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
2012
Open to Public Inspection
A For the 2012 calendar year, or tax year beginning 07-01-2012 , 2012, and ending 06-30-2013
BCheck if applicable:
CName of organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
3020 Childrens Way MC 5001
Suite
Room/suite
City or town, state or country, and ZIP + 4
San Diego, CA921234282
D Employer identification number

95-1691313
E Telephone number

G Gross receipts $ 916,986,436
F Name and address of principal officer:
Donald B Kearns MD MMM
3020 Childrens WayMC 5001
San Diego,CA921234282
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
www.rchsd.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: 1954
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE HOSPITAL PROVIDES COMPREHENSIVE PEDIATRIC MEDICAL SERVICES IN SAN DIEGO, SOUTHERN RIVERSIDE, AND IMPERIAL COUNTIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 21
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 21
5 Total number of individuals employed in calendar year 2011 (Part V, line 2a) ...... 5 4,236
6 Total number of volunteers (estimate if necessary) ............. 6 525
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 862,465
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b -51,586
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 153,359,580 151,069,577
9 Program service revenue (Part VIII, line 2g) ......... 595,525,825 624,368,389
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 13,783,698 31,713,570
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 7,291,687 11,486,627
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 769,960,790 818,638,163
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 0 0
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) 298,452,862 317,567,741
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet337,853    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 361,731,376 383,231,747
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 660,184,238 700,799,488
19 Revenue less expenses. Subtract line 18 from line 12....... 109,776,552 117,838,675
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,235,958,112 1,361,773,690
21 Total liabilities (Part X, line 26)............. 681,730,466 608,124,628
22 Net assets or fund balances. Subtract line 21 from line 20..... 554,227,646 753,649,062
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
 
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ............
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y
Form 990 (2012)
Form 990 (2012)
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 RESTORE, SUSTAIN AND ENHANCE THE HEALTH AND DEVELOPMENTAL POTENTIAL OF CHILDREN THROUGH EXCELLENCE IN CARE, EDUCATION, RESEARCH AND ADVOCACY.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? ......................
If “Yes,” describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program services? ............................
If “Yes,” describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations 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 $ 528,837,949 including grants of $   ) (Revenue $ 624,368,389 )
Rady Children's Hospital San Diego (the Hospital) is a regional tertiary and quaternary referral center and provides comprehensive inpatient and outpatient acute, psychiatric and intensive care pediatric services. The Hospital also is the sole pediatric provider and designated pediatric trauma center for San Diego County and is the primary source of pediatric and neonatal intensive care services for both San Diego and Imperial Counties. On its main campus the Hospital operates the only level 4 full scope neonatal intensive care unit in San Diego County. In addition, the Hospital operates an 11-bed level 2 neonatal intensive care unit in rancho springs and two level 2 neonatal intensive care units for Scripps Health located in La Jolla and Encinitas; an 11-bed pediatric medical unit for Sharp Health located at its Sharp Grossmont Campus; and two units for palomar pomerado health, a 17-bed pediatric medical unit and a level 3, 12-bed neonatal iNtensive care unit, both located at palomar medical center in escondido. The Hospital is amalgamated with the University of California, San Diego, Health Sciences, and serves as a center for graduate and post-graduate education in the field of pediatrics. Annually, the Hospital has approximately 17,000 inpatient admissions and approximately 330,000 visits per year in its outpatient departments. Additionally, the emergency department and urgent care centers provide approximately 70,000 and 47,000 visits, respectively, per year.
4b (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4c (Code:   ) (Expenses $   including grants of $   ) (Revenue $   )
4d Other program services (Describe in Schedule O.)
(Expenses $   including grants of $   ) (Revenue $   )
4e Total program service expensesMediumBullet528,837,949
Form 990 (2012)
Form 990 (2012)
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 (see instructions)? 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, or have a section 501(h) election in effect during the tax year? If “Yes,” complete Schedule C, Part IIClick to see attachment........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19? If “Yes,” complete Schedule C,
Part IIIClick to see attachment............................
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If “Yes,” complete Schedule D, Part IClick to see attachment........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If “Yes,” complete Schedule D, Part IIClick to see attachment...
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If “Yes,” complete Schedule D, Part III Click to see attachment....................
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If “Yes,” complete Schedule D, Part IVClick to see attachment..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments? If “Yes,” complete Schedule D, Part VClick to see attachment......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10?
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 VIIClick to see attachment.......
11b
 
No
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If “Yes,” complete Schedule D, Part VIIIClick 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 IXClick to see attachment............
11d
Yes
 
e
Did the organization report an amount for other liabilities in Part X, line 25? If “Yes,” complete Schedule D, Part XClick 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 XClick 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 and XII 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 and XII is optional Click to see attachment
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If “Yes,” complete Schedule E....
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States?.....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If “Yes,” complete Schedule F, Parts I and IV.........
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 United States? If “Yes,” complete Schedule F, Parts II and IV
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 United States? If “Yes,” complete Schedule F, Parts III and IV...
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 (see instructions)....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If “Yes,” complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If “Yes,” complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If “Yes,” complete Schedule H.... Click to see attachment
20a
Yes
 
b
If “Yes” to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see list of attachments
20b
Yes
 
Form 990 (2012)
Form 990 (2012)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants and other assistance to any government or organization in the United States on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II...
21
 
No
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........
22
 
No
23
Did the organization answer “Yes” to Part VII, Section A, line 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 lines 24b through 24d and complete Schedule K. If “No,” go to line 25................ Click to see list of attachments
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, highest compensated employee, or disqualified person outstanding as of the end of the organization’s tax year? If “Yes,” complete Schedule L,
Part II.......................... Click to see attachment
26
Yes
 
27
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons? If “Yes,” complete Schedule L, Part III......... Click to see attachment
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, or key employee? If “Yes,” complete Schedule L, Part IV .......................... Click to see attachment
28a
 
No
b
A family member of a current or former officer, director, trustee, or key employee? If “Yes,”
complete Schedule L, Part IV..................... Click to see attachment
28b
 
No
c
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner? If “Yes,” complete Schedule L, Part IV... Click to see attachment
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If “Yes,” complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If “Yes,” complete Schedule M.............
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If “Yes,” complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If “Yes,” complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If “Yes,” complete Schedule R, Part I........ Click to see attachment
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If “Yes,” complete Schedule R, Part II, III, or IV, and Part V, line 1........................ Click to see attachment
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
 
No
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If “Yes,” complete Schedule R, Part V, line 2...
35b
 
 
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 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Form 990 (2012)
Form 990 (2012)
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
697
b
Enter the number of Forms W-2G included in line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
4,236
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, securities account, or other financial 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 as charitable contributions?...
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. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the 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 amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If “No,” provide an explanation in Schedule O..
14b
 
 
Form 990 (2012)
Form 990 (2012)
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
21
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent ...................
1b
21
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
 
No
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If “Yes,” provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If “Yes,” did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe in Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If “No,” go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If “Yes,” describe in Schedule O how this was done.......................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process in Schedule O (see instructions).
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If “Yes,” did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the States with which a copy of this Form 990 is required to be filedMediumBullet
CA
18
Section 6104 requires an organization to make its Form 1023 (or 1024 if applicable), 990, and 990-T (501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how), the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, physical address, and telephone number of the person who possesses the books and records of the organization:
MediumBulletROGER ROUX3020 CHILDRENS WAY MC 5001San DiegoCA921234282 (858) 966-5824
Form 990 (2012)
Form 990 (2012)
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. 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 organization compensated any current officer, director, or trustee.
(A)
Name and Title 		(B)
Average hours per week (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(1) LISA A BARKETT........................................................................
BOARD MEMBER
 .34
........................34 		X                
(2) Andrew S Clark........................................................................
BOARD MEMBER
 0.0
.......................0.0 		X                
(3) JOHN M GILCHRIST JR........................................................................
Board Member
 .41
........................62 		X                
(4) DAVID F HALE........................................................................
CHAIR
 .92
.......................1.71 		X   X            
(5) S Douglas Hutcheson........................................................................
Board Member
 .55
........................55 		X                
(6) Jeffrey A Jacobs........................................................................
Board Member
 .13
........................13 		X                
(7) Greg T Lucier........................................................................
Board Member
 .1
........................1 		X                
(8) CATHERINE J MACKEY PHD........................................................................
Board Member
 .46
........................46 		X                
(9) Tina Nova PhD........................................................................
Board Member
 .14
........................14 		X                
(10) Michael P Peckham........................................................................
Board Member
 .5
........................5 		X                
(11) THEODORE D ROTH........................................................................
VICE CHAIR
 .75
.......................1.12 		X   X            
(12) Mark A Snell........................................................................
Board member
 .05
........................05 		X                
(13) G Diego Miralles MD........................................................................
Board Member
 .38
........................58 		X                
(14) SCOTT N WOLFE ESQ........................................................................
Board Member
 .68
.......................1.02 		X                
(15) David A Brenner MD........................................................................
Board Member
 .23
........................23 		X                
(16) James Harley........................................................................
Board Member
 .37
........................37 		X                
(17) Pradeep Khosla PhD........................................................................
Board Member
 .24
........................24 		X                
Form 990 (2012)
Form 990 (2012)
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 (list any hours for related organizations below dotted line) 		(C)
Position (do not check more than one box, unless person is both an officer and a director/trustee) 		(D)
Reportable compensation from the organization (W- 2/1099-MISC) 		(E)
Reportable compensation from related organizations (W- 2/1099-MISC) 		(F)
Estimated amount of other compensation from the organization and related organizations
Individual Trustee or Director; Institutional Trustee; Officer; Key Employee; Highest compensated employee; Former;
(18) Gail R Knight MD........................................................................
Board Member
 0.0
.......................0.0 		X                
(19) Harry M Rady........................................................................
Board Member
 .57
........................57 		X                
(20) William B Sailer Esq........................................................................
Board Member
 .82
.......................1.67 		X                
(21) John D Stobo Md........................................................................
Board Member
 0.0
.......................0.0 		X                
(22) Roger Roux........................................................................
SVP/CFO
 15.75
.......................24.25 		    X       627,566 0 60,681
(23) Kathleen A Sellick........................................................................
President/CEO
 14.0
.......................26.0 		    X       1,072,822 0 88,868
(24) Margareta E Norton........................................................................
SVP/COO
 16.0
.......................24.0 		    X       682,839 0 75,387
(25) Belinda Santos........................................................................
assistant Secretary
 20.0
.......................20.0 		    X       87,570 0 16,515
(26) Albert Oriol........................................................................
VP, CIO
 40.0
.......................0.0 		      X     373,052 0 54,658
(27) David B Gillig........................................................................
SVP/Exec Dir
 14.0
.......................26.0 		      X     558,946 0 20,172
(28) Irvin A Kaufman MD........................................................................
SVP/HEALTH AFFAIRS
 20.0
.......................20.0 		      X     597,040 0 83,137
(29) Timothy Lee Jacoby........................................................................
VP,FACILITIES,CONSTR &PLANNING
 40.0
.......................0.0 		      X     365,064 0 37,022
(30) Angela Marie Vieira........................................................................
VP/GENERAL COUNSEL
 40.0
.......................0.0 		      X     315,429 0 53,879
(31) Barbara Ryan........................................................................
VP/GOVERNMENT AFFAIRS
 40.0
.......................0.0 		      X     295,661 0 96,565
(32) Charles Wilson........................................................................
Sr. Director/chadwick center
 40.0
.......................0.0 		      X     296,964 0 102,739
(33) Chris Abe........................................................................
SR. DIR ANCILLARY/SUPP SVCS
 40.0
.......................0.0 		      X     248,812 0 49,698
(34) Mary Jane Fagan........................................................................
VP/PATIENT CARE SERVICES/CNO
 40.0
.......................0.0 		      X     304,226 0 44,724
(35) Mohammed Mamoon Syed........................................................................
VP, Human Resources
 40.0
.......................0.0 		      X     296,360 0 36,003
(36) Scott D Campbell........................................................................
VP, CFO, MPF
 40.0
.......................0.0 		      X     295,002 0 57,137
(37) Beth Mohr........................................................................
VP, Controller
 40.0
.......................0.0 		      X     209,109 0 41,584
(38) Glenn F Billman........................................................................
Chief quality Officer
 40.0
.......................0.0 		        X   263,837 0 75,119
(39) Barbara L Holt........................................................................
NICU Director
 40.0
.......................0.0 		        X   250,604 0 10,475
(40) Craig C Kishaba........................................................................
Directr, Business & Comm Devlp
 40.0
.......................0.0 		        X   215,249 0 63,026
(41) Kristin Gist........................................................................
Sr Dir, Developmental Svcs
 40.0
.......................0.0 		        X   214,318 0 49,822
(42) Kenneth H Schell........................................................................
Pharmacist in Chief
 40.0
.......................0.0 		        X   202,707 0 65,783
(43) Blair Sadler........................................................................
FORMER PRESIDENT/CEO
 0.0
.......................0.0 		          X 274,789 0 0
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)............MediumBullet 8,047,966 0 1,182,994
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet543
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If “Yes,” complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If “Yes,” complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If “Yes,” complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
Children's Specialists of San Diego, 3020 Childrens Way Mc 5001SAN DIEGOCA92123 Medical Services 75,600,235
Scripps Memorial- La Jolla, 4275 Campus Point Ct Cp-1SAN DIEGOCA92121 Medical Claims 5,625,297
Quest Diagnostics Nichols, 33608 Ortega HwySAN JUAN CAPISTRANOCA92675 Medical Services 1,911,073
Zanett Commercial Solutions Inc 59, 3899 Solutions CenterCHICAGOIL606773008 Medical Services 1,668,089
AMN Healthcare INC, 12400 High Bluff DriveSAN DIEGOCA92130 Medical services 11,985,485
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet79
Form 990 (2012)
Form 990 (2012)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response to any question in this Part VIII ..............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512, 513, or 514
Contributions, Gifts, Grants and Other Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d 5,435,439
e Government grants (contributions)1e 100,629,144
f All other contributions, gifts, grants, and
similar amounts not included above1f 		45,004,994
g Noncash contributions included in lines
1a-1f:$ 		 
h Total. Add lines 1a-1f.......MediumBullet 151,069,577
Program Service Revenue Business Code
2a NET PATIENT SERVICE REVENUE 621400 533,559,654 533,559,654    
b CAPITATED CONTRACT REVENUE 623000 68,617,437 68,617,437    
c OUTPATIENT PHARMACEUTICAL 446110 7,800,499 7,800,499    
d CONFERENCE & TUITION REVENUE 611710 1,416,588 1,416,588    
e MEDICAL SERVICES REIMBURSEMENT 611710 4,150,136 4,150,136    
f All other program service revenue . 8,824,075 8,824,075    
g Total. Add lines 2a–2f........MediumBullet 624,368,389
Other Revenue 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 11,769,395     11,769,395
4 Income from investment of tax-exempt bond proceeds..MediumBullet 0      
5 Royalties...........MediumBullet 0      
(i) Real (ii) Personal
6a Gross rents 1,734,285  
b Less: rental expenses    
c Rental income or (loss) 1,734,285 0
d Net rental income or (loss).......MediumBullet 1,734,285     1,734,285
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 118,292,448  
b Less: cost or other basis and sales expenses 98,348,273  
c Gain or (loss) 19,944,175  
d Net gain or (loss)..........MediumBullet 19,944,175     19,944,175
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet 0    
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet 0      
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet 0      
Miscellaneous Revenue Business Code
11a PARKING 812930 2,051,231     2,051,231
b FOOD SERVICE REVENUE 721000 1,633,324     1,633,324
c DUKE ENERGY CONSENT PAYMENT 900099 2,750,000     2,750,000
d All other revenue .... 3,317,787   862,465 2,455,322
e Total. Add lines 11a–11d ...... MediumBullet 9,752,342
12 Total revenue. See Instructions......MediumBullet 818,638,163 624,368,389 862,465 42,337,732
Form 990 (2012)
Form 990 (2012)
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).Check if Schedule O contains a response to any question in this Part IX ...............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising expenses
1 Grants and other assistance to governments and organizations in the United States. See Part IV, line 21 0  
2 Grants and other assistance to individuals in the United States. See Part IV, line 22 0  
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16 0  
4 Benefits paid to or for members 0  
5 Compensation of current officers, directors, trustees, and key employees .... 7,100,287 1,786,336 4,976,098 337,853
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .... 0      
7 Other salaries and wages 247,810,628 188,056,641 59,753,987  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 17,129,148 12,915,269 4,213,879  
9 Other employee benefits ....... 26,450,141 19,943,239 6,506,902  
10 Payroll taxes ........... 19,077,537 14,384,342 4,693,195  
11 Fees for services (non-employees):        
a Management ...... 2,570,060 785,867 1,784,193  
b Legal ......... 988,319   988,319  
c Accounting ........... 1,286,742   1,286,742  
d Lobbying ........... 137,590   137,590  
e Professional fundraising services. See Part IV, line 17 0  
f Investment management fees ...... 678,577   678,577  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 177,841,313 136,456,618 41,384,695  
12 Advertising and promotion .... 845,259 135,887 709,372  
13 Office expenses ....... 1,940,747 867,531 1,073,216  
14 Information technology ...... 609,067 206,553 402,514  
15 Royalties .. 0      
16 Occupancy ........... 13,126,752 10,501,402 2,625,350  
17 Travel ............ 1,028,789 658,880 369,909  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ...... 0      
19 Conferences, conventions, and meetings .... 223,945 130,376 93,569  
20 Interest ........... 18,833,211 15,066,569 3,766,642  
21 Payments to affiliates ....... 0      
22 Depreciation, depletion, and amortization ..... 39,719,572 13,901,850 25,817,722  
23 Insurance .............. 4,589,137 1,596 4,587,541  
24 Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a TAXES AND LICENSES 25,627,653 24,196,244 1,431,409  
b FOOD SUPPLIES 1,751,369 24,332 1,727,037  
c DUES AND SUBSCRIPTIONS 1,208,957 242,808 966,149  
d MEDICAL SUPPLIES 75,714,801 74,065,722 1,649,079  
e All other expenses 14,509,887 14,509,887    
25 Total functional expenses. Add lines 1 through 24e 700,799,488 528,837,949 171,623,686 337,853
26 Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2012)
Form 990 (2012)
Page 11
Part X Balance Sheet Check if Schedule O contains a response to any question in this Part X ...............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash—non-interest-bearing ............. 18,365,024 1 32,422,283
2 Savings and temporary cash investments ......... 0 2 0
3 Pledges and grants receivable, net ........... 0 3 0
4 Accounts receivable, net ............. 154,051,033 4 145,711,164
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
50,000 5 50,000
6 Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
0 6 0
7 Notes and loans receivable, net ............. 461,785 7 454,561
8 Inventories for sale or use .............. 6,151,565 8 7,269,187
9 Prepaid expenses and deferred charges .......... 3,800,165 9 8,496,380
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 769,739,052
b Less: accumulated depreciation ..... 10b 282,984,177 495,886,712 10c 486,754,875
11 Investments—publicly traded securities .......... 367,029,315 11 511,679,337
12 Investments—other securities. See Part IV, line 11 ..... 52,969,207 12 49,452,883
13 Investments—program-related. See Part IV, line 11 ..... 0 13 0
14 Intangible assets ............... 3,275,951 14 2,863,117
15 Other assets. See Part IV, line 11 ........... 133,917,355 15 116,619,903
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,235,958,112 16 1,361,773,690
Liabilities 17 Accounts payable and accrued expenses ......... 147,563,261 17 128,785,742
18 Grants payable ................. 0 18 0
19 Deferred revenue ................ 540,803 19 350,059
20 Tax-exempt bond liabilities ............. 408,441,248 20 405,151,674
21 Escrow or custodial account liability. Complete Part IV of Schedule D.. 0 21 0
22 Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
persons. Complete Part II of Schedule L.......... 0 22 0
23 Secured mortgages and notes payable to unrelated third parties .. 6,012,144 23 5,586,096
24 Unsecured notes and loans payable to unrelated third parties .... 0 24 0
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 119,173,010 25 68,251,057
26 Total liabilities. Add lines 17 through 25......... 681,730,466 26 608,124,628
Net Assets or Fund Balance Organizations that follow SFAS 117 (ASC 958), check here MediumBullet and complete lines 27 through 29, and lines 33 and 34.
27 Unrestricted net assets .............. 497,846,929 27 695,236,478
28 Temporarily restricted net assets ........... 47,961,029 28 48,649,858
29 Permanently restricted net assets ........... 8,419,688 29 9,762,726
Organizations that do not follow SFAS 117 (ASC 958), 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 ........... 554,227,646 33 753,649,062
34 Total liabilities and net assets/fund balances ........ 1,235,958,112 34 1,361,773,690
Form 990 (2012)
Form 990 (2012)
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
818,638,163
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
700,799,488
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
117,838,675
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
554,227,646
5
Net unrealized gains (losses) on investments ...............
5
20,658,115
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
60,924,626
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
753,649,062
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
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If “Yes,” to line 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?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If “Yes,” did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits
3b
Yes
 
Form 990 (2012)
Form 990, Special Condition Description:
Special Condition Description
Additional Data


Software ID:  
Software Version:  
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
2012
Open to Public
Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
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 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 monetary support
Yes No Yes No Yes No
Total                  

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 2
Part II
Support Schedule for Organizations Described in Sections 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)..            
11 Total support (Add lines 7 through 10).            
12
12
 
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........................................right arrow
Section C. Computation of Public Support Percentage
14
14
 
15
15
 
16a
b
17a
b
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 ..................................................... right arrow
Schedule A (Form 990 or 990-EZ) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 3
Part III
Support Schedule for Organizations Described in Section 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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) right arrow (a) 2008 (b) 2009 (c) 2010 (d) 2011 (e) 2012 (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) 2012
Schedule A (Form 990 or 990-EZ) 2012
Page 4
Part IV
Supplemental Information. Complete this part to provide the explanations required by Part II, line 10; Part II, line 17a or 17b; and 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) 2012

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
2012
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ





Form 990-PF




Check if your organization is covered by the General Rule or a Special Rule.  
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.
General Rule
Special Rules
......................... Arrow Bullet   $    
Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990; or check the box on line H of its
Form 990-EZ or on Part I, line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).
For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.
Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 2
Name of organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
  		Employer identification number

95-1691313
Part I
Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
     
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
RESTRICTED
RESTRICTED
 

     
RESTRICTED
RESTRICTED  
RESTRICTED, RESTRICTED   RESTRICTED

$RESTRICTED


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


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

     
 
   

$  


(Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 3
Name of organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
  		Employer identification number

95-1691313
Part II
Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
     
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
(a) No.
from
Part I		 (b)
Description of noncash property given		 (c)
FMV (or estimate)
(see instructions) 		(d)
Date received
 
$    
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

Schedule B (Form 990, 990-EZ, or 990-PF) (2012)
Page 4
Name of organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
  		Employer identification number

95-1691313
Part III
Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
that total more than $1,000 for the year. Complete columns (a) through (e) and the following line entry.
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
(a) No.
from
Part I		 (b) Purpose of gift (c) Use of gift (d) Description of how gift is held
 
(e) Transfer of gift
Transferee's name, address, and ZIP 4 Relationship of transferor to transferee
 
 
       
 
Schedule B (Form 990, 990-EZ, or 990-PF) (2012)

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
2012
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 35c (Proxy Tax), then
Round Bullet Section 501(c)(4), (5), or (6) organizations: Complete Part III.
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

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

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

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

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










For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.
Cat. No. 50084S
Schedule C (Form 990 or 990-EZ) 2012

Schedule C (Form 990 or 990-EZ) 2012
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 SchCMd Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) Total
             
2a Lobbying nontaxable amount          
             
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		         
             
c Total lobbying expenditures          
             
d Grassroots nontaxable amount          
             
e Grassroots ceiling amount
(150% of line 2d, column (e))		          
             
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2012


Schedule C (Form 990 or 990-EZ) 2012
Page 3
Part II-B
Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).
For each “Yes” response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.
(a)
No
Yes
(b)
Amount
1
During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:
a
Volunteers? .........................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
No
c
Media advertisements? ....................................
 
No
 
d
Mailings to members, legislators, or the public? .........................
 
No
 
e
Publications, or published or broadcast statements? .......................
 
No
 
f
Grants to other organizations for lobbying purposes? .......................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
Yes
 
137,590
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
No
 
i
Other activities? ..........................
 
No
 
j
Total. Add lines 1c through 1i ...............................
137,590
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 carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered “No” OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, line 2; and Part ll-B, line 1. Also, complete this part for any additional information.
Identifier Return Reference Explanation
Schedule C, Part II-B, Line 1G   Paid outside consultants to increase and obtain funding for building development projects and to influence federal, state and local legislation as it affects Rady Children's Hospital's healthcare reimbursement and regulations.
Schedule C (Form 990 or 990EZ) 2012

Additional Data


Software ID:  
Software Version:  

SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b
SchDMd Bullet Attach to Form 990. SchDMd Bullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
Part I
Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.
(a) Donor advised funds (b) Funds and other accounts
1 Total number at end of year .........    
2 Aggregate contributions to (during year) ...    
3 Aggregate grants from (during year) .....    
4 Aggregate value at end of year ........    
5
Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............
6
Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................
Part II
Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.
Held at the End of the Year
a Total number of conservation easements ....................... 2a  
b Total acreage restricted by conservation easements .................. 2b  
c Number of conservation easements on a certified historic structure included in (a) ..... 2c  
d Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register .................... 2d  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................
6
Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet $  
8
Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................
9
In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.
1a
If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.
b
If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:
(i)
Revenues included in Form 990, Part VIII, line 1 ........................SchDMd Bullet $  
(ii)
Assets included in Form 990, Part X ..............................SchDMd Bullet $  
2
If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:
a
Revenues included in Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
Assets included in Form 990, Part X ...............................SchDMd Bullet $  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 52283D
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
Using the organization’s acquisition, 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 XIII.
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 XIII 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 XIII. Check here if the explanation has been provided in Part XIII ........
Part V
Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.
(a)Current year (b)Prior year b (c)Two years back (d)Three years back (e)Four years back
1a Beginning of year balance .... 48,036,828 49,723,607 42,252,279 37,093,561 51,130,326
b Contributions ........ 15,277,049 296,255 151,852 275,375 170,821
c Net investment earnings, gains, and losses 5,535,659 -222,291 9,243,544 6,593,869 -12,186,268
d Grants or scholarships ..... 0 0 0 0 0
e Other expenditures for facilities
and programs ........ 		1,920,393 1,667,699 1,799,491 1,603,715 1,874,174
f Administrative expenses .... 72,554 93,045 124,576 106,811 147,144
g End of year balance ...... 66,856,589 48,036,827 49,723,608 42,252,279 37,093,561
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet81.840 %
b
Permanent endowment SchDMd Bullet14.690 %
c
Temporarily restricted endowment SchDMd Bullet3.470 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
Yes
 
(ii) related organizations ........................
3a(ii)
Yes
 
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. See Form 990, Part X, line 10.
Description of property (a) Cost or other basis (investment) (b)Cost or other basis (other) (c) Accumulated depreciation (d) Book value
1a Land .................   17,107,314 17,107,314
b Buildings ................   542,806,432 153,683,106 389,123,326
c Leasehold improvements ............   6,172,000 5,280,972 891,028
d Equipment ................   183,625,103 121,602,541 62,022,562
e Other .................   20,028,203 2,417,558 17,609,145
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 486,753,375
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 3
Part VII
Investments—Other Securities. See Form 990, Part X, line 12.
(a) Description of security or category
(including name of security)		 (b)Book value (c) Method of valuation:
Cost or end-of-year market value
(1)Financial derivatives    
(2)Closely-held equity interests    
Other








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








Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)Small Bullet  
Part IX
Other Assets. See Form 990, Part X, line 15.
(a) Description (b) Book value
(1) BOND INDENTURE AGREEMENTS 71,315,665
(2) RECEIVABLES FROM AFFILIATES 10,604,735
(3) EXECUTIVE COMPENSATION 480,201
(4) DEFERRED FINANCING COSTS 2,661,468
(5) ASSET DEPOSITS 129,775
(6) ASSET-SEC DEP 55,605
(7) ASSETS LIMITED TO USE 265,985
(8) PENSION FUNDED STATUS 31,106,469

Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet 116,619,903
Part X
Other Liabilities. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes 0
PAYABLE TO BENEFICIARIES 111,740
INTEREST RATE SWAPS 46,789,568
DEFFERED COMPENSATION 634,572
MALPRACTICE IBNR 3,336,829
BENEFITS PAYABLE 14,244,458
SANFORD INVSTMNT OCEANSIDE BUI 2,948,673
SECURITY DEPOSITS 185,217


Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 68,251,057
2. Fin 48 (ASC 740) Footnote. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII .....................................................
Schedule D (Form 990) 2012

Schedule D (Form 990) 2012
Page 4
Part XI 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 XIII.) ............ 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 XIII.) ........... 4b  
c Add lines 4a and 4b....................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII 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 XIII.) ............ 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 XIII.) ............ 4b  
c Add lines 4a and 4b....................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Identifier Return Reference Explanation
Schedule D, Part V, Line 4   Rady Children's board designated endowment funds support the highest and most urgent needs of the organization as determined by ItS Board of Trustees. In addition, donor designated (or restricted) endowment funds support a wide range of Initiatives Identified by the donor.
Schedule D (Form 990) 2012

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
2012
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...
1a
Yes
 
b
If "Yes," was it a written policy? .......................
1b
Yes
 
2
If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.
3
Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.
a
Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?
If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:
3a
Yes
 
b
Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate
which of the following was the family income limit for eligibility for discounted care: .........
3b
Yes
 
c
If the organization used factors other than FPG in determining eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.
4
Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? ..............

4

Yes

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

5a

 

No
b
If "Yes," did the organization's financial assistance 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 discountedcare to a patient who was eligibile for free or discounted care? ..............
5c
 
 
6a
Did the organization prepare a community benefit report during the tax year? ..........
6a
Yes
 
b
If "Yes," did the organization make it available to the public? ..............
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) .. 		    3,963,919 0 3,963,919 0.570 %
b Medicaid (from Worksheet 3,
column a) .... 		    305,721,946 309,127,982 -3,406,036 0.490 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		    2,040,818 15,512 2,025,306 0.290 %
d Total Financial Assistance
and Means-Tested
Government Programs . 		    311,726,683 309,143,494 2,583,189 0.370 %
Other Benefits
 40   23,318,029 12,556,223 10,761,806 1.540 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		13   14,255,839 4,333,986 9,921,853 1.420 %
g Subsidized health services
(from Worksheet 6) .. 		11   25,269,995 12,936,393 12,333,602 1.760 %
h Research (from Worksheet 7) 25   2,879,043 0 2,879,043 0.410 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		           
j Total. Other Benefits .. 89   65,722,906 29,826,602 35,896,304 5.130 %
k Total. Add lines 7d and 7j . 89   377,449,589 338,970,096 38,479,493 5.500 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part II
Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development            
3 Community support            
4 Environmental improvements            
5 Leadership development and training for community members            
6 Coalition building            
7 Community health improvement advocacy 1   35,558 0 35,558 0.010 %
8 Workforce development 1   235,587 0 235,587 0.030 %
9 Other            
10 Total 2   271,145 0 271,145 0.040 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
 
No
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
4,806,559
3
Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......
3
 
4
Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.
Section B. Medicare
5
Enter total revenue received from Medicare (including DSH and IME).....
5
1,340,260
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
2,867,251
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
-1,526,991
8
Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI.......................

9b

Yes

 
Part IV
Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)
(a) Name of entity (b) Description of primary
activity of entity 		(c) Organization's
profit % or stock
ownership % 		(d) Officers, directors,
trustees, or key
employees' profit %
or stock ownership % 		(e) Physicians'
profit % or stock
ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information
Section A. Hospital Facilities
(list in order of size from largest to smallest—see instructions)
How many hospital facilities did the organization operate during the tax year?1
Name, address, and primary website address 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital Research Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 Rady Children's Hospital San Diego
3020 Childrens Way MC 5133
San Diego,CA92123 		X   X X   X X      
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)
Rady Children's Hospital San Diego
Name of hospital facility or facility reporting group  
For single facility filers only: line Number of Hospital Facility (from Schedule H, Part V, Section A)  
Yes No
Community Health Needs Assessment (Lines 1 through 8c are optional for tax years begining on or before March 23, 2012)
1 During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 9.................... 1 Yes  
If “Yes,” indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
2 Indicate the tax year the hospital facility last conducted a CHNA: 20 12
3 In conducting its most recent CHNA, did the hospital facility take into account input from representatives of the community served by the hospital facility, including those with special knowledge of or expertise in public health? 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 Yes  
4 Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI................................ 4 Yes  
5 Did the hospital facility make its CHNA report widely available to the public? ............. 5 Yes  
If “Yes,” indicate how the CHNA report was made widely available (check all that apply):
a
b
c
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply to date):
a
b
c
d
e
f
g
h
i
7 Did the hospital facility address all of the needs identified in its most recently conducted CHNA? If “No,” explain in Part VI which needs it has not addressed and the reasons why it has not addressed such needs ........ 7   No
8a Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)? ........................... 8a   No
b If "Yes" to line 8a, did the organization file Form 4720 to report the section 4959 excise tax? ...... 8b    
c If "Yes" to line 8b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $  

Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Financial Assistance Policy Yes No
9 Did the hospital facility have in place during the tax year a written financial assistance policy that:
Explained eligibility criteria for financial assistance, and whether such assistance includes free or discounted care? 9 Yes  
10 Used federal poverty guidelines (FPG) to determine eligibility for providing free care?........... 10 Yes  
If "Yes," indicate the FPG family income limit for eligibility for free care: 250.%
If "No," explain in Part VI the criteria the hospital facility used.
11 Used FPG to determine eligibility for providing discounted care?................. 11 Yes  
If “Yes,” indicate the FPG family income limit for eligibility for discounted care: 450.%
If "No," explain in Part VI the criteria the hospital facility used.
12 Explained the basis for calculating amounts charged to patients?................. 12 Yes  
If “Yes,” indicate the factors used in determining such amounts (check all that apply):
a
b
c
d
e
f
g
h
13 Explained the method for applying for financial assistance?................... 13 Yes  
14 Included measures to publicize the policy within the community served by the hospital facility?....... 14 Yes  
If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
a
b
c
d
e
f
g
Billing and Collections
15 Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained actions the hospital facility may take upon non-payment?....... 15 Yes  
16 Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP:
a
b
c
d
e
17 Did the hospital facility or an authorized third party perform any of the following actions during the tax year before making reasonable efforts to determine the patient’s eligibility under the facility’s FAP?.......... 17   No
If “Yes,” check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

18 Indicate which efforts the hospital facility made before initiating any of the actions listed in line 17 (check all that apply):
a
b
c
d
e
Policy Relating to Emergency Medical Care
Yes No
19 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?.......... 19 Yes  
If “No,” indicate why:
a
b
c
d
Charges to Individuals Eligible for Assistance under the FAP (FAP-Eligible Individuals)
20 Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.
a
b
c
d
21 During the tax year, did the hospital facility charge any FAP-eligible individuals 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? ............................ 21   No
If “Yes,” explain in Part VI.
22 During the tax year, did the hospital facility charge any FAP-eligible individuals an amount equal to the gross charge for any service provided to that individual? ......................... 22   No
If “Yes,” explain in Part VI.
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VFacility Information (continued)

Section C. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?19
Name and address Type of Facility (describe)
1 Chadwick Center for Children & Families
1261 Third Avenue Suite D
Chula Vista,CA91911 		Trauma Counseling
2 Rady Children's Specialists of San Diego
477 North El Camino Real
Encinitas,CA92024 		Clinic
3 Rady Children's Specialists of San Diego
625 West Citracado Parkway
Escondido,CA92025 		Clinic/ urgent care
4 Rady Children's Specialists of San Diego
25485 Medical Center Drive Suite 1
Murrieta,CA92562 		Clinic
5 Sanford Children's Clinic
3605 Vista Way Suite 130
Oceanside,CA92056 		Clinic/urgent care
6 Rady Children's Developmental Services
667 San Rodolfo Drive Suite 126
Solana Beach,CA92075 		Clinic
7 City Heights Wellness Center
4440 Wightman Street Suite 200
San Diego,CA92105 		Wellness center
8 HomeCare
8291 Aero Place Suite 130
San Diego,CA92123 		Home HealthCare
9 Polinsky Children's Center Medical Clini
9400 Ruffin Court Building B
San Diego,CA92123 		CLINIC
10 Rady Children's Specialists of San Diego
6386 Alvarado Court Suite 210
San Diego,CA92123 		Clinic
11 Rady Children's Specialists of San Diego
3750 Convoy St Suite 301
San Diego,CA92111 		Clinic
12 Rady Children's Specialists of San Diego
385 W Main Street
El Centro,CA92243 		Clinic
13 Rady Children's
7910 Frost Suite 140
San Diego,CA92123 		Clinics
14 Rady Children's
8010 Frost Suite 140
San Diego,CA92123 		Clinics
15 Rady Children's
7920 Frost Suite 140
San Diego,CA92123 		Clinics
16 Nelson Family Pavilion
8001 Frost Street
San Diego,CA92123 		Clinics
17 Rady Children's
8110 Birmingham Drive
San Diego,CA92123 		Clinics
18 Chadwick Center for Children & Families
3665 kearny villa road
san diego,CA92123 		trauma counseling
19 Rady Children's Development Services
445 marine avenue suite 120
del mar,CA92014 		clinic
Schedule H (Form 990) 2012
Schedule H (Form 990) 2012
Page
Part VI
Supplemental Information
Complete this part to provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; Part V, Section A; and Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
8 Facility reporting group(s). If applicable, for each hospital facility in a facility reporting group provide the descriptions required for Part V, Section B, lines 1j, 3, 4, 5c, 6i, 7, 10, 11, 12h, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22.
Identifier ReturnReference Explanation
SCHEDULE H, PART I, LINE 7   THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN ITEM 7. FOR CERTAIN CATEGORIES, PRIMARILY CHARITY CARE AND MEANS-TESTED GOVERNMENT PROGRAMS, THE COST TO CHARGE RATIO WAS CALCULATED USING WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES AND APPLIED TO THOSE CATEGORIES. IN OTHER CATEGORIES, THE BEST AVAILABLE DATA WAS DERIVED FROM THE HOSPITAL'S DETAILED FINANCIAL INFORMATION. SCHEDULE H, PART II, COMMUNITY BUILDING ACTIVITIES RADY CHILDREN'S CENTER FOR HEALTHIER COMMUNITIES PROVIDES THE FACES FOR THE FUTURE PROGRAM AT A LOCAL HIGH SCHOOL. THE FACES PROGRAM IS A YOUTH AND FUTURE HEALTHCARE WORKFORCE DEVELOPMENT PROGRAM THAT PREPARES UNDERREPRESENTED, ETHNICALLY DIVERSE YOUTH FOR CAREERS IN ALL AREAS OF THE HEALTH PROFESSIONS. THE PROGRAM ALSO AIMS TO ASSIST LOCAL PUBLIC SCHOOLS IN MOTIVATING AND PREPARING UNDERREPRESENTED HIGH SCHOOL STUDENTS FOR ENTRY INTO COLLEGE, HEALTHCARE/RESEARCH CAREERS AND OTHER VIABLE EMPLOYMENT OPPORTUNITIES IN THE HEALTHCARE INDUSTRY. THE PARTICIPATING STUDENTS ROTATE THROUGH CLINICAL DEPARTMENTS AT RADY CHILDREN'S HOSPITAL - SAN DIEGO AND RECEIVE MENTORSHIP.
SCHEDULE H, PART III, LINE 2   for uninsured patients that do not qualify for charity care, RCHSD recognizes revenue on the basis of its standard rates for services provided, or on the basis of discounted rates if negotiated or provided by policy. On the basis of historical experience, a significant portion of RCHSD's uninsured patients are unable or unwilling to pay for the services provided. Thus, RCHSD records a significant provision for bad debts related to uninsured patients in the period services are provided. RCHSD records its provision for bad debts based upon the historical experience, as well as collection trends for major payor types. SCHEDULE H, PART III, LINE 3 RCHSD does not treat any part of the bad debt as community benefit expense. SCHEDULE H, PART III, LINE 4 SEE PAGE 14 OF THE AUDITED FINANCIAL STATEMENTS Scheudle H, Part III, Line 8 THE MEDICARE ALLOWABLE COSTS REPORTED IN THE ORGANIZATION'S MEDICARE COST REPORT AS REFLECTED IN THE AMOUNT REPORTED IN PART III, LINE 6 ARE DETERMINED USING A PRO FORMA COST REPORT AS DESCRIBED IN PART I, LINE 7 ABOVE. THE ORGANIZATION BELIEVES THAT THE TEFRA COST LIMITATION SHOULD BE INCLUDED AS A COMMUNITY BENEFIT, BASED ON THE INPATIENT COST OVER THE TEFRA LIMITS.
SCHEDULE H, PART III, LINE 9B   IN ITS BILLING AND COLLECTION ACTIVITY, RADY CHILDREN'S HOSPITAL - SAN DIEGO TREATS ALL PATIENTS AND PATIENT FAMILIES OR REPRESENTATIVES WITH FAIRNESS, DIGNITY AND RESPECT. RCHSD DOES NOT UTILIZE WAGE GARNISHMENTS, LIENS ON A PATIENT'S PRIMARY RESIDENCE, OR BODY ATTACHMENTS IN ITS COLLECTION ACTIVITIES. RCHSD ONLY UTILIZES THOSE OUTSIDE OR THIRD PARTY COLLECTION AGENCIES THAT AGREE TO COMPLY WITH APPLICABLE STATE AND FEDERAL LAWS AND WITH RCHSD POLICIES, AND RCHSD DEBT COLLECTION STANDARDS AND PRACTICES. IN DETERMINING THE DEBT THAT RCHSD SEEKS TO RECOVER, RCHSD WILL CONSIDER ONLY THE INCOME AND CERTAIN MONETARY ASSETS OF THE PATIENT/GUARANTOR ELIGIBLE FOR THE RCHSD FINANCIAL ASSISTANCE PROGRAM. IN MAKING THIS DETERMINATION, RCHSD WILL NOT CONSIDER RETIREMENT OR DEFERRED COMPENSATION PLANS (EITHER QUALIFIED OR NON-QUALIFIED UNDER THE INTERNAL REVENUE CODE), THE FIRST $10,000 OR THE REMAINING 50 PERCENT OF THE PATIENT/GUARANTOR'S MONETARY ASSETS. RCHSD SHALL NOT SEND AN ACCOUNT TO A COLLECTION AGENCY IF THE PATIENT HAS A PENDING APPLICATION FOR THE RCHSD FINANCIAL ASSISTANCE PROGRAM OR GOVERNMENT-SPONSORED INSURANCE PROGRAM OR IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL BY NEGOTIATING AN INTEREST FREE, EXTENDED PAYMENT PLAN OR BY MAKING REGULAR PARTIAL PAYMENTS OF A REASONABLE AMOUNT. A "PENDING APPLICATION" IS DEFINED AS AN APPLICATION THAT HAS BEEN FULLY COMPLETED AND INCLUDES COPIES OF THE REQUIRED DOCUMENTATION BY THE PATIENT/GUARANTOR, SUBMITTED TO THE RELEVANT PUBLIC AGENCY IN THE CASE OF GOVERNMENT PROGRAMS AND TO RCHSD IN THE CASE OF THE RCHSD FINANCIAL ASSISTANCE PROGRAM. IF A PATIENT ACCOUNT IS SENT TO COLLECTIONS AND IT IS DETERMINED THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE PATIENT ACCOUNT IS REMOVED FROM THE COLLECTION PROCESS AND THE FINANCIAL ASSISTANCE APPLICATION PROCESS IS IMPLEMENTED.
SCHEDULE H, PART V   Schedule H, Part V, Line 3 In conducting its most recent CHNA, the hospital facility took into account input from representatives of the community served by the hospital, including those with special knowledge of or expertise in public health. This was done through three methods: an electronic survey for community leaders and health experts, key informant interviews, and community forums for residents in vulnerable communities throughout San Diego County. Community Leader and Health Experts: Community leaders and health experts were chosen based on their discipline and knowledge of health issues affecting San Diego County. The CHNA Advisory Workgroup developed a list of over 100 possible community leaders and health experts. A health expert or leader was defined as a person with special knowledge of or expertise in public health. The list was compiled to ensure representation of experts in both the 15 health conditions and 26 health drivers that had been identified as priority health conditions in the County. Health experts and leaders were identified from hospital settings, community-based organizations, government policy, legal, and health advocacy organizations. Contact information was verified and initial emails were sent to the list of health experts and leaders in San Diego in order to gauge potential interest in participating in the CHNA health prioritization survey. At the time of this initial e-mail, interested respondents were asked which conditions they had expertise in, what populations they served and what regions they worked in. This initial feedback gave the CHNA Advisory Workgroup an idea of the coverage of data that would ultimately be gathered on health conditions, regions and populations served. Targeted outreach to additional health experts and leaders was then initiated to fill gaps of under-represented conditions, regions, or vulnerable populations. A CHNA survey was emailed to over 120 health experts and leaders, with 88 people completing the survey. When designing the survey, the diversity of the knowledge of the respondents was taken into account. Some respondents had knowledge of specific diseases or conditions and the health drivers affecting those diseases. Other leaders had a general knowledge of health drivers and how they affect multiple health outcomes. To accommodate these different perspectives, the survey was created so that the respondents could answer the survey from one of the two perspectives. Both perspectives allowed respondents to comment on poor health conditions and health drivers as they completed the survey. Key Informant Interviews: Key informants were selected based on their ability to understand health policy, and their knowledge of issues throughout San Diego County. Five key informant interviews were conducted to: 1.) gather more in-depth understanding of the health conditions most affecting San Diego; 2.) aid in the process of prioritizing health conditions; 3.) make connections between the health conditions and associated health drivers; 4.) gain information about the system or policy changes that could potentially impact health conditions; and 5.) get health conditions specific recommendations as well as overall recommendations. Resident Feedback: Five community forums with local residents were conducted to gain resident's perspective on the health needs of their communities, identify health conditions most affecting their communities, and identify community recommendations on how hospitals could help to meet their health needs. Recognizing that health needs differ across the region and that socioeconomic factors impact health outcomes, the Dignity Health Community Need Index (CNI) was used to identify communities with the highest level of health disparities and needs. Residents in five of these neighborhoods provided input on the health needs of their communities in a community forum setting. Neighborhood community collaborative agencies or organizations within each neighborhood helped to recruit community members to participate in the focus groups. Recruitment included the stipulation that focus group participants were living in the neighborhood and were not affiliated with local hospitals and health centers. Focus groups were conducted in El Cajon, Oceanside, Escondido, Logan Heights, and San Ysidro. During the focus groups, Geographical Informational Systems (GIS) maps displaying CNI scores by zip code in San Diego County as well as the County of San Diego's HHSA region of the neighborhood were displayed and hand-outs in both English and Spanish explaining the CNI score were distributed to each participant. Information about the health resources available in their neighborhoods was also provided to community members. Schedule h, part v, line 4 Rady Children's Hospital - San Diego conducted its CHNA with the following hospitals(see CHNA, Page 4): - Kaiser Foundation Hospital - San Diego - Palomar Health - Scripps Health - Sharp HealthCare - Tri-City Medical Center - University of California San Diego Health System schedule h, part v, line 5 http://www.rchsd.org/health-safety/community-health-needs-assessment/ schedule h, part v, line 7 Rady Children's is not addressing cardiovascular disease for the pediatric population as it was identified in the CHNA as a top health need for the adult population, not pediatric. Rady Children's provides cardiology, cardiovascular and other related medical services, which are more appropriate for the pediatric population. Schedule h, part v, line 14g ALL LANGUAGE REGARDING THE POLICY IS COMMUNICATED TO PATIENTS VIA SIGNAGE IN ALL ADMITTING AREAS. AT THE POINT OF REGISTRATION, ALL PATIENTS RECEIVE BROCHURES EXPLAINING THE FACILITY'S financial assistance PROGRAM AND THE AVAILABILITY OF GOVERNMENT SPONSORED PROGRAMS; ALL INITIAL STATEMENTS TO UNINSURED PATIENTS INCLUDES VERBIAGE INFORMING PATIENTS OF THE FACILITY'S financial assistance PROGRAM AND A COPY OF THE CHARITY CARE APPLICATION. A summary of the financial assistance policy is posted on the hospital's website. scheudle h, part v, line 20d The hospital determined, during the tax year, the maximum amounts that can be charged to FAP eligible individuals for emergency or other medically necessary care, based on Medi-Cal rates (AB 774).
SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT Rady Children's Hospital - San Diego is committed to improve the health status of the community. RCHSD, in conjunction with its hospital partners, participates in the hospital association of San Diego and imperial counties (HASDIC). HASDIC partners and Rady Children's together conducted a new CHNA in 2013. In addition, through a myriad of community-based programs, RCHSD assesses various patient population needs on an ongoing basis. Based on the results of the triennial San Diego community health needs assessment, as well as ongoing assessments, RCHSD offers a variety of programs to address the physical, mental and social health needs of children. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE RCHSD provides written information about the availability of the RCHSD financial assistance program, including a brochure that is disseminated throughout our patient clinics. This information is provided at patient registration, including patient informational materials, emergency department, outpatient clinics, and patient financial services. In addition, a statement regarding the financial assistance program is included on patient billing statements. Written notice is provided to potentially eligible patients during the registration process or as soon as possible thereafter and during the billing process. This information is provided in English and Spanish and is translated for patients/guarantors who speak other languages. Notification of financial assistance discusses, at a minimum, the following: - if a patient meets certain income requirements, the patient may be eligible for a government -sponsored health insurance program or the RCHSD financial assistance program. - identification of RCHSD financial counseling - patient financial services phone number with hours of availability so that patients may call to obtain further information about the financial assistance program. Rady children's provides healthcare support services to the community through the financial counseling team. Rady children's financial counselors proactively explore and assist patients/guarantors in applying for health insurance coverage from public and private payment programs. - the RCHSD website provides information about the financial assistance program, and the financial assistance policy and financial assistance program application are posted on the RCHSD website. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION There are approximately 775,000 children between the ages of infant to 17 that reside in San Diego County. The median household income in 2011 was $62,771 and approximately 38 percent of families are considered low income. Rady Children's Hospital - San Diego has participated in a county-wide health needs assessment every three years previously through the Community Health Improvement Partners (CHIP) since the inception of SB697. In 2013, the CHNA was conducted through HASDIC. The most recent health needs assessment, funded in part by RCHSD, and other local participating hospital providers was completed in 2013. The 2013 CHNA findings were in keeping with health needs identified in prior CHNAs, and included obesity, diabetes and behavioral health needs. Rady Children's works to help improve the health status of the community through a variety of programs. Rady children's hospital - San Diego is a regional tertiary and quaternary referral center and the largest provider of pediatric hospital services in San Diego county. RCHSD provides comprehensive care and treatment to children ranging in age from newborn through independent adulthood. RCHSD is the sole pediatric level 1 trauma center serving San Diego and imperial counties. Also, RCHSD is the pediatric safety net hospital for the region with a medi-cal payor mix hovering over 50%. Rchsd serves as the teaching hospital for the school of medicine at the University of California, San Diego (UCSD) and, in 2001, RCHSD and UCSD amalgamated where RCHSD became the pediatric provider of inpatient and outpatient medical and surgery services and certain other clinical services for UCSD pediatric patients. There are three large health systems operating in San Diego, Sharp Healthcare, Scripps Health and Kaiser Permanente, as well as other hospital providers. To help care for pediatric patients, RCHSD collaborates with sharp healthcare, Scripps Health and Palomar Pomerado health through affiliated program agreements. SCHEDULE H, PART VI, LINE 5 promotion of community health The Rady Children's Hospital and Health Center is governed by an 21-member Board of Trustees. The majority of the organization's governing body is comprised of persons representing the San Diego community, who are neither employees nor contractors of the organization. RCHSD extends medical staff privileges to all qualified physicians in its community. RCHSD applies its surplus funds to support the highest and most urgent needs of the organization and the community including improving patient care; providing support for our patients' families; research; developmental services; mental health services; child abuse prevention and treatment services; education programs; and purchasing state-of-the art equipment and technology to further enhance patient care. RCHSD promotes the health of the community it serves through a variety of mechanisms. The RCHSD Community Benefit Report for fiscal year 2013 (July 1, 2012 through June 30, 2013) provides detailed information on over 30 programs and related activities RCHSD conducts each year to improve patient's health status. From providing free medical education training seminars to community-based physicians and other health providers, support groups, parent educational resource materials, pediatric research, to programs directed to improve the health needs of patients, RCHSD uses a multi-pronged approach to provide benefit to the community. SCHEDULE H, PART VI, LINE 7 RCHSD files a community benefit report in the state of California.
Schedule H (Form 990) 2012
Additional Data


Software ID:  
Software Version:  
Schedule J
(Form 990)
Department of the Treasury
Internal Revenue Service
Compensation Information
For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
Part I
Questions Regarding Compensation
Yes
No
1a
Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.
b
If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of 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 filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.
4
During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:
a
Receive a severance payment or change-of-control payment? ................
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.
Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.
5
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:
a
The organization? ...........................
5a
 
No
b
Any related organization? .........................
5b
 
No
If "Yes," to line 5a or 5b, describe in Part III.
6
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:
a
The organization? ...........................
6a
 
No
b
Any related organization? .........................
6b
 
No
If "Yes," to line 6a or 6b, describe in Part III.
7
For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............
7
 
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 Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 2
Part II
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.
For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.
(A) Name and Title (B) Breakdown of W-2 and/or 1099-MISC compensation (C) Retirement and other deferred compensation (D) Nontaxable
benefits		 (E) Total of columns
(B)(i)-(D) 		(F) Compensation
reported as deferred
in prior Form 990
(i) Base compensation (ii) Bonus & incentive compensation (iii) Other reportable compensation
(1)Albert OriolVP, CIO (i)
(ii)		 290,070
0 		31,533
0 		51,449
0 		41,160
0 		13,498
0 		427,710
0 		40,982
0
(2)David B GilligSVP/Exec Dir (i)
(ii)		 298,929
0 		0
0 		260,017
0 		-8,549
0 		28,721
0 		579,118
0 		74,218
0
(3)Roger RouxSVP/CFO (i)
(ii)		 437,710
0 		75,986
0 		113,870
0 		44,707
0 		15,974
0 		688,247
0 		101,382
0
(4)Kathleen A SellickPresident/CEO (i)
(ii)		 648,666
0 		215,180
0 		208,976
0 		57,757
0 		31,111
0 		1,161,690
0 		192,623
0
(5)Margareta E NortonSVP/COO (i)
(ii)		 468,381
0 		98,477
0 		115,981
0 		59,862
0 		15,525
0 		758,226
0 		101,948
0
(6)Irvin A Kaufman MDSVP/HEALTH AFFAIRS (i)
(ii)		 428,687
0 		59,089
0 		109,264
0 		74,493
0 		8,644
0 		680,177
0 		96,946
0
(7)Timothy Lee JacobyVP,FACILITIES,CONSTR &PLANNING (i)
(ii)		 291,436
0 		24,923
0 		48,705
0 		26,986
0 		10,036
0 		402,086
0 		36,836
0
(8)Angela Marie VieiraVP/GENERAL COUNSEL (i)
(ii)		 243,049
0 		26,156
0 		46,224
0 		38,354
0 		15,525
0 		369,308
0 		34,369
0
(9)Barbara RyanVP/GOVERNMENT AFFAIRS (i)
(ii)		 222,472
0 		24,387
0 		48,802
0 		86,529
0 		10,036
0 		392,226
0 		35,780
0
(10)Charles WilsonSr. Director/chadwick center (i)
(ii)		 231,363
0 		16,610
0 		48,991
0 		71,628
0 		31,111
0 		399,703
0 		39,179
0
(11)Chris AbeSR. DIR ANCILLARY/SUPP SVCS (i)
(ii)		 194,851
0 		12,283
0 		41,678
0 		34,173
0 		15,525
0 		298,510
0 		29,526
0
(12)Blair SadlerFORMER PRESIDENT/CEO (i)
(ii)		 0
0 		0
0 		274,789
0 		0
0 		0
0 		274,789
0 		0
0
(13)Mary Jane FaganVP/PATIENT CARE SERVICES/CNO (i)
(ii)		 253,106
0 		28,435
0 		22,685
0 		44,724
0 		0
0 		348,950
0 		12,685
0
(14)Mohammed Mamoon SyedVP, Human Resources (i)
(ii)		 241,984
0 		26,186
0 		28,190
0 		22,505
0 		13,498
0 		332,363
0 		18,190
0
(15)Scott D CampbellVP, CFO, MPF (i)
(ii)		 248,777
0 		25,932
0 		20,293
0 		35,058
0 		22,079
0 		352,139
0 		10,293
0
(16)Glenn F BillmanChief quality Officer (i)
(ii)		 239,013
0 		17,067
0 		7,757
0 		44,008
0 		31,111
0 		338,956
0 		7,757
0
(17)Barbara L HoltNICU Director (i)
(ii)		 226,611
0 		0
0 		23,993
0 		-3,023
0 		13,498
0 		261,079
0 		0
0
(18)Craig C KishabaDirectr, Business & Comm Devlp (i)
(ii)		 202,401
0 		11,500
0 		1,348
0 		36,307
0 		26,719
0 		278,275
0 		1,348
0
(19)Kristin GistSr Dir, Developmental Svcs (i)
(ii)		 184,337
0 		13,938
0 		16,043
0 		49,822
0 		0
0 		264,140
0 		14,743
0
(20)Beth MohrVP, Controller (i)
(ii)		 179,175
0 		19,800
0 		10,134
0 		32,940
0 		8,644
0 		250,693
0 		134
0
(21)Kenneth H SchellPharmacist in Chief (i)
(ii)		 190,177
0 		11,470
0 		1,060
0 		34,672
0 		31,111
0 		268,490
0 		1,060
0
Schedule J (Form 990) 2012

Schedule J (Form 990) 2012
Page 3
Part III
Supplemental Information
Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.
Identifier Return Reference Explanation
Schedule J, Part I, Line 4b   Rady Children's Hospital - San Diego has established a non-qualified plan pursuant to 457(f) of the Internal Revenue Code. The purpose of this plan is to incentivize Rady Children's Hospital - San Diego eligible senior management employees (President, Senior Vice Presidents, Vice Presidents, Senior Managing Directors) in recognition of the fact that they are required to devote significant amounts of time, skill and energy to the organization and to provide these individuals with additional deferral opportunities. The amounts listed in Schedule J Part II, Column (C) are subject to substantial future service requirements to the organization and are subject to substantial risk of forfeiture. Once vested and not otherwise deferred, the amounts under this plan are reported on Form W-2 as taxable compensation to the individual.
Schedule J (Form 990) 2012

Additional Data


Software ID:  
Software Version:  
Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number
95-1691313
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 CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 1309114Z0 10-26-2006 194,219,503 See Part VI   X   X   X
B CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 130795VK0 07-02-2008 128,845,000 Current refunding Series 2007AB.   X   X   X
C CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 130795VT1 07-31-2008 101,155,000 Current refunding Series 2006CD.   X   X   X
D California Health Facilities Financing Authority
  		52-1643828 13033LUU9 11-22-2011 100,079,621 refund loan,renov,constr&equip pur   X   X   X
CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 1307955Y9 06-14-2012 115,580,000 Reissuance of 2008B & 2008D Bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 117,735,000 65,000,000 50,580,000 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 200,466,865 128,845,192 101,088,384 100,250,752
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 1,866,248 803,735 820,490 1,682,270
8 Credit enhancement from proceeds . . . . . . . . . . . 5,734,000 526,457 335,833 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 101,343,671 0 0 67,374,136
11 Other spent proceeds . . . . . . . . . . . . . . 91,522,945 127,515,000 100,000,014 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 31,194,347
13 Year of substantial completion . . . . . . . . . . . . 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X   X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . . X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0% 0% 0% 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   %   %   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . . 0%   %   %   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.   %   %   %   %
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X X     X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X           X  
b Exception to rebate? . . . . . . . . X   X         X
c No rebate due? . . . . . . . . . .
X   X          
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X   X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X   X   X     X
b Name of provider . . . . . . . . . Goldman Sachs
  		Goldman Sachs
  		Goldman Sachs
  		 
 
c Term of hedge . . . . . . . . . . 1.76 35.19 28.06  
d Was the hedge superintegrated? . . . . . .   X   X   X    
e Was a hedge terminated? . . . . . . . X   X   X      
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X   X   X     X
b Name of provider . . . . . . . . . Hypo Repurchase Agrt
  		Natixis
  		Hypo Repurchase Agrt
  		0
 
c Term of GIC . . . . . . . . . . 2.55 2.27 2.55  
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X   X   X      
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X X     X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
2006ABCD Bonds 0 Part I, f: The Issue Date of the 1993 Bonds was 04/01/1993, the Issue Date of the 1996 Bonds was 02/07/1996, and the Issue Date of the 2004 capital lease was 03/19/2004. Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds. Part II, 13: The 2006 Series CD Bonds, which were refunded by the 2008 Bonds, comprised the new money portion of the issue. Since the only portion allocable to the remainder of the issue (2006 Series AB) is the refunding portion, the year of substantial completion is not applicable. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 2c: The rebate computation was performed as of October 26, 2011. Part IV, 4e: The 2006 Series C Goldman Sachs hedge was originally entered into a term of 29.82 years but was deemed terminated on July 31, 2008 and had a term of 1.76 years. Part IV, 4e: The 2006 Series D Bank of New York hedge was originally entered into a term of 33.58 years but was terminated on June 27, 2008 and had a term of 0.43 years. This hedge was replaced by a Goldman Sachs hedge. Part IV, 4e: The 2006 Series D Goldman Sachs hedge was originally entered into a term of 33.14 years but was deemed terminated on July 31, 2008 and had a term of 0.08 years. Part IV, 5a: The 2006 Series CD Bonds proceeds were invested in the Hypo Repurchase Agreement which was transferred to the 2008CD Bonds on the date of their refundings.
2007AB Bonds 0 Part I, f: The issue date of the 2007AB Bonds was 10/24/07 Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 2c: The rebate computation was performed as of July 2, 2013. Part IV, 4e: The 2008AB Goldman Sachs hedge was originally entered into a term of 39.15 years but was restructured on June 15, 2012 and has a term of 35.19 years. Part IV, 4e: The 2008 Series B Goldman Sachs hedge was originally entered into a term of 39.15 years but was deemed terminated on June 15, 2012 and had a term of 3.96 years. Part IV, 5a: Transferred proceeds of the Series 2007 Project Fund were invested in the Natixis GIC.
2006CD Bonds 0 Part I, f: The issue date of the 2006CD Bonds was 10/26/06 Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds and the cumulative rebate liability paid to the IRS no later than 9/29/13. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 4e: The 2008 Series C Goldman Sachs hedge was originally entered into a term of 29.82 years but was reintegrated from the 2006 Series C bonds on July 31, 2008 and has a term of 28.06 years. Part IV, 4e: The 2008 Series D Goldman Sachs hedge was originally entered into a term of 33.14 years but was reintegrated from the 2006 Series D bonds on July 31, 2008 and had a restructured term of 33.06 years. This hedge was deemed terminated on June 14, 2012 and had a term of 3.87 years. Part IV, 5a: Transferred proceeds of the Series 2008CD Project Fund were invested in the Hypo Repurchase Agreement.
2011 Bonds 0 Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds.
2008-B and 2008-D 0 Part I, f: The issue date of the prior 2008B Bonds was 7/2/2008. The issue date of the prior 2008D Bonds was 7/31/2008. Part II, 13: Since the proceeds of the 2012-B and 2012-D Bonds are used for refunding purposes, the year of substantial completion is not applicable. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 4e: The 2012 Series B Goldman Sachs hedge was originally entered into a term of 39.15 years but was reintegrated from the 2008 Series B bonds on June 15, 2012 and has a term of 35.19 years. Part IV, 4e: The 2012 Series D Goldman Sachs hedge was originally entered into a term of 33.58 years but was reintegrated from the 2008 Series D bonds on June 15, 2012 and has a term of 29.19 years.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax Exempt Bonds
SchKMediumBullet Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet Attach to Form 990. SchKMediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public
Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number
95-1691313
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 CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 1309114Z0 10-26-2006 194,219,503 See Part VI   X   X   X
B CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 130795VK0 07-02-2008 128,845,000 Current refunding Series 2007AB.   X   X   X
C CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 130795VT1 07-31-2008 101,155,000 Current refunding Series 2006CD.   X   X   X
D California Health Facilities Financing Authority
  		52-1643828 13033LUU9 11-22-2011 100,079,621 refund loan,renov,constr&equip pur   X   X   X
CALIFORNIA STATEWIDE COMM DEVELOPMENT AUTHORITY
  		68-0164610 1307955Y9 06-14-2012 115,580,000 Reissuance of 2008B & 2008D Bonds   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . . 117,735,000 65,000,000 50,580,000 0
2 Amount of bonds legally defeased . . . . . . . . . . . 0 0 0 0
3 Total proceeds of issue . . . . . . . . . . . . . . 200,466,865 128,845,192 101,088,384 100,250,752
4 Gross proceeds in reserve funds . . . . . . . . . . . . 0 0 0 0
5 Capitalized interest from proceeds . . . . . . . . . . . 0 0 0 0
6 Proceeds in refunding escrows . . . . . . . . . . . . 0 0 0 0
7 Issuance costs from proceeds . . . . . . . . . . . . 1,866,248 803,735 820,490 1,682,270
8 Credit enhancement from proceeds . . . . . . . . . . . 5,734,000 526,457 335,833 0
9 Working capital expenditures from proceeds . . . . . . . . . 0 0 0 0
10 Capital expenditures from proceeds . . . . . . . . . . . 101,343,671 0 0 67,374,136
11 Other spent proceeds . . . . . . . . . . . . . . 91,522,945 127,515,000 100,000,014 0
12 Other unspent proceeds . . . . . . . . . . . . . . 0 0 0 31,194,347
13 Year of substantial completion . . . . . . . . . . . . 2010 2010 2010
Yes No Yes No Yes No Yes No
14 Were the bonds issued as part of a current refunding issue? . . . . . X   X   X     X
15 Were the bonds issued as part of an advance refunding issue? . . . . .   X   X   X   X
16 Has the final allocation of proceeds been made? . . . . . . . . X   X   X     X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . . X   X   X   X  
Part III
Private Business Use
A B C D
Yes No Yes No Yes No Yes No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .   X   X   X   X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . . X   X   X   X  
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 2
Part III
Private Business Use (Continued)
A B C D
Yes No Yes No Yes No Yes No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . . X   X   X   X  
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property? . . . . . . . . . . . . . . . . X   X   X   X  
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .   X   X   X   X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property? .                
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government . . SchKMediumBullet 0% 0% 0% 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   %   %   %   %
6 Total of lines 4 and 5 . . . . . . . . . . . . . . . 0%   %   %   %
7 Does the bond issue meet the private security or payment test? . . . . .   X   X   X   X
8a Has there been a sale or disposition of any of the bond financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?. . . . . . . . . . . . . . . . .   X   X   X   X
b If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of.   %   %   %   %
c If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .   X   X   X   X
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under
Regulations sections 1.141-12 and 1.145-2?
X   X   X   X  
Part IV
Arbitrage
A B C D
Yes No Yes No Yes No Yes No
1 Has the issuer filed Form 8038-T? . . . . .   X   X X     X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . . X           X  
b Exception to rebate? . . . . . . . . X   X         X
c No rebate due? . . . . . . . . . .
X   X          
If you checked "No rebate due" in line 2c, provide in Part VI the date the rebate computation was performed
3 Is the bond issue a variable rate issue? . . . . X   X   X     X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue? X   X   X     X
b Name of provider . . . . . . . . . Goldman Sachs
  		Goldman Sachs
  		Goldman Sachs
  		 
 
c Term of hedge . . . . . . . . . . 1.76 35.19 28.06  
d Was the hedge superintegrated? . . . . . .   X   X   X    
e Was a hedge terminated? . . . . . . . X   X   X      
Schedule K (Form 990) 2012
Schedule K (Form 990) 2012
Page 3
Part IV
Arbitrage (Continued)
A B C D
Yes No Yes No Yes No Yes No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)? . . . . . . . . . X   X   X     X
b Name of provider . . . . . . . . . Hypo Repurchase Agrt
  		Natixis
  		Hypo Repurchase Agrt
  		0
 
c Term of GIC . . . . . . . . . . 2.55 2.27 2.55  
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . X   X   X      
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .   X X     X   X
7 Has the organization established written procedures to monitor the requirements of section 148? . . . X   X   X   X  
Part V
Procedures To Undertake Corrective Action
A B C D
Yes No Yes No Yes No Yes No
1 Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations? X   X   X   X  
Part VI
Supplemental Information. Complete this part to provide additional information for responses to questions on Schedule K (see instructions).
Identifier Return Reference Explanation
2006ABCD Bonds 0 Part I, f: The Issue Date of the 1993 Bonds was 04/01/1993, the Issue Date of the 1996 Bonds was 02/07/1996, and the Issue Date of the 2004 capital lease was 03/19/2004. Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds. Part II, 13: The 2006 Series CD Bonds, which were refunded by the 2008 Bonds, comprised the new money portion of the issue. Since the only portion allocable to the remainder of the issue (2006 Series AB) is the refunding portion, the year of substantial completion is not applicable. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 2c: The rebate computation was performed as of October 26, 2011. Part IV, 4e: The 2006 Series C Goldman Sachs hedge was originally entered into a term of 29.82 years but was deemed terminated on July 31, 2008 and had a term of 1.76 years. Part IV, 4e: The 2006 Series D Bank of New York hedge was originally entered into a term of 33.58 years but was terminated on June 27, 2008 and had a term of 0.43 years. This hedge was replaced by a Goldman Sachs hedge. Part IV, 4e: The 2006 Series D Goldman Sachs hedge was originally entered into a term of 33.14 years but was deemed terminated on July 31, 2008 and had a term of 0.08 years. Part IV, 5a: The 2006 Series CD Bonds proceeds were invested in the Hypo Repurchase Agreement which was transferred to the 2008CD Bonds on the date of their refundings.
2007AB Bonds 0 Part I, f: The issue date of the 2007AB Bonds was 10/24/07 Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 2c: The rebate computation was performed as of July 2, 2013. Part IV, 4e: The 2008AB Goldman Sachs hedge was originally entered into a term of 39.15 years but was restructured on June 15, 2012 and has a term of 35.19 years. Part IV, 4e: The 2008 Series B Goldman Sachs hedge was originally entered into a term of 39.15 years but was deemed terminated on June 15, 2012 and had a term of 3.96 years. Part IV, 5a: Transferred proceeds of the Series 2007 Project Fund were invested in the Natixis GIC.
2006CD Bonds 0 Part I, f: The issue date of the 2006CD Bonds was 10/26/06 Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds and the cumulative rebate liability paid to the IRS no later than 9/29/13. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 4e: The 2008 Series C Goldman Sachs hedge was originally entered into a term of 29.82 years but was reintegrated from the 2006 Series C bonds on July 31, 2008 and has a term of 28.06 years. Part IV, 4e: The 2008 Series D Goldman Sachs hedge was originally entered into a term of 33.14 years but was reintegrated from the 2006 Series D bonds on July 31, 2008 and had a restructured term of 33.06 years. This hedge was deemed terminated on June 14, 2012 and had a term of 3.87 years. Part IV, 5a: Transferred proceeds of the Series 2008CD Project Fund were invested in the Hypo Repurchase Agreement.
2011 Bonds 0 Part II, 3: The difference between the Issue Price listed in Part I(e) is due to interest earnings on Bond Proceeds.
2008-B and 2008-D 0 Part I, f: The issue date of the prior 2008B Bonds was 7/2/2008. The issue date of the prior 2008D Bonds was 7/31/2008. Part II, 13: Since the proceeds of the 2012-B and 2012-D Bonds are used for refunding purposes, the year of substantial completion is not applicable. Part III, 7: As provided in Treasury Regulation Section 1.141-4(c)(2)(i)(B), the amount of private payments taken into account under the private payment test may not exceed the amount of private business use and/or unrelated trade or business use. Accordingly, the amount of private payments for the reporting period does not exceed the amount stated in Part III, line 6. The organization has not undertaken an analysis of the private security test with respect to the bonds, as the level of private business use and/or unrelated trade or business reported in Part III, line 6, is not in excess of amounts permitted under Section 145 of the Code. Part IV, 4e: The 2012 Series B Goldman Sachs hedge was originally entered into a term of 39.15 years but was reintegrated from the 2008 Series B bonds on June 15, 2012 and has a term of 35.19 years. Part IV, 4e: The 2012 Series D Goldman Sachs hedge was originally entered into a term of 33.58 years but was reintegrated from the 2008 Series D bonds on June 15, 2012 and has a term of 29.19 years.
Schedule K (Form 990) 2012

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet Attach to Form 990 or Form 990-EZ. MediumBullet See separate instructions.
OMB No. 1545-0047
2012
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
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) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No





2
Enter the amount of tax incurred by 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-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22
(a) Name of interested person (b) Relationship with organization (c) Purpose of loan (d) Loan to or from the organization? (e)Original principal amount (f)Balance due (g) In default? (h) Approved by board or committee? (i)Written agreement?
To From Yes No Yes No Yes No
(1) Roger G Roux SVP/CFO/treasurer Relocation Loan   X 50,000 50,000   No Yes   Yes  
Total ......Small Bullet $ 50,000
Part III
Grants or Assistance Benefitting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of assistance (d) Type of assistance (e) Purpose of assistance
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 50056A
Schedule L (Form 990 or 990-EZ) 2012
Schedule L (Form 990 or 990-EZ) 2012
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
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) 2012

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
2012
Open to Public
Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
Identifier Return Reference Explanation
Part VI, Section A Line 6   Rady Children's Hospital and Health Center (RCHHC) is the sole member as that term is defined in California Corporations Code 5056 ("Member")of Rady Children's Hospital - San Diego (RCHSD). Part VI, Section A Lines 7a and 7b The RCHSD Board of Directors consists of those individuals serving as the Board of Trustees of the Member. Only the Member may remove a Director. The following actions of the RCHSD Board require "prior written approval" of the Member to be effective: o Any amendment, revision, modification of the Articles of Incorporation or the bylaws o Any change in the nature of the business activities of RCHSD o Approval of operating and capital budgets of RCHSD o Borrowing any amount or incurring any debt in the amount of $100,000 or more o Making or incurring any unbudgeted extraordinary or non-recurring expense or expenditure of $100,000. The RCHSD Board cannot authorize or direct any officer of RCHSD to perform or commit any of the following acts, without prior written approval of the Member: o Borrow money in RCHSD's name or utilize property owned by RCHSD as security for loans, except in the ordinary course of business o Make, execute, or deliver any assignment for the benefit or creditors, or any bond, confession, judgment, chattel mortgage, security agreement, deed, guaranty, indemnity bond, surety bond, contract to sell or bill of sale of the property of RCHSD, except in the ordinary course of business. o Acquire, purchase, develop, improve, sell, lease or mortgage any corporate real estate or any interest therein or enter into any contract for any such purposes. o Make any loan or investment of any RCHSD assets, or enter into any contract or incur any liability on behalf of RCHSD other than for fair consideration or in the ordinary course of business relating to its normal daily operation. Part VI, Section B,Line 11a Review of Form 990 The Form 990 was reviewed by the CFO and then provided to the organization's Audit and Corporate Responsibility Committee for review. Following review by the Committee, the returns were 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.
Part VI, Section B, Line 12c Conflict of Interest Policy 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. If a person discloses a potential or actual conflict, the person with the conflict of interest is excluded from any discussion or approval of any such related transaction. 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, Line 15 Determination of Compensation 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 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. 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 and how it was obtained.
Part VI, Section C, Line 19   The federal tax laws do not mandate that the organization's governing documents and conflict of interest policy be made available for public inspection. The organization makes its financial statements available upon request and they are also attached to this Form 990.
part xi, reconciliation of net assets line 9 market adjustment on swap - 33,360,544 change in split interest agreements - (30,734) change in defined benefit cost - 27,584,000 UBI from investment partnerships - 10,816 ============= total 60,924,626
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED PHYSICIAN SERVICES TOTAL FEES:XXX-XX-XXXX
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED INSURANCE SERVICES TOTAL FEES:10675164
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASED SERVICES FROM UCSD TOTAL FEES:14999984
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:REPAIRS AND MAINTENANCE TOTAL FEES:4304149
OTHER FEES FOR SERVICES FOR NON-EMPLOYEES FORM 990 PART IX LINE 11G DESCRIPTION:MISC MEDICAL SERVICES TOTAL FEES:46734952
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2012

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
2012
Open to Public Inspection
Name of the organization
RADY CHILDREN'S HOSPITAL - SAN DIEGO
 
Employer identification number

95-1691313
Part I
Identification of Disregarded Entities (Complete if the organization answered "Yes" to Form 990, Part IV, line 33.)
(a)
Name, address, and EIN (if applicable) 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" to 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 entity?
Yes No
(1) Rady Children's Hospital and Health Cent

3020 Childrens Way MC 5001

San Diego,CA92123
95-3545901 		Support CA 7 501(c)(3) NA
 
 
No
(2) Rady Children's Hospital Research Center

3020 Childrens WayMC 5001

San Diego,CA92123
95-3814185 		Research CA 11A 501(c)(3) RCHHC
 
 
No
(3) Rady Children's Hospital Foundation - SD

3020 Childrens WayMC 5001

San Diego,CA92123
33-0170626 		Fundraising CA 7 501(c)(3) RCHHC
 
 
No
(4) Rady Children's Health Services - SD

3020 Childrens WayMC 5001

San Diego,CA92123
33-0278018 		Support CA 11A 501(c)(3) RCHHC
 
 
No






For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to 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" to 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
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) Children's Hospital Integrated Risk Prot

22 Victoria StreetHamilton
Hamilton   HM12
BD
Captive insur BD RCHHC
  		C CORP. 0 0 0 %   No
(2) Rady Children's Physician Management Ser

3860 Calle FortunadaSuite 200
San Diego,CA921234282
33-0670694 		Management CA RCHHC
  		C CORP 0 0 0 %   No
(3) Children's Hospital Insurance Ltd

Canons Court 22 Victoria Street
Hamilton HM12    
BD
captive insur BD RCHHC
  		C corp 0 0 0 %   No








Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 3
Part V
Transactions With Related Organizations (Complete if the organization answered "Yes" to Form 990, Part IV, line 34, 35b, or 36.)
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
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 or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
 
No
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
 
No
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
Yes
 
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of other organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" to Form 990, Part IV, line 37.)
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under section 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V—UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2012
Schedule R (Form 990) 2012
Page 5
Part VII
Supplemental Information
Complete this part to provide additional information for responses to questions on Schedule R (see instructions).
Identifier Return Reference Explanation

Additional Data


Software ID:  
Software Version: