2019-05-15T19:09:46-05:00 2018-06-30 KPMG LLP 550 S Hope St Suite 1500 Los Angeles CA 90071 990 2017-07-01 956097416 CHOC Foundation % MIKALYN KLUTH CHOC 7149973000 1201 West La Veta Avenue Orange CA 92868 KERRI RUPPERT SCHILLER cfo 7149973000 2019-05-07 true VALERIE J BALL P00178114 4803675764 2019-05-10 167.68.102.5 95488420191355000050 2019-05-15 P AFC1CABF2724952AFBFC3879A4882118A11459E7 AFC1CABF2724952AFBFC3879A4882118A11459E7 2017 2019-02-21 02:37:17Z kimberly c cripe 1201 West La Veta Avenue orange CA 92868 88170780 false X www.choc.org X 1964 CA SUPPORTING CLINICAL AND NONCLINICAL SVCS Medical education, research & allied fields of pediatric at Children's Hospital of OC, Children's Hospital at Mission and its affiliates. 22 21 54 0 0 1328 28667067 33196520 0 0 1721189 7074451 0 0 30388256 40270971 28041777 16078697 0 0 5481522 6309392 0 0 6761021 4381383 4159127 37904682 26547216 -7516426 13723755 63406293 74531199 1443699 3179060 61962594 71352139 CHOC FOUNDATION WAS FORMED TO HELP SUPPORT CLINICAL AND NONCLINICAL SERVICES, MEDICAL EDUCATION, RESEARCH AND ALLIED FIELDS OF PEDIATRICS AT CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHILDREN'S HOSPITAL AT MISSION AND TO SUPPORT ITS AFFILIATES. false false 15762045 15762045 0 Childrens hospital of Orange County provides specialized pediatric services for the care of children and young adults. During this year, there were 65,577 days of inpatient care; 91,787 emergency room visits; 11,591 surgeries; 2,454 day health visits and 608,814 primary and specialty care clinic visits. Funds raised helps to offset cost of services provided to indigent families. 316652 316652 0 Children hospital at Mission funds support affiliated acute care pediatric hospital. Facility provides pediatric, young adult, neonatal and care for emergency services. There were 7,099 inpatient care days (including pediatric trauma visits); 15,137 emergency room visits; 653 surgeries and 22,685 outpatient visits. 2009484 0 0 CHOC Foundation generates community awareness and resources for CHOC Children's and CHOC Children's at Mission. The Foundation secures philanthropic support for health and well being of children. 18088181 true true false false false false false false false true true false false false true true true true false false false false false false true false false true false true false false false false false false false false true false false false false true false false false true X 94 0 true 54 true true true false false false false true true false false false false X 22 21 false false false false true true true true true false false true true true true true true true true false CA X MIKALYN KLUTH 7145094124 1201 WEST LA VETA AVENUE ORANGE CA 92868 X KIMBERLY CRIPE Director/President 5.0 35.0 X X 0 1598515 88781 TONY BOUTELLE Director 1.0 0.0 X 0 0 0 MICHAEL CHAO MD Director 1.0 0.0 X 0 0 0 ANNIKA CHASE Director/President 1.0 0.0 X 0 0 0 Lili Daftarian Director 1.0 0.0 X 0 0 0 Jeff Elghanayan Director 1.0 3.5 X 0 0 0 Jerry Flannery Director 1.0 0.0 X 0 0 0 Christopher Harrison Director 1.0 0.0 X 0 0 0 Steve Holley Director 1.5 0.0 X 0 0 0 Cary Hyden Director 1.0 0.0 X 0 0 0 Daniel Hyman Director/Vice Chair 1.5 0.0 X X 0 0 0 Ali Kavianian MD Director 1.0 0.0 X 0 0 0 Jason Knight MD Director 1.0 0.0 X 0 0 0 Gigi Kroll MD Director 1.0 0.0 X 0 0 0 Delphine Lee Director 1.5 0.0 X 0 0 0 Heather Madden Director/Secretary 1.5 0.0 X X 0 0 0 Adrienne Matros Director 1.5 0.0 X 0 0 0 Chris Rommel Director/Vice Chair 1.5 0.0 X X 0 0 0 Jon Storbeck Director 1.0 0.0 X 0 0 0 David Sugden Director 1.5 0.0 X 0 0 0 David Willis Director 1.0 0.0 X 0 0 0 SHRUTI MIYASHIRO Chair 3.0 0.0 X 0 0 0 Kerri Ruppert Schiller EVP/CFO/Assistant Secretary 4.0 36.0 X 0 849340 69400 Dennis McClellan Vice President (thru 3/2018) 40.0 0.0 X 656191 0 58836 Patrice Poidmore Executive Director 40.0 0.0 X 277175 0 42813 Joann Ferchland-Parella Associate VP, Principal Gifts 40.0 0.0 X 239316 0 17691 Kara Kipp Director Major Gifts 40.0 0.0 X 228605 0 32349 Wayne Combs Associate VP, OPERATIONS & ADM 40.0 0.0 X 198546 0 20465 Douglas Corbin Chief Development Officer 40.0 0.0 X 188452 0 2088 1788285 2447855 332423 19 false true false CI PARTNERS DIRECT LLC 1601 EASTMAN AVE SUITE 202 VENTURA CA 930036471 Consulting 334907 Woodmark Group 1424 NE 155TH STREET STE 100 SHORELINE WA 98155 Consulting 128162 2 X 3548724 29647796 383889 33196520 0 837950 837950 0 0 0 0 0 51649675 45413174 6236501 6236501 6236501 2486635 3548724 2486635 0 0 0 0 0 0 0 0 40270971 7074451 16078697 16078697 0 0 0 432788 142820 142820 147148 0 4355101 1088775 217755 3048571 100774 15539 12105 73130 1092869 51593 623917 417359 327860 48730 53672 225458 667104 209894 197144 260066 0 0 0 0 68595 68595 811820 178299 127178 506343 738565 72762 20552 645251 30787 7115 4314 19358 168003 8224 60176 99603 0 272153 94015 94015 84123 81554 4659 15257 61638 0 224988 13717 13102 198169 0 0 74118 24459 24459 25200 11698 2274 2274 7150 DONOR EVENT EXPENSE 529122 529122 DUES 459077 45842 19912 393323 TAXES & LICENSES 21543 767 767 20009 26547216 18088181 1698014 6761021 7754760 9129369 1060550 367232 11156264 16586922 0 0 0 0 0 0 0 0 0 0 254738 475442 1231250 600903 175159 630347 42487794 46924526 0 0 0 0 0 0 517028 417361 63406293 74531199 817345 1247803 0 0 0 0 0 0 0 0 0 0 0 0 0 0 626354 1931257 1443699 3179060 X 22056177 23274689 18660731 26309514 21245686 21767936 61962594 71352139 63406293 74531199 X 13723755 -4609851 475000 -199359 X false true X true false X 29891118 25814412 23622305 28646524 33196520 141170879 0 0 29891118 25814412 23622305 28646524 33196520 141170879 16725799 124445080 629152 603492 646537 685470 837950 3402601 0 1902114 1889252 2291610 2601070 2486635 11170681 155744161 0.79904 0.69460 X 39537672 1351071 2355682 720562 42523863 32329250 4389756 3471548 652882 39537672 32289235 787732 -75491 0 672226 0 32329250 30854374 1095767 910970 0 571876 0 32289235 25687579 1865288 4042450 0 740943 0 30854374 0.36830 0.51190 0.11980 false false 0 115941 112140 3801 0 490716 488763 1953 624593 624593 630347 0 PAYABLE TO AFFILIATES 1931257 1931257 X 35507331 -4609851 475000 -4134851 39642182 628789 628789 40270971 26117787 26117787 429429 429429 26547216 ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740: GAAP requires the Organization's management to evaluate tax positions taken by the organization and recognizes 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, 2018, there are no uncertain tax positions taken or expected to be taken that would require recognition of a liability or disclosure in the financial statements. OTHER CHANGES IN NET ASSETS PART XI, LINE 4B CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS $99,667 DONOR EVENT EXPENSE $529,122 =============== TOTAL LINE 4B $628,789 PART XII, LINE 4B DONOR EVENT EXPENSE $529,122 Impairment $(99,693) =============== TOTAL LINE 4B $429,429 Schedule D, Part V, Line 4 The endowment fund is used to support hospital programs addressing the needs of the underserved, social services to patients and families in need, and research and treatment of children's diseases and disorders. CHOC GALA 2662597 1129512 1533085 50634 105000 323393 870113 183945 GUILDS 1415926 1052783 363143 9299 194287 18295 5000 136262 5 1956836 1366429 590407 23826 131951 144383 2194 288053 6035359 3548724 2486635 83759 431238 486071 877307 608260 2486635 true CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 West La Veta Avenue ORANGE CA 92868 952321786 501(c)(3) 15762045 n/a n/a HOSPITAL OPERATIONS AND CHARITABLE CARE CHILDREN'S HOSPITAL AT MISSION 1201 West La Veta Avenue ORANGE CA 92868 330528802 501(c)(3) 316652 n/a n/a HOSPITAL OPERATIONS AND CHARITABLE CARE 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS - PART I, LINE 1 CHOC Foundation receives contributions on behalf of Children's Hospital of Orange County and Children's Hospital at Mission, both affiliated 501(c)(3) organizations. Donations are generally restricted or designated by donors for various purposes at inception. The funds are then distributed to the appropriate organization according to donor stipulations for medical programs or for the new tower construction as designated. X X X X false true false false false false false false false KIMBERLY CRIPE Director/President 0 957940 0 352837 0 287738 0 62556 0 26225 0 1687296 0 43791 Dennis McClellan Vice President (thru 3/2018) 432781 0 140530 0 82880 0 58588 0 248 0 715027 0 52562 0 Kerri Ruppert Schiller EVP/CFO/Assistant Secretary 0 553886 0 140832 0 154622 0 37638 0 31762 0 918740 0 21706 Patrice Poidmore Executive Director 214569 0 46911 0 15695 0 11996 0 30817 0 319988 0 0 0 Joann Ferchland-Parella Associate VP, Principal Gifts 190738 0 34101 0 14477 0 686 0 17005 0 257007 0 0 0 Kara Kipp Director Major Gifts 175571 0 38906 0 14128 0 6516 0 25833 0 260954 0 0 0 Wayne Combs Associate VP, OPERATIONS & ADM 175171 0 10000 0 13375 0 1041 0 19424 0 219011 0 0 0 Douglas Corbin Chief Development Officer 150010 0 25312 0 13130 0 1856 0 232 0 190540 0 0 0 SCHEDULE J, LINE 4A SOME 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 THE CURRENT KEY EMPLOYEES WERE REPORTED AT THEIR FULL VALUE IN A PREVIOUS TAX YEAR. NO PAYMENTS WERE MADE DURING 2017. COMPENSATION FROM AN AFFILIATED ORGANIZATION KIMBERLY 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, CRC REAL ESTATE CORPORATION AND CHILDREN'S HOSPITAL AT MISSION (ALL IRC Section 501(C)(3) AFFILIATES). MS. CRIPE DEVOTES APPROXIMATELY 13% OF HER TIME EACH WEEK TO CHOC FOUNDATION 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, CRC REAL ESTATE CORPORATION AND CHILDREN'S HOSPITAL AT MISSION (ALL IRC Section 501(C)(3) AFFILIATES). MS. SCHILLER DEVOTES APPROXIMATELY 10% OF HER TIME EACH WEEK TO CHOC FOUNDATION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS affairs. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN - PART I, LINE 4b Children'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) 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 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 individual received payments from the Plan during calendar year 2017:MS. CRIPE ($189,761) AND MS. SCHILLER ($93,078) X 12 348889 Average Market Value X Airplane Tickets 1 20000 Retail price X Medical Equipment 1 15000 MSRP false true true SCHEDULE M, PART I, COLUMN B THE NUMBER LISTED IN PART I, LINE 9 COLUMN (B) WAS DETERMINED BASED ON THE NUMBER OF CONTRIBUTIONS RECEIVED. Information Regarding Common Paymaster 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 CHOC Foundation. CHOC Foundation has 54 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 CHOC Foundation. Form 990, Part I, Line 7B Part I, Line 7B includes section 512(a)(7) qualified transportation fringe benefit amounts that are not revenue and therefore not reported on form 990. members or stockholders Form 990, Part VI, Section A, Line 6 The sole member of CHOC Foundation is Children's HealthCare of California (CHC). persons who may elect members of the governing body Form 990, Part VI, Section A, Line 7a Directors of CHOC Foundation shall be elected annually by the Member, based on the nomination(s) provided by CHOC Foundation'S Board of Directors. the governing body's decisions subject to approval Form 990, Part VI, Section A, Line 7b The approval of the Member shall be required with respect to any of the following actions: (1) Changing the purposes and powers of CHOC Foundation; (2) Obligating CHOC Foundation to undertake any capital expenditure in excess of $1,000,000; (3) Adopting CHOC Foundation'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 Foundation to act as guarantor with respect to any debt of any person or other entity; (8) Accepting any donation which is conditioned upon CHOC Foundation'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 any of the following: (a) any financial obligation on the part of CHOC Foundation in an amount in excess of $5,000,000, (b) any purpose or activity which is outside the scope of CHOC Foundation's ordinary course of business, or (c) a term in excess of five years (unless the contract is terminable at will); (10) involving CHOC Foundation in any merger, acquisition, corporate restructuring, or formal affiliation; (11) Involving CHOC Foundation as a member, shareholder, or partner in any new corporation, partnership, or other legal entity; (12) Dissolving CHOC Foundation; (13) Entering into any transaction involving the sale, lease, conveyance, exchange, transfer or other disposition of all or substantially all of CHOC Foundation's assets; (14) Amending CHOC Foundation'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. PROCESS OF REVIEW Form 990, Part VI, Section B, Line 11B Prior to filing, the tax return and related schedules are provided to the 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 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. MONITORING AND ENFORCING COMPLIANCE OF CONFLICT INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C 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). 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 contacted via written communication. The procedures for addressing any conflict of interest may include but are 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 conflict, the substance of the transaction or the arrangement being considered; (3)the person with the conflict of interest is excluded from any discussion or approval of such transaction; (4)if applicable alternatives to the proposed transaction are investigated, competitive bids or comparable valuations are obtained; and (5)the transaction or action must be approved by a majority of disinterested persons. PROCESS OF DETERMINING COMPENSATION OF THE CEO AND OFFICERS FORM 990, PART VI, SECTION B, LINE 15 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 closed sessions with no staff members present. This review was last performed in October 2017. All comparative salary data, such as annual compensation survey comprising 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 Board of Directors. disclosure copy - FORM 990, PART VI, SECTION C, LINE 19 While 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. Form 990, Part XI, Line 5 Change in value of Split-Interest Agreement $ (99,667) IMPAIRMENT $ (99,693) ROUNDING DIFFERENCE $ 1 ------------ Total $(199,359) CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC) 1201 West La Veta Avenue ORANGE CA 92868 330265266 HEALTH CARE CA 501(C)(3) 7 NA false CHILDREN'S HOSPITAL OF ORANGE COUNTY 1201 West La Veta Avenue ORANGE CA 92868 952321786 HEALTH CARE CA 501(C)(3) 3 CHC false CHILDREN'S HOSPITAL AT MISSION 1201 West La Veta Avenue ORANGE CA 92686 330528802 HEALTH CARE CA 501(C)(3) 3 CHC false CRC REAL ESTATE CORPORATION 1201 West La Veta Avenue ORANGE CA 92868 330612565 real estate CA 501(C)(3) 11a CHC false false true false false false false false false false false true true true false false false false false false