2022-07-13T09:00:55-05:00 2021-08-31 PricewaterhouseCoopers LLP 101 SEAPORT BLVD SUITE 500 BOSTON MA 02210 990 2020-09-01 320359189 PACKARD CHILDREN'S HEALTH ALLIANCE % PATRICK IDEMOTO PACK 6504978000 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 DANA HAERING CFO 6507212222 2022-07-06 true DANA HAERING 999009999 GWEN SPENCER P00641463 6175305000 2022-06-20 2 2020 2022-09-23 18:48:47Z PATRICK IDEMOTO 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 119394567 false X WWW.STANFORDCHILDRENS.ORG X 2011 CA SEE SCHEDULE O 9 3 388 0 0 0 0 4748302 105542760 114646265 0 0 0 0 105542760 119394567 0 0 0 0 32716506 37452897 0 0 0 92816440 95773396 125532946 133226293 -19990186 -13831726 36301332 36765810 28008946 28299452 8292386 8466358 X SEE SCHEDULE O false false 121082661 114646265 SEE SCHEDULE O 121082661 true false false false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 81 0 true 388 true false false false false false false false false false false false false X 9 3 true false false false true true true true true false false true true true true true false false false false CA X PATRICK IDEMOTO 6507235636 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 Dana Haering EVP & CFO 3.0 47.0 X 0 1096753 69322 Dennis P Lund MD DIRECTOR/CHAIR 1.0 50.0 X X 0 974477 66335 TIM CORNELL MD DIRECTOR 1.0 50.0 X 0 763923 107475 Edward Kopetsky SVP & CIO 0.0 50.0 X 0 776164 83458 MARCIA COHEN DIRECTOR 1.0 51.0 X 0 725407 61838 Cameron D'alpe CAO PHYS PRAC, CEO TO 2/21 17.0 33.0 X X 0 613185 63978 PATRICK IDEMOTO INTERIM CEO AS OF 3/1/21 25.0 25.0 X X 0 590514 70763 ANDREW SMITH MEDICAL DIRECTOR, SECRETARY 50.0 0.0 X X 448965 0 67606 RICK VANCE COO 50.0 0.0 X 367096 0 35253 TZIELAN LEE MD DIRECTOR 1.0 50.0 X 0 304002 43290 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 50.0 0.0 X 293054 0 53913 MALAVIKA NARAYAN DIR. OF PHYSCN NET. FIN. 50.0 0.0 X 0 321906 0 MICHAEL LIPMAN DIRECTOR, PROVIDER RECRUIT. 50.0 0.0 X 260415 0 15542 TAMMY OJEDA-LEAO DIRECTOR GENERAL PEDIACTRICS 50.0 0.0 X 186119 0 76873 DOROTHY NAIDU DIRECTOR, CLINICAL QUALITY 50.0 0.0 X 211221 0 30861 TIFFANY AUBREY DIR. OF PRACTICE OPERATIONS 50.0 0.0 X 199975 0 22631 SAMAR S SHAKOOR DIR - PHYSICIAN RELATIONS 50.0 0.0 X 172730 0 42511 SUSAN AULT PRACTICE MANAGER III 50.0 0.0 X 179830 0 31146 EMILY KRUGER DIR., PHYSICIAN NETWORK FIN. 50.0 0.0 X 0 170980 38493 MALINDA MITCHELL DIRECTOR/ VICE CHAIR 1.0 0.0 X X 0 0 0 JOHN WALKER DIRECTOR 1.0 3.0 X 0 0 0 LISA ERBURU MD DIRECTOR 1.0 50.0 X 0 0 0 2319405 6337311 981288 40 true true false PACKARD MEDICAL GROUP INC 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 PHYSICIAN SERVICES 58654902 SANOFI PASTEUR INC 12458 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 Medical supplies 7983849 G AND G ORGANIZATION LTD DBA PFS GR 2600 NORTH LOOP WEST STE 150 HOUSTON TX 77092 Service 2644261 MCKESSON MEDICAL-SURGICAL PO BOX 848001 DALLAS TX 94582 Medical supplies 1291011 CAREMARK LLC DEPARTMENT LA 21403 PASADENA CA 911851403 Service 1114597 23 4748302 4748302 PATIENT SERVICES 900099 96140792 96140792 MEDICARE/MEDICAID 900099 8138529 8138529 PROGRAM SUPPORT 900099 10366944 10366944 114646265 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 119394567 114646265 0 0 0 0 1418911 1046782 372129 0 20686861 17231780 3455081 917640 459902 457738 12578411 10754679 1823732 1851074 1634304 216770 170928 84209 86719 253613 253613 47569 47569 0 0 0 65547715 61946468 3601247 71025 30792 40233 15875799 15690479 185320 3920631 3920631 0 6462983 6462939 44 41657 25951 15706 0 0 0 0 2655064 1841005 814059 488853 30374 458479 UNCOLLECTIBLES 917969 917969 LICENSES & TAXES 242228 26391 215837 DUES & SUBSCRIPTIONS 231905 176033 55872 UTILITIES 161205 161205 -1315748 -1359232 43484 133226293 121082661 12143632 0 X 0 0 -486922 61620 0 0 9107987 10610515 0 0 0 0 0 0 0 0 780839 741014 20788353 17516703 4064199 3271650 0 0 0 0 0 0 7875199 6784991 14960030 15296020 36301332 36765810 5462180 6919918 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22546766 21379534 28008946 28299452 X 8292386 8466358 0 0 8292386 8466358 36301332 36765810 X -13831726 14005698 X false true X true false X SCHEDULE A, PART I PACKARD CHILDREN'S HEALTH ALLIANCE WAS RECOGNIZED AS A HEALTHCARE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) OF THE INTERNAL REVENUE CODE. PCHA DOES NOT OPERATE A FACILITY THAT IS OR IS REQUIRED TO BE LICENSED AS A HOSPITAL. THEREFORE, PCHA IS NOT REQUIRED TO FILE FORM 990, SCHEDULE H. 5904286 5233565 670721 14179082 12283138 1895944 704985 704985 3271650 OTHER ASSETS 3070876 RIGHT OF USE LEASE ASSETS 12163000 SECURITY DEPOSITS 62144 15296020 0 DUE TO RELATED PARTIES, NET 8914387 RIGHT OF USE LEASE LIABILITIES 12465147 21379534 X SCHEDULE D, PART X, LINE 2 FIN 48 PCHA IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF STANFORD UNIVERSITY, WHICH INCLUDE THE FOLLOWING NOTE: IN ACCORDANCE WITH THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, MANAGEMENT REGULARLY EVALUATES ITS TAX POSITIONS AND DOES NOT BELIEVE PCHA HAS ANY UNCERTAIN TAX POSITIONS THAT REQUIRE DISCLOSURE OR ADJUSTMENT TO THE FINANCIAL STATEMENTS. false true false false false false false true false TZIELAN LEE MD DIRECTOR 0 260945 0 43057 0 0 0 24179 0 19111 0 347292 0 0 TIM CORNELL MD DIRECTOR 0 315740 0 141155 0 307028 0 16872 0 90603 0 871398 0 0 MARCIA COHEN DIRECTOR 0 607941 0 117206 0 260 0 28500 0 33338 0 787245 0 0 MALAVIKA NARAYAN DIR. OF PHYSCN NET. FIN. 0 282271 0 39635 0 0 0 0 0 0 0 321906 0 0 Dennis P Lund MD DIRECTOR/CHAIR 0 410562 0 485276 0 78639 0 26425 0 39910 0 1040812 0 0 Dana Haering EVP & CFO 0 680989 0 157750 0 258014 0 52450 0 16872 0 1166075 0 137520 Cameron D'alpe CAO PHYS PRAC, CEO TO 2/21 0 418385 0 75092 0 119708 0 48295 0 15683 0 677163 0 73452 EMILY KRUGER DIR., PHYSICIAN NETWORK FIN. 0 170980 0 0 0 0 0 15530 0 22963 0 209473 0 0 RICK VANCE COO 338061 0 29035 0 0 0 16800 0 18453 0 402349 0 0 0 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 273426 0 19628 0 0 0 16784 0 37129 0 346967 0 0 0 MICHAEL LIPMAN DIRECTOR, PROVIDER RECRUIT. 242874 0 17541 0 0 0 14061 0 1481 0 275957 0 0 0 DOROTHY NAIDU DIRECTOR, CLINICAL QUALITY 194470 0 16751 0 0 0 12352 0 18509 0 242082 0 0 0 ANDREW SMITH MEDICAL DIRECTOR, SECRETARY 384998 0 63967 0 0 0 16800 0 50806 0 516571 0 0 0 TIFFANY AUBREY DIR. OF PRACTICE OPERATIONS 187267 0 12708 0 0 0 4122 0 18509 0 222606 0 0 0 TAMMY OJEDA-LEAO DIRECTOR GENERAL PEDIACTRICS 174059 0 12060 0 0 0 9661 0 67212 0 262992 0 0 0 Edward Kopetsky SVP & CIO 0 565139 0 108132 0 102893 0 55589 0 27869 0 859622 0 0 PATRICK IDEMOTO INTERIM CEO AS OF 3/1/21 0 464337 0 78620 0 47557 0 67276 0 3487 0 661277 0 0 SUSAN AULT PRACTICE MANAGER III 172508 0 7322 0 0 0 12269 0 18877 0 210976 0 0 0 SAMAR S SHAKOOR DIR - PHYSICIAN RELATIONS 161620 0 11110 0 0 0 10311 0 32200 0 215241 0 0 0 PROCEDURES FOR DETERMINING COMPENSATION SCHEDULE J, PART I, LINE 3 PCHA RELIED ON LPCH, A RELATED ORGANIZATION, TO DETERMINE OFFICER COMPENSATION. LPCH'S PROCESS FOR DETERMINING COMPENSATION REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED ON INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF LPCH. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS, AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B CERTAIN OFFICERS OF PCHA ARE PROVIDED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS BY LPCH, A RELATED ORGANIZATION. FOR EACH CALENDAR YEAR, A HYPOTHETICAL ACCOUNT IS ESTABLISHED FOR EACH PARTICIPANT AND CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION) AS OF THE LAST DAY OF EACH QUARTER. THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN EACH CALENDAR YEAR ACCOUNT ON THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE SECOND CALENDAR YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED (OR, IF LATER, THE DATE ON WHICH THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION). THE PARTICIPANT BECOMES FULLY VESTED IN HIS OR HER ACCOUNTS UNDER THE SERP UPON THE EARLIEST OF (A) DISCHARGE FROM EMPLOYMENT WITHOUT CAUSE; (B) ENTITLEMENT TO LONG-TERM DISABILITY INCOME BENEFITS; (C) ATTAINMENT OF AGE OF 60 WHILE EMPLOYED OR IF LATER, THE PARTICIPANT'S COMPLETION OF TWO FULL YEARS OF PARTICIPATION; (D) COMPLETION OF SEVEN YEARS AS AN ELIGIBLE EMPLOYEE; OR (E) THE DATE OF DEATH, PRIOR TO PAYMENT OR FORFEITURE, WITH BENEFITS PAYABLE TO THE BENEFICIARY. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING INDIVIDUALS IN CALENDAR YEAR 2020: DANA HAERING $ 225,791 EDWARD KOPETSKY $ 69,871 CAMERON D'ALPE $ 117,920 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (C). SCHEDULE J, PART I, LINE 7 CERTAIN OFFICERS AND OTHERS AS ENUMERATED IN SCHEDULE J, PART II PARTICIPATE IN SERP, WHICH WAS DESCRIBED ABOVE UNDER SCHEDULE J, PART I, LINE 4B. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. ORGANIZATION'S PRIMARY EXEMPT PURPOSE FORM 990, PART I, LINE 1 & PART III, LINE 1 AT PCHA, THE FOCUS IS ON PATIENT CARE AND COMMUNITY OUTREACH TO ENSURE PATIENT ACCESS TO PCHA'S SERVICES. PCHA PHYSICIANS, NON-MD CLINICIANS, AND STAFF ASSUME THE ROLE OF EDUCATORS TO IMPROVE THE PHYSICAL AND BEHAVIORAL WELL-BEING OF CHILDREN IN THE COMMUNITIES IT SERVES. THE OVERALL STRATEGY TO ACCOMPLISH THE OBJECTIVE IS TWOFOLD: BECOME A RELIED UPON RESOURCE FOR CAREGIVERS/PARENTS AND PROVIDE PREVENTATIVE CARE FOR CHILDREN. EDUCATION IS THE KEY FOR BOTH STRATEGIES. WHILE MULTIPLE COMMUNITY SERVICES WILL BE OFFERED AT THE MEDICAL SITES, A SIGNIFICANT PART OF THE OUTREACH EFFORTS WILL BE SPENT SERVING THE PCHA COMMUNITY. PROGRAM SERVICE DESCRIPTION FORM 990, PART III, LINE 4A DURING THE PERIOD OF SEPTEMBER 2020 THROUGH AUGUST 2021 (FY 2021), PCHA PRIMARILY FOCUSED ON OPERATIONS AND EXISTING PROVIDER VISIT GROWTH. IN ADDITION, WE CONTINUE TO INCREASE OUR AVAILABILITY AT MANY OF OUR SITES BY INCREASING THE NUMBER OF PROVIDERS. THIS YEAR WE CONTINUED TO IMPROVE SERVICES OFFERED VIA OUR PATIENT PORTAL INCLUDING DIRECTLY SCHEDULING APPOINTMENTS, REQUESTING PRESCRIPTIONS, VIEWING BILLING STATEMENTS AND COMMUNICATING WITH MEDICAL PROVIDERS. THE THREE LARGEST SERVICES PCHA OPERATED IN FISCAL YEAR 2021 WERE: GENERAL PEDIATRICS - BAYSIDE GENERAL PEDIATRICS - PENINSULA PEDIATRICS GENERAL PEDIATRICS - PEDIATRIC ASSOCIATES BAYSIDE BAYSIDE PEDIATRICS WAS ESTABLISHED IN OAKLAND IN 1979 AND HAS GROWN THROUGHOUT THE EAST BAY INTO A NETWORK OF 9 PEDIATRIC OFFICES, WITH A DEDICATED TEAM WHO HAVE OUTSTANDING CREDENTIALS AND EXPERIENCE. WE PROVIDE PERSONALIZED, HIGH-QUALITY, AND PATIENT-CENTERED CARE. OUR PEDIATRICIANS SPECIALIZE IN THE CARE OF NEWBORNS, CHILDREN AND ADOLESCENTS AT ALL 9 OF OUR OFFICES. IN ADDITION, WE HAVE A PEDIATRICIAN WITH PULMONOLOGY EXPERIENCE WHO BRINGS EXPERTISE IN ASTHMA CARE TO OUR PATIENTS. WE ALSO PROVIDE TRAVEL MEDICINE SERVICES. WE ARE COMMITTED TO PROVIDING EXCELLENT CARE TO ALL CHILDREN AND THEIR FAMILIES. PENINSULA PEDIATRICS AT PENINSULA PEDIATRIC MEDICAL GROUP, OUR FAMILY OF EXPERIENCED AND CARING PEDIATRICIANS HAS BEEN SERVING CHILDREN IN THE BAY AREA FOR GENERATIONS. WE SPECIALIZE IN CARING FOR NEWBORNS THROUGH ADOLESCENTS IN THEIR LATE TEENS. WE WORK WITH PARENTS TO HELP CHILDREN REACH THEIR HIGHEST POTENTIAL BY GIVING THEM THE TOOLS THEY NEED TO LIVE A HEALTHY LIFE. WE STRIVE TO BE UNDERSTANDING AND AVAILABLE TO THE FAMILIES WE ARE PRIVILEGED TO SERVE, AND OFFER OUR SERVICES IN BURLINGAME, SAN MATEO AND MENLO PARK. PEDIATRIC ASSOCIATES MEDICAL GROUP THE PEDIATRIC ASSOCIATES MEDICAL GROUP HAS 8 PHYSICIANS IN TWO SAN JOSE LOCATIONS, SAMARITAN, AND CAMDEN. THE GROUP HAS BEEN PROVIDING THE FULL CONTINUUM OF GENERAL PEDIATRIC SERVICES TO CHILDREN AND YOUNG ADULTS FOR OVER 30 YEARS. PATIENT VISITS PROVIDED IN THE FISCAL YEAR 2021 FOR EACH OF THE LARGEST SERVICES ARE: BAYSIDE: 62,553 PENINSULA PEDIATRICS: 36,012 PEDIATRIC ASSOCIATES: 19,605 DURING FISCAL YEAR 2021 PCHA PROVIDED 256,310 OFFICE VISITS. FAMILY/BUSINESS RELATIONSHIP FORM 990, PART VI, LINE 2 MARCIA COHEN, TIM CORNELL, TZIELAN LEE, AND DENNIS LUND ARE EMPLOYEES OF STANFORD SCHOOL OF MEDICINE. DANA HAERING IS AN OFFICER OF LUCILE SALTER PACKARD CHILDREN'S HOSPITAL. DENNIS LUND IS AN OFFICER AND DIRECTOR OF LUCILE SALTER PACKARD CHILDREN'S HOSPITAL. MEMBERS FORM 990, PART VI, LINE 6 STANFORD UNIVERSITY AND LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD ARE THE MEMBERS OF PCHA. FORM 990, PART VI, LINE 7A STANFORD UNIVERSITY AND LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD, AS THE MEMBERS OF PCHA, APPOINT THE PCHA BOARD OF DIRECTORS. TWO OF THE DIRECTORS MUST BE PERSONS WHO RESIDE IN THE COMMUNITIES SERVED BY PCHA AND WHO ARE NOT COMPENSATED BY PCHA, THE MEMBERS, OR ANY MEDICAL GROUP AFFILIATED WITH PCHA. FORM 990, PART VI, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY ONE OR MORE MEMBERS: - ENTERING INTO PROFESSIONAL SERVICE AGREEMENTS WITH NEW MEDICAL GROUPS - ACQUISITION, MERGER, OR CONSOLIDATION OF ANY OTHER ENTITY. PROCEDURES FOR REVIEWING FORM 990 FROM GOVERNING BODY FORM 990, PART VI, LINE 11 WORKING WITH PRICEWATERHOUSECOOPERS, THE FORM 990 IS PREPARED FOR MANAGEMENT'S REVIEW. A DRAFT OF THE FORM 990 IS MAILED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW, ALONG WITH AN EXECUTIVE SUMMARY OF RECENT CHANGES AND NEW REQUIREMENTS. THE DRAFT FORM 990 IS REVIEWED AT THE AUDIT AND COMPLIANCE COMMITTEE MEETING. A FINAL FORM 990 IS THEN DISTRIBUTED TO THE FULL BOARD BEFORE FILING WITH THE IRS. PRICEWATERHOUSECOOPERS SIGNS THE FINAL RETURN AS PAID PREPARER. PROCEDURES FOR MONITORING AND ENFORCING COMPLIANCE WITH CONFLICT-OF-INTEREST POLICY FORM 990, PART VI, LINE 12C OFFICERS, DIRECTORS AND EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") AT THE TIME OF APPOINTMENT AT PCHA. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS. A DISCLOSURE THAT APPEARS TO BE A CONFLICT WILL BE RESOLVED BY A MUTUAL AGREEABLE PLAN WITH THE PCHA CHIEF EXECUTIVE OFFICER THAT OUTLINES THE STEPS THE OFFICER, DIRECTOR OR EMPLOYEE MUST TAKE TO RECTIFY THE CONFLICT. PROCEDURES FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15 FOR THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER, PCHA RELIED ON LPCH, A RELATED ORGANIZATION, TO DETERMINE OFFICER COMPENSATION. LPCH'S PROCESS FOR DETERMINING COMPENSATION REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF LPCH. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS, AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES. THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES WHO ARE EMPLOYEES OF PCHA IS DETERMINED BY A PROCESS THAT INCLUDES A REVIEW OF COMPARABILITY DATA AND CONTEMPORANEOUS SUBSTANTIATION OF THE DECISION. COMPENSATION DECISIONS WITH RESPECT TO OFFICERS AND KEY EMPLOYEES WHOSE COMPENSATION EXCEEDS A SPECIFIED THRESHOLD ARE MADE BY THE PCHA COMPENSATION COMMITTEE. FORM 990, PART VI, LINE 19 THE STATEMENTS OF OPERATIONS AND BALANCE SHEET ARE INCLUDED IN THE ANNUAL REPORT POSTED ON THE ORGANIZATION'S PUBLIC WEBSITE. COPIES OF THE FINANCIAL STATEMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. COPIES OF THE GOVERNING DOCUMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. THE CONFLICT OF INTEREST POLICY IS NOT CURRENTLY AVAILABLE FOR PUBLIC INSPECTION. RECONCILIATION FORM 990, PART XI, LINE 9 EQUITY TRANSFERS TO PCHA FROM LPCH IN FY21 $14,005,698 FORM 990 PART IX LINE 11G DESCRIPTION:TEMP LABOR - MEDICAL PHYSICIAN TOTAL FEES:1323652 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL SERVICE TOTAL FEES:71943 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:6385978 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER MEDICAL SERVICES TOTAL FEES:57766142 THE BRD OF TRUST LELAND STANF JR UNIV 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 941156365 EDUCATION CA 501(C)(3) 2 NA false FUNDACION STANFORD UNIVERSITY EN CHILE AV CONDELL 189 PROVIDENCIA SANTIAGO CI CI N/A HOSPITAL COMMITTEE FOR THE L-P AREAS 1111 E STANLEY BLVD LIVERMORE CA 94550 941429628 HOSPITAL CA 501(C)(3) 3 SHC true JAEDAN BUPIN STANFORD CENTER IN THE REPU RESEARCH KR 501(C)(3) N/A Stanford true LUCILE PACKARD FOUNDATION FOR CHILDREN'S 400 HAMILTON AVENUE SUITE 340 PALO ALTO CA 94301 770440090 HEALTHCARE CA 501(C)(3) 7 LPCH true LUCILE SALTER PACKARD CHILDRENS HOSPITAL 725 WELCH ROAD MC 5553 PALO ALTO CA 94304 770003859 HEALTHCARE CA 501(C)(3) 3 STANFORD true SHR HOLDINGS INC 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 943187167 REAL ESTATE CA 501(C)(25) N/A STANFORD true STANFORD FACULTY CLUB PO BOX 7229 STANFORD CA 94309 941187089 FAC INTERACT. CA 501(C)(7) N/A STANFORD true STANFORD FEDERAL CREDIT UNION 1860 EMBARCADERO RD PALO ALTO CA 94303 941492212 CREDIT UNION CA 501(C)(1) N/A STANFORD true STANFORD HABITAT CONSERVATION BOARD 415 BROADWAY REDWOOD CITY CA 94063 461882243 CONSERVATION CA 501(C)(3) 7 STANFORD true STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD CA 94305 946174066 HEALTHCARE CA 501(C)(3) 3 STANFORD true STANFORD HEALTH CARE ADVANTAGE 1221 BROADWAY 3RD FLOOR OAKLAND CA 94612 464071746 HEALTHCARE CA 501(c)(3) 12A, I SHC true STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BLDG 11 CAPE TOWN SF EDUCATION SF 501(C)(3) N/A STANFORD true STANFORD UNIVERSITY BOOKSTORE BLDG 60 MAIN QUAD NO 105 STANFORD CA 94305 940894150 SUPPORT CA 501(C)(3) 12A, I STANFORD true SU EMP BEN TRUST POST RETEMPYNT BEN 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 943246199 BENEFITS CA 501(C)(9) N/A STANFORD true THE DUDLEY E CHAMBERS FOUNDATION JP MORGAN CHASE PO BOX 3038 MILWAUKEE WI 53201 386841793 SUPPORT NY 501(C)(3) 12D, III-O STANFORD true THE FREIDENRICH SUPPORT FOUNDATION 485 BROADWAY MAILCODE 8838 REDWOOD CITY CA 94063 300519583 SUPPORT CA 501(C)(3) 12A, I STANFORD true THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD CAUSEWAY HK 986078093 SUPPORT HK 501(C)(3) N/A STANFORD true THE STANFORD TRUST 65 HIGH STREET OXFORD UK OX1 46L SUPPORT UK 501(C)(3) N/A STANFORD true UNIVERSITY HEALTHCARE ALLIANCE 7999 GATEWAY BLVD STE 300 NEWARK CA 94560 943192446 HEALTHCARE CA 501(C)(3) 3 SHC true VALLEYCARE MEDICAL FOUNDATION INC 1111 E STANLEY BLVD LIVERMORE CA 94550 262593526 SUPPRT SHC-VC CA 501(C)(3) PF HOSP CMTE LP true VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE CA 94550 943382224 SR. 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SCHEDULE R, PART IV, LINE 5 CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 6 CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 7 OTHER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.