2026-05-13T11:23:19-05:00 2025-06-30 135565207 KPMG LLP 550 SOUTH HOPE STREET SUITE 1500 LOS ANGELES CA 90071 990 2024-07-01 330528802 CHILDREN'S HOSPITAL AT MISSION CHIL 7149973000 1201 WEST LA VETA AVENUE ORANGE CA 92868 JAMES ULI EVP & CFO 7145098451 2026-05-07 1 0 HOLLY MOEN P01800653 2139724000 2026-05-12 2024 2025-03-06 01:10:19Z KIMBERLY C CRIPE 1201 WEST LA VETA AVENUE ORANGE CA 92868 114969964 0 X WWW.CHOC.ORG X 1991 CA TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. 14 14 219 49 0 0 117900 234163 102904977 113922271 674448 783345 61772 5278 103759097 114945057 25000000 0 0 0 22660267 24003850 0 0 0 54593406 60451056 102253673 84454906 1505424 30490151 80237078 96342042 39618526 42662210 40618552 53679832 TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. 0 0 76521986 113922271 CHILDREN'S HOSPITAL AT MISSION (CHAM) PROVIDES SPECIALIZED PEDIATRIC SERVICES FOR THE MEDICAL /SURGICAL CARE OF CHILDREN FROM BIRTH TO AGE 18. THERE WERE 9,119 INPATIENT CARE DAYS; 14,530 EMERGENCY ROOM VISITS; 457 SURGERIES AND 20,628 OUTPATIENT VISITS. SEE OUR COMPLETE COMMUNITY BENEFIT PLAN ON OUR WEBSITE AT HTTPS://CHOC.ORG/FILES/FY25_RCHM_COMMUNITY_BENEFIT_REPORT.PDF. 76521986 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 36 0 1 219 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MARY NGUYEN 7145094124 1201 WEST LA VETA AVENUE ORANGE CA 928683874 SAM AURIEMMA DIRECTOR 1.00 3.00 X 0 0 0 CHRIS FURMAN DIRECTOR 1.00 3.00 X 0 0 0 JOE KIANI DIRECTOR 1.00 2.00 X 0 0 0 DOUGLAS MCCOMBS CHAIR 3.00 4.00 X X 0 0 0 BRAD MCEACHERN DIRECTOR 1.00 2.00 X 0 0 0 MARIA MINON MD DIRECTOR 1.00 2.00 X 0 0 0 JIM MORRIS VICE CHAIR 1.00 3.00 X X 0 0 0 JOE NUZZOLESE DIRECTOR 1.00 2.00 X 0 0 0 KEN POTROCK DIRECTOR 1.00 2.00 X 0 0 0 LINDA ROSE DIRECTOR 1.00 2.00 X 0 0 0 MARSHALL ROWEN MD DIRECTOR 1.00 4.00 X 0 0 0 KIMBERLY SENTOVICH DIRECTOR 1.00 2.00 X 0 0 0 JASJIT SINGH MD DIRECTOR 1.00 2.00 X 0 0 0 GADDI VASQUEZ DIRECTOR 1.00 2.00 X 0 0 0 KIMBERLY CRIPE PRESIDENT & CEO 4.00 36.00 X 0 2413249 31405 PATRICK FRIAS MD PRESIDENT & CEO 4.00 36.00 X 0 2518676 44864 KERRI RUPPERT SCHILLER EVP & CFO (THRU 04/2025) 9.00 31.00 X 0 1142441 40202 JAMES ULI JR EVP & CFO 4.00 36.00 X 0 1131345 22310 KIMBERLEY MILSTIEN EVP & COO, REGIONAL PRESIDENT 9.00 31.00 X 0 1045450 135453 JAY GABRIEL CHIEF LEGAL OFFICER & SECRETARY 4.00 36.00 X 0 898091 49577 JILL STRICKLAND CHIEF ADMINISTRATIVE OFFICER (CAO) 4.00 36.00 X 0 898556 33381 SANDIP GODAMBE SVP, MEDICAL AFFAIRS & CMO 10.00 30.00 X 0 965105 90332 EMMA SANDHU VP, CHIEF QUALITY AND PATIENT SAFETY OFFICER 40.00 0.00 X 515987 0 42727 JENNIE RODRIGUEZ VP, CNO CCMH (START 08/2024) 40.00 0.00 X 345290 0 14018 KRISTY HAFFAR CLINICAL NURSE IV 12 AWS 40.00 0.00 X 238962 0 21211 EVA ESMAEILI NURSE MANAGER-NICU 40.00 0.00 X 231796 0 37012 ALLISON LEE O'BRIEN CLINICAL NURSE IV 12 AWS 40.00 0.00 X 225216 0 7719 PAUL VAN DOLAH EXEC VP & CTO (FORMER COO) 0.00 40.00 X 0 996363 1912 1557251 12009276 572123 81 1 1 0 AYA HEALTHCARE INC PO BOX 674907 DALLAS TX 752674907 TEMPORARY STAFFING 2229211 1 234163 234163 PATIENT REVENUE 621400 113922271 113922271 113922271 808252 808252 24907 -24907 -24907 -24907 OTHER REVENUE 621400 5278 5278 5278 114945057 113922271 0 788623 X 413550 206775 206775 19272477 17345229 1927248 564892 508403 56489 2327484 2094736 232748 1425447 1282902 142545 12019992 10817993 1201999 8263 7437 826 17267 17267 37562333 33806096 3756237 320127 288114 32013 427629 384866 42763 1922704 1730434 192270 11633 10470 1163 20852 18767 2085 775219 697697 77522 470649 423584 47065 PROVIDER PROGRAM FEE 6762669 6762669 LICENSE AND TAXES 71093 63984 7109 OSHPD FEE 4917 4425 492 55709 50138 5571 84454906 76521986 7932920 0 4999983 4326871 6985372 17678152 19718125 18751279 338694 426904 23154127 18495195 4998158 4658932 5800679 5800679 37396067 44699225 80237078 96342042 11367237 15050811 117726 117726 28133563 27493673 39618526 42662210 X 39561410 52233199 1057142 1446633 40618552 53679832 80237078 96342042 X 30490151 117557 -17546428 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 17267 17267 0 PART II-B, LINE 1: GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES FORM 990, SCHEDULE C, PART II-B, LINE 1 DURING FYE 06/30/2025, CHILDREN'S HOSPITAL AT MISSION PAID DUES TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA, $17,267 OF WHICH SUPPORTED LOBBYING PURPOSES. 2420 2420 49198 13359 35839 15022702 12488986 2533716 7807411 5992850 1814561 272396 272396 4658932 OTHER RECEIVABLE 3300 PROVIDER FEE PROGRAM RECEIVABLE 17582866 RECEIVBLES FROM RELATED PARTY 1188765 OPERATING LEASE ROU ASSETS 24582745 BENEFICIAL INT IN FDN 321139 INVESTMENT IN OCMRRG 1018410 OTHER ASSETS 2000 44699225 DUE TO RELATED PARTIES 3347382 OPERATING LEASE LIABILITY 24146291 27493673 X PART X, LINE 2: U.S. GAAP REQUIRES THE ORGANIZATION'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2025, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. 1 1 X 1 X 400.000000000000 1 X 550.000000000000 1 1 0 1 1 48723 0 48723 0.00060 34140991 19400003 14740988 0.17450 34189714 19400003 14789711 0.17510 56425 6525 49900 0.00060 56425 6525 49900 0.00060 34246139 19406528 14839611 0.17570 1 6821335 X 1 1 1 1 CHILDREN'S HOSPITAL AT MISSION 27700 MEDICAL CENTER ROAD MISSION VIEJO CA 92691 WWW.CHOC.ORG 060000348 X X X CHILDREN'S HOSPITAL AT MISSION 1 0 0 1 X X X X X X X X X 22 1 1 0 1 X SEE PART V, SECTION C X 1 22 1 SEE PART V, SECTION C 0 1 X 400.000000000000 550.000000000000 X X 1 1 X X X X 1 X HTTPS://WWW.CHOC/PATIENTS-FAMILY/PAY-BILL/ X HTTPS://CHOC.ORG/PATIENTS-FAMILY/PAY-BILL X HTTPS://CHOC.ORG/PATIENTS/BILLING/FINANCIAL-RESOURCES X X X X X X 1 X 0 X X X X 1 X 0 0 CHILDREN'S HOSPITAL AT MISSION PART V, SECTION B, LINE 5: CHILDREN'S HOSPITAL AT MISSION (CHAM) AND ITS AFFILIATE, CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) CONDUCTED THE CHNA PROCESS IN THE FALL OF 2022, WITH INPUT AND DATA FROM NUMEROUS AUTHORITATIVE, PUBLICLY AVAILABLE SOURCES, A SURVEY OF COMMUNITY LEADERS FROM VARIOUS BUSINESSES, SOCIAL SERVICE, AND PUBLIC AGENCIES AND A SURVEY OF THE COMMUNITY-AT-LARGE. THE CHNA REPORT INCLUDES BOTH PRIMARY AND SECONDARY DATA ANALYSES THAT FOCUS ON THE HEALTH AND SOCIAL NEEDS OF THE POPULATION IN EACH CHOC HOSPITAL'S PRIMARY SERVICE AREA. CHILDREN'S HOSPITAL AT MISSION PART V, SECTION B, LINE 6A: CHOC AND CHAM TOGETHER CONDUCTED THE HEALTH NEEDS ASSESSMENTS.SCHEDULE H, PART V, LINES 7A & 10ATHE COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS PUBLISHED IN 2022 CAN BE FOUND AT THE FOLLOWING HTTPS://CHOC.ORG/FILES/CHOC_2022_CHNA_REPORT.PDFTHE LATEST IMPLEMENTATION PLAN COVERS 2022-204, WHICH CAN BE FOUND AT THE FOLLOWING URL: HTTPS://CHOC.ORG/FILES/CHNA-IMPLEMENTATION-PLAN_2023.PDFA NEW CHNA WAS APPROVED IN THE 2025 TAX YEAR. WE ARE CONTINUING TO REPORT THE 2022 CHNA ON THE 2024 RETURN, BUT THE NEXT CHNA WAS NONETHELESS TIMELY CONDUCTED IN ACCORDANCE WITH THE "EVERY THREE YEARS" REQUIREMENT (WITH A CHNA CONDUCTED IN 2022 AND 2025). CHILDREN'S HOSPITAL AT MISSION PART V, SECTION B, LINE 11: ADDRESSING HIGH PRIORITY COMMUNITY HEALTH NEEDS CHAM COORDINATES ITS RESPONSE TO ITS MOST RECENT CHNA WITH ITS LARGER AFFILIATE, CHOC.CHOC'S AND CHAM'S MOST RECENT CHNA IDENTIFIED TWO HIGH-PRIORITY HEALTH NEEDS: 1) BEHAVIORAL HEALTH: THE CONCERNS INCLUDE MENTAL HEALTH CONDITIONS (DEPRESSION, ANXIETY, STRESS, EATING DISORDERS AND SUICIDAL IDEATION) AND SUBSTANCE USE. 2) ACCESS TO PEDIATRIC HEALTHCARE SERVICES: THE CONCERNS INCLUDE ABILITY TO ACCESS HEALTH CARE SERVICES (PREVENTIVE, MENTAL, AND PRIMARY CARE; SERVICES FOR CHILDREN WITH SIGNFICANT HEALTHCARE NEEDS), AVIABILITY OF APPOINTMENTS DURING TIMES THAT ARE CONVENIENT FOR PARENTS OR CAREGIVERS, LONG WAIT TIMES AND PROVIDERS NOT TAKING NEW PATIENTS, COMPLEX NAVIGATION SYSTEMS, AND LACK OF ACCESS TO CULTURALLY AND LINGUISTICALLY APPROPRIATE SERVICES (E.G., PROVIDERS WHO SPEAK THE PATIENT'S LANGUAGE AND UNDERSTAND THE PATIENT'S CULTURE). THE ORGANIZATION IS DEVELOPING STRATEGIC PLANS TO ADDRESS THESE HIGH PRIORITY NEEDS:1) BEHAVORIAL HEALTH: THE AREAS OF FOCUS WOULD BE TO EXPAND ACCESS TO MENTAL HEALTH SERVICES (WHICH INCLUDE CULTURALLY AND LINGUISTICALLY APPROPRIATE THERAPISTS, AND IMPROVE TIMELY AND AFFORDABLE MENTAL HEALTHCARE), EDUCATION ABOUT BEHAVIORAL HEALTH ISSUES WITH A FOCUS ON ENGAGING ADOLESCENTS AND YOUNG ADULTS, AND PERINATAL, PRENATAL, AND PARENTS OF INFANTS, AND PROGRAMS TO PREVENT SUBSTANCE USE OR ADDITION.2) ACCESS TO PEDIATRIC HEALTHCARE SERVICES: THE AREAS OF FOCUS WOULD BE TO EXPAND ACCESS TO PRIMARY HELATHCARE SERVICES, MAKE APPOINTMENTS AVAILABLE DURING TIMES THAT ARE CONVENIENT FOR THE PATIENT, TEAMWORK BETWEEN HEALTHCARE ORGANIZATIONS AND COMMUNITY-BASED ORGANIZATIONS AND TOOLS TO ASSIST PATIENTS AND FAMILITEIS IN NAVIGATING THE HEALTHCARE SYSTEM. PART I, LINE 6A: THE ORGANIZATION'S COMMUNITY BENEFIT PLAN IS CONTAINED IN A REPORT PREPARED BY CHOC AND CHAM ANNUALLY AND IS FILED IN ACCORDANCE WITH CALIFORNIA SB697. PART I, LINE 7: THE ORGANIZATION USES THE COST-TO-CHARGE RATIO METHODOLOGY TO DETERMINE THE COST OF CHARITY CARE AND UNREIMBURSED COST OF CARE PROVIDED TO MEDI-CAL PATIENTS. COSTS ARE ACCOUNTED FOR USING AN INTERNAL DECISION SUPPORT SYSTEM. THE COST-TO-CHARGE RATIO FOLLOWS THE METHOD DEFINED BY THE MEDICARE COST REPORT AND IS UPDATED MONTHLY USING THE MOST RECENT ORGANIZATIONAL INFORMATION.PROVIDER FEE PROGRAMCHAM RECOGNIZED REVENUES FOR THE FEE FOR SERVICE AND MANAGED CARE PORTIONS OF THE FOLLOWING PROGRAMS:1) QAF 7 - 12 MONTH PROGRAM ENDED DECEMBER 31, 2022- $292,3882) QAF 8 - 12 MONTH PROGRAM ENDED DECEMBER 31, 2023 - $612,3713) QAF 9 - 12 MOMNTH PROGRAM ENDED DECEMBER 31, 2024 - $9,702,910CHAM RECOGNIZED TOTAL PROVIDER FEES AND OTHER EXPENSES OF $6,762,669. THE AMOUNTS WERE RECOGNIZED AS NET PATIENT REVENUE AND OPERATING EXPENSES, RESPECTIVELY, IN THE FISCAL YEAR ENDED JUNE 30, 2025. PART II, COMMUNITY BUILDING ACTIVITIES: COMMUNITY SUPPORT IS BEST EXEMPLIFIED BY THE ORGANIZATION'S INCREASED EMPHASIS ON COMMUNITY OUTREACH AND COMMUNITY EDUCATION, WHICH INCLUDES INJURY PREVENTION SAFETY AND WELLNESS. THE ORGANIZATION HAS 84 DIFFERENT COMMUNITY BENEFIT PROGRAMS CATEGORIZED ACCORDING TO THE CALIFORNIA COMMUNITY BENEFITS LAW, SB697. WITHIN THESE CATEGORIES, THE CATEGORY WHICH MOST CLOSELY CORRELATES TO LINE 3, COMMUNITY SUPPORT, IS HEALTHCARE ACCESS. THROUGH HEALTHCARE ACCESS, THE ORGANIZATION INCREASES ACCESS TO QUALITY PEDIATRIC HEALTHCARE RESOURCES AND INFORMATION TO FAMILIES, ESPECIALLY LOW-INCOME AND MEDICALLY UNDERSERVED, THROUGHOUT ORANGE COUNTY. THIS IS ACCOMPLISHED THROUGH COMMUNITY OUTREACH CLINICS AND EDUCATION. PART III, LINE 2: THE ORGANIZATION CHARGES BAD DEBT FOR (A) THE WRITE-OFF OF PATIENT ACCOUNTS WHERE FAMILIES DID NOT COOPERATE IN THE COMPLETION OF MEDI-CAL OR CHARITY CARE APPLICATIONS AND WHERE INSUFFICIENT INFORMATION COULD BE OBTAINED REGARDING THE FINANCIAL STATUS OF THE FAMILY, AND (B) A PROVISION FOR OUTSTANDING ACCOUNTS RECEIVABLE FROM SELF-PAY (INCLUDING PENDING MEDI-CAL AND PENDING CHARITY) ACCOUNTS. UNDER NEW REVENUE RECOGNITION CRITERIA, ACCOUNTS PREVIOUSLY WRITTEN OFF AS BAD DEBT ARE NOW RECORDED AS DEDUCTIONS FROM REVENUE.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. PART III, LINE 3: THE HOSPITAL FOLLOWS HFMA STATEMENT 15 AND THEREFORE NO PART OF BAD DEBT, AS DEFINED BY STATEMENT 15, REPRESENTS AMOUNTS ATTRIBUTABLE TO PATIENTS ELIGIBLE TO RECEIVE FINANCIAL ASSISTANCE. PART III, LINE 4: AUDITED FINANCIAL STATEMENT FOOTNOTE: PATIENT ACCOUNTS RECEIVABLE ARE RECORDED AT THE INVOICED AMOUNT, NET OF ANY EXPECTED CONTRACTUAL ADJUSTMENTS AND DO NOT BEAR INTEREST. THE ORGANIZATION HAS AGREEMENTS WITH THIRD-PARTY PAYORS THAT PROVIDE FOR PAYMENTS AT AMOUNTS DIFFERENT FROM THE ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. PATIENT SERVICES REVENUES ARE REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED. CONTRACTUAL ADJUSTMENTS ARISING UNDER REIMBURSEMENT ARRANGEMENTS WITH THIRD-PARTY PAYORS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ARE ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. IMPLICIT PRICE CONCESSIONS ARE TAKEN BASED ON HISTORICAL COLLECTION EXPERIENCE AND REFLECT THE ESTIMATED AMOUNTS THE ORGANIZATION EXPECTS TO COLLECT. PART III, LINE 8: AS A CHILDREN'S HOSPITAL, CHAM MEDICARE ALLOWABLE COSTS ARE ZERO. THEREFORE, THERE IS NO AMOUNT ENTERED ON PART III LINE 6 AND NO MEDICARE SHORTFALL REPORTED ON LINE 7. PART III, LINE 9B: THE HOSPITAL'S WRITTEN BAD-DEBT COLLECTION POLICY STATES THE FOLLOWING:1. IF A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM (FAP) AND IS MAKING EVERY EFFORT TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, CHAM 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 CHM IS FORCED TO SEND THE ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY WILL REFLECT THE REDUCED PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE FAP. AT NO TIME WILL A PATIENT ACCOUNT BE REFERRED TO AN OUTSIDE COLLECTION AGENCY IF THE ACCOUNT IS LESS THAN 150 DAYS FROM ORIGINAL BILLING.2. IN DEALING WITH IDENTIFIED UNINSURED PATIENTS AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL, CHAM WILL NOT USE WAGE GARNISHMENTS OR LIENS ON PATIENT'S OR PATIENT FAMILY'S PRIMARY RESIDENCE AS A MEANS OF COLLECTING UNPAID CHAM BILLS. THIS REQUIREMENT DOES NOT PRECLUDE CHAM FROM PURSUING REIMBURSEMENT FROM THIRD PARTY LIABILITY SETTLEMENTS. PART VI, LINE 2: NEEDS ASSESSMENT:IN ADDITION TO THE TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENT, CHAM REGULARLY TRACKS KEY DEMOGRAPHIC CHANGES IN THE PEDIATRIC POPULATION OF ITS COMMUNITY AND THE UTILIZATION OF KEY SERVICES DELIVERED AND EVALUATES THE PROGRAMS IT PROVIDES TO MEET IDENTIFIED NEEDS. THROUGH CONSTANT CONTACT WITH A VARIETY OF COMMUNITY CONSTITUENTS, CHAM IS ABLE TO LEARN ABOUT EMERGING TRENDS AND NEEDS. IT THEN EVALUATES OPTIONS TO MEET THOSE NEEDS, EITHER ALONE OR IN COLLABORATION WITH OTHERS IN THE COMMUNITY.ALL OF THE PROGRAMS ASSOCIATED WITH THE COMMUNITY HEALTH NEEDS ASSESSMENT ARE AVAILABLE IN THE REPORT ON THE HOSPITAL'S WEBSITE AT THE FOLLOWING URL: HTTPS://CHOC.ORG/FILES/CHOC_2022_CHNA_REPORT.PDF ANDHTTPS://CHOC.ORG/FILES/CHNA-IMPLEMENTATION-PLAN_2023.PDF AS WELL AS PAPER COPY THT IS AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. 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 PLAN. THE FINANCIAL ASSISTANCE POLICY IS AVAILABLE IN ENGLISH AND SPANISH. PART VI, LINE 4: THE HOSPITAL SERVES ALL OF ORANGE COUNTY AND A LIMITED NUMBER OF PATIENTS FROM THE WESTERN RIM OF RIVERSIDE COUNTY, THE NORTHERN PORTION OF SAN DIEGO COUNTY AND SOUTHEAST AREAS OF LOS ANGELES COUNTY. THE PRIMARY SERVICE AREA IS ORANGE COUNTY AND IS THE SOURCE OF APPROXIMATELY 85% OF ITS PATIENTS. THE COMMUNITY SERVED BY THE HOSPITAL INCLUDES FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS.COMMUNITY CHARACTERISTICS: POPULATION AND SOCIOECONOMIC DATA PROJECTIONS HAVE BEEN COLLECTED FROM A VARIETY OF LOCAL COUNTY AND STATE SOURCES REPRESENTING COMMUNITY DEMOGRAPHIC, SOCIAL AND ECONOMIC FACTORS, HEALTH ACCESS AND UTILIZATION, AND RESOURCES AVAILABLE IN THE COMMUNITY FOR THE 2022 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) REPORT, THE MOST RECENTLY AVAILABLE. ORANGE COUNTY'S POPULATION IS 3,203,504, MAKING IT THE THIRD MOST POPULOUS COUNTY IN CALIFORNIA. THE MEDIAN AGE IS 38.1, AND CHILDREN UP TO 18 YEARS OF AGE MAKE UP 24% OF THE TOTAL POPULATION. IN THE CHOC SERVICE AREA. 17.1% OF CHILDREN UNDER THE AGE OF 18 LIVE IN POVERTY, COMPARED TO 21.1% OF CALIFORNIA'S CHILDREN. ORANGE COUNTY'S POPULATION IS DIVERSE, WITH 49.9% OF THE POPUATION BEING WHITE; 2.1% BEING BLACK/AFRICAN AMERICAN; .4% BEING AMERICAN INDIAN/ALASKA NATIVE; 14.9% BEING ASIAN; .6% BEING PACIFIC ISLANDER; 5.5% IDENTIFYING AS MULTIPLE RACES; AND 26.6% AS OTHER. OF THE TOTAL ORANGE COUNTY POPULATION, 34.1% IDENTIFY AS HISPANIC ETHNICITY. PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHRADY CHILDREN'S HEALTH (RCH) IS THE NOT-FOR-PROFIT, TAX-EXEMPT PARENT CORPORATION OF CHOC AND CHAM. THE HOSPITALS ARE THE PRINCIPAL TERTIARY AND QUATERNARY PEDIATRIC HOSPITALS SERVING ORANGE COUNTY AND ARE THE ONLY HOSPITALS EXCLUSIVELY SERVING INFANTS, CHILDREN AND ADOLESCENTS. CHAM ALSO OFFERS PEDIATRIC TRAUMA SERVICES TO THE COMMUNITY. THE ORGANIZATION IS COMPRISED OF TWO HOSPITALS, SEVERAL PRIMARY AND SPECIALTY CLINICS, PROGRAMS AND SERVICES; AND FOUR CENTERS OF EXCELLENCE, THE CHOC HEART, NEUROSCIENCE, ONCOLOGY AND ORTHOPEDIC 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, 2025, 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: HTTPS://WWW.CHOC.ORG/FILES/COMMUNITYBENEFITPLANFY2024CCMH.PDFTHE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPOSED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF.CLINICAL PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS AS MEMBERS OF THE MEDICAL STAFF. MEDICAL STAFF MEMBERS PROVIDE PATIENT CARE AND HAVE ACCESS TO HOSPITAL RESOURCES (INCLUDING EQUIPMENT, FACILITIES AND PERSONNEL) WHICH ARE NECESSARY TO EFFECTIVELY EXERCISE THEIR PRIVILEGES. PHYSICIANS ARE QUALIFIED TO BE MEMBERS OF THE MEDICAL STAFF IF THEY MEET THE FOLLOWING CRITERIA: SECTION 1. NATURE OF MEDICAL STAFF MEMBERSHIP ON THE MEDICAL STAFF OF CHAM IS A PRIVILEGE THAT SHALL BE EXTENDED ONLY TO PROFESSIONALLY COMPETENT PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS SET FORTH IN THESE BYLAWS. A PRACTITIONER MAY ADMIT OR PROVIDE SERVICES TO PATIENTS IN THE HOSPITAL ONLY IF THE PRACTITIONER IS A MEMBER OF THE MEDICAL STAFF OR HAS BEEN GRANTED TEMPORARY PRIVILEGES IN ACCORDANCE WITH THE BYLAWS, RULES AND REGULATIONS. APPOINTMENT TO THE MEDICAL STAFF SHALL CONFER ONLY SUCH CLINICAL PRIVILEGES AND PREROGATIVES AS HAVE BEEN GRANTED IN ACCORDANCE WITH THESE BYLAWS. SECTION 2. QUALIFICATIONS FOR MEMBERSHIP A. ONLY PRACTITIONERS WHO HOLD AN UNRESTRICTED LICENSE TO PRACTICE MEDICINE, DENTISTRY, PODIATRY OR CLINICAL PSYCHOLOGY IN THE STATE OF CALIFORNIA, WHO CAN DOCUMENT THE FOLLOWING WITH SUFFICIENT ADEQUACY TO ASSURE THE MEDICAL STAFF AND THE GOVERNING BODY THAT ANY PATIENT TREATED BY THEM IN THE HOSPITAL WILL RECEIVE CARE OF THE GENERALLY RECOGNIZED PROFESSIONAL LEVEL AND EFFICIENCY ESTABLISHED BY THE MEDICAL STAFF AND HOSPITAL, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF THEIR BACKGROUND; EDUCATION; EXPERIENCE; JUDGMENT; TRAINING; DEMONSTRATED CURRENT COMPETENCE; ABILITY TO COMMUNICATE INCLUDING A DEMONSTRATED PROFICIENCY IN THE ENGLISH LANGUAGE SUCH THAT THERE IS REASONABLE ASSURANCE THAT THERE WILL BE NO RISK OF MISUNDERSTANDING IN COMMUNICATION WITH ENGLISH SPEAKING COLLEAGUES, PATIENTS AND HEALTH CARE WORKERS; PHYSICAL AND MENTAL HEALTH STATUS; ADHERENCE TO THE ETHICS OF THEIR PROFESSION; GOOD REPUTATION; AND ABILITY TO WORK WITH OTHERS. NO PRACTITIONER SHALL BE ENTITLED TO MEMBERSHIP ON THE MEDICAL STAFF OR TO THE EXERCISE OF PARTICULAR CLINICAL PRIVILEGES IN THE HOSPITAL MERELY BECAUSE HE IS DULY LICENSED TO PRACTICE MEDICINE, DENTISTRY, CLINICAL PSYCHOLOGY OR PODIATRY IN THIS OR IN ANY OTHER STATE, HOLDS A CERTAIN DEGREE, IS CERTIFIED BY ANY CLINICAL BOARD, OR THAT HE IS A MEMBER OF SOME PROFESSIONAL ORGANIZATION, OR THAT HE HAD IN THE PAST, OR PRESENTLY HAS SUCH PRIVILEGES AT ANOTHER HOSPITAL INCLUDING BUT NOT LIMITED TO MISSION HOSPITAL OR CHOC. NO APPLICANT SHALL BE DENIED MEMBERSHIP ON THE BASIS OF SEX, SEXUAL ORIENTATION, RACE, RELIGION, ANCESTRY, AGE, CREED, COLOR, NATIONAL ORIGIN, MARITAL STATUS, HANDICAP OR DISABILITY (EXCEPT TO THE EXTENT THE HANDICAP OR DISABILITY PREVENTS THE PRACTITIONER FROM PERFORMING ESSENTIAL FUNCTIONS OR POSES A HEALTH OR SAFETY RISK TO THE PRACTITIONER OR OTHERS AND THE HANDICAP OR DISABILITY CANNOT BE REASONABLY ACCOMMODATED OR ON THE BASIS OF ANY OTHER CRITERION THAT IS NOT RELATED TO AN INDIVIDUAL'S PROFESSIONAL CAPABILITIES (CHAM MEDICAL STAFF BYLAWS). B. ONLY PRACTITIONERS WHO MAINTAIN IN FORCE PROFESSIONAL LIABILITY INSURANCE IN NOT LESS THAN THE MINIMUM AMOUNTS JOINTLY DETERMINED BY THE GOVERNING BODY AND THE MEDICAL STAFF EXECUTIVE COMMITTEE, BUT IN NO EVENT LESS THAN $1.0 MILLION PER INCIDENT AND $3.0 MILLION IN THE AGGREGATE IN A POLICY YEAR, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF. THE INSURANCE MUST COVER ALL PRIVILEGES THE PRACTITIONER IS GRANTED BY THE BODY. A CARRIER ADMITTED DOING BUSINESS IN CALIFORNIA OR A MUTUAL COOPERATIVE TRUST MUST PROVIDE THE INSURANCE. INFORMATION REGARDING EACH APPLICANT'S AND MEMBER'S INSURANCE COVERAGE MUST BE PROVIDED IN THE FORM OF A CURRENT CERTIFICATE OF INSURANCE WHICH SHALL BE MAINTAINED IN EACH PRACTITIONER'S CREDENTIALS FILE. INFORMATION REGARDING INSURANCE COVERAGE MUST BE PROVIDED AT THE TIME OF APPOINTMENT AND REAPPOINTMENT AND IMMEDIATELY UPON RECEIPT OF EACH ANNUAL RENEWAL CERTIFICATE. EACH MEMBER SHALL REPORT TO THE MEDICAL STAFF SERVICES OFFICE ANY REDUCTION, RESTRICTION, CLAIMS, CANCELLATION OR TERMINATION OF THE REQUIRED PROFESSIONAL LIABILITY INSURANCE OR CHANGE IN CARRIER IMMEDIATELY UPON THE NOTICE OF ACTION OR CHANGE. C. ACCEPTANCE OF MEMBERSHIP ON THE MEDICAL STAFF SHALL CONSTITUTE THE STAFF MEMBER'S CERTIFICATION THAT HE HAS IN THE PAST, AND HIS AGREEMENT THAT HE WILL IN THE FUTURE, BEHAVE ACCORDING TO ETHICAL PRINCIPLES APPLICABLE TO HIS PROFESSION, AND WILL ABIDE BY ALL STATE AND FEDERAL LAWS AND REGULATIONS GOVERNING THE PROFESSION, INCLUDING, BUT NOT LIMITED TO, MEDICARE/MEDICAID LAWS AND REGULATIONS. FURTHER, ALL MEMBERS OF THE MEDICAL STAFF SHALL PLEDGE THAT THEY WILL NOT RECEIVE FROM, OR PAY TO ANOTHER PHYSICIAN, DENTIST, CLINICAL PSYCHOLOGIST OR PODIATRIST, EITHER DIRECTLY OR INDIRECTLY, ANY PART OF A FEE RECEIVED FOR PROFESSIONAL SERVICES AND THEY WILL NOT DECEIVE A PATIENT AS TO THE IDENTITY OF AN OPERATING SURGEON, OR ANY OTHER MEDICAL PRACTITIONER PROVIDING TREATMENT. PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM: CHAM AND CHOC ARE MEMBERS OF A SYSTEM. BOTH HOSPITALS HAVE A SOLE CORPORATE MEMBER, RADY CHILDREN'S HEALTH (RCH) THAT PROVIDES MANAGEMENT SERVICES TO BOTH HOSPITALS. THE HOSPITALS SHARE A COMMON MISSION AND ARE STRATEGICALLY ALIGNED IN THEIR EFFORT TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. PART VI, LINE 7, REPORTS FILED WITH STATES CA X X X X 0 1 0 0 0 0 0 0 0 PATRICK FRIAS MD PRESIDENT & CEO 0 1409191 0 657743 0 451742 0 10350 0 34514 0 2563540 0 0 KIMBERLY CRIPE PRESIDENT & CEO 0 1330701 0 790183 0 292365 0 16534 0 14871 0 2444654 0 70483 KERRI RUPPERT SCHILLER EVP & CFO (THRU 04/2025) 0 751917 0 225449 0 165075 0 20570 0 19632 0 1182643 0 30164 KIMBERLEY MILSTIEN EVP & COO, REGIONAL PRESIDENT 0 767424 0 276442 0 1584 0 125688 0 9765 0 1180903 0 0 JAMES ULI JR EVP & CFO 0 794247 0 215496 0 121602 0 10350 0 11960 0 1153655 0 0 SANDIP GODAMBE SVP, MEDICAL AFFAIRS & CMO 0 668514 0 255953 0 40638 0 60119 0 30213 0 1055437 0 39054 PAUL VAN DOLAH EXEC VP & CTO (FORMER COO) 0 701498 0 189409 0 105456 0 1912 0 0 0 998275 0 28018 JAY GABRIEL CHIEF LEGAL OFFICER & SECRETARY 0 598826 0 180316 0 118949 0 19364 0 30213 0 947668 0 19490 JILL STRICKLAND CHIEF ADMINISTRATIVE OFFICER (CAO) 0 631640 0 171090 0 95826 0 10350 0 23031 0 931937 0 0 EMMA SANDHU VP, CHIEF QUALITY AND PATIENT SAFETY 330755 0 110766 0 74466 0 14322 0 28405 0 558714 0 44583 0 JENNIE RODRIGUEZ VP, CNO CCMH (START 08/2024) 280801 0 64489 0 0 0 5945 0 8073 0 359308 0 0 0 EVA ESMAEILI NURSE MANAGER-NICU 216576 0 15220 0 0 0 12382 0 24630 0 268808 0 0 0 KRISTY HAFFAR CLINICAL NURSE IV 12 AWS 224040 0 7370 0 7552 0 13612 0 7599 0 260173 0 0 0 ALLISON LEE O'BRIEN CLINICAL NURSE IV 12 AWS 216846 0 8370 0 0 0 0 0 7719 0 232935 0 0 0 PART I, LINE 4B SCHEDULE J: PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) ESTABLISHED A NONQUALIFIED DEFERRED COMPENSATION PLAN EFFECTIVE JANUARY 1, 2010, IN WHICH CERTAIN INDIVIDUALS LISTED ON THE FORM 990, PART VII AND SCHEDULE J ARE PARTICIPANTS. UNDER THE ESTABLISHED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE PLAN) OR SERP, FOR EACH PLAN YEAR THAT BEGINS PRIOR TO THE PARTICIPANT'S CASH DATE, CHOC SHALL CREATE A NEW SERP ACCOUNT ON ITS BOOKS FOR THE PARTICIPANT AND SHALL CREDIT TO SUCH ACCOUNT AT TIMES SPECIFIED. THE PARTICIPANTS OF THE PLAN ARE GENERAL CREDITORS OF THE COMPANY. THE PARTICIPANT'S SERP ACCOUNT SHALL BE UTILIZED SOLELY AS A DEVICE FOR THE MEASUREMENT AND DETERMINATION OF THE AMOUNTS TO BE PAID TO THE PARTICIPANT UNDER THIS PLAN. THE FOLLOWING INDIVIDUALS RECEIVED PAYMENTS FROM THE PLAN DURING CALENDAR YEAR. DR. FRIAS ($398,132), MS. CRIPE ($264,989), MS. SCHILLER ($113,407), MR. ULI JR. ($106,603), MS. STRICKLAND ($80,826), MR. VAN DOLAH ($104,384), MR. GABRIEL ($72,752), DR. GODAMBE ($39,054) AND MS. SANDHU ($44,583). THE COMPANY PROVIDES AN INCENTIVE PLAN TO ALL ELIGIBLE MEMBERS OF MANAGEMENT, INCLUDING CERTAIN INDIVIDUALS LISTED IN PART II OF SCHEDULE J. INCENTIVES ARE EARNED BASED ON ACHIEVEMENT OF ORGANIZATION AND INDIVIDUAL GOALS TYPICALLY RELATED TO QUALITY, PATIENT SAFETY, OPERATING, AND FINANCIAL PERFORMANCE AS WELL AS OTHER SIGNIFICANT CLINICAL, QUALITY, AND STRATEGIC ACHIEVEMENTS. THE COMPANY MAINTAINS A CORPORATE MEMBERSHIP IN A SOCIAL CLUB THAT IS UTILIZED FOR BUSINESS PURPOSES BY ITS EXECUTIVES, INCLUDING CERTAIN INDIVIDUALS LISTED IN PART II OF SCHEDULE J. USE OF THE CLUB AND PAYMENTS TO THE CLUB FOR BUSINESS-RELATED EXPENSES ARE SUBJECT TO THE COMPANY'S WRITTEN POLICIES AND PROCEDURES THAT INCLUDE A REQUIREMENT TO DOCUMENT THE PURPOSE AND ATTENDEES OF THE BUSINESS MEETING PRIOR TO PAYMENT. COMPENSATION FROM AN AFFILIATED ORGANIZATION KIMBERLY C. CRIPE IS COMPENSATED THROUGH THE PARENT COMPANY, RADY CHILDREN'S HEALTH (RCH), HOWEVER, IN ADDITION TO HER RESPONSIBILITIES FOR THE PARENT COMPANY, SHE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHOC FOUNDATION, CRC REAL ESTATE CORPORATION AND CHILDREN'S HOSPITAL AT MISSION (ALL IRC SECTION 501(C)(3) AFFILIATES). MS. CRIPE DEVOTES APPROXIMATELY 5% OF HER TIME EACH WEEK TO CHILDREN'S HOSPITAL AT MISSION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS AFFAIRS. KERRI RUPPERT SCHILLER IS COMPENSATED THROUGH THE PARENT COMPANY, RADY CHILDREN'S HEALTH (RCH), HOWEVER, IN ADDITION TO HER RESPONSIBILITIES FOR RCH, SHE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHOC FOUNDATION, CRC REAL ESTATE CORPORATION AND CHILDREN'S HOSPITAL AT MISSION (ALL IRC SECTION 501(C)(3) AFFILIATES). MS. SCHILLER DEVOTES APPROXIMATELY 5% OF HER TIME EACH WEEK TO CHILDREN'S HOSPITAL AT MISSION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS AFFAIRS. KIM MILSTEIN IS COMPENSATED THROUGH THE PARENT COMPANY, HOWEVER, IN ADDITION TO HER RESPONSIBILITIES FOR THE PARENT COMPANY, SHE ALSO SERVES AS AN OFFICER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHILDREN'S HOSPITAL AT MISSION AND CRC REAL ESTATE CORPORATION (ALL IRC SECTION 501(C)(3) AFFILIATES). MS. MILSTIEN DEVOTES APPROXIMATELY 16% OF HER TIME EACH WEEK TO CHILDREN'S HOSPITAL AT MISSION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON CHILDREN'S HOSPITAL OF ORANGE COUNTY BUSINESS AFFAIRS. FORM 990, PART I, LINE 5 AND PART V, LINE 2 CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) ACTS AS A COMMON PAYMASTER, ISSUING FORMS W-2 AND 1099 ON BEHALF OF CHILDREN'S HOSPITAL AT MISSION. CHILDREN'S HOSPITAL AT MISSION HAS 219 EMPLOYEES, HOWEVER BECAUSE OF THE COMMON PAYMASTER ARRANGEMENT RESULTING IN THE FORMS W-2 BEING ISSUED UNDER CHOC'S EMPLOYER IDENTIFICATION NUMBER, THERE ARE NO W-2S ISSUED DIRECTLY BY CHILDREN'S HOSPITAL AT MISSION. FORM 990, PART VI, SECTION A, LINE 4 THE GOVERNING DOCUMENTS WERE AMENDED TO MAKE RADY CHILDREN'S HEALTH THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 6 ORGANIZATION MEMBER INFORMATION THE SOLE MEMBER OF CHILDREN'S HOSPITAL AT MISSION (CHAM) IS THE PARENT COMPANY, RADY CHILDREN'S HEALTH (RCH). FORM 990, PART VI, SECTION A, LINE 7A PLEASE SEE THE EXPLANATION FOR LINE 7B. FORM 990, PART VI, SECTION A, 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 CHAM; (2) OBLIGATING CHAM TO UNDERTAKE ANY CAPITAL EXPENDITURE IN EXCESS OF $5,000,000; (3) ADOPTING CHAM'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 CHAM TO ACT AS GUARANTOR WITH RESPECT TO ANY DEBT OF ANY PERSON OR OTHER ENTITY; (8) ACCEPTING ANY DONATION WHICH IS CONDITIONED UPON CHAM'S UNDERTAKING ANY UNBUDGETED CAPITAL EXPENDITURE IN EXCESS OF $5,000,000 OR ANY UNBUDGETED EXPENDITURE IN EXCESS OF $5,000,000; (9) ENTERING INTO ANY CONTRACT WHICH INVOLVES THE FOLLOWING: (A) ANY FINANCIAL OBLIGATION ON THE PART OF CHAM IN AN AMOUNT IN EXCESS OF $5,000,000 OR (B) ANY PURPOSE OR ACTIVITY WHICH IS OUTSIDE THE SCOPE OF CHAM'S ORDINARY COURSE OF BUSINESS. (10) INVOLVING CHAM IN ANY MERGER, ACQUISITION, CORPORATE RESTRUCTURING, OR FORMAL AFFILIATION; (11) INVOLVING CHAM AS A MEMBER, SHAREHOLDER, OR PARTNER IN ANY NEW CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITY; (12) DISSOLVING CHAM; (13) ENTERING INTO ANY TRANSACTION INVOLVING THE SALE, CONVEYANCE, EXCHANGE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF CHAM'S ASSETS; (14) AMENDING CHAM'S ARTICLES OF INCORPORATION; (15) ADOPTING NEW BYLAWS OR AMENDING EXISTING BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B PROCESS OF REVIEW BEFORE FILING, KNOWLEDGEABLE EXPERIENCED MEMBERS OF MANAGEMENT REVIEW THE TAX RETURN AND RELATED SCHEDULES. MANAGEMENT REVIEWERS ALSO INTERACT THROUGHOUT THE YEAR WITH EXECUTIVES OF THE ORGANIZATION AND MEMBERS OF THE GOVERNING BOARD OF DIRECTORS TO ENHANCE ACCURACY AND COMPLETENESS OF THE RETURNS. FINAL DRAFTS OF THE TAX RETURNS ARE PROVIDED TO MEMBERS OF THE GOVERNING BOARD AT LEAST ONE WEEK PRIOR TO FILING FOR FINAL REVIEW AND THEIR COMMENTS, IF ANY, ARE INCORPORATED INTO THE FINAL RETURN PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C MONITORING/ENFORCING COMPLIANCE OF CONFLICT OF INTEREST POLICY THE CHIEF COMPLIANCE OFFICER IS CHARGED WITH MONITORING PROPOSED OR ONGOING TRANSACTIONS FOR CONFLICTS OF INTEREST AND ADDRESSING ANY POTENTIAL OR ACTUAL CONFLICTS. PURSUANT TO THE CONFLICT-OF-INTEREST POLICY, AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE, AIMED AT DETERMINING ANY FAMILY AND BUSINESS RELATIONSHIPS AND TRANSACTIONS OR OTHER TRANSACTIONS THAT MAY POSE A POTENTIAL CONFLICT, IS DISTRIBUTED TO ALL COVERED PERSONS (I.E., BOARD MEMBERS, OFFICERS AND EXECUTIVE LEADERSHIP OR KEY EMPLOYEES). COVERED PERSONS ARE REQUIRED TO DISCLOSE REAL OR POTENTIAL CONFLICTS AT THE TIME WHEN SUCH CONFLICTS ARISE. WHEN AN INDIVIDUAL BECOMES A COVERED PERSON AND ANNUALLY THEREAFTER, EACH COVERED PERSON IS REQUIRED TO SIGN A STATEMENT AFFIRMING THAT HE/SHE: (1) HAS RECEIVED A COPY OF THE CONFLICT-OF-INTEREST POLICY AND UNDERSTANDS SAID POLICY; (2) HAS READ THE POLICY AND UNDERSTANDS SAID POLICY; AND (3) AGREES TO COMPLY WITH ALL REQUIREMENTS OF THE POLICY, INCLUDING COMPLETING THE CONFLICT-OF-INTEREST QUESTIONNAIRE. THE COMPLETED QUESTIONNAIRES ARE REVIEWED BY THE COMPLIANCE OFFICER AND ANY PERSONS WITH ACTUAL OR POTENTIAL CONFLICTS ARE INFORMED VIA WRITTEN COMMUNICATION. THE PROCEDURES FOR ADDRESSING ANY CONFLICT OF INTEREST INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED TO THE BOARD OF DIRECTORS; (2) THE INTERESTED PERSON RESPONDS TO FACTUAL QUESTIONS RELATED TO THE SUBSTANCE OF THE TRANSACTION OR ARRANGEMENT BEING CONSIDERED; (3) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM ANY DISCUSSION OR APPROVAL OF SUCH TRANSACTION; (4) ALTERNATIVES TO THE PROPOSED TRANSACTION ARE INVESTIGATED, COMPETITIVE BIDS OR COMPARABLE VALUATIONS ARE OBTAINED; (5) THE TRANSACTION OR ACTION MUST BE APPROVED BY A MAJORITY OF DISINTERESTED PERSONS. FORM 990, PART VI, SECTION B, 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 CONSULTING FIRM TO PROVIDE RELEVANT COMPARABILITY DATA AND OTHER COMPENSATION STUDIES. THE CEO, OFFICERS AND EXECUTIVE MANAGEMENT SALARIES, INCENTIVES AND BENEFITS, AS WELL AS OVERALL COMPENSATION PHILOSOPHY AND POLICIES, ARE DISCUSSED WITH THE INDEPENDENT CONSULTANT REPRESENTATIVES AND THE COMPENSATION COMMITTEE MEMBERS, IN PERSON, IN CLOSED SESSIONS WITH NO STAFF MEMBERS PRESENT. THIS ANNUAL REVIEW WAS LAST PERFORMED IN OCTOBER 2024. ALL COMPARATIVE MARKET DATA, SUCH AS ANNUAL COMPENSATION SURVEY COMPRISED OF A PEER GROUP OF COMPARABLY SIZED PEDIATRIC HOSPITALS, IS WELL DOCUMENTED AND THERE ARE MINUTES FROM THESE MEETINGS THAT DOCUMENT THE MEMBERS PRESENT AND VOTING, THE COMPARATIVE DATA USED AND HOW IT WAS OBTAINED AND THE DELIBERATIONS AND DECISIONS OF THE COMMITTEE. THE RESULTS AND RECOMMENDATIONS FROM THE COMMITTEE ARE SHARED IN AN EXECUTIVE SESSION WITH THE PARENT COMPANY'S BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE FOR PUBLIC INSPECTION. FORM 990 AND THE COPY OF AUDITED FINANCIAL STATEMENTS ATTACHED TO IT ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G NURSING REGISTRY PERSONNEL: PROGRAM SERVICE EXPENSES 1,087,857. MANAGEMENT AND GENERAL EXPENSES 120,873. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,208,730. DR-DIRECT-INFECTION CONTROL: PROGRAM SERVICE EXPENSES 75,038. MANAGEMENT AND GENERAL EXPENSES 8,338. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 83,376. DR-DIRECT-OPHTHALMOLOGY: PROGRAM SERVICE EXPENSES 32,400. MANAGEMENT AND GENERAL EXPENSES 3,600. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 36,000. DR-COVERG-CHILD PSYCHIATRY: PROGRAM SERVICE EXPENSES 201,604. MANAGEMENT AND GENERAL EXPENSES 22,400. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 224,004. DR-COVERG-NEUROLOGICAL SURG: PROGRAM SERVICE EXPENSES 303,415. MANAGEMENT AND GENERAL EXPENSES 33,713. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 337,128. DR-COVERG-NEUROLOGY: PROGRAM SERVICE EXPENSES 85,072. MANAGEMENT AND GENERAL EXPENSES 9,452. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 94,524. DR-COVERG-NICU: PROGRAM SERVICE EXPENSES 75,600. MANAGEMENT AND GENERAL EXPENSES 8,400. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,000. DR-COVERG-PICU: PROGRAM SERVICE EXPENSES 833,683. MANAGEMENT AND GENERAL EXPENSES 92,632. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 926,315. DR-COVERG-SURGERY GENERAL: PROGRAM SERVICE EXPENSES 256,689. MANAGEMENT AND GENERAL EXPENSES 28,521. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 285,210. MEDICAL SERV-CONTRACTED HOSP: PROGRAM SERVICE EXPENSES 29,551,414. MANAGEMENT AND GENERAL EXPENSES 3,283,494. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,834,908. MEDICAL SERVICES-SSA: PROGRAM SERVICE EXPENSES 761,598. MANAGEMENT AND GENERAL EXPENSES 84,622. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 846,220. COLLECTION AGENCY SERV FEES: PROGRAM SERVICE EXPENSES 395,811. MANAGEMENT AND GENERAL EXPENSES 43,979. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 439,790. OTHER MISC PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 145,915. MANAGEMENT AND GENERAL EXPENSES 16,213. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 162,128. FORM 990, PART XI, LINE 9: TRANSFER TO CHC -14,000,000. TRANSFER TO RCH -3,800,000. OTHER CHANGES IN NET ASSETS 253,572. CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC) 1201 WEST LA VETA AVENUE ORANGE CA 92868 330265266 HEALTHCARE CA 501(C)(3) LINE 12A, I N/A 0 CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 WEST LA VETA AVENUE ORANGE CA 92868 952321786 HEALTHCARE CA 501(C)(3) LINE 7 RCH 0 CHOC FOUNDATION 1201 WEST LA VETA AVENUE ORANGE CA 92868 956097416 FUNDRAISING CA 501(C)(3) LINE 7 RCH 0 CRC REAL ESTATE CORPORATION 1201 WEST LA VETA AVENUE ORANGE CA 92868 330612565 REAL ESTATE CA 501(C)(3) LINE 12B, II RCH 0 PROVIDENCE SPEECH AND HEARING CENTER 1301 W PROVIDENCE AVENUE ORANGE CA 92868 956154473 HEALTHCARE CA 501(C)(3) LINE 7 CHOC 0 UNITED CEREBRAL PALSY ASSOC OF OC 1201 E DYER ROAD 150 SANTA ANA CA 92705 951856340 HEALTHCARE CA 501(C)(3) LINE 10 CHOC 0 RADY CHILDREN'S HEALTH SERVICES - SAN DIEGO 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 330278018 SUPPORT RCHSD CA 501(C)(3) LINE 12A, I RCHSD 0 RADY CHILDREN'S HOSPITAL - SAN DIEGO 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 951691313 HOSPITAL CA 501(C)(3) LINE 3 RCH 0 RADY CHILDREN'S HOSPITAL FOUNDATION - SAN DIEGO 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 330170626 FUNDRAISING CA 501(C)(3) LINE 7 RCH 0 RADY CHILDREN'S HOSPITAL RESEARCH CENTER 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 953814185 RESEARCH CA 501(C)(3) LINE 12A, I RCH 0 RADY CHILDREN'S HEALTH FKA RADY CHILDREN'S HOSPITAL AND HEALTH CENTER 3020 CHILDRENS WAY MC 5001 SAN DIEGO CA 92123 953545901 SUPPORT AFFILIATES CA 501(C)(3) LINE 12B, II RCH 0 CHILDREN'S HEALTH PLAN OF CALIFORNIA 1201 WEST LA VETA AVENUE ORANGE CA 92868 474876858 SUPPORT AFFILIATES CA 501(C)(3) LINE 12B, II RCH 0 ORANGE COUNTY MEDICAL RECIPROCAL INSURANCE COMPANY A RISK RETENTION GROUP 7400 E GAINEY CLUB DR 111 SCOTTSDALE AZ 85258 201620666 INSURANCE AZ N/A C 109820 4139990 0.50000 0 CHILDREN'S HOSPITAL INSURANCE LIMITED CANONS COURT 23 VICTORIA STREET HAMILTON BD HM 12 CAPTIVE INSURANCE BD CHIRP C 0 CHILDREN'S HOSPITAL INTEGRATED RISK PROTECTIVE LIMITED DORCHESTER HOUSE PO BOX 2020 HAMILTON BD HM HY CAPTIVE INSURANCE BD RCH C 0 CRUT (1) 3020 CHILDRENS WAY MC 5133 SAN DIEGO CA 92123 CRUT CA RCH T 0 RADY CHILDREN'S PHYSICIAN MGMT SERVICES INC 3860 CALLE FORTUNADA SUITE 200 SAN DIEGO CA 92123 330670694 MANAGEMENT SVCS CA RCH C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0