2011-05-16T11:36:37-05:00 2010-06-30 KPMG LLP 355 S Grand Ave Suite 2000 Los Angeles CA 90071 990 2009-07-01 330265266 CHILDREN'S HEALTHCARE OF CALIFORNIA CHIL 7149973000 455 S Main Street Orange CA 928683874 KERRI R SCHILLER 2011-05-13 2139724000 2009 2016-02-24 21:20:13Z KIMBERLY C CRIPE 455 S MAIN STREET ORANGE CA 928683874 8457299 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 7100000 500000 1830000 1845000 -628412 4039131 0 29039 8301588 6413170 5500000 4000000 0 0 1993643 1877966 0 0 414548 1609403 2267518 9103046 8145484 -801458 -1732314 88826510 91808066 981441 1193811 87845069 90614255 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 7523660 4000000 1873000 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 70,735 days of inpatient care; 75,020 emergency room visits; 155,832 primary and specialty care visits; 9,329 surgeries provided by CHOC and CHM. 7523660 true true false false false false false false false true false true false false false false false false false false false true false true false false false false false false false false false false false false false true true false false true 1 0 true 3 true false false false false false false false false false 10 9 false false false 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 KIMBERLY C CRIPE 2.0 X X 1131003 0 27090 JEFF ELGHANAYAN 1.0 X 0 0 0 WILLAIM GURTNER 1.0 X 0 0 0 L KENNETH HEULER DDS 2.0 X X 0 0 0 MARSHALL ROWEN MD 1.0 X X 0 0 0 PATRICK SALAS 1.5 X 0 0 0 MARK STEVENS 1.0 X X 0 0 0 RALPH CLAYMAN MD 0.5 X 0 0 0 MAUREEN ZEHNTNER 1.0 X 0 0 0 JANET T DAVIDSON 1.0 X 0 0 0 KERRI RUPPERT SCHILLER 4.0 X X 619500 0 14603 Debra Mathias 0.5 X 586332 0 13601 2336835 0 55294 3 false true false KPMG LLP PO BOX 120001 DALLAS TX 75312 ACCOUNTING/AUDIT 693906 THE CHARTIS GROUP DEPART 5925 CAROL STREEAM IL 60122 INSURANCE CLAIMS 159988 HUB INT'L OF CALIFORNIA 6101 West Centiela Avenue STE 210 CULVER CITY CA 90230 INSURANCE SERVICES 146786 3 500000 500000 MANAGEMENT SERVICES 621990 1845000 1845000 1845000 3846583 3846583 0 0 2236677 2044129 192548 192548 192548 0 0 0 MISCELLANEOUS 900099 29039 28000 1039 29039 6413170 1873000 0 4040170 4000000 4000000 0 0 0 1830063 1555553 91504 183006 0 0 0 0 47903 40718 2395 4790 326203 277273 16310 32620 5994 5095 300 599 650000 552500 32500 65000 0 0 436335 370884 21817 43634 405414 344601 20271 40542 0 1187 1009 59 119 0 0 0 9332 7932 467 933 0 0 0 0 0 158772 134956 7939 15877 Taxes and licenses 1113 946 56 111 Other expenses 273168 232193 13658 27317 8145484 7523660 207276 414548 107077 175716 17453326 12531011 85378 73393 70765350 78606604 62604 56584 352775 364758 88826510 91808066 756132 803480 225309 390331 981441 1193811 X 19934202 15004441 67910867 75609814 0 87845069 90614255 88826510 91808066 X false true true X false X false false false 0 0 0 7100000 500000 7600000 0 0 0 7100000 500000 7600000 2056224 5543776 3659921 3857002 3751479 4439844 3846583 19554829 0 4923 0 0 29039 33962 27188791 7785154 0.20390 0.65624 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 DUE TO RELATED PARTY 390331 390331 6413170 8145484 -1732314 4507520 -6020 4501500 2769186 10914670 4507520 -6020 4501500 6413170 6413170 8145484 8145484 8145484 fin 48 form 990 schedule d line 10 EFFECTIVE JULY 01, 2007, CHILDREN'S HEALTHCARE OF CALIFORNIA AND AFFILIATES ADOPTED THE PROVISIONS OF FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, AN INTERPRETATION OF FASB STATEMENT NO. 109 (FIN 48). CHILDREN'S HEALTHCARE OF CALIFORNIA AND AFFILIATES' ADOPTION OF FIN 48 DID NOT RESULT IN ANY MATERIAL IMPACT ON ITS COMBINED FINANCIAL STATEMENTS. other revenue recorded on books but not on the return form 990 schedule d part xii, line 2d valuation adjustment-ltd. partnership investment ($6,020) This relates to Child Health Corporation of America (CHCA) a taxable cooperative owned by 43 childrens hospitals, including CHOC, Childrens Health Investment I LLC (CHIC I) and Childrens Health Investment II LLC (CHIC II). CHOC's respective ownerships in these three companies is 2.33% , 2.88% and 1.2% valued at $25,000, $12,310 and $19,274 respectively. RECONCILIATION OF CHANGE IN NET ASSETS FORM 990, SCHEDULE D, PART XI, LINE 8 VALUATION ADJUSTMENT-LTD. PARTNERSHIP INVESTMENT ($6,020) true CHOC Children's Foundation 455 S Main street Orange CA 92868 956097416 501(C)(3) 4000000 0 N/A N/A FURTHER FDN Fund Raising PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS: FORM 990, SCHEDULE I, PART I, LINE 2 The CHC Finance Committee recommends to the CHC Board of Directors and to the Boards of affiliated tax-exempt corporations, plans for securing capital and operating funds in accordance with the annual approved operating and capital budgets for each Corporation or an adopted Plan of Finance. CHC receives funds from its tax-exempt affiliates in accordance to the bylaws of the corporation. X X X X false true false false false false false false false KIMBERLY C CRIPE 712995 0 207305 0 210703 0 14743 0 12347 0 1158093 0 0 0 KERRI RUPPERT SCHILLER 405686 0 101481 0 112333 0 7393 0 7210 0 634103 0 0 0 Debra Mathias 378088 0 98285 0 109959 0 1254 0 12347 0 599933 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. In the current year there were no increases attributable to the separation agreement for any persons listed on this return. Supplemental Nonqualified Retirement Plan Part I, Line 4B Children's Hospital of Orange County (CHOC) established a nonqualified deferred compensation plan in 2002 in which certain individuals listed on the Form 990, Part VII and Schedule J are participants. Under the plan, a grantor trust was established for which CHOC is the grantor. The principal of the trust and any earnings thereon are held separate and apart from other funds of CHOC and are to be used exclusively for the uses and purposes of plan participants and CHOC's general creditors. The company established a capital accumulation account on its books for each plan participant for each election of benefits accrued under the plan. The capital accumulation account is utilized solely as a device for the measurement and determination of the amounts to be paid to the participants under the plan. The participant is a general unsecured creditor of the company for the payment of capital accumulation account benefits. CHOC contributed to the trust such money or other assets in the amounts and at the times determined in its sole discretion. The participant is entitled to his/her capital accumulation account benefit under the earliest of (1) remaining employed by the company to the deferred vesting for the account; (2) disability; (3) 24 months following involuntary separation from service without reasonable cause; or (4) following a voluntary separation from service if certain non-compete stipulations are met. In December 2008, the CHOC compensation committee dissolved this plan and all assets were disbursed involuntarily to the participants. The following individuals received payments from the dissolution of this supplemental non-qualified retirement plan during calendar year 2009: Kimberly C. Cripe ($159,223), Kerri Ruppert Schiller ($79,208), and Debra Mathias ($77,914). 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 50% 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 79% 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 form 990 and related schedules was provided to the CHC Executive Review Committee, an empowered board committee delegated with this authority. The Chief Financial Officer reviewed the return with the Committee, a copy of the return is also provided to the full board of directors, prior to filing the return with the Internal Revenue Service. 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. organization board of directors Information Form 990, Part VI, Section A, line 7a On January 1, 2009, the bylaws of Children's HealthCare of California (CHC) were amended to accommodate the affiliation agreement with the University of California, Irvine (University). As part of the Affiliation Agreement, one-third of the Directors are representatives of the University. The University Directors include two designated Directors. For the remaining number to complete the one-third requirement, community members are nominated by the two University designated directors and presented to the CHC Board of Directors Nominating Committee. Directors of CHC are elected annually by the Board based on the nomination(s) at the Board's annual meeting. SCHEDULE R, 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: (B) and (C) contributions to/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 finance 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. CHILDREN'S HOSPITAL OF ORANGE COUNTY 455 S MAIN STREET ORANGE CA 928683874 952321786 HEALTH CARE CA 501(c)(3) 3 N/A children's hospital at mission 455 S Main Street Orange CA 928683874 330528802 HEALTH CARE CA 501(c)(3) 3 N/A CHOC FOUNDATION 455 S MAIN STREET ORANGE CA 928683874 956097416 Fund Raising CA 501(c)(3) 7 N/A CHOCO REALTY CORPORATION 455 S MAIN STREET ORANGE CA 928683874 330011853 REAL ESTATE CA 501(c)(3) 11 N/A CRC REAL ESTATE CORPORATION 455 S MAIN STREET ORANGE CA 928683874 330612565 REAL ESTATE CA 501(c)(3) 11 N/A CHOC Thrift Stores Inc 455 S MAIN STREET ORANGE CA 928683874 330266422 Fund Raising CA 501(c)(3) 9 NA OCMRRG 2999 North 4th Street Suite 250 PHOENIX AZ 85108 201620666 INSURANCE AZ CHOC C CORP 0 0 0.00000 OCMRRG 2999 North 4th Street Suite 250 phoenix AZ 85108 201620666 INSURANCE AZ CHOC AT MISSION C CORP 0 0 0.00000 false true true true false false false false false false true false false false false false false false CHOC FOUNDATION B 4000000 CRC REAL ESTATE CORPORATION C 500000 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 120000 CHOCO REALTY CORPORATION K 150000 CRC REAL ESTATE CORPORATION K 75000