2012-05-15T14:05:57-04:00 2011-06-30 KPMG LLP 355 S Grand Ave Suite 2000 Los Angeles CA 90071 990 2010-07-01 330265266 CHILDREN'S HEALTHCARE OF CALIFORNIA CHIL 7149973000 455 S Main Street Orange CA 928683874 KERRI RUPPERT SCHILLER 2012-05-11 2139724000 2010 2016-02-24 21:20:13Z KIMBERLY C CRIPE 455 S MAIN STREET ORANGE CA 928683874 55233914 false X www.choc.org X 1986 CA THE RECEIPT OF DISTRIBUTIONS AND GRANTS For THE MAKING OF DISTRIBUTIONS AND GRANTS TO CHILDREN'S HOSPITAL OF ORANGE COUNTY AND TO AFFILIATED EXEMPT ORGS. FOR FURTHERANCE OF THEIR OBJECTIVES. 10 9 3 0 0 0 500000 4800000 1845000 1815000 4039131 5511165 29039 0 6413170 12126165 4000000 0 0 0 1877966 1699846 0 0 401141 2267518 2311577 8145484 4011423 -1732314 8114742 91808066 104506012 1193811 622182 90614255 103883830 X THE PRIMARY EXEMPT PURPOSE OF CHILDREN'S HEALTHCARE OF CALIFORNIA INCLUDES WITHOUT LIMITATION THE RECEIPT OF DISTRIBUTIONS AND GRANTS FOR THE MAKING OF DISTRIBUTIONS AND GRANTS TO CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) AND TO AFFILIATED EXEMPT ORGANIZATIONS IN THE FURTHERANCE OF THEIR CHARITABLE OBJECTIVES AND PURPOSES. THESE AFFILIATED ORGANIZATIONS INCLUDE: CHILDREN'S HOSPITAL OF ORANGE COUNTY CHILDREN'S HOSPITAL AT MISSION CHOC FOUNDATION CHOCO REALTY CORPORATION CRC REAL ESTATE CORPORATION false false 3409709 0 1815000 Children's Healthcare of California (CHC) supports the Mission of Children's Hospital of Orange County (CHOC) and Children's Hospital at Mission (CHM). CHOC and CHM provide pediatric services to children in Orange County and its surrounding area. The activities of CHC help to offset services to indigent families and provide current state of the art medical equipment and facilities. During the year, there were 68,718 days of inpatient care; 71,890 emergency room visits; 9,200 surgeries; 1,263 day health visits and 154,949 clinic visits provided by CHOC and CHM. 3409709 true true false false false false false false false false false false false true true false true false false false false false false false false false false false true false false false false false false false false false false false false false true true true false false true X 6 0 true 3 true false false false false false false false false false false X 10 9 false false true false false true false true true false false true true true true true true true true false CA X DONALD NOBLE 7149973000 455 S MAIN STREET ORANGE CA 928683874 X KIMBERLY C CRIPE 2.0 X X 1049159 0 73291 JEFF ELGHANAYAN 1.0 X 0 0 0 WILLAIM GURTNER 1.0 X 0 0 0 MARSHALL ROWEN MD 1.0 X X 0 0 0 PATRICK SALAS 1.0 X 0 0 0 MARK STEVENS 1.0 X X 0 0 0 MAUREEN ZEHNTNER 0.5 X 0 0 0 JANET T DAVIDSON 1.0 X 0 0 0 JAY KEAR 0.0 X 0 0 0 RALPH CLAYMAN MD 0.5 X 0 0 0 KERRI RUPPERT SCHILLER 3.0 X 563558 0 99342 DEBRA MATHIAS 0.5 X 517130 0 95474 2129847 0 268107 3 false true false KPMG LLP PO BOX 120001 DALLAS TX 75312 ACCOUNTING/AUDIT 708357 THE CHARTIS GROUP DEPART 5925 CAROL STREAM IL 60122 CONSULTING SERVICES 206477 HUB INT'L OF CALIFORNIA 6101 West Centiela Avenue STE 210 CULVER CITY CA 90230 INSURANCE SERVICES 176251 3 4800000 4800000 MANAGEMENT SERVICES 621990 1815000 1815000 1815000 3035038 3035038 0 0 45583876 43107749 2476127 2476127 2476127 0 0 0 0 12126165 1815000 0 5511165 0 0 0 0 1655193 1406914 82760 165519 0 0 0 0 44653 37955 2233 4465 354997 301747 17750 35500 25163 21389 1258 2516 620000 527000 31000 62000 0 0 501916 426628 25096 50192 642585 546197 32130 64258 0 3640 3094 182 364 0 0 0 0 0 0 0 0 0 143552 122019 7178 14355 DUES AND SUBSCRIPTIONS 19400 16490 970 1940 TAXES & LICENSES 324 276 16 32 4011423 3409709 200573 401141 175716 125220 12531011 15384210 73393 89559 78606604 88128357 56584 46676 364758 731990 91808066 104506012 803480 520428 390331 101754 1193811 622182 X 15004441 18785935 75609814 85097895 90614255 103883830 91808066 104506012 X 8114742 5154833 X false true true X false X 0 0 7100000 500000 4800000 12400000 0 0 7100000 500000 4800000 12400000 12400000 3857002 3751479 4439844 3846583 3035038 18929946 4923 0 0 29039 0 33962 31363908 8253154 0.39536 0.27950 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED PARTY 101754 101754 12126165 4011423 8114742 5164742 -9908 5154834 13269576 17280999 5164742 -9908 5154834 12126165 12126165 4011423 4011423 4011423 fin 48 form 990 schedule d line 10 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 (OR ASSET) 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, 2011, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. other revenue recorded on books but not on the return form 990 schedule d part xi, line 8 & PART xii, LINE 2D valuation adjustment-ltd. partnership investment ($9,908) X X X X false true false false false false false false false KIMBERLY C CRIPE 710811 0 169688 0 168660 0 54579 0 18712 0 1122450 0 0 0 KERRI RUPPERT SCHILLER 419474 0 80404 0 63680 0 80630 0 18712 0 662900 0 0 0 DEBRA MATHIAS 396210 0 71257 0 49663 0 76762 0 18712 0 612604 0 0 0 Severance Arrangements, PART I, LINE 4A 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. 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). Compensation Footnotes 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 501(c)(3) affiliates). Ms. Cripe devotes approximately 75% of her time each week to Children's Hospital of Orange County 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 63% of her time each week to Children's Hospital of Orange County 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 501(c)(3) affiliates). Ms. Mathias devotes approximately 88% of her time each week to Children's Hospital of Orange County responsibilities with the balance of her time being spent on Children's Hospital at Mission's business affairs. 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 Children's Healthcare of California (CHC). CHC has 3 employees, however because of the common paymaster arrangement, the Forms W-2 were issued under CHOC's employer identification number. PROCESS OF REVIEW FORM 990, PART VI, SECITON B, LINE 11A Prior to filing, the tax return and related schedules are provided to the CHC 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 May 2012 Board of Directors meeting. MONITORING AND ENFORCING COMPLIANCE OF CONFLICT OF 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 or key employees). Covered persons are required to disclose real or potential conflict 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. PROCESS OF DETERMINING COMPENSATION OF THE CEO AND OTHER OFFICERS FORM 990, PART VI, SECTION B, LINE 15 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 CEO, 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 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 executive session with the Board of Directors. DISCLOSURE POLICY 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 OTHER CHANGES IN NET ASSETS OR FUND BALANCES UNREALIZED GAINS: $ 5,164,742 VALUATION ADJUSTMENT IN PARTNERSHIP INVESTMENT: $ (9,908) ------------- TOTAL $ 5,154,834 CHANGES TO BYLAWS PART VI, SECTION A, LINE 4 QUALIFICATIONS OF DIRECTORS: Updated the positions for the Board to reflect the mirrored Boards of CHOC/CCMH - Position #1, #2, and #4 will be a Director from the mirrored Boards. The Chief Financial Officer is the only executive with the right to attend Board meetings and participate in discussion without being a member. ADVISORY COMMITTEES: Changed the Audit Committee to Audit and Compliance Committee. AUDIT AND COMPLIANCE COMMITEE: Added compliance responsibilities to this committee. Ensure that the Corporation and its affiliates maintain compliance plans, designed to encourage good stewarship and compliance with applicable federal and state laws. Review and approve annual internal audit and corporate compliance work plans for the Corporation and its affiliates. Review management reports about internal audit and corporate compliance issues of significant concern, and actions to address such issues. CHIEF FINANCIAL OFFICER: The President of the Corporation will appoint the CFO instead of being elected by the Board. HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KIMBERLY C. CRIPE TITLE:DIRECTOR / PRESIDENT HOURS:38 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JEFF ELGHANAYAN TITLE:DIRECTOR HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLAIM GURTNER TITLE:DIRECTOR HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARSHALL ROWEN, M.D. TITLE:DIRECTOR / VICE CHAIR HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK STEVENS TITLE:DIRECTOR / CHAIR HOURS:6 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MAUREEN ZEHNTNER TITLE:DIRECTOR HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JANET T. DAVIDSON TITLE:DIRECTOR HOURS:5 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JAY KEAR TITLE:DIRECTOR HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RALPH CLAYMAN, M.D. TITLE:DIRECTOR HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KERRI RUPPERT SCHILLER TITLE:CFO / ASSISTANT SECRETARY HOURS:37 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DEBRA MATHIAS TITLE:Exec. Vice President / COO HOURS:40 CHILDREN'S HOSPITAL OF ORANGE COUNTY 455 S MAIN STREET ORANGE CA 92868 952321786 HEALTH CARE CA 501(c)(3) 3 chc children's hospital at mission 455 S Main Street Orange CA 92868 330528802 HEALTH CARE CA 501(c)(3) 3 chc CHOC FOUNDATION 455 S MAIN STREET ORANGE CA 92868 956097416 Fund Raising CA 501(c)(3) 7 chc CHOCO REALTY CORPORATION 455 S MAIN STREET ORANGE CA 92868 330011853 REAL ESTATE CA 501(c)(3) 11 chc CRC REAL ESTATE CORPORATION 455 S MAIN STREET ORANGE CA 92868 330612565 REAL ESTATE CA 501(c)(3) 11 chc CHOC Thrift Stores Inc 455 S MAIN STREET ORANGE CA 92868 330266422 Fund Raising CA 501(c)(3) 9 chc OCMRRG 2999 North 4th Street Suite 250 PHOENIX AZ 85108 201620666 INSURANCE AZ CHOC C CORP 0 0 0.00000 false false true true false false false false false false true false false false false false false false CHILDREN'S HOSPITAL AT MISSION C 2400000 CRC REAL ESTATE CORPORATION C 2400000 CHOCO REALTY CORPORATION D 265486600 CHILDREN'S HOSPITAL OF ORANGE COUNTY D 265486600 CHILDREN'S HOSPITAL OF ORANGE COUNTY K 999996 CHILDREN'S HOSPITAL AT MISSION K 500004 CHOC FOUNDATION K 90000 CHOCO REALTY COPORATION K 150000 CRC REAL ESTATE CORPORATION K 75000 part v, line 2, column (c) THE METHODS USED BY CHC TO DETERMINE THE VALUE OF THE AMOUNTS LISTED IN SCHEDULE R PART V LINE 2 COLUMN (C) WERE: (C) contributions from related organizations are determined based on the recipient charitable organization's annual operational and capital needs and were approved by CHC's board. (D) LOANS WITH RELATED EXEMPT ORGANIZATIONS ARE DETERMINED BASED ON THE RECIPIENT CHARITABLE ORGANIZATION'S OPERATIONAL NEEDS AND ARE APPROVED BY CHC'S BOARD. (K) Management fees are developed internally by management in conjunction with the annual operating and capital budgets based on resources required by affiliates and supported by time studies, work products and other statistics to support allocations.