2013-07-29T13:56:48-05:00 2011-08-31 PricewaterhouseCoopers LLP 125 High Street Boston MA 02110 990 2010-09-01 946174066 STANFORD HEALTH SERVICES STAN 6507234000 300 Pasteur Drive MC 5555 Stanford CA 94305 DANIEL J MORISSETTE 2013-07-21 true PRICEWATERHOUSECOOPERS LLP 6175305000 2010 2016-02-24 21:20:13Z X STANFORD HOSPITAL AND CLINICS DANIEL J MORISSETTE CFO 300 PASTEUR DRIVE MC 5516 STANFORD CA 94305 2510897420 false X http://www.stanfordhospital.org X 1957 CA SEE SCHEDULE O 24 15 11418 1132 3303484 -1394577 39927716 137848570 2027623922 2248410144 74264128 124638706 0 0 2141815766 2510897420 271742 150000 0 0 818222897 860643738 0 0 4699020 1137155464 1234492755 1955650103 2095286493 186165663 415610927 2302517586 2710928362 1417872044 1410093186 884645542 1300835176 X SEE SCHEDULE O. false false 1937246884 150000 2248410144 SEE SCHEDULE O. 1937246884 true true false true false false true false true true true false true true true false true false false false false false false false false true true true false true true false false false false false true false false true true true false false false true true true true false false true 724 0 true 11418 true true true true BD false false false true true false false false false X 24 15 true false false false true true false true true false false false true true true false false true true false CA X CONTROLLER 6507234000 1510 PAGE MILL ROAD M/C 5555 PALO ALTO CA 94304 X MARC ANDREESSEN 2.0 X 0 0 0 BRYAN BOHMAN MD 2.0 X 150000 0 0 SUSAN L BOSTROM 2.0 X 0 0 0 MARIANN BYERWALTER 2.0 X 0 0 0 BRUCE COZADD 2.0 X 0 0 0 CHRISTOPHER DAWES 2.0 X 1155878 0 48137 JOHN FREIDENRICH 2.0 X 0 0 0 STEPHEN T HEARST 2.0 X 0 0 0 JOEL HYATT 2.0 X 0 0 0 RON JOHNSON 2.0 X 0 0 0 CHARLES KOOB 2.0 X 0 0 0 JOHN LEVIN 2.0 X 0 0 0 JOHN LILLIE 2.0 X 0 0 0 TED LOVE MD 2.0 X 0 0 0 ALBERT MARTIN MD 2.0 X 0 0 0 JOHN MORGRIDGE 2.0 X 0 38300 0 WOODROW A MYERS MD 2.0 X 0 0 0 DENISE OLEARY 2.0 X 0 0 0 PHILIP PIZZO MD 2.0 X 0 610317 262738 CHRISTOPHER REDLICH 2.0 X 0 0 0 KATHRYN RENSCHLER MD 2.0 X 0 0 0 NORMAN RIZK MD 2.0 X 0 631611 30544 JOHN SCULLY 2.0 X 0 0 0 PETER STAMOS 2.0 X 0 0 0 ANN WEINACKER MD 2.0 X 0 330951 35851 SCOTT WOOD MD 2.0 X 0 0 0 JON STEVE YOUNG 2.0 X 0 0 0 WILLIAM YOUNGER 2.0 X 0 0 0 AMIR DAN RUBIN 50.0 X X 0 0 0 DANIEL GINSBURG 50.0 X 897357 0 122413 DANIEL MORISSETTE 50.0 X 948018 0 116564 MICHAEL J PETERSON 50.0 X 640876 0 40448 CAROLYN BYERLY 50.0 X 561381 0 29834 NANCY LEE 50.0 X 536633 0 42394 JERROLD MAKI 50.0 X 431683 0 30511 MARK TORTORICH 25.0 X 426232 0 67166 MARTHA MARSH 50.0 X 1476201 0 32752 KEVIN TABB 50.0 X 714628 0 102027 SRIDHAR SESHADRI 50.0 X 618801 0 44694 JENNIFER VARGAS 50.0 X 645396 0 98898 JEFFREY GUARDINO 50.0 X 574185 0 13263 9777269 1611179 1118234 3461 false true false STANFORD UNIVERSITY 651 SERRA STREET STANFORD CA 94305 PROF. SERVICES 316961327 PEROT SYSTEMS 7489 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 IT OUTSOURCING 47639087 RAFAEL VINOLY ARCHITECTS PC 50 VANDAM STREET NEW YORK NY 10013 CONSTRUCTION 32779722 ACCENTURE LLP 161 N CLARK STREET CHICAGO IL 60601 IT CONSULTING 29599109 BLUE CROSS OF CALIFORNIA 4553 LA TIENDA DRIVE THOUSAND OAKS CA 91362 MEDICAL 25974199 226 137848570 9368563 137848570 PATIENT REVENUE 900099 2131290930 2131290930 OUTREACH LAB CLINIC 900099 10307834 10307834 REIMBURSED/SHARED EXPENSES 900099 79012975 79012975 HOUSESTAFF 900099 19017109 19017109 CLINIC REVENUE 900099 7762103 7762103 1019193 -2628287 3303484 343996 2248410144 125367376 125367376 0 0 -728670 -728670 -728670 -728670 0 0 0 0 2510897420 2244762664 3303484 124982702 150000 150000 0 0 0 7378513 3660812 3593442 124259 0 0 0 0 555317609 521013524 34220277 83808 49596523 46081348 3509071 6104 202332679 185361372 16958217 13090 46018414 43034426 2976137 7851 635875 625831 10044 6080641 6080641 1247598 1247598 455850 455850 0 0 44953350 38521285 5641266 790799 2351281 2198566 152715 63956471 52291912 11574291 90268 60235510 38539169 21695465 876 0 51481150 46794929 4520933 165288 2647660 2079360 556279 12021 0 741091 611550 129541 45776099 45776099 0 96655400 79397156 17258244 8955809 7650192 1305617 OTHER PURCHASED SERVICES 427082687 407429346 16507163 3146178 SUPPLIES 291740568 290006653 1710142 23773 LICENSE AND TAXES 1464061 702866 761195 DUES AND SUBSCRIPTIONS 1226589 655926 570663 PROV FOR DOUBTFUL ACCOUNTS 82201308 82201308 44603757 42007404 2361648 234705 2095286493 1937246884 153340589 4699020 3175 1750 325812316 395469338 284047038 316641815 2000000 1250000 19147976 19657400 9714862 21955029 1666723757 802562382 859274027 864161375 896954557 745196908 54139524 57321284 140697574 2302517586 2710928362 201771341 217408321 825483436 818471337 390617267 374213528 1417872044 1410093186 X 785092472 1078759515 93061654 215584245 6491416 6491416 884645542 1300835176 2302517586 2710928362 X 415610927 578707 X false true true X false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false true 33687 false true 189025 true 205697 true 27441 false 455850 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B LOBBYING ACTIVITIES INCLUDE: - SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS; - MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS; AND - SENDING OR DISTRIBUTING LETTERS OR PUBLICATIONS (INCLUDING NEWSLETTERS, BROCHURES, ETC.) TO MEMBERS OR TO THE GENERAL PUBLIC. SHC BELONGS TO CERTAIN TRADE ASSOCIATIONS IN WHICH A PORTION OF DUES PAID TO THESE ORGANIZATIONS IS SPENT ON EFFORTS TO INFLUENCE LEGISLATIVE MATTERS IN THE HEALTH CARE INDUSTRY. DURING FY11, SHC PAID DUES OF APPROXIMATELY $333,018 TO THESE TRADE ASSOCIATIONS AND THE APPROXIMATE AMOUNT OF THE DUES SPENT ON LOBBYING PURPOSES WAS $70,092. X false 11926477 1845660 252403 13519734 10864850 1173551 111924 11926477 13498859 -2572393 61616 10864850 0.00000 0.48020 0.51980 false true true 20517753 20517753 736832125 377838212 358993913 38431973 15158604 23273369 678487602 406469629 272017973 192454304 3095937 189358367 864161375 MANAGED POOL 825836344 F OTHER INVESTMENTS 71118213 F 896954557 PLEDGES RECEIVABLE 121608074 OTHER ASSETS 18102097 ASSETS HELD BY TRUSTEE 987403 140697574 0 THIRD PARTY PAYOR LIABILITIES 22658607 DUE TO RELATED PARTIES 29659071 SELF-INSURED RESERVES 96175865 OTHER LIABILITIES 174150985 PENSION LIABILITY 51569000 374213528 2510897420 2095286493 415610927 -125704 704411 578707 416189634 2431353455 -125704 3167029 3041325 2428312130 82585290 82585290 2510897420 2015163824 -79012975 -79012975 2094176799 1109694 1109694 2095286493 PART III, LINE 4 SHC MAINTAINS A COLLECTION OF DONATED ART FOR PUBLIC EXHIBITION AT HOSPITAL FACILITIES. PART V, LINE 4 ENDOWMENT FUNDS STANFORD HOSPITAL AND CLINICS' (SHC) ENDOWMENT CONSISTS OF VARIOUS INDIVIDUAL FUNDS WHICH ARE RESTRICTED TO PARTICULAR USES. SHC HAS FUNDS TO SUPPORT MEDICAL DIRECTOR OF THE HOSPITAL'S CANCER CENTER, CLINICAL SERVICES, AND FUNDS FOR THE CONSTRUCTION OF SHC'S BUILDING. SHC ALSO HAS FUNDS TO SUPPORT EDUCATIONAL PROGRAMS, CHAPLAINCY PROGRAMS, PATIENT CARE, INDIGENT CARE AND THE HEALTH LIBRARY TECHNOLOGY. SCHEDULE D, PART X FIN 48 STANFORD HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. STANFORD HOSPITAL HAS NO UNCERTAIN TAX POSITIONS PERTAINING TO UNRELATED BUSINESS INCOME. PART XI, LINE 8 OTHER CHANGES IN NET ASSETS EQUITY TRANSFER ($12,869,103) ADDITIONAL MINIMUM PENSION LIABILITY $12,902,000 INTEREST RATE SWAP MTM $671,827 PET/CT INCOME BOOK/TAX DIFFERENCE ($317) ROUNDING ADJUSTMENT TO BALANCE TO FINANCIAL STATEMENTS $4 CHANGE IN NET ASSETS $704,411 PART XII, LINE 2D OTHER REVENUE ON F/S NOT ON RETURN INTEREST RATE SWAP MTM $671,827 PET/CT PER F/S $3,571,998 UNRESTRICTED FUNDS TRANSFER TO STANFORD UNIVERSITY ($6,968,315) CHANGE IN MINIMUM PENSION LIABILITY $12,902,000 RESTRICTED FUNDS EQUITY TRANSFER $355,234 FUND TRANSFER TO UNIVERSITY HEALTHCARE ALLIANCE ($13,224,337) UNRESTRICTED FUNDS TRANSFER TO LUCILE SALTER PACKARD CHILDREN'S HOSPITAL $5,858,621 ROUNDING ADJUSTMENT TO BALANCE TO FINANCIAL STATEMENTS $1 TOTAL OTHER REVENUE ON F/S NOT ON RETURN $3,167,029 PART XII, LINE 4B OTHER REVENUE ON RETURN NOT ON F/S REIMBURSEMENT OF SHARED EXPENSE $79,012,975 PET/CT PER 2011 K1 $3,621,815 INTEREST INCOME & NET LONG TERM CAPITAL LOSS FROM PET/CT K1 ($49,500) TOTAL OTHER REVENUE $82,585,290 PART XIII, LINE 4A OTHER EXPENSES ON F/S NOT ON RETURN REIMBURSEMENT OF SHARED EXPENSE ($79,012,975) PART XIII, LINE 4B OTHER EXPENSE ON RETURN NOT ON F/S PURCHASED SERVICES $1,109,694 true true true X 400. true X true false true true 21676659 21676659 0.01080 174117449 86123506 87993942 0.04370 195794108 86123506 109670601 0.05450 4174891 4174891 0.00210 62353581 11549809 50803772 0.02520 4237718 2141317 2096401 0.00100 1226182 1226182 0.00060 71992372 13691126 58301246 0.02890 267786480 99814632 167971847 0.08340 86432 86432 5000 5000 60210 60210 151642 151642 true 20673436 1732568 458369625 553621302 -95251677 X true true 1 1 STANFORD HOSPITAL AND CLINICS

300 PASTEUR DRIVE STANFORD CA 94305

X X X X STANFORD HOSPITAL AND CLINICS 1 PART I, LINE 7G THE AMOUNTS REPORTED IN PART 1, LINE 7G INCLUDE LIFE FLIGHT COSTS OF $2,096,401. PART I, LINE 7, COLUMN F THE AMOUNT OF BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN, IS $82,201,308. PART I, LINE 7 THE COST REPORTED FOR OTHER BENEFITS ARE DIRECT COST PLUS ALLOCATED OVERHEAD USING AS FILED FY10 MEDICARE COST REPORT OVERHEAD ALLOCATION PERCENTAGE. PART II COMMUNITY BUILDING ACTIVITIES THROUGH ITS TRAUMA SERVICES DEPARTMENT, SHC SUPPORTED SEVERAL TRAFFIC AND DRIVING SAFETY EDUCATIONAL PROGRAMS DESIGNED TO REDUCE TRAFFIC-RELATED INJURIES AND DEATHS AMONG YOUNG DRIVERS, BICYCLISTS AND PEDESTRIANS. CONDUCTED IN PARTNERSHIP WITH THE TRAFFIC SAFE COMMUNITY NETWORK (TSCN), PALO ALTO DRUG AND ALCOHOL COMMUNITY COLLABORATIVE, PALO ALTO UNIFIED SCHOOL DISTRICT AND A VARIETY OF OTHER COMMUNITY AND PUBLIC SAFETY AGENCIES, THESE PROGRAMS COLLECTIVELY REACHED ALMOST 19,000 STUDENTS AT 29 SCHOOLS. SHC PLAYS A KEY ROLE IN DISASTER PLANNING FOR THE COMMUNITY. THROUGH THE OFFICE OF EMERGENCY MANAGEMENT (OEM), SHC COLLABORATES WITH LOCAL MUNICIPALITIES, COUNTY GOVERNMENT AND OTHER HOSPITALS TO COORDINATE PLANNING, MITIGATION, RESPONSE AND RECOVERY ACTIVITIES FOR EVENTS THAT COULD ADVERSELY IMPACT THE COMMUNITY. THE GOAL OF THESE ACTIVITIES IS TO MINIMIZE THE IMPACT UPON LIFE, PROPERTY AND THE ENVIRONMENT FROM CATASTROPHIC EVENTS SUCH AS PANDEMIC FLU, EARTHQUAKES AND OTHER DISASTERS. SHC'S OEM WORKS WITH EMERGENCY MEDICAL SERVICES (EMS) IN BOTH SAN MATEO AND SANTA CLARA COUNTIES ON JOINT DISASTER EXERCISES, DISASTER PLANNING AND MITIGATION AND BEST PRACTICES. OEM IS ALSO AN ACTIVE MEMBER ON THE PALO ALTO EMERGENCY PREPAREDNESS WORK GROUP. SHC'S OEM PROVIDES A CRITICAL SERVICE FOR COUNTY EMS, CENTERS FOR DISEASE CONTROL AND PREVENTION AND OTHER HOSPITALS AND COUNTY AGENCIES BY MAINTAINING CACHES OF EMERGENCY MEDICAL EQUIPMENT AND SUPPLIES FOR READY ACCESS AND DEPLOYMENT IN THE CASE OF DISASTER OR EMERGENCIES. OEM PROVIDES REGULAR INVENTORY REVIEW AND 24/7 SECURITY TO ENSURE THAT THESE EMS SUPPLIES ARE SERVICE-READY AT ALL TIMES. FOR EXAMPLE, THE OEM CACHE SUPPLY, MAINTAINED IN EAST PALO ALTO, CAN PROVIDE CARE TO ABOUT 1,000 TRAUMA AND BURN PATIENTS. WORKFORCE DEVELOPMENT: SHC CONTINUED ITS SUPPORT OF THE STANFORD MEDICAL YOUTH SCIENCE PROGRAM. THE PROGRAM'S MISSION IS TO INCREASE KNOWLEDGE ABOUT THE SCIENCES AND HEALTH PROFESSIONS AND TO OFFER GUIDANCE ABOUT COLLEGE ADMISSIONS TO LOW-INCOME AND UNDERREPRESENTED MINORITY STUDENTS. THE STUDENTS LEARN ABOUT POTENTIAL CAREERS IN HEALTH AND MEDICINE THROUGH HANDS-ON ACTIVITIES, SHADOWING AND DISCUSSION GROUPS. THE INTERNSHIPS ARE IN VARIOUS HOSPITAL DEPARTMENTS, INCLUDING SURGERY, CARDIAC CARE AND INTENSIVE CARE UNITS, TRANSPLANTATIONS, NEUROLOGY AND HOSPITAL ADMINISTRATION. COALITION BUILDING: SHC SUPPORTS THE WORK OF THE SAN MATEO COUNTY FALL PREVENTION TASK FORCE BOTH FINANCIALLY AND WITH STAFF REPRESENTATION. PART III, LINE 4 SHC FY 2011 FINANCIAL STATEMENT DID NOT HAVE DESCRIPTIONS FOR BAD DEBT EXPENSE. THE COST FOR BAD DEBT EXPENSES IN LINE 2 AND 3 ARE BASED ON THE BAD DEBTS CHARGES AT ESTABLISHED RATE MULTIPLYING THE RATIO OF THE TOTAL FY 2011 COST (EXCLUDING BAD DEBT EXPENSES) TO THE TOTAL FY 2011 CHARGES. MOST OF THE COMMUNITY BENEFITS ARE RELATED TO COMMUNITY ACTIVITIES OR PROGRAMS NOT ASSOCIATED WITH PATIENT CARE. SINCE THE BAD DEBT EXPENSES ARE ONLY RELATED TO THE COLLECTION OF PATIENT CARE SERVICE, THE COST FOR OTHER COMMUNITY PROGRAM DOES NOT INCLUDE BAD DEBTS. SHC HAS ESTABLISHED CHARITY CARE POLICY APPROVED BY SHC'S GOVERNING BODY. THE CHARITY CARE IS PROVIDED WHEN THE PATIENT MEETS THE CRITERIA AND SUFFICIENT INFORMATION IS PROVIDED. IT IS DESIRABLE FOR SHC TO DETERMINE THE ELIGIBILITY FOR CHARITY CARE BEFORE OR AT THE TIME OF SERVICE. HOWEVER DUE TO THE CIRCUMSTANCES AND AVAILABILITY OF THE PATIENT INFORMATION SHC MAY BE UNABLE TO DETERMINE THE AMOUNT OF CHARITY CARE UNTIL AN EXTENDED PERIOD OF TIME OR AFTER THE ACCOUNTS ARE TRANSFERRED TO BAD DEBTS. AS A RESULT SHC HAS ESTABLISHED PROCEDURES CODES TO TRACK THE ACCOUNTS IN BAD DEBTS AND SUBSEQUENTLY DETERMINED AS CHARITY CARE ELIGIBLE. THE ESTIMATED BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE CHARITY CARE REPORTED IN LINE 2 ABOVE WAS $6,889,003. THE COST ASSOCIATED TO SUCH CHARITY AMOUNT WAS $1,732,568. PART III, LINE 8 SHC HAS BEEN UTILIZING A COST ACCOUNTING (TSI) SYSTEM TO MONITOR ITS OPERATION COST. THE SYSTEM SEPARATES THE COST INTO 4 MAJOR CATEGORIES, VARIABLE DIRECT COST, FIXED DIRECT COST, VARIABLE INDIRECT COST AND FIXED INDIRECT COST. THE OVERHEAD COSTS ARE ALLOCATED TO THE REVENUE GENERATED PATIENT CARE COST CENTERS AND INDIVIDUAL PATIENT ACCOUNT BASED ON THE STEP DOWN METHODOLOGY AND VARIOUS STATISTICAL UNITS OF SERVICES. THE COST OF CHARGE RATIO (RCC) FOR MEDICARE PROGRAM IS DETERMINED BY THE TOTAL COST OF SHC DISCHARGED AND FINAL BILLED MEDICARE PATIENTS, INCLUDING ALL 4 COST CATEGORIES MENTIONED ABOVE AND DIVIDED BY THE TOTAL CORRESPONDING DISCHARGED AND FINAL BILLED MEDICARE CHARGES FOR FY 2011. THE AMOUNT OF THE COST FOR PART III, SECTION B LINE 6 IS DETERMINED BY APPLYING THE PAYER SPECIFIC RCC TO ALL CHARGES FOR MEDICARE RELATED PROGRAMS, INCLUDING TRADITIONAL MEDICARE PROGRAM AND MANAGED CARE SENIOR PROGRAMS RESPECTIVELY. PART III, LINE 9B IT IS THE POLICY OF SHC TO FOLLOW THE STANDARDS AND PRACTICES FOR COLLECTION OF PATIENT DEBT IN ACCORDANCE WITH THE REQUIREMENTS OF CALIFORNIA ASSEMBLY BILL 774. SHC HAS A VARIETY OF OPTIONS FOR PATIENTS FACING FINANCIAL HARDSHIP, INCLUDING UNINSURED DISCOUNTING, NO INTEREST PAYMENT ARRANGEMENTS, AND A CHARITY CARE PROGRAM. PATIENTS WHO APPLY FOR CHARITY CARE AND QUALIFY MAY RECEIVE UP TO 100% FINANCIAL ASSISTANCE. SHC DOES NOT ALLOW THEIR COLLECTION AGENCIES TO REPORT DEBT TO CREDIT BUREAUS, GARNISH WAGES, OR FILE LIENS ON PRIMARY RESIDENCES. PART VI, LINE 2 NEEDS ASSESSMENT COMMUNITY ASSESSMENT PROCESS SHC IS AN ACTIVE PARTICIPANT IN THE ASSESSMENT COLLABORATIVES IN SAN MATEO AND SANTA CLARA COUNTIES; THE HEALTHY COMMUNITY COLLABORATIVE OF SAN MATEO COUNTY AND THE SANTA CLARA COUNTY COMMUNITY BENEFITS COALITION (SCCCBC). SHC PLAYS A LEADERSHIP ROLE AS A MEMBER OF THE EXECUTIVE COMMITTEE OF THE SCCCBC. ORGANIZATIONS ACTIVE IN THESE ONGOING COLLABORATIVES ARE LISTED BELOW. SAN MATEO COUNTY: HEALTH PLAN OF SAN MATEO HOSPITAL CONSORTIUM OF SAN MATEO COUNTY KAISER FOUNDATION HEALTH PLAN KAISER PERMANENTE, REDWOOD CITY KAISER PERMANENTE, SOUTH SAN FRANCISCO LUCILE PACKARD CHILDREN'S HOSPITAL PENINSULA FAMILY YMCA PENINSULA HEALTHCARE DISTRICT PENINSULA LIBRARY SYSTEM HEALTH DEPARTMENT HEALTH SERVICES HOSPITAL COUNCIL, NORTHERN & CENTRAL CALIFORNIA HUMAN SERVICES AGENCY SAN MATEO MEDICAL CENTER SEQUOIA HEALTHCARE DISTRICT SEQUOIA HOSPITAL SETON MEDICAL CENTER STANFORD HOSPITAL & CLINICS Sutter Health, Peninsula & Coastal Region YOUTH & FAMILY ENRICHMENT SERVICES SANTA CLARA COUNTY: COMMUNITY HEALTH PARTNERSHIP COUNCIL ON AGING, SILICON VALLEY EL CAMINO HOSPITAL FIRST 5 SANTA CLARA COUNTY HEALTHY SILICON VALLEY KAISER PERMANENTE SAN JOSE & SANTA CLARA KIDS IN COMMON LUCILE PACKARD CHILDREN'S HOSPITAL HOSPITAL COUNCIL, NORTHERN & CENTRAL CALIFORNIA O'CONNOR HOSPITAL PROJECT CORNERSTONE - YMCA PUBLIC HEALTH DEPARTMENT SAINT LOUISE REGIONAL HOSPITAL SANTA CLARA FAMILY HEALTH PLAN SANTA CLARA VALLEY HEALTH & HOSPITAL SYSTEM SOCIAL SERVICE AGENCY STANFORD HOSPITAL & CLINICS THE HEALTH TRUST VETERANS ADMINISTRATION - PALO ALTO UNITED WAY SILICON VALLEY The Santa Clara County Community Benefits Coalition released the Santa Clara County Health Profile Report in July 2010. The full report is available at www.sccphd.org. The Healthy Community Collaborative of San Mateo County released the 2011 Community Assessment - Health and Quality of Life in San Mateo County in October 2011. The full report is available at www.smhealth.org/hpp. THE GOAL OF EACH GROUP IS TO PRODUCE AN ASSESSMENT FOR GUIDING PROGRAM PLANNING AS WELL AS POLICY AND ADVOCACY EFFORTS AIMED AT IMPROVING THE HEALTH STATUS OF RESIDENTS OF THOSE COUNTIES. THE ASSESSMENTS ARE ALSO DESIGNED TO STIMULATE COLLABORATIVE ACTION AS WELL AS ACTION BY INDIVIDUAL ORGANIZATIONS TO ADDRESS PRESSING COMMUNITY HEALTH NEEDS. Key Findings Among the key findings in Santa Clara County: - 1.8 million residents: 52 percent white, 30 percent Asian, 26 percent Hispanic, 2.6 percent African-American[ii] - By 2020, one in six county residents will be at least 65 years old - Top 3 causes of death were cancer, heart disease and stroke - 33 percent of adults reported having one or more chronic conditions - About two in 10 adults do not have health insurance, increasing to four in 10 among Hispanic adults Among the key findings in San Mateo County: - 718,989 residents: 53 percent white, 25 percent Hispanic, 25 percent Asian, 3 percent African-American[iv] - Number of adults over 65 years of age will increase 72 percent by 2030 - Leading cause of death is cancer - FALLS ARE A KEY ISSUE LEADING TO hospitalization, loss of independence and death among seniors - Access and affordability of health care are a significant problem Prioritization of Community Need To prioritize the many pressing community health needs, SHC developed the following selection criteria: 1. A needs assessment process has identified the issue as significant and important to a diverse group of community stakeholders. 2. The issue affects a relatively large number of individuals. 3. The issue has serious impact at the individual, family or community level. 4. If left unaddressed, the issue is very liable to become more serious. 5. The issue offers potential for program intervention that can result in measurable impact. 6. SHC has the required expertise and human and financial resources to make an impact. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SHC HAS SIGNS POSTED AND BROCHURES AVAILABLE IN EACH PATIENT REGISTRATION AND CLINIC AREA REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE. ADDITIONALLY, THERE IS A SINGLE PAGE NOTICE IN EVERY PATIENT BILLING STATEMENT THAT DESCRIBES THE AVAILABILITY OF FINANCIAL ASSISTANCE AND OFFERING ASSISTANCE WITH DETERMINING IF THEY MAY QUALIFY FOR FINANCIAL ASSISTANCE OR ANY GOVERNMENT PROGRAMS. PART VI, LINE 4 COMMUNITY INFORMATION SHC IS A REGIONAL REFERRAL CENTER FOR AN ARRAY OF ADULT SPECIALTIES, DRAWING PATIENTS FROM THROUGHOUT CALIFORNIA, ACROSS THE COUNTRY, AND INTERNATIONALLY. HOWEVER, A MAJORITY OF SHC'S PATIENTS ARE RESIDENTS OF SAN MATEO AND SANTA CLARA COUNTIES. THEREFORE, FOR PURPOSES OF ITS COMMUNITY BENEFIT PROGRAM INITIATIVES, SHC HAS IDENTIFIED THESE TWO COUNTIES AS ITS TARGET COMMUNITY. WITHIN THESE TWO COUNTIES, SHC FOCUSES MOST OF ITS RESOURCES AND EFFORTS ON VULNERABLE, AT-RISK POPULATIONS IN LOW-INCOME AREAS; AREAS SUCH AS EAST PALO ALTO, THE NEIGHBORHOODS OF BELLE HAVEN AND NORTH FAIR OAKS IN SOUTH SAN MATEO COUNTY, AND DOWNTOWN AND EAST SAN JOSE. THERE ARE AREAS OF POVERTY, HIGH UNEMPLOYMENT, POOR ACCESS TO CARE AND HEALTH DISPARITIES AND, THEREFORE, PRESENT TREMENDOUS OPPORTUNITIES TO IMPROVING THE HEALTH AND WELL-BEING OF COMMUNITY MEMBERS. SHC PARTNERS WITH COMMUNITY-BASED CLINICS IN THESE AREAS AS WELL AS SENIOR CENTERS WHOSE PRIMARY POPULATION IS LOW-INCOME OLDER ADULTS WHERE THE HOSPITAL PROVIDES FREE PROGRAMMING ON FALL PREVENTION AND CHRONIC DISEASE MANAGEMENT. MOST OF SHC'S COMMUNITY PARTNERS WORK IN FEDERALLY DESIGNATED AREAS SUCH 'MEDICALLY UNDERSERVED' AND 'PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE' SUCH AS SAMARITAN HOUSE FREE CLINIC REDWOOD CITY AND RAVENSWOOD FAMILY HEALTH CENTER. SHC ALSO PARTNERS WITH COMMUNITY GROUPS THAT SERVE VARIOUS ETHNIC, MINORITY COMMUNITIES TO REDUCE CANCER-RELATED HEALTH DISPARITIES. EXAMPLES INCLUDE: - JOYLIFE CLUB - HEALTHY COOKING FOR CANCER PATIENTS AND FAMILIES: SEMINARS ON NUTRITION AND COOKING DEMONSTRATIONS FOR MEMBERS OF THE ASIAN-AMERICAN COMMUNITY - LATINAS CONTRA CANCER - HEALTHY EATING/HEALTHY LIVING EDUCATION AND SCREENING CAMPAIGN: CLASSES ON NUTRITION, COOKING DEMONSTRATIONS AND AN EARLY DETECTION SCREENING CAMPAIGN FOR MEMBERS OF THE HISPANIC COMMUNITY - ASIAN & PACIFIC ISLANDER HEALTH FORUM - TONGAN CANCER EDUCATION PROGRAM: AN EDUCATIONAL EVENT ON CANCER PREVENTION, DETECTION, TREATMENT AND SURVIVORSHIP FOR MEMBERS OF THE TONGAN COMMUNITY PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH A MAJORITY OF SHC'S TRUSTEES ARE MEMBERS OF THE COMMUNITY SERVED BY THE HOSPITAL AND ARE NOT EMPLOYED BY THE HOSPITAL, NOR ARE THEY FAMILY MEMBERS OF PERSONS EMPLOYED BY THE HOSPITAL. SHC EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY IT SERVES WHO WISH TO JOIN THE STAFF, CONSISTENT WITH THE SIZE AND NATURE OF ITS FACILITIES. EXCESS RECEIPTS FROM SHC'S OPERATIONS ARE DEVOTED TO IMPROVEMENT OF ITS FACILITIES, DEBT SERVICE, MEDICAL TRAINING, AND RESEARCH. SHC HAS USED OPERATIONAL REVENUE TO UPDATE AND EXPAND ITS FACILITIES AND SERVICES, IMPROVE SYSTEMS TO ENHANCE QUALITY, TO FUND RESEARCH, AND FOR OTHER PURPOSES TO IMPROVE PATIENT CARE. Investments in Vulnerable Populations SHC's largest community benefit investment was in improving access to needed health care services for vulnerable community members. In FY11, SHC contributed more than $112.7 million, or 67 percent of its community benefit expenditures, to activities supporting vulnerable populations (excluding uncompensated Medicare). SHC's uncompensated expense (cost less reimbursement) for Medi-Cal was $87,993,942. Charity care for uninsured and underinsured patients totaled $21,676,659. In addition to the investments in charity care and uncompensated Medi-Cal, SHC's contribution to other community benefit activities for vulnerable populations were nearly $3.1 million in FY11. These activities provide essential services for those most in need in our communities. SHC supports five community clinics and a transitional medical unit in a homeless shelter as part of its Improve Access to Care initiative: Cardinal Free Clinics, which includes Arbor Free and Pacific Free Clinics, Ravenswood Family Health Center; MayView Community Health Center; Samaritan House Redwood City Free Clinic; and Medical Respite Center at EHC Life Builder's Boccardo Regional Center in San Jose. The goal of this initiative is to build community capacity to deliver quality primary and preventive health care. Benefits for the Larger Community SHC supported a wide-range of activities that benefit the broader community. In FY11, SHC contributed more than $4.5 million to support these activities. These activities including the Stanford Health Library, 27 different programs to support community members fighting cancer, various support groups, traffic and bicycle safety programs, cancer clinic trials website and phone lines, Stanford Life Flight and medical transport service, and emergency planning for the community. Health Research, Education and Training SHC is the setting for training medical students, residents and fellows from the Stanford School of Medicine and, as such, makes a significant contribution to training the next generation of healthcare providers. In FY11, SHC contributed more than $50.8 million to support health research, education and training. Of this amount, nearly $43.6 million was spent to train medical residents and interns. In addition to training physicians, SHC supports the training of other health professionals. In FY11, SHC invested more than $7.2 million for such training. Hospital departments such as Rehabilitation Services, Nursing and Clinical Labs provided clinical rotations for physical therapy, respiratory therapy, occupational therapy, speech therapy, nursing and laboratory science students from local colleges and universities. In addition, physician assistant students are trained by SHC physician assistants. SHC also provides a training ground for pharmacy residents and students, radiology and nuclear medicine students and psychology students. Benefits for Vulnerable Populations $112,746,201 Medicare (uncompensated expense) $95,251,677 Benefits for the Larger Community $4,563,266 Health Research, Education and Training $50,803,772 Total Excluding Uncompensated Expense of Medicare $168,113,239 Total Including Uncompensated Expense of Medicare $263,364,916 PART VI, LINE 7 ALL STATES IN WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT: CALIFORNIA true Mayview Community Health 270 Grant Ave Palo Alto CA 94306 942239468 501(C)(3) 70000 HEALTH PROVIDER Avenidas 450 Bryant Palo Alto CA 94301 941480548 501(C)(3) 30000 SENIOR HEALTH CARE Samaritan House Free Clinic 4031 Pacific Blvd San Mateo CA 94403 237416272 501(C)(3) 25000 PATIENT SERVICES 100 Black Men of San Jose Inc 1101 Winchester San Jose CA 95128 770371690 501(C)(3) 7500 CANCER EDUCATION Latinas Contra Cancer 255 North Market St 175 San Jose CA 95110 562412069 501(C)(3) 10000 cancer education AsianPacific Island Health Forum 450 Sutter San Francisco CA 94108 943030866 501(C)(3) 7500 cancer education 6 PROCEDURES FOR MONITORING USE OF GRANT FUNDS SCHEDULE I, PART I, LINE 2 When a grant is approved, someone with signature authority from the organization receiving the grant signs the grant agreement, which includes a statement of when the funds were received and how much was received. They also agree to submit grant reports demonstrating progress on agreed upon goals and objectives. Soft and hard copies of grant agreement letters, grant reports, and other relevant information are kept by the Executive Director of Community Partnerships for Stanford Hospital & Clinics. X X true true X X X X X false true false false false false false true false CHRISTOPHER DAWES 675148 0 293251 0 187479 0 26950 0 21187 0 1204015 0 0 0 PHILIP PIZZO MD 0 591226 0 0 0 19091 0 238500 0 24238 0 873055 0 0 NORMAN RIZK MD 0 277279 0 239557 0 114775 0 24500 0 6044 0 662155 0 0 ANN WEINACKER MD 0 181100 0 116771 0 33080 0 21497 0 14354 0 366802 0 0 DANIEL GINSBURG 620762 0 236722 0 39873 0 100122 0 22291 0 1019770 0 0 0 DANIEL MORISSETTE 571210 0 254489 0 122319 0 94094 0 22470 0 1064582 0 0 0 MICHAEL J PETERSON 481167 0 69560 0 90149 0 22050 0 18398 0 681324 0 0 0 CAROLYN BYERLY 356212 0 126691 0 78478 0 22050 0 7784 0 591215 0 0 0 NANCY LEE 303130 0 86861 0 146642 0 22050 0 20344 0 579027 0 39328 0 JERROLD MAKI 257356 0 70985 0 103342 0 22050 0 8461 0 462194 0 0 0 MARK TORTORICH 259288 0 65878 0 101066 0 55759 0 11407 0 493398 0 0 0 MARTHA MARSH 615954 0 472761 0 387486 0 22050 0 10702 0 1508953 0 0 0 KEVIN TABB 433401 0 177652 0 103575 0 77626 0 24401 0 816655 0 0 0 SRIDHAR SESHADRI 327850 0 130183 0 160768 0 22050 0 22644 0 663495 0 40945 0 JENNIFER VARGAS 416350 0 139309 0 89737 0 73480 0 25418 0 744294 0 0 0 JEFFREY GUARDINO 473929 0 97256 0 3000 0 0 0 13263 0 587448 0 0 0 SCHEDULE J, PART I, LINE 1A TRAVEL POLICY STANFORD HOSPITAL AND CLINICS ("SHC") TRAVEL POLICY GENERALLY REQUIRES ALL EMPLOYEES TO USE THE MOST ECONOMICAL MODE OF TRANSPORTATION AVAILABLE CONSISTENT WITH THE AUTHORIZED BUSINESS PURPOSE OF THE TRAVEL IN ORDER TO BE FULLY REIMBURSED. SHC OFFICERS AND OTHER INDIVIDUALS ENUMERATED IN SCHEDULE J ARE FULLY SUBJECT TO THE SAME POLICIES AND PROCEDURES AS ANY OTHER EMPLOYEE OF SHC. ON RARE OCCASIONS IN CALENDAR YEAR 2010, FIRST CLASS TRAVEL WAS APPROVED BY THE CFO OR CONTROLLER. CERTAIN INDIVIDUALS LISTED IN PART VII FLEW FIRST CLASS IN CALENDAR YEAR 2010. ALL FIRST CLASS TRAVEL WAS FOR BUSINESS PURPOSES AND CONSIDERED NON-TAXABLE EXPENSE REIMBURSEMENT. HOUSING ALLOWANCE THE FOLLOWING INDIVIDUALS RECEIVED HOUSING AS A TAXABLE BENEFIT AND THE AMOUNT HAS BEEN INCLUDED IN SCHEDULE J, PART II, COLUMN B (III). JERROLD MAKI, JENNIFER VARGAS, MARK TORTORICH, KEVIN TABB, DANIEL GINSBURG. SCHEDULE J, PART I, LINE 4B STANFORD HOSPITAL AND CLINICS ("SHC") PROVIDES ALL SENIOR EXECUTIVES WITH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS. AT THE LAST DATE OF EACH QUARTER EACH PARTICIPANT'S ACCOUNT IS CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION). THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN THE ACCOUNT AS FOLLOWS: (A) THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE SECOND CALENDAR YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED AND THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION; (B) DISCHARGE FROM EMPLOYMENT WITHOUT CAUSE; (C) ENTITLEMENT TO LONG-TERM DISABILITY INCOME BENEFITS; (D) THE PARTICIPANT ATTAINS THE AGE OF 60 WHILE EMPLOYED OR IF LATER, THE PARTICIPANT'S COMPLETION OF TWO FULL YEARS OF PARTICIPATION; OR (E) THE PARTICIPANT COMPLETES SEVEN YEARS AS AN ELIGIBLE EMPLOYEE. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING INDIVIDUALS IN CALENDAR YEAR 2010: CHRISTOPHER DAWES $ 118,198 MARTHA MARSH $ 74,784 MICHAEL PETERSON $ 60,853 NANCY LEE $ 116,379 CAROLYN BYERLY $ 45,646 MARK TORTORICH $ 34,401 KEVIN TABB $ 48,898 SRIDHAR SESHADRI $ 123,958 DANIEL MORISSETTE $ 73,033 JERROLD MAKI $ 33,623 JENNIFER VARGAS $ 50,266 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). PHILLIP PIZZO PARTICIPATES IN A DEFERRED COMPENSATION PLAN AT STANFORD UNIVERSITY, A RELATED ORGANIZATION. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. THESE AMOUNTS APPEAR IN SCHEDULE J, PART II, COLUMN (C). PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. DR. GUARDINO IS AN EMPLOYEE OF MENLO HEALTH ALLIANCE ("MHA"), A DISREGARDED ENTITY WITH RESPECT TO SHC. MHA HAS ITS OWN BENEFIT PLANS AND DID NOT PROVIDE SERP TO DR. GUARDINO. SCHEDULE J, PART II, DESCRIPTION FOR COLUMN B(II) OFFICERS AND OTHERS WITH AMOUNTS IN THIS COLUMN RECEIVE BONUS AWARDS AND INCENTIVE COMPENSATION. SCHEDULE J, PART II, DESCRIPTION FOR COLUMN B(III) OTHER REPORTABLE COMPENSATION IN SCHEDULE J-1, COLUMN B-III INCLUDES HOUSING ASSISTANCE, SERP CASH DISTRIBUTION, GRANT MONIES, ACCRUED VACATION PAY OUT, GROUP TERM LIFE, AND TAXABLE MOVING ASSISTANCE. IN ADDITION, SHC HAS PROVIDED VARIOUS ITEMS OF "LISTED PROPERTY" (E.G. COMPUTERS AND PERIPHERALS) TO THE ABOVE LISTED EMPLOYEES PRINCIPALLY FOR THEIR BUSINESS USE. SCHEDULE J, PART I, LINE 7 OFFICERS AND OTHERS AS ENUMERATED IN SCHEDULE J, PART II PARTICIPATE IN A DEFERRED COMPENSATION PLAN. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. SCHEDULE J, PART II DIRECTORS ARE NOT COMPENSATED IN THEIR CAPACITY AS DIRECTORS OF SHC. HOWEVER, THE INDIVIDUALS LISTED WERE ALSO EMPLOYEES OF RELATED ORGANIZATIONS, POSITIONS FOR WHICH THEY RECEIVED COMPENSATION AS REPORTED IN PART II. CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033FMM9 2003-07-01 105707934 2003A - SEE ATTACH. K - I(F) false false false CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033f3u2 2008-06-02 428500000 2008AB - SEE ATTACH. K - I(F) false false false CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13033LJH1 2010-06-16 310291489 2010AB - SEE ATTACH. K. - I(F) false false false 21405000 0 107274311 0 7050758 0 1124444 0 0 99099109 2006 false false true true 1675000 0 428500000 0 0 0 0 0 0 0 428500000 true false true true 0 0 310291489 0 0 0 0 0 0 0 310291489 true false true true false true true true true 0.00200 0.00000 0.00200 true false true true true true 0.00000 0.00000 0.00000 true false true true true true 0.00000 0.00000 0.00000 true false false false true SEE ATTACH K-IV4B true false false false true true SEE ATTACH K-IV3B false false false false true false false false false false true SEE SCHEDULE O AMIR DAN RUBIN HOUSING LOAN X 1250000 1250000 false true true 1250000 MEDTRONIC SEE PART V 15840330 PAYMENT FOR PRODUCTS false BETH DAWES SEE PART V 64762 COMPENSATION FOR EMPLOYMENT false VARIAN MEDICAL SYSTEMS SEE PART V 2005440 PAYMENT FOR PRODUCTS false EXPRESSSCRIPTS SEE PART V 9119233 PAYMENT FOR PRODUCTS false RELATIONSHIP BETWEEN PERSONS AND ORGANIZATION FORM 990, SCHEDULE L, PART IV COLUMN (B) MEDTRONIC: A DIRECTOR OF SHC IS ALSO A DIRECTOR OF MEDTRONIC. THE DIRECTOR DID NOT PARTICIPATE IN ANY WAY IN DECISION MAKING ABOUT THE RELATIONSHIP BETWEEN SHC AND METRONIC. BETH DAWES: EMPLOYEE IS A FAMILY MEMBER OF A DIRECTOR. VARIAN MEDICAL SYSTEMS: A DIRECTOR OF SHC IS ALSO A DIRECTOR OF VARIAN MEDICAL SYSTEMS. THE DIRECTOR DID NOT PARTICIPATE IN ANY WAY IN DECISION MAKING OR DISCUSSION OF THE RELATIONSHIP BETWEEN SHC AND VARIAN MEDICAL SYSTEMS. EXPRESSSCRIPTS: A DIRECTOR OF SHC IS ALSO A DIRECTOR OF EXPRESSSCRIPTS. THE DIRECTOR DID NOT PARTICIPATE IN ANY WAY IN DECISION MAKING ABOUT THE RELATIONSHIP BETWEEN SHC AND EXPRESSSCRIPTS. X 20 9363563 MEAN VALUE ON DOT X 2 5000 APPRAISAL 3 false true true SCHEDULE M, PART I, COLUMN B STANFORD HOSPITAL AND CLINICS IS REPORTING THE NUMBER OF CONTRIBUTIONS. SCHEDULE M, PART I, QUESTION 32B STANFORD HOSPITAL AND CLINICS UTILIZES THE SERVICES OF STANFORD UNIVERSITY TO ASSIST WITH THE SOLICITATION AND PROCESSING OF NON-CASH GIFTS. STANFORD HOSPITAL AND CLINICS IS AMENDING ITS FORM 990 TO REFLECT UPDATED INFORMATION IN PART VII AND SCHEDULE J. MISSION FORM 990, PART I, LINE 1 & PART III, LINE 1 STANFORD HOSPITAL AND CLINICS ("SHC") IS A NON-PROFIT CALIFORNIA PUBLIC BENEFIT CORPORATION OF WHICH THE BOARD OF TRUSTEES OF LELAND STANFORD JUNIOR UNIVERSITY (THE "UNIVERSITY") IS THE SOLE MEMBER. THE OBJECTIVE AND THE PURPOSE OF SHC IS TO PROVIDE PATIENT CARE SERVICES, SUPPORT, BENEFIT AND FURTHER THE CHARITABLE, AND SCIENTIFIC AND EDUCATIONAL PURPOSES OF THE UNIVERSITY AND THE UNIVERSITY'S SCHOOL OF MEDICINE. SHC OPERATES A LICENSED ACUTE CARE HOSPITAL, A CANCER CENTER IN PALO ALTO, AN AMBULATORY OUTPATIENT CENTER IN REDWOOD CITY AND NUMEROUS OUTPATIENT PHYSICIAN CLINICS IN THE SAN FRANCISCO BAY AREA, IN COMMUNITY SETTINGS AND IN ASSOCIATION WITH REGIONAL HOSPITALS. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A STANFORD HOSPITAL AND CLINICS ("SHC") IS KNOWN WORLDWIDE FOR ADVANCED PATIENT CARE PROVIDED BY ITS PHYSICIANS AND STAFF, PARTICULARLY IN AREAS SUCH AS CARDIAC CARE, CANCER TREATMENT, NEUROLOGY, NEUROSURGERY, ORTHOPEDICS, SURGERY AND ORGAN TRANSPLANTS. SHC HAD 24,970 PATIENT DISCHARGES. SHC HAD 137,733 PATIENT DAYS INCLUDING ACUTE, BEHAVIORIAL HEALTH, AND SHORT STAY OUTPATIENT. TOTAL OUTPATIENT AND EMERGENCY ROOM VISITS WERE 450,150 FOR THE FISCAL YEAR ENDED AUGUST 31, 2011. Summary of SHC Community Benefit Activities: Investments in Vulnerable Populations SHC's largest community benefit investment was in improving access to needed health care services for vulnerable community members. In FY11, SHC contributed more than $112.7 million, or 67 percent of its community benefit expenditures, to activities supporting vulnerable populations (excluding uncompensated Medicare). SHC's uncompensated expense (cost less reimbursement) for Medi-Cal was $87,993,942. Charity care for uninsured and underinsured patients totaled $21,676,659. In addition to the investments in charity care and uncompensated Medi-Cal, SHC's contribution to other community benefit activities for vulnerable populations were nearly $3.1 million in FY11. These activities provide essential services for those most in need in our communities. SHC supports five community clinics and a transitional medical unit in a homeless shelter as part of its Improve Access to Care initiative: Cardinal Free Clinics, which includes Arbor Free and Pacific Free Clinics, Ravenswood Family Health Center; MayView Community Health Center; Samaritan House Redwood City Free Clinic; and Medical Respite Center at EHC Life Builder's Boccardo Regional Center in San Jose. The goal of this initiative is to build community capacity to deliver quality primary and preventive health care. Benefits for the Larger Community SHC supported a wide-range of activities that benefit the broader community. In FY11, SHC contributed more than $4.5 million to support these activities. These activities including the Stanford Health Library, 27 different programs to support community members fighting cancer, various support groups, traffic and bicycle safety programs, cancer clinic trials website and phone lines, Stanford Life Flight and medical transport service, and emergency planning for the community. Health Research, Education and Training SHC is the setting for training medical students, residents and fellows from the Stanford School of Medicine and, as such, makes a significant contribution to training the next generation of healthcare providers. In FY11, SHC contributed more than $50.8 million to support health research, education and training. Of this amount, nearly $43.6 million was spent to train medical residents and interns. In addition to training physicians, SHC supports the training of other health professionals. In FY11, SHC invested more than $7.2 million for such training. Hospital departments such as Rehabilitation Services, Nursing and Clinical Labs provided clinical rotations for physical therapy, respiratory therapy, occupational therapy, speech therapy, nursing and laboratory science students from local colleges and universities. In addition, physician assistant students are trained by SHC physician assistants. SHC also provides a training ground for pharmacy residents and students, radiology and nuclear medicine students and psychology students. Benefits for Vulnerable Populations $112,746,201 Medicare (uncompensated expense) $95,251,677 Benefits for the Larger Community $4,563,266 Health Research, Education and Training $50,803,772 Total Excluding Uncompensated Expense of Medicare $168,113,239 Total Including Uncompensated Expense of Medicare $263,364,916 FAMILY/BUSINESS RELATIONSHIPS FORM 990, PART VI, LINE 2 CHRISTOPHER DAWES IS AN EMPLOYEE, CHIEF EXECUTIVE OFFICER AND A DIRECTOR OF LUCILE SALTER PACKARD CHILDREN'S HOSPITAL. THE FOLLOWING INDIVIDUALS ARE DIRECTORS AT LUCILE SALTER PACKARD CHILDREN'S HOSPITAL: JOHN LILLIE DENISE O'LEARY MARIANN BYERWALTER PHILIP PIZZO THE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF STANFORD UNIVERSITY: PHILIP PIZZO, DEAN OF THE STANFORD SCHOOL OF MEDICINE NORMAN RIZK JOHN MORGRIDGE ANN WEINACKER MD THE FOLLOWING INDIVIDUALS ARE TRUSTEES AT STANFORD UNIVERSITY: MARIANN BYERWALTER RON JOHNSON WOODROW MYERS HAS A BUSINESS RELATIONSHIP WITH PETER STAMOS. JOHN MORGRIDGE IS THE CHAIRMAN EMERITUS OF CISCO AND FOR PART OF FY 11 SUSAN BOSTROM WAS A KEY EMPLOYEE OF CISCO. MEMBERS FORM 990, PART VI, LINE 6 STANFORD UNIVERSITY IS THE SOLE MEMBER OF STANFORD HOSPITAL AND CLINICS ("SHC"). ELECTION BY MEMBERS FORM 990, PART VI, LINE 7A STANFORD UNIVERSITY, AS THE SOLE MEMBER OF SHC, APPOINTS THE SHC BOARD OF DIRECTORS. REVIEW OF FORM 990 FORM 990, PART VI, LINE 11B THE 990 TAX RETURN IS PREPARED BY THE FINANCE DEPARTMENT OF SHC. THE FINANCIAL DATA IS EXTRACTED FROM THE AUDITED FINANCIAL STATEMENT AND SUPPLEMENTAL INFORMATION AUDITED BY THE INDEPENDENT ACCOUNTING FIRM OF PRICEWATERHOUSECOOPERS (PWC). COMPENSATION DATA IS EXTRACTED FROM PAYROLL RECORDS. OTHER INFORMATION IS PROVIDED BY THE RELEVANT AREAS WITH EXPERTISE IN SHC. UPON COMPLETION, THE RETURN IS REVIEWED BY THE SENIOR MANAGEMENT OF SHC, THE COUNSEL OF SHC, STANFORD UNIVERSITY TAX COMPLIANCE AND EXTERNAL TAX ACCOUNTANT (PWC). THE DRAFT FORM 990 IS REVIEWED AT THE AUDIT AND COMPLIANCE COMMITTEE MEETING. THE FORM 990 IS THEN FORWARDED TO ALL BOARD MEMBERS FOR THEIR REVIEW. THE CFO OF SHC AND PWC AS PAID PREPARER SIGN THE RETURN PRIOR TO FILING WITH IRS. WHEN STANFORD HOSPITAL AND CLINICS RECEIVES CONTRIBUTIONS FROM DONORS WHO WISH TO REMAIN ANONYMOUS BUT OTHERWISE MEET THE SCHEDULE B THRESHOLD REPORTING REQUIREMENTS, THE BOARD REVIEWS THE FORM 990 WITHOUT DISCLOSURE OF THESE DONORS' NAME IN ORDER TO PROTECT THE DONORS' ANONYMITY. CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C OFFICERS, DIRECTORS AND EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") WITHIN 30 DAYS OF BEGINNING SERVICE AT SHC. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS. FURTHERMORE, OFFICERS, DIRECTORS AND EMPLOYEES ARE REQUIRED TO UPDATE THEIR DISCLOSURE STATEMENT WITHIN TEN (10) BUSINESS DAYS OF A MATERIAL CHANGE IN THEIR SITUATIONS THAT MAY CREATE AN ACTUAL OR PERCEIVED CONFLICT-OF-INTEREST. A DISCLOSURE THAT APPEARS TO BE A CONFLICT WILL BE RESOLVED BY A MUTUAL AGREEABLE PLAN WITH THE VICE PRESIDENT OF HUMAN RESOURCES THAT OUTLINES THE STEPS THE OFFICER, DIRECTOR OR EMPLOYEE MUST TAKE TO RECTIFY THE CONFLICT. IN MATTERS THAT ARE UNCLEAR OR QUESTIONABLE, THE OFFICE OF CHIEF COMPLIANCE OFFICER WILL BE CONSULTED FOR A RULING. IF FURTHER INQUIRY IS NECESSARY THE OFFICE OF THE GENERAL COUNSEL WILL BE CONSULTED FOR A RULING. WHISTLEBLOWER POLICY FORM 990, PART VI, LINE 13 SHC FOLLOWS A WRITTEN FALSE CLAIMS RECOVERY POLICY, WHICH COVERS MANDATORY WHISTLEBLOWER OBLIGATIONS. THIS POLICY WAS NOT APPROVED BY THE BOARD BY THE END OF FY 2011. AN AUTHORIZED COMMITTEE OF SHC'S BOARD ADOPTED THE WHISTLEBLOWER POLICY BEFORE THE END OF FY 2012. DOCUMENT RETENTION AND DESTRUCTION POLICY FORM 990, PART VI, LINE 14 SHC CURRENTLY HAS A DOCUMENT RETENTION AND DESTRUCTION POLICY FOR ITS MEDICAL RECORDS THAT HAS BEEN APPROVED BY ITS GOVERNING BODY. ALL OTHER DOCUMENT RETENTION AND DESTRUCTION POLICIES WERE APPROVED BY MANAGEMENT BY THE END OF FY 2011. AN AUTHORIZED COMMITTEE OF SHC'S BOARD ADOPTED THE DOCUMENT RETENTION AND DESTRUCTION POLICY BEFORE THE END OF FY 2012. PROCEDURES FOR DETERMINING COMPENSATION FORM 990, PART VI, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR SHC'S CEO AND OTHER TOP MANAGEMENT REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTS ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF SHC. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES. AVAILABILITY OF GOVERNING DOCUMENTS FORM 990, PART VI, LINE 19 COPIES OF THE FINANCIAL STATEMENTS ARE AVAILABLE ON SHC'S WEBSITE. FURTHERMORE, THE STATEMENTS OF OPERATIONS AND BALANCE SHEET ARE PART OF THE UNIVERSITY'S ANNUAL REPORT POSTED ON THE ORGANIZATION'S PUBLIC WEBSITE. COPIES OF THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. HOURS AT RELATED ORGANIZATIONS FORM 990, PART VII CHRISTOPHER DAWES: 50 HOURS AT LUCILE SALTER PACKARD CHILDREN'S HOSPITAL PHILIP PIZZO: 50 HOURS AT STANFORD UNIVERSITY NORMAN RIZK: 50 HOURS AT STANFORD UNIVERSITY JOHN MORGRIDGE: 10 HOURS AT STANFORD UNIVERSITY ANN WEINACKER MD: 50 HOURS AT STANFORD UNIVERSITY UNDER A PURCHASED SERVICES ARRANGEMENT WITH LPCH, SHC LEASES CERTAIN EMPLOYEES TO LPCH. SHC PAYS THE LEASED EMPLOYEES DIRECTLY AND FILES THE REQUIRED FEDERAL AND STATE INFORMATIONAL RETURNS. CHRISTOPHER DAWES IS A DIRECTOR OF SHC. FOR FY11 HE WAS ALSO THE PRESIDENT AND CEO OF THE LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD, A RELATED ORGANIZATION. MR. DAWES RECEIVES COMPENSATION FROM SHC FOR HIS SERVICES AT LPCH UNDER THE PURCHASE SERVICE ARRANGEMENT DESCRIBED ABOVE. MR DAWES RECEIVED NO COMPENSATION FOR HIS DUTIES AS A DIRECTOR OF SHC. FORM 990, PART X, COLUMN (B) END OF YEAR BALANCES REFLECT THE FOLLOWING RECLASSIFICATIONS: - INVESTMENT IN UNIVERSITY MANAGED POOL AND OTHER INVESTMENTS FROM LINE 13 (INVESTMENTS - PROGRAM RELATED) TO LINE 12 (INVESTMENTS - OTHER SECURITIES); AND - ASSETS HELD BY TRUSTEE FROM LINE 13 (INVESTMENTS - PROGRAM RELATED) TO LINE 15 (OTHER ASSETS). RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 ADDITIONAL MINIMUM PENSION LIABILITY $12,902,000 INTEREST RATE SWAP MTM $671,827 EQUITY TRANSFER $355,234 CHANGE IN NET UNREALALIZED GAINS ($125,704) PET/CT INCOME: BOOK/TAX DIFFERENCE ($317) TRANSFER TO UNITED HEALTHCARE ALLIANCE ($13,224,337) ROUNDING ADJUSTMENT TO BALANCE TO FINANCIAL STATEMENTS $4 OTHER CHANGES IN NET ASSETS $578,707 TAX EXEMPT BONDS FORM 990, SCHEDULE K, PART I, ATTACH.K-I(F) BOND ISSUES: A CUSIP#: 13033FMM9 SERIES: 2003 SERIES A DESCRIPTION OF PURPOSE: ACQUISITION OF LAND AND BUILDINGS, HOSPITAL FACILITY RENOVATIONS, INFORMATION TECHNOLOGY SOFTWARE AND HARDWARE, MEDICAL AND OTHER EQUIPMENT. BOND ISSUES: B CUSIP#: 13033F3U2 SERIES: 2008 SERIES A&B DESCRIPTION OF PURPOSE:CURRENT REFUNDING OF 2006 SERIES A & B; DATE OF ISSUE MARCH 9, 2006. BOND ISSUES: C CUSIP#: 13033LJH1 SERIES: 2010 SERIES A DESCRIPTION OF PURPOSE: CURRENT REFUNDING OF 1998 SERIES B; DATE OF ISSUE MARCH 31, 1998. BOND ISSUES: C CUSIP#: 13033LJH1 SERIES: 2010 SERIES B DESCRIPTION OF PURPOSE: CURRENT REFUNDING OF 2003 SERIES B, C, AND D; DATE OF ISSUE JULY 1, 2003. FORM 990, SCHEDULE K, PART II, LINE 3A Total proceeds of issue does not match issue price due to $1,566,377 of interest earnings from the project fund. TAX-EXEMPT BONDS F0RM 990, SCHEDULE K, PART IV, ATTACH. K-IV3(B)&(C) ISSUE: B SERIES: 2008 SERIES B1 NAME OF PROVIDER: DEUTSCHE BANK AG* TERM OF HEDGE: 10 ISSUE: B SERIES: 2008 SERIES B2 NAME OF PROVIDER: DEUTSCHE BANK AG* TERM OF HEDGE: 10 * Novated from original counterparty, J.P. Morgan Chase Bank N.A. effective January 1, 2011. TAX-EXEMPT BONDS F0RM 990, SCHEDULE K, ATTACH K-IV4(B),(C), AND (D) ISSUE: A SERIES: 2003A/RESERVE FUND NAME OF PROVIDER: LEHMAN BROTHERS SPECIAL FINANCING, INC. TERM OF GIC: 5.2 ISSUE: A SERIES: 2003A/PROJECT FUND NAME OF PROVIDER: TRINITY FUNDING COMPANY, LLC TERM OF GIC: 2.9 NOTE: IN REFERENCE TO PART IV4(D), THE GIC FOR THE PROJECT FUND SATISFIED THE REGULATORY SAFE HARBOR FOR ESTABLISHING FAIR MARKET VALUE, WHILE THE FAIR MARKET VALUE OF THE GIC FOR THE RESERVE FUND WAS DEMONSTRATED TO THE SATISFACTION OF THE IRS ON PRIOR AUDIT. 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