TY 2014 Form 990

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) JOHN LILLIE........................................................................ DIRECTOR	3.0 .......................0.0	X		0	0	0
(2) KENNETH L COX MD........................................................................ DIRECTOR/CMO (UNTIL 03/16/15)	3.0 .......................50.0	X		0	491,737	39,697
(3) CHRISTOPHER G DAWES........................................................................ PRESIDENT/CEO	50.0 .......................2.0	X	X	1,550,002	0	270,770
(4) MARIANN BYERWALTER........................................................................ DIRECTOR	3.0 .......................2.0	X		0	0	0
(5) DAVID ALEXANDER MD........................................................................ DIRECTOR	3.0 .......................0.0	X		0	0	0
(6) THOMAS KRUMMEL MD........................................................................ DIRECTOR	3.0 .......................51.0	X		0	1,088,073	46,578
(7) CHRISTY SANDBORG MD........................................................................ DIRECTOR	3.0 .......................50.0	X		0	383,034	48,936
(8) BERNADINE C FONG........................................................................ DIRECTOR (UNTIL 12/31/14)	3.0 .......................51.0	X		0	27,905	538
(9) DANA G MEAD JR........................................................................ DIRECTOR	3.0 .......................0.0	X		0	0	0
(10) MARY B CRANSTON........................................................................ CHAIR	3.5 .......................2.0	X	X	0	0	0
(11) HARRY R HAGEY........................................................................ DIRECTOR	3.0 .......................0.0	X		0	0	0
(12) HUGH O'BRODOVICH MD........................................................................ DIRECTOR	3.0 .......................50.0	X		0	738,923	45,896
(13) SUSAN ORR........................................................................ VICE CHAIR	3.0 .......................0.0	X	X	0	0	0
(14) ANNE BASS........................................................................ DIRECTOR	3.0 .......................0.0	X		0	0	0
(15) JEFFREY CHAMBERS........................................................................ DIRECTOR	3.0 .......................0.0	X		0	13,978	0
(16) JONATHAN COSLET........................................................................ DIRECTOR	3.0 .......................0.0	X		0	0	0
(17) WILLIAM CROWN........................................................................ DIRECTOR	3.0 .......................0.0	X		0	0	0

(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)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) SUSAN FORD DORSEY........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(19) ANN LIVERMORE........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(20) JOHN WALKER........................................................................ DIRECTOR	3.0 .......................1.0	X				0	0	0
(21) AMIR DAN RUBIN........................................................................ DIRECTOR	3.0 .......................52.25	X				0	3,047,978	359,230
(22) J TAYLOR CRANDALL........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(23) JANE SHAW........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(24) VAUGHN WILLIAMS........................................................................ DIRECTOR	3.0 .......................2.0	X				0	0	0
(25) JAMES WOODY MD........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(26) LLOYD B MINOR MD........................................................................ DIRECTOR	3.0 .......................54.0	X				0	1,599,819	372,985
(27) ELAINE CHAMBERS........................................................................ CHAIR (AS OF 01/01/15)	3.5 .......................0.0	X				0	0	0
(28) JOHN LEVIN........................................................................ DIRECTOR	3.0 .......................2.0	X				0	0	0
(29) DENNIS P LUND MD........................................................................ DIRECTOR/CMO (as of 03/17/15)	3.0 .......................1.0	X				0	0	0
(30) SUE BOSTROM........................................................................ DIRECTOR (as of 09/01/14)	3.0 .......................0.0	X				0	0	0
(31) FRANK LEE........................................................................ DIRECTOR	3.0 .......................2.0	X				0	0	0
(32) JANESTA NOLAND MD........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(33) JOEL PODOLNY........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(34) MINDY ROGERS........................................................................ DIRECTOR(AS OF 04/01/15)	3.0 .......................2.0	X				0	0	0
(35) BILL THOMPSON........................................................................ DIRECTOR (AS OF 01/01/15)	3.0 .......................0.0	X				0	0	0
(36) JORGE TITINGER........................................................................ DIRECTOR	3.0 .......................0.0	X				0	0	0
(37) ANNE MCCUNE........................................................................ CHIEF OPERATING OFFICER	50.0 .......................0.0		X			679,692	0	96,496
(38) DANA HAERING........................................................................ VP & CFO	50.0 .......................2.0		X			461,970	0	40,998
(39) OWEN R AURELIO........................................................................ VP CLINICAL SERVICES	50.0 .......................0.0			X		345,291	0	69,516
(40) MARK TORTORICH........................................................................ VP PLANNING, DESIGN, CONSTRUC	25.0 .......................25.0			X		0	440,439	48,449
(41) EDWARD KOPETSKY........................................................................ VP & CIO	50.0 .......................0.0			X		686,822	0	118,828
(42) KIM ROBERTS........................................................................ CAO PHYSICIAN PRAC	25.0 .......................25.0			X		495,724	0	122,014
(43) CRAIG T ALBANESE........................................................................ VP of Quality & PI	63.0 .......................0.0			X		0	588,342	81,577
(44) SUSAN COSTELLO........................................................................ VP PATIENT CARE SRVCS & CNO	50.0 .......................0.0			X		566,449	0	99,233
(45) MICHAEL LANE........................................................................ VP-LPCH CONSTRUCTION IN ADMIN	50.0 .......................0.0			X		404,322	0	98,013
(46) CAMERON D'ALPE........................................................................ VP Ambulatory Services	50.0 .......................0.0			X		297,505	0	35,065
(47) TIMOTHY W CARMACK........................................................................ FORMER VP & CFO	50.0 .......................0.0				X	805,055	0	3,700
(48) JAMES MCCAUGHEY........................................................................ Chief Strategy Officer	50.0 .......................0.0				X	467,873	0	68,119
(49) GREGORY J SOUZA........................................................................ VP HR	50.0 .......................0.0				X	503,210	0	26,132
(50) WARREN CHANDLER........................................................................ LPCH ASSISTANT CIO	50.0 .......................0.0				X	397,737	0	68,023
(51) MARK AMEY........................................................................ CTO	50.0 .......................0.0				X	424,664	0	59,110

(A) Name and business address	(B) Description of services	(C) Compensation
STANFORD HEALTH CARE, 300 PASTEUR DR STANFORD,CA94305	MED LAB/PURCH SVCS	105,706,882
DPR CONSTRUCTION INC, 1450 VETERANS BLVD REDWOOD CITY,CA94063	CONSTRUCTION	163,267,863
STANFORD UNIVERSITY, 450 SERRA MALL STANFORD,CA94303	PURCHASED SERVICES	28,253,569
HGA, 170 Maiden Lane SAN FRANCISCO,CA94108	ARCHITECTURE	20,974,985
OWENS MINOR, 18250 STANFORD ROAD TRACY,CA95377	MED PROD SUPPLIER	16,633,450
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 377

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 domestic organizations and domestic governments. See Part IV, line 21 ....	919,275	919,275
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............	0
4	Benefits paid to or for members ....	0
5	Compensation of current officers, directors, trustees, and key employees ....	4,998,412	2,038,535	2,685,745	274,132
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	808,755		808,755
7	Other salaries and wages ....	312,753,099	295,015,871	17,737,228
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	27,220,893	25,548,141	1,672,752
9	Other employee benefits .......	111,781,380	103,208,615	8,572,765
10	Payroll taxes ...........	24,772,338	23,263,608	1,508,730
11	Fees for services (non-employees):
a	Management ......	13,760,468	7,290,322	6,470,146
b	Legal .........	2,506,947		2,506,947
c	Accounting ...........	482,076		482,076
d	Lobbying ...........	49,565	49,565
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	375,850,349	354,437,602	21,412,747
12	Advertising and promotion ....	7,199,103	7,196,916	2,187
13	Office expenses .......	105,003,803	103,051,121	1,952,682
14	Information technology ......	31,572,729	14,691,961	16,880,768
15	Royalties ..	0
16	Occupancy ...........	21,128,566	13,330,623	7,797,943
17	Travel ............	951,034	758,422	192,612
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	0
20	Interest ...........	13,870,378	13,870,378
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	53,828,509	40,446,668	13,381,841
23	Insurance ..............	5,298,203	2,669,398	2,628,805
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	PROVIDER FEES	43,156,385	43,156,385
b	UNCOLLECTIBLES	9,971,840	9,971,840
c	UTILITIES	6,773,510	6,153,432	620,078
d	DUES AND SUBSCRIPTIONS	2,689,232	879,328	1,809,904
e	All other expenses	20,015,152	5,475,603	1,231,297	13,308,252
25	Total functional expenses. Add lines 1 through 24e	1,197,362,001	1,073,423,609	110,356,008	13,582,384
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 if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	1,895	1	1,895
2	Savings and temporary cash investments .........	174,359,105	2	335,075,518
3	Pledges and grants receivable, net ...........	14,132,171	3	30,543,839
4	Accounts receivable, net .............	240,238,943	4	291,804,875
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	4,200,342	8	7,178,752
9	Prepaid expenses and deferred charges ..........	9,065,437	9	7,980,163
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,432,428,676
b	Less: accumulated depreciation .....	10b	360,293,275	862,124,548	10c	1,072,135,401
11	Investments—publicly traded securities ..........	68,830,418	11	69,312,835
12	Investments—other securities. See Part IV, line 11 .....	1,203,366,302	12	967,155,380
13	Investments—program-related. See Part IV, line 11 .....	10,831,129	13	3,399,006
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	23,359,632	15	26,699,336
16	Total assets. Add lines 1 through 15 (must equal line 34)......	2,610,509,922	16	2,811,287,000
	17	Accounts payable and accrued expenses .........	128,603,108	17	167,090,779
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	566,174,379	20	559,686,467
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	62,339,518	25	84,685,434
26	Total liabilities. Add lines 17 through 25.........	757,117,005	26	811,462,680
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	1,250,688,478	27	1,337,179,747
28	Temporarily restricted net assets ...........	399,362,510	28	458,239,166
29	Permanently restricted net assets ...........	203,341,929	29	204,405,407
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........	1,853,392,917	33	1,999,824,320
34	Total liabilities and net assets/fund balances ........	2,610,509,922	34	2,811,287,000

- TIN:

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.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

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.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

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.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

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)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

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) 2014

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)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

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

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... 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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization Lucile Salter Packard Children's Hospital at Stanford

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	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization Lucile Salter Packard Children's Hospital at Stanford

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) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. 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

(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

(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

(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

(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) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

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

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

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) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

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

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

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) 2014

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 Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

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:

Volunteers? .........................................

Yes

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Yes

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Yes

72,000

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Yes

94,421

Other activities? ..........................

Total. Add lines 1c through 1i ...............................

166,421

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

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

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

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."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

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? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

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, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
ORGANIZATIONS EXEMPT UNDER SECTION 501(C)(3)	FORM 990, SCHEDULE C, PART II B LESS THAN 1% OF THE TOTAL VOLUNTEER HOURS DONATED TO LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD ("LPCH") WERE USED TO ATTEMPT TO INFLUENCE LEGISLATIVE MATTERS. STAFF INTERACTS ON A REGULAR BASIS WITH ELECTED OFFICIALS AND THEIR STAFF ON ALL LEVELS OF GOVERNMENT. MOST IS RELATIONSHIP BUILDING AND MAINTAINING AS WELL AS WORKING ON COLLABORATIVE PROGRAMS AND PROJECTS TO ENHANCE THE OVERALL HEALTH OF THE COMMUNITY. IN FY15, ROUGHLY 20% OF THE CHIEF GOVERNMENT RELATIONS OFFICER'S TIME AND ROUGHLY 20% OF THE SENIOR POLICY MANAGER'S TIME WAS SPENT ON LOBBYING ON SPECIFIC LEGISLATIVE ISSUES - VALUE APPROXIMATELY $96,735 (INCLUDES DOLLARS ALLOCATED FOR BENEFITS). IN ADDITION, IN FY15, THE HOSPITAL HAD A LOBBYIST IN WASHINGTON D.C. AND A NON-LOBBYIST ADVOCATE IN SACRAMENTO. LPCH BELONGS TO CERTAIN TRADE ASSOCIATIONS, A PORTION OF DUES PAID TO WHICH IS SPENT ON EFFORTS TO INFLUENCE LEGISLATIVE MATTERS IN THE HEALTH CARE INDUSTRY. DURING THE FY2015, THE APPROXIMATE AMOUNT OF THE DUES SPENT ON LOBBYING PURPOSES WAS $94,421.

Return Reference

Explanation

ORGANIZATIONS EXEMPT UNDER SECTION 501(C)(3)

FORM 990, SCHEDULE C, PART II B LESS THAN 1% OF THE TOTAL VOLUNTEER HOURS DONATED TO LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD ("LPCH") WERE USED TO ATTEMPT TO INFLUENCE LEGISLATIVE MATTERS. STAFF INTERACTS ON A REGULAR BASIS WITH ELECTED OFFICIALS AND THEIR STAFF ON ALL LEVELS OF GOVERNMENT. MOST IS RELATIONSHIP BUILDING AND MAINTAINING AS WELL AS WORKING ON COLLABORATIVE PROGRAMS AND PROJECTS TO ENHANCE THE OVERALL HEALTH OF THE COMMUNITY. IN FY15, ROUGHLY 20% OF THE CHIEF GOVERNMENT RELATIONS OFFICER'S TIME AND ROUGHLY 20% OF THE SENIOR POLICY MANAGER'S TIME WAS SPENT ON LOBBYING ON SPECIFIC LEGISLATIVE ISSUES - VALUE APPROXIMATELY $96,735 (INCLUDES DOLLARS ALLOCATED FOR BENEFITS). IN ADDITION, IN FY15, THE HOSPITAL HAD A LOBBYIST IN WASHINGTON D.C. AND A NON-LOBBYIST ADVOCATE IN SACRAMENTO. LPCH BELONGS TO CERTAIN TRADE ASSOCIATIONS, A PORTION OF DUES PAID TO WHICH IS SPENT ON EFFORTS TO INFLUENCE LEGISLATIVE MATTERS IN THE HEALTH CARE INDUSTRY. DURING THE FY2015, THE APPROXIMATE AMOUNT OF THE DUES SPENT ON LOBBYING PURPOSES WAS $94,421.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

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.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

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 value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

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? ............

Yes No

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? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

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.


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

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

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)? .......................................

Yes No

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.

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.

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)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

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:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

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):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

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?........

Yes No

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.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

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 ....	308,872,000	280,799,140	266,394,140	270,361,140	270,472,140
b	Contributions ........	853,000	643,000	1,184,000	822,000	34,000
c	Net investment earnings, gains, and losses	12,649,000	42,123,000	29,497,000	8,136,000	41,601,000
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	14,803,000	14,693,140	16,276,000	12,925,000	41,746,000
f	Administrative expenses ....
g	End of year balance ......	307,571,000	308,872,000	280,799,140	266,394,140	270,361,140

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

66.000 %

Temporarily restricted endowment SchDMd Bullet

34.000 %

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

Yes

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

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		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	24,232,500		24,232,500
b	Buildings ................	382,941,352	160,506,942	222,434,410
c	Leasehold improvements ............	34,100,859	14,872,969	19,227,890
d	Equipment ................	292,854,386	146,825,689	146,028,697
e	Other .................	698,299,579	38,087,675	660,211,904
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				1,072,135,401

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther 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.)		0

Part VIII

InvestmentsProgram 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.)

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.)...........

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		0
DUE TO GOVERNMENT AGENCIES		1,967,008
DUE TO RELATED PARTIES, NET		40,792,802
SELF-INSURANCE RESERVE		41,925,624






Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		84,685,434
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) 2014

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 (losses) 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
SCHEDULE D, PART III, LINE 4	LPCH DOES NOT RECOGNIZE CONTRIBUTIONS OF WORKS OF ART ON LPCH'S FINANCIALS SINCE 1) THEY ARE HELD FOR PUBLIC EXHIBITION RATHER THAN FINANCIAL GAIN; 2) THEY ARE PROTECTED, KEPT UNENCUMBERED, CARED FOR, AND PRESERVED; 3) ARE SUBJECT TO AN ORGANIZATIONAL POLICY THAT REQUIRES THE PROCEEDS FROM SALES OF COLLECTION ITEMS TO BE USED TO ACQUIRE OTHER ITEMS FOR COLLECTION.
SCHEDULE D, PART V, LINE 4	ENDOWMENT FUNDS LPCH'S ENDOWMENT CONSISTS OF VARIOUS INDIVIDUAL FUNDS. THE USES OF THE FUNDS ARE RESTRICTED TO DONORS' STIPULATIONS. THESE FUNDS ARE USED TO SUPPORT THE MISSION OF LPCH.

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE F(Form 990)

Department of the Treasury
Internal Revenue Service

Statement of Activities Outside the United States

Complete if the organization answered "Yes" to Form 990,Part IV, line 14b, 15, or 16. Right pointing arrow large image

Attach to Form 990. Right pointing arrow large image

Information about Schedule F (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization
Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Part I

General Information on Activities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 14b.

For grantmakers. Does the organization maintain records to substantiate the amount of its grants

and other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria

used to award the grants or assistance? ...........................

Yes

For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.

Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)

(a) Region		(d) Activities conducted in region (by type) (e.g., fundraising, program services, investments, grants to recipients located in the region)	(e) If activity listed in (d) is a program service, describe specific type of service(s) in region	(f) Total expenditures for and investments in region
	Europe (Including Iceland and Greenland)	Program Services	CONFERENCES	6,907
	East Asia and the Pacific	Program Services	CANCER CENTER	9,493















3a	Sub-total .....			16,400
b	Total from continuation sheets to Part I ...
c	Totals (add lines 3a and 3b)			16,400

For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2014

Schedule F (Form 990) 2014

Page 2

Part II

Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.

1 (a) Name of organization		(b) IRS code section and EIN (if applicable)	(a)(c) Region	(b)(d) Purpose of grant	(e) Amount of cash grant	(f) Manner of cash disbursement	(g) Amount of non-cash assistance	(h) Description of non-cash assistance	(i) Method of valuation (book, FMV, appraisal, other)

Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .... MediumBullet

Enter total number of other organizations or entities ....................... MediumBullet

Schedule F (Form 990) 2014

Schedule F (Form 990) 2014Page 3

Part III

Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" to Form 990, Part IV, line 16.

Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance		(b) Region	(c) Number of recipients	(d) Amount of cash grant	(e) Manner of cash disbursement	(f) Amount of non-cash assistance	(g) Description of non-cash assistance	(h) Method of valuation (book, FMV, appraisal, other)

Schedule F (Form 990) 2014

Page 4

Part IV

Foreign Forms

Schedule F (Form 990) 2014

Page 5

Part V

Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information (see instructions).

ReturnReference	Explanation

Schedule F (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H (Form 990)

Department of the TreasuryInternal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule H (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a ...

Yes

If "Yes," was it a written policy? .......................

Yes

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.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

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.

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:

Yes

100% 150% 200% Other 400 %

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: .........

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used 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.

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"? ..............

Yes

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

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? ......

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? ..............

Did the organization prepare a community benefit report during the tax year? ..........

Yes

If "Yes," did the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

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) ..		393	2,753,416		2,753,416	0.230 %
b	Medicaid (from Worksheet 3, column a) ....		23,724	416,562,532	233,537,219	183,025,313	15.410 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) .			0	0
d	Total Financial Assistance and Means-Tested Government Programs .		24,117	419,315,948	233,537,219	185,778,729	15.640 %
Other Benefits		13	304	2,516,094	70,755	2,445,339	0.210 %
e	Community health improvement services and community benefit operations (from Worksheet 4) ..	13	304	2,516,094	70,755	2,445,339	0.210 %
f	Health professions education (from Worksheet 5) ..	6		10,839,368		10,839,368	0.910 %
g	Subsidized health services (from Worksheet 6) ..	2		231,214		231,214	0.020 %
h	Research (from Worksheet 7)
i	Cash and in-kind contributions for community benefit (from Worksheet 8)	7	5,723	4,603,828	6,073	4,597,755	0.390 %
j	Total. Other Benefits ..	28	6,027	18,190,504	76,828	18,113,676	1.530 %
k	Total. Add lines 7d and 7j .	28	30,144	437,506,452	233,614,047	203,892,405	17.170 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2014

Schedule H (Form 990) 2014

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)	(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development	1	85,247	85,247	0.010 %
3	Community support	3	1,471,476	1,471,476	0.120 %
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	1	226,207	226,207	0.020 %
8	Workforce development	1	293,688	293,688	0.020 %
9	Other
10	Total	6	2,076,618	2,076,618	0.170 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

2,702,369

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. ......

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

Enter total revenue received from Medicare (including DSH and IME).....

4,250,759

Enter Medicare allowable costs of care relating to payments on line 5.....

9,571,034

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-5,320,275

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:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

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.......................

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) 2014

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 (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	LUCILE SALTER PACKARD CHILDREN'S HSPT 725 WELCH ROAD PALO ALTO,CA94304	X	X

Schedule H (Form 990) 2014

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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)

	LUCILE SALTER PACKARD CHILDREN'S HSPT
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a State as a hospital facility in the current tax year or the immediately preceding tax year?.......................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C..........

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 12....................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 12

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 Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public? ..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): WWW.STANFORDCHILDRENS.ORG

Other website (list url): COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. .............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 12

Is the hospital facility's most recently adopted implementation strategy posted on a website? ........

Yes

If "Yes" (list url): http://www.stanfordchildrens.org/en/about/gov

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

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)? ...........................

12a

If "Yes" to line 12a, did the organization file Form 4720 to report the section 4959 excise tax? ......

12b

If "Yes" to line 12b, 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) 2014

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Part VFacility Information (continued)

	LUCILE SALTER PACKARD CHILDREN'S HSPT
Name of hospital facility or letter of facility reporting group

Yes

Financial Assistance Policy (FAP)

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 included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 400.%
and FPG family income limit for eligibility for discounted care of 400.%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application.

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application.

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process.

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications.

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?.......

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url): www.stanfordchildrens.org

The FAP application form was widely available on a website (list url): www.stanfordchildrens.org

A plain language summary of the FAP was widely available on a website (list url):
www.stanfordchildrens.org

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

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 all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

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:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2014

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Part VFacility Information (continued)

	LUCILE SALTER PACKARD CHILDREN'S HSPT
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other 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?.........

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 18. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

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.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

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? ................................

If "Yes," explain in Section C.

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? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2014

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Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
PART V, SECTION B , LINE 5	IN TAX YEAR 2013, LPCH, IN COLLABORATION WITH LOCAL AREA NON-FOR-PROFIT HOSPITAL ORGANIZATIONS AND SAN MATEO AND SANTA CLARA COUNTY DEPARTMENTS OF PUBLIC HEALTH, CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WITH APPLIED SURVEY RESEARCH (ASR), A LOCAL NONPROFIT SOCIAL RESEARCH FIRM. THE PURPOSE OF THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS TO COLLECT COMMUNITY INPUT VIA PRIMARY QUALITATIVE RESEARCH IN OUR DEFINED COMMUNITY AND PRIMARY SERVICE AREAS OF BOTH SAN MATEO AND SANTA CLARA COUNTIES, IN ORDER TO INFORM LPCHS COMMUNITY BENEFIT SERVICES AND ACTIVITIES. THE CHNA PROCESS UTILIZED BOTH PRIMARY AND SECONDARY DATA TO REACH CONCLUSIONS THAT ULTIMATELY LED TO THE IDENTIFICATION OF SIGNIFICANT HEALTH NEEDS. THIS RESEARCH FOCUSED ON THE ORGANIZATION'S TARGET POPULATION OF BABIES, CHILDREN, ADOLESCENTS, AND EXPECTANT MOTHERS. THE CHNA PROCESS USED THREE STRATEGIES FOR COLLECTING INPUT FROM PERSONS AND GROUPS THAT REPRESENT THE BROAD INTEREST OF THE COMMUNITY LPCH SERVES: KEY INFORMANT INTERVIEWS WITH HEALTH EXPERTS, FOCUS GROUPS WITH COMMUNITY SERVICE PROVIDERS, AND FOCUS GROUPS WITH COUNTY RESIDENTS. EACH GROUP AND INTERVIEW WAS RECORDED AND SUMMARIZED AS A STAND-ALONE PIECE OF DATA. WHEN ALL GROUPS HAD BEEN CONDUCTED, THE TEAM USED QUALITATIVE RESEARCH SOFTWARE TOOLS TO ANALYZE THE INFORMATION AND TABULATE ALL HEALTH CONDITIONS THAT WERE MENTIONED, ALONG WITH HEALTH DRIVERS DISCUSSED. ASR THEN ANALYZED THE LIST OF CONDITIONS THAT HAD BEEN MENTIONED IN MULTIPLE FOCUS GROUPS AND KEY INFORMANT INTERVIEWS, WITH SPECIAL ATTENTION TO THOSE THAT HAD BEEN LISTED BY A FOCUS GROUP AS A TOP NEED. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS AND IS POSTED ON THE ORGANIZATION'S WEBSITE AT COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG AND A PRINTED OR DIGITAL COPY IS ALSO AVAILABLE, FREE OF CHARGE, FROM THE HOSPITAL UPON REQUEST. INPUT FROM HEALTH EXPERTS AND COMMUNITY SERVICE PROVIDERS OVERALL: IN ALL, ASR CONSULTED WITH ALMOST 100 PROFESSIONALS WHO REPRESENTED VARIOUS ORGANIZATIONS AND SECTORS IN OUR SERVICE AREA. THESE REPRESENTATIVES EITHER WORK IN THE HEALTH FIELD OR IMPROVE HEALTH CONDITIONS BY SERVING THOSE FROM THE TARGET POPULATIONS. THE HEALTH EXPERTS AND COMMUNITY SERVICE PROVIDERS WHO WERE CONSULTED CAME FROM THE FOLLOWING TYPES OF ORGANIZATIONS: -Public health departments -County health & hospital systems -Private hospital systems -Health insurance providers -Mental/behavioral health or violence prevention providers -School system representatives -Community center representatives -Non-profit agencies providing basic needs -Other non-profit agencies serving children and families Organizations and other groups consulted with for completion of CHNA: -STARVista -Boys and Girls Club - North San Mateo County (SMC) -City of South San Francisco Parks and Recreation -City of South San Francisco Police Department -Asian American Recovery Services -Partnership for a Safe and Healthy Pacific -Pyramid Alternatives -SMC Probation Office -SMC Health System -Safe Harbor Shelter -SMC Human Service Agency -Daly City Youth Health Center -RotaCare Clinic - Daly City -North Peninsula Neighborhood Services -Kaiser Permanente -Ravenswood Family Health Center -Samaritan House -RotaCare Clinic Half Moon Bay -Peninsula Family Services Agency -Coastside Hope -Santa Clara County (SCC) Public Health Dept. -SCC County Health and Hospital System -Mayview Community Health Center -Asian American for Community Health (AACI) -Gardner Health System -Puente de le Costa Sur -Behavioral Health and Recovery Services -SMC Sheriff's office -Saint Francis Center of Redwood City -Healthy Weight Collaborative -San Mateo Medical Center -Community Health Partnership -Rebekah's Children Services -Community Solutions -CARAS -Gilroy Unified School District -City of Gilroy -City of Morgan Hill -Saint Louise Hospital -City of Gilroy Chamber of Commerce -Morgan Hill Unified School District Board -West Valley Community Services -United Way Silicon Valley -InnVision Shelter Network -Sunnyvale Community Services -Mountain View Community Services -Silicon Valley Council of Nonprofits -Santa Clara Family Health Foundation -Stanford Hospital and Clinics -City of Sunnyvale -The Health Trust -Second Harvest Food Bank -Somos Mayfair -SCC Dept. of Alcohol and Drug Services -Project Cornerstone -Kids in Common -Columbia Neighborhood Center -San Jose Unified School District -Abilities United -City of San Jose Mayor's Gang Prevention Task Force -Santa Clara County YMCA -Packard Children's Adolescent Medicine Clinic -Bay Area Women Sports Initiative -Community Health Awareness Council -Belmont-Redwood Shores School District -Ronald McDonald House at Stanford -Silicon Valley Community Foundation -Peninsula Conflict Resolution Center -San Mateo YMCA -Planned Parenthood Mar Monte -Peninsula YMCA -School Health Clinics
PART V, SECTION B, LINE 6	LPCHS MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING HOSPITAL FACILITIES: EL CAMINO HOSPITAL, KAISER PERMANENTE SAN MATEO REGION, KAISER PERMANENTE SANTA CLARA REGION, MILLS-PENINSULA HEALTH SERVICES, OCONNOR HOSPITAL, SAINT LOUISE REGIONAL HOSPITAL, SAN MATEO MEDICAL CENTER, SETON MEDICAL CENTER, SEQUOIA HOSPITAL, STANFORD HEALTH CARE. LPCHS MOST RECENT CHNA WAS CONDUCTED IN COLLABORATION WITH THE FOLLOWING ORGANIZATIONS THAT ARE NOT HOSPITAL FACILITIES: HEALTH PLAN OF SAN MATEO, HOSPITAL CONSORTIUM OF SAN MATEO COUNTY, HOSPITAL COUNCIL OF NORTHERN & SOUTHERN CALIFORNIA, PENINSULA HEALTH CARE DISTRICT, SAN MATEO COUNTY HUMAN SERVICES AGENCY, SAN MATEO COUNTY HEALTH DEPARTMENT, SILICON VALLEY COMMUNITY FOUNDATION, SANTA CLARA COUNTY PUBLIC HEALTH DEPARTMENT, UNITED WAY SILICON VALLEY LPCH IDENTIFIED 8 SIGNIFICANT HEALTH NEEDS AND PRIORITIZED 3 AREAS TO FOCUS ITS WORK AND RESOURCES BASED ON THE HOSPITALS EXPERTISE AND THE DEMOGRAPHICS OF THE COMMUNITY THE HOSPITAL SERVES. THE HOSPITAL CHOSE TO PRIORITIZE THREE SIGNIFICANT HEALTH NEEDS BASED UPON THE ABILITY TO AFFECT THE MOST CHANGE IN THESE AREAS. THE HOSPITAL, HOWEVER, WILL CONTINUE TO LEVERAGE ITS RESOURCES TO WORK WITH OTHERS ON THE REMAINING AREAS FOR THE LIFE OF THIS CHNA. MANY OF THE SIGNIFICANT HEALTH NEEDS OVERLAP AND THUS WILL RECEIVE ATTENTION AS THE HOSPITAL CONDUCTS ITS WORK AROUND THE THREE PRIORITY AREAS IDENTIFIED BELOW. AT THE END OF THE DAY, ALL EIGHT IDENTIFIED HEALTH NEEDS WILL RECEIVE ATTENTION AND RESOURCES. SIGNIFICANT HEALTH NEEDS: 1. MENTAL HEALTH 2. PEDIATRIC OBESITY 3. ACCESS TO PRIMARY HEALTH CARE SERVICES THE OTHER SIGNIFICANT IDENTIFIED HEALTH NEEDS INCLUDE: 1. DIABETES 2. SUBSTANCE ABUSE 3. VIOLENCE AND ABUSE 4. ASTHMA 5. INFANT/BIRTH OUTCOMES PART V, SECTION B, LINE 9 LPCH UPDATED ITS IMPLEMENTATION STRATEGY IN TAX YEAR 2013.
PART V, SECTION B , LINE 11	PLEASE SEE RESPONSE TO PART V, SECTION B, LINE 6 ABOVE.
PART V, SECTION B , LINE 16I	LPCH ALSO ATTACHES A COPY OF ITS FINANCIAL ASSISTANCE POLICY TO BILLING INVOICES.
PART V, SECTION B, LINE 20E	WHEN PATIENTS EXPRESS INABILITY TO PAY, WE OFFER FINANCIAL ASSISTANCE TO PATIENTS/GUARANTORS.

Schedule H (Form 990) 2014

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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) 2014

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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
PART I, LINE 7, COLUMN (F)	THE AMOUNT OF BAD DEBT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN LINE 7, COLUMN (F) WAS $9,971,840. PART I, LINE 7 SOME OF THE AMOUNTS IN LINE 7 WERE CALCULATED BASED ON A COST ACCOUNTING SYSTEM. THESE ITEMS INCLUDE CHARITY CARE AT COST, UNREIMBURSED MEDICAID COST, AND UNREIMBURSED COSTS RELATED TO OTHER MEANS-TESTED GOVERNMENT PROGRAMS. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS, BUT EXCLUDES RESEARCH AND SOME GRANT RELATED COSTS. OTHER BENEFIT COSTS ARE DIRECT, SEPARATELY IDENTIFIABLE COSTS INCURRED BY THE ORGANIZATION. PART II COMMUNITY BUILDING ACTIVITIES LPCH INVESTS IN VARIOUS COMMUNITY BUILDING ACTIVITIES IN ORDER TO IMPROVE THE COMMUNITY'S HEALTH THROUGH A FOCUS ON THE ROOT CAUSES OF HEALTH PROBLEMS, SUCH AS POVERTY, ENVIRONMENTAL ISSUES, ETC. LPCH'S COMMUNITY BUILDING ACTIVITIES INCLUDE: SUPPORT FOR COMMUNITY-BASED NONPROFITS WORKING TO ADDRESS THE ROOT CAUSES OF HEALTH ISSUES FOR CHILDREN AND EXPECTANT MOTHERS; SUPPORT FOR COMMUNITY EMERGENCY MANAGEMENT, ADVOCACY FOR CHILDREN'S HEALTH ISSUES, AND SUPPORT FOR ORGANIZATIONS WORKING ON ECONOMIC DEVELOPMENT IN THE COMMUNITY.
PART III, LINE 2	THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 2 IS BASED ON A COST ACCOUNTING SYSTEM. THE HOSPITAL APPLIED THE SAME SYSTEM-WIDE COST TO CHARGE RATIO FROM THE COST ACCOUNTING SYSTEM TO ITS BAD DEBT BASED ON CHARGES AS WAS APPLIED TO ITS CHARITY CARE BASED ON CHARGES. THE COST TO CHARGE RATIO FROM THE ORGANIZATION'S COST ACCOUNTING SYSTEM DOES ADDRESS ALL PATIENT SEGMENTS AND EXCLUDES RESEARCH AND SOME GRANT RELATED COSTS. PART III, LINE 4 THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT INCLUDE A SPECIFIC FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. IN THE CONTEXT OF DESCRIBING THE PROCESS FOR ESTIMATING THE ULTIMATE COLLECTIBILTY OF PATIENT RECEIVABLES, THE FOOTNOTES DO NOTE THAT "REVISIONS IN THE RESERVE FOR DOUBTFUL ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO THE PROVISION FOR DOUBTFUL ACCOUNTS," OR BAD DEBT EXPENSE. SO INCLUDED IN THE ORGANIZATION'S BAD DEBT EXPENSE ARE REVISIONS TO ITS RESERVES FOR DOUBTFUL ACCOUNTS, AND WRITE-OFFS TO BAD DEBT FOR SUCH THINGS AS THE PATIENT LIABILITY. BAD DEBT WRITE-OFFS RESULT FROM UNSETTLED ACCOUNTS WHERE THE INABILITY TO PAY HAS NOT BEEN DETERMINED. BAD DEBT WRITE-OFFS DO NOT APPLY TO ACCOUNTS THAT QUALIFY FOR CHARITY (IF AN ACCOUNT WAS INITIALLY DEEMED BAD DEBT BUT SUBSEQUENT INFORMATION QUALIFIED IT FOR CHARITY, THE BAD DEBT WRITE-OFF IS REVERSED AND REPLACED WITH CHARITY WRITE-OFFS).
PART III, LINE 8	THE MEDICARE SHORTFALL OF ($5,320,275) REPORTED IN PART III, LINE 7 WAS CALCULATED BASED ON A COST ACCOUNTING SYSTEM. THIS AMOUNT SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE THE RATES PAID BY MEDICARE DO NOT ACCURATELY REFLECT THE COST OF CARE PROVIDED BY THE HOSPITAL. ACCORDINGLY, THE HOSPITAL MUST SUBSIDIZE THE COST OF CARE PROVIDED TO MEDICARE BENEFICIARIES WITH OTHER REVENUES.
PART III, LINE 9B	IF A PATIENT IS ATTEMPTING TO QUALIFY FOR ELIGIBILITY UNDER LPCH'S CHARITY CARE OR DISCOUNT PAYMENT POLICY AND IS ATTEMPTING IN GOOD FAITH TO SETTLE AN OUTSTANDING BILL WITH LPCH BY NEGOTIATING A REASONABLE PAYMENT PLAN OR BY MAKING REGULAR PARTIAL PAYMENTS OF A REASONABLE AMOUNT, LPCH SHALL NOT SEND THE UNPAID BILL TO ANY COLLECTION AGENCY OR OTHER ASSIGNEE, UNLESS THAT ENTITY AGREES TO COMPLY WITH THE PROVISIONS OF ARTICLE 3 OF THE HEALTH AND SAFETY CODE. LPCH OR OTHER ASSIGNEE SHALL NOT, IN DEALING WITH PATIENTS ELIGIBLE UNDER LPCH'S CHARITY CARE OR DISCOUNT PAYMENT POLICIES, USE WAGE GARNISHMENTS OR LIENS ON PRIMARY RESIDENCES AS A MEANS OF COLLECTING UNPAID HOSPITAL BILLS.
PART VI, LINE 2	LPCH PARTICIPATES IN COLLABORATIVE PROCESSES IN SAN MATEO AND SANTA CLARA COUNTIES THAT ASSESS COMMUNITY HEALTH NEEDS. THE AFFORDABLE CARE ACT, ENACTED BY CONGRESS ON MARCH 23, 2010, AND CALIFORNIA SENATE BILL 697 STIPULATES THAT NON-PROFIT HOSPITAL ORGANIZATIONS COMPLETE A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS. LPCH FULFILLED THIS REQUIREMENT BY CONDUCTING THE ASSESSMENT BETWEEN SEPTEMBER 2012 AND MARCH 2013,RECEIVING APPROVAL FROM THE HOSPITALS BOARD OF TRUSTEES IN MAY 2013 AND POSTING IT TO LPCHS WEBSITE. PER IRS REQUIREMENTS, THE ASSESSMENT INCLUDED FEEDBACK FROM THE COMMUNITY AND EXPERTS IN PUBLIC HEALTH AND CLINICAL CARE AND TOOK INTO ACCOUNT THE HEALTH NEEDS OF VULNERABLE POPULATIONS, INCLUDING MINORITIES, THOSE WITH CHRONIC ILLNESS, LOW-INCOME POPULATIONS, AND MEDICALLY UNDERSERVED POPULATIONS. THE COMMUNITY HEALTH NEEDS ASSESSMENT, AND THE RESULTING LIST OF PRIORITIZED HEALTH NEEDS, ARE TO SERVE AS THE BASIS FOR COMMUNITY BENEFIT INVESTMENTS BETWEEN 2014 AND 2016. LPCH COLLABORATED WITH OTHER HOSPITALS, THE PUBLIC HEALTH DEPARTMENTS IN TWO COUNTIES, AND COMMUNITY ORGANIZATIONS TO PREPARE THE 2013 TRIENNIAL COMMUNITY-WIDE HEALTH NEEDS ASSESSMENTS MANDATED UNDER CALIFORNIA SENATE BILL 697 AND THE IRS. FOR MORE INFORMATION ABOUT OUR 2013 COMMUNITY HEALTH NEEDS ASSESSMENT PROCESS AND FINDINGS, PLEASE VISIT OUR WEBSITE: HTTP://WWW.COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG LPCH IS CURRENTLY IN THE PROCESS OF CONDUCTING THE NEXT COMMUNITY HEALTH NEEDS ASSESSMENT TO BE COMPLETED IN 2016.
PART VI, LINE 3	PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: FINANCIAL COUNSELING DEPARTMENT WORKS DIRECTLY WITH ANY PATIENT WHO EXPRESSES QUESTIONS OR CONCERNS ABOUT THEIR ABILITY TO PAY FOR SERVICES. FURTHER, FINANCIAL ASSISTANCE POLICIES ARE POSTED AND AVAILABLE IN ALL PATIENT CHECK-IN AREAS,ONLINE, AND ON PATIENT BILLING CORRESPONDENCE. ALL PATIENT SCHEDULING, REGISTRATION, CHECK-IN, AND CUSTOMER SERVICE STAFF ARE EDUCATED ON POLICIES AND ARE TRAINED TO DIRECT PATIENTS TO THE FINANCIAL COUNSELING DEPT. A. PUBLIC NOTICE CONCERNING THE AVAILABILITY OF FINANCIAL ASSISTANCE UNDER THE FINANCIAL ASSISTANCE POLICY IS GIVEN BY THE FOLLOWING MEANS: 1. NOTICES ARE POSTED IN VISIBLE LOCATIONS WHERE THERE ARE HIGH VOLUMES OF INPATIENT AND/OR OUTPATIENT ADMITTING/REGISTRATIONS, BILLING OFFICES, ADMITTING OFFICES AND HOSPITAL OUTPATIENT SERVICE SETTINGS. 2. POSTED NOTICES EXPLAIN THAT LPCH HAS A VARIETY OF OPTIONS AVAILABLE INCLUDING FINANCIAL ASSISTANCE AND DISCOUNTS TO PATIENTS WHO ARE UNINSURED OR UNDERINSURED. 3. NOTICES INCLUDE A CONTACT TELEPHONE NUMBER A PATIENT CAN CALL TO OBTAIN MORE INFORMATION ABOUT THE POLICY AND TO APPLY FOR FINANCIAL ASSISTANCE. B. THE LPCH WEBSITE INCLUDES AN EXPLANATION OF THE FINANCIAL ASSISTANCE/CHARITY CARE POLICY, THE UNINSURED PATIENT DISCOUNT POLICY, THE AVAILABILITY OF SUCH ASSISTANCE AND DISCOUNTS, AND A TELEPHONE NUMBER. C. LPCH BILLING STATEMENTS INFORM THE PATIENT THAT FINANCIAL ASSISTANCE IS AVAILABLE BY CONTACTING THE LPCH CUSTOMER SERVICE CENTER.
PART VI, LINE 4	LPCH IS A REGIONAL HOSPITAL SERVING CHILDREN, ADOLESCENTS, AND PREGNANT WOMEN FROM THE GREATER SAN FRANCISCO BAY AREA, NORTHERN CALIFORNIA, CALIFORNIA AND THE WESTERN UNITED STATES, COMMUNITY BENEFIT PROGRAMMING IS FOCUSED LARGELY ON SANTA CLARA AND SAN MATEO COUNTIES, ALTHOUGH, WE DO PERFORM COMMUNITY BENEFIT PROJECTS IN NEIGHBORING COUNTIES AS OUR PATIENTS SPAN THE BREADTH OF THE SAN FRANCISCO BAY AREA. SANTA CLARA AND SAN MATEO COUNTIES ARE PRIMARILY URBAN-SUBURBAN, WITH SOME SMALL RURAL COMMUNITIES ALONG THE SAN MATEO COAST. THERE ARE 20 INCORPORATED CITIES IN SAN MATEO COUNTY AND 15 IN SANTA CLARA COUNTY, RANGING FROM POPULATIONS OF 1 MILLION TO SMALL ENCLAVES OF UNDER 10,000. ACCORDING TO THE LATEST DATA, SAN MATEO COUNTY HAS A POPULATION OF 758,581; 257,941 HOUSEHOLDS WITH CHILDREN; AND 33.35 PERCENT FAMILIES HAVE CHILDREN UNDER THE AGE OF 18. 22 PERCENT OF THE TOTAL POPULATION IS UNDER AGE 18. MEDIAN HOUSEHOLD INCOME IS $88,202 WITH PER CAPITA INCOME AT $45,732. ABOUT 7.6% OF THE POPULATION IS BELOW THE FPL WITH 11% OF THOSE UNDER AGE 18 LIVING IN POVERTY. ETHNIC BREAKDOWN IN SAN MATEO COUNTY: 62.5% WHITE, 3% BLACK, 29.3% ASIAN/PACIFIC ISLANDER, 25.3% HISPANIC OR LATINO, .9% NATIVE AMERICAN. SANTA CLARA COUNTY HAS A POPULATION OF 1,894,605; 609,377 HOUSEHOLDS; AND 435,873 FAMILIES, WITH 38.8% OF THE HOUSEHOLDS HAVING CHILDREN UNDER 18. 23.4% OF THE POPULATION IS UNDER AGE 18. MEDIAN HOUSEHOLD INCOME IS $91,702, WITH PER CAPITA INCOME AT $41,513. ABOUT 10.2% OF THE POPULATION IS BELOW THE FPL, WITH 13% OF THOSE UNDER AGE 18 LIVING IN POVERTY. ETHNIC BREAKDOWN IN SANTA CLARA COUNTY: 56.4% WHITE, 2.9% BLACK, 35.4% ASIAN/PACIFIC ISLANDER, 26.6% HISPANIC OR LATINO, 1.3% NATIVE AMERICAN. SAN MATEO AND SANTA CLARA COUNTIES ARE TWO OF THE MOST AFFLUENT COUNTIES IN THE NATION. BUT, THERE ARE HUGE INCOME DISPARITIES BETWEEN THE VERY WEALTHY, WHOSE NUMBERS AND MAGNITUDE OF NET WORTH SKEW DATA LIKE AVERAGE HOUSEHOLD INCOME, AND THE VERY POOR. IN ADDITION, THE 2015 FEDERAL POVERTY GUIDELINE WAS DEFINED AS AN ANNUAL INCOME OF $20,090 FOR A FAMILY OF THREE. HOWEVER, THIS GUIDELINE DOES NOT TAKE INTO ACCOUNT THE ACTUAL COST TO BE BARELY SELF-SUFFICIENT IN THESE TWO HIGH-COST COUNTIES. A BETTER MEASURE IS THE SELF-SUFFICIENCY STANDARD FOR CALIFORNIA, WHICH MEASURES HOW MUCH INCOME IS NEEDED FOR A FAMILY OF A SPECIFIC COMPOSITION TO ADEQUATELY MEET ITS MINIMAL BASIC NEEDS: HOUSING, FOOD, CHILD CARE, OUT-OF-POCKET MEDICAL EXPENSES, TRANSPORTATION, AND OTHER NECESSARY SPENDING AND PROVIDES A MORE COMPLETE PICTURE OF WHAT IT TAKES FOR FAMILIES TO MAKE ENDS MEET. THIS STANDARD IS CALCULATED BY DR. DIANA PEARCE AT THE UNIVERSITY OF WASHINGTON, IN CONJUNCTION WITH WIDER OPPORTUNITIES FOR WOMEN IN WASHINGTON DC AND THE INSIGHT CENTER OF COMMUNITY ECONOMIC DEVELOPMENT. FOR A FAMILY OF ONE ADULT, A PRESCHOOLER AND ONE SCHOOL-AGED CHILD IN SAN MATEO COUNTY, THE INCOME REQUIRED IS $78,945. IN SANTA CLARA COUNTY, IT IS $77,973. THE SELF-SUFFICIENCY INCOME NEEDS CHANGES DEPENDING ON THE MAKE-UP OF THE FAMILY. THE LATEST DATA AVAILABLE SHOWS THE PERCENTAGE OF CHILDREN 0-18 LIVING IN POVERTY IN SANTA CLARA COUNTY AT 11% AND IN SAN MATEO COUNTY AT 13%. HOWEVER, AS NOTED ABOVE, THE FEDERAL POVERTY GUIDELINES USED TO COMPILE THESE NUMBERS DO NOT REFLECT THE ACTUAL COST OF LIVING IN THESE TWO COUNTIES, SO THE PERCENTAGES OF ACTUAL POVERTY ARE HIGHER IF THIS IS TAKEN INTO CONSIDERATION. ANOTHER INDICATOR IS THE PERCENTAGE OF PUBLIC SCHOOL CHILDREN ELIGIBLE TO RECEIVE THE FREE/ REDUCED LUNCH PROGRAMS: MOST RECENT DATA SUGGESTS, 31% IN SANTA CLARA COUNTY AND 29% IN SAN MATEO COUNTY.
PART VI, LINE 5	LPCH MAKES ANNUAL COMMUNITY INVESTMENT GRANTS TO COMMUNITY NONPROFITS WORKING ON SIGNIFICANT HEALTH NEEDS AS DETERMINED BY THE MOST RECENT CHNA. IN ADDITION, THE HOSPITAL MAKES SIGNIFICANT INVESTMENTS THAT PROMOTE THE HEALTH OF THE COMMUNITY. THESE PROGRAMS ARE FULLY DESCRIBED IN THE FY2015 COMMUNITY BENEFIT REPORT AND IMPLEMENTATION STRATEGY FILED FEBRUARY 2015 WITH THE STATE OF CALIFORNIA OFFICE OF STATEWIDE HEALTH PLANNING AND DEVELOPMENT. A THOROUGH ACCOUNTING OF THE HOSPITALS EFFORTS TO PROMOTE COMMUNITY HEALTH CAN BE READ IN THE REPORT, WHICH IS AVAILABLE AT COMMUNITYBENEFIT.STANFORDCHILDRENS.ORG BELOW IS A LISTING OF LPCH'S SERVICES AND ACTIVITIES THAT PROMOTE THE HEALTH OF THE COMMUNITY WE SERVE: HEALTH PROFESSIONS EDUCATION THE HOSPITAL IS A MAJOR EMPLOYER IN THE COMMUNITY IT SERVES AND, AS AN ACADEMIC MEDICAL CENTER, INVESTS SIGNIFICANTLY IN TRAINING THE HEALTH-CARE PROFESSIONALS OF THE FUTURE. THE HOSPITAL IS A MAJOR PROVIDER OF TRAINING FOR RESIDENT PHYSICIANS, FELLOWS AND MEDICAL STUDENTS, NURSES AND ALLIED HEALTH PROFESSIONS FROM AROUND THE REGION FROM VARIOUS ORGANIZATIONS. THE HOSPITAL PROVIDES ANNUAL FUNDING FOR PEDIATRIC RESIDENTS ADVOCACY AND COMMUNITY HEALTH TRAINING AND PARTICIPATES IN STATE AND NATIONAL COLLABORATIVES WORKING ON MATERNAL AND PEDIATRIC HEALTH. COMMUNITY HEALTH IMPROVEMENT THE HOSPITAL CONDUCTS MULTIPLE PROGRAMS THAT ARE OFFERED AT NO COST TO COMMUNITY MEMBERS AND SEEK TO IMPROVE THE HEALTH AND HEALTH KNOWLEDGE OF THE COMMUNITY. THESE ACTIVITIES INCLUDE DIRECT MEDICAL SERVICES FOR IMPOVERISHED TEENS, CHILD SAFETY PROGRAMS, COMMUNITY HEALTH LECTURES AND SEMINARS, ONGOING RESEARCH IN THE AREAS OF CHILD AND MATERNAL HEALTH ETC. COMMUNITY BUILDING ACTIVITIES THE HOSPITAL PARTICIPATES IN A MYRIAD OF COMMUNITY BUILDING ACTIVITIES THAT SEEK TO IMPROVE THE COMMUNITYS HEALTH AND SAFETY. THESE SERVICES AND ACTIVITIES ARE EITHER PROVIDED BY THE HOSPITAL ITSELF OR INVOLVE SUPPORT FOR COMMUNITY ORGANIZATIONS WORKING IN THE AREAS OF: POVERTY, HOMELESSNESS, ECONOMIC DEVELOPMENT ETC. HOSPITAL LEADERSHIP ALSO VOLUNTEERS THEIR EXPERTISE ON MULTIPLE COMMUNITY NONPROFIT BOARDS WORKING TO IMPROVE THE HEALTH OF THE COMMUNITY. THE HOSPITAL ALSO SUPPORTS LOCAL EMERGENCY MANAGEMENT EFFORTS, SUPPORTS ECONOMIC DEVELOPMENT IN THE REGION THROUGH TRANSPORTATION AND HOUSING ADVOCACY, AND ADVOCATES FOR CHILDRENS HEALTH ISSUES. IN FISCAL YEAR 2015, LUCILE PACKARD CHILDRENS HOSPITAL STANFORD PROVIDED OVER $15,000,000 IN FUNDING FOR THESE EFFORTS. PART VI, LINE 7 CA

Schedule H (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

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

2014

Open to Public
Inspection

Name of the organization
Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number
77-0003859

Part I

General Information on Grants and Assistance

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? ....................................

Yes No

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 Domestic Organizations and Domestic Governments. 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 section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) RAVENSWOOD FAMILY HEALTH CENTER 1798A BAY RD EAST PALO ALTO,CA94303	94-3372130	501(c)(3)	184,500	CHILD HEALTH SVCS.
(2) SAN MATEO COUNTY CHILDREN'S HEALTH INITIATI 701 GATEWAY BLVD SAN FRANCISCO,CA94080	94-6000532	501(C)(3)	50,000	HEALTHY KIDS PREMIUMS
(3) PUENTE 620 NORTH STREET PESCADERO,CA94060	37-1484262	501(C)(3)	25,000	Support for care coordination for South San Mateo County Coastside residents
(4) MAYVIEW COMMUNITY HEALTH CENTER 670 GRANT AVE PALO ALTO,CA94306	94-2239648	502(C)(3)	25,000	Community Benefit grant.
(5) HEALTH TEACHER INC 5500 MARYLAND WAY BRENTWOOD SUITE 200 BRENTWOOD,TN37027	20-3456491	C CORP	28,000	ONLINE HEALTH EDUCATION
(6) SAN MATEO MEDICAL CENTER 222 WEST 39TH AVE SAN MATEO,CA94403	94-6000532	Government	600,000	Community Partnership Admin
(7) HOSPITAL COUNCIL OF NORTHERN AND CENTRAL 1215 K StreetSte 730 Sacramento,CA95814	94-1533644	C Corp	6,775	CHNA GRANT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2014

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. 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

SCHEDULE I, PART I, LINE 2

THE ORGANIZATIONS PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES. LPCH DOES NOT SPONSOR AN OPEN GRANT PROCESS THAT SOLICITS COMMUNITY ORGANIZATIONS TO APPLY FOR GRANTS, PARTICIPATE IN A GRANT SELECTION PROCESS, AND THEN BE "AWARDED" A GRANT. RATHER, THE HOSPITAL CONSULTS ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ORDER TO IDENTIFY PRIORITY COMMUNITY HEALTH NEEDS. LPCH THEN IDENTIFIES COMMUNITY ORGANIZATIONS THAT ARE WORKING IN AN ARENA THAT FOCUSES ON ONE OR MORE OF THE CHNA IDENTIFIED COMMUNITY HEALTH NEEDS, AND IDENTIFIES PROJECTS THAT POSE AN OPPORTUNITY FOR PARTNERSHIP AND HAVE THE POTENTIAL TO POSITIVELY IMPACT COMMUNITY HEALTH AND THEN COMMITS FUNDING TO IT. OR, THE HOSPITAL MAY DESIGN, TOGETHER WITH A COMMUNITY ORGANIZATION, A PROJECT THAT ADDRESSES AN IDENTIFIED NEED AND THEN COMMIT FUNDS TO THAT PROJECT. ANY ORGANIZATION RECEIVING LPCH COMMUNITY INVESTMENT FUNDING MUST BE A 501 (C)(3) ORGANIZATION OR GOVERNMENT ORGANIZATION LOCATED IN THE HOSPITALS PRIMARY OR SECONDARY SERVICE AREA THAT SHARES THE HOSPITALS COMMUNITY BENEFIT MISSION OF IMPROVING THE HEALTH STATUS OF LOCAL CHILDREN, ADOLESCENTS OR PREGNANT WOMEN WITH A FOCUS ON SERVING THE COMMUNITYS MOST VULNERABLE. IN COLLABORATION WITH THE GRANTEE ORGANIZATIONS LEADERSHIP, GRANT GOALS AND METRICS ARE DETERMINED ANNUALLY PRIOR TO FUNDING BEING AWARDED. A PROGRESS REPORT IS REQUIRED AT SIX MONTHS, A SITE VISIT IS CONDUCTED IF APPROPRIATE, AND A FINAL ANNUAL REPORT OUTLINING PROGRESS TOWARDS THE AGREED UPON GOALS IS REQUIRED AT THE END OF THE FUNDING CYCLE. IN ADDITION, A GRANT AGREEMENT ACCOMPANIES EACH FUNDING AWARD THAT CLEARLY ARTICULATES THE ALLOWED USAGE OF THE FUNDS AND THE RESTRICTED NATURE OF THOSE FUNDS. LPCHS GRANT MAKING DECISIONS RECEIVE OVERSIGHT FROM BOTH THE COMMUNITY BENEFIT ADVISORY COUNCIL, COMPRISED OF COMMUNITY LEADERS, AS WELL AS THE LPCH BOARD OF DIRECTORS. BOTH THE COMMUNITY BENEFIT ADVISORY COUNCIL AND THE LPCH BOARD OF DIRECTORS MEET THROUGHOUT THE YEAR. LPCH HAS DEDICATED COMMUNITY BENEFIT STAFF WHO, UNDER THE DIRECTION OF THE CHIEF GOVERNMENT AND COMMUNITY RELATIONS OFFICER, CONDUCTS ONGOING OVERSIGHT OF ALL GRANTEE ORGANIZATIONS THROUGHOUT THE GRANT YEAR. LPCH ALSO PROVIDES SMALLER FINANCIAL SUPPORT (LESS THAN $15,000) TO NOT-FOR-PROFIT ORGANIZATIONS SERVING CHILDREN, ADOLESCENTS AND PREGNANT WOMEN TO SUPPORT THEIR PROGRAM OR TO PRESENT SYMPOSIA, SEMINARS OR CONFERENCES. TYPICAL EXAMPLES OF THE HOSPITALS SPONSORSHIP ARE: KIDS IN COMMONS CHILDRENS AGENDA 2015 CONFERENCE AN ANNUAL ADVOCACY CONFERENCE DISCUSSING THE HEALTH AND WELLNESS OF CHILDREN AND ADOLESCENTS IN OUR COMMUNITY; SUPPORT FOR SUMMER LUNCH PROGRAMS TO FEED CHILDREN AND YOUTH WHO OTHERWISE HAVE LITTLE OR NO ACCESS TO FREE SCHOOL LUNCH; FUNDING FOR PEDIATRIC RESIDENTS TO CONDUCT HEALTH IMPROVEMENT PROJECTS IN THE COMMUNITY; AND SO ON. LPCH ALSO PROVIDES FUNDS IN THE $200 TO $20,000 RANGE TO SPONSOR BOTH EDUCATIONAL AND FUNDRAISING EVENTS FOR ORGANIZATIONS SUCH AS THE MARCH OF DIMES, RONALD MCDONALD HOUSE, FEDERALLY QUALIFIED HEALTH CENTERS, ETC.

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

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

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Part I

Questions Regarding Compensation

Yes

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.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

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....

Yes

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? ..

Yes

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.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

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:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

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:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

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 ............

Yes

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 .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

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 in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KENNETH L COX MDDIRECTOR/CMO (UNTIL 03/16/15)	(i) (ii)	0 ............................... 284,382	0 ............................... 207,355	0 ............................... 0	0 ............................... 26,000	0 ............................... 13,697	0 ............................... 531,434	0 ............................... 0
2CHRISTOPHER G DAWESPRESIDENT/CEO	(i) (ii)	885,545 ............................... 0	487,700 ............................... 0	176,757 ............................... 0	240,500 ............................... 0	30,270 ............................... 0	1,820,772 ............................... 0	0 ............................... 0
3THOMAS KRUMMEL MDDIRECTOR	(i) (ii)	0 ............................... 577,257	0 ............................... 510,816	0 ............................... 0	0 ............................... 26,000	0 ............................... 20,578	0 ............................... 1,134,651	0 ............................... 0
4CHRISTY SANDBORG MDDIRECTOR	(i) (ii)	0 ............................... 239,032	0 ............................... 144,002	0 ............................... 0	0 ............................... 24,807	0 ............................... 24,129	0 ............................... 431,970	0 ............................... 0
5TIMOTHY W CARMACKFORMER VP & CFO	(i) (ii)	14,658 ............................... 0	0 ............................... 0	790,397 ............................... 0	0 ............................... 0	3,700 ............................... 0	808,755 ............................... 0	0 ............................... 0
6HUGH O'BRODOVICH MDDIRECTOR	(i) (ii)	0 ............................... 494,235	0 ............................... 218,848	0 ............................... 25,840	0 ............................... 25,004	0 ............................... 20,892	0 ............................... 784,819	0 ............................... 0
7OWEN R AURELIOVP CLINICAL SERVICES	(i) (ii)	269,756 ............................... 0	44,460 ............................... 0	31,075 ............................... 0	38,968 ............................... 0	30,548 ............................... 0	414,807 ............................... 0	0 ............................... 0
8MARK TORTORICHVP PLANNING, DESIGN, CONSTRUC	(i) (ii)	0 ............................... 288,984	0 ............................... 92,739	0 ............................... 58,716	0 ............................... 23,400	0 ............................... 25,049	0 ............................... 488,888	0 ............................... 0
9JAMES MCCAUGHEYChief Strategy Officer	(i) (ii)	334,374 ............................... 0	81,606 ............................... 0	51,893 ............................... 0	40,500 ............................... 0	27,619 ............................... 0	535,992 ............................... 0	0 ............................... 0
10EDWARD KOPETSKYVP & CIO	(i) (ii)	447,793 ............................... 0	139,771 ............................... 0	99,258 ............................... 0	89,304 ............................... 0	29,524 ............................... 0	805,650 ............................... 0	55,078 ............................... 0
11AMIR DAN RUBINDIRECTOR	(i) (ii)	0 ............................... 1,704,324	0 ............................... 1,022,000	0 ............................... 321,654	0 ............................... 321,942	0 ............................... 37,288	0 ............................... 3,407,208	0 ............................... 270,987
12KIM ROBERTSCAO PHYSICIAN PRAC	(i) (ii)	386,566 ............................... 0	66,883 ............................... 0	42,275 ............................... 0	82,358 ............................... 0	39,656 ............................... 0	617,738 ............................... 0	34,100 ............................... 0
13LLOYD B MINOR MDDIRECTOR	(i) (ii)	0 ............................... 1,340,166	0 ............................... 200,000	0 ............................... 59,653	0 ............................... 315,600	0 ............................... 57,385	0 ............................... 1,972,804	0 ............................... 0
14CRAIG T ALBANESEVP of Quality & PI	(i) (ii)	0 ............................... 308,448	0 ............................... 279,894	0 ............................... 0	0 ............................... 26,000	0 ............................... 55,577	0 ............................... 669,919	0 ............................... 0
15ANNE MCCUNECHIEF OPERATING OFFICER	(i) (ii)	519,505 ............................... 0	116,556 ............................... 0	43,631 ............................... 0	67,282 ............................... 0	29,214 ............................... 0	776,188 ............................... 0	0 ............................... 0
16DANA HAERINGVP & CFO	(i) (ii)	363,693 ............................... 0	98,134 ............................... 0	143 ............................... 0	29,924 ............................... 0	11,074 ............................... 0	502,968 ............................... 0	0 ............................... 0
17SUSAN COSTELLOVP PATIENT CARE SRVCS & CNO	(i) (ii)	394,418 ............................... 0	159,444 ............................... 0	12,587 ............................... 0	70,639 ............................... 0	28,594 ............................... 0	665,682 ............................... 0	0 ............................... 0
18MICHAEL LANEVP-LPCH CONSTRUCTION IN ADMIN	(i) (ii)	357,179 ............................... 0	46,310 ............................... 0	833 ............................... 0	75,744 ............................... 0	22,269 ............................... 0	502,335 ............................... 0	0 ............................... 0
19CAMERON D'ALPEVP Ambulatory Services	(i) (ii)	257,564 ............................... 0	39,941 ............................... 0	0 ............................... 0	21,225 ............................... 0	13,840 ............................... 0	332,570 ............................... 0	0 ............................... 0
20GREGORY J SOUZAVP HR	(i) (ii)	326,502 ............................... 0	115,534 ............................... 0	61,174 ............................... 0	23,000 ............................... 0	3,132 ............................... 0	529,342 ............................... 0	0 ............................... 0
21WARREN CHANDLERLPCH ASSISTANT CIO	(i) (ii)	314,039 ............................... 0	83,698 ............................... 0	0 ............................... 0	40,500 ............................... 0	27,523 ............................... 0	465,760 ............................... 0	0 ............................... 0
22MARK AMEYCTO	(i) (ii)	305,301 ............................... 0	80,594 ............................... 0	38,769 ............................... 0	35,000 ............................... 0	24,110 ............................... 0	483,774 ............................... 0	0 ............................... 0

Schedule J (Form 990) 2014

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

SCHEDULE J, PART I, LINE 1A

HOUSING ONE OFFICER, ONE KEY EMPLOYEE, AND ONE HIGHEST COMPENSATED EMPLOYEE RECEIVED HOUSING AS A TAXABLE BENEFIT AND THE AMOUNT HAS BEEN INCLUDED IN SCHEDULE J, PART II,COLUMN B(III). SEVERANCE OR CHANGE-OF-CONTROL PAYMENT SCHEDULE J, PART I, LINE 4A UNDER THE TERMS OF A SEVERANCE ARRANGEMENT WITH TIMOTHY W CARMACK, HE RECEIVED A PAYMENT OF $719,945. SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN SCHEDULE J, PART I, LINE 4B LPCH AND stanford health care ("shc") PROVIDE ALL SENIOR EXECUTIVES WITH A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO SUPPLEMENT THEIR RETIREMENT BENEFITS. AT THE LAST DATE OF EACH QUARTER EACH PARTICIPANT'S ACCOUNT IS CREDITED WITH AN AMOUNT EQUAL TO A PERCENTAGE OF BASE SALARY (DEPENDING ON THE INDIVIDUAL'S POSITION). THE COMPENSATION COMMITTEE MAY DETERMINE THAT CREDITS SHALL BE MADE IN ADDITION TO THOSE ABOVE IN ITS SOLE DISCRETION. A PARTICIPANT BECOMES VESTED IN THE ACCOUNT AS FOLLOWS: (A) THE FIRST BUSINESS DAY OF JANUARY FOLLOWING THE YEAR IN WHICH THE ACCOUNT WAS ESTABLISHED AND THE PARTICIPANT COMPLETES TWO FULL YEARS OF PARTICIPATION; (B) DISCHARGE FROM EMPLOYMENT; (C) ENTITLEMENT TO LONG-TERM DISABILITY; OR (D) THE PARTICIPANT ATTAINS THE AGE OF 60 WHILE EMPLOYED. THE FOLLOWING AMOUNTS BECAME VESTED AND WERE PAID TO THE FOLLOWING INDIVIDUALS IN CALENDAR YEAR 2014: CHRISTOPHER G. DAWES $153,393 EDWARD KOPETSKY $55,106 KIM ROBERTS $34,576 OWEN R. AURELIO $22,654 GREGORY J. SOUZA $36,217 JAMES MCCAUGHEY $41,518 Anne McCune $17,388 MARK TORTORICH $38,051 AMIR DAN RUBIN $284,718 FOR CERTAIN INDIVIDUALS LISTED ON SCHEDULE J, PART II, AMOUNTS CREDITED UNDER THE PLAN ARE INCLUDED ON SCHEDULE J, PART II, COLUMN (C). CHRISTOPHER DAWES, PRESIDENT OF LPCH HAS A NONQUALIFIED DEFERRED COMPENSATION ARRANGEMENT. UNDER THE AGREEMENT, MR. DAWES RECEIVES AN ANNUAL CREDIT TO HIS ACCOUNT THROUGH 2016 PROVIDED HE REMAINS EMPLOYED IN HIS CURRENT POSITION. AMOUNTS CREDITED UNDER THE PLAN WILL BE PAYABLE UPON THE EARLIER OF: (1) TERMINATION WITHOUT CAUSE; (2) DISABILITY; (3) DEATH; OR (4) AUGUST 31, 2016 PROVIDED MR. DAWES REMAINS EMPLOYED AT THAT DATE. THE CREDIT TO MR. DAWES ACCOUNT FOR CALENDER YEAR 2014 OF $240,500 IS INCLUDED IN SCHEDULE J, PART II, COLUMN (C). LLOYD B. MINOR PARTICIPATES IN A DEFERRED COMPENSATION PLAN AT STANFORD UNIVERSITY, A RELATED ORGANIZATION. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. THESE AMOUNTS APPEAR IN SCHEDULE J, PART II, COLUMN C. PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. SCHEDULE J, PART I, LINE 7 CERTAIN OFFICERS AND OTHERS AS ENUMERATED IN SCHEDULE J, PART II PARTICIPATE IN A DEFERRED COMPENSATION PLAN SPONSORED BY LPCH. ANNUALLY, AMOUNTS ARE CREDITED TO THE PLAN BASED ON PERFORMANCE AND CERTAIN OTHER FACTORS. PLAN BALANCES ARE SUBJECT TO FORFEITURE AND/OR PAYMENT ONLY IF CERTAIN CONDITIONS ARE MET. LPCH HAS AN ANNUAL PERFORMANCE INCENTIVE PLAN. PERFORMANCE TARGETS AND PAYOUT METRICS ARE ESTABLISHED AND APPROVED BY THE COMPENSATION COMMITTEE AT THE BEGINNING OF EACH PERFORMANCE CYCLE. CERTAIN INDIVIDUALS ALSO RECEIVED DISCRETIONARY BONUSES RECOMMENDED BY THE CEO AND APPROVED BY THE COMPENSATION COMMITTEE. SCHEDULE J, PART II, DESCRIPTION FOR COLUMN B(III) OTHER REPORTABLE COMPENSATION IN SCHEDULE J, COLUMN B-III INCLUDES HOUSING ASSISTANCE, SEVERANCE PAYMENTS, SERP CASH DISTRIBUTION, ACCRUED VACATION PAY OUT, AND GROUP TERM LIFE. IN ADDITION, LPCH HAS PROVIDED VARIOUS ITEMS OF "LISTED PROPERTY" (E.G. COMPUTERS AND PERIPHERALS) TO THE ABOVE LISTED EMPLOYEES PRINCIPALLY FOR THEIR BUSINESS USE.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

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

Information about Schedule K (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number
77-0003859

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
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	CALIFORNIA HEALTH FACILITIES FINAN AUT	52-1643828	13033LWQ6	03-21-2012	93,450,000	REFUND 2008 ISSUE		X		X		X
B	CALIFORNIA HEALTH FACILITIES FINAN AUTH	52-1643828	13033LWR4	03-21-2012	270,684,581	FINANCE HEALTH FAC & REDEMPTION OF		X		X		X
C	CALIFORNIA HEALTH FACILITIES FINAN AUTH	52-1643828	13033L3G0	05-08-2014	208,381,669	TO FINANCE HEALTH FACILITIES		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired . . . . . . . . . . . . . .	0		0		208,381,669
2 Amount of bonds legally defeased . . . . . . . . . . .	0		0		0
3 Total proceeds of issue . . . . . . . . . . . . . .	93,450,000		270,684,581		0
4 Gross proceeds in reserve funds . . . . . . . . . . . .	0		0		0
5 Capitalized interest from proceeds . . . . . . . . . . .	0		2,021,018		5,152,068
6 Proceeds in refunding escrows . . . . . . . . . . . .	0		0		0
7 Issuance costs from proceeds . . . . . . . . . . . .	547,136		2,687,575		1,996,822
8 Credit enhancement from proceeds . . . . . . . . . . .	0		0		0
9 Working capital expenditures from proceeds . . . . . . . . .	0		0		0
10 Capital expenditures from proceeds . . . . . . . . . . .	0		210,635,687		117,305,255
11 Other spent proceeds . . . . . . . . . . . . . .	92,902,864		58,857,496		0
12 Other unspent proceeds . . . . . . . . . . . . . .	0		0		83,927,524
13 Year of substantial completion . . . . . . . . . . . .
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? . . . . .	X			X		X
15 Were the bonds issued as part of an advance refunding issue? . . . . .		X	X			X
16 Has the final allocation of proceeds been made? . . . . . . . .	X			X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? . . . . . . . . . . . . . .	X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? . . . . . . .		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? . . . . . . . . .		X		X		X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2014

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? . . . . . . . . . . . .	X			X	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? . . . . . . . . . . . . . . .		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
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 . .	0 %		0 %		0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government . . . . . . .
6 Total of lines 4 and 5 . . . . . . . . . . . . .
7 Does the bond issue meet the private security or payment test? . . . . .		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
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of.
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? . . . . . . . . . . . . .		X		X		X
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

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? . .		X		X		X
2 If "No" to line 1, did the following apply? . . . .
a Rebate not due yet? . . . . . . . .	X		X			X
b Exception to rebate? . . . . . . . .
c No rebate due? . . . . . . . .		X	X
If "Yes" to 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
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider . . . . . . . . .	0		0		0
c Term of hedge . . . . . . . . . .
d Was the hedge superintegrated? . . . .
e Was the hedge terminated? . . . . . .

Schedule K (Form 990) 2014

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
b Name of provider . . . . . . . . .	0		0		0
c Term of GIC . . . . . . . . . .
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? . . . . .
6 Were any gross proceeds invested beyond an available temporary period? . . . . . . . .		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? . . .	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

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
SCHEDULE K, PART IV, LINE 2C	AN ARBITRAGE REBATE ANALYSIS HAS BEEN PERFORMED FOR 2008 SERIES A,B, AND C BONDS AND 2012 SERIES A AND B BONDS IN FY2013. THE DATES OF THE ANALYSES IS PROVIDED BELOW. NO PAYMENT WAS DUE TO THE IRS FOR THESE BONDS IN FY2015. BOND A ARBITRAGE ANALYSIS OPINION LETTER ISSUED ON 9/26/2013 FOR BOND A. BOND B ARBITRAGE ANALYSIS OPINION LETTER ISSUED ON 4/4/2013 FOR BOND B.

Schedule K (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

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

Information about Schedule L (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) 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	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

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?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No






Total ...... $

Part III

Grants or Assistance Benefiting 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) 2014

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?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) ELIZABETH DAWES	SEE PART V	76,646	COMP FOR EMPLOYMENT		No
(2) KATHLEEN COX	SEE PART V	176,909	COMP FOR EMPLOYMENT		No
(3) ANGELA KOPETSKY	SEE PART V	134,089	COMP FOR EMPLOYMENT		No
(4) LUKE AURELIO	SEE PART V	92,291	COMP FOR EMPLOYMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
FORM 990, SCHEDULE L, PART IV COLUMN (B)	ELIZABETH DAWES: EMPLOYEE IS A FAMILY MEMBER OF AN OFFICER. KATHLEEN COX: EMPLOYEE IS A FAMILY MEMBER OF A DIRECTOR. ANGELA KOPETSKY: EMPLOYEE IS A FAMILY MEMBER OF A KEY EMPLOYEE. LUKE AURELIO: EMPLOYEE IS A FAMILY MEMBER OF A KEY EMPLOYEE.

Schedule L (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ 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

2014

Open to Public
Inspection

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

Return Reference	Explanation
ORGANIZATION'S PRIMARY EXEMPT PURPOSE	FORM 990, PART I, LINE 1 THE SPECIFIC AND PRIMARY EXEMPT PURPOSES OF LPCH ARE TO SUPPORT, BENEFIT AND FURTHER THE CHARITABLE, SCIENTIFIC AND EDUCATIONAL PURPOSES OF THE BOARD OF TRUSTEES OF THE LELAND STANFORD JUNIOR UNIVERSITY (THE "UNIVERSITY"), INCLUDING ITS SCHOOL OF MEDICINE, AND STANFORD HEALTH CARE ("SHC") BY OPERATING AND MANAGING A CONSOLIDATED MEDICAL FACILITY THAT OFFERS COMPREHENSIVE MEDICAL CARE SERVICES FOR CHILDREN AND ADOLESCENTS AND OBSTETRICAL SERVICES FOR PREGNANT WOMEN AND FURTHERS TEACHING AND RESEARCH IN THE MEDICAL SCIENCES AND OTHER FIELDS RELATING TO THE HEALTH AND WELL-BEING OF INFANTS, CHILDREN, ADOLESCENTS AND PREGNANT WOMEN, IN COOPERATION WITH AND IN SUPPORT OF THE UNIVERSITY'S SCHOOL OF MEDICINE AND SHC. FORM 990, PART III, LINE 4a PROGRAM SERVICE DESCRIPTION JOHNSON CENTER OF EXCELLENCE THE JOHNSON CENTER IS A CENTER OF EXCELLENCE THAT ENCOMPASSES MATERNITY CARE AND HIGH RISK OBSTETRICS AS WELL AS HEALTHY NEWBORN AND NEONATAL INTENSIVE CARE BUILT UPON A SUCCESSFUL ACADEMIC-COMMUNITY HOSPITAL PARTNERSHIP. WITH A STRONG SUPPORT FROM LOCAL PROVIDERS, OBSTETRICIANS IN PRIVATE PRACTICE CONTINUED TO CHOOSE LPCH TO DELIVER THEIR PATIENTS. THE CENTER'S SERVICES INCLUDE PRENATAL DIAGNOSIS, GENETIC COUNSELING, HIGH RESOLUTION FETAL ULTRASOUND SERVICES, HIGH RISK PRENATAL CARE, DELIVERY, LACTATION AND PARENTING SUPPORT AND NEWBORN INTENSIVE CARE. IN ADDITION, THE BEHAVIORAL-DEVELOPMENT PEDIATRICS PROGRAM OFFERS LONG-TERM FOLLOW-UP FOR PATIENTS GRADUATING FROM THE NEONATAL INTENSIVE CARE UNIT. THE JOHNSON CENTER ALSO MANAGES SEVERAL CLINICAL OUTREACH SERVICES IN MATERNAL-FETAL MEDICINE, PROVIDING EARLY DIAGNOSIS AND CONSULTATIVE SERVICES FOR HIGH RISK MATERNITY CARE THROUGHOUT THE REGION: REDWOOD CITY, MOUNTAIN VIEW, FREMONT, SALINAS AND SANTA CRUZ. Additionally, we have added the Fertility and Reproductive Health Services to the Johnson Center, having transitioned them successfully from Stanford early in Fiscal 2015. These services run the spectrum of IUI, IVF, multiple pregnancy loss, and male fertility factor considerations. THE JOHNSON CENTER CONTINUES TO LEAD IN THE DEVELOPMENT AND EVALUATION OF SIMULATION TRAINING, BOTH IN THE LABORATORY AND ON-SITE. SIMULATION TRAINING PROVIDES STAFF AND THE COMMUNITY AN OPPORTUNITY TO LEARN IN A SUPPORTED ENVIRONMENT. OBSTETRIC DISCHARGES FROM THE JOHNSON CENTER INCREASED TO 4,774 IN FISCAL YEAR 2015 - COMPARED TO THE PRIOR YEAR DISCHARGES OF 4,685. IN 2015 THE AVERAGE LENGTH OF STAY FOR OBSTETRIC PATIENTS WAS 3.4 DAYS. OBSTETRIC PATIENTS FROM THE PRIMARY SERVICE AREA COUNTIES OF SAN MATEO AND SANTA CLARA ACCOUNTED FOR 85% OF DISCHARGES. TWELVE PERCENT OF PATIENTS CAME FROM THE EIGHT BAY AREA COUNTIES AND 2% FROM THE REMAINING CALIFORNIA COUNTIES. THE JOHNSON CENTER NEONATAL INTENSIVE CARE UNIT SERVED A TOTAL OF 1,630 INPATIENTS IN FISCAL YEAR 2015 WITH AN AVERAGE LENGTH OF STAY OF 12 DAYS. OF THESE INPATIENTS, 68% WERE FROM THE PRIMARY SERVICE AREA, WITH 26% COMING FROM THE EIGHT-COUNTY BAY AREA AND 6% FROM OUTSIDE THE BAY AREA. FORM 990, PART III, LINE 4b PROGRAM SERVICE DESCRIPTION CHILDREN'S HEART CENTER THE HEART CENTER'S VISION IS TO BRING TOGETHER PROFESSIONAL AND FACILITY RESOURCES UNDER ONE CENTER OF EXCELLENCE THAT SERVES BOTH OUR LOCAL PATIENTS AND THE GREATER COMMUNITY. WITH A MULTIDISCIPLINARY TEAM SPECIALLY TRAINED TO DIAGNOSE AND TREAT INFANTS, CHILDREN, AND YOUNG ADULTS WITH CONGENITAL AND ACQUIRED HEART DISEASES, THE CENTER CARES FOR CHILDREN REQUIRING SPECIALIZED CARDIOTHORACIC SERVICES ON A NATIONAL AND INTERNATIONAL BASIS, DRAWING PATIENTS FROM ALL OVER CALIFORNIA, AT LEAST 29 DIFFERENT STATES, AND SEVERAL DIFFERENT COUNTRIES. THE PROGRAM GOALS ARE AIMED AT CONTINUING THE INTEGRATION AND EXPANSION OF THE CLINICAL, ADMINISTRATIVE, AND ACADEMIC ACTIVITIES TO BETTER SERVE OUR PEDIATRIC POPULATION -- CARDIOLOGY, CARDIAC SURGERY, CARDIAC INTENSIVE CARE, CARDIAC ANESTHESIA, AND CARDIAC IMAGING. ADDITIONALLY, WE CONTINUE TO FOCUS ON EARLY IDENTIFICATION OF CARDIAC ANOMALIES THROUGH OUR FETAL ECHOCARDIOGRAPHY PROGRAM, IN CONJUNCTION WITH THE CENTER FOR FETAL AND MATERNAL HEALTH. IN 2015, OUR VENTRICULAR ASSIST DEVICE PROGRAM CONTINUED TO GROW TO CARE FOR THE SICKEST OF CHILDREN WITH ADVANCED HEART FAILURE, AND WE IMPLANTED 30 ASSIST DEVICES OVER THE PAST THREE YEARS. IN ADDITION, WE HAVE ADDED WE ADDED THE HEARTWARE SYSTEM TO OUR ARMAMENTARIUM OF IMPLANTABLE DEVICES IN APPROPRIATE CASES, WHICH ALLOWS FOR THE EARLY DISCHARGE OF PATIENTS ON VENTRICULAR ASSIST DEVICES TO A HOME SETTING WHILE THEY WAIT FOR THEIR HEART TRANSPLANT. THE NUMBER OF INPATIENTS SERVED BY THE HEART CENTER INCREASED FROM 1,061 IN FISCAL YEAR 2014 TO 1,114 IN FISCAL YEAR 2015. OF THESE, THERE WERE 558 CARDIAC SURGERIES AND 26 HEART TRANSPLANTS. THE INPATIENT PROGRAM HAD A CASE MIX INDEX OF 4.7, REFLECTING THE HIGHLY COMPLEX POPULATION THAT WE SERVE. TWENTY-FOUR PERCENT OF PATIENTS CAME FROM OUR PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, 29% CAME FROM THE EIGHT-COUNTY BAY AREA, 28% CAME FROM OTHER AREAS WITHIN CALIFORNIA, 16% CAME FROM OTHER STATES IN FISCAL YEAR 2015. FORM 990, PART III, LINE 4c PROGRAM SERVICE DESCRIPTION CANCER CENTER OF EXCELLENCE THE BASS CENTER IS A CENTER OF EXCELLENCE THAT OFFERS COMPREHENSIVE CARE AND INNOVATIVE THERAPIES FOR CHILDREN WITH CANCER AND BLOOD DISEASES. THIS STATE-OF-THE-ART FACILITY INTEGRATES INPATIENT AND OUTPATIENT CARE AND HAS A 27-BED INPATIENT UNIT (15 HEMATOLOGY/ONCOLOGY BEDS AND 12 STEM CELL TRANSPLANT BEDS) ALONG WITH A CONTIGUOUS 8-BED DAY HOSPITAL, INFUSION ROOM, LAB, AND CLINIC. THE CENTER ALSO HAS EIGHT BEDS ALLOCATED TO THE PROGRAM TO SUPPORT CHEMOTHERAPY INPATIENT INFUSIONS AT THE LPCH-LICENSED INPATIENT UNIT AT EL CAMINO HOSPITAL OF MOUNTAIN VIEW CALIFORNIA. THE CENTER IS STAFFED BY INDIVIDUALS TRAINED IN THE SPECIALIZED NEEDS OF PEDIATRIC CANCER PATIENTS AND INCLUDES APPROPRIATE ISOLATION ROOMS. THE PROGRAM DIAGNOSES AND TREATS APPROXIMATELY 200 NEW CANCER PATIENTS PER YEAR AND PERFORMED 36 STEM CELL TRANSPLANT IN FISCAL YEAR 2015. THE BASS CENTER'S GOAL IS TO OFFER A COMPREHENSIVE PROGRAM THAT WILL SERVE MORE PATIENTS, TO DEVELOP A MORE ROBUST RESEARCH PLATFORM, AND TO EXPAND THE CENTER'S GEOGRAPHIC REACH TO PROVIDE MORE CHILDREN WITH ACCESS TO THE SPECIALIZED SERVICES OFFERED BY THE CENTER. INPATIENT DISCHARGES FOR HEMATOLOGY/ONCOLOGY AND STEM CELL TRANSPLANT IN FISCAL YEAR 2015 TOTALED 1,157 WITH AN AVERAGE LENGTH OF STAY OF 6.6 DAYS. THE BASS CENTER IS A STRONG REGIONAL PROGRAM WITH 50% OF PATIENTS COMING FROM THE PRIMARY SERVICE AREA OF SAN MATEO AND SANTA CLARA COUNTIES, 34% FROM THE EIGHT SURROUNDING BAY AREA COUNTIES, 13% FROM OTHER CALIFORNIA COUNTIES, AND 3% FROM OUTSIDE THE STATE OF CALIFORNIA.
FORM 990, PART III, LINE 4D	PROGRAM SERVICE DESCRIPTION OTHER PROGRAMS IN ADDITION TO THE THREE PROGRAMS DESCRIBED ABOVE, LPCH PROVIDES CLINICAL SERVICES THROUGH THREE ADDITIONAL CENTERS OF EXCELLENCE: CENTER FOR CHILDREN'S BRAIN AND BEHAVIOR THIS CENTER SPECIALIZES IN TREATING DISORDERS OF BRAIN DEVELOPMENT AND FUNCTION, WHICH MAY MANIFEST THEMSELVES IN BEHAVIORAL, EMOTIONAL, LEARNING, LANGUAGE, DEVELOPMENT, SENSATION, OR MOVEMENT ABNORMALITIES. THE CENTER COMBINES THE EXPERTISE OF SPECIALISTS IN A BROAD RANGE OF DISEASES, INCLUDING EPILEPSY, AUTISM AND DEVELOPMENTAL DISORDERS, MOVEMENT DISORDERS, CEREBROVASCULAR DISORDERS, DEPRESSION, BIPOLAR AND ANXIETY DISORDERS, TRAUMATIC BRAIN INJURY, NEUROGENETIC DISORDERS, BRAIN TUMORS, AND CONGENITAL CENTRAL NERVOUS SYSTEM DEFECTS. THE HOSPITAL'S CENTER FOR BRAIN TUMORS IS ONE OF THE LEADING PROGRAMS IN THE COUNTRY. THE EATING DISORDER PROGRAM LINKS AN INPATIENT PROGRAM WITH AN EVIDENCE-BASED OUTPATIENT PROGRAM THAT COORDINATES MEDICAL AND PSYCHIATRIC TREATMENT. IN 2015 THE CENTER CONTINUED TO EXPAND SERVICES FOR CHILDREN WITH COMPLEX NEUROLOGICAL DISEASES SUCH AS NEUROMUSCULAR DISEASE, MOVEMENT DISORDERS, STROKE AND EPILEPSY. IN ALL OF THE CENTER'S PROGRAMS, PSYCHIATRISTS, PSYCHOLOGISTS, NEUROSURGEONS, AND NEUROLOGISTS WORK CLOSELY WITH BASIC RESEARCHERS TO DISCOVER THE INNER WORKINGS OF THE BRAIN AND HOW IT IMPACTS BEHAVIOR SO THAT CHILDREN COPING WITH COMPLEX CONDITIONS MAY LEAD MORE FULL AND PRODUCTIVE LIVES. CENTER FOR CYSTIC FIBROSIS AND PULMONARY DISEASES THIS CENTER INTEGRATES AN INTERDISCIPLINARY TEAM OF CLINICIANS AND RESEARCHERS FROM LPCH AND THE STANFORD SCHOOL OF MEDICINE. THEIR COMBINED EFFORTS HAVE PRODUCED A PROGRAM THAT FOCUSES ON LEADING EDGE CARE OF CHILDREN WITH A PLETHORA OF RESPIRATORY AND PULMONARY CONDITIONS, FROM THE COMMON AND SIMPLE TO THE COMPLEX AND RARE. THE CENTER IS ONE OF THE LARGEST CARE PROVIDERS FOR CHILDREN WITH CONDITIONS SUCH AS CYSTIC FIBROSIS, ASTHMA, CHRONIC LUNG DISEASE OF INFANCY RESULTING FROM PREMATURE BIRTH AND IMMATURE LUNGS, ACUTE OR CHRONIC RESPIRATORY INFECTIONS, MULTI-SYSTEM DISORDERS THAT AFFECT BREATHING AND LUNGS SUCH AS CEREBRAL PALSY, NEUROMUSCULAR DISEASES SUCH AS SPINAL MUSCULAR ATROPHY (SMA) AND OTHER MUSCULAR DYSTROPHIES, AS WELL AS OTHER GENETIC AND METABOLIC DISORDERS THAT IMPACT SWALLOWING AND BREATHING. IN ADDITION, THE CENTER IS HOME TO A DEDICATED PEDIATRIC SLEEP PROGRAM AND OPERATES ONE OF THE FEW ACTIVE LUNG TRANSPLANT PROGRAMS IN THE UNITED STATES DEDICATED EXCLUSIVELY TO CHILDREN. CENTER FOR TRANSPLANT AND TISSUE ENGINEERING THIS CENTER PERFORMS PEDIATRIC KIDNEY, LIVER, AND INTESTINAL TRANSPLANTS AND SPECIALIZES IN DIALYSIS AND TRANSPLANTATION OF INFANTS, CHILDREN, AND HIGHLY COMPLEX CASES. THE TRANSPLANT PROGRAM RANKS AMONG THE TOP PROGRAMS IN THE NATION IN THE NUMBER OF PEDIATRIC KIDNEY AND LIVER TRANSPLANTS PERFORMED, AND CONTINUES TO DELIVER OUTCOMES AMONG THE BEST IN THE COUNTRY. THE TRANSPLANT TEAM HAS PIONEERED NEW APPROACHES TO IMMUNOSUPPRESSION AND CONTINUES TO DEVELOP AND IMPLEMENT INNOVATIVE TREATMENT STRATEGIES TO REDUCE POST-TREATMENT COMPLICATIONS AND IMPROVE OUTCOMES. ADDITIONALLY, RESEARCH AND EDUCATION ARE PRIMARY COMPONENTS OF THE HOSPITAL'S MISSION AND INTEGRAL TO THE HOSPITAL'S CLINICAL OPERATIONS. THE HOSPITAL IS COMMITTED TO SUPPORTING AND FUNDING QUALITY GRADUATE MEDICAL EDUCATION PROGRAMS AND EXCELLENCE IN RESIDENCY TRAINING AND RESEARCH. LPCH CURRENTLY SPONSORS 21 RESIDENCY/FELLOWSHIP PROGRAMS APPROVED BY THE ACCREDITATION COUNCIL FOR GRADUATE MEDICAL EDUCATIONS WITH OVER 165 ENROLLED RESIDENTS AND FELLOWS (STATED IN FULL TIME EQUIVALENTS). RESIDENCY PROGRAMS IN PHARMACY, SOCIAL WORK, HOSPITAL CHAPLAINCY, AND NURSING ARE ALSO PROVIDED. LPCH PARTNERS WITH STANFORD SCHOOL OF MEDICINE TO CONDUCT RESEARCH IN ALL SIX CENTERS OF EXCELLENCE DESCRIBED ABOVE. LPCH IS ALSO COMMITTED TO ADVOCACY AND COMMUNITY OUTREACH TO IMPROVE THE HEALTH STATUS OF CHILDREN AND PREGNANT WOMEN BY DEVELOPING AND SUPPORTING INNOVATIVE PROGRAMS (WITHIN ITS PRIMARY SERVICE AREAS OF SAN MATEO AND SANTA CLARA COUNTIES AND BEYOND) TO ENHANCE ITS OWN AND THE COMMUNITY'S CAPACITY TO CARE FOR CHILDREN AND PREGNANT WOMEN. THESE PROGRAMS INCLUDE: - MOBILE ADOLESCENCE HEALTH SERVICES - CARE A VAN FOR KIDS - PARTNERSHIPS WITH 3 FEDERALLY QUALIFIED HEALTH CLINICS - GRANT SUPPORT TO LOCAL NONPROFITS FOR COMMUNITY HEALTH IMPROVEMENT PROGRAMS - SUPPORT FOR PEDIATRIC WEIGHT CONTROL PROGRAM - SUPPORT OF CHILDREN'S HEALTH INSURANCE INITIATIVES - SUPPORT FOR PEDIATRIC RESIDENT ADVOCACY PROGRAM - VARIOUS COMMUNITY HEALTH EDUCATION PROGRAMS - PRACTICAL SUPPORT TO PATIENT AND FAMILIES (MEALS, TRANSPORTATION, INFANT CAR SEATS, BABY CARE EQUIPMENT, AND OTHER EXPENSES). EQUIPMENT AND SUPPLY DONATIONS TO A NUMBER OF OVERSEAS MISSIONS. IN THE COUNTIES THAT COMPRISE THE HOSPITAL'S PRIMARY SERVICE AREA, NEARLY ALL CHILDREN ARE ELIGIBLE FOR HEALTH INSURANCE COVERAGE THROUGH EITHER GOVERNMENT-SPONSORED OR LOCAL INITIATIVE INSURANCE PROGRAMS. HOWEVER, NEARLY ALL OF THESE PROGRAMS REIMBURSE THE HOSPITAL AT AMOUNTS FAR LESS THAN THE COST OF SERVICES PROVIDED. ADDITIONALLY, PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE HOSPITAL'S CHARITY CARE POLICY RECEIVE SERVICES WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES.
EXECUTIVE COMMITTEE	FORM 990, PART VI, LINE 1A IF A MATTER NORMALLY REQUIRING ACTION BY THE BOARD OF DIRECTORS ARISES BETWEEN MEETINGS OF THE BOARD AND IS A MATTER WHICH, IN THE OPINION OF ANY FOUR (4) OUT OF SIX (6) OF THE CHAIR OF THE BOARD, THE VICE CHAIR, THE DEAN OF THE STANFORD UNIVERSITY SCHOOL OF MEDICINE, THE PRESIDENT OF THE CORPORATION, THE CHAIR OF THE FINANCE COMMITTEE AND THE CHAIR OF THE AUDIT COMMITTEE, REQUIRES ACTION BY THE BOARD BEFORE THE NEXT REGULAR OR SPECIAL MEETING OF THE BOARD, THEN ANY FOUR (4) OR MORE OUT OF THOSE SIX (6) DIRECTORS ACTING AS A COMMITTEE OF THE BOARD OF DIRECTORS, ARE AUTHORIZED JOINTLY TO TAKE WHATEVER ACTION IS NECESSARY TO RESOLVE THE MATTER, AND SUCH ACTION WILL CONSTITUTE AUTHORIZED ACTION OF THE BOARD TO THE SAME EXTENT AS IF IT HAS BEEN ADOPTED AT A MEETING OF THE BOARD; PROVIDED, HOWEVER, THAT AT LEAST ONE (1) OF THE FOUR (4) DIRECTORS ACTING AS A COMMITTEE OF THE BOARD PURSUANT TO THIS SECTION SHALL BE AN "OUTSIDE DIRECTOR," AS DEFINED IN BYLAWS AND PROVIDED, FURTHER, THAT THE DIRECTORS ACTING AS A COMMITTEE OF THE BOARD SHALL NOT IN ANY CASE BE AUTHORIZED BY THIS SECTION TO EXERCISE THOSE POWERS WHICH BY LAW, THE ARTICLES OF INCORPORATION, THESE BYLAWS OR SPECIFIC ACTION BY THE MEMBER, SET FORTH IN A RESOLUTION OF THE MEMBER, MAY BE EXERCISED ONLY BY THE MEMBER OR MAY NOT BE DELEGATED TO A COMMITTEE OF THE BOARD.
FAMILY/BUSINESS RELATIONSHIPS	FORM 990, PART VI, LINE 2 KENNETH COX, THOMAS KRUMMEL, HUGH O'BRODOVICH, LLOYD MINOR, AND CHRISTY SANDBORG ARE EMPLOYEES OF STANFORD UNIVERSITY. LLOYD MINOR IS THE DEAN OF THE STANFORD SCHOOL OF MEDICINE AND FRANK LEE AND VAUGHN WILLIAMS ARE TRUSTEES OF STANFORD UNIVERSITY. DAVID ALEXANDER IS THE CEO AND A DIRECTOR OF LUCILE PACKARD FOUNDATION FOR CHILDREN'S HEALTH (LPFCH). CHRISTOPHER DAWES, LLOYD MINOR, AND J. TAYLOR CRANDALL ARE DIRECTORS OF LPFCH. AMIR DAN RUBIN IS CEO AND A DIRECTOR AND MARK TORTORICH IS AN EMPLOYEE OF SHC. MARY CRANSTON, MARIANN BYERWALTER, CHRISTOPHER DAWES, AND LLOYD MINOR, ARE DIRECTORS OF SHC. CHRISTOPHER DAWES AND KENNETH COX ARE VOTING MEMBERS ON THE SUMIT INSURANCE BOARD OF DIRECTORS. CHRISTOPHER DAWES AND KENNETH COX ARE MEMBERS OF THE LLC GOVERNING BOARD OF CONTRA COSTA PEDIATRIC VENTURE. CHRISTOPHER DAWES AND KENNETH COX ARE MEMBERS OF THE LLC GOVERNING BOARD OF SAN FRANCISCO PEDIATRIC VENTURE. SIGNIFICANT CHANGES TO THE ORGANIZATION'S GOVERNING DOCUMENTS FORM 990, PART VI, LINE 4 EFFECTIVE FEBRUARY 2015 LPCH AMENDED ITS BYLAWS TO PROVIDE THAT THE CHAIR AND MEMBERS OF ALL COMMITTEES SHALL BE APPOINTED ANNUALLY BY THE CHAIR OF THE BOARD SUBJECT TO THE APPROVAL OF A MAJORITY VOTE OF THE DIRECTORS THEN IN OFFICE, AS PROVIDED IN SECTION 5212 OF THE NONPROFIT CORPORATION LAW. THE ORGANIZATION ALSO CREATED ADDITIONAL VICE CHAIR POSITIONS ON THE BOARD. EFFECTIVE JUNE 2015, LPCH AMENDED ITS BYLAWS TO INCREASE THE NUMBER OF ELECTED DIRECTORS TO 26 AND UPDATED THE JOB DESCRIPTION OF THE CHIEF MEDICAL OFFICER.
MEMBERS	FORM 990, PART VI, LINE 6 STANFORD UNIVERSITY IS THE SOLE MEMBER OF LPCH. FORM 990, PART VI, LINE 7A STANFORD UNIVERSITY, AS THE SOLE MEMBER OF LPCH, APPOINTS THE LPCH BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B THE SOLE MEMBER, STANFORD UNIVERSITY, MAY REMOVE AN ELECTED DIRECTOR AT ANY TIME WITHOUT CAUSE.
PROCEDURES FOR REVIEWING FORM 990 FROM GOVERNING BODY	FORM 990, PART VI, LINE 11 WORKING WITH PRICEWATERHOUSECOOPERS, THE FORM 990 IS PREPARED FOR MANAGEMENT'S REVIEW. A DRAFT OF THE FORM 990 IS MAILED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW, ALONG WITH AN EXECUTIVE SUMMARY OF RECENT CHANGES AND NEW REQUIREMENTS. THE DRAFT FORM 990 IS REVIEWED AT THE AUDIT AND COMPLIANCE COMMITTEE MEETING. A FINAL FORM 990 IS THEN DISTRIBUTED TO THE FULL BOARD BEFORE FILING WITH THE IRS. PRICEWATERHOUSECOOPERS SIGNS THE FINAL RETURN AS PAID PREPARER. PROCEDURES FOR MONITORING AND ENFORCING COMPLIANCE WITH CONFLICT OF INTEREST POLICY FORM 990, PART VI, LINE 12C OFFICERS, DIRECTORS AND EMPLOYEES ARE REQUIRED TO COMPLETE AN INITIAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT ("DISCLOSURE STATEMENT") WITHIN 30 DAYS OF BEGINNING SERVICE AT LPCH. ADDITIONALLY, AN UPDATED DISCLOSURE STATEMENT IS REQUIRED THEREAFTER ON AN ANNUAL BASIS. FURTHER, OFFICERS, DIRECTORS AND EMPLOYEES ARE REQUIRED TO UPDATE THEIR DISCLOSURE STATEMENT WITHIN TEN (10) BUSINESS DAYS OF A MATERIAL CHANGE IN THEIR SITUATIONS THAT MAY CREATE AN ACTUAL OR PERCEIVED CONFLICT-OF-INTEREST. A DISCLOSURE THAT APPEARS TO BE A CONFLICT WILL BE RESOLVED BY A MUTUAL AGREEABLE PLAN WITH THE VICE PRESIDENT OF HUMAN RESOURCES THAT OUTLINES THE STEPS THE OFFICER, DIRECTOR OR EMPLOYEE MUST TAKE TO RECTIFY THE CONFLICT. IN MATTERS THAT ARE UNCLEAR OR QUESTIONABLE, THE OFFICE OF CHIEF COMPLIANCE OFFICER WILL BE CONSULTED FOR A RULING. IF FURTHER INQUIRY IS NECESSARY THE OFFICE OF THE GENERAL COUNSEL WILL BE CONSULTED FOR A RULING.
PROCEDURES FOR DETERMINING COMPENSATION	FORM 990, PART VI, LINE 15 THE PROCESS FOR DETERMINING COMPENSATION FOR LPCH'S CEO AND OTHER TOP MANAGEMENT REQUIRES COMPENSATION TO BE REVIEWED AND APPROVED BY A COMPENSATION COMMITTEE OF THE BOARD, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE ENGAGES AN INDEPENDENT CONSULTANT, WHO PROVIDES THE COMMITTEE WITH COMPARABLE MARKET DATA FROM THE FORMS 990 OF COMPARABLE ORGANIZATIONS SUPPLEMENTED BY PUBLISHED COMPENSATION AND BENEFITS SURVEYS TO BE CONSIDERED IN EVALUATING TOTAL COMPENSATION PACKAGES FOR EACH INDIVIDUAL EXECUTIVE. THE COMMITTEE CONDUCTS A REVIEW OF THIS COMPARABILITY DATA AND DOCUMENTED ITS DELIBERATIONS AND DISCUSSION IN MINUTES THAT ARE RETAINED WITH THE OTHER GOVERNANCE MATERIALS OF LPCH. THE VALUE OF EACH PAY ELEMENT AND THE TOTAL PACKAGE ARE REVIEWED EACH SEPTEMBER PRIOR TO ANY PAY ACTIONS BEING APPROVED BY THE COMPENSATION COMMITTEE. SPECIFIC FACTS AND CIRCUMSTANCES OF EACH ROLE, INCUMBENT, THEIR PERFORMANCE, SKILLS, AND RESPONSIBILITIES ARE REVIEWED AND ASSESSED INDIVIDUALLY. THE COMMITTEE RECEIVES RECOMMENDATIONS FROM THE CEO AS TO PAY ACTIONS FOR EACH INCUMBENT. THESE RECOMMENDATIONS ARE DISCUSSED AND THE RESULTS OF THE DELIBERATIONS ARE DOCUMENTED AS TO THE FINAL PAY ACTION APPROVED ALONG WITH THE RATIONALE FOR THE DECISION. THIS PROCESS OCCURS ANNUALLY AND IN CONJUNCTION WITH ANY PROGRAMMATIC CHANGE THAT COULD POTENTIALLY IMPACT THE PAY OR BENEFITS OF EXECUTIVES.
FORM 990, FORM 990, PART VI, LINE 19	THE STATEMENTS OF OPERATIONS AND BALANCE SHEET ARE INCLUDED IN THE ANNUAL REPORT POSTED ON THE ORGANIZATION'S PUBLIC WEBSITE. COPIES OF THE FINANCIAL STATEMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. COPIES OF THE GOVERNING DOCUMENTS ARE GENERALLY NOT AVAILABLE FOR PUBLIC INSPECTION BUT REQUESTS WILL BE EVALUATED ON A CASE-BY-CASE BASIS. THE CONFLICT OF INTEREST POLICY IS NOT CURRENTLY AVAILABLE FOR PUBLIC INSPECTION.
OTHER FEES FOR SERVICES	FORM 990, PART IX, LINE 11G Temp Labor - Medical Physician $23,020,807 Other Purchased services $205,332,014 Other Professional service $32,535 Other Medical Services (Medical Group) $147,464,993 ____________ TOTAL $375,850,349 RECONCILIATION FORM 990, PART XI, LINE 9 CHANGE IN VALUE OF BENEFICIAL INTEREST IN REMAINDER TRUSTS ($564,222) ADJUSTMENT FOR MINIMUM PENSION ($678,000) AND POST RETIREMENT LIABILITY TRANSFER TO STANFORD UNIVERSITY AND OTHER ($53,515,084) ______________ ($54,757,306)

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

Lucile Salter Packard Children's
Hospital at Stanford

Employer identification number

77-0003859

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

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?
(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	Yes	No
(1) THE BRD OF TRUST LELAND STANF JR UNIV 3145 PORTER DRIVE PALO ALTO,CA94304 94-1156365	EDUCATION	CA	501(C)(3)	2	NA		No
(2) STANFORD HEALTH CARE 300 PASTEUR DRIVE MC 5555 STANFORD,CA94305 94-6174066	HEALTHCARE	CA	501(C)(3)	3	STANFORD	Yes
(3) HOSPITAL COMMITTEE FOR THE L-P AREAS 1111 E STANLEY BLVD LIVERMORE,CA94550 94-1429628	HOSPITAL	CA	501(C)(3)	3	SHC	Yes
(4) VALLEYCARE MEDICAL FOUNDATION INC 5655 W LAS POSITAS BLVD 220 PLEASANTON,CA94588 26-2593526	SUPPORT VCHS	CA	501(C)(3)	9	HOSP CMTE LP	Yes
(5) VALLEYCARE SENIOR HOUSING 1111 E STANLEY BLVD LIVERMORE,CA94550 94-3382224	SR. FACILITY	CA	501(C)(3)	11C, III-FI	HOSP CMTE LP	Yes
(6) THE FREIDENRICH SUPPORT FOUNDATION 3145 PORTER DRIVE PALO ALTO,CA94304 30-0519583	SUPPORT	CA	501(C)(3)	11A, I	STANFORD	Yes
(7) SHR HOLDINGS INC 3145 PORTER DRIVE PALO ALTO,CA94304 94-3187167	REAL ESTATE	CA	501(C)(25)	N/A	STANFORD	Yes
(8) SU EMP BEN TRUST POST RETEMPYNT BEN 3145 PORTER DRIVE PALO ALTO,CA94304 94-3246199	BENEFITS	CA	501(C)(9)	N/A	STANFORD	Yes
(9) UNIVERSITY HEALTHCARE ALLIANCE 855 OAK GROVE AVE SUITE 100 MENLO PARK,CA94205 94-3192446	HEALTHCARE	CA	501(C)(3)	3	SHC	Yes
(10) THE DUDLEY E CHAMBERS FOUNDATION JP MORGAN CHASE PO BOX 3038 MILWAUKEE,WI53201 38-6841793	SUPPORT	NY	501(C)(3)	11D, III-O	STANFORD	Yes
(11) STANFORD UNIVERSITY BOOKSTORE BLDG 60 MAIN QUAD NO 105 STANFORD,CA94305 94-0894150	SUPPORT	CA	501(C)(3)	11A, I	STANFORD	Yes
(12) PACKARD CHILDREN'S HEALTH ALLIANCE 725 WELCH ROAD MC5551 PALO ALTO,CA94304 32-0359189	HEALTHCARE	CA	501(C)(3)	3	LPCH	Yes
(13) STANFORD HABITAT CONSERVATION BOARD 3160 PORTER DR STE 200 PALO ALTO,CA94304 46-1882243	CONSERVATION	CA	501(C)(3)	7	STANFORD	Yes
(14) STANFORD FACULTY CLUB PO BOX 7229 STANFORD,CA94309 94-1187089	FAC INTERACT.	CA	501(C)(7)	N/A	STANFORD	Yes
(15) THE HONG KONGSU CHARITABLE TRUST 1401 CAROLINE CENTER 28 PING ROAD,CAUSEWAY HK 98-6078093	SUPPORT	HK	501(C)(3)		STANFORD	Yes
(16) THE STANFORD TRUST 65 HIGH STREET OXFORD OX1 46L UK	SUPPORT	UK	501(C)(3)		STANFORD	Yes
(17) STANFORD PROGRAMME (CAPE TOWN) NPC WAVERLY BUSINESS PARK BUILDING 11 CAPE TOWN SF	EDUCATION	SF	501(C)(3)		STANFORD	Yes
(18) STANFORD FEDERAL CREDIT UNION 1860 EMBARCADERO RD PALO ALTO,CA94303 94-1492212	CREDIT UNION	CA	501(C)(1)	N/A	STANFORD	Yes
(19) STANFORD HEALTH CARE ADVANTAGE 3220 BLUME DR STE 260 RICHMOND,CA948065741 46-4071746	HEALTHCARE	CA	501(c)(3)	11A, I	SHC	Yes
(20) STANFORD SCHOOLS CORPORATION 475 POPE STREET MENLO PARK,CA94025 20-2699147	EDUCATIONAL	CA	501(C)(3)	2	STANFORD	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2014

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
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No
(1) ATWATER 12 LP 2100 ROSS AVE STE 1600 DALLAS,TX75201 75-2944481	INVESTMENTS	DE	NA
(2) AVENUE ASIA CAPITAL PARTNERS LP 399 PARK AVE 6TH FL NEW YORK,NY10022 01-0553224	INVESTMENTS	DE	NA
(3) JER R E QUALIFIED PARTNERS EUROPE LP 7950 JONES BRANCH DR STE 220 MCLEAN,VA22107 54-2029560	INVESTMENTS	DE	NA
(4) PALO ALTO LP 13 CASTLE STREET ST. HELIER XC JE4 9WG JE	INVESTMENTS	JE	NA
(5) SANDPIPER FUND LP 2000 MCKINNEY AVE STE 2125 DALLAS,TX75201 26-0341626	INVESTMENTS	TX	NA
(6) SAROFIM MULTIFAMILY PARTNERS LP 8115 PRESTON RD STE 400 DALLAS,TX75225 20-1929002	RE DEVELOPMENT	DE	NA
(7) SCP REAL ASSETS FUND (A) LP 450 PARK AVE 23RD FL NEW YORK,NY10022 20-3949682	INVESTMENTS	DE	NA
(8) FORTRESS IW COINVESTMENT (FUND B) LP 1345 AVE OF THE AMERICAS 23RD FL NEW YORK,NY10105 98-0509639	INVESTMENTS	CJ	NA
(9) STANFORD PET-CT LLC 300 PASTEUR DRIVE M/C 5555 STANFORD,CA94305 61-1423414	MED. DIAGNOST	CA	NA
(10) CEE EQUITY HOLDINGS LP ELIZABETH HOUSE 9 CASTLE ST ST. HELIER,,JEJE4 2QP JE	INVESTMENTS	JE	NA
(11) LSF V DHB HOLDINGS LP 2711 N HASKELL AVE STE 1700 DALLAS,TX75204 27-2858604	INVESTMENTS	DE	NA
(12) SIC SNOWCREEK VIII LLC 635 KNIGHT WAY STANFORD,CA94305 27-5431605	RE DEVELOPMENT	CA	NA
(13) SUMIT HOLDING INTERNATIONAL LLC 1400 PAGE MILL ROAD MC5713 PALO ALTO,CA94304 26-3934706	HOLDING COMPANY	DE	SHC	RELATED	-1,949,597	19,547,332		No	0		No	24.700 %
(14) ARCOLA VENTURE LLC C/O STANFORD MGMT CO 635 KNIGHT W STANFORD,CA943057297 37-1689632	RE DEVELOPMENT	DE	NA
(15) BLACKSTONE REP VII TE 7-NQ LP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK,NY10154 90-0878802	INVESTMENTS	DE	NA
(16) OUTLAWS CASINO LTD 3160 PORTER DR PALO ALTO,CA94304 84-1457498	HOLDING COMPANY	CO	NA
(17) STANFORD EMANUEL RAD ONCOLOGY CENTER 825 DELBON AVE TURLOCK,CA95382 20-8885091	RADIOLOGY	CA	NA
(18) ARCOLA RESIDENTIAL VENTURE LLC 635 KNIGHT WAY STANFORD,CA943057297 90-0818278	REAL ESTATE	CA	NA
(19) STANFORD-STARTX FUND LLC 3145 PORTER DRIVE PALO ALTO,CA94304 46-4297719	INVESTMENTS	DE	NA
(20) CLAIRVUE CAPITAL PARTNERS II-TE 1 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO,CA94111 80-0909516	INVESTMENTS	DE	NA
(21) CLAIRVUE CAPITAL PARTNERS II-TE 2 LP 150 CALIFORNIA STREET STE 850 SAN FRANCISCO,CA94111 80-0909556	INVESTMENTS	DE	NA
(22) KEB INVESTORS II LP WASHINGTON MALL STE 304 7 REID ST HAMILTON HM 11 BD 94-1156365	INVESTMENTS	BD	NA
(23) SEQUOIA MFM OPERATING COMPANY LLC 770 WELCH ROAD LPCH- ADMIN MC5551 PALO ALTO,CA94304 47-5060529	MFM PROGRAM	CA	LPCH	RELATED	3,127,971	4,353,411		No	0		No	57.000 %
(24) SP SMC PARTNERS LLC 2711 CENTERVILLE RD STE 400 WILMINGTON,DE19808	INVESTMENTS	DE	NA

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?
(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		Yes	No
(1) STANFORD SGGS EUROPE INC UGLAND HOUSE S CHURCH ST PO BOX 309GT, GEORGE TOWN CJ 13-1684331	INVESTMENTS	CJ	NA	C CORP
(2) BLACK RIVER EMEA INVESTORS FUND LTD UGLAND HOUSE S CHURCH ST GEORGE TOWN CJ 98-0428006	INVESTMENTS	CJ	NA	C CORP
(3) EAST SAIL C/O INTL FS INC IFS COURT TWENTYEIGHT, CYBERCITY, EBENE MP	INVESTMENTS	MP	NA	C CORP
(4) GAVEA INVESTMENT FUND II-C LP PO BOX 896GT HARBOUR CENTRE GEORGE TOWN,CAYMAN ISLANDS CJ 98-0537952	INVESTMENTS	CJ	NA	C CORP
(5) LS ALBERTA III LP C/O JE ROBERT COS 1650 TYSON BLVD MCLEAN,VA22102 98-0493425	INVESTMENTS	CA	NA	C CORP
(6) CLAT (15)	CHARITABLE TR	CA	NA	TRUST
(7) CRT (536)	CHARITABLE TR	CA	NA	TRUST
(8) OTHER (7)	CHARITABLE TR	CA	NA	TRUST
(9) PIF (77)	CHARITABLE TR	CA	NA	TRUST
(10) ALPINE CHALET INC PO BOX 9988 SOUTH LAKE TAHOE,CA96158 94-1556099	SKI LODGE	CA	NA	C CORP
(11) STANFORD (BEIJING) CNSLTNG CO LTD (WFOE) 5275TH FLBLDG CACADEMY SOUTH RD HAIDAN DISTRICT,BEIJING CH	EDUCATION	CH	NA	C CORP
(12) STANFORD UNIV MED NETWORK RISK AUTHORITY 1400 PAGE MILL RD MSC 5713 PALO ALTO,CA94304 46-1132002	RISK MGMT CON	CA	SHC	C CORP	-12,089	-12,089	18.000 %	Yes
(13) PROFESSIONAL EXCHANGE ASSURANCE COMPANY 201 MERCHANT STREET SUITE 2400 HONOLULU,HI96813 90-0897686	INSURANCE	HI	NA	C CORP
(14) ARCOLA RES DEVELOPMENT CORP C/O SMC 635 KNIGHT WAY STANFORD,CA943057297 80-0804754	INVESTMENT	DE	NA	C CORP
(15) BREP VII ALBERTA FEEDER(OFFSHORE)TE7 LP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK,NY10154 98-1066351	INVESTMENTS	CA	NA	C CORP
(16) BREP VII ALBERTA FEEDER(OFFSHORE)TE7NQLP C/O THE BLACKSTONE GROUP 345 PARK NEW YORK,NY10154 98-1066355	INVESTMENTS	CA	NA	C CORP
(17) WEST FACE ALTERNATIVE CREDIT CAYMAN LP PO BOX 10008 WILLOW HOUSE GRAND CAYMAN,CAYMAN ISLANDSKY1-1001 CJ 98-1140761	INVESTMENTS	CJ	NA	C CORP
(18) MIDPOINT TECHNOLOGY PARK OWNERS ASSOC 3145 PORTER DRIVE PALO ALTO,CA94304 94-3287254	REAL ESTATE	CA	NA	C CORP
(19) BIENVILLE ARGENTINA OPPS OFFSHORE FUND 405 LEXINGTON AVE 34TH FLOOR NEW YORK,NY10174	INVESTMENTS	CJ	NA	C CORP
(20) ICHIGO JAPAN FUND K 1 NORTH BRIDGE RD 6-8 SINGAPORE,SINGAPORE179094 SN	INVESTMENTS	CJ	NA	C CORP
(21) AFFINITY MEDICAL SOLUTIONS INC 1221 BROADWAY 3RD FLOOR OAKLAND,CA94612 20-3134011	HEALTHCARE	DE	NA	C CORP
(22) BISHOP ROCK OPPORTUNITY OFFSHORE FUND C/O SMC 635 KNIGHT WAY STANFORD,CA94305	INVESTMENTS	CJ	NA	C CORP

Schedule R (Form 990) 2014

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

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 . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .

Yes

o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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
(1) STANFORD HOSPITAL AND CLINICS (SHC)	K,L	77,151,008	FMV
(2) STANFORD HOSPITAL AND CLINICS (SHC)	N	28,555,874	FMV
(3) STANFORD HOSPITAL AND CLINICS (SHC)	O,P	3,052,011	FMV
(4) STANFORD HOSPITAL AND CLINICS (SHC)	M	-3,338,284	FMV
(5) STANFORD HOSPITAL AND CLINICS (SHC)	Q	26,600,000	FMV
(6) SEQUOIA MFM OPERATING COMPANY LLC	R	601,104	FMV
(7) OTHER TRUST	C	692,158

Schedule R (Form 990) 2014

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)	(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?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2014

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation
SCHEDULE R, PART IV, LINE 6	CHARITABLE LEAD ANNUITY TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 7	CHARITABLE REMAINDER TRUSTS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 1	OTHER TRUSTS ARE PRINCIPALLY DOMICILIED IN CALIFORNIA.
SCHEDULE R, PART IV, LINE 2	POOLED INVESTMENT FUNDS ARE PRINCIPALLY DOMICILED IN CALIFORNIA.
SCHEDULE R, PART V	THE PURCHASED SERVICES PAYMENT WITH STANFORD HOSPITAL AND CLINICS IS CALCULATED BASED ON THE RATIO OF DIRECT COST TO CHARGES PLUS NEGOTIATED OVERHEAD. THE SHARED SERVICES WITH STANFORD HOSPITAL AND CLINICS IS A NEGOTIATED FIXED DOLLAR ANNUAL RATE. FOR OTHER SERVICES, PAYMENT IS BASED ON EITHER NEGOTIATED RATE OR CONTRACT AGREEMENT. ON EITHER NEGOTIATED RATE OR CONTRACT AGREEMENT.

Schedule R (Form 990) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: SEE SCHEDULE O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	34
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	26
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	3,693
6	Total number of volunteers (estimate if necessary) .............	6	981
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	42,069,111	71,660,572
9	Program service revenue (Part VIII, line 2g) .........	1,055,949,686	1,284,282,316
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	35,746,360	43,482,771
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,980,523	-5,263,457
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	1,135,745,680	1,394,162,202
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	667,833	919,275
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)	428,833,531	482,334,877
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 13,582,384
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	607,776,183	714,107,849
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,037,277,547	1,197,362,001
19	Revenue less expenses. Subtract line 18 from line 12.......	98,468,133	196,800,201
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	2,610,509,922	2,811,287,000
21	Total liabilities (Part X, line 26).............	757,117,005	811,462,680
22	Net assets or fund balances. Subtract line 21 from line 20.....	1,853,392,917	1,999,824,320

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 340,742,000 including grants of $ ) (Revenue $ 369,744,000 )
	SEE SCHEDULE O

4b	(Code: ) (Expenses $ 249,652,000 including grants of $ ) (Revenue $ 325,998,000 )
	SEE SCHEDULE 0

4c	(Code: ) (Expenses $ 150,478,000 including grants of $ ) (Revenue $ 138,342,000 )
	SEE SCHEDULE O

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 332,551,609 including grants of $ 919,275 ) (Revenue $ 450,198,316 )
4e	Total program service expenses1,073,423,609

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	8,086,316	8,420,228	2,219,903

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		71,660,572

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			71,660,572
			Business Code
2a	PATIENT SERVICE		900099	969,093,951	969,093,951
b	GOVERNMENT FUND		900099	6,570,578	6,570,578
c	MEDICARE/MEDICAID		900099	202,189,000	202,189,000
d	PROVIDER FEE		900099	79,775,269	79,775,269
e	CONTRACT REVENUE		900099	16,048,197	16,048,197
f	All other program service revenue .			10,605,321	10,605,321
g	Total. Add lines 2a–2f........			1,284,282,316
3	Investment income (including dividends, interest, and other similar amounts).......			43,135,348			43,135,348
4	Income from investment of tax-exempt bond proceeds..			347,423			347,423
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents		2,255,651
b	Less: rental expenses		4,821,953
c	Rental income or (loss)	0	-2,566,302
d	Net rental income or (loss).......			-2,566,302			-2,566,302
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
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..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a	CAFETERIA		900099	2,111,360			2,111,360
b	INVESTMENT INCOME FROM RELATED PROGRAM		900099	-13,385,429			-13,385,429
c	INSURANCE REIMBURSEMENT FOR LOSS RECOVERY		900099	1,721,312			1,721,312
d	All other revenue ....			6,855,602			6,855,602
e	Total. Add lines 11a–11d ......			-2,697,155
12	Total revenue. See Instructions......			1,394,162,202	1,284,282,316		38,219,314


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			1,895	1	1,895
2	Savings and temporary cash investments .........			174,359,105	2	335,075,518
3	Pledges and grants receivable, net ...........			14,132,171	3	30,543,839
4	Accounts receivable, net .............			240,238,943	4	291,804,875
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			4,200,342	8	7,178,752
9	Prepaid expenses and deferred charges ..........			9,065,437	9	7,980,163
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	1,432,428,676
b	Less: accumulated depreciation .....	10b	360,293,275	862,124,548	10c	1,072,135,401
11	Investments—publicly traded securities ..........			68,830,418	11	69,312,835
12	Investments—other securities. See Part IV, line 11 .....			1,203,366,302	12	967,155,380
13	Investments—program-related. See Part IV, line 11 .....			10,831,129	13	3,399,006
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			23,359,632	15	26,699,336
16	Total assets. Add lines 1 through 15 (must equal line 34)......			2,610,509,922	16	2,811,287,000
17	Accounts payable and accrued expenses .........			128,603,108	17	167,090,779
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			566,174,379	20	559,686,467
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			0	23	0
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			62,339,518	25	84,685,434
26	Total liabilities. Add lines 17 through 25.........			757,117,005	26	811,462,680
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			1,250,688,478	27	1,337,179,747
28	Temporarily restricted net assets ...........			399,362,510	28	458,239,166
29	Permanently restricted net assets ...........			203,341,929	29	204,405,407
	Organizations that do not follow SFAS 117 (ASC 958), check here 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 ...........			1,853,392,917	33	1,999,824,320
34	Total liabilities and net assets/fund balances ........			2,610,509,922	34	2,811,287,000

1	Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes,"the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926)......................................	Yes	No
2	Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; do not file with Form 990)............................	Yes	No
3	Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471)..............................	Yes	No
4	Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621)...............................................	Yes	No
5	Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships. (see Instructions for Form 8865)....................................	Yes	No
6	Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to file Form 5713, International Boycott Report (see Instructions for Form 5713; do not file with Form 990).....................................	Yes	No