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 private foundations)
MediumBullet Do not enter Social Security numbers on this form as it may be made public. By law, the IRS
generally cannot redact the information on the form.
MediumBullet Information about Form 990 and its instructions is at www.IRS.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
A For the 2013 calendar year, or tax year beginning 07-01-2013 , 2013, and ending 06-30-2014
BCheck if applicable:
CName of organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Doing Business As
 
 
Number and street (or P.O. box if mail is not delivered to street address)
4650 SUNSET BOULEVARD
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
LOS ANGELES, CA900270982
D Employer identification number

95-1690977
E Telephone number

G Gross receipts $ 1,292,972,937
F Name and address of principal officer:
DIEMLAN LANNIE TONNU
4650 SUNSET BOULEVARD
LOS ANGELES,CA900270982
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.CHLA.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. (see instructions)
H(c)
Group exemption number MediumBullet  
K Form of organization:
 
L Year of formation: 1901
M State of legal domicile: CA
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: PROMOTION AND ADVANCEMENT OF CHILDREN'S HEALTH THROUGH PATIENT CARE, RESEARCH, AND EDUCATION.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 69
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 51
5 Total number of individuals employed in calendar year 2013 (Part V, line 2a) ...... 5 5,811
6 Total number of volunteers (estimate if necessary) ............. 6 500
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 36,294
b Net unrelated business taxable income from Form 990-T, line 34 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 115,036,083 101,182,945
9 Program service revenue (Part VIII, line 2g) ......... 735,921,091 676,537,449
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 14,622,702 38,838,537
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 4,093,891 6,482,850
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)................... 869,673,767 823,041,781
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 7,223,810 3,611,905
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) 400,984,720 422,880,718
16a Professional fundraising fees (Part IX, column (A), line 11e)..... 348,364 400,619
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet14,162,616    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 424,900,286 442,572,681
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 833,457,180 869,465,923
19 Revenue less expenses. Subtract line 18 from line 12....... 36,216,587 -46,424,142
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 1,745,766,595 1,714,611,002
21 Total liabilities (Part X, line 26)............. 621,479,251 606,737,237
22 Net assets or fund balances. Subtract line 21 from line 20..... 1,124,287,344 1,107,873,765
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 (2013)
Form 990 (2013)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III ..............
1
Briefly describe the organization’s mission: THE HOSPITAL'S PRINCIPAL MISSION IS TO PROMOTE AND ADVANCE THE STATE OF CHILDREN'S HEALTH, FOCUSING ON TERTIARY AND QUATERNARY SPECIALTIES IN PATIENT CARE, RESEARCH, AND EDUCATION.
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 $ 577,800,409 including grants of $ 3,611,905 ) (Revenue $ 635,216,758 )
MEDICAL CARE PROVIDED TO CHILDRENIT IS THE POLICY OF THE HOSPITAL TO STRIVE TO MAINTAIN QUALITY HEALTH CARE DELIVERY IN A MANNER THAT RESPECTS THE DIGNITY OF THE INDIVIDUAL AND FAMILY, REGARDLESS OF THE ABILITY TO PAY. UNDER THE HOSPITAL'S POLICY, MEDICAL CARE MAY BE PROVIDED WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES TO PEOPLE WHO ARE UNINSURED OR UNDERINSURED AND CANNOT AFFORD TO PAY FOR THEIR OWN MEDICAL CARE. THE HOSPITAL PROVIDES ADDITIONAL COMMUNITY SUPPORT BY PROVIDING CARE TO PATIENTS WHO PARTICIPATE IN PROGRAMS, LIKE MEDI-CAL, THAT DO NOT PAY FULL CHARGES. APPROXIMATELY THREE-FOURTHS OF THE HOSPITAL'S PATIENTS ARE COVERED BY MEDI-CAL PROGRAMS.
4b (Code:   ) (Expenses $ 46,595,740 including grants of $   ) (Revenue $ 31,423,682 )
GRADUATE MEDICAL EDUCATION PROVIDES TRAINING AND EDUCATION TO MEDICAL STUDENTS IN LOS ANGELES COUNTY WHO, IN TURN, PROVIDE SERVICES TO PATIENTS AT THE HOSPITAL. ALSO, INCLUDES EDUCATION REVENUE FROM THE RESIDENCY AND FELLOWSHIP PROGRAMS AT CHLA. THE HOSPITAL SUBSIDIZES A LARGE PART OF THE COST OF TRAINING PHYSICIANS, ALLIED HEALTH PROFESSIONALS, AND OTHER HEALTH CARE WORKERS IN ITS EMERGENCY ROOM, CLINICS, INPATIENT AREAS, AND OTHER PARTS OF ITS FACILITIES.
4c (Code:   ) (Expenses $ 80,350,483 including grants of $   ) (Revenue $ 9,897,009 )
RESEARCH REVENUES FURTHER THE EXEMPT PURPOSE OF CHLA BY PROVIDING THE PATIENTS OF CHLA ACCESS TO NEW TECHNOLOGIES, DISCOVERIES AND MEDICATIONS FOR TREATMENT. RESULTS OF THIS RESEARCH IS DISSEMINATED THROUGH PUBLICATIONS IN SCIENTIFIC JOURNALS AND PRESENTATIONS BY THE PRINCIPAL INVESTIGATORS. THE HOSPITAL SUBSIDIZES A LARGE PART OF THE COST OF MEDICAL RESEARCH TAKING PLACE IN ITS FACILITIES.
(Code:   ) (Expenses $ 543,615 including grants of $   ) (Revenue $ 558,553 )
OTHER PROGRAM SERVICE REVENUES ALSO INCLUDE RESIDENTS HOUSING AND MISCELLANEOUS TUITION AND EDUCATION INCOME.
4d Other program services (Describe in Schedule O.)
(Expenses $ 543,615 including grants of $   ) (Revenue $ 558,553 )
4e Total program service expensesMediumBullet705,290,247
Form 990 (2013)
Form 990 (2013)
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
 
No
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
Yes
 
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 other assistance to or for any foreign organization? 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 other assistance to or for foreign individuals? 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).... Click to see attachment
17
Yes
 
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............ Click to see attachment
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................... Click to see attachment
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?
20b
Yes
 
Form 990 (2013)
Form 990 (2013)
Page 4
Part IV
Checklist of Required Schedules (continued)
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II... Click to see attachment
21
Yes
 
22
Did the organization report more than $5,000 of grants or other assistance to individuals in the United States on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........ Click to see attachment
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, 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 25a................ Click to see attachment
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds?......................
24c
Yes
 
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
Did the organization report any amount on Part X, line 5, 6, or 22 for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons? If so, 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
Yes
 
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
Yes
 
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
Yes
 
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..Click to see attachment
29
Yes
 
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M............. Click to see attachment
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N,
Part I...........................
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II......................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I........ Click to see attachment
33
Yes
 
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
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2... Click to see attachment
35b
 
No
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 (2013)
Form 990 (2013)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V ..............
Yes
No
1a
Enter the number reported in Box 3 of Form 1096 Enter -0- if not applicable ..
1a
554
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
5,811
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file (see instructions)
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, 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
Yes
 
b
If "Yes," did the organization notify the donor of the value of the goods or services provided?.....
7b
Yes
 
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
0
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 (2013)
Form 990 (2013)
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 or note to any line 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
69
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
51
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? ...........................
4
Yes
 
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
 
No
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
 
No
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
 
No
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .........................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
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:
MediumBulletGRACE OH4650 SUNSET BLVDLOS ANGELESCA900270980 (323) 361-7450
Form 990 (2013)
Form 990 (2013)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line 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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) RICHARD CORDOVA........................................................................
PRESIDENT & CEO/TRUSTEE
 40.00
.......................   		X   X       774,110 0 49,557
(2) MARY DEE HACKER........................................................................
TRUSTEE/VP PATIENT CARE
 40.00
.......................   		X   X       441,362 0 71,586
(3) HENRI FORD MD........................................................................
TRUSTEE/FAC PHYSICIAN/VP
 40.00
.......................   		X   X       722,156 0 0
(4) STUART SIEGEL MD........................................................................
TRUSTEE/FACULTY PHYSICIAN
 40.00
.......................   		X           343,859 0 0
(5) BRENT POLK MD........................................................................
TRUSTEE/FACULTY PHYSICIAN
 40.00
.......................   		X   X       583,191 0 0
(6) BONNIE MCCLURE........................................................................
TRUSTEE/FUNDRAISER COORD
 30.00
.......................   		X           64,000 0 0
(7) MARK D KRIEGER MD........................................................................
TRUSTEE/FACULTY PHYSICIAN
 40.00
.......................   		X           200,250 0 0
(8) CARL GRUSHKIN MD........................................................................
TRUSTEE/FACULTY PHYSICIAN
 2.00
.......................   		X           209,445 0 0
(9) ARNOLD KLEINER........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(10) ELIZABETH LOWE........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(11) CATHY SIEGEL WEISS........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(12) MARION ANDERSON........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(13) JOHN JACK PETTKER........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(14) THEODORE SAMUELS........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(15) BROOKE ANDERSON........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(16) ASHWIN ADARKAR........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(17) JUNE BANTA........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
Form 990 (2013)
Form 990 (2013)
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; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) LYNDA BOONE FETTER........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(19) ALEX CHAVES SR........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(20) MARTHA CORBETT........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(21) MARGARET EBERHARDT........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(22) RICHARD FARMAN........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(23) PEGGY GALBRAITH........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(24) MARY HART........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(25) MEGAN M HERNANDEZ........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(26) MARCIA WILSON HOBBS........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(27) JAMES HUNT........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(28) WILLIAM HURT........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(29) TODD E MOLZ........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(30) SUSAN MALLORY........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(31) CAROL MANCINO........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(32) ELIZABETH HUNT PRICE........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(33) ALEX MENESES........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(34) CARYLL SPRAGUE MINGST........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(35) MARY ADAMS O'CONNELL........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(36) CHESTER CHET PIPKIN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(37) RONALD PREISSMAN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(38) DR CARMEN PULIAFITO........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(39) ALAN PURWIN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(40) DAYLE ROATH........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(41) KATHY LUPPEN ROSE........................................................................
TRUSTEE THROUGH MARCH 2014
 1.00
.......................   		X           0 0 0
(42) W SCOTT SANFORD........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(43) PAUL SCHAEFFER........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(44) THOMAS SIMMS........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(45) VICTORIA SIMMS PHD........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(46) LISA STEVENS........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(47) JAMES TERRILE........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(48) HON DICKRAM M TEVRIZIAN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(49) JOYCE BOGART TRABULUS........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(50) PEGGY TSIANG CHERNG PHD........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(51) ALYCE WILLIAMSON........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(52) ALAN WILSON........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(53) JEFFREY WORTHE........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(54) DICK ZIEGLER........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(55) KEVIN BROGAN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(56) GARY COHEN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(57) DEBBIE FREUND........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(58) KATHLEEN MCCARTHY KOSTLAN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(59) EUGENE MITCHELL........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(60) ELIZABETH RAHN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(61) STEVEN ROUNTREE........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(62) ALAN RUDNICK........................................................................
TRUSTEE
 2.00
.......................   		X           0 0 0
(63) RICHARD ZAPANTA MD........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(64) KIMBERLY SHEPHERD........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(65) JAIME LEE CURTIS........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(66) JIHEE HUH........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(67) WILLIAM WARDLAW........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(68) GLORIA HOLDEN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(69) MICHAEL MADDEN........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(70) JAY CARSON........................................................................
TRUSTEE
 1.00
.......................   		X           0 0 0
(71) DIEMLAN LANNIE TONNU........................................................................
SVP/CFO/TREASURER
 40.00
.......................   		    X       598,827 0 103,070
(72) LAWRENCE FOUST........................................................................
SVP-GEN COUNSEL/SEC
 40.00
.......................   		    X       509,777 0 82,575
(73) MICHELLE CRONKHITE........................................................................
ASSISTANT SECRETARY
 40.00
.......................   		    X       69,359 0 9,317
(74) DEANN MARSHALL........................................................................
SVP, CHIEF DEV & MKTG OFFICER
 40.00
.......................   		      X     508,893 0 105,223
(75) RODNEY HANNERS........................................................................
SVP OPERATIONS/COO
 40.00
.......................   		      X     846,126 0 99,028
(76) GAIL MARGOLIS........................................................................
VP, GOVERNMENT & PUBLIC POLICY
 40.00
.......................   		        X   314,753 0 57,827
(77) GRACE OH........................................................................
AVP, ASSOC GEN COUNSEL
 40.00
.......................   		        X   362,181 0 70,540
(78) TIM MALSEED........................................................................
AVP, CHIEF APPLICATIONS OFFICER
 40.00
.......................   		        X   358,775 0 46,065
(79) MARTY MILLER........................................................................
VP, CHIEF INFORMATION OFFICER
 40.00
.......................   		        X   397,008 0 70,879
(80) KEITH HOBBS........................................................................
VP, ANCILLARY & SUPPORT SERVICES
 40.00
.......................   		        X   343,500 0 59,480
(81) CLAUDIA LOONEY........................................................................
FORMER SVP-DEVELOPMENT
 40.00
.......................   		          X 391,217 0 8,589
(82) ROBERT ADLER MD........................................................................
FORMER TRUSTEE/FACULTY PHYSICIAN
 40.00
.......................   		          X 398,678 0 0
(83) ROBERT KAY MD........................................................................
FORMER TRUSTEE/FACULTY PHYSICIAN
 40.00
.......................   		          X 153,525 0 0
(84) ROBERTA WILLIAMS MD........................................................................
FORMER TRUSTEE/FACULTY PHYSICIAN
 40.00
.......................   		          X 309,720 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 8,900,712 0 833,736
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organizationMediumBullet889
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
Yes
 
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
Yes
 
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
COMFORCE TECHNICAL SERVICES INC999 STEWART AVENUE SUITE 100BETHPAGENY11714 HEALTHCARE WORKFORCE MGMT 2,233,009
RUDOLPH AND SLETTEN INC1600 SEAPORT BOULEVARD SUITE 350REDWOOD CITYCA94063 CONSTRUCTION MGMT 1,204,351
THE HALE CORPORATION513 SOUTH MYRTLE AVENUE AMONROVIACA91016 CONSTRUCTION MGMT 1,184,634
PARKING COMPANY OF AMERICA523 WEST 6TH STREET SUITE 528LOS ANGELESCA90014 PARKING SERVICES 1,064,991
INTER-CON SECURITY SYSTEMS INC210 SOUTH DE LACEY AVENUEPASADENACA91105 SECURITY SERVICES 851,727
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet60
Form 990 (2013)
Form 990 (2013)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII .............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512-514
Contributions, Gifts, GrantAmt and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues....1b  
c Fundraising events....1c  
d Related organizations...1d  
e Government grants (contributions)1e 43,644,810
f All other contributions, gifts, grants, and
similar amounts not included above1f 		57,538,135
g Noncash contributions included in lines
1a-1f:$ 		832,981
h Total. Add lines 1a-1f.......MediumBullet 101,182,945
Program Service RevenueAmt Business Code
2a PATIENT REVENUE 621110 635,216,758 635,216,758    
b EDUCATION REVENUE 900099 22,927,682 22,927,682    
c RESEARCH REVENUE 900099 9,897,009 9,897,009    
d GRADUATE MEDICAL EDUCATION 900099 8,496,000 8,496,000    
e
f All other program service revenue .        
g Total. Add lines 2a–2f........MediumBullet 676,537,449
OtherAmt RevenueAmt 3 Investment income (including dividends, interest, and other similar amounts).......MediumBullet 9,677,693   25,735 9,651,958
4 Income from investment of tax-exempt bond proceeds..MediumBullet        
5 Royalties...........MediumBullet 284,111     284,111
(i) Real (ii) Personal
6a Gross rents    
b Less: rental expenses    
c Rental income or (loss)    
d Net rental income or (loss).......MediumBullet        
(i) Securities (ii) Other
7a Gross amount from sales of assets other than inventory 499,092,000  
b Less: cost or other basis and sales expenses 469,635,160 295,996
c Gain or (loss) 29,456,840 -295,996
d Net gain or (loss)..........MediumBullet 29,160,844     29,160,844
8a Gross income from fundraising events (not including
$  
of contributions reported on line 1c). See Part IV, line 18 ..
a  
b Less: direct expenses ...b  
c Net income or (loss) from fundraising events..MediumBullet      
9a Gross income from gaming activities.
See Part IV, line 19 ...
a  
b Less: direct expenses ...b  
c Net income or (loss) from gaming activities...MediumBullet        
10a Gross sales of inventory, less
returns and allowances .
a  
b Less: cost of goods sold ..b  
c Net income or (loss) from sales of inventory..MediumBullet        
Miscellaneous Revenue Business Code
11a PARKING GARAGE 812930 2,715,192     2,715,192
b CHILD DEVELOPMENT CENTER 624410 1,236,726     1,236,726
c RESIDENT'S HOUSING 900099 470,305 470,305    
d All other revenue .... 1,776,516 88,248 10,559 1,677,709
e Total. Add lines 11a–11d ...... MediumBullet 6,198,739
12 Total revenue. See Instructions......MediumBullet 823,041,781 677,096,002 36,294 44,726,540
Form 990 (2013)
Form 990 (2013)
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 or note to any line 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 3,611,905 3,611,905
2 Grants and other assistance to individuals in the United States. See Part IV, line 22    
3 Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16    
4 Benefits paid to or for members    
5 Compensation of current officers, directors, trustees, and key employees .... 4,350,957 472,823 3,467,129 411,005
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....        
7 Other salaries and wages 353,317,518 285,858,339 60,103,249 7,355,930
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 6,906,727 5,764,818 993,613 148,296
9 Other employee benefits ....... 33,547,445 29,611,861 3,081,784 853,800
10 Payroll taxes ........... 24,758,071 20,291,114 3,904,111 562,846
11 Fees for services (non-employees):        
a Management ...... 86,203 86,086 117  
b Legal ......... 1,135,837 142,766 993,071  
c Accounting ........... 608,897   608,897  
d Lobbying ........... 56,842   56,842  
e Professional fundraising services. See Part IV, line 17 400,619 400,619
f Investment management fees ...... 1,304,185   1,304,185  
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ........ 144,731,591 93,818,847 48,137,513 2,775,231
12 Advertising and promotion .... 3,773,501 3,773,501    
13 Office expenses ....... 116,575,616 112,637,580 3,719,442 218,594
14 Information technology ...... 32,200,000 19,169,689 13,026,329 3,982
15 Royalties .. 140,027 140,027    
16 Occupancy ........... 5,093,046 3,075,517 1,277,313 740,216
17 Travel ............ 3,138,949 2,208,327 807,668 122,954
18 Payments of travel or entertainment expenses for any federal, state, or local public officials ......        
19 Conferences, conventions, and meetings .... 2,431,326 1,386,619 723,130 321,577
20 Interest ........... 22,767,467 21,581,282 1,186,185  
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization ..... 51,291,261 48,889,018 2,402,243  
23 Insurance .............. 2,606,510 2,470,711 135,799  
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 HOSPITAL FEE PROGRAM 17,491,375 17,491,375 0 0
b UTILITIES 11,599,220 11,020,144 578,701 375
c PROVISION FOR BAD DEBTS 8,385,995 8,385,995 0 0
d MINOR EQUIPMENT 2,397,305 2,271,153 108,508 17,644
e All other expenses 14,757,528 11,130,750 3,397,231 229,547
25 Total functional expenses. Add lines 1 through 24e 869,465,923 705,290,247 150,013,060 14,162,616
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 (2013)
Form 990 (2013)
Page 11
Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ............. 393,731 1 6,095
2 Savings and temporary cash investments ......... 26,671,972 2 4,982,972
3 Pledges and grants receivable, net ........... 86,184,393 3 77,697,300
4 Accounts receivable, net ............. 120,085,788 4 125,010,396
5 Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
Schedule L ..................
291,294 5 221,379
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
  6  
7 Notes and loans receivable, net ............. 832,482 7 580,000
8 Inventories for sale or use .............. 6,802,184 8 7,687,746
9 Prepaid expenses and deferred charges .......... 4,554,792 9 9,712,061
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 1,459,152,995
b Less: accumulated depreciation ..... 10b 542,379,829 911,087,506 10c 916,773,166
11 Investments—publicly traded securities .......... 507,618,625 11 539,405,599
12 Investments—other securities. See Part IV, line 11 ..... 5,121,549 12 5,371,846
13 Investments—program-related. See Part IV, line 11 .....   13  
14 Intangible assets ...............   14  
15 Other assets. See Part IV, line 11 ........... 76,122,279 15 27,162,442
16 Total assets. Add lines 1 through 15 (must equal line 34)...... 1,745,766,595 16 1,714,611,002
Liabilities 17 Accounts payable and accrued expenses ......... 83,872,499 17 79,441,047
18 Grants payable .................   18  
19 Deferred revenue ................ 10,468,538 19 2,885,291
20 Tax-exempt bond liabilities ............. 487,314,409 20 486,309,228
21 Escrow or custodial account liability. Complete Part IV of Schedule D..   21  
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..........   22  
23 Secured mortgages and notes payable to unrelated third parties ..   23  
24 Unsecured notes and loans payable to unrelated third parties ....   24  
25 Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D.................... 39,823,805 25 38,101,671
26 Total liabilities. Add lines 17 through 25......... 621,479,251 26 606,737,237
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 .............. 834,693,032 27 808,486,179
28 Temporarily restricted net assets ........... 139,982,752 28 146,844,484
29 Permanently restricted net assets ........... 149,611,560 29 152,543,102
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 ........... 1,124,287,344 33 1,107,873,765
34 Total liabilities and net assets/fund balances ........ 1,745,766,595 34 1,714,611,002
Form 990 (2013)
Form 990 (2013)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI ..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
823,041,781
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
869,465,923
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
-46,424,142
4
Net assets or fund balances at beginning of year (must equal Part X, line 33, column (A)) ..
4
1,124,287,344
5
Net unrealized gains (losses) on investments ...............
5
31,740,167
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
-1,729,604
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 33, column (B))
10
1,107,873,765
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line 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 (2013)
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.
right arrow Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2009 (b) 2010 (c) 2011 (d) 2012 (e) 2013 (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) 2013
Schedule A (Form 990 or 990-EZ) 2013
Page 4
Part IV
Supplemental Information. 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) 2013

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.
Arrow Bullet Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
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 its Form 990PF, Part I, line 2, 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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 2
Name of organization
CHILDREN'S HOSPITAL LOS ANGELES
  		Employer identification number

95-1690977
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, RESTRICTEDRESTRICTED

$RESTRICTED


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


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

   
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 3
Name of organization
CHILDREN'S HOSPITAL LOS ANGELES
  		Employer identification number

95-1690977
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) (2013)

Schedule B (Form 990, 990-EZ, or 990-PF) (2013)
Page 4
Name of organization
CHILDREN'S HOSPITAL LOS ANGELES
  		Employer identification number

95-1690977
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) (2013)

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.SchCMd Bullet Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
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
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
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) 2013

Schedule C (Form 990 or 990-EZ) 2013
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) ....... 56,842  
c Total lobbying expenditures (add lines 1a and 1b) ................... 56,842  
d Other exempt purpose expenditures ........................ 705,233,405  
e Total exempt purpose expenditures (add lines 1c and 1d) ............... 705,290,247  
f Lobbying nontaxable amount. Enter the amount from the following table in both
columns.		 1,000,000  
If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
Not over $500,00020% of the amount on line 1e.
Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
Over $17,000,000$1,000,000.
g Grassroots nontaxable amount (enter 25% of line 1f) ................. 250,000  
h Subtract line 1g from line 1a. If zero or less, enter -0-. ................ 0  
i Subtract line 1f from line 1c. If zero or less, enter -0-. ................ 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) 2010 (b) 2011 (c) 2012 (d) 2013 (e) Total
2a Lobbying nontaxable amount 1,000,000 1,000,000 1,000,000 1,000,000 4,000,000
b Lobbying ceiling amount
(150% of line 2a, column(e)) 		6,000,000
c Total lobbying expenditures 61,012 49,816 46,582 56,842 214,252
d Grassroots nontaxable amount 250,000 250,000 250,000 250,000 1,000,000
e Grassroots ceiling amount
(150% of line 2d, column (e))		 1,500,000
f Grassroots lobbying expenditures          
Schedule C (Form 990 or 990-EZ) 2013


Schedule C (Form 990 or 990-EZ) 2013
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? .........................................
 
 
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....
 
 
c
Media advertisements? ....................................
 
 
 
d
Mailings to members, legislators, or the public? .........................
 
 
 
e
Publications, or published or broadcast statements? .......................
 
 
 
f
Grants to other organizations for lobbying purposes? .......................
 
 
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? ........
 
 
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......
 
 
 
i
Other activities? ..........................
 
 
 
j
Total. Add lines 1c through 1i ...............................
 
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
 
b
If "Yes," enter the amount of any tax incurred under section 4912 .................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....
 
d
If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......
 
 
Part III-A
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).
Yes
No
1
Were substantially all (90% or more) dues received nondeductible by members? ................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........
3
 
 
Part III-B
Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."
1
Dues, assessments and similar amounts from members .....................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).
a
Current year .........................................
2a
 
b
Carryover from last year ....................................
2b
 
c
Total ............................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................
4
 
5
Taxable amount of lobbying and political expenditures (see instructions) ..............
5
 
Part IV
Supplemental Information
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.
Return Reference Explanation
Schedule C (Form 990 or 990EZ) 2013

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. SchDMd Bullet Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
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) 2013

Schedule D (Form 990) 2013
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 .... 570,394,064 528,012,698 542,188,938 495,093,405 471,903,453
b Contributions ........ 43,017,518 49,282,881 39,523,985 32,136,775 30,649,271
c Net investment earnings, gains, and losses 70,018,758 46,289,884 -69,784 63,246,838 45,036,808
d Grants or scholarships .....          
e Other expenditures for facilities
and programs ........ 		64,511,013 53,191,399 53,630,441 48,288,079 52,496,127
f Administrative expenses ....          
g End of year balance ...... 618,919,327 570,394,064 528,012,698 542,188,939 495,093,405
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet71.120 %
b
Permanent endowment SchDMd Bullet24.650 %
c
Temporarily restricted endowment SchDMd Bullet4.230 %
The percentages in lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) unrelated organizations ........................
3a(i)
 
No
(ii) related organizations ........................
3a(ii)
 
No
b
If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
 
 
4
Describe in Part XIII the intended uses of the organization's endowment funds.
Part VI
Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. 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 .................   25,551,282 25,551,282
b Buildings ................   1,042,834,954 286,446,560 756,388,394
c Leasehold improvements ............        
d Equipment ................   350,647,457 250,964,064 99,683,393
e Other .................   40,119,302 4,969,205 35,150,097
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......SchDMdBullet 916,773,166
Schedule D (Form 990) 2013

Schedule D (Form 990) 2013
Page 3
Part VII
Investments—Other Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. 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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.
(a) Description of investment (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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.
(a) Description (b) Book value








Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........Small Bullet  
Part X
Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.
1.(a) Description of liability (b) Book value
Federal income taxes  
INTEREST RATE SWAP 10,194,563
WORKERS COMPENSATION INSURANCE RESERVE 12,808,281
DEFERRED BENEFITS 6,181,059
MALPRACTICE TAIL RESERVE 3,800,000
LIABILITY UNDER UNITRUST AGREEMENTS 3,017,477
DEFERRED REVENUE/DEPOSITS LT 2,100,291



Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 38,101,671
2. Liability for uncertain tax positions 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) 2013

Schedule D (Form 990) 2013
Page 4
Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
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
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.
Return Reference Explanation
PART V, LINE 4: ENDOWMENT FUNDS ARE INTENDED TO BE USED ACCORDING TO THE DONOR'S WISHES WHICH VARY FROM ONGOING PROGRAM SUPPORT, TO SPECIFIC RESEARCH, TO BUILDING OR ASSET ACQUISITION, OR SUPPORT OF ACADEMIC CHAIRS WITHIN THE ORGANIZATION.
PART X, LINE 2: THE HOSPITAL ACCOUNTS FOR INCOME TAXES IN ACCORDANCE WITH FASB ASC 740, INCOME TAXES. FASB ASC 740 PRESCRIBES A COMPREHENSIVE MODEL FOR HOW A COMPANY SHOULD RECOGNIZE, MEASURE, PRESENT, AND DISCLOSE IN ITS CONSOLIDATED FINANCIAL STATEMENTS UNCERTAIN TAX POSITIONS THAT THE COMPANY HAS TAKEN, OR EXPECTS TO TAKE, ON A TAX RETURN. DURING THE YEARS ENDED JUNE 30, 2014 AND JUNE 30, 2013, THE HOSPITAL DID NOT RECORD ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS.
Schedule D (Form 990) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE G (Form 990 or 990-EZ)
Department of the Treasury
Internal Revenue Service
Supplemental Information Regarding
Fundraising or Gaming Activities
Complete if the organization answered "Yes" to Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrowAttach to Form 990 or Form 990-EZ. right arrowSee separate instructions.
right arrowInformation about Schedule G (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
Part I
Fundraising Activities. Complete if the organization answered "Yes" to Form 990, Part IV, line 17.
Form 990-EZ filers are not required to complete this part.
1
Indicate whether the organization raised funds through any of the following activities. Check all that apply.
a e
b f
c g
d
2a
Did the organization have a written or oral agreement with any individual (including officers, directors, trustees
or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?
b
If "Yes," list the ten highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.
(i) Name and address of individual
or entity (fundraiser) 		(ii) Activity (iii) Did fundraiser have custody or control of contributions? (iv) Gross receipts
from activity 		(v) Amount paid to
(or retained by)
fundraiser listed in
col. (i) 		(vi) Amount paid to
(or retained by)
organization
Yes No
 
CHILDREN'S MIRACLE NETWORK
205 WEST 700 SOUTH
 
SALT LAKE CITY, UT84101 		GENERAL FUNDRAISING   No 4,009,924 400,619 3,609,305
             
             
             
             
             
             
             
             
             
Total .................right arrow 4,009,924 400,619 3,609,305
3
List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.
CA
For Paperwork Reduction Act Notice, see the Instructions for Form 990or 990-EZ.
Cat. No. 50083H
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 2
Part II
Fundraising Events. Complete if the organization answered "Yes" to Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.
(a) Event #1

 
(event type) 		(b) Event #2

 
(event type) 		(c) Other events

 
(total number) 		(d) Total events
(add col. (a) through col. (c))
VerticalRevenue 1 Gross receipts . . .        
2 Less: Contributions . .        
3 Gross income (line 1
minus line 2) . . . 		       
VerticalDirectExpenses 4 Cash prizes . . .        
5 Noncash prizes . .        
6 Rent/facility costs . .        
7 Food and beverages .        
8 Entertainment . . .        
9 Other direct expenses .        
10 Direct expense summary. Add lines 4 through 9 in column (d) ........... right arrow  
11 Net income summary. Subtract line 10 from line 3, column (d)........... right arrow  
Part III
Gaming. Complete if the organization answered "Yes" to Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.
VerticalRevenue (a) Bingo (b) Pull tabs/Instant
bingo/progressive bingo 		(c) Other gaming (d) Total gaming (add col.(a) through col.(c))
1 Gross revenue . . . .        
VerticalDirectExpenses 2 Cash prizes . . . .        
3 Non-cash prizes . . .        
4 Rent/facility costs . . .        
5 Other direct expenses . .        
6 Volunteer labor . . .
%
%
%
7 Direct expense summary. Add lines 2 through 5 in column (d) ........... right arrow  
8 Net gaming income summary. Subtract line 7 from line 1, column (d) ......... right arrow  
9
Enter the state(s) in which the organization operates gaming activities:
a
Is the organization licensed to operate gaming activities in each of these states? ............
b
If "No," explain:
 
10a
Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? .....
b
If "Yes," explain:
 
Schedule G (Form 990 or 990-EZ) 2013
Schedule G (Form 990 or 990-EZ) 2013
Page 3
11
Does the organization operate gaming activities with nonmembers? .................
12
Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity
formed to administer charitable gaming? ..........................
13
Indicate the percentage of gaming activity operated in:
a
The organization's facility ......................
13a
%
b
An outside facility ........................
13b
%
14
Enter the name and address of the person who prepares the organization's gaming/special events books and records:
Name right arrow
Address right arrow
15a
Does the organization have a contract with a third party from whom the organization receives gaming
revenue? ......................................
b
If "Yes," enter the amount of gaming revenue received by the organization right arrow $   and the
amount of gaming revenue retained by the third party right arrow $   .
c
If "Yes," enter name and address of the third party:
Name right arrow
Address right arrow
 
 
16
Gaming manager information:
Name right arrow
Gaming manager compensation right arrow $  
Description of services provided right arrow
 
17
Mandatory distributions:
a
Is the organization required under state law to make charitable distributions from the gaming proceeds to
retain the state gaming license? ............................
b
Enter the amount of distributions required under state law distributed to other exempt organizations or spent
in the organization's own exempt activities during the tax year right arrow$  
Part IV
Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v), and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also complete this part to provide any additional information (see instructions).
Return Reference Explanation
SCHEDULE G, PART I, LINE 2B, COLUMN (V) FUNDS SUBMITTED DIRECTLY TO CHILDREN'S MIRACLE NETWORK BY SPONSOR PARTNERS ARE REMITTED TO MEMBER HOSPITALS ON A QUARTERLY BASIS BY CHILDREN'S MIRACLE NETWORK. FUNDS REMITTED DIRECTLY TO MEMBER HOSPITALS AS A RESULT OF A CHILDREN'S MIRACLE NETWORK FUNDRAISING PROGRAM ARE REPORTED BACK TO CHILDREN'S MIRACLE NETWORK FOR THE PURPOSES TRACKING FUNDRAISING RESULTS BUT THOSE ARE DEPOSITED BY THE MEMBER HOSPITAL. MEMBER HOSPITALS PAY AN ANNUAL MEMBERSHIP FEE, WHICH DIFFERS FOR EACH MEMBER HOSPITAL AND DEPENDS LARGELY ON ITS MARKET TERRITORY POPULATION. THESE FEES ARE ANALOGOUS TO FRANCHISE FEES, WHERE HOSPITALS "OWN" MARKET TERRITORY IN WHICH THEY FUNDRAISE USING THE CHILDREN'S MIRACLE NETWORK BRAND. CHILDREN'S MIRACLE NETWORK FURNISHES FUNDRAISING MATERIALS THAT ARE ESSENTIAL TO THE CAMPAIGNS. SUCH MATERIALS INCLUDE THE PAPER ICONS, COLLATERAL MATERIALS, AND COIN CANNISTERS. MATERIALS ARE SENT DIRECTLY TO LOCATIONS OF SPONSOR PARTNERS (SUCH AS AN INDIVIDUAL COSTCO WAREHOUSE). IT IS THE RESPONSIBILITY OF EACH HOSPITAL TO PAY FOR THE COST OF THESE MATERIALS. MATERIALS COSTS ARE BILLED SEPARATE FROM THE ANNUAL MEMBERSHIP FEE AND ARE SENT INTERMITTENTLY DEPENDING ON THE FREQUENCY OF THE CAMPAIGNS.
Schedule G (Form 990 or 990-EZ) 2013
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.
MediumBullet Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
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

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......
5b
 
No
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) .. 		1 3,200 3,231,659   3,231,659 0.380 %
b Medicaid (from Worksheet 3,
column a) .... 		    176,165,611 95,793,498 80,372,113 9.330 %
c Costs of other means-tested
government programs (from
Worksheet 3, column b) . 		           
d Total Financial Assistance
and Means-Tested
Government Programs . 		1 3,200 179,397,270 95,793,498 83,603,772 9.710 %
Other Benefits
 17 193,146 1,562,318   1,562,318 0.180 %
e Community health
improvement services and
community benefit operations
(from Worksheet 4) ..
f Health professions education
(from Worksheet 5) .. 		7 7,335 64,561,407 44,544,017 20,017,390 2.320 %
g Subsidized health services
(from Worksheet 6) .. 		1 5,283 4,028,090   4,028,090 0.470 %
h Research (from Worksheet 7) 1   110,553,901 77,368,768 33,185,133 3.850 %
i Cash and in-kind
contributions for community
benefit (from Worksheet 8) 		4 13,400 4,387,986   4,387,986 0.510 %
j Total. Other Benefits .. 30 219,164 185,093,702 121,912,785 63,180,917 7.330 %
k Total. Add lines 7d and 7j . 31 222,364 364,490,972 217,706,283 146,784,689 17.040 %
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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 1 7,500 40,000   40,000 0 %
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 2 200,000 220,000   220,000 0.030 %
8 Workforce development 5 18,193 867,068   867,068 0.100 %
9 Other            
10 Total 8 225,693 1,127,068   1,127,068 0.130 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
8,385,995
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
2,032,878
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
2,032,878
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
 
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) 2013
Schedule H (Form 990) 2013
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, primary website address, and state license number 		Licensed Hospital General-Medical-Surgical Children's Hospital Teaching Hospital Critical Hospital ResearchGrp Facility ER-24Hours ER-Other Other (Describe) Facility reporting group
1 CHILDREN'S HOSPITAL LOS ANGELES
4650 SUNSET BLVD
LOS ANGELES,CA900270982
WWW.CHLA.ORG
930000032 		X X X X   X X      
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
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)
CHILDREN'S HOSPITAL LOS ANGELES
Name of hospital facility or facility reporting group  
If reporting on Part V, Section B for a single hospital facility only: line number of
hospital facility (from Schedule H, Part V, Section A) 		1
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 persons who represent the broad interests 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   No
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
d
6 If the hospital facility addressed needs identified in its most recently conducted CHNA, indicate how (check all that apply as of the end of the tax year):
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) 2013
Schedule H (Form 990) 2013
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: 100.000000000000%
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: 350.000000000000%
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
i
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 individual’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 individual’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) 2013
Schedule H (Form 990) 2013
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 individual 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 individual 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) 2013
Schedule H (Form 990) 2013
Page
Part V
Facility Information (continued)
Section C. Supplemental Information for Part V, Section B.Provide descriptions required for Part V, Section B, lines 1j, 3, 4, 5d, 6i, 7, 10, 11, 12i, 14g, 16e, 17e, 18e, 19c, 19d, 20d, 21, and 22. If applicable, provide separate descriptions for each facility in a facility reporting group, designated by "Facility A," "Facility B," etc.
Form and Line Reference Explanation
CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY THE ADVANCEMENT PROJECT HEALTHY CITY, BIEL CONSULTING AND THE OFFICE OF COMMUNITY AFFAIRS AT CHILDREN'S HOSPITAL LOS ANGELES. OTHER INSTITUTIONS, ORGANIZATIONS AND AGENCIES-AS WELL AS MEMBERS OF THE CHILDREN'S HOSPITAL COMMUNITY BENEFIT ADVISORY COMMITTEE-ALSO CONTRIBUTED TIME AND RESOURCES TO ASSIST WITH THIS ASSESSMENT.THE ADVANCEMENT PROJECT HEALTHY CITY IS AN INFORMATION AND ACTION RESOURCE ORGANIZATION THAT CREATED THE FOCUSED DATA MAPS USED IN THE ASSESSMENT. MELISSA BIEL OF BIEL CONSULTING CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT. BIEL CONSULTING IS AN INDEPENDENT CONSULTING FIRM THAT WORKS WITH HOSPITALS, CLINICS AND COMMUNITY-BASED NONPROFIT ORGANIZATIONS. DR. BIEL HAS OVER 10 YEARS OF EXPERIENCE CONDUCTING HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENTS.SOURCES OF DATA INCLUDE THE U.S. CENSUS 2010 DECENNIAL CENSUS AND AMERICAN COMMUNITY SURVEY, CALIFORNIA HEALTH INTERVIEW SURVEY, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, CALIFORNIA EMPLOYMENT DEVELOPMENT DEPARTMENT, LOS ANGELES COUNTY HEALTH SURVEY, LOS ANGELES HOMELESS SERVICES AUTHORITY, UNIFORM DATA SET, CDC NATIONAL HEALTH STATISTICS, NATIONAL CANCER INSTITUTE, U.S. DEPARTMENT OF EDUCATION, AND OTHERS. WHEN PERTINENT, THESE DATA SETS ARE PRESENTED IN THE CONTEXT OF CALIFORNIA STATE.TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. TWENTY INTERVIEWS WERE COMPLETED DURING MARCH AND APRIL 2013. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS. ADDITIONALLY, INPUT WAS OBTAINED FROM LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH OFFICIALS. FOR THE INTERVIEWS, COMMUNITY STAKEHOLDERS IDENTIFIED BY KEY DEPARTMENTS AT CHILDREN'S HOSPITAL LOS ANGELES WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS, OR REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE "CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY."
CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 7: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), HEALTH AND SOCIAL NEEDS WERE IDENTIFIED THROUGH AN EXAMINATION OF PRIMARY AND SECONDARY DATA AND THEN PRIORITIZED THROUGH A STRUCTURED PROCESS USING THE RELATIVE WORTH METHOD. THIS METHOD IS A RANKING STRATEGY WHERE EACH PARTICIPANT IN THE PROCESS RECEIVED A FIXED NUMBER OF POINTS TO RANK EACH IDENTIFIED NEED. THE PRIORITY AREAS THAT ARE BEING ADDRESSED ARE: ACCESS TO CARE, HEALTH PROMOTION AND PREVENTION, OBESITY AND WORKFORCE DEVELOPMENT. OTHER HEALTH AND SOCIAL NEEDS THAT WERE IDENTIFIED, SUCH AS MENTAL HEALTH, CHRONIC DISEASE CONDITIONS, COMMUNITY SAFETY, AND EARLY CHILDHOOD DEVELOPMENT, ARE ALREADY BEING ADDRESSED BY OTHER LOCAL AND REGIONAL COMMUNITY ORGANIZATIONS. CHLA'S IMPLEMENTATION STRATEGY CAN BE FOUND ON THEIR WEBSITE AT WWW.CHLA.ORG.
CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 20D: THE HOSPITAL WILL CHARGE THE GREATER OF THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS DETERMINED BY THE FOLLOWING METHODS: - LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE - AVERAGE OF ITS THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES - MEDICARE RATES
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VFacility Information (continued)

Section D. 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?  
Name and address Type of Facility (describe)
1
2
3
4
5
6
7
8
9
10
Schedule H (Form 990) 2013
Schedule H (Form 990) 2013
Page
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.
Form and Line Reference Explanation
CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 3: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY THE ADVANCEMENT PROJECT HEALTHY CITY, BIEL CONSULTING AND THE OFFICE OF COMMUNITY AFFAIRS AT CHILDREN'S HOSPITAL LOS ANGELES. OTHER INSTITUTIONS, ORGANIZATIONS AND AGENCIES-AS WELL AS MEMBERS OF THE CHILDREN'S HOSPITAL COMMUNITY BENEFIT ADVISORY COMMITTEE-ALSO CONTRIBUTED TIME AND RESOURCES TO ASSIST WITH THIS ASSESSMENT.THE ADVANCEMENT PROJECT HEALTHY CITY IS AN INFORMATION AND ACTION RESOURCE ORGANIZATION THAT CREATED THE FOCUSED DATA MAPS USED IN THE ASSESSMENT. MELISSA BIEL OF BIEL CONSULTING CONDUCTED THE COMMUNITY HEALTH NEEDS ASSESSMENT. BIEL CONSULTING IS AN INDEPENDENT CONSULTING FIRM THAT WORKS WITH HOSPITALS, CLINICS AND COMMUNITY-BASED NONPROFIT ORGANIZATIONS. DR. BIEL HAS OVER 10 YEARS OF EXPERIENCE CONDUCTING HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENTS.SOURCES OF DATA INCLUDE THE U.S. CENSUS 2010 DECENNIAL CENSUS AND AMERICAN COMMUNITY SURVEY, CALIFORNIA HEALTH INTERVIEW SURVEY, CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, CALIFORNIA EMPLOYMENT DEVELOPMENT DEPARTMENT, LOS ANGELES COUNTY HEALTH SURVEY, LOS ANGELES HOMELESS SERVICES AUTHORITY, UNIFORM DATA SET, CDC NATIONAL HEALTH STATISTICS, NATIONAL CANCER INSTITUTE, U.S. DEPARTMENT OF EDUCATION, AND OTHERS. WHEN PERTINENT, THESE DATA SETS ARE PRESENTED IN THE CONTEXT OF CALIFORNIA STATE.TARGETED INTERVIEWS WERE USED TO GATHER INFORMATION AND OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL. TWENTY INTERVIEWS WERE COMPLETED DURING MARCH AND APRIL 2013. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS. ADDITIONALLY, INPUT WAS OBTAINED FROM LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH OFFICIALS. FOR THE INTERVIEWS, COMMUNITY STAKEHOLDERS IDENTIFIED BY KEY DEPARTMENTS AT CHILDREN'S HOSPITAL LOS ANGELES WERE CONTACTED AND ASKED TO PARTICIPATE IN THE NEEDS ASSESSMENT. INTERVIEWEES INCLUDED INDIVIDUALS WHO ARE LEADERS AND REPRESENTATIVES OF MEDICALLY UNDERSERVED, LOW-INCOME, MINORITY AND CHRONIC DISEASE POPULATIONS, OR REGIONAL, STATE OR LOCAL HEALTH OR OTHER DEPARTMENTS OR AGENCIES THAT HAVE "CURRENT DATA OR OTHER INFORMATION RELEVANT TO THE HEALTH NEEDS OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY."
CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 7: AS PART OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), HEALTH AND SOCIAL NEEDS WERE IDENTIFIED THROUGH AN EXAMINATION OF PRIMARY AND SECONDARY DATA AND THEN PRIORITIZED THROUGH A STRUCTURED PROCESS USING THE RELATIVE WORTH METHOD. THIS METHOD IS A RANKING STRATEGY WHERE EACH PARTICIPANT IN THE PROCESS RECEIVED A FIXED NUMBER OF POINTS TO RANK EACH IDENTIFIED NEED. THE PRIORITY AREAS THAT ARE BEING ADDRESSED ARE: ACCESS TO CARE, HEALTH PROMOTION AND PREVENTION, OBESITY AND WORKFORCE DEVELOPMENT. OTHER HEALTH AND SOCIAL NEEDS THAT WERE IDENTIFIED, SUCH AS MENTAL HEALTH, CHRONIC DISEASE CONDITIONS, COMMUNITY SAFETY, AND EARLY CHILDHOOD DEVELOPMENT, ARE ALREADY BEING ADDRESSED BY OTHER LOCAL AND REGIONAL COMMUNITY ORGANIZATIONS. CHLA'S IMPLEMENTATION STRATEGY CAN BE FOUND ON THEIR WEBSITE AT WWW.CHLA.ORG.
CHILDREN'S HOSPITAL LOS ANGELES PART V, SECTION B, LINE 20D: THE HOSPITAL WILL CHARGE THE GREATER OF THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP-ELIGIBLE INDIVIDUALS DETERMINED BY THE FOLLOWING METHODS: - LOWEST NEGOTIATED COMMERCIAL INSURANCE RATE - AVERAGE OF ITS THREE LOWEST NEGOTIATED COMMERCIAL INSURANCE RATES - MEDICARE RATES
Schedule H (Form 990) 2013
Additional Data


Software ID:  
Software Version:  
Schedule I
(Form 990)
Department of the Treasury
Internal Revenue Service
Grants and Other Assistance to Organizations,
Governments and Individuals in the United States
Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet Attach to Form 990
lBullet Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number
95-1690977
Part I
General Information on Grants and Assistance
1
Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Governments and Organizations in the United States. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC Code section
if applicable		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
non-cash assistance		 (h) Purpose of grant
or assistance
(1) CALIFORNIA HEALTH FOUNDATION AND TRUST
1215 K STREET SUITE 800
SACRAMENTO,CA95814 		94-1498687 501(C)(3) 3,611,905 0     SUPPORT CHARITABLE ACTIVITIES AT HOSPITALS AND HEALTH SYSTEMS IN CALIFORNIA






















2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
0
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2013

Schedule I (Form 990) 2013
Page 2
Part III
Grants and Other Assistance to Individuals in the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.
(a)Type of grant or assistance (b)Number of
recipients		 (c)Amount of
cash grant		 (d)Amount of
non-cash assistance		 (e)Method of valuation (book,
FMV, appraisal, other)		 (f)Description of non-cash assistance












Part IV
Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.
Return Reference Explanation
PART I, LINE 2: GRANTS WILL ONLY BE MADE TO 501(C)(3) ORGANIZATIONS TO ENSURE THE FUNDS WILL BE USED PROPERLY.
Schedule I (Form 990) 2013


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, line 23.
SchJMediumBullet Attach to Form 990. SchJMediumBullet See separate instructions.
SchJMediumBullet Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
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
Yes
 
2
Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..
2
Yes
 
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
Yes
 
8
Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................
8
 
No
9
If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
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)RICHARD CORDOVAPRESIDENT & CEO/TRUSTEE (i)
(ii)		 637,921
0 		100,000
0 		36,189
0 		7,650
0 		41,907
0 		823,667
0 		0
0
(2)MARY DEE HACKERTRUSTEE/VP PATIENT CARE (i)
(ii)		 254,360
0 		62,000
0 		125,002
0 		49,268
0 		22,318
0 		512,948
0 		95,867
0
(3)HENRI FORD MDTRUSTEE/FAC PHYSICIAN/VP (i)
(ii)		 600,750
0 		0
0 		121,406
0 		0
0 		0
0 		722,156
0 		0
0
(4)STUART SIEGEL MDTRUSTEE/FACULTY PHYSICIAN (i)
(ii)		 343,859
0 		0
0 		0
0 		0
0 		0
0 		343,859
0 		0
0
(5)BRENT POLK MDTRUSTEE/FACULTY PHYSICIAN (i)
(ii)		 583,191
0 		0
0 		0
0 		0
0 		0
0 		583,191
0 		0
0
(6)MARK D KRIEGER MDTRUSTEE/FACULTY PHYSICIAN (i)
(ii)		 200,250
0 		0
0 		0
0 		0
0 		0
0 		200,250
0 		0
0
(7)CARL GRUSHKIN MDTRUSTEE/FACULTY PHYSICIAN (i)
(ii)		 209,445
0 		0
0 		0
0 		0
0 		0
0 		209,445
0 		0
0
(8)DIEMLAN LANNIE TONNUSVP/CFO/TREASURER (i)
(ii)		 394,996
0 		103,000
0 		100,831
0 		74,722
0 		28,348
0 		701,897
0 		65,758
0
(9)LAWRENCE FOUSTSVP-GEN COUNSEL/SEC (i)
(ii)		 337,606
0 		91,000
0 		81,171
0 		66,421
0 		16,154
0 		592,352
0 		63,671
0
(10)DEANN MARSHALLSVP, CHIEF DEV & MKTG OFFICER (i)
(ii)		 311,412
0 		89,000
0 		108,481
0 		85,558
0 		19,665
0 		614,116
0 		49,306
0
(11)RODNEY HANNERSSVP OPERATIONS/COO (i)
(ii)		 406,240
0 		102,000
0 		337,886
0 		58,861
0 		40,167
0 		945,154
0 		300,164
0
(12)GAIL MARGOLISVP, GOVERNMENT & PUBLIC POLICY (i)
(ii)		 235,269
0 		56,000
0 		23,484
0 		36,628
0 		21,199
0 		372,580
0 		0
0
(13)GRACE OHAVP, ASSOC GEN COUNSEL (i)
(ii)		 271,979
0 		58,003
0 		32,199
0 		38,525
0 		32,015
0 		432,721
0 		30,898
0
(14)TIM MALSEEDAVP, CHIEF APPLICATIONS OFFICER (i)
(ii)		 266,476
0 		55,170
0 		37,129
0 		44,107
0 		1,958
0 		404,840
0 		26,101
0
(15)MARTY MILLERVP, CHIEF INFORMATION OFFICER (i)
(ii)		 276,054
0 		70,000
0 		50,954
0 		37,968
0 		32,911
0 		467,887
0 		30,748
0
(16)KEITH HOBBSVP, ANCILLARY & SUPPORT SERVICES (i)
(ii)		 238,308
0 		59,000
0 		46,192
0 		37,323
0 		22,157
0 		402,980
0 		35,893
0
(17)CLAUDIA LOONEYFORMER SVP-DEVELOPMENT (i)
(ii)		 26,727
0 		98,271
0 		266,219
0 		1,177
0 		7,412
0 		399,806
0 		195,274
0
(18)ROBERT ADLER MDFORMER TRUSTEE/FACULTY PHYSICIAN (i)
(ii)		 398,678
0 		0
0 		0
0 		0
0 		0
0 		398,678
0 		0
0
(19)ROBERT KAY MDFORMER TRUSTEE/FACULTY PHYSICIAN (i)
(ii)		 153,525
0 		0
0 		0
0 		0
0 		0
0 		153,525
0 		0
0
(20)ROBERTA WILLIAMS MDFORMER TRUSTEE/FACULTY PHYSICIAN (i)
(ii)		 309,720
0 		0
0 		0
0 		0
0 		0
0 		309,720
0 		0
0
Schedule J (Form 990) 2013

Schedule J (Form 990) 2013
Page 3
Part III
Supplemental Information
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.
Return Reference Explanation
PART I, LINE 1A HENRI FORD RECEIVED A HOUSING ALLOWANCE OF $121,406 IN CALENDAR YEAR 2013, WHICH WAS TREATED AS TAXABLE COMPENSATION. RICHARD CORDOVA HAS A DISCRETIONARY SPENDING ACCOUNT OF $36,000 FOR CALENDAR YEAR 2013. THIS ACCOUNT IS TO BE USED FOR CHLA BUSINESS ACTIVITIES IN HIS ROLE AS CEO. THIS AMOUNT WAS REPORTED AS TAXABLE INCOME ON HIS FORM W-2.
PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN CHLA'S 457(F) PLAN, A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. AMOUNTS DEFERRED UNDER SECTION 457(F) PLAN ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. THESE AMOUNTS WILL BE REPORTED AS COMPENSATION FOR THE YEAR PAID. AMOUNTS RECOGNIZED AS TAXABLE COMPENSATION ON THE EMPLOYEE'S 2013 FORM W-2 REFLECT PAYMENTS RECEIVED BY THE EMPLOYEE DURING CALENDAR YEAR 2013 THAT WERE PREVIOUSLY REPORTED AS DEFERRED COMPENSATION IN PRIOR YEAR FORM 990S: GRACE OH - $30,898 DEANN MARSHALL - $49,306 TIM MALSEED - $26,101 MARTY MILLER - $30,748 RODNEY HANNERS - $300,164 DIEMLAN (LANNIE) TONNU - $65,758 CLAUDIA LOONEY - $195,274 LAWRENCE FOUST - $63,671 MARY DEE HACKER - $95,867 KEITH HOBBS - $35,893
PART I, LINE 7 CHLA MAINTAINS AN EXECUTIVE BONUS PROGRAM THAT AWARDS INCENTIVE COMPENSATION BASED UPON ACHIEVEMENT OF ORGANIZATIONAL OBJECTIVES INCLUDING HEALTH OUTCOMES, QUALITY IMPROVEMENT, LEVEL OF COMMUNITY BENEFIT PROVIDED AND OTHER MEASURES AS DETERMINED ANNUALLY BY THE COMPENSATION COMMITTEE. ALTHOUGH THE AMOUNT OF BONUS INCENTIVES THAT EACH EMPLOYEE MAY BE GRANTED IS BASED ON A FIXED FORMULA, THE COMPENSATION COMMITTEE HAS THE DISCRETION TO DETERMINE THE EXTENT OF THE GOALS THAT HAVE BEEN MET BY EACH EMPLOYEE. PURSUANT TO THE AFFILIATE AGREEMENT WITH THE UNIVERSITY OF SOUTHERN CALIFORNIA ("USC"), AN UNRELATED ORGANIZATION, THE FOLLOWING COMPENSATION AMOUNTS WERE PAID TO THE FOLLOWING LISTED INDIVIDUALS BY USC. USC WAS SUBSEQUENTLY REIMBURSED BY CHLA FOR THE AMOUNTS: ROBERT ADLER, M.D. (FORMER) - $398,678 HENRI FORD, M.D. - $600,750 ROBERT KAY, M.D. (FORMER) - $153,525 STUART E. SIEGEL, M.D. - $343,859 ROBERTA G. WILLIAMS, M.D. (FORMER) - $309,720 BRENT POLK, M.D. - $583,191 MARK D. KRIEGER, M.D. - $200,250 CARL GRUSHKIN, M.D. - $209,445 IN ADDITION TO HER FUNDRAISING ACTIVITIES, BONNIE MCCLURE ALSO ADMINISTERS THE HOSPITAL'S PHOTOGRAPHIC AND MEMORABILIA ARCHIVES AND ADMINISTERS THE TOUR DOCENT PROGRAM. SHE WAS COMPENSATED $64,000 FOR HER SERVICES.
Schedule J (Form 990) 2013

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.
SchKMediumBulletInformation about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number
95-1690977
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 COMMUNITIES DEVELOPMENT AUTHORITY INSURED REVENUE BOND
  		68-0164610 130795CQ8 04-24-2007 170,792,342 FINANCED THE COSTS OF MAJOR EXPANSION AND MODERNIZATION OF THE HOSPITAL   X   X   X
B CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY INSURED REVENUE BOND
  		68-0164610 NONEAVAIL 12-18-2009 29,865,000 REFUNDED SERIES 2008 BONDS X     X   X
C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY INSURED REVENUE BONDS
  		52-1643828 13033LHC4 05-20-2010 186,024,080 REFUNDED SERIES 2004 & 2008 BONDS AND A PORTION OF SERIES 1999 CERTIFICATE X     X   X
D CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY INSURED REVENUE BONDS
  		52-1643828 13033LB22 08-15-2012 182,930,717 REFUNDED SERIES 2009 AND 2010B AND 1999   X   X   X
Part II
Proceeds
A B C D
1 Amount of bonds retired . . . . . . . . . . . . . .        
2 Amount of bonds legally defeased . . . . . . . . . . . 30,000,000 30,000,000 51,000,000  
3 Total proceeds of issue . . . . . . . . . . . . . . 170,792,342 29,865,000 186,024,080 182,930,717
4 Gross proceeds in reserve funds . . . . . . . . . . . .        
5 Capitalized interest from proceeds . . . . . . . . . . .        
6 Proceeds in refunding escrows . . . . . . . . . . . .        
7 Issuance costs from proceeds . . . . . . . . . . . . 1,500,000   2,644,798 2,310,722
8 Credit enhancement from proceeds . . . . . . . . . . . 5,213,423   5,213,423  
9 Working capital expenditures from proceeds . . . . . . . . . 9,301,225      
10 Capital expenditures from proceeds . . . . . . . . . . . 159,991,117      
11 Other spent proceeds . . . . . . . . . . . . . .        
12 Other unspent proceeds . . . . . . . . . . . . . .        
13 Year of substantial completion . . . . . . . . . . . . 2009 2010 2011 2013
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) 2013
Schedule K (Form 990) 2013
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            
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 0.800 %      
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 . . . . . . . . . . . . . 0.800 %      
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? . . . . . . . . . . . . .                
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   X   X
b Exception to rebate? . . . . . . . .   X   X   X   X
c No rebate due? . . . . . . . . X   X   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 & CO
  		 
  		 
  		 
 
c Term of hedge . . . . . . . . . . 0.100000000000      
d Was the hedge superintegrated? . . . .   X            
e Was the hedge terminated? . . . . . . X              
Schedule K (Form 990) 2013
Schedule K (Form 990) 2013
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 . . . . . . . . . AIG MATCHED FUNDING
  		 
  		 
  		 
 
c Term of GIC . . . . . . . . . . 1.400000000000      
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . . 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
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. Provide additional information for responses to questions on Schedule K (see instructions).
Return Reference Explanation
SCHEDULE K SUPPLENTAL INFORMATION PART III, LINE 3B AND 3D: WHILE CHLA DOES NOT ROUTINELY ENGAGE BOND COUNSEL OR OTHER OUTSIDE COUNSEL TO REVIEW ANY CONTRACTS OR AGREEMENTS RELATING TO TAX-EXEMPT BOND-FINANCED PROPERTY, CHLA UTILIZES ITS FULL-TIME IN-HOUSE LEGAL DEPARTMENT TO REVIEW ANY SUCH CONTRACTS. CHLA'S GENERAL COUNSEL'S OFFICE HAS DEVELOPED INTERNAL PROCEDURES FOR REVIEWING CONTRACTS RELATING TO TAX-EXEMPT BOND-FINANCED PROPERTIES TO ENSURE COMPLIANCE WITH PROPER SAFE HARBORS. PART IV, LINE 4C, COLUMN A: THERE WERE TWO CONTRACTS WITH THE PROVIDER, ONE WITH A TERM OF 1.3 YEARS, THE OTHER WITH A TERM OF 2.3 YEARS.
PART III, LINE 9: CHLA DOES NOT HAVE ANY NONQUALIFIED BONDS.
PART IV, LINE 2C: BOND A: CALCULATION PERFORMED ON 04/24/2014. BOND B: BOND WAS DEFEASED ON 08/15/2012. BOND C: CALCULATION PERFORMED ON 05/20/2014. BOND D: CALCULATION PERFORMED ON 08/15/2014.
Schedule K (Form 990) 2013

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.
MediumBulletInformation about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
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) HENRI FORD DIRECTOR OF CHLAMG, VICE PRESIDENT AND CHIEF OF SURGERY HOUSING ASSISTANCE   X 237,495 22,574   No Yes   Yes  
(2) DEANN MARSHALL SVP, CHIEF DEV & MKTG OFFICER HOUSING ASSISTANCE   X 300,000 87,500   No Yes   Yes  
(3) DEANN MARSHALL SVP, CHIEF DEV & MKTG OFFICER HOUSING ASSISTANCE   X 100,000 111,305   No Yes   Yes  
Total ......Small Bullet $ 221,379
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) 2013
Schedule L (Form 990 or 990-EZ) 2013
Page 2
Part IV
Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.
(a) Name of interested person (b) Relationship between interested person and the organization (c) Amount of transaction (d) Description of transaction (e) Sharing of organization's revenues?
Yes No
(1) MR WILLIAM H HURT TRUSTEE CHAIRMAN OF CAPITAL STRATEGY RESEARCH, INC. (AN AFFILIATE OF CGT) 271,071 THE HOSPITAL HAS INVESTMENT ACCOUNTS WITH CAPITAL GUARDIAN TRUST (CGT).   No
(2) MR ALAN PURWIN TRUSTEE PRESIDENT OF HELINET AVIATION 212,367 PROVIDES TRANSPORTATION SERVICES FOR THE HOSPITAL.   No
(3) MR ALEX CHAVES SR TRUSTEE OWNER OF PARKING COMPANY OF AMERICA 3,760,745 PROVIDES PARKING SERVICES FOR THE HOSPITAL.   No
(4) THEODORE R SAMUELS TRUSTEE SR. VP AND DIRECTOR OF CAPITAL GUARDIAN TRUST COMPANY 271,071 PAYMENT FOR INVESTMENT SERVICES TO THE HOSPITAL.   No
(5) CARL GRUSHKIN MD TRUSTEE PRESIDENT FOR CHILDREN'S HOSPITAL LOS ANGELES MEDICAL GROUP ("CHLAMG") 10,955,805 CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.   No
(6) HENRI R FORD MD TRUSTEE DIRECTOR FOR CHLAMG, CHIEF OF SURGERY 10,955,805 CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.   No
(7) LISA STEVENS TRUSTEE EXECUTIVE VP AND REGIONAL PRESIDENT OF WELLS FARGO & CO. 307,903 PAYMENT FOR BANKING SERVICES AS WELL AS REPAYMENT OF HOUSING MORTGAGE.   No
(8) KIMBERLY SHEPHERD TRUSTEE HER MOTHER IS A TRUSTEE OF UNIVERSITY OF SOUTHERN CALIFORNIA 0 REIMBURSEMENT OF FACULTY SALARIES TO USC BY CHLA. ZERO AMOUNT REFLECTS REIMBURSEMENT NATURE OF TRANSACTION.   No
(9) MEGAN HERNANDEZ TRUSTEE HUSBAND IS ENRIQUE HERNANDEZ, FOUNDER AND HEAD OF INTER-CON SECURITY SYSTEM 2,820,484 PROVIDES PRIVATE SECURITY SERVICES FOR THE HOSPITAL.   No
(10) BRENT POLK TRUSTEE CHAIR, DEPT OF PEDIATRICS AND VP OF ACADEMIC AFFAIRS 10,955,805 CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.   No
(11) ROBERT ADLER FORMER TRUSTEE DIRECTOR FOR CHLAMG 10,955,805 CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.   No
(12) CARMEN PULIAFITO TRUSTEE DEAN OF USC AND DIRECTOR FOR CHLAMG 10,955,805 CHLAMG IS THE PEDIATRIC FACULTY PHYSICIAN PLAN FOR THE UNIVERSITY OF SOUTHERN CALIFORNIA AT CHLA. PAYMENT IS FOR ADMINISTRATIVE AND COVERAGE SERVICES PROVIDED BY FACULTY PHYSICIANS.   No
(13) ALAN WILSON TRUSTEE SR. VP AND DIRECTOR OF CAPITAL GUARDIAN TRUST COMPANY 271,071 PAYMENT FOR INVESTMENT SERVICES TO THE HOSPITAL.   No
(14) MR JAMES TERRILE TRUSTEE OFFICER OF CAPITAL RESEARCH GLOBAL INVESTORS (AN AFFILIATE OF CGT) 271,071 THE HOSPITAL HAS INVESTMENT ACCOUNTS WITH CAPITAL GUARDIAN TRUST (CGT).   No
(15) MR LAWRENCE FOUST FORMER GENERAL DIRECTOR OF BETA HEALTHCARE GROUP 1,699,053 THE HOSPITAL USES BETA AS ITS INSURANCE PROVIDER.   No
Part V
Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).
Return Reference Explanation
Schedule L (Form 990 or 990-EZ) 2013

Additional Data


Software ID:  
Software Version:  




SCHEDULE M
(Form 990)

Department of the Treasury
Internal Revenue Service
Noncash Contributions
Right pointing arrow large imageComplete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image Attach to Form 990.
Right pointing arrow large imageInformation about Schedule M (Form 990) and its instructions is at www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
Part I
Types of Property
(a)
Check if applicable 		(b)
Number of contributions or items contributed 		(c)
Noncash contribution amounts reported on
Form 990, Part VIII, line 1g 		(d)
Method of determining
noncash contribution amounts
1 Art—Works of art ....        
2 Art—Historical treasures .        
3 Art—Fractional interests ..        
4 Books and publications ..      
5 Clothing and household
goods ....... 		     
6 Cars and other vehicles ..        
7 Boats and planes ....        
8 Intellectual property ...        
9 Securities—Publicly traded . X 51 832,981 COST OR SELLING PRICE
10 Securities—Closely held stock .        
11 Securities—Partnership, LLC,
or trust interests .... 		       
12 Securities—Miscellaneous ..        
13 Qualified conservation
contribution—Historic
structures ..... 		       
14 Qualified conservation
contribution—Other ... 		       
15 Real estate—Residential .        
16 Real estate—Commercial ..        
17 Real estate—Other ...        
18 Collectibles .....        
19 Food inventory ...        
20 Drugs and medical supplies .        
21 Taxidermy ......        
22 Historical artifacts ....        
23 Scientific specimens ..        
24 Archeological artifacts ...        
25 Other Right pointing arrow large image ( )
26 Other Right pointing arrow large image( )
27 Other Right pointing arrow large image( )
28 Other Right pointing arrow large image ( )
29
Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement ...
29
0
Yes
No
30a
During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that
it must hold for at least three years from the date of the initial contribution, and which is not required to be used
for exempt purposes for the entire holding period? ..................
30a
 
No
b
If "Yes," describe the arrangement in Part II.
31
Does the organization have a gift acceptance policy that requires the review of any non-standard contributions?
31
Yes
 
32a
Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash
contributions? ..........................
32a
Yes
 
b
If "Yes," describe in Part II.
33
If the organization did not report an amount in column (c) for a type of property for which column (a) is checked,
describe in Part II.
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 51227J
Schedule M (Form 990) (2013)
Schedule M (Form 990) (2013)
Page 2
Part II
Supplemental Information. Provide the information required by Part I, lines 30b,
32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.
Return Reference Explanation
PART I, COLUMN (B): CHLA IS REPORTING THE NUMBER OF CONTRIBUTIONS.
PART I, LINE 32B: THE HOSPITAL USES BROKERAGE HOUSES TO SELL NON-CASH CONTRIBUTIONS.
Schedule M (Form 990) (2013)
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.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2013
Open to Public
Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
Return Reference Explanation
FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITTEE CONSISTS OF ONLY ACTIVE, VOTING MEMBERS OF THE BOARD OF TRUSTEES AND IS COMPOSED OF THE CO-CHAIRPERSONS OF THE BOARD; THE PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE HOSPITAL; THE CHAIRPERSONS OF THE BOARD'S ADVANCEMENT; FINANCE; AUDIT; SAFETY AND QUALITY; SERVICE AND ACCESS; COMPENSATION; GOVERNMENT RELATIONS; INVESTMENT; GOVERNANCE; NOMINATING; AND RESEARCH INSTITUTE COMMITTEES AND SEVERAL OTHER TRUSTEES ELECTED BY THE BOARD OF TRUSTEES. THE EXECUTIVE COMMITTEE MAY ACT WITH THE FULL AUTHORITY OF THE BOARD OF TRUSTEES EXCEPT ON THOSE MATTERS THAT ARE REQUIRED BY LAW OR THE BYLAWS TO BE DECIDED BY THE FULL BOARD OF TRUSTEES. ALL ACTIONS OF THE EXECUTIVE COMMITTEE ARE REFLECTED IN MINUTES OF THE COMMITTEE, CONTEMPORANEOUSLY DOCUMENTED AND REPORTED TO BOTH THE EXECUTIVE COMMITTEE AND THE FULL BOARD OF TRUSTEES AT THEIR NEXT MEETINGS.
FORM 990, PART VI, SECTION A, LINE 2 1. ALAN WILSON (TRUSTEE) - BUSINESS RELATIONSHIPS AMONG THEODORE SAMUELS (TRUSTEE), WILLIAM HURT (TRUSTEE) AND JAMES TERRILE (TRUSTEE) 2. SUSAN MALLORY (TRUSTEE) - BUSINESS RELATIONSHIPS AMONG MARION ANDERSON (TRUSTEE) AND MARCIA HOBBS (TRUSTEE) 3. ELIZABETH RAHN (TRUSTEE) - BUSINESS RELATIONSHIP WITH SUSAN MALLORY (TRUSTEE) 4. MARCIA HOBBS (TRUSTEE) - FAMILY RELATIONSHIP WITH BONNIE MCCLURE (TRUSTEE) 5. CARL GRUSHKIN (TRUSTEE) - BUSINESS RELATIONSHIP WITH ROBERT ADLER (FORMER TRUSTEE)
FORM 990, PART VI, SECTION A, LINE 4 THE FOLLOWING CHANGES WERE MADE TO THE BYLAWS DURING THE YEAR: - CHAIR OR VICE CHAIR OF A COMMITTEE MAY NOW SERVE 2 TERMS WITH THE FIRST TERM LASTING 2 YEARS INSTEAD OF 1 OR TWO YEARS - COMMITTEE CHAIRS SHALL NOT HOLD THEIR RESPECTIVE OFFICES FOR MORE THAN TWO CONSECUTIVE TERMS INSTEAD OF 1 - THERE IS NO TERM LIMIT FOR VICE CHAIRS, WHO MAY SERVE AN UNLIMITED NUMBER OF ONE OR TWO YEAR RENEWAL TERMS - COMMITTEE CHAIRS AND VICE CHAIRS SERVE AT THE PLEASURE OF THE CO-CHAIRS AND MAY BE REMOVED BY THE CO-CHAIRS BEFORE THE EXPIRATION OF THEIR FULL TERMS - THE NOMINATING COMMITTEE IS MERGED INTO THE GOVERNANCE COMMITTEE - CHLA SHALL HAVE A SERVICE AND ACCESS COMMITTEE CONSISTING OF AT LEAST 5 ACTIVE TRUSTEES - CHLA'S SAFETY, QUALITY AND SERVICE COMMITTEE SHALL NOW BE CALLED SAFETY AND QUALITY COMMITTEE
FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS PREPARED BY DELOITTE TAX LLP, WORKING IN CONJUNCTION WITH CHLA'S FINANCE DEPARTMENT. CHLA'S DIRECTOR OF ACCOUNTING HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE CHIEF FINANCIAL OFFICER. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY AND/OR KNOWLEDGE ABOUT THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE CHIEF FINANCIAL OFFICER AND GENERAL COUNSEL, IN PARTICULAR, REVIEW THE FORM 990 AND ENSURE ACCURACY OF DESCRIPTIONS AND THAT DISCLOSURE IS COMPLETE. THE DRAFT FORM 990 IS REVIEWED BY THE AUDIT COMMITTEE OF CHLA, ACTING ON BEHALF OF THE BOARD OF TRUSTEES OF CHLA. ONCE THE DRAFT FORM 990 HAS BEEN REVIEWED AND DISCUSSED BY THE AUDIT COMMITTEE, ANY CHANGES RESULTING FROM THEIR REVIEW IS INCORPORATED INTO THE FINAL DRAFT OF THE FORM 990. THE FINAL DRAFT OF THE FORM 990 IS THEN DISTRIBUTED TO THE BOARD OF TRUSTEES VIA A SECURE WEB SITE FOR THEIR REVIEW AND COMMENTS PRIOR TO THE FILING OF THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12C CHLA REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST QUESTIONNAIRE WHICH IS REQUIRED TO BE ANSWERED BY ALL OFFICERS AND MEMBERS OF THE BOARD OF TRUSTEES, KEY MEDICAL STAFF MEMBERS, AS WELL AS CERTAIN KEY EMPLOYEES THAT ARE DESIGNATED ANNUALLY BY THE GOVERNANCE COMMITTEE. THESE ANNUAL DISCLOSURES ARE REVIEWED BY A COMBINATION OF CHLA'S GENERAL COUNSEL, COMPLIANCE OFFICER, CHIEF EXECUTIVE OFFICER, GOVERNANCE COMMITTEE OF THE BOARD AND THE FULL BOARD OF TRUSTEES, DEPENDING ON THE INDIVIDUAL MAKING THE DISCLOSURE. ADDITIONALLY, THE LEGAL DEPARTMENT OF CHLA REVIEWS CONTRACTUAL RELATIONSHIPS ENTERED INTO BY CHLA. FURTHERMORE, BOARD MEMBERS AND OFFICERS ARE ASKED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ON A CONTINUOUS BASIS THROUGHOUT THE YEAR. IF A POTENTIAL CONFLICT EXISTS, THE BOARD OR COMMITTEE DETERMINES WHETHER THE BOARD MEMBER OR OFFICER SHOULD BE EXCLUDED FROM VOTING ON THAT PARTICULAR MATTER.
FORM 990, PART VI, SECTION B, LINE 15 15. A. THE PROCESS FOR DETERMINING THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER OF CHLA IS CONDUCTED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF CHLA, ACTING ON BEHALF OF THE BOARD OF TRUSTEES OF THE ORGANIZATION. THE COMPENSATION COMMITTEE REPORTED ITS DELIBERATIONS AND DECISIONS TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. IN DETERMINING THE CHIEF EXECUTIVE OFFICER'S COMPENSATION DURING THE TAX PERIOD OF THIS INFORMATION RETURN THE COMPENSATION COMMITTEE WORKED WITH AND RELIED UPON THE COUNSEL AND EXPERTISE OF MERCER CONSULTING, A FIRM WITH EXPERIENCE AND EXPERTISE IN THE AREA OF NON-PROFIT ORGANIZATION EXECUTIVE COMPENSATION. MERCER CONSULTING PROVIDED REPORTS TO THE COMPENSATION COMMITTEE, WHICH FURNISHED THE BASIS FOR THE ESTABLISHMENT OF THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE. THEIR REPORTS WERE BASED ON A REVIEW OF THE EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO CHLA BASED ON VARIOUS METRICS SUCH AS HOSPITAL TYPE AND REVENUE. THE COMPENSATION COMMITTEE DELIBERATED ON THE ISSUE OF THE CHIEF EXECUTIVE OFFICER'S COMPENSATION PACKAGE IN LIGHT OF THESE REPORTS AND QUESTIONS WERE ASKED OF, AND ANSWERED BY, MERCER REGARDING SUCH REPORTS AND OTHER RELEVANT MATTERS. BASED ON SUCH DELIBERATIONS, THE COMPENSATION COMMITTEE NEGOTIATED A WRITTEN CONTRACT WITH THE CEO. 15. B. THE PROCESS FOR DETERMINING THE COMPENSATION OF OFFICERS AND OTHER KEY EMPLOYEES OF CHLA IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT OF CHLA, AND THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF CHLA, ACTING ON BEHALF OF THE BOARD OF TRUSTEES OF THE ORGANIZATION. IN DETERMINING SUCH EMPLOYEE'S COMPENSATION, DURING THE 2013 COMPENSATION SEASON THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WORKED WITH AND RELIED UPON THE COUNSEL AND EXPERTISE OF MERCER CONSULTING, A FIRM WITH EXPERIENCE AND EXPERTISE IN THE AREA OF NON-PROFIT ORGANIZATION EXECUTIVE COMPENSATION. MERCER PROVIDED AN EXECUTIVE COMPENSATION REPORT TO THE HUMAN RESOURCES DEPARTMENT AND COMPENSATION COMMITTEE WHICH FURNISHED THE BASIS FOR THE ESTABLISHMENT OF SUCH EMPLOYEES' COMPENSATION PACKAGE DURING THE FOLLOWING YEAR. MERCER'S REPORT WAS BASED ON A REVIEW OF EXECUTIVE COMPENSATION PRACTICES OF A VARIETY OF ORGANIZATIONS THAT ARE CONSIDERED COMPARABLE TO CHLA BASED ON VARIOUS METRICS SUCH AS HOSPITAL TYPE AND REVENUE. IN ADDITION, THE CHIEF EXECUTIVE OFFICER MADE A RECOMMENDATION TO THE COMPENSATION COMMITTEE WITH RESPECT TO EACH OF SUCH EMPLOYEES' COMPENSATION PACKAGE IN LIGHT OF THE MERCER REPORT AND IN LIGHT OF THE EXECUTIVE'S PERFORMANCE. AT THE COMPENSATION COMMITTEE MEETING ADDRESSING SUCH MATTERS, QUESTIONS WERE ASKED OF, AND ANSWERED BY, MERCER REGARDING SUCH REPORT AND OTHER RELEVANT MATTERS. BASED ON SUCH DELIBERATIONS, THE COMPENSATION COMMITTEE MADE A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR.
FORM 990, PART VI, SECTION C, LINE 19 CHLA DOES NOT MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC. CHLA'S FINANCIAL STATEMENTS ARE CONTAINED IN ITS FORM 990, WHICH IS AVAILABLE FOR PUBLIC INSPECTION DURING BUSINESS HOURS.
FORM 990, PART VII: THE HOURS REPORTED FOR EACH OF THE FACULTY PHYSICIANS RELATES TO THEIR TOTAL COMPENSATION FROM ALL SOURCES AS REPORTED IN COLUMN D OF PART VII.
FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL FEES: PROGRAM SERVICE EXPENSES 75,253,652. MANAGEMENT AND GENERAL EXPENSES 21,934,719. FUNDRAISING EXPENSES 527,691. TOTAL EXPENSES 97,716,062. MEDICAL-RELATED SERVICES: PROGRAM SERVICE EXPENSES 10,531,051. MANAGEMENT AND GENERAL EXPENSES 3,846,950. FUNDRAISING EXPENSES 8,368. TOTAL EXPENSES 14,386,369. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 8,034,144. MANAGEMENT AND GENERAL EXPENSES 22,355,844. FUNDRAISING EXPENSES 2,239,172. TOTAL EXPENSES 32,629,160.
FORM 990, PART XI, LINE 9: CHANGE IN VALUE OF SPLIT-INTEREST AGREEMENTS -210,138. TRANSFERS AND OTHER -699,193. CHANGE IN SWAP MARK TO MARKET -432,636. INVESTMENT IN DISREGARDED ENTITY -387,637.
SCHEDULE H, PART VI: LETTER FROM RICHARD CORDOVA, CEO, ON COMMUNITY BENEFIT AT CHILDREN'S HOSPITAL LOS ANGELES: OUR CONNECTION WITH COMMUNITIES IS ESSENTIAL TO WHO WE ARE AND WHAT WE DO. SINCE 1901, CHILDREN'S HOSPITAL LOS ANGELES HAS DEDICATED ITSELF TO SERVING CHILDREN, ADOLESCENTS, FAMILIES AND THE BROADER COMMUNITY. WORKING WITH A BROAD SPECTRUM OF STAKEHOLDERS IS WHAT HELPS US FULFILL OUR MISSION OF CREATING HOPE AND BUILDING HEALTHIER FUTURES. FROM FAMILIES TO WHOLE COMMUNITIES, FROM CIVIC TO COMMUNITY-BASED ORGANIZATIONS, FROM RESEARCHERS TO ACADEMIC INSTITUTIONS, FROM ELECTED OFFICIALS TO GOVERNMENT AGENCIES-EACH MEMBER OF OUR COMMUNITY CONTRIBUTES TO OUR UNDERSTANDING OF HOW WE CAN POSITIVELY IMPACT THE LIVES OF CHILDREN AND ADOLESCENTS WELL BEYOND THE WALLS OF OUR HOSPITAL. DURING THIS TIME OF UNPRECEDENTED CHANGE IN HEALTH CARE ACROSS OUR COUNTRY, CHILDREN'S HOSPITAL LOS ANGELES REMAINS CONSTANT IN ITS ABILITY TO DELIVER QUALITY CARE TO OUR COMMUNITY. OUR STAFF CONTINUE TO DEDICATE THEMSELVES TO ENSURING THAT OUR COMMUNITY HEALTH AND OUTREACH INITIATIVES, PROGRAMS AND EXISTING CONNECTIONS THRIVE. THIS REPORT DEMONSTRATES THE DEPTH OF OUR COMMITMENT AND CONNECTION TO THE COMMUNITY-IN 2014, CHLA PROVIDED $222.6 MILLION IN COMMUNITY BENEFIT SERVICES AND ACTIVITIES. A FEW OF THESE TREMENDOUS EFFORTS INCLUDE: - SICKLE CELL DISEASE RESEARCH - CARING FOR CHILDHOOD CANCER SURVIVORS - OBESITY PREVENTION - INCREASING ACCESS TO HEALTH INSURANCE - WORKFORCE DEVELOPMENT PROGRAMS FOR ADOLESCENTS AND YOUNG ADULTS CHILDREN'S HOSPITAL LOS ANGELES IS PROUD TO HAVE STRONG CONNECTIONS WITH OUR COMMUNITIES. ON BEHALF OF OUR INSTITUTION, I LOOK FORWARD TO STRENGTHENING OUR WORK TOGETHER IN THE COMING YEAR. THANK YOU FOR TAKING THE TIME TO LEARN MORE ABOUT OUR EFFORTS IN THIS YEAR'S COMMUNITY BENEFIT REPORT. SINCERELY, RICHARD D. CORDOVA, FACHE PRESIDENT AND CHIEF EXECUTIVE OFFICER CHILDREN'S HOSPITAL LOS ANGELES
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2013

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBullet Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
CHILDREN'S HOSPITAL LOS ANGELES
 
Employer identification number

95-1690977
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on 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
(1) CHLA HOLDINGS LLC
4650 SUNSET BLVD
LOS ANGELES,CA900270980
27-3653228 		INVESTMENT VEHICLE CA 35,810 261,977 CHILDREN'S HOSPITAL OF LOS ANGELES
 
(2) CHILDREN'S HEALTH SYSTEM OF LOS ANGELES LLC
4650 SUNSET BLVD
LOS ANGELES,CA90027
95-1690977 		HEALTHCARE SERVICES CA 0 0 CHILDREN'S HOSPITAL OF LOS ANGELES
 
(3) CHILDREN'S HOSPITAL LOS ANGELES HEALTH NETWORK LLC
4650 SUNSET BLVD
LOS ANGELES,CA90027
95-1690977 		HEALTHCARE SERVICES CA 0 0 CHILDREN'S HOSPITAL OF LOS ANGELES
 
(4) CHLA INTERNATIONAL LLC
4650 SUNSET BLVD
LOS ANGELES,CA90027
47-1738947 		HEALTHCARE SERVICES DE 0 0 CHILDREN'S HOSPITAL OF LOS ANGELES
 




Part II
Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.
(a)
Name, address, and EIN of related organization


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1) ANCHORS GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118986 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(2) ANTELOPE VALLEY GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118987 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(3) BEL AIR GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118835 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(4) CENTENNIAL GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
14-1878642 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(5) CHILDREN'S CHAIN GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-4559789 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(6) DELLA ROBBIA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118990 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(7) DELTA DELTA DELTA FOR CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
23-7294093 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(8) EL SEGUNDO AUXILIARY GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118991 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(9) FLINTRIDGE GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118993 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(10) FOCUS

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
80-0290181 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(11) FRIENDS OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
14-1878647 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(12) GLENDALE AUXILIARY OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118994 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(13) GREEN HOUSE

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
23-7215226 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(14) HEALING ARTS REACHING KIDS (HARK)

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
20-4459362 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(15) LA PROVIDENCIA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6128178 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(16) LAS HERMANAS GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6128176 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(17) LAS MADRINAS INC

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-1959907 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(18) LAS PRIMERAS GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121928 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(19) MARY DUQUE OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121921 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(20) MARY DUQUE JUNIORS OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-3786303 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(21) MEN'S GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
26-0109744 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(22) MONROVIA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121929 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(23) NORTHRIDGE GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121930 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(24) PASADENA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121932 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(25) PENINSULA COMMITTEE

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
23-7091175 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(26) PROJECT CHLA

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-4524737 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(27) SAN ANTONIO GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121934 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(28) SANTA MONICA BAY AUXILIARY OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
23-7293607 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(29) SIERRA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121935 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(30) SOUTH BAY AUXILIARY OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6118996 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(31) SPIRITUAL CARE OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
20-0872821 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(32) THIS LITTLE LIGHT OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-4445549 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(33) TOLUCA GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6098666 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(34) WESTSIDE GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6059321 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(35) WHITTIER GUILD OF CHILDREN'S HOSPITAL LOS ANGELES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
95-6121939 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(36) BRIGHTEYES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
46-1214808 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(37) TEEN IMPACT AFFILIATES

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
45-4799602 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
(38) YOUNG PROFESSIONALS COUNCIL

4650 SUNSET BLVD MS 4

LOS ANGELES,CA90027
46-1301196 		FUNDRAISING CA 501(C)(3) 11D N/A
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



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

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




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



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) CHLA ESBT

4650 SUNSET BOULEVARD
LOS ANGELES,CA90027
20-3115169 		INVESTMENT CA  
T 84,687   100.000 % Yes  
(2) CRUT-11

4650 SUNSET BOULEVARD
LOS ANGELES,CA90027
 CHARITABLE TRUST CA  
T         No
(3) CRAT-3

4650 SUNSET BOULEVARD
LOS ANGELES,CA90027
 CHARITABLE TRUST CA  
T         No
(4) MMR LIT-1

4650 SUNSET BOULEVARD
LOS ANGELES,CA90027
 CHARITABLE TRUST CA  
T         No
(5) CHILDREN'S HOSPITAL LOS ANGELES MEDICAL FOUNDATION

4650 SUNSET BOULEVARD
LOS ANGELES,CA90027
95-1690977 		HEALTHCARE SERVICES CA  
C       Yes  




Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on 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
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
 
No
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
 
No
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
 
No
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
 
No
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
 
No
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved





Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

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




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






























Schedule R (Form 990) 2013
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013
Additional Data


Software ID:  
Software Version: