DOERNBECHER CHILDREN'S HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
DOERNBECHER CHILDREN'S HOSPITAL (EIN 93-0579589)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201131369349306878
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

FieldValueIRS element (for citing)
Timestamp2011-05-16T16:46:16-07:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN930579589EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Doernbecher Childrens HospitalBusinessNameLine1
Business Name Line2FoundationBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlDOERNameControl
Phone5032281730Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11121 SW Salmon StreetAddressLine1
CityPortlandCity
StateORState
ZIP Code97205ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSusan H NicolName
TitleExecutive DirectorTitle
Date Signed2011-05-16DateSigned
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSusan H NicolNameOfPrincipalOfficerPerson
Gross Receipts27837363GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501cXOrganization501c
Web Sitewww.doernbecherfoundation.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1924YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionDoernbecher Children's Hospital Foundation is a nonprofit organization established in 1924 that exists to secure private philanthropic support for Doernbecher Childrens Hospital.ActivityOrMissionDescription
Nbr Voting Members Governing Body36NbrVotingMembersGoverningBody
Nbr Independent Voting Members34NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers350TotalNbrVolunteers
Total Gross UBI54633TotalGrossUBI
Contributions Grants Prior Year11075231ContributionsGrantsPriorYear
Contributions Grants Current Year9799044ContributionsGrantsCurrentYear
Program Service Revenue CY8594ProgramServiceRevenueCY
Investment Income Prior Year172588InvestmentIncomePriorYear
Investment Income Current Year416619InvestmentIncomeCurrentYear
Other Revenue Prior Year162009OtherRevenuePriorYear
Other Revenue Current Year59569OtherRevenueCurrentYear
Total Revenue Prior Year11409828TotalRevenuePriorYear
Total Revenue Current Year10283826TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year10439850GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY11267716GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year1337194TotalFundrsngExpCurrentYear
Other Expense Prior Year2861390OtherExpensePriorYear
Other Expenses Current Year2649803OtherExpensesCurrentYear
Total Expenses Prior Year13301240TotalExpensesPriorYear
Total Expenses Current Year13917519TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1891412RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-3633693RevenuesLessExpensesCY
Total Assets BOY42345414TotalAssetsBOY
Total Assets EOY42920320TotalAssetsEOY
Total Liabilities BOY2781459TotalLiabilitiesBOY
Total Liabilities EOY5463687TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY39563955NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY37456633NetAssetsOrFundBalancesEOY
Mission DescriptionDoernbecher Children's Hospital Foundation is a nonprofit organization established in 1924 that exists to secure private philanthropic support for Doernbecher Childrens Hospital.MissionDescription
Significant New Program ServicestrueSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense11415831Expense
Grants11415831Grants
Revenue484782Revenue
DescriptionContributions, grants, transfers to Doernbecher Children's Hospital make possible comprehensive and innovative healthcare, education and research for the children of our region.Description
Total Program Service Expense11415831TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundstrueDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109631NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Nbr Voting Governing Body Members36NbrVotingGoverningBodyMembers
Number Independent Voting Members34NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledWAStatesWhereCopyOfReturnIsFiled
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLori Mueller VP Fin AdmNamePerson
Telephone Number5032208313TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11121 SW Salmon 100AddressLine1
CityPortlandCity
StateORState
ZIP Code97205ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (38 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
Xandra T McKeown
Past Pres.1.00XX000
Todd Stucky CLU ChFC
Director1.00X000
Timothy L Brackney
Director1.00X000
Terry J Grover
Director1.00X000
Susan Nicol
Executive Direc40.00X172788051836
Sohrab Vossoughi
Director1.00X000
Shirley N Pape
Director1.00X000
Sean T Keys
Director1.00X000
Ronald G Brake
President10.00XX000
Roger W Mills
Director1.00X000
Richard L Wright Jr
Director1.00XX000
Rebecca D Welch
Director1.00X000
Patricia E Smith
Director1.00X000
Michael F Doherty
Director1.00X000
M Wakefield Mack
Director1.00X000
Lori Mueller
VP Finance40.00X153872046162
Linda R Hickey
Director1.00X000
Linda B Maletis
Director1.00X000
Kelly J Johnson
Exec Vice-Pres.1.00XX000
Junki Yoshida
Director1.00X000
Judi C Inglis
Director1.00X000
Joseph E Robertson MD MBA
Director1.00X07305230
J Craig Wessel
Director1.00X000
H Stacy Nicholson MD MPH
Director1.00X03090000
Gerald E Reser
Director1.00X000
Elizabeth K Johnson
Director1.00X000
Edward J Hepp
Director1.00X000
DJ Wilson
Director1.00X000
Dirk T Davis
VP Finance1.00XX000
David F Evans
Director1.00X000
Christina H Blackwell
Director1.00X000
Cheryl C Joshi
Director1.00X000
Cathrine McCoy
Director1.00X000
Carol K Ehlen
Secretary1.00XX000
Candace D Young
Director1.00X000
Bryan L Timm
Director1.00X000
Arthur K Olmsted
Director1.00X000
Allyn C Ford
Director1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org326660TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1039523TotalReportableCompFrmRltdOrgs
Total Other Compensation97998TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcestrueCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Federated Campaigns481087FederatedCampaigns
Fundraising Events1132939FundraisingEvents
All Other Contributions8185018AllOtherContributions
Noncash Contributions1212651NoncashContributions
Total Contributions9799044TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Public Education454454
Outreach Activities81408140
FieldValueIRS element (for citing)
Total Program Service Revenue8594TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column341832TotalRevenueColumn
Exclusion$341,832ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities17448470Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities17373683Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities74787Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column74787TotalRevenueColumn
Exclusion$74,787ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events161927GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events1132939CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses179854FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-17927TotalRevenueColumn
Exclusion-$17,927ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountUnrelated Business RevenueUnrelatedBusinessRevenue
Miscellaneous Sales90009922863$22,863
Holiday Card Sales4532205463354633
FieldValueIRS element (for citing)
Total Other Revenue77496TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column10283826TotalRevenueColumn
Related Or Exempt Function Income8594RelatedOrExemptFunctionIncome
Unrelated Business Revenue54633UnrelatedBusinessRevenue
Exclusion$421,555ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total11267716Total
Program Services11267716ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6927Total
Management And General5210ManagementAndGeneral
Fundraising1717Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total83249Total
Program Services14950ProgramServices
Management And General67899ManagementAndGeneral
Fundraising400Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total91534Total
Program Services5794ProgramServices
Management And General26312ManagementAndGeneral
Fundraising59428Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total11000Total
Management And General11000ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total14203Total
Program Services2544ProgramServices
Management And General11553ManagementAndGeneral
Fundraising106Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total71973Total
Management And General2938ManagementAndGeneral
Fundraising69035Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total12986Total
Management And General6031ManagementAndGeneral
Fundraising6955Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total4453Total
Management And General728ManagementAndGeneral
Fundraising3725Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4260Total
Management And General4260ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total21492Total
Management And General21492ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralFundraisingFundraisingProgram ServicesProgramServices
Printing and Publications1172529928107324
Other Nonoperating Activities316420316420
Membership fees134450134450
Management & Admin Fee830688566920138941124827
Contracted Staff754224754224

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total174692Total
Management And General113803ManagementAndGeneral
Fundraising60889Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13917519Total
Program Services11415831ProgramServices
Management And General1164494ManagementAndGeneral
Fundraising1337194Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY356020BOY
EOY602270EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3815885BOY
EOY1535165EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1797076BOY
EOY639445EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY446674BOY
EOY458938EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY5100BOY
EOY0EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis44561LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec31468LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1554BOY
EOY13093EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY27916820BOY
EOY28835290EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY7985746BOY
EOY10816744EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY20539BOY
EOY19375EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY42345414BOY
EOY42920320EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY707073BOY
EOY880347EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2074386BOY
EOY4583340EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2781459BOY
EOY5463687EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY28050586BOY
EOY24328236EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY1554BOY
EOY13093EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY11511815BOY
EOY13115304EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY39563955BOY
EOY37456633EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY42345414BOY
EOY42920320EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12713753CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17580941CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13543219CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11075231CurrentTaxYearMinus1Year
Current Tax Year9799074CurrentTaxYear
Total64712218Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12713753CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years17580941CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years13543219CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year11075231CurrentTaxYearMinus1Year
Current Tax Year9799074CurrentTaxYear
Total64712218Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total7933197AmountsSubstContributorsTotal
Public Support Total17056779021PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years231814CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years334250CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years410252CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year172588CurrentTaxYearMinus1Year
Current Tax Year241832CurrentTaxYear
Total1390736Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Total Support66102954TotalSupport
Public Support Pertcentage1700.85890PublicSupportPertcentage170
Public Support Pertcent Prior Year0.86070PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Number DA Fs Held1NumberDAFsHeld
Donor Advised Contributions11508DonorAdvisedContributions
Grants Paid From Donor Funds5000GrantsPaidFromDonorFunds
Aggregate DAF Value110367AggregateDAFValue
Disclosed Orgs Legal ControltrueDisclosedOrgsLegalControl
Disclosed For Charitable PurposestrueDisclosedForCharitablePurposes

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance15804093BeginningOfYearBalance
Contributions2627373Contributions
Investment Earnings Or Losses1769021InvestmentEarningsOrLosses
Grants Or Scholarships10128GrantsOrScholarships
Other Expenditures884440OtherExpenditures
Administrative Expenses204516AdministrativeExpenses
End Of Year Balance19101403EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance20902325BeginningOfYearBalance
Contributions657043Contributions
Investment Earnings Or Losses-4609052InvestmentEarningsOrLosses
Grants Or Scholarships10419GrantsOrScholarships
Other Expenditures899161OtherExpenditures
Administrative Expenses236643AdministrativeExpenses
End Of Year Balance15804093EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.26180BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.72390PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.01430TermEndowmentEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6000OtherCostOrOtherBasis
Depreciation6000Depreciation

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis38561OtherCostOrOtherBasis
Depreciation25468Depreciation
Book Value13093BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13093TotalOfBookValueLandBuildings
Total Of Book Value Securities10816744TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Liability for life income agreements$1,712,691
Due to other institutions$116,515
Due to OHSU$2,754,134
FieldValueIRS element (for citing)
Total Of Amounts4583340TotalOfAmounts
Total Revenue10283826TotalRevenue
Total Expenses13917519TotalExpenses
Excess Or Deficit For Year-3633693ExcessOrDeficitForYear
Net Unrealized GL On Investments1621918NetUnrealizedGLOnInvestments
Investment Expenses229423InvestmentExpenses
Other$133,876OtherAmount
Total Adjustments1985217TotalAdjustments
Excess Or Deficit Per FS-1648476ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt12039620TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1621918NetUnrealizedGainsInvestments
Other Revenues133876OtherRevenues
Revenue Not Rptd F9901755794RevenueNotRptdF990
Revenue Subtotal10283826RevenueSubtotal
Total Revenue Per Form99010283826TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13688096TotExpensesEtcAuditedFinclStmt
Expenses Subtotal13688096ExpensesSubtotal
Investment Expenses Not Included2229423InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt229423ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013917519TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990Change in Value of Life Income Agmt $133876
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesChange in Value of Life Income Agmts $133876
Part V, Line 4Part V, Line 4: Intended uses of the endowment fund.An endowed fund may support a specific department, program, people or purposes such as a faculty professorship or chair, scholarship or fellowship, research activity, visiting lecturer or patient care.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Nike AuctionNameOfEvent1
Gross Receipts Event1695988GrossReceiptsEvent1
Charitable Contributions Event1671925CharitableContributionsEvent1
Gross Revenue Event124063GrossRevenueEvent1
Other Direct Expenses Event150346OtherDirectExpensesEvent1
Name Of Event2Heart AuctionNameOfEvent2
Gross Receipts Event2544853GrossReceiptsEvent2
Charitable Contributions Event2412169CharitableContributionsEvent2
Gross Revenue Event2132684GrossRevenueEvent2
Other Direct Expenses Event2121264OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events54025GrossReceiptsOtherEvents
Charitable Contrib Other Events48845CharitableContribOtherEvents
Gross Revenue Other Events5180GrossRevenueOtherEvents
Other Direct Expenses Other Events8244OtherDirectExpensesOtherEvents
Gross Receipts Total1294866GrossReceiptsTotal
Charitable Contributions Total1132939CharitableContributionsTotal
Gross Revenue Total Events161927GrossRevenueTotalEvents
Other Direct Expenses Total Events179854OtherDirectExpensesTotalEvents
Direct Expense Summary Events179854DirectExpenseSummaryEvents
Net Income Summary-17927NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrant
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)70310Pediatric Student Fin. Aid
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)5945040Pediatric Related Instruction
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)5699760Pediatric Public Support
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)4355960Pediatric Institutional Support
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)42591870Pediatric Academic Support
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)20347630Pediatric Capital Projects
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)20070980Pediatric Related Research
Oregon Health & Science University
3181 SW Sam Jackson Park RdPortlandOR97239931176109170 (c) (1)13595610Pediatric Clinical Support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationTransfers are made to Oregon Health & Science University for the benefit of Doernbecher Children's Hospital (DCH) and the Department of Pediatrics based upon DCH providing authorized documentation of satisfaction of donors' intent. Authorization is controlled and limited to select individuals with the knowledge and responsibility of ensuring the transfers are made in accordance with donor intent. Documentation can include providing labor, equipment and construction reports produced that substantiate salary expenses, equipment purchases and construction costs incurred.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgs
Susan Nicol
1727882073531101224624
Lori Mueller
1538721846527697200034
Joseph E Robertson MD MBA
6840321982326668730523
H Stacy Nicholson MD MPH
309000309000

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions8NumberOfContributions
Noncash Contribs Rptd F9901165483NoncashContribsRptdF990
Method Of Determining RevenuesFMV-SalesPriceMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionAuction ItemsDescription
Number Of Contributions65NumberOfContributions
Noncash Contribs Rptd F99047168NoncashContribsRptdF990
Method Of Determining RevenuesCostMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedtrueThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierPart I, Line 32, Hire and Use of Third PartiesIdentifier
ExplanationThe organization partners with Volunteers of America for the collection and sale of gifts of automobiles. The organization also engages the services of real estate agents when selling gifts of real property. The organization uses stock brokers to process and sell securities. The services of marketing firms in the solicitation of planned gifts is also used.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableWhile federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspections, limited information on the governing documents, conflict of interest policy and financial statements is available at the organization's website. This information is not readily available for the general public and requests for this information are assessed on a case by case basis by the relevant foundation employee before disclosure.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsAn annual conflict of interest questionnaire and statement to sign are provided to each covered person to disclose any interests that could give rise to conflicts of interest. Covered persons include officers, directors, chief executive, chief finance executive and senior management. The Executive Committee and the President of the Board reviews conflict of interest statements. The President determines the action to take regarding any persons with conflict of interest. This may include, but not limited to, asking the person not to participate in related decisions or asking the person to resign from the position.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessThe VP of Finance and the Controller of the Oregon Health and Science University Foundation review the final draft of Form 990. In addition, the final draft of Form 990 is also reviewed by an outside accounting firm. This draft is then provided to the organization's finance and audit committee, and then to the executive committee. The executive committee reviews the form and upon its approval, the committee recommends the final copy to the Board for acceptance and authorization. The final copy of the return is approved by the voting Board. The Executive Director of the Foundation reviews and signs the return before it is filed.
Form 990, Part III, Line 2Form 990, Part III, Line 2: New ServicesDoernbecher Children's Hospital Foundation is a 501c(3) organization that exists to solicit private philanthropic support for Doernbecher Children's Hospital and to invest and manage gifts to honor donors' wishes. Each year the commitment and generosity of thousands of donors - individuals, companies, foundations and organizations - helps provide innovative health care, educate tomorrow's pediatric experts, and support pioneering research to benefit children in Oregon, southwest Washington and beyond. Among other accomplishments during the 2009-2010 fiscal year, the Doernbecher Foundation:Addressed the growing incidence of pediatric diabetes in Oregon and southwest Washington by establishing an endowed professorship for the Medical Director of the Pediatric Diabetes Program at the Harold Schnitzer Diabetes Health Center. Enabled by an anonymous $1 million gift, the Vivian Nye Endowed Professorship will make it possible to expand the pediatrics program and recruit a leader for child and adolescent care at the Schnitzer Center, the only facility west of the Rocky Mountains that cares for both pediatric and adult patients within the same clinical enterprise. Raised $695,000 in the 2010 fiscal period from Doernbecher Freestyle, a partnership with Oregon-based Nike, Inc. Entering its seventh year, this innovative program gives six Doernbecher patients the chance to design unique athletic shoes. This year's shoes were marketed nationally, with proceeds, including funds raised during an annual unveiling/auction event, benefiting Doernbecher.Received more than $326,000 collectively raised for Doernbecher by children from more than 100 schools across Oregon and southwest Washington through the annual Kids Making Miracles program. Celebrating its 18th year, the program helps kids hold a wide range of fund-raising events in their communities, instilling the values of philanthropy while providing valuable experience in organization and leadership. Generated more than $321,000 in pledges through the annual Doernbecher radiothon on radio station 99.5 FM "The Wolf."Raised more than $586,000 at the 11th Annual Heart of Doernbecher Auction to support Doernbecher's Epilepsy Monitoring Program. Received nearly $3.2 million in bequest gifts facilitated by the Department of Gift Planning and supporting a variety of programs. These include $1.2 million from the Irene & Willard Olds Trust Estate in support of the area of greatest need at Doernbecher; $215,421 from the Pauline A. Mandel Estate to support the Pediatric Emergency Department program; $176,707 from the Elsbeth Jeworek Estate for the Underfunded Medical Care Needs Fund; and $162,288 from the Donovan A. Croxton Trust Estate in support of the Pediatrics Preclinical Testing Initiative. The foundation also received $218,583 in other planned gifts including three charitable gift annuities totaling $174,000 from Louis and Oda Bush, one gift annuity for $20,000 from Donald J. Matson and another for $24,583 from Nan Shaffner.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Doernbechers Children Hospital Group
1121 SW Salmon Street Suite 100PortlandOR97205931329815FundraisingOR501(c)(3)7NA
Oregon Health & Science University
3181 SW Sam Jackson Park RoadPortlandOR97239931176109Hospital, university, researchOR170(c)(1)NA
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Oregon Health & Science UniversityBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypebTransactionType
Amount Involved11267716AmountInvolved

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