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
2011
Open to Public Inspection
A For the calendar year, or tax year beginning 01-01-2011 and ending 12-31-2011
BCheck if applicable:
CName of organization
PALO ALTO MEDICAL FOUNDATION
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
2350 EL CAMINO REAL
 
Room/suite
City or town, state or country, and ZIP + 4
MOUNTAIN VIEW, CA94040
D Employer identification number

94-1156581
E Telephone number

G Gross receipts $ 1,443,772,539
F Name and address of principal officer:
RICHARD SLAVIN
2350 EL CAMINO REAL
MOUNTAIN VIEW,CA94040
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SUTTERHEALTH.ORG
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: 1948
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 33
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 16
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 4,811
6 Total number of volunteers (estimate if necessary) .... 6 115
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 788,118
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) ......... 11,754,378 12,137,091
9 Program service revenue (Part VIII, line 2g) ......... 1,260,777,844 1,423,263,685
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 7,426,391 6,353,541
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 1,898,763 1,681,752
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 1,281,857,376 1,443,436,069
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,254,228 898,873
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) 344,544,043 344,293,995
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f).... 845,714,491 957,881,870
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 1,191,512,762 1,303,074,738
19 Revenue less expenses. Subtract line 18 from line 12....... 90,344,614 140,361,331
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,060,828,791 1,087,802,514
21 Total liabilities (Part X, line 26)............. 401,346,309 426,273,079
22 Net assets or fund balances. Subtract line 21 from line 20..... 659,482,482 661,529,435
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 use only
Print/type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name Right pointing arrowhead image

Firm's EIN Right pointing arrowhead image
Firm's address Right pointing arrowhead image



Phone no.
May the IRS discuss this return with the preparer shown above? See instructions .........bullet
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2011)
Form 990 (2011)
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: SEE SCHEDULE O
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 organization’s program service accomplishments for each of its three largest program services, as measured 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 $ 1,106,313,824 including grants of $ 898,873 ) (Revenue $ 1,423,263,685 )
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$ 1,106,313,824
Form 990 (2011)
Form 990 (2011)
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 I..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part II.........................
4
 
No
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
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which 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
Yes
 
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 temporarily restricted endowments, permanent endowments, 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
Yes
 
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, investment, and program service activities outside the United States or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Part I.........
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..
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..
16
 
No
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 I
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..........
18
 
No
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...................
19
 
No
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H.....
20a
 
No
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statement to this return? Note. All Form 990 filers that operated one or more hospitals must attach audited financial statements.
20b
 
 
Form 990 (2011)
Form 990 (2011)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization 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
Yes
 
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
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? 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
 
No
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
Yes
 
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...........................
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
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, 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
35b
Yes
 
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 (2011)
Form 990 (2011)
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
741
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
4,811
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
 
No
b
If “Yes,” did the organization notify the donor of the value of the goods or services provided?.....
7b
 
 
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
 
 
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 (2011)
Form 990 (2011)
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
If the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
1a
33
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
16
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
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? .................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ............
7b
Yes
 
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
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? ....
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done ....................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did 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 15a or 15b, 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,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take 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 made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
JOHN A HOEBEKE
2350 W EL CAMINO REAL
MOUNTAIN VIEW,CA94040
(650) 934-8650
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) THOMAS E BAILARD
TRUSTEE
 1.0 X           0 0 0
(2) BRUCE G BAINTON MD
TRUSTEE
 1.0 X           0 0 0
(3) AUGUST BENZ
TRUSTEE
 1.0 X           0 0 0
(4) JORDAN BLOOM
TRUSTEE
 1.0 X           0 0 0
(5) ROBERT BREMNER
TRUSTEE
 1.0 X           0 0 0
(6) C TERRIGAL BURN MD
TRUSTEE
 1.0 X           0 0 0
(7) SHEILA O'CONNOR BURNS
TRUSTEE
 1.0 X           0 0 0
(8) WARREN D CHINN
TRUSTEE
 1.0 X           0 0 0
(9) GEORGE COHEN MD
TRUSTEE
 1.0 X           0 0 0
(10) SUSAN FORD DORSEY
TRUSTEE
 1.0 X           0 0 0
(11) MEG DURBIN MD
TRUSTEE
 1.0 X           0 0 0
(12) PATRICK FRY
PRESIDENT & CEO, SUTTER HEALTH
 1.0 X           0 3,045,216 2,196,089
(13) MICHAEL R GAULKE
TRUSTEE
 1.0 X           0 0 0
(14) JEFF GERARD
REGIONAL PRES PENINSULA COSTAL
 1.0 X   X       0 1,098,963 576,027
(15) VINITA GUPTA
TRUSTEE
 1.0 X           0 0 0
(16) HARRY HANSON
TRUSTEE
 1.0 X           0 0 0
(17) PETER HARRIS
TRUSTEE
 1.0 X           0 0 0
Form 990 (2011)
Form 990 (2011)
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 (do not check more than one box, unless person is both an officer and a director/trustee) 		(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) CARY HILL MD
TRUSTEE
 1.0 X           0 0 0
(19) ROBERT JAUNICH II
TRUSTEE/CHAIR
 1.0 X   X       0 0 0
(20) NOMI KHAN MD
TRUSTEE
 1.0 X           0 0 0
(21) JOSEPH LACY MD
TRUSTEE
 1.0 X           0 0 0
(22) RICHARD M LEVY PHD
TRUSTEE/CHAIR, FIN & PLANNING
 1.0 X   X       0 0 0
(23) BENJAMIN MASER MD
TRUSTEE
 1.0 X           0 0 0
(24) ANTHONY P MEIER
TRUSTEE
 1.0 X           0 0 0
(25) ROBERT MERWIN
CEO, MILLS PENINSULA HLTH SVCS
 1.0 X           0 847,603 507,285
(26) LAWRENCE G MOHR
TRUSTEE
 1.0 X           0 0 0
(27) RICHARD MORGAN MD
TRUSTEE
 1.0 X           0 0 0
(28) ELIZABETH NEWSON MD
TRUSTEE
 1.0 X           0 0 0
(29) MARGARET I RAFFIN
TRUSTEE
 1.0 X           0 0 0
(30) BRIAN C ROACH MD
DIV. PRESIDENT SAN MATEO, PAMF
 40.0 X           0 516,826 206,955
(31) RICHARD SLAVIN MD
DIVISION PRESIDENT PAMF
 40.0 X   X       0 842,265 324,909
(32) MARGARET TAYLOR
TRUSTEE
 1.0 X           0 0 0
(33) JANE VARNER MD
TRUSTEE
 1.0 X           0 0 0
(34) KAREN HALL
VP & REG. GENERAL COUNSEL, PC
 40.0     X       0 349,005 122,624
(35) SHARON KUTIS
CFO, PALO ALTO MEDICAL FOUND
 40.0     X       0 562,138 189,645
(36) LAWRENCE DEGHETALDI
DIVISION PRESIDENT PAMF
 40.0       X     0 669,966 318,005
(37) JAMES HEREFORD
COO, PAMF
 40.0       X     0 456,800 116,281
(38) FRANCIS MARZONI
DIVISION PRESIDENT PAMF
 40.0       X     0 737,719 284,666
(39) ELIZABETH VILARDO-MORGAN MD
DIV. PRESIDENT CAMINO, PAMF
 40.0       X     0 492,853 204,324
(40) PAUL TANG
CMO, PAMF
 40.0         X   618,495 0 56,109
(41) HAROLD LUFT
DIRECTOR RESEARCH INSTITUTE
 40.0         X   503,084 0 43,676
(42) CECILIA MONTALVO
VP STRATEGIC PLANNING PAMF
 40.0         X   0 453,158 172,935
(43) MICHAEL REANDEAU
REG CIO, PENINSULA COASTAL
 40.0         X   0 445,002 127,453
(44) DEBBIE GOODIN
VP HUMAN RESOURCES, PAMF
 40.0         X   0 431,700 167,141
(45) PAUL DECHANT MD
CEO, SGMF
 0.0           X 0 663,560 307,865
(46) MARK MCLAUGHLIN
DIRECTOR OF RESEARCH, FINANCE
 0.0           X 222,287 0 25,447
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 1,343,866 11,612,774 5,947,436
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet659
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. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
PALO ALTO FOUNDATION MEDICAL GROUP
2350 W EL CAMINO REAL 3RD FLOOR
MOUNTAIN VIEW,CA94040 		MEDICAL SERVICES 446,100,019
MILLS PENINSULA MEDICAL GROUP INC
577 AIRPORT BLVD STE 300
BURLINGAME,CA94010 		MEDICAL SERVICES 52,667,053
MPMG MEDICAL CLINICS INC
577 AIRPORT BLVD STE 300
BURLINGAME,CA94010 		MEDICAL SERVICES 22,467,123
SUTTER CONNECT CARE OF FINANCE DEPT
PO BOX 255448
SACRAMENTO,CA95865 		BILLING SERVICES 17,998,965
SEDGWICK CLAIMS MGMT SVC INC
PO BOX 102514
ATLANTA,GA303682514 		CLAIMS MGMT SERVICE 6,510,478
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet99
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a 13,623
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 1,076,876
e Government grants (contributions)1e 4,459,333
f All other contributions, gifts, grants, and
similar amounts not included above1f 		6,587,259
g Noncash contributions included in lines 1a-1f:$ 311,837
h Total. Add lines 1a-1f.......MediumBullet 12,137,091
Program Service Revenue Business Code
2a PATIENT SERVICE REVENUE 622,110 1,423,263,685 1,423,263,685    
b
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 1,423,263,685
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 6,338,050     6,338,050
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 1,220,333  
b Less: rental expenses 326,699  
c Rental income or (loss) 893,634  
d Net rental income or (loss).......MediumBullet 893,634     893,634
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory   25,262
b Less: cost or other basis and sales expenses   9,771
c Gain or (loss)   15,491
d Net gain or (loss)..........MediumBullet 15,491     15,491
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
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  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a UBI - CONTRACTED ANIMAL SERVICES 541,900 762,895   762,895  
b UBI - HEALTH MGMT RESOURCES 454,110 25,223   25,223  
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 788,118
12 Total revenue. See Instructions....MediumBullet 1,443,436,069 1,423,263,685 788,118 7,247,175
Form 990 (2011)
Form 990 (2011)
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).
Check if Schedule O contains a response to any question in this Part IX. .........
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 United States. See Part IV, line 21 811,658 811,658
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 87,215 87,215
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 0      
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 229,551,139 182,699,151 46,851,988 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 19,544,527 16,062,446 3,482,081 0
9 Other employee benefits ....... 73,889,633 54,887,310 19,002,323 0
10 Payroll taxes ........... 21,308,696 15,776,209 5,532,487 0
11 Fees for services (non-employees):        
a Management ...... 5,807,939 272,056 5,535,883 0
b Legal ......... 975,351 484,040 491,311 0
c Accounting ........... 202,368 28,858 173,510 0
d Lobbying ........... 0      
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 855,396 0 855,396 0
g Other .......... 485,511,499 485,393,733 117,766 0
12 Advertising and promotion .... 3,496,658 330,439 3,166,219 0
13 Office expenses ....... 11,993,145 2,530,832 9,462,313 0
14 Information technology ...... 40,214,656 40,214,656 0 0
15 Royalties .. 0      
16 Occupancy ........... 31,331,898 16,917,154 14,414,744 0
17 Travel ............ 745,905 366,878 379,027 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 697,796 381,457 316,339 0
20 Interest ........... 9,390,830 9,390,830 0 0
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 52,416,774 42,921,453 9,495,321 0
23 Insurance .............. 11,734,959 2,073,724 9,661,235 0
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24f. If line 24f amount exceeds 10% of line 25, column (A) amount, list line 24f expenses on Schedule O.)
a PURCHASED SERVICES 164,459,052 112,352,882 52,106,170 0
b MEDICAL SUPPLIES 95,010,184 94,753,101 257,083 0
c REPAIRS AND MAINTENANCE 18,341,371 7,390,070 10,951,301 0
d ALL OTHER EXPENSES 24,696,089 20,187,672 4,508,417 0
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 1,303,074,738 1,106,313,824 196,760,914 0
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2011)
Form 990 (2011)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 0 1 0
2 Savings and temporary cash investments ....... 72,645,850 2 60,292,288
3 Pledges and grants receivable, net ......... 3,425,842 3 4,708,767
4 Accounts receivable, net ......... 123,493,653 4 100,387,275
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L .......... 0 5 0
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 .......... 0 6 0
7 Notes and loans receivable, net ............. 0 7 0
8 Inventories for sale or use .............. 3,412,707 8 2,431,416
9 Prepaid expenses and deferred charges ............ 4,505,418 9 4,563,335
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,053,529,292
b Less: accumulated depreciation. ..... 10b 342,105,704 638,640,613 10c 711,423,588
11 Investments—publicly traded securities .......... 130,376,030 11 117,966,535
12 Investments—other securities. See Part IV, line 11 ...... 0 12 0
13 Investments—program-related. See Part IV, line 11 .. 2,211,004 13 2,211,004
14 Intangible assets ......... 2,586,390 14 2,586,390
15 Other assets. See Part IV, line 11 ........... 79,531,284 15 81,231,916
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,060,828,791 16 1,087,802,514
Liabilities 17 Accounts payable and accrued expenses . 103,829,240 17 127,979,453
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 0 19 0
20 Tax-exempt bond liabilities .......... 263,349,078 20 263,353,986
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 1,343,597 23 1,397,536
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D..... 32,824,394 25 33,542,104
26 Total liabilities. Add lines 17 through 25..... 401,346,309 26 426,273,079
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 ..... 615,629,517 27 628,001,652
28 Temporarily restricted net assets ..... 34,401,672 28 23,564,954
29 Permanently restricted net assets ..... 9,451,293 29 9,962,829
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 ..... 659,482,482 33 661,529,435
34 Total liabilities and net assets/fund balances ..... 1,060,828,791 34 1,087,802,514
Form 990 (2011)
Form 990 (2011)
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
1,443,436,069
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
1,303,074,738
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
140,361,331
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
659,482,482
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-138,314,378
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
661,529,435
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
Yes
 
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
Yes
 
Form 990 (2011)
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
2011
Open to Public
Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2007 (b) 2008 (c) 2009 (d) 2010 (e) 2011 (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) 2011
Schedule A (Form 990 or 990-EZ) 2011
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) 2011

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
2011
Name of organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
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 on line H of its
Form 990-EZ or on Part I, 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) (2011)

Page 2
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
PALO ALTO MEDICAL FOUNDATION
  		Employer identification number

94-1156581
Part I
Contributors (see Instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total 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)
Total contributions		 (d)
Type of contribution
 
 
 

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)

Page 3
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
PALO ALTO MEDICAL FOUNDATION
  		Employer identification number

94-1156581
Part II
Noncash Property (see Instructions). Use duplicate copies of Part II if additional space is needed.
     
(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) (2011)

Page 4
Schedule B (Form 990, 990-EZ, or 990-PF) (2011)
Name of organization
PALO ALTO MEDICAL FOUNDATION
  		Employer identification number

94-1156581
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total 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 $  
Use duplicate copies of Part III if additional space is needed
(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) (2011)

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, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
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 can 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 through 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, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax 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 (ASC 958), 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 (ASC 958), 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 $ 1,545,081
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 (ASC 958), 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) 2011

Schedule D (Form 990) 2011
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 .... 29,798,661 28,386,314 22,798,516 28,024,903
b Contributions ........ 746,138 569,017 2,079,571 2,982,394
c Net investment earnings, gains, and losses ... -986,538 2,324,258 5,015,365 -6,174,934
d Grants or scholarships ..... 354,273      
e Other expenditures for facilities
and programs ........ 		16,323,217 1,316,985 1,339,118 1,875,346
f Administrative expenses ....   163,943 168,020 158,500
g End of year balance ...... 12,880,771 29,798,661 28,386,314 22,798,517
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet0 %
b
Permanent endowment SchDMd Bullet77.400 %
c
Temporarily restricted endowment SchDMd Bullet22.600 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
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
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   144,933,570 144,933,570
b Buildings ................   431,567,212 117,768,259 313,798,953
c Leasehold improvements ............   58,273,115 17,421,228 40,851,887
d Equipment ................   279,136,542 206,089,799 73,046,743
e Other .................   139,618,853 826,418 138,792,435
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 711,423,588
Schedule D (Form 990) 2011

Schedule D (Form 990) 2011
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) must 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) must 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) INTERCOMPANY RECEIVABLES 8,343,745
(2) UNAMORTIZED FINANCING COSTS 1,263,997
(3) OTHER RECEIVABLES 21,902,062
(4) OTHER ASSETS 49,722,112





Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 81,231,916
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
INSURANCE LIABILITIES 28,511,667
OTHER LIABILITIES 5,030,437







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 33,542,104
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) 2011

Schedule D (Form 990) 2011
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 through 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 must 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 must 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
DESCRIPTION OF THE ORGANIZATION'S COLLECTIONS PART III, QUESTION 4 ORGANIZATION HAS ARTWORK BEING DISPLAYED IN PUBLIC PLACES OF THE MEDICAL FACILITY FOR DECORATIVE PURPOSES.
INTENDED USES OF THE ORGANIZATION'S ENDOWMENT FUNDS PART V, QUESTION 4 SHOCKLEY ENDOWMENT - UNRESTRICTED INVESTMENT INCOME (USE BY PAMF FOR GENERAL PURPOSES) IN TEMP UNTIL APPROPRIATED FOR EXPENDITURE. REALIZED AND UNREALIZED GAIN/LOSS GOES BACK INTO THE ENDOWMENT CORPUS. RICHARD BABBS ENDOWMENT - TO SUPPORT THE ADMINISTRATIVE TIME OF PHYSICIAN TO OVERSEE THE PAMF BREAST DIAGNOSTIC CENTER, TECHNOLOGISTS, RADIOLOGY ASSISTANTS, AND STAFF OF THE CENTER, AS WELL AS IMAGINING EQUIPMENT AND SUPPLY NEEDS OF THE CENTER. ELY ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT THE SALARY AND BENEFITS OF THE RESEARCH INSTITUTE DIRECTOR. COMMUNITY HEALTH CARE ENDOWMENT - TEMP RESTRICTED EARNINGS TO HELP MEET THE NEEDS OF THE UNDERSERVED (MENTAL AND PHYSICAL) WITHIN THE PAMF SERVICE AREA. GEORGE DICK ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT STUDYING THE AGING PROCESS OF ELDERLY INDIVIDUALS. DOHRMANN FAMILY ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT RESEARCH. HEALTH CARE ENDOWMENT - TEMP RESTRICTED EARNINGS TO FUND HEALTH CARE PROJECTS FOR THE PALO ALTO DIVISION AND MEET THE NEEDS OF THE UNDERSERVED WITHIN THE PALO ALTO. KILBANE ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT CANCER RESEARCH AND CANCER PROGRAMS IN RADIATION ONCOLOGY AND MEDICAL ONCOLOGY. MILO FELLOWSHIP ENDOWMENT - TEMP RESTRICTED EARNINGS WILL BE USED BY THE FOUNDATION TO PROVIDE GRANTS IN AID AND SUPPORT PROMISING POST DOCTORAL SCIENTISTS ENGAGED IN RESEARCH RELATING TO THE CAUSE, DIAGNOSIS, TREATMENT AND CURE OF CANCER. EACH GRANT SHALL BE KNOWN AS THE EDITH J MILO MEMORIAL FELLOWSHIP IN THE RESEARCH ON CANCER. THOMAS R MITCHELL ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT THE ESTABLISHMENT AND MAINTENANCE OF THE COMPUTERIZED ONCOLOGY DATABASE ALLOWING PHYSICIANS MORE ACCESS FROM OFF- SITE LOCATIONS. DOROTHY RHODES ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT CASH AWARDS AS PART OF THE BRAVO EMPLOYEE RECOGNITION PROGRAM. RESEARCH INSTITUTE ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT RESEARCH. PEDIATRIC ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT PEDIATRICS. RUSSELL ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT PROGRAMS AND SERVICES OF THE CLARK-DAVIS PEDIATRIC CENTER. SAIER ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT THE PURCHASE OF EQUIPMENT, SUPPLIES AND OTHER EXPENSES DIRECTLY RELATED TO SUPPORT OF THE MEDICAL RESEARCH MISSION OF THE RESEARCH INSTITUTE. STEVENS MEMORIAL ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT STUDYING THE AGING PROCESS OF ELDERLY INDIVIDUALS. NURSING SCHOLARSHIP ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT NURSING EDUCATION SCHOLARSHIPS. THE BLAIR STRATFORD NURSING ENDOWMENT WAS ESTABLISHED BY BLAIR STRATFORD IN HONOR OF DR. RICHARD BABB TO FUND NURSING EDUCATION THROUGH SCHOLARSHIPS FOR QUALIFIED PAMF CANDIDATES IN THE PALO ALTO, CAMINO, SANTA CRUZ, AND PALOMARES DIVISIONS (SEE SPECIAL PURPOSE FUND PROPOSAL AND APPROVAL FORM). DUSTERBERRY ENDOWMENT - TEMP RESTRICTED EARNINGS TO BENEFIT CHILDREN IN THE GEOGRAPHIC AREA OF THE TRI-CITIES AND THE FREMONT UNIFIED SCHOOL DISTRICT AND TO FUND SCHOOL CONFERENCES, NEW PROGRAMS, STUDENT TUITION, AND SCHOLARSHIPS. PHYSICIAN ENDOWMENT - TEMP RESTRICTED EARNINGS TO SUPPORT THE RECRUITMENT AND RETENTION OF PHYSICIANS.
ASC 740 (FIN48) FOOTNOTE FROM AUDIT PART X, LINE 2 THIS ORGANIZATION WAS PART OF A CONSOLIDATED FINANCIAL SYSTEM AUDIT. THE ASC 740 AUDIT FOOTNOTE DISCLOSURE FOR THE SUTTER SYSTEM IS AS FOLLOWS: SUTTER HEALTH AND MOST AFFILIATES HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE, (PURSUANT TO INTERNAL REVENUE CODE SECTION 501(C)(3)), AND THE CALIFORNIA FRANCHISE TAX BOARD (PURSUANT TO CALIFORNIA REVENUE AND TAXATION CODE 23701(D)) AND, GENERALLY, ARE NOT SUBJECT TO TAXES ON INCOME. CERTAIN ACTIVITIES OF SUTTER ARE SUBJECT TO INCOME TAXES; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE COMBINED FINANCIAL STATEMENTS. WITH RESPECT TO ITS FOR-PROFIT SUBSIDIARIES AND TAXABLE ACTIVITIES, SUTTER RECORDS INCOME TAXES USING THE LIABILITY METHOD UNDER WHICH DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE FINANCIAL ACCOUNTING AND TAX BASIS OF ASSETS AND LIABILITIES. DEFERRED TAX ASSETS OR LIABILITIES AT THE END OF EACH PERIOD ARE DETERMINED USING THE CURRENTLY ENACTED TAX RATE EXPECTED TO APPLY TO TAXABLE INCOME IN THE PERIODS THAT THE DEFERRED TAX ASSET OR LIABILITY IS EXPECTED TO BE REALIZED OR SETTLED. SUTTER RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. SUTTER RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AT DECEMBER 31, 2011 AND 2010, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS.
Schedule D (Form 990) 2011

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
2011
Open to Public
Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number
94-1156581
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) COMMUNITY FOUNDATION7807 SOQUEL DR
APTOS,CA95003 		94-2808039 501(C)(3) 126,000       GENERAL SUPPORT
(2) MEDSHARE INTERNATIONAL3240 CLIFTON SPRINGS RD
DECATUR,GA30034 		58-2433968 501(C)(3) 52,776       GENERAL SUPPORT
(3) EL CAMINO HOSPITAL FOUNDATION2500 GRANT RD
MOUNTAIN VIEW,CA94040 		94-2823235 501(C)(3) 40,000       GENERAL SUPPORT
(4) EL CAMINO HOSPITAL ROTACARE2500 GRANT RD
MOUNTAIN VIEW,CA94040 		94-3167314 501(C)(3) 39,107       GENERAL SUPPORT
(5) AMERICAN CANCER SOCIETY1720 SO AMPHLETT BLVD
SAN MATEO,CA94402 		94-1170350 501(C)(3) 38,000       GENERAL SUPPORT
(6) MAIN STREET MEDIA GROUP LLCPO BOX 742178
LOS ANGELES,CA90074 		20-0490677 501(C)(3) 27,776       GENERAL SUPPORT
(7) SANTA CRUZ WOMENS HEALTH CENTER250 LOCUST ST
SANTA CRUZ,CA95060 		23-7428303 501(C)(3) 25,000       GENERAL SUPPORT
(8) SALUD PARA LA GENTE195 AVIATION WY
WATSONVILLE,CA95076 		94-2705747 501(C)(3) 20,000       GENERAL SUPPORT
(9) CABRILLO COLLEGE6500 SOQUEL
APTOS,CA95003 		77-0385111 501(C)(3) 15,250       GENERAL SUPPORT
(10) MARCH OF DIMESPO BOX 1657
WILKESBARR,PA18703 		13-1846366 501(C)(3) 15,000       GENERAL SUPPORT
(11) PATHWAYS TO HOSPICE FOUNDATION201 SAN ANTONIO CIR
MOUNTAIN VIEW,CA94040 		77-0280660 501(C)(3) 15,000       GENERAL SUPPORT
(12) COMMUNITY HEALTH AWARENESS COUNCILPO BOX 335
MOUNTAIN VIEW,CA94042 		94-2223670 501(C)(3) 11,000       GENERAL SUPPORT
(13) SCHOOL OF IMAGINATION INC7567 AMADOR VALLEY BLVD
DUBLIN,CA94568 		20-8683005 501(C)(3) 10,000       GENERAL SUPPORT
(14) SACRED HEART COMMUNITY SERVICES13851 SOUTH 1ST ST
SAN JOSE,CA95110 		23-7179787 501(C)(3) 10,000       GENERAL SUPPORT
(15) CARDIAC THERAPY FDN OF THE MIDPENINSULA4000 MIDDLEFIELD RD
PALO ALTO,CA94303 		77-0336212 501(C)(3) 10,000       GENERAL SUPPORT
(16) FRIENDS OF CHILDREN WITH SPECIAL NEEDS2300 PERALTA BLVD
FREMONT,CA94536 		77-0446853 501(C)(3) 10,000       GENERAL SUPPORT
(17) SANTA CLARA FAMILY HEALTH FOUNDATION INC210 EAST HACIENDA AVE
CAMPBELL,CA95008 		77-0545774 501(C)(3) 10,000       GENERAL SUPPORT
(18) AMERICAN RED CROSS SILICON VALLEY CHAPTER2731 NORTH FIRST ST
SAN JOSE,CA95134 		94-1156472 501(C)(3) 10,000       GENERAL SUPPORT
(19) NORTRE DAME DE NAMUR UNIVERSITY1500 RALSTON AVE
BELMONT,CA94002 		94-1156646 501(C)(3) 10,000       GENERAL SUPPORT
(20) FAMILY SERVICE AGENCY OF SAN MATEO24 SECOND AVE
SAN MATEO,CA94401 		94-1186169 501(C)(3) 10,000       GENERAL SUPPORT
(21) PENINSULA VOLUNTEERS INC800 MIDDLE AVE
MENLO PARK,CA94025 		94-1294939 501(C)(3) 10,000       GENERAL SUPPORT
(22) LEGAL AID SOCIETY OF SAN MATEO COUNTY521 E 5TH AVE
SAN MATEO,CA94402 		94-1451894 501(C)(3) 10,000       GENERAL SUPPORT
(23) AVENIDAS450 BRYANT ST
PALO ALTO,CA94301 		94-1480548 501(C)(3) 10,000       GENERAL SUPPORT
(24) MAYVIEW COMMUNITY HEALTH CTR270 GRAND AVE
PALO ALTO,CA94306 		94-2239648 501(C)(3) 10,000       GENERAL SUPPORT
(25) SENIOR NETWORK SERVICES OF SANTA CRUZ1777-A CAPITOLA RD
SANTA CRUZ,CA95062 		94-2259716 501(C)(3) 10,000       GENERAL SUPPORT
(26) NEXT DOOR SOLUTIONS TO DOMESTIC VIOLENCE234 E GISH RD
SAN JOSE,CA95112 		94-2420708 501(C)(3) 10,000       GENERAL SUPPORT
(27) DOMINICAN HOSPITAL FOUNDATION1555 SOQUEL DR
SANTA CRUZ,CA95065 		94-2450442 501(C)(3) 10,000       GENERAL SUPPORT
(28) ECUMENICAL HUNGER PROGRAM2411 PULGAS AVE
EAST PALO ALTO,CA94303 		94-2476942 501(C)(3) 10,000       GENERAL SUPPORT
(29) HOSPICE OF SANTA CRUZ COUNTY940 DISC DR
SCOTTS VALLEY,CA95066 		94-2497618 501(C)(3) 10,000       GENERAL SUPPORT
(30) MAITRI234 E GISH RD
SAN JOSE,CA95112 		94-3132087 501(C)(3) 10,000       GENERAL SUPPORT
(31) TEEN PREGNANCY COALITION SAN MATEO COUNTY120 JAMES AVE
REDWOOD CITY,CA94062 		94-3227947 501(C)(3) 10,000       GENERAL SUPPORT
(32) OMBUDSMAN SERVICES OF SAN MATEO COUNTY INC711 NEVADA ST
REDWOOD CITY,CA94061 		94-3397402 501(C)(3) 10,000       GENERAL SUPPORT
(33) YMCA OF SILICON VALLEY3412 ROSS RD
PALO ALTO,CA94303 		94-1156318 501(C)(3) 9,000       GENERAL SUPPORT
(34) WOMEN CARE2901 PARK STE A1
SOQUEL,CA95073 		77-0410099 501(C)(3) 8,250       GENERAL SUPPORT
(35) COMMUNITY SERVICES AGENCY204 STIERLIN RD
MOUNTAIN VIEW,CA94043 		94-1422465 501(C)(3) 6,000       GENERAL SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
35
3
Enter total number of other organizations listed in the line 1 table ......................... . Bullet Image
0
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2011

Schedule I (Form 990) 2011
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
(1) HONORARIUMS/STIPENDS-PARI 4 1,800      
(2) PATIENT ASSISTANCE-PARI 32 13,115      
(3) PRE-MED/NURSING SCHOLARSHIPS-PARI 15 72,300      









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
PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS PART I, LINE 2 THE HEALTH CARE ENDOWMENT COMMITTEE (HCEC) (CURRENT/PAST TRUSTEES AND PHYSICIANS) APPROVE THE GRANTS. THE OUTSIDE FIRM OF KRAMER, BLUM AND ASSOCIATES IS RETAINED AND IT SENDS OUT THE REQUESTS FOR PROPOSALS (RFP'S) TO THE AGENCIES THAT ARE INVITED TO APPLY. THE FIRM DOES THE DUE DILIGENCE TO DETERMINE IF THE AGENCIES ARE QUALIFIED, AND WORTHY OF A HCEC GRANT. THE FIRM PROVIDES THE ENDOWMENT COMMITTEE WITH A DOCKET AND ITS RECOMMENDATIONS PRIOR TO THE MEETING TO APPROVE OR NOT APPROVE THE PROPOSALS. THE SUTTER HEALTH SYSTEM HAS AN OVERLAP IN LEADERSHIP WHICH MONITORS THE USE OF GRANTS BETWEEN AFFILIATES.
Schedule I (Form 990) 2011


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
2011
Open to Public Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
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 or provision 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. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
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
 
No
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
Yes
 
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 Regulations 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) 2011

Schedule J (Form 990) 2011
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and column (E) for that individual.
(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 as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) LAWRENCE DEGHETALDI (i)
(ii)		 0
457,451 		0
210,947 		0
1,568 		0
297,338 		0
20,667 		0
987,971 		0
250,405
(2) PATRICK FRY (i)
(ii)		 0
1,556,049 		0
1,472,283 		0
16,884 		0
2,163,921 		0
32,168 		0
5,241,305 		0
1,637,694
(3) JEFF GERARD (i)
(ii)		 0
658,710 		0
434,975 		0
5,278 		0
556,451 		0
19,576 		0
1,674,990 		0
456,135
(4) KAREN HALL (i)
(ii)		 0
268,050 		0
80,684 		0
271 		0
104,481 		0
18,143 		0
471,629 		0
80,684
(5) JAMES HEREFORD (i)
(ii)		 0
263,112 		0
100,000 		0
93,688 		0
110,017 		0
6,264 		0
573,081 		0
0
(6) SHARON KUTIS (i)
(ii)		 0
426,799 		0
134,483 		0
856 		0
176,262 		0
13,383 		0
751,783 		0
191,882
(7) FRANCIS MARZONI (i)
(ii)		 0
698,064 		0
30,000 		0
9,655 		0
270,943 		0
13,723 		0
1,022,385 		0
30,000
(8) ROBERT MERWIN (i)
(ii)		 0
570,826 		0
271,164 		0
5,613 		0
486,829 		0
20,456 		0
1,354,888 		0
338,126
(9) BRIAN C ROACH MD (i)
(ii)		 0
371,616 		0
143,829 		0
1,381 		0
191,135 		0
15,820 		0
723,781 		0
143,829
(10) RICHARD SLAVIN MD (i)
(ii)		 0
786,819 		0
50,000 		0
5,446 		0
306,745 		0
18,164 		0
1,167,174 		0
50,000
(11) ELIZABETH VILARDO-MORGAN MD (i)
(ii)		 0
464,187 		0
0 		0
28,666 		0
185,003 		0
19,321 		0
697,177 		0
0
(12) PAUL TANG (i)
(ii)		 540,843
0 		25,500
0 		52,152
0 		31,225
0 		24,884
0 		674,604
0 		0
0
(13) HAROLD LUFT (i)
(ii)		 427,584
0 		75,500
0 		0
0 		21,880
0 		21,796
0 		546,760
0 		0
0
(14) CECILIA MONTALVO (i)
(ii)		 0
331,748 		0
117,756 		0
3,654 		0
154,768 		0
18,167 		0
626,093 		0
135,539
(15) MICHAEL REANDEAU (i)
(ii)		 0
321,245 		0
114,779 		0
8,978 		0
120,257 		0
7,196 		0
572,455 		0
125,757
(16) DEBBIE GOODIN (i)
(ii)		 0
314,727 		0
115,951 		0
1,022 		0
148,970 		0
18,171 		0
598,841 		0
137,426
(17) PAUL DECHANT MD (i)
(ii)		 0
465,490 		0
185,838 		0
12,232 		0
286,517 		0
21,348 		0
971,425 		0
210,227
(18) MARK MCLAUGHLIN (i)
(ii)		 167,628
0 		15,500
0 		39,159
0 		15,632
0 		9,815
0 		247,734
0 		0
0
Schedule J (Form 990) 2011

Schedule J (Form 990) 2011
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
RELEVANT INFORMATION REGARDING COMPENSATION ITEMS PART I, QUESTION 1A FIRST-CLASS TRAVEL: CERTAIN OFFICERS AND KEY EMPLOYEES OF SUTTER HEALTH MAY UPGRADE TO FIRST-CLASS TRAVEL FOR FLIGHTS GREATER THAN FOUR HOURS IN DURATION. TAX INDEMNIFICATION: STANDARD POLICY FOR ALL SUTTER HEALTH EMPLOYEES IS THAT NON-CASH GIFTS AND AWARDS ARE GROSSED-UP FOR TAX PURPOSES. THE AMOUNT OF THE GROSS-UP IS ADDED TO THE EMPLOYEE'S WAGES AND TAXED ACCORDINGLY.
SUPPLEMENTAL COMPENSATION INFORMATION PART I, QUESTION 3 THE CEO OF THE ORGANIZATION IS AN EMPLOYEE OF SUTTER HEALTH. THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION.
NONQUALIFIED RETIREMENT PLAN PART I, QUESTION 4B THE PURPOSE OF THE NONQUALIFIED RETIREMENT PLAN IS TO PROVIDE SUTTER HEALTH EXECUTIVES WITH A COMPETITIVE RETIREMENT BENEFIT CONSISTENT WITH SUTTER HEALTH'S OVERALL COMPENSATION PHILOSOPHY FOR ALL EMPLOYEES. CONTRIBUTIONS ARE DESIGNED TAKING INTO CONSIDERATION LOST RETIREMENT BENEFITS THAT WOULD OTHERWISE BE OBTAINED THROUGH THE QUALIFIED PENSION PLAN. SUTTER'S PLANS ARE DESIGNED CONSISTENT WITH COMPETITIVE INDUSTRY PRACTICES. THE RETIREMENT PLAN FOR SUTTER HEALTH EMPLOYEES IS A COMBINATION OF SOCIAL SECURITY, 403B EMPLOYER MATCH CONTRIBUTIONS AND QUALIFIED PLAN BENEFITS. SUTTER HEALTH EXECUTIVES ARE GENERALLY INELIGIBLE FOR EMPLOYER MATCH CONTRIBUTIONS. ADDITIONALLY, QUALIFIED PLAN BENEFITS CAPS HAVE THE EFFECT OF SUBSTANTIALLY REDUCING RETIREMENT BENEFITS THAT ARE OTHERWISE PROVIDED TO ALL EMPLOYEES. THE EFFECT IS THAT EXECUTIVES OFTEN DO NOT RECEIVE THE SAME LEVEL OF RETIREMENT BENEFIT ON AN INCOME REPLACEMENT BASIS AS OTHER EMPLOYEES. TO ENSURE A COMPETITIVE RETIREMENT BENEFIT AND TO ADDRESS THE SHORTFALLS DESCRIBED ABOVE, SUTTER HEALTH MAKES AN ANNUAL CONTRIBUTION TO A NON-QUALIFIED 457(F) PLAN FOR ITS EXECUTIVES. THE FORMULA HAS TWO PARTS: (1) 4% TO 7% OF BASE SALARY (COMMENSURATE WITH MANAGEMENT LEVEL), PLUS (2) A CONTRIBUTION STARTING AT 5% (BASED UPON TENURE) FOR EARNINGS BEYOND THE PENSION PAY CAP. THE LATTER OF WHICH IS DESIGNED TO HELP RESTORE LOST PENSION BENEFITS FORFEITED UNDER THE QUALIFIED PLAN FOR EARNINGS OVER THE PENSION PAY CAP LIMIT. CONTRIBUTIONS ARE ALSO MADE FOR A SMALL GROUP OF SENIOR LEVEL EXECUTIVES WHOSE ESTIMATED RETIREMENT BENEFIT (SOCIAL SECURITY PLUS QUALIFIED PLAN BENEFITS PLUS 457F) FALLS BELOW 50% - 65% OF FINAL 4-YEAR AVERAGE BASE SALARY WHEN RETIRING AT AGE 65. TARGET BENEFIT LEVELS VARY BY YEARS OF SERVICE. UNLIKE SUTTER HEALTH'S QUALIFIED PLAN WHERE EMPLOYEE BENEFITS ARE GUARANTEED (I.E., A DEFINED BENEFIT), SUTTER'S NON-QUALIFIED PLAN BENEFITS ARE NOT GUARANTEED BY SUTTER HEALTH. INVESTMENT RISK IS BORNE BY PARTICIPANTS AND BENEFITS ARE NOT PROTECTED SHOULD SUTTER HEALTH BECOME INSOLVENT.
NON-FIXED PAYMENTS PART I, QUESTION 7 SPOT AWARDS ARE INFREQUENTLY USED TO REWARD EMPLOYEES. THERE ARE NO SPECIFIC GUIDELINES FOR THE AMOUNT OF THE SPOT AWARD BUT THE AMOUNT TENDS TO NOT EXCEED 5% OF GROSS PAY. ANNUAL INCENTIVE PLAN (AIP) THE PURPOSE OF THE PLAN IS TO FOCUS EXECUTIVES ON SPECIFIC, SHORTER-TERM GOALS THAT ARE CRITICAL TO THE ACHIEVEMENT OF AFFILIATE, REGION, AND SYSTEM-WIDE OBJECTIVES THAT DRIVE OVERALL ORGANIZATION PERFORMANCE. A PORTION OF THE PLAN AWARD IS DISCRETIONARY IN THAT THE SUPERVISOR MAY ADD +/- 5% TO THE AWARD PROVIDED THE TOTAL AWARD (FORMULA PORTION PLUS DISCRETIONARY) DOES NOT EXCEED THE MAXIMUM ESTABLISHED FOR ANY GIVEN EXECUTIVE. LONG TERM PERFORMANCE PLANS SUTTER HEALTH ALSO EMPLOYS LONG TERM PERFORMANCE PLANS WHICH ARE DESIGNED TO FOCUS ON LONGER TERM STRATEGIC OBJECTIVES OF THE ORGANIZATION. SUTTER'S LONG TERM PERFORMANCE PLAN APPROACH IS A COMBINATION OF BOTH LONGER TERM MEASURES OF ORGANIZATION SUCCESS AND KEY ORGANIZATION STRATEGIES WHICH REQUIRE THE COMBINED EFFORT OF ALL LEADERSHIP TO ACHIEVE SUCCESS. SUTTER USES A COMMON FATE APPROACH IN THAT ALL PLAN PARTICIPANTS ARE MEASURED AGAINST THE SAME, ORGANIZATION-WIDE CRITERIA VS. INDIVIDUAL EFFORTS. THIS FOSTERS A COMMON PURPOSE ACROSS LEADERSHIP AND A SHARED SENSE OF ACCOUNTABILITY FOR THE OVERALL SUCCESS OF SUTTER HEALTH. TO ENSURE THAT EXTRAORDINARY EFFORTS BY INDIVIDUALS CAN BE RECOGNIZED AND THAT ACTIONS OF LEADERSHIP ARE CONSISTENT WITH SUPPORTING SUTTER HEALTH'S OVERALL MISSION, VISION, AND VALUES, SUTTER'S LONG TERM INCENTIVE PLAN APPROACH ALSO INCORPORATES A COMBINATION OF CEO AND SUTTER HEALTH COMPENSATION COMMITTEE DISCRETION. IN SOME CASES, THE SUTTER HEALTH COMPENSATION COMMITTEE HAS DELEGATED AUTHORITY TO THE PRESIDENT & CEO TO MODIFY INDIVIDUAL AWARDS WITHIN LIMITS THAT HAVE BEEN PRE-APPROVED BY THE SUTTER HEALTH COMPENSATION COMMITTEE. THIS INCLUDES BOTH THE REDUCTION AND INCREASE OF AWARD AMOUNTS. SUCH MODIFICATIONS GENERALLY DO NOT EXCEED +/- 20% AND ARE EMPLOYED JUDICIOUSLY. IN ALL CASES, THE COMPENSATION COMMITTEE OF THE BOARD DETERMINES ACHIEVEMENT OF ORGANIZATION GOALS AND MAKES FINAL AWARD DETERMINATION WHICH MAY RESULT IN A REDUCTION OF AWARD IF APPROPRIATE. ALL SENIOR EXECUTIVE AWARDS ARE REVIEWED FOR COMPENSATION REASONABLENESS AND APPROVED PRIOR TO PAYMENT BY THE COMPENSATION COMMITTEE.
Schedule J (Form 990) 2011

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 Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number
94-1156581
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 CSCDA 2005A
  		68-0164610 130911U24 10-19-2005 276,217,522 CONSTRUCT & EQUIP FACILITY   X   X   X
B CSCDA 2005BC
  		68-0164610 130795EG8 05-01-2007 49,994,066 REFUNDING - 10/19/2005   X   X   X
C CSCDA 2008BC
  		68-0164610 130795TD9 05-14-2008 291,999,417 CONSTRUCT & EQUIP FACILITY   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 0 0 0  
2 Amount of bonds legally defeased . . . . . . . . . . 0 0 0  
3 Total proceeds of issue . . . . . . . . . . . . . 284,787,106 52,179,709 306,625,587  
4 Gross proceeds in reserve funds . . . . . . . . 21,070,840 3,461,872 0  
5 Capitalized interest from proceeds . . . . . . . . . . 0 0 31,655,776  
6 Proceeds in refunding escrows . . . . . . . . . . . 0 0 0  
7 Issuance costs from proceeds . . . . . . . . . . . 0 0 0  
8 Credit enhancement from proceeds . . . . . . . . . . 0 0 0  
9 Working capital expenditures from proceeds . . . . . . . 0 0 0  
10 Capital expenditures from proceeds . . . . . . . . . . 189,282,478 0 262,221,018  
11 Other spent proceeds . . . . . . . . . . . 74,433,788 48,717,837 11,427,232  
12 Other unspent proceeds . . . . . . . . . . . 0 0 1,321,561  
13 Year of substantial completion . . . . . . . . . . .
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . .   X X     X    
15 Were the bonds issued as part of an advance refunding issue? . . . .   X   X   X    
16 Has the final allocation of proceeds been made? . . . . . . X   X   X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . X   X   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   X   X    
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X      
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2011
Schedule K (Form 990) 2011
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 of bond-financed property? . . . . . . . . . X   X   X      
b If ‘Yes’ to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . X   X   X      
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . X   X   X      
d If ‘Yes’ to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? . X   X   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% 0% 0%   %
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 0.00000% 0.00000% 0%   %
6 Total of lines 4 and 5 . . .. . . . . . . . . 0% 0% 0%   %
7 Does the bond issue meet the private security or payment test? . . . X   X   X      
8 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   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   X   X    
2 Is the bond issue a variable rate issue?   X   X   X    
3a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?   X   X   X    
b Name of provider . . . . . . . . 0
  		0
  		0
  		 
 
c Term of hedge . . . . . . . .        
d Was the hedge superintegrated? . . . .                
e Was a hedge terminated? . . . . .                
4a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . .   X   X   X    
b Name of provider . . . . . . 0
  		0
  		0
  		 
 
c Term of GIC . . . . . . .        
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . .                
5 Were any gross proceeds invested beyond an available temporary period? . . . . . .   X   X   X    
6 Did the bond issue qualify for an exception to rebate? .   X   X   X    
7 Has the organization established written procedures to monitor the requirements of section 148? . . .   X   X   X    
Schedule K (Form 990) 2011

Schedule K (Form 990) 2011
Page 3
Part V
Procedures To Undertake Corrective Action
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? . . . . . . . . . . . . . .
Part VI
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
SEE SCHEDULE O 0  
Schedule K (Form 990) 2011

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
2011
Open to Public Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
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
Total ...............Small Bullet $  
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) 2011
Schedule L (Form 990 or 990-EZ) 2011
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) PALO ALTO FOUNDATION MEDICAL GROUP SEE PART V 446,100,019 SEE PART V   No
(2) VARIAN MEDICAL SYSTEMS SEE PART V 321,840 SEE PART V   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
DESCRIPTIONS OF BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV GEORGE COHEN MD, MEG DURBIN MD, NOMI KHAN MD, RICHARD MORGAN MD, C TERRIGAL BURN MD, ELIZABETH NEWSOM MD, JOSEPH LACY MD, JANE VARNER MD, PETER HARRIS MD, CARY HILL MD, THE PALO ALTO MEDICAL FOUNDATION (PAMF) TRUSTEES, WERE ALSO SHAREHOLDERS & ON THE BOARD OF DIRECTORS OF PALO ALTO FOUNDATION MEDICAL GROUP(PAFMG). CONTRACTED SERVICES WERE PROVIDED BY PAFMG THROUGH THE PROFESSIONAL SERVICES AGREEMENT WHEREIN PAFMG PROVIDED THE PROFESSIONAL SERVICES RENDERED TO PAMF PATIENTS. BENJAMIN MASER MD, TRUSTEE OF PALO ALTO MEDICAL FOUNDATION (PAMF), ALSO IS A SHAREHOLDER & TREASURER OF PALO ALTO FOUNDATION MEDICAL GROUP(PAFMG). CONTRACTED SERVICES WERE PROVIDED BY PAFMG THROUGH THE PROFESSIONAL SERVICES AGREEMENT WHEREIN PAFMG PROVIDED THE PROFESSIONAL SERVICES RENDERED TO PAMF PATIENTS. RICHARD LEVY IS A TRUSTEE OF PALO ALTO MEDICAL FOUNDATION (PAMF) AND PART OWNER AND DIRECTOR OF VARIAN MEDICAL SYSTEMS. DURING THE YEAR PAMF PAID VARIAN FOR MEDICAL EQUIPMENT VIA AN ARMS-LENGTH AGREEMENT.
Schedule L (Form 990 or 990-EZ) 2011

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
2011
Open to Public Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash 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 ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 9 274,654 FMV OF STOCK
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
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 ( COMPUTER EQUIPMENT ) X 1 37,183 FMV
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
0
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 noncash
contributions? ............................
32a
 
No
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) 2011
Schedule M (Form 990) 2011
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33 and whether the organization is reporting in Part I, column (b) the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Identifier Return Reference Explanation
PART I, COLUMN (B)   COLUMN (B) REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED.
Schedule M (Form 990) 2011
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
2011
Open to Public
Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
Identifier Return Reference Explanation
MISSION STATEMENT FORM 990, PART I, LINE 1 AND PART III, LINE 1 WE ENHANCE THE WELL-BEING OF THE PEOPLE IN OUR COMMUNITIES THROUGH COMPASSION, EXCELLENCE AND INNOVATION IN HEALTH CARE SERVICE, RESEARCH AND EDUCATION.
EXEMPT PURPOSE ACHIEVEMENTS FORM 990, PART III, LINE 4A THE PALO ALTO MEDICAL FOUNDATION FOR HEALTH CARE, RESEARCH AND EDUCATION (PAMF) IS A NOT-FOR-PROFIT HEALTH CARE ORGANIZATION THAT IS A PIONEER IN BOTH MULTISPECIALTY GROUP PRACTICE OF MEDICINE AND OUTPATIENT MEDICINE. IN 1993, PAMF AFFILIATED WITH SUTTER HEALTH, A FAMILY OF NOT-FOR-PROFIT HOSPITALS AND PHYSICIAN ORGANIZATIONS THAT SHARE RESOURCES AND EXPERTISE TO ADVANCE HEALTH CARE QUALITY. IN 2009, PAMF, MILLS-PENINSULA HEALTH SERVICES (MPHS), SUTTER MATERNITY AND SURGERY CENTER AND MENLO PARK SURGICAL HOSPITAL CAME TOGETHER TO FORM SUTTER HEALTH'S PENINSULA COASTAL REGION. SERVING MORE THAN 100 COMMUNITIES IN NORTHERN CALIFORNIA, SUTTER HEALTH IS A REGIONAL LEADER IN CARDIAC CARE AS WELL AS CARE OF WOMEN AND CHILDREN, AND IS A PIONEER IN ADVANCED PATIENT SAFETY TECHNOLOGY. IN 2008, THE PHYSICIANS OF THE FORMER CAMINO MEDICAL GROUP, PALO ALTO MEDICAL CLINIC AND SANTA CRUZ MEDICAL CLINIC MERGED INTO A SINGLE PHYSICIAN GROUP CALLED THE PALO ALTO FOUNDATION MEDICAL GROUP (PAFMG) TO CONTRACT WITH PAMF TO PROVIDE PHYSICIAN SERVICES AND IN 2010, A NEW MULTISPECIALTY PHYSICIAN GROUP, PENINSULA MEDICAL CLINIC (PMC), WAS FORMED. NOW, PAMF'S 1,096 AFFILIATED PHYSICIANS AND 4,310 EMPLOYEES SERVE MORE THAN 730,000 PATIENTS AT 40 SITES THROUGHOUT THE BAY AREA. PAMF'S MISSION IS TO ENHANCE THE WELL-BEING OF THE PEOPLE IN OUR COMMUNITIES THROUGH COMPASSION, EXCELLENCE AND INNOVATION IN HEALTH CARE SERVICES, RESEARCH AND EDUCATION. PAMF HAS THREE DIVISIONS: 1. HEALTH CARE 2. EDUCATION 3. RESEARCH HEALTH CARE DIVISION PAMF'S HEALTH CARE DIVISION CONSISTS OF FOUR DIVISIONS: 1. PALO ALTO, SERVING ALAMEDA, SAN MATEO AND SANTA CLARA COUNTIES 2. CAMINO, SERVING SANTA CLARA COUNTY 3. SANTA CRUZ , SERVING SANTA CRUZ COUNTY 4. MILLS-PENINSULA, SERVING SAN MATEO COUNTY THESE DIVISIONS OFFER MORE THAN 45 MEDICAL SPECIALTIES, A FULL RANGE OF MEDICAL SERVICES, AND STATE-OF-THE-ART TECHNOLOGY. THIS TECHNOLOGY INCLUDES THE MOST ADVANCED DIAGNOSTIC IMAGING AND TREATMENT DEVICES, AN ELECTRONIC HEALTH RECORD SYSTEM, THREE LICENSED ACUTE-CARE FACILITIES, AND ONE ACCREDITED HOME HEALTH AGENCY. PAMF'S ADVANCED CAPABILITIES AND EMPHASIS ON OUTPATIENT CARE ALLOW PHYSICIANS AND STAFF TO MINIMIZE HOSPITALIZATION OF PATIENTS, REDUCING THE OVERALL COST OF MEDICAL CARE SIGNIFICANTLY WHILE MAINTAINING THE HIGHEST QUALITY OF CARE FOR PATIENTS. AS PART OF ITS COMMITMENT TO SERVING ITS COMMUNITY, PAMF PROVIDES CARE TO MEDICALLY INDIGENT PATIENTS AND THOSE ENROLLED IN MEDICARE, MEDI-CAL, AND OTHER GOVERNMENT PROGRAMS WHOSE REIMBURSEMENTS FALL SHORT OF COVERING THE COST OF PROVIDING CARE. ACHIEVEMENTS - PAMF RECEIVED A THREE-YEAR ACCREDITATION FROM THE INSTITUTE OF MEDICAL QUALITY (IMQ) IN 2010. RECOGNIZED BY THE MEDICAL BOARD OF CALIFORNIA, MANY LIABILITY CARRIERS, WORKERS' COMPENSATION AND INSURERS, IMQ'S AMBULATORY PROGRAM WAS DESIGNED TO PROMOTE QUALITY CARE AND ASSURE COMPLIANCE WITH GOVERNMENT REGULATIONS. - FOR THE EIGHTH CONSECUTIVE YEAR, THE INTEGRATED HEALTHCARE ASSOCIATION (IHA) HAS NAMED THE PALO ALTO MEDICAL FOUNDATION (PAMF) AS ONE OF THE MOST OUTSTANDING PHYSICIAN GROUPS IN CALIFORNIA BASED ON ITS PAY-FOR-PERFORMANCE (P4P) PROGRAM MEASURE FOR SIX CONSECUTIVE YEARS. IN OVERALL PERFORMANCE, PAMF RANKED AS A "TOP PERFORMER" IN PATIENT EXPERIENCE, INFORMATION TECHNOLOGY AND CLINICAL QUALITY, SUCH AS CANCER SCREENINGS, IMMUNIZATIONS AND DIABETES CARE. - PAMF IS RATED FOUR OUT OF FOUR STARS BY THE CALIFORNIA OFFICE OF THE PATIENT ADVOCATE (OPA) IN A STATEWIDE ASSESSMENT OF ALL MEDICAL GROUPS. MEDICAL GROUPS ARE RANKED IN TWO CATEGORIES: MEETING NATIONAL STANDARDS OF CARE, AND PATIENT RATINGS. THE OPA, AN INDEPENDENT STATE OFFICE IN CONJUNCTION WITH THE DEPARTMENT OF MANAGED HEALTH CARE, WAS CREATED TO REPRESENT THE INTERESTS OF HEALTH PLAN MEMBERS TO GET THE CARE THEY DESERVE AND TO PROMOTE TRANSPARENCY AND QUALITY HEALTH CARE BY PUBLISHING AN ANNUAL QUALITY OF CARE REPORT CARD. (2012) - MORE THAN 70 PERCENT OF PAMF'S PATIENTS ARE USING MY HEALTH ONLINE (FORMERLY KNOWN AS PAMFONLINE). ACCESS WAS ENHANCED WITH THE CREATION AND IMPLEMENTATION OF THE MY HEALTH ONLINE MOBILE FORMATS VIA THE MYCHART APP ON BOTH ANDROID AND APPLE DEVICES. (2012) - PAMF BECAME ONE OF FIRST ONCOLOGY PRACTICES IN U.S. RECOGNIZED BY QUALITY ONCOLOGY PRACTICE INITIATIVE (QOPI) CERTIFICATION PROGRAM, AN AFFILIATE OF THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY (ASCO) - THE WORLD'S LEADING PROFESSIONAL ORGANIZATION REPRESENTING PHYSICIANS WHO CARE FOR PEOPLE WITH CANCER. (2011) - PAMF'S VASCULAR CENTER AT THE MOUNTAIN VIEW CENTER WAS RECOGNIZED FOR ITS COMMITMENT TO PROVIDING A HIGH LEVEL OF PATIENT CARE AND QUALITY TESTING FOR THE DIAGNOSIS OF VASCULAR DISEASE BY THE INTERSOCIETAL COMMISSION FOR THE ACCREDITATION OF VASCULAR LABORATORIES. (2011) - SUTTER HEALTH PRESIDENT'S AWARD - THIS AWARD RECOGNIZES OUTSTANDING PERFORMANCE IN THE AREAS OF CLINICAL QUALITY, SERVICE EXCELLENCE, COMMUNITY BENEFIT AND CHARITY CARE, EMPLOYEE AND PHYSICIAN SATISFACTION, TARGETED GROWTH AND FINANCIAL HEALTH. (2011) - THE SOCIETY FOR ADOLESCENT HEALTH AND MEDICINE AWARDED THE 2011 HILARY E.C. MILLAR AWARD FOR INNOVATIVE APPROACHES TO ADOLESCENT HEALTH CARE TO THE PALO ALTO MEDICAL FOUNDATION'S (PAMF) WELLNESS ASSESSMENT FOR YOUTH TO GET ORGANIZED PROGRAM - KNOWN AS WAY2GO!. - THE CALIFORNIA ASSOCIATION OF PHYSICIAN GROUPS RATED PAMF AS "ELITE" IN ITS ANNUAL STANDARDS OF EXCELLENCE SURVEY. CAPG'S STANDARDS OF EXCELLENCE SURVEY EVALUATES THE FEATURES AND CAPABILITIES OF MEDICAL GROUPS ACROSS CALIFORNIA IN FOUR KEY AREAS TO RATE "THE INFRASTRUCTURE OF A HEALTH CARE ORGANIZATION...THE TOOLS, PEOPLE, AND PROCESSES" NEEDED TO DELIVER HIGH-QUALITY, AFFORDABLE CARE AND A POSITIVE PATIENT EXPERIENCE. THESE FOUR AREAS ARE CARE MANAGEMENT, HEALTH INFORMATION TECHNOLOGY, ACCOUNTABILITY AND TRANSPARENCY, AND PATIENT-CENTERED CARE. (2011)
EXEMPT PURPOSE ACHIEVEMENTS (CONTINUED) FORM 990, PART III, LINE 4A RESEARCH DIVISION THE MISSION OF THE PAMF RESEARCH INSTITUTE IS TO BE A WORLD LEADER IN THE AREAS OF BIOMEDICAL, CLINICAL, HEALTH POLICY, PUBLIC HEALTH RESEARCH AND RESEARCH TRAINING. THE RESEARCH INSTITUTE ALSO OVERSEES CLINICAL TRIALS CONDUCTED BY PAMF PHYSICIANS. THE RESEARCH INSTITUTE RECEIVES FUNDING FROM THE NATIONAL INSTITUTES OF HEALTH, OTHER GOVERNMENT GRANTS, AND FROM INDIVIDUAL GIFTS FROM DONORS. IN 2011, PAMF'S RESEARCH INSTITUTE RECEIVED MORE THAN 20 GRANTS FOR A TOTAL OF MORE THAN $10 MILLION FROM THE GOVERNMENT, NON-GOVERNMENT AND NON-INDUSTRY BASED PROGRAMS. PAMF'S RESEARCH PROGRAMS ARE NATIONALLY KNOWN AND HAVE MADE NUMEROUS DISCOVERIES LEADING TO IMPROVEMENT OF CARE FOR THE ENTIRE COMMUNITY. FOR EXAMPLE: - THE ARCHIVES OF INTERNAL MEDICINE PUBLISHED THREE RANDOMIZED CONTROLLED TRIALS WHICH EXAMINED THE EFFECTIVENESS OF BEHAVIORAL AND EDUCATIONAL INTERVENTIONS FOR PATIENTS WITH POORLY CONTROLLED DIABETES. - PAMFRI PILOTED AN INNOVATIVE PROGRAM USING SHARED MEDICAL APPOINTMENTS TO PROMOTE WEIGHT LOSS. LATHA PALANIAPPAN, M.D., M.S., AN ASSOCIATE INVESTIGATOR AT THE PAMF RESEARCH INSTITUTE AND HER RESEARCH TEAM, CAREFULLY STUDIED THE SPECIALIZED SMAS FOR MORE THAN TWO YEARS. THE FINDINGS FROM THIS STUDY WERE PUBLISHED IN THE JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE. EDUCATION DIVISION PAMF'S EDUCATION DIVISION PROVIDES HEALTH EDUCATION THROUGH HEALTH PROMOTION CLASSES, SUPPORT GROUPS AND COMMUNITY OUTREACH. IT PROVIDES FINANCIAL SUPPORT TO COMMUNITY ORGANIZATIONS, PROJECTS RELATED TO HEALTH CARE, IN-KIND ASSISTANCE THROUGH DONATIONS OF MEDICAL EQUIPMENT, AND HEALTH FAIRS AND PROGRAMS. PAMF'S HEALTH EDUCATION PROGRAMS FOCUS ON WELLNESS, PRENATAL/POSTPARTUM CARE AND DISEASE MANAGEMENT. PAMF ALSO OFFERS NEED-BASED SCHOLARSHIPS FOR EDUCATION CLASSES. IN ADDITION, THE EDUCATION DIVISION OFFERS FREE COMMUNITY LECTURES, HEALTH RESOURCE CENTERS, SUPPORT GROUPS, AND PROVIDES RELIABLE HEALTH INFORMATION TO THE PUBLIC THROUGH PAMF'S WEBSITE, PAMF.ORG. SEPARATE WEB SITES FOR PRETEENS, TEENS AND PARENTS OFFER MEDICALLY ACCURATE AND AGE-APPROPRIATE INFORMATION FOR THOSE IN THE COMMUNITY AND AROUND THE WORLD. THE TEEN SITE HAS RECEIVED MORE THAN 13 MILLION VISITS FROM AROUND THE WORLD SINCE IT LAUNCHED IN 2001, AND THE PRETEEN SITE HAS RECEIVED MORE THAN 1.7 MILLION VISITS SINCE IT WAS LAUNCHED IN 2004. PAMF IS COMMITTED TO BEING AN ACTIVE MEMBER OF THE COMMUNITIES IT SERVES, AND SUPPORTS VARIOUS COMMUNITY PROGRAMS AND SERVICES SUCH AS PROJECTS AND EDUCATIONAL ACTIVITIES WITH LOCAL SCHOOL DISTRICTS, AND PARTNERSHIPS WITH COMMUNITY ORGANIZATIONS, INCLUDING CLOSE PARTNERSHIPS WITH COMMUNITY CLINICS IN UNDERSERVED AREAS. PAMF'S PHYSICIANS AND STAFF MEMBERS ALSO DONATE HUNDREDS OF HOURS TO COMMUNITY SERVICE. COMMUNITY BENEFIT IN 2011, THE TOTAL AMOUNT OF COMMUNITY BENEFIT PROVIDED TO THE COMMUNITIES PAMF SERVES WAS $15,782,712, AND THE TOTAL AMOUNT OF CHARITY CARE IN 2011 WAS $3,006,971 (COMBINED TOTAL COMMUNITY BENEFIT: $18,789,683). PAMF'S COMMUNITY BENEFIT EFFORTS INCLUDE MYRIAD PROGRAMS AND BENEFITS FOR THE BROADER COMMUNITY, INCLUDING BUT NOT LIMITED TO: - MONETARY DONATIONS AND IN-KIND SUPPORT TO LOCAL COMMUNITY GROUPS AND ORGANIZATIONS - HEALTH EDUCATION CLASSES, LECTURES AND PRESENTATION TO THE COMMUNITY - ON-SITE CLINICAL EDUCATION PROGRAMS AND PRECEPTORSHIPS FOR MEDICAL STUDENTS, MEDICAL RESIDENTS, MEDICAL FELLOWS, NURSING STUDENTS, LABORATORY TECHNOLOGISTS, RADIOLOGY TECHNOLOGISTS, PHARMACY STUDENTS - COMMUNITY ORGANIZATION BOARD MEMBERSHIPS - SCHOOL-BASED HEALTH AND WELLNESS PROGRAMS - CHILDHOOD OBESITY PROGRAMS - HEALTH EDUCATION PRESENTATIONS IN LOCAL ORGANIZATIONS WITH AT-RISK POPULATIONS, ETHNICALLY DIVERSE POPULATIONS, AGE-FOCUSED HEALTH AND WELLNESS - DISEASE SPECIFIC PROGRAMS FOR REQUESTING COMMUNITY ORGANIZATIONS AND ON-SITE PROGRAMS WHICH ARE FREE AND OPEN TO ALL COMMUNITY MEMBERS - SENIOR FAIRS - TEEN MENTAL HEALTH OUTREACH AND COLLABORATIONS - FREE MAMMOGRAPHY PROJECT WITH RAVENSWOOD FAMILY HEALTH CENTER (PROVIDING HUNDREDS OF FREE MAMMOGRAPHIES AND BREAST HEALTH COUNSELING TO LOW INCOME WOMEN) - FREE HIGH SCHOOL SPORTS PHYSICALS - PHYSICIANS STAFFING MOUNTAIN VIEW ROTACARE FREE CLINIC AND PROVIDING SPECIALTY CARE AT PAMF'S MOUNTAIN VIEW CENTER - FUNDING OF TWO CLINICAL STAFF POSITIONS AT ROTACARE - SUPPORT OF THE HEALTHY KIDS PROGRAMS IN SANTA CRUZ AND SANTA CLARA COUNTIES
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS FORM 990, PART VI, QUESTIONS 6 & 7A THIS CORPORATION IS AN AFFILIATE OF SUTTER HEALTH, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. SUTTER HEALTH IS THE SOLE MEMBER WITH THE RIGHT TO ELECT AT LEAST A MAJORITY OF THE MEMBERS OF THE BOARD OF DIRECTORS.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS FORM 990, PART VI, QUESTION 7B SUTTER HEALTH AS THE SOLE MEMBER OF THE ORGANIZATION IS ENTITLED TO EXERCISE FULLY ALL RIGHTS AND PRIVILEGES OF MEMBERS OF NONPROFIT CORPORATIONS UNDER THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW, AND ALL OTHER APPLICABLE LAWS. THE MEMBER HAS THE RIGHTS AND POWERS TO APPOINT (AND REMOVE) MEMBERS OF THE CORPORATION'S BOARD OF DIRECTORS, SUBJECT TO THE PROVISIONS OF THE BYLAWS. IN ADDITION, THE MEMBER HAS THE RIGHT TO APPROVE THE FOLLOWING ACTIONS OF THE CORPORATION'S BOARD OF DIRECTORS: (A) MERGER, CONSOLIDATION, REORGANIZATION OR DISSOLUTION OF THE CORPORATION. (B) AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION. (C) ADOPTION OF OPERATING BUDGETS AND CAPITAL BUDGETS (ALTHOUGH THE BOARD IS EMPOWERED TO DEVELOP ITS OWN BUDGETS WITHIN THE GUIDELINES AND OBJECTIVES SET BY THE GENERAL MEMBER). (D) EXPENDITURES BEYOND APPROVED BUDGETS AND IN EXCESS OF A DOLLAR AMOUNT, NOT LESS THAN $200,000, TO BE SET BY THE GENERAL MEMBER. (E) BORROWING IN EXCESS OF A DOLLAR AMOUNT, NOT LESS THAN $200,000, TO BE SET BY THE GENERAL MEMBER (FOR THE PURPOSE OF THIS SECTION 14.1, "BORROWING" INCLUDES, BUT IS NOT LIMITED TO, LEASE AGREEMENTS AND INSTALLMENT CONTRACTS). (F) PURCHASE, SALE, LEASE, DISPOSITION, HYPOTHECATION, EXCHANGE, GIFT, PLEDGE OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT, NOT LESS THAN $200,000, TO BE SET BY THE GENERAL MEMBER AND NOT PREVIOUSLY INCLUDED IN THE CAPITAL BUDGET. (G) APPOINTMENT OF AN INDEPENDENT AUDITOR AND CORPORATE COUNSEL. (H) APPROVAL OF TRANSACTIONS OF THIS CORPORATION IN WHICH A TRUSTEE OR OFFICER OF THIS CORPORATION HAS A MATERIAL FINANCIAL INTEREST. (I) APPROVAL OF SELECTION OF THE CHIEF EXECUTIVE OFFICER. (J) ADOPTION OF QUALITY IMPROVEMENT PROCEDURES OR STANDARDS THAT DO NOT MEET OR EXCEED GUIDELINES OR PROCEDURES ESTABLISHED BY THE GENERAL MEMBER. (NOTWITHSTANDING THE FOREGOING, IT IS UNDERSTOOD AND AGREED THAT THE GENERAL MEMBER WILL NOT IMPOSE GUIDELINES OR PROCEDURES THAT MAY HAVE A MATERIAL ADVERSE EFFECT ON THE CORPORATION, WITHOUT THE PRIOR APPROVAL OF THIS CORPORATION.) (K) THE CREATION OF ANY SUBSIDIARY ORGANIZATION.
DESCRIBE THE PROCESS USED BY MGMT &/OR GOVERNING BODY TO REVIEW FORM 990 FORM 990, PART VI, QUESTION 11B SUTTER HEALTH HAS A CENTRALIZED TAX DEPARTMENT RESPONSIBLE FOR THE PREPARATION OF THE FORM 990. ANNUALLY THE TAX DEPARTMENT PROVIDES TRAINING AND EDUCATION TO AFFILIATE PERSONNEL WHO ASSIST THE TAX DEPARTMENT IN COLLECTING AND REVIEWING DATA TO BE REPORTED ON THE FORM 990. THE PREPARATION MATERIAL IS REVIEWED BY VARIOUS DEPARTMENTS INCLUDING TAX, FINANCE, LEGAL, AND HUMAN RESOURCES. A NATIONAL ACCOUNTING FIRM PREPARES AND/OR REVIEWS THE RETURN. A COMPLETED RETURN IS THEN REVIEWED BY THE TAX DEPARTMENT, THE AFFILIATE, AND THE CFO BEFORE THE RETURN IS FILED. A COPY OF THE FORM 990 HAS BEEN PROVIDED TO ALL MEMBERS OF THE GOVERNING BODY BEFORE FILING THE FORM.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12 EMPLOYEES ARE EDUCATED ON THE CONFLICT OF INTEREST POLICY AND THE NEED TO MAKE DISCLOSURE AS PART OF ANNUAL COMPLIANCE EDUCATION. IN ADDITION, ANNUALLY A DISCLOSURE STATEMENT IS COMPLETED BY ALL DIRECTORS AND OFFICERS THAT INCLUDES AN ACKNOWLEDGEMENT THAT THEY HAVE READ THE CONFLICT OF INTEREST POLICY. ON THIS STATEMENT THE INDIVIDUAL WILL LIST A WIDE RANGE OF INFORMATION WHICH INCLUDES BUSINESS RELATIONSHIPS, EMPLOYMENT RELATIONSHIPS, PROPERTY INTERESTS, AND THOSE OF RELATED PARTIES. THE CEO AND BOARD CHAIR WILL REVIEW THE STATEMENTS AND MONITOR SITUATIONS THAT MAY POSE A POTENTIAL CONFLICT OF INTEREST. THE CEO AND BOARD CHAIR MAY CONSULT WITH THE OFFICE OF THE GENERAL COUNSEL AS NECESSARY. IF THERE IS A POTENTIAL CONFLICT OF INTEREST RELATED TO A PARTICULAR TRANSACTION, THE INTERESTED INDIVIDUAL MUST DISCLOSE THE EXISTENCE AND NATURE OF THE RELATIONSHIP. THE BOARD CHAIR MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE THE CONFLICT. UNTIL THE POTENTIAL CONFLICT IS RESOLVED, THE BOARD CHAIR MAY REQUEST THE INDIVIDUAL TO NOT PARTICIPATE DURING RELATED PRESENTATIONS AND DISCUSSIONS. IN ALL CIRCUMSTANCES INVOLVING AN ACTUAL CONFLICT, THE INTERESTED INDIVIDUAL SHALL REFRAIN FROM VOTING ON ANY MATTER RELATED TO THE TRANSACTION.
PROCESS FOR DETERMINING COMPENSATION FORM 990, PART VI, QUESTION 15 THE COMPENSATION COMMITTEE OF THE SUTTER HEALTH BOARD OF DIRECTORS RETAINS ULTIMATE DISCRETIONARY AUTHORITY OVER ALL ELEMENTS OF COMPENSATION TO ENSURE THAT ORGANIZATIONAL PURPOSES ARE APPROPRIATELY BEING SERVED. THE COMPENSATION COMMITTEE USES CREDIBLE DATA SOURCES AND MAINTAINS AN OBJECTIVE "ARMS LENGTH" DECISION-MAKING PROCESS, ENSURING THE INTEGRITY OF SUTTER'S EXECUTIVE PROGRAMS AND CONSISTENCY WITH THE ORGANIZATION'S OVERALL MISSION. IN ORDER TO ENSURE EXTERNAL COMPETITIVENESS, NATIONAL, CALIFORNIA AND LOCAL MARKET AREA COMPENSATION DATA COMPARISONS ARE REVIEWED. COMPETITIVE ANALYSIS INCLUDES: (A) BASE SALARY, (B) TOTAL CASH (BASE SALARY + ANNUAL INCENTIVE) AND (C) TOTAL REMUNERATION (BASE SALARY + ANNUAL INCENTIVE + BENEFITS AND LONG TERM INCENTIVE). THIS ANALYSIS INCLUDES COMPARABLE ORGANIZATIONS AND GEOGRAPHIC CONSIDERATIONS. FOR THE MOST SENIOR EXECUTIVE POSITIONS, NATIONAL COMPARISONS FOR ORGANIZATIONS SIMILAR IN SIZE, SCOPE AND COMPLEXITY AS SUTTER HEALTH ARE MOST APPROPRIATE SINCE IT IS A NATIONAL MARKETPLACE IN WHICH SUTTER COMPETES FOR EXECUTIVE TALENT. ON THE OTHER HAND, BECAUSE CALIFORNIA'S UNDERLYING COMPENSATION STRUCTURE IS HIGHER THAN NATIONAL DATA (ESPECIALLY IN THE BAY AREA), REGIONAL PAY COMPARISONS AND ADJUSTMENTS ARE MADE. OFFICERS AND KEY EMPLOYEES OF THIS ORGANIZATION WHO ARE SUTTER HEALTH EMPLOYEES UNDERGO A REVIEW AND COMPENSATION COMMITTEE APPROVAL, AND SUCH APPROVAL IS RECORDED IN THE MINUTES.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC FORM 990, PART VI, QUESTION 19 THE SUTTER HEALTH SYSTEM POSTS ITS CURRENT AND PAST AUDITED FINANCIAL STATEMENTS AT SUTTERHEALTH.ORG. OTHER DOCUMENTS ARE ALSO LOCATED AT THIS WEBSITE INCLUDING THE ANNUAL REPORT, MISSION STATEMENT, HISTORY, AND LINKS TO AFFILIATE WEBSITES. THE GOVERNING DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
HOURS PER WEEK DEVOTED TO RELATED ORGANIZATION FORM 990, PART VII THE FOLLOWING BOARD MEMBERS OF THE ORGANIZATION ARE FULL-TIME EMPLOYEES (40 HOURS PER WEEK) OF SUTTER HEALTH AND THEIR SUTTER HEALTH SALARIES ARE REPORTED HEREIN. THESE INDIVIDUALS RECEIVE NO COMPENSATION FOR THEIR SERVICE AS BOARD MEMBERS OF THIS ORGANIZATION. JEFF GERARD PATRICK FRY ROBERT MERWIN
OTHER CHANGES IN FUND BALANCE FORM 990, PART XI, LINE 5 EQUITY TRANSFERS (NET) $(135,319,586) CHANGE IN UNREALIZED GAIN/(LOSS) ON INVESTMENTS (5,503,736) INTEREST INCOME FROM K-1 (158) RENTAL INCOME FROM K-1 (49,307) PARTNERSHIP INCOME ON BOOKS 65,257 ADJUSTMENTS TO BEGINNING BALANCE 2,792,036 ANNUITY TRUE-UP (297,949) CHANGE IN SPLIT INTEREST (935) -------------- $(138,314,378) ==============
SCHEDULE K SUPPLEMENTAL INFORMATION SCHEDULE K, PART VI GLOBAL DISCLOSURE PART I, COLUMN (E): THE ORGANIZATION'S SOLE CORPORATE MEMBER IS A CONDUIT BORROWER OF TAX-EXEMPT BOND ISSUES THAT ALLOCATES PORTIONS OF EACH ISSUE TO CERTAIN SUBSIDIARY ORGANIZATIONS. THE OUTSTANDING BOND LIABILITY ALLOCATED TO THIS ORGANIZATION IS REPORTED ON FORM 990, PART X, BALANCE SHEET. WITH THE EXCEPTION OF PART I(F), THE SCHEDULE K FOR THIS ORGANIZATION IS REPORTING INFORMATION FOR THE ENTIRE BOND ISSUE. PART II, LINE 7: ISSUANCE COSTS WERE FUNDED THROUGH EQUITY CONTRIBUTIONS. PAMF SPECIFIC PART I, COLUMN (E): THE FILING ORGANIZATION RECEIVED BOND PROCEEDS IN THE AMOUNTS OF: $148,293,125 FROM THE 2005A ISSUE, $31,866,092 FROM THE 2005BC ISSUE AND $94,769,437 FROM THE 2008BC ISSUE. PART I, LINE B, COLUMN (F): THE INITIAL BONDS ISSUED IN 2005 WERE "NEW MONEY" BONDS THAT WERE RETIRED AND REISSUED ON MAY 1, 2007. ACCORDINGLY, WHERE APPROPRIATE, SCHEDULE K REFLECTS THE CURRENT REFUNDING BONDS THAT WERE TREATED AS REISSUED RATHER THAN REFLECTING THE ORIGINAL "NEW MONEY" BONDS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2011

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
2011
Open to Public Inspection
Name of the organization
PALO ALTO MEDICAL FOUNDATION
 
Employer identification number

94-1156581
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) ADOLESCENT TREATMENT CENTERS INC

390 40TH STREET

OAKLAND,CA94609
68-0088443 		HEALTHCARE CA 501(C)(3) 3 SUTTER EBH
 
Yes
 
(2) ALTA BATES SUMMIT FOUNDATION

3012 SUMMIT STREET 3RD FLOOR

OAKLAND,CA94609
51-0160184 		FUNDRAISING CA 501(C)(3) 11a - I SUTTER EBH
 
Yes
 
(3) CALIFORNIA PACIFIC MEDICAL CTR FOUND

2015 STEINER STREET 2ND FLOOR

SAN FRANCISCO,CA94115
94-2728423 		FUNDRAISING CA 501(C)(3) 11a - I SUTTER WBH
 
Yes
 
(4) DELTA MEMORIAL HOSPITAL FOUNDATION

3901 LONE TREE WAY

ANTIOCH,CA94509
94-2417022 		FUNDRAISING CA 501(C)(3) 11a - I SUTTER EBH
 
Yes
 
(5) EAST BAY PERINATAL CENTER

350 HAWTHORNE AVE

OAKLAND,CA94609
51-0172285 		HEALTHCARE CA 501(C)(3) 3 SUTTER EBH
 
Yes
 
(6) EDEN MEDICAL CENTER

20103 LAKE CHABOT ROAD

CASTRO VALLEY,CA94546
94-2948100 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(7) MARIN COMMUNITY HEALTH

250 BON AIRE ROAD

GREENBRAE,CA94904
94-2994751 		SUPPORTING OR CA 501(C)(3) 11b - II SUTTER HLTH
 
Yes
 
(8) MILLS-PENINSULA HEALTH SERVICES

1501 TROUSDALE DRIVE

BURLINGAME,CA94010
94-1156265 		HOSPITAL CA 501(C)(3) 3 PAMF
 
Yes
 
(9) MILLS-PENINSULA HOSPITAL FOUNDATION

1501 TROUSDALE DRIVE

BURLINGAME,CA94010
23-7288765 		FUNDRAISING CA 501(C)(3) 11a - I MPHS
 
Yes
 
(10) SAMUEL MERRITT UNIVERSITY

450 30TH STREET 2840

OAKLAND,CA94609
94-2992642 		UNIVERSITY CA 501(C)(3) 2 SUTTER EBH
 
Yes
 
(11) SUTTER AUBURN FAITH HOSPITAL FOUNDATION

11815 EDUCATION ST

AUBURN,CA95602
94-2594966 		FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(12) SUTTER CENTRAL VALLEY HOSPITALS

1800 COFFEE ROAD SUITE 76

MODESTO,CA95355
94-1080917 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(13) SUTTER COAST HOSPITAL

800 E WASHINGTON BLVD

CRESCENT CITY,CA95531
94-2988520 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(14) SUTTER DAVIS HOSPITAL FOUNDATION

PO BOX 1617

DAVIS,CA95617
68-0217870 		FUNDRAISING CA 501(C)(3) 11a - I SUTTER SSR
 
Yes
 
(15) SUTTER EAST BAY HOSPITALS

3012 SUMMIT STREET 3RD FLOOR

OAKLAND,CA94609
94-1196176 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(16) SUTTER EAST BAY MEDICAL FOUNDATION

3687 MT DIABLO BLVD 200

LAFAYETTE,CA94549
94-2690415 		HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(17) SUTTER GOULD MEDICAL FOUNDATION

600 COFFEE ROAD

MODESTO,CA95355
94-1682256 		HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(18) SUTTER HEALTH

2200 RIVER PLAZA DRIVE

SACRAMENTO,CA95833
94-2788907 		SUPPORTING OR CA 501(C)(3) 11c III-FI NA
 
 
No
(19) SUTTER HEALTH PACIFIC

91-2301 FT WEAVER RD

EWA BEACH,HI96706
99-0298651 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(20) SUTTER HEALTH SACRAMENTO SIERRA REGION

PO BOX 160727

SACRAMENTO,CA95816
94-1156621 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(21) SUTTER INSURANCE SERVICES CORPORATION

745 FORT STREET SUITE 800

HONOLULU,HI96813
99-0289310 		INSURANCE SER HI 501(C)(3) 11b - II SUTTER HLTH
 
Yes
 
(22) SUTTER MEDICAL CENTER FOUNDATION

PO BOX 160727

SACRAMENTO,CA95816
94-2788906 		FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(23) SUTTER MEDICAL CENTER CASTRO VALLEY

20130 LAKE CHABOT RD 103

CASTRO VALLEY,CA94546
77-0146047 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(24) SUTTER MEDICAL FOUNDATION

2800 L STREET 7TH FLOOR

SACRAMENTO,CA95816
68-0273974 		HEALTH CARE CA 501(C)(3) 11b - II SUTTER HLTH
 
Yes
 
(25) SUTTER ROSEVILLE MEDICAL CTR FOUNDATION

ONE MEDICAL PLAZA

ROSEVILLE,CA95661
68-0040113 		FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(26) SUTTER SOLANO CHARITABLE FOUNDATION

300 HOSPITAL DRIVE

VALLEJO,CA94589
94-2668262 		FUNDRAISING CA 501(C)(3) 7 SUTTER SSR
 
Yes
 
(27) SUTTER VISITING NURSE ASSOC AND HOSPICE

1900 POWELL ST 300

EMERYVILLE,CA94608
94-6068843 		HEALTH CARE CA 501(C)(3) 9 SUTTER HLTH
 
Yes
 
(28) SUTTER WEST BAY HOSPITALS

2333 BUCHANAN STREET

SAN FRANCISCO,CA94115
94-0562680 		HOSPITAL CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(29) SUTTER WEST BAY MEDICAL FOUNDATION

2015 STEINER STREET 1ST FLOOR

SAN FRANCISCO,CA94115
94-2948131 		HEALTHCARE CA 501(C)(3) 3 SUTTER HLTH
 
Yes
 
(30) TRACY HOSPITAL FOUNDATION

1420 N TRACY BLVD

TRACY,CA95376
68-0318845 		FUNDRAISING CA 501(C)(3) 11a - I SUTTER CVH
 
Yes
 
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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
(1) MAGNETIC IMAGING AF

175 LENNON
WLN CK,CA94598
94-2953833 		PATIENT CARE CA NA
  		N/A                
(2) SURG CTR OF ABSMC

3875 TELEGRAPH
OAKLAND,CA94609
47-0946086 		OUTPATIENT SURG CA NA
  		N/A                
(3) ALTA CT SERVICES LP

175 LENNON
WLN CK,CA94598
94-3083464 		PATIENT CARE CA NA
  		N/A                
(4) CALIFORNIA PACIFIC ADV IMAGING LLC

PO BOX 6102
NOVATO,CA94948
56-2311840 		MRI JOINT VENTURE CA NA
  		N/A                
(5) SAN FRANCISCO ENDOSCOPY CENTER LLC

3000 RIVERCHASE
BIRMINGHAM,AL35244
91-2160588 		ENDOSCOPY JV CA NA
  		N/A                
(6) PRESIDIO SURGERY CENTER LLC

1635 DIVISADERO
SF,CA94115
32-0144060 		AMBULATORY SURG CA NA
  		N/A                
(7) SUTTER FAIRFIELD SURGERY CTR

2700 LOW CT
FAIRFIELD,CA94533
30-0233892 		SURGERY CA NA
  		N/A                
(8) TWIN CITIES SURGICAL HOSPITAL LLC

250 S WACKER
CHICAGO,IL60606
35-2182617 		SURGERY CA NA
  		N/A                
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) HEALTH VENTURES INC
350 HAWTHORNE ST
OAKLAND,CA94609
94-2918780 		HEALTH SERVICE CA NA
  		C CORP      












Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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 related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property from related 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) MILLS PENINSULA HEALTH SERVICES

 O 37,443,953 FMV
(2) MILLS PENINSULA HEALTH SERVICES

 P 19,560,353 FMV
(3) SUTTER WEST BAY HOSPITALS

 P 1,627,241 FMV
(4)
(5)
(6)
Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(e)
Are all
partners
section
501(c)(3)
organizations? 		(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 Yes No






























Schedule R (Form 990) 2011
Schedule R (Form 990) 2011
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
Additional Data


Software ID:  
Software Version: