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
CHILDREN'S HOSPITAL COLORADO
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
13123 E 16TH AVENUE
 
Room/suite
City or town, state or country, and ZIP + 4
AURORA, CO80045
D Employer identification number

84-0166760
E Telephone number

G Gross receipts $ 663,248,713
F Name and address of principal officer:
JAMES E SHMERLING
13123 E 16TH AVENUE
AURORA,CO80045
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHILDRENSCOLORADO.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: 1908
M State of legal domicile: CO
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH- QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a)..... 3 27
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 24
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ... 5 4,992
6 Total number of volunteers (estimate if necessary) .... 6 1,920
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 3,111,662
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 731,386
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 19,651,007 22,635,860
9 Program service revenue (Part VIII, line 2g) ......... 631,280,882 626,051,296
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 5,305,784 12,529,186
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 510,970 558,979
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 656,748,643 661,775,321
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 1,317,533 391,592
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) 300,124,999 324,881,451
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).... 280,293,775 275,396,623
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 581,736,307 600,669,666
19 Revenue less expenses. Subtract line 18 from line 12....... 75,012,336 61,105,655
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,473,383,057 1,522,794,877
21 Total liabilities (Part X, line 26)............. 488,758,866 525,206,058
22 Net assets or fund balances. Subtract line 21 from line 20..... 984,624,191 997,588,819
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: TO IMPROVE THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY.
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 $ 429,695,490 including grants of $ 391,592 ) (Revenue $ 626,051,296 )
ROUTINE INPATIENT SERVICES; ANCILLARY INPATIENT SERVICES SUCH AS LAB RADIOLOGY, OPERATING ROOM, RECOVERY ROOM, CENTRAL SUPPLIES, ETC.; OUTPATIENT SERVICES SUCH AS EMERGENCY ROOM, ORTHO CLINIC, ONCOLOGY CLINIC, ETC. SEE SCHEDULE O FOR ADDITIONAL INFORMATION
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$ 429,695,490
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 IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
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
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in 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
Yes
 
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
Yes
 
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
 
No
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......... Click to see attachment
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II.. Click to see attachment
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III.. Click to see attachment
16
 
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..... Click to see attachment
20a
Yes
 
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. Click to see list of attachments
20b
Yes
 
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
 
No
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II......................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or 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 M
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............
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
502
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
4,992
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
27
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
24
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
Yes
 
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
 
No
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
Yes
 
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
Yes
 
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
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
CARLO ROTOLA CONTROLLER
13123 E 16TH AVENUE
AURORA,CO80045
(720) 777-2788
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) CATHY M FINLON
CHAIRMAN OF BOARD UNTIL 4/12
 1.0 X   X       0 0 0
(2) TERRANCE CARROLL
BOARD MEMBER
 1.0 X           0 0 0
(3) KELLY KENNEDY
CHCO FNDN BOARD OF TRUSTEES
 1.0 X           0 0 0
(4) RUSSELL DISPENSE
BOARD MEMBER
 1.0 X           0 0 0
(5) DONALD M ELLIMAN
BOARD MEMBER
 1.0 X           0 0 0
(6) MARY GITTINGS-CRONIN
BOARD MEMBER
 1.0 X           0 0 0
(7) COLE FINEGAN
SECRETARY
 1.0 X   X       0 0 0
(8) ERIC HARTMEISTER
PRES OF THE ASSN OF VOLUNTEERS
 1.0 X           0 0 0
(9) MARIA GUAJARDO PHD
BOARD MEMBER
 1.0 X           0 0 0
(10) WILLIAM LINDSAY
BOARD MEMBER
 1.0 X           0 0 0
(11) RANDY HERTEL
BOARD MEMBER
 1.0 X           0 0 0
(12) ROXANN HEADLEY MD
BOARD MEMBER
 1.0 X           0 0 0
(13) ROBERT HOTTMAN
CHAIRMAN/TREASURER
 1.0 X   X       0 0 0
(14) JOY JOHNSON
VICE-CHAIRMAN OF BOARD
 1.0 X   X       0 0 0
(15) KEVIN REIDY
BOARD MEMBER
 1.0 X           0 0 0
(16) BRADLEY SMITH DDS
BOARD MEMBER
 1.0 X           0 0 0
(17) RICHARD KRUGMAN MD
BOARD MEMBER, VICE CHANCELLOR
 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) LILLY MARKS
BOARD MEMBER, VP HLTH AFFAIRS
 1.0 X           0 0 0
(19) JODY MATHIE
BOARD MEMBER
 1.0 X           0 0 0
(20) R SCOTT NYCUM
BOARD MEMBER
 1.0 X           0 0 0
(21) JAMES E SHMERLING DHA
PRESIDENT AND CEO
 40.0 X   X       1,343,817 0 143,383
(22) ANN SPERLING
BOARD MEMBER
 1.0 X           0 0 0
(23) PAUL RADY
BOARD MEMBER
 1.0 X           0 0 0
(24) THOMAS HONIG
BOARD MEMBER
 1.0 X           0 0 0
(25) JANE SCHUMAKER
BOARD MEMBER, EXEC DIR UPI
 1.0 X           0 0 0
(26) CRAIG PONZIO
IMMEDIATE PAST CHAIR
 1.0 X           0 0 0
(27) HAL STEIN MD
BOARD MEMBER
 1.0 X           0 0 0
(28) BENJAMIN WALTON
BOARD MEMBER
 1.0 X           0 0 0
(29) CANDY ERGEN
BOARD MEMBER
 1.0 X           0 0 0
(30) ANDREW SIROTNAK MD
PRESIDENT OF THE MEDICAL STAFF
 1.0 X           0 0 0
(31) JENA HAUSMANN
SR. VP/CHIEF OPERATING OFFICER
 40.0     X       562,891 0 80,924
(32) LEONARD J DRYER JR
SR. VP-CFO
 40.0     X       580,875 0 29,140
(33) MARY ANNE LEACH
SR. VP-CIO
 40.0     X       350,862 0 43,022
(34) JOHN LACOUTURE
CHIEF LEGAL OFFICER
 40.0     X       365,555 0 43,225
(35) KELLY JOHNSON
SR. VP/CHIEF NURSING OFFICER
 40.0     X       324,614 0 52,238
(36) JEFFREY HARRINGTON
VP FINANCE
 40.0     X       271,329 0 45,537
(37) MICHEAL WUKITSCH
VP HUMAN RESOURCE
 40.0     X       296,165 0 48,185
(38) SUZY JAEGER
VP AMBULATORY AND OPERATIONS
 40.0     X       280,771 0 45,788
(39) JERROD MILTON
VP OPERATIONS
 40.0     X       216,404 0 41,834
(40) BETH GAFFNEY
VP OPERATIONS
 40.0     X       271,213 0 32,446
(41) AMY CASSERI
CHIEF STRATEGY OFFICER
 40.0     X       391,405 0 58,563
(42) JOAN BOTHNER MD
CHIEF MEDICAL OFFICER
 40.0     X       635,754 0 0
(43) DENNIS MATTHEWS
PPAARDI-IN-CHIEF
 40.0     X       266,351 0 0
(44) STEPHEN DANIELS
PEDIATRIC-IN-CHIEF
 40.0     X       490,335 0 0
(45) DANIEL HYMAN MD
CHIEF QUALITY OFFICER
 40.0     X       480,954 0 0
(46) FRED SUCHY
CHIEF RESEARCH OFFICER
 40.0     X       434,508 0 0
(47) TIMOTHY CROMBLEHOME
SURGEON-IN-CHIEF
 40.0     X       96,082 0 0
(48) MICHAEL CLARK
EXEC DIR RESEARCH ADMIN
 40.0         X   204,218 0 16,116
(49) SUSAN DILTZ
DIR INFRASTRUCTURE & TECH SVCS
 40.0         X   191,857 0 24,616
(50) MARY BETH MARTIN
EXEC DIR MATERNAL-FETAL PROG
 40.0         X   196,660 0 23
(51) DAVID ROGERS
HEART INSTITUTE ADMINISTRATOR
 40.0         X   184,499 0 15,660
(52) QI WEI
SCI DIR MOLECULAR DIAGNOSTICS
 40.0         X   288,357 0 20,713
(53) LINDA POWERS
DIR NURSING PROJECTS
 40.0           X 161,337 0 21,675
(54) MARGI MORSE
DIR ADVANCED PRACTICE NURSING
 40.0           X 156,392 0 20,246
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 9,043,205 0 783,334
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet319
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
Yes
 
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
UNIVERSITY PHYSICIANS INC
13611 E COLFAX
AURORA,CO80045 		PHYSICIAN SERVICES 41,398,169
UCDHSC
4200 E 9TH AVENUE
AURORA,CO80045 		EDUCATIONAL SERVICES 13,175,821
CROTHALL HEALTHCARE
13028 COLLECTION CENTER DRIVE
CHICAGO,IL60693 		ENVIRONMENTAL SVCS 5,702,631
HOSPITAL SHARED SERVICES
PO BOX 17033
DENVER,CO80217 		COURIER AND SECURITY 2,788,947
STERLING RICE GROUP INC
1801 13TH STREET
BOULDER,CO80302 		MARKETING SERVICES 2,714,389
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet116
Form 990 (2011)
Form 990 (2011)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 16,252,350
e Government grants (contributions)1e 5,890,412
f All other contributions, gifts, grants, and
similar amounts not included above1f 		493,098
g Noncash contributions included in lines 1a-1f:$  
h Total. Add lines 1a-1f.......MediumBullet 22,635,860
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 622,110 599,607,105 599,607,105    
b RESEARCH FUNDING 541,900 10,974,785 10,654,891 319,894  
c CAFETERIA 722,210 3,613,204 3,613,204    
d LAB BILLING 561,000 1,475,989   1,475,989  
e ALL OTHER REVENUE 900,099 10,380,213 9,064,434 1,315,779  
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 626,051,296
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 6,997,762     6,997,762
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties............MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 558,979  
b Less: rental expenses    
c Rental income or (loss) 558,979  
d Net rental income or (loss).......MediumBullet 558,979     558,979
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 7,002,515 2,300
b Less: cost or other basis and sales expenses   1,473,392
c Gain or (loss) 7,002,515 -1,471,092
d Net gain or (loss)..........MediumBullet 5,531,424     5,531,424
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            
b            
c            
d All other revenue ....        
e Total. Add lines 11a–11d ......MediumBullet 0
12 Total revenue. See Instructions....MediumBullet 661,775,321 622,939,634 3,111,662 13,088,165
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 21 391,592 391,592
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
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 .... 8,324,170 0 8,324,170 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 254,574,796 186,565,066 68,009,730 0
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 11,307,202 8,024,105 3,283,097 0
9 Other employee benefits ....... 32,244,390 22,882,086 9,362,304 0
10 Payroll taxes ........... 18,430,893 13,079,400 5,351,493 0
11 Fees for services (non-employees):        
a Management ...... 0      
b Legal ......... 754,635 535,523 219,112 0
c Accounting ........... 450,240 319,511 130,729 0
d Lobbying ........... 226,371 226,371 0 0
e Professional fundraising. See Part IV, line 17.. 0  
f Investment management fees ...... 0      
g Other .......... 71,233,182 50,550,306 20,682,876 0
12 Advertising and promotion .... 3,425,921 2,431,189 994,732 0
13 Office expenses ....... 6,988,364 4,959,261 2,029,103 0
14 Information technology ...... 8,385,020 5,950,392 2,434,628 0
15 Royalties .. 0      
16 Occupancy ........... 14,865,861 10,549,491 4,316,370 0
17 Travel ............ 2,141,948 1,520,024 621,924 0
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 771,718 547,646 224,072 0
20 Interest ........... 7,445,050 5,283,346 2,161,704 0
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 43,412,341 30,807,372 12,604,969 0
23 Insurance .............. 2,760,236 1,958,789 801,447 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 HOSPITAL PROVIDER FEE 10,509,283 10,509,283 0 0
b EQUIPMENT RENTAL & MAINT. 11,108,775 7,883,292 3,225,483 0
c MEDICAL SUPPLIES 70,430,749 49,980,864 20,449,885 0
d ALL OTHER EXPENSES 20,486,929 14,740,581 5,746,348 0
e
f All other expenses        
25 Total functional expenses. Add lines 1 through 24f 600,669,666 429,695,490 170,974,176 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 .......... 2,976,751 1 17,028,690
2 Savings and temporary cash investments ....... 0 2 0
3 Pledges and grants receivable, net ......... 6,311,905 3 7,929,264
4 Accounts receivable, net ......... 63,626,154 4 74,367,084
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 .............. 4,352,337 8 5,559,573
9 Prepaid expenses and deferred charges ............ 4,108,287 9 4,983,633
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 976,249,212
b Less: accumulated depreciation. ..... 10b 253,392,723 656,989,118 10c 722,856,489
11 Investments—publicly traded securities .......... 328,834,213 11 256,754,739
12 Investments—other securities. See Part IV, line 11 ...... 149,891,498 12 165,423,503
13 Investments—program-related. See Part IV, line 11 .. 0 13 0
14 Intangible assets ......... 0 14 0
15 Other assets. See Part IV, line 11 ........... 256,292,794 15 267,891,902
16 Total assets. Add lines 1 through 15 (must equal line 34)... 1,473,383,057 16 1,522,794,877
Liabilities 17 Accounts payable and accrued expenses . 90,142,909 17 100,805,633
18 Grants payable .......... 0 18 0
19 Deferred revenue .......... 0 19 0
20 Tax-exempt bond liabilities .......... 367,500,092 20 360,298,473
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 .. 0 23 0
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..... 31,115,865 25 64,101,952
26 Total liabilities. Add lines 17 through 25..... 488,758,866 26 525,206,058
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 ..... 722,819,263 27 726,871,896
28 Temporarily restricted net assets ..... 164,571,388 28 163,961,629
29 Permanently restricted net assets ..... 97,233,540 29 106,755,294
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 ..... 984,624,191 33 997,588,819
34 Total liabilities and net assets/fund balances ..... 1,473,383,057 34 1,522,794,877
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
661,775,321
2
Total expenses (must equal Part IX, column (A), line 25) ....
2
600,669,666
3
Revenue less expenses. Subtract line 2 from line 1 ...
3
61,105,655
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
984,624,191
5
Other changes in net assets or fund balances (explain in Schedule O) ...
5
-48,141,027
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
997,588,819
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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
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
CHILDREN'S HOSPITAL COLORADO
  		Employer identification number

84-0166760
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
CHILDREN'S HOSPITAL COLORADO
  		Employer identification number

84-0166760
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
CHILDREN'S HOSPITAL COLORADO
  		Employer identification number

84-0166760
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 C
(Form 990 or 990-EZ)

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

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet Complete if the organization is described below.
SchCMd Bullet Attach to Form 990 or Form 990-EZ. SchCMd Bullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public
Inspection
If the organization answered “Yes” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, line 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV.
2
Political expenditures ....................................SchCMd Bullet
$  
3
Volunteer hours ........................................
 

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

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

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










For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2011

Schedule C (Form 990 or 990-EZ) 2011
Page 2
Part II-A
Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).
A Check expenses, and share of excess lobbying expenditures).
B Check
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(b) Affiliated group
totals
1a Total lobbying expenditures to influence public opinion (grass roots lobbying) ...... 4,000  
b Total lobbying expenditures to influence a legislative body (direct lobbying) ....... 222,371  
c Total lobbying expenditures (add lines 1a and 1b) ................... 226,371  
d Other exempt purpose expenditures ........................ 429,469,120  
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 429,695,491  
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000  
  If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:    
  Not over $500,00020% of the amount on line 1e.    
  Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.    
  Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.    
  Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.    
  Over $17,000,000$1,000,000.    
       
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000  
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................    
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................    
j If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting
section 4911 tax for this year? ......................................

4-Year Averaging Period Under Section 501(h)
(Some organizations that made a section 501(h) election do not have to complete all of the five
columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
  Calendar year (or fiscal year
beginning in) 		(a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) Total
             
2a Lobbying non-taxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		        6,000,000
             
c Total lobbying expenditures 401,887 268,141 226,300 226,371 1,122,699
             
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		         1,500,000
             
f Grassroots lobbying expenditures 56,000 4,000 4,000 4,000 68,000
Schedule C (Form 990 or 990-EZ) 2011


Schedule C (Form 990 or 990-EZ) 2011
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? ..........................
 
 
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2 are answered “No” OR (b) Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, Part II-A; line 5; and Part ll-B, line 1.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
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 $  
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 .... 31,490,541 29,283,714 24,854,564 33,761,116
b Contributions ........        
c Net investment earnings, gains, and losses ... 213,181 3,172,990 5,828,658 -7,949,952
d Grants or scholarships .....        
e Other expenditures for facilities
and programs ........ 		566,993 900,247 1,341,892 956,600
f Administrative expenses .... 68,435 65,916 57,616  
g End of year balance ...... 31,068,294 31,490,541 29,283,714 24,854,564
2
Provide the estimated percentage of the year end balance (line 1g) held as:
a
Board designated or quasi-endowment SchDMd Bullet  
b
Permanent endowment SchDMd Bullet100.000 %
c
Temporarily restricted endowment SchDMd Bullet  
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)
Yes
 
(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 .................   8,498,814 8,498,814
b Buildings ................   552,735,667 74,951,673 477,783,994
c Leasehold improvements ............   10,559,451 6,545,919 4,013,532
d Equipment ................   266,552,951 166,526,018 100,036,933
e Other .................   137,902,329 5,369,113 132,533,216
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 722,866,489
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    
(3)Other
(A) INVESTMENT IN LAUNDRY CORP 		125,000 C

(B) ICAP ABSOLUTE RET RETENTION 		9,786,453 F

(C) FORTRESS CREDIT OPPORTUNITY FU 		7,626,746 F

(D) VIKING GLOBAL EQUITIES III LTD 		14,120,488 F

(E) FARALLON CAPITAL PARTNERS LP 		11,882,216 F

(F) CONVEXITY CAPITAL OFFSHORE LP 		29,792,498 F

(G) NEWPORT ASIA 		12,894,769 F

(H) KING STREET 		13,651,958 F

(I) HIGHFIELDS CAPITAL LTD 		16,350,039 F

(J) DENHAM COMMODITY PARTNERS FUND 		4,155,959 F

(K) CAPITAL GUARDIAN 		14,989,870 F

(L) SILCHESTER INTERNATIONAL 		25,376,595 F

(M) MOUNT KELLETT 		4,670,912 F
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 165,423,503
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) RECEIVABLE FROM FOUNDATION 2,440,566
(2) PERPETUAL TRUST ASSETS-TAMMEN 31,068,294
(3) CHILDREN'S HOSPITAL FOUNDATION 209,966,000
(4) DEFERRED DEBT ISSUANCE COSTS 4,354,502
(5) OTHER MISCELLANEOUS RECEIVABLE 19,116,338
(6) EXECUTIVE DEFERRED TRUST 946,202



Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 267,891,902
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Book value
Federal Income Taxes 0
SELF INSURANCE TRUST LIABILITY 6,405,000
ACCRUED INTEREST PAYABLE 1,328,758
DUE TO RESTRICTED FUND 4,808,587
VALUE OF INTEREST RATE SWAP 42,528,492
DEFINED BENEFIT OBLIGATION 395,723
INVESTMENT IN NORTH ASC 1,488,753
FASB PENSION LIABILITY 7,146,639


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 64,101,952
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) .................... 1 661,775,321
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2 600,669,666
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3 61,105,655
4 Net unrealized gains (losses) on investments .......................... 4 -14,233,927
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV.) ................................. 8 -31,485,137
9 Total adjustments (net). Add lines 4 through 8 ......................... 9 -45,719,064
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10 15,386,591
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1 667,443,569
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 5,668,248
e Add lines 2a through 2d ..................... 2e 5,668,248
3 Subtract line 2e from line 1..................... 3 661,775,321
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.) ...... 5 661,775,321
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1 652,056,978
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 51,387,312
e Add lines 2a through 2d...................... 2e 51,387,312
3 Subtract line 2e from line 1..................... 3 600,669,666
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.) ...... 5 600,669,666
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
INTENDED USE OF ENDOWMENT FUNDS SCHEDULE D PART V, LINE 4 THE HOSPITAL IS THE INCOME BENEFICIARY OF THE H.H. TAMMEN TRUST, A PERPETUAL TRUST UNDER WHICH THE HOSPITAL HAS THE IRREVOCABLE RIGHT TO RECEIVE THE INCOME EARNED ON THE TRUST ASSETS IN PERPETUITY. FUNDS ARE USED TO SUPPORT HOSPITAL ACTIVITIES.
ASC 740 FOOTNOTE SCHEDULE D, PART X, LINE 2 THE HOSPITAL EVALUATES WHETHER THERE ARE ANY UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. AS OF DECEMBER 31, 2011 AND 2010, THE HOSPITAL HAS DETERMINED THAT NO PROVISION IS REQUIRED FOR UNCERTAIN TAX POSITIONS.
OTHER ADJUSTMENTS PART XI, LINE 8 REVENUE REPORTED ON SEPARATE TAX RETURN $ 5,668,248 CHANGE IN VALUE OF INTEREST RATE SWAP $ (28,582,934) EXPENSES REPORTED ON SEPARATE TAX RETURN $ (8,570,451) ------------ TOTAL $ (31,485,137) =============
OTHER ADJUSTMENTS PART XII, LINE 2D REVENUE REPORTED ON SEPARATE TAX RETURN $ 5,668,248
OTHER ADJUSTMENTS PART XIII, LINE 2D CHANGE IN VALUE OF INTEREST RATE SWAP $ 28,582,934 EXPENSES REPORTED ON SEPARATE TAX RETURN $ 8,570,451 UNREALIZED LOSS ON INVESTMENTS $ 14,233,927 ----------- $ 51,387,312 ===========
Schedule D (Form 990) 2011

Additional Data


Software ID:  
Software Version:  




SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990. Right pointing arrow large image See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
Part I
General Information on Activities Outside the United States. Complete if the organization answered
“Yes” to Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants
and other assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? ..............................
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other
assistance outside the United States.
3
Activites per Region. (Use Part V if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees or agents in region or independent contractors (d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in region		 (f) Total
expenditures for region/investments
in region
Central America and the Caribbean 0 0 Investments N/A 72,022,308
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total ..... 0 0 72,022,308
b Total from continuation sheets to Part I ...      
c Totals (add lines 3a and 3b) 0 0 72,022,308
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990,
Part IV, line 15, for any recipient who received more than $5,000. Check this box if no one recipient received more than $5,000 ........ MediumBullet
Use Part V if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount of
of non-cash
assistance 		(h) Description
of non-cash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2
Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .....MediumBullet
 
3
Enter total number of other organizations or entities ........................MediumBullet
 
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.
Use Part V if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
non-cash
assistance 		(g) Description
of non-cash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926 (see instructions for Form 926).................
2 Did the organization have an interest in a foreign trust during the tax year? If " Yes," the organization may be required to file Form 3520 and/or Form 3520-A. (see instructions for Forms 3520 and 3520-A)..........
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with respect to Certain Foreign Corporations. (see instructions for Form 5471)..............................
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If "Yes," the organization may be required to file Form 8621, Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see instructions for Form 8621)
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with respect to Certain Foreign Partnerships. (see instructions for Form 8865)....................................
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see instructions for Form 5713)................................................
Schedule F (Form 990) 2011
Schedule F (Form 990) 2011
Page 5
Part V
Supplemental Information
Complete this part to provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).
Identifier ReturnReference Explanation
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
     
Schedule F (Form 990) 2011
Additional Data


Software ID:  
Software Version:  



SCHEDULE H (Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a....
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG to determine eligibility for providing discounted care? If "Yes," indicate which of the
following was the family income limit for eligibility for discounted care: ............
3b
Yes
 
c
If the organization did not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during the tax year? ............................

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount?......
5b
Yes
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care?...............
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year?...........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ...............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance
and Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    4,135,557 962,238 3,173,319 0.530 %
b Medicaid (from Worksheet 3, column a) .....     244,934,314 165,272,618 79,661,696 13.260 %
c Costs of other means-tested government programs (from Worksheet 3, column b) .     25,833,427 23,520,149 2,313,278 0.390 %
dTotal Financial Assistance and
Means-Tested Government Programs ..... 		    274,903,298 189,755,005 85,148,293 14.180 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    6,889,105 527,174 6,361,931 1.060 %
f Health professions education
(from Worksheet 5) .. 		    22,163,259 6,599,650 15,563,609 2.590 %
g Subsidized health services
(from Worksheet 6) .. 		    40,743,869 26,597,972 14,145,897 2.360 %
h Research (from Worksheet 7)     19,137,944 0 19,137,944 3.190 %
i Cash and in-kind contributions for community benefit (from Worksheet 8) ....     763,155 0 763,155 0.130 %
jTotal Other Benefits ...     89,697,332 33,724,796 55,972,536 9.330 %
kTotal. Add lines 7d and 7j. ..     364,600,630 223,479,801 141,120,829 23.510 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing     978   978 0 %
2 Economic development     11,087   11,087 0 %
3 Community support     54,825   54,825 0.010 %
4 Environmental improvements     332,193   332,193 0.060 %
5 Leadership development and training for community members     68,144   68,144 0.010 %
6 Coalition building            
7 Community health improvement advocacy     796,844   796,844 0.130 %
8 Workforce development     317,090   317,090 0.050 %
9 Other            
10 Total     1,581,161   1,581,161 0.260 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense........
2
14,146,550
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy .....
3
1,414,655
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
1,680,818
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
3,139,258
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-1,458,440
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures
(see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest)
How many hospital facilities did the organization operate during the tax year?4
Name and address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe)
1 CHILDREN'S HOSPITAL COLORADO
13123 E 16TH AVENUE
AURORA,CO80045 		X   X X   X X    
2 CHILDREN'S HOSPITAL COLORADO - NORTH
469 WEST STATE HIGHWAY 7
BROOMFIELD,CO80023 		X   X            
3 CHILDREN'S HOSPITAL COLORADO - PARKER
19284 COTTONWOOD DRIVE
PARKER,CO80138 		X   X       X    
4 CHILDREN'S HOSPITAL CO - ST JOSEPH HOSPL
1830 FRANKLIN STREET
DENVER,CO80218 		X   X       X    
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

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

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
CHILDREN'S HOSPITAL COLORADO - NORTH
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):2

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
CHILDREN'S HOSPITAL COLORADO - PARKER
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):3

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
CHILDREN'S HOSPITAL CO - ST JOSEPH HOSPL
Name of Hospital Facility:  
Line Number of Hospital Facility (from Schedule H, Part V, Section A):4

Yes No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2011)
1 During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. ..................... 1    
If “Yes,” indicate what the Needs Assessment describes (check all that apply):
a A definition of the community served by the hospital facility
b Demographics of the community
c Existing health care facilities and resources within the community that are available to respond to the health needs of the community
d How data was obtained
e The health needs of the community
f Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
g The process for identifying and prioritizing community health needs and services to meet the community health needs
h The process for consulting with persons representing the community’s interests
i Information gaps that limit the hospital facility’s ability to assess the community’s health needs
j Other (describe in Part VI)
2 Indicate the tax year the hospital facility last conducted a Needs Assessment: 20  
3 In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted. 3    
4 Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................ 4    
5 Did the hospital facility make its Needs Assessment widely available to the public? ........... 5    
If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
a Hospital facility’s website
b Available upon request from the hospital facility
c Other (describe in Part VI)
6 If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
a Adoption of an implementation strategy to address the health needs of the hospital facility’s community
b Execution of the implementation strategy
c Participation in the development of a community-wide community benefit plan
d Participation in the execution of a community-wide community benefit plan
e Inclusion of a community benefit section in operational plans
f Adoption of a budget for provision of services that address the needs identified in the Needs Assessment
g Prioritization of health needs in the community
h Prioritization of services that the hospital facility will undertake to meet health needs in its community
i Other (describe in Part VI)
7 Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs. .... 7    
Financial Assistance Policy
Did the hospital facility have in place during the tax year a written financial assistance policy that:
8 Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 8 Yes  
9 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 9 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 200.%
If "No," explain in Part VI the criteria the hospital facility used.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Yes No
10 Used FPG to determine eligibility for providing discounted care?................. 10 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 400.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Explained the basis for calculating amounts charged to patients?................. 11 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a Income level
b Asset level
c Medical indigency
d Insurance status
e Uninsured discount
f Medicaid/Medicare
g State regulation
h Other (describe in Part VI)
12 Explained the method for applying for financial assistance?................... 12 Yes  
13 Included measures to publicize the policy within the community served by the hospital facility?....... 13 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a The policy was posted on the hospital facility’s web site
b The policy was attached to all billing invoices
c The policy was posted in the hospital facility’s emergency rooms or waiting rooms
d The policy was posted in the hospital facility’s admissions offices
e The policy was provided, in writing, to patients upon admission to the hospital facility
f The policy was available upon request
g Other (describe in Part VI)
Billing and Collections
14 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 14 Yes  
15 Check all of the following collection actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
16 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 16   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a Reporting to credit agency
b Lawsuits
c Liens on residences
d Body attachments
e Other similar actions (describe in Part VI)
17 Indicate which efforts the hospital facility made before initiating any of the actions checked in line 16 (check all that apply):
a Notified patients of the financial assistance policy upon admission
b Notified patients of the financial assistance policy prior to discharge
c Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
d Documented its determination of whether patients were eligible for financial assistance under the hospital facility’s financial assistance policy
e Other (describe in Part VI)
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
Yes No
18 Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?.......... 18 Yes  
If “No,” indicate why:
a The hospital facility did not provide care for any emergency medical conditions
b The hospital facility’s policy was not in writing
c The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
d Other (describe in Part VI)
Individuals Eligible for Financial Assistance
19 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged
b The hospital facility used the average of it's three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged
c The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged
d Other (describe in Part VI)
20 Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?......... 20   No
If “Yes,” explain in Part VI.
21 Did the hospital facility charge any of its FAP-eligible patients an amount equal to the gross charge for any services provided to that patient?............................... 21   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?13
Name and address Type of Facility (describe)
1 TCH CENTER FOR CANCER & BLOOD DISORDERS
320 E FONTANERO STREET
COLORADO SPRINGS,CO80907 		OP PED SPECIALTY CARE FOR CANCER & BLOOD DISORDERS
2 THE CHILDREN'S HOSPITAL WESTMINSTER
7577 W 103RD STREET SUITE 200
WESTMINSTER,CO80021 		THERAPY CARE
3 THE CHILDREN'S HOSPITAL AT LUTHERAN
3455 LUTHERAN PARKWAY SUITE 230
WHEAT RIDGE,CO80033 		URGENT CARE; PED SPECIALIST; SPORTS MEDICINE
4 CHILDREN'S AFTER HOURS CARE LITTLETON
7700 S BROADWAY
LITTLETON,CO80122 		OP PED SPECIALTY; REHAB THERAPY; SPORTS MEDICINE
5 THE CHILDREN'S HOSPITAL LITTLETON
151 W COUNTY LINE ROAD
LITTLETON,CO80129 		URGENT CARE
6 KIDSTREET
3615 MARTIN LUTHER KING BLVD
DENVER,CO80205 		REHAB THERAPY
7 THE CHILDREN'S HOSPITAL PARKER ADVENTIST
9395 CROWN CREST BLVD
PARKER,CO80138 		THERAPY CARE
8 CARE BY TCH PARKER
9399 CROWN CREST BLVD
PARKER,CO80138 		PEDIATRIC SPECIALIST
9 THE CHILDREN'S HOSPITAL PUEBLO
704 FORTINO BLVD SUITE A
PUEBLO,CO81008 		THERAPY CARE
10 TCH CTR FOR CANCER & BLOOD DISORDERS
7720 S BROADWAY
LITTLETON,CO80122 		OP PED SPECIALTY CARE FOR CANCER & BLOOD DISORDERS
11 TCH PULMONARY CARE CENTENNIAL
9760 S UNIVERSITY BLVD
CENTENNIAL,CO80112 		PULMONARY CARE
12 THE CHILDREN'S HOSPITAL CENTENNIAL
9094 E MINNERAL AVE STE 110
CENTENNIAL,CO80112 		ORTHOPEDIC CARE
13 THE CHILDREN'S HOSPITAL SURGERY CTR
9218 KIMMER DRIVE
LONE TREE,CO80138 		OP SURGERY
Schedule H (Form 990) 2011
Schedule H (Form 990) 2011
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 9, 10, 11h, 13g, 15e, 16e, 17e, 18d, 19d, 20, and 21.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
PART I, LINE 6A   CHILDREN'S HOSPITAL COLORADO INCLUDES SELECT COMMUNITY BENEFIT INFORMATION IN THE HOSPITAL'S ANNUAL REPORT. CHILDREN'S HOSPITAL COLORADO ALSO REGULARLY HIGHLIGHTS COMMUNITY BENEFIT EFFORTS IN A NUMBER OF COMMUNICATION VEHICLES INCLUDING HOSPITAL WEBSITE, MEDIA STORIES AND PUBLICATIONS SUCH AS THE COLORADO HOSPITAL ASSOCIATION'S ANNUAL COMMUNITY BENEFIT REPORT.
PART I, LINE 7   IN 2011 CHILDREN'S HOSPITAL COLORADO PROVIDED $141,120,829, OR 23.49% OF TOTAL OPERATING EXPENSES, IN BENEFIT TO THE COMMUNITY. FINANCIAL ASSISTANCE (CHARITY CARE) AND MEANS-TESTED GOVERNMENT PROGRAMS (MEDICAID AND OTHER) AT CHILDREN'S HOSPITAL COLORADO ACCOUNTED FOR $85,148,293, OR 14.18% OF TOTAL OPERATING EXPENSES. MEDICAID PAYMENT SHORTFALLS CONTINUE TO COMPRISE THE MAJORITY OF THIS FIGURE, ACCOUNTING FOR $79,661,696 OF THE TOTAL SHORTFALL. IN 2011, MEDICAID VOLUME, AS A PERCENT OF TOTAL PATIENT CHARGES, WAS 41.9% WITH REIMBURSEMENT ONLY COVERING 67% OF COST. THE SHORTFALL FOR FINANCIAL ASSISTANCE (CHARITY CARE) PROVIDED IN 2011 WAS $3,173,319. THIS REPRESENTS THE COST OF PROVIDING THESE SERVICES CALCULATED USING THE HOSPITAL'S COST ACCOUNTING SYSTEM. OTHER BENEFITS ACCOUNTED FOR $55,972,536, OR 9.32% OF TOTAL OPERATING EXPENSES. OTHER BENEFITS INCLUDE HEALTH PROFESSIONS EDUCATION ($15,563,609, OR 2.59% OF TOTAL OPERATING EXPENSES), RESEARCH ACTIVITY ($19,137,944, OR 3.19% OF TOTAL OPERATING EXPENSES), SUBSIDIZED HEALTH SERVICES ($14,145,897, OR 2.36% OF THE TOTAL OPERATING EXPENSES), COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS ($6,361,931, OR 1.06% OF TOTAL OPERATING EXPENSES) AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS ($763,155, OR .13% OF TOTAL OPERATING EXPENSES). INCLUDED IN SUBSIDIZED HEALTH SERVICES ARE THOSE WHICH CHILDREN'S HOSPITAL COLORADO PROVIDES TO ITS PATIENT POPULATION AT A LOSS. IN 2011 PROGRAMS ASSOCIATED WITH THESE LOSSES ARE MENTAL HEALTH, REPRODUCTIVE AND REHABILITATION SERVICES. ALSO, INCLUDED IN SUBSIDIZED SERVICES IS THE NET COMMUNITY BENEFIT EXPENSE RELATED TO LOSSES ASSOCIATED WITH THE HOSPITAL'S INVESTMENT IN AN AMBULATORY SURGERY CENTER. THE NUMBER REFLECTED IN SUBSIDIZED HEALTH SERVICES EXCLUDES BAD DEBT, MEDICAID AND OTHER MEANS TESTED GOVERNMENT PROGRAM SHORTFALLS AND FINANCIAL ASSISTANCE (CHARITY CARE). CHILDREN'S HOSPITAL COLORADO IS COMMITTED TO SERVING ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY.
PART II   IN 2011, CHILDREN'S HOSPITAL COLORADO PROVIDED $1,581,161 IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTED THE HEALTH OF THE BROADER COMMUNITY. SERVING ON NONPROFIT COMMUNITY BOARDS AND HELPING THE COMMUNITY PREPARE FOR A DISASTER ARE ACTIVITIES THAT THE HOSPITAL REGULARLY ENGAGES IN TO SUPPORT THE HEALTH OF THE COMMUNITY. ADDITIONALLY, SIGNIFICANT RESOURCES WERE ALLOCATED IN 2011 TO SUPPORT EFFORTS TO ENGAGE COMMUNITY MEMBERS IN ADVOCATING FOR ACCESS TO HEALTH CARE AS WELL AS PROVIDING EDUCATIONAL SESSIONS FOR BOTH POLICYMAKERS AND ADVOCATES ON CHILD HEALTH ISSUES OF IMPORTANCE. IMPROVING THE HEALTH OF THE COMMUNITY THROUGH ENVIRONMENTAL EFFORTS WAS ALSO A PRIORITY, INCLUDING A CAR POOL NETWORK AND BUS PASSES FOR EMPLOYEES AS WELL AS RECYCLING AND RETRO COMMISSIONING EFFORTS. FINALLY, THE HOSPITAL CONTRIBUTED SUBSTANTIAL RESOURCES TO PROGRAMS THAT PROVIDE A PIPELINE FOR AT RISK HIGH SCHOOL STUDENTS AND YOUNG ADULTS WITH DEVELOPMENTAL DISABILITIES TO PURSUE MEDICAL CAREERS.
PART III, LINE 4   FOOTNOTE IN AUDITED FINANCIALS: NONE CHILDREN'S HOSPITAL COLORADO ESTIMATES BAD DEBT RESERVES BASED ON HISTORICAL EXPERIENCE. THE HOSPITAL EXPENSES UNCOLLECTIBLE BALANCES 120 DAYS AFTER THE FIRST BILLING CYCLE. THE HOSPITAL DOES NOT REPORT ANY BAD DEBT AMOUNT IN COMMUNITY BENEFIT.
PART III, LINE 8   THE SHORTFALL REPORTED IN LINE 7 REPRESENTS MEDICARE SHORTFALLS FOR HIGH NEEDS PEDIATRIC PATIENTS SERVED BY CHILDREN'S HOSPITAL COLORADO. IF CHILDREN'S HOSPITAL COLORADO DID NOT SUBSIDIZE THIS HIGHLY SPECIALIZED CARE, ACCESS FOR THIS POPULATION WOULD BE LIMITED, THUS WE VIEW THIS CARE AS COMMUNITY BENEFIT. THE HOSPITAL UTILIZED COST TO CHARGE RATIO METHODOLOGY TO ARRIVE AT THIS NUMBER. THE AMOUNT INCLUDES ALL PAYMENTS SHORT OF COSTS.
PART III, LINE 9B   YES, THE ORGANIZATION DOES HAVE A WRITTEN DEBT COLLECTION POLICY. PRIOR TO DEBT REFERRALS, ACCOUNTS WITH ANY CHARITY CARE OR FINANCIAL ASSISTANCE CASES ARE REVIEWED TO ENSURE THE BALANCE IS NOT DUE FROM AN OUTSIDE PAYER. ONCE CONFIRMED THE OUTSTANDING BALANCE IS THE PATIENT'S RESPONSIBILITY, THE HOSPITAL PROVIDES SLIDING SCALE DISCOUNTS BASED ON INCOME AND/OR EXPENSES. PARENTS WHOSE CHILDREN DO NOT QUALIFY FOR MEDICAID CAN ALSO APPLY FOR THIS DISCOUNT PLAN. THE HOSPITAL HAS A DEDICATED FINANCIAL COUNSELING DEPARTMENT THAT WORKS CLOSELY WITH PARENTS TO ESTABLISH PAYMENT PLANS.
PART V, LINE 19   CHILDREN'S HOSPITAL OF COLORADO USES A BLENDED AVERAGE OF ALL COMMERCIAL INSURANCE REIMBURSEMENT RATE.
PART VI, LINE 2 NEEDS ASSESSMENT ACROSS THE HOSPITAL, NUMEROUS INTERNAL AND EXTERNAL DATA SOURCES ARE REGULARLY MONITORED AND UTILIZED TO IDENTIFY TRENDS AND OPPORTUNITIES TO IMPACT CHILD HEALTH. IN TERMS OF A FORMAL COMMUNITY NEEDS ASSESSMENT, CHILDREN'S HOSPITAL COLORADO HAS CONTRACTED WITH A THIRD PARTY, THE CENTER FOR PUBLIC HEALTH PRACTICE AT THE COLORADO SCHOOL OF PUBLIC HEALTH, TO CONDUCT A HEALTH CARE NEEDS ASSESSMENT REGARDING COLORADO CHILDREN. THE ASSESSMENT IS IN PROCESS AND WILL BE REPORTED ON IN A SUBSEQUENT YEAR. THE ASSESSMENT WILL CONSIDER THE IMMEDIATE COMMUNITY WHERE THE HOSPITAL MAIN CAMPUS IS LOCATED AS WELL AS STATEWIDE INFORMATION. THE METHODS USED WILL ASSESS HEALTH OUTCOMES AND RISK FACTORS FOR ALL CHILDREN UNDER AGE 21 IN THESE POPULATIONS USING BOTH QUANTITATIVE AND QUALITATIVE METHODS.
PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE CHILDREN'S HOSPITAL COLORADO HAS A PROCESS FOR INFORMING AND EDUCATING FAMILIES ABOUT HOW THEY MAY BE BILLED FOR PATIENT CARE AND THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE. CHILDREN'S HOSPITAL COLORADO'S FULL TIME PATIENT FINANCIAL COUNSELORS ARE DEDICATED TO WORKING WITH FAMILIES TO PROVIDE GUIDANCE REGARDING AVAILABLE FINANCIAL ASSISTANCE WHICH ENSURES THAT ITS PATIENT POPULATION RECEIVES THE CRITICAL CARE IT NEEDS. ADDITIONALLY, CHILDREN'S HOSPITAL COLORADO PROVIDES PATIENT ASSISTANCE TO HELP IDENTIFY COMMUNITY-BASED RESOURCES, FACILITATE SERVICES AND PROVIDE APPROPRIATE REFERRAL ASSISTANCE TO HELP WITH CONTINUITY OF CARE. INPATIENT PROCESS: THIS PROCESS APPLIES TO PATIENTS WHO ARE BEING ADMITTED FOR OBSERVATION, SURGERY OR OTHER INPATIENT SERVICES. IF THE PATIENT IS PRE-SCHEDULED, CHILDREN'S HOSPITAL COLORADO PATIENT ACCESS WORKS TO CONTACT THE FAMILY PRIOR TO ADMISSION TO ARRANGE FOR A FINANCIAL SCREENING APPOINTMENT. REGARDLESS OF WHETHER AN APPOINTMENT IS SET PRIOR TO ADMISSION, THE PATIENT FINANCIAL COUNSELING TEAM WORKS WITH THE FAMILY TO DETERMINE THEIR SELF-PAY STATUS (EITHER NON-COMMERCIAL OR GOVERNMENT INSURANCE) AND SUBSEQUENTLY WORKS WITH THEM TO SCREEN FOR FINANCIAL ASSISTANCE OPTIONS. OUTPATIENT PROCESS: WHEN A PATIENT SCHEDULES A NON-EMERGENT OR URGENT OUTPATIENT CLINIC VISIT, THEY WILL IDENTIFY THEMSELVES AS SELF-PAY IF THEY DO NOT HAVE EITHER COMMERCIAL OR GOVERNMENT INSURANCE. AT THIS POINT, THEY ARE GIVEN TWO OPTIONS: (1) PAY $200 DEPOSIT AT THE TIME OF APPOINTMENT AND BE BILLED ANY REMAINING BALANCE OR (2) SCHEDULE TIME WITH PATIENT FINANCIAL COUNSELING FOR ASSISTANCE. IF THE PATIENT WAS SEEN IN THE EMERGENCY DEPARTMENT OR URGENT CARE WITHOUT THE PRE-SCREEN, THEY STILL HAVE THE OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE WITH THE PATIENT FINANCIAL COUNSELING OFFICE. ALL SELF-PAY FAMILIES ARE AUTOMATICALLY GIVEN A 35 PERCENT DISCOUNT. CHILDREN'S HOSPITAL COLORADO HAS A FORMAL POLICY REGARDING ELIGIBILITY CRITERIA FOR CHARITY CARE. THE DECISION TO PROVIDE CHARITY CARE WILL BE, IN ALL CASES, BASED ON A REVIEW OF THE INCOME, ASSETS AND LIABILITIES OF THE FAMILY AT THE TIME OF ADMISSION TO THE HOSPITAL OR CLINIC. THE LEVELS OF CHARITY CARE AND FINANCIAL ASSISTANCE PROVIDED BY CHILDREN'S HOSPITAL COLORADO WILL BE DETERMINED BASED ON FEDERAL POVERTY GUIDELINES WHICH MAY BE ADJUSTED UP TO 250 PERCENT AND REVISED FROM TIME TO TIME. FAMILIES WITH ADJUSTED GROSS INCOME BETWEEN 250 PERCENT AND 400 PERCENT OF FEDERAL POVERTY GUIDELINES MAY ALSO BE CONSIDERED FOR CHARITY CARE WITH A CAP FOR OUT-OF-POCKET RESPONSIBILITY. DETERMINATION OF ELIGIBILITY WILL BE EFFECTIVE FOR SIX MONTHS AND APPLY TO ALL PATIENTS REGARDLESS OF IMMIGRATION STATUS. CHILDREN'S COLORADO WORKS TO PROVIDE NECESSARY HOSPITAL-RELATED SERVICES CONSISTENT WITH ITS MISSION, ITS STATUS AS A NONPROFIT HOSPITAL AND ITS STEWARDSHIP RESPONSIBILITY TO ITS DONORS.
PART VI, LINE 4 COMMUNITY INFORMATION CHILDREN'S HOSPITAL COLORADO SERVES INFANTS, TODDLERS, ADOLESCENTS, TEENS AND YOUNG ADULTS, PRIMARILY FROM NEWBORNS THROUGH AGE 21. CHILDREN'S HOSPITAL COLORADO ALSO TREATS INDIVIDUALS OVER THE AGE OF 21 WITH SPECIAL NEEDS OR CONGENITAL DISORDERS THAT REQUIRE CONTINUED CARE. CHILDREN, NEWBORN TO AGE 2, REPRESENT THE LARGEST PROPORTION OF THE POPULATION SERVED BY CHILDREN'S COLORADO. IN THE STATE OF COLORADO, THERE ARE APPROXIMATELY ONE MILLION CHILDREN AND ADOLESCENTS; 70 PERCENT RESIDE WITHIN DENVER'S SEVEN COUNTY METROPOLITAN AREA, BORDERED ON THE NORTH BY BROOMFIELD COUNTY AND ON THE SOUTH BY DOUGLAS COUNTY. CHILDREN'S HOSPITAL COLORADO SERVES PATIENTS AND FAMILIES FROM THE SEVEN-STATE MOUNTAIN REGION, WITH 10 PERCENT OF ITS PATIENT POPULATION TRAVELING FROM OUT OF THE STATE. IN ADDITION, CHILDREN'S HOSPITAL COLORADO DELIVERS HIGH-QUALITY CARE IN MORE THAN 400 OUTREACH CLINICS OUTSIDE ITS PRIMARY SERVICE AREA EACH YEAR. DEMOGRAPHICALLY, CHILDREN SERVED HAVE DIVERSE CULTURAL AND ETHNIC BACKGROUNDS -- CHILDREN'S HOSPITAL COLORADO TRANSLATES MEDICAL CARE AND EDUCATION INSTRUCTIONS INTO 65 LANGUAGES (INCLUDING SIGN LANGUAGE) TO DELIVER CULTURALLY SENSITIVE, HIGH-QUALITY PEDIATRIC HEALTHCARE. THE MAJORITY OF ITS PATIENTS SPEAK ENGLISH, FOLLOWED BY SIGNIFICANT NUMBERS OF FAMILIES WHO SPEAK SPANISH, ARABIC, BURMESE, VIETNAMESE, SOMALIAN, RUSSIAN, AND KOREAN. CHILDREN'S HOSPITAL COLORADO IS THE LARGEST PROVIDER OF HEALTH CARE SERVICES FOR LOW-INCOME CHILDREN IN COLORADO, WITH 46.6 PERCENT OF ALL PATIENTS SERVED COVERED BY MEDICAID INSURANCE OR OTHER GOVERNMENT PROGRAMS; 50.9 PERCENT OF CHILDREN ARE INSURED BY COMMERCIAL INSURANCE, WHILE 2.5 PERCENT OF CHILDREN ARE NOT INSURED.
PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH IN 2011, CHILDREN'S HOSPITAL COLORADO PROVIDED 23.49% OF TOTAL OPERATING EXPENSES IN BENEFIT TO THE COMMUNITY BY COMMITTING TO IMPROVING THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH-QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY. CHILDREN'S HOSPITAL COLORADO WORKS TO DELIVER ON THIS MISSION NOT ONLY IN THE DENVER METRO AREA AND THE STATE OF COLORADO, BUT ALSO THROUGHOUT THE ROCKY MOUNTAIN REGION. THERE ARE EXTENSIVE EFFORTS LED BY CHILDREN'S HOSPITAL COLORADO THAT POSITIVELY IMPACT THE HEALTH AND SAFETY OF CHILDREN IN THE COMMUNITY - TO DESCRIBE ALL OF THEM IN DETAIL IS NOT REALISTIC IN A LIMITED SPACE, THUS BELOW ARE SOME OF THE HIGHLIGHTS. OUR BOARD OF DIRECTORS AT THE TIME OF FILING THIS FORM 990, CHILDREN'S HOSPITAL COLORADO'S BOARD OF DIRECTORS IS MADE UP OF 22 VOLUNTEERS FROM THE DENVER AREA COMMUNITY AND SIX EXECUTIVE LEADERS FROM THE HOSPITAL AND ITS AFFILIATED INSTITUTIONS. BOARD SERVICE IS A COMMITMENT TO HELP FURTHER THE HOSPITAL'S MISSION OF IMPROVING THE HEALTH OF CHILDREN THROUGH THE PROVISION OF HIGH QUALITY, COORDINATED PROGRAMS OF PATIENT CARE, EDUCATION, RESEARCH AND ADVOCACY. THE BOARD REPRESENTS THE COMMUNITY AT LARGE INCLUDING THE BROADER MEDICAL COMMUNITY AND PROVIDES EXPERTISE IN MANY AREAS OF BUSINESS AND COMMUNITY RELATIONS, SUCH AS BANKING, REAL ESTATE, INSURANCE, MARKETING/PR, ETC. ALL ARE PASSIONATE ABOUT THE HOSPITAL'S MISSION, MANY THROUGH PERSONAL EXPERIENCE, AND MOST HAVE THE ABILITY TO FUNDRAISE. WHILE THE MAJORITY OF BOARD OF DIRECTORS ARE CAUCASIAN, BOARD COMPOSITION IS ALSO REPRESENTATIVE OF THE AFRICAN-AMERICAN AND LATINO POPULATIONS. MEDICAL FACULTY PROFILE CHILDREN'S HOSPITAL COLORADO HAS AN OPEN MEDICAL STAFF, MEANING COMMUNITY PRACTITIONERS CAN HOLD PRIVILEGES AT THE HOSPITAL. IT HAS APPROXIMATELY 1,700 MEDICAL STAFF MEMBERS THAT INCLUDE ADVANCED PRACTICE NURSES, MORE THAN HALF OF WHOM ARE COMMUNITY-BASED. THOUGH THERE ARE THOUSANDS OF REFERRING PROVIDERS ALONG THE FRONT RANGE OF THE ROCKY MOUNTAINS AND THE PRAIRIES, CHILDREN'S HOSPITAL COLORADO'S COMMUNITY STAFF MEMBERS ARE ITS FRONT-LINE PARTNERS IN ADVANCING A CONTINUUM OF CARE FOR YOUNG PATIENTS. ITS COMMUNITY CLINICAL STAFF MEMBERS PROVIDE TRAINING OPPORTUNITIES IN PRIMARY CARE FOR MEDICAL STUDENTS AND RESIDENTS HELPING TO BROADEN THE MEDICAL EDUCATION OF TOMORROW'S PEDIATRIC DOCTORS. CHILDREN'S HOSPITAL COLORADO IS AFFILIATED WITH FAMILY MEDICINE RESIDENCY PROGRAMS IN COLORADO AND WYOMING. THIS PROVIDES FOR A PEDIATRIC ROTATION AT THE HOSPITAL WHICH PROVIDES A SIGNIFICANT BENEFIT TO THE REGION THAT HAS A LARGE RURAL POPULATION AND A SHORTAGE OF RURAL PHYSICIANS. CHILDREN'S HOSPITAL COLORADO ALSO ENSURES THAT THE PRIMARY CARE PERSPECTIVE IS ADDRESSED IN DISCUSSIONS ABOUT HOW TO BEST PROVIDE THE BROADEST SPECTRUM OF CARE TO THE REGION'S CHILDREN. ADDITIONALLY, BOTH HOSPITAL AND COMMUNITY MEDICAL STAFF SERVE ON VARIOUS BOARDS AND COMMITTEES, SUCH AS THE COLORADO CHAPTER OF THE AAP, MDA NATIONAL CLINICAL ADVISORY COMMITTEE, COLORADO CHILDREN'S IMMUNIZATION COALITION, THE STATE TRAUMA BOARD, VARIOUS HEALTH ADVISORY BOARDS AND NUMEROUS SCHOOL HEALTH PROGRAMS. MANY PARTICIPATE IN INTERNATIONAL MEDICAL MISSIONS TO IMPROVE THE HEALTH OF CHILDREN WORLDWIDE. CHILDREN'S HEALTH ADVOCACY INSTITUTE (CHAI) THE MISSION OF CHAI IS TO IMPROVE THE HEALTH AND SAFETY OF CHILDREN BY ENGAGING PUBLIC AND PRIVATE PARTNERS IN CREATING A THRIVING COMMUNITY FOR CHILDREN. CHAI SERVES AS A CENTRALIZED RESOURCE FOR THE HOSPITAL TO IDENTIFY COMMUNITY CHILD HEALTH NEEDS AND DEVELOP AND IMPLEMENT EVIDENCE BASED PROGRAMS AND STRATEGIES IN PARTNERSHIP WITH THE COMMUNITY THAT SEEK TO ADDRESS THESE NEEDS. RECOGNIZING CHILDHOOD OBESITY AS A MAJOR CHILD HEALTH NEED IN OUR COMMUNITY, CHAI HAS ACTIVELY WORKED TO DEVELOP PROGRAMMING THAT WILL SUPPORT CHILDREN AND FAMILIES IN PREVENTING THE ONSET OF OBESITY. ONE SUCH PROGRAM THAT WAS ESTABLISHED IN 2011 IS "BIKES FOR LIFE". BIKES FOR LIFE CONNECTS CHILDREN WITHOUT ACCESS TO A BICYCLE WITH A HELMET, BICYCLE AND BICYCLE LOCK. AFTER COMPLETING A BIKE CLINIC WHERE THEY ARE FITTED FOR THEIR HELMET AND BIKE, LEARN HOW TO RIDE, AND TAUGHT BIKE SAFETY AND RULES OF THE ROAD, THE CHILDREN SET GOALS ABOUT INCREASING PHYSICAL ACTIVITY. THE CHILDREN ENROLLED IN THE PROGRAM ARE FOLLOWED BY RESEARCHERS FOR A YEAR TO STUDY IMPACT ON HEALTH INDICATORS AND THE CHILD'S PHYSICAL ACTIVITY LEVELS AND SEDENTARY TIME. CHAI ALSO CONTINUED LEADING A STATEWIDE HEALTH LITERACY COLLABORATIVE THAT PROVIDES COMPREHENSIVE HEALTH AND SAFETY LESSON PLANS AND TEACHER RESOURCES TO NEARLY 500 SCHOOLS IN SIX COUNTIES. THIS TRANSLATES TO NEARLY 350,000 STUDENTS IN GRADES K-12 POTENTIALLY IMPACTED IF THE RESOURCE IS FULLY UTILIZED BY THE SCHOOLS. OTHER CHAI PROGRAMS THAT BENEFITED THE COMMUNITY IN 2011 INCLUDED THE ONGOING LEADERSHIP OF THE SAFE KIDS DENVER METRO COALITION AND THE SAFE KIDS COLORADO COALITION. THE MISSION OF SAFE KIDS IS TO IDENTIFY AND PREVENT INJURIES IN CHILDREN AGES 14 AND YOUNGER THROUGH A COMBINED PROGRAM OF EDUCATION, RESEARCH, ADVOCACY AND MEDIA. ACCIDENTAL CHILDHOOD INJURY IS A LEADING KILLER OF CHILDREN 14 AND UNDER, SO EFFORTS TO EDUCATE ABOUT SAFETY, INJURY AND TRAUMA PREVENTION ARE CRITICAL TO HELP AVOID THESE UNNECESSARY TRAGEDIES. EXAMPLES OF ACTIVITIES THAT CHILDREN'S COLORADO AND SAFE KIDS PROMOTES ARE CAR SEAT INSTALLATIONS AND INSPECTIONS, BICYCLE HELMET SAFETY EDUCATION AND SAFE SLEEP ENVIRONMENTS. THE HOSPITAL ALSO INCREASED THE COMMUNITY'S CAPACITY TO HELP ENSURE CAR SEATS ARE BEING USED AND ARE INSTALLED CORRECTLY BY TRAINING AND CERTIFYING CHILD PASSENGER SAFETY TECHNICIANS ACROSS THE STATE. TEEN DRIVING AND CAR SEATS FOR CHILDREN WITH SPECIAL HEALTH CARE NEEDS ARE ALSO PROGRAMMATIC FOCUS AREAS FOR CHILDREN'S HOSPITAL COLORADO. LEGISLATIVE ADVOCACY IN ADDITION TO IMPROVING THE HEALTH OF KIDS THROUGH COMMUNITY-BASED ADVOCACY PROGRAMS, CHILDREN'S HOSPITAL COLORADO HAS A ROBUST LEGISLATIVE ADVOCACY PROGRAM THAT WORKS TO POSITIVELY INFLUENCE PUBLIC POLICY BOTH AT A HIGH LEVEL AND THROUGH GRASSROOTS SUPPORT. IT PROACTIVELY SUPPORTS LEGISLATION ON BEHALF OF PEDIATRIC HEALTHCARE INTERESTS ON A LOCAL, STATE AND NATIONAL LEVEL. BOTH COMMUNITY AND HOSPITAL STAFF SERVE ON ADVOCACY COMMITTEE GROUPS THAT INFLUENCE LEGISLATION THAT PROMOTES CHILDREN'S HEALTHCARE ISSUES. CHILDREN'S HOSPITAL COLORADO HAS A GRASSROOTS ADVOCACY NETWORK COMPRISED OF NEARLY 4000 ADVOCATES ACROSS THE STATE. THE GOAL IN LEADING THIS NETWORK IS TO MAKE IT SIMPLE FOR ALL COMMUNITY MEMBERS TO SPEAK UP ON BEHALF OF CHILD HEALTH ISSUES. DURING 2011, CHILDREN'S HOSPITAL COLORADO LED A SUCCESSFUL EFFORT TO PROTECT COLORADO YOUTH BY ENACTING A REQUIREMENT THAT ALL ORGANIZED SPORTS COACHES RECEIVE CONCUSSION EDUCATION, AND THAT ANY CHILD WHO SUSTAINS OR IS SUSPECTED OF SUSTAINING A CONCUSSION IS REMOVED FROM PLAY, RETURNING ONLY UPON BEING CLEARED BY A MEDICAL PROVIDER. EXTENSIVE COMMUNITY EDUCATION EFFORTS LED BY CHILDREN'S HOSPITAL COLORADO HAVE SUPPORTED THE IMPLEMENTATION OF THIS LEGISLATION. GLOBAL HEALTH INSTITUTE THE GLOBAL HEALTH INSTITUTE AT CHILDREN'S HOSPITAL COLORADO WAS FORMED TO SERVE AS THE CENTRALIZED POINT OF CONTACT AT CHILDREN'S HOSPITAL COLORADO TO SUPPORT INTERNATIONAL ADVOCACY ACTIVITIES. ACTIVITIES INCLUDE PARTNERING WITH ONE OR MORE ORGANIZATIONS TO BUILD CAPACITY WITHIN IDENTIFIED INTERNATIONAL COMMUNITIES AND DELIVER ON-GOING CLINICAL SERVICES SUCH AS CONTINUING CONSULTATIVE SUPPORT, TRAINING AND EDUCATION. SUPPORT WILL ALSO BE GIVEN TO THE EVACUATION OF CHILDREN IN NEED, EITHER BECAUSE OF A NATURAL DISASTER OR INDIVIDUAL NEED BASIS.
PARTNERING WITH COMMUNITY PROVIDERS   DURING THE SPRING OF 2011, CHILDREN'S HOSPITAL COLORADO, COLORADO PEDIATRIC PARTNERS AND PHYSICIAN HEALTH PARTNERS FORMED A NON-PROFIT PARTNERSHIP, COLORADO PEDIATRIC COLLABORATIVE (CPC), TO IMPROVE THE QUALITY, COORDINATION AND EFFICIENCY OF HEALTHCARE FOR CHILDREN IN COLORADO. CPC IS THE FIRST ORGANIZATION OF ITS KIND IN THE DENVER AREA COMBINING THE EXPERTISE OF A HOSPITAL, PRIMARY CARE PHYSICIANS, SPECIALISTS AND A MEDICAL MANAGEMENT COMPANY TO IMPROVE THE OVERALL QUALITY OF CARE FOR THE CHILDREN AND FAMILIES THEY SERVE. MORE THAN 200 PHYSICIANS FROM THE METRO AREA - PRIMARY CARE PEDIATRICIANS, PEDIATRIC SPECIALISTS AND PHYSICIANS INCLUDING FACULTY FROM THE UNIVERSITY OF COLORADO SCHOOL OF MEDICINE - WILL COLLABORATE WITH CHILDREN'S HOSPITAL COLORADO TO INCREASE FOCUS ON KEY PEDIATRIC HEALTH ISSUES, SUCH AS ASTHMA, OBESITY AND IMMUNIZATIONS IN THOUSANDS OF CHILDREN IN THE DENVER METRO AREA. THE FORMATION OF CPC IS A STEP TOWARD CREATING A MEDICAL NEIGHBORHOOD AND PROVIDING HIGH-QUALITY, ACCOUNTABLE HEALTHCARE, KEY ELEMENTS OF HEALTHCARE REFORM. CHILDREN AND FAMILIES WILL RECEIVE MORE STREAMLINED CARE, AND PHYSICIANS WILL BE ABLE TO EXCHANGE IMPORTANT HEALTH INFORMATION TO TREAT CHILDREN EFFICIENTLY AND EFFECTIVELY. ORAL HEALTH RECOGNIZING THE LINK BETWEEN ORAL HEALTH AND PHYSICAL HEALTH, AS WELL AS THE BENEFIT OF EARLY INTERVENTION WHEN IT COMES TO ORAL HEALTH, THE CHILDREN'S HOSPITAL COLORADO DENTAL CLINIC CONDUCTED DENTAL SCREENINGS AND ORAL HEALTH EDUCATION IN LOCAL SCHOOLS AND COMMUNITY BASED ORGANIZATIONS, IMPACTING NEARLY 3000 CHILDREN. CHILDREN NEEDING FURTHER CARE WERE REFERRED TO THE HOSPITAL'S DENTAL CLINIC FOR A FOLLOW UP VISIT. FAMILY SUPPORT BEREAVEMENT GROUPS AND SPECIALIZED SUPPORT GROUPS FOR FAMILIES DEALING WITH A PARTICULAR ILLNESS ARE OFFERED THROUGHOUT THE HOSPITAL AS A MEANS TO ENSURE THE NEEDS OF THE ENTIRE FAMILY ARE BEING MET. ADDTIONALLY, CHILDREN'S HOSPITAL COLORADO SUPPORTS A NUMBER OF COMMUNITY-BASED CAMPS DESIGNED AROUND CHILDREN WITH SPECIFIC CONDITIONS AND HEALTH CARE NEEDS. OTHER EFFORTS TO MEET THE NEEDS OF FAMILIES BEYOND THE PROVISION OF MEDICAL CARE INCLUDED NEARLY 23,000 STAFF HOURS SPENT PROVIDING FINANCIAL COUNSELING FOR FAMILIES AS WELL AS MANAGING PROGRAMS SUCH AS THE FAMILY NAVIGATOR, WHICH HELPS CONNECT FAMILIES OF CHILDREN WITH COMPLEX MEDICAL NEEDS WITH NEEDED SERVICES AND SUPPORT UPON LEAVING THE HOSPITAL AND RETURNING TO THE COMMUNITY, AND THE MEDICAL LEGAL PARTNERSHIP, WHICH HELPS ADDRESS THE LEGAL NEEDS OF PATIENT FAMILIES. PARENT EDUCATION CHILDREN'S HOSPITAL COLORADO PROVIDES SERVICES TO PARENTS - FREE OF CHARGE - THAT EDUCATE AND GUIDE THEM THROUGH COMMON CONCERNS AND QUESTIONS. OFTEN, PARENTS NEED QUICK TIPS, IDEAS AND ALTERNATE APPROACHES TO VARIOUS CHILDHOOD ISSUES. CHILDREN'S HOSPITAL COLORADO'S PARENT ADVICE LINE PROVIDES MORE THAN 275 TOPICS RELATED TO THE HEALTH OF THEIR INFANTS, CHILDREN AND TEENAGERS. THE MESSAGES WERE DEVELOPED BY ONE OF CHILDREN'S HOSPITAL COLORADO'S PEDIATRICIANS. CHILDREN'S HOSPITAL COLORADO PROVIDES CONSUMER HEALTH INFORMATION TO THE PUBLIC THROUGH ITS FAMILY HEALTH LIBRARY, SERVING NEARLY 25,000 PEOPLE. THE HOSPITAL'S EXTERNAL WEBSITE IS ANOTHER WAY THE HOSPITAL MAKES HEALTH AND SAFETY RESOURCES WIDELY AVAILABLE TO THE PUBLIC, REACHING OVER A MILLION PEOPLE EACH YEAR. ADDITIONALLY, CHILDREN'S HOSPITAL COLORADO CONDUCTS FREE PARENTING SEMINARS TO MEMBERS OF THE COMMUNITY. TOPICS ADDRESSED INCLUDE: SUCCESSFUL PARENTING STRATEGIES, SOLVING COMMON SLEEP PROBLEMS, POTTY TRAINING, AND HELPING TEENS AND TWEENS COPE WITH CHALLENGING ISSUES. LEADERSHIP IN THE COMMUNITY THE HOSPITAL'S DEDICATED STAFF MEMBERS DO NOT LIMIT THEIR CARE TO ONLY HOSPITALIZED PATIENTS. STAFF MEMBERS CONTRIBUTE THOUSANDS OF HOURS ON STAFF TIME OR AS A VOLUNTEER TO ACTIVITIES SUCH AS: EDUCATING COMMUNITY GROUPS ABOUT FIRST AID, NUTRITION, INJURY PREVENTION, EATING DISORDERS/MENTAL HEALTH ISSUES AND OTHER IMPORTANT TOPICS; PARTICIPATING IN COMMUNITY COMMITTEES, NON-PROFIT BOARDS, HEALTH COALITIONS AND OTHER SIMILAR ORGANIZATIONS; PARTICIPATING IN HEALTH FAIRS, COMMUNITY CLINICS, HANDICAPPED SPORTS PROGRAMS, AND CAMPS FOR CHILDREN WITH SPECIAL NEEDS. COLORADO BREASTFEEDING COALITION, COLORADO RURAL HEALTH CENTER BOARD, COLORADO SPEECH, LANGUAGE, AND HEARING ASSOCIATION, COLORADO MANAGED CARE COLLABORATIVE BOARD, AURORA HEALTH CARE ACCESS TASK FORCE, MARCH OF DIMES, AND THE COLORADO ASSOCIATION OF SCHOOL NURSES ARE JUST A FEW OF THE MANY ORGANIZATIONS WHERE STAFF MEMBERS DEDICATE THEIR TIME AND EXPERTISE. CHILDREN'S HOSPITAL COLORADO ALSO USES ITS INFLUENCE IN THE COMMUNITY TO SERVE AS A CONVENOR ON KEY CHILD HEALTH ISSUES. FOR EXAMPLE, IN EARLY 2011 THE HOSPITAL CONVENED NEARLY 100 STAKEHOLDERS FROM A VARIETY OF PERSPECTIVES - MEDICAL, INSURANCE, GOVERNMENT, SCHOOLS, PARENTS, COMMUNITY-BASED ORGANIZATIONS AND MORE - TO EXPLORE HOW TO ADDRESS BEHAVIORAL HEALTH NEEDS IN COLORADO. RESEARCH LEADERSHIP AT THE HOSPITAL BELIEVES THAT ADVANCES IN RESEARCH LEAD TO IMPROVED OUTCOMES FOR ALL CHILDREN, THROUGH BOTH TREATMENT AND PREVENTION EFFORTS IN AND OUTSIDE OF HOSPITAL SETTINGS. RESEARCH IN CHILDHOOD DISEASES FORMALLY BEGAN IN 1978 AT CHILDREN'S HOSPITAL COLORADO. TODAY, CHILDREN'S HOSPITAL COLORADO IS NATIONALLY RECOGNIZED FOR ITS EXCELLENCE IN RESEARCH IN THE DISEASES OF THE NEWBORN, CHILD, AND TEEN. CHILDREN'S HOSPITAL COLORADO RESEARCH INSTITUTE SERVES AS AN UMBRELLA ORGANIZATION FOR ALL RESEARCH AT THE HOSPITAL. PROGRAMS UNDER THIS UMBRELLA INCLUDE THE SPONSORED PROGRAMS OFFICE, THE COLORADO MULTIPLE INSTITUTIONAL REVIEW BOARD (COMIRB), THE CLINICAL TRIALS ORGANIZATION, AND THE CLINICAL TRANSLATIONAL RESEARCH CENTER. THE RESEARCH INSTITUTE HAS ALSO FOCUSED ON NEW, YOUNG CHILDREN'S HOSPITAL COLORADO INVESTIGATORS BY FUNDING THEM FOR PROJECTS THAT MAY SUBSEQUENTLY PROVIDE THE PRELIMINARY DATA NECESSARY FOR THE INVESTIGATOR TO COMPETE FOR FUNDS FROM OUTSIDE AGENCIES. MORE THAN HALF OF RESEARCH INSTITUTE GRANT RECIPIENTS HAVE BEEN SUCCESSFUL IN OBTAINING ADDITIONAL FUNDS FROM OUTSIDE GRANTING AGENCIES SUCH AS THE NATIONAL INSTITUTES OF HEALTH AND THE AMERICAN HEART ASSOCIATION, AS WELL AS OTHER FOUNDATIONS AND GRANTING AGENCIES. FINALLY, THE COLORADO CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTE, FOUNDED IN 2008, SPECIFICALLY PROMOTES COLLABORATION BETWEEN PRIMARY CARE PHYSICIANS AND PRINCIPLE INVESTIGATORS TO ENSURE A "CONTINUUM OF RESEARCH" THAT BROADENS PARTICIPATION IN BASIC RESEARCH AND FACILITATES THE TRANSLATION OF RESEARCH ADVANCES TO PRIMARY CARE APPLICATIONS. KIDS ARE OUR BOTTOM LINE DRIVEN BY ITS MISSION AND DREAM OF A WORLD WHERE CHILDREN NO LONGER NEED A HOSPITAL, THE HOSPITAL RE-INVESTS ANY AVAILABLE SURPLUS FUNDS TO CONTINUE TO IMPROVE AND EXPAND UPON CURRENT PEDIATRIC PATIENT NEEDS.
Schedule H (Form 990) 2011
Additional Data


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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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number
84-0166760
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) ROUND UP RIVER RANCHPO BOX 8589
AVON,CO81620 		20-4632248 501(C)(3) 16,560       GENERAL PROGRAM SUPPORT
(2) CHILDREN'S HEALTH FOUNDATION400 WEST MAIN ST
ASPEN,CO81611 		20-2015631 501(C)(3) 10,000       GENERAL PROGRAM SUPPORT
(3) FETAL HOPE FOUNDATION9786 SOUTH HOLLAND ST
LITTLETON,CO80127 		20-0837174 501(C)(3) 12,500       GENERAL PROGRAM SUPPORT
(4) COLORADO CHILDREN'S CAMPAIGN225 E 16TH AVENUE
DENVER,CO80203 		74-2374672 501(C)(3) 20,000       GENERAL PROGRAM SUPPORT
(5) AURORA ECONOMIC DEVELOPMENT14001 E ILIFF AVENUE
AURORA,CO80014 		84-0776480 501(C)(3) 10,000       GENERAL PROGRAM SUPPORT
(6) MARCH OF DIMES FOUNDATION1325 S COLORADO BLVD
DENVER,CO80222 		13-1846366 501(C)(3) 30,000       GENERAL PROGRAM SUPPORT
(7) THE CHILDREN'S MUSEUM2121 CHILDRENS MUSEUM DR
DENVER,CO80211 		84-0658142 501(C)(3) 25,000       GENERAL PROGRAM SUPPORT
(8) THE WILDLIFE EXPERIENCE10035 SOUTH PEORIA ST
PARKER,CO80104 		84-1511730 501(C)(3) 25,000       GENERAL PROGRAM SUPPORT
(9) AURORA CHAMBER OF COMMERCE14305 E ALAMEDA AVE
AURORA,CO80012 		84-0417773 501(C)(3) 6,366       GENERAL PROGRAM SUPPORT
(10) DOUGLAS COUNTY SOCCER ASSOC DBA REAL COLORADO8200 SOUTH AKRON ST
CENTENNIAL,CO80112 		74-2392779 501(C)(3) 60,000       GENERAL PROGRAM SUPPORT
(11) ST ANTHONY HOSPITAL FOUNDATION4231 W 16TH AVE
DENVER,CO80204 		84-0902211 501(C)(3) 5,500       GENERAL PROGRAM SUPPORT
(12) KROENKE SPORTS CHARITIES1000 CHOPPER CIRCLE
DENVER,CO80204 		84-1511484 501(C)(3) 22,500       GENERAL HEALTH AND EDUCATION
(13) DENVER BOTANIC GARDENS909 YORK STREET
DENVER,CO80206 		84-0440359 501(C)(3) 6,666       GENERAL PROGRAM SUPPORT
(14) NATIONAL WESTERN STOCK SHOW4655 HUMBOLDT ST
DENVER,CO80216 		84-0517361 501(C)(3) 12,500       GENERAL PROGRAM SUPPORT
(15) METRO DENVER ECONOMIC DEVELOPMENTPO BOX 5751
DENVER,CO80217 		84-0186760 501(C)(3) 10,000       GENERAL PROGRAM SUPPORT
(16) SOUTH METRO FIRE RESCUEPO BOX 324
PARKER,CO80138 		84-1174330 501(C)(3) 10,000       GENERAL PROGRAM SUPPORT
(17) RONALD MCDONALD HOUSE1300 EAST 21ST AVE
DENVER,CO80205 		84-0728926 501(C)(3) 10,000       GENERAL PROGRAM SUPPORT
(18) DENVER METRO CHAMBER OF COMMERCEPO BOX 5751
DENVER,CO80217 		84-0186760 501(C)(3) 25,000       GENERAL PROGRAM SUPPORT
(19) DENVER METRO CHAMBER LEADERSHIP1445 MARKET STREET
DENVER,CO80202 		84-0186760 501(C)(3) 14,000       GENERAL PROGRAM SUPPORT
(20) DENVER ART MUSEUM100 W 14TH AVE PKWY
DENVER,CO80204 		84-6038240 501(C)(3) 20,000       GENERAL PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
20
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













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 SCHEDULE I, PART I, LINE 2 CHILDREN'S HOSPITAL COLORADO RELIES ON THE GOVERNANCE PRACTICES OF THE RECIPIENT EXEMPT ORGANIZATIONS TO MONITOR THE USE OF FUNDS AS INTENDED.
Schedule I (Form 990) 2011


Additional Data


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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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
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
 
 
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
 
 
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) JAMES E SHMERLING DHA (i)
(ii)		 726,877
0 		365,768
0 		251,172
0 		128,088
0 		15,295
0 		1,487,200
0 		223,490
0
(2) JENA HAUSMANN (i)
(ii)		 385,611
0 		160,286
0 		16,994
0 		65,791
0 		15,133
0 		643,815
0 		0
0
(3) LEONARD J DRYER JR (i)
(ii)		 377,674
0 		119,530
0 		83,671
0 		14,700
0 		14,440
0 		610,015
0 		0
0
(4) MARY ANNE LEACH (i)
(ii)		 242,342
0 		69,259
0 		39,261
0 		37,232
0 		5,790
0 		393,884
0 		0
0
(5) JOHN LACOUTURE (i)
(ii)		 278,248
0 		86,127
0 		1,180
0 		28,307
0 		14,918
0 		408,780
0 		0
0
(6) KELLY JOHNSON (i)
(ii)		 248,998
0 		61,428
0 		14,188
0 		37,751
0 		14,487
0 		376,852
0 		0
0
(7) JEFFREY HARRINGTON (i)
(ii)		 199,087
0 		55,024
0 		17,218
0 		31,199
0 		14,338
0 		316,866
0 		0
0
(8) MICHEAL WUKITSCH (i)
(ii)		 227,922
0 		50,981
0 		17,262
0 		33,295
0 		14,890
0 		344,350
0 		0
0
(9) SUZY JAEGER (i)
(ii)		 200,926
0 		54,205
0 		25,640
0 		31,449
0 		14,339
0 		326,559
0 		0
0
(10) JERROD MILTON (i)
(ii)		 158,791
0 		40,344
0 		17,269
0 		28,589
0 		13,245
0 		258,238
0 		0
0
(11) BETH GAFFNEY (i)
(ii)		 153,707
0 		47,603
0 		69,903
0 		26,542
0 		5,904
0 		303,659
0 		0
0
(12) AMY CASSERI (i)
(ii)		 276,949
0 		97,795
0 		16,661
0 		44,692
0 		13,871
0 		449,968
0 		0
0
(13) LINDA POWERS (i)
(ii)		 119,089
0 		19,743
0 		22,505
0 		10,189
0 		11,486
0 		183,012
0 		0
0
(14) MARGI MORSE (i)
(ii)		 111,741
0 		22,168
0 		22,483
0 		8,760
0 		11,486
0 		176,638
0 		0
0
(15) MICHAEL CLARK (i)
(ii)		 143,506
0 		27,315
0 		33,397
0 		11,225
0 		4,891
0 		220,334
0 		0
0
(16) SUSAN DILTZ (i)
(ii)		 144,544
0 		30,436
0 		16,877
0 		10,588
0 		14,028
0 		216,473
0 		0
0
(17) MARY BETH MARTIN (i)
(ii)		 117,815
0 		62,319
0 		16,526
0 		0
0 		23
0 		196,683
0 		0
0
(18) DAVID ROGERS (i)
(ii)		 147,497
0 		22,277
0 		14,725
0 		9,801
0 		5,859
0 		200,159
0 		0
0
(19) QI WEI (i)
(ii)		 147,036
0 		135,102
0 		6,219
0 		11,614
0 		9,099
0 		309,070
0 		0
0
(20) JOAN BOTHNER MD (i)
(ii)		 509,418
0 		126,336
0 		0
0 		0
0 		0
0 		635,754
0 		0
0
(21) DENNIS MATTHEWS (i)
(ii)		 212,773
0 		53,578
0 		0
0 		0
0 		0
0 		266,351
0 		0
0
(22) STEPHEN DANIELS (i)
(ii)		 423,171
0 		67,164
0 		0
0 		0
0 		0
0 		490,335
0 		0
0
(23) DANIEL HYMAN MD (i)
(ii)		 365,277
0 		115,677
0 		0
0 		0
0 		0
0 		480,954
0 		0
0
(24) FRED SUCHY (i)
(ii)		 389,508
0 		45,000
0 		0
0 		0
0 		0
0 		434,508
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
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 4B CHILDREN'S HOSPITAL COLORADO ("CHILDREN'S COLORADO") SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN WAS FROZEN. LEONARD J. DRYER, JR. IS THE ONLY PARTICIPANT IN THE PLAN. THERE WERE NO CONTRIBUTIONS OR PAYOUTS DURING 2011.
SUPPLEMENTAL COMPENSATION INFORMATION SCHEDULE J, PART I, LINE 7 CERTAIN INDIVIDUALS ARE ELIGIBLE TO PARTICIPATE IN THE INCENTIVE PLAN FOR CHILDREN'S COLORADO, THE COMPONENTS OF WHICH INCLUDE ACHIEVEMENT OF ORGANIZATIONAL PERFORMANCE GOALS AND INDIVIDUAL PERFORMANCE GOALS. BECAUSE THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS RESERVES THE RIGHT TO CHANGE, AMEND OR TERMINATE THIS PLAN AT ANY TIME, FOR ANY REASON, AT ITS SOLE DISCRETION AND BECAUSE OF CERTAIN OTHER CONDITIONS OF THE PLAN, LINE 7 REGARDING "NON-FIXED PAYMENTS" IS ANSWERED YES. NOTE THAT PRIOR TO THE PAYMENT OF ANY AMOUNTS TO AN INDIVIDUAL WHO IS CONSIDERED A DISQUALIFIED PERSON, THE COMPENSATION COMMITTEE SHALL CERTIFY IN WRITING THE EXTENT TO WHICH THE PERFORMANCE FACTORS ESTABLISHED BY THE COMPENSATION COMMITTEE HAVE BEEN SATISFIED AND SHALL APPROVE THE PAYMENT OF SUCH BONUSES TO SUCH INDIVIDUALS. SEE SCHEDULE O DISCLOSURE FOR PART VI, LINES 15A/B FOR ADDITIONAL INFORMATION ON EXECUTIVE COMPENSATION. OTHER INFORMATION CHILDREN'S COLORADO PAID UNIVERSITY PHYSICIANS INCORPORATED, AN UNRELATED TAX-EXEMPT ORGANIZATION, FOR SERVICES PROVIDED BY THE FOLLOWING INDIVIDUALS WHO ARE LISTED ON FORM 990, PART VII: JOAN BOTHNER, M.D. - $509,418 BASE COMPENSATION AND $126,336 OF 2010 BONUS PAID IN 2011 DENNIS MATTHEWS - $212,773 BASE COMPENSATION AND $53,578 OF 2010 BONUS PAID IN 2011 STEPHEN DANIELS - $423,171 BASE COMPENSATION AND $67,164 OF 2010 BONUS PAID IN 2011 DANIEL HYMAN, M.D. - $365,277 BASE COMPENSATION AND $115,677 OF 2010 BONUS PAID IN 2011 FRED SUCHY - $389,508 BASE COMPENSATION AND $45,000 OF 2010 BONUS PAID IN 2011 TIMOTHY CROMBLEHOME - $46,082 BASE COMPENSATION AND $50,000 BONUS PAID IN 2011
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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number
84-0166760
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 CITY OF AURORA CO
  		84-6000564 05155XBT5 06-06-2008 258,814,487 SER 2008 A/B - SEE SCHEDULE O   X   X   X
B CITY OF AURORA CO
  		84-6000564 05155XBV0 12-10-2008 67,580,000 SER 2008C - SEE SCHEDULE O   X   X   X
C CITY OF AURORA CO
  		84-6000564 05155XBX6 05-25-2010 59,999,130 SER 2010A - SEE SCHEDULE O   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . 0 5,625,000 0  
2 Amount of bonds legally defeased . . . . . . . . . . 0 0 0  
3 Total proceeds of issue . . . . . . . . . . . . . 258,814,487 67,580,000 59,999,130  
4 Gross proceeds in reserve funds . . . . . . . . 0 0 0  
5 Capitalized interest from proceeds . . . . . . . . . . 0 0 0  
6 Proceeds in refunding escrows . . . . . . . . . . . 0 0 0  
7 Issuance costs from proceeds . . . . . . . . . . . 2,564,487 580,000 709,432  
8 Credit enhancement from proceeds . . . . . . . . . . 0 0 0  
9 Working capital expenditures from proceeds . . . . . . . 0 0 0  
10 Capital expenditures from proceeds . . . . . . . . . . 256,250,000 67,000,000 59,289,698  
11 Other spent proceeds . . . . . . . . . . . 0 0 0  
12 Other unspent proceeds . . . . . . . . . . . 0 0 0  
13 Year of substantial completion . . . . . . . . . . . 2008 2008 2012
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? . . . . .                
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              
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 0.00000% 0% 0.00000%   %
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% 0.00000%   %
6 Total of lines 4 and 5 . . .. . . . . . . . . 0.00000% 0% 0.00000%   %
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
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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
(1) CHILDREN'S NORTH ASC
  		X   5,450,000 4,535,000   No Yes   Yes  
Total ...............Small Bullet $ 4,535,000
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) WELLS FARGO HONIG - CHCo DIRECTOR 305,292 BANKING SERVICE FEES   No
(2) LOCKTON COMPANY LINDSAY - CHCo DIRECTOR 471,000 CONSULTING FEES   No
(3) MATTHEW M DRYER SON OF OFFICER 74,243 COMPENSATION   No
(4) DEBRA SHMERLING WIFE OF OFFICER 13,517 COMPENSATION   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
Identifier Return Reference Explanation
VOLUNTEERS FORM 990, PART I, LINE 6 VOLUNTEERS CHAPTERS AT CHILDREN'S HOSPITAL COLORADO THE VOLUNTEER CHAPTERS WITHIN THE ASSOCIATION OF VOLUNTEERS AT CHILDREN'S PROVIDE A VARIETY OF SERVICES TO THE HOSPITAL, OUR PATIENTS AND THEIR FAMILIES. THE CHAPTER VOLUNTEERS FUNCTION BOTH AS VOLUNTEERS IN THE HOSPITAL, AS WELL AS COMMUNITY-BASED VOLUNTEERS. BOULDER CHAPTER (1967) THE BOULDER CHAPTER BEGAN AS A CIRCLE OF FRIENDS DEDICATED TO MEETING THE NEED OF FUNDING REQUESTS FOR NON-CAPITAL IMPROVEMENTS AT CHILDREN'S HOSPITAL COLORADO. THEIR INITIAL PROJECTS WERE GOLF TOURNAMENTS, AUCTIONS AND MORE. CURRENTLY, THE CHAPTER HOSTS THE FOLLOWING EVENTS. - A DAY AT HIGHLAND HILLS MINIATURE GOLF AND RACEWAY IN JUNE - A COOPERATIVE EFFORT WITH GIAMBRACCO AND SONS GARDEN CENTER DURING THE SPRING AND SUMMER; PROCEEDS OF FLOWER SALES BENEFIT THE CHAPTER - TEDDY BEAR TEA AT THE BOULDERADO HOTEL THE SATURDAY AFTER THANKSGIVING - GIFT WRAPPING THE FIRST WEEKEND OF DECEMBER AT THE BOULDER BARNES & NOBLE BOOKSTORE THIS GROUP MEETS THE FIRST TUESDAY OF EVERY MONTH AT 7:00 P.M. AT A MEMBER'S HOME, WITH THE EXCEPTION OF JULY AND AUGUST. CANCER CENTER CHAPTER (1993) THE CANCER CENTER CHAPTER BEGAN AS AN EFFORT TO CELEBRATE THE ART WORK OF ONCOLOGY AND BLOOD DISORDER PATIENTS. CORPORATE SPONSORS WERE ESTABLISHED TO FUND THE TRANSFORMATION OF THE ARTWORK INTO WINTER HOLIDAY CARDS. PROCEEDS OF THE CARDS ARE USED TO IMPROVE THE QUALITY AND SATISFACTION OF PATIENT CARE BY PROVIDING WIGS, MEDICAL BRACELETS, EYE EXAM EQUIPMENT AND TEACHING AIDES. FUNDS ARE ALSO DELEGATED TO PURCHASING EQUIPMENT RELATED TO PROCESSING TUMOR SAMPLES, TEACHING MATERIALS FOR ONCOLOGY STUDENTS AND TO THE HOPE CLINIC, WHICH PROVIDES LONG-TERM SERVICES FOR SURVIVORS OF CANCER. CARDIAC KIDS CHAPTER (2001) THE MISSION OF THE CARDIAC KIDS CHAPTER, DEVELOPED BY MOTHERS OF CARDIAC PATIENTS, IS TO PROVIDE EMOTIONAL SUPPORT AND EDUCATION FOR THE FAMILIES OF CHILDREN WITH HEART DISORDERS. THE GROUP ALSO EDUCATES THE PUBLIC REGARDING HEART DISEASE AND HEART TRANSPLANTS AMONG CHILDREN. EACH DAY THE CHAPTER STRIVES TO ENHANCE THE WORK OF CHILDREN'S HOSPITAL COLORADO HEART INSTITUTE AND HELPS TO PROMOTE ORGAN DONATION. ONE OF THE CHAPTER'S PROJECTS HAS BEEN THE CREATION OF A 150-PAGE MANUAL GUIDING PARENTS THROUGH THE PROCESSES OF SURGERIES, CRITICAL CARE ISSUES, FOLLOW UP CARE AND MORE. THIS CHAPTER'S EVENTS INCLUDE THE FOLLOWING: - A REUNION PICNIC IN JULY - PUMPKIN PATCH DAY IN OCTOBER - TEXAS HOLD'EM POKER TOURNAMENT IN THE FALL THIS CHAPTER MEETS MONTHLY ON THE SECOND TUESDAY OF EVERY MONTH AT VARYING LOCATIONS IN THE DENVER METRO AREA. EMPLOYEES AS VOLUNTEERS (2011) EMPLOYEES AS VOLUNTEERS CHAPTER IS MADE UP OF EMPLOYEES AT THE CHILDREN'S HOSPITAL COLORADO. IN ADDITION TO HOSTING SPECIAL EVENTS AT THE HOSPITAL FOR PATIENTS AND THEIR FAMILIES, THE MEMBERS LEND THEIR SUPPORT AT VARIOUS EVENTS BOTH IN THE COMMUNITY AND AT THE HOSPITAL. FRIENDS OF THE HOSPITAL SPORTS PROGRAM (1986) THIS CHAPTER WAS DEVELOPED TO BE A FUNDRAISING ARM OF THE HOSPITAL SPORTS PROGRAM TO PROVIDE FUNDING SO THAT CHILDREN WITH DISABILITIES CAN PARTICIPATE IN THE DISABLED SKI PROGRAM AT WINTER PARK. THIS PROGRAM HELPS CHILDREN AND TEENS TO BUILD A SENSE OF FREEDOM AND SELF ESTEEM THROUGH SKIING. THIS AWARD-WINNING PROGRAM ALLOWS CHILDREN TO EXPAND THEIR HORIZONS, NOT ONLY THROUGH THE SKI PROGRAM, BUT ALSO THROUGH GOLF ACTIVITIES. IN ADDITION, THIS CHAPTER WAS INSTRUMENTAL IN THE CREATION OF THE COURAGE CLASSIC, A 3-DAY BIKE RIDE THROUGH THE COLORADO ROCKIES, AND REMAINS A CRUCIAL INGREDIENT FOR THE BIKE TOUR'S SUCCESS EVERY JULY. THROUGHOUT THE YEAR, THE CHAPTER SELLS BROOMS THAT ARE HANDMADE BY MEMBERS, BLANKETS WITH KIDS' PICTURES ON THEM AND A JOHN FIELDER CALENDAR. IN PARTNERSHIP WITH THE DENVER ROUNDTABLE, A CAR CRUISE IS HOSTED EACH FALL. REVENUES FROM THEIR FUNDRAISING EFFORTS ALLOW CHILDREN TO PARTICIPATE IN THE SPORTS PROGRAM. THE CHAPTER MEETS THE SECOND WEDNESDAY OF EVERY MONTH AT CHILDREN'S HOSPITAL COLORADO WITH THE EXCEPTION OF FEBRUARY, JULY AND DECEMBER. GIFT OF GRACIE (2009) THE GIFT OF GRACIE CHAPTER WAS FOUNDED BY TIFFANY PETERSON, WHOSE DAUGHTER, GRACIE, WAS A PATIENT AT CHILDREN'S HOSPITAL COLORADO. THE GIFT OF GRACIE CHAPTER WAS FOUNDED BY TIFFANY PETERSON FOLLOWING HER DAUGHTER GRACIE'S EXPERIENCE AS A PATIENT AT CHILDREN'S HOSPITAL COLORADO. THE MISSION OF THIS CHAPTER IS TO RAISE FUNDS TO SUPPLY THE HOSPITAL WITH BOOKS AND OTHER MATERIALS WHICH WILL ENHANCE THE HOSPITAL EXPERIENCE FOR THE PATIENTS AND THEIR FAMILIES. THIS GROUP HOSTS AN ANNUAL GOLF TOURNAMENT AND A BIRTHDAY CELEBRATION IN HONOR OF DR. SEUSS. MEETINGS ARE HELD ON THE FIRST SUNDAY OF EACH MONTH. PLEASE VISIT WWW.GIFTOFGRACIE.ORG FOR MORE INFORMATION. HIGHLANDS RANCH CHAPTER (1990) THE HIGHLANDS RANCH CHAPTER SUPPORTS VARIOUS DEPARTMENTS AND CAUSES AT CHILDREN'S HOSPITAL COLORADO. THE GROUP IS COMPRISED OF MEMBERS FROM THE HIGHLANDS RANCH /CASTLE ROCK AREAS, ON MAY 6TH THE CHAPTER HOSTED THE "TASTE OF HIGHLANDS RANCH" FOOD AND WINE/AUCTION. THEY WILL HOST A CHILDREN'S BRUNCH AND CHAMPAGNE TEA FOR ADULTS ON DECEMBER 17TH AT THE CHEROKEE RANCH AND CASTLE IN SEDALIA. FUNDS RAISED BY THIS CHAPTER HAVE BEEN USED FOR MEDICAL TRAINING MANNEQUINS, XBOX 360 GAMES, EDUCATIONAL RESOURCE BOOKS FOR OUR NETWORKS OF CARE FACILITIES, AND FOR PRECIOUS PRINTS - A PROGRAM ADMINISTERED BY THE PASTORAL CARE DEPARTMENT. HIGHLANDS RANCH YOUTH VOLUNTEER CHAPTER (2010) THE HIGHLANDS RANCH YOUTH CHAPTER IS COMPRISED OF STUDENTS FROM THE FOUR HIGHLANDS RANCH HIGH SCHOOLS.THIS GROUP ENJOYS HOSTING BLOOD DRIVES TO RAISE AWARENESS FOR THE HOSPITAL AND HOSTING CRAFT PARTIES FOR PATIENTS AND THEIR FAMILIES. HYDROCEPHALUS INFORMATION NETWORK CHAPTER (1997) THE HYDROCEPHALUS INFORMATION NETWORK WAS DEVELOPED BY MOTHERS OF CHILDREN WHO SUFFER WITH A SYNDROME KNOWN AS "WATER ON THE BRAIN." MANY CHILDREN WITH THIS CONDITION REQUIRE AS MANY AS 20 SURGERIES BEFORE THE AGE OF 15. THIS CHAPTER'S MISSION IS DEDICATED TO RAISING AWARENESS ABOUT THIS NEUROLOGICAL CONDITION. EACH YEAR, THE CHAPTER HOSTS A SUMMER WEEKEND CAMP IN ESTES PARK, WHICH INCLUDES TENTS, A CAMPFIRE, SWIMMING AND A BASEBALL GAME. IN ADDITION, THE CHAPTER HOSTS A "BREAKFAST WITH SANTA" FUNDRAISER FOR THE PUBLIC AND "AN EVENING WITH SANTA" FOR THE CHAPTER AND ITS MEMBERS. MORNING GLORIES CHAPTER THE MORNING GLORIES CHAPTER IS A SUPPORT GROUP THAT CREATES HAND-SEWN GOODS FOR CHILDREN'S HOSPITAL COLORADO CHILD LIFE AND THERAPEUTIC RECREATION SPECIALISTS. THEY SEW EYE PATCHES, BLANKETS, HATS FOR ONCOLOGY PATIENTS AND TINY HOSPITAL GOWNS FOR THE DOLLS CHILD LIFE SPECIALISTS USE TO TEACH PATIENTS ABOUT UPCOMING PROCEDURES. THIS GROUP HOLDS "OUTINGS" INSTEAD OF MONTHLY MEETINGS AT PLACES SUCH AS BOOK BINDING COMPANIES AND MUSEUMS, SO THEY CAN STRETCH THEIR LEGS AND BACKS AFTER LONG HOURS AT SEWING MACHINES. OUTINGS TAKE PLACE ON THE THIRD WEDNESDAY MORNING OF EVERY MONTH. PRESCRIPTION PETS CHAPTER (1984) THE AWARD-WINNING PRESCRIPTION PET PROGRAM, ALSO KNOWN AS RXPETS, IS A DOG-ASSISTED THERAPY AND VISITATION PROGRAM THAT BEGAN IN 1984 AS A COOPERATIVE EFFORT BETWEEN CHILDREN'S AND THE DENVER AREA VETERINARY MEDICAL SOCIETY (DAVMS). SPECIALLY-TRAINED VOLUNTEER DOG OWNERS TAKE THEIR DOGS ON ROUNDS TO VISIT PATIENTS AT CHILDREN'S HOSPITAL COLORADO. IN 1984, A WRITTEN PRESCRIPTION FROM THE CHILD'S PHYSICIAN WAS NECESSARY FOR A DOG VISIT, HENCE THE NAME, "PRESCRIPTION PET PROGRAM." ALL PRESCRIPTION PET DOGS HAVE PASSED A VIGOROUS SCREENING AND HAVE BEEN APPROVED BY VETERINARIANS WHO VOLUNTEER THEIR TIME. THEIR VISITS WITH PATIENTS CAN RANGE FROM A FEW MINUTES TO 15 MINUTES OR LONGER, DEPENDING ON THE CHILD'S RESPONSE AND CONDITION. THE DOGS ALSO ASSIST THE MEDICAL STAFF IN THE PSYCHIATRIC UNITS AND IN THE PHYSICAL REHABILITATION DEPARTMENT. PRESCRIPTION PETS' PROCEEDS HAVE GONE TO THE EMERGENCY DEPARTMENT FOR ART WORK, A SHUTTLE VAN FOR STAFF AND FAMILIES, AND TO CAREPAGES, A WEBSITE FOR FAMILIES TO COMMUNICATE WITH LOVED ONES THROUGH A BLOG. MEETINGS ARE HELD QUARTERLY, ON THE 2ND WEDNESDAY OF THE MONTH.
VOLUNTEERS FORM 990, PART I, LINE 6 PRESCRIPTION PET PROGRAM VOLUNTEERING FOR THE PRESCRIPTION PET PROGRAM THE PRESCRIPTION PET PROGRAM IS A POPULAR PROGRAM - NOT ONLY WITH OUR PATIENTS, BUT ALSO WITH COMMUNITY VOLUNTEERS! WE CURRENTLY HAVE A WAITING LIST OF PET VOLUNTEERS FOR THE PROGRAM. BUT TO LEARN MORE ON HOW YOU CAN BECOME INVOLVED IN CHILDREN'S HOSPITAL COLORADO PRESCRIPTION PET PROGRAM OR OTHER VOLUNTEER OPPORTUNITIES, PLEASE CONTACT THE VOLUNTEER OFFICE AT 720-777-6887. BUILDING THE PRESCRIPTION PET PROGRAM AT CHILDREN'S HOSPITAL COLORADO IN 1978, FERN BECHTEL, DIRECTOR OF VOLUNTEERS AT CHILDREN'S HOSPITAL COLORADO, SAW THE POSITIVE EFFECTS OF PET VISITATION ON HER SON AS HE RECOVERED FROM EXTENSIVE SURGERY. SHE DETERMINED THAT THE KIDS AT CHILDREN'S HOSPITAL COLORADO WOULD BENEFIT FROM A SIMILAR PROGRAM AND BEGAN TO WORK TOWARD THAT GOAL. BECHTEL TEAMED UP WITH DRS. JAN FACINELLI AND JIM HOUCHENS, DENVER VETERINARIANS, AND MARY JO CLEAVELAND, HEAD NURSE OF ONCOLOGY AT CHILDREN'S HOSPITAL COLORADO, TO ESTABLISH THE FIRST DOG VISITATION PROTOCOLS. IN 1984, THE FIRST DOG VISITED THE KIDS AT CHILDREN'S HOSPITAL COLORADO (ONE DOG, 20 VISITS TO THE ONCOLOGY UNIT) UNDER CLOSE SUPERVISION OF MEDICAL STAFF. A WRITTEN PRESCRIPTION FROM THE CHILD'S PHYSICIAN WAS NECESSARY FOR A DOG VISIT. THIS WAS THE ORIGIN OF THE NAME PRESCRIPTION PET PROGRAM. THE PET PROGRAM GREW STEADILY. IN 1990, THE PROGRAM RECEIVED THE AMERICAN HOSPITAL AWARD FOR VOLUNTEER EXCELLENCE (HAVE). THIS WAS THE FIRST TIME AN ANIMAL-ASSISTED PROGRAM RECEIVED THE AWARD. THE SAME YEAR, THE RXPETS PROGRAM WAS HONORED BY THE AMERICAN SOCIETY OF DIRECTORS OF VOLUNTEER SERVICES WITH ITS "EXTRAORDINARY PROGRAM" AWARD; RX PETS WON A "DAVMS SERVICE AWARD" FROM THE DENVER AREA VETERINARY MEDICAL SOCIETY AS WELL. WINDSOR GARDENS CHAPTER (1975) THE WINDSOR GARDENS CHAPTER SUPPORTS THE NEONATAL AND CARDIAC INFANT PATIENTS BY KNITTING AND CROCHETING BABY BLANKETS, BOOTIES AND HATS FOR THE TINY PATIENTS. THEY ALSO MAKE HATS FOR THE CANCER AND BLOOD DISORDER PATIENTS. EVERY ITEM THEY PRODUCE IS STITCHED WITH LOVE. SOME OF THE MEMBERS OF THIS CHAPTER HAVE BEEN VOLUNTEERS FOR OVER 50 YEARS. IN ADDITION TO HOSTING A BLOOD DRIVE, THIS CHAPTER RAISES FUNDS THROUGH A SUMMER ICE CREAM AND MUSIC SOCIAL AND AND A FALL CRAFT FAIR SCHEDULED FOR OCTOBER 27TH THROUGH 29TH. FUNDS FROM THEIR EVENTS HAVE BEEN DISPERSED FOR A REUNION FOR PATIENTS TREATED IN THE NEWBORN CENTER, SCHOLARSHIPS FOR PATIENTS TO REHABILITATION CAMPS, ACTIVITIES FOR PATIENTS, AND WELCOME PROGRAM BAGS FOR THE BREATHING INSTITUTE. MEETINGS ARE HELD AT WINDSOR GARDENS ON THE 3RD MONDAY OF THE MONTH, WITH THE EXCEPTION OF JULY AND DECEMBER, AT 9:30 AM. YOUNG PROFESSIONALS (2011) THE YOUNG PROFESSIONALS IS COMPOSED OF YOUNG PROFESSIONALS WHO GENEROUSLY GIVE THEIR TIME AND TALENTS AS IN-SERVICE VOLUNTEERS. THEIR MISSION IS TO PROVIDE SOCIAL OPPORTUNITIES FOR THIS KEY SEGMENT OF OUR VOLUNTEER POPULATION WHILE SUPPORTING AND HOSTING VARIOUS SPECIAL AND FUNDRAISING EVENTS. CHILDREN'S HOSPITAL COLORADO JUNIOR VOLUNTEER PROGRAM THE JUNIOR VOLUNTEER PROGRAM IS DESIGNED TO ENCOURAGE YOUTH TO GET INVOLVED WITH THEIR COMMUNITY BY PROVIDING VOLUNTEER SERVICES TO PATIENTS AND FAMILIES AT CHILDREN'S HOSPITAL COLORADO. THEY SUPPORT THE HOSPITAL BY WORKING IN A NUMBER OF DEPARTMENTS, AS WELL AS SUPPORTING FUNDRAISING ACTIVITIES. THE PROGRAM IS DESIGNED FOR TEENAGERS AGES 13-18. BOTH FULL-YEAR AND SUMMER VOLUNTEER OPPORTUNITIES ARE AVAILABLE. THE JUNIOR VOLUNTEER PROGRAM PROVIDES A GREAT OPPORTUNITY FOR THOSE THAT WISH TO PURSUE CAREERS IN THE MEDICAL FIELD. ALL PROSPECTIVE VOLUNTEERS MUST COMPLETE AN APPLICATION, INTERVIEW AND HEALTH SCREENING BEFORE BEGINNING VOLUNTEER WORK. JUNIOR VOLUNTEER ADVISORY COMMITTEE WITHIN THE JUNIOR VOLUNTEER PROGRAM THERE IS A COMMITTEE DESIGNED TO REPRESENT THE JUNIOR VOLUNTEERS AND PROVIDE LEADERSHIP OPPORTUNITIES. THE JUNIOR VOLUNTEER ADVISORY COMMITTEE PROMOTES AND RECOGNIZES EXCELLENT VOLUNTEERS WHO HAVE GONE ABOVE AND BEYOND CARE WITH THE ABC AWARD. THROUGHOUT THE YEAR THE COMMITTEE ORGANIZES VARIOUS ACTIVITIES FOR THE HOSPITAL. THE SIGNATURE PROJECT OF THE COMMITTEE IS THE CRAFT FAIR FANTASTICA. THIS ONE-WEEK CRAFT FAIR ENCOURAGES CREATIVITY AMONG PATIENTS AND THEIR SIBLINGS BY ALLOWING THEM THE CHANCE TO PARTICIPATE IN ARTS AND CRAFTS ACTIVITIES. AN ADDITIONAL SERVICE PROJECT THIS COMMITTEE ORGANIZES IS CAKE-A-PALOOZA. THIS EVENT OCCURS ONCE A MONTH, PROVIDING PATIENTS AND THEIR FAMILIES AN OPPORTUNITY FOR RELAXATION AND REFRESHMENT. SCHOLARSHIPS EACH YEAR THE JUNIOR VOLUNTEER PROGRAM PROVIDES TWO $2,500 SCHOLARSHIPS FOR OUTSTANDING JUNIOR VOLUNTEERS. THESE TWO JUNIOR VOLUNTEER RECOGNITION SCHOLARSHIPS ARE AWARDED TO EXCELLENT VOLUNTEERS; ONE FOR JUNIOR VOLUNTEERS PURSUING A DEGREE IN THE MEDICAL OR ALLIED HEALTH FIELDS AND ONE IN RECOGNITION OF OUTSTANDING COMMUNITY SERVICE AND CONTRIBUTIONS TO CHILDREN'S HOSPITAL COLORADO.
ADDITIONAL PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A WHEN IT WAS FOUNDED IN 1908 IN DENVER, CHILDREN'S HOSPITAL COLORADO SET OUT TO BE A LEADER IN PROVIDING THE BEST HEALTHCARE OUTCOMES FOR CHILDREN. THAT CALLING HAS CONSISTENTLY MADE US ONE OF THE TOP 10 CHILDREN'S HOSPITALS IN THE NATION AND A PLACE PARENTS ACROSS THE ROCKY MOUNTAIN REGION HAVE COME TO TRUST. AS A PRIVATE, NOT-FOR-PROFIT PEDIATRIC HEALTHCARE NETWORK, CHILDREN'S HOSPITAL COLORADO IS 100% DEDICATED TO CARING FOR KIDS AT ALL AGES AND STAGES OF GROWTH. WE HAVE MORE THAN 1,000 PEDIATRIC SPECIALISTS AND MORE THAN 3,000 FULL-TIME EMPLOYEES HELPING TO CARRY OUT OUR MISSION. WE PROVIDE COMPREHENSIVE PEDIATRIC CARE AT OUR MAIN CAMPUS AND AT OUR 15 REGIONAL LOCATIONS. ROUTINE INPATIENT SERVICES; ANCILLARY INPATIENT SERVICES SUCH AS LAB RADIOLOGY, OPERATING ROOM, RECOVERY ROOM, CENTRAL SUPPLIES, ETC.; OUTPATIENT SERVICES SUCH AS EMERGENCY ROOM, ORTHO CLINIC, ONCOLOGY CLINIC, ETC. EDUCATION CHILDREN'S HOSPITAL COLORADO IS COMMITTED TO PROVIDING CONTINUING EDUCATIONAL OPPORTUNITIES THAT WILL ENHANCE AND ADVANCE THE PEDIATRIC KNOWLEDGE AND CLINICAL SKILLS OF DOCTORS, NURSES AND OTHER HEALTHCARE PROFESSIONALS ACROSS THE REGION. THESE EDUCATIONAL TOPICS RANGE FROM PRIMARY CARE TO CRITICAL CARE AND ARE AVAILABLE IN-PERSON AND ONLINE. THIS IS OUR WAY OF ENSURING KIDS ACROSS THE REGION HAVE ACCESS TO UP-TO-DATE TECHNIQUES AND TREATMENT FOR KIDS. RESEARCH WE ARE AT THE FOREFRONT OF RESEARCH IN CHILDHOOD DISEASE WITH SEVERAL NATIONALLY AND INTERNATIONALLY RECOGNIZED MEDICAL AND SURGICAL PROGRAMS. TOGETHER, WITH OUR PARTNERS, WE ARE RESPONSIBLE FOR VIRTUALLY ALL OF THE PEDIATRIC RESEARCH PUBLISHED IN THE ROCKY MOUNTAIN REGION FOR AT LEAST A DECADE. WE ARE ALWAYS STRIVING TO FIND NEW AND BETTER WAYS TO CURE KIDS SO YOU CAN BE SURE YOU ARE RECEIVING THE BEST CARE FOR YOUR CHILD AT OUR FACILITIES. ADVOCACY OUR CLINICAL WORK MAY BE THE MOST VISIBLE PART OF OUR MISSION, BUT ADVOCACY IS JUST AS IMPORTANT. ADVOCACY IS HOW WE INFLUENCE DECISIONS RELATING TO CHILDREN'S HEALTH POLICY ISSUES, SUCH AS INJURY PREVENTION AND ACCESS TO QUALITY CARE. CHILDREN'S HOSPITAL COLORADO'S ADVOCACY EFFORTS EXPAND OUT INTO COMMUNITIES ACROSS COLORADO AND ARE AIMED AT MAKING SURE THAT KIDS' CONCERNS ARE ALWAYS HEARD WHEN PUBLIC POLICIES ARE MADE. FROM PROVIDING IMMUNIZATIONS AND CAR SEAT CHECKS, OUR GOAL IS TO HELP KEEP KIDS HEALTHY AND OUT OF THE HOSPITAL. WE ENVISION A WORLD WHERE NO CHILD NEEDS A HOSPITAL. UNTIL WE MAKE THAT HAPPEN, WE'RE HERE FOR YOUR KIDS.
SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS SINCE PRIOR FORM 990 WAS FILED FORM 990, PART VI, LINE 4 THE ARTICLES OF INCORPORATION AND BYLAWS WERE BOTH AMENDED AND RESTATED TO REFLECT CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM AS THE SOLE MEMBER OF CHILDREN'S HOSPITAL COLORADO.
DESCRIPTION OF CLASSES OF MEMBERS OF STOCKHOLDERS FORM 990, PART VI, LINE 6 CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM IS THE SOLE MEMBER OF CHILDREN'S HOSPITAL COLORADO.
GOVERNANCE DECISIONS REQUIRING APPROVAL FORM 990, PART VI, LINE 7B CHILDREN'S HOSPITAL COLORADO HEALTH SYSTEM AS THE SOLE MEMBER HAS CERTAIN APPROVAL POWERS AS DESCRIBED IN THE AMENDED AND RESTATED BYLAWS DATED SEPTEMBER 22, 2011.
PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990 FORM 990, PART VI, LINE 11B CHILDREN'S HOSPITAL COLORADO'S FINANCE DEPARTMENT WORKS CLOSELY WITH HUMAN RESOURCES, CORPORATE COMPLIANCE, LEGAL AND PUBLIC RELATIONS TO GATHER ALL OF THE DATA REQUIRED TO COMPLETE THE FORM 990. THE CONTROLLER CONDUCTS A REVIEW WITH THE CFO PRIOR TO THE DRAFT BEING DISTRIBUTED TO THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE MADE, THE FORM IS SIGNED BY THE CFO, AND A FINAL COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS VIA A SECURED WEBSITE.
PROCESS USED TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST FORM 990, PART VI, LINE 12C ALL EMPLOYEES AND BOARD MEMBERS MUST PROMPTLY PROVIDE A WRITTEN DESCRIPTION OF MATERIAL FACTS OF AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO CORPORATE COMPLIANCE AND/OR GENERAL COUNSEL ON THE APPROPRIATE DISCLOSURE FORM. SUCH DISCLOSURE WILL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF THE CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. POLICIES AND PROCEDURES FOR DISCLOSING CONFLICTS OF INTEREST ARE TO BE FOLLOWED ACCORDING TO THE INDIVIDUAL'S FUNCTION, IN COMPLIANCE WITH STATE AND FEDERAL REGULATIONS. COMPLETED DISCLOSURE FORMS ARE SUBJECT TO AUDIT REVIEW BY LEGAL, THE CORPORATE COMPLIANCE PROGRAM, AND THE AUDIT AND BUSINESS ETHICS COMMITTEE OF THE BOARD OF DIRECTORS. FAILURE TO COMPLY WITH CONFLICT OF INTEREST POLICIES MAY LEAD TO DISCIPLINARY ACTION UP TO AND INCLUDING TERMINATION OF EMPLOYMENT OR WORKING RELATIONSHIP WITH THE CHILDREN'S COLORADO. ONCE THE CONFLICT OF INTEREST COMMITTEE HAS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WITH RESPECT TO A PARTICULAR AGREEMENT/CONTRACT THEN: 1. THE COI COMMITTEE WILL EXERCISE DUE DILIGENCE TO DETERMINE WHETHER CHILDREN'S HOSPITAL COULD OBTAIN A MORE ADVANTAGEOUS AGREEMENT/CONTRACT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES AND, IF APPROPRIATE, WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT. 2. IN CONSIDERING WHETHER TO ENTER INTO THE PROPOSED AGREEMENT/CONTRACT, THE COI COMMITTEE MAY APPROVE SUCH CONTRACT, TRANSACTION OR ARRANGEMENT ONLY IF THE DISINTERESTED PERSON OR COMMITTEE DETERMINE BY A MAJORITY VOTE THAT: * THE PROPOSED CONTRACT, TRANSACTION OR ARRANGEMENT IN CHILDREN'S COLORADO BEST INTERESTS AND FOR COLORADO CHILDREN'S OWN BENEFIT; AND * THE PROPOSED TRANSACTION IS FAIR AND REASONABLE TO CHILDREN'S COLORADO, TAKING INTO ACCOUNT, AMONG OTHER RELEVANT FACTORS, WHETHER TCH COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES.
PROCESS FOR DETERMINING COMPENSATION OF TOP OFFICIAL, OFFICERS, & KEY EMP FORM 990, PART VI, LINES 15A AND 15B CHILDREN'S COLORADO HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWS AND APPROVES ANY PROPOSED INCREASES RELATED TO ANY OFFICERS AND KEY EMPLOYEES OF THE COMPANY. THE CEO'S COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE ALONG WITH THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS EACH YEAR. ONCE A CHANGE IN COMPENSATION IS APPROVED FORMAL DOCUMENTS ARE COMPLETED, SIGNED AND FORWARDED TO THE HUMAN RESOURCE DEPARTMENT FOR IMPLEMENTATION. HUMAN RESOURCES RETAIN ALL DOCUMENTATION AS TO HOW THE COMPENSATION WAS DETERMINED AND APPROVED IN THE INDIVIDUAL'S PERSONNEL FILE. EXECUTIVE COMPENSATION IS FOCUSED ON TOTAL REMUNERATION: -- TOTAL CASH COMPENSATION IS TARGETED AROUND THE 50TH PERCENTILE OF THE MARKET o REVIEW MARKET RATIO - SHOULD FALL BETWEEN 80% TO 120% OF MARKET o REVIEW 25TH, 50TH, AND 75TH PERCENTILE -- BASE SALARY - INDIVIDUAL QUALIFICATIONS AND PERFORMANCE DETERMINES MARKET POSITION -- VARIABLE PAY -LEADERSHIP INCENTIVE IS IN PLACE WHICH REWARDS FOR ORGANIZATIONAL PERFORMANCE WITH A SMALL COMPONENT ALSO BASED ON DIVISION PERFORMANCE o AWARDS ARE BASED ON ACHIEVEMENT OF PRE-ESTABLISHED COLORADO CHILDREN'S GOALS WHICH SUPPORT THE STRATEGIC PLAN -- BENEFITS - TARGETED AT THE "MIDDLE OF MARKET" DECISION FACTORS IN EXECUTIVE COMPENSATION DECISIONS: -- MARKET DATA FROM INDEPENDENT COMPENSATION SURVEYS THAT REFLECT FUNCTIONALLY COMPARABLE POSITIONS IN ORGANIZATIONS OF SIMILAR SIZE AND SCOPE -- DIFFICULTIES IN RECRUITING AND RETAINING EXECUTIVES -- SKILLS, EXPERIENCE AND PERFORMANCE HISTORY OF INDIVIDUAL EXECUTIVES -- CRITICAL BUSINESS OR STRATEGIC ISSUES THAT THE ORGANIZATION MAY FACE o WHEN ASSESSING EXECUTIVE COMPENSATION, CHILDREN'S COLORADO CONSIDERS BOTH MARKET RATIO AND THE POSITION OF AN EXECUTIVE'S PAY RELATIVE TO COMPETITIVE MARKET PERCENTILES. CHILDREN'S COLORADO WILL RARELY PAY ABOVE THE 75TH PERCENTILE OF THE MARKET REGARDLESS OF MARKET RATIO. 2011 MARKET ANALYSIS O CONDUCTED BY INTEGRATED HEALTHCARE STRATEGIES O UTILIZED APPROVED PEER GROUP FROM MARCH 2010 MEETING OF THE EXECUTIVE COMPENSATION COMMITTEE O ON POSITIONS WITH INSUFFICIENT DATA (LESS THAN 6 MATCHES) -- USED EXPANDED PEER GROUP OF 22 PEDIATRIC HOSPITALS IF PEER GROUP DATA WAS INSUFFICIENT O BENCHMARKED BASE PAY, TOTAL CASH COMPENSATION, AND BENEFITS 2011 CUSTOM PEER GROUP O ATLANTA O BOSTON O CHICAGO O CINCINNATI O COLUMBUS O DALLAS O HOUSTON O LOS ANGELES O MIAMI O MILWAUKEE O MINNEAPOLIS O PALO ALTO O PHILADELPHIA O SEATTLE O WASHINGTON D.C.
AVAILABILITY OF CERTAIN DOCUMENTS FORM 990, PART VI, LINE 19 THESE DOCUMENTS ARE MADE AVAILABLE UPON REASONABLE REQUEST.
HOURS DEVOTED TO RELATED ORGANIZATIONS FORM 990, PART VII JAMES E. SHMERLING IS EMPLOYED AND COMPENSATED BY CHILDREN'S COLORADO. HE WORKS 39 HOURS PER WEEK FOR CHILDREN'S COLORADO AND 1 HOUR PER WEEK FOR CHILDREN'S HEALTH CORPORATION, A RELATED TAX-EXEMPT ORGANIZATION. JENA HAUSMANN IS EMPLOYED AND COMPENSATED BY CHILDREN'S COLORADO. SHE WORKS 39 HOURS PER WEEK FOR CHILDREN'S COLORADO AND 1 HOUR PER WEEK FOR CHILDREN'S HEALTH CORPORATION, A RELATED TAX-EXEMPT ORGANIZATION. LEONARD J. DRYER, JR. IS EMPLOYED AND COMPENSATED BY CHILDREN'S COLORADO HE WORKS 39 HOURS PER WEEK FOR CHILDREN'S COLORADO AND 1 HOUR PER WEEK FOR CHILDREN'S HEALTH CORPORATION, A RELATED TAX-EXEMPT ORGANIZATION.
RECONCILIATION OF NET ASSETS FORM 990, PART XI UNREALIZED GAIN ON INVESTMENTS $(14,233,927) REVENUE REPORTED ON OTHER TAX-RETURN 5,668,248 CHANGE IN VALUE OF INTEREST RATE SWAP (28,582,934) EXPENSES REPORTED ON SEPARATE COMPANY TAX RETURN (8,570,451) OTHER CHANGE IN UNRESTRICTED NET ASSETS (10,687,000) CHANGE IN RESTRICTED NET ASSETS (609,000) CHANGE IN PERMANENTLY RESTRICTED NET ASSETS 9,521,000 CUMULATIVE EFFECT OF CHANGE IN ACCOUNTING PRINCIPLE (646,963) ------------ TOTAL $(48,141,027) ============
SCHEDULE K, PART I, COLUMN F DESCRIPTION OF PURPOSES OF BONDS HOSPITAL REVENUE REFUNDING BONDS SERIES 2008 - THE PURPOSE OF THIS BOND ISSUE IS TO REFUND BONDS THAT WERE PREVIOUSLY ISSUED ON 1/22/04 AND 4/7/08. THE REMAINING WEIGHTED AVERAGE MATURITY OF THE BONDS CURRENTLY REFUNDED WAS 11.8929 YEARS. HOSPITAL REVENUE REFUNDING BONDS SERIES 2008C - THE PURPOSE OF THIS BOND ISSUE IS TO REFUND BONDS THAT WERE PREVIOUSLY ISSUED ON 1/22/04. THE REMAINING WEIGHTED AVERAGE MATURITY OF THE BONDS CURRENTLY REFUNDED WAS 14.5966 YEARS. HOSPITAL REVENUE BONDS SERIES 2010A - THE PURPOSE OF THIS BOND ISSUE IS TO PAY FOR THE CONSTRUCTION OF A NEW TEN-STORY ADDITION TO THE EXISTING FACILITY, EQUIPMENT FOR THAT ADDITION, AND EXPANSION OF AN EXISTING PARKING GARAGE. THE WEIGHTED AVERAGE MATURITY OF THE BONDS IS 29.1602 YEARS.
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


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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
CHILDREN'S HOSPITAL COLORADO
 
Employer identification number

84-0166760
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) CHILDREN'S HOSPITAL COLORADO HLTH SYSTEM

13123 EAST 16TH AVENUE

AURORA,CO80045
 HEALTHCARE CO 501(C)(3) 7 NA
 
 
No
(2) CHILDREN'S HEALTH CORPORATION

13123 EAST 16TH AVENUE

AURORA,CO80045
74-2235572 		SUPPORTING CO 501(C)(3) 11, TYPE I CH-COLORADO
 
Yes
 
(3) CHILD HEALTH MANAGEMENT SERVICES INC

13123 EAST 16TH AVENUE

AURORA,CO80045
74-2266667 		IT SERVICE CO 501(C)(3) 3 CH-COLORADO
 
Yes
 
(4) THE CHILDREN'S HOSPITAL FOUNDATION

13123 EAST 16TH AVENUE

AURORA,CO80045
84-0813462 		FOUNDATION CO 501(C)(3) 7 CHCHS
 
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) CHILDREN'S NORTH SURGERY CENTER LLC

13123 E 16TH AVE
AURORA,CO80045
26-2394578 		OUTPATIENT SURG CO NA
  		RELATED -1,473,392 -1,488,753   No 0   No 73.000 %












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) RMCHS MANAGEMENT SERVICES
13123 E 16TH AVE
AURORA,CO80045
84-0957415 		BILLING CO NA
  		C CORP 5,668,248 115,488 100.000 %












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
Yes
 
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
Yes
 
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
Yes
 
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
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
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) CHILDRENS NORTH SURGERY CENTER LLC

 B 465,000 SEE PART VII
(2) CHILDRENS NORTH SURGERY CENTER LLC

 D 5,450,000 SEE PART VII
(3) CHILDRENS NORTH SURGERY CENTER LLC

 A, I 501,706 SEE PART VII
(4) THE CHILDRENS HOSPITAL FOUNDATION

 C 16,252,350 SEE PART VII
(5) RMCHS MANAGEMENT SERVICES

 L 5,668,248 SEE PART VII
(6) RMCHS MANAGEMENT SERVICES

 M 2,384,197 SEE PART VII
(7) RMCHS MANAGEMENT SERVICES

 N 6,186,254 SEE PART VII
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
METHOD USED TO DETERMINE AMOUNTS OF TRANSACTIONS WITH CONTROLLED ENTITIES SCHEDULE R, PART V, LINE 2 THE AMOUNTS REPORTED ON LINES 2(1), 2(3), 2(4), 2(5), 2(6) AND 2(7) OF SCHEDULE R, PART V ARE THE ACTUAL AMOUNTS REPORTED ON COLORADO CHILDREN'S FINANCIAL STATEMENTS. THE AMOUNT REPORTED ON LINE 2(2) IS THE MAXIMUM AMOUNT OF THE LOAN GUARANTEED BY COLORADO CHILDREN'S.
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