2017-05-15T11:19:11-05:00 2016-06-30 KPMG LLP 550 S Hope St Suite 1500 Los Angeles CA 90071 990 2015-07-01 952321786 Children's Hospital of Orange County % DONALD NOBLE CHIL 7149973000 1201 West La Veta Avenue Orange CA 92868 KERRI RUPPERT SCHILLER CFO/Assistant Secret 2017-05-12 true valerie j ball P00178114 2139724000 2017-05-03 2015 2021-01-29 14:40:06Z CHOC CHILDREN'S HOSPITAL KIMBERLY C CRIPE 1201 West La Veta Avenue ORANGE CA 92868 681558030 false X www.choc.org X 1964 CA TO NURTURE, ADVANCE AND PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. 13 12 3462 933 117813 9661 17829818 23317129 593927271 634733133 4108781 9741494 2242865 2810494 618108735 670602250 0 35000000 0 0 236399214 276511731 0 0 0 338695770 339027240 575094984 650538971 43013751 20063279 1040357156 1054252640 492793311 522121075 547563845 532131565 X TO NURTURE, ADVANCE AND PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. false false 588751944 35000000 634615320 CHILDREN'S HOSPITAL OF ORANGE COUNTY - PROVIDES SPECIALIZED PEDIATRIC SERVICES FOR THE CARE OF CHILDREN. DURING THIS YEAR, THERE WERE 66,021 DAYS OF INPATIENT CARE; 81,257 EMERGENCY ROOM VISITS(INCLUDING PEDIATRIC TRAUMA VISITS); 7,810 SURGERIES; AND 134,422 PRIMARY AND SPECIALTY CARE CLINIC VISITS. OUR CALIFORNIA MEDICAL FOUNDATION PROVIDED 312,090 PEDIATRIC SUBSPECIALTY SERVICE ENCOUNTERS AS WELL AS 90,078 PRIMARY CARE VISITS TO PATIENTS THROUGHOUT ORANGE COUNTY AND BEYOND. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. SEE OUR COMPLETE COMMUNITY BENEFIT REPORT ON OUR WEBSITE AT WWW.CHOC.ORG. 588751944 true true false true false false false false false true true false false false true true false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true X 546 0 true 3462 true true true false false false false false false false false false X 13 12 false false true false true true true true true false false true true true true true true true true false CA X DONALD NOBLE 7145094038 1201 WEST LA VETA AVENUE ORANGE CA 92868 KIMBERLY CRIPE DIRECTOR/PRESIDENT 30.0 10.0 X X 0 1413813 83775 Sam Auriemma Director/Vice Chair 2.0 2.0 X X 0 0 0 Michael Coglazier Director 2.0 1.0 X 0 0 0 DICK ACKERMAN DIRECTOR 2.0 1.5 X 0 0 0 Vijay Dhar MD Director 1.0 1.0 X 0 0 0 David Dukes Director/Chair 3.0 3.5 X X 0 0 0 CHANCELLOR Howard Gillman Director 1.0 2.0 X 0 0 0 Douglas McCombs Director 2.0 2.0 X 0 0 0 Thomas Tierney Director 1.0 1.5 X 0 0 0 Howard Federoff MD DIRECTOR 1.0 2.0 X 0 0 0 JOE KIANI DIRECTOR 2.0 1.0 X 0 0 0 Marshall ROWEN MD Director 2.0 5.0 X 0 0 0 KIM Sentovich DIRECTOR 2.0 1.5 X 0 0 0 Jay Gabriel Secretary 35.0 5.0 X 588875 0 49026 Matthew Gerlach Executive Vice President/COO 33.5 6.5 X 0 665662 106464 Kerri Ruppert Schiller CFO/Assistant Secretary 24.0 16.0 X 0 776744 75322 Maria Minon VP/CMO 40.0 0.0 X 736002 0 47032 Hale Kuhlman V.P., Specialty Physician SRV 40.0 0.0 X 410961 0 43480 Melanie Patterson VP Patient Care Svcs, CNO 40.0 0.0 X 397610 0 83153 Marcia Folli VP Ancillary Services 20.0 20.0 X 256614 256612 28474 Mark Headland VP/Chief Information Officer 40.0 0.0 X 473955 0 38621 Nick Anas MD Pediatrician in Chief 40.0 0.0 X 562982 0 55320 Michael Weiss VP CHOC Health Alliance 40.0 0.0 X 497662 0 23542 William Rohde Vice President Finance 40.0 0.0 X 412007 0 23458 Jan Lansing VP Marketing & Communications 40.0 0.0 X 428250 0 26300 4764918 3112831 683967 449 false true false PEDIATRIC SUBSPECIATLY FACULTY 1201 West La Veta Ave ORANGE CA 92868 MEDICAL DIR & SERV 62014699 CERNER CORPORATION PO Box 412702 KANSAS CITY MO 64141 CONSULTING 9292473 RADY CHILDRENS HOSPITAL 3020 Childrens Way MC 5001 SAN DIEGO CA 92123 MANAGEMENT SERVICES 7551554 TECH KNOWLEDGE ASSOCIATES 1 Centerpointe Drive Ste 200 LA PALMA CA 90623 BIOMEDICAL SERVICES 5083646 PRISM HEALTHCARE PARTNERS LTD 190 South La Salle St Ste 2900 CHICAGO IL 60603 CONSULTING 2710345 73 X 22068632 1248497 23317129 NET PATIENT REVENUE 900099 523171180 523171180 PREMIUM REVENUE 900099 55855154 55855154 MGMT/OCCUPANCY SERVICES 900099 20080129 20080129 DRUGS/MEDICAL SUPPLIES SOLD 900099 15483342 15483342 COVERAGE FEE REVENUE 900099 4863588 4863588 15279740 15161927 117813 634733133 6638336 6638336 0 0 328149 328149 0 328149 328149 10413954 3644984 10339081 616699 74873 3028285 3103158 3103158 0 0 0 CAFETERIA 900099 1608398 1608398 GIFT SHOP 900099 260375 260375 PARKING 900099 613572 613572 2482345 670602250 634615320 117813 12551988 X 35000000 35000000 0 0 0 1785185 1606666 178519 0 223727997 201355197 22372800 5524195 4971776 552419 30520525 27468473 3052052 14953829 13458446 1495383 21255647 19130082 2125565 1526428 1373785 152643 288158 259342 28816 64616 58154 6462 0 145927 131334 14593 131471147 118324031 13147116 0 12938321 11644489 1293832 0 0 11820944 10638850 1182094 889784 800806 88978 0 921766 829589 92177 15569673 14012706 1556967 0 40115729 36104156 4011573 3716523 3344871 371652 SUPPLIES 74781814 67303633 7478181 PRCHSD SRVCS FRM OT. HOSP. 4283454 4283454 DUES & SUBSCRIPTIONS 1740916 1566824 174092 UBIT EXPENSE 2002 2002 17494391 15085280 2409111 650538971 588751944 61787027 0 93873051 100543204 78451252 105547315 3101637 9950820 142844104 136590443 0 0 0 0 0 0 10471829 10593293 8443527 15619048 980967255 344242217 656677770 636725038 0 0 35058 113690 0 0 1216000 1216000 45242928 37353789 1040357156 1054252640 65717270 80237171 0 0 243502 291758 353086553 346952738 0 0 0 0 9048358 7184570 0 0 64697628 87454838 492793311 522121075 X 493501650 471653269 53376043 59792144 686152 686152 547563845 532131565 1040357156 1054252640 X 20063279 -29439770 -6055789 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 64616 64616 false grants to other organizations for lobbying purposes form 990, schedule c, part II-B, line 1i during fye 06/30/2016, children's hospital of orange county paid dues, a portion of which supports lobbying purposes to various healthcare associations: California Children's Hospital Association $ 24,062 Hospital Association of Southern California $ 18,902 National Association of Children's Hospitals $ 21,652 Total dues paid for lobbying purposes: $ 64,616 6423443 576987 -138 7000292 5309995 1111818 29620 27991 6423442 4931872 370905 131258 0 124040 5309995 4919888 5159 61328 0 54503 4931872 4406780 584493 -7094 0 64290 4919889 0.90200 0.09800 false true true 44581251 44581251 640758449 140529279 500229170 15012077 10568612 4443465 265777316 192172971 73604345 14838162 971355 13866807 636725038 0 DERIVATIVE FINANCIAL INSTRUMEN 67917463 LIABILITY FOR WORKER'S COMP. 6857167 PAYABLE TO ST. JOSEPH HOSPITAL 436236 POSTRETIREMENT BENEFIT OBLIGAT 2770556 PAYABLE TO RELATED PARTIES 4647 PAYABLE TO THIRD PARTIES 3197581 OTHER LIABILITIES 6271188 87454838 X 633450331 -29439770 -6219908 -35659678 669110009 1492241 1492241 670602250 649046730 649046730 1492241 1492241 650538971 ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740: U.S. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE CHOC'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY CHOC AND RECOGNIZE A TAX LIABILITY IF CHOC 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 CHOC AND HAS CONCLUDED THAT AS OF JUNE 30, 2016, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE COMBINED FINANCIAL STATEMENTS. RECONCILIATION OF REVENUE & EXPENSE PART XI, LINE 2D CHANGE IN BENEFICIAL INTEREST IN CHOC FOUNDATION $ (7,055,786) NET INCOME OF OCMRRG $ 835,878 ================================================== TOTAL $ (6,219,908) Part XI, Line 4b Reclass of Non-Operating Expenses $ 1,492,241 PART XI AND PART XII, LINE 4B RECLASS OF NON-OPERATING EXPENSES $ 1,492,241 Use of endowment funds 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. true true X true X true X true true false true true 1490893 0 1490893 0.00230 97982491 1697484 96285007 0.14800 99473384 1697484 97775900 0.15030 10097717 1252920 8844797 0.01360 17607479 2286276 15321203 0.02360 2529873 2529873 0.00390 4700 4700 30239769 3539196 26700573 0.04110 129713153 5236680 124476473 0.19140 4134623 246591 3888032 0.00600 4134623 246591 3888032 0.00600 true 25043099 238318 264894 -26576 X true true 1 1 Children's Hospital of Orange County 1201 West La Veta Avenue Orange CA 92868 www.choc.org 060000011 X X X Children's Hospital of Orange County 1 false false true X X X X X X X X X 14 true true false true X http://www.choc.org/about X true 14 true http://www.choc.org/about false true X 200. 400. X X X true true X X true X www.choc.org X WWW.CHOC.ORG X WWW.CHOC.ORG X X X X X true X false X X X X true X false false Schedule H, Part V Additional Information Schedule H, Part V, Line 5 SURVEYS and interviews were used to gather opinions and impressions from people who represent the broad interests of the community. IN ADDITION, LEADERS OF community based organizations participated in SURVEYS and interviews in october 2013. Included were people from health provider community benefit organizations, county and city governments, hospitals, community clinics/fhqc's and health advocacy education organizations. SCHEDULE H, PART V, LINE 6a CHILDREN'S HOSPITAL OF ORANGE COUNTY AND CHOC CHILDREN'S AT MISSION TOGETHER CONDUCTED THE HEALTH NEEDS ASSESSMENTS. SCHEDULE H, PART V, LINE 10A THE HOSPITAL'S IMPLEMENTATION STRATEGY IS INCLUDED AT THE END OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) LOCATED AT HTTP://WWW.CHOC.ORG/ABOUT. Schedule H, Part V, Line 11 Addressing High Priority Community Health Needs CHOC's most recent CHNA identified three high-priority needs: Mental Health, Obesity and Autism. In 2013, CHOC developed its new seven-year strategic plan - CHOC 2020. This long-range plan has five goals, one of which is CHOC's Pediatric System of Care". For CHOC, the Pediatric System of Care includes assuring access to the full continuum of healthcare services addressing both the physical and behavioral health of children we serve; creating and implementing processes for the seamless transitioning of patients from one care provider to the next; and, actively engaging patients and families in taking responsibility for their healthcare. The three high-priority needs are recognized in CHOC 2020 as critical elements of the CHOC Pediatric System of Care. Specific initiatives for the high-priority needs are as follows: Pediatric Mental Health CHOC Children's, in partnership with committed organizations and community groups, aspires to create an outstanding mental health system of care for all children, teens and young adults in Orange County. Our goal is to provide a comprehensive approach to pediatric mental illness. Among the initiatives will be the creation of CHOC Children's Mental Health Inpatient Center. Orange County currently has only 32 inpatient adolescent psychiatric beds for a population of roughly 3 million, and not a single bed for children under 12. The Center will have 18 beds in a secured and healing environment, in addition to an outdoor area for recreation. The Center will provide a safe, nurturing place for children ages 3 to 18, and specialty programming for children younger than 12. Construction is expected to begin in 2016 and be completed in MID 2018. In addition to opening the new mental health inpatient center, CHOC has initiated and will be pursuing the following action in support of the pediatric mental health system of care: - Expanded in 2015 mental health services for CHOC patients being treated for serious/chronic illnesses (these children are more likely to have mental health problems, such as depression and severe anxiety, than their healthier peers). - OpenED an intensive outpatient program in 2016 to keep struggling children out of the hospital and assist those who have been released. - ExpandED CHOC's outpatient eating disorders program IN 2016. - Continue to facilitate and work on multiple county-wide projects with a community task force formed by CHOC Children's and Pastor Rick and Kay Warren, founders of Saddleback Church. Obesity CHOC has convened a multi-disciplinary coalition of community members to work on the issue of obesity. This task force includes representatives from the health care community (physicians, dieticians, and psychologists), the University of California - Irvine, Orange County Social Services and the school districts throughout the community. Efforts to date include offering 9 classes and educational materials, and starting a Kids Fit Club. Adequate and proper nutrition is important for a child's normal growth and development. CHOC Children's Clinical Nutrition and Lactation Services aim to be a reliable source of nutrition and lactation information for our patients, families and community. We are here to help patients with growth and development, while giving them a foundation for lifelong health and wellness. We provide family-centered, culturally sensitive care that is custom for every individual, using evidence-based techniques and best practices with a multidisciplinary approach. Developmental Disabilities, specifically Autism Recognizing the pervasiveness of autism in the Orange County pediatric population, CHOC has actively supported For OC Kids, an organization that diagnoses and treats children up to 6 years of age. More recently, CHOC has engaged in a partnership with the Children and Families Commission of Orange County, the University of California - Irvine, Chapman University and the Thompson Center for Autism (Columbia, MO) to establish the Center for Autism and Neurodevelopment Disorders in Santa Ana. CHOC is providing financial support for an additional neuro-developmental pediatrician, psychology and physical therapy services in order to expand access to the services for a greater number of Orange County children including those over eight years old. There were no significant needs identified but not addressed from the most recently conducted CHNA. SCHEDULE H, PART V, LINE 22D, OTHER THE MAXIMUM AMOUNTS THAT MAY BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY SERVICES ARE DETERMINED BY THE FEE-FOR-SERVICE MEDI-CAL RATE. THE RATE IS DETERMINED ANNUALLY BY THE ALLOWABLE COST-TO-CHARGE RATIO AS DETERMINED BY THE ANNUAL MEDI-CAL COST REPORT. 31 ORANGE PRIMARY CARE CLINIC 455 SOUTH MAIN STREET ORANGE CA 92868 CLINIC CLINICA CHOC PARA NINOS-SANTA ANA 406 SOUTH MAIN STREET SANTA ANA CA 92701 CLINIC SANTA ANA BOYS AND GIRLS CLUB 1000 WEST HIGHLAND SANTA ANA CA 92703 CLINIC ASTHMA BREATHMOBILE 455 SOUTH MAIN STREET ORANGE CA 92868 CLINIC GARDEN GROVE CLINIC 10602 CHAPMAN AVENUE GARDEN GROVE CA 92840 CLINIC CHOC CHILDREN'S ENDOCRINE & DIABETES CTR 520 SUPERIOR AVE SUITE 160 NEWPORT BEACH CA 92663 CLINIC CHOC CHILDREN'S HOSPITAL SPECIALTY CLINICS 455 SOUTH MAIN S ORANGE CA 92868 CLINIC CHOC UROLOGY CENTER 505 S MAIN ST SUITE 100 ORANGE CA 92868 CLINIC PEDIATRIC PSYCHOLOGY 1120 West LA VETA AVENUE SUITE 470 ORANGE CA 92868 PHYSICIAN OFFICE BLOOD&DONORAPHERESIS 505 SOUTH MAIN STREET SUITE 185 ORANGE CA 92868 CLINIC CHOC NEUROLOGY CENTER 1120 West LA VETA AVENUE SUITE 125 ORANGE CA 92868 CLINIC CORONA CARDIOLOGY & GASTROENTEROLOGY 260 E ONTARIO AVE SUITE 204 CORONA CA 92882 PHYSICIAN OFFICE FOUNTAIN VALLEY GASTROENTEROLOGY 11100 WARNER AVE SUITE 252 FOUNTAIN VALLEY CA 92708 PHYSICIAN OFFICE IRVINE CARDIOLOGY 16300 SAND CANYON AVE SUITE 811 IRVINE CA 92618 Physician Office CHOC CHILDREN'S MISSION VIEJO CLINIC 27800 MEDICAL CENTER ROAD BLDG 2 MISSION VIEJO CA 92691 CLINIC NEWPORT BEACH OTOLARYNGOLOGY 466 OLD NEWPORT BLVD NEWPORT BEACH CA 92663 Physician Office CHOC CHILDREN'S SPECIALISTS CARDIOLOGY 505 SOUTH MAIN STREET SUITE 200 ORANGE CA 92868 PHYSICIAN OFFICE CHOC CHILDREN'S SPCLST PEDIATRIC SURGERY 505 SOUTH MAIN STREET SUITE 225 ORANGE CA 92868 PHYSICIAN OFFICE CHOC CHILDREN'S ALLERGY 725 West LA VETA SUITE 100 ORANGE CA 92868 PHYSICIAN OFFICE CHOC CHILDREN'S SPECIALISTS OPTHAMOLOGY 1010 west LA VETA SUITE 640 ORANGE CA 92868 PHYSICIAN OFFICE CHOC Children's Health Center 845 MAGNOLIA 101 CORONA CA 92879 clinic CHOC Children's SPECLST OTOLARYNGOLOGY 1010 west la veta suite 640 orange CA 92868 physician office CHOC Children's Health Center 19582 Beach Blvd Suite 380 Huntington Beach CA 92648 Clinic CCN SEA VIEW PEDIATRICS 2 JOURNEY STE 100 ALISO VIEJO CA 92653 PHYSICIAN OFFICE CCN SEA VIEW PEDIATRICS 23521 PASEO DE VALENCIA STE 200 LAGUNA HILLS CA 92656 PHYSICIAN OFFICE CCN SEA VIEW PEDIATRICS 15875 LAGUNA CANYON ROAD STE 120 IRVINE CA 92618 PHYSICIAN OFFICE CCN SEA VIEW PEDIATRICS 1031 EAST AVENIDA PICO STE 106 SAN CLEMENTE CA 92673 PHYSICIAN office CCN SOUTH ORANGE COUNTY PEDIATRIC ASSOC 23321 EI TORO ROAD STE Fg lake forest CA 92630 physician office CCN SOUTH ORANGE COUNTY PEDIATRIC ASSOC 30212 tomas ste 220 rancho santa margarita CA 92688 physician office CCN SOUTH ORANGE COUNTY PEDIATRIC ASSOC 777 corporate drive ste 250 ladera ranch CA 92694 physician office CCN SOUTH ORANGE COUNTY PEDIATRIC ASSOC 1300 avenida vista hermosa ste 20 san clemente CA 92673 physician office SCHEDULE H, PART I, LINE 6A THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS CONTAINED IN A REPORT PREPARED BY CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC CHILDREN'S) AND CHOC CHILDREN'S AT MISSION HOSPITAL (CCMH) ANNUALLY AND IS FILED IN ACCORDANCE WITH CALIFORNIA SB697. SCHEDULE H, PART I, LINE 7 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. The State of California has a provider fee program that, combined with federal matching funds, has provided supplemental medi-cal payments to hospitals in the state. IN 2015, CMS ISSUED FINAL REQUIRED FEDERAL APPROVAL FOR THE FEE FOR SERVICE PORTION OF THE 36 MONTH CALIFORNIA PROVIDER FEE PROGRAM. THIS APPROVAL COVERED THE 12 MONTH PERIOD FROM JULY 1, 2015-JUNE 30, 2016. IN FISCAL YEAR 2016, CHOC RECOGNIZED REVENUES UNDER THIS 12 MONTHS OF THE FEE FOR SERVICE PORTION OF THE PROGRAM OF $36,949,000 AND PROVIDER FEES AND OTHER EXPENSES OF $9,753,000. IN ADDITION, CMS ISSUED FINAL APPROVAL IN 2015 OF 60%, AND IN 2016, 40% OF THE MANAGED CARE PORTION OF THE 36 MONTH PROGRAM FOR THE 6 MONTHS ENDED JUNE 30, 2014. UNDER THIS PORTION OF THE PROGRAM, CHOC RECOGNIZED REVENUES OF $11,341,000 AND PROVIDER FEE AND OTHER EXPENSES OF $3,213,000. THE AMOUNTS WERE RECOGNIZED AS NET PATIENT REVENUE AND OPERATING EXPENSES, RESPECTIVELY, IN THE YEAR ENDED JUNE 30, 2016. THE CHNA REPORT IS AVAILABLE AT HTTP://WWW.CHOC.ORG/ABOUT SCHEDULE H, 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 86 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. SCHEDULE H, PART III, LINE 2 THE ORGANIZATION CHARGES BAD DEBT FOR (A) THE WRITE-OFF OF PATIENT ACCOUNTS WHERE FAMILIES DID NOT COOPERATE WITH CHOC IN THE COMPLETION OF MEDI-CAL OR CHARITY CARE APPLICATIONS AND WHERE INSUFFICIENT INFORMATION COULD BE OBTAINED REGARDING THE FINANCIAL STATUS OF THE FAMILY, AND (B) A PROVISION FOR OUTSTANDING ACCOUNTS RECEIVABLE FROM SELF-PAY (INCLUDING PENDING MEDI-CAL AND PENDING CHARITY) ACCOUNTS. 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. SCHEDULE H, 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. SCHEDULE H, 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 ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CHOC'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN CHOC'S EXISTING PATIENT ACCOUNTS RECEIVABLE. CHOC DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. CHOC REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS ON A MONTHLY BASIS AS WELL AS AGE OF ACCOUNTS AND OTHER FACTORS. PAST-DUE BALANCES OVER 90 DAYS AND OVER A SPECIFIED AMOUNT ARE REVIEWED INDIVIDUALLY FOR COLLECTABILITY. THERE ARE OTHER FACTORS THAT CAN IMPACT COLLECTIONS, SUCH AS CHANGES IN THE ECONOMY, WHICH IN TURN HAVE AN IMPACT ON UNEMPLOYMENT RATES AND THE NUMBER OF UNINSURED AND UNDERINSURED PATIENTS, THE INCREASED BURDEN OF CO-PAYMENTS TO BE MADE BY PATIENTS WITH INSURANCE AND BUSINESS PRACTICES RELATED TO COLLECTION EFFORTS. THESE FACTORS CONTINUOUSLY CHANGE AND CAN HAVE AN IMPACT ON COLLECTION TRENDS AND THE ESTIMATION PROCESS. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS REMOTE, BUT IN NO CASE BEYOND ONE YEAR FROM DATE OF SERVICE. SCHEDULE H, PART III, LINE 8 THE ALLOWABLE COST IS BASED ON A COST TO CHARGE RATIO OF .2967 AS DETERMINED BY THE ORGANIZATION'S FILED MEDICARE COST REPORT. SHORTFALLS ARE CONSIDERED A COMMUNITY BENEFIT BECAUSE THE DOLLAR VALUE OF BENEFITS PROVIDED BY LEGISLATIVE CATEGORY LINK TO THE DOLLARS IDENTIFIED BY COMMUNITY NEEDS. CHOC REPORTS UNPAID COSTS OF PUBLIC PROGRAMS AS GOVERNMENT PAYOR SHORTFALLS. THE PRINCIPAL MEASURE FOR MONITORING COMMUNITY BENEFIT SERVICES IS THE DOLLAR VALUE OF BENEFITS RETURNED TO THE COMMUNITY PER DOLLAR OF TAX EXEMPTION VALUE RECEIVED. SCHEDULE H, PART III, LINE 9B THE HOSPITAL'S WRITTEN BAD-DEBT COLLECTION POLICY STATES THE FOLLOWING: 1. IF A PATIENT QUALIFIES FOR ASSISTANCE UNDER THE FINANCIAL ASSISTANCE PROGRAM (FAP) AND IS MAKING EVERY EFFORT TO SETTLE AN OUTSTANDING BILL WITHIN A REASONABLE TIME PERIOD, CHOC OR ITS AGENT WILL NOT SEND, NOR INTIMATE THAT IT WILL SEND, THE UNPAID ACCOUNT TO AN OUTSIDE AGENCY IF DOING SO MAY NEGATIVELY IMPACT A PATIENT'S CREDIT. IF CHOC IS FORCED TO SEND THE ACCOUNT TO AN OUTSIDE COLLECTION AGENCY, THE AMOUNT REFERRED TO THE AGENCY WILL REFLECT THE REDUCED PAYMENT LEVEL FOR WHICH THE PATIENT WAS ELIGIBLE UNDER THE 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, CHOC WILL NOT USE WAGE GARNISHMENTS OR LIENS ON PATIENT'S OR PATIENT FAMILY'S PRIMARY RESIDENCE AS A MEANS OF COLLECTING UNPAID CHOC BILLS. THIS REQUIREMENT DOES NOT PRECLUDE CHOC FROM PURSUING REIMBURSEMENT FROM THIRD PARTY LIABILITY SETTLEMENTS. SCHEDULE H PART VI LINE 2 NEEDS ASSESSMENT: IN ADDITION TO THE TRI-ANNUAL COMMUNITY HEALTH NEEDS ASSESSMENT, CHOC 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, CHOC 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 WWW.CHOC.ORG AS WELL AS A PAPER COPY THAT IS AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. SCHEDULE H PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: PATIENTS ARE INFORMED OF THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS AND UNDER THE HOSPITAL'S CHARITY CARE POLICY IN OUR FINANCIAL ASSISTANCE AND DISCOUNT PROGRAM POLICY. THIS INFORMATION, EITHER IN FULL OR IN SUMMARY, IS POSTED IN ALL OF THE HIGH TRAFFIC PATIENT AREAS: ADMITTING, EMERGENCY ROOM, CLINIC AND THE BUSINESS OFFICE. THE PATIENTS ARE ALSO INFORMED IF THERE IS A FINANCIAL NEED IDENTIFIED BY THE HOSPITAL FINANCIAL COUNSELORS WHEN SPEAKING TO THE FAMILIES ABOUT THEIR INSURANCE OR LACK OF INSURANCE. PATIENTS ARE PROVIDED A COPY OF THE HOSPITAL'S PATIENT FINANCIAL ASSISTANCE AND DISCOUNT PAYMENT PROGRAM POLICY. FAMILIES ARE ALSO NOTIFIED ON EVERY PATIENT STATEMENT THAT IF THERE IS A FINANCIAL NEED THEY SHOULD CALL THE DESIGNATED PHONE NUMBER FOR MORE INFORMATION AND ASSISTANCE. FINANCIAL ASSISTANCE COMMUNICATION - AS PART OF THE HOSPITAL'S 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 HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS EMPHASIZED IN PUBLIC RELATIONS AND MEDIA RELATIONS EFFORTS, FOUNDATION CAMPAIGNS, AND SELECTED MARKETING CAMPAIGNS. THE FINANCIAL ASSISTANCE POLICY IS ALSO INCLUDED AS PART OF THE ANNUAL COMMUNITY BENEFIT REPORT. The Financial Assistance Policy is available in english and spanish. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION - THE HOSPITAL SERVES ALL OF ORANGE COUNTY AND A LIMITED, ALTHOUGH SIGNIFICANT, NUMBER OF PATIENTS FROM THE WESTERN RIM OF RIVERSIDE AND SAN BERNARDINO COUNTIES, THE NORTHERN PORTION OF SAN DIEGO COUNTY AND SOUTHEAST AREAS OF LOS ANGELES COUNTY. THE PRIMARY SERVICE AREA IS THE CENTRAL-NORTHERN PORTION OF ORANGE COUNTY, AND IS THE SOURCE OF APPROXIMATELY 72% OF ITS PATIENTS. SIGNIFICANT CITIES IN THIS AREA ARE: SANTA ANA, ANAHEIM, FULLERTON, ORANGE, AND GARDEN GROVE. THE SECONDARY SERVICE AREA INCLUDES ALL THE OTHER ORANGE COUNTY CITIES AND UNINCORPORATED AREAS. THE COMMUNITY SERVED BY THE HOSPITAL INCLUDES FEDERALLY-DESIGNATED MEDICALLY UNDERSERVED AREAS AND POPULATIONS. COMMUNITY CHARACTERISTICS - POPULATION AND SOCIOECONOMIC DATA PROJECTIONS FOR 2016 ARE PROVIDED BY CLARITAS, A THIRD-PARTY VENDOR THAT MAKES PROJECTIONS BASED ON DEMOGRAPHIC ANALYSIS OF ORANGE COUNTY, INCLUDING THE COMBINED SERVICE AREAS OF BOTH HOSPITALS CHOC AND CCMH. TOTAL POPULATION OF THE COUNTY WAS 3.2 MILLION, ACCORDING TO 2016 ESTIMATES, MAKING IT THE THIRD LARGEST COUNTY IN CALIFORNIA. THE MEDIAN AGE IS 36.4, AND CHILDREN UP TO 18 YEARS OF AGE MAKE UP 25% OF THE TOTAL POPULATION. THE LARGEST RACE/ETHNICITY SUBGROUP IS WHITE, AT 43%. LATINOS/HISPANICS ARE 34% OF THE POPULATION. ASIANS/PACIFIC ISLANDERS ARE 19% OF THE TOTAL, AND THE AFRICAN AMERICAN POPULATION REPRESENTS APPROXIMATELY 2% OF THE TOTAL ORANGE COUNTY POPULATION. SOCIOECONOMIC PROFILE THE U.S. CENSUS AMERICAN COMMUNITY SURVEY FOR 2016 INDICATED THAT 17.6% OF CHILDREN UNDER THE AGE OF 18 IN ORANGE COUNTY, 23% IN CALIFORNIA, AND 22.0% IN THE U.S. WERE BELOW THE POVERTY LEVEL. THE U.S. BUREAU OF THE CENSUS ESTIMATED THAT IN 2016, THE COUNTY'S MEDIAN HOUSEHOLD INCOME is $74,163. The percentage of the hospital's patients who are uninsured or Medicaid recipients was 62.1%. THERE ARE 29 OTHER HOSPITALS SERVING THE COMMUNITY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC) IS THE NOT-FOR-PROFIT, TAX-EXEMPT PARENT CORPORATION OF CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC CHILDREN'S) AND CHOC CHILDREN'S AT MISSION HOSPITAL (CCMH). THE HOSPITALS ARE THE PRINCIPAL TERTIARY AND QUATERNARY PEDIATRIC HOSPITALS SERVING ORANGE COUNTY AND ARE THE ONLY HOSPITALS EXCLUSIVELY SERVING INFANTS, CHILDREN AND ADOLESCENTS. THE ORGANIZATION IS COMPRISED OF TWO HOSPITALS; A NUMBER OF PRIMARY AND SPECIALTY CLINICS THROUGHOUT ORANGE AND RIVERSIDE COUNTIES, PROGRAMS AND SERVICES; AND FOUR CENTERS OF EXCELLENCE, THE CHOC HEART, NEUROSCIENCE, hyundai cancer institute AND ORTHOPAEDIC INSTITUTES. CHOC ALSO HAS A RESEARCH INSTITUTE PERFORMING BASIC SCIENCE AND CLINICAL RESEARCH. THROUGH ITS JOINT RESIDENCY PROGRAM WITH UC IRVINE, THE ORGANIZATION ALSO TRAINS TOMORROW'S PHYSICIANS. THE COMMUNITY BENEFIT PLAN FOR THE FISCAL YEAR ENDING JUNE 30, 2016, DESCRIBES THE BENEFIT PLANNING PROCESS, THE BENEFITS PROVIDED, AND THE ECONOMIC VALUE OF THE BENEFITS. COMMUNITY BENEFITS ARE FREE OR SUBSIDIZED PROGRAMS AND SERVICES PROVIDED TO MEET IDENTIFIED COMMUNITY NEEDS AND TO SERVE THE PUBLIC INTEREST. THE ORGANIZATION'S COMMUNITY BENEFIT PLAN IS AVAILABLE ONLINE AT: HTTP://WWW.CHOC.ORG/ABOUT. THE MAJORITY OF THE ORGANIZATION'S GOVERNING BODY IS COMPOSED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. CLINICAL PRIVILEGES ARE GRANTED TO ALL QUALIFIED PHYSICIANS AS MEMBERS OF THE MEDICAL STAFF. MEDICAL STAFF MEMBERS PROVIDE PATIENT CARE AND HAVE ACCESS TO HOSPITAL RESOURCES (INCLUDING EQUIPMENT, FACILITIES AND PERSONNEL) WHICH ARE NECESSARY TO EFFECTIVELY EXERCISE THEIR PRIVILEGES. PHYSICIANS ARE QUALIFIED TO BE MEMBERS OF THE MEDICAL STAFF IF THEY MEET THE FOLLOWING CRITERIA: ONLY PRACTICING PHYSICIANS, DENTISTS, PSYCHOLOGISTS OR PODIATRISTS SHALL BE DEEMED TO POSSESS BASIC QUALIFICATIONS FOR MEMBERSHIP ON THE MEDICAL STAFF, EXCEPT FOR THE HONORARY AND RETIRED STAFF CATEGORIES IN WHICH CASE THESE CRITERIA SHALL ONLY APPLY AS DEEMED INDIVIDUALLY APPLICABLE BY THE MEDICAL STAFF, AND WHO: (A) DOCUMENT THEIR (1) CURRENT LICENSURE, (2) ADEQUATE EXPERIENCE, EDUCATION, AND TRAINING, (3) CURRENT PROFESSIONAL COMPETENCE, (4) GOOD JUDGMENT, AND (5) CURRENT ADEQUATE PHYSICAL AND MENTAL HEALTH STATUS, SO AS TO DEMONSTRATE TO THE SATISFACTION OF THE MEDICAL STAFF THAT THEY ARE PROFESSIONALLY AND ETHICALLY COMPETENT AND THAT PATIENTS TREATED BY THEM CAN REASONABLY EXPECT TO RECEIVE QUALITY MEDICAL CARE. (B) ARE DETERMINED (1) TO ADHERE TO THE ETHICS OF THEIR RESPECTIVE PROFESSIONS, (2) TO BE ABLE TO WORK COOPERATIVELY WITH OTHERS SO AS NOT TO ADVERSELY AFFECT PATIENT CARE, (3) TO KEEP AS CONFIDENTIAL, AS REQUIRED BY LAW, ALL INFORMATION OR RECORDS RECEIVED IN THE PHYSICIAN-PATIENT RELATIONSHIP, AND (4) TO BE WILLING TO PARTICIPATE IN AND PROPERLY DISCHARGE THOSE RESPONSIBILITIES DETERMINED BY THE MEDICAL STAFF AND BE BOUND BY THE MEDICAL STAFF BYLAWS, RULES AND REGULATIONS, AND POLICIES. (C) WHO MAINTAIN IN FORCE PROFESSIONAL LIABILITY INSURANCE IN NOT LESS THAN THE MINIMUM AMOUNTS JOINTLY DETERMINED BY THE BOARD OF DIRECTORS AND THE MEDICAL EXECUTIVE COMMITTEE, BUT IN NO EVENT LESS THAN $1.0 MILLION PER INCIDENT AND $3.0 MILLION IN THE AGGREGATE IN A POLICY YEAR; PROVIDED, HOWEVER, THAT IN THE EVENT THAT (AND FOR SO LONG AS) SUCH INSURANCE IS NOT AVAILABLE ON COMMERCIALLY REASONABLE TERMS TO PHYSICIANS PRACTICING IN A PARTICULAR SPECIALTY OR SUB-SPECIALTY AREA OF MEDICAL PRACTICE, THE FOREGOING REQUIREMENTS MAY BE MODIFIED OR WAIVED WITH RESPECT TO ALL PHYSICIANS PRACTICING IN SUCH SPECIALTY OR SUB-SPECIALTY AREA, SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS UPON REQUEST OF THE MEDICAL EXECUTIVE COMMITTEE. ADMINISTRATIVE STAFF AND MEMBERS ON A LEAVE OF ABSENCE DO NOT NEED TO SHOW EVIDENCE OF INSURANCE. THE ORGANIZATION APPLIES ITS SURPLUS FUNDS TO IMPLEMENT IMPROVEMENTS IN PATIENT CARE, MEDICAL EDUCATION AND RESEARCH. DURING THE REPORTING YEAR ENDED JUNE 30, 2013, THE ORGANIZATION COMPLETED THE CONSTRUCTION OF A STATE-OF-THE-ART $552 MILLION HOSPITAL TOWER ON ITS MAIN CAMPUS IN THE CITY OF ORANGE. CONSTRUCTION OF THE 7 STORY BUILDING STARTED IN 2009 AND OPENED ITS DOORS TO PATIENTS IN 2013. THE NEW TOWER INCLUDES INPATIENT AND OUTPATIENT CARE FOR CHILDREN, WITH EMERGENCY DEPARTMENT, OPERATING ROOMS, A MEDICAL LABORATORY, PATHOLOGY DEPARTMENT AND IMAGING AND RADIOLOGY SERVICES. The emergency department became a designated trauma unit in October 2014. THERE IS ALSO A LARGE CONFERENCE AREA TO ACCOMMODATE AND SUPPORT SOME OF THE ORGANIZATION'S TEACHING ACTIVITIES. THE CHOC ENDOWMENT FUNDS ARE IN PART USED TO FUND MEDICAL RESEARCH, CLINICAL PROGRAMS AND SERVICES, AND TO RECRUIT AND RETAIN DOCTORS WHO ARE THE BEST IN THEIR FIELDS. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: FOR OVER 50 YEARS, CHOC CHILDREN'S HAS BEEN STEADFASTLY COMMITTED TO PROVIDING THE HIGHEST QUALITY MEDICAL CARE TO CHILDREN. AFFILIATED WITH THE UNIVERSITY OF CALIFORNIA, IRVINE, OUR REGIONAL PEDIATRIC HEALTHCARE NETWORK INCLUDES A STATE-OF-THE ART 279 BED HOSPITAL IN THE CITY OF ORANGE AND A HOSPITAL-WITHIN-A-HOSPITAL IN MISSION VIEJO. CHOC ALSO OFFERS MANY PRIMARY AND SPECIALTY CARE CLINICS, MORE THAN 86 ADDITIONAL PROGRAMS AND SERVICES, A PEDIATRIC RESIDENCY PROGRAM, AND FOUR CENTERS OF EXCELLENCE - THE CHOC CHILDREN'S HEART, NEUROSCIENCE, ORTHOPAEDIC, AND HYUNDAI CANCER INSTITUTES. THE ECONOMIC VALUE OF THE 86 BENEFIT SERVICES PROVIDED BY CHOC AND CCMH IN FISCAL YEAR 2016 IS $134.5 MILLION. OF THESE DOLLARS, 77.5% ($104.3 MILLION) SERVED THE ECONOMICALLY DISADVANTAGED. THE ECONOMIC VALUE OF SAVINGS FROM NOT-FOR-PROFIT STATUS IS $12.4 MILLION. THUS, THE HOSPITALS RETURN $10.83 IN COMMUNITY BENEFITS FOR EACH $1 SAVED FROM TAX-EXEMPT STATUS. IN ADDITION TO THE $134.5 MILLION IN BENEFITS PROVIDED FOR BY THE HOSPITALS REFERENCED ABOVE, BOARD MEMBERS, PHYSICIANS, EMPLOYEES AND VOLUNTEERS CONTRIBUTED 48,000 HOURS OF VOLUNTEER SERVICE TO THE COMMUNITY. SCHEDULE H PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT: A COMMUNITY BENEFIT REPORT IS FILED ANNUALLY IN THE STATE OF CALIFORNIA. true CHILDREN'S HEALTHCARE OF CALIFORNIA 1201 West La Veta Avenue ORANGE CA 92868 330265266 501(c)(3) 35000000 N/A N/A SUPPORT 1 0 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS - PART I, LINE 2 The grant form CHOC to CHC was in accordance with the bylaws of both organizations. X X X X false true false false false false false false false KIMBERLY CRIPE DIRECTOR/PRESIDENT 0 838732 0 317258 0 257823 0 63390 0 20385 0 1497588 0 44445 Jay Gabriel Secretary 394002 0 95920 0 98953 0 23120 0 25906 0 637901 0 51763 0 Matthew Gerlach Executive Vice President/COO 0 474320 0 140238 0 51104 0 89986 0 16478 0 772126 0 0 Maria Minon VP/CMO 492691 0 118685 0 124626 0 37845 0 9187 0 783034 0 19455 0 Kerri Ruppert Schiller CFO/Assistant Secretary 0 495562 0 139228 0 141954 0 49440 0 25882 0 852066 0 22282 Mark Headland VP/Chief Information Officer 311437 0 72531 0 89987 0 32390 0 6231 0 512576 0 12447 0 Hale Kuhlman V.P., Specialty Physician SRV 268970 0 60107 0 81884 0 27002 0 16478 0 454441 0 10782 0 Melanie Patterson VP Patient Care Svcs, CNO 295615 0 68461 0 33534 0 62025 0 21128 0 480763 0 0 0 Marcia Folli VP Ancillary Services 135221 135221 32803 32802 88590 88589 14225 14225 12 12 270851 270849 106600 0 Nick Anas MD Pediatrician in Chief 460109 0 0 0 102873 0 30788 0 24532 0 618302 0 0 0 Michael Weiss VP CHOC Health Alliance 372337 0 88821 0 36504 0 5450 0 18092 0 521204 0 0 0 William Rohde Vice President Finance 276538 0 59061 0 76408 0 12605 0 10853 0 435465 0 37732 0 Jan Lansing VP Marketing & Communications 279396 0 68368 0 80486 0 15019 0 11281 0 454550 0 11028 0 SEVERANCE ARRANGEMENTS,PART I, LINE 4A Part I, 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 current key employees were reported at their full value in a previous tax year. 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 individuals received payments from the Plan during calendar year 2015: Ms. Cripe ($165,908), Mr. Gabriel ($51,763), Dr. Minon ($72,663), Ms. Schiller ($83,035), Mr. Headland ($46,172), Mr. Kuhlman ($39,667), Ms. Folli ($137,022), DR. ANAS ($68,621), MR. ROHDE ($37,732) and MS. LANSING ($41,064). Compensation from an affiliated organization Kimberly C. Cripe is compensated through Children's HealthCare of California (CHC), however, in addition to her responsibilities for CHC, she also serves as an officer of Children's Hospital of Orange County, CHOC Foundation, CRC Real Estate Corporation and Children's Hospital at Mission (all IRC Section 501(c)(3) affiliates). Ms. Cripe devotes approximately 75% of her time each week to Children's Hospital of Orange County responsibilities with the balance of her time being spent on the other related organizations' business affairs. Kerri Ruppert Schiller is compensated through Children's HealthCare of California (CHC), however, in addition to her responsibilities for CHC, she also serves as an officer of Children's Hospital of Orange County, CHOC Foundation, CRC Real Estate Corporation and Children's Hospital at Mission (all IRC Section 501(c)(3) affiliates). Ms. Schiller devotes approximately 60% of her time each week to Children's Hospital of Orange County responsibilities with the balance of her time being spent on the other related organizations' business affairs. Matthew Gerlach IS COMPENSATED THROUGH CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC), HOWEVER, IN ADDITION TO HIS RESPONSIBILITIES FOR CHC, HE 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). MR. Gerlach DEVOTES APPROXIMATELY 84% OF HIS TIME EACH WEEK TO CHILDREN'S HOSPITAL OF ORANGE COUNTY RESPONSIBILITIES WITH THE BALANCE OF HIS TIME BEING SPENT ON CHILDREN'S HOSPITAL AT MISSION'S BUSINESS AFFAIRS. Marcia Folli is compensated through Children's Hospital at Mission; however, in addition to her responsibilities for Children's Hospital at Mission, she also serves as V.P. of Ancillary Services at Children's Hospital of Orange County, an IRC Section 501(c)(3) affiliate. Ms. Folli devotes approximately 50% of her time each week to Children's Hospital of Orange County with the balance of her time being spent on Children's Hospital at Mission business affairs. A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033LBP1 2009-06-30 137686600 CONSTRUCT A HOSPITAL false false false B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033LBT3 2009-06-30 127800000 CONSTRUCT A HOSPITAL false false false C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033LRT6 2011-11-03 105003490 CONSTRUCT A HOSPITAL false false false A 15380000 0 137832494 10875040 0 0 1838778 0 0 17244250 107849999 0 2013 false true true true B 8675000 0 128231076 0 0 0 1382488 0 0 126850189 0 0 2013 false false true true C 495000 0 105081739 0 0 0 0 0 0 105081328 0 0 2013 false false true true A false false true true false 0.00161 0.00161 false false false true B false false true true false 0 false false false true C false false true true false 0 false false false true A false true false false 0 false 0 false true B false true true true MORGAN STANLEY 30. false false false 0 false true C false true false false 0 false 0 false true A true B true C true PART II, LINE 3 CUMULATIVE INTEREST EARNED ON ISSUE A: $ 145,894 CUMULATIVE INTEREST EARNED ON ISSUE B: $ 431,076 CUMULATIVE INTEREST EARNED ON ISSUE C: $ 78,249 part iv, line 2c Bond A: Rebate computation was performed on 07/15/16 FORM 990, PART I, LINE 5 AND PART V, LINE 2 INFORMATION REGARDING CHOC AS THE COMMON PAYMASTER: Children's Hospital of Orange County is the common paymaster of the following: CHILDREN'S HEALTHCARE OF CALIFORNIA CHILDREN'S HOSPITAL AT MISSION CHOC FOUNDATION All wages and employee specific information, including volunteers, are retained with Children's Hospital of Orange County. COMMUNITY BENEFIT REPORT HIGHLIGHTS: CHOC IS DEDICATED TO PROVIDING THE HIGHEST QUALITY TERTIARY, QUATERNARY INPATIENT CARE AS WELL AS SPECIALTY AND PRIMARY CARE TO CHILDREN IN A FAMILY CENTERED ENVIRONMENT. ACCESS TO QUALITY PEDIATRIC HEALTHCARE RESOURCES AND INFORMATION TO FAMILIES, INCLUDING LOW-INCOME AND MEDICALLY UNDERSERVED, THROUGHOUT ORANGE AND CONTIGUOUS COUNTIES, IS ACCOMPLISHED BY OFFERING: (1) PEDIATRIC INTENSIVE CARE UNIT (PICU). THE 30 BED PICU AT CHOC IS STAFFED BY INTENSIVISTS AND CLINICIAN STAFF AND IS EQUIPPED WITH ADVANCED COMPUTERIZED MONITORING SYSTEMS AND OFFERS CARE TO CRITICALLY ILL OR INJURED CHILDREN WITH LIFE-THREATENING DISORDERS. (2) ONCOLOGY UNIT STAFFED BY SPECIALISTS TRAINED TO TREAT THE COMPLEX CONDITIONS THAT ACCOMPANY PEDIATRIC CANCERS, WHICH INCLUDES A 28-BED HEMATOLOGY/ONCOLOGY UNIT. THE UNIT OFFERS THE LATEST IN MEDICAL AND SURGICAL ONCOLOGY INCLUDING CHEMOTHERAPY, RADIOTHERAPY AND BLOOD AND MARROW TRANSPLANTATION. IN ADDITION, CHOC OFFERS A 22 CHAIR OUTPATIENT INFUSION CENTER. (3) CHOC'S NEONATAL INTENSIVE CARE UNIT (NICU) TAKES CARE OF INFANTS WHO NEED CRITICAL CARE (MOST OFTEN PREMATURE BABIES SUFFERING FROM RESPIRATORY AND CIRCULATORY PROBLEMS AS WELL AS CONGENITAL ANOMALIES REQUIRING SURGERY) THAT CAN BE ADMITTED TO THE NICU WITHIN MINUTES OF BIRTH. THE 66-BED NICU AT CHOC INCLUDES TWO EIGHT-BED NURSERIES, TWO NINE-BED NURSERIES, SIX ISOLATION ROOMS, 12 BEDS THAT PROVIDE PRIVATE ROOMING, A TWO-BED EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) UNIT AND A 12-BED MOTHER-BABY UNIT WITHIN SAINT JOSEPH HOSPITAL OF ORANGE. CHOC'S ECMO UNIT IS THE ONLY ONE OF ITS KIND IN ORANGE COUNTY AND ONE OF ONLY 72 IN THE UNITED STATES. CHOC ALSO HAS SOUTHERN CALIFORNIA'S ONLY ECMO TRANSPORT UNIT. CHOC HAS A DESIGNATED SMALL BABY UNIT OF 12 BEDS THAT CARES FOR BABIES THAT WEIGH LESS THAN 1,000 GRAMS AT BIRTH OR 27 WEEKS OR LESS GESTATION PERIOD. (4) CHOC'S CARDIOVASCULAR INTENSIVE CARE UNIT (CVICU) MEETS THE GROWING NEED FOR SPECIALIZED HEART SERVICES IN ORANGE COUNTY. THIS 12-BED UNIT INCLUDES TWO SPECIAL PROCEDURE TREATMENT ROOMS THAT ENABLE PHYSICIANS TO PERFORM SURGERY ON CHILDREN WHO OTHERWISE COULD NOT BE TRANSPORTED OUT OF THE UNIT AND INTO THE OPERATING ROOMS. ALL OF THE CVICU ROOMS ARE OUTFITTED WITH TECHNOLOGY TO MONITOR CHILDREN AFTER COMPLEX OPERATIONS AND SURGICAL PROCEDURES. (5) IN MARCH 2013, CHOC COMPLETED AND OPENED SERVICES IN A NEW STATE-OF-THE-ART PATIENT TOWER. ALL INPATIENT AND OUTPATIENT ANCILLARY SERVICES PREVIOUSLY PURCHASED FROM SAINT JOSEPH HOSPITAL OF ORANGE ARE NOW AVAILABLE WITHIN CHOC'S FACILITIES. THE SERVICES INCLUDE FULL CLINICAL LABORATORY SERVICES, AN EMERGENCY DEPARTMENT DEDICATED SOLELY TO PEDIATRIC CARE, FULL IMAGING SERVICES AND SURGICAL SERVICES, INCLUDING CATH LAB AND FULL CARDIAC CARE. In addition, CHOC's emergency department became a designated trauma unit in october 2014. THESE DEDICATED SERVICES HAVE GREATLY ENHANCED THE TOTAL CARE GIVEN TO CHOC'S PATIENTS. (6) THE CHOC CANCER, NEUROSCIENCE, HEART AND ORTHOPAEDIC INSTITUTES OFFER INNOVATIVE ADVANCED MODELS OF CARE IN THE EVALUATION, MANAGEMENT AND TREATMENT OF THE MOST COMPLEX PEDIATRIC AND ADOLESCENT CONDITIONS. CHOC PROVIDES AND ENHANCES THE COMMUNITY'S ACCESS TO BEHAVIORAL HEALTH INFORMATION AND SOCIAL AND EMOTIONAL SERVICES, TARGETING THE UNDERSERVED. CHOC OFFERS OUTPATIENT SPECIALTY CARE IN MULTIPLE SPECIALTIES THROUGH CLINICS IN ORANGE AND NEWPORT BEACH. CHOC ACTIVELY SUPPORTS COMMUNITY ACTION AND LEADERSHIP. CHOC ACTIVELY RECRUITS, RECOGNIZES AND ADVOCATES FOR THE IMPORTANCE OF VOLUNTEER LEADERSHIP AND COMMUNITY ASSISTANCE IN PROVIDING CARE FOR CHILDREN. CHOC PROVIDES COMMUNITY-WIDE EDUCATION AND HEALTH INFORMATION RESOURCES AND INJURY PREVENTION. IN ADDITION, CHOC OFFERS SERVICES THROUGH ITS OUTREACH CLINICS THAT SERVE SURROUNDING COMMUNITIES TO PROVIDE PREVENTATIVE AND PRIMARY CARE IN LOW-INCOME, HIGH RISK AREAS WHERE CHILDREN HAVE LIMITED ACCESS TO CARE. CHOC'S OUTREACH CLINICS INCLUDE THE CHOC ORANGE COMMUNITY CLINIC, CLINICA PARA NIOS IN SANTA ANA, THE CHOC CLINIC AT SANTA ANA BOYS AND GIRLS CLUB, AND CHOC GARDEN GROVE CLINIC. CHOC ALSO PROVIDES CARE THROUGH MOBILE CLINICS, INCLUDING BREATH MOBILES AND ASTHMA CARE. IN FY 2016, CHOC ADDED SEVERAL NEW PEDIATRIC PRIMARY CARE PRACTICES TO EXPAND CHOC'S PRIMARY CARE NETWORK OFFERED IN SOUTH ORANGE COUNTY. SEE OUR COMMUNITY BENEFITS REPORT ON OUR WEBSITE AT WWW.CHOC.ORG. LINES 6 & 7A - ORGANIZATION MEMBER INFORMATION THE SOLE MEMBER OF CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) IS CHILDREN'S HEALTHCARE OF CALIFORNIA (CHC). LINE 7B - ORGANIZATION MEMBER INFORMATION THE APPROVAL OF THE MEMBER SHALL BE REQUIRED WITH RESPECT TO ANY OF THE FOLLOWING ACTIONS: (1) CHANGING THE PURPOSES AND POWERS OF CHOC; (2) OBLIGATING CHOC TO UNDERTAKE ANY CAPITAL EXPENDITURE IN EXCESS OF $5,000,000; (3) ADOPTING CHOC'S ANNUAL OPERATING AND CAPITAL BUDGETS; (4) ADOPTING A LONG-TERM CAPITAL BUDGET; (5) BUYING, SELLING, LEASING, MORTGAGING, PLEDGING, OR OTHERWISE HYPOTHECATING ANY REAL PROPERTY; (6) INCURRING ANY INDEBTEDNESS IN EXCESS OF $5,000,000; (7) OBLIGATING CHOC TO ACT AS GUARANTOR WITH RESPECT TO ANY DEBT OF ANY PERSON OR OTHER ENTITY; (8) ACCEPTING ANY DONATION WHICH IS CONDITIONED UPON CHOC'S UNDERTAKING ANY UNBUDGETED CAPITAL EXPENDITURE IN EXCESS OF $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 CHOC IN AN AMOUNT IN EXCESS OF $5,000,000 or (B) ANY PURPOSE OR ACTIVITY WHICH IS OUTSIDE THE SCOPE OF CHOC'S ORDINARY COURSE OF BUSINESS. (10) INVOLVING CHOC IN ANY MERGER, ACQUISITION, CORPORATE RESTRUCTURING, OR FORMAL AFFILIATION; (11) INVOLVING CHOC AS A MEMBER, SHAREHOLDER, OR PARTNER IN ANY NEW CORPORATION, PARTNERSHIP, OR OTHER LEGAL ENTITY; (12) DISSOLVING CHOC; (13) ENTERING INTO ANY TRANSACTION INVOLVING THE SALE, CONVEYANCE, EXCHANGE, TRANSFER OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF CHOC'S ASSETS; (14) AMENDING CHOC'S ARTICLES OF INCORPORATION; (15) ADOPTING NEW BYLAWS OR AMENDING EXISTING BYLAWS. FORM 990, PART VI, SECTION A Line 4 - changes to bylaws Changes to bylaws included the following below: Purpose: the operation of medical research foundation clinics was added to the purposes of the corporation. RESERVED POWERS: REMOVES THE REQUIREMENT OF THE MEMBER'S APPROVAL TO ENTER INTO A CONTRACT THAT INVOLVES A TERM IN EXCESS OF 10 YEARS. THE MEMBER'S APPROVAL IS REQUIRED TO MAKE ANY CHANGE TO THE BYLAWS, NOT JUST THOSE THAT WOULD AFFECT THE MEMBER'S RIGHTS. POWERS: CLARIFIED THAT THE MEMBER HAS THE POWER TO INITIATE AN ACTION AS TO A SUBSIDIARY AS WELL AS APPROVE THE SUBSIDIARY'S ACTION. QUALIFICATIONS OF DIRECTORS: REMOVED REQUIREMENT THAT THE CHIEF LEGAL OFFICER ("CLO") MUST BE SECRETARY TO ATTEND MEETINGS OF THE BOARD. VACANCIES: REVISED SO THAT A VACANCY ON THE BOARD MAY BE FILLED BY THE VOTE OF THE REMAINING DIRECTORS, SUBJECT TO RATIFICATION BY THE MEMBER. QUORUM: REVISED SO A QUORUM SHALL BE A MAJORITY OF THE DIRECTORS THEN IN OFFICE. OFFICERS: DELETED THE REFERENCE TO THE FIRST VICE CHAIR AND SECOND VICE CHAIR AND REPLACED WITH ONE VICE CHAIR. Form 990, Part VI, Section B LINE 11b - REVIEW OF FORM 990: PRIOR TO FILING, THE TAX RETURN AND RELATED SCHEDULES ARE PROVIDED TO THE CHOC EXECUTIVE COMPENSATION COMMITTEE, AN EMPOWERED BOARD COMMITTEE DELEGATED WITH THIS AUTHORITY. THE CHIEF FINANCIAL OFFICER REVIEWS THE REPORT WITH THE COMMITTEE PRIOR TO FILING THE FINAL RETURN. PRIOR TO THE FILING OF THE FORM 990 WITH THE INTERNAL REVENUE SERVICE, A COMPLETE COPY OF THE FINAL FORM 990 IS ALSO SENT ELECTRONICALLY TO ALL BOARD MEMBERS VIA DIRECTOR'S DESK, A SECURE WEB SITE THAT PROVIDES A CONFIDENTIAL AND SECURE ACCESS FOR ALL BOARD MATERIALS TO OUR BOARD MEMBERS. LINE 12C - CONFLICT OF INTEREST COMPLIANCE: 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. LINE 15 - COMPENSATION DETERMINATION: An independent Board Committee of THE ORGANIZATION charged with the duties of the compensation committee, whose members are disinterested and independent, is in place with a written compensation committee charter. This Committee annually retains an independent healthcare compensation firm to provide relevant comparability data and other compensation studies. The CEO, officers and executive management salaries and incentives, as well as overall compensation philosophy and policies, are discussed with the independent consultant representatives and the compensation committee members, in person, in closed sessions with no staff members present. This review was last performed in OCTOBER 2015. 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. FORM 990, PART VI, SECTION C line 19 - disclosure policy FEDERAL TAX LAWS DO NOT MANDATE THAT THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY BE MADE AVAILABLE FOR PUBLIC INSPECTION. FORM 990 AND THE COPY OF AUDITED FINANCIAL STATEMENTS ATTACHED TO IT ARE MADE AVAILABLE UPON REQUEST. RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 9 CHANGE IN BENEFICIAL INTEREST IN CHOC FOUNDATION $(7,055,786) Net income of OCMRRG $ 835,878 Other Changes in Fund Balance $ 164,119 =============================================================== Line 9 Total Other changes in fund balance $(6,055,789) FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:67425666 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:34824400 FORM 990 PART IX LINE 11G DESCRIPTION:MISC PURCHASED SERVICES TOTAL FEES:20666976 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:5446944 FORM 990 PART IX LINE 11G DESCRIPTION:COLLECTION AGENCY FEES TOTAL FEES:1536526 FORM 990 PART IX LINE 11G DESCRIPTION:SECURITY SERVICES TOTAL FEES:1519739 FORM 990 PART IX LINE 11G DESCRIPTION:JANITORIAL SERVICES TOTAL FEES:43300 FORM 990 PART IX LINE 11G DESCRIPTION:COURIER SERVICES TOTAL FEES:7596 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 at Mission 1201 West La Veta Avenue ORANGE CA 92868 330528802 HEALTH CARE CA 501(c)(3) 3 CHC false CHOC FOUNDATION 1201 West La Veta Avenue ORANGE CA 92868 956097416 Fund Raising CA 501(c)(3) 7 CHC false CRC REAL ESTATE CORPORATION 1201 West La Veta Avenue ORANGE CA 92868 330612565 REAL ESTATE CA 501(c)(3) 11 CHC false CHOC Thrift Stores Inc 455 S MAIN STREET orange CA 92868 330266422 Fund Raising CA 501(c)(3) 9 CHC false ORANGE COUNTY MEDICAL RECIPROCAL INS CO 2999 North 4th Street Suite 250 phoenix AZ 85108 201620666 insurance AZ CHOC c corp 74202 2813273 0.50000 true false true true false true false false false false true true false true false false false false false true ORANGE COUNTY MEDICAL RECIPROCAL INS CO m 653783 PER AGREEMENT PART V, LINE 2, COLUMN(C) OCMRRG PROVIDES MEDICAL PROFESSIONAL LIABILITY AND GENERAL LIABILITY COVERAGE OF UP TO $250,000 PER CLAIM ON A CLAIMS-MADE BASIS TO CHOC.