Form990
Click to see attachment
Department of the Treasury
Internal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except black lung benefit trust or private foundation)

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2010 and ending 12-31-2010
BCheck if applicable:
CName of organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Doing Business As
HUNTINGTON MEMORIAL HOSPITAL
 
Number and street (or P.O. box if mail is not delivered to street address)
100 WEST CALIFORNIA BLVD
 
Room/suite
City or town, state or country, and ZIP + 4
PASADENA, CA91105
D Employer identification number

95-1644036
E Telephone number

G Gross receipts $ 947,700,045
F Name and address of principal officer:
STEPHEN A RALPH
100 WEST CALIFORNIA BLVD
PASADENA,CA91105
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.huntingtonhospital.com
H(a)
Is this a group return for
affiliates?
H(b)
Are all affiliates included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1892
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: AT HUNTINGTON, OUR MISSION IS TO EXCEL AT THE DELIVERY OF HEALTH CARE TO OUR COMMUNITY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 25
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 21
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 3,122
6 Total number of volunteers (estimate if necessary) .... 6 1,431
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 6,331,543
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 37,839,846 29,540,020
9 Program service revenue (Part VIII, line 2g) ......... 462,837,589 532,305,711
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... -2,579,910 14,877,220
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 4,664,933 4,203,374
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 502,762,458 580,926,325
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 16,030 307,800
14 Benefits paid to or for members (Part IX, column (A), line 4) .... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 257,473,822 260,123,518
16a Professional fundraising fees (Part IX, column (A), line 11e).... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet2,537,480    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 215,766,122 272,391,965
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 473,255,974 532,823,283
19 Revenue less expenses. Subtract line 18 from line 12...... 29,506,484 48,103,042
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 734,848,062 795,006,358
21 Total liabilities (Part X, line 26)............ 378,336,469 380,559,931
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 356,511,593 414,446,427
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: AT HUNTINGTON, OUR MISSION IS TO EXCEL AT THE DELIVERY OF HEALTH CARE TO OUR COMMUNITY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 452,964,995 including grants of $ 307,800 ) (Revenue $ 535,029,668 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services. (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet$ 452,964,995
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part III........................
5
 
 
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
Yes
 
11
If the organization’s answer to any of the following questions is ‘Yes,’ then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable:
a
Did the organization report an amount for land, buildings, and equipment in Part X, line10? If “Yes,” complete Schedule D, Part VI.Click to see attachment
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VII.Click to see attachment
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIII.Click to see attachment
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part IX.Click to see attachment
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I......... Click to see attachment
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
Yes
 
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part IClick to see attachment
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II.......... Click to see attachment
18
Yes
 
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III................... Click to see attachment
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see list of attachments
20b
 
No
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
Yes
 
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
609
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable.
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements filed for the calendar year ending with or within the year covered by this return .....................
2a
3,122
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?

Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?.............................
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No,” provide an explanation in Schedule O.....
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account or securities account)?.......................
4a
 
No
b
If "Yes," enter the name of the foreign country: MediumBullet
See instructions for filing requirements for Form TD F 90-22.1, Report of Foreign Bank and Financial Accounts.
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If “Yes” to line 5a or 5b, did the organization file Form 8886-T? ........
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible?..........
6a
 
No
b
If “Yes,” did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?........................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?....................
7a
Yes
 
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?...........................
7c
 
No
d
If “Yes,” indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?..........................
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?...................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?...............
7h
 
No
8
Sponsoring organizations maintaining donor advised funds and section 509(a)(3) supporting organizations. Did the supporting organization, or a donor advised fund maintained by a sponsoring organization, have excess business holdings at any time during the year?................
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the organization make any taxable distributions under section 4966?.........
9a
 
 
b
Did the organization make a distribution to a donor, donor advisor, or related person?......
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) ........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If “Yes,” enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state?
Note. All 501(c)(29) organizations must list in Schedule O each state in which they are licensed to issue qualified health plans, the amount of reserves required by each state, and the amount of reserves the organization allocated to each state.
13a
 
 
b
Enter the aggregate amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans.
13b
 
c
Enter the aggregate amount of reserves on hand.
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
 
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
25
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
21
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
Yes
 
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
Yes
 
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
 
No
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
Yes
 
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
Yes
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
PRISCILA MAINIT
100 WEST CALIFORNIA BLVD
PASADENA,CA91105
(626) 397-5337
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (Box 5 of Form W-2 and/or Box 7 of Form 1099-MISC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) Michelle Quinones Chino
Board of Directors
 1.0 X           0 0 0
(2) Suzanne Crowell
Board of Directors
 1.0 X           0 0 0
(3) R-lene Mijares deLang
Board of Directors
 1.0 X           0 0 0
(4) Kalman Edelman MD
Board of Directors
 1.0 X           0 0 0
(5) Charles Elachi PhD
Board of Directors
 1.0 X           0 0 0
(6) Reed Gardiner
Board of Directors
 1.0 X           0 0 0
(7) Winston Gooden PhD
Board of Directors
 1.0 X           0 0 0
(8) Steven G Katz MD
Board of Directors
 1.0 X           0 0 0
(9) David M Kirchheimer
Board of Directors
 1.0 X           0 0 0
(10) Ellen Lee
Board of Directors
 1.0 X           0 0 0
(11) Harvey Lenkin
Board of Dir - Vice Chairman
 1.0 X   X       0 0 0
(12) Leonard M Marangi
Board of Directors - Secretary
 1.0 X   X       0 0 0
(13) Allen W Mathies Jr MD
Board of Directors
 1.0 X           5,000 0 27,186
(14) Lois S Matthews
Board of Directors
 1.0 X           0 0 0
(15) Paul L H Ouyang
Board of Directors - Treasurer
 1.0 X   X       0 0 0
(16) Kathleen Good Podley
Board of Directors
 1.0 X           0 0 0
(17) Carmen A Puliafito MD
Board of Directors
 1.0 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Stephen A Ralph
Board of Dir - President/CEO
 55.0 X   X       722,082 0 297,114
(19) James F Rothenberg
Board of Directors - Chairman
 1.0 X   X       0 0 0
(20) Charles F Sharp MD
Board of Directors
 1.0 X           125,000 0 0
(21) John C Siciliano
Board of Directors
 1.0 X           0 0 0
(22) Rosemary Simmons
Board of Directors
 1.0 X           0 0 0
(23) Jaynie Studenmund
Board of Directors
 1.0 X           0 0 0
(24) Jon R Yasuda
Board of Directors
 1.0 X           0 0 0
(25) Robert Y Yu
Board of Directors
 1.0 X           0 0 0
(26) James S Noble
SVP, Chief Financial Officer
 55.0     X       517,033 0 63,291
(27) Jane Haderlein
SVP, External Affairs
 55.0       X     412,373 0 54,570
(28) Bonnie L Kass
VP, Chief Nurse Executive
 55.0       X     344,484 0 68,339
(29) Bernadette L Merlino
VP, Clinical Strategy
 55.0       X     311,349 0 49,803
(30) Debra L Tafoya
Vice President & CIO HR/IS
 55.0       X     294,724 0 59,036
(31) Paula Verrette MD
VP, Quality/PI
 55.0       X     414,528 0 94,441
(32) Jeffrey P Weigand
President, Congress Service
 55.0       X     250,267 0 39,416
(33) Christopher Williams
VP, Facilities & Construction
 55.0       X     301,847 0 57,641
(34) Samuel I Breneiser
Exec Dir, Contract/Prov Rltn
 40.0         X   242,109 0 22,702
(35) James C Liu
Medical Physicist Phd
 40.0         X   234,048 0 22,653
(36) Rebecca Armato
Exec Dir,Interoperability Svcs
 40.0         X   216,016 0 5,302
(37) Peggy Crabtree
Exec Director, Cardiac Svcs
 40.0         X   215,627 0 35,128
(38) Angel Hovanessian
Dir,Patient Access & Rev Cycle
 40.0         X   211,333 0 17,430
(39) Scott T Cebula
Former VP, Chief Info Officer
 0.0           X 415,085 0 26,323
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,232,905 0 940,375
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet382
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Tower General Contractors
10923 Randall Street Suite E
SUN VALLEY,CA91352 		Construction 13,729,459
E H Butland Corporation
6100 Yolanda Ave
RESEDA,CA91335 		Construction 6,747,356
Davis Wright Tremaine LLP
1201 Third Avenue Suite 2200
SEATTLE,WA98101 		Legal Svcs 1,717,199
Crothall Laundry Services
13028 Collections Center Dr
CHICAGO,IL60693 		Laundry Svcs 1,700,582
Aramark Corp
25271 Network Place
CHICAGO,IL60673 		Management Svcs 1,425,352
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet113
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c 272,392
d Related organizations...1d 3,798,875
e Government grants (contributions)1e 1,369,215
f All other contributions, gifts, grants, and
similar amounts not included above1f 		24,099,538
g Noncash contributions included in lines 1a-1f:$ 4,230,015
h Total. Add lines 1a-1f.......MediumBullet 29,540,020
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 622,110 519,813,986 519,813,986    
b MANAGEMENT SERVICE REVENUE 541,610 5,774,689   5,774,689  
c PARKING REVENUE 812,930 1,349,354 1,349,354    
d RENTAL INCOME 531,120 1,255,558 1,255,558    
e LABORATORY REVENUE 621,500 1,195,972 639,118 556,854  
f All other program service revenue . 2,916,152 2,916,152    
g Total. Add lines 2a–2f........MediumBullet 532,305,711
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 3,591,823     3,591,823
4 Income from investment of tax-exempt bond proceeds..MediumBullet 837,613     837,613
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross Rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 375,502,244  
b Less: cost or other basis and sales expenses 365,054,460  
c Gain or (loss) 10,447,784  
d Net gain or (loss)..........MediumBullet 10,447,784     10,447,784
8a Gross income from fundraising events (not including
$ 272,392
of contributions reported on line 1c). See Part IV, line 18 ...
a 109,213
b Less: direct expenses ...b 141,688
c Net income or (loss) from fundraising events..MediumBullet -32,475   -32,475
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a 1,867,645
b Less: cost of goods sold ..b 1,577,572
c Net income or (loss) from sales of inventory..MediumBullet 290,073 86,042   204,031
Miscellaneous Revenue Business Code
11a FOOD SERVICES 722,310 2,635,363 2,635,363    
b CONCIERGE SERVICE REVENUE 900,099 1,307,861     1,307,861
c DAYCARE 624,410 2,552 2,552    
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 3,945,776
12 Total revenue. See Instructions....MediumBullet 580,926,325 528,698,125 6,331,543 16,356,637
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 300,000 300,000
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16 7,800 7,800
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 4,628,779 130,000 4,498,779  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 12,510 12,510    
7 Other salaries and wages 178,733,297 160,289,176 17,422,335 1,021,786
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 16,323,845 11,587,912 4,671,034 64,899
9 Other employee benefits ....... 45,203,490 35,595,844 9,359,473 248,173
10 Payroll taxes ........... 15,221,597 13,338,617 1,801,683 81,297
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 2,290,006   2,290,006  
c Accounting ........... 811,285   811,285  
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 633,337   633,337  
g Other .......... 41,216,634 31,551,919 9,324,541 340,174
12 Advertising and promotion .... 0      
13 Office expenses ....... 101,277,140 95,896,185 5,053,031 327,924
14 Information technology ...... 5,040,215 3,547,625 1,472,721 19,869
15 Royalties .. 0      
16 Occupancy ........... 16,706,144 11,397,245 5,251,329 57,570
17 Travel ............ 584,824 304,739 118,078 162,007
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 507,722 198,748 305,816 3,158
20 Interest ........... 11,372,835 8,004,939 3,323,064 44,832
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 30,096,732 23,954,803 6,045,428 96,501
23 Insurance .............. 2,562,596 2,562,596    
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a HOSPITAL FEES PROGRAM 35,396,900 35,396,900    
b BAD DEBT EXPENSE 17,617,188 17,617,188    
c IMPAIRMENT CHARGES 4,340,572   4,340,572  
d FOOD/DAY CARE/CLINICAL 817,083 696,527 118,951 1,605
e ALL OTHER EXPENSES 1,120,752 573,722 479,345 67,685
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 532,823,283 452,964,995 77,320,808 2,537,480
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 14,515 1 14,887
2 Savings and temporary cash investments ....... 16,112,485 2 36,084,283
3 Pledges and grants receivable, net ......... 12,821,364 3 13,218,745
4 Accounts receivable, net ......... 82,683,399 4 80,432,184
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 684,525 5 665,119
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 9,191,769 8 7,699,546
9 Prepaid expenses and deferred charges ............ 5,074,945 9 5,148,789
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 649,982,738
b Less: accumulated depreciation. ..... 10b 269,888,151 367,193,625 10c 380,094,587
11 Investments—publicly traded securities .......... 181,339,025 11 208,484,777
12 Investments—other securities. See Part IV, line 11 ......   12  
13 Investments—program-related. See Part IV, line 11 .. 1,724,626 13 1,959,323
14 Intangible assets ......... 0 14 2,957,809
15 Other assets. See Part IV, line 11 ........... 58,007,784 15 58,246,309
16 Total assets. Add lines 1 through 15 (must equal line 34)... 734,848,062 16 795,006,358
Liabilities 17 Accounts payable and accrued expenses . 57,493,313 17 61,741,157
18 Grants payable ..........   18  
19 Deferred revenue .......... 296,453 19 449,163
20 Tax-exempt bond liabilities .......... 222,117,842 20 217,593,075
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 98,428,861 25 100,776,536
26 Total liabilities. Add lines 17 through 25..... 378,336,469 26 380,559,931
Net Assets or Fund Balance Organizations that follow SFAS 117, check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets ..... 251,464,797 27 307,259,265
28 Temporarily restricted net assets ..... 84,683,346 28 84,321,683
29 Permanently restricted net assets ..... 20,363,450 29 22,865,479
Organizations that do not follow SFAS 117, check here MediumBullet and complete lines 30 through 34.
30 Capital stock or trust principal, or current funds .....   30  
31 Paid-in or capital surplus, or land, building or equipment fund .....   31  
32 Retained earnings, endowment, accumulated income, or other funds   32  
33 Total net assets or fund balances ..... 356,511,593 33 414,446,427
34 Total liabilities and net assets/fund balances ..... 734,848,062 34 795,006,358
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
580,926,325
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
532,823,283
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
48,103,042
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
356,511,593
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
9,831,792
6
Net assets or fund balances at end of year. Combine lines 3, 4, and 5 (must equal Part X, line 33, column (B)) . . . . . .
6
414,446,427
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service
Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....            
2 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......            
3 The value of services or facilities furnished by a governmental unit to the organization without charge..            
4 Total. Add lines 1 through 3..            
5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..            
6 Public Support. Subtract line 5 from line 4.            
Section B. Total Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
7 Amounts from line 4..            
8 Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
9 Net income from unrelated business activities, whether or not the business is regularly carried on..            
10 Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..            
11 Total support (Add lines 7 through 10).            
12
12
 
13
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
18
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .            
2 Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......            
3 Gross receipts from activities that are not an unrelated trade or business under section 513..            
4 Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...            
5 The value of services or facilities furnished by a governmental unit to the organization without charge..            
6 Total. Add lines 1 through 5.            
7a Amounts included on lines 1, 2, and 3 received from disqualified persons...            
b Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.            
c Add lines 7a and 7b..            
8 Public Support (Subtract line 7c from line 6.)            
Section B. Total Support
Calendar year (or fiscal year beginning in) (a) 2006 (b) 2007 (c) 2008 (d) 2009 (e) 2010 (f) Total
9 Amounts from line 6...            
10a Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..            
b Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.            
c Add lines 10a and 10b.            
11 Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.            
12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)            
13 Total support (Add lines 9, 10c, 11 and 12.).            
14
Section C. Computation of Public Support Percentage
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
19a
b
20
Schedule A (Form 990 or 990-EZ) 2010
Schedule A (Form 990 or 990-EZ) 2010
Page 4
Part IV
Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
 
Explanation
 
 
 
 
Schedule A (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
Schedule B
(Form 990, 990-EZ,
or 990-PF)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors
Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
OMB No. 1545-0047
2010
Name of organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule—
Special Rules
......................... Arrow Bullet   $    
Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
PASADENA HOSPITAL ASSOCIATION LTD
  		Employer identification number

95-1644036
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




(Complete Part II if there is
a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
PASADENA HOSPITAL ASSOCIATION LTD
  		Employer identification number

95-1644036
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
PASADENA HOSPITAL ASSOCIATION LTD
  		Employer identification number

95-1644036
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


Software ID:  
Software Version:  
SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 .........SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 ......SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............
4a
Was a correction made? .........................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c) except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities ....................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b..SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ..........................
5
Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.
(a) Name (b) Address (c) EIN (d) Amount paid from filing organization's funds. If none, enter -0-. (e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2010

Schedule C (Form 990 or 990-EZ) 2010
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
Organization's
Totals 		(b) Affiliated Group
Totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ......    
b Total lobbying expenditures to influence a legislative body (direct lobbying) .......    
c Total lobbying expenditures (add lines 1a and 1b) ...................    
d Other exempt purpose expenditures ........................    
e Total exempt purpose expenditures (add lines 1c and 1d) ...............    
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		    
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) .................    
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2007 (b) 2008 (c) 2009 (d) 2010 (e) Total
             
2a Lobbying non-taxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots non-taxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2010


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
Yes
 
30,665
j
Total. lines 1c through 1i ...................................
30,665
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
No
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
ORGANIZATION EXEMPT UNDER SEC 501(C)(3) THAT HAS NOT FILED FORM 5768 SCHEDULE C, PART II-B, LINE 1I PASADENA HOSPITAL ASSOCIATION, LTD. PAID DUES OF $217,327 TO HOSPITAL ASSOCIATION OF SOUTHERN CALIFORNIA. OF THIS AMOUNT, $30,665 IS ATTRIBUTABLE TO LOBBYING EXPENSES FOR HEALTHCARE ISSUES.
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance .... 103,936,580 96,161,818 120,091,776
b Contributions ........ 3,472,120 10,670,976 -4,811,679
c Investment earnings or losses ... 4,150,745 5,524,131 -10,911,774
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		3,258,429 8,420,345 8,206,505
f Administrative expenses ....      
g End of year balance ...... 108,301,016 103,936,580 96,161,818
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet40.809 %
b
Permanent endowment: SchDMd Bullet21.113 %
c
Term endowment: SchDMd Bullet38.079 %
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................      
b Buildings ................        
c Leasehold improvements ............   409,590,084 158,479,041 251,111,043
d Equipment ................   182,841,793 111,409,110 71,432,683
e Other .................   57,550,861 0 57,550,861
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 380,094,587
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet  
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) LEGACIES & BEQUEST ASSETS 33,225,785
(2) CASH VALUE INSURANCE 1,035,275
(3) DUE FROM AFFILIATES 2,838,832
(4) ACCRUED RECEIVABLE DONATIONS 501,430
(5) DUE FROM THIRD PARTY PAYORS 6,994,366
(6) DEBT ISSUE COST 1,748,891
(7) CONTRACT ACQUISITION COST 1,103,575
(8) OTHER ACCOUNTS RECEIVABLE 10,518,989
(9) INCENTIVE TO LESSEE 279,166
Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 58,246,309
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes 0
ACCRUED PENSION COST 68,069,334
ACCRUED SELF INSURANCE CLAIMS 20,565,300
DUE TO AFFILIATES 5,986,957
CAPITAL LEASE & OTH. FINANCING 4,914,854
PV GIFT ANNUITY & CRT 1,240,091




Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 100,776,536
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
ENDOWMENT FUNDS SCHEDULE D, PART V, LINE 4 BOARD DESIGNATED ENDOWMENTS CONSIST OF THE FUNDS THAT OUR BOARD PUTS ASIDE FOR CURRENT OR FUTURE PROJECTS. TERM ENDOWMENTS ARE THE FUNDS WE RECEIVE FROM RESTRICTED DONATIONS TO BE USED IN OPERATIONS. PERMANENT ENDOWMENT FUNDS ARE KEPT IN OUR INVESTMENT PORTFOLIO AND WE USE THE RETURN ON INVESTMENTS TO FUND OUR OPERATIONS.
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE F
(Form 990)

Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,
Part IV, line 14b, 15, or 16.
Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of the grants or
assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award
the grants or assistance? ...................................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of grant funds outside the
United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .....      
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b)      
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
TUITION AND RENT Sub-Saharan Africa 1 7,800 WIRE TRNSFER      
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2010
Schedule F (Form 990) 2010
Page 5
Part V
Supplemental Information
Complete this part to provide the information (see instructions) required in Part I, line 2, and any additional information.
Identifier ReturnReference Explanation
FORM 990, PART III, COLUMN (C)   THE GRANT WAS USED TO PROVIDE TUITION AND RENTAL ASSISTANCE TO A MEDICAL STUDENT IN TANZANIA TO SUPPORT HIS MEDICAL EDUCATION. ACCOUNTING METHOD USED FORM 990, PART III, COLUMN (D) THE AMOUNT OF THE GRANT IN PART III WAS DETERMINED USING THE ACCRUAL METHOD OF ACCOUNTING.
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2010
Additional Data


Software ID:  
Software Version:  



SCHEDULE G
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19,
or if the organization entered more than $15,000 on Form 990-EZ, line 6a.
right arrow Attach to Form 990 or Form 990-EZ. right arrow See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If “Yes,” list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization. Form 990-EZ filers are not required to complete this table.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
Total .................right arrow      
3
List all states in which the organization is registered or licensed to solicit funds or has been notified it is exempt from registration or licensing.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 on Form 990-EZ, line 6a. List events with gross receipts greater than $5,000.
(a) Event #1

FALL FOOD/WINE
(event type) 		(b) Event #2

 
(event type) 		(c) Other Events

0
(total number) 		(d) Total Events
(Add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . . 381,605     381,605
2 Less: Charitable
contributions . . . 		272,392     272,392
3 Gross income (line 1
minus line 2) . . . 		109,213     109,213
VerticalDirectExpenses 4 Cash prizes . . .        
5 Non-cash prizes . .        
6 Rent/facility costs . . 5,000     5,000
7 Food and beverages . . 569     569
8 Entertainment . . . 3,600     3,600
9 Other direct expenses . 132,519     132,519
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow 141,688
11 Net income summary. Combine lines 3 and 10 in column (d)............ right arrow -32,475
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (Add col. (a) through col. (c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
 
 
 
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Combine lines 1 and 7 in column (d) .......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," Explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," Explain:
 
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ...........................
Schedule G (Form 990 or 990-EZ) 2010
Schedule G (Form 990 or 990-EZ) 2010
Page 3
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
 
b
An outside facility ........................
13b
 
14
Provide the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Complete this part to provide additional information for responses to quuestion on Schedule G (see instructions.)
Identifier ReturnReference Explanation
Schedule G (Form 990 or 990-EZ) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
Yes
 
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		  1,398 16,664,614 6,690,114 9,974,500 1.940 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		  24,049 94,295,898 79,968,714 14,327,184 2.780 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....            
dTotal Charity Care and
Means-Tested Government Programs ..... 		  25,447 110,960,512 86,658,828 24,301,684 4.720 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		26 305,438 5,701,530 352,535 5,348,995 1.040 %
f Health professions education
(from Worksheet 5) .. 		4 5,138 16,609,325 1,214,971 15,394,354 2.990 %
g Subsidized health services
(from Worksheet 6) .. 		7 19,618 7,260,498 2,243,093 5,017,405 0.970 %
h Research (from Worksheet 7) 1 0 717,363 0 717,363 0.140 %
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		  0 637,710 0 637,710 0.120 %
jTotal Other Benefits ... 38 330,194 30,926,426 3,810,599 27,115,827 5.260 %
kTotal. Add lines 7d and 7j. .. 38 355,641 141,886,938 90,469,427 51,417,511 9.980 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development 1 0 3,910 0 3,910 0 %
3 Community support 1 213 15,614 0 15,614 0 %
4 Environmental improvements            
5 Leadership development and training for community members 1 216 1,236 0 1,236 0 %
6 Coalition building 1 100 31,130 4,505 26,625 0.010 %
7 Community health improvement advocacy 1 3,480 427,015 0 427,015 0.080 %
8 Workforce development            
9 Other 3 1,250 94,772 0 94,772 0.020 %
10 Total 8 5,259 573,677 4,505 569,172 0.110 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
14,328,933
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
131,021,601
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
145,107,715
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-14,086,114
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?1
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 Huntington Memorial Hospital
100 W California Blvd
Pasadena,CA91109 		X X   X     X    
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:Huntington Memorial Hospital
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet those needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Development of a community benefit plan for the facility
d Participation in community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the CHNA
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs. 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8    
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?.. 9    
If “Yes,” indicate the FPG family income limit for eligibility for free care:   %
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 5
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care to low income individuals?......... 10    
If “Yes,” indicate the FPG family income limit for eligibility for discounted care:   %
11 Explained the basis for calculating amounts charged to patients?................. 11    
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12    
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13    
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted at all times on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........ 14    
15 Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments or arrests
e Other (describe in Part VI)
16 Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?................................... 16    
If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other (describe in Part VI)
17 Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
e Other (describe in Part VI)
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 6
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18    
If “No,” indicate the reasons why (check all that apply):
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility did not have a policy relating to emergency medical care
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Charges for Medical Care
19 Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
a The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
b The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
c The hospital facility used the Medicare rate for those services
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20    
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?................................... 21    
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 7
Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?7
Name and address Type of Facility (Describe)
1 HUNTINGTON HOSP CANCER CNTRRAD ONCOLOGY
625 S Fair Oaks Ave Suite 100
PASADENA,CA91105 		DIAGNOSTIC/TREATMENT CENTER
2 HUNTINGTON HOSP CANCER CNTRRAD ONCOLOGY
625 S Fair Oaks Ave Suite 100
PASADENA,CA91105 		DIAGNOSTIC/TREATMENT CENTER
3 HUNTINGTON HOSP CANCER CNTRRAD ONCOLOGY
625 S Fair Oaks Ave Suite 100
PASADENA,CA91105 		DIAGNOSTIC/TREATMENT CENTER
4 HUNTINGTON HOSP CANCER CNTRRAD ONCOLOGY
625 S Fair Oaks Ave Suite 100
PASADENA,CA91105 		DIAGNOSTIC/TREATMENT CENTER
5 HUNTINGTON HOSP CANCER CNTRRAD ONCOLOGY
625 S Fair Oaks Ave Suite 100
PASADENA,CA91105 		DIAGNOSTIC/TREATMENT CENTER
6 HUNTINGTON HOSP CANCER CNTRRAD ONCOLOGY
625 S Fair Oaks Ave Suite 100
PASADENA,CA91105 		DIAGNOSTIC/TREATMENT CENTER
7 HUNTINGTON HOSP CANCER CNTRRAD ONCOLOGY
625 S Fair Oaks Ave Suite 100
PASADENA,CA91105 		DIAGNOSTIC/TREATMENT CENTER
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
PART I, LINE 6A   PASADENA HOSPITAL ASSOCIATION, LTD., DOING BUSINESS AS HUNTINGTON MEMORIAL HOSPITAL (HMH), COMPLETES AN ANNUAL COMMUNITY BENEFITS REPORT AND POSTS THIS REPORT ON THE HOSPITAL'S WEBSITE, LIKEWISE THIS REPORT IS SUBMITTED TO A STATE AGENCY THAT MAKES IT AVAILABLE TO THE PUBLIC.
PART I, LINE 7, COLUMN F   OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN (A) WERE $532,823,283. THE BAD DEBT INCLUDED IN THIS AMOUNT WAS $17,617,188. THIS LEFT US WITH TOTAL EXPENSES OF $515,206,095 FOR PURPOSES OF CALCULATING LINE 7, COLUMN (F). PART I, LINE 7B, COLUMN F THE UNREIMBURSED MEDICAID PERCENTAGE OF TOTAL EXPENSE IS INDICATING A MARKED DECLINE OVER THE PRIOR YEAR (5.48% IN TY2009 COMPARED TO 2.83% IN TY2010). THE PRIMARY CONTRIBUTOR TO THIS IS RELATED TO THE CALIFORNIA DEPARTMENT OF HEALTHCARE SERVICES HOSPITAL FEE PROGRAM. THIS SUPPLEMENTAL MEDI-CAL (CALIFORNIA MEDICAID) PROGRAM AIMS TO HELP CALIFORNIA HOSPITALS REGAIN SOME OF THE BILLIONS THEY LOST DURING 2009 BECAUSE OF LOWER MEDI-CAL REIMBURSEMENT RATES. FOR TY2010, THIS PROGRAM COVERED 21 MONTHS (APRIL 2, 2009 THROUGH DECEMBER 31, 2010) AND RESULTED IN HMH MITIGATING THE MEDI-CAL LOSSES INCURRED BY APPROXIMATELY $10 MILLION.
PART I, LINE 7G   HMH SUBSIDIZED SOME CLINICS AND PROGRAMS RELATED TO LOW-INCOME TRAUMA, SENIOR AND PERINATAL POPULATIONS. THESE INCLUDED A TRAUMA INTERAGENCY COMMUNICATION PROGRAM/TRAINING, LOW-INCOME SENIOR CARE CLINICS, LOW-INCOME MEDICARE/MEDI-CAL CLINICS, LOW-INCOME PERINATAL CLINICS AND EXPERIENCED A SHORT FALL FROM A STATE FUNDED CARE COORDINATION ASSOCIATED WITH THE MULTIPURPOSE SENIOR SERVICES PROGRAM (MSSP) FOR LOW-INCOME MEDICARE/MEDI-CAL POPULATIONS. NO COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS ARE INCLUDED.
PART I, LINE 7   MEDICAL CARE SERVICES PROVIDED TO CHARITY AND MEDI-CAL BENEFICIARIES RESULT IN SHORTFALLS FOR THE HOSPITAL. THESE SHORTFALL COSTS ARE NET OF ANY APPLICABLE PAYMENTS RECEIVED FROM CHARITY OR MEDI-CAL. THE METHOD FOR DETERMINING THESE SHORTFALLS IS BASED ON ACTUAL COSTS AS CALCULATED BY A COST ACCOUNTING SYSTEM. THIS ROBUST COST ACCOUNTING SYSTEM PRIMARILY UTILIZES A RELATIVE VALUE UNIT (RVU) COSTING APPROACH WHICH IS CALCULATED USING A SIMULTANEOUS EQUATIONS METHODOLOGY. THE COST ACCOUNTING SYSTEM INCLUDES ALL THE PATIENT TYPES (INPATIENT, OUTPATIENT & EMERGENCY) AND PAYORS (MEDICARE, MEDI-CAL, COMMERCIAL HMO, SENIOR HMO AND ALL OTHERS) SEEKING SERVICES AT THE HOSPITAL. PART I, LINE 7I PASSED INTO LAW BY THE CALIFORNIA STATE GOVERNMENT AND APPROVED BY CMS IN 2010, THE CALIFORNIA HOSPITAL FEE PROGRAM PROVIDED ENHANCED REVENUES RELATED TO PROVISION OF SERVICES TO MEDICAID BUSINESS, OFFSET TO A DEGREE BY THE REQUIREMENT TO PAY A FEE {KNOWN AS THE QUALITY ASSURANCE (QA) FEE} BASED ON ESTABLISHED RATES APPLIED TO EACH HOSPITAL'S HISTORICAL PATIENT DAYS. IN ADDITION TO THE QA FEE, HMH ENTERED INTO AN AGREEMENT WITH A 501(C)(3) CHARITABLE TRUST, CALIFORNIA HEALTH FOUNDATION & TRUST TO PLEDGE OVER $637,710 IN ADDITIONAL SUPPORT FOR THE CALIFORNIA HOSPITAL FEE PROGRAM DURING 2010. COMMUNITY BUILDING ACTIVITIES PART II HMH PLAYS AN ACTIVE ROLE IN COMMUNITY COALITION BUILDING IN COLLABORATION WITH A BROAD RANGE OF COMMUNITY AND PUBLIC ORGANIZATIONS ENCOMPASSING THE PUBLIC SECTOR, FAITH COMMUNITY, AND PRIVATE BUSINESS. BEYOND HEALTH CARE, HMH PARTICIPATES IN DEVELOPMENT OF SOCIAL AND ECONOMIC PROGRAMS TO ENCOURAGE IMPROVEMENTS IN SAFETY AND LEADERSHIP TRAINING, RECREATIONAL ACTIVITIES, "NEIGHBORHOOD CLUBS" OFFERING ASSISTANCE TO SINGLE PARENTS AND ELDERLY RESIDENTS, INCREASED INVOLVEMENT OF PARENTS IN SCHOOL POLICIES, ETC. SPECIFICALLY TO HEALTH CARE RELATED COMMUNITY BUILDING ACTIVITIES, HMH ENGAGES IN ACTIVITIES THAT INCLUDE OFFERING AN AMBULATORY CARE CENTER TO UNDER-INSURED AND UNINSURED PERSONS, PROVIDING SPECIALIZED PROGRAMS AND SERVICES FOR SENIORS AND PERSONS WHO ARE DISABLED (SENIOR CARE NETWORK), PROVIDING DEDICATED, MULTI-SESSION COMMUNITY HEALTH EDUCATION PROGRAMS ON TOPICS SUCH AS OBESITY PREVENTION, DIABETES AND ASTHMA FOR CHILDREN AND THEIR FAMILIES AS WELL AS ADULTS; PROVIDING COMMUNITY HEALTH EDUCATION AND SUPPORT PROGRAMS FOR A VARIETY OF HEALTH CONDITIONS AND DISEASES, HOSTING FLU CLINICS, OFFERING A HEALTH SCIENCE LIBRARY AND PARTNERING WITH COMMUNITY ORGANIZATIONS. THESE ACTIVITIES ILLUSTRATE HMH'S COMMITMENT TO SUPPORTING AND BUILDING THE COMMUNITY. IN EFFORTS TO IMPROVE ACCESS TO HEALTHCARE, HMH IS SPONSORING A GRANT SPECIFICALLY FOR THE START-UP AND OPERATION OF A NEWLY FORMED BUSINESS, PASADENA COMMUNITY URGENT CARE CENTER. THIS THREE YEAR GRANT FOR SUPPORT OF THE COMMUNITY HEALTH IMPROVEMENT ADVOCACY HAD THE FIRST INSTALLMENT OF APPROXIMATELY $300,000 DURING TY2010.
PART III, LINE 4   THE FOOTNOTES TO THE HMH FINANCIAL STATEMENTS DO NOT SPECIFICALLY ADDRESS THE RECORDING OF BAD DEBT EXPENSE. THE BAD DEBT EXPENSE AMOUNT IN THE STATEMENTS OF REVENUES AND EXPENSES AT HMH ARE INITIALLY WRITTEN DOWN TO THE NET AMOUNT TO REFLECT THE AMOUNT DUE HMH. THIS AMOUNT IS NET OF ANY CASH PAYMENTS RECEIVED AND ANY COURTESY DISCOUNTS OFFERED TO EITHER UNDER-INSURED OR UNINSURED PATIENTS. THE PORTION OF THIS NET RECEIVABLE THAT IS DUE FROM THE PATIENT IS DERIVED THROUGH ELIGIBILITY INQUIRY WITH THE RESPECTIVE INSURANCE CARRIERS. TO DETERMINE THE AMOUNT FOR SCHEDULE H, PART III, LINE 2, HMH USES A COST ACCOUNTING SYSTEM TO DETERMINE THE COST OF PATIENT ENCOUNTERS / ACCOUNTS. GIVEN BAD DEBT COLLECTIONS CAN SPAN MULTIPLE TAX YEARS IT IS NECESSARY TO APPORTION ONLY THE COSTS ASSOCIATED WITH THE CURRENT TAX YEAR. THIS IS ACCOMPLISHED USING A RATIO WHEREBY HMH APPLIES A BAD DEBT RATIO [UNCOLLECTED AMOUNT FROM PATIENT / TOTAL AMOUNT DUE FROM PATIENT AND/OR INSURANCE] TO TOTAL ENCOUNTER COST FROM THE COST ACCOUNTING SYSTEM FOR EACH ACCOUNT WRITTEN OFF TO BAD DEBT IN THE CURRENT YEAR.
PART III, LINE 8   THE MEDICARE SHORTFALL INCURRED BY HMH IS A COMMUNITY BENEFIT BECAUSE THE HOSPITAL PROVIDES NEEDED ACUTE, REHABILITATIVE, PSYCHIATRIC, OUTPATIENT AND TRAUMA CARE TO ASSIST THE ELDERLY AND ADULTS WHO ARE DISABLED RETURN TO GOOD HEALTH, ALL WHILE BEING PAID REIMBURSEMENT RATES FROM MEDICARE THAT COVER ONLY A FRACTION OF THE COST OF PROVIDING SUCH CARE. THE REPORTED MEDICARE SHORTFALL AMOUNT IS CONSISTENT WITH THE FILED COST REPORT AND IS NET OF DIRECT GME REVENUES AND COSTS REFLECTED IN PART I. THE MEDICARE COST REPORT CALCULATES MEDICARE COSTS FOR ACUTE CARE HOSPITALS USING RATIOS OF COST-TO-CHARGES AND CALCULATED PER DIEM AVERAGE.
PART III, LINE 9B   HMH DOES NOT PURSUE COLLECTION OF AMOUNTS FOR CARE WITHOUT CHARGE TO PATIENTS WHO MEET CERTAIN CRITERIA AND ARE KNOWN TO QUALIFY FOR CHARITY CARE. UNINSURED PATIENTS ARE AUTOMATICALLY EXTENDED COURTESY DISCOUNTS ON ALL INPATIENT AND EMERGENCY SERVICES TO PATIENTS WHO MEET CERTAIN LOW-INCOME GUIDELINES BUT ARE NOT ELIGIBLE FOR CHARITY CARE. THE CHARITY POLICY AND PROCEDURE SEEKS TO DIFFERENTIATE BETWEEN PATIENTS WHO DEMONSTRATE AN INABILITY TO PAY, VERSUS BAD DEBT, WHICH IS THE UNWILLINGNESS OF THE PATIENT TO PAY. THE COURTESY DISCOUNT AVERAGES APPROXIMATELY 70% OF GROSS CHARGES. THE BALANCE (APPROXIMATELY 30% OF GROSS CHARGE) IS BILLED TO THE PATIENT.
NEEDS ASSESSMENT   HMH PERFORMS A COMMUNITY NEEDS ASSESSMENT EVERY 3 YEARS, IN ACCORDANCE WITH CALIFORNIA COMMUNITY BENEFITS LEGISLATION FOR NOT-FOR-PROFIT HOSPITALS. REVIEW AND ANALYSIS OF HEALTH RELATED DATA, COMPARED WITH NATIONAL BENCHMARKS AND REGIONAL EXPERIENCES, COMBINED WITH CONSULTATION WITH COMMUNITY LEADERS AND REPRESENTATIVES OF LOCAL AGENCIES, ARE CONSIDERED IN IDENTIFYING THE TOP HEALTH ISSUES AND OPPORTUNITIES FOR IMPROVEMENT TO ARRIVE AT THE COMMUNITY NEEDS USED IN DETERMINING THE COMMUNITY BENEFITS PLAN.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE   THE ORGANIZATION PROVIDES EDUCATION TO PATIENTS ABOUT ELIGIBILITY FOR ASSISTANCE IN SEVERAL WAYS. FINANCIAL COUNSELORS ARE ON HAND TO EVALUATE PATIENTS FOR THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS, OR THE HOSPITAL'S CHARITY CARE AND DISCOUNT POLICIES, AND FACILITATE APPLICATION FOR ASSISTANCE. PATIENTS WHO ARE UNINSURED ARE GIVEN A NOTICE AT THE TIME OF ADMISSION/REGISTRATION, AND HMH POSTS NOTICES INFORMING PATIENTS OF ITS CHARITY CARE POLICY. ADDITIONALLY, HMH'S WEBSITE POSTS PAYMENT OPTIONS AND ALTERNATIVES AVAILABLE TO PATIENTS WITHOUT HEALTHCARE COVERAGE.
COMMUNITY INFORMATION   HUNTINGTON MEMORIAL HOSPITAL, LOCATED IN PASADENA, DEFINED THE "COMMUNITY" IT SERVES FOR PURPOSES OF NEEDS ASSESSMENT TO INCLUDE THE SERVICE AREA OF PASADENA, ALTA DENA, SAN MARINO, AND SOUTH PASADENA. THE SERVICE AREA POPULATION IS ESTIMATED AT 239,724 AS OF 2007, HAS INCREASED 8% SINCE CENSUS 2000, AND IS FORECAST TO INCREASE AN ADDITIONAL 6% IN THE NEXT 5 YRS. IN COMPARISON TO 2007 STATISTICS FOR LOS ANGELES COUNTY, THE SERVICE AREA HAS A HIGHER PROPORTION OF: PERSONS AGE 18-64 YEARS, AND 65 YEARS AND OLDER, PERSONS OF WHITE, ASIAN OR PACIFIC ISLANDER AND BLACK RACES, PERSONS SPEAKING ENGLISH AT HOME, ADULTS WITH SOME COLLEGE TO A COLLEGE DEGREE, AND EMPLOYED PERSONS. IT HAS A LOWER PROPORTION OF FAMILIES BELOW POVERTY LEVEL. HEART DISEASE AND CANCER WERE THE TOP TWO LEADING CAUSES OF DEATH IN THE SERVICE AREA.
PROMOTION OF COMMUNITY HEALTH   HMH HAS AN OPEN MEDICAL STAFF, AND A COMMUNITY BOARD (BOARD OF DIRECTORS COMPOSED PRIMARILY OF COMMUNITY MEMBERS). HMH CONDUCTS NUMEROUS ACTIVITIES THAT CONTRIBUTE TO PROMOTING THE HEALTH OF THE COMMUNITY. HMH PROVIDES CHARITY CARE FOR PATIENTS WITHOUT THE ABILITY TO PAY FOR NECESSARY TREATMENT, ABSORBS UNPAID COSTS OF CARE FOR PATIENTS WITH MEDI-CAL AND MEDICARE, OPERATES AN EMERGENCY ROOM ON A 24-HOUR BASIS, AND OFFERS AN AMBULATORY CARE CLINIC TO SERVE UNDER-INSURED AND UNINSURED PERSONS. HMH ALSO PROVIDES SPECIALIZED PROGRAMS AND SERVICES FOR SENIORS AND PERSONS WHO ARE DISABLED, PROVIDES COMMUNITY HEALTH EDUCATION, PREVENTION, AND SUPPORT PROGRAMS FOR A VARIETY OF HEALTH CONDITIONS AND DISEASES, HOSTS FLU CLINICS, OFFERS A HEALTH SCIENCES LIBRARY AND GRADUATE MEDICAL EDUCATION, AND PARTNERS WITH COMMUNITY ORGANIZATIONS.
STATES WHICH ORGANIZATION FILES A COMMUNITY BENEFIT REPORT   CALIFORNIA
Schedule H (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number
95-1644036
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21 for any recipient that received more than $5,000. Check this box if no one recipient received more than $5,000. Use
Part IV and Schedule I-1 (Form 990) if additional space is needed ......................... lBullet
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) HUNTINGTON MEDICAL FOUNDATION133 N ALTADENA DRIVE
2ND FLOOR
PASADENA,CA91107 		95-4434428 501(c)(3) 300,000       TO SUPPORT THE OPERATION OF THE URGENT CARE CENTER






















2
Enter total number of section 501(c)(3) and government organizations ......................... Bullet Image
1
3
Enter total number of other organizations ................................ . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2010

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance













Part IV
Supplemental Information. Complete this part to provide the information required in Part I, line 2, and any other additional information.
Identifier Return Reference Explanation
DESCRIPTION OF ORGANIZATION'S PROCEDURES FOR MONITORING THE USE OF GRANTS SCHEDULE I, PART I, LINE 2 THE USAGE OF THE GRANT IS MONITORED BY THE HOSPITAL'S EXTERNAL AFFAIRS AND THE PROGRESS OF THE OPERATION OF THE COMMUNITY URGENT CARE CENTER IS PERIODICALLY REPORTED TO THE BOARD.
Schedule I (Form 990) 2010


Additional Data


Software ID:  
Software Version:  


Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....
2
Yes
 
3
Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ...............
4a
Yes
 
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? ........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) Stephen A Ralph (i)
(ii)		 519,008
0 		156,240
0 		46,834
0 		261,165
0 		35,949
0 		1,019,196
0 		0
0
(2) Scott T Cebula (i)
(ii)		 51,916
0 		46,910
0 		316,259
0 		0
0 		26,323
0 		441,408
0 		43,012
0
(3) Jane Haderlein (i)
(ii)		 325,948
0 		65,313
0 		21,112
0 		20,800
0 		33,770
0 		466,943
0 		0
0
(4) Bonnie L Kass (i)
(ii)		 238,495
0 		59,374
0 		46,615
0 		23,979
0 		44,360
0 		412,823
0 		0
0
(5) Bernadette L Merlino (i)
(ii)		 220,795
0 		57,576
0 		32,978
0 		21,466
0 		28,337
0 		361,152
0 		0
0
(6) James S Noble (i)
(ii)		 385,420
0 		106,882
0 		24,731
0 		24,000
0 		39,291
0 		580,324
0 		0
0
(7) Debra L Tafoya (i)
(ii)		 229,637
0 		52,874
0 		12,213
0 		23,578
0 		35,458
0 		353,760
0 		0
0
(8) Paula Verrette MD (i)
(ii)		 319,052
0 		71,255
0 		24,221
0 		77,895
0 		16,546
0 		508,969
0 		0
0
(9) Jeffrey P Weigand (i)
(ii)		 193,592
0 		22,258
0 		34,417
0 		5,761
0 		33,654
0 		289,682
0 		0
0
(10) Christopher Williams (i)
(ii)		 233,121
0 		56,872
0 		11,854
0 		20,571
0 		37,070
0 		359,488
0 		0
0
(11) Samuel I Breneiser (i)
(ii)		 188,191
0 		31,689
0 		22,228
0 		5,335
0 		17,367
0 		264,811
0 		0
0
(12) James C Liu (i)
(ii)		 232,104
0 		1,038
0 		906
0 		1,946
0 		20,708
0 		256,702
0 		0
0
(13) Rebecca Armato (i)
(ii)		 190,405
0 		21,097
0 		4,513
0 		0
0 		5,302
0 		221,318
0 		0
0
(14) Peggy Crabtree (i)
(ii)		 172,140
0 		27,375
0 		16,112
0 		286
0 		34,841
0 		250,754
0 		0
0
(15) Angel Hovanessian (i)
(ii)		 181,773
0 		18,622
0 		10,938
0 		4,906
0 		12,523
0 		228,762
0 		0
0

Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 1A STEPHEN A. RALPH, CEO, HAS A MEMBERSHIP IN THE ATHENAEUM, WHICH IS A SOCIAL CLUB IN PASADENA. MR. RALPH USES THE CLUB FOR BUSINESS PURPOSES. THERE WAS NO PERSONAL USE IN 2010; THEREFORE, NO AMOUNT WAS INCLUDED IN TAXABLE COMPENSATION.
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 4A SCOTT T. CEBULA, FORMER VP CIO, DEPARTED FROM THE HOSPITAL IN 2009 AND AS PART OF HIS SEVERANCE PACKAGE RECEIVED $415,085 IN 2010.
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 4B PASADENA HOSPITAL ASSOCATION (PHA) ADOPTED A 457(F) DEFINED BENEFIT RETIREMENT PLAN, EFFECTIVE DECEMBER 31, 2005. THE PLAN COVERS MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM OF PHA. THE NORMAL RETIREMENT DATE OF THE PLAN IS AGE 65, WHEN A SINGLE LUMP SUM IS PROVIDED TO THE PARTICIPANT. EACH PARTICIPANT OF THE PLAN IS FULLY VESTED AFTER 20 YEARS OF SERVICE, AND BENEFITS ARE PRORATED FOR PARTICIPANTS WITH LESS THAN 20 YEARS OF SERVICE. AS MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM OF PHA, CERTAIN PERSONS LISTED ON PART VII OF THE 990 PARTICIPATE IN THE PLAN. PARTICIPANTS THAT RECEIVED DISTRIBUTIONS FROM THE 457F RETIREMENT PLAN IN 2010 ARE AS FOLLOWS: SCOTT T. CEBULA - $43,011
Schedule J (Form 990) 2010

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number
95-1644036
Part I
Bond Issues
(a) Issuer Name (b) Issuer EIN (c) CUSIP # (d) Date Issued (e) Issue Price (f) Description of Purpose (g) Defeased (h) On
Behalf of
Issuer 		(i) Pool
financing
Yes No Yes No Yes No
A CA Statewide Communities Development Authority
  		68-0164610 130911J92 05-18-2005 236,905,804 SEE PART V   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . . 0      
2 Amount of bonds defeased . . . . 0      
3 Total proceeds of issue . . . . 252,598,431      
4 Gross proceeds in reserve funds . . 16,004,114      
5 Capitalized interest from proceeds. 14,917,982      
6 Proceeds in refunding escrow. . . . . 0      
7 Issuance costs from proceeds . . . 1,748,891      
8 Credit enhancement from proceeds. 0      
9 Working capital expenditures from proceeds . . 0      
10 Capital expenditures from proceeds . . 163,114,000      
11 Other spent proceeds . . 0      
12 Other unspent proceeds. . . 3,011      
13 Year of substantial completion . . . 2008
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue?   X            
15 Were the bonds issued as part of an advance refunding issue? X              
16 Has the final allocation of proceeds been made? . .   X            
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . X              
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use? X              
b Are there any research agreements that may result in private business use of bond-financed property? . .   X            
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0.003 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . .. . . . . . 0.003 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue?   X            
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X            
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? . X              
b Name of provider . GEFC
  		 
  		 
  		 
 
c Term of GIC . . 27.      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . X              
5 Were any gross proceeds invested beyond an available temporary period? .   X            
6 Did the bond issue qualify for an exception to rebate? . . .   X            
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
DESCRIPTION OF PURPOSE SCHEDULE K, PART I, COLUMN(F) THE PURPOSE OF THE BONDS WERE TO CONSTRUCT NEW FACILITIES, EQUIP EXISTING AND NEW FACILITIES, AND TO REFUND BONDS ISSUED 8/13/1996.
Schedule K (Form 990) 2010

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V lines 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBulletSee separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





2
Enter the amount of tax imposed on the organization managers or disqualified persons during the year under section 4958. ......................... Bullet Image$
 
3
Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ....... Bullet Image$
 

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
(1) CHRISTOPHER WILLIAMS
- HOME LOAN 		  X 300,000 278,235   No Yes   Yes  
(2) JAMES S NOBLE
- HOME LOAN 		  X 400,000 386,884   No Yes   Yes  
Total ...............Small Bullet $ 665,119
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) SHERRY KIRCHHEIMER WIFE OF BOARD OF DIRECTOR 12,510 EMPLOYMENT   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
NonCash Contributions
Right pointing arrow large imageComplete if the organization answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles .. X 2 200 COST / SELLING PRICE
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous .. X 29 4,222,040 COST / SELLING PRICE
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( MEDICAL EQUIPMENT ) X 1 7,775 OPINIONS OF EXPERTS
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
1
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
NON CASH CONTRIBUTION SCHEDULE M, PART I HUNTINGTON COLLECTION USES RITEWAY TO SELL THE CARS THEY RECEIVE FROM DONORS. RITEWAY WILL ISSUE FORM 1098-C, IF NECESSARY.
USE OF THIRD PARTIES SCHEDULE M, LINE 32B HMH USES OUTSIDE INVESTMENT COMPANIES TO HANDLE THE SELLING OF STOCK DONATIONS.
Schedule M (Form 990) 2010
Additional Data


Software ID:  
Software Version:  
SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Identifier Return Reference Explanation
PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A PATIENT SERVICES: HUNTINGTON HOSPITAL IS A 635-BED, NOT-FOR-PROFIT COMMUNITY HOSPITAL LOCATED IN PASADENA, CALIFORNIA. FOUNDED IN 1892, HUNTINGTON HOSPITAL IS COMMITTED TO PROVIDING EXCELLENT PATIENT CARE DELIVERED WITH COMPASSION AND RESPECT. THE HOSPITAL OFFERS A FULL COMPLEMENT OF ACUTE MEDICAL CARE AND COMMUNITY SERVICES, RANGING FROM GENERAL MEDICINE TO THE FOREMOST SPECIALIZED PROGRAMS IN CARDIOVASCULAR SERVICES, ONCOLOGY, AND THE NEUROSCIENCES. THE HOSPITAL HAS THE ONLY TRAUMA CENTER IN THE REGION. IN ADDITION, HUNTINGTON OFFERS WOMEN'S AND CHILDREN'S SERVICES, STATE-OF-THE ART ORTHOPEDIC SURGERY, IN AND OUTPATIENT PSYCHIATRIC SERVICES AND THE HUNTINGTON HOSPITAL SENIOR CARE NETWORK. AS A TEACHING FACILITY AFFILIATED WITH THE UNIVERSITY OF SOUTHERN CALIFORNIA'S KECK SCHOOL OF MEDICINE, HUNTINGTON SUPPORTS 39 RESIDENTS EACH YEAR, SPECIALIZING IN MEDICINE OR SURGERY. APPROXIMATELY ONE-THIRD OF HUNTINGTON'S RESIDENTS REMAIN IN THE AREA TO PRACTICE, PROVIDING A SEAMLESS TRANSITION THROUGH GENERATIONS OF CARE. RECENTLY, HUNTINGTON HOSPITAL RECEIVED NUMEROUS AWARDS, RECOGNITIONS, AND CERTIFICATIONS: - GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION FOR ACHIEVING NATIONAL STANDARDS FOR HEALTH CARE QUALITY AND SAFETY - GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION FOR THE HOSPITAL'S STROKE PROGRAM, DESIGNATING THE HOSPITAL A PRIMARY STROKE CENTER - GOLD SEAL OF APPROVAL FROM THE JOINT COMMISSION FOR THE HOSPITAL'S TOTAL HIP AND KNEE REPLACEMENT PROGRAMS - MAGNET RECOGNITION BY AMERICAN NURSES CREDENTIALING CENTER - DESIGNATION AS A STEMI (ST SEGMENT ELEVATION MYOCARDIAL INFARCTION) RECEIVING CENTER WHERE EMERGENCY MEDICAL SERVICE PERSONNEL GIVE PATIENTS HAVING POSSIBLE MYOCARDIAL INFARCTIONS A 12-LEAD EKG IN THE FIELD AND A HOSPITAL TEAM IS READY WHEN A PATIENT ARRIVES IN THE EMERGENCY DEPARTMENT - NAMED TO TARGET STROKE HONOR ROLL BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE ASSOCIATION - MAXIMUM FIVE-YEAR ACCREDITATION FROM THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATION - GOLD MEDAL FOR EXCELLENCE IN SUPPORTING ORGAN DONATION FROM THE U.S. DEPARTMENT OF HEALTH SERVICES - HIGH RELIABILITY TEAM AWARD FROM THE VOLUNTEER HOSPITAL ASSOCIATION - OUTSTANDING ACHIEVEMENT AWARD FROM THE AMERICAN COLLEGE OF SURGEONS' COMMISSION ON CANCER - THE BREAST IMAGING CENTER IS DESIGNATED A CENTER OF EXCELLENCE BY THE AMERICAN COLLEGE OF RADIOLOGY - THE BARIATRIC SURGERY PROGRAM IS RECOGNIZED AS A CENTER OF EXCELLENCE BY THE AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY - CENTERS OF DISTINCTION FOR BARIATRIC SURGERY, JOINT REPLACEMENT, SPINE SURGERY, AND CARDIAC CARE BY THE BLUE CROSS BLUE SHIELD ASSOCIATION - ORTHOPEDIC CARE TOTAL JOINT REPLACEMENT AND SPINE SURGERY BY AETNA INSTITUTES OF QUALITY - SUPERLATIVE STANDARD OF EXCELLENCE BY THE INSTITUTE OF SAFE MEDICATION PRACTICES - ACCREDITATION BY THE INTERSOCIETAL COMMISSION FOR THE ACCREDITATION OF VASCULAR LABORATORIES (ICAVL) - RANKED AMONG THE TOP TEN IN THE GREATER LOS ANGELES AREA IN U.S. NEWS AND WORLD REPORT FOR THE FOLLOWING EIGHT SPECIALTIES: DIABETES AND ENDOCRINOLOGY, GASTROENTEROLOGY, GERIATRICS, KIDNEY DISORDERS, NEUROLOGY AND NEUROSURGERY, ORTHOPEDICS, PULMONARY, AND UROLOGY - DISTINGUISHED HOSPITAL AWARD FOR CLINICAL EXCELLENCE AND WOMEN'S HEALTH EXCELLENCE AWARD IN 2010 FROM HEALTHGRADESTM, A LEADING INDEPENDENT HEALTH CARE RATINGS COMPANY. IN ADDITION, HUNTINGTON HOSPITAL IS RECOGNIZED BY HEALTHGRADES FOR EXCELLENCE IN CARE FOR HEART ATTACKS (IN HOSPITAL AND SIX MONTHS), HEART FAILURE (IN HOSPITAL AND SIX MONTHS), BACK AND NECK SURGERY, TOTAL KNEE REPLACEMENT, MATERNITY CARE, AND PNEUMONIA (IN HOSPITAL, IN HOSPITAL AND ONE MONTH, IN HOSPITAL AND SIX MONTHS) - SUSTAINED IMPROVEMENT AWARD BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR ACHIEVEMENT IN ELIMINATING VENTILATOR-ASSOCIATED PNEUMONIA (VAP)- ONE OF ONLY 37 HOSPITALS NATIONWIDE TO BE RECOGNIZED. COMMUNITY BENEFITS: HUNTINGTON HOSPITAL PROVIDES CHARITY CARE FOR PATIENTS WITHOUT THE ABILITY TO PAY FOR NECESSARY TREATMENT, ABSORBING THE UNPAID COSTS OF CARE FOR PATIENTS WITH MEDI-CAL AND MEDICARE, OPERATING AN EMERGENCY ROOM ON A 24-HOUR BASIS, OFFERING AN AMBULATORY CARE CENTER TO SERVE UNDER-INSURED AND UNINSURED PERSONS, PROVIDING SPECIALIZED PROGRAMS AND SERVICES FOR SENIORS AND PERSONS WITH DISABILITIES (SENIOR CARE NETWORK), PROVIDING DEDICATED, MULTI-SESSION COMMUNITY HEALTH EDUCATION PROGRAMS ON TOPICS SUCH AS OBESITY PREVENTION, DIABETES AND ASTHMA FOR CHILDREN AND THEIR FAMILIES AND ADULTS; PROVIDING COMMUNITY HEALTH EDUCATION AND SUPPORTING PROGRAMS FOR A VARIETY OF HEALTH CONDITIONS AND DISEASES, HOSTING FLU CLINICS, OFFERING A HEALTH SCIENCES LIBRARY, AND PARTNERING WITH COMMUNITY ORGANIZATIONS. IN ADDITION, IN FISCAL YEAR 2010, HUNTINGTON HOSPITAL PROVIDED GRADUATE MEDICAL EDUCATION PROGRAMS FOR GENERAL SURGERY AND INTERNAL MEDICINE RESIDENTS, PHARMACY RESIDENTS, AND OTHER HEALTH CARE PROFESSIONALS SUCH AS REGISTERED NURSES, RESPIRATORY CARE PRACTITIONERS, PHARMACY TECHNICIANS, PARAMEDICS, RADIOLOGY AND ULTRASOUND TECHNICIANS, PHYSICAL AND OCCUPATIONAL THERAPISTS, CHAPLAINS, DIETITIANS, AND SOCIAL WORKERS.
FILING OF FORM 1098-C FORM 990, PART V, LINE 7H THE ORGANIZATION RECEIVED TWO VEHICLE DONATIONS, BOTH OF WHICH HAD CLAIMED VALUE LESS THAN THE FILING THRESHOLD FOR FORM 1098-C.
EXPL OF NATURE OF DIVERSION, CORRECTIVE ACTION AND PERTINENT CIRCUMSTANCES FORM 990, PART VI, LINE 5 THE ORGANIZATION IDENTIFIED POTENTIAL LOSSES RELATED TO ALLEGED FRAUD ACTIVITIES CONDUCTED BY A FORMER EMPLOYEE INVOLVED IN OVERSEEING MAJOR CONSTRUCTION PROJECTS. WITH THE HELP OF LEGAL COUNSEL ENGAGED TO ASSIST IN THE INVESTIGATION, IT WAS DETERMINED THAT LOSSES ESTIMATED AT APPROXIMATELY $4.3 MILLION HAD RESULTED FROM FALSIFICATION AND CIRCUMVENTION OF INTERNAL CONTROLS BY A VARIETY OF MEANS. AUDITORS WERE ENGAGED TO IDENTIFY PROCESSES TO STRENGTHEN CONTROLS, AND THE DEFICIENCIES WERE REMEDIATED. AN ONGOING CRIMINAL INVESTIGATION CONDUCTED BY LAW ENFORCEMENT PERSONNEL HAS RESULTED IN A CRIMINAL INDICTMENT OF THE FORMER EMPLOYEE. THE ORGANIZATION IS SEEKING RESTITUTION THROUGH INSURANCE RECOVERY AND JUDGEMENT IN A CIVIL SUIT FILED AGAINST THE PERPETRATOR OF THE ALLEGED FRAUD.
DESC CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, LINE 7A THE TRUSTEES OF THE COLLIS P. AND HOWARD HUNTINGTON MEMORIAL HOSPITAL TRUST HAVE THE POWER OF ELECTING REPLACEMENT TRUSTEES OF THE TRUST'S BOARD IN THEIR CAPACITY AS TRUSTEES. ALL TRUSTEES ALSO SERVE ON THE BOARD OF DIRECTORS OF PASADENA HOSPITAL ASSOCIATION, DBA HUNTINGTON MEMORIAL HOSPITAL. DESC THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B FINANCIAL DATA IS GATHERED FROM AND VERIFIED BY VARIOUS DIRECTORS. THE DATA USED IN PREPARATION OF THE RETURN BY THE OUTSIDE TAX PREPARER IS REVIEWED BY THE CHIEF FINANCIAL OFFICER PRIOR TO FILING. A COPY OF THE FILED RETURN IS SENT TO EACH MEMBER OF THE BOARD.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C THE PROCESS OF DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS IS GOVERNED BY THE ORGANIZATION'S POLICIES, WHEREBY INDIVIDUALS IN POSITIONS OF LEADERSHIP (OFFICERS, DIRECTORS, AND MANAGEMENT PERSONNEL) ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS. ONCE DISCLOSED, A REVIEW OF ANY POTENTIAL CONFLICTS IS CONDUCTED AT THE LEVEL OF CHIEF EXECUTIVE OFFICER IN CONJUNCTION WITH THE COMPLIANCE OFFICER. BASED ON THIS EVALUATION, IT MAY BE NECESSARY TO FOLLOW-UP WITH THE INDIVIDUAL AND REQUEST ANY ADDITIONAL INFORMATION DEEMED RELEVANT, OR DISCUSS WAYS TO MITIGATE OR ELIMINATE THE RISK OF CONFLICT. ANY CONCERNS OF CONFLICTS OF INTEREST ARE ADDRESSED BY THE AUDIT & COMPLIANCE COMMITTEE AND THE FINDINGS AND RECOMMENDATIONS ARE REPORTED TO THE BOARD OF DIRECTORS. AFTER DISCUSSION WITH THE INTERESTED PERSON, HE/SHE WILL LEAVE THE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODY'S DELIBERATIONS AND DECISIONS REGARDING THE TRANSACTION OR ARRANGEMENT WITH THE HOSPITAL.
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUN Form 990, Part VI, LINES 15A & 15B EXECUTIVE COMPENSATION IS SET BY THE COMPENSATION COMMITTEE OF THE GOVERNING BOARD IN CONJUNCTION WITH INDEPENDENT CONSULTANTS WHO PERFORM COMPARABLE DATA ANALYSIS AND PROVIDE INSIGHT. THE EXECUTIVE COMPENSATION REVIEW IS CONDUCTED FOR CEO & VP POSITIONS EVERY 2 YRS, AND THE FINDINGS ARE DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE LAST REPORT WAS GIVEN TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS IN NOVEMBER 2010.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII STEPHEN A. RALPH SPENT ON AVERAGE 1 HOUR PER WEEK AS VICE-CHAIR OF HUNTINGTON MEDICAL FOUNDATION AND ON AVERAGE 1 HOUR PER WEEK AS PRESIDENT OF COLLIS P. & HOWARD HUNTINGTON MEMORIAL HOSPITAL TRUST. JAMES S. NOBLE SPENT ON AVERAGE 1 HOUR PER WEEK AS ASSISTANT SECRETARY/TREASURER OF COLLIS P. & HOWARD HUNTINGTON MEMORIAL HOSPITAL TRUST.
BALANCE SHEET PRESENTATION FORM 990, PART X, COLUMN A THE BEGINNING OF THE YEAR BALANCES HAVE BEEN RESTATED TO CONFORM WITH THE 2009 AMENDED FORM 990.
RECONCILIATION OF NET ASSETS FORM 990, PART XI, LINE 5 UNREALIZED GAIN (LOSS) ON MARKETABLE SECURITIES $ 4,918,913 ACCRUED PENSION LIABILITY $ 3,742,721 UNREALIZED GAIN (LOSS) ON OTHER INVESTMENTS $ 640,589 GAIN (LOSS) ON SUBSIDIARY $ 248,687 RATE LOCK TERMINATION BOND 2005 $ 158,343 UNREALIZED GAIN (LOSS) ON ENDOWMENT INVESTMENTS $ 90,064 LOSS ON FUNDRAISING EVENT $ 32,475 ----------- TOTAL OTHER CHANGES IN NET ASSETS $ 9,831,792
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
PASADENA HOSPITAL ASSOCIATION LTD
 
Employer identification number

95-1644036
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)
(a)
Name, address, and EIN of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income
(e)
End-of-year assets


 		(f)
Direct controlling
entity

















Part II
Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section
(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled organization
Yes No
(1) COLLIS P HOWARD HUNTINGTON MEM HOSP TRST

100 W CALIFORNIA BLVD

PASADENA,CA91109
95-6027688 		SUPPORT PHA CA 501(C)(3) 11, III-FI NA
 
 
 
(2) HUNTINGTON MEDICAL FOUNDATION

133 N ALTADENA DRIVE 2ND FLR

PASADENA,CA91107
95-4434428 		HLTHCARE SVCS CA 501(C)(3) 3 PHA
 
 
 
(3) HUNTINGTON MEM HOSP FLINTRIDGE LA CANADA

PO BOX 563

LA CANADA,CA91012
95-6016968 		FUNDRAISING CA 501(c)(3) 11, III-FI NA
 
 
 
(4) WOMEN'S AUXILIARY HUNTINGTON MEM HOSP

930 S EL MOLINO AVE

PASADENA,CA91106
95-6195080 		FUNDRAISING CA 501(c)(3) 11, III-FI NA
 
 
 






For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V—UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)
(a)
Name, address, and EIN of related organization



 		(b)
Primary activity



 		(c)
Legal domicile
(state or
foreign
country)
 		(d)
Direct controlling
entity


 		(e)
Type of entity
(C corp, S corp,
or trust)

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) CONGRESS SERVICES CORPORATION
804 SOUTH FAIR OAKS AVENUE
PASADENA,CA91105
95-3978299 		MANAGEMENT SVCS CA NA
  		C CORP 649,926 2,053,116 100.000 %
(2) SEE PART VII
100 WEST CALIFORNIA BLVD
PASADENA,CA91105
94-6749776 		SUPPORT CA NA
  		TRUST 0 73,624 52.380 %
(3) SEE PART VII
100 WEST CALIFORNIA BLVD
PASADENA,CA91105
95-7125307 		SUPPORT CA NA
  		TRUST 0 892,840 73.360 %








Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type(a-r) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) HUNTINGTON MEDICAL FOUNDATION

 B 300,000  
(2) HUNTINGTON MEDICAL FOUNDATION

 D 1,033,678  
(3) CONGRESS SERVICES CORPORATION

 N 59,468  
(4) CONGRESS SERVICES CORPORATION

 R 598,730  
(5) CONGRESS SERVICES CORPORATION

 R 190,749  
(6) SCHAMADAN CHARITABLE REMAINDER TRUST

   0  
(7) SUPPLE ENDOWMENT CRT

   0  
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A CORPORATION OR TRUST SCHEDULE R, PART IV 2. SCHAMADAN HUNTINGTON MEMORIAL HOSPITAL CHARITABLE REMAINDER UNITRUST 3. DR. PELLETIER AND LORRAINE E. SUPPLE CHARITABLE REMAINDER UNITRUST
Additional Data


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