2016-05-09T17:33:33-05:00 2015-06-30 KPMG LLP 55 SECOND STREET SUITE 1400 SAN FRANCISCO CA 94105 990 2014-07-01 237444901 Northridge Hospital Foundation % RANDY BRADLEY NORT 8188858500 18300 ROSCOE BOULEVARD NORTHRIDGE CA 91328 MICHAEL TAYLOR CFO 8188855321 2016-05-06 true VALERIE J BALL P00178114 4159635100 2016-05-09 2014 2016-08-17 19:52:53Z BRIAN HAMMEL 18300 ROSCOE BLVD NORTHRIDGE CA 91328 10299888 false X www.dignityhealth.org X 1974 CA To advance the mission, vision and values of Dignity Health dba Northridge Hospital Medical Center through philanthropic initiatives and financial support. 34 27 0 296 0 4562884 5232341 0 0 1067883 1262839 -51339 -2644 5579428 6492536 2934551 3805037 0 0 0 0 0 0 147127 871331 1258831 3805882 5063868 1773546 1428668 18607133 19091749 474553 358675 18132580 18733074 X NORTHRIDGE HOSPITAL FOUNDATION'S MISSION IS TO SUPPORT, FINANCIALLY AND OTHERWISE, THE CHARITABLE PURPOSES AND ACTIVITIES OF DIGNITY HEALTH DBA, NORTHRIDGE HOSPITAL MEDICAL CENTER, WHICH PROVIDES HIGH-VALUE AND QUALITY HEALTHCARE SERVICES AND PROGRAMS TO THE RESIDENTS OF THE SAN FERNANDO VALLEY. false false 3927802 3805037 0 THE FOUNDATION IS AN IRC SEC 509(A)(3) SUPPORTING ORGANIZATION TO DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CENTER ("HOSPITAL"). AS A SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF THE HOSPITAL WHICH INCLUDE MAKING PAYMENTS DIRECTLY TO THE HOSPITAL. 3927802 true true false true false false false false false true false false false true true true false true false false false false false false true true false true false true false false false false false false false false false false false false false true true false false false true X 0 0 0 false false false false false true true false false false false X 34 27 true false false false true true true true true false false false true true true true true false false false CA X RANDY BRADLEY 6023072546 3033 NORTH 3RD AVE PHEONIX AZ 85301 X Robert Bob Allen Board Member 1.0 0.0 X 0 0 0 Azmi Atiya MD Ex-officio Board Member 1.0 0.0 X 0 18369 0 Frederic Benning Board Member 1.0 0.0 X 0 0 0 Robert Caruso Board Member 1.0 0.0 X 0 0 0 Marcia Cevallos-Hoffer Board Member 1.0 0.0 X 0 0 0 Melanie Coto Board Member 1.0 0.0 X 0 0 0 Brett Dalton Board Member (ended 11/1/14) 1.0 0.0 X 0 0 0 David R Feeley Board Member 1.0 0.0 X 0 0 0 Steve Foitle Board Member 1.0 0.0 X 0 0 0 Anne Gardner Board Member 1.0 0.0 X 0 0 0 Joan Geisbush Ex-officio Board Member 4.0 0.0 X 0 0 0 Mary Grim Board Member 1.0 40.0 X 0 130344 21900 Meredith S Hale MD Board Member/Chairman Emeretis 0.01 0.0 X 0 0 0 Barbara Hawthorne Board Member 1.0 0.0 X 0 0 0 Mardee Jessop Board Member 1.0 0.0 X 0 48081 32009 Sonia Kang Board Member 1.0 0.0 X 0 0 0 Dorothy Lake Board Member 1.0 0.0 X 0 0 0 Albert M Lapides Board Member (Deceased 6/2015) 1.0 0.0 X 0 0 0 Grace LeLand Board Member 1.0 40.0 X 0 127442 14990 Bill Newbold Board Member 1.0 0.0 X 0 0 0 Darell F Norris Board Member/Director Emeritus 2.0 0.0 X 0 0 0 Becky Palazzola Board Member (ended 1/2015) 1.0 0.0 X 0 0 0 Dana Pump Board Member 1.0 0.0 X 0 0 0 David Pump Board Member 1.0 0.0 X 0 0 0 Oscar Rivas Board Member 1.0 0.0 X 0 0 0 Afshin Safa MD Board Member 1.0 0.5 X 0 5500 0 Saliba Salo Ex-officio Board Member 1.0 40.0 X 0 684610 109232 Vanessa Terzian Board Member 1.0 0.0 X 0 0 0 Enrique Wong Board Member 1.0 0.0 X 0 0 0 Maurice Zeitlin MD Board Member 1.0 0.0 X 0 0 0 Pamela Alfenito Secretary 1.0 0.0 X X 0 0 0 Donald G Gloistein Treasurer 2.0 0.0 X X 0 0 0 Brian P Hammel Foundation President 40.0 0.0 X X 0 289165 62927 Patrick Hawthorne Chair 4.0 0.0 X X 0 0 0 Valerie Kohler Vice-Chair 1.0 0.0 X X 0 0 0 Michael S Taylor Hospital CFO 1.0 40.0 X X 0 326327 64497 Tony Torres Immediate Past chair 4.0 0.0 X X 0 0 0 0 1629838 305555 0 false true false 0 X 263126 1519267 1943711 1506237 14978 5232341 0 281243 0 281243 0 0 0 0 0 4556162 3574566 981596 981596 0 981596 207811 263126 228857 -21046 0 -21046 21670 3929 17741 0 17741 0 RECEIPT FROM CLASS ACTION LITIGATION 900099 661 661 661 6492536 0 1260195 X 3805037 3805037 0 0 0 0 0 0 0 0 0 0 0 2340 0 2340 0 24 0 24 0 0 50236 0 50236 0 1135369 78004 928785 128580 0 32128 18692 1561 11875 3478 1739 1739 0 0 0 8075 5298 2777 0 0 13048 13048 0 0 0 0 0 0 DUES AND SUBSCRIPTIONS 1617 441 1176 0 DONOR RECOGNITION 1660 0 0 1660 DONOR CULTIVATION 5012 0 0 5012 OTHER EXPENSES 5844 5543 301 5063868 3927802 988939 147127 X 0 0 479971 607812 521986 443923 0 0 0 0 0 0 0 0 0 0 782281 21000 0 14729618 15914072 0 0 0 0 0 0 2093277 2104942 18607133 19091749 114417 121684 353442 171548 0 0 0 0 0 0 0 0 0 0 0 0 6694 65443 474553 358675 X 7691238 7765312 10219104 10745524 222238 222238 18132580 18733074 18607133 19091749 X 1428668 -839820 11646 X false true X true false X X X 1 DIGNITY HEALTH (DBA NORTHRIDGE HOSPITAL MED CTR) 941196203 3 true 3805037 1258831 1 3805037 1258831 true false false false false false false false false false false false false false false true false SCHEDULE A, PART I, LINE 11G THE FOUNDATION PROVIDED OR PURCHASED FOR THE BENEFIT OF DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CENTER, VARIOUS SERVICES, FACILITIES AND GOODS. SEE FORM 990, PART IX FOR FURTHER DETAILS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 24 24 false SCH C, PART II-B, LINE I LOBBYING PORTION FOR ANNUAL MEMBERSHIP DUES: ASSOCIATION FOR HEALTHCARE; $24. 3594821 -35214 44899 3514708 3149119 447653 1951 3594821 2883517 1500 269576 5474 3149119 3047215 1747 -164500 945 2883517 2596213 452934 1932 3047215 0.93000 0.06000 0.01000 false false BENEFICIAL INTEREST IN CRUT 2102233 INVESTMENT IN CRT & ANNUITY 2709 2104942 0 CHARITABLE REMAINDER TRUSTS 2657 DUE TO RELATED PARTIES 62786 65443 X SCH D, PART V, LINE 4 - ENDOWMENT FUNDS ENDOWMENT FUNDS ARE USED TO PROVIDE AWARDS FOR OUTSTANDING RESIDENCY NURSES AND DOCTORS. THE INCOME FROM RETURN ON THE INVESTED BOARD DESIGNATED QUASI ENDOWMENT FUNDS ARE USED TO SUPPORT THE CAPITAL AND PROGRAM NEEDS AT THE HOSPITAL. SCHEDULE D, PART X, LINE 2 - FIN 48 (ASC 740)FOOTNOTE DIGNITY HEALTH REVIEWS ITS TAX POSITIONS ANNUALLY AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. STEPPING OUT 303271 157275 145996 0 8403 26836 92180 14167 25338 GOLF TOURNAMENT 146271 94926 51345 0 1513 380 34112 407 14008 1 21395 10925 10470 0 2652 300 6073 689 1799 470937 263126 207811 0 12568 27516 132365 15263 41145 228857 -21046 21670 3929 false 21670 3929 3929 17741 CA true false false false 1.00000 TONETTE BARCELLONA 18300 Roscoe Blvd Northridge CA 91328 false Brian Hammel 0 SUPERVISE GAMING ACTIVITIES, RECORDKEEPING, HIRING X X true 19503 true Dignity Health DBA Northridge Hospital Medical Ctr 18300 Roscoe Blvd Northridge CA 91328 941196203 501(c)(3) 3803427 1610 FMV CLOTHING/BOOKS/TOYS Hospital Support 1 0 SCH I, PART 1, LINE 2 AS A SEC. 509(A)(3) SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES EXCLUSIVELY FOR THE BENEFIT OF, TO PERFORM THE FUNCTIONS OF, OR TO CARRY OUT THE PURPOSES OF THE GRANTEE LISTED IN PART II, ITEM 1 (DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL MEDICAL CENTER), WHICH INCLUDE MAKING PAYMENTS DIRECTLY TO THE BENEFICIARY ORGANIZATION. AS SUCH, THE FOUNDATION DOES NOT MONITOR THE HOSPITAL'S USE OF THE GRANT FUNDS. false true false false false false false false false Mary Grim Board Member 0 113164 0 17019 0 161 0 12968 0 8932 0 152244 0 0 Saliba Salo Ex-officio Board Member 0 385181 0 272464 0 26965 0 53999 0 55233 0 793842 0 0 Brian P Hammel Foundation President 0 204719 0 69798 0 14648 0 27780 0 35147 0 352092 0 0 Michael S Taylor Hospital CFO 0 261030 0 63538 0 1759 0 30958 0 33539 0 390824 0 0 Part I, Line 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION, DIGNITY HEALTH, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. SCHEDULE J, PART I, LINE 4A CERTAIN OFFICERS PARTICIPATE IN A DIGNITY HEALTH SEVERANCE PLAN THAT PROVIDES FAIR COMPENSATION, RANGING FROM PAYMENTS OF 6 MONTHS TO 2 YEARS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE PLAN. NO PAYMENTS OCCURRED DURING 2014 PURSUANT TO THIS PLAN. SCHEDULE J, PART I, LINE 4B CERTAIN LISTED PERSONS are eligible to participate in one of two non-qualified 457(f) plans that are subject to substantial risk of forfeiture, as required by the IRS. The 2007 Executive Deferred Compensation Plan is for executives hired prior to June 30, 2006. The benefit is intended to bridge the difference, if any, between the benefit provided under the Dignity Health Excess Benefit Plan had benefit service not been frozen at January 1, 2008, and the benefits provided from all other qualified and non-qualified plans. Benefits vest under this 457(f) plan at the later of the date the participant attains age 62 or is credited with 15 years of service. The 2010 Executive Deferred Compensation Plan is for certain officers and key employees, primarily those who are not eligible to participate in the Dignity Health Excess Benefit Plan or the 2007 Executive Deferred Compensation Plan described above. This benefit provides an annual accrual of 10% of total compensation and is payable annually on July 1 once vested, which is age 62 with 5 years of service; the plan also allows for special awards. NO PAYMENTS OCCURRED DURING 2014 PURSUANT TO THIS PLAN. Compensation amounts for the supplemental nonqualified retirement plans discussed above are reported as deferred compensation in the year accrued (Schedule J, Part II, column C) and are reflected again as reportable compensation in the year paid (Schedule J, Part II, column B(iii)). PART II, SUPPLEMENTAL DISCLOSURES ALTHOUGH THE ORGANIZATION DOES NOT DIRECTLY EMPLOY ANY PERSONNEL, THE SUPPORTED ORGANIZATION'S EXECUTIVE COMPENSATION PHILOSOPHY is designed to assist THE ORGANIZATION in attracting and retaining the caliber of executives required to enable Dignity Health to fulfill its mission of providing high quality healthcare for all persons regardless of their ability to pay for services, improving the quality of life in the communities Dignity Health serves, promoting patient and employee satisfaction, and ensuring financial stability. A substantial portion of executive compensation is performance based and is linked to organizational goals approved in advance by the Human Resources and Compensation Committee. These goals include attainment of annual and long-term financial performance, certain health care quality standards and Dignity Health's commitment to serving the poor and disenfranchised in the communities it serves. Total compensation, which includes base salary, annual and long-term incentive compensation, is established to approximate the prevailing market conditions for executives of companies of similar size, revenues and complexity. FORM 990, PARTS V, VI, VII, XI and XII Form 990, Part V, Line 2a THE ORGANIZATION DOES NOT HAVE EMPLOYEES. AS A SUPPORTING ORGANIZATION, THE FOUNDATION OPERATES FOR THE BENEFIT OF THE HOSPITAL AND UTILIZES THE EMPLOYEES OF THAT HOSPITAL. THE PROPORTIONATE SALARIES AND BENEFITS FOR THESE INDIVIDUALS ARE ALLOCATED TO THE FOUNDATION. THE SALARIES OF THESE EMPLOYEES ARE INCLUDED IN THE HOSPITAL ENTITY'S FORM W-3 AND FEDERAL EMPLOYMENT TAX RETURNS. Form 990, Part VI, Section A, Line 2 BOARD MEMEBERS DANA PUMP AND DAVID PUMP - FAMILY RELATIONSHIP BOARD MEMBERS PATRICK HAWTHORNE AND BARBARA HAWTHORNE - FAMILY RELATIONSHIP Form 990, Part VI, Section A, Line 6 The organization has a sole corporate member, Dignity Health, a 501(c)(3) exempt organization. Form 990, Part VI, Section A, Line 7a Dignity Health, as the sole corporate member, ratifies the selection of members and the Dignity Health Board approves new Board members of the foundation. Form 990, Part VI, Section A, Line 7b RESERVED RIGHTS OF THE CORPORATE MEMBER INCLUDE ADOPTION OF MISSION AND PHILOSOPHY STATEMENTS, AMENDMENT OR RESTATEMENT OF ARTICLES OF INCORPORATION AND BYLAWS, DISSOLUTION OF THE CORPORATION, ACQUISITION OF ANOTHER CORPORATION, CREATION OF A NEW SUBSIDIARY, MERGER OR CONSOLIDATION WITH ANOTHER CORPORATION, PARTICIPATION AS A GENERAL OR LIMITED PARTNER IN ANY VENTURE, INCURRING LONG-TERM INDEBTEDNESS IN EXCESS OF NORMAL OPERATING REQUIREMENTS, RATIFICATION OF BOARD MEMBER APPOINTMENTS AND DISMISSALS, SELECTION AND REMOVAL OF INDEPENDENT AUDITORS, AND TRANSACTIONS OUTSIDE THE ORDINARY COURSE OF BUSINESS. Form 990, Part VI, Section B, Line 11B THE HOSPITAL'S ACCOUNTING DEPARTMENT HAS WORKED CLOSELY WITH DIGNITY HEALTH AND AN INDEPENDENT ACCOUNTING FIRM ENGAGED TO REVIEW THE RETURN. IT PRESENTED THE FINAL DRAFT OF THE FORM 990 TO THE CHAIR OF THE FINANCE AND INVESTMENT COMMITTEE EXCLUDING COMPENSATION SCHEDULES AND SCHEDULE B. COMPENSATION INFORMATION WERE REVIEWED BY CFO FOR THE FINAL DRAFT. IN ADDITION TO CONSULTING WITH THE CFO, THE FINANCE COMMITTEE CHAIR MET WITH THE FOUNDATION CEO AND ITS STAFF. DIGNITY HEALTH ALSO MET WITH THE ACCOUNTING FIRM HIRED TO REVIEW THE FORM 990. DUE TO TIMING, THE FINAL FORM 990 WILL BE REVIEWED BY THE FINANCE AND INVESTMENT COMMITTEE AND WILL REPORT BACK TO THE BOARD REGARDING ITS OVERSIGHT OF THE FORM 990, AGAIN EXCLUDING COMPENSATION SCHEDULES AND SCHEDULE B, SUBSEQUENT TO FILING WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Section B, Line 12C THE FOUNDATION HAS ADOPTED DIGNITY HEALTH'S CONFLICTS OF INTEREST POLICY. Under such policies, the EVP/General Counsel is responsible for collecting, reviewing and validating annual disclosures of all covered persons (i.e., Board and Board Committee members, officers and executive leadership, key employees, management personnel at the vice president level and above, and any other personnel at his or her discretion). All covered persons are required to disclose real or potential conflicts arising from the business, financial and personal interests held by such covered persons or their family members. Covered persons are required to disclose to their superiors and to relevant decision makers any interest that may present a conflict, or the appearance of a conflict, of interest. Such disclosure is required on a transactional basis at the time such conflicts arise, when an individual becomes a covered person, and annually thereafter. Each covered person is required to certify at least annually that he/she: (1) has received a copy of the policy applicable to his/her position; (2) has read the policy and understands said policy; and (3) agrees to comply with all requirements of the policy, including completing the conflicts of interest disclosure statement as required by the policy. The President/CEO and EVP/General Counsel prepare annual reports of reported conflicts of interest, which are provided to the Board of Directors, Committee Chairs, and key leaders of the organization to enable responsible individuals to monitor and manage disclosed conflicts of interest and assure decisions are made in the organization's best interests. The procedures for addressing a conflict of interest related to a proposed transaction include, but are not limited to, the following: (1) the conflicting interest is fully disclosed to the Board of Directors; (2) the interested person responds to factual questions related to the substance of the transaction or arrangement being considered, after which he/she shall leave the meeting; (3) the interested person is excluded from the discussion and approval of such transaction; (4) if warranted, alternatives to the proposed transaction are investigated, and competitive bids or comparable valuations are obtained; (5) the transaction or action is approved by a majority of disinterested persons, consistent with any requirements of bylaws or policies; and (6) any conflicting issues arising during the course of a board meeting which cannot be resolved may be referred to an independent committee of the Board of Directors. There are similar conflicts of interest provisions under the Standards of Conduct, which are applicable to all employees and which are administered by the VP/Corporate Compliance Officer who has reporting responsibility to the President/CEO as well as to the Audit and Compliance Committee of the Board of Directors. Form 990, Part VI, Section B, Line 15 THE FOUNDATION PRESIDENT IS COMPENSATED BY DIGNITY HEALTH DBA NORTHRIDGE HOSPITAL AND MEDICAL CENTER. FOR 2014 COMPENSATION, DIGNITY HEALTH'S Board of Directors appoints a Human Resources and Compensation Committee, comprised of independent directors, who are accountable for setting reasonable compensation packages for the organization's top management official. The Human Resources and Compensation Committee approves, consistent with the organization's philosophy and principles, the annual performance goals and criteria to be used in determining merit increases and variable compensation criteria for the top management official. The Human Resources and Compensation Committee also engages outside legal counsel as necessary and qualified independent compensation and benefits specialists (independent experts) to review, analyze and provide benchmarking data for the total compensation and benefits packages of officers and key executives. Appropriate comparable data is obtained from the independent experts, (e.g., total economic benefits paid by similarly situated organizations, both taxable and tax-exempt, for similar job responsibilities). Key deliberations of the Committee are documented in meeting minutes which are approved at the next Committee meeting and provided to the Board of Directors. The documentation of the deliberations includes (a) the terms of the transaction approved and the date approved, (b) the members of the Committee who were present during discussion of the approved transaction and those who voted on it, and (c) the comparability data obtained and relied upon by the Committee and how the data was obtained. Form 990, Part VI, Section C, Line 19 Federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection. The organization makes its financial statements available on its website and upon request. Form 990, Part VII, Section A THE SUPPORTED ORGANIZATION DOES NOT COMPENSATE DIRECTORS, AZMI ATIYA, MD, MARY GRIM, MARDEE JESSOP, GRACE LELAND, SALIBA SALO, AFSHIN SAFA, MD, BRIAN HAMMEL AND MICHAEL TAYLOR FOR THEIR SERVICES AS BOARD MEMBERS. ALL COMPENSATION AND BENEFITS REPORTED FOR DIRECTORS REPRESENT COMPENSATION AS EITHER AN EMPLOYEE OF THE SUPPORTED ORGANIZATION OR FOR PHYSICIAN SERVICES FOR THE SUPPORTED ORGANIZATION. Form 990. Part XI, Line 9 CHANGE IN VALUE OF SPLIT INTEREST AGREEMENTS; $11,646. FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:1124758 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER PURCHASED SERVICES TOTAL FEES:10611 Dignity Health dba Northridge Hospital 18300 Roscoe Boulevard Northridge CA 91328 941196203 Hospital CA 501(c)(3) 3 NA false Charitable Remainder Unitrust (2) INVESTMENTS CA NHF TRUST 1.00000 true Charitable Remainder Unitrust (1) INVESTMENTS CA NHF TRUST 0.50000 true false true true false false false false true false false true false false false false false false false NONE