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

MediumBullet The organization may have to use a copy of this return to satisfy state reporting requirements.
OMB No. 1545-0047
2010
Open to Public Inspection
A For the calendar year, or tax year beginning 10-01-2010 and ending 09-30-2011
BCheck if applicable:
CName of organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
9300 VALLEY CHILDRENS PLACE
 
Room/suite
City or town, state or country, and ZIP + 4
MADERA, CA936368761
D Employer identification number

94-1294954
E Telephone number

G Gross receipts $ 754,060,739
F Name and address of principal officer:
MICHELE WALDRON
9300 VALLEY CHILDRENS PLACE
MADERA,CA936368761
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHILDRENSCENTRALCAL.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: 1949
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) .... 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) .... 4 11
5 Total number of individuals employed in calendar year 2010 (Part V, line 2a) ... 5 2,918
6 Total number of volunteers (estimate if necessary) .... 6 528
7a Total unrelated business revenue from Part VIII, column (C), line 12 .. 7a 1,001,231
b Net unrelated business taxable income from Form 990-T, line 34 .. 7b 0
Revenues; Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 23,867,645 21,770,337
9 Program service revenue (Part VIII, line 2g) ......... 343,754,551 479,173,553
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 6,102,417 4,857,119
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 8,319,875 7,470,362
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 382,044,488 513,271,371
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 239,584 265,040
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) 211,444,448 221,933,180
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).... 128,644,288 170,720,632
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 340,328,320 392,918,852
19 Revenue less expenses. Subtract line 18 from line 12...... 41,716,168 120,352,519
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............ 551,109,623 697,990,469
21 Total liabilities (Part X, line 26)............ 247,720,377 309,774,983
22 Net assets or fund balances. Subtract line 21 from line 20 ..... 303,389,246 388,215,486
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title.
Paid Preparer's Use Only Preparer's
signatureBig Right Arrow 		Date
right pointing bullet image Preparer’s taxpayer identification number
(see instructions)
Firm’s name (or yours
if self-employed),
address, and ZIP + 4Big Right Arrow




 		EIN right pointing bullet image
Phone no. right pointing bullet image
May the IRS discuss this return with the preparer shown above? (see instructions) .........
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2010)
Form 990 (2010)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response to any question in this Part III . . . . . . . . . .
1
Briefly describe the organization’s mission: TO PROVIDE HIGH QUALITY COMPREHENSIVE HEALTHCARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ....................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ..........................
If “Yes,” describe these changes on Schedule O.
4
Describe the exempt purpose achievements for each of the organization’s three largest program services by expenses.
Section 501(c)(3) and 501(c)(4) organizations and section 4947(a)(1) trusts are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 29,317,109 including grants of $ 265,040 ) (Revenue $ 162,588,250 )
SEE SCHEDULE O
4b (Code:   ) (Expenses $ 273,102,463 including grants of $ 0 ) (Revenue $ 316,585,303 )
SEE SCHEDULE O
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$ 302,419,572
Form 990 (2010)
Form 990 (2010)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If “Yes,” complete Schedule AClick to see attachment.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? Click to see attachment........
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If “Yes,” complete Schedule C, Part IClick to see attachment..........
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities? If “Yes,” complete Schedule C,
Part IIClick to see attachment.........................
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C, Part IIIClick to see attachment........................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts where donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete
Schedule D, Part IClick to see attachment.......................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,”
complete Schedule D, Part IVClick to see attachment...................
9
 
No
10
Did the organization, directly or through a related organization, hold assets in term, permanent,or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment
10
 
No
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
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part X.Click to see attachment
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If “Yes,” complete Schedule D, Part X.Click to see attachment
11f
 
No
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If “Yes,” complete Schedule D, Parts XI, XII, and XIII Click to see attachment
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If “Yes,” and if the organization answered ‘No’ to line 12a, then completing Schedule D, Parts XI, XII, and XIII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, and program service activities outside the United States? If “Yes,” complete Schedule F, Part I.........
14b
 
No
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or assistance to any organization or entity located outside the U.S.? If “Yes,” complete Schedule F, Part II..
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or assistance to individuals located outside the U.S.? If “Yes,” complete Schedule F, Part III..
16
 
No
17
Did the organization report a total of more than $15,000, of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If “Yes,” complete Schedule G, Part I
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II..........
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
Form 990 (2010)
Form 990 (2010)
Page 4
Part IV
Checklist of Required Schedules (continued)
20a
Did the organization operate one or more hospitals? If “Yes,” complete Schedule H..... Click to see attachment
20a
Yes
 
b
Did the organization attach its audited financial statement to this return? Note: All Form 990 filers that operate one or more hospitals must attach audited financial statements. ..... Click to see attachment
20b
Yes
 
21
Did the organization report more than $5,000 of grants and other assistance to governments and organizations in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.. Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants and other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III..... Click to see attachment
22
Yes
 
23
Did the organization answer “Yes” to Part VII, Section A, questions 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If “Yes,” complete Schedule J................ Click to see attachment
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer questions 24b–24d and complete Schedule K. If “No,” go to line 25................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
 
No
d
Did the organization act as an “on behalf of” issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3) and 501(c)(4) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If “Yes,” complete Schedule L, Part I...... Click to see attachment
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If “Yes,” complete Schedule L, Part I................ Click to see attachment
25b
 
No
26
Was a loan to or by a current or former officer, director, trustee, key employee, highly compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II........................... Click to see attachment
26
 
No
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor, or a grant selection committee member, or to a person related to such an individual? If “Yes,” complete Schedule L, Part III............... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties? (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV ......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or owner? If “Yes,” complete Schedule L, Part IV.. Click to see attachment
28c
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule MClick to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M............ Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I........................... Click to see attachment
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II.......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Parts II, III, IV, and V, line 1..................... Click to see attachment
34
Yes
 
35
Is any related organization a controlled entity within the meaning of section 512(b)(13)? .....
35
Yes
 
a
Did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2... Click to see attachment
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If “Yes,” complete Schedule R, Part V, line 2........... Click to see attachment
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If “Yes,” complete Schedule R, Part VIClick to see attachment
37
 
No
38
Did the organization complete Schedule O and provide explanations in Schedule O for Part VI, lines 11 and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2010)
Form 990 (2010)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response to any question in this Part V . . . . . . . . . .
Yes
No
1a
Enter the number reported in Box 3 of Form 1096. Enter -0- if not applicable. .......
1a
253
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
2,918
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 (2010)
Form 990 (2010)
Page 6
Part VI
Governance, Management, and Disclosure For each “Yes” response to lines 2 through 7b below, and for a “No” response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response to any question in this Part VI . . . . . . . . . .
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year ..............
1a
15
b
Enter the number of voting members included in line 1a, above, who are independent .................
1b
11
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
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? ..
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed?
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Does the organization have members or stockholders? ................
6
 
No
7a
Does the organization have members, stockholders, or other persons who may elect one or more members of the governing body? .........................
7a
 
No
b
Are any decisions of the governing body subject to approval by members, stockholders, or other persons? ..
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O .....
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal
Revenue Code.)
Yes
No
10a
Does the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” does the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with those of the organization? ....
10b
 
 
11a
Has the organization provided a copy of this Form 990 to all members of its governing body before filing the form?
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review the Form 990. .....
12a
Does the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Are officers, directors or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ...........................
12b
Yes
 
c
Does the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this is done ....................
12c
Yes
 
13
Does the organization have a written whistleblower policy? ...............
13
Yes
 
14
Does the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line a or b, describe the process in Schedule O. (See instructions.)
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” has the organization adopted a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and taken steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you make these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization makes its governing documents, conflict of interest policy, and financial statements available to the public.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization: MediumBullet
MICHELE WALDRON CFO
9300 VALLEY CHILDRENS PLACE
MADERA,CA93636
(559) 353-3000
Form 990 (2010)
Form 990 (2010)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response to any question in this Part VII . . . . . . . . . .
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation, and current key employees. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

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

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

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

List persons in the following order: individual trustees or directors; institutional trustees; officers; key employees; highest
compensated employees; and former such persons.
Check this box if neither the organization nor any related organizations compensated any current or former officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) GORDON ALEXANDER
FORMER CEO, TERMED 11/13/11
 34.00 X   X       421,879 0 25,128
(2) BRUCE ALBRIGHT
BOARD MEMBER
 1.00 X           0 0 0
(3) SUSAN BOYD TERM ENDED
FORMER FDN CHAIR, EFFECT. 12/31/10
 1.00 X           0 0 0
(4) GREG COLEMAN
FORMER BOARD CHAIRMAN
 1.00 X   X       0 0 0
(5) DR LINDA FRALEY
BOARD MEMBER
 1.00 X           0 0 0
(6) RICHARD SHEHADEY
FOUNDATION CHAIRMAN OF BOARD
 1.00 X           0 0 0
(7) STEPHANIE HOULDING
GUILD COORDINATING COUNCIL CHAIR
 1.00 X           0 0 0
(8) DR GRACIE ESQUIVEL-AGUILAR RESIG
FORMER BOARD MEMB., EFFECT. 12/31/10
 1.00 X           0 0 0
(9) DR DEVONNA KAJI
CHIEF OF STAFF
 1.00 X           68,333 0 0
(10) DENNIS KELLER RESIGNED
FORMER BOARD MEMB., EFFECT. 12/31/10
 1.00 X           0 0 0
(11) DAVID KRAUSE
BOARD VICE CHAIRMAN
 1.00 X   X       0 0 0
(12) DR ROBERT KUBO
BOARD MEMBER
 1.00 X           0 0 0
(13) MENDY LAVAL
BOARD SECRETARY
 1.00 X   X       0 0 0
(14) JEFF MAYER
BOARD CHAIRMAN
 1.00 X   X       0 0 0
(15) DAVE OLSON
BOARD MEMBER
 1.00 X           0 0 0
(16) PAT RICCHIUTI
BOARD MEMBER
 1.00 X           0 0 0
(17) DR CHARLES SMITH
BOARD MEMBER
 1.00 X           0 0 0
Form 990 (2010)
Form 990 (2010)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(A)
Name and Title 		(B)
Average hours per week (describe hours for related organizations in Schedule O) 		(C)
Position (check all that apply) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) BILL SMITTCAMP
BOARD MEMBER
 1.00 X           0 0 0
(19) MICHELE R WALDRON
CFO
 38.00     X       438,660 0 187,363
(20) TODD SUNTRAPAK
COO
 40.00     X       434,960 0 169,094
(21) DAVID CHRISTENSEN
VP, MEDICAL AFFAIRS & CMO
 40.00       X     432,851 0 56,000
(22) BEVERLY HAYDEN-PUGH
VP, CHIEF NURSING OFFICER
 40.00       X     326,887 0 148,161
(23) JESSIE HUDGINS
VP, FACILITIES
 40.00       X     302,991 0 159,908
(24) MARTA BOYER
FORMER VP, HR, TERMED 5/4/12
 40.00       X     302,909 0 164,887
(25) JANE WILLSON
VP, CORPORATE DEVELOPMENT
 40.00       X     300,410 0 133,330
(26) DAVID SINGH
VP, REVENUE CYCLE MANAGEMENT
 40.00       X     272,926 0 21,440
(27) RICK WOLF
VP, GENERAL COUNCIL, EFFECT. 5/29/11
 40.00       X     257,484 0 61,136
(28) WILLIAM F HAUG
STRATEGIC ADVISOR
 40.00         X   726,523 0 81,181
(29) RANDALL GUERRERO
EXECUTIVE DIRECTOR, CRITICAL CARE
 40.00         X   228,589 0 25,818
(30) STEPHANIE VANCE
EXECUTIVE DIRECTOR, FINANCE
 40.00         X   231,149 0 26,133
(31) JEFFREY LEFORS
EXECUTIVE DIRECTOR, PROF SRVCS
 40.00         X   224,352 0 18,848
(32) KAMELA LOO
CHARGE NURSE
 40.00         X   232,294 0 32,589
(33) MARK ZIELAZINSKI
FORMER VP AND CIO, TERMED 3/19/10
 40.00           X 101,459 0 14,678
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 5,304,656 0 1,325,694
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 in reportable compensation from the organizationMediumBullet391
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual .............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person .....
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
SPECIALTY MEDICAL GROUP
9300 VALLEY CHILDRENS PLACE
MADERA,CA93636 		SUBSPEC PHYSICIAN SERVICES 10,315,363
PEDIATRIC ANETHESIA ASSOCIATION
6235 N FRESNO ST STE 103
FRESNO,CA93710 		ANETHESIA/CRITICAL CARE 7,177,200
CROTHALL HEALTHCARE INC
1654 MARTHALER LANE
WEST ST PAUL,MN55118 		HOUSEKEEPING SERVICES 3,865,967
MEDQUIST INC
PO BOX 102467
ATLANTA,GA30368 		TRANSCRIPTION SERVICES 1,464,587
EMERGENCY PHYSICIANS MEDICAL
3300 DOUGLAS BOULEVARD 200
ROSEVILLE,CA95661 		EMERGENCY PHYSICIAN SERVICES 1,263,772
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization MediumBullet60
Form 990 (2010)
Form 990 (2010)
Page 9
Part VIII
Statement of Revenue
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, gifts, grants and other similar amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 6,980,041
e Government grants (contributions)1e 14,289,786
f All other contributions, gifts, grants, and
similar amounts not included above1f 		500,510
g Noncash contributions included in lines 1a-1f:$ 162,795
h Total. Add lines 1a-1f.......MediumBullet 21,770,337
Program Service Revenue Business Code
2a PATIENT SERVICES 900,099 478,947,640 478,947,640    
b OUTSIDE LAB SERVICES 900,099 225,913 225,913    
c
d
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 479,173,553
Other Revenue 3 Investment income (including dividends, interest
and other similar amounts).....MediumBullet 5,801,727     5,801,727
4 Income from investment of tax-exempt bond proceeds..MediumBullet 863,009     863,009
5 Royalties............MediumBullet        
(i) Real (ii) Personal
6a Gross Rents 115,382  
b Less: rental expenses 78,093  
c Rental income or (loss) 37,289  
d Net rental income or (loss).......MediumBullet 37,289     37,289
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 238,575,447 80,777
b Less: cost or other basis and sales expenses 240,430,518 33,323
c Gain or (loss) -1,855,071 47,454
d Net gain or (loss)..........MediumBullet -1,807,617     -1,807,617
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      
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        
10a Gross sales of inventory, less
returns and allowances .
a 563,046
b Less: cost of goods sold ..b 247,434
c Net income or (loss) from sales of inventory..MediumBullet 315,612     315,612
Miscellaneous Revenue Business Code
11a CAFETERIA REVENUE 900,099 2,648,218     2,648,218
b MANAGEMENT SERVICES 541,610 1,001,231   1,001,231  
c            
d All other revenue .... 3,468,012     3,468,012
e Total. Add lines 11a–11d ......MediumBullet 7,117,461
12 Total revenue. See Instructions....MediumBullet 513,271,371 479,173,553 1,001,231 11,326,250
Form 990 (2010)
Form 990 (2010)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A) but are not required to complete columns (B), (C), and (D).
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21 70,601 70,601
2 Grants and other assistance to individuals in the U.S. See Part IV, line 22 194,439 194,439
3 Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 5,582,713   5,582,713  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 416,322   416,322  
7 Other salaries and wages 151,310,490 119,506,393 31,804,097  
8 Pension plan contributions (include section 401(k) and section 403(b) employer contributions) .... 7,660,113 7,052,646 607,467  
9 Other employee benefits ....... 44,286,855 33,271,979 11,014,876  
10 Payroll taxes ........... 12,676,687 9,466,060 3,210,627  
11 Fees for services (non-employees):        
a Management ...... 2,337,794 81,494 2,256,300  
b Legal ......... 666,712   666,712  
c Accounting ........... 124,425   124,425  
d Lobbying ...........        
e Professional fundraising. See Part IV, line 17..    
f Investment management fees ...... 1,038,313   1,038,313  
g Other .......... 26,195,787 25,739,624 456,163  
12 Advertising and promotion .... 514,084 514,084    
13 Office expenses ....... 45,247,471 38,964,639 6,282,832  
14 Information technology ...... 2,792,056   2,792,056  
15 Royalties ..        
16 Occupancy ........... 5,067,354 3,479,159 1,588,195  
17 Travel ............ 430,389 188,339 242,050  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 196,953 34,403 162,550  
20 Interest ........... 8,204,504 6,287,752 1,916,752  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 17,378,557 10,631,835 6,746,722  
23 Insurance .............. 3,567,117 81,490 3,485,627  
24 Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a HOSPITAL FEE PROGRAM 31,297,533 31,297,533    
b PURCHASED SERVICES 17,587,433 10,204,587 7,382,846  
c BAD DEBT 4,936,280 4,936,280    
d DUES 1,069,523 89,945 979,578  
e RECRUITMENT 416,715 208,358 208,357  
f All other expenses 1,651,632 117,932 1,533,700  
25 Total functional expenses. Add lines 1 through 24f 392,918,852 302,419,572 90,499,280 0
26 Joint costs. Check here MediumBullet if following
SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation 		       
Form 990 (2010)
Form 990 (2010)
Page 11
Part X Balance Sheet
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing .......... 13,958 1 12,928
2 Savings and temporary cash investments ....... 66,636,227 2 83,116,020
3 Pledges and grants receivable, net ......... 443,362 3 580,092
4 Accounts receivable, net ......... 47,075,250 4 48,997,977
5 Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..........   5  
6 Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
Schedule L ..........   6  
7 Notes and loans receivable, net .............   7  
8 Inventories for sale or use .............. 4,398,129 8 4,865,891
9 Prepaid expenses and deferred charges ............ 4,210,879 9 12,358,917
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 395,479,286
b Less: accumulated depreciation. ..... 10b 148,234,420 234,118,257 10c 247,244,866
11 Investments—publicly traded securities .......... 82,642,915 11 135,169,007
12 Investments—other securities. See Part IV, line 11 ...... 90,980,874 12 148,422,858
13 Investments—program-related. See Part IV, line 11 .. 868,246 13 998,628
14 Intangible assets .........   14  
15 Other assets. See Part IV, line 11 ........... 19,721,526 15 16,223,285
16 Total assets. Add lines 1 through 15 (must equal line 34)... 551,109,623 16 697,990,469
Liabilities 17 Accounts payable and accrued expenses . 33,468,678 17 82,493,887
18 Grants payable ..........   18  
19 Deferred revenue ..........   19  
20 Tax-exempt bond liabilities .......... 163,930,551 20 159,874,416
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
22 Payables to current and former officers, directors, trustees, key
employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities. Complete Part X of Schedule D..... 50,321,148 25 67,406,680
26 Total liabilities. Add lines 17 through 25..... 247,720,377 26 309,774,983
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 ..... 298,209,989 27 383,617,976
28 Temporarily restricted net assets ..... 5,179,257 28 4,597,510
29 Permanently restricted net assets .....   29  
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 ..... 303,389,246 33 388,215,486
34 Total liabilities and net assets/fund balances ..... 551,109,623 34 697,990,469
Form 990 (2010)
Form 990 (2010)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response to any question in this Part XI . . . . . . . . . .
1
Total revenue (must equal Part VIII, column (A), line 12) . . .
1
513,271,371
2
Total expenses (must equal Part IX, column (A), line 25) . . . . .
2
392,918,852
3
Revenue less expenses. Subtract line 2 from line 1 . . . .
3
120,352,519
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) . .
4
303,389,246
5
Other changes in net assets or fund balances (explain in Schedule O) . . . .
5
-35,526,279
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
388,215,486
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response to any question in this Part XII . . . . . . . . . .
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?..
2a
 
No
b
Were the organization’s financial statements audited by an independent accountant?........
2b
Yes
 
c
If “Yes,” to 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O............................
2c
Yes
 
d
If “Yes” to line 2a or 2b, check a box below to indicate whether the financial statements for the year were issued on a separate basis, consolidated basis, or both:
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? ................
3a
 
No
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits. ..
3b
 
 
Form 990 (2010)
Additional Data


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

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

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

94-1294954
Part I
Reason for Public Charity Status (All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
f
g
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization? ................
11g(i)
 
 
(ii) a family member of a person described in (i) above? ......................
11g(ii)
 
 
(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................
11g(iii)
 
 
h
(i)
Name of supported organization 		(ii)
EIN 		(iii)
Type of organization (described on lines 1- 9 above or IRC section (see instructions)) 		(iv)
Is the organization in col. (i) listed in your governing document? 		(v)
Did you notify the organization in col. (i) of your support? 		(vi)
Is the organization in col. (i) organized in the U.S.? 		(vii)
Amount of support?
Yes No Yes No Yes No
Total                  

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

Additional Data


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

94-1294954
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




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

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part I
Name of organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
  		Employer identification number

94-1294954
Part I
Contributors (see Instructions)
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Aggregate contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

     
 
   

$  




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

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part II
Name of organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
  		Employer identification number

94-1294954
Part II
Noncash Property (see Instructions)
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)
Page 1 of 1 of Part III
Name of organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
  		Employer identification number

94-1294954
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet $  
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b)
Purpose of gift		 (c)
Use of gift		 (d)
Description of how gift is held
 
(e)
Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data


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

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

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

94-1294954
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










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

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

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


Schedule C (Form 990 or 990-EZ) 2010
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
(a)
Yes
No
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
Yes
 
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
Yes
 
0
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
Yes
 
72,040
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
13,794
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? If "Yes," describe in Part IV ..........................
 
No
 
j
Total. lines 1c through 1i ...................................
85,834
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ...........................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2010

Additional Data


Software ID:  
Software Version:  

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

94-1294954
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .......    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) ...    
4 Aggregate value at end of year .......    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06 ........ 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................
9
In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 52283D
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.
5
During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........
Part IV
Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
b
If "Yes," explain the arrangement in Part XIV and complete the following table:
Amount
c Beginning balance ................................. 1c  
d Additions during the year .............................. 1d  
e Distributions during the year ............................. 1e  
f Ending balance ................................... 1f  
2a
Did the organization include an amount on Form 990, Part X, line 21? .....................
b
If “Yes,” explain the arrangement in Part XIV.
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current Year (b)Prior Year (c)Two Years Back (d)Three Years Back (e)Four Years Back
1a Beginning of year balance ....      
b Contributions ........      
c Investment earnings or losses ...      
d Grants or scholarships .....      
e Other expenditures for facilities
and programs ........ 		     
f Administrative expenses ....      
g End of year balance ......      
2
Provide the estimated percentage of the year end balance held as:
a
Board designated or quasi-endowment: SchDMd Bullet  
b
Permanent endowment: SchDMd Bullet  
c
Term endowment: SchDMd Bullet  
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)
 
 
(ii) related organizations ........................
3a(ii)
 
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIV the intended uses of the organization's endowment funds.
Part VI
Investments—Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of investment (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   2,188,788 2,188,788
b Buildings ................   247,313,756 56,817,826 190,495,930
c Leasehold improvements ............   2,299,393 1,929,669 369,724
d Equipment ................   119,737,341 76,092,801 43,644,540
e Other .................   23,940,008 13,394,124 10,545,884
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........SchDMdBullet 247,244,866
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
(3)Other
(A) LIMITED PARTNERSHIPS 		148,422,858 F








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)Small Bullet 148,422,858
Part VIII
Investments—Program Related. See Form 990, Part X, line 13.
(a) Description of investment type (b) Book value (c) Method of valuation:
Cost or end-of-year market value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of Liability (b) Amount
Federal Income Taxes  
MALPRACTICE RESERVE 2,076,000
ACCRUED PENSION LIABILITY 59,698,478
457 LIABILITY 1,731,972
SB 1732 LIABILITY 1,070,045
OTHER 44,444
CONSTRUCTION RETAINS ACCOUNT 2,785,741



Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)Small Bullet 67,406,680
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).
Schedule D (Form 990) 2010

Schedule D (Form 990) 2010
Page 4
Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1 Total revenue (Form 990, Part VIII, column (A), line 12) .................... 1  
2 Total expenses (Form 990, Part IX, column (A), line 25) ..................... 2  
3 Excess or (deficit) for the year. Subtract line 2 from line 1 ............. 3  
4 Net unrealized gains (losses) on investments .......................... 4  
5 Donated services and use of facilities ............................. 5  
6 Investment expenses ................................... 6  
7 Prior period adjustments .................................. 7  
8 Other (Describe in Part XIV) ................................. 8  
9 Total adjustments (net). Add lines 4 - 8 ............................. 9  
10 Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 ......... 10  
Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1 Total revenue, gains, and other support per audited financial statements ....... 1  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains on investments .......... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIV): ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ...... 5  
Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1 Total expenses and losses per audited financial statements ............. 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities .......... 2a  
b Prior year adjustments .............. 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIV): ............ 2d  
e Add lines 2a through 2d...................... 2e  
3 Subtract line 2e from line 1..................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIV): ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ...... 5  
Part XIV
Supplemental Information
Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D (Form 990) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet Attach to Form 990. MediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
 
Employer identification number

94-1294954
Part I
Charity Care and Certain Other Community Benefits at Cost
Yes
No
1a
Does the organization have a charity care policy? If "No," skip to question 6a...........
1a
Yes
 
b
If "Yes," is it a written policy? .......................
1b
Yes
 
2
If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.
3
Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.
a
Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low
income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If
"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....
3b
Yes
 
c
If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.
4
Does the organization's policy provide free or discounted care to the "medically indigent"? ......
4
Yes
 
5a
Does the organization budget amounts for free or discounted care provided under its charity care policy? ...
5a
 
No
b
If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........
5b
 
 
c
If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............
5c
 
 
6a
Does the organization prepare an annual community benefit report?.............
6a
Yes
 
6b
If "Yes," does the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Charity Care and Certain Other Community Benefits at Cost
Charity Care and
Means-Tested Government Programs		 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Charity care at cost (from
Worksheets 1 and 2) .. 		    11,000   11,000 0 %
b Unreimbursed Medicaid (from
Worksheet 3, column a) . 		    273,102,463 316,585,302 -43,482,839 0 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....     6,998,678 4,238,110 2,760,568 0.710 %
dTotal Charity Care and
Means-Tested Government Programs ..... 		    280,112,141 320,823,412 -40,711,271 0.710 %
Other Benefits
e Community health improvement
services and community
benefit operations (from
(Worksheet 4) .... 		    484,530   484,530 0.120 %
f Health professions education
(from Worksheet 5) .. 		    2,782,197 633,482 2,148,715 0.550 %
g Subsidized health services
(from Worksheet 6) .. 		           
h Research (from Worksheet 7)            
i Cash and in-kind contributions
to community groups
(from Worksheet 8) .. 		    68,500   68,500 0.020 %
jTotal Other Benefits ...     3,335,227 633,482 2,701,745 0.690 %
kTotal. Add lines 7d and 7j. ..     283,447,368 321,456,894 -38,009,526 1.400 %
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 2
Part II
Community Building Activities Complete this table if the organization conducted any community building activities.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building     334   334 0 %
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     334   334  
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense (at cost).....
2
1,741,859
3
Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..
3
0
4
Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
189,397
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
241,969
7
Subtract line 6 from line 5. This is the surplus or (shortfall)........
7
-52,572
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:
Section C. Collection Practices
9a
Does the organization have a written debt collection policy? ...............
9a
Yes
 
b
If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......
9b
Yes
 
Part IV
Management Companies and Joint Ventures
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership% 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 3
Part VFacility Information
Section A. Hospital Facilities
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many hospital facilities did the organization operate during the tax year?2
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 CENTRAL CALIFORNIA
9300 VALLEY CHILDRENS PLACE
MADERA,CA936368761 		    X            
2 CHILDREN'S HOSPITAL CENTRAL CA HOME CARE
7555 N DEL MAR AVE
FRESNO,CA93711 		    X            
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 4
Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)
Name of Hospital Facility:NOT APPLICABLE
Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

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

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

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

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, measured by total revenue per facility, from largest to smallest)
How many non-hospital facilities did the organization operate during the tax year?  
Name and address Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2010
Schedule H (Form 990) 2010
Page 8
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2 Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Identifier ReturnReference Explanation
    PART I, LINE 7: CHARITY CARE AT COST WAS CALCULATED USING A COST-TO-CHARGE RATIO DERIVED FROM WORKSHEET 2. THE DECISION SUPPORT SYSTEM WAS USED TO CALCULATE COST-TO-CHARGE FOR DETERMINING UNREIMBURSED MEDI-CAL AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THIS DECISION SUPPORT SYSTEM ADDRESSES ALL PATIENT SEGMENTS (I.E INPATIENT, OUTPATIENT, ETC.). IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING CHILDREN'S HOSPITAL CENTRAL CALIFORNIA, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. IN 2011, THE HOSPITAL RECEIVED APPROXIMATELY $68,478,000 IN NET REVENUE THROUGH THE STATE'S HOSPITAL FEE PROGRAM. BECAUSE THIS NET REVENUE RECOGNIZED IN 2011 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2011, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2011. WHILE THE PROGRAM'S PAYMENTS HAVE PLAYED AN IMPORTANT ROLE IN OFFSETTING SOME OF THE HOSPITAL'S LOSSES, THE PROGRAM'S LIMITED DURATION MEANS THAT IT WILL NOT SERVE AS A LONG-TERM SOLUTION TO THE HOSPITAL'S CHRONIC MEDI-CAL PAYMENT SHORTFALLS.
    PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4936280.
    PART III, LINE 4: THERE IS NO FINANCIAL STATEMENT FOOTNOTE ON BAD DEBT. ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE ESTIMATED BASED ON HISTORICAL WRITE-OFF PERCENTAGES AND REVIEW OF LARGE BALANCE SELF-PAY ACCOUNTS. DOUBTFUL ACCOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE AFTER ADEQUATE COLLECTION EFFORT IS EXHAUSTED AND RECORDED AS RECOVERIES OF BAD DEBT IF SUBSEQUENTLY COLLECTED. THE COST OF BAD DEBT WRITE-OFFS WERE CALCULATED BY APPLYING THE OVERALL COST TO CHARGE RATIO OF THE ORGANIZATION TO THE CHARGES WRITTEN OFF.
    PART III, LINE 8: MEDICARE ALLOWABLE COST IS CALCULATED USING THE FILED 2011 MEDICARE COST REPORT. MEDICARE SHORTFALL SHOULD BE INCLUDED AS A COMPONENT OF COMMUNITY BENEFIT BECAUSE REIMBURSEMENT IS NOT NEGOTIABLE AND DOES NOT COVER THE COST TO PROVIDE SERVICES. ADDITIONALLY, THE MAJORITY OF THE HOSPITAL'S MEDICARE PATIENTS WOULD BE COVERED BY MEDI CAL IF THEY DID NOT FALL UNDER THE MEDICARE COVERAGE OPTION.
    PART III, LINE 9B: COLLECTION ATTEMPTS ARE DISCONTINUED ONCE CHARGES ARE DETERMINED TO BE ELIGIBLE FOR CHARITY CARE OR FINANCIAL ASSISTANCE; INSURANCE COLLECTION ATTEMPTS CONTINUE AS APPROPRIATE.
    PART VI, LINE 2: NEEDS ASSESSMENT: CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS ESTABLISHED BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT. CONSISTENT WITH STATE LAW, CHILDREN'S HOSPITAL COMPLETES A FORMAL ASSESSMENT OF UNMET PEDIATRIC HEALTH CARE NEEDS IN THE COMMUNITY EVERY THREE YEARS. THE HOSPITAL'S MOST RECENT ASSESSMENT WAS COMPLETED IN AUGUST 2011 AND INCLUDED THE FOLLOWING ACTIVITIES: * REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT - UNDER THE AUSPICES OF THE CENTRAL VALLEY HEALTH POLICY INSTITUTE, CALIFORNIA STATE UNIVERSITY, FRESNO, CHILDREN'S HOSPITAL PARTNERED WITH OTHER HOSPITALS IN A FOUR COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. SOURCES OF DATA INCLUDED KEY STAKEHOLDER INTERVIEWS AS WELL PUBLISHED HEALTH STATUS INDICATOR DATA. * SUPPLEMENTAL STAKEHOLDER INTERVIEWS - IN ADDITION TO THE INTERVIEWS CONDUCTED AS PART OF THE NEEDS ASSESSMENT DESCRIBED ABOVE, CHILDREN'S HOSPITAL STAFF CONDUCTED ADDITIONAL INTERVIEWS TO EXPLORE MORE THOROUGHLY THE ISSUES AS THEY RELATE TO CHILDREN. INTERVIEWS WERE CONDUCTED WITH OVER A DOZEN KEY ORGANIZATIONS, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS, SCHOOL DISTRICTS, FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, AND A VARIETY OF COMMUNITY-BASED NONPROFIT AGENCIES SERVING LOW INCOME, NEEDY CHILDREN AND FAMILIES. PARTICULAR AREAS OF INTEREST INCLUDED CHRONIC DISEASE MANAGEMENT (ASTHMA, OBESITY, DIABETES), SERVICES FOR CHILDREN WITH, OR AT RISK FOR DEVELOPMENTAL DELAYS, ACCESS TO PRIMARY AND PREVENTATIVE SERVICES, CHILD ABUSE AND UNINTENTIONAL INJURY PREVENTION, MENTAL HEALTH, AND CAPACITY OF COMMUNITY-BASED PROVIDERS TO MANAGE KIDS WITH COMPLEX MEDICAL CONDITIONS.
    PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: EACH PATIENT THAT PRESENTS AS A SELF PAY PATIENT IS DIRECTED TO A FINANCIAL COUNSELOR. THE FINANCIAL COUNSELOR EDUCATES PATIENTS AND THEIR FAMILIES ABOUT GOVERNMENT AND CHARITY CARE PROGRAMS AND ASSISTS WITH RELATED APPLICATIONS. IF A PATIENT IS NOT COUNSELED BY A FINANCIAL COUNSELOR ON THE DATE OF SERVICE, FOLLOW UP ATTEMPTS ARE MADE BY THE COUNSELORS AND THE BUSINESS OFFICE TO CONTINUE TO INFORM AND EDUCATE PATIENTS OF AVAILABLE PROGRAMS. IN ADDITION, THE CHARITY CARE POLICY IS POSTED ON THE HOSPITAL'S WEBSITE AND THERE IS SIGNAGE THROUGHOUT THE HOSPITAL INFORMING PATIENTS OF THE AVAILABILITY OF THE CHARITY CARE PROGRAM.
    PART VI, LINE 4: COMMUNITY INFORMATION: AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL'S PRIMARY SERVICE AREA EXTENDS FROM STOCKTON IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE EASTERN SIERRA. THE SERVICE AREA INCLUDES 10 COUNTIES, COVERS OVER 45,000 SQUARE MILES AND IS HOME TO OVER 1.2 MILLION CHILDREN AGES 0-17. IN 2011, CHILDREN'S HOSPITAL HAD 13,270 INPATIENT CASES, 69,006 EMERGENCY DEPARTMENT VISITS AND A COMBINED 173,714 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL BENEFITS COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 64% OF THE OUTPATIENT VISITS AT CHILDREN'S HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 5 YEARS OF AGE OR YOUNGER AND 2/3 WERE AN ETHNICITY OTHER THAN CAUCASIAN.
    PART VI, LINE 6: PROMOTION OF COMMUNITY HEALTH: CHILDREN'S HOSPITAL PARTNERS WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING THE FOLLOWING. CHILD ABUSE PREVENTION - PREVENTING AND PROTECTING CHILDREN FROM ABUSE AND NEGLECT FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH A NUMBER OF PRIVATE AND PUBLIC AGENCIES, THE PROGRAM PROVIDED EDUCATION, LEADERSHIP, AND DIRECT SERVICES FOR CHILDREN WHO WERE VICTIMS OF ABUSE AND TO PARENTS AND COMMUNITY-BASED ORGANIZATIONS TO HELP PREVENT ABUSE.CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN - CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. TO HELP ENSURE THESE CHILDREN RECEIVE MEDICALLY APPROPRIATE CARE AT SCHOOL, CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO REFERRING HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. TOPICS COVERED INCLUDED CARE FOR HIGH RISK NEWBORNS, HYPOTHERMIA, PEDIATRIC TRAUMA AND CHILD MALTREATMENT, PEDIATRIC LABORATORY SKILLS, SHAKEN BABY SYNDROME, TO NAME A FEW. IN 2011, CHILDREN'S HOSPITAL PROVIDED 22 SEPARATE CONTINUING MEDICAL EDUCATION PROGRAMS TO A TOTAL OF 285 PRIMARY CARE PROVIDERS. PEDIATRIC SUBSPECIALTY PHYSICIANS FROM CHILDREN'S HOSPITAL SERVED AS THE FEATURED FACULTY, PROVIDING COMMUNITY BASED PHYSICIANS WITH GUIDANCE ON HOW TO MANAGE A WIDE ARRAY OF COMPLEX PEDIATRIC MEDICAL CONDITIONS IN A NUMBER OF TOPICAL AREAS INCLUDING OBESITY AND DIABETES, ONCOLOGY, GASTROENTEROLOGY AND GENETICS. PROGRAMS WERE PROVIDED AT LOCATIONS THROUGHOUT THE HOSPITAL'S SERVICE AREA, INCLUDING BAKERSFIELD, MADERA, MERCED, MODESTO AND SAN LUIS OBISPO. DEVELOPMENTAL DISABILITIES - CHILDREN'S HOSPITAL PROVIDED EDUCATION TO PROVIDERS AND FAMILIES IN A NUMBER OF WAYS, INCLUDING THROUGH THE HOSTING OF SEVERAL CONFERENCES AND WORKING WITH BIRTHING HOSPITALS IN FRESNO AND TULARE COUNTIES AS PART OF THE HOSPITAL'S NEONATAL STABILIZATION PROJECT. THE HOSPITAL CONTINUED TO PARTICIPATE IN COALITIONS FOCUSED ON IMPROVING CARE COORDINATION FOR INFANTS AND CHILDREN WITH, OR AT RISK FOR, DEVELOPMENTAL DELAYS, INCLUDING KERN COUNTY'S MEDICALLY VULNERABLE INFANT WORK GROUP INITIATIVE, AND FIRST 5 FRESNO'S MODEL OF CARE PARTNERSHIP OVERSIGHT COMMITTEE AND SYSTEMS OF CARE COMMITTEE. ALSO, THE HOSPITAL EXPANDED EDUCATION AND TECHNICAL ASSISTANCE OFFERED THROUGH ITS HIGH RISK INFANT FOLLOW UP PROGRAM TO OTHER PROVIDERS AND COMMUNITY BASED AGENCIES REGARDING SCREENING AND ASSESSMENT FOR DEVELOPMENTAL DELAYS IN HIGH RISK INFANTS. LAST, CHILDREN'S HOSPITAL MAINTAINED ITS STRONG PARTNERSHIP WITH THE MARCH OF DIMES IN SUPPORT OF HEALTHY MOMS AND HEALTHY BABIES.INJURY PREVENTION 2011 - RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN, CHILDREN'S HOSPITAL OPERATES AN UNINTENTIONAL INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. SUPPORTED BY A CAST OF 75 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2011: DISTRACTED & RECKLESS TEEN DRIVING, PEDIATRIC TRAUMA, WATER SAFETY, WHEELED SPORTS SAFETY, CHILD PASSENGER SAFETY, THE CHOKING GAME, SPORTS INJURIES, LITHIUM (BUTTON) BATTERY INGESTION, CHILD MALTREATMENT, MUNCHAUSEN SYNDROME BY PROXY, AND ABUSIVE HEAD TRAUMA.AS THE LEAD AGENCY FOR SAFE KIDS CENTRAL VALLEY, CHILDREN'S HOSPITAL LED THE COALITION OF 9 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS TO MEET THE MISSION OF SAFE KIDS IN DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. THE PROGRAM PROVIDED EDUCATION TO OVER 12,330 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,955 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS.IN 2011, CHILDREN'S HOSPITAL INJURY PREVENTION ALSO PROVIDED 23 TELEVISION INTERVIEWS AND MEDIA EVENTS TO ADDRESS CHILD SAFETY ISSUES. THE HOSPITAL NOW PROVIDES A MONTHLY CHILD SAFETY SEGMENT ON TWO LOCAL NEWS PROGRAMS BROADCAST THROUGHOUT THE CENTRAL VALLEY. OBESITY PREVENTION - CHILDREN'S HOSPITAL APPLIED FOR AND RECEIVED FUNDING FROM THE CENTRAL VALLEY HEALTH NETWORK TO SERVE AS THE ADVOCACY COORDINATOR FOR THE KAISER HEAL ZONE PROJECT IN THE CITY OF MADERA. IN ITS ROLE AS BOTH ADVOCACY COORDINATOR AND CHAIR OF THE MADERA HEAL ZONE PARTNERSHIP COMMITTEE, CHILDREN'S HOSPITAL PROVIDED CONSIDERABLE SUPPORT IN THE DEVELOPMENT AND IMPLEMENTATION OF KEY WORK PLAN COMPONENTS. AS THE FOUNDER AND NOW A MEMBER OF THE CHILDHOOD OBESITY PREVENTION TASK FORCE OF FRESNO AND MADERA COUNTIES, CHILDREN'S HOSPITAL PLAYED A LEAD ROLE IN SUPPORTING THE TASK FORCE'S ACTIVITIES IN 2011. EXAMPLES INCLUDE FORMING A COLLABORATIVE AMONG PEDIATRICIANS AND PAYERS FOR THE PURPOSE OF DESIGNING AND IMPLEMENTING A NEW DELIVERY AND PAYMENT MODEL FOR CHILDHOOD OBESITY TREATMENT AND PREVENTION, AND HOSTING A CONFERENCE FOR PRIMARY CARE PROVIDERS ON OBESITY PREVENTION AND ADVOCACY.CHILDREN'S HOSPITAL ALSO PREPARED AND CONVENED TWO CONTINUING MEDICAL EDUCATION PROGRAMS TITLED "CHILDHOOD OBESITY AND RELATED COMORBIDITIES".THE MISSION OF CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. THE HOSPITAL OPERATES AN OPEN MEDICAL STAFF AND IS AN INDEPENDENT NON PROFIT ORGANIZATION GOVERNED BY A VOLUNTEER BOARD OF TRUSTEES WHICH IS THEREFORE ACCOUNTABLE TO OUR COMMUNITY AND ONLY OUR COMMUNITY.
REPORTS FILED WITH STATES PART VI, LINE 7 CA
Schedule H (Form 990) 2010
Additional Data


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Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
 
Employer identification number
94-1294954
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) PRIVATE HEALTH NEWS INC1776 MENTOR AVE SUITE 210
CINCINNATI,OH45212 		30-0059144   9,000       CREATION OF E-HEALTH NEWSLETTER
(2) STAYWELL CONTENT SERVICESPO BOX 759
MORRISVILLE,PA190670759 		13-4036258   13,395       PROVIDE HEALTH INFORMATION VIA CHCC WEBSITE
(3) MARCH OF DIMES4201W SHAW 105
FRESNO,CA93722 		13-1846366 501(C)(3) 10,000       MARCH FOR BABIES SPONSOR
(4) UCSF FOUNDATION155 N FRESNO STREET
FRESNO,CA93701 		94-3281661 GOVERNMENT 9,600       VALLEY VISION SPONSORSHIP
(5) UC MERCED FOUNDATION5200 NORTH LAKE RAOD
MERCED,CA95343 		27-0093858 GOVERNMENT 20,000       MEDICAL EDUCATION














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

Schedule I (Form 990) 2010
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Use Schedule I-1 (Form 990) if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance
(1) NURSING SCHOLARSHIP 3 4,926      
(2) EDUCATION SCHOLARSHIP - NEONATAL FOCUS 2 3,249      
(3) CAFETERIA MEALS 11262   59,125 FMV MEAL COUPONS FOR PATIENT FAMILIES AS NEEDED
(4) TAXI, BUS AND TRANSIT SERVICES 8579   127,139 BOOK SUBSIDATION OF BUS AND TRANSIT SERVICES







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
PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: NURSING SCHOLARSHIPS ARE DESIGNED TO HELP EMPLOYEES MEET FINANCIAL NEEDS THAT ARE NOT COVERED BY OTHER TUITION REIMBURSEMENT PROGRAMS. A SCHOLARSHIP COMMITTEE REVIEWS APPLICATIONS BI-ANNUALLY BASED ON CERTAIN CRITERIA. RECIPIENTS ARE CHOSEN BY THE COMMITTEE AND THE CHIEF NURSING OFFICER APPROVES THE SELECTIONS. ALL RECIPIENTS ARE EMPLOYEES OF THE HOSPITAL AND THE HOSPITAL IS MADE AWARE WHEN THE RECIPIENT COMPLETES THEIR EDUCATION. OTHER SERVICES PROVIDED ARE PURCHASED FROM VARIOUS VENDORS AND ARE SUPPLIED TO PATIENTS AND THEIR FAMILIES. THE RECORDS FOR THESE PURCHASED SERVICES ARE MAINTAINED BY THE HOSPITAL.
Schedule I (Form 990) 2010


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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
2010
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
 
Employer identification number

94-1294954
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....
1b
 
 
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.
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
Yes
 
b
Any related organization? .........................
5b
Yes
 
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
Yes
 
b
Any related organization? .........................
6b
Yes
 
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
No
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990
Cat. No. 50053T
Schedule J (Form 990) 2010

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

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.
(A) Name (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported in prior
Form 990 or
Form 990-EZ
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1) GORDON ALEXANDER (i)
(ii)		 371,364
0 		35,000
0 		15,515
0 		17,673
0 		7,455
0 		447,007
0 		0
0
(2) MICHELE R WALDRON (i)
(ii)		 368,246
0 		50,234
0 		20,180
0 		172,453
0 		14,910
0 		626,023
0 		0
0
(3) TODD SUNTRAPAK (i)
(ii)		 373,283
0 		31,103
0 		30,574
0 		154,184
0 		14,910
0 		604,054
0 		0
0
(4) DAVID CHRISTENSEN (i)
(ii)		 347,363
0 		76,539
0 		8,949
0 		40,469
0 		15,531
0 		488,851
0 		0
0
(5) BEVERLY HAYDEN-PUGH (i)
(ii)		 276,527
0 		29,084
0 		21,276
0 		140,706
0 		7,455
0 		475,048
0 		0
0
(6) JESSIE HUDGINS (i)
(ii)		 265,395
0 		17,590
0 		20,006
0 		148,726
0 		11,182
0 		462,899
0 		0
0
(7) MARTA BOYER (i)
(ii)		 262,014
0 		30,809
0 		10,086
0 		161,160
0 		3,727
0 		467,796
0 		0
0
(8) JANE WILLSON (i)
(ii)		 258,558
0 		32,634
0 		9,218
0 		125,875
0 		7,455
0 		433,740
0 		0
0
(9) DAVID SINGH (i)
(ii)		 229,966
0 		34,155
0 		8,805
0 		17,713
0 		3,727
0 		294,366
0 		0
0
(10) RICK WOLF (i)
(ii)		 232,646
0 		24,515
0 		323
0 		46,226
0 		14,910
0 		318,620
0 		0
0
(11) WILLIAM F HAUG (i)
(ii)		 573,138
0 		132,301
0 		21,084
0 		77,454
0 		3,727
0 		807,704
0 		0
0
(12) RANDALL GUERRERO (i)
(ii)		 209,236
0 		18,624
0 		729
0 		10,908
0 		14,910
0 		254,407
0 		0
0
(13) STEPHANIE VANCE (i)
(ii)		 194,923
0 		19,437
0 		16,789
0 		11,223
0 		14,910
0 		257,282
0 		0
0
(14) JEFFREY LEFORS (i)
(ii)		 197,073
0 		10,032
0 		17,247
0 		15,121
0 		3,727
0 		243,200
0 		0
0
(15) KAMELA LOO (i)
(ii)		 227,495
0 		0
0 		4,799
0 		25,134
0 		7,455
0 		264,883
0 		0
0
(16) MARK ZIELAZINSKI (i)
(ii)		 66,744
0 		26,289
0 		8,426
0 		10,950
0 		3,728
0 		116,137
0 		0
0
Schedule J (Form 990) 2010

Schedule J (Form 990) 2010
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.
Identifier Return Reference Explanation
  PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS INCLUDE A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) AND A DEFERRED COMPENSATION PLAN FOR SELECTED EXECUTIVES. WILLIAM HAUG RECEIVED A DISTRIBUTION FROM THE SERP PLAN DURING THE YEAR ENDING 9/30/2011 IN THE AMOUNT OF $2,395,047. NO AMOUNTS WERE PAID OUT OF THE DEFINED COMPENSATION PLAN DURING THE YEAR. EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO THE DEFERRED COMPENSATION PLAN AND THE CHANGE IN ACTUARIAL VALUE OF SERP BENEFITS FOR THE YEAR ENDING 9/30/2011 ARE AS FOLLOWS: GORDON ALEXANDER - DEFERRED COMPENSATION PLAN $16,500; DEFINED CONTRIBUTION SERP PLAN $9,423 WILLIAM HAUG - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $44,280 MICHELE WALDRON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $145,174 TODD SUNTRAPAK - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $130,094 BEVERLY HAYDEN-PUGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $107,931 JESSIE HUDGINS - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $120,365 MARTA BOYER - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $134,211 DAVID CHRISTENSEN - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $32,219 RICK WOLF - DEFERRED COMPENSATION PLAN $0; CHANGE IN SERP ACTUARIAL VALUE $34,549 JANE WILLSON - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $101,789 MARK ZIELAZINSKI - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 DAVID SINGH - DEFERRED COMPENSATION PLAN $16,500; CHANGE IN SERP ACTUARIAL VALUE $0 STEPHANIE VANCE - DEFERRED COMPENSATION PLAN $16,500; NOT ELIGIBLE FOR SERP JEFFREY LEFORS - DEFERRED COMPENSATION PLAN $16,500; NOT ELIGIBLE FOR SERP
  PART I, LINE 5 AN EXECUTIVE INCENTIVE PLAN HAS BEEN ESTABLISHED THAT ALLOWS FOR PAYMENT OF INCENTIVES BASED ON BOTH ORGANIZATION-WIDE AND INDIVIDUAL GOALS. SUCH GOALS ARE RELATED TO A VARIETY OF METRICS INCLUDING REVENUE, OPERATIONAL AND QUALITY RESULTS OF THE HOSPITAL AND FOUNDATION. THE INCENTIVE PLAN HAS BEEN APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE COMMITTEE REVIEWS THE FORECASTED PAYOUTS AT THE END OF EACH YEAR BASED ON THE FINANCIAL AND OPERATING RESULTS.
  PART I, LINE 6 SEE EXPLANATION FOR LINE 5, ABOVE
Schedule J (Form 990) 2010

Additional Data


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Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Schedule O (Form 990).
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2010
Open to Public
Inspection
Name of the organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
 
Employer identification number
94-1294954
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 COUNTY OF MADERA
  		94-6000518 556902DN1 02-04-2010 39,512,854 TO REFUND SERIES 2006 BONDS ISSUED ON 6/26/06.   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired. . . . .        
2 Amount of bonds defeased . . . .        
3 Total proceeds of issue . . . . 39,512,854      
4 Gross proceeds in reserve funds . . 4,363,296      
5 Capitalized interest from proceeds.        
6 Proceeds in refunding escrow. . . . .        
7 Issuance costs from proceeds . . .        
8 Credit enhancement from proceeds.        
9 Working capital expenditures from proceeds . .        
10 Capital expenditures from proceeds . .        
11 Other spent proceeds . .        
12 Other unspent proceeds. . .        
13 Year of substantial completion . . .
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? X              
15 Were the bonds issued as part of an advance refunding issue?   X            
16 Has the final allocation of proceeds been made? . . X              
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . X              
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . .   X            
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . .   X            
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2010
Schedule K (Form 990) 2010
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use?   X            
b Are there any research agreements that may result in private business use of bond-financed property? . .   X            
c Does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts or research agreements relating to the financed property? . X              
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . . . . . . . . . . . . SchKMediumBullet 0 %      
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . SchKMediumBullet 0 %      
6 Total of lines 4 and 5 . . .. . . . . . 0 %      
7 Has the organization adopted management practices and procedures to ensure the post-issuance compliance of its tax-exempt bond liabilities? X              
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has a Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate, been filed with respect to the bond issue? . . .   X            
2 Is the bond issue a variable rate issue?   X            
3a Has the organization or the governmental issuer entered into a hedge with respect to the bond issue?   X            
b Name of provider .  
  		 
  		 
  		 
 
c Term of hedge . .        
d Was the hedge superintegrated? .                
e Was a hedge terminated? .                
4a Were gross proceeds invested in a GIC? .   X            
b Name of provider .  
  		 
  		 
  		 
 
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            
6 Did the bond issue qualify for an exception to rebate? . . . X              
Schedule K (Form 990) 2010

Schedule K (Form 990) 2010
Page 3
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
Schedule K (Form 990) 2010

Additional Data


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

94-1294954
Part I
Excess Benefit Transactions (section 501(c)(3) and section 501 (c)(4) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.
1(a) Name of disqualified person (b) Description of transaction (c) Corrected?
Yes No





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

Part II
Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 26, or Form 990-EZ, Part V, line 38a.
(a) Name of interested person and purpose (b) Loan to or from the organization? (c)Original principal amount (d)Balance due (e) In default? (f) Approved by board or committee? (g)Written agreement?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b)Relationship between interested person and the organization (c)Amount of grant or type of assistance
For Privacy Act and Paperwork Reduction Act Notice, see the
Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2010
Schedule L (Form 990 or 990-EZ) 2010
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) WISHON RADIOLOGY MEDICAL GROUP
  		ENTITY FOR WHICH DR. CHARLES SMITH, DIRECTOR, IS AN OFFICER 848,915 DR. SMITH PROVIDES MEDICAL DIRECTOR SERVICES AND TELERADIOLOGIST COVERAGE THROUGH WISHON RADIOLOGY MEDICAL GROUP   No
(2) PRODUCER'S DAIRY FOODS INC
  		ENTITY FOR WHICH RICHARD SHEHADEY, DIRECTOR, IS AN OWNER 103,573 PURCHASE OF FOOD PRODUCTS TO BE SOLD IN HOSPITAL CAFETERIA AND FOR PATIENT MEALS   No
Part V
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule L (see instructions).
Identifier Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2010

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

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

94-1294954
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of Contributions or items contributed 		(c)
Contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded .        
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( PHARMACY FREEZER ) X 1 4,000 COST
26 Other Right pointing arrow large image ( HCIN EQUIPMENT ) X 1 146,495 COST
27 Other Right pointing arrow large image ( FUN CENTERS ) X 2 8,500 COST
28 Other Right pointing arrow large image ( WHEELCHAIRS ) X 1 3,800 COST
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1-28 that it
must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell non-cash
contributions? ............................
32a
 
No
b
If "Yes," describe in Part II.
33
If the organization did not report revenues in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) 2010
Schedule M (Form 990) 2010
Page 2
Part II
Supplemental Information. Complete this part to provide the information required by Part I, lines 30b,
32b, and 33. Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule M (Form 990) 2010
Additional Data


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

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

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

94-1294954
Identifier Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 2   BRUCE ALBRIGHT, DIRECTOR AND JEFF MAYER, DIRECTOR, HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11   A DRAFT OF THE FORM 990 IS UPLOADED TO A SECURED BOARD PORTAL PRIOR TO THE FILING DATE. BOARD MEMBERS ARE ASKED TO REVIEW THE FORM 990 AND PRESENT ANY QUESTIONS THEY MAY HAVE TO THE CFO. THE CFO PRESENTS HIGHLIGHTS OF KEY SECTIONS OF THE FORM 990 AT THE FINANCE COMMITTEE MEETING THAT IS HELD BEFORE THE FILING DATE AND ANSWERS QUESTIONS OR ADDRESSES ANY CONCERNS AT THIS MEETING. CHANGES CAN THEN BE MADE IF WARRANTED BEFORE THE 990 IS FILED.
  FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL BOARD OF TRUSTEES MAINTAINS A CONFLICT OF INTEREST POLICY WITHIN THE HOSPITAL'S CORPORATE BYLAWS. THE POLICY REQUIRES EACH TRUSTEE TO DISCLOSE PERSONAL FINANCIAL INTERESTS BY EXECUTING ANNUAL STATEMENTS AND REPORTING SPECIFIC INTERESTS ON AN AD HOC BASIS. A STANDING GOVERNANCE COMMITTEE IS TASKED TO REVIEW DISCLOSED INTERESTS, TO ASSESS WHETHER A CONFLICT OF INTEREST EXISTS AND MAKE RECOMMENDATIONS REGARDING FURTHER ACTION AS MAY BE NECESSARY TO MITIGATE OR ELIMINATE A CONFLICT. THE HOSPITAL MAINTAINS A SEPARATE BUT SIMILAR POLICY GOVERNING INDIVIDUALS EMPLOYED IN COVERED POSITIONS.
  FORM 990, PART VI, SECTION B, LINE 15 AS PROVIDED BY THE HOSPITAL BYLAWS, A COMPENSATION COMMITTEE HAS BEEN ESTABLISHED THAT CONSISTS OF A CHAIR AND AT LEAST THREE MEMBERS OF THE BOARD OF TRUSTEES. THE PRIMARY ROLE OF THE COMMITTEE IS TO ENSURE THAT COMPENSATION IS REASONABLY RELATED TO THE DUTIES PERFORMED FOR THE HOSPITAL AND WITH THE COMPETITIVE EMPLOYMENT MARKET. DUTIES AND ACTIVITIES SPECIFIC TO CEO, OFFICER, AND KEY EMPLOYEES OF THE ORGANIZATION INCLUDE: 1) PERIODIC REVIEW BASED ON THE INDEPENDENT ADVICE OF AN EXTERNAL QUALIFIED COMPENSATION CONSULTANT 2) REVIEW OF MARKET DATA FOR EQUIVALENT POSITIONS 3) REVIEW AND APPROVAL OF TERMS AND CONDITIONS OF THE CEO'S EMPLOYMENT AND OVERSIGHT TO ASSURE FORMAL AND TIMELY PERFORMANCE ASSESSMENTS ARE CONDUCTED 4) REVIEW AND APPROVAL OF EXECUTIVE LEVEL COMPENSATION TO ASSURE THAT TERMS AND CONDITIONS OF EMPLOYMENT ARE MARKET COMPETITIVE
  FORM 990, PART VI, SECTION C, LINE 19 A COPY OF CHILDREN'S HOSPITAL'S ARTICLES OF INCORPORATION IS ON FILE WITH THE CALIFORNIA SECRETARY OF STATE. A COPY OF THE CORPORATE BYLAWS OF CHILDREN'S HOSPITAL CENTRAL CALIFORNIA IS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. CONFLICT OF INTEREST MANAGEMENT IS DESCRIBED IN ARTICLE 10 OF THE BYLAWS. THE HOSPITAL PREPARES ANNUAL FINANCIAL STATEMENTS WHICH ARE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM PRIOR TO SUBMITTAL TO RELEVANT STATE AGENCIES.
HOURS PER WEEK DEVOTED TO RELATED ORGANIZATIONS: FORM 990, PART VII, SECTION A, COLUMN B: MICHELE WALDRON'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 38 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 2 HRS GORDON ALEXANDER'S TIME IS DIVIDED AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 34 HRS CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 6 HRS BRUCE ALLBRIGHT, SUSAN BOYD, DR. ROBERT KUBO, JEFF MAYER, DAVE OLSON, RICHARD SHEHADEY AND BILL SMITTCAMP DIVIDE THEIR TIME AS FOLLOWS: CHILDREN'S HOSPITAL CENTRAL CALIFORNIA 1 HR CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION 1 HR
CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST -23,116,729. TRADING LOSS INCLUDED IN INVESTMENT INCOME PER AFS -12,373,418. TRANSFER TO ENDOWMENT -36,129. ROUNDING -3. TOTAL TO FORM 990, PART XI, LINE 5: -35,526,279.
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE ONE FORM 990 PART III, LINE 4A: I. DESCRIPTION OF PROGRAM SERVICE ONE NEARLY 60 YEARS AGO, OUR FOUNDING MOTHERS HAD A DREAM TO CARE FOR CHILDREN IN A HOSPITAL AS SPECIAL AS ITS PATIENTS. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA HAS FLOURISHED EVER SINCE, CARING FOR HUNDREDS OF THOUSANDS OF CHILDREN. OUR MISSION GUIDES US AS WE TRAVEL THE ROAD TO OUR FUTURE ALONGSIDE STAFF, PHYSICIANS, CHILDREN, FAMILIES, OUR COMMUNITY AND OUR PARTNERS THROUGHOUT THE REGION. MISSION THE MISSION OF CHILDREN'S HOSPITAL IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO CHILDREN REGARDLESS OF THEIR ABILITY TO PAY, AND TO CONTINUOUSLY IMPROVE THE HEALTH AND WELL-BEING OF CHILDREN. VISION OUR VISION CAPTURES THE PATH WE'VE TRAVELED AND SHOWCASES OUR COMMITMENT AND PASSION TO BE THE BEST. OUR CLEAR FOCUS IS TO CONTINUE TO PROVIDE THE BEST CARE AND THE BEST QUALITY PEDIATRIC SERVICES AVAILABLE ANYWHERE WITH A VISION TO BECOME THE NATION'S BEST CHILDREN'S HOSPITAL. CORE VALUES THE FOLLOWING CORE ORGANIZATIONAL VALUES GUIDE THE INVESTMENTS AND SUPPORT PROVIDED BY CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM. EXCELLENCE - WE DEPEND ON EXCEPTIONAL PEOPLE TO PROVIDE EXCEPTIONAL QUALITY HEALTH CARE AND SERVICES THROUGHOUT CHILDREN'S HOSPITAL. WE SET HIGH STANDARDS AND WE SUPPORT EACH OTHER AS WE STRIVE TO ACHIEVE THEM. WE INVEST IN EACH OTHER AND WE VALUE THE INDIVIDUAL AND CULTURAL DIFFERENCES THAT MAKE US STRONG. WE ARE PROUD OF OUR SUPERIOR SERVICES AS MEASURED BY QUALITY OUTCOMES. COMPASSIONATE CARE - WE TREAT EVERY CHILD, EVERY FAMILY, EACH OTHER, OUR VISITORS AND OUR VENDORS WITH RESPECT, KINDNESS, HOPE, JOY AND GOOD HUMOR. WE DISPLAY OUR HELPFUL, HEALING, FAMILY-CENTERED SPIRIT AT EVERY OPPORTUNITY. WE RECOGNIZE THE IMPORTANCE OF PLAYFULNESS IN HUMAN INTERACTION AND IN THE HEALTH OF CHILDREN. WE LOOK FOR WAYS TO EASE SUFFERING AND PROVIDE COMFORT. INTEGRITY - WE ARE HONEST, ETHICAL AND RESPONSIBLE IN OUR WORK AND IN THE WAY WE DEAL WITH OTHERS. WE KEEP OUR PROMISES AND ADMIT OUR MISTAKES. WE KNOW OURSELVES AND WE AVOID HIDDEN AGENDAS. BY THE WAY WE LIVE OUR LIVES EVERYDAY, WE ARE WORTHY OF THE TRUST PEOPLE PLACE IN US. INNOVATION - WE EMBRACE CHANGE, CREATIVITY, CONTINUOUS LEARNING AND PERSONAL GROWTH. WE INCORPORATE NEW IDEAS, TECHNOLOGY AND METHODS TO IMPROVE THE HEALTH CARE AND SERVICES WE PROVIDE. WE ANTICIPATE FUTURE TRENDS AND WE CREATE STRATEGIC PLANS TO INSURE FUTURE GROWTH AND CONTINUED VITALITY. COLLABORATION - WE BUILD ENDURING INTERNAL AND EXTERNAL RELATIONSHIPS, JOINING WITH COLLEAGUES ACROSS ORGANIZATIONAL BOUNDARIES TO IMPROVE THE CARE AND SERVICES WE PROVIDE. WE ENCOURAGE AND REWARD BOTH INDIVIDUAL AND TEAM ACHIEVEMENTS. WE PUT THE COMMON GOOD AHEAD OF NARROW INTERESTS. STEWARDSHIP - WE ARE RESOURCEFUL, ADAPTABLE AND RESILIENT. WE HAVE A "CAN DO" ATTITUDE THAT GETS THE JOB DONE. WE ARE FISCALLY RESPONSIBLE AND EFFICIENT WITH OUR TIME. WE PROTECT OUR RESERVES AND MANAGE OUR OPERATING COSTS IN ORDER TO INVEST IN OUR FUTURE. WE ARE EACH PERSONALLY DEDICATED TO MAKING CHILDREN'S HOSPITAL BETTER BECAUSE WE WERE HERE. COMMITMENT TO THE COMMUNITY AS A NOT-FOR-PROFIT ORGANIZATION GOVERNED BY ITS OWN BOARD OF TRUSTEES, CHILDREN'S HOSPITAL IS SOLELY COMMITTED TO ADDRESSING THE MEDICAL NEEDS OF OUR REGION'S SICKEST CHILDREN. WITH 348 BEDS, 220 PHYSICIANS AND OVER 2,200 FULL-TIME EQUIVALENT EMPLOYEES, CHILDREN'S HOSPITAL OFFERS ACCESSIBILITY TO OVER 40 FETAL, NEONATAL AND PEDIATRIC SUBSPECIALTIES, ALL COMMITTED TO PROVIDING THE HIGHEST LEVEL OF QUALITY CARE POSSIBLE. EXAMPLES INCLUDE THE HOSPITAL'S NEONATAL AND PEDIATRIC INTENSIVE CARE UNITS THAT MAINTAIN LOW MORTALITY RATES, WHEN COMPARED NATIONALLY, WHILE TREATING SOME OF THE SICKEST CHILDREN. WHILE PROVIDING EXCEPTIONAL CARE IS THE SINGLE GREATEST CONTRIBUTION THE HOSPITAL MAKES FOR OUR CHILDREN AND THEIR FAMILIES, THE HOSPITAL ALSO APPRECIATES THAT IT IS UNIQUELY POSITIONED TO SUPPORT THE NEEDS OF CHILDREN IN OTHER WAYS AS WELL. AS AN EXTENSION OF THE HOSPITAL'S MISSION AND VISION, THE GOAL OF CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS TO ADVANCE THE HEALTH AND WELLBEING OF UNDERSERVED, MEDICALLY NEEDY CHILDREN THROUGH COLLABORATION AND COMMON CONCERN. THIS COMMUNITY BENEFITS REPORT SUMMARIZES THE CONTRIBUTIONS PROVIDED BY CHILDREN'S HOSPITAL TO ITS COMMUNITY FOR FISCAL YEAR 2011 (OCTOBER 1, 2010 THRU SEPTEMBER 30, 2011). II. SERVICE AREA DEMOGRAPHICS AND PATIENT VOLUME SERVICE AREA DEMOGRAPHICS AS THE ONLY PEDIATRIC SPECIALTY HOSPITAL LOCATED IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL'S PRIMARY SERVICE AREA EXTENDS FROM STOCKTON IN THE NORTH TO BAKERSFIELD IN THE SOUTH, AND FROM THE CENTRAL COAST TO THE EASTERN SIERRA. THE SERVICE AREA INCLUDES 10 COUNTIES, COVERS OVER 45,000 SQUARE MILES AND IS HOME TO OVER 1.2 MILLION CHILDREN AGES 0-17. CHILDREN'S HOSPITAL'S PATIENT VOLUME IN 2011, CHILDREN'S HOSPITAL HAD 13,270 INPATIENT CASES, 69,006 EMERGENCY DEPARTMENT VISITS AND A COMBINED 173,714 OUTPATIENT CENTER, DAY SURGERY, RADIOLOGY AND LABORATORY VISITS. MEDI-CAL COVERED 75% OF THE HOSPITAL'S TOTAL INPATIENT DAYS AND 64% OF TOTAL OUTPATIENT VISITS AT THE HOSPITAL. NEARLY 2/3 OF THE HOSPITAL'S INPATIENT POPULATION CONSISTED OF CHILDREN 5 YEARS OF AGE OR YOUNGER AND 2/3 WERE AN ETHNICITY OTHER THAN CAUCASIAN. III. ASSESSING AND UNDERSTANDING COMMUNITY NEEDS CHILDREN'S HOSPITAL'S COMMUNITY BENEFITS PROGRAM IS ESTABLISHED BASED ON A COLLABORATIVE COMMUNITY HEALTH NEEDS ASSESSMENT. CONSISTENT WITH STATE LAW, CHILDREN'S HOSPITAL COMPLETES A FORMAL ASSESSMENT OF UNMET PEDIATRIC HEALTH CARE NEEDS IN THE COMMUNITY EVERY THREE YEARS. THE HOSPITAL'S MOST RECENT ASSESSMENT WAS COMPLETED IN AUGUST 2011 AND INCLUDED THE FOLLOWING ACTIVITIES. FORMAL NEEDS ASSESSMENT PROCESS * REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT - UNDER THE AUSPICES OF THE CENTRAL VALLEY HEALTH POLICY INSTITUTE, CALIFORNIA STATE UNIVERSITY, FRESNO, CHILDREN'S HOSPITAL PARTNERED WITH OTHER HOSPITALS IN A FOUR COUNTY REGION TO CONDUCT AN ASSESSMENT OF HEALTH NEEDS FOR BOTH CHILDREN AND ADULTS. SOURCES OF DATA INCLUDED KEY STAKEHOLDER INTERVIEWS AS WELL PUBLISHED HEALTH STATUS INDICATOR DATA. FOR A COPY OF THE NEEDS ASSESSMENT, VISIT THE FOLLOWING LINK. HTTP://WWW.CSUFRESNO.EDU/CCCHHS/INSTITUTES_PROGRAMS/CVHPI/PUBLICATIONS/ * SUPPLEMENTAL STAKEHOLDER INTERVIEWS - IN ADDITION TO THE INTERVIEWS CONDUCTED AS PART OF THE NEEDS ASSESSMENT DESCRIBED ABOVE, CHILDREN'S HOSPITAL STAFF CONDUCTED ADDITIONAL INTERVIEWS TO EXPLORE MORE THOROUGHLY THE ISSUES AS THEY RELATE TO CHILDREN. INTERVIEWS WERE CONDUCTED WITH OVER A DOZEN KEY ORGANIZATIONS, INCLUDING COUNTY PUBLIC HEALTH DEPARTMENTS, SCHOOL DISTRICTS, FEDERALLY QUALIFIED HEALTH CENTERS, INDIVIDUAL PEDIATRICIANS, AND A VARIETY OF COMMUNITY-BASED NONPROFIT AGENCIES SERVING LOW INCOME, NEEDY CHILDREN AND FAMILIES. PARTICULAR AREAS OF INTEREST INCLUDED CHRONIC DISEASE MANAGEMENT (ASTHMA, OBESITY, DIABETES), SERVICES FOR CHILDREN WITH, OR AT RISK FOR DEVELOPMENTAL DELAYS, ACCESS TO PRIMARY AND PREVENTATIVE SERVICES, CHILD ABUSE AND UNINTENTIONAL INJURY PREVENTION, MENTAL HEALTH, AND CAPACITY OF COMMUNITY-BASED PROVIDERS TO MANAGE KIDS WITH COMPLEX MEDICAL CONDITIONS. IV. A SNAPSHOT OF COMMUNITY HEALTH NEEDS IN 2010 CHILDREN IN CENTRAL CALIFORNIA ARE DISPROPORTIONATELY DISADVANTAGED WHEN COMPARED TO CHILDREN IN OTHER PARTS OF THE STATE AND NATION. CONSIDER THE STATISTICS BELOW COMPARING THE EIGHT CENTRAL VALLEY COUNTIES (FRESNO, KERN, KINGS, MERCED, MADERA, SAN JOAQUIN, STANISLAUS, AND TULARE) TO CALIFORNIA AS A WHOLE. KEEP IN MIND, THESE COUNTIES MAKE UP A MAJORITY OF THE HOSPITAL'S SERVICE AREA.
    INDICATOR* DESCRIPTION CENTRAL STATEWIDE VALLEY POVERTY PERCENT OF CHILDREN LIVING 25.50 19.9 IN POVERTY, 2009 CHILD ABUSE SUBSTANTIATED CASES OF CHILD 9.35 8.7 MALTREATMENT PER 1,000 POP, 2010 INFANT AVERAGE NUMBER OF INFANT 6.00 5.2 MORTALITY DEATHS PER 1,000 LIVE BIRTHS UNDER ONE YEAR OF AGE FOR THE THREE YEAR PERIOD 2005-2007 LOW BIRTH PERCENT OF BABIES BORN WEIGHING 6.60 6.8 WEIGHT INFANTS LESS THAN 2500 GRAMS IN 2009 PRENATAL PERCENT OF WOMEN RECEIVING 24.60 18.7 CARE INADEQUATE PRENATAL CARE DURING THE FIRST TRIMESTER OF PREGNANCY IN 2009 TEEN BIRTH RATE FOR MOTHERS AGES 56.30 37.1 PREGNANCY 15-19 PER 1000 LIVE BIRTHS, 2007 ASTHMA PERCENT OF CHILDREN AGES 0-17 16.40 13.0 DIAGNOSED WITH ASTHMA, 2007 IMMUNIZATIONS PERCENT OF CHILDREN WHO HAVE 94.80 91.7 RECEIVED ALL REQUIRED IMMUNIZATIONS AT THE TIME THEY ENTERED KINDERGARTEN, 2008 OBESITY PERCENT OF CHILDREN AGES 0-5 16.50 15.7 OVERWEIGHT FOR AGE IN 2009 PERCENT OF CHILDREN AGES 6-19 23.10 23.1 OVERWEIGHT FOR AGE IN 2009 UNINSURED PERCENT OF CHILDREN AGES 12-17 13.50 9.9 WITH NO HEALTH INSURANCE AT LEAST PART OF THE YEAR, 2007
    * DATA SOURCES. - POVERTY: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/CHILD_POVERTY250.ASPX - CHILD ABUSE: CHILD WELFARE DYNAMIC REPORT SYSTEM, HTTP://CSSR.BERKELEY.EDU/UCB_CHILDWELFARE/REFRATES.ASPX - INFANT MORTALITY: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/INFANT_MORTALITY.ASPX - LOW BIRTH WEIGHT: CALIFORNIA DEPARTMENT OF HEALTH SERVICES, CENTER FOR HEALTH STATISTICS, CD-ROM PUBLIC USE BIRTH AND DEATH FILES - PRENATAL CARE: CALIFORNIA DEPARTMENT OF HEALTH SERVICES, CENTER FOR HEALTH STATISTICS, CD-ROM PUBLIC USE BIRTH AND DEATH FILES - TEEN BIRTHS: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/TEEN_BIRTHS.ASPX - ASTHMA: HTTP://WWW.CHIS.UCLA.EDU/ - IMMUNIZATIONS: HTTP://WWW.KIDSDATA.ORG/DATA/TOPIC/TABLE/IMMUNIZATIONS-KINDERGARTENERS. - OBESITY: HTTP://WWW.DHCS.CA.GOV/SERVICES/CHDP/DOCUMENTS/PEDNSS/2009/16B0TO5.PDF - UNINSURED: HTTP://WWW.CHIS.UCLA.EDU/ THE SHORT-TERM AND LONG-TERM IMPLICATIONS OF THESE STATISTICS ARE SIGNIFICANT. FOR CHILDREN AND THEIR FAMILIES, IT MEANS CHRONIC ILLNESS ACCOMPANIED BY FREQUENT VISITS TO PHYSICIAN OFFICES, CLINICS OR HOSPITAL EMERGENCY ROOMS, MISSED DAYS AT SCHOOL, AND MISSED DAYS AT WORK. FOR HEALTH CARE PROVIDERS LIKE CHILDREN'S HOSPITAL, IT MEANS ALREADY SCARCE RESOURCES ARE STRETCHED EVEN THINNER TO ADDRESS SIGNIFICANT HEALTH NEEDS. THE OPPORTUNITY IS FOR HEALTH CARE PROVIDERS AND THE BROADER COMMUNITY TO ADDRESS THESE AND OTHER HEALTH CHALLENGES FACING OUR REGION'S CHILDREN THROUGH COLLABORATION AND COMMON CONCERN. IV. COMMUNITY BENEFITS PROGRAM A COMMUNITY BENEFIT IS GENERALLY DEFINED AS A CLINICAL OR NON-CLINICAL PROGRAM OR SERVICE THAT - PROVIDES TREATMENT AND/OR PROMOTES HEALTH AND HEALING IN RESPONSE TO AN IDENTIFIED COMMUNITY HEALTH NEED OR SERVICE GAP IDENTIFIED THROUGH THE COMMUNITY NEEDS ASSESSMENT PROCESS, - IS INTENDED TO BENEFIT THE COMMUNITY AS OPPOSED TO THE HOSPITAL, AND - RESULTS IN A LOW OR NEGATIVE FINANCIAL MARGIN FOR THE HOSPITAL. ALSO INCLUDED IN THE DEFINITION IS THE PROVISION OF CHARITY CARE AND THE UNREIMBURSED COST OF PROVIDING HEALTH CARE SERVICES TO THOSE ENROLLED IN PUBLIC PROGRAMS, INCLUDING MEDI-CAL. FOR FY 2011, CHILDREN'S HOSPITAL DEDICATED IN EXCESS OF $2,681,924 IN COMMUNITY BENEFITS THAT CONTINUE THE HOSPITAL'S LONG TRADITION OF BEING AN ACTIVE AND INTEGRAL PART OF CENTRAL CALIFORNIA. DUE TO THE HOSPITAL'S RECEIPT OF HOSPITAL FEE PROGRAM REVENUE IN 2011, THE FIGURE ABOVE DOES NOT INCLUDE THE HOSPITAL'S COSTS ASSOCIATED WITH UNCOMPENSATED MEDI-CAL, WHICH WAS $25,804,563 IN 2011. A SUMMARY OF THE HOSPITAL'S COMMUNITY BENEFITS PROGRAM ACTIVITIES IN 2011 IS PROVIDED BELOW. PLEASE NOTE THAT THESE ACTIVITIES WERE DEVELOPED BASED ON THE HOSPITAL'S COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED IN 2008. THE OUTCOMES OF THE NEEDS ASSESSMENT PROCESS DESCRIBED ABOVE WILL BE USED TO DEVELOP THE HOSPITAL'S COMMUNITY BENEFIT PROGRAM ACTIVITIES FOR 2012-2014. COMMUNITY HEALTH NEEDS CHILDREN'S HOSPITAL PARTNERS WITH A VARIETY OF COMMUNITY-BASED ORGANIZATIONS TO HELP ADDRESS ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT, INCLUDING THE FOLLOWING. CHILD ABUSE PREVENTION - PREVENTING AND PROTECTING CHILDREN FROM ABUSE AND NEGLECT FORM THE CORNERSTONE OF THE GUILD'S OF CHILDREN'S HOSPITAL CHILD ABUSE PREVENTION AND TREATMENT CENTER. IN PARTNERSHIP WITH A NUMBER OF PRIVATE AND PUBLIC AGENCIES, THE PROGRAM PROVIDED EDUCATION, LEADERSHIP, AND DIRECT SERVICES FOR CHILDREN WHO WERE VICTIMS OF ABUSE AND TO PARENTS AND COMMUNITY-BASED ORGANIZATIONS TO HELP PREVENT ABUSE. CAPACITY FOR MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN - CHILDREN'S HOSPITAL RECOGNIZES THE CRITICAL ROLE THAT COMMUNITY BASED PROVIDERS AND ORGANIZATIONS PLAY IN MEETING THE NEEDS OF MEDICALLY COMPLEX CHILDREN AND IS COMMITTED TO MAKING SURE THEY HAVE THE CLINICAL SKILLS TO TAKE CARE OF THIS PATIENT POPULATION. SCHOOL NURSES - TO HELP ENSURE THESE CHILDREN RECEIVE MEDICALLY APPROPRIATE CARE AT SCHOOL, CHILDREN'S HOSPITAL PARTNERED WITH THE CALIFORNIA SCHOOL NURSE ORGANIZATION AND INDIVIDUAL SCHOOL DISTRICTS TO PROVIDE TRAINING TO SCHOOL NURSES ON A VARIETY OF CLINICAL PROCEDURES AND TOPICS CRITICAL TO KEEPING CHILDREN HEALTHY. ADDITIONALLY, CHILDREN'S HOSPITAL PARTICIPATED IN AND HOSTED THE SCHOOL HEALTH ADVISORY PANEL'S QUARTERLY MEETINGS. THE PANEL IS A CONSORTIUM OF SCHOOL DISTRICT HEALTH DIRECTORS THROUGHOUT THE CENTRAL VALLEY THAT SERVES AS A LINK BETWEEN SCHOOL-BASED HEALTH CARE PROFESSIONALS AND CHILDREN'S HOSPITAL FOR THE PURPOSE OF IDENTIFYING AND ADDRESSING EMERGING ISSUES IMPACTING THE HEALTH AND WELLBEING OF STUDENTS IN GRADES K-12. REFERRING HOSPITALS/COMMUNITY BASED ORGANIZATIONS - CHILDREN'S HOSPITAL PROVIDED SIGNIFICANT OUTREACH EDUCATION TO REFERRING HOSPITALS AND COMMUNITY BASED ORGANIZATIONS TO MAKE SURE THEY HAVE THE CLINICAL EXPERTISE NEEDED TO CARE FOR MEDICALLY COMPLEX CHILDREN. TOPICS COVERED INCLUDED CARE FOR HIGH RISK NEWBORNS, HYPOTHERMIA, PEDIATRIC TRAUMA AND CHILD MALTREATMENT, PEDIATRIC LABORATORY SKILLS, SHAKEN BABY SYNDROME, TO NAME A FEW. PRIMARY CARE PHYSICIANS ($23,071) - IN 2011, CHILDREN'S HOSPITAL PROVIDED 22 SEPARATE CONTINUING MEDICAL EDUCATION PROGRAMS TO A TOTAL OF 285 PRIMARY CARE PROVIDERS. PEDIATRIC SUBSPECIALTY PHYSICIANS FROM CHILDREN'S HOSPITAL SERVED AS THE FEATURED FACULTY, PROVIDING COMMUNITY BASED PHYSICIANS WITH GUIDANCE ON HOW TO MANAGE A WIDE ARRAY OF COMPLEX PEDIATRIC MEDICAL CONDITIONS IN A NUMBER OF TOPICAL AREAS INCLUDING OBESITY AND DIABETES, ONCOLOGY, GASTROENTEROLOGY AND GENETICS. PROGRAMS WERE PROVIDED AT LOCATIONS THROUGHOUT THE HOSPITAL'S SERVICE AREA, INCLUDING BAKERSFIELD, MADERA, MERCED, MODESTO AND SAN LUIS OBISPO. DEVELOPMENTAL DISABILITIES - CHILDREN'S HOSPITAL PROVIDED EDUCATION TO PROVIDERS AND FAMILIES IN A NUMBER OF WAYS, INCLUDING THROUGH THE HOSTING OF SEVERAL CONFERENCES AND WORKING WITH BIRTHING HOSPITALS IN FRESNO AND TULARE COUNTIES AS PART OF THE HOSPITAL'S NEONATAL STABILIZATION PROJECT. THE HOSPITAL CONTINUED TO PARTICIPATE IN COALITIONS FOCUSED ON IMPROVING CARE COORDINATION FOR INFANTS AND CHILDREN WITH, OR AT RISK FOR, DEVELOPMENTAL DELAYS, INCLUDING KERN COUNTY'S MEDICALLY VULNERABLE INFANT WORK GROUP INITIATIVE, AND FIRST 5 FRESNO'S MODEL OF CARE PARTNERSHIP OVERSIGHT COMMITTEE AND SYSTEMS OF CARE COMMITTEE. ALSO, THE HOSPITAL EXPANDED EDUCATION AND TECHNICAL ASSISTANCE OFFERED THROUGH ITS HIGH RISK INFANT FOLLOW UP PROGRAM TO OTHER PROVIDERS AND COMMUNITY BASED AGENCIES REGARDING SCREENING AND ASSESSMENT FOR DEVELOPMENTAL DELAYS IN HIGH RISK INFANTS. LAST, CHILDREN'S HOSPITAL MAINTAINED ITS STRONG PARTNERSHIP WITH THE MARCH OF DIMES ($10,000) IN SUPPORT OF HEALTHY MOMS AND HEALTHY BABIES. INJURY PREVENTION 2011 - RECOGNIZING THAT UNINTENTIONAL INJURY IS THE NATION'S LEADING CAUSE OF DEATH IN CHILDREN, CHILDREN'S HOSPITAL OPERATES AN UNINTENTIONAL INJURY PREVENTION PROGRAM TO INCREASE COMMUNITY AWARENESS OF CHILDHOOD INJURIES AND THOSE MEASURES THAT CAN BE TAKEN TO DECREASE THEIR PREVALENCE THROUGHOUT CENTRAL CALIFORNIA. SUPPORTED BY A CAST OF 75 HOSPITAL EMPLOYEE VOLUNTEERS, THE PROGRAM COVERED THE FOLLOWING TOPICS IN 2011: DISTRACTED & RECKLESS TEEN DRIVING, PEDIATRIC TRAUMA, WATER SAFETY, WHEELED SPORTS SAFETY, CHILD PASSENGER SAFETY, THE CHOKING GAME, SPORTS INJURIES, LITHIUM (BUTTON) BATTERY INGESTION, CHILD MALTREATMENT, MUNCHAUSEN SYNDROME BY PROXY, AND ABUSIVE HEAD TRAUMA. AS THE LEAD AGENCY FOR SAFE KIDS CENTRAL VALLEY, CHILDREN'S HOSPITAL LED THE COALITION OF 9 LOCALLY BASED AGENCIES IN A VARIETY OF PROJECTS TO MEET THE MISSION OF SAFE KIDS IN DECREASING UNINTENTIONAL DEATH AND INJURY TO KIDS AGED 14 AND UNDER. THE PROGRAM PROVIDED EDUCATION TO OVER 12,330 CHILDREN AND FAMILIES AT A HOST OF COMMUNITY BASED VENUES THROUGHOUT THE CENTRAL VALLEY. IN ADDITION, THE HOSPITAL PROVIDED TRAINING AND CONDUCTED OUTREACH TO 1,955 HEALTH CARE, EDUCATION, LAW ENFORCEMENT, AND CHILD WELFARE PROFESSIONALS THROUGH NATIONAL, STATE, REGIONAL, AND LOCAL CONFERENCES AND SEMINARS. IN 2011, CHILDREN'S HOSPITAL INJURY PREVENTION ALSO PROVIDED 23 TELEVISION INTERVIEWS AND MEDIA EVENTS TO ADDRESS CHILD SAFETY ISSUES. THE HOSPITAL NOW PROVIDES A MONTHLY CHILD SAFETY SEGMENT ON TWO LOCAL NEWS PROGRAMS BROADCAST THROUGHOUT THE CENTRAL VALLEY. OBESITY PREVENTION - CHILDREN'S HOSPITAL APPLIED FOR AND RECEIVED FUNDING FROM THE CENTRAL VALLEY HEALTH NETWORK TO SERVE AS THE ADVOCACY COORDINATOR FOR THE KAISER HEAL ZONE PROJECT IN THE CITY OF MADERA. IN ITS ROLE AS BOTH ADVOCACY COORDINATOR AND CHAIR OF THE MADERA HEAL ZONE PARTNERSHIP COMMITTEE, CHILDREN'S HOSPITAL PROVIDED CONSIDERABLE SUPPORT IN THE DEVELOPMENT AND IMPLEMENTATION OF KEY WORK PLAN COMPONENTS.
    THE HEAL ZONE PROJECT IS A THREE YEAR (JULY 2011-JUNE 2014), $1 MILLION INITIATIVE FUNDED BY KAISER NORTHERN CALIFORNIA INTENDED TO PROMOTE HEALTHY EATING AND ACTIVE LIVING IN THE CITY OF MADERA THROUGH THE FOLLOWING THREE GOALS. - DECREASING CALORIE CONSUMPTION AND REDUCING THE AVAILABILITY OF SUGARY DRINKS AND UNHEALTHY SNACKS - INCREASING THE CONSUMPTION OF FRUITS AND VEGETABLES - INCREASING PHYSICAL ACTIVITY ADDITIONALLY, AS THE FOUNDER AND NOW A MEMBER OF THE CHILDHOOD OBESITY PREVENTION TASK FORCE OF FRESNO AND MADERA COUNTIES, CHILDREN'S HOSPITAL PLAYED A LEAD ROLE IN SUPPORTING THE TASK FORCE'S ACTIVITIES IN 2011. EXAMPLES INCLUDE FORMING A COLLABORATIVE AMONG PEDIATRICIANS AND PAYERS FOR THE PURPOSE OF DESIGNING AND IMPLEMENTING A NEW DELIVERY AND PAYMENT MODEL FOR CHILDHOOD OBESITY TREATMENT AND PREVENTION, AND HOSTING A CONFERENCE FOR PRIMARY CARE PROVIDERS ON OBESITY PREVENTION AND ADVOCACY ($334). CHILDREN'S HOSPITAL ALSO PREPARED AND CONVENED TWO CONTINUING MEDICAL EDUCATION PROGRAMS TITLED "CHILDHOOD OBESITY AND RELATED COMORBIDITIES". POISON CONTROL ($48,195) - THE CENTRAL CALIFORNIA POISON CONTROL CENTER IS LOCATED ON THE CHILDREN'S HOSPITAL CAMPUS AND RECEIVES A DONATION OF OFFICE SPACE AND SUPPLIES. IN ADDITION TO PROVIDING EMERGENCY TELEPHONE ADVICE REGARDING POISON EXPOSURES, THE POISON CONTROL CENTER OPERATES SEVERAL PROGRAMS CRITICAL TO A CULTURALLY DIVERSE, AGRICULTURALLY BASED COMMUNITY LIKE THE CENTRAL VALLEY. THE CENTER HAS BEEN EXPRESSLY RESPONSIVE TO THE GROWING AND LARGELY UNDERSERVED LATINO POPULATION BY DEVELOPING SPECIALIZED TEACHING TOOLS AND PROGRAM INTERVENTIONS IN SPANISH, AND PROVIDING CUSTOMIZED TRAININGS FOR COMMUNITY HEALTH WORKERS IN SPANISH. ALSO, THE CENTER CONTRACTS WITH THE STATE DEPARTMENT OF PESTICIDE REGULATION (DPR) TO ASSIST PHYSICIANS IN COMPLYING WITH MANDATORY REPORTING REQUIREMENTS FOR PESTICIDE EXPOSURES. THE POISON CONTROL CENTER ALSO PROVIDES THE STATE DPR WITH CASE DATA AND INFORMATION ON THE HEALTH ISSUES RELATED TO PESTICIDE EXPOSURE IN CALIFORNIA. OTHER ($7,809) - CHILDREN'S PROVIDED SUPPORT TO OTHER PROGRAMS THAT TARGET THE NEEDS OF UNDERSERVED CHILDREN OR BROADER COMMUNITY BASED HEALTH ISSUES INCLUDING CAMP TAYLOR (A SUMMER CAMP FOR CHILDREN WITH CANCER AND THEIR FAMILIES), THE AMERICAN HEART ASSOCIATION, FRESNO CENTER FOR NEW AMERICANS, AND THE AMERICAN RED CROSS. HEALTH CARE WORK FORCE DEVELOPMENT CHILDREN'S IS COMMITTED TO PROMOTING AN ADEQUATE SUPPLY OF HIGHLY TRAINED PROFESSIONALS TO MEET OUR REGION'S FUTURE DEMAND FOR PEDIATRIC HEALTH CARE SERVICES. ACTIVITIES SUPPORTED BY THE HOSPITAL IN 2011 INCLUDED THE FOLLOWING. PHYSICIAN EDUCATION: TO HELP ENSURE AN ADEQUATE SUPPLY OF PHYSICIANS IN CENTRAL CALIFORNIA, CHILDREN'S HOSPITAL SUPPORTED PHYSICIAN EDUCATION IN A NUMBER OF WAYS IN 2011. * CONTRIBUTIONS TO MEDICAL SCHOOLS ($29,600): CHILDREN'S HOSPITAL PROVIDED FINANCIAL SUPPORT TO THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO - FRESNO MEDICAL EDUCATION PROGRAM AND THE UNIVERSITY OF MERCED'S SAN JOAQUIN VALLEY PROGRAM IN MEDICAL EDUCATION PROGRAM. * PEDIATRIC RESIDENCY PROGRAM ($1,736,310) - CHILDREN'S HOSPITAL IS A MAJOR AFFILIATE OF THE UNIVERSITY OF CALIFORNIA SAN FRANCISCO - FRESNO PEDIATRIC RESIDENCY PROGRAM. STRUCTURED AS A THREE-YEAR FULLY ACCREDITED POST-GRADUATE RESIDENCY, THE TRAINING PROGRAM IS HELPING TO ADDRESS THE CRITICAL SHORTAGE OF BOTH PEDIATRICIANS AND PEDIATRIC SUBSPECIALTY PHYSICIANS IN THE CENTRAL VALLEY BY OFFERING ROTATIONS IN GENERAL PEDIATRICS, PEDIATRIC SURGERY, FAMILY PRACTICE, AND EMERGENCY MEDICINE. IN 2011, 31 MEDICAL RESIDENTS RECEIVED TRAINING AT CHILDREN'S HOSPITAL. * PHARMACY RESIDENCY PROGRAM ($352,433) - CHILDREN'S HOSPITAL SUPPORTED A PHARMACY RESIDENCY PROGRAM IN 2011 THAT PROVIDED TRAINING TO 6 RESIDENTS. HEMATOLOGY CLASS ($7,300) - CHILDREN'S HOSPITAL MADE A DONATION TO CALIFORNIA STATE UNIVERSITY - FRESNO FOR A HEMATOLOGY CLASS TAUGHT. HEALTH CAREERS PROMOTION - CHILDREN'S HOSPITAL CONTINUED TO PROMOTE HEALTH CAREERS THROUGH THE HOSPITAL'S JOB SHADOWING PROGRAM THAT OFFERS HIGH SCHOOL AND COLLEGE STUDENTS THE OPPORTUNITY TO SHADOW HOSPITAL PHYSICIANS, EMPLOYEES, AND VOLUNTEERS. ADDITIONALLY, THE HOSPITAL PARTNERED WITH SUNNYSIDE DOCTORS' ACADEMY, CLOVIS NORTH HIGH SCHOOL, AND THE CENTER FOR ADVANCED RESEARCH AND TECHNOLOGY FOR INTERNSHIP ROTATIONS AT THE HOSPITAL. COMMUNITY HEALTH EDUCATION COMMUNITY HEALTH EDUCATION IS A PARAMOUNT PRIORITY TO THE HOSPITAL, WHICH HAS A LONG-STANDING COMMITMENT TO PROVIDING COMMUNITY WELLNESS AND PREVENTION EDUCATION PROGRAMS. CLASSES WERE OFFERED AT THE HOSPITAL AS WELL AS AT OTHER COMMUNITY VENUES. CLASSES WERE TAUGHT BY CHILDREN'S HOSPITAL PROFESSIONALS WHO HAVE SPENT YEARS STUDYING AND GAINING EXPERIENCE IN THEIR CHOSEN FIELDS. CLASSES WERE OPEN TO THE COMMUNITY AT NO COST. EXAMPLES OF CLASSES OFFERED IN 2011 INCLUDE THE FOLLOWING. ASTHMA BASICS - THIS CLASS PROVIDED INFORMATION ABOUT CONTROLLING ASTHMA; PROPER USE OF MEDICATIONS; PEAK FLOW METERS; METER DOSE INHALERS AND SPACERS; RECOGNIZING EARLY WARNING SIGNS OF ASTHMA; ENVIRONMENTAL CONTROL AND WHAT TRIGGERS AN ASTHMA ATTACK.
    CPR FOR FAMILY AND FRIENDS - OFFERED TO FAMILIES WHO WERE TAKING A CHILD HOME FROM CHILDREN'S HOSPITAL, THIS CLASS PRESENTED INFORMATION ON THE AMERICAN HEART ASSOCIATION'S (AHA) PEDIATRIC CHAIN OF SURVIVAL, SIGNS OF CHOKING, PREVENTION OF SUDDEN INFANT DEATH SYNDROME, AND PREVENTION OF THE MOST COMMON FATAL INJURIES IN INFANTS AND CHILDREN. THE COURSE ALSO PRESENTED INFORMATION ABOUT THE AHA ADULT CHAIN OF SURVIVAL AND SIGNS OF CARDIAC ARREST, HEART ATTACK, STROKE AND CHOKING IN ADULTS. CHILDREN'S HOSPITAL ALSO PROVIDED ACCESS TO EDUCATIONAL INFORMATION VIA ITS WEBSITE, INCLUDE THE FOLLOWING TWO SERVICES. E-HEALTH NEWSLETTER ($9,000) - CHILDREN'S HOSPITAL APPRECIATES HOW DIFFICULT IT IS FOR PARENTS TO KEEP UP WITH ALL THE LATEST CHILD HEALTH AND SAFETY INFORMATION. E-HEALTH NEWSLETTER PROVIDES TRUSTED, CREDIBLE CHILD HEALTH AND SAFETY INFORMATION FROM HOSPITAL PEDIATRIC EXPERTS AS WELL AS OTHER EXPERTS FROM AROUND THE COUNTRY. MOST IMPORTANT, FAMILIES ARE ABLE TO CUSTOMIZE THE INFORMATION TO MEET A CHILD'S HEALTH AND SAFETY INFORMATION NEEDS. HEALTH ENCYCLOPEDIA ($13,395) - THE CHILDREN'S HEALTH ENCYCLOPEDIA CONTAINS THOUSANDS OF PAGES OF INFORMATION ON PEDIATRIC DISEASES, CONDITIONS AND TREATMENTS, AS WELL AS SECTIONS ON HOW TO KEEP KIDS HEALTHY. THE ENCYCLOPEDIA IS AVAILABLE IN ENGLISH AND SPANISH FAMILY ASSISTANCE FAMILY CENTERED CARE IS A CORNERSTONE OF CHILDREN'S HOSPITAL. THE HOSPITAL UNDERSTANDS THAT FAMILIES MUST BE GIVEN SUPPORT AND RESOURCES TO EFFECTIVELY PARTICIPATE IN THEIR CHILD'S CARE. CULTURALLY COMPETENT HEALTH CARE - WITH A SERVICE AREA THAT IS HOME TO OVER 100 DOCUMENTED LANGUAGES AND 37 DISTINCT CULTURES, CHILDREN'S HOSPITAL IS COMMITTED TO MEETING THE NEEDS OF A VERY DIVERSE PATIENT POPULATION. AS IT HAS DONE FOR YEARS, THE HOSPITAL IN 2011 PROVIDED LANGUAGE ASSISTANT 24 HOURS A DAY, SEVEN DAYS A WEEK. CHILDREN'S HOSPITAL ALSO WORKED WITH A VARIETY OF ETHNIC GROUPS TO ENSURE THAT THE HOSPITAL WAS PROVIDING CARE IN AS CULTURALLY SENSITIVE A MANNER AS POSSIBLE. TRANSPORTATION ($127,138) - CHILDREN'S HOSPITAL'S SOCIAL WORK DEPARTMENT ASSISTED FAMILIES WITH TRANSPORTATION BY PROVIDING TAXI VOUCHERS AND BUS TOKENS. IN ADDITION, CHILDREN'S HOSPITAL SUBSIDIZED BUS AND TRANSIT SERVICES FROM FRESNO AND THE KINGS COUNTY RURAL AREAS. PUBLIC TRANSPORTATION HAS BEEN A PROBLEM IN THE CENTRAL VALLEY FOR YEARS AND THUS CHILDREN'S HOSPITAL IS CONTINUING TO WORK WITH THE COMMUNITY TO IMPROVE PUBLIC TRANSPORTATION AND IN TURN IMPROVE ACCESS TO CARE. CAFETERIA MEALS ($59,125) - MEAL COUPONS WERE PROVIDED TO BREAST-FEEDING MOMS WHOSE INFANTS WERE IN THE HOSPITAL. SOCIAL WORKERS ALSO PROVIDED PATIENTS' FAMILIES WITH MEAL COUPONS WHEN THEY ARRIVED AND WERE NOT PREPARED FOR A LONG STAY AT THE HOSPITAL. FAMILY ASSISTANCE FUND ($41,405) - WHEN SUPPORT FOR SERVICES WERE NOT AVAILABLE THROUGH A COMMUNITY PROGRAM OR ANOTHER FUNDING SOURCE, SOCIAL WORKERS WERE ABLE TO ACCESS THESE HOSPITAL FUNDS TO HELP PATIENTS AND FAMILIES OBTAIN ITEMS NEEDED UPON RETURN HOME OR ASSIST WITH TRANSPORTATION FOR FOLLOW UP CARE. ENROLLMENT INTO HEALTH INSURANCE - CHILDREN'S HOSPITAL COMMITS SIGNIFICANT RESOURCES IN HELPING FAMILIES FIND HEALTH INSURANCE COVERAGE FOR THEMSELVES AND THEIR UNINSURED CHILDREN. SERVICES PROVIDED BY THE HOSPITAL INCLUDED FINANCIAL COUNSELORS AS WELL AS A CONTRACTED VENDOR WITH EXPERTISE IN ENROLLMENT SERVICES ($203,309). THROUGH THESE SERVICES, CHILDREN'S HOSPITAL SCREENS UNINSURED AND UNDER-INSURED FAMILIES FOR ELIGIBILITY IN MEDI-CAL, HEALTHY FAMILIES, THE CALIFORNIA CHILDREN'S SERVICES PROGRAM, AS WELL AS THE CHILDREN'S HOSPITAL FINANCIAL ASSISTANCE PROGRAM. ONCE ELIGIBILITY IS DETERMINED, THE HOSPITAL ASSISTS IN THE COMPLETION OF APPLICATIONS, AND SUBMITS APPLICATIONS TO THE APPROPRIATE PROCESSING OR FUNDING AGENCIES. CHILDREN'S HOSPITAL ALSO SUPPORTED OUTREACH AND ENROLLMENT SERVICES OFFERED THROUGH THE FRESNO HEALTHY COMMUNITIES ACTION PROGRAM ($2,500).
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS - PROGRAM SERVICE TWO PART III, LINE 4B: COMMITMENT TO MEDI-CAL CHILDREN'S HOSPITAL'S COMMITMENT TO SERVING ITS COMMUNITY IS EVIDENCED BY THE LARGE NUMBER OF PATIENTS ITS SERVES THAT ARE COVERED BY MEDI-CAL. IN 2011, OF THE HOSPITAL'S 84,322 TOTAL INPATIENT DAYS, 62,777 (75%) WERE COVERED BY MEDI-CAL. THE HOSPITAL HAS HISTORICALLY BEEN ABLE TO NEGOTIATE INCREASES TO ITS MEDI-CAL INPATIENT REIMBURSEMENT. THESE INCREASES, HOWEVER, HAVE NOT OFFSET THE RISING COST OF CARE FOR THESE PATIENTS AND IN RECENT YEARS, ADDITIONAL RATES FREEZES AND CUTBACKS IN GOVERNMENT FUNDING CONTINUE TO PUT PRESSURE ON THE HOSPITAL'S ABILITY TO PROVIDE CARE. IN ADDITION, THE MEDI-CAL OUTPATIENT FEE SCHEDULE REIMBURSEMENT REMAINS SIGNIFICANTLY BELOW COST. THE COMBINED NET EFFECT OF TOTAL MEDI-CAL REIMBURSEMENT AND DISPROPORTIONATE SHARE FUNDING IN RELATION TO THE COST OF THESE SERVICES RESULTED IN A NET LOSS TO THE HOSPITAL IN 2011 OF $25,804,563. THIS FIGURE IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS, AND ALSO EXCLUDES THE REVENUE AND EXPENSES ASSOCIATED WITH THE HOSPITAL FEE PROGRAM, WHICH IS DESCRIBED IN MORE DETAIL BELOW. HOSPITAL FEE PROGRAM - IN 2009, CALIFORNIA IMPLEMENTED THE HOSPITAL FEE PROGRAM THROUGH WHICH HOSPITALS IN CALIFORNIA, INCLUDING CHILDREN'S HOSPITAL CENTRAL CALIFORNIA, RECEIVED SUPPLEMENTAL MEDI-CAL PAYMENTS. CALIFORNIA IMPLEMENTED THE PROGRAM TO HELP OFFSET A PORTION OF HOSPITAL MEDI-CAL PAYMENT SHORTFALLS ACCRUED OVER CURRENT AND PRIOR YEARS. THE PROGRAM WAS FUNDED BY A QUALITY ASSURANCE FEE PAID BY HOSPITALS THAT THE STATE THEN USED TO COLLECT ADDITIONAL FEDERAL FUNDING. HOSPITAL FEE PROGRAMS LIKE CALIFORNIA'S ARE ALLOWABLE UNDER FEDERAL LAW, AND THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES APPROVED CALIFORNIA'S PROGRAM. CALIFORNIA'S PROGRAM WAS IMPLEMENTED IN TWO PARTS, WITH PART ONE COVERING THE PERIOD APRIL 1, 2009 THROUGH DECEMBER 31, 2010, AND PART TWO COVERING THE PERIOD JANUARY 1, 2011 THROUGH JUNE 30, 2011. IN 2011, CHILDREN'S HOSPITAL RECOGNIZED $68,478,000 IN PART ONE PROGRAM REVENUE, NET OF THE HOSPITAL'S QUALITY ASSURANCE FEE AND HOSPITAL CONTRIBUTIONS TO THE CALIFORNIA HEALTH FOUNDATION AND TRUST (CHFT). CHFT WAS ESTABLISHED UNDER THE PROGRAM FOR THE PURPOSE OF SUPPORTING CHARITABLE ACTIVITIES. RECOGNIZED NET REVENUE FROM PART TWO OF THE PROGRAM FALLS WITHIN THE HOSPITAL'S 2012 FISCAL YEAR AND THEREFORE IS NOT INCLUDED HERE. AS THE HOSPITAL'S HOSPITAL FEE PROGRAM REVENUE RECOGNIZED IN 2011 EXCEEDED THE HOSPITAL'S UNCOMPENSATED MEDI-CAL COSTS IN 2011, THE HOSPITAL IS NOT REPORTING ANY UNCOMPENSATED MEDI-CAL IN 2011. FOR DECADES, CALIFORNIA HAS BEEN UNABLE TO REIMBURSE HOSPITALS LIKE CHILDREN'S FOR MEDI-CAL SERVICES AT LEVELS WHICH COVER COSTS. THE FUTURE LOOKS EVEN WORSE GIVEN RECENTLY ENACTED MEDI-CAL FUNDING CUTS AT BOTH THE STATE AND FEDERAL LEVELS, ALONG WITH THE PRESSURE THAT ONGOING GOVERNMENT BUDGET DEFICITS WILL PLAY ON REDUCING MEDI-CAL FUNDING EVEN FURTHER. WHILE THE PROGRAM'S PAYMENTS HAVE PLAYED AN IMPORTANT ROLE IN OFFSETTING SOME OF THE HOSPITAL'S LOSSES, THE PROGRAM'S LIMITED DURATION MEANS THAT IT WILL NOT SERVE AS A LONG-TERM SOLUTION TO THE HOSPITAL'S CHRONIC MEDI-CAL PAYMENT SHORTFALLS. CHARITY CARE IN KEEPING WITH OUR MISSION, CHILDREN'S HOSPITAL CONTINUES TO ACCEPT ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. IN 2011, CHILDREN'S HOSPITAL PROVIDED $11,000 IN CHARITY CARE. THE AMOUNT REPRESENTS COSTS ASSOCIATED WITH PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY WITHOUT CHARGE, OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES IN RELATION TO THE COST OF THESE SERVICES. CHARITY CARE INCLUDES COUNTY INDIGENT AND FREE CARE, WHICH IS BASED ON THE PATIENT'S INABILITY TO PAY FOR SERVICES. IN ORDER TO ASSIST FAMILIES WITH ONGOING CARE NEEDS, CHILDREN'S HOSPITAL'S FINANCIAL ASSISTANCE POLICY REQUIRES PATIENT FAMILIES TO APPLY FOR APPROPRIATE GOVERNMENT FUNDING IN CONJUNCTION WITH APPLYING FOR FINANCIAL ASSISTANCE (CHARITY CARE). AS A RESULT, MANY FAMILIES QUALIFY FOR GOVERNMENT PROGRAMS AND DO NOT ULTIMATELY REQUIRE CHARITY CARE. THE HOSPITAL'S CHARITY CARE AMOUNT IS SEPARATE FROM AND DOES NOT INCLUDE THE COMMUNITY BENEFIT ACTIVITIES AND EXPENSES NOTED IN PREVIOUS SECTIONS.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2010

Additional Data


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

OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
 
Employer identification number

94-1294954
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 CENTRAL CALIFORNIA FOUNDATION

9300 VALLEY CHILDRENS PLACE

MADERA,CA93636
94-2797447 		PHILANTHROPY/FUNDRAISING FOR THE HOSPITAL CA 501(C)(3) 11 TYPE I N/A
 
No












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



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No












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



 		(b)
Primary activity



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


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

 		(f)
Share of total income



 		(g)
Share of
end-of-year
assets

 		(h)
Percentage
ownership
(1) SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA
9300 VALLEY CHILDRENS PLACE
MADERA,CA93636
77-0450620 		MEDICAL GROUP CA N/A
 C 39,331,832 5,059,081 100.000 %












Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III or IV.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1k
Yes
 
l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .
1l
Yes
 
m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
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) CHILDREN'S HOSPITAL CENTRAL CALIFORNIA FOUNDATION

 C 6,980,041 CASH VALUE
(2) SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA

 K 1,001,231 CASH VALUE
(3) SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA

 L 10,715,131 CASH VALUE
(4)
(5)
(6)
Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Are all
partners
section
501(c)(3)
organizations? 		(e)
Share of
end-of-year
assets 		(f)
Disproprtionate allocations? 		(g)
Code V—UBI
amount in box
20 of Schedule K-1
(Form 1065) 		(h)
General or
managing
partner?
Yes No Yes No Yes No






























Schedule R (Form 990) 2010
Schedule R (Form 990) 2010
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation
Additional Data


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