2011-05-16T11:38:15-05:00 2010-06-30 KPMG LLP 355 S Grand Ave Suite 2000 Los Angeles CA 90071 990 2009-07-01 956097416 CHOC Foundation CHOC 7149973000 455 S Main Street Orange CA 928683874 Kerri Ruppert Schiller 2011-05-13 2139724000 2009 2016-02-24 21:20:13Z CHOC Children's Foundation kimberly c cripe 455 s main street orange CA 928683874 19146974 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 21 1000 0 0 13561991 18351396 0 0 393456 158334 0 0 13955447 18509730 7907962 7944697 0 0 2835507 2338375 0 0 893236 3790541 3455802 14534010 13738874 -578563 4770856 28361124 33261526 483463 402336 27877661 32859190 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 7743810 7743810 0 CHILDREN'S HOSPITAL OF ORANGE COUNTY (CHOC) PROVIDES PEDIATRIC SERVICES FOR THE MEDICAL/SURGICAL CARE OF CHILDREN FROM BIRTH TO AGE 17; 61,467 DAYS OF INPATIENT CARE; 56,366 EMERGENCY ROOM VISITS; 12,479 DISCHARGES; 155,832 PRIMARY AND SPECIALTY CARE VISITS; AND 8,240 SURGERIES PERFORMED DURING THE FISCAL YEAR. SEE OUR COMPLETE COMMUNITY BENEFIT REPORT ON OUR WEBSITE AT WWW.CHOC.ORG 200887 200887 0 Children's Hospital at Mission - Funds support affiliated acute care pediatric hospital. Facility provides pediatric, neonatal, and care for emergency services. There were 9,268 inpatient care days; 18,654 Emergency room visits; 1,089 surgeries and 8,612 outpatient visits. 4582813 0 0 Pediatric Medical Services 12527510 true true false false false 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 true 62 0 true 21 true false false false false false true true false false false 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 KIMBERLY C CRIPE 5.0 X X 0 1131003 27090 DONNA BIANCHI 1.0 X 0 0 0 JIM CAUDILL 1.0 X 0 0 0 JANET DAVIDSON 1.0 X 0 0 0 JEFF ELGHANAYAN 1.0 X X 0 0 0 ALLEN FAZIO 1.0 X 0 0 0 CHRIS FURMAN 2.0 X X 0 0 0 CHRIS GRIFFTH 1.0 X 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 0 0 0 CRAIG MILLET 1.0 X 0 0 0 MARK MOSES 1.0 X 0 0 0 TOM VEGH 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 BOB WAGNER 1.0 X 0 0 0 BOB ALLISON 1.0 X 0 0 0 SAM AURIEMMA 1.0 X 0 0 0 KERRI RUPPERT SCHILLER 4.0 X 0 619500 14603 TANYA LIEBER 40.0 X 296333 0 13481 JERI STATHIS 40.0 X 166604 0 3908 PATRICE POIDMORE 40.0 X 116556 0 5272 HEATHER L INCH-DESUTA 40.0 X 161881 0 7576 LOIS F AUGUSTINE 40.0 X 106643 0 15472 DOLORES M KORF 40.0 X 109438 0 5551 957455 1750503 92953 6 false true false INTERSECTION STUDIO 4120 MIchael Ave LOS ANGELES CA 90066 MARKETING 236461 1 3278312 4000000 11073084 144806 18351396 0 155902 155902 0 0 28251 25819 2432 2432 2432 611425 3278312 611425 0 0 0 0 18509730 0 0 158334 7944697 7944697 0 0 0 220027 73343 73342 73342 0 1749125 1399300 87456 262369 30562 24450 1528 4584 198832 159065 9942 29825 139829 111864 6991 20974 1254402 1003522 62720 188160 0 0 0 0 15047 15047 493742 394994 24687 74061 140871 140871 19415 15532 971 2912 45915 36732 2296 6887 0 274453 219562 13723 41168 24311 19448 1216 3647 0 3396 3396 0 0 28254 22603 1413 4238 5431 4344 272 815 DUES 175711 140568 8786 26357 TAXES & LICENSES 86843 69475 4342 13026 UNCOLLECTIBLE PLEDGES 888011 888011 13738874 12527510 318128 893236 476729 2783406 14775393 17226105 5779369 5470130 98893 64497 391627 230421 189460 161206 5053707 5311644 1987573 2244538 28361124 33261526 93975 130561 389488 271775 483463 402336 X 10446280 13060703 9226766 9909368 8204615 9889119 27877661 32859190 28361124 33261526 X false true true X false X 8100569 11954508 15602800 13561991 18351396 67571264 8100569 11954508 15602800 13561991 18351396 67571264 87097 67484167 838828 1077030 556256 479980 155902 3107996 1313818 1087406 1204491 748754 611425 4965894 75645154 5138699 0.89211 0.85822 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8204615 1680574 124137 120207 9889119 7045698 1223025 -64108 8204615 1.00000 false false 150403 35824 114579 241224 194597 46627 161206 TRUST RECEIVABLE 1554788 OTHER RECEIVABLE 689750 2244538 0 PAYABLE TO AFFILIATES 271775 271775 18509730 13738874 4770856 143354 67319 210673 4981529 18720403 143354 67319 210673 18509730 18509730 13738874 13738874 13738874 ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 EFFECTIVE JULY 1, 2007, CHOC CHILDREN'S FOUNDATION ADOPTED THE PROVISIONS OF FASB INTERPRETATION NO. 48, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. CHOC CHILDREN'S FOUNDATION'S ADOPTION OF FIN 48 DID NOT RESULT IN ANY MATERIAL IMPACT ON ITS FINANCIAL STATEMENTS. change in net assets from Form 990 to financial statements part XI, line 8 change in value of split-interest agreements - $67,319 other revenue on books but not on return Part XII, line 2d change in value of split-interest agreements - $67,319 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 1511207 1361774 149433 15255 72000 7508 250 54420 Guilds Events 1006144 931439 74705 74705 4 1372386 985099 387287 16000 26367 67155 5095 272670 3889737 3278312 611425 31255 98367 74663 5345 401795 611425 true CHILDREN'S HOSPITAL OF ORANGE COUNTY 455 SOUTH MAIN STREET ORANGE CA 928683874 952321786 501(c)(3) 7743810 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) 200887 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 712995 0 207305 0 210703 0 14743 0 12347 0 1158093 0 0 KERRI RUPPERT SCHILLER 0 405686 0 101481 0 112333 0 7393 0 7210 0 634103 0 0 TANYA LIEBER 224723 0 11736 0 59874 0 4537 0 8944 0 309814 0 0 0 JERI STATHIS 154916 0 0 0 11688 0 3657 0 251 0 170512 0 0 0 HEATHER L INCH-DESUTA 150383 0 0 0 11498 0 940 0 6636 0 169457 0 0 0 Form 990, Part VII, 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. In the current year there were no increases attributable to the separation agreement for any persons listed on this return. 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 13% 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 Nonqualifed 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 Tanya Lieber ($38,058). chad lieber family member of officer 95243 payment of compensation false X 4 144806 SALE OF SECURITES 0 false true false 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 30 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, SECITON B, LINE 11A Prior to filing, the tax return and related schedules are provided to the Executive Committee of CHOC Foundation and the CHOC Executive Compensation Committee. Both are empowered Board committees delegated with this authority. The Chief Financial Officer reviews the report with the Committees prior to filing the return. The Form 990 is provided to the Board and reviewed at the May Board Meeting. MONITORING 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. CHILDREN'S HEALTHCARE OF CALIFORNIA 455 S MAIN STREET ORANGE CA 928683874 330265266 HEALTH CARE CA 501(c)(3) 11D na CHILDREN'S HOSPITAL OF ORANGE COUNTY 455 S MAIN STREET ORANGE CA 928683874 952321786 HEALTH CARE CA 501(c)(3) 3 na CHILDREN'S HOSPITAL AT MISSION 455 S MAIN STREET ORANGE CA 926863874 330528802 HEALTH CARE CA 501(c)(3) 3 na CRC REAL ESTATE CORPORATION 455 S MAIN STREET ORANGE CA 928683874 330612565 real estate CA 501(c)(3) 11a na CHOCO REALTY CORPORATION 455 S MAIN STREET ORANGE CA 928683874 330011853 real estate CA 501(c)(3) 11A NA choc Thrift Stores Inc 455 S MAIN STREET orange CA 928683874 330266422 fund raising CA 501(c)(3) 9 NA false true true false false false false false false true true false false false false false false false