2016-07-14T14:39:49-05:00 2015-08-31 PricewaterhouseCoopers LLP 101 SEAPORT BOULEVARD Boston MA 02210 990 2014-09-01 320359189 Packard Children's Health Alliance % KIM ROBERTS FINANCE DEPT PACK 6504978000 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 GREG HOGUE CONTROLLER 6175305000 2016-07-13 true Gwen Spencer P00641463 6175305000 2014 2016-09-27 15:27:22Z KIM ROBERTS 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 71682237 false X WWW.PCHA.ORG X 2011 CA SEE SCHEDULE O 7 2 261 0 0 0 0 55151112 71682237 7526 0 0 0 55158638 71682237 0 0 0 0 13629258 18991883 0 0 0 50054529 64114095 63683787 83105978 -8525149 -11423741 30162362 27470485 13650990 19605453 16511372 7865032 X SEE SCHEDULE O false false 76679675 71682237 SEE SCHEDULE O 76679675 true false false false false false false false false false true false false false true false false true false false false false false false false false false false false true false false false false false false false false false false false false false true true false false false true 70 0 true 261 true false false false false false false false false false false X 7 2 false false false false true true true true true false false true true true true true false false false false CA X KIM ROBERTS FINANCE DEPT 6507212222 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 X MARCIA COHEN Director/VICE CHAIR 1.0 50.0 X 0 484541 86398 WILLIAM KENNEDY MD DIRECTOR/CHAIRMAN 1.0 50.0 X 0 393079 36496 KIM ROBERTS PRESIDENT & CEO 25.0 25.0 X X 0 495724 122014 JACOB CHACKO Director 1.0 0.0 X 0 0 0 JOHN WALKER DIRECTOR (AS OF 1/1/2015) 1.0 3.0 X 0 0 0 DENNIS P LUND MD DIRECTOR (as of 03/16/15) 1.0 3.0 X 0 0 0 ANDREW SMITH MEDICAL DIRECTOR 30.0 0.0 X X 353748 0 38189 BERNADINE CHUCK FONG DIRECTOR (UNTIL 12/31/14) 50.0 4.0 X 0 27905 538 KENNETH L COX MD SECRETARY (UNTIL 03/16/15) 2.0 51.0 X X 0 491737 39697 DANA HAERING CFO 2.0 50.0 X 0 461970 40998 MARGARET JOHNSON SR DIR FINANCE(UNTIL 08/16/15) 12.0 0.0 X 0 239273 39074 MALAVIKA NARAYAN SR DIR FINANCE(AS OF 08/17/15) 12.0 0.0 X 0 125294 6051 RICK VANCE COO 50.0 0.0 X 310987 0 33589 CARLOTTA GABARD PRACTICE ADMINISTRATOR 50.0 0.0 X 219147 0 25535 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 50.0 0.0 X 208389 0 30365 MICHAEL LIPMAN PROVIDER RECRUIT. AND DEV. DIR 50.0 0.0 X 202581 0 25214 DOROTHY NAIDU DIRECTOR, CLINICAL QUALITY 50.0 0.0 X 149749 0 12244 AUBYN REDMOND DIRECTOR, PRACTICE OPERATIONS 50.0 0.0 X 138090 0 6090 1582691 2719523 542492 19 false true false PACKARD MEDICAL GROUP INC 725 WELCH ROAD MC 5551 PALO ALTO CA 94304 PHYSICIAN SERVICES 38566740 ADP PO Box 31001-1874 PASADENA CA 91110 Payroll & Benefits 574454 Excite Health Partners PO Box 823424 PHILADELPHIA PA 19182 Consulting/Valuation 548143 314E Corporation 47102 Mission Falls Ct Suite 219 FREMONT CA 94539 Consulting/Valuation 529231 ADECCO MEDICAL SCIENCE Department LA 21403 PASADENA CA 91185 Payroll & Benefits 508029 25 0 PATIENT SERVICES 900099 63529069 63529069 GOVERNMENT FUND 900099 12750 12750 PROGRAM SUPPORT 900099 8125148 8125148 OTHER INCOME - RISK POOL 900099 15270 15270 71682237 0 0 0 0 0 0 0 0 0 0 0 71682237 71682237 X 0 0 0 0 327425 147341 180084 0 12530019 11354550 1175469 798755 753921 44834 4186171 3914321 271850 1149513 1044976 104537 1159801 703797 456004 591601 591601 15529 15529 0 0 0 43960465 41628235 2332230 37820 21425 16395 9692821 9113682 579139 2252961 1251213 1001748 0 4012328 4012328 70398 46899 23499 0 0 0 0 1727380 917509 809871 283974 66 283908 UNCOLLECTIBLES 501532 501532 RECRUITMENT 61424 58564 2860 LICENSES & TAXES 136262 171229 -34967 DUES & SUBSCRIPTIONS 105217 60203 45014 -495418 977884 -1473302 83105978 76679675 6426303 0 0 0 -203998 823805 0 0 13149619 8306776 0 0 0 0 0 0 0 0 558453 399940 10131834 3989773 5412322 6142061 0 0 0 0 0 0 11005286 11064286 240680 733617 30162362 27470485 5068433 6639828 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8582557 12965625 13650990 19605453 X 16511372 7865032 0 0 0 0 16511372 7865032 30162362 27470485 X -11423741 2777401 X false true X true false X SCHEDULE A, PART I PACKARD CHILDREN'S HEALTH ALLIANCE WAS RECOGNIZED AS A HEALTHCARE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) OF THE INTERNAL REVENUE CODE. PCHA DOES NOT OPERATE A FACILITY THAT IS OR IS REQUIRED TO BE LICENSED AS A HOSPITAL. THEREFORE, PCHA IS NOT REQUIRED TO FILE FORM 990, SCHEDULE H. 834777 325866 508911 2150769 2622375 -471606 7146288 1041532 6104756 6142061 0 DUE TO RELATED PARTIES, NET 12965625 12965625 false true false false false false false false false MARCIA COHEN Director/VICE CHAIR 0 431816 0 52200 0 525 0 26000 0 60398 0 570939 0 0 MARGARET JOHNSON SR DIR FINANCE(UNTIL 08/16/15) 0 203593 0 27341 0 8339 0 13247 0 25827 0 278347 0 0 WILLIAM KENNEDY MD DIRECTOR/CHAIRMAN 0 282927 0 96222 0 13930 0 24766 0 11730 0 429575 0 0 KIM ROBERTS PRESIDENT & CEO 0 386566 0 66883 0 42275 0 82358 0 39656 0 617738 0 34100 ANDREW SMITH MEDICAL DIRECTOR 291443 0 50305 0 12000 0 23000 0 15189 0 391937 0 0 0 DANA HAERING CFO 0 363693 0 98134 0 143 0 29924 0 11074 0 502968 0 0 KENNETH L COX MD SECRETARY (UNTIL 03/16/15) 0 284382 0 207355 0 0 0 26000 0 13697 0 531434 0 0 CARLOTTA GABARD PRACTICE ADMINISTRATOR 207199 0 11948 0 0 0 23000 0 2535 0 244682 0 0 0 TIKA MARTIN DIRECTOR, HUMAN RESOURCES 190287 0 18102 0 0 0 17500 0 12865 0 238754 0 0 0 MICHAEL LIPMAN PROVIDER RECRUIT. AND DEV. DIR 188290 0 14291 0 0 0 23000 0 2214 0 227795 0 0 0 DOROTHY NAIDU DIRECTOR, CLINICAL QUALITY 141372 0 8377 0 0 0 0 0 12244 0 161993 0 0 0 RICK VANCE COO 250321 0 49127 0 11539 0 17500 0 16089 0 344576 0 0 0 PROCEDURES FOR DETERMINING COMPENSATION SCHEDULE J, PART I, LINE 3 PCHA RELIED ON LPCH, A RELATED ORGANIZATION, TO DETERMINE OFFICER COMPENSATION. LPCH'S PROCESS FOR DETERMINING COMPENSATION REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF LPCH. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS, AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B CERTAIN OFFICERS OF PACKARD CHILDREN'S HEALTH ALLIANCE ARE PROVIDED A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS BY LPCH, A RELATED ORGANIZATION. AT THE LAST DATE OF EACH QUARTER EACH PARTICIPANT'S ACCOUNT IS CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION). THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN THE ACCOUNT AS FOLLOWS: (a) the first business day of January following the year in which the account was established and the participant completes two full years of participation; (b) discharge from employment; (c) entitlement to long-term disability; or (d) the participant attains the age of 60 while employed. The following amount became vested and wAS paid to the following individual in calendar year 2014: KIM ROBERTS $34,576 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (C). CERTAIN OFFICERS AND OTHERS AS ENUMERATED IN SCHEDULE J, PART II PARTICIPATE IN A DEFERRED COMPENSATION PLAN SPONSORED BY LPCH. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. ORGANIZATION'S PRIMARY EXEMPT PURPOSE FORM 990, PART I, LINE 1 & PART III, LINE 1 At PCHA, the focus is on patient care and community outreach to ensure patient access to PCHA's services. PCHA physicians, non MD clinicians, and staff assume the role of educators to improve the physical and behavioral well-being of children in the communities it serves. The overall strategy to accomplish the objective is twofold: become a relied upon resource for caregivers/parents andprovide preventative care for children. Education is the key for both strategies. While multiple community services will be offered at the medical sites, a significant part of the outreach efforts will be spent serving the PCHA community. FORM 990, PART III, LINE 4A PROGRAM SERVICE DESCRIPTION During the period of September 2014 through August 2015 (FY 2015), PCHA continued its dramatic growth by adding the following practices and services to its network: SOUTH BASCOM PEDIATRICS - SAN JOSE ENT - WALNUT CREEK AND EMERYVILLE SILICON VALLEY PEDIATRICS - SAN JOSE PEDIATRICS ASSOCIATES - SAN JOSE IN ADDITION, WE CONTINUE TO INCREASE OUR AVAILABILITY AT MANY OF OUR SITES BY INCREASING THE NUMBER OF PROVIDERS. TO DRAMATICALLY IMPROVE OUR ACCESS TO PATIENT MEDICAL INFORMATION, LAST YEAR WE UPGRADED ALL OF OUR SITES TO ONE COMMON CORE ELECTRONIC MEDICAL RECORD WHICH IS INTEROPERABLE WITH THE OTHER FOUR LARGE HEALTHCARE SYSTEMS IN OUR REGION. THIS ALLOWS DEMOGRAPHIC, INSURANCE AND CLINICAL INFORMATION TO BE TRANSFERRED TO VARIOUS CLINICAL PROVIDERS SUPPORTING PATIENTS WHEREVER THEY NEED MEDICAL CARE. THIS YEAR WE IMPLEMENTED OUR PATIENT PORTAL TO IMPROVE ACCESS TO PATIENT HEALTH AND DEMOGRAPHIC DATA, DIRECTLY SCHEDULE APPOINTMENTS, REQUEST PRESCRIPTIONS, VIEW BILLING STATEMENTS AND COMMUNICATE WITH MEDICAL PROVIDERS. THE THREE LARGEST SERVICES PCHA OPERATED IN FISCAL YEAR 2015 WERE: GENERAL PEDIATRICS - BAYSIDE GENERAL PEDIATRICS - PENINSULA PEDIATRICS CARDIOLOGY - PEDIATRIC CARDIOLOGY MEDICAL GROUP. Bayside Bayside Pediatrics was established in Oakland in 1979, and has grown throughout the East Bay into a network of 10 pediatric and family practice offices, with a dedicated team of pediatricians and family practitioners who have outstanding credentials and experience. We provide personalized, high-quality and patient-centered care. Our pediatricians specialize in the care of newborns, children and adolescents at all 10 of our offices, and our family practitioners provide adult care at two of our offices (Berkeley and Alameda). In addition, we have a pediatrician with pulmonology experience who brings expertise in asthma care to our patients. We also provide Travel Medicine services. We are committed to providing excellent care to all children and their families. Peninsula Pediatrics At Peninsula Pediatric Medical Group, our family of experienced and caring pediatricians has been serving children in the Bay Area for generations. We specialize in caring for newborns through adolescents in their late teens. We work with parents to help children reach their highest potential by giving them the tools they need to live a healthy life. We strive to be understanding and available to the families we are privileged to serve, and offer our services in Burlingame and San Mateo. PEDIATRIC ASSOCIATES MEDICAL GROUP The Pediatric Associates Medical Group has seven physicians in two San Jose locations, Samaritan and Camden. The group has been providing the full continuum of general pediatric services to children and young adults for over 30 years. PATIENT VISITS PROVIDED IN THE FISCAL YEAR 2015 FOR EACH OF THE LARGEST SERVICES ARE: BAYSIDE: 101,650 PENINSULA PEDIATRICS: 38,077 PEDIATRIC ASSOCIATES: 25,230 DURING FISCAL YEAR 2015 PCHA PROVIDED 256,025 OFFICE VISITS. NETWORK GROWTH FOR FISCAL YEAR 2016 IS PROJECTED TO BE 20 ADDITIONAL PHYSICIANS AND TO OPEN A MULTISPECIALTY OFFICE IN FREMONT. MEMBERS FORM 990, PART VI, LINE 6 STANFORD UNIVERSITY AND LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD ARE THE MEMBERS OF PCHA. FORM 990, PART VI, LINE 7A STANFORD UNIVERSITY AND LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD, AS THE MEMBERS OF PCHA, APPOINT THE PCHA BOARD OF DIRECTORS. TWO OF THE DIRECTORS MUST BE PERSONS WHO RESIDE IN THE COMMUNITIES SERVED BY PCHA AND WHO ARE NOT COMPENSATED BY PCHA, THE MEMBERS, OR ANY MEDICAL GROUP AFFILIATED WITH PCHA. FORM 990, PART VI, LINE 7B THE FOLLOWING ACTIONS MUST BE APPROVED BY ONE OR MORE MEMBERS: - ENTERING INTO PROFESSIONAL SERVICE AGREEMENTS WITH NEW MEDICAL GROUPS - ACQUISITION, MERGER, OR CONSOLIDATION OF ANY OTHER ENTITY PROCEDURES FOR REVIEWING FORM 990 FROM GOVERNING BODY FORM 990, PART VI, LINE 11 WORKING WITH PRICEWATERHOUSECOOPERS, THE FORM 990 IS PREPARED FOR MANAGEMENT'S REVIEW. A DRAFT OF THE FORM 990 IS MAILED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW, ALONG WITH AN EXECUTIVE SUMMARY OF RECENT CHANGES AND NEW REQUIREMENTS. THE DRAFT FORM 990 IS REVIEWED AT THE AUDIT AND COMPLIANCE COMMITTEE MEETING. A FINAL FORM 990 IS THEN DISTRIBUTED TO THE FULL BOARD BEFORE FILING WITH THE IRS. PRICEWATERHOUSECOOPERS SIGNS THE FINAL RETURN AS PAID PREPARER. PROCEDURES FOR MONITORING AND ENFORCING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C OFFICERS, DIRECTORS AND EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") AT THE TIME OF APPOINTMENT AT PCHA. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS. A DISCLOSURE THAT APPEARS TO BE A CONFLICT WILL BE RESOLVED BY A MUTUAL AGREEABLE PLAN WITH THE PCHA CHIEF EXECUTIVE OFFICER THAT OUTLINES THE STEPS THE OFFICER, DIRECTOR OR EMPLOYEE MUST TAKE TO RECTIFY THE CONFLICT. DOCUMENT RETENTION POLICY FORM 990, PART VI, LINE 14 PCHA IS IN THE PROCESS OF DEVELOPING ITS OWN DOCUMENT RETENTION POLICY FOR ADOPTION BY THE BOARD OF DIRECTORS. PROCEDURES FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15 FOR THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER, PCHA RELIED ON LPCH, A RELATED ORGANIZATION, TO DETERMINE OFFICER COMPENSATION. LPCH'S PROCESS FOR DETERMINING COMPENSATION REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF LPCH. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS, AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES. the compensation of other officers and key employees who are employees of PCHA is determined by a process that includes a review of comparability data and contemporaneous substantiation of the decision. Compensation decisions with respect to officers and key employees whose compensation exceeds a specified threshold are made by the PCHA compensation committee. FORM 990, PART VI, LINE 19 THE STATEMENTS OF OPERATIONS AND BALANCE SHEET ARE INCLUDED IN THE ANNUAL REPORT POSTED ON THE ORGANIZATION'S PUBLIC WEBSITE. COPIES OF THE FINANCIAL STATEMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. COPIES OF THE GOVERNING DOCUMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. THE CONFLICT OF INTEREST POLICY IS NOT CURRENTLY AVAILABLE FOR PUBLIC INSPECTION. FORM 990, PART IX, LINE 11G TEMPORARY LABOR $605,941 Other Purchased services $6,401,254 Other Professional services $53,300 OTHER MEDICAL SERVICES $36,899,970 Total $43,960,465 RECONCILIATION FORM 990, PART XI, LINE 9 EQUITY TRANSFERS TO PCHA FROM LPCH $2,777,401 THE BRD OF TRUST LELAND STANF JR UNIV 3145 PORTER DRIVE PALO ALTO CA 94304 941156365 EDUCATION CA 501(C)(3) 2 NA false STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD CA 94305 946174066 HEALTHCARE CA 501(C)(3) 3 STANFORD true LUCILE SALTER PACKARD CHILDRENS HOSPITAL 725 WELCH ROAD MC 5553 PALO ALTO CA 94304 770003859 HEALTHCARE CA 501(C)(3) 3 STANFORD true HOSPITAL COMMITTEE FOR THE L-P AREAS 1111 E STANLEY BLVD LIVERMORE CA 94550 941429628 HOSPITAL CA 501(C)(3) 3 SHC true VALLEYCARE MEDICAL FOUNDATION INC 5655 W LAS POSITAS BLVD 220 PLEASANTON CA 94588 262593526 SUPPORT VCHS CA 501(C)(3) 9 HOSP CMTE LP true VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE CA 94550 943382224 SR. FACILITY CA 501(C)(3) 11C, III-FI HOSP CMTE LP true THE FREIDENRICH SUPPORT FOUNDATION 3145 PORTER DRIVE PALO ALTO CA 94304 300519583 SUPPORT CA 501(C)(3) 11A, I STANFORD true SHR HOLDINGS INC 3145 PORTER DRIVE PALO ALTO CA 94304 943187167 REAL ESTATE CA 501(C)(25) N/A STANFORD true SU EMP BEN TRUST POST RETEMPYNT BEN 3145 PORTER DRIVE PALO ALTO CA 94304 943246199 BENEFITS CA 501(C)(9) N/A STANFORD true UNIVERSITY HEALTHCARE ALLIANCE 855 OAK GROVE AVE SUITE 100 MENLO PARK CA 94205 943192446 HEALTHCARE CA 501(C)(3) 3 SHC true THE DUDLEY E CHAMBERS FOUNDATION JP MORGAN CHASE PO BOX 3038 MILWAUKEE WI 53201 386841793 SUPPORT NY 501(C)(3) 11D, III-O STANFORD true STANFORD UNIVERSITY BOOKSTORE BLDG 60 MAIN QUAD NO 105 STANFORD CA 94305 940894150 SUPPORT CA 501(C)(3) 11A, I STANFORD true STANFORD HABITAT CONSERVATION BOARD 3160 PORTER DR STE 200 PALO ALTO CA 94304 461882243 CONSERVATION CA 501(C)(3) 7 STANFORD true STANFORD FACULTY CLUB PO BOX 7229 STANFORD CA 94309 941187089 FAC INTERACT. CA 501(C)(7) N/A STANFORD true THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD CAUSEWAY HK 986078093 SUPPORT HK 501(C)(3) STANFORD true THE STANFORD TRUST 65 HIGH STREET OXFORD UK OX1 46L SUPPORT UK 501(C)(3) STANFORD true STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BUILDING 11 CAPE TOWN SF EDUCATION SF 501(C)(3) STANFORD true STANFORD FEDERAL CREDIT UNION 1860 EMBARCADERO RD PALO ALTO CA 94303 941492212 CREDIT UNION CA 501(C)(1) N/A STANFORD true STANFORD HEALTH CARE ADVANTAGE 3220 BLUME DR STE 260 RICHMOND CA 948065741 464071746 HEALTHCARE CA 501(c)(3) 11A, I SHC true STANFORD SCHOOLS CORPORATION 475 POPE STREET MENLO PARK CA 94025 202699147 EDUCATIONAL CA 501(C)(3) 2 STANFORD true ATWATER 12 LP 2100 ROSS AVE STE 1600 DALLAS TX 75201 752944481 INVESTMENTS DE NA AVENUE ASIA CAPITAL PARTNERS LP 399 PARK AVE 6TH FL NEW YORK NY 10022 010553224 INVESTMENTS DE NA JER R E QUALIFIED PARTNERS EUROPE LP 7950 JONES BRANCH DR STE 220 MCLEAN VA 22107 542029560 INVESTMENTS DE NA PALO ALTO LP 13 CASTLE STREET ST. HELIER JE XC JE4 9WG INVESTMENTS JE NA SANDPIPER FUND LP 2000 MCKINNEY AVE STE 2125 DALLAS TX 75201 260341626 INVESTMENTS TX NA SAROFIM MULTIFAMILY PARTNERS LP 8115 PRESTON RD STE 400 DALLAS TX 75225 201929002 RE DEVELOPMENT DE NA SCP REAL ASSETS FUND (A) LP 450 PARK AVE 23RD FL NEW YORK NY 10022 203949682 INVESTMENTS DE NA FORTRESS IW COINVESTMENT (FUND B) LP 1345 AVE OF THE AMERICAS 23RD FL NEW YORK NY 10105 980509639 INVESTMENTS CJ NA STANFORD PET-CT LLC 300 PASTEUR DRIVE M/C 5555 STANFORD CA 94305 611423414 MED. DIAGNOST CA NA CEE EQUITY HOLDINGS LP ELIZABETH HOUSE 9 CASTLE ST ST. HELIER, JE JE JE4 2QP INVESTMENTS JE NA LSF V DHB HOLDINGS LP 2711 N HASKELL AVE STE 1700 DALLAS TX 75204 272858604 INVESTMENTS DE NA SIC SNOWCREEK VIII LLC 635 KNIGHT WAY STANFORD CA 94305 275431605 RE DEVELOPMENT CA NA SUMIT HOLDING INTERNATIONAL LLC 1400 PAGE MILL ROAD MC5713 PALO ALTO CA 94304 263934706 HOLDING COMPANY DE NA ARCOLA VENTURE LLC C/O STANFORD MGMT CO 635 KNIGHT W STANFORD CA 943057297 371689632 RE DEVELOPMENT DE NA BLACKSTONE REP VII TE 7-NQ LP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK NY 10154 900878802 INVESTMENTS DE NA OUTLAWS CASINO LTD 3160 PORTER DR PALO ALTO CA 94304 841457498 HOLDING COMPANY CO NA STANFORD EMANUEL RAD ONCOLOGY CENTER 825 DELBON AVE TURLOCK CA 95382 208885091 RADIOLOGY CA NA ARCOLA RESIDENTIAL VENTURE LLC 635 KNIGHT WAY STANFORD CA 943057297 900818278 REAL ESTATE CA NA STANFORD-STARTX FUND LLC 3145 PORTER DRIVE PALO ALTO CA 94304 464297719 INVESTMENTS DE NA CLAIRVUE CAPITAL PARTNERS II-TE 1 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO CA 94111 800909516 INVESTMENTS DE NA CLAIRVUE CAPITAL PARTNERS II-TE 2 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO CA 94111 800909556 INVESTMENTS DE NA KEB INVESTORS II LP WASHINGTON MALL STE 304 7 REID ST HAMILTON BD HM 11 941156365 INVESTMENTS BD NA SEQUOIA MFM OPERATING COMPANY LLC 770 WELCH ROAD LPCH- ADMIN MC5551 PALO ALTO CA 94304 475060529 MFM PROGRAM CA NA SP SMC PARTNERS LLC 2711 CENTERVILLE RD STE 400 WILMINGTON DE 19808 INVESTMENTS DE NA STANFORD SGGS EUROPE INC UGLAND HOUSE S CHURCH ST PO BOX 309GT, GEORGE TOWN CJ 131684331 INVESTMENTS CJ NA C CORP BLACK RIVER EMEA INVESTORS FUND LTD UGLAND HOUSE S CHURCH ST GEORGE TOWN CJ 980428006 INVESTMENTS CJ NA C CORP EAST SAIL C/O INTL FS INC IFS COURT TWENTYEIGHT, CYBERCITY, EBENE MP INVESTMENTS MP NA C CORP GAVEA INVESTMENT FUND II-C LP PO BOX 896GT HARBOUR CENTRE GEORGE TOWN CAYMAN ISLANDS CJ 980537952 INVESTMENTS CJ NA C CORP LS ALBERTA III LP C/O JE ROBERT COS 1650 TYSON BLVD MCLEAN VA 22102 980493425 INVESTMENTS CA NA C CORP CLAT (15) CHARITABLE TR CA NA TRUST CRT (536) CHARITABLE TR CA NA TRUST OTHER (7) CHARITABLE TR CA NA TRUST PIF (77) CHARITABLE TR CA NA TRUST ALPINE CHALET INC PO BOX 9988 SOUTH LAKE TAHOE CA 96158 941556099 SKI LODGE CA NA C CORP STANFORD (BEIJING) CNSLTNG CO LTD (WFOE) 5275TH FLBLDG CACADEMY SOUTH RD HAIDAN DISTRICT BEIJING CH EDUCATION CH NA C CORP STANFORD UNIV MED NETWORK RISK AUTHORITY 1400 PAGE MILL RD MSC 5713 PALO ALTO CA 94304 461132002 RISK MGMT CON CA NA C CORP PROFESSIONAL EXCHANGE ASSURANCE COMPANY 201 MERCHANT STREET SUITE 2400 HONOLULU HI 96813 900897686 INSURANCE HI UHA C CORP 15270 674492 0.29800 true ARCOLA RES DEVELOPMENT CORP C/O SMC 635 KNIGHT WAY STANFORD CA 943057297 800804754 INVESTMENT DE NA C CORP BREP VII ALBERTA FEEDER(OFFSHORE)TE7 LP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK NY 10154 981066351 INVESTMENTS CA NA C CORP BREP VII ALBERTA FEEDER(OFFSHORE)TE7NQLP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK NY 10154 981066355 INVESTMENTS CA NA C CORP WEST FACE ALTERNATIVE CREDIT CAYMAN LP PO BOX 10008 WILLOW HOUSE GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1001 981140761 INVESTMENTS CJ NA C CORP MIDPOINT TECHNOLOGY PARK OWNERS ASSOC 3145 PORTER DRIVE PALO ALTO CA 94304 943287254 REAL ESTATE CA NA C CORP BIENVILLE ARGENTINA OPPS OFFSHORE FUND 405 LEXINGTON AVE 34TH FLOOR NEW YORK NY 10174 INVESTMENTS CJ NA C CORP ICHIGO JAPAN FUND K 1 NORTH BRIDGE RD 6-8 SINGAPORE SINGAPORE SN 179094 INVESTMENTS CJ NA C CORP AFFINITY MEDICAL SOLUTIONS INC 1221 BROADWAY 3RD FLOOR OAKLAND CA 94612 203134011 HEALTHCARE DE NA C CORP BISHOP ROCK OPPORTUNITY OFFSHORE FUND C/O SMC 635 KNIGHT WAY STANFORD CA 94305 INVESTMENTS CJ NA C CORP false false true false false false false false false false false false false false false false false false true SCHEDULE R, PART IV, LINE 6 CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 7 CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 1 OTHER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA. SCHEDULE R, PART IV, LINE 2 POOLED INVESTMENT FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.