CHILDRENS HOSPITAL AT MISSION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: CHILDRENS HOSPITAL AT MISSION (EIN 33-0528802)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-15
IRS object ID: 201301359349308485
Schema version: 2011v1.5
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-15T17:15:10-05:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	355 S Grand Ave Suite 2000	AddressLine1
City	Los Angeles	City
State	CA	State
ZIP Code	90071	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	330528802	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL AT MISSION	BusinessNameLine1

Field	Value	IRS element (for citing)
In Care Of Name	% DONALD NOBLE	InCareOfName
Name Control	CHIL	NameControl
Phone	7149973000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	455 S MAIN STREET	AddressLine1
City	ORANGE	City
State	CA	State
ZIP Code	928683874	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	KERRI RUPPERT SCHILLER	Name
Title	SENIOR VP/CFO	Title
Date Signed	2013-05-14	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Phone	2139724000	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-25 16:41:14Z	BuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

Field	Value	IRS element (for citing)
Business Name Line1	CHOC Children's at Mission Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	KIMBERLY C CRIPE	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	455 S MAIN STREET	AddressLine1
City	ORANGE	City
State	CA	State
ZIP Code	928683874	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	58796458	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.CHOC.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1991	YearFormation
State Legal Domicile	CA	StateLegalDomicile
Activity Or Mission Description	TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	17	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	16	NbrIndependentVotingMembers
Total Nbr Employees	141	TotalNbrEmployees
Total Nbr Volunteers	126	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	175182	ContributionsGrantsPriorYear
Contributions Grants Current Year	80467	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	54151956	ProgramServiceRevenuePriorYear
Program Service Revenue CY	58573208	ProgramServiceRevenueCY
Investment Income Prior Year	43166	InvestmentIncomePriorYear
Investment Income Current Year	75529	InvestmentIncomeCurrentYear
Other Revenue Prior Year	328	OtherRevenuePriorYear
Other Revenue Current Year	67254	OtherRevenueCurrentYear
Total Revenue Prior Year	54370632	TotalRevenuePriorYear
Total Revenue Current Year	58796458	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	2400000	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	600000	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	11688670	SalariesEtcPriorYear
Salaries Etc Current Year	11288076	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	41693238	OtherExpensePriorYear
Other Expenses Current Year	38525431	OtherExpensesCurrentYear
Total Expenses Prior Year	55781908	TotalExpensesPriorYear
Total Expenses Current Year	50413507	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-1411276	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	8382951	RevenuesLessExpensesCY
Total Assets BOY	38947731	TotalAssetsBOY
Total Assets EOY	38403781	TotalAssetsEOY
Total Liabilities BOY	15785951	TotalLiabilitiesBOY
Total Liabilities EOY	6792016	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	23161780	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	31611765	NetAssetsOrFundBalancesEOY
Mission Description	TO NURTURE, ADVANCE, & PROTECT THE HEALTH AND WELL-BEING OF CHILDREN.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	47826854	Expense
Grants	600000	Grants
Revenue	58573208	Revenue
Description	Facility provides specialized pediatric services for the medical/surgical care of children from birth to age 18. There were 7,743 inpatient care days; 17,075 emergency room visits; 827 surgeries and 6,566 outpatient visits. See our complete community benefit report on our website at www.choc.org.	Description
Total Program Service Expense	47826854	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Info In Schedule O Part V	X	InfoInScheduleOPartV
Number Forms Transmitted With1096	7	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	141	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	17	NbrVotingGoverningBodyMembers
Number Independent Voting Members	16	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	true	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
States Where Copy Of Return Is Filed	CA	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	DONALD NOBLE	NamePerson
Telephone Number	7149973000	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	455 S MAIN STREET	AddressLine1
City	ORANGE	City
State	CA	State
ZIP Code	928683874	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
KIMBERLY C CRIPE
DIRECTOR/PRESIDENT	2.0	X	X	0	1225790	77828
RALPH CLAYMAN MD
DIRECTOR	1.0	X		0	0	0
JEFF ELGHANAYAN
DIRECTOR/2ND VICE CHAIR	1.0	X	X	0	0	0
WILLIAM GURTNER
DIRECTOR	1.0	X		0	0	0
MUSTAFA KABEER MD
DIRECTOR	1.0	X		0	0	0
JAY KEAR
DIRECTOR/FIRST VICE CHAIR	1.0	X	X	0	0	0
DOUGLAS MCCOMBS
DIRECTOR / SECRETARY	1.0	X	X	0	0	0
MARK STEVENS
DIRECTOR/CHAIR	1.0	X	X	0	0	0
MAUREEN ZEHNTNER
DIRECTOR	1.0	X		0	0	0
JANET T DAVIDSON
DIRECTOR	1.0	X		0	0	0
MARSHALL ROWEN MD
DIRECTOR	1.0	X		0	0	0
DAVID DUKES
DIRECTOR	1.0	X		0	0	0
JOE DUNN
DIRECTOR	1.0	X		0	0	0
GEORGE KALOGRIDIS
DIRECTOR	1.0	X		0	0	0
TIM RISTOFF
DIRECTOR	1.0	X		0	0	0
vijay Dhar MD
director	1.0	X		0	0	0
thomas tierney
director	1.0	X		0	0	0
KERRI RUPPERT SCHILLER
CFO/Assistant Secretary	4.0		X	0	593059	109936
DEBRA MATHIAS
EXEC. VICE PRESIDENT / COO	4.5		X	0	580844	108489
MARCIA FOLLI
VICE PRESIDENT / CNO	40.0			265316	0	45156	X
BONNIE GRAVETT
Clinical Nurse III	40.0			164697	0	24507		X
Elizabeth Drake
Clinical Nurse II	40.0			133645	0	18701		X
paula castano
Nursing Supervisor	40.0			132753	0	17980		X
Linda Starn
Director Patient care services	40.0			138999	0	9098		X
Michelle Spensiero
Clinical Nurse II	40.0			121943	0	10991		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	957353	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	2399693	TotalReportableCompFrmRltdOrgs
Total Other Compensation	422686	TotalOtherCompensation
Number Individuals GT100 K	21	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
PEDIATRIC SUBSPECIALTY FACULTY
455 SOUTH MAIN ST	ORANGE	CA	92868	Medical Dir & Serv	791107
COMFORCE TECHNICAL SERVICES
PO BOX 31001-0893	PASADENA	CA	91110	TEMPORARY STAFFING	284635
Pediatric Surgical Associates
1120 W LA VETA AVENUE SUITE 100	ORANGE	CA	92868	Medical Dir & Serv	212496
Neurosurgical Specialists Inc
24 Jewel flower	IRVINE	CA	92603	Medical Dir & Serv	109500

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	4	NumberOfContractorsGT100K
All Other Contributions	80467	AllOtherContributions
Total Contributions	80467	TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES	621400	58427946	58427946
CLINIC RENTAL INCOME	900099	145262	145262

Field	Value	IRS element (for citing)
Total Program Service Revenue	58573208	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	75529	TotalRevenueColumn
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$75,529	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
MEDICAL STAFF DEPOSITS	900099	62556	$62,556
MISCELLANEOUS REVENUE	900099	4698	$4,698

Field	Value	IRS element (for citing)
Total Other Revenue	67254	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	58796458	TotalRevenueColumn
Related Or Exempt Function Income	58573208	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$142,783	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	600000	Total
Program Services	600000	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	238032	Total
Program Services	238032	ProgramServices

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	8872232	Total
Program Services	7985009	ProgramServices
Management And General	887223	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	298351	Total
Program Services	268516	ProgramServices
Management And General	29835	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	1215584	Total
Program Services	1094026	ProgramServices
Management And General	121558	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	663877	Total
Program Services	597489	ProgramServices
Management And General	66388	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	8873088	Total
Program Services	7985779	ProgramServices
Management And General	887309	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	17710	Total
Management And General	17710	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	33999	Total
Program Services	30599	ProgramServices
Management And General	3400	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	2303327	Total
Program Services	2072994	ProgramServices
Management And General	230333	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	0	Total

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	161512	Total
Program Services	145361	ProgramServices
Management And General	16151	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	636122	Total
Program Services	572510	ProgramServices
Management And General	63612	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1581901	Total
Program Services	1423711	ProgramServices
Management And General	158190	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	13717	Total
Program Services	12345	ProgramServices
Management And General	1372	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	3386	Total
Program Services	3047	ProgramServices
Management And General	339	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	0	Total

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	654758	Total
Program Services	589282	ProgramServices
Management And General	65476	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	338781	Total
Program Services	304903	ProgramServices
Management And General	33878	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices
PURCHASED SRVS OTHR HOSP.	18810362	18810362
PROVISION FOR BAD DEBT	3783561	3783561
LEGAL SETTLEMENT	27215	27215
PROVIDER PROGRAM FEE	1247199	1247199

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	38793	Total
Program Services	34914	ProgramServices
Management And General	3879	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	50413507	Total
Program Services	47826854	ProgramServices
Management And General	2586653	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	188473	BOY
EOY	240756	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	11205876	BOY
EOY	10392839	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	14077894	BOY
EOY	12276523	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	896759	BOY
EOY	303864	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	15470046	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	8325706	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	6209605	BOY
EOY	7144340	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	6369124	BOY
EOY	8045459	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	38947731	BOY
EOY	38403781	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	3906214	BOY
EOY	3564677	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	7144624	BOY
EOY	1239010	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	4735113	BOY
EOY	1988329	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	15785951	BOY
EOY	6792016	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	22089612	BOY
EOY	30509505	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1072168	BOY
EOY	1102260	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	23161780	BOY
EOY	31611765	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	38947731	BOY
EOY	38403781	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	8382951	ReconcilationRevenueExpenses
Reconcilation Other Changes	67034	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Both	X	FinancialStatementBoth
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amts		ArtPublicExhibitionAmts
Held Works Of Art Amts		HeldWorksOfArtAmts
Current Year Minus3 Years		CurrentYearMinus3Years
Land		Land
Buildings		Buildings

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	8577508	OtherCostOrOtherBasis
Depreciation	4284090	Depreciation
Book Value	4293418	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5444555	OtherCostOrOtherBasis
Depreciation	4041616	Depreciation
Book Value	1402939	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1447983	OtherCostOrOtherBasis
Book Value	1447983	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	7144340	TotalOfBookValueLandBuildings

Other Assets OtherAssets (6 entries)

DescriptionDescription	Book ValueBookValue
GOODWILL NET OF AMORTIZATION	5737500
RECEIVABLE FROM THIRD-PARTY	1962704
NICU SUNK COSTS, NET OF AMORT.	63179
I/C RECEIVABLE CHOC	2289
BENEFICIAL INT. IN CHOC FND.	20951
INVESTMENT IN OCMRRG	258836

Field	Value	IRS element (for citing)
Total Book Value Other Assets	8045459	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
DUE TO CHC	$41,667
DUE TO CHOC	$1,711,976
LONG TERM ACCRUED TAIL COVERAGE	$234,686

Field	Value	IRS element (for citing)
Total Of Amounts	1988329	TotalOfAmounts
Total Revenue	58796458	TotalRevenue
Total Expenses	50413507	TotalExpenses
Excess Or Deficit For Year	8382951	ExcessOrDeficitForYear
Net Unrealized GL On Investments	69403	NetUnrealizedGLOnInvestments
Other	-$2,369	OtherAmount
Total Adjustments	67034	TotalAdjustments
Excess Or Deficit Per FS	8449985	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	58863492	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	69403	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	69403	RevenueNotRptdF990
Revenue Subtotal	58794089	RevenueSubtotal
Other Revenues Not Included	2369	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	2369	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	58796458	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	50413507	TotExpensesEtcAuditedFinclStmt
Expenses Subtotal	50413507	ExpensesSubtotal
Total Expenses Per Form990	50413507	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
other changes in net assets	form 990, schedule d, part XI, line 8 & part XII, Line 4B	Change in beneficial interest in CHOC Foundation (2,369)
ASC 740	Form 990, Schedule D, Part X	ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE ORGANIZATION'S MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT AS OF JUNE 30, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	false	ExpensesExceededBudget
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	226871	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	226871	NetCommunityBenefitExpense
Percent Of Total Expense	0.00490	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15432298	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9373110	DirectOffsettingRevenue
Net Community Benefit Expense	6059188	NetCommunityBenefitExpense
Percent Of Total Expense	0.12990	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15659169	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9373110	DirectOffsettingRevenue
Net Community Benefit Expense	6286059	NetCommunityBenefitExpense
Percent Of Total Expense	0.13480	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	15659169	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9373110	DirectOffsettingRevenue
Net Community Benefit Expense	6286059	NetCommunityBenefitExpense
Percent Of Total Expense	0.13480	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Total Community Building Expense	11987	TotalCommunityBuildingExpense
Net Community Building Expense	11987	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	7	NumberOfActivitiesOrPrograms
Total Community Building Expense	11987	TotalCommunityBuildingExpense
Net Community Building Expense	11987	NetCommunityBuildingExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	false	BadDebtExpenseReported
Bad Debt Expense	$1,582,169	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	0	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	0	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	0	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL AT MISSION	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	27700 MEDICAL CENTER ROAD	AddressLine1
City	MISSION VIEJO	City
State	CA	State
ZIP Code	92691	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
Childrens Hospital	X	ChildrensHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HOSPITAL AT MISSION	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	400.	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
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) AND CHOC CHILDREN'S AT MISSION HOSPITAL (CCMH) ANNUALLY AND IS FILED IN ACCORDANCE WITH CALIFORNIA SB697.
SCHEDULE H, PART I, LINE 7, COLUMN (F)	THE BAD DEBT EXPENSE INCLUDED IN FORM 990, PART IX, LINE 25 BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $3,783,561. 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. In fiscal year 2012, the CMS issued final required federal approval of two California programs to impose a provider fee on hospitals that, combined with federal matching funds, has been used to provide supplemental Medi-Cal payments to hospitals in the State. The first program received final approval in December 2011 and was enacted to provide supplemental Medi-Cal payments for up to six months retroactive to January 2011 and expiring on June 30, 2011. Revenues under the program of $1,710,717, and provider fees and other expenses totaling $614,766 were recognized as net patient revenue and operating expenses, respectively, in the year ended June 30, 2012. The CMS also issued final required approval of a second California provider fee program to provide supplemental Medi-Cal payments to hospitals in the State. This program was enacted to provide supplemental Medi-Cal payments for up to 30 months retroactive to July 2011 and expiring on December 31, 2013. Revenues under this program of $1,161,751, and provider fees and other expenses totaling $632,433 were recognized as net patient revenue and operating expenses, respectively, in the year ended June 30, 2012. The result is that the unreimbursed Medi-Cal on Part I Line 7B is lower than in prior years.
SCHEDULE H, PART II	Community support is defined as those activities supporting community leadership. The organization has 95 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.	Community building activities
SCHEDULE H, PART III, LINE 1	The organization reports bad debt expense as an operating expense in accordance with U.S. GAAP. HFMA Statement no. 115, which requires bad debt to be recognized as a reduction from net patient revenue has been adopted as an accounting standard in the U.S and will be effective with CCMH's 2012 Form 990. SCHEDULE H, PART III, LINE 4 THE ORGANIZATION CHARGES BAD DEBT FOR (A) THE WRITE-OFF OF PATIENT ACCOUNTS WHERE FAMILIES DID NOT COOPERATE 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. 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 CCMH'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN CCMH'S EXISTING PATIENT ACCOUNTS RECEIVABLE. CCMH DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. CCMH REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS ON A MONTHLY BASIS. 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 INCREASE 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 CASES BEYOND ONE YEAR FROM DATE OF SERVICE.
SCHEDULE H, PART III, LINE 8	AS A CHILDREN'S HOSPITAL, CCMH MEDICARE ALLOWABLE COSTS ARE ZERO. THEREFORE THERE IS NO AMOUNT ENTERED ON LINE PART III LINE 6 AND NO MEDICARE SHORTFALL REPORTED ON LINE 7. 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, CCMH 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 CCMH 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, CCMH WILL NOT USE WAGE GARNISHMENTS OR LIENS ON PATIENT'S OR PATIENT FAMILY'S PRIMARY RESIDENCE AS A MEANS OF COLLECTING UNPAID CCMH BILLS. THIS REQUIREMENT DOES NOT PRECLUDE CCMH FROM PURSUING REIMBURSEMENT FROM THIRD PARTY LIABILITY SETTLEMENTS. SCHEDULE H, PART V, LINE 19D, 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.
SCHEDULE H, PART VI, LINE 2	NEEDS ASSESSMENT: THE HOSPITAL PLAYED A LEADERSHIP ROLE IN THE ORANGE COUNTY HEALTH NEEDS ASSESSMENT (OCHNA). OCHNA was A COMMUNITY-BASED, NOT-FOR-PROFIT PROJECT CREATED AND DESIGNED TO MEET THE REQUIREMENTS OF SB697 FOR ALL HEALTHCARE ASSOCIATION OF SOUTHERN CALIFORNIA (HASC) MEMBER HOSPITALS IN ORANGE COUNTY,TO PRODUCE A COMPREHENSIVE, COUNTYWIDE ANALYSIS OF HEALTH NEEDS AND SERVICES. THE OCHNA PROJECT WAS A COLLABORATIVE EFFORT AND WAS JOINTLY FUNDED BY THE COUNTY OF ORANGE HEALTHCARE AGENCY AND 27 FOR-PROFIT AND NOT-FOR-PROFIT HOSPITALS, AND OTHER ORGANIZATIONS AND PROVIDERS. ITS GOAL WAS TO ACHIEVE MAXIMUM, VALID AND RELIABLE INFORMATION THAT CAN BE ANALYZED BY ZIP CODE, IN ORDER TO PROVIDE HOSPITALS WITH DATA SIGNIFICANT TO THEIR SERVICE AREAS. IN ADDITION, THIS PROCESS WAS THE BASIS OF THE COUNTYWIDE REPORT THAT WAS MADE AVAILABLE TO THE LARGER COMMUNITY OF HEALTH AND HUMAN SERVICES PROVIDERS. OCHNA STARTED DATA COLLECTION FOR ITS HEALTH ASSESSMENT IN 1997. THE LATEST SURVEY RESULTS FOR ORANGE COUNTY WERE FOR 2010 AND PUBLISHED IN THE "HEALTH NEEDS ASSESSMENT". OCHNA WAS AN ONGOING PROCESS WITH PARTICIPATION AND SUPPORT FROM HEALTHCARE PROVIDERS AND GOVERNMENT AGENCIES. THE HOSPITAL'S EXECUTIVE MANAGEMENT UTILIZED THE OCHNA HEALTH NEEDS FINDINGS TO DEVELOP THE HOSPITALS' GOALS FOR MEETING THE NEEDS INDENTIFIED IN SIX BROAD AREAS: HEALTHCARE ACCESS - INCREASE ACCESS TO QUALITY PEDIATRIC HEALTHCARE RESOURCES AND INFORMATION TO FAMILIES, ESPECIALLY LOW-INCOME AND MEDICALLY UNDERSERVED, THROUGHOUT ORANGE COUNTY. BEHAVIORAL HEALTH ACCESS - ENHANCE THE COMMUNITY'S ACCESS TO BEHAVIORAL HEALTH INFORMATION AND SERVICES, TARGETING THE UNDERSERVED. DISEASE PREVENTION - INCREASE AWARENESS OF DISEASE PREVENTION AND PROMOTE EARLY INTERVENTION OF MAJOR DISEASES THAT AFFECT THE COMMUNITY. INFORMATION RESOURCE - PROVIDE THE COMMUNITY WITH RESOURCES FOR INFORMATION AND EDUCATION OF HEALTH RISK BEHAVIORS. INJURY PREVENTION - ACTIVELY CONTRIBUTE TO REDUCING THE NUMBER OF UNINTENTIONAL INJURIES TO YOUNG CHILDREN, ESPECIALLY TARGETING LOW-INCOME, DIVERSE AND MEDICALLY UNDERSERVED POPULATIONS. COMMUNITY ACTION - ACTIVELY RECRUITS, RECOGNIZE AND ADVOCATE FOR THE IMPORTANCE OF VOLUNTEER LEADERSHIP AND COMMUNITY ASSISTANCE IN PROVIDING CARE FOR CHILDREN.
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 HOSPITALS' 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 HOSPITALS' 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.
SCHEDULE H, PART VI, LINE 4	COMMUNITY INFORMATION: THE HOSPITAL SERVES ALL OF ORANGE COUNTY AND A LIMITED NUMBER OF PATIENTS FROM THE WESTERN RIM OF RIVERSIDE COUNTY, THE NORTHERN PORTION OF SAN DIEGO COUNTY AND SOUTHEAST AREAS OF LOS ANGELES COUNTY. THE PRIMARY SERVICE AREA IS THE SOUTHERN PORTION OF ORANGE COUNTY, AND IS THE SOURCE OF APPROXIMATELY 86% OF ITS PATIENTS. SIGNIFICANT CITIES IN THIS AREA ARE: MISSION VIEJO, SAN CLEMENTE, SAN JUAN CAPISTRANO, LAGUNA NIGUEL, AND ALISO VEIJO. THE SECONDARY SERVICE AREA INCLUDES ALL THE OTHER ORANGE COUNTY CITIES AND UNINCORPORATED AREAS. COMMUNITY CHARACTERISTICS: POPULATION AND SOCIOECONOMIC DATA PROJECTIONS FOR 2012 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 CHM. TOTAL POPULATION OF THE COUNTY WAS 3.04 MILLION, ACCORDING TO 2012 ESTIMATES, MAKING IT THE THIRD LARGEST COUNTY IN CALIFORNIA. THE MEDIAN AGE IS 35.7, AND CHILDREN UP TO 17 YEARS OF AGE MAKE UP 24.9% OF THE TOTAL POPULATION. THE LARGEST RACE/ETHNICITY SUBGROUP IS WHITE, AT 43%. LATINOS/HISPANICS ARE 34% OF THE POPULATION. ASIANS/PACIFIC ISLANDERS ARE 18% 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 2007-11 INDICATED THAT 14.6% OF CHILDREN UNDER THE AGE OF 18 IN ORANGE COUNTY, 19.9% IN CALIFORNIA, AND 22.5% IN THE U.S. WERE BELOW THE POVERTY LEVEL. THIS SURVEY ALSO INDICATED THAT 14.4% OF THE ORANGE COUNTY POPULATION OF ALL AGES WERE LIVING BELOW THE POVERTY LEVEL. THE U.S. BUREAU OF THE CENSUS ESTIMATED THAT IN 2012, THE COUNTY'S MEDIAN HOUSEHOLD INCOME WAS $71,312. THE PERCENTAGE OF THE HOSPITAL'S PATIENTS WHO ARE UNINSURED OR MEDICAID RECIPIENTS WAS 56.8%. THERE ARE 32 OTHER HOSPITALS SERVING THE COMMUNITY: ANAHEIM GENERAL HOSPITAL - ANAHEIM, CALIFORNIA ANAHEIM REGIONAL MEDICAL CENTER - ANAHEIM, CALIFORNIA CHAPMAN MEDICAL CENTER - ORANGE, CALIFORNIA CHILDREN'S HOSPITAL OF ORANGE COUNTY - ORANGE, CALIFORNIA COASTAL COMMUNITIES HOSPITAL - SANTA ANA, CALIFORNIA COLLEGE HOSPITAL COSTA MESA - COSTA MESA, CALIFORNIA FOUNTAIN VALLEY REGIONAL HOSPITAL AND MEDICAL CENTER - FOUNTAIN VALLEY, CALIFORNIA GARDEN GROVE HOSPITAL AND MEDICAL CENTER - GARDEN GROVE, CALIFORNIA HEALTHBRIDGE CHILDREN'S REHABILITATION HOSPITAL - ORANGE, CALIFORNIA HOAG MEMORIAL HOSPITAL PRESBYTERIAN - NEWPORT BEACH, CALIFORNIA HOAG ORTHOPEDIC INSTITUTE - IRVINE, CALIFORNIA HUNTINGTON BEACH HOSPITAL AND MEDICAL CENTER - HUNTINGTON BEACH, CALIFORNIA KAISER FOUNDATION HOSPITAL - ANAHEIM, CALIFORNIA KINDRED HOSPITAL - BREA - BREA, CALIFORNIA KINDRED HOSPITAL - WESTMINSTER - WESTMINSTER, CALIFORNIA LA PALMA INTERCOMMUNITY HOSPITAL - LA PALMA, CALIFORNIA LOS ALAMITOS MEDICAL CENTER - LOS ALAMITOS, CALIFORNIA MISSION HOSPITAL REGIONAL MEDICAL CENTER - MISSION VIEJO, CALIFORNIA MISSION HOSPITAL - LAGUNA BEACH - LAGUNA BEACH, CALIFORNIA NEWPORT BAY HOSPITAL - NEWPORT BEACH, CALIFORNIA NEWPORT SPECIALTY HOSPITAL - TUSTIN, CALIFORNIA ORANGE COAST MEMORIAL MEDICAL CENTER - FOUNTAIN VALLEY, CALIFORNIA PLACENTIA-LINDA COMMUNITY HOSPITAL - PLACENTIA, CALIFORNIA SADDLEBACK MEMORIAL MEDICAL CENTER - LAGUNA HILLS, CALIFORNIA SADDLEBACK MEMORIAL MEDICAL CENTER - SAN CLEMENTE, CALIFORNIA ST. JOSEPH HOSPITAL - ORANGE, CALIFORNIA ST. JUDE MEDICAL CENTER - FULLERTON, CALIFORNIA TUSTIN REHABILITATION HOSPITAL - TUSTIN, CALIFORNIA UNIVERSITY OF CALIFORNIA, IRVINE MEDICAL CENTER - ORANGE, CALIFORNIA WEST ANAHEIM MEDICAL CENTER - ANAHEIM, CALIFORNIA WESTERN MEDICAL CENTER - ANAHEIM, CALIFORNIA WESTERN MEDICAL CENTER - SANTA ANA, CALIFORNIA
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; SEVERAL PRIMARY AND SPECIALTY CLINICS, PROGRAMS AND SERVICES; AND FOUR CENTERS OF EXCELLENCE, THE CHOC HEART, NEUROSCIENCE, ONCOLOGY AND ORTHOPAEDIC INSTITUTES. CHOC ALSO HAS A RESEARCH INSTITUTE PERFORMING BASIC SCIENCE AND CLINICAL RESEARCH. THROUGH ITS RESIDENCY PROGRAM, THE ORGANIZATION ALSO TRAINS TOMORROW'S PHYSICIANS. THE COMMUNITY BENEFIT PLAN FOR THE FISCAL YEAR ENDING JUNE 30, 2012, 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/COMMUNITYBENEFITPLAN.PDF. 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: SECTION 1. NATURE OF MEDICAL STAFF MEMBERSHIP MEMBERSHIP ON THE MEDICAL STAFF OF CHOC CHILDREN'S AT MISSION HOSPITAL IS A PRIVILEGE THAT SHALL BE EXTENDED ONLY TO PROFESSIONALLY COMPETENT PRACTITIONERS WHO CONTINUOUSLY MEET THE QUALIFICATIONS, STANDARDS AND REQUIREMENTS SET FORTH IN THESE BYLAWS. A PRACTITIONER MAY ADMIT OR PROVIDE SERVICES TO PATIENTS IN THE HOSPITAL ONLY IF THE PRACTITIONER IS A MEMBER OF THE MEDICAL STAFF OR HAS BEEN GRANTED TEMPORARY PRIVILEGES IN ACCORDANCE WITH THE BYLAWS, RULES AND REGULATIONS. APPOINTMENT TO THE MEDICAL STAFF SHALL CONFER ONLY SUCH CLINICAL PRIVILEGES AND PREROGATIVES AS HAVE BEEN GRANTED IN ACCORDANCE WITH THESE BYLAWS. SECTION 2. QUALIFICATIONS FOR MEMBERSHIP A. ONLY PRACTITIONERS WHO HOLD AN UNRESTRICTED LICENSE TO PRACTICE MEDICINE, DENTISTRY, PODIATRY OR CLINICAL PSYCHOLOGY IN THE STATE OF CALIFORNIA, WHO CAN DOCUMENT THE FOLLOWING WITH SUFFICIENT ADEQUACY TO ASSURE THE MEDICAL STAFF AND THE GOVERNING BODY THAT ANY PATIENT TREATED BY THEM IN THE HOSPITAL WILL RECEIVE CARE OF THE GENERALLY RECOGNIZED PROFESSIONAL LEVEL AND EFFICIENCY ESTABLISHED BY THE MEDICAL STAFF AND HOSPITAL, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF THEIR BACKGROUND; EDUCATION; EXPERIENCE; JUDGMENT; TRAINING; DEMONSTRATED CURRENT COMPETENCE; ABILITY TO COMMUNICATE INCLUDING A DEMONSTRATED PROFICIENCY IN THE ENGLISH LANGUAGE SUCH THAT THERE IS REASONABLE ASSURANCE THAT THERE WILL BE NO RISK OF MISUNDERSTANDING IN COMMUNICATION WITH ENGLISH SPEAKING COLLEAGUES, PATIENTS AND HEALTH CARE WORKERS; PHYSICAL AND MENTAL HEALTH STATUS; ADHERENCE TO THE ETHICS OF THEIR PROFESSION; GOOD REPUTATION; AND ABILITY TO WORK WITH OTHERS. NO PRACTITIONER SHALL BE ENTITLED TO MEMBERSHIP ON THE MEDICAL STAFF OR TO THE EXERCISE OF PARTICULAR CLINICAL PRIVILEGES IN THE HOSPITAL MERELY BECAUSE HE IS DULY LICENSED TO PRACTICE MEDICINE, DENTISTRY, CLINICAL PSYCHOLOGY OR PODIATRY IN THIS OR IN ANY OTHER STATE, HOLDS A CERTAIN DEGREE, IS CERTIFIED BY ANY CLINICAL BOARD, OR THAT HE IS A MEMBER OF SOME PROFESSIONAL ORGANIZATION, OR THAT HE HAD IN THE PAST, OR PRESENTLY HAS SUCH PRIVILEGES AT ANOTHER HOSPITAL INCLUDING BUT NOT LIMITED TO MISSION HOSPITAL OR CHOC CHILDREN'S (CHOC). NO APPLICANT SHALL BE DENIED MEMBERSHIP ON THE BASIS OF SEX, SEXUAL ORIENTATION, RACE, RELIGION, ANCESTRY, AGE, CREED, COLOR, NATIONAL ORIGIN, MARITAL STATUS, HANDICAP OR DISABILITY (EXCEPT TO THE EXTENT THE HANDICAP OR DISABILITY PREVENTS THE PRACTITIONER FROM PERFORMING ESSENTIAL FUNCTIONS OR POSES A HEALTH OR SAFETY RISK TO THE PRACTITIONER OR OTHERS AND THE HANDICAP OR DISABILITY CANNOT CHOC CHILDREN'S AT MISSION HOSPITAL MEDICAL STAFF BYLAWS (2/23/09) PAGE 6 BE REASONABLY ACCOMMODATED) OR ON THE BASIS OF ANY OTHER CRITERION THAT IS NOT RELATED TO AN INDIVIDUAL'S PROFESSIONAL CAPABILITIES. B. ONLY PRACTITIONERS WHO MAINTAIN IN FORCE PROFESSIONAL LIABILITY INSURANCE IN NOT LESS THAN THE MINIMUM AMOUNTS JOINTLY DETERMINED BY THE GOVERNING BODY AND THE MEDICAL STAFF EXECUTIVE COMMITTEE, BUT IN NO EVENT LESS THAN $1.0 MILLION PER INCIDENT AND $3.0 MILLION IN THE AGGREGATE IN A POLICY YEAR, SHALL BE QUALIFIED FOR MEMBERSHIP ON THE MEDICAL STAFF. THE INSURANCE MUST COVER ALL PRIVILEGES THE PRACTITIONER IS GRANTED BY THE GOVERNING BODY. A CARRIER ADMITTED TO DO BUSINESS IN CALIFORNIA OR A MUTUAL COOPERATIVE TRUST MUST PROVIDE THE INSURANCE. INFORMATION REGARDING EACH APPLICANT'S AND MEMBER'S INSURANCE COVERAGE MUST BE PROVIDED IN THE FORM OF A CURRENT CERTIFICATE OF INSURANCE WHICH SHALL BE MAINTAINED IN EACH PRACTITIONER'S CREDENTIALS FILE. INFORMATION REGARDING INSURANCE COVERAGE MUST BE PROVIDED AT THE TIME OF APPOINTMENT AND REAPPOINTMENT AND IMMEDIATELY UPON RECEIPT OF EACH ANNUAL RENEWAL CERTIFICATE. EACH MEMBER SHALL REPORT TO THE MEDICAL STAFF SERVICES OFFICE ANY REDUCTION, RESTRICTION, CLAIMS, CANCELLATION OR TERMINATION OF THE REQUIRED PROFESSIONAL LIABILITY INSURANCE OR CHANGE IN CARRIER IMMEDIATELY UPON THE NOTICE OF ACTION OR CHANGE. C. ACCEPTANCE OF MEMBERSHIP ON THE MEDICAL STAFF SHALL CONSTITUTE THE STAFF MEMBER'S CERTIFICATION THAT HE HAS IN THE PAST, AND HIS AGREEMENT THAT HE WILL IN THE FUTURE, BEHAVE ACCORDING TO ETHICAL PRINCIPLES APPLICABLE TO HIS PROFESSION, AND WILL ABIDE BY ALL STATE AND FEDERAL LAWS AND REGULATIONS GOVERNING THE PROFESSION, INCLUDING, BUT NOT LIMITED TO, MEDICARE/MEDICAID LAWS AND REGULATIONS. FURTHER, ALL MEMBERS OF THE MEDICAL STAFF SHALL PLEDGE THAT THEY WILL NOT RECEIVE FROM, OR PAY TO ANOTHER PHYSICIAN, DENTIST, CLINICAL PSYCHOLOGIST OR PODIATRIST, EITHER DIRECTLY OR INDIRECTLY, ANY PART OF A FEE RECEIVED FOR PROFESSIONAL SERVICES AND THEY WILL NOT DECEIVE A PATIENT AS TO THE IDENTITY OF AN OPERATING SURGEON, OR ANY OTHER MEDICAL PRACTITIONER PROVIDING TREATMENT. D. A PRACTITIONER APPLYING FOR APPOINTMENT TO THE MEDICAL STAFF AND FOR THE GRANTING OR EXTENSION OF CLINICAL PRIVILEGES MUST HAVE BEEN OR BECOME, WHICHEVER IS APPROPRIATE, CERTIFIED BY THE NATIONAL SPECIALTY BOARD PERTAINING TO THE PRACTITIONER'S CLINICAL PRIVILEGES OF THE AMERICAN BOARD OF MEDICAL SPECIALTIES, THE AMERICAN OSTEOPATHIC ASSOCIATION, OR THE AMERICAN BOARD OF DENTISTRY WITHIN FIVE (5) YEARS FROM THE COMPLETION OF THE PRACTITIONER'S TRAINING PROGRAM. BOARD CERTIFICATION MUST CORRESPOND TO THE CLINICAL PRIVILEGES REQUESTED AND PROGRAM COMPLETED. AN EXTENSION OF THIS TIME PERIOD OR EXEMPTION FROM THESE REQUIREMENTS WILL BE GRANTED ONLY UNDER EXTRAORDINARY CIRCUMSTANCES AND FOR DEMONSTRATED GOOD CAUSE AS DETERMINED SOLELY AT THE DISCRETION OF THE MEDICAL STAFF EXECUTIVE COMMITTEE AND THE GOVERNING BODY. IF THE MEDICAL STAFF APPLICANT OR MEMBER IS REQUIRED BY THE SPECIALTY BOARD TO RE-CERTIFY IN ORDER TO MAINTAIN BOARD CERTIFICATION, THE PRACTITIONER MUST BECOME RE-CERTIFIED IN ORDER TO OBTAIN AND/OR MAINTAIN MEDICAL STAFF MEMBERSHIP AND CLINICAL PRIVILEGES UNLESS EXEMPTED BY THE ABOVE PARAGRAPH. CURRENT MEMBERS OF THE MEDICAL STAFF WHO WERE NOT, AS OF DATE OF ADOPTION OF THIS AMENDMENT, BOARD CERTIFIED OR PROGRESSING TOWARD BOARD CERTIFICATION, AND WHO CANNOT REASONABLY BE EXPECTED TO PURSUE BOARD CERTIFICATION, MAY BE CONSIDERED FOR RENEWAL OF MEDICAL STAFF MEMBERSHIP IF THEY CAN DOCUMENT SUFFICIENT TRAINING, EXPERIENCE, AND COMPETENCE, AND OTHERWISE MEET THE REQUIREMENTS OF MEDICAL STAFF MEMBERSHIP. E. PHYSICIANS WHO ARE RESIDENTS OR FELLOWS IN GRADUATE MEDICAL EDUCATION PROGRAMS AND WHO ARE ASSIGNED TO RESIDENCY OR FELLOWSHIP ROTATIONS AT CHOC CHILDREN'S AT MISSION HOSPITAL OR MISSION HOSPITAL SHALL NOT BY VIRTUE OF SUCH ASSIGNMENT BE CONSIDERED MEMBERS OF THE MEDICAL STAFF WHILE FUNCTIONING IN THEIR ROLES AS RESIDENTS OR FELLOWS. THE ORGANIZATION APPLIES ITS SURPLUS FUNDS TO PLANNED CAPITAL PROJECTS TO FURTHER COMMUNITY ACCESS TO HEALTH CARE. EXCESS FUNDS, IF ANY, ARE TRANSFERRED TO CHC, THE SOLE MEMBER OF THE CORPORATION, IN ACCORDANCE WITH THE ORGANIZATION'S BYLAWS.
SCHEDULE H, PART VI, LINE 6	AFFILIATED HEALTH CARE SYSTEM: CCMH AND CHOC ARE MEMBERS OF A TWO-HOSPITAL SYSTEM. BOTH HOSPITALS HAVE A SOLE CORPORATE MEMBER, CHILDREN'S HEALTHCARE OF CALIFORNIA, THAT PROVIDES MANAGEMENT SERVICES TO BOTH HOSPITALS. THE HOSPITALS SHARE A COMMON MISSION AND ARE STRATEGICALLY ALIGNED IN THEIR EFFORT TO MEET THE HEALTHCARE NEEDS OF THE COMMUNITY. SCHEDULE H, PART VI, LINE 7 A COMMUNITY BENEFIT REPORT IS FILED ANNUALLY IN THE STATE OF CALIFORNIA.

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	true	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	CHILDREN'S HEALTHCARE OF CALIFORNIA	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	455 s main street	AddressLine1
City	orange	City
State	CA	State
ZIP Code	928683874	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	330265266	EINOfRecipient
IRC Section	501(c)(3)	IRCSection
Amount Of Cash Grant	600000	AmountOfCashGrant
Method Of Valuation	N/A	MethodOfValuation
Description Of Non Cash Assistance	N/A	DescriptionOfNonCashAssistance
Purpose Of Grant	Support	PurposeOfGrant

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	1	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	0	TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	Procedure for monitoring the use of grant funds - part i, line 2	Identifier
Explanation	Grant funds are monitored for appropriate use per the specific grant agreements. The grant expenditures are consistently tracked and reconciled per existing policies and procedures. In addition, CHOC has an A-133 audit performed each year by its independent audit firm.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KIMBERLY C CRIPE
0	726625	0	196891	0	302274	0	55927	0	21901	0	1303618	0	38625
KERRI RUPPERT SCHILLER
0	443436	0	96396	0	53227	0	88035	0	21901	0	702995	0	0
DEBRA MATHIAS
0	425653	0	101338	0	53853	0	86588	0	21901	0	689333	0	0
MARCIA FOLLI
197741	0	35558	0	32017	0	45156	0	0	0	310472	0	0	0
BONNIE GRAVETT
153295	0	114	0	11288	0	9006	0	15501	0	189204	0	0	0
Elizabeth Drake
123157	0	114	0	10374	0	7428	0	11273	0	152346	0	0	0
paula castano
122018	0	432	0	10303	0	2479	0	15501	0	150733	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Severance Arrangements, 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.
Supplemental Nonqualified Retirement Plan	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) for each Plan year that begins prior to the participant's cash date, CHOC shall create a new SERP account on its books for the Participant and shall credit to such account at times specified. The participants of the plan are general creditors of the company. The participant's SERP account shall be utilized solely as a device for the measurement and determination of the amounts to be paid to the participant under this plan. The participant is entitled to his/her SERP benefit amount upon the earliest of (1) remaining employed with the Company to the third anniversary of the first day of the Plan Year for which the SERP account was created; (2) remaining employed with the Company to the Participant's 60th birthday; (3) remaining employed with the Company to the date the Participant has both attained at least age 55 and has completed at least 10 years of service; (4) disability; (5) involuntary separation from service without reasonable cause; (6) voluntary separation from service for good reason or (7) death. The following individual received payments from the Plan during calendar year 2011: Ms. Cripe ($159,816). As stated in previous filings, in December 2008, the CHOC executive compensation committee dissolved the previous non-qualified retirement plan and all assets were disbursed involuntarily to the participants. The following individual listed on schedule J received payments from the dissolution of the plan in calendar 2011, which are included as a component of the amount reported on schedule J, Part II, column B: Ms. Cripe ($64,984).	Part I, Line 4B
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, CHOCO Realty Corporation, CRC Real Estate Corporation and Children's Hospital at Mission (all IRC Section 501(c)(3) affiliates). Ms. Cripe devotes approximately 5% of her time each week to Children's Hospital at Mission 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, CHOCO Realty Corporation, CRC Real Estate Corporation and Children's Hospital at Mission (all IRC Section 501(c)(3) affiliates). Ms. Schiller devotes approximately 10% of her time each week to Children's Hospital at Mission responsibilities with the balance of her time being spent on the other related organizations' business affairs. Debra Mathias 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 and Children's Hospital at Mission (both IRC Section 501(c)(3) affiliates). Ms. Mathias devotes 11% of her time to Children's Hospital at Mission responsibilities with the balance of her time being spent on Children's Hospital of Orange County business affairs.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (23 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
Form 990, Part I, Line 5 and Part V, Line 2	Children's Hospital of Orange County (CHOC) acts as a common paymaster, issuing forms W-2 and 1099 on behalf of Children's Hospital at Mission. Children's Hospital at Mission has 141 employees, however because of the common paymaster arrangement resulting in the forms W-2 being issued under CHOC's employer identification number, there are no W-2s issued directly by Children's Hospital at Mission. Lines 6 & 7a - Organization Member Information The sole member of Children's Hospital at Mission (CHM) 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 CCMH; (2) Obligating CCMH to undertake any capital expenditure in excess of $5,000,000; (3) Adopting CCMH'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 CCMH to act as guarantor with respect to any debt of any person or other entity; (8) Accepting any donation which is conditioned upon CCMH's undertaking any unbudgeted capital expenditure in excess of $2,000,000 or any unbudgeted expenditure in excess of $2,000,000; (9) Entering into any contract which involves any of the following: (a) any financial obligation on the part of CCMH in an amount in excess of $5,000,000, (b) any purpose or activity which is outside the scope of CCMH's ordinary course of business, or (c) a term in excess of five years (unless the contract is terminable at will); (10) involving CCMH in any merger, acquisition, corporate restructuring, or formal affiliation; (11) Involving CCMH as a member, shareholder, or partner in any new corporation, partnership, or other legal entity; (12) Dissolving CCMH; (13) Entering into any transaction involving the sale, lease, conveyance, exchange, transfer or other disposition of all or substantially all of CCMH's assets; (14) Amending CCMH's articles of Incorporation; (15) Adopting new bylaws or amending existing bylaws, in the event that such action would affect any of the Member's rights under the bylaws or as provided by applicable law.
Form 990, Part VI	Line 4 - CHANGES TO BYLAWS 1. Increased the authorized number of directors from "thirteen (13) to sixteen (16)" to "Thirteen (13) to seventeen (17)". 2. Reduced the percentage of authorized directors who can be members of the hospital's medical staff from twenty-five percent (25%) to twenty percent (20%). Line 11a - PROCESS OF REVIEW 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. The Form 990 is also a scheduled agenda item at the April 2013 Board of Directors meeting. Line 12c - MONITORING/ENFORCING COMPLIANCE OF CONFLICT OF INTEREST POLICY The Compliance Officer is charged with monitoring proposed or ongoing transactions for conflicts of interest and addressing any potential or actual conflicts. Pursuant to the conflict of interest policy, an annual conflict of interest questionnaire, aimed at determining any family and business relationships and transactions or other transactions that may pose a potential conflict, is distributed to all covered persons (i.e., board members, officers and executive leadership 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 15A - Compensation Determination Process - Top Management Official: An independent Board committee, 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 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 executive sessions with no staff members present. All comparative salary data is well documented and there are minutes from these meetings that document the members present and voting, the comparative data used 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. Line 15B - Compensation Determination Process - Other Officers and Key Employees: The Organization has no other officers or key employees. Kimberly C. Cripe, Kerri Ruppert Schiller, and Debra Mathias are employees of Children's Healthcare of California (CHC) and are compensated by CHC. An independent Board Committee of CHC 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 officers and key employees of CHC 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. All comparative salary data is well documented and there are minutes from these meetings that document the members present and voting, the comparative data used and the deliberations and decisions of the committee. The results and recommendations from the committee are shared in a closed session with the Board of Directors.
Form 990, Part VI, Section C	Line 19 - DISCLOSURE POLICY While federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection, the organization makes its financial statements available upon request.
Form 990, Part XI, Line 5	Unrealized Gains $69,403. Change in Beneficial interest in CHOC FND $(2,369) ----------- Total Changes 67,034
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:KIMBERLY C. CRIPE TITLE:DIRECTOR/PRESIDENT HOURS:38	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:RALPH CLAYMAN, M.D. TITLE:DIRECTOR HOURS:3	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:JEFF ELGHANAYAN TITLE:DIRECTOR/2ND VICE CHAIR HOURS:4	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:WILLIAM GURTNER TITLE:DIRECTOR HOURS:3	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:MUSTAFA KABEER, M.D. TITLE:DIRECTOR HOURS:1	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:JAY KEAR TITLE:DIRECTOR/FIRST VICE CHAIR HOURS:2	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:DOUGLAS MCCOMBS TITLE:DIRECTOR / SECRETARY HOURS:2	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:MARK STEVENS TITLE:DIRECTOR/CHAIR HOURS:6	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:MAUREEN ZEHNTNER TITLE:DIRECTOR HOURS:2	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:JANET T. DAVIDSON TITLE:DIRECTOR HOURS:5	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:MARSHALL ROWEN, M.D. TITLE:DIRECTOR HOURS:3	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:DAVID DUKES TITLE:DIRECTOR HOURS:1	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:JOE DUNN TITLE:DIRECTOR HOURS:1	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:GEORGE KALOGRIDIS TITLE:DIRECTOR HOURS:1	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:TIM RISTOFF TITLE:DIRECTOR HOURS:2	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:vijay Dhar, M.D. TITLE:director HOURS:2	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:thomas tierney TITLE:director HOURS:2	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:KERRI RUPPERT SCHILLER TITLE:CFO/Assistant Secretary HOURS:36	FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATION	NAME:DEBRA MATHIAS TITLE:EXEC. VICE PRESIDENT / COO HOURS:36	FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg
CHILDREN'S HOSPITAL OF ORANGE COUNTY
455 S MAIN STREET	ORANGE	CA	92868	952321786	HEALTH CARE	CA	501(c)(3)	3	CHC	false
CHOC FOUNDATION
455 S MAIN STREET	ORANGE	CA	92868	956097416	FUND RAISING	CA	501(c)(3)	7	CHC	false
CHOCO REALTY CORPORATION
455 S MAIN STREET	ORANGE	CA	92868	330011853	REAL ESTATE	CA	501(c)(3)	11	CHC	false
CRC REAL ESTATE CORPORATION
455 S MAIN STREET	ORANGE	CA	92868	330612565	REAL ESTATE	CA	501(c)(3)	11	CHC	false
CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC)
455 S MAIN STREET	ORANGE	CA	92868	330265266	HEALTH CARE	CA	501(c)(3)	7	NA	false
choc thrift stores inc
455 S MAIN STREET	orange	CA	92868	330266422	Fund Raising	CA	501(c)(3)	9	CHC	false

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	OCMRRG	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2999 North 4th Street Suite 250	AddressLine1
City	phoenix	City
State	AZ	State
ZIP Code	85108	ZIPCode

Field	Value	IRS element (for citing)
EIN	201620666	EIN
Primary Activity	Insurance	PrimaryActivity
Legal Domicile State	AZ	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	CHOC	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C Corp	TypeOfEntity
Share Of Total Income	42633	ShareOfTotalIncome
Share Of EOY Assets	2621196	ShareOfEOYAssets
Percentage Ownership	0.50000	PercentageOwnership

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	true	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	false	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	false	SharingOfPaidEmployees
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	false	OtherTransferToOtherOrg
Other Transfer From Other Org	false	OtherTransferFromOtherOrg