2018-05-15T16:49:57-05:00 2017-06-30 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-07-01 941657474 Children's Hospital & Research Cntr Fndn CHIL 5104283814 2201 Broadway No 600 Oakland CA 94612 Erin Hickey President 5104283814 2018-05-15 1 Richard Croghan P00089862 4159561500 2018-05-14 2016 2022-09-23 18:48:47Z UCSF Benioff Children's Hospitals Fn Shahan Soghikian 2201 Broadway No 600 Oakland CA 94612 30541280 0 X give.ucsfbenioffchildrens.org X 1967 CA UCSF Benioff Children's Hospitals Foundation IS A NOT-FOR-PROFIT PUBLIC BENEFIT CORPORATION THAT HAS BEEN IN OPERATION SINCE 1967. ITS PRIMARY GOAL IS TO ACQUIRE CHARITABLE GIFTS AND OTHER RESOURCES FOR UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND and San Francisco's PROGRAMS, SERVICES AND OPERATIONS. 21 17 0 500 0 0 21912355 29951933 0 0 5484 -89526 82037 -63875 21999876 29798532 16400368 18965208 0 0 4092564 3524836 0 0 2911235 2765748 3306409 23258680 25796453 -1258804 4002079 203035914 230659262 5839007 4919068 197196907 225740194 X UCSF Benioff Children's Hospitals Foundation IS DEDICATED TO BRINGING HEALTH AND WELL BEING TO CHILDREN THROUGH PHILANTHROPIC AND VOLUNTEER SUPPORT FOR UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND and SAN FRANCISCO. 0 0 20138262 18965208 SEE SCHEDULE OCHILDREN'S HOSPITAL & RESEARCH CENTER FOUNDATION, DBA UCSF BENIOFF CHILDREN'S HOSPITALS FOUNDATION, HAS A 21-MEMBER BOARD OF DIRECTORS COMPRISED OF COMMUNITY LEADERS AND KEY HOSPITAL LEADERSHIP. THE BOARD PROVIDES DIRECTION AND OVERSIGHT TO PLANNING AND IMPLEMENTING A COMPREHENSIVE FUND DEVELOPMENT PROGRAM THAT INCLUDES: MAJOR AND ANNUAL GIFTS; PLANNED GIVING; FOUNDATION AND CORPORATE GRANTS; CHILDREN'S MIRACLE NETWORK HOSPITALS AND CAUSE RELATED MARKETING; SPECIAL EVENTS; AND A COMPREHENSIVE CAMPAIGN.THE GENEROSITY OF OUR DONORS IS A SOURCE OF GREAT STRENGTH FOR UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND. FROM JULY 2016 - JUNE 2017, THE FOUNDATION DISTRIBUTED $18,946,736 TO THE HOSPITAL IN SUPPORT OF CLINICAL PROGRAMS, BREAKTHROUGH RESEARCH, PEDIATRIC ADVOCACY, COMMUNITY OUTREACH, MEDICAL TRAINING, AND FACILITIES. THESE FUNDS ARE PART OF UCSF BENIOFF OAKLAND'S $200 MILLION COMPREHENSIVE CAMPAIGN, WHICH SUPPORTS PHASE 1 OF THE HOSPITAL'S MASTER PLAN MODERNIZATION PROJECT, AS WELL AS OTHER CORE AREAS OF ITS MISSION. A KEY GUIDING PRINCIPLE OF THE MASTER PLAN IS TO DESIGN A FACILITY THAT IS DISTINCTLY FOR CHILDREN AND FAMILIES, WITH DESIGNATED IN-PATIENT AND OUT-PATIENT ZONES. THE PROJECT'S FIRST PHASE INCLUDES CREATING A SECOND OUTPATIENT CENTER AND RENOVATING THE PEDIATRIC INTENSIVE CARE UNIT (PICU), NEONATAL INTENSIVE CARE UNIT (NICU), AND POST ANESTHESIA CARE UNIT (PACU). OTHER CAMPAIGN FUNDING PRIORITIES INCLUDE ANNUAL FUND AND UNRESTRICTED SUPPORT, CAPITAL EQUIPMENT AND FACILITY RENOVATIONS, RESEARCH, COMMUNITY PROGRAMS AND ADVOCACY, AND EDUCATION.FOR MORE THAN 100 YEARS, UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND HAS BEEN A FIXTURE IN OAKLAND AND THE SURROUNDING BAY AREA. THE HOSPITAL IS ONE OF ONLY FIVE ACS PEDIATRIC LEVEL I TRAUMA CENTERS IN THE STATE, AND HAS ONE OF THE LARGEST PEDIATRIC INTENSIVE CARE UNITS IN NORTHERN CALIFORNIA. FOR THE PERIOD JULY 2016 THROUGH JUNE 2017, CHILDREN'S HAD 10,000 INPATIENT STAYS, 46,000 EMERGENCY DEPARTMENT VISITS, 9,000 SURGICAL CASES AND 283,000 OUTPATIENT CLINIC VISITS. 20138262 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 0 0 0 0 1 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 1 41 0 1 0 0 0 0 0 0 1 1 0 0 0 0 X 21 17 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 CA X Erin Hickey 5104283814 2201 Broadway Suite 600 Oakland CA 94612 SHAHAN SOGHIKIAN Chairman 2.00 X X 0 0 0 Carrie Wheeler Vice Chair 2.00 X X 0 0 0 ED PENHOET PHD SECRETARY 2.00 X X 0 0 0 Jeffrey Cheung Treasurer 2.00 X X 0 0 0 Erin Hickey Foundation President 20.00 20.00 X X 0 244048 0 LOUIS LAVIGNE JR Director 2.00 X 0 0 0 Valli Benesch Director 2.00 X 0 0 0 Carolyn Klebanoff MD Director 2.00 X 0 0 0 David Beier Director 2.00 X 0 0 0 Lynne Benioff Director 2.00 X 0 0 0 Thomas Bret Director 2.00 X 0 0 0 Farah Champsi Director 2.00 X 0 0 0 Charles Lavon Cole III Director 2.00 X 0 0 0 Timothy Kendall Director 2.00 X 0 0 0 Jason Moment Director 2.00 X 0 0 0 Elisa Stad Director 2.00 X 0 0 0 Robin Washington Director 2.00 X 0 0 0 Melissa Williams Director 2.00 X 0 0 0 JOHN FORD UCSF Fdn Vice Chancellor 2.00 38.00 X 0 485321 63788 MARK LARET UCSF President/CEO 2.00 38.00 X 0 1205185 149011 BERTRAM LUBIN MD Hospital President/CEO (Thru 12/16) 8.00 32.00 X X 0 854167 39848 Michael Anderson MD Hospital President/CEO 8.00 32.00 X X 0 17720 0 Gwenn Lennox Sr. Development Director 40.00 X 0 121080 25499 Kathyrn Merriam Sr. Director Ext. Relation 40.00 X 0 117082 27317 Eric Sloan Institutional Giving Director 40.00 X 0 116878 16053 Charlotte Biern Former Sr. VP & CDO (thru 12/15) 26.70 13.30 X 0 372196 0 0 3533677 321516 0 1 1 0 Siino & Associates LLC 101 Gregory Lane Suite 37 Pleasant Hill CA 94523 Professional Services 360891 Community Counseling Services PO Box 824885 Philadelphia PA 191824885 Fundraising Consultant 105000 2 54814 1375578 6911425 21610116 272573 29951933 7172 7172 155123 251821 -96698 -96698 -96698 427052 1375578 490927 -63875 -63875 29798532 0 0 -153401 X 18965208 18965208 185700 185700 2356406 788741 877114 690551 356768 123895 137776 95097 448544 155766 173218 119560 177418 61612 68515 47291 21708 21708 91320 91320 648 648 953019 369840 583179 127579 10151 117428 147949 880 74900 72169 91860 36496 8344 47020 629802 629802 75780 1103 41039 33638 785 25 760 42000 42000 490771 4561 486210 11538 11538 Children's Miracle Ntwk 546261 546261 printing & publications 69587 111 69476 membership dues 5802 3207 2595 25796453 20138262 2746956 2911235 -827413 2408109 1126362 1972073 3292955 2720866 3385992 4207754 800000 800000 416013 205348 418463 417439 12562 1024 191373986 212703717 3271927 3468664 183530 2171707 203035914 230659262 1513010 626884 51069 18449 800000 800000 3474928 3473735 5839007 4919068 X 152965255 178585303 18989774 20950681 25241878 26204210 197196907 225740194 203035914 230659262 X 4002079 24608943 -67735 X 0 1 X 1 0 X 21703263 19915230 25524104 30235547 29995304 127373448 21703263 19915230 25524104 30235547 29995304 127373448 31552099 95821349 3955220 4126046 4121673 556809 7172 12766920 140140368 0.68380 0.67150 X Additional Information: The information reported in 2015 column is for 18 months from January 1, 2015 through June 30, 2016. The company changed their year-end and filed a short-year return for tax year January 1, 2015 to June 30, 2015. The information from the short year combined with 12-month period from July 1, 2015 through June 30, 2016 is reported in 2015 column. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 191373986 1122277 24517991 4310537 212703717 199250756 608250 -8485020 191373986 198633566 1172133 18367565 18759707 162801 199250756 171920558 1462078 27227279 1976349 198633566 157488220 1405925 14473919 1447506 171920558 0.80440 0.12320 0.07240 0 1 1 65915 65915 0 190806 190296 510 161742 161228 514 1024 FIXED PAYMENT DUE TO DONORS 3219745 Due to UCSF BENIOFF Children's Hospital Oakland 253990 3473735 X 54830667 24608943 -67735 24541208 30289459 -490928 -490928 29798531 26297030 500578 500578 25796452 0 25796452 Part V, Line 4: THE PERMANENTLY RESTRICTED ENDOWMENTS GENERATE TEMPORARILY RESTRICTED FUNDS TO BE USED AS DESIGNATED BY THE DONOR. THE UNRESTRICTED ENDOWMENT FUNDS ARE USED TO SUPPORT OPERATIONS OR SPECIAL REQUIREMENTS OF THE UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND. BOARD DESIGNATED FUNDS SUPPORT CHILDREN'S HOSPITAL OAKLAND RESEARCH INSTITUTE (CHORI). Part X, Line 2: The Foundation is exempt from federal income tax under Section 501(c)(3) of the Internal Revenue Code and 23701d of the California Franchise Tax Board except to the extent of unrelated business taxable income as defined under IRC Sections 511 through 515. Therefore, no provision for income taxes has been provided in these financial statements. Part XI, Line 2d - Other Adjustments: change in split interest GIFT AGREEMENTS -67,735. Part XI, Line 4b - Other Adjustments: Special Event Expenses reclassed to revenue -490,928. Part XII, Line 2d - Other Adjustments: Special Event Expenses reclassed to revenue 490,928. EXPENSES RELATED TO FOUNDATION FOR CHILDREN'S CARE 9,650. X X X X X X 1 Car Donation Srvcs Inc 4971 Pacheco Blvd Martinez CA 94553 vehicle donation program 1 32610 17543 15066 32610 17543 15066 CA AK AL AR AZ CO CT DC DE FL GA HI IL IA ID IN KS KY LA MA MD ME MI MN MS MO MT NC ND NH NJ NM NY NE NV OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY NOTES & WORDS 1001104 962550 38554 79282 93547 156520 73616 Score 4 Kids 151694 92750 58944 907 8275 66931 5 649832 320278 329554 2971 2465 6413 1802630 1375578 427052 83160 104287 156520 146960 490927 -63875 1 UCSF Benioff Children's Hospital Oakland 747 52ND STREET Oakland CA 94609 940382330 501(c)(3) 18946736 Unrestricted general support and various donor designated The Regents of the University of California 1111 Franklin Street Oakland CA 94607 946036493 501(c)(3) 7560 GENERAL SUPPORT CHILDREN'S HOSPITAL OAKLAND FAMILY HOUSE 5222 DOVER STREET OAKland CA 94609 942909976 501(c)(3) 10912 GENERAL SUPPORT 3 0 Part I, Line 2: There is no specific procedure for monitoring the use of funds transferred to UCSF Benioff Children's Hospital Oakland, a related organization. As part of the overall operation of related organizations, UCSF Benioff Children's Hospital Oakland keeps careful track of the use of funds granted by UCSF Benioff Children's Hospitals Foundation. 1 0 0 0 0 0 0 1 0 Erin Hickey Foundation President 0 244048 0 0 0 0 0 0 0 0 0 244048 0 0 JOHN FORD UCSF Fdn Vice Chancellor 0 464213 0 0 0 21108 0 60339 0 3449 0 549109 0 0 MARK LARET UCSF President/CEO 0 1004777 0 185156 0 15252 0 127073 0 21938 0 1354196 0 0 BERTRAM LUBIN MD Hospital President/CEO (Thru 12/16) 0 703810 0 133470 0 16887 0 20271 0 19577 0 894015 0 0 Charlotte Biern Former Sr. VP & CDO (thru 12/15) 0 0 0 0 0 372196 0 0 0 0 0 372196 0 0 Part I, Line 4a The following individuals received a severance payment during the year: -Charlotte Biern - $330,741 Part I, Line 7 THE PURPOSE OF THE EXECUTIVE VARIABLE COMPENSATION PROGRAM (EVCP) IS TO FOCUS EXECUTIVES ON SPECIFIC, ANNUAL GOALS THAT ARE CRITICAL TO THES SUCCESS OF THE HOSPITAL AND ITS SUSTAINABILITY FOR THE FUTURE. THE EVCP IS DESIGNED TO ALIGN THE INTERESTS OF ALL BOARD AND EXECUTIVE STAKEHOLDERS TOWARDS THE MISSION, VISION AND GOALS OF THE HOSPITAL. THE BOARD OF DIRECTORS APPROVED THIS PLAN. IN ORDER FOR ANY BONUSES TO BE PAID THROUGH THE EVCP, THE GOALS WHICH ARE BASED ON A COMBINATION OF OVERALL HOSPITAL-WIDE ORGANIZATIONAL PERFORMANCE, DEPARTMENTAL, AND INDIVIDUAL PERFORMANCE MUST BE MET. THE MIX OF THESE CATEGORIES IN THE CALCULATION MAY DIFFER BY EXECUTIVE POSITION, A MAXIMUM BONUS OF 30% OF SALARY PER YEAR MAY BE EARNED FOR ACCOMPLISHMENTS OF GOALS. THE PARTICIPANT MUST ALSO BE AN EMPLOYEE IN GOOD STANDING AT THE TIME THE AWARD IS PAID. UCSF Clinical Enterprise Management Recognition Plan The purpose of the Regental approved University of California Clinical Enterprise Management Recognition Plan (CEMRP or Plan) is to provide at-risk, variable incentive compensation opportunity to those employees responsible for achieving or exceeding key Clinical Enterprise objectives. Consistent with healthcare industry practices, UC Health Systems use performance-based incentive compensation programs to encourage and reward achievement of specific financial and/or nonfinancial objectives (e.g., quality of care or patient satisfaction and safety, budget performance) and strategic objectives which relate to the Clinical Enterprise's mission. Awards amounts will be reviewed and approved by the CEO, Chancellor and Administrative Oversight Committee (AOC). X 41 20753 Fair Market Value X 17 251821 Fair Market Value 0 0 1 1 Part I, Line 32b: The Foundation uses Car Donation Services to process the pick up and sale of donated cars. Form 990, Part VI, Section A, line 6 THERE IS ONE VOTING MEMBER OF THE CORPORATION: UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. THE MEMBER MAY EXERCISE ITS VOTE AND ATTEND MEMBERSHIP MEETINGS OF THE CORPORATION BY RESOLUTION OF ITS BOARD OF DIRECTORS OR THROUGH THE ACTION OF ANY PERSON EXPRESSLY AUTHORIZED BY THE MEMBER'S BOARD OF DIRECTORS. THE ARTICLES OF INCORPORATION CURRENTLY STATE THAT THE SPECIFIC PURPOSES OF THE CORPORATION ARE TO RECEIVE AND MAINTAIN A FUND OR FUNDS OF REAL OR PERSONAL PROPERTY, OR BOTH, AND, SUBJECT TO THE RESTRICTIONS AND LIMITATIONS HEREINAFTER SET FORTH, TO USE AND APPLY THE WHOLE OR ANY PART OF THE INCOME THERE FROM AND THE PRINCIPAL THEREOF EXCLUSIVELY FOR CHARITABLE, RELIGIOUS, SCIENTIFIC, LITERARY, OR EDUCATIONAL PURPOSES, BY CONTRIBUTIONS TO UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND. HENCE, THE HOSPITAL "MAY RECEIVE A SHARE OF PROFITS, EXCESS DUES, OR NET ASSETS UPON DISSOLUTION OF THE ORGANIZATION." Form 990, Part VI, Section A, line 7a See response to LINE 6 above. Form 990, Part VI, Section A, line 7b THE FOLLOWING ITEMS SHALL REQUIRE THE APPROVAL OF THE MEMBER: (A) THE CORPORATION'S ANNUAL BUDGET (B) THE CORPORATION'S ASSUMPTION OF ANY INDEBTEDNESS OTHER THAN INDEBTEDNESS INCURRED IN THE NORMAL COURSE OF THE CORPORATION'S BUSINESS OPERATIONS. Form 990, Part VI, Section B, line 11b ASSISTANT VICE CHANCELLOR OF DEVELOPMENT REVIEWS WITH THE CONTROLLER. THE RETURN IS THEN TAKEN TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Section B, line 12c BOARD MEMBERS, EXECUTIVE OFFICERS AND MANAGERS OF THE HOSPITAL MUST DISCLOSE ALL OUTSIDE ACTIVITIES AND FINANCIAL RELATIONSHIPS THAT MAY CREATE THE APPEARANCE OF A CONFLICT OF INTEREST AND ALSO MUST SUBMIT ANNUAL CONFLICT OF INTEREST REPORTING AND CERTIFICATION FORMS TO HOSPITAL ADMINISTRATION. IF A CONFLICT IS DISCLOSED, THEN SUCH CONFLICT IS REFERRED TO THE COMPLIANCE OFFICER, LEGAL COUNSEL, AND THE BOARD OF DIRECTORS FOR CONSIDERATION. A BOARD MEMBER, EXECUTIVE OFFICERS OR MANAGER WITH THE CONFLICT IS GIVEN AN OPPORTUNITY TO EXPLAIN THE CONFLICT TO THE BOARD OF DIRECTORS BEFORE A DECISION IS MADE AND THEN MUST RECUSE HIM/HERSELF FROM ANY BOARD DISCUSSIONS, DECISION AND VOTE, ON ANY ISSUE FOR WHICH THE CONFLICT EXISTS. THE HOSPITAL CANNOT PROCEED WITH A TRANSACTION THAT IS DETERMINED TO INVOLVE A CONFLICT OF INTEREST UNLESS THE TRANSACTION HAS BEEN APPROVED BY THE BOARD OF DIRECTORS. Form 990, Part VI, Section B, line 15a Compensation recommendations for the Senior Vice President are made by the Executive Committee (Compensation Committee) of the Board of Directors with the input of an independent consulting firm, FutureSense, Inc. Those recommendations are approved by the Executive Committee on behalf of the Board per Board delegation and are recorded in the minutes. FutureSense, Inc. specializes in healthcare compensation and has substantial expertise in executive compensation. The recommendations include comparisons to benchmark market compensation for comparable positions for base and total compensation. Compensation for UCSF Health executive positions is recommended by the compensation manager/analyst and HR leadership using data from the Manager and Executive Compensation Survey (MEC) by Sullivan Cotter and other executive salary surveys. Surveys are updated each year. Once the recommendation is determined the compensation manager/analyst works with the Human Resources Executive Compensation Unit who manages executive-level compensation and programmatic processes and is the primary resource and business partner for executive-level questions, executive program compensation strategies and compliance. The Executive Compensation Analyst prepares executive compensation items subject to local endorsement by the UCSF Compensation Committee as well as Presidential and Regental approval; ensuring critical policy and process compliance, consistent within the directives of the Office of the President and Regents. Form 990, Part VI, Section C, line 19 The financial statements, conflict of interest policy, and governing/organizing documents are available to the public by individual requests with response via electronic or us mail. 990, Part IX, Statement of Functional Expenses EMPLOYEES COMPENSATED BY RELATED ORGANIZATION: The OFFICERS and employees are employed and compensated by UCSF BENIOFF children's hospital OAkland (BCHO). BCHO reports 100% of the individual's compensation on W-2's issued by BCHO. Some of the employees are assigned duties to other related organizations (See Schedule R for additional information regarding the related organizations). As a result of these assignments, wage and benefit costs are allocated to related organizations. The wage and benefit costs allocated to each organization are reported on Form 990, Part IX, Statement of Functional Expenses for each individual as being compensated directly from the filing organization and the balance of compensation is reported as compensation from related organizations. Form 990, Part XI, line 9: change in split interest GIFT AGREEMENTS -67,735. CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND 747 52nd street oakland CA 946091809 940382330 healthcare CA 501(c)(3) Line 3 N/A 0 Foundation for Children's Care DBA Family Legacy Fund 2201 broadway ste 600 oakland CA 94612 912145422 support charitable activities of Children's Fndn CA 501(c)(3) Line 12a, I CHILDREN'S HOSPITAL & RESEARCH CNTR FNDN 1 BayChildren's Physicians 747 52nd Street Oakland CA 94609 861175591 Medical foundation CA 501(c)(3) Line 10 The Regents of The University of California 0 Children's Hospital Oakland Family House 5222 Dover St Oakland CA 94609 942909976 Temporary lodging for patient families CA 501(c)(3) Line 7 CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND 0 THE REGENTS OF THE UNIVERSITY OF CALIFORNIA 1111 FRANKLIN STREET Oakland CA 94607 946036493 PUBLIC EDUCATIONAL INSTITUTION CA 501(c)(3) Line 6 N/A 0 UC San Francisco Foundation 220 Montgomery Street 5th Floor San Francisco CA 94104 942829914 Educational Foundation CA 501(c)(3) Line 5 N/A 0 CHARITABLE REMAINDER TRUSTS (137) HOLDING CO CA UCSF Benioff Children's Hospitals Fndn T 0 0 1 1 1 0 0 0 0 0 0 0 1 1 1 1 0 1 1 0