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.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL AND HEALTH CENTER
Employer identification number
95-3545901
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
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(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
Provide the following information about the supported organization(s).
(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.") ....
558,305
661,990
960,984
5,120,753
409,230
7,711,262
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..
558,305
661,990
960,984
5,120,753
409,230
7,711,262
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.
7,711,262
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..
558,305
661,990
960,984
5,120,753
409,230
7,711,262
8
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
191,277
275,343
143,859
1,854,066
422,186
2,886,731
9
Net income from unrelated business activities, whether or not the business is regularly carried on..
-29,202
-41,316
-105,490
-16,619
-50,585
-243,212
10
Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
161,443
381,910
2,461
221,282
-105,536
661,560
11
Total support (Add lines 7 through 10).
11,016,341
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
4,876,026
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
69.998 %
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
72.723 %
16a
33 1/3% support test—2010.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2009.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2009.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
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
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2009 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2009 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2010.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2009.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
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:
-
TIN:
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.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2010
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL AND HEALTH CENTER
Employer identification number
95-3545901
Identifier
Return Reference
Explanation
FORM 990, PART III, LINE 1
MISSION DESCRIPTION
Rady Children's Hospital and Health Center (RCHHC) was formed to acquire, establish, maintain, conduct, operate, raise funds for, and otherwise support, directly or indirectly through its affiliates, facilities and programs for the benefit of children and adults with diseases, disorders, and other health problems of pediatric origin, including providing resources for charity care, research, and education. In addition, RCHHC solicits and receives grants and donations to be used to promote and advance the welfare and activities of its affiliates.
PART VI
Section B, Line 11B - The Form 990 was reviewed by the Chief Financial Officer and then provided to the organization's Audit and Corporate Responsibility Committee for review. Following review by the Committee, the Form 990 was finalized, signed and submitted to the Internal Revenue Service. A complete copy of the Form 990 was provided to each voting board member prior to filing. Section B, Line 12c - On an annual basis and upon election or appointment, the policy and disclosure statement is distributed to all Board members, officers, and key employees and medical staff leaders. All completed and signed statements are returned to the Corporate Compliance Officer for review. Financial interest disclosures by board members and officers are brought to the RCHHC Board of Trustees or the Audit and Corporate Responsibility Committee for review and, as needed, appropriate action. Financial interest disclosures by key employees and medical staff leaders are reviewed by the Corporate Compliance Officer and referred to the President and Chief Executive Officer or to the RCHHC Board of Trustees. The Corporate Compliance Officer reports annually to the Executive Corporate Compliance Committee and the Audit and Corporate Responsibility Committee a summary of all disclosures and action taken, if any. All other employees are required to complete a disclosure statement on an annual basis that is reviewed by the Corporate Compliance Officer.
PART VI, SECTION B & C
Section B Line 15 - Rady Children's Hospital and Health Center/Rady Children's Hospital - San Diego working through the Board Compensation Committee has a process for establishing, reviewing and approving compensation of officers and key employees of the organization on a no less than an annual basis. The Compensation Committee is comprised of independent, lay members of the Board of Trustees. Prior to conducting its review, the Chair of the Compensation Committee determines whether any member has a conflict of interest with respect to the matter(s) under review. If there is a conflict, the conflicted member recuses himself/herself and is not present during discussion or vote on the arrangement under review. In determining and approving the compensation arrangement, the Committee considers all components of compensation. It considers comparability data and usually retains an independent compensation consultant to provide comparability data to the committee. Total compensation is targeted to be between the 50th and 75th percentiles of the comparability data. The Committee's deliberations and decisions are documented in minutes that are reviewed at its next meeting or sixty days after action. The Committee's written records include the (1) terms of the arrangement with the disqualified person (including the date the arrangement was approved); (2) a list of members present during the discussion of the transaction (and how the members voted when it was approved); and (3) a description of the comparable data relied on by the Committee. Section C, Line 19 - While federal tax laws do not mandate that the organization's governing documents, conflict of interest policy and financial statements be made available for public inspection, the organization makes its financial statements available upon request.
PART XI, RECONCILIATION OF NET ASSETS
UNREALIZED GAINS ON INVESTMENT: 3,939,139 book to tax adjustment for investment partnership:(2,842,395) --------- 1,096,744
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FORM 990 PART VII
NAME:Lisa A Barkett TITLE:Board Member HOURS:
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HOURS DEVOTED FOR RELATED ORGANIZATION
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NAME:Catherine J Mackey, PhD TITLE:Board Member HOURS:1
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NAME:G. Diego Miralles, MD TITLE:Board Member HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION
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NAME:Michael P Peckham TITLE:Board Member HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION
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NAME:Harry M Rady TITLE:Board Member HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:Theodore D Roth TITLE:Board Member/vice chair HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:Scott N Wolfe, Esq TITLE:Board Member HOURS:1
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:David A Brenner, MD TITLE:Board Member HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION
FORM 990 PART VII
NAME:Marye Anne Fox, PhD TITLE:Board Member HOURS:
HOURS DEVOTED FOR RELATED ORGANIZATION
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NAME:Mary Hilfilker, MD TITLE:Board Member HOURS:1
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NAME:Anthony E Magit, MD TITLE:Board Member HOURS: