CHILDRENS HOSPITAL AT MISSION: Form 990, tax year 2009
View the entire original 990 at ProPublica ↗
- Organization
- CHILDRENS HOSPITAL AT MISSION (EIN 33-0528802)
- Tax period
- 2009-07-01 to 2010-06-30
- Filed
- 2011-05-16
- IRS object ID
- 201121369349304737
- Schema version
- 2009v1.7
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-05-16T14:04:52-05:00 | Timestamp |
| Tax Period End Date | 2010-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 355 S Grand Ave Suite 2000 | AddressLine1 |
| City | Los Angeles | City |
| State | CA | State |
| ZIP Code | 90071 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2009-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330528802 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Children's Hospital At Mission | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHIL | NameControl |
| Phone | 7149973000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 S Main Street | AddressLine1 |
| City | Orange | City |
| State | CA | State |
| ZIP Code | 928683874 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Kerri Ruppert Schiller | Name |
| Title | Senior VP & CFO | Title |
| Date Signed | 2011-05-13 | DateSigned |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2139724000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2009 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHOC Children's at Mission Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KIMBERLY C CRIPE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 s main street | AddressLine1 |
| City | orange | City |
| State | CA | State |
| ZIP Code | 928683874 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 49618562 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c | X | Organization501c |
| Web Site | www.choc.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1991 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | TO NURTURE, ADVANCE, AND PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 149 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 338873 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 292391 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 47454810 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 49172559 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 172887 | InvestmentIncomePriorYear |
| Investment Income Current Year | 83031 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 476668 | OtherRevenuePriorYear |
| Other Revenue Current Year | 70581 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 48443238 | TotalRevenuePriorYear |
| Total Revenue Current Year | 49618562 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 5000000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11041162 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11214570 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 36520062 | OtherExpensePriorYear |
| Other Expenses Current Year | 37673518 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 52561224 | TotalExpensesPriorYear |
| Total Expenses Current Year | 48888088 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -4117986 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 730474 | RevenuesLessExpensesCY |
| Total Assets BOY | 32105192 | TotalAssetsBOY |
| Total Assets EOY | 35090109 | TotalAssetsEOY |
| Total Liabilities BOY | 8362452 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10603572 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 23742740 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 24486537 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO NURTURE, ADVANCE, AND PROTECT THE HEALTH AND WELL-BEING OF CHILDREN. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 46383965 | Expense |
| Revenue | 49172559 | Revenue |
| Description | PROVIDES SPECIALIZED PEDIATRIC SERVICES FOR THE MEDICAL/SURGICAL CARE OF CHILDREN FROM BIRTH TO AGE 18. THERE WERE 9,268 DAYS OF INPATIENT CARE; 18,654 EMERGENCY ROOM VISITS; 8,612 OUTPATIENT VISITS; 1,089 SURGERIES WERE PERFORMED DURING THE FISCAL YEAR. | Description |
| Total Program Service Expense | 46383965 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Balance Sheet Amounts Reported | true | BalanceSheetAmountsReported |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 29 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 149 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DONALD NOBLE | NamePerson |
| Telephone Number | 7149973000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 S MAIN STREET | AddressLine1 |
| City | ORANGE | City |
| State | CA | State |
| ZIP Code | 928683874 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| KIMBERLY C CRIPE | ||||||||
| DIRECTOR/PRESIDENT | 2.0 | X | X | 0 | 1131003 | 27090 | ||
| RALPH CLAYMAN MD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JEFF ELGHANAYAN | ||||||||
| DIRECTOR / 2ND VICE CHAIR | 2.0 | X | X | 0 | 0 | 0 | ||
| ED GRIER | ||||||||
| DIRECTOR / 1ST VICE CHAIR | 2.0 | X | X | 0 | 0 | 0 | ||
| WILLIAN GURTNER | ||||||||
| DIRECTOR | 2.0 | X | 0 | 0 | 0 | |||
| MUSTAFA KABEER MD | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JAY KEAR | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| MEREDITH KHACHIGIAN | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| DOUGLAS MCCOMBS | ||||||||
| DIRECTOR / SECRETARY | 1.0 | X | X | 0 | 0 | 0 | ||
| MARK STEVENS | ||||||||
| CHAIR | 1.0 | X | X | 0 | 0 | 0 | ||
| MAUREEN ZEHNTNER | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| JANET T DAVIDSON | ||||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | |||
| MARSHALL ROWEN MD | ||||||||
| DIRECTOR/VICE CHAIR | 1.0 | X | X | 0 | 0 | 0 | ||
| KERRI RUPPERT SCHILLER | ||||||||
| SR. VICE PRESIDENT & CFO | 3.0 | X | 0 | 619500 | 14603 | |||
| DEBRA MATHIAS | ||||||||
| EXEC. VICE PRESIDENT / COO | 8.0 | X | 0 | 586332 | 13601 | |||
| MARCIA FOLLI | ||||||||
| VICE PRESIDENT & CNO | 40.0 | 290499 | 0 | 12417 | X | |||
| BONNIE L GRAVETT | ||||||||
| CLINICAL NURSE III | 40.0 | 150726 | 0 | 15550 | X | |||
| LAURIE A GAUTHIER | ||||||||
| DIRECTOR CLINICAL SERVICES | 40.0 | 156879 | 0 | 21607 | X | |||
| ELIZABETH DRAKE | ||||||||
| CLINICAL NURSE II | 40.0 | 128563 | 0 | 19476 | X | |||
| LINDA STARN | ||||||||
| DIRECTOR CLINICAL SERVICES | 40.0 | 134326 | 0 | 7822 | X | |||
| BARBARA SILVERS | ||||||||
| CLINICAL NURSE II | 40.0 | 135751 | 0 | 14128 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 996744 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2336835 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 146294 | TotalOtherCompensation |
| Number Individuals GT100 K | 34 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| COMFORCE TECHNICAL SERVICES | |||||
| PO BOX 31001-0893 | PASADENA | CA | 91110 | TEMPORARY STAFFING | 303865 |
| PEDIATRIC SUBSPECIALTY FACULTY | |||||
| 455 SOUTH MAIN ST | ORANGE | CA | 92868 | Medical Dir & Serv | 366000 |
| Pediatric Surgical Associates | |||||
| 1120 W LA VETA AVENUE SUITE 100 | ORANGE | CA | 92868 | Medical Dir & Serv | 214996 |
| West Coast Pediatrics | |||||
| 1010 W La Veta Ave 710 | Orange | CA | 92868 | Medical services | 109500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 200887 | RelatedOrganizations |
| Government Grants | 91504 | GovernmentGrants |
| Total Contributions | 292391 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT SERVICES | 621400 | 49050775 | 49050775 |
| CLINIC RENTAL INCOME | 900099 | 121784 | 121784 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 49172559 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 83031 | TotalRevenueColumn |
| Exclusion | $83,031 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 70581 | TotalRevenueColumn |
| Exclusion | $70,581 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 70581 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 49618562 | TotalRevenueColumn |
| Related Or Exempt Function Income | 49172559 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $153,612 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221035 | Total |
| Program Services | 221035 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8919486 | Total |
| Program Services | 8027537 | ProgramServices |
| Management And General | 891949 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 265036 | Total |
| Program Services | 238532 | ProgramServices |
| Management And General | 26504 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1118633 | Total |
| Program Services | 1006770 | ProgramServices |
| Management And General | 111863 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 690380 | Total |
| Program Services | 621342 | ProgramServices |
| Management And General | 69038 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8823088 | Total |
| Program Services | 7940780 | ProgramServices |
| Management And General | 882308 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17619 | Total |
| Management And General | 17619 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12000 | Total |
| Program Services | 10800 | ProgramServices |
| Management And General | 1200 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1876240 | Total |
| Program Services | 1688618 | ProgramServices |
| Management And General | 187622 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80373 | Total |
| Program Services | 72336 | ProgramServices |
| Management And General | 8037 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 123974 | Total |
| Program Services | 111576 | ProgramServices |
| Management And General | 12398 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1533518 | Total |
| Program Services | 1380166 | ProgramServices |
| Management And General | 153352 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18527 | Total |
| Program Services | 16674 | ProgramServices |
| Management And General | 1853 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13663 | Total |
| Program Services | 12297 | ProgramServices |
| Management And General | 1366 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 939880 | Total |
| Program Services | 845892 | ProgramServices |
| Management And General | 93988 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 314597 | Total |
| Program Services | 283137 | ProgramServices |
| Management And General | 31460 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCH. SVC FROM OTHER HOSPITAL | 20419357 | 20419357 | |
| PROVISION FOR BAD DEBT | 3365023 | 3365023 | |
| MEDICAL SUPPLIES | 7436 | 6692 | 744 |
| MISCELLANEOUS | 103906 | 93516 | 10390 |
| TAXES AND LICENSES | 24317 | 21885 | 2432 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48888088 | Total |
| Program Services | 46383965 | ProgramServices |
| Management And General | 2504123 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 399340 | BOY |
| EOY | 224560 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5056183 | BOY |
| EOY | 9182063 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 64139 | BOY |
| EOY | 20000 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13378366 | BOY |
| EOY | 13182629 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 394638 | BOY |
| EOY | 407474 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 13290439 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 7156976 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6482951 | BOY |
| EOY | 6133463 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6329575 | BOY |
| EOY | 5939920 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32105192 | BOY |
| EOY | 35090109 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6558143 | BOY |
| EOY | 8673532 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1804309 | BOY |
| EOY | 1930040 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8362452 | BOY |
| EOY | 10603572 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22622723 | BOY |
| EOY | 23439372 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1120017 | BOY |
| EOY | 1047165 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23742740 | BOY |
| EOY | 24486537 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32105192 | BOY |
| EOY | 35090109 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8448478 | OtherCostOrOtherBasis |
| Depreciation | 3687272 | Depreciation |
| Book Value | 4761206 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4841961 | OtherCostOrOtherBasis |
| Depreciation | 3469704 | Depreciation |
| Book Value | 1372257 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 6133463 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| GOODWILL NET OF AMORTIZATION | 5737500 |
| NICU SUNK COSTS, NET OF AMORT. | 63179 |
| I/C RECEIVABLE CHOC | 33007 |
| I/C RECEIVABLE CHOC FOUNDATION | 7061 |
| OTHER ASSETS | 99173 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 5939920 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO CHILDREN'S HEALTHCARE OF CALIFORNIA | $43,410 |
| DUE TO CHILDREN'S HOSPITAL OF ORANGE COUNTY | $1,651,944 |
| OTHER LIABILITIES | $234,686 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1930040 | TotalOfAmounts |
| Total Revenue | 49618562 | TotalRevenue |
| Total Expenses | 48888088 | TotalExpenses |
| Excess Or Deficit For Year | 730474 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 57462 | NetUnrealizedGLOnInvestments |
| Other | -$44,139 | OtherAmount |
| Total Adjustments | 13323 | TotalAdjustments |
| Excess Or Deficit Per FS | 743797 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 49631885 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 57462 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 57462 | RevenueNotRptdF990 |
| Revenue Subtotal | 49574423 | RevenueSubtotal |
| Other Revenues Not Included | 44139 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 44139 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 49618562 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 48888088 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 48888088 | ExpensesSubtotal |
| Total Expenses Per Form990 | 48888088 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Reconciliation of Change in Net Assets | form 990, schedule d, part XI, line 8 | Change in beneficial interest in CHOC Foundation ($44,139) Contributions ($45,000) Auditors year end adjustment $861 Total ($44,139) |
| Other Revenue on Return but not on financial statements | FORM 990, SCHEDULE D, PART XII, LINE 4B | Change in beneficial interest in CHOC Foundation $44,139 Contributions $45,000 Auditor's year end adjustment ($861) Total $44,139 |
| FIN 48 | Form 990, Schedule D, Part X | Children's Healthcare of California ("CHC") and Affiliates adopted the provisions of FASB Interpretation No. 48 ("FIN 48") effectively on July 01, 2007. This adoption did not result in any material impact on the combined financial statements of CHC and Affiliates. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 249385 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 249385 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00550 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13236729 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4353773 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8882956 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.19510 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13486114 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4353773 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9132341 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.20060 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13486114 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4353773 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9132341 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.20060 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 19925 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 19925 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 4 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 19925 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 19925 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | false | BadDebtExpenseReported |
| Bad Debt Expense | $806,865 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 0 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 0 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 0 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
Form990 Schedule H Part V Form990ScheduleHPartV
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHILDREN'S HOSPITAL AT MISSION | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 27700 MEDICAL CENTER ROAD | AddressLine1 |
| City | MISSION VIEJO | City |
| State | CA | State |
| ZIP Code | 92691 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| Childrens Hospital | X | ChildrensHospital |
Form990 Schedule H Part VI Form990ScheduleHPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| General Explanation | The organization uses the Federal Poverty Guidlines (FPG) to determine eligibility for providing free and discounted care to low income individuals. In doing so, the organization follows methodologies recommended by the American Hospital Association. | GeneralExplanation |
| General Explanation | The organization's community benefit report is contained in a report prepared by Children's Hospital of Orange County (CHOC) and CHOC Children's at Mission Hospital (CCMH) annually and is filed in accordance with California SB697. | GeneralExplanation |
| General Explanation | The organization did not include subsidized health services costs attributable to a physician clinic in the table in Part I, line 7g. | GeneralExplanation |
| General Explanation | The bad debt expense included in Form 990, Part IX, Line 25 but subtracted for purposes of calculating the percentage in this column is $3,365,023. | GeneralExplanation |
| General Explanation | THE ORGANIZATION USES THE COST-TO-CHARGE RATIO METHODOLOGY TO DETERMINE THE COST OF CHARITY CARE AND UNREIMBURSED COST OF CARE PROVIDED TO MEDI-CAL PATIENTS. COSTS ARE ACCOUNTED FOR USING AN INTERNAL DECISION SUPPORT SYSTEM. THE COST-TO-CHARGE RATIO FOLLOWS THE METHOD DEFINED BY THE MEDICARE COST REPORT AND IS UPDATED MONTHLY USING THE MOST RECENT ORGANIZATIONAL INFORMATION. PART III, LINE 1 THE ORGANIZATION REPORTS BAD DEBT EXPENSE AS AN OPERATING EXPENSE IN ACCORDANCE WITH US GAAP. HFMA STATEMENT NO. 15, WHICH REQUIRES BAD DEBT TO BE RECOGNIZED AS A REDUCTION FROM NET PATIENT REVENUE, HAS NOT YET BEEN ADOPTED AS AN ACCOUNTING STANDARD IN THE US. | GeneralExplanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| DEBRA MATHIAS | |||||||||||||
| 0 | 378088 | 0 | 98285 | 0 | 109959 | 0 | 1254 | 0 | 12347 | 0 | 599933 | 0 | 0 |
| MARCIA FOLLI | |||||||||||||
| 186056 | 0 | 44282 | 0 | 60161 | 0 | 12417 | 0 | 0 | 0 | 302916 | 0 | 0 | 0 |
| BONNIE L GRAVETT | |||||||||||||
| 139599 | 0 | 0 | 0 | 11127 | 0 | 3241 | 0 | 12309 | 0 | 166276 | 0 | 0 | 0 |
| LAURIE A GAUTHIER | |||||||||||||
| 133483 | 0 | 12056 | 0 | 11340 | 0 | 9260 | 0 | 12347 | 0 | 178486 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Severance Arrangements, PART I, 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. | |
| Supplemental Nonqualified Retirement Plan | 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); Ms. Foli ($38,564). | Part I, Line 4B |
| Compensation from an affiliated Organization | 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 5% of her time each week to Children's Hospital at Mission 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 8% of her time each week to Children's Hospital at Mission 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 20% of her time to Children's Hospital at Mission responsibilities with the balance of her time being spent on Children's Hospital of Orange County business affairs. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| 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 Hospital at Mission. Children's Hospital at Mission has 149 employees, however because of the common paymaster arrangement resulting in the forms W-2 being issued under CHOC's employer identified number, there are no W-2s issued directly by Children's Hospital at Mission. Form 990, Part VI, Section A: Line 4 - Changes to Organization's Documents: As of August 2009, the BY-Laws of CHOC Children's at Mission Hospital (CCMH) were amended to change the composition of the Board of Directors. The number of Directors comprising the Board will not be less than 13 and not more than 16 (formerly 9 and 13). In addition, the Board of CCMH shall be comprised of the same individuals who serve as the members of the Board of Directors of Children's Hospital of Orange County and for the same terms and/or periods of qualifications. Lines 6 & 7a - Organization Member Information The sole member of Children's Hospital at Mission (CHM) is Children's HealthCare of California (CHC). Line 7b - Organization Member Information The approval of the Member shall be required with respect to any of the following actions: (1) Changing the purposes and powers of CHOC; (2) Obligating CHOC to undertake any capital expenditure in excess of $5,000,000; (3) Adopting CHOC'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 $5,000,000; (7) Obligating CHOC to act as guarantor with respect to any debt of any person or other entity; (8) Accepting any donation which is conditioned upon CHOC's undertaking any unbudgeted capital expenditure in excess of $2,000,000 or any unbudgeted expenditure in excess of $2,000,000; (9) Entering into any contract which involves any of the following: (a) any financial obligation on the part of CHOC in an amount in excess of $5,000,000, (b) any purpose or activity which is outside the scope of CHOC's ordinary course of business, or (c) a term in excess of five years (unless the contract is terminable at will); (10) involving CHOC in any merger, acquisition, corporate restructuring, or formal affiliation; (11) Involving CHOC as a member, shareholder, or partner in any new corporation, partnership, or other legal entity; (12) Dissolving CHOC; (13) Entering into any transaction involving the sale, lease, conveyance, exchange, transfer or other disposition of all or substantially all of CHOC's assets; (14) Amending CHOC'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. |
| Form 990, Part VI, Section B | noLine 11a - PROCESS OF REVIEW Prior to filing, the tax return and related schedules are provided to the organization's executive review committee, an empowered board committee delegated with this authority. The Chief Financial Officer reviewed the report with the committee prior to filing the final return. The final return is provided to the board of directors at its May meeting. Line 12c - MONITORING/ENFORCING COMPLIANCE OF CONFLICT OF INTEREST POLICY 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 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 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. 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, Kerri Ruppert Schiller, and Debra Mathias 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 Director |
| Form 990, Part VI, Section C | Line 19 - DISCLOSURE POLICY 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. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| CHILDREN'S HOSPITAL OF ORANGE COUNTY | |||||||||
| 455 S MAIN STREET | ORANGE | CA | 928683874 | 952321786 | HEALTH CARE | CA | 501(c)(3) | 3 | NA |
| CHOC FOUNDATION | |||||||||
| 455 S MAIN STREET | ORANGE | CA | 928683874 | 956097416 | FUND RAISING | CA | 501(c)(3) | 7 | NA |
| CHOCO REALTY CORPORATION | |||||||||
| 455 S MAIN STREET | ORANGE | CA | 928683874 | 330011853 | REAL ESTATE | CA | 501(c)(3) | 11 | NA |
| CRC REAL ESTATE CORPORATION | |||||||||
| 455 S MAIN STREET | ORANGE | CA | 928683874 | 330612565 | REAL ESTATE | CA | 501(c)(3) | 11 | NA |
| CHILDREN'S HEALTHCARE OF CALIFORNIA | |||||||||
| 455 S MAIN STREET | ORANGE | CA | 928683874 | 330265266 | HEALTH CARE | CA | 501(c)(3) | 3 | NA |
| choc thrift stores inc | |||||||||
| 455 S MAIN STREET | orange | CA | 928683874 | 330266422 | Fund Raising | CA | 501(c)(3) | 9 | na |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCMRRG | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2999 North 4th Street Suite 250 | AddressLine1 |
| City | phoenix | City |
| State | AZ | State |
| ZIP Code | 85108 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201620666 | EIN |
| Primary Activity | insurance | PrimaryActivity |
| Legal Domicile State | AZ | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | na | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C Corp | TypeOfEntity |
| Share Of Total Income | 8978 | ShareOfTotalIncome |
| Share Of EOY Assets | 1896316 | ShareOfEOYAssets |
| Percentage Ownership | 0.50000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Comments