2012-05-15T15:50:51-04:00 2011-06-30 KPMG LLP 355 S Grand Ave Suite 2000 Los Angeles CA 90071 990 2010-07-01 956097416 CHOC Foundation CHOC 7149973000 455 S Main Street Orange CA 928683874 KERRI RUPPERT SCHILLER 2012-05-11 2139724000 2010 2016-02-24 21:20:13Z CHOC Children's Foundation kimberly c cripe 455 s main street orange CA 928683874 53159480 false X www.choc.org X 1964 CA SUPPORTING CLINICAL AND NONCLINICAL SERVICES, MEDICAL EDUCATION, RESEARCH AND ALLIED FIELDS OF PEDIATRICS AT CHILDREN'S HOSPITAL OF ORANGE COUNTY,CHILDREN'S HOSPITAL AT MISSION AND ITS AFFILIATES. 21 20 25 0 0 0 18351396 48406024 0 0 158334 607634 0 18509730 49013658 7944697 41981317 0 0 2338375 2810348 0 0 1063841 3455802 2682729 13738874 47474394 4770856 1539264 33261526 36350124 402336 711659 32859190 35638465 CHOC FOUNDATION WAS FORMED TO HELP SUPPORT CLINICAL AND NONCLINICAL SERVICES, MEDICAL EDUCATION, RESEARCH AND ALLIED FIELDS OF PEDIATRICS AT CHILDREN'S HOSPITAL OF ORANGE COUNTY, CHILDREN'S HOSPITAL AT MISSION AND TO SUPPORT ITS AFFILIATES. false false 41806136 41806136 0 Children's Hospital of Orange County - Provides specialized pediatric services for the care of children. During this year, there were 59,515 days of inpatient care; 54,553 Emergency room visits; 8,209 surgeries; 1,263 day health visits and 146,425 primary and specialty care clinic visits. Funds raised help to offset cost of services provided to indigent families. 175181 175181 0 Children's Hospital at Mission - Funds support affiliated acute care pediatric hospital. Facility provides pediatric, neonatal, and care for emergency services. There were 9,203 inpatient care days; 17,337 Emergency room visits; 991 surgeries and 8,524 outpatient visits. 4069233 0 0 support of pediatric medical services, community education and safety. 46050550 true true false false false false false false true true false false false true true true true false false false false false false true false false true false true false false false false false false true false true false false false false true false false false false true X 61 0 true 25 true false false false false false true true false false false true false X 21 20 false false false false true true true true true false false true true true true true true true false false CA X DONALD NOBLE 7149973000 455 S MAIN STREET ORANGE CA 928683874 X KIMBERLY C CRIPE 4.0 X X 0 1049159 73291 JANET DAVIDSON 1.0 X 0 0 0 CHRIS FURMAN 2.0 X X 0 0 0 CHRIS GRIFFITH 1.0 X 0 0 0 EMILE HADDAD 1.0 X 0 0 0 MARILYN HESTER-ROBBINS 1.0 X 0 0 0 JAY KEAR 1.0 X 0 0 0 HEATHER MADDEN 1.0 X X 0 0 0 MARK MOSES 1.0 X 0 0 0 SAM AURIEMMA 1.0 X X 0 0 0 TERRY ADAMS 1.0 X 0 0 0 JERRY FLANNERY 1.0 X 0 0 0 MICHAEL MUHONEN MD 1.0 X 0 0 0 robert WAGNER 1.0 X 0 0 0 robert ALLISON 1.0 X 0 0 0 CHRISTINE BREN 1.0 X 0 0 0 DELPHINE LEE 1.0 X X 0 0 0 ADRIENNE MATROS 1.0 X 0 0 0 BARRY RYAN 1.0 X 0 0 0 KEN VENNER 1.0 X 0 0 0 Allen Fazio 1.0 X 0 0 0 KERRI RUPPERT SCHILLER 4.0 X 0 563558 99342 TANYA LIEBER 40.0 X 252589 0 20070 LOIS F AUGUSTINE 40.0 X 106768 0 20048 DOLORES M KORF 40.0 X 109776 0 7582 BETH BRADLEY 40.0 X 141951 0 5894 Heather Inch-Desuta 40.0 X 190257 0 13410 PATRICE POIDMORE 40.0 X 132551 0 6764 933892 1612717 246401 8 false true false INTERSECTION STUDIO 4120 MIchael Ave LOS ANGELES CA 90066 MARKETING 172800 1 4246145 44159879 219523 48406024 0 423050 423050 0 0 3398071 3213487 184584 184584 184584 932335 4246145 932335 0 0 0 0 49013658 607634 41981317 41981317 0 0 0 212531 70843 70844 70844 0 2132458 1705966 106623 319869 32627 26102 1631 4894 278777 223021 13939 41817 153955 123164 7698 23093 1189697 951758 59485 178454 754 603 38 113 0 0 0 33432 33432 494471 395576 24724 74171 245677 245677 28568 22855 1428 4285 71060 56848 3553 10659 0 344375 275500 17219 51656 33100 26480 1655 4965 0 6619 6619 0 0 26822 21458 1341 4023 3262 2610 163 489 DUES 172935 138348 8647 25940 TAXES & LICENSES 19279 15423 964 2892 UNCOLLECTIBLE PLEDGES 12678 12678 47474394 46050550 360003 1063841 2783406 1279013 17226105 6361886 5470130 7114174 64497 166909 399099 257244 161206 141855 5311644 19529438 2244538 1756849 33261526 36350124 130561 372159 271775 339500 402336 711659 X 13060703 12516370 9909368 12297740 9889119 10824355 32859190 35638465 33261526 36350124 X 1539264 1240011 X false true true X false X 11954508 15602800 13561991 18351396 48506024 107976719 11954508 15602800 13561991 18351396 48506024 107976719 28928884 79047835 1077030 556256 479980 155902 423050 2692218 1087406 1204491 748754 611425 932335 4584411 115253348 0.68586 0.89210 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 17504600 1121168 1645508 0 384500 0 19886776 15437152 2824539 127384 0 3247 881228 17504600 14147708 1358552 27794 0 91902 5000 15437152 0.42280 0.54430 0.03290 false false 150403 50317 100085 248696 206926 41770 141855 0 PAYABLE TO AFFILIATES 339500 339500 49013658 47474394 1539264 1037950 202061 1240011 2779275 50353669 1037950 100000 202061 1340011 49013658 49013658 47574394 100000 100000 47474394 47474394 ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER ASC 740 ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE ORGNAIZATION'S MANAGEMENT TO EVALUATE TAX POSITION TAKEN BY THE ORGANIZATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE ORGANIZATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD 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, 2011, THERE ARE NO UNCERTIAN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. other changes in net assets part XI, line 8 & Part XII, line 2d change in value of split-interest agreements - $ 202,061. Schedule D, Part V, Line 4 The endowment fund is used for hospital programs and charity care including research and treatment of children's diseases and disorders. none false CHOC WALK 2110690 1859642 251048 21533 72000 7698 149817 GUILD EVENTS 1174543 1092695 81848 81848 4 1893247 1293808 599439 7565 128812 32607 12625 417830 5178480 4246145 932335 29098 200812 40305 12625 649495 932335 true CHILDREN'S HOSPITAL OF ORANGE COUNTY 455 SOUTH MAIN STREET ORANGE CA 928683874 952321786 501(c)(3) 41806136 0 n/a n/a HOSPITAL OPERATIONS AND CHARITABLE CARE CHILDREN'S HOSPITAL AT MISSION 455 SOUTH MAIN STREET ORANGE CA 928683874 330528802 501(c)(3) 175181 0 n/a n/a HOSPITAL OPERATIONS AND CHARITABLE CARE 2 0 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS - PART I, LINE 1 CHOC Foundation receives contributions on behalf of CHOC and Children's Hospital at Mission, both affiliated 501(c)(3) organizations. Donations are generally restricted or designated by donors for various purposes at inception. The funds are then distributed to the appropriate organization according to donor stipulations for medical programs or for the new tower construction as designated. X X X X false true false false false false false false false KIMBERLY C CRIPE 0 710811 0 169688 0 168660 0 54579 0 18712 0 1122450 0 0 KERRI RUPPERT SCHILLER 0 419474 0 80404 0 63680 0 80630 0 18712 0 662900 0 0 TANYA LIEBER 216079 0 0 0 36510 0 5575 0 14495 0 272659 0 0 0 Heather Inch-Desuta 173506 0 5000 0 11751 0 4184 0 9226 0 203667 0 0 0 Schedule J, Line 4a Some of the organization's personnel listed on form 990 Part VII and Schedule J participate in a separation arrangement that provides for a portion of the employee's annual salary based on their position in the organization. For the senior executive level, the amount is based on years of service up to a maximum number of months. Unpaid severance under the separation agreements for current key employees were reported at their full value in a previous tax year. Compensation from an Affiliated Organization KIMBERLY 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 501(C)(3) AFFILIATES). MS. CRIPE DEVOTES APPROXIMATELY 10% OF HER TIME EACH WEEK TO CHOC FOUNDATION 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 501(C)(3) AFFILIATES). MS. SCHILLER DEVOTES APPROXIMATELY 10% OF HER TIME EACH WEEK TO CHOC FOUNDATION RESPONSIBILITIES WITH THE BALANCE OF HER TIME BEING SPENT ON THE OTHER RELATED ORGANIZATIONS' BUSINESS affairs. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN - PART I, LINE 4b Children's Hospital of Orange County (CHOC or the Company) established a nonqualified deferred compensation plan effective January 1, 2010 in which certain individuals listed on the form 990, Part VII and Schedule J are participants. Under the established Supplemental Executive Retirement Plan (the Plan) 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 2010: Ms. Cripe ($100,765). 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 individuals listed on Schedule J received payments from the dissolution of the plan in calendar 2010, which are included as a component of the amount reported on Schedule J, Part II, column B: Ms. Schiller ($11,923). chad lieber family member of key emp. 101278 payment of compensation false X 1 14279 REsale VALUE X 15 205244 average market value 0 false true true SCHEDULE M, PART I, LINE 32A The Foundation utilizes the services of an independent third party stockbroker to sell securities received as donations. SCHEDULE M, PART I, COLUMN B THE NUMBER LISTED IN PART I, LINE 9 COLUMN (B) WAS DETERMINED BASED ON THE NUMBER OF CONTRIBUTIONS RECEIVED. Information Regarding Common Paymaster 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 CHOC Foundation. CHOC Foundation has 25 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 CHOC Foundation. members or stockholders Form 990, Part VI, Section A, Line 6 The sole member of CHOC Foundation is Children's HealthCare of California (CHC). persons who may elect members of the governing body Form 990, Part VI, Section A, Line 7a Directors of CHOC Foundation shall be elected annually by the Member, based on the nomination(s) provided by CHOC Foundation'S Board of Directors. the governing body's decisions subject to approval Form 990, Part VI, Section A, Line 7b The approval of the Member shall be required with respect to any of the following actions: (1) Changing the purposes and powers of CHOC Foundation; (2) Obligating CHOC Foundation to undertake any capital expenditure in excess of $1,000,000; (3) Adopting CHOC Foundation'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 $1,000,000; (7) Obligating CHOC Foundation to act as guarantor with respect to any debt of any person or other entity; (8) Accepting any donation which is conditioned upon CHOC Foundation's undertaking any unbudgeted capital expenditure in excess of $1,000,000 or any unbudgeted expenditure in excess of $1,000,000; (9) Entering into any contract which involves any of the following: (a) any financial obligation on the part of CHOC Foundation in an amount in excess of $1,000,000, (b) any purpose or activity which is outside the scope of CHOC Foundation's ordinary course of business, or (c) a term in excess of five years (unless the contract is terminable at will); (10) involving CHOC Foundation in any merger, acquisition, corporate restructuring, or formal affiliation; (11) Involving CHOC Foundation as a member, shareholder, or partner in any new corporation, partnership, or other legal entity; (12) Dissolving CHOC Foundation; (13) Entering into any transaction involving the sale, lease, conveyance, exchange, transfer or other disposition of all or substantially all of CHOC Foundation's assets; (14) Amending CHOC Foundation'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. PROCESS OF REVIEW Form 990, Part VI, Section B, Line 11A Prior to filing, the tax return and related schedules are provided to the 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. MONITORNING AND ENFORCING COMPLIANCE OF CONFLICT INTEREST POLICY FORM 990, PART VI, SECTION B, LINE 12C 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). 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 contacted via written communication. The procedures for addressing any conflict of interest may include but are not limited to the following: (1)the conflicting interest is fully disclosed to the Board of Directors; (2)the interested person responds to factual questions related to the conflict, the substance of the transaction or the arrangement being considered; (3)the person with the conflict of interest is excluded from any discussion or approval of such transaction; (4)if applicable alternatives to the proposed transaction are investigated, competitive bids or comparable valuations are obtained; and (5)the transaction or action must be approved by a majority of disinterested persons. PROCESS OF DETERMINING COMPENSATION OF THE CEO AND OFFICERS FORM 990, PART VI, SECTION B, LINE 15 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 and Kerri Ruppert Schiller 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. disclosure copy - FORM 990, PART VI, SECTION C, LINE 19 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 $ 1,037,950 Change in value of Split-Interest Agreement $ 202,061 ------------ Total change in Net Assets $ 1,240,011 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KIMBERLY C. CRIPE TITLE:DIRECTOR / PRESIDENT HOURS:36 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JANET DAVIDSON TITLE:DIRECTOR HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAY KEAR TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:SAM AURIEMMA TITLE:DIRECTOR / VICE CHAIR HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:Allen Fazio TITLE:Director HOURS:1 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KERRI RUPPERT SCHILLER TITLE:CFO / ASSISTANT SECRETARY HOURS:36 CHILDREN'S HEALTHCARE OF CALIFORNIA(CHC) 455 S MAIN STREET ORANGE CA 928683874 330265266 HEALTH CARE CA 501(C)(3) 7 NA CHILDREN'S HOSPITAL OF ORANGE COUNTY 455 S MAIN STREET ORANGE CA 928683874 952321786 HEALTH CARE CA 501(C)(3) 3 CHC CHILDREN'S HOSPITAL AT MISSION 455 S MAIN STREET ORANGE CA 926863874 330528802 HEALTH CARE CA 501(C)(3) 3 CHC CRC REAL ESTATE CORPORATION 455 S MAIN STREET ORANGE CA 928683874 330612565 real estate CA 501(C)(3) 11a CHC CHOCO REALTY CORPORATION 455 S MAIN STREET ORANGE CA 928683874 330011853 real estate CA 501(C)(3) 11A CHC choc Thrift Stores Inc 455 S MAIN STREET orange CA 928683874 330266422 fund raising CA 501(C)(3) 9 CHC false true true false false false false false false true true false false false false false false false