ROWEN AND DORSEY INC
MARSHALL ROWEN M.D., BOD260000MEDICAL SERVICESfalse
Pediatric Surgical Associates
MUSTAFA KABEER, M.D., BOD656246medical servicesfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (25 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
form 990, PART I, LINE 5 AND PART V, LINE 2INFORMATION REGARDING CHOC AS THE COMMON PAYMASTER: Children's Hospital of Orange County is the common paymaster of the following: CHILDREN'S HEALTHCARE OF CALIFORNIA CHILDREN'S HOSPITAL AT MISSION CHOC FOUNDATION All wages and employee specific information, including volunteers, are retained with Children's Hospital of Orange County.
FORM 990, PART III, LINE 4ACommunity Benefit Report Highlights: CHOC is dedicated to providing the highest quality tertiary, quaternary inpatient care as well as specialty and primary care to children in a family centered environment. Access to quality pediatric healthcare resources and information to families, including low-income and medically underserved, throughout Orange and contiguous counties, is accomplished by offering: (1) Pediatric Intensive Care Unit (PICU). The 30 bed PICU at CHOC is staffed by intensivists and clinician staff and is equipped with advanced computerized monitoring systems and offers care to critically ill or injured children with life-threatening disorders. (2) Oncology Unit staffed by specialists trained to treat the complex conditions that accompany pediatric cancers. This includes a 28-bed hematology/oncology unit and a 12-bed oncology intensive care unit (OICU). The unit offers the latest in medical and surgical oncology including chemotherapy, radiotherapy and blood and marrow transplantation. CHOC also opened a 22 chair outpatient infusion center in 2008. (3) CHOC's neonatal intensive care unit (NICU) takes care of infants who need critical care (most often premature babies suffering from respiratory and circulatory problems as well as congenital anomalies requiring surgery) that can be admitted to the NICU within minutes of birth. The 54-bed NICU at CHOC includes two eight-bed nurseries, two nine-bed nurseries, six isolation rooms, 12 beds that provide private rooming and a two-bed extracorporeal membrane oxygenation (ECMO) unit. CHOC's ECMO unit is the only one of its kind in Orange County and one of only 72 in the United States. CHOC also has Southern California's only ECMO transport unit. CHOC designated a small baby unit of 12 beds in March 2010. The unit cares for babies that weigh less than 1,000 grams at birth or 27 weeks or less gestation period. (4) CHOC's cardiovascular intensive care unit (CVICU) meets the growing need for specialized heart services in Orange County. This 12-bed unit was opened in October 2007. It includes two special procedure treatment rooms that enable physicians to perform surgery on children who otherwise could not be transported out of the unit. All of the CVICU rooms are outfitted with technology to monitor children after complex operations and surgical procedures. (5) The CHOC Cancer, Neuroscience, Heart and Orthopaedic Institutes offer innovative advanced models of care in the evaluation, management and treatment of the most complex pediatric and adolescent conditions. CHOC provides and enhances the community's access to behavioral health information and social and emotional services, targeting the underserved. CHOC offers outpatient specialty care in multiple specialties through clinics in Orange and Newport Beach. CHOC actively supports community action and leadership. CHOC actively recruits, recognizes and advocates for the importance of volunteer leadership and community assistance in providing care for children. CHOC provides community-wide education and health information access using programs including disease prevention education, information resources and injury prevention. In addition, CHOC offers services through its outreach clinics that serve surrounding communities to provide preventative and primary care in low-income, high risk areas where children have limited access to care. CHOC's outreach clinics include the CHOC Orange Community Clinic, Clinica Para Ninos in Santa Ana, the CHOC Clinic at Santa Ana Boys and Girls Club, CHOC Costa Mesa Clinic and CHOC Garden Grove Clinic. CHOC also provides care through mobile clinics, including Breathmobiles and Asthma care. See our Community Benefits Report on our website at www.choc.org
LINES 6 & 7A - ORGANIZATION MEMBER INFORMATIONTHE SOLE MEMBER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) IS CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC). LINE 7B - ORGANIZATION MEMBER INFORMATION THE APPROVAL OF THE MEMBER SHALL BE REQUIRED WITH RESPECT TO ANY OF THE FOLLOWING ACTIONS: (1) CHANGING THE PURPOSES AND POWERS OF CHOC; (2) OBLIGATING CHOC TO UNDERTAKE ANY CAPITAL EXPENDITURE IN EXCESS OF $5,000,000; (3) ADOPTING CHOC'S ANNUAL OPERATING AND CAPITAL BUDGETS; (4) ADOPTING A LONG-TERM CAPITAL BUDGET; (5) BUYING, SELLING, LEASING, MORTGAGING, PLEDGING, OR OTHERWISE HYPOTHECATING ANY REAL PROPERTY; (6) INCURRING ANY INDEBTEDNESS IN EXCESS OF $5,000,000; (7) OBLIGATING CHOC TO ACT AS GUARANTOR WITH RESPECT TO ANY DEBT OF ANY PERSON OR OTHER ENTITY; (8) ACCEPTING ANY DONATION WHICH IS CONDITIONED UPON CHOC'S UNDERTAKING ANY UNBUDGETED CAPITAL EXPENDITURE IN EXCESS OF $2,000,000 OR ANY UNBUDGETED EXPENDITURE IN EXCESS OF $2,000,000; (9) ENTERING INTO ANY CONTRACT WHICH INVOLVES ANY OF THE FOLLOWING: (A) ANY FINANCIAL OBLIGATION ON THE PART OF CHOC IN AN AMOUNT IN EXCESS OF $5,000,000, (B) ANY PURPOSE OR ACTIVITY WHICH IS OUTSIDE THE SCOPE OF CHOC'S ORDINARY COURSE OF BUSINESS, OR (C) A TERM IN EXCESS OF FIVE YEARS (UNLESS THE CONTRACT IS TERMINABLE AT WILL); (10) INVOLVING CHOC IN ANY MERGER, ACQUISITION, CORPORATE RESTRUCTURING, OR FORMAL AFFILIATION; (11) INVOLVING CHOC AS A MEMBER, SHAREHOLDER, OR PARTNER IN ANY NEW CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITY; (12) DISSOLVING CHOC; (13) ENTERING INTO ANY TRANSACTION INVOLVING THE SALE, LEASE, CONVEYANCE, EXCHANGE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF CHOC'S ASSETS; (14) AMENDING CHOC'S ARTICLES OF INCORPORATION; (15) ADOPTING NEW BYLAWS OR AMENDING EXISTING BYLAWS, IN THE EVENT THAT SUCH ACTION WOULD AFFECT ANY OF THE MEMBER'S RIGHTS UNDER THE BYLAWS OR AS PROVIDED BY APPLICABLE LAW.
FORM 990, PART VI, SECTION BLINE 11A - REVIEW OF FORM 990: Prior to filing, the tax return and related schedules are provided to the CHOC Executive compensation Committee, an empowered Board committee delegated with this authority. The Chief Financial Officer reviews the report with the committee prior to filing the final return. Prior to the filing of the Form 990 with the Internal Revenue Service, a complete copy of the final Form 990 is also sent electronically to all Board members via Director's Desk, a secure web site that provides a confidential and secure access for all Board materials to our Board members. The Form 990 is also a scheduled agenda item at the May 2012 Board of Directors meeting. LINE 12C - CONFLICT OF INTEREST COMPLIANCE: The Compliance Officer is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to the conflict of interest policy, an annual conflict of interest questionnaire, aimed at determining any family and business relationships and transactions or other transactions that may pose a potential conflict, is distributed to all covered persons (i.e., board members, officers and executive leadership or key employees). Covered persons are required to disclose real or potential conflicts at the time when such conflicts arise. When an individual becomes a covered person and annually thereafter, each covered person is required to sign a statement affirming that he/she: (1) has received a copy of the Conflict of Interest Policy and understands said policy; (2) has read the policy and understands said policy; and (3) agrees to comply with all requirements of the policy, including completing the conflict of interest questionnaire. The completed questionnaires are reviewed by the Compliance Officer and any persons with actual or potential conflicts are informed via written communication. The procedures for addressing any conflict of interest includes but is not limited to the following: (1) the conflicting interest is fully disclosed to the Board of Directors; (2)the interested person responds to factual questions related to the substance of the transaction or arrangement being considered; (3) the person with the conflict of interest is excluded from any discussion or approval of such transaction; (4) alternatives to the proposed transaction are investigated, competitive bids or comparable valuations are obtained; (5) the transaction or action must be approved by a majority of disinterested persons. LINE 15 - COMPENSATION DETERMINATION: An independent Board Committee of the Organization charged with the duties of the compensation committee, whose members are disinterested and independent, is in place with a written compensation committee charter. This Committee annually retains an independent healthcare compensation firm to provide relevant comparability data and other compensation studies. The CEO, officers and executive management salaries and incentives, as well as overall compensation philosophy and policies, are discussed with the independent consultant representatives and the compensation committee members, in person, in executive sessions with no staff members present. All comparative salary data is well documented and there are minutes from these meetings that document the members present and voting, the comparative data used and the deliberations and decisions of the committee. The results and recommendations from the committee are shared in an executive session with the Board of Directors.
FORM 990, PART VI, SECTION CWHILE FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS BE MADE AVAILABLE FOR PUBLIC INSPECTION, THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.line 19 - disclosure policy
RECONCILIATION OF NET ASSETSNET UNREALIZED GAINS ON INVESTMENT $ 3,393,354 CHANGE IN BENEFICIAL INTEREST IN CHOC FOUNDATION 2,238,109 Adjustment for Income from Investment Partnerships 16,008 Prior period adjustment (2,322,620) ------------- $ 3,324,851FORM 990, PART XI, LINE 5
CHANGES TO BYLAWSPurposes and Powers: Revised name of corporation to Children's Hospital of Orange County, d.b.a. CHOC Children's Orange. Qualifications of Directors: Updated title to Vice President of Medical Affiars/Chief Medical Officer (the "VPMA/CMO") Advisory Committees: Deleted Physician Agreements Committee and Corporate Compliance Committee as Advisory Committees. Planning Committee: Removed "campus master planning" from responsibilities because this will be handled by the Construction Committee. Physician Agreements Committee: Removed Physician Agreement Committee as an Advisory Committee of the Corporation because the Internal Compliance Oversight committee will take over these responsiblities. Corporate Compliance Committee: Removed Corporate Compliance Committee because this moved to CHC as the Audit and Compliance Committee. Quality: Revised duties of the Quality committee. Deleted "consistently improving care, treatment, and services that address the needs of patients, families and the community."FORM 990, PART VI, LINE 4
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:KIMBERLY C. CRIPE TITLE:DIRECTOR / PRESIDENT HOURS:10FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MEREDITH KHACHIGIAN TITLE:DIRECTOR HOURS:1FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:JAY KEAR TITLE:DIRECTOR / FIRST VICE CHAIR HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DOUGLAS MCCOMBS TITLE:DIRECTOR / SECRETARY HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MARSHALL ROWEN, M.D. TITLE:DIRECTOR HOURS:3FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MARK STEVENS TITLE:DIRECTOR / CHAIR HOURS:3FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MAUREEN ZEHNTNER TITLE:DIRECTOR HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:RALPH CLAYMAN M.D. TITLE:DIRECTOR HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:JANET T. DAVIDSON TITLE:DIRECTOR HOURS:4FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DAVID DUKES TITLE:DIRECTOR HOURS:1FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:JOE DUNN TITLE:DIRECTOR HOURS:1FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:JEFF ELGHANAYAN TITLE:DIRECTOR / 2ND VICE CHAIR HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:WILLIAM GURTNER TITLE:DIRECTOR HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MUSTAFA KABEER, M.D. TITLE:DIRECTOR HOURS:1FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:GEORGE KALOGRIDIS TITLE:DIRECTOR HOURS:1FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:TIM RISTOFF TITLE:DIRECTOR HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:KERRI RUPPERT SCHILLER TITLE:SR. VICE PRESIDENT & CFO HOURS:15FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DEBRA MATHIAS TITLE:EXEC. VICE PRESIDENT / COO HOURS:5FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC)
455 S MAIN STREETORANGECA92868330265266HEALTH CARECA501(c)(3)7NA
Children's Hospital at Mission
455 S MAIN STREETORANGECA92868330528802HEALTH CARECA501(C)(3)3CHC
CHOC FOUNDATION
455 S MAIN STREETORANGECA92868956097416Fund RaisingCA501(C)(3)7CHC
CHOCO REALTY CORPORATION
455 S MAIN STREETORANGECA92868330011853REAL ESTATECA501(C)(3)11CHC
CRC REAL ESTATE CORPORATION
455 S MAIN STREETORANGECA92868330612565REAL ESTATECA501(C)(3)11CHC
CHOC Thrift Stores Inc
455 S MAIN STREETorangeCA92868330266422Fund RaisingCA501(C)(3)9CHC

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1ocmrrgBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12999 North 4th Street Suite 250AddressLine1
CityphoenixCity
StateAZState
ZIP Code85108ZIPCode
FieldValueIRS element (for citing)
EIN201620666EIN
Primary ActivityinsurancePrimaryActivity
Legal Domicile StateAZLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1naBusinessNameLine1
FieldValueIRS element (for citing)
Type Of Entityc corpTypeOfEntity
Share Of Total Income42277ShareOfTotalIncome
Share Of EOY Assets2381834ShareOfEOYAssets
Percentage Ownership0.50000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1ocmrrgBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypelTransactionType
Amount Involved1032337AmountInvolved

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
Identifierpart v, line 2, column(c)Identifier
ExplanationOCMRRG provides medical professional liability and general liability coverage of up to $250,000 per claim on a claims-made basis to CHOC.Explanation